Meta-analysis of the impact of role stress on the turnover intention of medical staff in tertiary hospitals

BACKGROUND

This study aimed to conduct a meta-analysis on the effect of role stress on the turnover intention of medical staff in tertiary hospitals.

METHODS

Based on the inclusion and exclusion criteria of literatures, we searched the English language databases Science Direct, PubMed, Springerlink, CBM, ISI, and Web of Science for studies published between January 2000 and October 2020 on the effect of role stress on the turnover intention of medical staff in tertiary hospitals. Publications were strictly screened according to the standards, and RevMan5.3 was adopted to conduct a meta-analysis of the relevant data. The influence of role stress and its various dimensions, such as role conflict, role ambiguity, and role overload on medical staff in tertiary hospitals turnover intention was analyzed. The Q test was adopted for heterogeneity analysis and the Egger's test adopted to detect publication bias.

RESULTS

A total of 12 publications meeting the requirements were included in this study. The results showed that the combined correlation coefficient r between total role stress and turnover intention was 0.2503 (95% CI: 0.2235‒0.3489). There was also a positive correlation between role stress and the turnover intention of medical staff in tertiary hospitals (r=0.2503). The meta-analysis results of each dimension of role stress showed turnover intention was positively correlated with role conflict (r=0.2838), role ambiguity (r=0.2628), and role overload (r=0.2687).

CONCLUSIONS

The greater the role stress of medical staff in tertiary hospitals, the stronger the turnover intention. Measures must be taken to avoid the loss of medical staff and improve the quality of medical services.

Investigation on sleep quality in Chinese medical staff during the COVID-19 pandemic

The aims of this study were to evaluate the situation of sleep quality among Chinese medical staff during the coronavirus disease 2019 (COVID-19) pandemic. We used the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality among medical staff from 8 May 2020 to 22 May 2020 in People's Republic of China. A total of 101 (25%) participants were poor sleepers, while 303 (75%) were good sleepers, as defined by PSQI. The PSQI scores were higher in high age, married, master/doctor, nurse, and frequent night shifts groups when compared with those in middle and low age, unmarried and divorced/widowed, bachelor or below, clinician and other job, low frequency night shifts, respectively (all p < 0.01). Multiple linear regression analysis showed that higher PSQI score was positively associated with higher educational background, age, and more frequent night shifts (all p < 0.001). Sleep quality of medical staff should be improved, especially for high age, married, master/doctor, nurse, and frequent night shifts groups.

Gender Differences in Anger Among Hospital Medical Staff Exposed to Patients with COVID-19

Purpose: Occupational exposure to patients with COVID-19 is a stress factor. The aim of this study was to assess gender differences in anger among medical hospital staff. Methods: N=78 hospital employees with direct or indirect contact to patients with COVID-19 completed State-Trait Inventory-2. Results: Female personnel showed higher scores in the main "trait anger" scale and its subscale "anger temperament," whereas "anger control-out" was significant lower. Direct patient contact had no influence. Conclusion: More specific training for female hospital staff could achieve health-related equity. Focusing on anger as a leading indicator could lead to better prevention and self-monitoring. Registered at Clinicaltrials.gov (NCT04368312).

Protective and Risk Factors for Medical and Nursing Staff Suffering From Psychological Symptoms During COVID-19

Background: With the outbreak of the coronavirus disease 2019 (COVID-19) epidemic in China, the general public but also medical staff were confronted with psychological challenges, suffering from the highly infectious and unknown characteristics of COVID-19. In this study, we surveyed psychological symptoms including anxiety, depression, and sleep disorders in medical staff.

Method: A questionnaire star/WeChat link-based survey assessing the Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9 depression, the Insomnia Severity Index, Social Support scales in addition to lifestyle, and income level was conducted and included 8,288 medical staff from 24 provinces in China. Pearson Chi-square and Mann-Whitney U-tests were used to evaluate single risk factors and significant differences in psychological symptoms before and during the outbreak of COVID-19. Binary logistic regression analyses were conducted for the risk factors of anxiety, depression, and sleep disorder symptoms.

Results: Medical staff had a high incidence of psychological symptoms, which was more prominent during the COVID-19 epidemic. Comparatively, females, nurses, first-line department, never exercised, and low income were risk factors for psychological symptoms. Social support including objective support, subjective support, support utility, and regular sports over 3 times per week were protective and manageable elements that could protect from and manage the psychological symptoms of medical staff.

