Prediction Accuracy Between Terminally Ill Patients' Survival Length and the Estimations Made From Different Medical Staff, a Prospective Cohort Study

Background: Previous reports suggested the clinical predictions of survival (CPS) and prognostic scores had similar accuracy in patients with days to weeks of life. Objective: We aimed to evaluate and compare the accuracy of CPS by attending physicians, residents, and nurses in an acute palliative care unit at a medical center. Methods: This was a 1-year prospective cohort study. Survival prediction was made within 3 days after patients' admission and re-evaluated every week until patients' discharge or death. Associated factors of accurate survival predictions were also explored by multivariate logistic regression. Results: A total of 179 inpatients were recruited and 115 of them were included in this analysis. The mean age of participants was 72.9 years and the average length of actual survival was 11.5 ± 12.0 days. For patients with survival within 30 days, the medical staff tended to overestimate their life span. The predictions made by physicians and nurses showed much closer to actual survival length through repeated estimations. Patients with metastatic cancer (odds ratio: OR 2.77, 95% CI 1.23-6.22) or cognitive impairment (OR 2.39, 95% CI 1.12-5.11) had higher associations with accurate CPS. Poor performance status of ECOG (OR 1.82, 95% CI 1.09-3.02) and dysphagia (OR 2.01, 95% CI 1.07-3.77) were significant predictors for accurate CPS in patients with the survival of less than 2 weeks. Conclusions: The accuracy of CPS between different medical staff did not reveal significant differences in the study. The importance of re-evaluation for patients' survival length in clinical practice is worthy of attention.

Evidence-Based Design in the Hospital Environment: A Staff's Burnout Study in the COVID-19 Era

OBJECTIVE

This study aimed to evaluate the evidence-based design of the hospital physical space effect on the burnout of nurses and physicians during COVID-19. The research question was to identify the connection between daylight, nature-view windows, and hospital staff burnout during Covid-19.

BACKGROUND

The evidence-based design in the hospital environment affects the health of the medical staff. The promotion of the hospital environment has a significant effect on healthcare system improvement.

METHODS

This cross-sectional study was performed on 406 nurses and physician's burnout in Guilan province in 2020. Three questionnaires were used: demographic, physical space of the hospital, daylight, nature-view windows, and Maslach Burnout Inventory. Logistic regression (LR) analysis was used to determine the association between burnout and the hospital environment. The significance level was considered with p < .05.

RESULTS

The results showed statistically significant correlations between patient units and the environmental characteristics of the hospitals with staff's burnout (p < .001). Of note, 62.9% of physicians and 71.9% of nurses had moderate work-related burnout. The highest burnout score was seen among staffs of emergency departments adjusted multivariate LR model revealed that 27.1% of work-related burnout in nurses and physicians was predictable with age, light, marital status, and hospitals. Our results showed that accessing more daylight could reduce burnout (p = .018, odds ratio [OR] = 0.910).

CONCLUSION

Based on the result, the daylight impact on burnout reduction is more significant than other factors. It is suggested that adequate lighting, proper environmental design, and nature-view windows could create appropriate space for enhancing medical staff satisfaction and reducing burnout.

The mediating role of incentives in association between leadership attention and self-perceived continuous improvement in infection prevention and control among medical staff: A cross-sectional survey

Objectives

Promoting improvement in Infection Prevention and Control (IPC) is an important part of improving the quality of care. The influence of leadership attention and incentives on the self-perceived continuous improvement in IPC has drawn a lot of attention, but relevant academic research is still lacking. The objective of this study is to explore the effect of leadership attention on self-perceived continuous improvement in IPC among medical staff and its underlying mechanisms.

Method

The 3,512 medical staff from 239 health facilities in Hubei, China, were surveyed online during September 2020. Data on leadership attention, incentives, and improvement in Infection Prevention and Control were collected using self-administered questionnaires. Correlation analysis was used to analyze the relationship between leadership attention, incentives, and improvement in Infection Prevention and Control. Amos 24.0 was used to analyze the mediating role.

Results

The scores of leadership attention, incentives and self-perceived continuous improvement in Infection Prevention and Control were all high. The score of leadership attention was the highest (4.67 ± 0.59), followed by self-perceived continuous improvement (4.62 ± 0.59) and incentives in Infection Prevention and Control (4.12 ± 0.83). Leadership attention positively affected self-perceived continuous improvement in Infection Prevention and Control (β = 0.85, 95% CI = [0.83, 0.87]). Moreover, incentives partially mediated the effect of leadership attention on self-perceived continuous improvement in Infection Prevention and Control among medical staff (β = 0.13, 95% CI = [0.12, 0.15]).

Conclusion

Leadership attention positively affects self-perceived continuous improvement in Infection Prevention and Control among medical staff, and incentives mediates this relationship. The present study has valuable implications for self-perceived continuous improvement in Infection Prevention and Control from the perspective of leadership attention and incentives.

