P-149 Effects of with holding treatment on mental health in Canadian paramedics during the COVID-19 pandemic
Bibliographic record
Abstract
Introduction Psychological effects of withholding treatment that could have benefited a patient during a pandemic remain largely unknown. It is also unclear to what extent their reasons for withholding treatment contributed to the subsequent impact on mental health outcomes. Paramedics may have withheld treatments either due to fear of exposure, being directed by their service, or both. As such, the present research aimed to characterize withholding treatment and investigate potential negative mental health outcomes. Materials and Methods Paramedics from five provinces (Alberta, British Columbia, Manitoba, Ontario, Saskatchewan) working during the COVID-19 pandemic completed online questionnaires assessing withholding treatment (i.e., due to fear of exposure, directed by their service, or both), and mental health outcomes including depression (PHQ-9) and post-traumatic stress (PTSD) symptoms (PC-PTSD-5) as part of the COVID-19 Occupational Risks, Seroprevalence and Immunity among Paramedics (CORSIP) study. Results Of the 1453 participants, 54.2% reported withholding treatment due to fear of exposure (4.3%), as directed by their service (76.5%) or both (19.2%). Participants who withheld treatment reported higher rates of PTSD (M=2.6, p < .01) and depression (M=8.2, p < .001) symptoms than those that did not withhold treatments (MPTSD=2.3; Mdepression=6.4). Reason for withholding treatment and PTSD symptom severity were associated (p<.01). Paramedics who withheld treatment due to fear of exposure were more likely to report probable PTSD symptoms (23.5%) than those who withheld treatments as directed by their service (8.7%) or both (12.2%). Depression symptom severity did not differ by reasons for withholding treatment. Conclusions Withholding treatment is potentially traumatic and may influence the development of depression and PTSD symptoms. Withholding due to fear of exposure rather than being directed to increased PTSD symptoms. Further research will investigate the mental health impact of withholding treatment and reported reasons for withholding over time.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".