Conclusion: The susceptibility of psychological symptoms among medical staff should be of concern to policymakers and the public in the long-term, and the aggravation of mental health problems of medical staff could be eased by providing adequate social support during and after the COVID-19 outbreak.

Adverse Psychological Reactions and Psychological Aids for Medical Staff During the COVID-19 Outbreak in China

Background: The outbreak of the novel coronavirus disease COVID-19 caused panic and psychological stress throughout the World. We investigated the extent of adverse psychological reactions in two medical staff groups in China, and explored the importance of online psychological assistance for them. Methods: A cross-sectional online survey including Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) was utilized to assess anxiety, depression, and insomnia. Propensity score matching (PSM) was applied to match sex and age between the two groups. Differences in the prevalence of adverse psychological reactions between the two groups were compared by a Chi-square test. A multivariate logistic regression analysis was utilized to search for associated adverse psychological reaction factors of two groups. Results: A total of 2,920 medical staff took part in the survey, including 470 frontline and 2,450 non-frontline medical staff. The risk of the frontline group experiencing anxiety, depression, insomnia-early, insomnia-middle, and insomnia-late were 1.16, 1.28, 1.26, 1.22, 1.28 times those of the non-frontline group after PSM. For frontline medical staff, the spinsterhood state (OR = 1.23, 95% CI: 1.00-1.51; P = 0.05) was a risk factor for anxiety. Bachelor or college degree (OR = 2.23, 95% CI: 1.24-4.02, P = 0.01) and a contact history with COVID-19 patients (OR = 1.62, 95% CI: 1.10-2.40; P = 0.02) were risk factors for insomnia. For non-frontline medical staff, being a woman (OR = 1.49, 95% CI: 1.08-2.06, P = 0.01) was a risk factor for anxiety, whilst being in a middle age group was a protective factor for anxiety (OR = 0.70, 95% CI: 0.50-0.99, P = 0.04) and depression (OR = 0.65, 95% CI: 0.45-0.93, P = 0.02). Being a woman (OR = 1.47, 95% CI: 1.14-1.89, P = 0.003) and working in a COVID-19 unit (OR = 1.31, 95% CI: 1.11-1.54, P = 0.001) were risk factors for insomnia, whilst the spinsterhood state (OR = 0.80, 95% CI: 0.67-0.95; P = 0.01) was a protective factor for insomnia. Online forms of psychological aid were all popular with medical staff. Conclusions: The prevalence of anxiety, depression, and insomnia in frontline medical staff was significantly higher than in the non-frontline group. Appropriate intervention methods should be adopted according to the different influencing factors of the two groups. Online psychological aid was the preferred mechanism for relieving psychological problems.

A questionnaire survey on radiation protection among 282 medical staff from 26 endoscopy-fluoroscopy departments in Japan

BACKGROUND AND AIMS

It is essential for endoscopists, technologists, and nurses to understand radiation protection. However, protective equipment usage is still low, and there is little awareness of radiation protection in practice.

METHODS

We conducted a questionnaire survey on radiation protection from January to February 2020. The participants were medical staff, including medical doctors, nurses, and radiological and endoscopy technician in endoscopy-fluoroscopy departments. The questionnaire included 14 multiple-choice questions divided among three parts: background, equipment, and knowledge.

RESULTS

We surveyed a total of 282 subjects from 26 institutions. There were 168 medical doctors (60%), 90 nurses (32%), and 24 technologists (9%). Although almost all staff members (99%) always wore a lead apron, only a few wore a thyroid collar (32%) and lead glasses (21%). The rate of wearing a radiation dosimeter was insufficient (69%), especially among doctors (52%). A few subjects knew the radiation exposure dose of each procedure (15%), and slightly over half had attended lectures on radiation protection (64%) and knew about the three principles of radiation protection (59%). Protection adherence did not differ by years of experience, knowledge of fluoroscopy, awareness of radiation exposure doses, or attendance at basic lectures on radiation protection. However, medical doctors who were aware of the radiation exposure dose of each procedure were significantly more likely to wear dosimeters than those who were not (p = 0.0008).

CONCLUSION

Medical staff in endoscopy departments in Japan do not have enough radiation protection equipment or education.

