By , On 8th July 2020 Comments Off on Promoting Self-care during CoVID-19 and preventing Burnout

Even before the CoVID-19 pandemic, the high prevalence of burnout had been widely reported. Since then, many interventions have taken place to address burnout and to promote wellness, – including decreased workload, improved work schedules, electronic health record, mindfulness (including mindfulness-base-stress-reduction [MBSR]), and personal coaching.

Burn out is a series of worn-out responses to coping with stress and frustration, which may cause dysfunctional states of performance and affectual levels, consequently requiring external support or environmental changes to recover to previously functioning levels.

With the outbreak of the CoVID-19 pandemic, burnout levels have increased, due to self-isolation and staff shortages across different workplaces. Self-isolation reduces individuals’ interaction with others, which in turn can affect individuals’ mental health, as they are deprived of maintaining relationships with others and of obtaining the external support that they need for resilience. Thus, it becomes essential to recognize the importance of telehealth services as feasible and appropriate means for supporting individuals, their families, and health care providers during these times of pandemic (Montero-Marín, & García-Campayo, 2010; Brill, 1984; Fessell, & Cherniss, 2020; Shaw, 2020; Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, & Smith, 2020).

Telemedicine includes the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data and education using interactive audio, video or data communications.

While social isolation and distancing contributes to avoiding the spread of CoVID-19, it also reduces access to social support from family and friends, and it may cause loneliness, anxiety, and depressive symptoms. These psychological symptoms in turn, may have long-term health effects; thus, economically also requiring their treatment to be added to the cost burden of managing CoVID-19. The psychological impact of CoVID-19 has been globally recorded, including anxiety-driven panic buying and paranoia about attending community events. In addition, students, workers, and tourists who have been prevented from accessing their schools, workplaces, and homes, respectively, have experienced challenges in their mental health due to stress, reduced autonomy and concerns about income, job, and security. Therefore, it is crucial that the global public health services addressing CoVID-19 address both, physical and psychological needs of the general population as well as health care providers; thus making it likely that the provision of telehealth will help clients maintain psychological well-being and help manage their physical and mental health symptoms more favourably (Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, & Smith, 2020).

Because the necessary mental health services need to be made in the context of client-provider isolation, it becomes of utmost importance that telehealth be encouraged in these times of pandemic. The expansion of telehealth would reduce the risk of exposure to CoVID-19-infected people, by reducing in-person contact between individuals and their health care providers, between individuals in waiting rooms and commonly used clinic areas (such as toilets), and between individuals during their commute to mental health clinics. Telehealth can also be used more extensively to enhance the psychoeducation and promotion of self-help for symptoms of burnout, depression, anxiety, and PTSD during CoVID-19 outbreak (Liu, Yang, Zhang, Xiang, Liu, Hu, & Zhang, 2020; Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, & Smith, 2020).

Moreover, examples of and evidence to support the effectiveness of telehealth are quite robust, especially in the context of depression, anxiety, and PTSD. Videoconferencing, online forums, smartphone apps, text-messaging, and e-mails have been shown to be useful means of communication for the delivery of mental health services (e.g. García‐Lizana, & Muñoz‐Mayorga, 2010; Rees, & Maclaine, 2015; Turgoose, Ashwick, & Murphy, 2018; Backhaus, Agha, Maglione, Repp, Ross, Zuest, Rice-Thorp, Lohr, & Thorp, 2012; Kerst, Zielasek, & Gaebel, 2020; Kerst, Zielasek, & Gaebel, 2020; Kauer, Mangan, & Sanci, 2014; Torniainen-Holm, Pankakoski, Lehto, Saarelma, Mustonen, Joutsenniemi, & Suvisaari, 2016; Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, & Smith, 2020).

Despite reports of people in isolation actively seeking online support to address mental health needs, telehealth has still been restricted to special needs groups, leaving the wider population without appropriate access to it. While there is growing awareness of mortality rates associated with CoVID-19, we should also consider its impact on people’s mental health—both in the short- and in the long-term. In conclusion, telehealth services are perfectly suited to our present pandemic situation, by supporting both physical and psychosocial needs of both community members and health care providers who are at increased risk for burn out at this time, independent of their geographical location, without increasing risk of infection (Liu, Yang, Zhang, Xiang, Liu, Hu, & Zhang, 2020; Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, & Smith, 2020).

