Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Support for Nursing Home Caregivers During the COVID-19 Pandemic: A Review

PURPOSE

To review support systems for nursing home caregivers (NHCGs) that were implemented during the first year of the coronavirus disease 2019 (COVID-19) pandemic.

METHOD

Database searches in PubMed, ScienceDirect, and CINAHL resulted in five publications.

RESULTS

Studies differed in design, interventions, and outcomes. An urgent eye movement desensitization and reprocessing protocol was feasible and effective among nurses in services highly mobilized during the acute phase of the pandemic. The "self-help plus" psychological intervention was not associated with significant reductions in anxiety or posttraumatic symptoms but prompted exploration of non-specific factors influencing its effectiveness. The Extension for Community Healthcare Outcomes in Long-Term Care of the Elderly virtual program increased confidence among NHCGs. Self-compassion training was associated with positive changes for certified nursing assistants. Weekly debriefing sessions implemented at one hospital highlighted pathogenic and salutogenic factors.

CONCLUSION

The COVID-19 pandemic had a marked psychosocial impact on NHCGs and necessitated targeted interventions. Despite their limitations, these promising studies provided insights into potential support avenues. Policy considerations should stress the pivotal role of advanced practice nurses in shaping supportive work environments. Future research should focus on robust assessments of the efficacy of psychosocial interventions for NHCGs facing ongoing challenges posed by the pandemic, and even recurrent viral epidemics. [Journal of Gerontological Nursing, 50(10), 24-33.].

The Motivation for COVID-19 Vaccination and Preventive Behavior

COVID-19, a viral infection that emerged in late 2019, induces a severe acute respiratory syndrome marked by significant clinical symptoms, and the potential for progressive respiratory failure and death. People facing the threat of COVID-19 not only feared being infected, but were also worried about the side-effects of vaccination. This conflict affected their epidemic prevention behavior. To understand this issue, the present study explored whether infection anxiety affected the psychological avoidance or approach to getting vaccinated and the intention to take epidemic prevention measures. The study implemented a cross-sectional, web-based survey. We created questionnaires using Surveycake, an online e-form questionnaire platform. We used the snowball sampling method via a social media app to recruit participants. If individuals were willing to participate in the research, we emailed the e-form questionnaire link to them to collect data. After questionnaire collection, 288 questionnaires were returned, and 277 valid questionnaires were obtained for structural equation modeling analysis. According to the statistical results, it was found that infection anxiety was positively related to avoidance-avoidance conflict, and the power of infection anxiety on avoidance conflict was 23.0%. Infection anxiety was negatively related to approach-approach conflict regarding vaccination, and the power of infection anxiety on approach-approach conflict was 22.0%. Approach-approach conflict regarding vaccination was negatively related to prevention behavior, while avoidance-avoidance conflict regarding vaccination was positively related to prevention behavior. The two conflicts explained 12.5% of the total variance in prevention behavior. The study results highlight the long-term importance of achieving vaccine goals in order to prepare for future health emergencies similar to the recent COVID-19 pandemic.

The Mental Burden of the COVID-19 Pandemic: A Retrospective Post-pandemic View From a Romanian Sample

BACKGROUND

The enduring psychological effects of the COVID-19 pandemic continue to affect individuals long after the immediate health concerns have subsided. This research aims to identify specific groups within the Romanian population who are at a higher risk of experiencing mental health challenges that can interfere with everyday life and may lead to more serious mental health disorders.

METHODS

Conducted as a cross-sectional survey, this study assessed the severity of psychological distress using the Depression, Anxiety, and Stress Scale-21 (DASS-21) questionnaire in relation to COVID-19-related information and socio-demographic data to investigate the factors associated with psychological distress during the COVID-19 pandemic in Romania.

RESULTS

Analysis of 521 questionnaires, filled out by a predominantly middle-aged cohort of 320 women and 201 men (mean age = 42.24, SD = 11.96), revealed that 63.72% of participants worked outside the healthcare field. Those unemployed or retired reported significantly higher anxiety levels than individuals in other sectors. Moreover, living alone, experiencing the loss of close relatives (6.14%) or friends (33.59%), and undergoing hospitalization or reinfection due to COVID-19 were linked to significantly elevated distress scores.

CONCLUSION

By identifying the segments of the population most vulnerable to psychological distress, as evidenced by higher scores among the unemployed, retirees, individuals living alone, and those directly affected by COVID-19 through personal health or loss, targeted initiatives for psychological screening and therapy can be established. Such measures are essential for enhancing the post-pandemic mental well-being of Romanians, addressing the specific needs uncovered in this study. These findings are limited by the study type and sample size; therefore, more extensive, longitudinal research conducted on a larger population sample is necessary.

Parental marital status and anxiety symptoms in adolescents: the mediating effect of childhood maltreatment

Although previous studies have established the association between parental marital status and mental health problems in adolescents, however, the adverse effects of incomplete family settings and childhood maltreatment on adolescent anxiety symptoms have not been fully investigated. Moreover, whether childhood maltreatment can mediate the relationship between parental marital status and anxiety symptoms remains unclear. A population-based cross-sectional study was performed among 35,573 adolescents in elementary schools across 17 provinces in China. And childhood maltreatment, resilience, and anxiety symptoms were assessed among adolescents, respectively. The parental marital status was self-reported as having two married biological parents, divorced parents, stepparents, and single-parent. We found that the rates of anxiety symptoms among adolescents were 35.1% in intact families, 48.8% in divorced families, 49% in stepparent families, and 48% in single-parent families. Divorced parents (aOR = 1.191, 95% CI [1.060-1.337]) was an independent risk factor for adolescents' anxiety symptom while having stepparents and single-parent were not. In addition, emotional abuse (aOR = 1.300, 95% CI [1.285-1.316]), sexual abuse (aOR = 1.088, 95% CI [1.063-1.114]), and physical neglect (aOR = 1.019, 95% CI [1.007-1.031]) were all independent risk factors for anxiety symptoms in adolescents, while physical abuse and emotional neglect were not. The negative impacts of divorced and remarried parents on adolescent anxiety symptoms were mediated by childhood maltreatment partially (64.9% and 72.2%), while childhood maltreatment completely mediated the adverse impacts of single-parent on adolescent anxiety symptoms. Childhood maltreatment intervention strategies could be necessary for anxiety symptoms of adolescents in divorced/stepparent/single-parent families.

COVID-19 and stroke in women: impact on clinical, psychosocial and research aspects

Despite the growing interest in gender medicine, the influence of sex and gender on human diseases, including stroke, continues to be underestimated and understudied. The COVID-19 pandemic has overall impacted not only the occurrence and management of stroke but has also exacerbated sex and gender disparities among both patients and healthcare providers. This paper aims to provide an updated overview on the influence of sex and gender in stroke pathophysiology and care during COVID-19 pandemic, through biological, clinical, psychosocial and research perspectives. Gender equity and awareness of the importance of sexual differences are sorely needed, especially in times of health crisis but have not yet been achieved to date. To this purpose, the sudden yet worldwide diffusion of COVID-19 represents a unique learning experience that highlights critical unmet needs also in gender medicine. The failures of this recent past should be kept as food for thought to inspire proper strategies reducing inequalities and to address women's health and wellbeing issues, particularly in case of future pandemics.

Nurses' perceptions of medical service robots in negative-pressure isolated wards and in general wards: A cross-sectional survey

AIM

To evaluate nurses' workload during the coronavirus disease 2019 (COVID-19) pandemic and to identify their perception of medical serviced robots (MSRs) that may help with or replace the tasks of nurses in negative-pressure isolated wards and general wards.

DESIGN

Cross-sectional survey.

METHODS

A researcher-made questionnaire was applied that assessed nurses' current workload and their attitudes towards and perceptions of MSRs. A visual analogue scale (VAS) from 1 to 10 was used to assess workload. Perceptions evaluated on a 5-point Likert scale ranging from one point for 'strongly disagree' to five points for 'strongly agree'. A higher VAS score indicated a higher workload. On the other hands, a higher Likert score indicated a more positive perception and three points was neutral. The questionnaire was conducted on 150 nurses in negative-pressure isolated wards for the management of COVID-19 and 150 nurses in general wards. Quota sampling technique was used as sampling technique. Data analysis was performed through independent t-tests, chi-square tests and two-tailed tests. The p-value <0.05 was interpreted to statistically significant.

RESULTS

Two hundred eighty-two participants responded and 142 belonged to the negative-pressure isolated ward. The overall response rate was 94%, and 94.7% in the negative isolated ward. The mean score ± standard deviation for nursing-related psychological stress at the current work site was 7.18 ± 1.58 points, and the mean score for physical workload was 7.65 ± 1.48. The need for MSRs was rated as 3.66 ± 0.86 out of 5. Overall, a positive attitude towards MSRs was confirmed, with no difference between ward groups. The overall ratings were 3.14 ± 1.15 for perceived availability and 3.26 ± 1.13 for perceived efficiency. Both nurse groups perceived that MSRs were most available and efficient for monitoring and measurements. Nurses in negative-pressure isolated wards perceived MSRs more positively than did nurses in general wards regarding setting of alarms (p = 0.003) and delivery of medical devices/materials (p = 0.013). Based on these results, functional development of MSRs associated with monitoring, measurements, setting of alarms and delivery should be prioritized. No patient or public contribution.