Analysis of factors influencing the job satisfaction of medical staff in tertiary public hospitals, China: A cross-sectional study

Introduction

Since the outbreak of the novel coronavirus pneumonia (COVID-19), China has entered normalization phase of its epidemic prevention and control measures that emphasizes 'precise prevention and control,' 'dynamic zeroing', and 'universal vaccination'. However, medical staff continue to face physical and mental stress. The present study aimed to investigate the job satisfaction of medical staff in China, as well as any associated factors.

Methods

2,258 medical staff completed a questionnaire specially designed for this study. Independent samples t-tests, one-way analysis of variance, and binary logistic regression were used to analyze associated factors.

Results

Overall, 48.4% of the participants expressed satisfaction with their job; the highest-scoring dimension was interpersonal relationships (3.83 ± 0.73), while the lowest scoring dimension was salary and benefits (3.13 ± 0.94). The logistic regression model indicated that job satisfaction among medical staff is associated with being aged 40-49 years [odds ratio (OR) = 2.416] or > 50 years (OR = 2.440), having an above-undergraduate education level (OR = 1.857), holding a position other than doctor [i.e., nurse (OR = 3.696) or 'other' (OR = 2.423)], having a higher income (OR = 1.369), and having fewer monthly overtime shifts (OR = 0.735-0.543). Less than half of the medical staff expressed satisfaction with their job, indicating that the overall level is not high.

Discussion

This research enriches the study of medical workers' job satisfaction during periods when epidemic prevention and control has become familiar and routine. To improve medical workers' job satisfaction, administrators should seek to enhance medical staff's remuneration, reduce their work pressure, and meet their needs (where reasonable).

Changes of medical staffs' subjective well-being in China (2004-2020): A cross-temporal meta-analysis

Subjective well-being is a crucial index measuring the mental health of medical staffs, and it is necessary to examine the changes in subjective well-being (SWB) level of Chinese medical staffs with time. A cross-temporal meta-analysis was performed using papers that measured the SWB level of Chinese medical staffs between 2004 and 2020. Moreover, a time-lag analysis was conducted to define whether the macro-social indicators can explain the changes in SWB. A total of 47 papers were included in the final sample. The results revealed that score of SWB was significantly negatively correlated with the year. Score of SWB was significantly associated with six social indicators of economic condition (the residents' consumption level, housing prices, and old-age dependency ratio), social connectedness (the divorce rate and the urbanization level), and overall threat (the crime rate), which indicated that social change may account for the decline of Chinese medical staffs' SWB level. Our study revealed a decreasing trend of Chinese medical staffs' SWB level over time, which was associated with macro-social changes in diverse areas. In addition, combined with the corresponding macro-social indicators, a three-dimensional theoretical framework is proposed to explain the SWB for medical staffs as a group.

Associations between work-related variables and workplace violence among Chinese medical staff: A comparison between physical and verbal violence

Background

Workplace violence (WPV) against medical staff has been an important public health and societal problem worldwide. Although numerous studies have implied the differences between physical violence (PV) and verbal violence (VV) against medical staff, few studies were conducted to analyze the different associations between work-related variables, PV, and VV, especially in China.

Methods

A cross-sectional study was conducted among Chinese medical staff in public hospitals, and 3,426 medical staff were interviewed and analyzed. WPV, including PV and VV, were evaluated by the self-report of the medical staff. Work-related variables, physical disease, depression, and social-demographic variables were also measured. The work-related variables included types of medical staff, professional titles, hospital levels, managers, working years, job changing, working hours/week, night duty times/week, monthly income, self-reported working environment, and social position. Logistic regressions were conducted to examine the factors associated with PV and VV.

Results

A total of 489 medical staff (23.0%) reported the experience of PV and 1,744 (50.9%) reported the experience of VV. Several work-related variables were associated with PV and VV, including nurse (OR = 0.56 for PV, p < 0.01; OR = 0.76 for VV, p < 0.05), manager (OR = 1.86 for PV, p < 0.01; OR = 1.56 for VV, p < 0.001), night duty frequency/week (OR = 1.06 for PV, p < 0.01; OR = 1.03 for VV, p < 0.01), bad working environment (OR = 2.73 for PV, p < 0.001; OR = 3.52 for VV, p < 0.001), averaged working environment (OR = 1.51 for PV, p < 0.05; OR = 1.55 for VV, p < 0.001), and bad social position (OR = 4.21 for PV, p < 0.001; OR = 3.32 for VV, p < 0.001). Working years (OR = 1.02, p < 0.05), job changing (OR = 1.33, p < 0.05), and L2 income level (OR = 1.33, p < 0.01) were positively associated with VV, but the associations were not supported for PV (all p>0.05). The other associated factors were male gender (OR = 1.97 for PV, p < 0.001; OR = 1.28 for VV, p < 0.05) and depression (OR = 1.05 for PV, p < 0.001; OR = 1.04 for VV, p < 0.001).