To finalize, the following is a non-exhaustive list of tasks that individuals can engage in to prevent burnout and to promote self-care during our present pandemic times, provided by the World Health Organization (WHO, 2020):

  1. Minimize watching, reading, or listening to news about CoVID-19 that causes anxiety or distress. Seek information from trusted sources, such as the WHO website and local health authority platforms to avoid rumours and use it for taking practical steps to protect yourself and your loved ones. Seek information updates at specific times during the day, maximum once or twice per day.
  2. Be supportive of others. Assisting others with their needs can benefit both the person being assisted and the helper. For example, you may check by telephone on neighbours or people in your community who may need some additional support. Working together as a community can help create solidarity in addressing CoVID-19 together.
  3. Surround yourself with positive and hopeful stories and images of people who have experienced CoVID-19 and were successful; for example, stories of people who have recovered or who have supported a loved one and are willing to share their experience.
  4. Stay connected and maintain your social networks via telephone, e-mail, social media, or video conference. Also, try as much as possible to keep your daily routines or to create new routines for yourself in case your situation has changed.
  5. Attend to your own needs and feelings. Engage in healthy activities that you enjoy and find relaxing. Exercise regularly, keep regular sleep routines, and eat healthy.

Michelle Franca
BSc. Psych.,BAHons, MSc. Clinical Psych.

References

Backhaus, A., Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D., Rice-Thorp, N. M., Lohr, J., & Thorp, S. R. (2012). Videoconferencing psychotherapy: A systematic review. Psychological services9(2), 111.

Brill, P. L. (1984). The need for an operational definition of burnout. Family & Community Health: The Journal of Health Promotion & Maintenance.

Fessell, D., & Cherniss, C. (2020). Coronavirus Disease 2019 (COVID-19) and Beyond: Micropractices for Burnout Prevention and Emotional Wellness. Journal of the American College of Radiology.

García‐Lizana, F., & Muñoz‐Mayorga, I. (2010). Telemedicine for depression: a systematic review. Perspectives in Psychiatric Care46(2), 119-126.

Kauer, S. D., Mangan, C., & Sanci, L. (2014). Do online mental health services improve help-seeking for young people? A systematic review. Journal of Medical Internet Research16(3), e66.

Kerst, A., Zielasek, J., & Gaebel, W. (2020). Smartphone applications for depression: a systematic literature review and a survey of health care professionals’ attitudes towards their use in clinical practice. European archives of psychiatry and clinical neuroscience270(2), 139-152.

Liu, S., Yang, L., Zhang, C., Xiang, Y. T., Liu, Z., Hu, S., & Zhang, B. (2020). Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry7(4), e17-e18.

Montero-Marín, J., & García-Campayo, J. (2010). A newer and broader definition of burnout: Validation of the” Burnout Clinical Subtype Questionnaire (BCSQ-36)”. BMC Public Health10(1), 302.

Rees, C. S., & Maclaine, E. (2015). A systematic review of videoconference‐delivered psychological treatment for anxiety disorders. Australian Psychologist50(4), 259-264.

Shaw, S. C. (2020). Hopelessness, helplessness and resilience: The importance of safeguarding our trainees’ mental wellbeing during the COVID-19 pandemic. Nurse Education in Practice44, 102780.

Torniainen-Holm, M., Pankakoski, M., Lehto, T., Saarelma, O., Mustonen, P., Joutsenniemi, K., & Suvisaari, J. (2016). The effectiveness of email-based exercises in promoting psychological wellbeing and healthy lifestyle: a two-year follow-up study. BMC psychology4(1), 21.

Turgoose, D., Ashwick, R., & Murphy, D. (2018). Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder. Journal of telemedicine and telecare24(9), 575-585.

World Health Organization. (2020). Mental health and psychosocial considerations during the COVID-19 outbreak, 18 March 2020 (No. WHO/2019-nCoV/MentalHealth/2020.1). World Health Organization.

Zhou, X., Snoswell, C. L., Harding, L. E., Bambling, M., Edirippulige, S., Bai, X., & Smith, A. C. (2020). The role of telehealth in reducing the mental health burden from COVID-19. Telemedicine and e-Health26(4), 377-379.

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