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Characterizing burnout among healthcare epidemiologists in the early phases of the COVID-19 pandemic: A study of the SHEA Research Network. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY 2023; 3:e52. [PMID: 36970429 PMCID: PMC10031578 DOI: 10.1017/ash.2023.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 03/19/2023]
Abstract
Abstract
A multisite research team proposed a survey to assess burnout among healthcare epidemiologists. Anonymous surveys were disseminated to eligible staff at SRN facilities. Half of the respondents were experiencing burnout. Staffing shortages were a key stressor. Allowing healthcare epidemiologists to provide guidance without directly enforcing policies may improve burnout.
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Swed S, Bohsas H, Alibrahim H, Hafez W, Shoib S, Sawaf B, Rais MA, Aljabali A, Shaheen N, Elsayed M, Rakab A. Health-care provider burnout in Syria during COVID-19 pandemic's Omicron wave. Medicine (Baltimore) 2022; 101:e32308. [PMID: 36550866 PMCID: PMC9771336 DOI: 10.1097/md.0000000000032308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Health-care workers (HCWs) have dealt with various psychological problems during the COVID-19 epidemic, including sadness, mental discomfort, anxiety, and poor sleep. Burnout is a state of prolonged work-related psychological, emotional, and physical stress brought on by emotional weariness, depersonalization, and decreased professional success. This study aimed to determine how many HCWs burned out during the Omicron wave of the COVID-19 pandemic and determine what factors put them at risk for this psychological effect. This cross-sectional research was performed in Syria during the current Omicron wave of the COVID-19 pandemic to evaluate the burnout experienced by Syrian physicians who treat COVID-19 patients. The inclusion criteria were all Syrian HCWs who treated COVID-19 patients during the current Omicron wave of COVID-19. The data was collected between April 3 and March 20, 2022. We investigated whether the questionnaire used was valid and understandable to the participants. A total of 729 health-care providers were inquired in our study; however, 30 participants were disqualified because their answers were not fully completed. The overall age of the participants was 31 ± 9, and the ratio of males to females was almost equal. The majority (47.5%) of the sample study's participants are residents, and 72.8% who cared for COVID-19 patients. The prevalence of high levels of burnout in the sample study was 41.6%. Compared to men (22.3%), women were much more likely (27.9%) to report experiencing a high degree of emotional exhaustion; also, the participants who cared for COVID-19 patients were much more likely (30.1%) to report experiencing a high degree of emotional exhaustion compared to others, which individuals who cared for COVID19 patients were 1.76 times more likely than participants who did not care for COVID19 patients to experience severe burnout (odds ratio: 1.766, 95% confidence interval:1.2-2.4, P value < .001). Our research found severe burnout among Syrian health-care providers during the omicron wave of COVID-19, with clinicians caring for COVID-19 patients being considerably more likely to express high burnout than others.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine Aleppo University, Aleppo, Syria
- * Correspondence: Sarya Swed, Faculty of Medicine Aleppo University, Aleppo 22743, Syria (e-mail: )
| | | | | | - Wael Hafez
- NMC Royal Hospital, Khalifa City, Abu Dhabi, UAE
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
| | - Shiekh Shoib
- JLNM Hospital, Rainawari, Srinagar, India
- Directorate of Health Services, J&K, India
| | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Ahmed Aljabali
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour Shaheen
- Alexandria University, Alexandria Faculty of Medicine, Alexandria, Egypt
| | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg, Ulm, Germany
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Amine Rakab
- Assistant Professor of Clinical Medicine, Weill Cornell Medical College, Qatar
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Youssef D, Abboud E, Abou-Abbas L, Hassan H, Youssef J. Prevalence and correlates of burnout among Lebanese health care workers during the COVID-19 pandemic: a national cross-sectional survey. J Pharm Policy Pract 2022; 15:102. [PMID: 36527056 PMCID: PMC9756668 DOI: 10.1186/s40545-022-00503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has harshly burdened the healthcare systems. Health care workers (HCWs) are at substantial risk of infection and confronted several stressors as well leading them to experience burnout. This study aimed to assess the prevalence of burnout among Lebanese health HCWs and to identify its associated factors. METHODS A cross-sectional online survey was conducted between the first of November and the end of December 2020 among Lebanese HCWs working in all active hospitals operating across the country. Data were collected using an Arabic, anonymous, self-reported questionnaire comprising four sections: (a) basic sociodemographic characteristics, (b) exposure to COVID-19 covariates, (c) occupational factors, and (d) the measurements