Perception of COVID-19 Vaccination Amongst Physicians in Colombia

Introduction: The SARS-CoV-2/COVID-19 pandemic has triggered the need to develop rapidly effective and safe vaccines to prevent infection, particularly in those at-risk populations such as medical personnel. This study's objective was to assess the perception of COVID-19 vaccination amongst Colombian physicians featuring two different scenarios of COVID-19 vaccination. Methods: A cross-sectional analytical study was carried out through an online survey directed at medical staff in several cities in Colombia. The percentage of physicians who have a positive perception to be vaccinated and the associated factors that determine that decision were determined. A binomial regression analysis adjusted for age and sex was carried out, taking as a dependent variable the acceptance of free vaccination with an effectiveness of 60 and 80%. The most significant factors were determined in the non-acceptance of vaccination. Results: Between 77.0% and 90.7% of physicians in Colombia accept COVID-19 vaccination, according to the scenario evaluated where the vaccine's effectiveness was 60 or 80%, respectively. Medical specialty, having never paid for a vaccine, recommending the administration of the vaccine to their parents or people over 70 years, and dispensing the vaccine to their children, were the factors to consider to be vaccinated for free with an effectiveness of 60% and 80%. Conclusions: There is a high perception of the intention to vaccinate physicians in Colombia against COVID-19, and this is very similar to that of the general population.

Prevalence and determinants of secondary posttraumatic growth following trauma work among medical personnel: a cross sectional study

Background: People helping trauma victims as a part of their work may experience positive results, known as Secondary Posttraumatic Growth (SPTG). Aim: The present study aimed to determine the prevalence and determinants of SPTG among medical personnel, considering occupational load, job satisfaction, social support, and cognitive processing of trauma, understood as cognitive coping strategies. Methods: Subjects comprised 419 representatives of the medical profession, including paramedics and nurses. The age of the subjects varied from 19 to 65 (M = 39.60; SD = 11.03). Four standard measurement tools were utilized: the Secondary Posttraumatic Growth Inventory, the Job Satisfaction Scale, the Social Support Scale, which measured four support sources, and the Cognitive Processing of Trauma Scale to assess five cognitive coping strategies. Pearson's correlation coefficients were applied to analyse the connections between the variables. A linear stepwise regression analysis was used to identify the determinants of SPTG. Pearson's correlation coefficients with confidence intervals were applied to analyse the connections between the variables. Results: As many as 40% of participants experienced high levels of growth, with only 27.4% indicating a low level. The obtained results showed positive links between job satisfaction, all social support dimensions (from supervisors, co-workers, family, friends), all cognitive coping strategies (positive cognitive restructuring, downward comparison, resolution/acceptance, denial, regret), and SPTG. No significant connection between workload and SPTG total was discovered. The primary determinant of SPTG in the examined group of medical personnel is the cognitive processing of trauma, chiefly the strategy of positive cognitive restructuring. Conclusions: Paramedics and nurses, despite their exposure to secondary trauma, experience positive posttraumatic consequences of the profession that entails helping the injured parties. It is advisable to encourage the medical personnel to apply positive coping strategies, find satisfaction in their work, and benefit from social support to promote posttraumatic growth.

An Acute Stress Scale for Health Care Professionals Caring for Patients With COVID-19: Validation Study

BACKGROUND

The COVID-19 pandemic has affected the response capacity of the health care workforce, and health care professionals have been experiencing acute stress reactions since the beginning of the pandemic. In Spain, the first wave was particularly severe among the population and health care professionals, many of whom were infected. These professionals required initial psychological supports that were gradual and in line with their conditions.

OBJECTIVE

In the early days of the pandemic in Spain (March 2020), this study aimed to design and validate a scale to measure acute stress experienced by the health care workforce during the care of patients with COVID-19: the Self-applied Acute Stress Scale (EASE).

METHODS

Item development, scale development, and scale evaluation were considered. Qualitative research was conducted to produce the initial pool of items, assure their legibility, and assess the validity of the content. Internal consistency was calculated using Cronbach α and McDonald ω. Confirmatory factor analysis and the Mann-Whitney-Wilcoxon test were used to assess construct validity. Linear regression was applied to assess criterion validity. Back-translation methodology was used to translate the scale into Portuguese and English.

RESULTS

A total of 228 health professionals from the Spanish public health system responded to the 10 items of the EASE scale. Internal consistency was .87 (McDonald ω). Goodness-of-fit indices confirmed a two-factor structure, explaining 55% of the variance. As expected, the highest level of stress was found among professionals working in health services where a higher number of deaths from COVID-19 occurred (P<.05).

CONCLUSIONS

The EASE scale was shown to have adequate metric properties regarding consistency and construct validity. The EASE scale could be used to determine the levels of acute stress among the health care workforce in order to give them proportional support according to their needs during emergency conditions, such as the COVID-19 pandemic.