One year of COVID-19: A longitudinal study of individual and relational factors of psychological adjustment of individuals living in a romantic relationship in Portugal during the COVID-19 pandemic

This longitudinal study explored the impact of COVID-19 on individuals in romantic relationships. The sample spans three waves: first confinement (n = 52), deconfinement (n = 49), and second confinement (n = 26). The study tested sociodemographic factors, psychological adjustment (anxiety, depression, stress, well-being), COVID-19 threat perception, dyadic coping, and relationship quality. Results from repeated measures ANOVA and fuzzy set qualitative comparative analysis (fsQCA) models revealed a decline in anxiety, depression, and stress symptoms, coupled with improved relationship quality over time. Well-being and dyadic coping remained stable, while COVID-19 threat perception increased. QCA models emphasized the predictive power of initial mental states (anxiety, depression, stress, and well-being at W1) on subsequent adjustment. Notably, shorter relationship duration, healthcare worker status, and not having children, when combined with prior mental states, explained increased symptoms and diminished well-being. The study underscores the significance of addressing these factors in individuals navigating romantic relationships during the pandemic.

Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach

PURPOSE

This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach.

DESIGN

A cross-sectional design including an online self-reported questionnaire survey was used.

METHODS

A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS.

FINDINGS

Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences.

CONCLUSIONS

Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses' perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses' help-seeking preferences and behaviors to reduce mental illness during public health emergencies.

CLINICAL EVIDENCE

Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.

The Mediation Roles of Coping Modalities on the Relationship Between Stress and Quality of Life Among Jordanian Nurses

Nurses are at the frontline, dealing with people's most immense healthcare needs in stressful and demanding work environments. Consequently, it is essential to thoroughly examine how various coping mechanisms might affect the relationship between stress and quality of life (QOL). This study aimed to examine the mediation effect of both problem-focused coping (PFC) and emotion-focused coping (EFC) mechanisms on mitigating the effect of stress on the QOL among Jordanian nurses. A multisite cross-sectional descriptive correlational design was used in this study. An online survey was completed by 203 nurses using a convenience sampling technique between October 2023 and January 2024. The study included nurses working in different Jordanian healthcare sectors including governmental, private, and university-affiliated hospitals. Several measures were used to collect data, including questionnaires on sociodemographics, QOL, coping, and stress. Two models were hypothesized for this study. The two models were analyzed using Andrew Hayes Process Macro Model 4 for testing the mediation effects. Additionally, descriptive and correlational analyses were run prior to the main analysis. The results showed that coping significantly mediated the relationship between stress and QOL with variations between PFC and EFC. In conclusion, psychological distress symptoms were common among Jordanian nurses; psychological distress, coping, and QOL are correlating variables. Nurses' stress levels and coping modalities can predict QOL with a superior effect of PFC compared with EFC. Strategies should be put in place to improve effective coping to improve nurses' QOL. The results of this study have important implications for nursing education, practice, future research, and policy.

What Mattered Most: Personal, Work-Related, and Psychopathological Characteristics Associated with Healthcare Workers' Impairment of Functioning during COVID-19

Background: The COVID-19 pandemic greatly impacted healthcare workers (HWs) around the world. Italy was the first Western country hit by the pandemic, and several studies have been published targeting the mental health burden held by Italian HWs. Notwithstanding, only a few studies focused on the impact of COVID-19 on HWs' levels of functioning. Methods: An online survey was distributed to HWs in Italy through physicians' and nurses' associations, social networks, and researchers' direct contacts, between 4 April and 13 May 2020. Participants provided sociodemographic, work-related, and pandemic-related data and filled out a set of psychometric questionnaires (Patient Health Questionnaire-9-PHQ-9, General Anxiety Disorder-7-GAD-7, Impact of Event Scale-Revised-IES-R, and Work and Social Adjustment Scale-WSAS). Results: The final sample included 1041 HWs (mean age 45.01 ± 11.62, 63.9% females). In total, 58.1% of the subjects screened positive on the GAD-7, 27.5% on the PHQ-9, and 25.9% on the IES-R. Furthermore, 67.4% showed a significant level of impairment in functioning according to the WSAS, while 35.8% reached scores of moderate or worse impairment. In the multiple linear regressions, screening positive on any of the psychometric scales and being exposed to unusual suffering significantly predicted worse scores in all WSAS domains (p < 0.05). Having a history of mental disorders significantly predicted worse scores in the WSAS domain of work ability (p = 0.002), while being the parent of children younger than 18 years significantly predicted worse WSAS family functioning scores (p < 0.001). Conclusions: Our results corroborate extant data about the impact of the COVID-19 pandemic on HWs' mental health and shed light on its detrimental effect on functioning. Tailored interventions should be designed in order to support HWs during times of crisis.

Depression, Anxiety, and Psychological Resilience in Healthcare Workers during the Pandemic (COVID-19)

BACKGROUND/OBJECTIVES

The aim of this study is to examine the relationship between depression, anxiety, and psychological resilience variables with working conditions and various demographic variables in healthcare professionals who are actively involved in the pandemic process.

METHODS

This study included 1440 healthcare workers in different professions in two state hospitals accepted as pandemic hospitals. The research data were collected with the Sociodemographic Data Form, Hospital Anxiety and Depression Scale (HAD), and Psychological Resilience Scale (PRS). Independent samples t-test, one-way analysis of variance (ANOVA), and descriptive analyses were used to analyze the data.

RESULTS

As a result of the analyses, female participants had higher anxiety scores than male participants; healthcare professionals working as nurses, midwives, and health officers had higher anxiety scores than other healthcare professionals; those with less professional experience had higher anxiety scores than those with more professional experience; and those who had long hours of contact with COVID-19-positive patients (8 h or more per day) had higher anxiety scores than those with less contact. Single female healthcare workers reported higher depression symptoms than married female healthcare workers, those with children reported higher depression symptoms than those without children, and those with average professional experience (6-10 years) reported higher depression symptoms than those with more experience. Being single, having children, and having an average number of shifts (working at night) caused an increase in psychological resilience.

CONCLUSIONS

The results of the study may contribute to the structuring of health policies to protect and support the mental health of healthcare workers in ongoing and future pandemic processes.

The psychological impact of COVID-19 on front-line healthcare providers in the United Arab Emirates: A cross-sectional study

BACKGROUND

The COVID-19 pandemic has significantly impacted the psychological well-being of healthcare providers (HCPs) worldwide. Understanding the prevalence and associated factors of depression, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) among these providers is crucial. Assess the prevalence of major depression, GAD, and PTSD symptoms among HCPs in the United Arab Emirates (UAE) during the COVID-19 pandemic. Additionally, this study sought to identify demographic, work-related, and health-related factors associated with these psychological symptoms.

MATERIALS AND METHODS

A cross-sectional survey involving 992 HCPs across various healthcare institutions in the UAE was conducted. Participants were administered standardized assessment tools, including the Patient Health Questionnaire-9 (PHQ-9) for depression, the GAD-7) for GAD, and the Impact of Event Scale-Revised (IES-R) for PTSD. Independent t-tests and one-way analysis of variance (ANOVA) were employed to assess the prevalence and associated factors.

RESULTS

The findings revealed that approximately 19% of the participants exhibited significant symptoms of major depression (PHQ-9 ≥10), while 57.1% reported no significant anxiety symptoms, and 54.4% displayed minimal or no significant PTSD symptoms. Participants with COVID-19, family infections, and work overload showed higher depression, GAD, and PTSD symptoms. Married in-hospital workers significantly differed from single prehospital workers in psychological symptoms. Occupation, level of education, working department, and age significantly influenced the perceived severity of depression, GAD, and PTSD symptoms. Specifically, the ANOVA test revealed significant differences in depression (F = 3.01, P < 0.05), GAD (F = 11.4, P < 0.001), and PTSD symptoms (F = 3.6, P < 0.05) based on occupation. Nurses had higher depression (5.8 ± 7.4) and GAD (7.4 ± 6.6) scores, while physicians had elevated PTSD symptoms (22.4 ± 21.0). Participants with a bachelor's degree had significantly higher depression (7.0 ± 8.4), GAD (7.2 ± 7.4), and PTSD symptoms (22.9 ± 24.6) than those with diplomas or postgraduate degrees. In the intensive care unit (ICU), higher levels of depression (9.3 ± 9.1), GAD (7.6 ± 7.5), and PTSD symptoms (24.7 ± 25.4) were reported. Participants at the screening center had higher depression (5.4 ± 4.7) and PTSD symptoms (15.2 ± 16.8) than those in other prehospital departments. However, participants in PHCs reported higher levels of GAD symptoms (5.8 ± 7.1) compared to those at screening centers, and EMTs. Concerning age groups, participants between 50 and 60 years old experienced more depressive symptoms (8.3 ± 6.7), while those aged 40-49 reported higher GAD (8.5 ± 7.3) and PTSD symptoms (27.0 ± 19.0).

CONCLUSION

This study underscores the importance of proactive mental health support and tailored interventions for HCPs. It highlights the need for workload management and work-life balance, as well as personalized support for those directly affected by COVID-19. Moreover, it emphasizes the significance of pandemic preparedness and comprehensive training for HCPs. The study findings contribute to a deeper understanding of the diverse factors influencing the psychological well-being of HCPs during public health crises.

[Prevalence and underdiagnosis of burn out syndrome in critical services in the context of the COVID-19 pandemic]

Introduction: The importance of knowing the impact of work on people's health has increased after the COVID-19 pandemic. Burn Out (BO) syndrome arises from the tension emerging from the conflictive interaction between the worker and his or her employment. The objective was to describe the prevalence and frequency of diagnosis of BO in the health human resources of critical services of the Bahía Blanca Municipal Hospital in the context of the COVID-19 pandemic.Methods: Descriptive, cross-sectional study. The study population was the medical and nursing staff of the Intensive Care (IT), Emergency Medicine (SMU) and Clinic services who worked with COVID-19 during 2021. The Maslach Burnout Inventory (MBI) questionnaire was used and complementary closed questions to identify, among these cases, those that were diagnosed and treated by the institution.Results: Of the 219 workers, 55.3% (121/219) were nurses. In the SMU, 25% (24/96) of respondents had BO, followed by 20.4% (11/54) in Clinic and 8.7% (6/69) in IT (p value=0.004). Only 5.5% (12/219) of the total were diagnosed with BO by the institution and of this group, two people (0.9%) had previously consulted for characteristic symptoms.Discussion: A high prevalence of BO and a marked underdiagnosis were evident at the institutional level during the pandemic. Although the IT Service had the highest demand for attention, it was the one that presented the lowest BO values in relation to other services.