Conclusion

Both PV and VV were positively associated with work-related variables, such as doctor, manager, more night duty frequency, perceived bad working environment, or social position. Some variables were only associated with VV, such as working years, job changing, and monthly income. Some special strategies for the work-related variables should be applied for controlling PV and VV.

A study on differences about the influencing factors of depressive symptoms between medical staff and residents during 2022 city-wide temporary static management period to fighting against COVID-19 pandemic in Shanghai

Objectives

Our study aimed to identify the latent class of depressive symptoms in the Shanghai population during the city-wide temporary static management period and compare differences in the factors influencing depressive symptoms between medical staff and residents.

Methods

An online cross-sectional survey was conducted with 840 participants using questionnaires, including Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and self-compiled questionnaire (demographic characteristics and internet usage time). Latent class analysis (LCA) was performed based on participants' depressive symptoms. The latent class subgroups were compared using the chi-square test and t-test. Logistic regression was used in our study to analyze the factors influencing depressive symptoms within the medical staff group and residents group and then compare their differences.

Results

Two distinct subgroups were identified based on the LCA: the group with low-depressive symptoms and the group with high-depressive symptoms. There were significant differences between the two groups (P < 0.05) on age, education level, marital status, internet usage time, identity characteristics (medical staff or residents), family income level, living style, overall quality of sleep, and anxiety levels. Furthermore, logistic regression analysis results showed that compared with the residents group, the participants in the group of medical staff with "increasing internet usage time" and the "daytime dysfunction" would have nearly two times the possibility of getting serious depressive symptoms.

Conclusions

There are differences in the factors influencing depression symptoms between medical staff and residents during the 2022 city-wide temporary static management period to fighting against the COVID-19 pandemic in Shanghai. We should pay special attention to those with increasing internet usage time and daytime dysfunction in medical staff working in a special environment such as the COVID-19 pandemic.

Burnout, depression, anxiety and insomnia among medical staff during the COVID-19 epidemic in Shanghai

Background

Coronavirus disease 2019 (COVID-19) has progressively impacted our daily lives, resulting in unexpected physical and mental stress on medical staff. This study is designed to investigate the levels of and risk factors for burnout, depression, anxiety, and insomnia among medical staff during the COVID-19 epidemic breakout in Shanghai, China.

Methods

This cross-sectional survey was conducted from May 1 to May 31, 2022, among medical staff who were on the frontline during the epidemic breakout in Shanghai from different institutions. The MBI-HSS was used to assess burnout, PHQ-9, GAD-7 and ISI were used to evaluate mental status and insomnia.

Results

A total of 543 valid questionnaires were collected. The depersonalization, depression, anxiety, and insomnia scores of medical staff were significantly higher during the pandemic in Shanghai compared with norms, while lack of personal achievement scores were decreased. Working time, work unit, work environment and age are important influencers of burnout, depression and anxiety of medical staff. Long working hours are the most likely causes of burnout and emotional disorders. Medical staff in primary hospitals were most likely to suffer from burnout and emotional disorders, while medical staff in tertiary hospitals had a reduced sense of personal achievement. Young medical staff are prone to negative emotions such as depression and anxiety, while older medical staff have a lower sense of personal accomplishment. Medical staff who were not in the shelter hospitals or designated hospitals were more likely to have problems of emotional exhaustion, depersonalization and anxiety than those who were in the shelter hospitals or designated hospitals. Contracting COVID-19 had no effect on medical staff. Emotional exhaustion and depersonalization were positively correlated with anxiety, depression, and sleep disorders while personal achievement was negatively correlated with these factors.

Conclusion

Medical staff in Shanghai had high burnout, depression, anxiety and insomnia levels during the epidemic outbreak in Shanghai. During the COVID-19, medical staff may suffer different psychological problems which should be concerned. Care and supports about burnout, mental health and insomnia need to be taken to promote the mental health of medical staff according to different characteristics of medical staff.

Corrigendum: Relations among perceived stress, fatigue, and sleepiness, and their effects on the ambulatory arterial stiffness index in medical staff: A cross-sectional study

[This corrects the article DOI: 10.3389/fpsyg.2022.1010647.].

How does centralized isolation treatment strategy affect the medical staff's mental health during the COVID-19 pandemic?

Background

During the coronavirus 2019 (COVID-19) pandemic, the Chinese Government adopted a centralized isolation treatment (CIT) strategy for patients, which has greatly improved the efficiency of the pandemic response. However, compared to those in local hospitals, anti-COVID-19 medical staff in mobile cabin hospitals, where the CIT strategy was adopted, suffered more mental health problems. This study aimed to explore how the CIT strategy affected the medical staff's mental health by comparing anti-COVID-19 medical staff who worked in mobile cabin hospitals to those in fever clinics of local hospitals.

