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Qianlan Y, Ying L, Aibin C, Xiangrui S, Wenpeng C, Guanghui D, Wei D. Risk Perception and Emotion Reaction of Chinese Health Care Workers Varied During COVID-19: A Repeated Cross-Sectional Research. Int J Public Health 2021; 66:613057. [PMID: 34744576 PMCID: PMC8565291 DOI: 10.3389/ijph.2021.613057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/02/2021] [Indexed: 12/22/2022] Open
Abstract
Objectives: To examine risk perception and negative emotions during two periods of the COVID-19 and provide plausible intervention points for the psychological aid under a stressful condition. Methods: The current study adopted the repeated cross-sectional research and was participated by a cohort of Chinese HCWs who were assigned to work at the current disease resistance line. The between-group information about gender, profession, and location was collected in the demographic questionnaire. Risk perception questionnaire was adapted for COVID-19 to assess risk perception and the Chinese version of emotional self-rating scale (PANAS) was used to evaluate HCWs' negative emotions. Results: Findings revealed the risk perception and negative emotions of HCWs varied in different gender, profession, location, as well as different periods of COVID-19. Over the different periods, the predominated negative emotion expressed by HCWs varied, but negative emotion was consistently associated with risk perception and could be a significant indicator of risk perception. Conclusion: The significance of this research lies in its examination of risk perception and negative emotions of HCWs confronting the COVID-19 during two periods of the pandemic, which underscored the importance of monitoring the risk perception and negative emotions of HCWs to ensure safety and prevent the return of the pandemics.
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Affiliation(s)
| | - Liu Ying
- Navy Medical University, Shanghai, China
| | - Chen Aibin
- Navy Medical University, Shanghai, China
| | | | | | | | - Dong Wei
- Navy Medical University, Shanghai, China.,The Department of Psychology, Fudan University, Shanghai, China
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Zhang J, Song S, Zhang M, Wang R. Influencing factors for mental health of general practitioners in Hebei Province under the outbreak of COVID-19: A cross-sectional study. Int J Clin Pract 2021; 75:e14783. [PMID: 34482597 PMCID: PMC8646492 DOI: 10.1111/ijcp.14783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 09/02/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to understand the mental health status of general practitioners (GPs) in Hebei Province during the outbreak of coronavirus disease 2019, analyse influencing factors, and establish and evaluate the risk prediction model. METHODS During February 25-29, 2020, a self-designed questionnaire was used to conduct an online survey of GPs in Hebei Province. The survey included a questionnaire on GPs' basic information, a questionnaire on GPs' working hardware and software facilities, and a questionnaire on GPs' mental health condition. A total of 1040 participants returned the completely filled valid questionnaire, and the answers were analyzed using the χ2 test, Wilcoxon rank-sum test and logistic regression with SPSS 20.0 software. Based on the results of binary logistic regression analysis, a risk prediction model was established, and the receiver operating characteristic curve was used to evaluate the model. RESULTS The results showed that 44.2% (460/1040) of GPs expressed anxiety after the outbreak. Absence of prescreening clinics, fever clinics or isolated observation rooms in primary medical institutions; persons in the administrative area required to be isolated; low sleep quality of GPs and less than 6 hours of sleep per day of GPs were risk factors affecting the mental health status of GPs. Also, epidemic-related training and adequate protective equipment were the protective factors for the mental health status of GPs. CONCLUSION The government should strengthen the infrastructure construction of community institutions, equip them with sufficient epidemic protection equipment, ensure the rest time of GPs and strengthen mental health training to ensure the mental and physical health of GPs.
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Affiliation(s)
- Jinjia Zhang
- Department of General PracticeSecond Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Shibin Song
- Department of General PracticeSecond Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Min Zhang
- Department of General PracticeSecond Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Rongying Wang
- Department of General PracticeSecond Hospital of Hebei Medical UniversityShijiazhuangChina
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Kim SC, Sloan C, Chechel L, Redila M, Ferguson J. Severe Burnout and Poor Mental Health Among Healthcare Workers 6 Months After COVID-19 Pandemic Declaration: What Can We Learn for Future Emergencies? J Nurs Adm 2021; 51:554-560. [PMID: 34690302 DOI: 10.1097/nna.0000000000001063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to examine the predictors associated with severe burnout and poor mental health among healthcare workers during the COVID-19 pandemic as a learning opportunity for future emergent situations. BACKGROUND Modifiable predictors of mental health need to be further examined and quantified to prioritize human resource support in organizations as healthcare workers confront stressful situations. METHODS A cross-sectional survey was conducted among 271 healthcare workers from September 8 to October 10, 2020. RESULTS Approximately one-third reported severe burnout, as well as moderate/severe anxiety and depression. Feeling protected working with COVID-19 patients, high family functioning, and spirituality were associated with 2- to 4-fold lower odds of severe burnout. Satisfaction with the organization's communications predicted 2-fold lower odds of anxiety, whereas high resilience was associated with almost 4-fold lower odds of stress and depression. CONCLUSIONS Healthcare organizations may consider adopting programs to foster resilience, family and spiritual support, and effective communication strategies to reduce burnout and poor mental health among healthcare workers during pandemics and other situations of high stress.
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Affiliation(s)
- Son Chae Kim
- Author Affiliations: Professor (Dr Kim) and Associate Professor (Dr Sloan), School of Nursing, Point Loma Nazarene University, San Diego, California; Nurse Manager (Ms Chechel) and Nurse Manager (Mr Redila), University of California San Diego Health; and Associate Professor (Ms Ferguson), School of Nursing, MidAmerica Nazarene University, Olathe, Kansas
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Kapetanos K, Mazeri S, Constantinou D, Vavlitou A, Karaiskakis M, Kourouzidou D, Nikolaides C, Savvidou N, Katsouris S, Koliou M. Exploring the factors associated with the mental health of frontline healthcare workers during the COVID-19 pandemic in Cyprus. PLoS One 2021; 16:e0258475. [PMID: 34648565 PMCID: PMC8516220 DOI: 10.1371/journal.pone.0258475] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/28/2021] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The spread of COVID-19 into a global pandemic has negatively affected the mental health of frontline healthcare-workers. This study is a multi-centre, cross-sectional epidemiological study that uses nationwide data to assess the prevalence of stress, anxiety, depression and burnout among health care workers managing COVID-19 patients in Cyprus. The study also investigates the mechanism behind the manifestation of these pathologies, as to allow for the design of more effective protective measures. METHODS Data on the mental health status of the healthcare workers were collected from healthcare professionals from all over the nation, who worked directly with Covid patients. This was done via the use of 64-item, self-administered questionnaire, which was comprised of the DASS21 questionnaire, the Maslach Burnout Inventory and a number of original questions. Multivariable logistic regression models were used to investigate factors associated with each of the mental health measures. RESULTS The sample population was comprised of 381 healthcare professionals, out of which 72.7% were nursing staff, 12.9% were medical doctors and 14.4% belonged to other occupations. The prevalence of anxiety, stress and depression among the sample population were 28.6%, 18.11% and 15% respectively. The prevalence of burnout was 12.3%. This was in parallel with several changes in the lives of the healthcare professionals, including; working longer hours, spending time in isolation and being separated from family. DISCUSSION This study indicates that the mental health of a significant portion of the nation's workforce is compromised and, therefore, highlights the need for an urgent intervention particularly since many countries, including Cyprus, are suffering a second wave of the pandemic. The identified risk factors should offer guidance for employers aiming to protect their frontline healthcare workers from the negative effects of the COVID-19 pandemic.
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Affiliation(s)
| | - Stella Mazeri
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | - Despo Constantinou
- Infection Control Services, Nicosia General Hospital, Lemesou, Cyprus
- Cyprus Nurses and Midwives Association, Nicosia, Cyprus
| | - Anna Vavlitou
- Intensive Care Unit, Nicosia General Hospital, Nicosia, Cyprus
| | | | | | - Christoforos Nikolaides
- Cyprus Nurses and Midwives Association, Nicosia, Cyprus
- Infection Control Services, Limassol General Hospital, Nikaias, Kato Polemidia, Cyprus
| | - Niki Savvidou
- Infection Control Services, Paphos General Hospital, Paphos, Cyprus
| | - Savvas Katsouris
- Infection Control Services, Larnaca General Hospital, Larnaca, Cyprus
| | - Maria Koliou
- Department of Pediatrics, School of Medicine, University of Cyprus, Nicosia, Cyprus
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Békési D, Teker I, Torzsa P, Kalabay L, Rózsa S, Eőry A. To prevent being stressed-out: Allostatic overload and resilience of general practitioners in the era of COVID-19. A cross-sectional observational study. Eur J Gen Pract 2021; 27:277-285. [PMID: 34633272 PMCID: PMC8510612 DOI: 10.1080/13814788.2021.1982889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Responsibility of general practitioners (GPs) in delivering safe and effective care is always high but during the COVID-19 pandemic they face even growing pressure that might result in unbearable stress load (allostatic overload, AO) leading to disease. Objectives We aimed to measure AO of Hungarian GPs during the COVID-19 pandemic and explore their recreational resources to identify potential protective factors against stress load. Methods In a mixed-method design, Fava’s clinimetric approach to AO was applied alongside the Psychosocial Index (PSI); Kellner’s symptom questionnaire (SQ) to measure depression, anxiety, hostility and somatisation and the Public Health Surveillance Well-being Scale (PHS-WB) to determine mental, social, and physical well-being. Recreational resources were mapped. Besides Chi-square and Kruskal-Wallis tests, regression analysis was applied to identify explanatory variables of AO. Results Data of 228 GPs (68% females) were analysed. Work-related changes caused the biggest challenges leading to AO in 60% of the sample. While female sex (OR: 1.99; CI: 1.06; 3.74, p = 0.032) and other life stresses (OR: 1.4; CI: 1.2; 1.6, p < 0.001) associated with increased odds of AO, each additional day with 30 min for recreation purposes associated with 20% decreased odds (OR: 0.838; CI: 0.72; 0.97, p = 0.020). 3–4 days a week when time was ensured for recreation associated with elevated mental and physical well-being, while 5–7 days associated with lower depressive and anxiety symptoms, somatisation, and hostility. Conclusion Under changing circumstances, resilience improvement through increasing time spent on recreation should be emphasised to prevent GPs from the adverse health consequences of stress load.
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Affiliation(s)
- Dóra Békési
- Rácz Károly Clinical Medicine PhD School, Semmelweis University, Budapest, Hungary
| | | | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Sándor Rózsa
- Washington University, St. Louis, USA.,Károli Gáspár University of the Reformed Church, Budapest, Hungary
| | - Ajándék Eőry
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
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Zhao YJ, Zhang SF, Li W, Zhang L, Cheung T, Tang YL, Ng CH, Yang BX, Xiang YT. Mental health status and quality of life in close contacts of COVID-19 patients in the post-COVID-19 era: a comparative study. Transl Psychiatry 2021; 11:505. [PMID: 34601497 PMCID: PMC8487227 DOI: 10.1038/s41398-021-01623-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/04/2021] [Accepted: 08/13/2021] [Indexed: 01/19/2023] Open
Abstract
Close contacts of those with COVID-19 (CC) may experience distress and long-lasting mental health effects. However, the mental health status and quality of life (QOL) in CC have not been adequately examined. This study examined the mental health status and QOL in CC during the post-COVID-19 period. This cross-sectional study comprised 1169 CC and 1290 who were non-close contacts (non-CC). Demographic data were collected; depression, fatigue, post-traumatic stress symptoms (PTSS) and QOL were assessed using the Patient Health Questionnaire - 9 items (PHQ-9), fatigue numeric rating scale, Post-Traumatic Stress Disorder Checklist - 17 items (PCL-17), and the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. Analysis of covariance was used to compare depressive symptoms, QOL, fatigue, and PTSS between the CC and non-CC groups. Multiple logistic regression analyses were performed to determine the independent correlates for depression, fatigue, PTSS, and QOL in the CC group. Compared to the non-CC group, the CC group reported significantly more severe depression (F(1, 2458) = 5.58, p = 0.018) and fatigue (F(1, 2458) = 9.22, p = 0.002) in the post-COVID-19 period. No significant differences in PTSS and QOL between the CC and non-CC groups were found (F(1, 2458) = 2.93, p = 0.087 for PTSS; F(1, 2458) = 3.45, p = 0.064 for QOL). In the CC group, younger age, financial loss due to COVID-19, and perception of poor or fair health status were significantly associated with depression and fatigue, while frequent use of mass media was significantly associated with fatigue. In conclusion, close contacts of COVID-19 patients experienced high levels of depression and fatigue in the post-COVID-19 period. Due to the negative effects of depression and fatigue on daily functioning, early detection and timely interventions should be provided to this neglected population.