including the Copenhagen Burnout Inventory (CBI). CBI subscale cut-off score of 50 was used to assess the prevalence of burnout among HCWs. Multinomial logistic regression analyses were performed to examine the factors associated with the different aspects of burnout. RESULTS Out of the 1751 respondents, personal burnout (PB) was detected in its moderate and high-level aspects among 86.3% of Lebanese HCWs. Moderate and high levels of work-related burnout (WB), and client-related burnout (CB) hit 79.2% and 83.3% of HCWs, respectively. HCWs who were females, married, physicians, having a poor health status and specific living conditions (dependent child, elderly at home, family member with comorbidities, and a low income) were more likely to exhibit a high level of PB compared to no/low burnout level. Moreover, frontline HCWs, those infected by COVID-19 or those having a colleague infected by COVID-19, and those exhibiting a high perception of threat were more prone to experience a high-level PB rather than a low/no burnout. Working in a public hospital, extensive working hours, and insufficient sleeping hours were also found positively associated with high PB. However, older age and altruism were negatively associated with high PB compared to no/low PB among HCWs. As for WB, similar factors were found either positively or negatively associated with a high level of WB except health status and living conditions factors (dependent child or family member). As for CB, older age of HCWs (> 30 years) and altruism were negatively associated with high CB compared to no/low burnout level. However, working in the frontline, high threat perception, extensive working hours, insufficient sleeping hours, and low income were positively associated with high CB among HCWs compared to no/low burnout. CONCLUSION The prevalence of burnout among Lebanese HCWs during the pandemic was significant and alarming. Enacting and implementing preventive policies and effective interventions are urgently needed to cultivate wellness among HCWs.
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Affiliation(s)
- Dalal Youssef
- grid.412041.20000 0001 2106 639XBordeaux Research Center for Population Health, Institut de Santé Publique, d’épidémiologie et de Développement (ISPED), Bordeaux University, Bordeaux, France ,grid.490673.f0000 0004 6020 2237Clinical Trial Program, Ministry of Public Health, Beirut, Lebanon ,grid.490673.f0000 0004 6020 2237Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon
| | - Edmond Abboud
- grid.490673.f0000 0004 6020 2237Ministry of Public Health, Beirut, Lebanon
| | - Linda Abou-Abbas
- grid.411324.10000 0001 2324 3572Neuroscience Research Center, Lebanese University, Faculty of Medical Sciences, Beirut, Lebanon
| | - Hamad Hassan
- grid.490673.f0000 0004 6020 2237Ministry of Public Health, Beirut, Lebanon
| | - Janet Youssef
- Al Zahraa Hospital University Medical Center, Beirut, Lebanon
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154
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Pala AN, Chuang JC, Chien A, Krauth DM, Leitner SA, Okoye NM, Costello SC, Rodriguez RM, Sheira LA, Solomon G, Weiser SD. Depression, anxiety, and burnout among hospital workers during the COVID-19 pandemic: A cross-sectional study. PLoS One 2022; 17:e0276861. [PMID: 36490248 PMCID: PMC9733879 DOI: 10.1371/journal.pone.0276861] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/16/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Healthcare personnel have faced unprecedented mental health challenges during the COVID-19 pandemic. The study objective is to assess differences in depression, anxiety, and burnout among healthcare personnel with various occupational roles and whether financial and job strain were associated with these mental health outcomes. METHODS We employed an anonymous survey between July and August 2020 at an urban county hospital in California, USA. We assessed depression, anxiety, and burnout using validated scales, and asked questions on financial strain and job strain. We performed logistic and linear regression analyses. RESULTS Nurses (aOR 1.93, 95% CIs 1.12, 3.46), social workers (aOR 2.61, 95% CIs 1.35, 5.17), service workers (aOR 2.55, 95% CIs 1.20, 5.48), and administrative workers (aOR 2.93, 95% CIs 1.57, 5.61) were more likely than physicians to screen positive for depression. The odds of screening positive for anxiety were significantly lower for ancillary workers (aOR 0.32, 95% CIs 0.13-0.72) compared with physicians. Ancillary (aB = -1.77, 95% CIs -1.88, -0.47) and laboratory and pharmacy workers (aB -0.70, 95% CI -1.34, -0.06) reported lower levels of burnout compared with physicians. Financial strain partially accounted for differences in mental health outcomes across job categories. Lack of time to complete tasks and lack of supervisory support were associated with higher odds of screening positive for depression. Less job autonomy was associated with higher odds of screening positive for anxiety and higher burnout levels. CONCLUSIONS We found significant disparities in mental health outcomes across occupational roles. Policies to mitigate the adverse impact of COVID-19 on health workers' mental health should include non-clinical staff and address financial support and job characteristics for all occupational roles.
