psychological effects of long term exposure and radiation injury
DESCRIPTION
PSYCHOLOGICAL EFFECTS OF LONG TERM EXPOSURE AND RADIATION INJURY. Module XX. Syllabus. Introduction Medical consequences of radiation accidents Psychological consequences of radiation accidents What is psychological stress caused by the accident? What can we do about stress? - PowerPoint PPT PresentationTRANSCRIPT
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PSYCHOLOGICAL EFFECTS OF PSYCHOLOGICAL EFFECTS OF
LONG TERM EXPOSURE AND LONG TERM EXPOSURE AND RADIATION INJURYRADIATION INJURY
Module XXModule XX
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Module Medical XX - 2
SyllabusSyllabus Introduction Medical consequences of radiation
accidents Psychological consequences of radiation
accidents What is psychological stress caused by
the accident? What can we do about stress? Management of psychological effects Summary
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IntroductionIntroduction Importance of psychological impact of radiation
accidents underestimated in past Psychosocial effects may far outnumber any
direct health effects Reactions to nuclear and radiological accidents
similar Role of scientific community, and physicians in
particular, in influencing public perception of risk - and addressing psychological consequences of accidents
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Medical consequences of Medical consequences of radiation accidentsradiation accidents
Health effects directly related to radiation exposure Deterministic Stochastic
Health effects indirectly related to radiation exposure Caused by accident Caused by intervention
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Health effects directly related Health effects directly related to radiation exposureto radiation exposure
Not related to awareness of exposure or to subjective perception of risk
Can be prevented or reduced by protective action minimizing public exposure
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Health effects indirectly Health effects indirectly related to radiation exposure related to radiation exposure
Can far outnumber any direct effects Need to be taken into account Can affect hundreds of thousands Can last for many years Do not correlate well with actual exposure
but with subjective perception of risk Protective action to reduce exposure may
be counterproductive with regard to such effects
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Why do people fear Why do people fear ionizing radiation?ionizing radiation?
Unknown threat Can not be seen or felt Conflicting information in mass media Contradictory data from different “scientists” Use of “radiation theme” in economic and
political discussions Long term consequences of radiation exposure Lack of education of general public, physicians
and other professionals Social understanding of any situation involving
“radiation” is negative
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Psychological effectsPsychological effects
Psychological effects include
Mental suffering Changes in risk perception Modification in individual and social
behaviour
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Psychological effectsPsychological effects Major accidents (Chernobyl, TMI, Goiânia)
show that affected people believe health threatened doubt reports about accident and resulting
radiation doses get life style modified have somatic complains abuse drugs (alcohol, tranquilizers, sleeping
pills)
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Severity of psychological Severity of psychological reactionsreactions
Depends on factors related to accident:
abruptness, intensity, duration, availability of social support, etc.
factors related to individual:experience, personal loss, perception of threat,
personal coping ability, etc.
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What is psychological stress What is psychological stress caused by accident?caused by accident?
Normal reaction to abnormal event
Unusually strong psychological and emotional reactions which could interfere with ability to function during or after accident
Can become post traumatic stress disorder
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What is psychological stress What is psychological stress caused by accident? caused by accident?
New diagnostic entity “chronic environmental stress disorder” proposed
Principal characteristics: apathy, asthenia, diminished interest and “learned
helplessness”
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Changes in health behaviour Changes in health behaviour of affected peopleof affected people
Extensive medical examinations (active screening) increase anxiety about current and future effects
Change in illness behaviour and greater diagnostic capability together with vast screening programmes increase disease diagnoses in most organs and systems
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Stress reactionsStress reactions
Early Nausea Muscle tremors Sweating Dizziness Chills Increased heart rate Increased blood
pressure Hyperventilation
Late Fatigue Increased use of
alcohol and drugs Exaggerated startle
response Sleep - related
difficulties
Physical
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Stress reactionsStress reactions
Early Confusion Difficulty in making decisions Impaired thinking Difficulty problem solving Memory loss Calculation difficulties Difficulty remembering names
Delayed Decreased attention
span Poor concentration Memory problems Flashbacks
Cognitive
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Stress reactionsStress reactions
Early Anxiety Anger Fear Irritability Guilt Feeling overwhelmed Grief Hopelessness
Delayed Feeling abandoned Resentment Feeling alienation Withdrawal Numbness Depression
Emotional
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Psychological problemsPsychological problemsLateLate
Continuation of some early problems
Discrimination by other people Establishment of illness behaviour Concern about consequences of
exposure
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Psychological effects of Psychological effects of relocationrelocation
Relocation dubious Negative impact on mental well being If aimed to reduce risk of stochastic
effects: Consider only future avoidable dose Dose already achieved cannot be reduced
Involuntarily relocated people suffer most Elderly people especially likely to suffer
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What can we do about What can we do about stress?stress?