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Affiliation(s)
- Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Shu-Fang Zhang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei Province, China
| | - Wen Li
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Bing-Xiang Yang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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Martín J, Padierna Á, Villanueva A, Quintana JM. Evaluation of the mental health of health professionals in the COVID-19 era. What mental health conditions are our health care workers facing in the new wave of coronavirus? Int J Clin Pract 2021; 75:e14607. [PMID: 34231287 PMCID: PMC8420292 DOI: 10.1111/ijcp.14607] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/04/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The aims of this study were to analyse the mental health and health-related quality of life (HRQoL) of a broad sample of healthcare workers (HCWs) in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL. METHOD This prospective cohort study comprised 2089 HCWs who completed the Generalized Anxiety Disorder 7-item (GAD-7) Scale, the Patient Health Questionnaire-9 (PHQ-9), the Impact Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the health-related quality of life Questionnaire (EQ-5D). Sociodemographic and clinical data in relation to Covid-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL. RESULTS 80.87% of participants were female and 19.13% male; 82.38% were aged under 55 years; 39.13% were physicians and 50.17% were nurses or auxiliaries; 80.42% of the health workers have directly treated patients with Covid-19 and 12.28% have themselves tested positive for Covid-19. 38.58% of HCWs had clinical depression; over half (51.75%) had clinical anxiety; 60.4% had clinical stress; and 21.57% had clinical insomnia. Older professionals (>55 years) reported lower rates of anxiety, depression, insomnia, and stress. Having worked directly with Covid-19 patients appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our HCWs. The group of HCWs suffering the worst mental state were nursing home workers. CONCLUSIONS Our study confirms that symptomatology of anxiety, depression, stress, insomnia, and HRQoL were affected amongst HCW during the Covid-19 pandemic.
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Affiliation(s)
- Josune Martín
- Research UnitGaldakao‐Usansolo HospitalGaldakaoSpain
- Kronikgune Institute for Health Services ResearchBarakaldoSpain
- Health Services Research on Chronic Diseases Network – REDISSECGaldakaoSpain
| | - Ángel Padierna
- Department of PsychiatryGaldakao‐Usansolo HospitalGaldakaoSpain
| | - Ane Villanueva
- Research UnitGaldakao‐Usansolo HospitalGaldakaoSpain
- Kronikgune Institute for Health Services ResearchBarakaldoSpain
| | - José M. Quintana
- Research UnitGaldakao‐Usansolo HospitalGaldakaoSpain
- Health Services Research on Chronic Diseases Network – REDISSECGaldakaoSpain
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Subhas N, Pang NTP, Chua WC, Kamu A, Ho CM, David IS, Goh WWL, Gunasegaran YI, Tan KA. The Cross-Sectional Relations of COVID-19 Fear and Stress to Psychological Distress among Frontline Healthcare Workers in Selangor, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910182. [PMID: 34639482 PMCID: PMC8508284 DOI: 10.3390/ijerph181910182] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
Previous pandemics have demonstrated short and long-term impacts on healthcare workers’ mental health, causing knock-on effects on patient care and professional functioning. Indeed, the present COVID-19 pandemic has created unprecedented disruption in social interactions and working conditions. Malaysia has been under the Recovery Movement Control Order since June 2020; however, with the upsurge of cases, healthcare workers face pressure not only from working in resource-deprived settings but also from the increasing patient load. The primary objective of the present study was to examine the cross-sectional relationship of COVID-19 fear and stress to psychological distress (operationalized as anxiety and depression) in healthcare workers. The present sample included 286 frontline healthcare workers from three hospitals in Selangor, Malaysia. Self-administered questionnaires containing sociodemographic and occupational items, the Malay versions of the Coronavirus Stress Measure scale, the Fear of Coronavirus-19 scale, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 were distributed via online platforms. Hierarchical multiple regression findings suggest that age, shift work, and COVID-19 stress consistently predicted anxiety and depression among frontline healthcare workers after adjusting for sociodemographic and occupational variables. The present findings suggest that frontline healthcare workers are not only inoculated against COVID-19 itself but also against the psychological sequelae of the pandemic.
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Affiliation(s)
- Natasha Subhas
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Jalan Langat, Klang 41200, Malaysia;
- Correspondence: (N.S.); (N.T.-P.P.)
| | - Nicholas Tze-Ping Pang
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (W.-C.C.); (A.K.); (C.-M.H.)
- Correspondence: (N.S.); (N.T.-P.P.)
| | - Wei-Cheng Chua
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (W.-C.C.); (A.K.); (C.-M.H.)
| | - Assis Kamu
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (W.-C.C.); (A.K.); (C.-M.H.)
| | - Chong-Mun Ho
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (W.-C.C.); (A.K.); (C.-M.H.)
| | - Isabel Shamini David
- Department of Psychiatry and Mental Health, Hospital Banting, Banting 42700, Malaysia;
| | - William Wei-Liang Goh
- Department of Psychiatry and Mental Health, Hospital Segamat, KM6, Segamat 85000, Malaysia;
| | - Yogaraja Indran Gunasegaran
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Jalan Langat, Klang 41200, Malaysia;
| | - Kit-Aun Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
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Schmid B, Schulz SM, Schuler M, Göpfert D, Hein G, Heuschmann P, Wurmb T, Pauli P, Meybohm P, Rittner HL. Impaired psychological well-being of healthcare workers in a German department of anesthesiology is independent of immediate SARS-CoV-2 exposure - a longitudinal observational study. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2021; 19:Doc11. [PMID: 34539301 PMCID: PMC8422798 DOI: 10.3205/000298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 06/18/2021] [Indexed: 11/30/2022]
Abstract
Background: The study aimed to assess the mental well-being of healthcare professionals at a German department of anesthesiology and critical care with a specialized ICU for treatment of COVID-19 patients during the first two peaks of the 2020 pandemic, and identifying risk and protective factors. Methods: A single-center longitudinal, online-based survey was conducted in healthcare workers from a department of anesthesiology and critical care in Bavaria, the most affected federal state in Germany at the time of assessment. Validated scores for depression, anxiety, somatic disorders, burnout, resilience, and self-management were used and complemented by questions about perceived COVID-19-related stressors. In parallel, patient characteristics in the ICU were collected. Results: 24 and 23 critically ill COVID-19 patients were treated during both observation periods in April/May and November/December 2020, respectively. 87.5% and 78.2% of patients had moderate to severe acute respiratory distress syndrome. From March 6, 2020 onwards, the hospital had switched to a command and control-based hospital incident command system (HICS) and increased work forces. Point prevalence of depression-like symptoms (13.6% and 12.8%) and burnout (21.6% and 17.4%) in the department’s healthcare professionals was high. Exposure to SARS-CoV-2 did not increase psychological burden. Consequences of the lockdown were rated as highly distressing by a majority of all ICU personnel. High self-reported trait resilience was protective against signs of depression, generalized anxiety, and burnout. Conclusions: During the pandemic, healthcare professionals have been suffering from increased psychological distress compared to reference data for both the general population and ICU personnel. General effects of the lockdown appear more relevant than actual COVID-19 patient contact. High trait resilience has a protective effect, yet vulnerable individuals may require specific support. Prevention against potential after effects of the lockdown, and in particular measures allowing to avoid another lockdown, appear warranted.
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Affiliation(s)
- Benedikt Schmid
- Department of Anesthesiology, Würzburg University Hospital, Würzburg, Germany
| | - Stefan M Schulz
- Department of Psychology I - Biological Psychology, Clinical Psychology and Psychotherapy, Julius Maximilians University, Würzburg, Germany
| | - Michael Schuler
- Institute for Clinical Epidemiology and Biometry, Julius Maximilians University, Würzburg, Germany
| | - Dennis Göpfert
- Department of Anesthesiology, Würzburg University Hospital, Würzburg, Germany
| | - Grit Hein
- Department of Psychiatry, Würzburg University Hospital, Würzburg, Germany
| | - Peter Heuschmann
- Institute for Clinical Epidemiology and Biometry, Julius Maximilians University, Würzburg, Germany.,Clinical Trial Centre, Würzburg University Hospital, Würzburg, Germany
| | - Thomas Wurmb
- Department of Anesthesiology, Würzburg University Hospital, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology I - Biological Psychology, Clinical Psychology and Psychotherapy, Julius Maximilians University, Würzburg, Germany
| | - Patrick Meybohm
- Department of Anesthesiology, Würzburg University Hospital, Würzburg, Germany
| | - Heike L Rittner
- Department of Anesthesiology, Würzburg University Hospital, Würzburg, Germany
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Bojanowska A, Kaczmarek ŁD, Koscielniak M, Urbańska B. Changes in values and well-being amidst the COVID-19 pandemic in Poland. PLoS One 2021; 16:e0255491. [PMID: 34525095 PMCID: PMC8443041 DOI: 10.1371/journal.pone.0255491] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 07/17/2021] [Indexed: 01/07/2023] Open
Abstract
COVID-19 caused a global change in the lifestyles of people around the world. It provided a unique opportunity to examine how external circumstances impact two crucial aspects of functioning relating to "who I am" (values) and "how I feel" (well-being). Participants (N = 215) reported their values and subjective and eudaimonic well-being, nine months before the first lockdown in Poland and two weeks and four weeks into the first lockdown. We observed increased valuing of self-direction, security, conformity, humility, caring, and universalism and a decrease in valuing hedonism. Individuals experienced decreased subjective and eudaimonic well-being, with women responding with stronger negative affect intensity relative to men. Finally, we identified that individuals who were more open to change before the COVID-19 pandemic responded with higher eudaimonic well-being two weeks into lockdown relative to their less open to change peers. This study is unique in that it shows that well-being and individually held values are flexible and adaptive systems that react to external circumstances such as global critical events.
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Affiliation(s)
- Agnieszka Bojanowska
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Łukasz D. Kaczmarek
- Department of Psychology and Cognitive Science, Adam Mickiewicz University, Poznan, Poland
| | - Maciej Koscielniak
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Beata Urbańska
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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de Sire A, Marotta N, Raimo S, Lippi L, Inzitari MT, Tasselli A, Gimigliano A, Palermo L, Invernizzi M, Ammendolia A. Psychological Distress and Work Environment Perception by Physical Therapists from Southern Italy during COVID-19 Pandemic: The C.A.L.A.B.R.I.A Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9676. [PMID: 34574600 PMCID: PMC8465841 DOI: 10.3390/ijerph18189676] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 12/22/2022]
Abstract
The psychosocial impact of the work environment during the COVID-19 pandemic on health professionals is a growing issue. The present study examined specific psychosocial work environment indicators during the COVID-19 pandemic, through a multiple regression model of a self-administered cross-sectional online survey in a cohort of physical therapists from a region of Southern Italy from March 2020 to May 2021. The questionnaire contained items on work and healthcare issues related to COVID-19. Eighty physical therapists (29 male and 51 female), mean age 32.5 ± 10.1 years, were involved in this survey. The multiple regression analysis showed that "management activity" was significantly correlated to "therapist frustration" during the COVID-19 pandemic (ΔR2 = 0.16; p < 0.03). Findings of this study underline the importance of a healthy psychosocial work environment to enhance job satisfaction of all health professionals and to avoid role conflict and burnout syndrome during the COVID-19 pandemic.