Efficacy and feasibility of a novel semi-facial respirator with chitosan nanoparticles on the incidence of SARS-CoV-2 infection in healthcare professionals: randomized controlled trial

BACKGROUND

Evidence suggests that semi-facial respirators provide protection against contamination in high-risk environments, although the COVID-19 pandemic called for greater protection and viral inactivation capacity. Thus, the aim of this study was to investigate the efficacy of a novel semi-facial respirator containing chitosan nanoparticles, compared with a conventional N95 respirator on the incidence of laboratory-confirmed SARS-CoV-2 in healthcare professionals. The secondary outcomes were influenza infection, usability and comfort.

METHODS

Randomized controlled trial within a large public hospital (reference for COVID-19 patients) carried out between March 2021 and June 2023. We included 230 healthcare professionals exposed to SARS-Cov-2 and influenza, working in emergency departments, hospital wards, and intensive care units. Participants were assessed at baseline, after 10 days, and 21 days of follow-up. Researchers, participants, and outcome assessors were blinded to the allocated groups. Outcomes were analyzed by bivariate and multivariate comparisons using logistic regression. Crude (cOR) and adjusted odds ratios (aOR) were estimated, followed by 95% confidence intervals (CIs 95%). We adopted intention-to-treat (ITT) and complete-case (CC) analyses.

RESULTS

Baseline characteristics were considered homogeneous between groups, and usability and comfort were reported as excellent in both groups. Non-significant differences were found for all outcomes, both in the ITT and CC analyses. The incidence of COVID-19 and influenza were, respectively, cOR: 0.96 [CI95%: 0.21-4.42] and cOR: 1.25 [CI95%: 0.34-4.62]; and aOR: 1.08 [CI95%: 0.21-5.47] and aOR: 1.11 [CI95%: 0.17-7.01].

CONCLUSIONS

We found that the incidence of SARS-Cov-2 and influenza infections were similar between the new respirator compared to the conventional respirator. Furthermore, we observed that usability and comfort were similar and considered excellent for both respirators.

TRIAL REGISTRATION

Clinicaltrials.gov (NCT04490200, 29/07/2020).

Predictors of Poor Mental Health Outcomes in Healthcare Workers during COVID-19: A Two Waves Study

Objective: This cross-sectional study aimed to identify potential predictors of poor mental health outcomes among healthcare workers in two different waves of the COVID-19 emergency in Italy. Methods: An online survey collected data from N = 557 healthcare workers (21-77 years). The study predictors were sociodemographic characteristics, occupational status, factors related to the work environment, COVID-19-related adverse events, and lifetime traumatic events. The poor mental health outcomes that were considered were depersonalization/derealization, anxiety, depression, and somatization symptoms. Results: The main predictors of poor mental health outcomes were sleeping less than six hours per night, inadequate protective equipment measures, female gender, personal and familiar infection, living alone, working as a nurse, and working in a COVID-19 ward. Healthcare workers in 2021 reported experiencing more serious accidents and stressful events than those of the first wave. Depressive symptoms and COVID-19-related adverse events were higher in the second pandemic outbreak than in the first. Conclusions: Preventive strategies against poor mental health outcomes should be particularly focused on female nurses who live alone, work in areas with high infection rates, and have experienced the COVID-19 infection personally or who are close to people that have experienced the infection.

Patient safety in the pandemic: Experiences of charge nurses

AIM

The aim of this study was to identify charge nurses' experiences ensuring patient safety during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

The research was conducted with charge nurses between July 2021 and February 2022. Research data were collected using a semi-structured interview with two main questions, six sub-questions and an audio recording. Interviews were conducted with 12 charge nurses and lasted ≈30 min. The content analysis method was used to transfer the collected data to written documents and define them to analyse the individual interview data. Content analyses were conducted independently by three different researchers. Inclusion and exclusion criteria for content were established to ensure consistency among all researchers. Researchers independently developed a coding scheme for content analysis based on the research objectives and applied it to the content. Intercoder reliability was assessed with Cohen's kappa coefficient to measure the consistency of coding among researchers.

RESULTS

Three main themes were identified as a result of the content analysis. The themes identified after independent examination by the three researchers were 'ensuring safety and protection', 'sustaining motivation and resilience' and 'organizational restructuring and challenges'.

CONCLUSIONS

This study highlights the challenges faced by charge nurses during the COVID-19 pandemic and their critical role in maintaining patient safety. The findings emphasize the importance of organizational adaptability, continuous motivation and comprehensive risk management strategies. Charge nurses played a key role in enhancing safety measures and fostering a culture of resilience among healthcare staff. Moving forward, these insights should guide health policies and practices to better prepare for future public health crises, ensuring the safety of both patients and staff.

Experiences of Health-Care Professionals Who Served the Migrant Workers During the COVID-19 Pandemic in Singapore and Its Impact on Morale: A Brief Report

OBJECTIVE

Coronavirus disease 2019 (COVID-19) has caused psychological distress among health-care professionals (HCP) worldwide, suggesting that morale could also be affected. This warrants further investigation as HCPs' morale directly impacts delivery of quality care and work productivity. This study aims to explore the experiences of HCPs who served migrant workers in a local COVID-19 hotspot in Singapore and the impact on their morale.

METHODS

Eleven volunteer HCPs from a regional hospital in Singapore who served migrant workers in a local COVID-19 hotspot were recruited. Semi-structured face-to-face interviews were conducted, and recordings were transcribed verbatim. Transcripts were analyzed using thematic analysis. Morale of HCPs was evaluated based on responses.

RESULTS

Four main themes emerged: motivators, challenges, support, and leadership. Motivators or factors that drove HCPs to serve include varying personal reasons and a sense of duty to do good. Challenges faced by HCPs include a language barrier, keeping up with rapidly changing workflows, fear of contagion, and coping with emotions. Support and leadership were revealed to have boosted HCPs' morale.

CONCLUSIONS

Peer and social support and effective leadership have potential protective effects on HCPs' morale against negative experiences faced during the COVID-19 pandemic.

Effects of multisession prefrontal cortex tDCS or taVNS on stress, perceived stress and sleep quality: a double-blind, randomized controlled study

Introduction

Chronic stress is a condition characterized by prolonged stimulation, leading to mental and physical weakness. It can have detrimental effects on individuals' mental health and cognitive function, potentially causing various health issues. This article explores the potential of non-invasive neuromodulation techniques, specifically transcranial direct current stimulation (tDCS) and transcutaneous auricular vagus nerve stimulation (taVNS), in managing chronic stress and improving sleep quality.

Methods

The study conducted a randomized, double-blinded, controlled trial with participants experiencing chronic stress. In total, 100 participants were randomly assigned to one of four conditions: the anodal tDCS group (n = 50), the sham tDCS group (n = 50), the taVNS group (n = 50), or the sham taVNS group (n = 50). Within each condition, participants received five sessions of either active treatment or sham treatment, with 20 min of tDCS over the dorsolateral prefrontal cortex (2 mA) for the tDCS groups, or taVNS on the left ear (20 Hz) for the taVNS groups. At baseline, post-intervention, and 4 weeks thereafter, we evaluated stress using the Lipp's Inventory of Stress Symptoms for Adults (LSSI), perceived stress through the Perceived Stress Scale (PSS-10), and sleep quality via the Pittsburgh Sleep Quality Index (PSQI).

Results

The tDCS and taVNS interventions resulted in reduced stress levels, improved sleep quality, and enhanced perception of stress.

Discussion

These findings suggest that tDCS and taVNS hold promise as effective treatments for chronic stress, offering a safe and accessible approach to improving individuals' wellbeing and overall quality of life.

Clinical trial registration

https://ensaiosclinicos.gov.br/rg/RBR-2ww2ts8, identifier UTN: U1111-1296-1810; Brazilian Registry of Clinical Trials (REBEC) RBR-2ww2ts8.

A Comparison of Psychological Distress and Coping Styles among Physicians and Nurses in a COVID-19 Referral Hospital in Manila: A Cross-sectional Study

Objectives

This study aimed to compare the levels of depression, anxiety, and stress, and the coping styles among physicians and nurses in a COVID-19 referral hospital in Manila from June to July 2020.

Methods

A cross-sectional study among medical residents and nurses selected via convenience sampling was employed. Data were obtained through COVID Stressors and Stress Reduction Questionnaire, Depression, Anxiety, and Stress Scale-21, and Filipino Coping Strategies Scale. Descriptive and inferential analysis of data was done.

Results

Five hundred seventy-one (571) healthcare workers (total population: 1,650 nurses and physicians) participated in the study, representing 81.6% of the computed sample size of 700 respondents. Among the participants, 60.6 %, 69.0%, 48.9% reported symptoms of depression, anxiety, and stress, respectively. Nineteen percent (19%) of nurses reported severe to extremely severe depression, and 42.0% reported severe to extremely severe anxiety. In contrast, 30.8% of residents reported severe to extremely severe depression, and 28.4% conveyed severe to extremely severe anxiety. There was no association observed between perceived levels of stress between the two healthcare professions.There were more mildly to extremely severe anxious healthcare workers in the COVID areas (74.6%) compared to the non-COVID areas (61.2%). Differences in coping styles were observed among the participants' clinico-demographic characteristics. Top healthcare worker stressors include being negligent and endangering co-workers (88.6%), frequent modification of infection control procedures (87.0%), and discomfort from protective equipment (81.4%). Top stress-reducing factors include provision of food and vitamins (86.7%), sufficient rest (84.2%), and support from higher-ranking colleagues (73.7%).