Methods

Following the standard scale development procedure, this study first developed a scale measuring the mental health of anti-COVID-19 medical staff. Using SPSS 23.0 and Amos 23.0 software, the exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability analysis method were conducted to support the scale development. In the main investigation, a survey method using the developed scale was used, and 839 anti-COVID-19 medical staff from five hospitals in northern China were recruited as participants by snowball-sampling method. The first survey was conducted in February 2020, when the first round of COVID-19 was at a serious time. In April 2020, after the first round of COVID-19 in China was initially contained, and medical staff who worked in mobile cabin hospitals returned to local hospitals, a follow-up survey was conducted on these participants. Using SPSS 23.0 software, a series of 2 × 2 mixed-design ANOVA was conducted, in which working conditions (mobile cabin hospital vs. local hospital) served as a between-subject factor, time points (during vs. after the first round of COVID-19) served as a within-subject variable, and the indicators of the medical staff's mental health served as dependent variables respectively.

Results

The reliability and validity of the developed scale were desirable. The mental health problems of anti-COVID-19 medical staff were mainly manifested as anxiety, powerlessness, fear of infection, and somatization. Compared to those who worked in local hospitals, anti-COVID-19 medical staff who worked in mobile cabin hospitals where the CIT strategy was adopted suffered more powerlessness, fear of infection, and somatization. After returning to local hospitals, symptoms of fear of infection and powerlessness of medical staff who used to work in mobile cabin hospitals decreased significantly. However, their anxiety symptoms were not relieved, and their somatization symptoms even increased.

Conclusion

This study implied that the mental health of anti-COVID-19 medical staff in mobile cabin hospitals adopting CIT was worse than in local hospitals. Moreover, with the first outbreak in remission, the mental health recovery of medical staff in CIT hospitals was slower than in local hospitals. Relevant practitioners should pay more attention to the mental health condition of anti-COVID-19 medical staff who work in CIT hospitals. The psychological assistance service for them should continue even after they return to the local hospitals.

The use of Endo barrier for prevention of COVID-19 infection enables upper gastrointestinal endoscopy with high patient satisfaction in private clinic

Objectives

In the midst of the coronavirus disease 2019 (COVID-19) infection pandemic, practitioners who perform endoscopic examinations need to prevent infections through procedures, along with routine medical care. By using continuous suction, Endo barrier is thought to be effective in preventing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) droplets and aerosols. The study aimed to evaluate patient discomfort and satisfaction with the use of the Endo barrier during esophagogastroduodenoscopy (EGD). The study evaluated the system's effectiveness as well as the system's preparation time and the amount of burden on the medical staff.

Methods

EGD was performed on 788 consecutive cases using the Endo barrier. A questionnaire was used to survey patients after the procedure on four points: discomfort (feeling of pressure, breathlessness) and good points (feeling of relief and satisfaction) using a visual analog scale. In addition, patients were divided into two groups according to sedation status: with sedation (69.7%) and without sedation (30.3%), and their scores were compared. Additionally, the preparation time of the Endo barrier was measured.

Results

Patient discomfort was reported as minimal, resulting in a high level of satisfaction using this system. Although the overall results were better in the sedation group, the overall evaluation of the non-sedated group was also favorable. Furthermore, preparation time (30 s) was less burdensome for medical staff.

Conclusion

The Endo barrier is an easy-to-implement tool to prevent COVID-19 infection in private clinics, and both patients and staff were highly satisfied with the device with or without the use of sedation during EGD.

Knowledge, attitude, and practices on COVID-19 prevention and diagnosis among medical workers in the radiology department: A multicenter cross-sectional study in China

Objective

The aim of this study was to investigate the knowledge, attitude, and practice (KAP) of medical workers in the radiology department toward the prevention and diagnosis of COVID-19.

Methods

This multicenter cross-sectional study was conducted among medical workers in the radiology department of 17 hospitals between March and June 2022.

Results

A total of 324 medical workers were enrolled. The mean knowledge scores were 15.3 ± 3.4 (out of 23), attitude scores were 31.1 ± 5.6 (range 8-40), and practice scores were 35.1 ± 4.4 (range 8-40). Positive attitudes (OR = 1.235, 95% CI: 1.162-1.311, P < 0.001) and aged 41-50 years were independently associated with higher practice scores. Those with the better practice were more likely to be older (OR = 2.603, 95% CI: 1.242-5.452, P = 0.011), nurses (OR = 2.274, 95% CI: 1.210-4.272, P = 0.011) and with junior/intermediary/vice-senior title (OR = 2.326, 95% CI: 1.030-5.255, P = 0.042; OR = 2.847, 95% CI: 1.226-6.606, P = 0.015; OR = 4.547, 95% CI: 1.806-11.452, P = 0.001, respectively). Subgroup analysis revealed significant differences in knowledge between technicians and physicians and nurses and between staff working in tertiary hospitals and non-tertiary hospitals. Knowledge is positively correlated with attitude (β = 0.54, P < 0.001), and attitude is positively correlated with practice (β = 0.37, P < 0.001). Attitudes significantly mediated the association between knowledge and practice (β = 0.119, P < 0.001).

