Anxiety across the spectrum of healthcare workers was so high at the outset of the COVID-19 pandemic that Professor Zukiswa Zingela, psychiatrist and Executive Dean of the Faculty of Health Sciences at Nelson Mandela University, developed a psychological preparedness training programme to support healthcare workers.
“As healthcare workers we received medical training to diagnose and treat patients with COVID-19 but nothing about how to address our anxiety. I felt the psychiatry and mental health teams should be playing a tangible role and hence the development of the programme,” Prof Zingela explains.
Healthcare workers in three resource-limited hospitals in Nelson Mandela Bay, namely, Dora Nginza Hospital, Nelson Mandela Academic Hospital and Elizabeth Donkin Hospital, participated in the programme from mid-April 2020.
“It was designed to be short, sharp and useful so that in one to one-and-a-half hours they could leave the session with enhanced coping skills,” says Prof Zingela.
A paper was subsequently published on qualitative and quantitative data collected from 761 healthcare workers who participated in the programme. Results showed a significant positive change from pre- to post-intervention measures in the perceptions of health workers about the outbreak, their anxiety associated with the outbreak, their ability to control their reactions to stress and to support others.
This was published in March 2022 in the South African Journal of Psychiatry, titled: ‘Developing a healthcare worker psychological preparedness support programme for the COVID-19 outbreak’.
The psychological preparedness training programme has since been adapted into a short-learning programme (SLP) for working adults in any sector, and renamed Enhanced Preparedness Training (EPT). “It focuses on strengthening people’s self- and group coping and management skills,” Prof Zingela explains.
“It enhances self-management when faced with challenges and is achieved through a number of techniques aimed at instilling a sense of calm and an ability to manage stress. When we feel calm we are able to manage our fears, thoughts, feelings and behaviour; we are able to think logically about how to move forward and come up with feasible solutions.”
The programme is delivered in three parts which take the form of a 45-minute to 60-minite mind-care session, borrowing from theories of cognitive behavioural therapy that focus on what we are thinking and feeling, and how we behave when we interact with ourselves and others at work and at home.
The other two sessions are a 20-minute relaxation and mindfulness session followed by a 45-minute team-care session that looks at what role one can play to enhance the function of the team or work environment they are in.
“We all carry anxieties and fears when faced with challenges, and it is within our control to manage these or to seek help from someone who can assist us to achieve this. During the EPT programme we share different methods of mindfulness and relaxation, including guided imagery, mind-body feedback mechanism and grounding techniques. Through these, people learn how to manage and overcome the different forms of anxiety we all experience,” says Prof Zingela.
“When we feel anxious we start taking shorter, shallower breaths which disturbs the oxygen-carbon dioxide balance in our bodies. We also experience other effects like increased blood pressure which may lead to dizziness, dry mouth, pins and needles and even palpitations.
If this continues it can lead to a full-blown panic attack. The session on relaxation and mindfulness techniques helps with this. When we know how to normalise our breathing it immediately starts to reverse these physical symptoms and a sense of calm is restored which rejuvenates our coping skills.
“No matter how stressed we are or how hard our lives are, we have all experienced at least one moment when we felt peaceful or happy, and we draw on this,” Prof Zingela explains. “The grounding techniques are about achieving mindfulness through progressive relaxation that helps us to start focusing on the here and now, not on the regret or pain of the past or the fears we might have about the future.”
From September 2023 the EPT programme will be available to all who may wish to access it across the different faculties and externally. It will be offered countywide, both as a face-to-face intervention and online version.
The Faculty of Health Sciences works with internal and external facilitators who have a background in psychology, social work, and those in the medical and nursing professions with qualifications in mental health. The facilitators include the Director of the School of Behavioural and Lifestyle Sciences, Professor Zoleka Soji who is a clinical social worker, and the Dean of Learning and Teaching, Dr Phumeza Kota Nyati, who is a psychologist.
The EPT programme is structured in the form of two different options: the two-day programme for companies or individuals, and the three-day programme for professionals in the employee wellness sector who wish to train as facilitators of the programme . The Faculty is currently applying for the EPT programme to be approved for Continuous Professional Development.