Conclusion

This study has shown that more than half of the healthcare workers reported mild to extreme levels of depression and anxiety, while a little less than half reported mild to extreme levels of stress. The development and implementation of hospital interventions and programs based on the sources of distress and stress-reducing factors is recommended to mitigate the impact of sustained psychological distress on mental health and physical wellbeing of hospital healthcare workers.

Association of depressive symptoms with incidence and mortality rates of COVID-19 over 2 years among healthcare workers in 20 countries: multi-country serial cross-sectional study

BACKGROUND

Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic.

METHODS

This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates.

RESULTS

A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017).

CONCLUSIONS

This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics.

TRIAL REGISTRATION

Clinicaltrials.gov, NCT04352634.

Depression and Anxiety among Migrant Older Adults during the COVID-19 Pandemic in China: Network Analysis of Continuous Cross-Sectional Data

Many Chinese migrant older adults are more prone to mental health problems due to their "migrant" status. During the COVID-19 pandemic, restrictions on their mobility exacerbated these conditions. Mental health is a crucial dimension of healthy aging. Network analysis offers a novel method for exploring interactions between mental health problems at the symptom level. This study employs network analysis to examine the interactions between comorbid depressive and anxiety symptoms across different stages of the COVID-19 pandemic. Surveys were conducted from September 2019 to January 2020 (T1), September 2020 to January 2021 (T2), and September 2021 onwards (T3). Depression and anxiety symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Expected Influence (EI) and Bridge Expected Influence (Bridge EI) were used to identify central and bridge symptoms in the network. Network stability and accuracy tests were performed. Among the Chinese migrant older adults, the anxiety prevalence was 18.50% at T1, 21.11% at T2, and 9.38% at T3. The prevalence of depression was 26.95% at T1, 55.44% at T2, and 60.24% at T3. The primary central symptoms included 'Afraid something will happen' (A2), 'Irritability' (A6), 'Panic' (A7), 'Feeling of worthlessness' (D6), 'Anhedonia' (D1), and 'Feeling of fear' (A5). The major bridge symptoms included 'Feeling of fear' (A5), 'Panic' (A7), 'Irritability' (A6), 'Fatigue' (D4), 'Anhedonia' (D1), and 'Depressed or sad mood' (D2). Differences in network structure were observed across the periods. The network analysis further revealed the evolving relationships between central and bridge symptoms over time, highlighting the importance of targeted intervention strategies for central and bridge symptoms of comorbid depression and anxiety at different periods.

Immediate shock and residual stress: Unmasking the dual dynamics of covid-19 on the mental health of health professionals in China

Background

The pandemic of 2019 has created large scale disruption around the globe. It has posed extraordinary hurdles for Chinese health workers, affecting their mental health with respect to situations in the present as well as the future. Recognising the dynamic features of these mental health issues among health professionals is critical for developing effective support systems.

Objectives

This study aims to explore the dual impact of COVID-19 on the mental health of health professionals in China, both during and after the pandemic; to explore the probable underlying factors causing these mental health issues; to identify both adaptive and maladaptive coping behaviours employed by the health personnel; and to assess the organisational and social support to mitigate the effect of the pandemic on the mental health of the Chinese health professionals.

Method

To address these objectives an explorative qualitative research design has been adopted involving analysis of previous researches in the relevant field.

Results

The study confirms anxiety, depression, sleep disorders, PTSD, and burnout among medical personnel as immediate shock and residual stress, along with its demographic variations. Few maladaptive coping behaviours have been identified that can lead to delayed psychological effects even after a pandemic.

Conclusion

The key findings underscore the complicated interaction of immediate and delayed mental health challenges among health professionals, advocating for the deployment of tailored treatments and policy modifications to address the ever changing needs of this vital workforce.

Well-Being Outcomes of Health Care Workers After a 5-Hour Continuing Education Intervention: The WELL-B Randomized Clinical Trial

Importance

Compromised well-being in health care workers (HCWs) is detrimental to the workforce, organizations, and patients.

Objective

To test the effectiveness of Well-Being Essentials for Learning Life-Balance (WELL-B), a web-based continuing education program to deliver brief, evidence-based, reflective, psychological interventions to improve 4 dimensions of HCW well-being (ie, emotional exhaustion, emotional thriving, emotional recovery, and work-life integration).

Design, Setting, and Participants

A randomized clinical trial (RCT) of US inpatient and outpatient HCWs randomized 1:1 was conducted from January 3 through May 31, 2023, using a web-based intervention. Cohort 1 received 5 hours of WELL-B over 8 days; cohort 2 acted as the control group and received WELL-B after the end of the RCT. Eligibility criteria were US HCWs aged 18 years or older, including clinical (physician, nurse, and respiratory therapist) and nonclinical (administrative, information technology, and finance) roles.

Interventions

Continuing education sessions exposed participants to positive psychology interventions (gratitude letter, work-life integration, self-compassion and cultivating awe).

Main Outcomes and Measures

The primary outcome was emotional exhaustion on day 8; secondary outcomes included emotional thriving, emotional recovery, and work-life integration. All outcomes were measured using psychometrically valid scales previously reported in well-being RCTs and were assessed on days 1 and 8 (primary end point). Differences in outcome measures between the WELL-B intervention group and controls were assessed using t tests. Baseline-adjusted multiple linear regression models were evaluated to examine the association between the WELL-B intervention and the outcome measures after adjusting for additional covariates (sex, race and ethnicity, age, HCW role, and discipline). Intention-to-treat analysis was performed.

Results

The cohorts were similar at baseline, mostly female (528 [89%]) and nurses (177 [30%]). A total of 643 respondents participated in the study. In cohort 1, 331 participants initiated WELL-B, and 262 (71%) completed the day 8 follow-up; in cohort 2, 312 participants initiated WELL-B and 291 (77%) completed the day 8 follow-up. Compared with the control cohort, WELL-B significantly improved emotional exhaustion (estimate: -9.0; 95% CI, -13.1 to -4.9; P < .001), emotional thriving (estimate: 6.6; 95% CI, 3.2-10.0; P < .001), emotional recovery (estimate: 5.5; 95% CI, 2.0-9.0; P = .002), and work-life integration (estimate: -5.0; 95% CI, -8.2 to -1.9; P = .002). After adjusting for baseline outcome measures, sex, race and ethnicity, age, HCW role, and discipline, the linear regression model showed WELL-B improved day 8 emotional exhaustion (estimate: -9.6; 95% CI, -12.5 to -6.6; P < .001) compared with the control group. Favorable impressions of WELL-B were reported by more than 90% of the participants.

Conclusions and Relevance

In this RCT, brief well-being activities delivered during continuing education sessions improved short-term HCW emotional exhaustion, emotional thriving, emotional recovery, and work-life integration, with and without adjusting for covariates. Health care worker impressions of WELL-B were positive. These findings suggest that WELL-B is a beneficial intervention.

Trial Registration

ClinicalTrials.gov Identifier: NCT05636072.

Prevalence and risk factors of Burnout syndrome among intensive care unit members during the second wave of COVID-19: a single-center study

OBJECTIVE

To evaluate the prevalence of burnout among the intensive care unit team of a university hospital after the second wave of COVID-19 and identify the key factors associated with its development.

METHODS

This single-center study included 395 employees from a multidisciplinary team. The participants completed a questionnaire based on the Maslach Burnout Inventory. Multivariate analysis was used to identify the factors associated with burnout.

RESULTS

Of 395 participants, 220 responded to the questionnaire (response rate: 56%). The prevalence of Burnout syndrome, defined as a severe score in at least one dimension, was 64.5% (142/220). Emotional distress was the most prevalent dimension, with a severe score affecting 50.5% (111/220) of the participants, followed by depersonalization at 39.1% (86/220). Only 5.9% (13/220) had severe scores in all three dimensions. Multivariate analysis revealed that being a physician was significantly associated with severe burnout symptoms in at least one dimension (odds ratio (OR), 1.32; 95% confidence interval (95%CI): 1.57-9.05; p=0.003). Additionally, having two or more jobs was associated with burnout in the three dimensions (OR=1.65; 95%CI=1.39-19.59; p=0.01).

CONCLUSION

This study highlights the alarming prevalence of burnout among intensive care unit teams, particularly among physicians, following the second wave of COVID-19. This emphasizes the need for targeted interventions and support systems to mitigate burnout and reduce its negative impact on healthcare professionals' well-being and patient care.

The role of prior trauma exposure and subsequent posttraumatic stress disorder in reactions to the COVID-19 pandemic: A qualitative study

OBJECTIVE

A growing body of literature suggests that the COVID-19 pandemic is a traumatic stressor capable of causing posttraumatic stress symptoms. People with a history of trauma, particularly those with posttraumatic stress disorder (PTSD), may be particularly vulnerable to the negative mental health impacts of the pandemic. However, qualitative research exploring potential differences in the lived experiences of and reactions to COVID-19 between people with and without PTSD is lacking.

METHOD

Semistructured interviews were conducted with 31 women (n = 15 women with probable PTSD, n = 16 women without probable PTSD) recruited from an ongoing U.S.-based cohort study. Themes were identified using inductive thematic analysis.

RESULTS

The majority of women with PTSD described their level of fear or perceived safety related to COVID-19 as a major factor influencing their mental health during the pandemic. In contrast, women without PTSD indicated that their level of distress was largely driven by pandemic-related restrictions on normal activities and family events. Many women with PTSD also described feeling anger or frustration toward people they perceived as not taking the COVID-19 pandemic seriously. Only one participant without PTSD expressed similar feelings.

