Post Traumatic Growth in Radiation Medicine Following the COVID-19 Outbreak

PURPOSE/OBJECTIVE(S): It has been reported that adversarial growth during traumatic events potentially enhances coping with sequelae. The purpose of this work was to assess post-traumatic growth amongst radiation medicine staff members at the individual level as well as changes in perceptions of departmental culture following the outbreak of the COVID-19 pandemic declared as a US public health emergency in February 2020. MATERIALS/METHODS: A post-traumatic growth inventory (PTGI) survey comprising 21 growth indicators was disseminated electronically in May 2020 with the option of anonymous feedback to all 213 members of our multi-center radiation medicine department. The indicators were intended to measure perceptions of change in 3 domains following the outbreak: personal, interpersonal relationships and philosophy of life. In addition, 8 department safety culture survey questions were included in this survey taken from the National Hospital Patient Safety Culture Survey developed by the Agency for Healthcare Research and Quality (AHRQ). The goal was to assess changes in staff perceptions of department culture during the pandemic versus the baseline survey completed in 2019 ahead of the pandemic. The PTGI and AHRQ survey questions were scored using 6- and 5-point Likert scales with the higher scores yielding greatest perceived growth and most favorable perceptions respectively. Principal Factor Analysis with Varimax rotation was conducted on the PTGI indicators. Indicators with the highest degree of perceived change and department cultural improvements were identified. RESULTS: With a 56.3% survey response rate, factor analysis on the 21 PTGI indicators yielded Cronbach's alpha values of 0.958, 0.905 and 0.915 corresponding to the aforementioned domains. The average PTGI growth noted was 2.3 which fell between small and moderate on the Likert scale (none: 0, moderate 3, greatest 5.0). The values were 2.42 (personal), 2.11 (inter-personal) and 1.60 (philosophy) for the 3 domains. The total PTGI score was greater for staff members working from home (57.8) compared to frontline workers (43.7) out of 105 points (P-value 0.004). For the AHRQ survey there was an improvement of 18% in staff perceptions of safety culture. Of the 8 indicators, 7 showed improvements compared with baseline while 4 exceeded the 95(th) percentile of the nationwide responses in 2018. CONCLUSION: A fair to moderate degree of post-traumatic growth was observed during the pandemic, such as in areas of changing priorities on what is important, appreciation of life, compassion for others, and readiness to change. Least change was noted in religious beliefs and openness to express emotions. Staff perceptions of department priorities towards patient safety, effectiveness of policies and openness to staff questioning decisions improved substantially. Growth was thus perceived both at the individual and the department level.