Conclusion

The radiology medical workers showed moderate knowledge but good attitudes and practices of prevention and diagnosis of COVID-19. Attitudes were found to be positively associated with better practices of prevention and diagnosis of COVID-19. Attitudes significantly mediated the association between knowledge and practice.

The mediating role of resilience between perceived social support and sense of security in medical staff following the COVID-19 pandemic: A cross-sectional study

Background

The COVID-19 pandemic not only posed a serious threat to public life and health but also had a serious impact on people's mental health, especially that of medical staff. Perceived social support is an important factor in one's sense of security.

Objective

Following the COVID-19 pandemic, the goal is to explore the potential mediating role of resilience in the relationship between perceived social support and the sense of security of Chinese medical personnel.

Methods

The multi-stage proportionally stratified convenience sampling method was adopted to select 4,076 medical professionals from 29 hospitals in Guangdong Province between September 2020 and October 2020. The Sense of Security Scale for Medical Staff, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale were employed in this study. For statistical analysis and structural equation modeling (SEM), the SPSS 23.0 and Amos 24.0 software packages were used. Regression analysis was used to select the control variables to be included in the SEM. SEM analysis was conducted to verify the mediating effect of resilience on the relationship between perceived social support and a sense of security.

Results

Pearson's correlation analysis showed that perceived social support and resilience were positively associated with a sense of security (correlation coefficients range from 0.350 to 0.607, P < 0.01), and perceived social support (correlation coefficients range from 0.398 to 0.589, P < 0.01) was positively associated with resilience. Structural equation modeling revealed that resilience played a partial mediating role in the association between perceived social support and a sense of security (60.3% of the effect of perceived social support on security was direct, and 39.7% of the effect was mediated by resilience).

Conclusions

Hospital managers should make efforts to develop resilience. Interventions based on resilience should be developed to enhance the perception of social support and strengthen one's sense of security.

Health-related quality of life in Chinese medical staff: a latent profile analysis

Objective

To investigate subgroups of health-related quality of life (HRQoL) in the Chinese medical staff and identify the demographic factors associated with these profiles.

Methods

574 Chinese medical staff were surveyed online. HRQoL was measured by using the 36-Item Short Form Health Survey, Version 2. Latent profile analysis (LPA) was used to identify the profiles of HRQoL. The associations between HRQoL profiles and covariates were assessed using multinomial logistic regression.

Results

Three HRQoL profiles were developed: low HRQoL at 15.6%, moderate HRQoL at 46.9%, and high HRQoL at 37.6%. Multinomial logistic regression showed night shift times, aerobic exercise conditioning, and personality type significantly predicted the profile membership.

Conclusion

Our findings develop earlier approaches that only used total scores to evaluate this group's HRQoL and help them with tailored interventions to promote better HRQoL.

Assessment of selected psychosocial risk factors: stress, job burnout, and bullying in the case of medical staff as part of workplace ergonomics during the COVID-19 pandemic-A prospective pilot study

Background

The purpose of the pilot study conducted by the authors was to assess occupational risk in selected areas of psychosocial risk factors among health professions in a pilot study. Medical staff working in the healthcare sector experience stress, job burnout and bullying on a daily basis. Monitoring occupational risks in the above areas provides an opportunity to take appropriate preventive measures.

Methods

The prospective online survey included 143 health care workers from various professional groups. Eighteen participants did not complete the survey, and the results of 125 participants were eventually included in the analysis. The study used health and safety questionnaires in the healthcare sector, which are not widely used as screening tools in Poland.

Results

The following statistical methods were performed in the study: the Mann-Whitney test, Kruskal-Wallis test, Dunn's test. In addition, multivariate analysis was performed. The results obtained in the study indicate that the questionnaires used in the study can be widely used by employers or occupational medicine as screening tools.

Conclusions

Our findings show that level of education attainment in healthcare is correlated with higher chance of experiencing stress and burnout. Among the surveyed professions, nurses reported a higher amount of stress and burnout. Paramedics reported the highest chance of being bullied at work. This can be explained by their nature of work which requires directly interacting with patients and their families. In addition, it should be noted that the tools used can be successfully applied in workplaces as elements of workplace ergonomics assessment in the context of cognitive ergonomics.