CONCLUSIONS

This study found notable differences in reactions to the COVID-19 pandemic between people with and without PTSD, with findings that are likely relevant to future disasters. These findings can inform the development of preparedness policies for future disasters, pandemics, or other collective traumas to prevent distress and improve mental health, particularly for vulnerable populations such as individuals with preexisting PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Professional, educational and psychosocial impacts of the COVID-19 pandemic on pediatricians

OBJECTIVES

COVID-19 infection is not limited to medical aspects, but may have significant negative impacts on education, tourism, the economy as well as sociocultural, ethical, and legal aspects. We aimed to assess the multidimensional impact of the COVID-19 pandemic on pediatricians by examining their COVID-19 infection, domestic life and quarantine, as well as work patterns, educational activities, and psychosocial impact.

METHODS

An online survey consisted of seven sections and 68 questions was prepared through 'Google Forms.' The survey was sent via e-mail to physicians who are members of the National Pediatric Association of Turkey.

RESULTS

The pandemic has affected pediatricians working in our country in a multifaceted aspect. They experienced significant anxiety/depression/stress, 8% of them felt it at a pathological level and were receiving treatment, and women and young pediatricians were more vulnerable to the pandemic. The more adequately informed about the disease, the more prepared for COVID-19 and lower levels of psychological distress, which emphasizes the importance of education and institutional continuing support. Our study showed that academic education was seriously disrupted and the satisfaction rate with virtual education was low.

CONCLUSION

Although COVID-19 has less impact today, it has taught us that it is necessary to be ready for new pandemics in the future. The required measures should be taken urgently and effectively healthcare professionals should follow a rational and applicable disaster plan.

The Resilience Hub approach for addressing mental health of health and social care workers during the COVID-19 pandemic: a mixed-methods evaluation

Background

Resilience Hubs provide mental health screening, facilitation of access and direct provision of psychosocial support for health and social care keyworkers in England affected by the coronavirus disease 2019 pandemic.

Aim

To explore implementation of the Hubs, including characteristics of staff using the services, support accessed, costing data and a range of stakeholder perspectives on the barriers and enablers to Hub use and implementation of staff well-being support within the context of the pandemic.

Design

Mixed-methods evaluation.

Setting

Four Resilience Hubs.

Methods

Findings were integrated via mixed-method case studies, including: analyses of Hub mental health screening (N = 1973); follow-up questionnaire data (N = 299) on service use and health status of Hub clients; economic information provided by the Hubs; 63 interviews with Hub staff, wider stakeholders, Hub clients and keyworkers who did not use the Hubs.

Results

Findings were consistent across Hubs and workstreams. Most Hub clients were NHS staff. Under-represented groups included men, keyworkers from minority ethnic communities, care homes and emergency services staff. Clients reported comorbid mental health needs across multiple domains (anxiety; depression; post-traumatic stress; alcohol use; functioning). Their health status was lower than population norms and relevant pre-pandemic data. Several factors predicted higher needs, but having pre-pandemic emotional well-being concerns was one of the most robust predictors of higher need. Sixty per cent of participants who completed follow-up questionnaires reported receiving mental health support since Hub screening, most of which was directly or indirectly due to Hub support. High levels of satisfaction were reported. As in many services, staffing was the central component of Hub cost. Hubs were predominantly staffed by senior clinicians; this staffing model was consistent with the generally severe difficulties experienced by clients and the need for systemic/team-based working. Costs associated with health and social care use for Hub clients were low, which may be due to barriers to accessing support in general. Enablers to accessing Hubs included: a clear understanding of the Hubs, how to self-refer, and managerial support. Barriers included confusion between Hubs and other support; unhelpful beliefs about job roles, unsupportive managers, negative workplace cultures and difficulties caused by systemic issues. Some keyworkers highlighted a perceived need for further diversity and cultural competency training to improve reach to under-represented communities. Other barriers for these groups included prior negative experiences of services, structural inequalities and stigma. Some wider stakeholders had concerns around growing waiting times for Hub-provided therapy, and insufficient data on Hub usage and outcomes. Feedback was otherwise very positive.

Limitations

Main limitations included lack of comparative and pre-pandemic/baseline data, small numbers from under-represented groups limiting fine-grained analysis, and participant self-selection.

Conclusions

Findings highlighted the value of the Hub model of outreach, screening, support navigation and provision of direct support during the coronavirus disease 2019 pandemic, and as a potential model to respond to future crises. The research provided recommendations to improve Hub promotion, equality/diversity/inclusion access issues, management of specialist resources and collection of relevant data on Hub outcomes and activities. Broader recommendations for the primary prevention of mental health difficulties across the health and care system are made, as individual support offers should be an adjunct to, not a replacement for, resolutions to systemic challenges. Research recommendations are made to conduct more robust evaluations of the clinical and cost-effectiveness of the Hubs, using larger data sets and comparative data.

Study registration

This study is registered as researchregistry6303.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132269) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 29. See the NIHR Funding and Awards website for further award information.

COVID-19 pandemic impact on mental and professional cognition: A questionnaire survey on a sample of GP trainees and GPs

Background

Since the outbreak of 2019 coronavirus disease (COVID-19), general practitioners (GPs) have been working in the frontline under psychological and physical pressure. This study aims to evaluate the psychological health, career prospective, attitudes toward educational mode changes, and knowledge about COVID-19.

Methods

An online anonymous questionnaire survey was carried out on GP trainees and GPs from June 2022 to September 2022. The survey mainly consisted of four parts: 1) general information; 2) level of knowledge about COVID-19; 3) psychological and physical health impact; and 4) changes in professional perception.

Results

The total knowledge score of 43 GP trainees and 38 GPs was 334 and 283, respectively, without significant difference (z = -0.839, P = 0.402). There was no statistical difference between the scores of GP trainees and GPs for each subindicator of mental and physical disorders. Eleven GP trainees and four GPs had severe psychological disorder subindexes. Severe somatization disorder subindexes were found in eight GP trainees and five GPs. Also, 67.44% of GP trainees and 52.63% of GPs had a positive attitude toward GP career. Moreover, 62.79% of GP trainees and 52.63% of GPs considered the epidemic had no impact on their professional cognition. Among GP trainees, 62.8% and 32.6% considered the epidemic had no or slight impact on their academic activities, respectively. Also, 53.5% and 44.2% of GP trainees partially and fully approved online teaching, respectively. The most popular forms were live and recorded courses.

Conclusions

COVID-19 pandemic had no noticeable impact on their physical and mental health and their attitude toward GP career.

Anxiety and Depression Among Pediatric Emergency Nurses and Physicians During the Coronavirus Disease 2019 Pandemic

INTRODUCTION

To determine anxiety and depression levels among pediatric acute care nurses and physicians before and after vaccine implementation during the coronavirus disease 2019 pandemic.

METHODS

Prospective cross-sectional study of emergency medicine and urgent care providers at a metropolitan quaternary pediatric emergency department, including 2 satellite emergency departments and 7 urgent care sites. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-2. Nurses and physicians were surveyed twice using the Generalized Anxiety Disorder-7 in May 2020 and March 2021 and once with the Patient Health Questionnaire-2 in March 2021.

RESULTS

In total, 189 surveys were completed in May 2020 (response rate 48%), and 243 surveys were completed in March 2021 (response rate 52%). Nurses reported higher Generalized Anxiety Disorder-7 scores compared to physicians for both years, though Patient Health Questionnaire-2 scores were similar. Mean Generalized Anxiety Disorder-7 scores decreased for both nurses and physicians between the 2 response periods. Amongst those who had a history of anxiety, chronic medical conditions, or were living with a high-risk individual, higher rates of anxiety were observed. Respondents endorsed the need for increased psychological support during a pandemic, with adequate and timely psychological support provided by the hospital, and stated their households were financially affected by the pandemic. Respondents reported fewer feelings of anxiety after self and public vaccination.

DISCUSSION

Study findings support increased psychological support for frontline nurses and physicians during a pandemic, particularly for those with a history of anxiety or chronic medical conditions, or those living with a high-risk individual.

Does organisational myopia mediate the effect of occupational health and safety practices on the risk of occupational accidents in Turkish healthcare institutions?

Occupational health and safety (OHS) policies in healthcare institutions must be well managed, because healthcare practice involves many physical, biological, ergonomic, chemical, and psychosocial hazards that can affect the health of healthcare workers. In addition, their work performance may be affected by the so-called organisational myopia. In this context, the aim of our study was to determine how organisational myopia affects OHS practices in healthcare institutions and whether it increases the risk of occupational accidents. The study population consisted of a convenience sample of 420 healthcare professionals working throughout Turkey who completed a questionnaire addressing these three domains: organisational myopia, OHS practices, and risk of occupational accidents. Their responses were analysed with exploratory factor analysis, reliability analysis, and Spearman's correlation to assess the adequacy of measurement tools and identify relationships between variables, followed by mediation analysis. We found that OHS practices mitigate organisational myopia and the risk of occupational accidents. We also found no significant effect of organisational myopia on the risk of occupational accidents. Our findings underscore the importance of OHS practices in healthcare institutions and that organisational myopia should be evaluated in special contexts such as working time, experience, or routinisation.

Ohio Health Care Professionals' Pandemic-Related Help-Seeking Knowledge, Behaviors, and Concerns

BACKGROUND

Health care professionals (HCPs) historically exhibit high rates of stress, burnout, and low rates of service utilization from Employee Assistance Programs (EAPs) and Professional Health Programs (PHPs). New and magnified stressors that accompanied COVID-19 exacerbated HCPs' risk of burnout.

PURPOSE

During the pandemic, this study examined Ohio HCP's utilization of EAPs and PHPs, knowledge of available services, barriers to accessing services, and likelihood of future service utilization. Conditions needing to change to increase likelihood of future utilization were also explored.