Burnout and Its Relationship With Depressive Symptoms in Medical Staff During the COVID-19 Epidemic in China

Objective

The large-scale epidemic of Coronavirus Disease 2019 (COVID-19) has triggered unprecedented physical and psychological stress on health professionals. This study aimed to investigate the prevalence and risk factors of burnout syndrome, and the relationship between burnout and depressive symptoms among frontline medical staff during the COVID-19 epidemic in China.

Methods

A total of 606 frontline medical staff were recruited from 133 cities in China using a cross-sectional survey. The Maslach Burnout Inventory (MBI) was used to assess the level of burnout. Depressive symptoms were assessed by the Patient Health Questionnaire Depression (PHQ-9).

Results

During the COVID-19 pandemic, 36.5% of the medical staff experienced burnout. Personal and work-related factors were independently associated with burnout, including age (OR = 0.68, 95% CI: 0.52–0.89, p = 0.004), family income (OR = 0.72, 95% CI: 0.53–0.99, p = 0.045), having physical diseases (OR = 2.16, 95% CI: 1.42–3.28, p < 0.001), daily working hours (OR = 1.35, 95% CI: 1.03–1.77, p = 0.033), and profession of nurse (OR = 2.14, 95% CI: 1.12–4.10, p = 0.022). The correlation coefficients between the scores of each burnout subscale and the scores of depressive symptoms were 0.57 for emotional exhaustion, 0.37 for cynicism, and −0.41 for professional efficacy (all p < 0.001).

Conclusions

Our findings suggest that the prevalence rate of burnout is extremely high among medical staff during the COVID-19 pandemic, which is associated with other psychological disorders, such as depression. Psychological intervention for medical staff is urgently needed. Young and less experienced medical staff, especially nurses, should receive more attention when providing psychological assistance.

A cross-sectional survey on occupational stress and associated dyslipidemia among medical staff in tertiary public hospitals in Wenzhou, China

INTRODUCTION

Occupational stress is considered to be a harmful physical and emotional response to an individual's psychological and/or physiological state in the work environment and is highly prevalent among medical staff. However, few epidemiological studies have investigated occupational stress in medical staff. Our study aims to explore the characteristics of occupational stress and its relationship with dyslipidemia in Chinese medical staff at tertiary hospitals and establish the basis for future preventive strategies.

METHODS

A cross-sectional study was conducted in three tertiary public hospitals in Wenzhou City, Zhejiang Province, China. Data were collected using random sampling procedures to examine demographic characteristics and job-related data. The participants completed the Occupational Stress Inventory-Revised (OSI-R) questionnaires and serum lipids tests. Partial correlation analysis was conducted to explore the relationship between occupational stress and dyslipidemia.

RESULTS

A total of 1,176 medical staff responses to questionnaires were obtained. The occupational stress levels of medical staff were higher than those of normative populations, while their coping resources were lower. Most of the subscales of occupational stress demonstrated higher results for doctors and males than for nurses and females with crude analyses. Each subscale of OSI-R was found to be associated with a different type of blood lipid level.

CONCLUSIONS

The occupational stress level of medical staff in tertiary public hospitals in Wenzhou was high, and occupational stress may contribute to dyslipidemia. An investigation into occupational stress levels and their association with dyslipidemia in this population could draw more attention to medical staff in tertiary public hospitals.

[Proposal for Reduction Measures of Eye Lens Exposure Based on Actual Exposure Management in Radiation-exposed Medical Staff]

PURPOSE

To investigate the actual condition of the crystalline lens equivalent dose and effective dose according to the type of job and the type of duties in a medical institution. We also sought to clarify effective exposure reduction strategies.

METHODS

Equivalent crystalline lens doses, effective doses, job type, and duties for 8656 persons · year were obtained from 17 medical facilities. We analyzed the relationship between the effective dose and the crystalline lens equivalent dose in uniform exposure control and non-uniform exposure control conditions. Exposure data were obtained for 13 unique job types and duties.

RESULTS

The ratio of the lens equivalent dose to the effective dose of non-uniform exposure managers was 2 to 6 times and varied depending on the occupation. The percentage of persons whose annual lens equivalent dose exceeded 20 mSv was 4.75% for medical doctors, 1.17% for nurses, and 0.24% for radiological technologists. Highly exposed tasks included doctors in cardiology and gastroenterology performing angiography and endoscopy, nurses in endoscopy, and radiological technologists in radiography and CT examinations.