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Affiliation(s)
- Andrea Norcini Pala
- Columbia School of Social Work (CSSW), New York, NY, United States of America
| | - Jessica C. Chuang
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Ai Chien
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - David M. Krauth
- San Francisco (UCSF) Division of HIV, University of California, Infectious Disease and Global Medicine, San Francisco, CA, United States of America
| | - Stefano A. Leitner
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Nnenna M. Okoye
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Sadie C. Costello
- Division of Environmental Health Sciences, University of California, Berkeley, School of Public Health, CA, United States of America
| | - Robert M. Rodriguez
- San Francisco (UCSF) Department of Emergency Medicine, University of California, San Francisco, CA, United States of America
| | - Lila A. Sheira
- San Francisco (UCSF) Division of HIV, University of California, Infectious Disease and Global Medicine, San Francisco, CA, United States of America
| | - Gina Solomon
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Sheri D. Weiser
- San Francisco (UCSF) Division of HIV, University of California, Infectious Disease and Global Medicine, San Francisco, CA, United States of America
- * E-mail:
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Unal M, Yilmaz A, Yilmaz H, Tasdemir GY, Uluturk M, Kemanci A, Senol H, Altan B, Ozen M, Seyit M, Oskay A, Turkcuer I. The impact of COVID-19 on social support perception and stress of prehospital care providers. Australas Emerg Care 2022; 25:334-340. [PMID: 35534357 PMCID: PMC9069261 DOI: 10.1016/j.auec.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/10/2022] [Accepted: 04/28/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND This study seeks to explore the impact of COVID-19 outbreak on the social support perception and acute stress disorder of prehospital care providers (PCPs) in the province of Denizli. METHODS This descriptive and cross-sectional study was conducted between December 25, 2020 and January 25, 2021. Out of 510 ambulatory care staff constituting the study population, there were 287 PCPs (%56.2), including 13 physicians, 89 paramedics, 134 emergency medical technicians, and 51 individuals from other occupational groups (nurse, driver, cleaning staff, medical secretary) based at emergency health services. The data collection tools employed in the study include an introductory information form, Multidimensional Scale of Perceived Social Support (MSPSS), and National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS), which was organized as an online questionnaire. RESULTS We analyzed the data from 287 PCPs that completed the form and scales. The mean score of the NSESSS was calculated as 1.53 ± 0.79. The PCPs who experienced health problems (1.85 ± 0.69), suffered from mental problems and received psychotherapy and medication (2.57 ± 0.57), encountered COVID-19 patients (1.58 ± 0.8), provided care for COVID-19 patients (1.59 ± 0.79), and took polymerase chain reaction (PCR) tests (1.68 ± 0.78) had higher acute stress symptom levels. The total mean score of MSPSS was calculated as 66.28 ± 17.22. Total MSPSS scores of the participants varied significantly in terms of age, marital status, taking a COVID-19 test, suffering from mental problems, status of encountering a COVID-19 patient, and workplace satisfaction (p < 0.05). CONCLUSIONS The findings are suggestive of high perceptions of multidimensional social support and low acute stress symptom levels of the PCPs during the COVID-19 pandemic period.