Sociodemographic, occupational, and personal factors associated with sleep quality among Chinese medical staff: A web-based cross-sectional study

Background

Sleep quality among medical staff affects not only their own health but also the health of their patients. This study aimed to investigate the sociodemographic, occupational, and personal factors associated with sleep quality among medical staff in mainland China.

Methods

An online survey was conducted from January 10 to February 5, 2019, involving 3,684 medical staff (female: 84.9%; mean age: 31.6 ± 7.7; age range: 18-72). Sleep quality was measured by the Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI). Sociodemographic, occupational characteristics, and personal lifestyle factors were measured by standard questions. Binary logistic regression analyses were used to determine the factors associated with sleep quality.

Results

57.9% (95% CI: 56.3-59.5%) of the study population experienced poor sleep quality (C-PSQI > 5). Binary logistic regression showed that poor sleep quality were associated with lower level of education, higher level of hospital care, longer weekly working hours, more than 30 min of cell phone use at bedtime, shift work (OR 1.33, 95% CI[1.12-1.58], P = 0.001), lack of regular naps (OR 1.46, 95% CI[1.26-1.69], P < 0.001) and lack of routine exercise (OR 1.69, 95% CI[1.46-1.97], P < 0.001).

Conclusions

Poor sleep quality is highly prevalent among medical staff in mainland China. The findings indicate that appropriate strategies, such as implementing regular breaks, regulating overtime work and vacation interruptions, as well as developing exercise programs, relaxation training, and stress-management programs could help improve the sleep quality of medical staff.

Self-medication in Chinese residents and the related factors of whether or not they would take suggestions from medical staff as an important consideration during self-medication

Objective

To investigate the status of Chinese residents' self-medication behavior and the important factors to consider when purchasing OTC drugs, and to explore the related factors of the possibility that Chinese residents take medical staff's suggestions as important factors to consider when purchasing OTC drugs.

Study design

A cross-sectional survey.

Methods

A questionnaire was developed for exploring the sociodemographic characteristics of the respondents, their self-medication status, and important considerations. The questionnaire includes several scales including Health Literacy Scale-Short Form (HLS-SF), EQ-5D Visual Analog Scale (EQ-5D-VAS), Big Five Inventary-10 Items (BFI-10), and New General Self Efficacy Scale (NGSES). After carrying out a multi-stage sampling method, the questionnaire was conducted nationwide from July 10 to September 15, 2021. Next, descriptive statistics were conducted to analyze the general features. Logistic regression was then used to analyze the related factors of the possibility that the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs.

Results

Nine thousand two hundred fifty-six qualified questionnaires were received. 99.06% of Chinese adults had self-medication behaviors. The types of OTC drugs purchased most by the respondents were NSAIDs (5,421/9,256 people, 58.57%) and vitamins/minerals (4,851/9,256 people, 52.41%). 86.2% of the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. The results of multi-factor logistic regression showed that women, those living in the central and western regions of China, those suffering from chronic diseases, those with high agreeableness, high conscientiousness, high neuroticism and openness, high health literacy, high EQ-5D-VAS, and those with high self-efficacy are more likely to take medical staff's suggestions as important factors to consider.

Conclusion

The vast majority of Chinese adults have self-medication behavior. Important considerations when purchasing OTC drugs include medical staff's suggestions, drug safety and drug efficacy. Whether residents take the suggestions of medical staff as an important consideration is related to their sociological characteristics, agreeableness, conscientiousness, neuroticism, openness, health literacy, self-assessment health status, and self-efficacy. When purchasing and using OTC drugs, residents should carefully listen to the suggestions from medical staff. They should also carefully consider their own conditions before buying OTC drugs.

Beliefs and perceptions of electronic cigarettes among medical staff in respiratory departments of Fujian Province, China, in 2021

INTRODUCTION

Due to the popularity of e-cigarettes, more and more patients ask about e-cigarettes, and it is particularly important to understand doctors' beliefs and perceptions on e-cigarettes. The aim was to evaluate the belief and perception of electronic cigarettes among medical staff in the respiratory department of medical institutions located in Fujian Province.

METHODS

The electronic questionnaires were conveyed to the medical staff of the respiratory department in Fujian Province during March to April 2021. Descriptive statistics were calculated for all questions, and the relationship between relevant factors and the perception of e-cigarette-related statements was analyzed by logistic regression analysis.

RESULTS

Among 1028 medical staff in the respiratory departments of Fujian Province, 90.5% of medical staff agreed that electronic cigarettes are harmful to the human body; 61.4% of medical staff agreed that e-cigarettes cannot be regarded as a type of smoking cessation treatment; 71.7% of medical staff agreed that e-cigarettes could be a 'gateway' to other tobacco use; and 69.2% of medical staff agreed that electronic cigarettes are in 'Three No' states. The multivariate logistic regression analysis showed that the respondents' perception of 'e-cigarettes cannot be regarded as a type of smoking cessation treatment' were related to gender, professional title and whether they participated in the cessation clinic.