CONCLUSION

Thorough unequal exposure control for operations with high crystalline lens exposure, radiation protection education, and effective use of proper personal protective equipment such as the use of radiation protection glasses may reduce lens exposure levels.

A Key Factor for Psychosomatic Burden of Frontline Medical Staff: Occupational Pressure During the COVID-19 Pandemic in China

The global outbreak of COVID-19 has severely affected the entire population, especially healthcare staff on the frontline, who bear heavy psychosomatic burdens. A cross-sectional study was conducted with 723 participants in China from April 26 to May 9, 2020. We evaluated the psychosomatic status, including depression, anxiety, quality of life, somatic symptoms, stress, sleep disturbances, and posttraumatic stress symptoms in different exposure groups. We explored the risk factors that affect psychosomatic burdens and analyzed the relationship between psychosomatic problems and medical occupations. We found that the psychosomatic burdens of medical staff were significantly greater than those of non-medical staff (p < 0.01) and were positively related with the number of COVID-19 patients they came in contact with. Occupational pressure was a key factor for healthcare staff's psychosomatic problems (p < 0.01 for quality of life, somatic symptoms, anxiety, depression, stress; p = 0.012 for sleep disturbances), and it had a strong canonical correlation (p < 0.01). Workload and time allocation (WTA), one of the subdimensional indicators of occupational pressure, was strongly correlated with psychosomatic indicators. We suggest that rationalization of WTA is a desirable approach for anti-epidemic medical employees to alleviate psychosomatic burdens. Public health interventions should be undertaken to reduce the occupational pressure on this special population, which is critical for mitigation. This study presents results regarding the psychosomatic burdens of the healthcare workforce related to occupational pressure and provides multilevel data with groups of different exposure risks for policymakers to protect medical personnel. These findings draw attention to the working environments of healthcare workers and provide applicable results for clinical practice.

Psychological Impact of COVID-19 Cases on Medical Staff of Beijing Xiaotangshan Hospital

Purpose

To investigate the psychological impact of cases of coronavirus disease 19 (COVID-19) on medical staff of Beijing Xiaotangshan Hospital.

Methods

The 287 online questionnaires were distributed to medical staff working at Beijing Xiaotangshan Hospital, comprising three main sections and 17 questions: basic information, current departmental position, and the 12-item General Health Questionnaire (GHQ-12). The threshold for emotional distress was defined to be a total score of 4 on the GHQ-12 and above.

Results

A total of 255 members of medical staff participating in this study presented an emotional distress rate of 17%. Members who were male, aged 50–59, married with children, positioned as doctors, and in administration were the population with the highest rate of emotional distress. Furthermore, the severity of emotional distress among those under 30 was significantly lower than those aged 30–39 and 50–59. Doctors and other occupations shared a lower level of satisfaction on routine activities compared with nurses, so did staff in the administration compared with those who were working in screening or logistic departments. Besides, males and staff of the confirmation department had more difficulty in concentrating than females and those of the screening department, respectively.

Conclusion

Medical staff working at Xiaotangshan Hospital underwent relatively low levels of emotional distress thanks to sufficient medical and psychological preparations. However, special attention should be paid to those who were male, married with children, senior, doctors, in administration, and in the confirmation department.

The mental health of Chinese healthcare staff in non-epicenter of COVID-19: a cross-sectional study

BACKGROUND

The COVID-19 is a public health issue all over the world. It is an unprecedented challenge for society. Frontline medical staff are at high risk of mental health problems due to the overwhelming workload, worry of infection, and inadequate protective instruments. The study is to investigate the psychological status of medical staff in a women and children's hospital in non-epicenter of COVID-19 during the early stage of the COVID-19 outbreak.

METHODS

A total of 2,143 hospital medical staff participated in a cross-sectional online survey. Psychological response levels were assessed using the Psychological Questionnaire on Emergency Events in Public Health (PQEEPH), and mental health status was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale.

RESULTS

Eligible responses were received from 1,890 (90.6%) women and 197 (9.4%) men. In total, 10.3% of respondents rated the psychological impact of the outbreak as moderate or severe, and 4% reported severe anxiety symptoms.

CONCLUSIONS

Our findings indicated that the majority of the medical staff are in great level of mental health. The study demonstrates that females, the 31-40 age group, and those who have been widowed experienced greater levels of anxiety and therefore require more support. Furthermore, the cognition of medical workers might affect their emotional reactions. Measures to decrease anxiety during emergency outbreaks should therefore include communication strategies.