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Affiliation(s)
- Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.T.I.); (A.T.); (A.A.)
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.T.I.); (A.T.); (A.A.)
| | - Simona Raimo
- Laboratory of Cognitive Psychology, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (S.R.); (L.P.)
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Maria Teresa Inzitari
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.T.I.); (A.T.); (A.A.)
| | - Anna Tasselli
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.T.I.); (A.T.); (A.A.)
| | | | - Liana Palermo
- Laboratory of Cognitive Psychology, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (S.R.); (L.P.)
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.T.I.); (A.T.); (A.A.)
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Extreme psychische Belastungen während der Corona-Krise in China. GRUPPENPSYCHOTHERAPIE UND GRUPPENDYNAMIK 2021. [DOI: 10.13109/grup.2021.57.3.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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63
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Science Mapping of the Global Knowledge Base on Management, Leadership, and Administration Related to COVID-19 for Promoting the Sustainability of Scientific Research. SUSTAINABILITY 2021. [DOI: 10.3390/su13179631] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The pandemic caused by the COVID-19 virus has resulted in inevitable radical changes across almost all areas of daily life, with the pandemic having revealed perhaps the greatest crisis humanity has faced in modern history. This study aims to provide thematic and methodological recommendations for future sustainable research programs through a bibliometric analysis of publications focused on management, leadership, and administration related to COVID-19. The data for the study were obtained from the Web of Science Core Collection (WoSCC) bibliographic database and then analyzed according to thematic content analysis and bibliometric methodology. The study’s units of analysis include countries, journals, keywords, research models, sample/study group, and time to publication. VOSviewer software and visualization maps were used to report the findings obtained from the analyzed data. When the study’s results are evaluated regarding the number of related publications and total citations, it can be revealed that Anglo-American-, Chinese-, and European-centered dominance continues in COVID-19-related studies. The vast majority of publications on this subject area are concentrated in the field of health. In addition, the study’s findings revealed that the examined articles were generally published in journals considered as prestigious, have high impact factors, are published in the English language, and with articles published in a short time after a much-reduced editorial/review and publishing process. Unlike previous bibliometric reviews, this research comprehensively analyzed the management-, leadership-, and administration-oriented publications related to COVID-19 with a holistic approach, providing essential findings and recommendations for future sustainable thematic research opportunities.
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64
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Ni'matuzahroh, Ningrum V, Widayat, Dyah Artaria M, Suen MW. The COVID-19 pandemic and healthcare workers psychological well-being: a cross-sectional survey in Indonesia. Nurs Open 2021; 8:3212-3221. [PMID: 34427392 PMCID: PMC8510726 DOI: 10.1002/nop2.1034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/25/2021] [Accepted: 07/25/2021] [Indexed: 11/09/2022] Open
Abstract
Aim This study was conducted to investigate the relationships amongst psychological well‐being (PWB), emotional intelligence and coping strategies. Design This study employed a cross‐sectional survey design. Method A total of 146 healthcare workers (HCWs) were enrolled in this study. They were asked to finish several questionnaires, including the Wong and Law Emotional Intelligence Scale, the Brief‐Coping Orientation to Problems Experienced Scale and the PWB Scale. The obtained data were analysed using partial least squares structural equation modelling, employee SmartPLS, to estimate the contributions of influencing factors and evaluate the moderating effect of coping strategy (CS) on the relationship between emotional intelligence and PWB. Results Results revealed that emotional intelligence influenced PWB, and CS moderated both emotional intelligence and PWB. Furthermore, CS plays an essential role in improving PWB related to emotional intelligence amongst HCWs during the COVID‐19 outbreak.
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Affiliation(s)
- Ni'matuzahroh
- Department of Psychology, Asia University, Taiwan.,Department of Healthcare Administration Specialty in Psychology, Asia University, Taiwan.,Faculty of Psychology, University of Muhammadiyah Malang, Indonesia
| | - Valendriyani Ningrum
- Department of Dental Public Health, Faculty of Dentistry, Baiturrahmah University, Indonesia
| | - Widayat
- Department Management Faculty of Economics and Business, University of Muhammadiyah Malang, Indonesia
| | - Myrtati Dyah Artaria
- Department of Anthropology, Faculty of Social and Political Sciences, Universitas Airlangga, Indonesia
| | - Mein-Woei Suen
- Department of Psychology, Asia University, Taiwan.,Gender Equality Education and Research Center, Asia University, Taichung, Taiwan.,Department of Medical Research, Asia University Hospital, Asia University, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taiwan
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65
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Farì G, de Sire A, Giorgio V, Rizzo L, Bruni A, Bianchi FP, Zonno A, Pierucci P, Ranieri M, Megna M. Impact of COVID-19 on the mental health in a cohort of Italian rehabilitation healthcare workers. J Med Virol 2021; 94:110-118. [PMID: 34387886 PMCID: PMC8426878 DOI: 10.1002/jmv.27272] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/01/2021] [Accepted: 08/09/2021] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has had a strong impact on healthcare workers (HCWs), affecting their physical and mental health. In Italy, HCWs have been among the first exposed to unprecedented pressure, dealing with large numbers of infections during the first pandemic wave. However, the severe psychological consequences on HCWs find little evidence in the literature, especially in terms of comparison to the status quo ante pandemic. The aim of this study was to provide an assessment of the mental health burden in a cohort of Italian HCWs during the COVID-19 pandemic, comparing their condition with that before the emergency, to direct the promotion of mental well-being among HCWs worldwide. In this retrospective study, we included physicians, physical therapists, and nurses working in the Respiratory Intensive Care Unit, Neurology Unit, and Rehabilitation Unit from a Southern Italy University Hospital. All study participants underwent a battery of psychological tests, aimed at verifying their state of mental health during the COVID-19 emergency and before it. Depressive, anxiety, and burnout symptoms were assessed using the following questionnaires: Maslach Burnout Inventory, Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7. Depressive, anxiety, and burnout clinical relevance symptoms were present in HCWs during the COVID-19 pandemic more than those before the emergency. Fifty percent of the HCWs obtained a score clinically significant during the emergency. Moreover, a depersonalization factor showed a statistically significant increase in average scores (p < 0.0001). The PHQ-9 scale showed that 47.1% of the operators reported depressive state presence. The number of operators scoring above the cut-off for the anxiety scale tripled during the emergency (p < 0.0001). The female gender conferred greater risks for depression. Taken together, the findings of this study showed that our sample of Italian HCWs showed a greater risk for depression, anxiety, and stress during the COVID-19 pandemic. These data might be a starting point to plan mental health monitoring and prevention programs for HCWs, thus ensuring patients receive the best possible care performances even during healthcare crises such as the current pandemic.
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Affiliation(s)
- Giacomo Farì
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Giorgio
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - Laura Rizzo
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - Antonella Bruni
- Neuropsychiatric Rehabilitation Unit, Villa Patrizia Hospital, Piossasco, Turin, Italy
| | - Francesco P Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University, Bari, Italy
| | - Alessandra Zonno
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - Paola Pierucci
- Cardiothoracic Department, Respiratory and Sleep Medicine Unit, Aldo Moro University, Bari, Italy
| | - Maurizio Ranieri
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - Marisa Megna
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
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66
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Gualano MR, Sinigaglia T, Lo Moro G, Rousset S, Cremona A, Bert F, Siliquini R. The Burden of Burnout among Healthcare Professionals of Intensive Care Units and Emergency Departments during the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158172. [PMID: 34360465 PMCID: PMC8346023 DOI: 10.3390/ijerph18158172] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 12/18/2022]
Abstract
The primary aim was to evaluate the burnout prevalence among healthcare workers (HCWs) in intensive care units (ICUs) and emergency departments (EDs) during the COVID-19 pandemic. The secondary aim was to identify factors associated with burnout in this population. A systematic review was conducted following PRISMA guidelines by searching PubMed, Embase, PsychINFO, and Scopus from 1 January to 24 November 2020. Studies with information about burnout prevalence/level during the pandemic regarding ICU/ED HCWs were eligible. A total of 927 records were identified. The selection resulted in 11 studies. Most studies were conducted in April/May 2020. Samples ranged from 15 to 12,596 participants. The prevalence of overall burnout ranged from 49.3% to 58%. Nurses seemed to be at higher risk. Both socio-demographic and work-related features were associated with burnout. Many pandemic-related variables were associated with burnout, e.g., shortage in resources, worry regarding COVID-19, and stigma. This review highlighted a substantial burnout prevalence among ICU/ED HCWs. However, this population has presented a high burnout prevalence for a long time, and there is not sufficient evidence to understand if such prevalence is currently increased. It also outlined modifiable factors and the need to improve emergency preparedness both from an individual and structural level.
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67
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García-Hedrera FJ, Gil-Almagro F, Carmona-Monge FJ, Peñacoba-Puente C, Catalá-Mesón P, Velasco-Furlong L. Intensive care unit professionals during the COVID-19 pandemic in Spain: social and work-related variables, COVID-19 symptoms, worries, and generalized anxiety levels. Acute Crit Care 2021; 36:232-241. [PMID: 34510851 PMCID: PMC8435439 DOI: 10.4266/acc.2021.00213] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/12/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 outbreak has been identified as a pandemic and global health emergency. It presents as a severe acute respiratory disease. The rapid dissemination of the disease created challenges for healthcare systems and forced healthcare workers (HCWs) to deal with many clinical and nonclinical stresses. The aim of our research is to describe work conditions, symptoms experienced by HCWs, worries about contagion, and generalized anxiety symptoms and compare those findings across regions in Spain. METHODS This cross-sectional study was conducted using an online survey. Critical care units throughout Spain were included. The sample comprised HCWs working in intensive care units from March to May 2020. We assessed work variables, physical symptoms, worries about contagion, and anxiety (generalized anxiety disorder-7 questionnaire). RESULTS The final sample comprised 448 surveys. Among the respondents, 86.9% (n=389) were nursing professionals, and 84.8% (n=380) were women. All participants cared for coronavirus disease 2019 (COVID-19) patients during the study period. Workload during the pandemic in Madrid was judged to be higher than in other regions (P<0.01). The availability of personal protective equipment was found to be higher in Cataluña. The most frequently experienced symptom was headaches (78.1%). Worries about self-infection and the possibility of infecting others received mean scores of 3.11 and 3.75, respectively. Mean scores for generalized anxiety levels were 11.02, with 58.7% of the professionals presenting with generalized anxiety syndrome during the assessment. CONCLUSIONS In this study, we found high levels of anxiety among HCWs caring directly for COVID-19 patients, which could produce long-term psychological alterations that still need to be assessed.
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Affiliation(s)
| | - Fernanda Gil-Almagro
- Unidad de Cuidados Críticos, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - F. Javier Carmona-Monge
- Servicio de Anestesiología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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68
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Muzyamba C, Makova O, Mushibi GS. Exploring health workers' experiences of mental health challenges during care of patients with COVID-19 in Uganda: a qualitative study. BMC Res Notes 2021; 14:286. [PMID: 34311785 PMCID: PMC8312199 DOI: 10.1186/s13104-021-05707-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this study is to qualitatively investigate the lived experiences of mental health among frontline health workers providing COVID-19-realted care in Uganda. This study provides insights into the contextual realities of the mental health of health workers facing greater challenges given the lack of adequate resources, facilities and health workers to meet the demand brought about by COVID-19. RESULTS All in all, our findings suggest that healthcare workers are under enormous stress during this pandemic, however, in order to effectively respond to the COVID-19 pandemic in Uganda, it is important to understand their challenges and sources of these challenges. The government thus has the reasonability to address most of the sources that were highlighted (long working hours, lack of proper equipment, lack of sleep, exhaustion, and experiencing high death rate under their care). Further, the Ugandan social fabric presents an opportunity for coping through its strong communal links and networks. Scaling these forms of local responses is cheap but contextually useful for a country with limited resources like Uganda.
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Affiliation(s)
- Choolwe Muzyamba
- University of Amsterdam (UvA)/Utrecht University, Bijlmerdreef 702, 1103DS, Amsterdam, The Netherlands.