CONCLUSIONS

The medical staff of the respiratory department in Fujian Province put more emphasis on the adverse effects of e-cigarettes on health, but lack the cognition of the effect of e-cigarette smoking cessation. In order to better carry out smoking cessation work, it is necessary to strengthen the training of respiratory medical staff at all levels of medical institutions on e-cigarette knowledge.

Assessment of Knowledge, Attitude, Practice about COVID-19 among the Medical Staff of the National Academy of Medical Sciences

Introduction

Coronavirus is highly contagious in nature, it belong to the family of Severe Acute Respiratory Syndrome Corona virus (SARS-COV), which specially affect the respiratory system. Knowing about the virus transmission characteristics help to prevent the spread of this virus. World Health Organization suggests several infection prevention control (IPC) guidelines about the COVID-19. It is very important to have optimum awareness about COVID-19 for the medical persons because they have to deal with COVID-19 patient. The aim of this study is to assess the knowledge, attitude, and practice about COVID-19 among the medical staffs.

Method

A cross-sectional descriptive study was performed at the National Academy of Medical Sciences (NAMS) Kathmandu Nepal. Study was performed from February 2021 to April 2021. Totally 270 medical staffs were included in study. Self-administered questionnaires were developed for data collection. Knowledge, attitude and practice scores were evaluated and the association between qualitative variables with participants characteristic was assessed using Chi-square test through SPSS version 25 and Microsoft excel.

Results

The total response rate was 88% (264/300) among which 202 were female and 62 male. The study shows 64% participants never attended any IPC program. This study reveals that the mean knowledge, attitude and practice score of medical staff of NAMS were 6.91±1.115, 7.60±1.169 and 6.41±1.068 respectively. Study showed statically significance between having good knowledge with working experience and positive attitude. Participants who attend IPC program had good practice regarding COVID-19 (p -value >0.005)

Conclusion

Medical staffs of NAMS have optimal knowledge level, relatively positive attitude and average good practice in infection control for COVID -19. Regular updated infection prevention control program will enables the medical staff with good practice to deal with COVID-19.

A Nomogram-Based Study: A Way Forward to Predict the Anxiety Status in Medical Staff During the COVID-19 Pandemic

BACKGROUND AND OBJECTIVE

Anxiety influences job burnout and health. This study aimed to establish a nomogram to predict the anxiety status of medical staff during the coronavirus disease (COVID-19) pandemic.

METHODS

A total of 600 medical members were randomized 7:3 and divided into training and validation sets. The data was collected using a questionnaire. Logistic regression analysis and Akaike information criterion (AIC) were applied to investigate the risk factors for anxiety. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated to establish a nomogram.

RESULTS

Participation time (OR=44.28, 95% CI=13.13~149.32), rest time (OR=38.50, 95% CI=10.43~142.19), epidemic prevention area (OR=10.16, 95% CI=3.51~29.40), epidemic prevention equipment (OR=15.24, 95% CI=5.73~40.55), family support (OR=9.63, 95% CI=3.55~26.11), colleague infection (OR=6.25, 95% CI=2.18~19.11), and gender (OR=3.30, 95% CI=1.15~9.47) were the independent risk factors (P<0.05) for anxiety in medical staff. The areas under the receiver operating characteristic (ROC) curves of the training and validation sets were 0.987 and 0.946, respectively. The decision curve's net benefit shows the nomogram's clinical utility.

CONCLUSION

The nomogram established in this study exhibited an excellent ability to predict anxiety status with sufficient discriminatory power and calibration. Our findings provide a protocol for predicting and identifying anxiety status in medical staff during the COVID-19 pandemic.

Psychological and sleep disturbances among first-line, second-line, and at home medical staff during the COVID-19 pandemic in Shanghai, China

Objectives

Medical workers are prone to psychological and sleep disturbances during the coronavirus disease 2019 (COVID-19) pandemic. Little is known about the varying degrees of influence among vaccinated medical staff working in different positions. The current study is aimed to evaluate and compare depression, anxiety and sleep disturbances among first-line, second-line and at home vaccinated medical staff during the COVID-19 pandemic in Shanghai, China.

Methods

A cross-sectional online survey was conducted in May 2022. In addition to demographic data, levels of depression, anxiety, sleep quality, and insomnia were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and Athens Insomnia Scale (AIS).