Differences in the Association of Anxiety, Insomnia and Somatic Symptoms between Medical Staff and the General Population During the Outbreak of COVID-19

BACKGROUND

During the outbreak of coronavirus disease 2019 (COVID-19), occupational differences were recognized with respect to psychological issues, but there are no reports regarding the insomnia and anxiety comorbidities and their related factors among the general public and medical staff. Our study aimed to compare the prevalence of anxiety and anxiety with insomnia, as well as the relationship between different psychological symptoms between the two groups.

METHODS

A total of 605 medical staff and 1091 public respondents were assessed through an online questionnaire survey, including the 7-item Insomnia Severity Index (ISI), the somatization subscale of Symptom Checklist 90-Revised (SCL-90-R), and the 7-item Generalized Anxiety Disorder scale (GAD-7).

RESULTS

Compared with the general public, medical staff had a higher incidence of anxiety (45.5% vs 32.4%). The incidence of insomnia in anxious participants was 52.7% in medical staff and 44.6% in the general public, and the difference was significant (p < 0.05). The GAD-7 score and somatization subscore of the SCI-90 were independently associated with insomnia among anxiety participants in both groups (all p < 0.001).

CONCLUSION

Our findings suggest that during the epidemic period of COVID-19, medical staff experienced more anxiety and anxiety with insomnia. Somatization, anxiety and insomnia are highly correlated among medical staff and the general public.

Mental Health Literacy Levels of Medical Staff in China: An Assessment Based on a Meta-Analysis

Background: The awareness rate of mental health knowledge among medical staff is an important evaluation index to assess the service capacity of a country or region, and this indicator in China has not been quantitatively evaluated. Study Design: This study systematically combined pertinent quantitative study data from previous related studies to conclude the awareness rate of mental health knowledge among Chinese medical staff. Methods: Related studies from five electronic databases were searched, and a meta-analysis was conducted to obtain the combined result. The primary outcome of the present study was the awareness rate of medical staff or the sample size and the number of those who can answer the relevant questions correctly. We also performed a hierarchical analysis according to the sample group's region and specialty. The awareness rate of medical staff and corresponding 95% confidence intervals (CIs) were calculated. The heterogeneity was assessed with the I ² test, and Egger's test was used to evaluate publication bias. Results: A total of 15 articles with 11,526 medical staff were included in the present study; the overall awareness rate of mental health knowledge among Chinese medical staff was as low as 81%. The awareness rate of mental health knowledge among medical workers in developed regions is higher than that in developing regions. The awareness rate of mental health among medical staff in the department of psychiatry, non-psychiatry, and community medical staff was 88, 68, and 82%, respectively. Conclusion: The overall awareness rate among medical staff in this country is unsatisfactory, and the awareness rate in developed regions is higher than medical staff in developing regions. Psychiatric hospital staff has a higher awareness rate than community medical staff, and non-psychiatric hospital staff has the lowest awareness rate.

Analysis of Real-World Implementation of the Biopsychosocial Approach to Healthcare: Evidence From a Combination of Qualitative and Quantitative Methods

Aims: The modern medical model has been transformed into a biopsychosocial model. The integration of the biopsychosocial approach in healthcare can help improve the effectiveness of diagnosis and treatment. This study explored the actual application of the biopsychosocial approach in healthcare and provides a basis for targeted interventions to promote the biopsychosocial approach in healthcare. Methods: Study 1 involved one-on-one interviews with 30 medical staff and focus group interviews with 16 recent patients. Study 2 was a cross-sectional survey of 13,105 medical staff in Hangzhou, China that analyzed the status quo implementation of the biopsychosocial approach in healthcare. Results: Study 1 found that medical staff did not welcome patients to report information unrelated to their disease, hoping patients did not express their emotions. In the treatment process, patients believed that medical staff refused to attend to or did not encourage reporting of any information other than the disease, and that patients should have reasonable expectations for medical staff. Study 2 found that medical staff had a 37.5% probability of actively paying attention to the patient's psychosocial status. Female medical staff (38.5%) were actively concerned about the patient's psychosocial status significantly more than male medical staff (34.2%) (P < 0.01). The medical staff in the psychiatric department (58.4%) paid more active attention to the patient's psychosocial status than staff in the non-psychiatric departments (37.2%). Gender, department, hospital level, and professional title were the factors associated with the medical staff's attention to the patient's psychosocial status (P < 0.05). The influence of age on the probability of medical staff actively paying attention to the psychosocial status of patients increased with the number of years of employment. Participants that were 31-40 years old, had an intermediate professional title, and 11-15 years of employment were the least likely to actively pay attention to patients' psychosocial status. Conclusion: Although the biopsychosocial approach has been popularized for many years, it has not been widely used in medical care. Medical staff pay more attention to patients' physical symptoms and less attention to patients' psychosocial status. It is recommended that training will be provided to medical personnel on implementing a biopsychosocial approach with particular attention to the sociodemographic characteristics of medical personnel. Additionally, we propose helping patients set reasonable expectations, and formulating guidelines for implementing the biopsychosocial approach.