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69
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Mansueto G, Lopes FL, Grassi L, Cosci F. Impact of COVID-19 outbreak on Italian healthcare workers versus general population: Results from an online survey. Clin Psychol Psychother 2021; 28:1334-1345. [PMID: 34255890 PMCID: PMC8426916 DOI: 10.1002/cpp.2644] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/16/2021] [Accepted: 06/28/2021] [Indexed: 11/21/2022]
Abstract
Objective COVID‐19 pandemic has been a stressful condition. We explored life changes and health‐related consequences of COVID‐19 outbreak in Italian healthcare workers in comparison to the general population. Methods A total of 593 subjects participated to the online CoRonavIruS Health Impact Survey. Life events and changes, physical health and worries were evaluated referring to 2 weeks prior to the survey. Mood states and daily behaviour were retrospectively evaluated referring to 3 months before COVID‐19 (T1) and 2 weeks prior to the survey (T2). Student t test, Mann–Whitney test and multivariate logistic regression analyses were run. Results Five hundred and twenty‐one subjects were analysed (healthcare workers: n = 163, 31.84%; general population: n = 349, 68.16%). Healthcare workers were more likely to report fatigue and have spent more time outside home during the 2 weeks prior to the survey than the general population (χ2(df) = 266.03(17), p < 0.001, R2 = 0.57). From T1 to T2, healthcare workers had a significant increase in negative mood, worry, restlessness, loneliness and a decrease in happiness, while subjects from the general population had a statistically significant increase in negative mood, worry, attention, concentration difficulties and a decrease in happiness, pleasure related to daily activities, time spent outdoors and alcohol use. Conclusion In the framework of a growing literature on healthcare workers' status during the COVID‐19 pandemic, the present study allowed to identify fatigue and loneliness as psychosomatic modifiable variables in need of being monitored and, possibly managed, to ameliorate the health status of healthcare workers.
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Affiliation(s)
- Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy.,Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Fabiana Leão Lopes
- Human Genetics Branch, Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,Integrated Department of Mental Health and Pathological Addictions, University of Ferrara, Ferrara, Italy
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
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Donkers MA, Gilissen VJHS, Candel MJJM, van Dijk NM, Kling H, Heijnen-Panis R, Pragt E, van der Horst I, Pronk SA, van Mook WNKA. Moral distress and ethical climate in intensive care medicine during COVID-19: a nationwide study. BMC Med Ethics 2021; 22:73. [PMID: 34139997 PMCID: PMC8211309 DOI: 10.1186/s12910-021-00641-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background The COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19. Methods An extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19.
Results Three hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior. Conclusion Levels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-021-00641-3.
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Affiliation(s)
- Moniek A Donkers
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
| | - Vincent J H S Gilissen
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Nathalie M van Dijk
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Hans Kling
- Department of Spiritual Care Services, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ruth Heijnen-Panis
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Elien Pragt
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Iwan van der Horst
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Sebastiaan A Pronk
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Walther N K A van Mook
- Department of Intensive Care, Maastricht University Medical Center+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.,Academy for Postgraduate Medical Training, Maastricht University Medical Center+, Maastricht, The Netherlands.,School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
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Dong F, Liu HL, Yang M, Lu CL, Dai N, Zhang Y, Robinson N, Liu JP. Immediate Psychosocial Impact on Healthcare Workers During COVID-19 Pandemic in China: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:645460. [PMID: 34122233 PMCID: PMC8192844 DOI: 10.3389/fpsyg.2021.645460] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The corona virus disease-2019 (COVID-19) pandemic spread globally, and we aimed to investigate the psychosocial impact on healthcare workers (HWs) in China during the pandemic. Methods: In this systematic review and meta-analysis, we searched seven electronic databases for cross-sectional studies on psychosocial impact on HWs in relation to COVID-19 from January 1, 2020 to October 7, 2020. We included primary studies involving Chinese HWs during the pandemic, and data were extracted from the published articles. Our primary outcome was prevalence of anxiety, depression, and stress disorders. We pooled prevalence value with their 95% confidence interval using random effect models and assessed study quality on the basis of an 11-item checklist recommended by the Agency for Healthcare Research and Quality. The study protocol was registered in PROSPERO (CRD42020195843). Results: We identified 25 articles comprising a total of 30,841 completed questionnaires and 22 studies for meta-analysis. The prevalence of anxiety, depression, and stress disorders was 34.4% (29.5–39.4%), 31.1% (24.5–37.7%), and 29.1% (24.3–33.8%) for HWs. The pooled prevalence of anxiety disorders for HWs from late January to early February was 46.4% (42.9–49.9%), significantly higher than those in mid-term February (28.0%, 23.9–32.1%) and after late February (27.6%, 16.0–39.2%). The pooled prevalence of depression disorders for HWs from late January to early February was 46.5% (38.8–54.2%), significantly higher than those in mid-term February (27.1%, 19.8–34.5%) and after late February (32.9%, 16.2–49.5%). HWs working in Hubei Province had a higher prevalence of anxiety (37.9 vs. 30.8%) and a lower prevalence of depression (27.5 vs. 34.7%) than those working in other regions. Nurses had a higher prevalence of anxiety (44.1 vs. 29.0%) and depression (34.1 vs. 29.2%) than other HWs. Conclusions: About one-third of HWs in China suffered anxiety, depression, and stress at the early epidemic of COVID-19. HWs in Hubei Province, especially nurses, had a higher prevalence of psychological disorders. During the pandemic, a negative psychological state may persist in a proportion of Chinese HWs, fluctuating with the control of the pandemic. The long-term impact should continue to be observed. Attention should be paid to HWs for their psychological impact due to the pandemic. Systematic Review Registration: The study protocol was registered with PROSPERO (CRD42020195843).
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Affiliation(s)
- Fei Dong
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Liang Liu
- Gastroenterology Department, Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing, China
| | - Ming Yang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Chun-Li Lu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ning Dai
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Zhang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Nicola Robinson
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Anxiety, Post-Traumatic Stress, and Burnout in Health Professionals during the COVID-19 Pandemic: Comparing Mental Health Professionals and Other Healthcare Workers. Healthcare (Basel) 2021; 9:healthcare9060635. [PMID: 34071970 PMCID: PMC8229458 DOI: 10.3390/healthcare9060635] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/23/2022] Open
Abstract
The psychological impact of the pandemic on healthcare workers has been assessed worldwide, but there are limited data on how mental health professionals (MHPs) have been affected. Thus, this paper aims to investigate anxiety, post-traumatic stress, and burnout in a sample of MHPs. We conducted a descriptive, cross-sectional study on 167 participants: 56 MHPs, 57 physicians working closely with COVID-19 patients, and 54 physicians not working closely with such patients. MHPs reported good overall mental health. Most MHPs reported no post-traumatic stress, and their scores were significantly lower compared to HPs working closely with COVID-19 patients. MHPs' hyperarousal scores were also significantly lower compared to HPs working closely with COVID-19 patients, while their intrusion scores were statistically significantly lower than those of all other professionals. Multivariable logistic regressions showed that MHPs had lower odds of exhibiting state anxiety and low personal accomplishment compared to HPs not working closely with COVID-19 patients. In sum, MHPs seem to show almost preserved mental health. Thus, given the high mental healthcare demand during a pandemic, it would be useful to rely on these professionals, especially for structuring interventions to improve and support the mental health of the general population and other healthcare workers.
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73
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Zhang H, Li W, Li H, Zhang C, Luo J, Zhu Y, Wu H, Zhu Z, Xu Y, Wang J, Li C. Prevalence and dynamic features of psychological issues among Chinese healthcare workers during the COVID-19 pandemic: a systematic review and cumulative meta-analysis. Gen Psychiatr 2021; 34:e100344. [PMID: 34192242 PMCID: PMC8103554 DOI: 10.1136/gpsych-2020-100344] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 02/01/2021] [Accepted: 03/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background The COVID-19 pandemic has placed tremendous pressure on healthcare workers who are at the frontline in the battle against it, causing various forms of psychological distress. Aims To outline the prevalence and dynamic changing features of medical workers' psychological issues and to review the related national policies during the COVID-19 pandemic in China. Methods We systematically searched for studies on the psychological states of Chinese medical staff from 1 January 2020 to 8 May 2020. The aggregate prevalence of each psychological issue was calculated and plotted to observe the changes over time. Policies on psychological support for medical staff during the pandemic were reviewed to explore their link to the prevalence of psychological problems. Results In total, 26 studies were included in this study. A total of 22 062 medical workers were surveyed from 31 January to 27 February 2020. Medical staff exhibited a substantial prevalence of anxiety symptoms, depression symptoms, stress-related symptoms and sleep problems during the survey period, with aggregate prevalence rates of 27.0%, 26.2%, 42.1% and 34.5%, respectively. Cumulative meta-analyses revealed that the prevalence of psychological distress peaked at the beginning of the pandemic and subsequently exhibited a slow downward trend. Conclusion Chinese medical staff displayed significant psychological disturbance during the outbreak of the COVID-19 pandemic, which was especially severe at the early stage. Implementing supportive policies may help alleviate ongoing psychological problems in healthcare workers.
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Affiliation(s)
- Huijuan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Li
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caidi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinjing Luo
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yikang Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wu
- Department of Medical Psychology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuoying Zhu
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifeng Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
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Fleuren BPI, Poesen LT, Gifford RE, Zijlstra FRH, Ruwaard D, van de Baan FC, Westra DD. We're Not Gonna Fall: Depressive Complaints, Personal Resilience, Team Social Climate, and Worries about Infections among Hospital Workers during a Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4701. [PMID: 33925036 PMCID: PMC8124912 DOI: 10.3390/ijerph18094701] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/16/2021] [Accepted: 04/23/2021] [Indexed: 12/23/2022]
Abstract
Maintaining hospital workers' psychological health is essential for hospitals' capacities to sustain organizational functioning during the COVID-19 pandemic. Workers' personal resilience can be an important factor in preserving psychological health, but how this exactly works in high stakes situations, such as the COVID-19 pandemic, requires further exploration. Similarly, the role of team social climate as contributor to individual psychological health seems obvious, but how it exactly prevents workers from developing depressive complaints in prolonged crises remains under investigated. The present paper therefore applies conservation of resources theory to study the relationships between resilience, team social climate, and depressive complaints, specifically focusing on worries about infections as an important explanatory mechanism. Based on questionnaire data of 1126 workers from five hospitals in the Netherlands during the second peak of the pandemic, this paper estimates a moderated-mediation model. This model shows that personal resilience negatively relates to depressive complaints (β = -0.99, p < 0.001, 95%CI = -1.45--0.53), partially as personal resilience is negatively associated with worries about infections (β = -0.42, p < 0.001, 95%CI = -0.50--0.33) which in turn are positively related to depressive complaints (β = 0.75, p < 0.001, 95% CI = 0.31-1.19). Additionally, team social climate is associated with a lower effect of worries about being infected and infecting others on depressive complaints (β = -0.88, p = 0.03, 95% CI = -1.68--0.09). These findings suggest that resilience can be an important individual level resource in preventing depressive complaints. Moreover, the findings imply that hospitals have an important responsibility to maintain a good team social climate to shield workers from infection related worries building up to depressive complaints.
