By Kristine Olson, Tait Shanafelt, and Steve Southwick, JAMA, October 8, 2020
Many physicians and other health care workers have been experiencing enormous levels of stress and uncertainty while providing care for patients with coronavirus disease 2019 (COVID-19). Those who work in epicenters of the virus may care for high numbers of critically ill patients and experience psychological trauma related to exposure to many deaths in a short period of time or threat of death for themselves, colleagues, or loved ones. These clinicians may have encountered various challenges, such as not having enough personal protective equipment, being assigned to practice in areas outside their expertise, dealing with a lack of known therapeutics, making difficult decisions about rationing or prioritizing care, and facing disruptions affecting many aspects of health care and daily life. This acute stress among health care professionals is superimposed on preexisting high levels of occupationally related psychological and occupational stress.
Health care organizations and society have a responsibility to help address these stresses and challenges. Examples of psychological support include peer support and individual mental health services. In addition to these traditional forms of support for acute distress, there may be potential for accelerated personal and organizational change and growth that would often take years to occur.
Posttraumatic growth has been defined as “positive psychological change experienced as a result of a struggle with highly challenging life circumstances” and through establishing perspectives for a “new normal” when the old normal is no longer an option. Posttraumatic growth includes 5 domains: development of deeper relationships, openness to new possibilities, greater sense of personal strength, stronger sense of spirituality, and greater appreciation of life. The Posttraumatic Growth Inventory has been translated into 22 languages, and research using the inventory has found strong evidence for posttraumatic growth across numerous cultures and many different traumatized populations including among those surviving bereavement, natural disasters, motor vehicle and other crashes, medical conditions (eg, cancer, myocardial infarction, HIV), sexual and physical assault, refugee and hostage situations, and in combat veterans.
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