Food Safety Knowledge, Attitudes, and Self-Reported Practices Among Medical Staff in China Before, During and After the COVID-19 Pandemic

PURPOSE

To compare food safety knowledge, attitudes, and self-reported practices among medical staff in China before, during, and after the COVID-19 pandemic.

PATIENTS AND METHODS

The questionnaire was anonymous. All respondents were Chinese medical personnel. A Chi-square contingency table was used to compare the knowledge and attitudes of Chinese medical staff before, during and after COVID-19. R statistical software (v4.0.0) was used for analysis.

RESULTS

A total of 1431 valid responses (57.3% from female respondents) were included in our analysis. Medical professionals were geographically distributed as follows: eastern China, 55.5%; central China, 19.7%; western China, 24.1%; Hong Kong, Macau, or Taiwan, 0.05%. Medical professionals reported that they paid greater attention to food safety after the COVID-19 pandemic compared with before the epidemic. Self-reported knowledge of and attitudes toward food safety among medical staff were significantly different before, during, and after the COVID-19 pandemic (both P<0.001).

CONCLUSION

After the COVID-19 pandemic, medical professionals paid increasing attention to food safety, which is a clinically important change. Because medical professionals can influence public understanding of food safety, their increased attention to this subject may enable them to promote food safety knowledge more actively in their work. This may in turn promote a better understanding of food safety and protect the health of the general public.

Perceived Psychological Feelings Make Important Contributions to the Symptoms of Common Mental Disorders of Medical Staff During the COVID-19

OBJECTIVE

Lack of information about mental health status among medical staff during the epidemic of COVID-19 in China is one of the major barriers to psychological interventions. This paper aims to evaluate the contributions of perceived psychological feelings to the symptoms of common mental disorders among medical staff during the epidemic of COVID-19 in China.

METHOD

A large sample of medical staff based on a non-probability sampling design was collected from February 17 to 24, 2020. The symptoms of common mental disorders were screened based on self-reported instruments to evaluate psychological distress, anxious symptoms, and depressive symptoms during the past week. Perceived psychological feelings were based on self-report. Logistic regressions and elastic net regularizations were used to evaluate the independent effect of the psychological feelings controlled by hospitals and participants characteristics.

RESULTS

Totally 4,677 medical staff completed the survey. The prevalence of psychological distress, anxious symptoms, and depressive symptoms were 15.9% (95% CI 14.8-16.9), 16.0% (95% CI 15.0-17.1), and 34.6% (95% CI 33.2-35.9). Feelings of having adequate personal protective equipment, receiving enough emotional supports from both family members and colleagues were significantly associated with fewer symptoms of common mental disorders, while the feelings of overloaded work and insufficient rest times contributed to more psychological problems.

CONCLUSIONS

Psychological feelings make important contributions to the symptoms of common mental disorders of medical staff during the epidemic of COVID-19. Strategies of psychological aids or interventions could be developed based on these feelings.

Psychological Health Issues of Medical Staff During the COVID-19 Outbreak

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has caused public panic and psychological health problems, especially in medical staff. We aimed to investigate the psychological effect of the COVID-19 outbreak on medical staff. Methods: A cross-sectional study was conducted to examine the psychological impact of medical staff working in COVID-19 designated hospitals from February to March 2020 in China. We assessed psychological health problems using the Symptom Check List 90 (SCL-90). Results: Among 656 medical staff, 244 were frontline medical staff and 412 general medical staff. The prevalence of psychological health problems was 19.7%. The SCL-90 scores in frontline medical staff were significantly higher than that in general medical staff (mean: 141.22 vs. 129.54, P < 0.05). Furthermore, gender [odds ratio (OR) = 1.53, 95% CI = (1.02, 2.30), P = 0.042 for female vs. male] and the burden of current work [OR = 7.55, 95% CI = (3.75, 15.21), P < 0.001 for high burden; OR = 2.76, 95% CI = (1.80, 4.24), P < 0.001 for moderate burden vs. low burden] were associated with increased risk of poor psychological status. Conclusions: Medical staff experienced a high risk of psychological health problems during the outbreak of COVID-19, especially for frontline medical staff. Psychological health services are expected to arrange for medical staff in future unexpected infectious disease outbreaks.