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Affiliation(s)
- Bram P. I. Fleuren
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.T.P.); (F.R.H.Z.)
| | - Lieze T. Poesen
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.T.P.); (F.R.H.Z.)
| | - Rachel E. Gifford
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| | - Fred R. H. Zijlstra
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.T.P.); (F.R.H.Z.)
| | - Dirk Ruwaard
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| | - Frank C. van de Baan
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| | - Daan D. Westra
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
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Domínguez-Salas S, Gómez-Salgado J, Guillén-Gestoso C, Romero-Martín M, Ortega-Moreno M, Ruiz-Frutos C. Health care workers' protection and psychological safety during the COVID-19 pandemic in Spain. J Nurs Manag 2021; 29:1924-1933. [PMID: 33844359 PMCID: PMC8250215 DOI: 10.1111/jonm.13331] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/09/2021] [Accepted: 04/06/2021] [Indexed: 12/05/2022]
Abstract
Aims To analyse the relationship between work engagement, sense of coherence and psychological distress levels in Spanish health professionals who were active during the COVID‐19 pandemic lockdown. Background Work engagement and sense of coherence can help professionals to cope with work‐related psychological distress due to the harsh conditions of the COVID‐19 working environment. Methods Cross‐sectional observational study of 1,459 health care professionals. The Utrecht Work Engagement Scale, the Sense of Coherence Scale and Goldberg's General Health Questionnaire were distributed and analysed with descriptive and multiple linear regression methods. Results High levels of work engagement, especially in the dedication dimension, of sense of coherence, in particular in the meaningfulness dimension, and psychological distress were obtained. Significant correlations (p < .001) were identified between all the variables. Conclusions Work engagement and sense of coherence correlated positively with each other and both negatively with psychological distress. So, health care professionals, despite presenting psychological distress, perceive their work satisfactorily and positively despite the severity of the situation and the harsh conditions. Implications for Nursing Management Sense of coherence and work engagement are protective factors against psychological distress. Preventive measures for professionals should go through the dimensionalization of the problem and the adaptation of practical measures for daily management.
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Affiliation(s)
- Sara Domínguez-Salas
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | | | - Mónica Ortega-Moreno
- Department of Economy. Faculty of Labour Sciences, University of Huelva, Huelva, Spain
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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76
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Testoni I, Franco C, Gallo Stampino E, Iacona E, Crupi R, Pagano C. Facing COVID-19 Between Sensory and Psychoemotional Stress, and Instrumental Deprivation: A Qualitative Study of Unmanageable Critical Incidents With Doctors and Nurses in Two Hospitals in Northern Italy. Front Psychol 2021; 12:622894. [PMID: 33912104 PMCID: PMC8072146 DOI: 10.3389/fpsyg.2021.622894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic severely strained the already unprepared Italian healthcare system. This had repercussions on healthcare workers, stemming, in particular, from a lack of clear guidelines, adequate protective equipment, and professional preparedness. Such conditions were especially prevalent in Northern Italy. Objectives: This study aimed to examine COVID-19-related professional and psychoemotional stress among nurses and doctors in two hospitals in Northern Italy, along with the worst critical incidents affecting healthcare personnel. A parallel objective was to elicit healthcare professionals' opinions about what changes are needed in the healthcare system's operations, as well as about the relational/emotional skills that are needed to better manage relationships with patients in emergency situations. Participants: Snowball sampling was used to recruit participants and yielded 17 hospital professionals: six nurses (five female and one male) and 11 doctors (seven male and four female). Three of these professionals worked in intensive care and the others in different wards. All had close contact with COVID-19 patients. Methods: The study employed a qualitative research design, using in-depth interviews of ~60 min each that were conducted via Skype video calls. The interviews were recorded and transcribed, then analysed. The qualitative analysis employed mixed methods to identify the most relevant and recursive themes from the interviews. Results: Four fundamental themes emerged from our analysis of the interview texts: (1) disorganisation and psychoemotional stress; (2) urgency and critical incidents; (3) everything surreal; and (4) disruptions in empathetic relationships with patients. Conclusions: Through our analysis of the interview narratives, we found that systematic and in-depth psychological training is needed to prepare professionals for (1) altered relationships with patients in emergencies; (2) use of exceptional medical equipment; (3) elaboration of new bioethical models suitable for disasters and pandemics; and (4) engagement with the themes of death and dying.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Chiara Franco
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Enrica Gallo Stampino
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Erika Iacona
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Robert Crupi
- NewYork-Presbyterian Queens Hospital, New York, NY, United States
| | - Claudio Pagano
- Clinica Medica 3, Department of Medicine - DIMED, University of Padova, Padova, Italy
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77
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Hong X, Cao J, Wei J, Duan Y, Zhao X, Jiang J, Jiang Y, Geng W, Zhu H. Stress and psychological impact of the COVID-19 outbreak on the healthcare staff at the fever clinic of a tertiary general hospital in Beijing: a cross-sectional study. BJPsych Open 2021; 7:e76. [PMID: 33814026 PMCID: PMC8027548 DOI: 10.1192/bjo.2021.32] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND It is important to maintain the psychological well-being of front-line healthcare staff during the coronavirus disease 2019 (COVID-19) pandemic. AIMS To examine COVID-19-related stress and its immediate psychological impact on healthcare staff. METHOD All healthcare staff working in the fever clinic, from 20 January 2020 to 26 March 2020, of a tertiary general hospital were enrolled. Stress management procedures were in place to alleviate concerns about the respondents' own health and the health of their families, to help them adjust their work and to provide psychological support via a hotline. Qualitative interviews were undertaken and the Sources of Distress and the Impact of Event Scale-Revised (IES-R) were administered. RESULTS Among the 102 participants (25 males; median age 30 years, interquartile range (IQR) = 27-36), the median IES-R total score was 3 (IQR = 0-8), and 6 participants (6.0%) scored above the cut-off on the IES-R (≥20). Safety and security were acceptable or better for 92 (90.2%) participants. The top four sources of distress were worry about the health of one's family/others at 0.88 (IQR = 0.25-1.25), worry about the virus spread at 0.50 (IQR = 0.00-1.00), worry about changes in work at 0.50 (IQR = 0.00-1.00) and worry about one's own health at 0.25 (IQR = 0.25-0.75). There was a moderate correlation between the IES-R score and the Sources of Distress score (rho = 0.501, P = 0.001). CONCLUSIONS The stress levels of healthcare staff in the fever clinic during the COVID-19 epidemic were not elevated. Physio-psychosocial interventions, including fulfilment of basic needs, activation of self-efficacy and psychological support, are helpful and worth recommending in fighting COVID-19.
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Affiliation(s)
- Xia Hong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Jinya Cao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Yanping Duan
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Xiaohui Zhao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Jing Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Yinan Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Wenqi Geng
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Huadong Zhu
- Department of Emergency, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China
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78
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Psychological Distress, Fear of COVID-19, and Resilient Coping Abilities among Healthcare Workers in a Tertiary First-Line Hospital during the Coronavirus Pandemic. J Clin Med 2021; 10:jcm10071465. [PMID: 33918169 PMCID: PMC8038142 DOI: 10.3390/jcm10071465] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic is causing a heavy burden in hospital healthcare workers (HCW) in terms of increased work, organizational changes, risk exposure, and social stigma. The present study aims at evaluating the psychological outcome among HCWs at the final stages of the first wave of the COVID-19 pandemic. This cross-sectional and survey-based study was conducted during June 2020 among 996 HCWs of the University Hospital of Padova. All the subjects completed questionnaires investigating the perception of risk of infecting or being infected by COVID-19, psychopathological variables, and coping abilities. Compared to physicians and healthcare assistants, nurses showed higher levels of depression (p = 0.002), insomnia (p < 0.001), and generalized anxiety (p = 0.001). Females reported increased concerns about the possibility of infecting others (p = 0.046), greater anxiety (p < 0.001), COVID-19 related fears (p < 0.001), depression (p < 0.001), and post-traumatic distress (p < 0.001) than males. Being employed in a COVID-19 unit, being transferred to other units, and living with children and the elderly were factors associated with higher levels of psychological distress. Greater coping abilities were detected in physicians, and in those HCWs employed in COVID units. Our findings evidenced that the psychological consequences of the pandemic were non-homogeneously distributed across HCWs categories and pointed out the presence of specific in-hospital and out-of-hospital risk factors.
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79
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Eöry A, Békési D, Eöry A, Rózsa S. Physical Exercise as a Resilience Factor to Mitigate COVID-Related Allostatic Overload. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:200-206. [PMID: 33691321 PMCID: PMC8678241 DOI: 10.1159/000514331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The long-lasting threat of COVID-19 makes it necessary to explore strategies to improve coping skills which enable us to master a balanced life in the face of adversity. OBJECTIVE To unravel the most challenging aspects of COVID-19 in a nonclinical adult population and identify predictors of lost balance and consequent allostatic overload (AO). We examined the role of regular, moderate-intensity formula aerobic exercise (312 meridian exercise) in preventing allostatic overload through increasing well-being. METHODS An online survey was conducted to measure CO-VID-related allostatic overload according to clinimetric criteria. The Psychosocial Index (PSI), Kellner's Symptom Questionnaire (KSQ), short Depression Anxiety Stress Scales (DASS-21), Public Health Surveillance Well-Being Scale -(PHS-WB), and Whiteley-7 were used to explore mental health characteristics. Univariate statistics logistic regression analysis and a general linear model were used. RESULTS According to 442 valid answers, 217 adults practiced physical exercise (PE) frequently (fPE, 3-5 times/every day) while 120 did it less regularly (1-2 times/week), and 105 did not exercise/practiced irregularly (controls). Restriction-related stressors were most challenging, resulting in AO in 29% (n = 128) of the sample. The main predictors were additional stressors (p = 0.005) and anxiety symptoms (p < 0.001). The prevalence of AO was lower (p = 0.018) in the fPE group when compared to controls. KSQ distress symptoms were also lower in fPE (p < 0.0001), while total well-being was increased (p < 0.001) after adjusting for sex, age, and number of chronic diseases. According to the PHS-WB, both physical and mental well-being were higher (p = 0.003 and p = 0.004, respectively) in fPE. CONCLUSIONS Frequent moderate exercise is associated with better mental and physical well-being and a lower prevalence of AO.
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Affiliation(s)
- Ajandek Eöry
- Division of Integrative Medicine, Department of Family Medicine, Semmelweis University, Budapest, Hungary, .,Hungarian Acupuncture and Moxibustion Society, Budapest, Hungary,
| | - Dora Békési
- Rácz Károly Clinical Medicine PhD School Semmelweis University Hungary, Budapest, Hungary
| | - Ajandok Eöry
- Hungarian Acupuncture and Moxibustion Society, Budapest, Hungary
| | - Sandor Rózsa
- Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary,Department of Psychiatry, Washington University in St Louis, St Louis, Missouri, USA
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80
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Zhang Z, Fu W, Tian C, Zhang F, Zhao B, Mao J, Saligan LN. Professional identity of Chinese nursing students during the COVID-19 pandemic outbreak: A nation-wide cross-sectional study. Nurse Educ Pract 2021; 52:103040. [PMID: 33813343 DOI: 10.1016/j.nepr.2021.103040] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 01/16/2023]
Abstract
Practicing in unprecedented working environment and fighting against the COVID-19 crisis influenced the image of nursing in the general population, as well as among nurses themselves. This study aimed to describe the sense of professional identity among Chinese nursing students during the COVID-19 outbreak and to explore the relationship between psychological resilience and the sense of professional identity in this cohort. A nationwide online cross-sectional survey was conducted. Nursing students were recruited from 18 Chinese universities. The 10-item Connor-Davidson resilience scale (CD-RISC-10) evaluated psychological resilience and professional identity was assessed by the Professional Identity Questionnaire for Nursing Students (PIQNS). A total of 6348 respondents had a moderate level of professional identity to nursing (average PIQNS score at 62.02 ± 12.02). About 86% of respondents attributed the response to the COVID-19 pandemic in elevating the nursing image. Psychological resilience was the strongest contributor to professional identity (β = 0.371, P < 0.001). There was a high level of professional identity among Chinese nursing students during the COVID-19 crisis. Policy support and courses to enhance psychological resilience are critical to sustain professional identity among nursing students.