METHODS

A one-time survey was administered in July and August of 2021 to HCPs from 13 licensing boards in Ohio. This study used a subset of data to examine the extent of convergence between quantitative results-analyzed using frequency calculations-and results from thematic analysis of corresponding open-ended survey items. Qualitative results supported and elaborated the quantitative findings.

RESULTS

Fewer than 25% of respondents (N = 12,807) utilized EAPs or PHPs to address mental health concerns. Obstacles impeding service utilization included issues around awareness, time commitment, and confidentiality-a concern encompassing issues of stigma and fear of employment repercussions. Noting multiple obstacles to accessing EAPs and PHPs, HCPs in Ohio reported low rates of support service utilization and low likeliness to use services in the future despite their experiences of extreme stress and burnout.

CONCLUSIONS

Addressing the time commitment and confidentiality concerns could increase the likelihood of accessing services. Employers of HCPs should explore additional support mechanisms such as comprehensive wellness programs and innovative, brief intervention strategies to combat burnout, especially during viral outbreaks and other high-stress events.

MENTAL HEALTH STATUS AND JOB PERFORMANCE DURING COVID-19 PANDEMIC AMONG NURSES WORKING IN SECONDARY HEALTH FACILITIES IN IBADAN, NIGERIA

Background

The impact of the COVID-19 pandemic may not only affect the mental health of nurses, but may also affect nurses' job performance. The study was aimed at assessing the mental health status and job performance among nurses in secondary health facilities in Ibadan.

Methods

A cross-sectional study among 250 nurses in secondary health facilities in Ibadan, Nigeria. Generalized anxiety disorder, insomnia, depression, post-traumatic stress disorder (PTSD) and job performance were assessed using pre-tested standardized tools.

Results

About 34%, 17.2%, and 3.6% had mild, moderate, and severe anxiety, while 31%, 10.4%, and 6% experienced mild, moderate, and severe depression. Additionally, 12%, 2.4%, and 13.6% had mild, probable, and high PTSD. Job performance was significantly associated with marital status, anxiety, insomnia, depression, and PTSD symptoms (p<0.001).

Conclusion

This study highlights the need to prioritize the mental health of nurses in order to promote their efficiency.

Frontiers and hotspots in anxiety disorders: A bibliometric analysis from 2004 to 2024

Objective

This study aimed to analyze research on anxiety disorders using VOSviewer and CiteSpace to identify research hotspots and future directions.

Methods

We conduct ed a comprehensive search on the Web of Science Core Collection (WoSCC) for relevant studies about anxiety disorders published within the past two decades (from 2004 to 2024). VOSviewer and CiteSpace were mainly used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and other aspects to construct a knowledge atlas.

Results

A total of 22,267 publications related to anxiety disorders were retrieved. The number of publications about anxiety disorders has generally increased over time, with some fluctuations. The United States emerged as the most productive country, with Harvard University identified as the most prolific institution and Brenda W. J. H. Penninx as the most prolific author in the field.

Conclusion

This research identified the most influential publications, authors, journals, institutions, and countries in the field of anxiety research. Future research directions are involved advanced treatments based on pharmacotherapy, psychotherapy and digital interventions, mechanism exploration to anxiety disorders based on neurobiological and genetic basis, influence of social and environmental factors on the onset of anxiety disorders.

Attitude of the health team to the infant home care plan during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

Maintaining and improving infant health and continuing care at home are very important for the health system. According to the coronavirus disease 2019 (COVID-19) pandemic and its effects on the health system capacity and medical staff's physical-mental health, this study investigated the health staff's attitude on the implementation of an infant home care plan.

MATERIALS AND METHODS

This descriptive-analytical cross-sectional study was conducted on 130 nurses, midwives, and doctors working in the newborn care department in Isfahan health-therapeutic centers, with at least 6 months of work experience. The samples were selected by random multistage method and completed the researcher-made 5-point Likert questionnaire with 25 items and two areas of education support and security safety. The total score of this questionnaire varied from 25 to 125, and obtaining a score equal to or greater than 91 meant that people had a favorable opinion about home care for babies. The reliability of the questionnaire was reported by Cronbach's α of 0.79, and content validity ratio (CVR) and content validity index (CVI) scores of 0.88-0.99 and 0.79-0.1, respectively. Data analysis was performed using the Statistical Package for the Social Sciences version 18.0 (SPSS) (Chicago, USA) and analysis of descriptive statistics, Chi-square, and Pearson correlation tests at a 0.05 significance level.

RESULTS

The mean score of medical staff's attitude was obtained at 77.59 ± 11.71 and the security-safety and education-support domains scores were 41.3 ± 6.34 and 36.29 ± 6.11, respectively. In addition, a significant inverted relationship was observed between the mean score of medical staffs"attitude with age and the number of shifts.

CONCLUSION

According to the results, the medical staff's attitude about the infant home care program is neutral, and designing a professional educational period, considering economic preparations and responsibility assurance is essential for creating confidence and acceptance of the infant home care program by the medical staff.

Prevalence and associated factors of insomnia symptoms among doctors and nurses under the context of high prevalence of multiple infectious diseases: a cross-sectional study

Introduction

Insomnia symptoms are prevalent among healthcare workers and represent a potential public health problem. However, there is currently insufficient evidence on insomnia symptoms among doctors and nurses under the context of high prevalence of multiple infectious diseases after the pandemic in China. The purpose of this study was to analyze the prevalence of insomnia symptoms among doctors and nurses in third-grade class-A general hospitals under the context of high prevalence of multiple infectious diseases, and to explore the influence of demographic characteristics, work-related factors, health and lifestyle-related factors on insomnia symptoms.

Methods

An institution-based cross-sectional survey was conducted among doctors and nurses in two third-grade class-A general hospitals. A structured questionnaire was used to collect information on demographic characteristics, work-related factors, health and lifestyle-related factors, and insomnia symptoms among doctors and nurses. Multivariate logistics regression analysis was applied to identify factors significantly associated with insomnia symptoms among doctors and nurses, respectively.

Results

A total of 1,004 participants were included in this study, including 503 doctors and 501 nurses. The prevalence of insomnia symptoms in doctors and nurses was 47.7 and 51.3%, respectively. Multivariate logistics regression analysis showed that workplace violence (OR: 1.631, 95% CI: 1.050-2.532), doctor-patient relationship (OR: 1.603, 95% CI: 1.049-2.450), chronic pain (OR: 4.134, 95% CI: 2.579-6.625), chronic disease (OR: 1.825, 95% CI: 1.164-2.861), and anxiety symptoms (OR: 2.273, 95% CI: 1.357-3.807) were associated factors with insomnia symptoms in doctors. Education (OR: 0.301, 95% CI: 0.106-0.851), service years (OR: 1.978, 95% CI: 1.304-3.002), weekly working hours (OR: 1.694, 95% CI: 1.061-2.705), chronic pain (OR: 5.359, 95% CI: 3.241-8.860), and anxiety symptoms (OR: 2.472, 95% CI: 1.478-4.136) were associated factors with insomnia symptoms in nurses.

Conclusion

The prevalence of insomnia symptoms among doctors and nurses was high, and affected by many factors. This information can inform tailored interventions to insomnia symptoms by doctors and nurses who play an important role in public health.

Exploring Risk Perception, Mental Health, Mental Fatigue, Stigma, and the Quality of Life among UAE Healthcare Workers during the COVID-19 Pandemic: A National Multicentric Cross-Sectional Study

Globally, the COVID-19 pandemic has presented serious mental health challenges for healthcare professionals. This study investigated the mental health, mental fatigue, quality of life, and stigma of social discrimination among healthcare workers in the United Arab Emirates (UAE) during the COVID-19 pandemic. A correlational, cross-sectional, multi-centric design was employed to collect data from 1383 healthcare workers across various healthcare settings. Participants were recruited using combined cluster and purposive sampling techniques. Standardized questionnaires, including the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ), the Mental Fatigue Scale (MFS), the Social Discrimination Scale-Stigma Subscale (SDS), and the WHO Quality of Life Questionnaire-Brief (WHOQOL-BREF), were administered to assess the study variables. The results indicated significant mental health impacts, with high average scores for post-traumatic stress disorder (PTSD) (9.37 ± 6.74) and positive coping by inner strengths (17.63 ± 5.72). Mental fatigue was prevalent (8.15 ± 8.62), and stigma of social discrimination scored notably (23.83 ± 7.46). Quality of life was the highest in the social domain (65.38 ± 24.58). Significant correlations were observed between mental health subscales, mental fatigue, and quality of life domains. These findings highlight the critical need for targeted mental health support programs, improved social support networks, and personalized interventions to mitigate the mental health challenges faced by healthcare workers. Healthcare organizations can guarantee a resilient workforce that can handle future health crises by giving mental health resources and support systems top priority.

Female education ban by the Taliban: A descriptive survey study on suicidal ideation, mental health, and health-related quality of life among girls in Afghanistan

BACKGROUND

Following the Taliban's resurgence, Afghan girls were probited from attending school and university, likely causing adverse psychological effects. Therefore, the present study investigated depression, suicidal ideation, and quality of life (QoL) among Afghan girls banned from education by the Taliban.

METHODS

A survey study assessed depression, suicidal ideation, and QoL among 426 females prohibited from attending secondary schools, high schools, and universities by the Taliban. The study used the CES-D 20 Scale to assess depression, and the WHOQOL-Bref Questionnaire to assess QoL. Associations between variables were tested with chi-square tests, and predictors of QoL were analyzed through multivariate regression analysis.

RESULTS

Among the 426 participants, 87.6% exhibited depression symptoms and 49.8% reported suicidal thoughts. Significant predictors of overall QoL included monthly family income (B = 0.147, P = 0.001), recent others' behavior toward participants (B = -0.247, P < 0.001), physical illness (B = 0.110, P = 0.011), experiencing a recent traumatic event (B = 0.108, P = 0.015), depression (B = -0.159, P < 0.001) and suicidal ideation (B = -0.187, P < 0.001).

