Understanding resilience and stress in health care workers

Health care workers face extraordinary stresses at times. Since we are interested in what happens in transactions between providers and patients, it only makes sense that we are attentive to issues on both sides of that interaction. Our research in this area wasn’t planned – it emerged naturally when Toronto was particularly hard-hit by the SARS outbreak in 2003 and we found ourselves in the middle of it. We started by studying the impact of that event on the people we work with, and later expanded our research to develop evidence-based approaches to improving health care workers’ resilience and studying the impact of other high stress health care work – especially by collaborating with Janice Halpern on her large study of Toronto paramedics.

  • Maunder, R, Hunter, J, Vincent, L, Bennett, J, Peladeau, N, Leszcz, M, Sadavoy, J, Verhaeghe, L, Steinberg, R, Mazzulli, T. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 168 (10), 2003, 1245-1251.
  • Maunder R. The Experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned. Philosophical Transactions of the Royal Society, Series B, Biological Sciences. 359 (1447), 2004, 1117-1126.
  • Maunder, R, Lancee, W, Rourke, S, Hunter, J, Goldbloom, D, Balderson, K, Petryshen, P, Steinberg, R, Wasylenki, D, Koh, D, Fones, CSL. Factors associated with the psychological impact of SARS on nurses and other hospital workers in Toronto. Psychosom Med. 2004; 66: 938-942.
  • Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag Jr. B, Evans S, Fernandes C, Goldbloom DS, Gupta M, Hunter JJ, McGillis Hall L, Nagle LM, Pain C, Peczeniuk SS, Raymond G, Read N, Rourke SB, Steinberg RJ, Stewart T, VanDeVelde-Coke S, Veldhorst GG, Wasylenki DA. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases. 2006; 12: 1924-1932.
  • Lancee WJ, Maunder RG, Goldbloom DS and the Co-authors of the Impact of SARS Study. The prevalence of psychiatric disorders in Toronto hospital workers one to two years after SARS. Psychiatric Services. 59: 91-95, 2008.
  • Maunder RG, Leszcz, M, Savage D, Adam MA, Peladeau RN, Romano D, Rose M, Schulman B. Applying the lessons of SARS to pandemic influenza: An evidence-based approach to mitigating the stress experienced by healthcare workers. Canadian Journal of Public Health. 99: 486-488, 2008.
  • Maunder R, Lancee WJ, Mae R, Vincent L, Peladeau N, Beduz MA, Hunter JJ, Leszcz, M. Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: A randomized trial of the optimal dose of training. BMC Health Services Research. 10:72
  • Aiello A, Khayeri M, Raja S, Peladeau N, Romano D, Leszcz M, Maunder RG, Rose M, Adam MA, Pain C, Moore, A, Savage, D, Schulman, B. Resilience training for hospital workers in anticipation of an influenza pandemic. Journal of Continuing Education in the Health Professions. 31(1):15-20, 2011.
  • Halpern J, Maunder RG, Schwartz B, Gurevich M. Identifying risk of emotional sequelae after critical incidents. Emergency Medicine Journal. 28 (1) 51-56, 2011
  • Halpern J, Maunder RG, Schwartz B, Gurevich M. The Critical Incident Inventory: Derivation and validity of an instrument to identify characteristics of critical incidents experienced by paramedics. BMC Emergency Medicine. 08/2012; 12(1):10.
  • Halpern J, Maunder RG, Schwartz B, Gurevich M. Identifying, describing and expressing emotions after critical incidents in paramedics. Journal of Traumatic Stress. 25(1):111-4, 2012.
  • Halpern J, Maunder RG, Schwartz B, Gurevich M. Attachment insecurity, responses to critical incident distress and current emotional symptoms in ambulance workers. Stress and Health Stress Health. 28(1):51-60, 2012
  • Halpern J, Maunder RG, Schwartz B, Gurevich M. Downtime after critical incidents in emergency medical technicians (EMT)/paramedics. BioMed Research International. 2014 Apr 10.