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Affiliation(s)
- Zeyu Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Fengzhi Zhang
- Department of Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Bing Zhao
- The Central Hospital Affiliated to Shenyang Medical College, Shengyang, Liaoning Province, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
| | - Leorey N Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA
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81
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Cubitt LJ, Im YR, Scott CJ, Jeynes LC, Molyneux PD. Beyond PPE: a mixed qualitative-quantitative study capturing the wider issues affecting doctors' well-being during the COVID-19 pandemic. BMJ Open 2021; 11:e050223. [PMID: 33753449 PMCID: PMC7985981 DOI: 10.1136/bmjopen-2021-050223] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED The COVID-19 pandemic has brought unprecedented challenges to the medical workforce. This has put them at increased risk of burnout at a time when levels are already worryingly high in the profession, with recent studies consistently showing that around half of doctors meet the validated criteria for burnout. OBJECTIVES To understand the wider factors influencing and impacting upon hospital doctors' well-being during the COVID-19 pandemic in England. DESIGN Cross-sectional survey and mixed quantitative-qualitative analysis. SETTING Acute National Health Service (NHS) Foundation Trust in England. PARTICIPANTS An online survey was circulated in early June 2020 to all 449 doctors employed by the Trust. 242 doctors completed the survey (54% response rate). PRIMARY OUTCOME MEASURES Questions assessed occupational details, self-reported changes in physical and mental health, satisfaction with working hours and patterns, availability of personal protective equipment (PPE), medication and facilities, communication and sought to identify areas seen as having a significant effect on doctors' well-being. RESULTS 96% of respondents requiring PPE were able to access it. Nearly half of the respondents felt that their mental health had deteriorated since the start of the pandemic. Over a third stated that their physical health had also declined. Issues identified as having a negative impact on doctors included increased workload, redeployment, loss of autonomy, personal issues affecting family members, anxiety around recovery plans, inadequate access to changing and storage facilities and to rest areas that allow for social distancing. Doctors appreciated access to 'calm rooms' that were made available for staff, access to clinical psychology support, free drinks and free car parking on site. CONCLUSION The emerging themes are suggestive of increased burnout risk among doctors during the COVID-19 pandemic and encompass factors well beyond shortage of PPE. Small organisational initiatives and the implementation of changes suggested by survey respondents can have a positive impact on doctors' well-being.
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Affiliation(s)
| | - Yu Ri Im
- Faculty of Medicine, Imperial College London, London, UK
- Dept of Medicine, West Suffolk NHS Foundation Trust, Bury Saint Edmunds, UK
| | - Ciaran James Scott
- Dept of Anaesthetics, West Suffolk NHS Foundation Trust, Bury Saint Edmunds, UK
| | | | - Paul David Molyneux
- Neurology, West Suffolk NHS Foundation Trust, Bury Saint Edmunds, UK
- Department of Neurology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK
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82
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Alfonsi V, Scarpelli S, Gorgoni M, Pazzaglia M, Giannini AM, De Gennaro L. Sleep-Related Problems in Night Shift Nurses: Towards an Individualized Interventional Practice. Front Hum Neurosci 2021; 15:644570. [PMID: 33796014 PMCID: PMC8007770 DOI: 10.3389/fnhum.2021.644570] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/22/2021] [Indexed: 02/05/2023] Open
Abstract
Rotating shifts (mostly 8- or 12-h) are common among nurses to ensure continuity of care. This scheduling system encompasses several adverse health and performance consequences. One of the most injurious effects of night-time shift work is the deterioration of sleep patterns due to both circadian rhythm disruption and increased sleep homeostatic pressure. Sleep problems lead to secondary effects on other aspects of wellbeing and cognitive functioning, increasing the risk of errors and workplace accidents. A wide range of interventions has been proposed to improve the sleep quality of nurses and promote an increase in attention levels. In recent years, particular attention has been paid to individual and environmental factors mediating the subjective ability to cope with sleep deprivation during the night shift. Given the predictive role of these factors on the negative impact of a night shift, an individualized intervention could represent an effective countermeasure by ensuring suitable management of shift schedules. Therefore, the aims of this mini-review are to: (a) provide an updated overview of the literature on sleep problems in night shift nurses and their adverse consequences; and (b) critically analyze the psychosocial factors that mediate the negative impact of shift work with the ultimate goal of defining an effective countermeasure based on an individualized approach.
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Affiliation(s)
- Valentina Alfonsi
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Mariella Pazzaglia
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Luigi De Gennaro
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
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83
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Wu T, Jia X, Shi H, Niu J, Yin X, Xie J, Wang X. Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord 2021; 281:91-98. [PMID: 33310451 PMCID: PMC7710473 DOI: 10.1016/j.jad.2020.11.117] [Citation(s) in RCA: 649] [Impact Index Per Article: 216.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The global COVID-19 pandemic has generated major mental and psychological health problems worldwide. We conducted a meta-analysis to assess the prevalence of depression, anxiety, distress, and insomnia during the COVID-19 pandemic. METHODS We searched online biomedical databases (PubMed, Embase, Web of Science, Ovid, CNKI, and Wanfang Data) and preprint databases (SSRN, bioRxiv, and MedRxiv) for observational studies from January 1, 2020 to March 16, 2020 investigating the prevalence of mental health problems during the COVID-19 pandemic. RESULTS We retrieved 821 citations from the biomedical databases and 53 citations from the preprint databases: 66 studies with 221,970 participants were included in our meta-analysis. The overall pooled prevalence of depression, anxiety, distress, and insomnia was 31.4%, 31.9%, 41.1% and 37.9%, respectively. Noninfectious chronic disease patients, quarantined persons, and COVID-19 patients had a higher risk of depression (Q=26.73, p<0.01) and anxiety (Q=21.86, p<0.01) than other populations. The general population and non-medical staff had a lower risk of distress than other populations (Q=461.21, p< 0.01). Physicians, nurses, and non-medical staff showed a higher prevalence of insomnia (Q=196.64, p<0.01) than other populations. LIMITATIONS All included studies were from the early phase of the global pandemic. Additional meta-analyses are needed to obtain more data in all phases of the pandemic. CONCLUSIONS The COVID-19 pandemic increases the mental health problems of the global population, particularly health care workers, noninfectious chronic disease patients, COVID-19 patients, and quarantined persons. Interventions for mental health are urgently needed for preventing mental health problems.
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Affiliation(s)
- Tianchen Wu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiaoqian Jia
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jieqiong Niu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiaohan Yin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jialei Xie
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
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84
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Thatrimontrichai A, Weber DJ, Apisarnthanarak A. Mental health among healthcare personnel during COVID-19 in Asia: A systematic review. J Formos Med Assoc 2021; 120:1296-1304. [PMID: 33581962 DOI: 10.1016/j.jfma.2021.01.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/12/2020] [Accepted: 01/25/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has been associated with an insidious wave of psychological stress among healthcare personnel (HCP) in Asia. Mental exhaustion, burnout, fear, depression, anxiety, insomnia, and psychological stress among HCPs have intensified a daunting challenge during the COVID-19 pandemic. The consequences of such stress may negatively impact patient and HCP safety. This review article reports the associations of mental health status attributed to the COVID-19 pandemic among HCP and their impact on patient safety, and infection prevention and control practices during pandemics.
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Affiliation(s)
- Anucha Thatrimontrichai
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, United States
| | - Anucha Apisarnthanarak
- Division of Infectious Diseases, Department of Medicine, Thammasat University Hospital, Pratumthani, Thailand.
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85
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Busch IM, Moretti F, Mazzi M, Wu AW, Rimondini M. What We Have Learned from Two Decades of Epidemics and Pandemics: A Systematic Review and Meta-Analysis of the Psychological Burden of Frontline Healthcare Workers. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:178-190. [PMID: 33524983 PMCID: PMC8018214 DOI: 10.1159/000513733] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/12/2020] [Indexed: 12/13/2022]
Abstract
In light of the current coronavirus disease 2019 (COVID-19) pandemic and potential future infectious disease outbreaks, a comprehensive understanding of the negative effects of epidemics and pandemics on healthcare workers' mental health could inform appropriate support interventions. Thus, we aimed to synthesize and quantify the psychological and psychosomatic symptoms among frontline medical staff. We searched four databases up to March 19, 2020 and additional literature, with daily search alerts set up until October 26, 2020. Studies reporting psychological and/or psychosomatic symptoms of healthcare workers caring for patients with severe acute respiratory syndrome, H1N1, Ebola, Middle East respiratory syndrome, or COVID-19 were eligible for inclusion. Two reviewers independently conducted the search, study selection, quality appraisal, data extraction, and synthesis and involved a third reviewer in case of disagreement. We used random effects modeling to estimate the overall prevalence rates of psychological/psychosomatic symptoms and the I2 statistic. We included 86 studies, reporting data from 75,991 participants. Frontline staff showed a wide range of symptoms, including concern about transmitting the virus to the family (60.39%, 95% CI 42.53-76.96), perceived stress (56.77%, 95% CI 34.21-77.95), concerns about own health (45.97%, 95% CI 31.08-61.23), sleeping difficulties (39.88%, 95% CI 27.70-52.72), burnout (31.81%, 95% CI 13.32-53.89), symptoms of depression (25.72%, 95% CI 18.34-33.86), symptoms of anxiety (25.36%, 95% CI 17.90-33.64), symptoms of posttraumatic stress disorder (24.51%, 95% CI 18.16-31.46), mental health issues (23.11%, 95% CI 15.98-31.10), and symptoms of somatization (14.68%, 95% CI 10.67-19.18). We found consistent evidence for the pervasive and profound impact of large-scale outbreaks on the mental health of frontline healthcare workers. As the CO-VID-19 crisis continues to unfold, guaranteeing easy access to support structures for the entire healthcare workforce is vitally important.
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Affiliation(s)
- Isolde M. Busch
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Moretti
- Direzione Medica di Presidio Ospedale di Legnago, AULSS 9 Scaligera, Legnago, Italy
| | - Mariangela Mazzi
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Albert W. Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michela Rimondini
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy,
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86
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Peng M, Wang L, Xue Q, Yin L, Zhu BH, Wang K, Shangguan FF, Zhang PR, Niu YY, Zhang WR, Zhao WF, Wang H, Lv J, Song HQ, Min BQ, Leng HX, Jia Y, Chang H, Yu ZP, Tian Q, Yang Y, Zhu Z, Li W, Gao XL, Liu XL, Yang M, Wang P, Wei PH, Wang CX, Li JN, Jia LB, Huang XM, Li DN, Xu DJ, Deng YL, Si TM, Dong HQ, Wang YP, Cosci F, Wang HX. Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:127-136. [PMID: 33152729 PMCID: PMC7705943 DOI: 10.1159/000511823] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/24/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. OBJECTIVE During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. METHODS An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. RESULTS There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18-1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17-1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14-1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18-1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34-1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78-0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80-0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72-0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87-0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22-0.41; p < 0.01) were negatively associated. CONCLUSIONS In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.