CONCLUSIONS

In Taliban-ruled Afghanistan, the results indicated that female students who have been prohibited from studying in classes have a high prevalence of depression and suicidal ideation. Having depression and suicidal ideation significantly predicted decreased quality of life among female students.

Maintaining the Psychological Well-Being of Physicians in the Uncertain Work Environment: A Practitioners Perspective

COVID-19 significantly altered the healthcare ecosystem and forced us to stretch the capacity to ensure healthcare delivery services. Physicians were on the frontline and acted as an important cog in the wheel of healthcare delivery. This unprecedented situation forced them to adopt to a new norm amidst uncertainty, potentially impacting their mental well-being and overall health. The study aims to investigate the coping strategies for physicians to maintain their psychological well-being during uncertain events such as COVID-19. By employing Analytic Hierarchy Process (AHP), the research prioritizes coping strategies that can improve physicians' psychological well-being. This study affirms that the physicians working in healthcare during pandemic preferred adaptive strategies over maladaptive strategies. Maintained exercise, yoga/meditation (or similar), and behavioral disengagement are the three most preferred coping strategies. The study will benefit physicians and the policy makers, to achieve their agenda of enhancing physicians' psychological resilience during uncertain events, ultimately contributing to the continuity and quality of healthcare delivery.

Mental health of primary health care physicians and nurses following prolonged infection control rules: a national survey in China

Introduction

This study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the post-pandemic period in 2022.

Method

Region-stratified sampling was conducted to recruit a national sample of 4,246 respondents from 31 July 2022 to 12 August 2022. A total of 692 primary healthcare institutions were identified in 30 provincial-level administrative regions of China. An online questionnaire was used for assessing probable mental health disorders using Symptoms Checklist-90-Revised (SCL-90-R) and PTSD Checklist for DSM-5 (PCL-5), and sleeping problems using Insomnia Severity Index (ISI). Data on demographics and work were also collected. Bivariate analysis and multiple logistic regression were conducted to identify significant correlates of probable mental health disorders.

Results

A total of 4,246 valid questionnaires were identified. Results showed that relative to the prevalence of probable mental health disorders among health care workers at the early stage of the pandemic in China, there was an overall decreased prevalence except for somatization, PHO, and OCD among the current PHC physicians and nurses. Multiple logistic regressions showed that significant risk factors of common probable mental health disorders, namely psychological distress, SOM, DEP, ANX, PHO, OCD, PTSD, and insomnia, were female gender, multimorbidity, history of psychiatric disorders, quarantine experience, never asking anyone for help, and overtime work.

Conclusion

Attention should be given to preexisting psychiatric and multimorbid conditions, social support, and work-related stressors. Regular assessment and psychological interventions are needed to enhance the mental health of PHC professionals even after public health crisis.

The relationship between social media dependency and psychological distress due to misunderstanding and fear of COVID-19 in medical students

Improper use of social media during the COVID-19 outbreak, leading to fear and misunderstanding, can contribute to psychological disorders in vulnerable populations. This descriptive and analytical cross-sectional study was conducted in 2023 on 511 medical students of Babol University of Medical Sciences. Data were collected using demographic, psychological distress, fear and misunderstanding questionnaires related to COVID-19 and social media dependency. A total of 511 medical students, with an average age of Mean and S.D; 23.57 ± 3.03 participated in the study. The average psychological distress score was 23.82 ± 7.73 (out of 54), the average score of social media dependency was 17.53 ± 3.09 (out of 30), for the fear of COVID-19 was12.63 ± 2.56 (out of 35), and for the misperception of COVID-19 was 0.53 ± 0.09 (out of 18). Path analysis results) showed that direct path from improper use of social media to psychological distress is significant (P < 0.001, B = 0.19) but this relationship is not significant through fear and misperception related to COVID-19. Improper use of social media, identified as the strongest predictor, can directly increase psychological distress in medical students, without mediation through fear and misperception related to COVID-19. These findings should be taken into consideration when designing and evaluating interventions aimed at promoting mental health and fostering appropriate use of social media among students during disease outbreaks.

Level of patient contact and Impact of Event scores among Canadian healthcare providers during the COVID-19 pandemic

BACKGROUND

Healthcare providers (HCP) continue to provide patient care during the COVID-19 pandemic despite the known risks for transmission. Studies conducted early in the pandemic showed that factors associated with higher levels of distress among HCP included being of younger age, female, in close contact with people with COVID-19, and lower levels of education. The goal of this study was to determine if level of patient contact was associated with concern for post-traumatic stress disorder (PTSD) as measured by the Impact of Event Scale-Revised (IES-R).

METHODS

This cross-sectional study, embedded within a prospective cohort study, recruited HCP working in hospitals in four Canadian provinces from June 2020 to June 2023. Data were collected at enrolment and annually from baseline surveys with the IES-R scale completed at withdrawal/study completion. Modified Poisson regression was used to determine the association between level of patient contact and concern for PTSD (i.e., IES-R scores ≥24).

RESULTS

The adjusted rate ratio (RR) associated with concern for PTSD among HCP with physical contact/direct patient care was 1.19 (95% confidence interval (CI) 1.03, 1.38) times higher than for HCP with no direct contact. In fully adjusted linear regression models, physical care/contact was associated with higher avoidance and hyperarousal scores, but not intrusion scores.

CONCLUSIONS

Administrators and planners need to consider the impact of heightened and ongoing stress among HCP by providing early screening for adverse emotional outcomes and delivery of tailored preventive strategies to ensure immediate and long-term HCP health.

Psychological resilience factors in intensive care nursing: a hybrid multi-criteria decision-making model

PURPOSE

To analyze the key factors influencing the psychological resilience of intensive care unit (ICU) nurses during the COVID-19 pandemic and put forward suggestions promoting resilience based on key improvement factors and clinical experience.

METHODS

Data were collected from 35 ICU nurses in a hospital in Zhejiang Province, China, through a questionnaire survey conducted between January and February 2023. The Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was then used to construct and visualize the relationship structure between the factors. The DEMATEL-based Analytical Network Process (DANP) was applied to determine the influential weights of all factors. Finally, the key improvement factors were identified using importance-performance analysis (IPA).

RESULTS

Based on the cause-effect impact network diagram (CEIND), it was concluded that (C 11), (C 22), and (C 32) are the key factors that promote the improvement of psychological resilience among ICU nurses. Additionally, these factors were the key factors that influence psychological resilience. The confidence levels of these results and the gap were 99.6% and 0.4%, respectively, which exceed the threshold value of 95%, indicating good stability. Finally, for the case hospitals, (C 13) was identified as the key improvement factor.

CONCLUSIONS

Hospital administrators should support ICU nurses in enhancing their psychological resilience during major epidemics by: (i) Providing training on comprehensive protective measures and nursing skills; (ii) Effectively managing the human resources of nurses in the hospital to reduce their workload; (iii) Increasing social and organizational support for nurses to alleviate anxiety caused by large-scale public health events and improve their psychological resilience.

Fear of the unknown: Experience of frontline healthcare workers with coping strategies used to face the COVID 19 pandemic

The COVID 19 pandemic presented various challenges among health care workers, one of them being the impact it has on mental health. The psychological problems such as anxiety, depression, insomnia and stress, all consequences of the pandemic cause psychopathological outcomes reverberating negatively on the emotional well-being of health care workers. This study aimed to explore the experience of frontline healthcare workers (HCWs) during the COVID-19 pandemic in a middle-income country in Latin America and to identify the coping mechanisms they used to face stressful situations during this time. A qualitative study based on an interpretative paradigm was conducted allowing to examine complex, ambiguous and emotionally loaded topics to explore in detail the experience of frontline HCWs during the COVID-19 pandemic. Through convenience sampling eleven frontline HCWs were recruited to participate in semi-structured interviews. An inductive analysis was done with four pre-established categories: the experience of HCWs during the attention of COVID-19 patients, the experience during their own infection, the experience during the work reintegration and the coping mechanisms used. Our results show that fear and uncertainty predominated throughout the attention of COVID-19 patients. Participants used both coping strategies based on problem-solving efforts, such as routine changes, and emotional management efforts, like social support or psychological counselling. The choice of coping strategies was influenced by their personal beliefs, past emotional experiences, and prior medical formation. These findings provide public and private institutions insight for creating effective policies, based on the HCWs' preferences, to promote their psychological well-being.

Examination of the COVID-19 fear levels of nurses and their compliance to isolation

Background

It is very important for healthcare professionals to know the isolation precautions and apply the isolation rules correctly in COVID-19 process.

Aim

This study was conducted to determine the COVID-19 fear levels and isolation compliance levels of nurses.

Method

This descriptive, cross-sectional, and correlational study was conducted between December 2020-February 2021 with 217 nurses working in a public hospital in Istanbul/Turkey. Data were collected using the Sociodemographic-Form, the COVID-19 Fear Scale, and the Compliance with Isolation Measures Scale.

Results

Statistically significant difference was found between the level of compliance with the isolation measures and the education level of the nurses (p = .011), as well as their professional position (p = .026) (p < .05). A positive, low-level significant relationship was determined between the COVID-19 fear of nurses and their compliance with isolation measures (r = 0.168; p = .015).

Conclusions

It was determined that nurses' compliance with Isolation Precautions and their level of fear were high during the COVID-19 pandemic. It was observed that nurses' fear levels and isolation adaptation levels were related.