Accidents can not be predictedBUT
Psychological reaction to radiation accident could be
prevented / mitigatedusing different methods applied
before / during / after accident
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Management of psychological Management of psychological consequences after accidentconsequences after accident
Response to reduce psychological consequences Medical response Public health follow-up Social assistance Government action guidelines Community accountability
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How to reduce How to reduce psychological effectspsychological effects
Have ongoing information programme Give clear, simple and timely advice Provide consistent advice and assessment
(one official point) Use international guidance Ensure protective action justified Correct false information Consider education and counselling
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Warning populationWarning population Timely warning one of most important
psychological aspects of dealing with accidents
Provide people with sense of control over situation
Call for active attitude: Searching process Preparation for protective action
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Requirements for Requirements for warning messagewarning message
Consistent Accurate, timely and complete Clear Simple Sufficient Concrete Provided through multiply channels Frequently repeated
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Psychological support in Psychological support in different types of accidentsdifferent types of accidents
Psychological support is needed for:Accident
NoNoYesMedical misadministration in diagnosis and therapy
NoNoYesResult of use/misuse of industrial sources
NoNoYesLaboratory accidents
Not alwaysYesYes, if anyNuclear power satellite re-entryNot alwaysYesYesTransportation
Not alwaysYesYesInvolving lost/stolen sourcesYesYesYesCriticalityYesYesYesNuclear (reactor)
Emergency responders
General public
Affected victims
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Psychological stress of Psychological stress of injured individualsinjured individuals
Patient needs Comfort, relief of
symptoms Stability and
authoritative support Information Concern Hope Control Stimulation
Patient problems Overly scientific
approach Repeated tests,
examinations Photographs Reactions of others Too many “experts” Too much media
attention
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Medical staff problemsMedical staff problems Fear / anxiety Isolation by others Lack of knowledge (medical treatment,
long term effects, etc.) New experience:
Interactions with “experts,” public officials, reporters, etc.
Loss of autonomy (activities may be monitored/managed by authorities)
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Mitigation of psychological Mitigation of psychological consequencesconsequences
One of the functional requirements
Applicable for all planning categories
Should be performed by facility, local or national level of response
Depending on planning category
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Mitigation of psychological Mitigation of psychological consequencesconsequences
Establish written process for justifying, optimizing and authorizing different intervention or action levels following event for longer term protective action
Consider effects on mental health, economic conditions, employment, long term needs for social welfare and other non-radiological impact caused by taking longer term protective action
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Mitigation of psychological Mitigation of psychological consequencesconsequences
Establish capability for addressing public concerns and reactions during actual or perceived nuclear or radiological emergency
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Mitigation of psychological Mitigation of psychological consequencesconsequences
Ensure that affected people perceive, understand, believe, personalize, and respond to warning
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Mitigation of psychological Mitigation of psychological consequencesconsequences
Before long term monitoring or other activities are conducted in areas designed for unrestricted use after accident, ensure public understand reasons for these continuing activities (e.g. scientific investigations of behaviour of radioisotopes in environment)
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Mitigation of psychological Mitigation of psychological consequencesconsequences
Establish process to develop system of compensation for emergency workers and public following emergency after careful consideration of benefits and long term social, psychological and economic effects
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SummarySummary Psychological effects – more important in
current situation What is stress caused by accident? What can we do about stress? Management of psychological effects Psychological support in different types of
accidents Mitigation of psychological consequences