Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Psychological impacts and self-management by responders to emergency and disaster events involving animals: findings from a cross-sectional international survey(Taylor and Francis Group on behalf of the New Zealand Veterinary Association, 2025-10-01) De Grey SJ; Riley CB; Thompson KR; Squance HE; Cogger NAims: To examine the self-reported psychological impacts for professional and volunteer responders associated with attending animal-related emergencies and disasters, focusing on their experience and self-reported management. Methods: An online survey of professional and volunteer responders to animal-related emergencies was shared via social media and international response organisations. Questions addressed demographic, training and event-related factors, perceptions of effects on well-being and post-event management recovery techniques. A particular event was recalled in free-text, and respondents indicated how they had been affected using free-text reflection and Likert scale assessment. The revised Impact of Event Scale (IES-R) was used to identify evidence of possible post-traumatic stress disorder (PTSD). Factors associated with the self-assessed binary outcome of compromised mental well-being (yes or no) were evaluated using single-predictor and multivariable logistic regression. Results: Of 227 responses deemed sufficiently complete for analysis, participants’ rescue experience ranged from 1–60 years; 67% identified as female. Most respondents (57%; 129/227) reported that the incident described affected their mental well-being. A multivariable model found female responders more likely than males to report compromised well-being (OR = 2.37, 95% CI = 1.25–4.57; p = 0.009). The presence of an animal injury (OR = 2.84, 95% CI = 1.44–5.75; p = 0.003), injuries to a member of the public (OR = 3.73, 95% CI = 1.68–8.99; p = 0.002), or a team member (OR = 8.65 95% CI 2.25–57.67; p = 0.006), increased the odds of self-reported adverse mental health outcomes. Six per cent (13/227) of respondents had an IES-R score for which partial PTSD may be a clinical concern, and 3% (7/227) had a score indicative of possible PTSD, including four with a score that has been associated with PTSD and long-term health consequences. Of those who tried well-being support techniques, 95% (187/197) ranked talking with friends, family or teammates as effective. Debriefing with the team or mentor was also effective (95%; 187/197). Socialising was effective for 88% (119/135), and mindfulness or meditation for 87% (91/105). Conclusion and clinical relevance: Responders to emergencies involving animals are at risk of psychological trauma associated with these events, potentially leading to the compromise of mental well-being. Psychosocial supports self-identified as helpful for recovery include talking with others, socialising, physical or recreational activity, debriefing, and mindfulness or meditation, but their effectiveness requires objective evaluation so that education on mitigation and recovery strategies is well-informed.Item Respiratory support in the emergency department a systematic review and meta-analysis(Wiley Periodicals LLC on behalf of Sigma Theta Tau International, 2024-03-22) O'Donnell J; Pirret A; Hoare K; Fenn R; McDonald EBACKGROUND: An estimated 20% of emergency department (ED) patients require respiratory support (RS). Evidence suggests that nasal high flow (NHF) reduces RS need. AIMS: This review compared NHF to conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult ED patients. METHOD: The systematic review (SR) and meta-analysis (MA) methods reflect the Cochrane Collaboration methodology. Six databases were searched for randomized controlled trials (RCTs) comparing NHF to COT or NIV use in the ED. Three summary estimates were reported: (1) need to escalate care, (2) mortality, and (3) adverse events (AEs). RESULTS: This SR and MA included 18 RCTs (n = 1874 participants). Two of the five MA conclusions were statistically significant. Compared with COT, NHF reduced the risk of escalation by 45% (RR 0.55; 95% CI [0.33, 0.92], p = .02, NNT = 32); however, no statistically significant differences in risk of mortality (RR 1.02; 95% CI [0.68, 1.54]; p = .91) and AE (RR 0.98; 95% CI [0.61, 1.59]; p = .94) outcomes were found. Compared with NIV, NHF increased the risk of escalation by 60% (RR 1.60; 95% CI [1.10, 2.33]; p = .01); mortality risk was not statistically significant (RR 1.23, 95% CI [0.78, 1.95]; p = .37). LINKING EVIDENCE TO ACTION: Evidence-based decision-making regarding RS in the ED is challenging. ED clinicians have at times had to rely on non-ED evidence to support their practice. Compared with COT, NHF was seen to be superior and reduced the risk of escalation. Conversely, for this same outcome, NIV was superior to NHF. However, substantial clinical heterogeneity was seen in the NIV delivered. Research considering NHF versus NIV is needed. COVID-19 has exposed the research gaps and slowed the progress of ED research.Item Respiratory support of adults in the emergency department: A protocol for a prospective, observational, multicenter point prevalence study(Health Science Reports published by Wiley Periodicals LLC, 2023-01) O'Donnell J; Pirret A; Hoare K; McDonald EBackground and Aims Providing respiratory support (RS) to patients may improve their oxygenation and ventilation, reducing the work of breathing. Emergency department (ED) patients often need RS; COVID-19 has heightened this need. Patients receiving RS may need escalation of their treatment; hence, studies considering the prevalence of escalation are warranted. Method This is a protocol for a prospective, observational, multicenter point prevalence study (PPS). Researchers will collect data over 2 days. All participants are adult ED patients needing RS. The setting is four EDs in New Zealand. The primary research question asks, “Which patients receiving RS require escalation of therapy in the ED?” For example, transitioning from conventional oxygen therapy (COT) to intubation is deemed an escalation of therapy. A sample size of 80 participants is required to resolve the primary research question. Secondary research questions: (1) Which patients receive nasal high flow (NHF) in the ED? (2) How is NHF therapy delivered in the ED? (3) What are the effects of NHF therapy on physiological and patient-centered outcomes? Research Electronic Data Capture (REDCap) will be used for data organization. Data will be imported for analysis from REDCap to IBM SPSS software (Statistics for Windows, Version 27.0). Data reporting on the primary outcome shall be considered by analysis of variance, regression modeling, and determination of two treatment effects: Odds Ratio and Number Needed to Treat. Statistical significance for inferential statistics shall use a two-sided α with p-values fixed at ≤0.05 level of significance and 95% confidence intervals. This protocol has ethical approval from Massey University, New Zealand. Conclusion This novel PPS may reduce the evidence and clinical practice gap on RS delivery and ED patient outcomes, as evidenced by the emergence of COVID-19.