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Affiliation(s)
- Mao Peng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing Xue
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lu Yin
- Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Bo-heng Zhu
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Kun Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,Department of Neurology, Beijing Puren Hospital, Beijing, China
| | | | - Pei-ran Zhang
- Department of Public Economics, School of Economics, Fudan University, Shanghai, China
| | - Yan-yan Niu
- Department of Orthopedics, Jincheng People's Hospital, Shanxi Medical University, Jincheng, China
| | - Wen-rui Zhang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wen-feng Zhao
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Huang Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Lv
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hai-qing Song
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Bao-quan Min
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hai-xia Leng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Jia
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hong Chang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhi-peng Yu
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing Tian
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Yuan Yang
- Department of Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhou Zhu
- Department of Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Li
- Department of Neurology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Xiao-ling Gao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiao-lei Liu
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mei Yang
- Department of Psychology, Ningxia Fifth People's Hospital, Ningxia Medical University, Shizuishan, China
| | - Ping Wang
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Peng-hu Wei
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chun-xue Wang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jin-na Li
- Department of Neurology, Jincheng People's Hospital, Shanxi Medical University, Jincheng, China
| | - Long-bin Jia
- Department of Neurology, Jincheng People's Hospital, Shanxi Medical University, Jincheng, China
| | - Xiao-min Huang
- Department of Neurology, Ningcheng Center Hospital, Ningcheng, China
| | - Dong-ning Li
- Department of Neurology, Ningcheng Center Hospital, Ningcheng, China
| | - Dong-juan Xu
- Department of Neurology, Dongyang People's Hospital, Wenzhou Medical University, Dongyang, China
| | - Yun-long Deng
- Psychosomatic Health Institute, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Tian-mei Si
- Peking University Sixth Hospital, National Clinical Research Center for Mental Health Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Hui-qing Dong
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-ping Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Hong-xing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,Department of Neurology, Jincheng People's Hospital, Shanxi Medical University, Jincheng, China,Department of Neurology, Ningcheng Center Hospital, Ningcheng, China,Department of Neurology, Dongyang People's Hospital, Wenzhou Medical University, Dongyang, China,Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, Capital Medical University, Beijing, China,*Hong-xing Wang, Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, Capital Medical University, No. 45, Changchun St., Beijing 100053 (China),
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87
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Flynn J, O'Connor L, Hanlon M, Bellani G, Contreras M, Doherty A, Durand H, Fallon E, Gormley C, Laffey J, Molloy G, Sarma K, Strepparava MG, Russo S, Walsh J, McGuire BE. The identification of needs and development of best practice guidance for the psychological support of frontline healthcare workers during and after COVID-19: A protocol for the FLoWS project. HRB Open Res 2021; 3:54. [PMID: 33870088 PMCID: PMC8030118 DOI: 10.12688/hrbopenres.13117.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 01/17/2023] Open
Abstract
Recent estimates suggest that up to 34% of frontline workers in healthcare (FLWs) at the forefront of the COVID-19 pandemic response are reporting elevated symptoms of psychological distress due to resource constraints, ineffective treatments, and concerns about self-contamination. However, little systematic research has been carried out to assess the mental health needs of FLWs in Europe, or the extent of psychological suffering in FLWs within different European countries of varying outbreak severity. Accordingly, this project will employ a mixed-methods approach over three work packages to develop best-practice guidelines for alleviating psychological distress in FLWs during the different phases of the pandemic. Work package 1 will identify the point and long-term prevalence of psychological distress symptoms in a sample of Irish and Italian FLWs, and the predictors of these symptoms. Work package 2 will perform a qualitative needs assessment on a sample of Irish and Italian FLWs to identify sources of stress and resilience, barriers to psychological care, and optimal strategies for alleviating psychological distress in relation to the COVID-19 pandemic. Work package 3 will synthesise the findings from the preceding work packages to draft best practice guidelines, which will be co-created by a multidisciplinary panel of experts using the Delphi method. The guidelines will provide clinicians with a framework for alleviating psychological distress in FLWs, with particular relevance to the COVID-19 pandemic, but may also have relevance for future pandemics and other public health emergencies.
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Affiliation(s)
- Jack Flynn
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Laura O'Connor
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Michelle Hanlon
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Giacomo Bellani
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- San Gerardo Hospital, Monza, Italy
| | - Maya Contreras
- University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | | | - Hannah Durand
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Elaine Fallon
- Saolta University Health Care Group, Galway, Ireland
| | | | - John Laffey
- University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | - Gerry Molloy
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Kiran Sarma
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- San Gerardo Hospital, Monza, Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Jane Walsh
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Brian E. McGuire
- School of Psychology, National University of Ireland, Galway, Ireland
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88
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van Roekel H, van der Fels IMJ, Bakker AB, Tummers LG. Healthcare Workers Who Work With COVID-19 Patients Are More Physically Exhausted and Have More Sleep Problems. Front Psychol 2021; 11:625626. [PMID: 33488489 PMCID: PMC7820541 DOI: 10.3389/fpsyg.2020.625626] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
In this survey study of 7,208 Dutch healthcare workers, we investigate whether healthcare workers dealing with COVID-19 patients experience lower general health, more physical and mental exhaustion and more sleep problems than other healthcare workers. Additionally, we study whether there are differences in well-being within the group of healthcare workers working with COVID-19 patients, based on personal and work characteristics. We find healthcare workers who are in direct contact with COVID-19 patients report more sleep problems and are more physically exhausted than those who are not in direct contact with COVID-19 patients. Mental exhaustion and general health do not significantly differ between healthcare workers who are in direct contact with COVID-19 patients and those who are not. Among healthcare workers in direct contact with COVID-19 patients, lower well-being on one or more indicators is reported by those who are female, living alone, without leadership role, or without sufficient protective equipment. Regarding age, physical exhaustion is more prevalent under healthcare workers older than 55 years, whereas mental exhaustion is more prevalent under healthcare workers younger than 36 years. These results stress the need of mental and physical support of healthcare workers during a pandemic, catered to the needs of healthcare workers themselves.
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Affiliation(s)
| | | | - Arnold B Bakker
- Center of Excellence for Positive Organizational Psychology, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Lars G Tummers
- Utrecht School of Governance, Utrecht University, Utrecht, Netherlands
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89
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Gross JV, Mohren J, Erren TC. COVID-19 and healthcare workers: a rapid systematic review into risks and preventive measures. BMJ Open 2021; 11:e042270. [PMID: 33472783 PMCID: PMC7818819 DOI: 10.1136/bmjopen-2020-042270] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/16/2020] [Accepted: 12/30/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic is demanding for occupational medicine and for public health. As healthcare workers (HCWs) fight impacts of SARS-CoV-2 on front lines, we must create safe work environments through comprehensive risk assessments, evaluation and effective implementation of counter-measures. We ask: 'What does current literature report on health risks at workplaces regarding COVID-19?' and 'What do current studies report on the effectiveness of enacted preventative recommendations?' METHODS As a snapshot of early HCW research, on 26 April 2020, we conducted a rapid systematic literature search in three databases (PubMed, Web of Science and PsycInfo) for COVID-19-related health outcomes and preventive measures in healthcare-associated workplaces. RESULTS 27 studies were identified as relevant for exploring the risk of infection, 11 studies evaluated preventive measures. The studies described that SARS-CoV-2 impacts significantly on HCW's health and well-being, not only through infections (n=6), but also from a mental health perspective (n=16). 4 studies reported indirect risks such as skin injuries, one study described headaches to result from the use of personal protective equipment. Few studies provided information on the effectiveness of prevention strategies. Overall, most studies on health risks as well as on the effectiveness of preventive measures were of a moderate-to-low quality; this was mainly due to limitations in study design, imprecise exposure and outcome assessments. CONCLUSIONS Due to widespread exposure of HCW to SARS-CoV-2, workplaces in healthcare must be as safe as possible. Information from HCW can provide valuable insights into how infections spread, into direct and indirect health effects and into how effectively counter-measures mitigate adverse health outcomes. However, available research disallows to judge which counter-measure(s) of a current 'mix' should be prioritised for HCW. To arrive at evidence-based cost-effective prevention strategies, more well-conceived studies on the effectiveness of counter-measures are needed.
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Affiliation(s)
- J Valérie Gross
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital Cologne, Koln, Nordrhein-Westfalen, Germany
| | - Judith Mohren
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital Cologne, Koln, Nordrhein-Westfalen, Germany
| | - Thomas C Erren
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital Cologne, Koln, Nordrhein-Westfalen, Germany
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90
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Fu Y, Wang M, Zhao B, Liu B, Sun J, Feng Y, Wang Z, Li Q, Shi C, Xuan Y, Long S, Liu H, Chi T, Liao Z, Li B, Liu Q. Psychological Impact of COVID-19 Cases on Medical Staff of Beijing Xiaotangshan Hospital. Psychol Res Behav Manag 2021; 14:41-47. [PMID: 33500670 PMCID: PMC7822226 DOI: 10.2147/prbm.s287842] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/05/2020] [Indexed: 02/01/2023] Open
Abstract
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.
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Affiliation(s)
- Yuanbo Fu
- The Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, People's Republic of China
| | - Mina Wang
- The Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, People's Republic of China.,Beijing University of Chinese Medicine, Beijing 100029, People's Republic of China
| | - Bingcong Zhao
- The Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, People's Republic of China
| | - Baoli Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Jie Sun
- Beijing Xiao Tang Shan Hospital, Beijing 102200, People's Republic of China
| | - Yaohui Feng
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Zhengfang Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Qian Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Chunhong Shi
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Yabo Xuan
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Siqi Long
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
| | - Huan Liu
- Beijing Xiao Tang Shan Hospital, Beijing 102200, People's Republic of China
| | - Tiange Chi
- The First Clinical Medical School, Beijing University of Chinese Medicine, Beijing 100029, People's Republic of China
| | - Zehuan Liao
- School of Biological Sciences, Nanyang Technological University, Singapore 637551, Singapore.,Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm 17177, Sweden
| | - Bin Li
- The Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, People's Republic of China
| | - Qingquan Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, People's Republic of China
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91
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Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020601. [PMID: 33445712 PMCID: PMC7828167 DOI: 10.3390/ijerph18020601] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 12/12/2022]
Abstract
Prevention of post-traumatic stress symptoms (PTSS) in healthcare workers (HCWs) facing the current COVID-19 pandemic is a challenge worldwide as HCWs are likely to experience acute and chronic, often unpredictable, occupational stressors leading to PTSS. This review aims to analyze the literature to discover which topics have been focused on and what the latest developments are in managing the occupational risk of PTSS in HCWs during the current pandemic. For the purpose of this review, we searched for publications in MEDLINE/Pubmed using selected keywords. The articles were reviewed and categorized into one or more of the following categories based on their subject matter: risk assessment, risk management, occurrence rates. A total of 16 publications matched our inclusion criteria. The topics discussed were: “Risk Assessment”, “Occurrence Rates”, and “Risk Management”. Young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support were found to be predictors of PTSS. This review’s findings showed the need for urgent interventions aimed at protecting HCWs from the psychological impact of traumatic events related to the pandemic and leading to PTSS; healthcare policies need to consider preventive and management strategies toward PTSS, and the related psychic sequelae, in HCWs.
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92
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Kanstrup M, Singh L, Göransson KE, Widoff J, Taylor RS, Gamble B, Iyadurai L, Moulds ML, Holmes EA. Reducing intrusive memories after trauma via a brief cognitive task intervention in the hospital emergency department: an exploratory pilot randomised controlled trial. Transl Psychiatry 2021; 11:30. [PMID: 33431807 PMCID: PMC7798383 DOI: 10.1038/s41398-020-01124-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
Intrusive memories are common after trauma, and can cause significant distress. Interventions to prevent/reduce the occurrence of this core clinical feature of posttraumatic stress disorder are needed; they should be easy to deliver, readily disseminated and scalable. A novel one-session intervention by Iyadurai et al. 2018, Molecular Psychiatry, resulted in intrusion reduction over the subsequent week. Its feasibility in a different setting and longer-term effects (>1 month) need investigation. We conducted an exploratory open-label pilot randomised controlled trial (RCT) to investigate the feasibility and effects of a brief behavioural intervention to reduce intrusive memories in trauma-exposed patients in a Swedish hospital emergency department (ED). Participants (final N = 41) were randomly allocated to either intervention (including memory reminder cue then visuospatial cognitive task "Tetris" with mental rotation instructions) or active control (podcast) condition within 72 h of presenting to the ED (both conditions using their smartphone). Findings were examined descriptively. We estimated between-group effect sizes for the number of intrusive memories post-intervention at week 1 (primary outcome) and week 5 (secondary outcome). Compared to the control condition, participants in the intervention condition reported fewer intrusive memories of trauma, both at week 1 and week 5. Findings extend the previous evaluation in the UK. The intervention was readily implemented in a different international context, with a mixed trauma sample, with treatment gains maintained at 1 month and associated with some functional improvements. Findings inform future trials to evaluate the capacity of the cognitive task intervention to reduce the occurrence of intrusive memories after traumatic events.
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Affiliation(s)
- Marie Kanstrup
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Functional Area Medical Psychology, Karolinska University Hospital, Stockholm, Sweden.
| | - Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Katarina E Göransson
- Emergency and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Julia Widoff
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - Beau Gamble
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW Sydney, Sydney, Australia
| | - Emily A Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
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93
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De Kock JH, Latham HA, Leslie SJ, Grindle M, Munoz SA, Ellis L, Polson R, O’Malley CM. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health 2021; 21:104. [PMID: 33422039 PMCID: PMC7794640 DOI: 10.1186/s12889-020-10070-3] [Citation(s) in RCA: 401] [Impact Index Per Article: 133.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis. METHODS We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration's recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic. RESULTS The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes. CONCLUSIONS The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended.