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Affiliation(s)
- Medine Unal
- Pamukkale University, Faculty of Medicine, Department of Emergency Medicine, 20070 Denizli, Turkey
| | - Atakan Yilmaz
- Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey.
| | - Halis Yilmaz
- Pamukkale University, Health Science Institute, 20160 Denizli, Turkey
| | - Gulay Yigitoglu Tasdemir
- Pamukkale University, Faculty of Health Science, Departmant of Psychiatric Nursing, 20160 Denizli, Turkey
| | - Mehmet Uluturk
- Pamukkale University, Faculty of Medicine, Department of Emergency Medicine, 20070 Denizli, Turkey
| | - Aykut Kemanci
- Pamukkale University, Faculty of Medicine, Department of Emergency Medicine, 20070 Denizli, Turkey
| | - Hande Senol
- Pamukkale University, Medical Faculty, Department of Biostatistics, 20070 Denizli, Turkey
| | - Burak Altan
- Health Services Department, Provincial Health Directorate, Denizli, Turkey
| | - Mert Ozen
- Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey
| | - Murat Seyit
- Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey
| | - Alten Oskay
- Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey
| | - Ibrahim Turkcuer
- Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey
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Shanafelt TD, West CP, Dyrbye LN, Trockel M, Tutty M, Wang H, Carlasare LE, Sinsky C. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clin Proc 2022; 97:2248-2258. [PMID: 36229269 PMCID: PMC9472795 DOI: 10.1016/j.mayocp.2022.09.002] [Citation(s) in RCA: 181] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the prevalence of burnout and satisfaction with work-life integration (WLI) in US physicians at the end of 2021, roughly 21 months into the COVID-19 pandemic, with comparison to 2020, 2017, 2014, and 2011. METHODS Between December 9, 2021, and January 24, 2022, we surveyed US physicians using methods similar to those of our prior studies. Burnout, WLI, depression, and professional fulfillment were assessed with standard instruments. RESULTS There were 2440 physicians who participated in the 2021 survey. Mean emotional exhaustion and depersonalization scores were higher in 2021 than those observed in 2020, 2017, 2014, and 2011 (all P<.001). Mean emotional exhaustion scores increased 38.6% (2020 mean, 21.0; 2021 mean, 29.1; P<.001), whereas mean depersonalization scores increased 60.7% (2020 mean, 6.1; 2021 mean, 9.8; P<.001). Overall, 62.8% of physicians had at least 1 manifestation of burnout in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011 (all P<.001). Although these trends were consistent across nearly all specialties, substantial variability by specialty was observed. Satisfaction with WLI declined from 46.1% in 2020 to 30.2% in 2021 (P<.001). Mean scores for depression increased 6.1% (2020 mean, 49.54; 2021 mean, 52.59; P<.001). CONCLUSION A dramatic increase in burnout and decrease in satisfaction with WLI occurred in US physicians between 2020 and 2021. Differences in mean depression scores were modest, suggesting that the increase in physician distress was overwhelmingly work related. Given the association of physician burnout with quality of care, turnover, and reductions in work effort, these findings have profound implications for the US health care system.
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157
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VandeVusse A, Castillo PW, Kirstein M, Mueller J, Kavanaugh M. Disruptions and opportunities in sexual and reproductive health care: How COVID-19 impacted service provision in three US states. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2022; 54:188-197. [PMID: 36351551 PMCID: PMC9878085 DOI: 10.1363/psrh.12213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CONTEXT The COVID-19 pandemic abruptly disrupted the provision of sexual and reproductive health care in the United States. METHODS We conducted interviews with family planning clinic staff at 55 health care facilities in Arizona, Iowa, and Wisconsin in late 2020 and early 2021. We asked respondents about the challenges they faced and ways they adapted their service provision as a result of the pandemic. We conducted content and thematic analyses of the interview transcripts using an inductively developed qualitative coding scheme. RESULTS Family planning clinics and providers made a variety of changes to their clinic operations and service delivery. The three major areas of change for these facilities were implementation of COVID-19 safety procedures, shifting service delivery and staffing to meet patient needs, and the rapid uptake and expansion of telehealth. CONCLUSION While providers faced many challenges, they also described opportunities to innovate and rethink standard of care protocols that may continue to shape sexual and reproductive health care even after the pandemic abates.