Less Social Support for Patients With COVID-19: Comparison With the Experience of Nurses

Context: Since December 2019, more than 80,000 patients have been diagnosed with coronavirus disease 2019 (COVID-19) in China. Social support status of COVID-19 patients, especially the impact of social support on their psychological status and quality of life, needs to be addressed with increasing concern. Objectives: In this study, we used social support rating scale (SSRS) to investigate the social support in COVID-19 patients and nurses. Methods: The present study included 186 COVID-19 patients at a Wuhan mobile cabin hospital and 234 nurses at a Wuhan COVID-19 control center. Responses to a mobile phone app-based questionnaire about social support, anxiety, depression, and quality of life were recorded and evaluated. Results: COVID-19 patients scored significantly lower than nurses did on the Social Support Rating Scale (SSRS). Among these patients, 33.9% had anxiety symptoms, while 23.7% had depression symptoms. Overall SSRS, subjective social support scores and objective support scores of patients with anxiety were lower than those of patients without anxiety. This result was also found in depression. In addition, all dimensions of social support were positively correlated with quality of life. Interestingly, in all dimensions of social support, subjective support was found to be an independent predictive factor for anxiety, depression, and quality of life, whereas objective support was a predictive factor for quality of life, but not for anxiety and depression via regression analysis. Conclusion: Medical staffs should pay attention to the subjective feelings of patients and make COVID-19 patients feel respected, supported, and understood from the perspective of subjective support, which may greatly benefit patients, alleviate their anxiety and depression, and improve their quality of life.

Junior doctor perceptions of education and feedback on ward rounds

AIM

The literature suggests that feedback is wanted and needed in clinical medicine and specifically on ward rounds, yet it is often lacking. This study aimed to examine junior doctor perceptions of education and feedback on ward rounds in one clinical department at a tertiary paediatric hospital and the key influences on these perceptions.

METHODS

Six semi-structured focus groups were conducted over a period of 9 months comprising of 20 participants (post-graduate year 1-5) in a general medical department of a tertiary paediatric hospital. Qualitative analysis was performed on focus group transcripts using an inductive approach and codes and themes were generated in an iterative fashion with checking of themes between two researchers.

RESULTS

Feedback experiences were largely positive compared to previous rotations. Three overarching themes were identified which influenced trainee perceptions of education and feedback on ward rounds. These were: consultant influences (e.g. educational engagement), trainee influences (e.g. active seeking of feedback), and structural factors (e.g. organisational constraints).

CONCLUSIONS

Despite positive feedback experiences, the need to improve feedback for our junior doctors is clear, but how to do this remains challenging when navigating work-learning tensions. The notion of the educational alliance between the consultant and trainee is a potential useful solution, but it requires deliberate effort and dedicated time to establish given our increasingly complex and busy clinical environments.

The correlation analysis between the appearance anxiety and personality traits of the medical staff on nasal and facial pressure ulcers during the novel coronavirus disease 2019 outbreak

Aim

To investigate the psychological status of medical staff with medical device-related nasal and facial pressure ulcers (MDR PUs) during the outbreak of COVID-19, analyse the correlation between their psychological status and personality traits, so as to provide a reference for personalized psychological support.

Design

A total of 207 medical staff who were treating the COVID-19 epidemic from Hunan and Hubei provinces were enrolled in this analytic questionnaire-based study.

Methods

We used these measures: Eysenck Personality Questionnaire Short Scale (EPQ-RSC), Social Appearance Anxiety Scale (SAAS), Positive and Negative Affect Scale (PANAS) and demographic information forms online.

Results

Medical staff wearing protective equipment are particularly susceptible to nasal and facial MDR PUs, which is increasing their social appearance anxiety; neuroticism is significantly related to social appearance anxiety and negative emotion. We should pay more attention to their psychological state, cultivate good personality characteristics and reduce negative emotions, and thereby alleviate their MDR PUs-related appearance anxiety.