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Affiliation(s)
- Johannes H. De Kock
- University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
- NHS Highland, Department of Clinical Psychology, New Craigs Hospital, Inverness, IV3 8NP UK
| | - Helen Ann Latham
- NHS Highland, Nairn Healthcare Group, Cawdor Rd, Nairn, IV12 5EE UK
| | - Stephen J. Leslie
- NHS Highland, NHS Highland Cardiac Unit Raigmore Hospital, Inverness, IV2 3UJ UK
| | - Mark Grindle
- University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
| | - Sarah-Anne Munoz
- University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
| | - Liz Ellis
- University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
| | - Rob Polson
- University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
| | - Christopher M. O’Malley
- University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
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94
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De Leo A, Cianci E, Mastore P, Gozzoli C. Protective and Risk Factors of Italian Healthcare Professionals during the COVID-19 Pandemic Outbreak: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E453. [PMID: 33430022 PMCID: PMC7826805 DOI: 10.3390/ijerph18020453] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/29/2020] [Accepted: 01/05/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic put the Italian health system under great stress. The sudden reorganization of work practices and the emotional impact of the large number of the victims had many consequences on the well-being of the healthcare professionals (HCPs) involved in managing the crisis. In the available literature, most studies have focused on the risk aspects while only few studies also take into account protective factors. For this reason, it was decided to conduct, within psycho-sociological perspective, a qualitative study with the aim to explore in depth the protective and risk factors as experienced by HCPs who worked in the Italian healthcare system during the COVID-19 outbreak. A total of 19 semi-structured interviews were conducted with HCPs-9 nurses and 10 physicians (7M and 12F) with an average age of 43 (SD = 13.4)-selected using snowball sampling. Considering three different levels of analysis the results highlight the protective and risk factors: personal history level (intrinsic/ethical motivation and flexible role versus extrinsic motivation and static role), interpersonal level (perception of supportive relationships with colleagues, patients, and family versus bad relationships), and organizational level (good leadership and sustainable work purpose versus absence of support from management and undefined or confused tasks).
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Affiliation(s)
- Amalia De Leo
- Department of Psychology, Università degli studi della Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Eloisa Cianci
- Department of Psychology, Cattolica University, 20123 Milan, Italy; (E.C.); (P.M.); (C.G.)
| | - Paolo Mastore
- Department of Psychology, Cattolica University, 20123 Milan, Italy; (E.C.); (P.M.); (C.G.)
| | - Caterina Gozzoli
- Department of Psychology, Cattolica University, 20123 Milan, Italy; (E.C.); (P.M.); (C.G.)
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95
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Wang L, Nabi G, Zuo L, Wu Y, Li D. Impacts of the COVID-19 Pandemic on Mental Health and Potential Solutions in Different Members in an Ordinary Family Unit. Front Psychiatry 2021; 12:735653. [PMID: 35087429 PMCID: PMC8787187 DOI: 10.3389/fpsyt.2021.735653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/07/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
- Limin Wang
- Ministry of Education Key Laboratory of Molecular and Cellular Biology, Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - Ghulam Nabi
- Ministry of Education Key Laboratory of Molecular and Cellular Biology, Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - Lirong Zuo
- Ministry of Education Key Laboratory of Molecular and Cellular Biology, Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - Yuefeng Wu
- Ministry of Education Key Laboratory of Molecular and Cellular Biology, Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - Dongming Li
- Ministry of Education Key Laboratory of Molecular and Cellular Biology, Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
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96
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Bendau A, Ströhle A, Petzold MB. Mental Health in Health Professionals in the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:737-757. [PMID: 33973209 DOI: 10.1007/978-3-030-63761-3_41] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed enormous challenges to the healthcare systems worldwide, which are mainly shouldered by healthcare workers from all professions. This chapter outlines the potential stressors of the COVID-19 pandemic for health professionals and describes possible consequences for their mental health as well as potential interventions and coping strategies. The chapter is based on preliminary research on the psychosocial implications of the COVID-19 pandemic in health professionals and is complemented by findings from previous outbreaks of high-risk infectious diseases. High proportions of healthcare workers report acute symptoms of anxiety, depression, high psychological stress, and insomnia in the context of the COVID-19 pandemic. Coping strategies and self-care on an individual level, interventions on an institutional level such as specific training and institutional support, as well as social and psychological support can help to mitigate psychological strain. Further reliable and prospective studies regarding the mental health of health professionals, as well as further measures to protect their short- and long-term mental health, are required.
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Affiliation(s)
- Antonia Bendau
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Moritz Bruno Petzold
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
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97
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Holmes MR, Rentrope CR, Korsch-Williams A, King JA. Impact of COVID-19 Pandemic on Posttraumatic Stress, Grief, Burnout, and Secondary Trauma of Social Workers in the United St ates. CLINICAL SOCIAL WORK JOURNAL 2021; 49:495-504. [PMID: 33678920 PMCID: PMC7922703 DOI: 10.1007/s10615-021-00795-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 05/20/2023]
Abstract
The purpose of this study is to measure posttraumatic stress, grief, burnout, and secondary trauma experienced by employed social workers in the United States and to describe organizational support provided to social workers during the novel coronavirus disease 2019 (COVID-19) pandemic. This study used data from the first wave of the COVID-19 Pandemic and Emotional Well-Being Study, a prospective panel study examining the psychological impact of the COVID-19 pandemic, and includes a sample of 181 social workers. We conducted univariate analyses. Over a quarter (26.21%) of social workers met the diagnostic criteria for PTSD and 16.22% reported severe grief symptoms. While 99.19% of the sample reported average to high compassion satisfaction, 63.71% reported average burnout and 49.59% reported average secondary trauma. Findings indicate that social workers are reporting higher than national estimates of PTSD, indicating a greater need for more emotional support during the COVID-19 pandemic. Given the significance and severity of the pandemic, it is essential that organizations provide resources for both immediate and ongoing support for the emotional well-being of their employees.
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Affiliation(s)
- Megan R. Holmes
- Center On Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied, Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-7164 USA
| | - C. Robin Rentrope
- Center On Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied, Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-7164 USA
| | - Amy Korsch-Williams
- Center On Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied, Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-7164 USA
| | - Jennifer A. King
- Center On Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied, Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-7164 USA
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98
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Miranda FBG, Yamamura M, Pereira SS, Pereira CDS, Protti-Zanatta ST, Costa MK, Zerbetto SR. Sofrimento psíquico entre os profissionais de enfermagem durante a pandemia da COVID-19: Scoping Review. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo mapear sistematicamente a produção de conhecimento, com a literatura nacional e internacional, de situações de sofrimento psíquico que os profissionais de enfermagem vivenciam quando expostos à pandemia da COVID-19. Método Scoping Review conforme Joanna Briggs Institute Reviewer's Manual for Scoping Reviews e PRISMA-ScR. Executaram-se buscas nas bases eletrônicas entre abril e junho de 2020, por intermédio dos descritores. Revisores aos pares analisaram a relevância dos estudos, selecionando os que responderam à pergunta de investigação. Resultados selecionaram-se 38 estudos. As situações de sofrimento psíquico mais relatadas relacionaram-se à sobrecarga de trabalho, escassez ou ausência de equipamento de proteção individual, medo de se infectar, infectar outras pessoas e estar na linha de frente junto a pacientes com diagnóstico ou suspeita de COVID-19. Os sinais e sintomas de sofrimento psíquico mais encontrados foram ansiedade, depressão, insônia, estresse, estresse pós-traumático e medo. Conclusões e implicações para a prática os profissionais de enfermagem enfrentam situações de sofrimento psíquico, principalmente desencadeadas por fatores relacionados às condições de trabalho, manifestando sintomas depressivos, de ansiedade e de estresse, que podem permanecer por longo período. As instituições de saúde precisaram implementar ações de capacitação, proteção e segurança, bem como suporte e apoio psicossocial em curto espaço de tempo.
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99
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Bender AE, Berg KA, Miller EK, Evans KE, Holmes MR. "Making Sure We Are All Okay": Healthcare Workers' Strategies for Emotional Connectedness During the COVID-19 Pandemic. CLINICAL SOCIAL WORK JOURNAL 2021; 49:445-455. [PMID: 33456094 PMCID: PMC7798008 DOI: 10.1007/s10615-020-00781-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 05/11/2023]
Abstract
Healthcare workers have been on the front lines throughout the COVID-19 pandemic, treating affected patients and navigating overwhelmed healthcare systems. Emotional connection has been associated with resilient outcomes following collective trauma. This qualitative study examined how healthcare workers define emotional connectedness during the COVID-19 pandemic and their adaptive emotional connection strategies. Data were gathered through the first wave of the online COVID-19 Pandemic and Emotional Well-Being study, a prospective panel study of the psychological impact of COVID-19 on frontline workers and the general public. This study focused on three extended-response questions about definitions of and strategies for emotional connectedness. Data were analyzed using reflexive thematic analysis. Participants conceptualize emotional connectedness as having empathy and value, help and support, presence, and vulnerability. They also describe emotionally connected relationships as being characterized by mutuality and frequent contact. Participants identify current behavioral strategies for cultivating emotional connectedness, such as using technology, providing instrumental help or sending gifts via mail, and building quality time within their households. They also report challenges in maintaining these connections. Future research must contribute knowledge about effective interventions for essential healthcare workers in the aftermath of COVID-19. Specific recommendations for social work practitioners are also discussed.
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Affiliation(s)
- Anna E. Bender
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7164 USA
| | - Kristen A. Berg
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7164 USA
- Center for Health Care Research and Policy, The MetroHealth System, 2500 MetroHealth Dr., Cleveland, OH 44109 USA
| | - Emily K. Miller
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7164 USA
| | - Kylie E. Evans
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7164 USA
| | - Megan R. Holmes
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7164 USA
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100
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Hao Q, Wang D, Xie M, Tang Y, Dou Y, Zhu L, Wu Y, Dai M, Wu H, Wang Q. Prevalence and Risk Factors of Mental Health Problems Among Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:567381. [PMID: 34211406 PMCID: PMC8239157 DOI: 10.3389/fpsyt.2021.567381] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 05/10/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: The purpose of this meta-analysis was to summarize the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Methods: We applied an optimized search strategy across the PubMed, EMBASE, Scopus, PsycINFO, and four Chinese databases, with hand searching supplemented to identify relevant surveys. Studies were eligible for inclusion if they were published in peer-reviewed literature and used a validated method to assess the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Heterogeneity was quantified using Q statistics and the I 2 statistics. The potential causes of heterogeneity were investigated using subgroup analysis and meta-regression analysis. Sensitivity analysis was performed to examine the robustness of the results. Results: We pooled and analyzed data from 20 studies comprising 10,886 healthcare workers. The prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive-compulsive symptoms, and somatization symptoms was 24.1, 28.6, 44.1, 25.6, 35.0, 16.2, and 10.7%, respectively. Female and nurses had a high prevalence of depression and anxiety. Frontline healthcare workers had a higher prevalence of anxiety and a lower prevalence of depression than the those in the second-line. Furthermore, the proportion of moderate-severe depression and anxiety is higher in the frontline. Additionally, four studies reported on risk factors of mental health problems. Conclusions: In this systematic review, healthcare workers have a relatively high prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive-compulsive symptoms, and somatization symptoms during the COVID-19 pandemic, and focus should be on the healthcare workers at high risk of mental problems. Mental health problems in healthcare workers should be taken seriously, and timely screening and appropriate intervention for the high-risk group are highly recommended. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179189.
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Affiliation(s)
- Qinjian Hao
- The Center of Gerontology and Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Dahai Wang
- Department of Psychiatry, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, China
| | - Min Xie
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yiguo Tang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yikai Dou
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Ling Zhu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yulu Wu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Minhan Dai
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Hongmei Wu
- The Center of Gerontology and Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
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