Results

A total of 236 vaccinated medical workers completed the questionnaires, including 85 first-line medical staff (FMS), 82 second-line medical staff (SMS) and 69 at home medical staff (HMS). The proportions of depressive symptoms, anxiety symptoms, poor sleep quality, and insomnia were 52.1, 44.1, 55.9, and 49.2%, respectively. Compared with HMS, medical staff at work (FMS and SMS) got significantly higher frequency of poor sleep quality (both p < 0.001), insomnia (both p < 0.001), depressive (p < 0.001 and p = 0.003, respectively) and anxiety symptoms (p < 0.001 and p = 0.002, respectively). Compared with SMS, FMS were more likely to have poor sleep quality (p = 0.020). Besides, nurses got significantly higher percentage of poor sleep quality (OR = 1.352, p = 0.016) and insomnia (OR = 1.243, p = 0.041) than doctors. Whereas, the proportion of anxiety symptoms was increased in females than in males (OR = 2.772, p = 0.008).

Conclusions

Psychological and sleep disturbances are common among medical staff at work during the COVID-19 pandemic. More psychological intervention should be administrated for FMS, especially for nurses.

Posttraumatic stress disorder and depression of Chinese medical staff after 2 years of COVID-19: A multicenter study

BACKGROUND

In December 2019, coronavirus disease (COVID-19) was first reported in Wuhan, China, and has had a negative psychological impact on the medical staff. However, the long-term psychological effects of COVID-19 were still unclear. We aimed to assess the posttraumatic stress disorder (PTSD) and depression among medical staff 2 years after COVID-19 pandemic in Wuhan, China.

METHODS

We conducted a multicenter study in five general hospitals in Wuhan, China. PTSD was assessed using the PTSD Checklist-5. Depression was measured by the Center for Epidemiologic Studies Depression Scale. Multivariate adjusted logistic regression models were used to evaluate the association among demographic variables, depressive indicators, and PTSD.

RESULTS

In a sample of 1795 medical staff, 295 (16.40%) participants reported PTSD and 329 (18.30%) reported depression. After multivariate adjusted logistic regression analyses, participants involved in COVID-19 clinical work, unsafe working environment, poor doctor-patient relationship, unhealth status, work dissatisfaction, and low family support were at a high risk for PTSD and depression 2 years after the outbreak of COVID-19 pandemic.

CONCLUSIONS

Although it has been more than 2 years after the COVID-19 pandemic outbreak, the mental health of medical staff remains a concern. In particular, medical staff involved in the clinical care of COVID-19 patients showed a higher risk of PTSD and depression 2 years after the COVID-19 pandemic. This study may provide some useful suggestions for psychological interventions for medical staff.

Relations among perceived stress, fatigue, and sleepiness, and their effects on the ambulatory arterial stiffness index in medical staff: A cross-sectional study

Objective

To explore the relations among perceived stress, fatigue, sleepiness, and the pathway of their effects on the ambulatory arterial stiffness index (AASI) among medical staff.

Methods

This cross-sectional study was conducted at a tertiary hospital in Wuhan, China. Perceived stress, fatigue, and sleepiness were measured using the perceived stress scale (PSS), Fatigue assessment scale (FAS), and Epworth Sleepiness Scale (ESS), respectively. AASI was obtained from 24-h ambulatory blood pressure monitoring. Path analysis was used to clarify the relations among the PSS, FAS, and ESS scores, and their relations to AASI values.

Results

A total of 153 participants were included herein. The PSS and FAS correlated with the ESS (r = 0.424, p < 0.001), and the PSS correlated with the FAS (r = 0.614, p < 0.001). In addition, the ESS correlated with the AASI (r = 0.225, p = 0.005). According to the path analysis results, the PSS and FAS had no direct effect on the AASI, but did have an indirect effect on this index (β = 0.059, 95% confidence interval [CI] = 0.017-0.128, p = 0.005; β = 0.059, 95%CI = 0.016-0.135, p = 0.006, respectively) by influencing the ESS (β = 0.263, β = 0.262, p = 0.004).

Conclusion

Sleepiness was a mediator of the effects of perceived stress and fatigue on AASI.

[Obstacles in the Practice of Palliative Care Consultation Services in Grade A Tertiary Hospitals]

Objective To explore the obstacles in palliative care consultation services and put forward the suggestions for improving the services in grade A tertiary hospitals. Methods A semi-structured interview was conducted with 17 medical workers who had requested palliative care consultation services in Peking Union Medical College Hospital. Results The palliative care consultation services were hindered by five obstacle factors including insufficient knowledge of patients and their families about palliative care,unsound understanding of medical workers about palliative care,poor implementation of consultation opinions,limited labor of palliative care team,and poor economic benefits from palliative care.In view of such obstacles,the following suggestions were put forward,which included increasing the acceptance of palliative care by patients and their families,enriching the knowledge of medical staff on palliative care,establishing a new cooperation model between consultation team and medical staff,strengthening the institutional guarantee for the development of palliative care,and establishing and perfecting the laws and policies related to palliative care. Conclusion Although there are many difficulties in the in-hospital palliative care consultation services in grade A tertiary hospitals,the demand and expectation of medical staff for palliative care are still increasing.