Knowledge graph analysis of research on nurses' psychological resilience

In recent years, a surge in literature on psychological nurse resilience, largely driven by the COVID-19 pandemic, has prompted the need for a comprehensive understanding of the current state and emerging trends through reliable methodologies. The purpose of this study was to analyzes the research on nurses' psychological resilience through bibliometrics to understand the current situation, foundation, and hotspot of this research field. The Web of Science core collection database was used as the search source, and CiteSpace analysis software was employed to conduct bibliometric analysis on authors, countries, institutions, keywords, and references of nurse psychological resilience-related literature published from the establishment of the database to July 11, 2023. A total of 1060 articles were included in the final analysis. The study of nurses' psychological resilience had been highly popular and had formed a new and important research basis in recent years. China and the United States led in the number of publications and centrality respectively, with Monash Univ and Curtin Univ as top institutions in the number of publications and centrality respectively. The authors with the highest number of publications and the most frequently cited were Rees and Connor Km respectively. The most frequently cited article was Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 published by Lai, JB, etc. Important key keywords included mental health, resilience, stress, health, outbreak, acute respiratory syndrome, etc. The research topics in this field mainly focused on 4 aspects, including nurses' mental health, post-traumatic stress disorder, job burnout and job satisfaction, and intervention research on psychological resilience. The results of bibliometric analysis provide direct support for future scholars to explore and determine the research direction, hot spots, and find authoritative authors and institutions. At the moment, nurses' psychological resilience research has established a new foundation, primarily focusing on COVID-19-related topics. Given the potential prolonged coexistence of COVID-19 and other diseases, the main research focus remains innovating and validating effective psychological resilience intervention strategies for nurses' overall well-being.

A visualized and bibliometric analysis of nursing research during the COVID-19 pandemic

BACKGROUND

The global spread of Coronavirus disease 2019 (COVID-19) has been increasing since December 2019. A total of 8460 publications were obtained from the Web of Science Core Collection from 2019 to 2023, providing insights into the progress of nursing research throughout the COVID-19 pandemic.

METHODS

Bibliometric analysis was conducted on these articles using CiteSpace. The analysis focused on examining the distribution of these publications in terms of space and time, distribution of authors, subject categories, distribution of topics, and cited references.

RESULTS

These results may be explained from 3 perspectives. Initially, the number of yearly publications on nursing research consistently increased during the COVID-19 pandemic. Furthermore, a co-occurrence analysis of the countries and the authors revealed that certain countries, including the United States, China, and England, have successfully implemented organized and standardized nursing models. These countries also have well-developed and established nursing research systems. Notably, academic communities in specific regions, such as the team led by MD Stefan Gravenstein, Mor Vincent, and White Elizabeth at Brown University in the United States, have emerged as leaders in this field. Furthermore, examining the papers' subject categories and topic distribution indicate that nursing during the COVID-19 pandemic has been predominantly interdisciplinary, encompassing various disciplines such as clinical medicine, essential medicine, psychology, public health management, and even telematics science.

CONCLUSION SUBSECTIONGS

Our study provided valuable insights into acquiring knowledge on nursing research during the COVID-19 pandemic, pinpointed possible partners for researchers interested in nursing, and uncovered prevalent research patterns and popular subjects.

Burnout among Polish paramedics: insights from the Oldenburg Burnout Inventory

Introduction

Emergency medical services rely heavily on paramedics who, as frontline responders, face unique stressors that can potentially lead to burnout. This pilot study utilizes the Oldenburg Burnout Inventory (OLBI) to assess burnout levels among Polish paramedics. The aim is to contribute to the understanding of burnout in this specific professional context and identify key factors influencing burnout dimensions. Future research will build on these preliminary findings.

Materials and methods

A cross-sectional study was conducted from March 01 to April 30, 2023, utilizing an online survey accessible to Polish paramedics. The OLBI, a validated tool, was employed to measure burnout, focusing on two dimensions: exhaustion and withdrawal of involvement.

Results

Among the 147 participating paramedics, the majority were male (65.99%). Paramedics exhibited burnout symptoms across both dimensions measured by The Oldenburg Burnout Inventory scale (OLBI), with an average level for lack of commitment recorded at 20.09, an average level for exhaustion at 20.60. The study revealed that 41.5% of paramedics experienced low burnout, 44.9% reported moderate burnout, and 13.6% faced high burnout risks. Analysis showed that women experienced significantly higher levels of exhaustion compared to men (p = 0.01).

Conclusion

This pilot study provides valuable initial insights into burnout among Polish paramedics. The OLBI's two-factor structure, evaluating exhaustion and disengagement, proved reliable and valid in this context. The prevalence of burnout, with over 60% of paramedics experiencing moderate to high levels, highlights the urgency of addressing burnout in this profession. Future research will be essential to explore the underlying causes and develop targeted interventions.

Practical implications

Understanding the factors contributing to burnout among paramedics is crucial for developing targeted interventions. Strategies should focus on stress management training, organizational support, and well-being initiatives. Addressing gender-specific differences in burnout experiences is essential for tailoring interventions effectively. Proactive psychological support mechanisms and optimized working conditions can enhance paramedics' overall well-being, ensuring their continued effectiveness in providing emergency medical services.

Job burnout and its influencing factors among primary healthcare workers during the COVID-19 epidemic in Guangzhou, China, 2021-2022: from the perspective of institutional operation and management

BACKGROUND

The purpose of this study was to explore the job burnout of primary healthcare workers in Guangzhou during the prevention and control of COVID-19 epidemic and its influencing factors from the perspective of institutional operation and management in 2021-2022.

METHODS

A cross-sectional study involved 866 primary healthcare workers from different districts of Guangzhou, China. The Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was utilized to assess job burnout. From the perspective of organizational operation and management, the possible causes of job burnout among primary healthcare workers during COVID-19 have been categorized into 7 major aspects. Univariate and multivariate logistic regression analyses were conducted to identify influencing factors for job burnout in primary healthcare workers.

RESULTS

The detection rate of job burnout among primary healthcare workers was 78.29%. Men (OR = 2.39) and whose institution was located in urban-rural fringe (OR = 1.56) were more likely to detect job burnout. Conversely, institution heads showed a lower risk of job burnout. From the perspective of institutional operation and management, workers who were not satisfied with personnel management (OR = 2.41), materials and vehicles (OR = 2.89), subsidies and compensation (OR = 2.18), humanistic care (OR = 2.11), superior management (OR = 8.32) were found to have a higher risk of job burnout.

CONCLUSION

The detection rate of job burnout among primary healthcare workers in Guangzhou was relatively high during the period of COVID-19. When there is another sudden major epidemic, the managers of institutions can focus on and deal with the problems related to the operation and management of institutions such as personnel management, materials and vehicles, subsidies and compensation, humanistic care, and superior management, so as to provide logistical support for the workers and alleviate their job burnout.

The early-stage impacts of shock events on adult sleep: Lessons from the COVID-19 pandemic

The present study aims to estimate the early-stage association of the coronavirus disease 2019 (COVID-19) pandemic with sleep duration, 4 months after the initial outbreak, at a national level. Using the China Family Panel Studies in 2018 and its follow-up in 2020, 16,563 adult participants were analyzed in our study. The first wave transmissibility of the COVID-19 pandemic in mainland China was used as a quasi-natural experiment. The difference in difference method was employed to compare variations across participants interviewed before or after the pandemic and between groups from provinces with different COVID-19 severity. The study observed a decline in workday sleep duration among adults, regardless of their employment status. Specifically, working adults experienced a significant decrease in sleep duration on work days (-1.54, 95% confidence interval -2.16 to -0.92), alongside an increase on work-free days (2.41, 1.56-3.24), leading to a wider sleep discrepancy in sleep patterns (3.95, 3.31-4.59). Noteworthy, working-age adults (-2.00, -2.79 to -1.22) and males (-3.31, -4.31 to -2.30) exhibited greater sleep decreases on work days, whereas females exhibited a more pronounced disparity in sleep patterns (6.18, 4.73-7.63) between work and work-free days. The pandemic is significantly associated with prolonged changes in adults' sleep duration, including sleep decreases on work days and catch-up sleep on work-free days for working adults. To prepare for future global emergencies, the government may need to promote resilience to mitigate the pandemic's adverse impacts on the working population. Guaranteeing adequate sleep among working adults and reducing sleep debt should be prioritized in such efforts.

Validity Evidence of a Screening Tool for Early Detection of Clinical Crisis-Related Anxiety Amongst Medical Students

Construct: Psychological distress among students is a growing concern in medical education, even more so with the advent of COVID-19 pandemic. Anxiety is among students' mental health issues. High and persistent anxiety has many negative impacts on students' academic and personal life. Early detection is essential for timely intervention. Background: Currently, medical student anxiety is assessed using tools primarily designed for psychiatric purposes. Despite their excellent validity evidence, these tools contain sensitive items and do not explore stressors related to clinical activities. There is a need for contextualized tools to better identify anxiety-provoking factors specific to the medical education environment. Approach: We previously developed the Crisis Experience Rating Scale (CERS-7), a short screening tool to identify early on anxious students participating in clinical activities during the first wave of the COVID-19 pandemic. The present study sought to produce further validity evidence for the CERS-7. Medical students in their clinical years at two Swiss and one French medical school, all involved in COVID-19 clinical activity during the second wave of the pandemic, completed the CERS-7 and the State Anxiety Inventory (STAI-A), the best known and widely used tool to measure for general anxiety. We evaluated internal structure using confirmatory factor analysis (CFA) and relation to other variables using linear regression (LR) and receiver operating characteristic (ROC) curves with thresholds defined using the Youden index. Findings: There were 372 participants. CFA confirmed the two-factor structure of the CERS-7 scale from first-wave dataset. The CERS-7 total scale and subscales demonstrated validity evidence in relationship to the STAI-A scores and categories. A CERS-7 total scale score < 27.5 identified 93% of severely anxious students. Conclusion: The CERS-7 produces reliable scores to use for monitoring anxiety status when assigning students to clinical settings as well as for improving training conditions during clinical crisis.