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158
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Silver SR, Li J, Marsh SM, Carbone EG. Prepandemic Mental Health and Well-being: Differences Within the Health Care Workforce and the Need for Targeted Resources. J Occup Environ Med 2022; 64:1025-1035. [PMID: 36472564 PMCID: PMC9722331 DOI: 10.1097/jom.0000000000002630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Occupational stress and diminished well-being among health care workers were concerning even before the coronavirus disease 2019 pandemic exacerbated existing stressors and created new challenges for this workforce. Research on the mental health of health care workers has focused on physicians and nurses, with less attention to other occupations. METHODS To assess pre-coronavirus disease mental health and well-being among workers in multiple health care occupations, we used 2017 to 2019 data from the Behavioral Risk Factor Surveillance System. RESULTS Across the health care workforce, insufficient sleep (41.0%) and diagnosed depression (18.9%) were the most common conditions reported. Counselors had the highest prevalence of diagnosed depression. Health care support workers had elevated prevalences for most adverse health conditions. CONCLUSIONS Ensuring a robust health care workforce necessitates identifying and implementing effective occupation-specific prevention, intervention, and mitigation strategies that address organizational and personal conditions adversely affecting mental health.
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159
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Wu YL, Lin TW, Yang CY, Wang SSC. Demographics, employment, and proximity to covid-19 as predictors of preparedness among Taiwanese health social workers. SOCIAL WORK IN HEALTH CARE 2022; 62:41-58. [PMID: 36448628 DOI: 10.1080/00981389.2022.2147627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/08/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 struck the world violently and cause negative psychological consequences on health professionals. The preparedness of social workers for the pandemic is critical while facing these challenges and pressures. The study aimed to explore what are the roles of demographic, employment, and proximity to Covid-19 in predicting preparedness for the next wave of COVID among social workers in Taiwan. A total of 158 participants were conveniently sampled and multiple regression, univariate analysis, and two-way ANOVA were conducted. The results demonstrated that the demographic and employment variables significantly predicted preparedness, and there were significant differences among demographics on preparedness and an interaction effect between seniority and age. Consequently, middle-aged social workers with junior seniority years may have more difficulties in their preparation for the current situation. The implication of our findings is also discussed.
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Affiliation(s)
- Yi-Ling Wu
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Tsai-Wen Lin
- EMI Professional Development Center, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Yi Yang
- Department of Health and Welfare, University of Taipei, Taipei, Taiwan
- Department of Social Work, Taipei City Hospital, Taipei, Taiwan
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Terwilliger IA, Manojlovich M, Johnson JK, Williams MV, O’Leary KJ. Effect of COVID-19 on the implementation of a multifaceted intervention to improve teamwork and quality for hospitalized patients: a qualitative interview study. BMC Health Serv Res 2022; 22:1379. [DOI: 10.1186/s12913-022-08795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/06/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background
Healthcare organizations made major adjustments to deliver care during the COVID pandemic, yet little is known about how these adjustments shaped ongoing quality and safety improvement efforts. We aimed to understand how COVID affected four U.S. hospitals’ prospective implementation efforts in an ongoing quality improvement initiative, the REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) project, which implemented complementary interventions to redesign systems of care for medical patients.
Methods
We conducted individual semi-structured interviews with 40 healthcare professionals to determine how COVID influenced RESET implementation. We used conventional qualitative content analysis to inductively code transcripts and identify themes in MAXQDA 2020.
Results
We identified three overarching themes and nine sub-themes. The three themes were (1) COVID exacerbated existing problems and created new ones. (2) RESET and other quality improvement efforts were not the priority during the pandemic. (3) Fidelity of RESET implementation regressed.
Conclusion
COVID had a profound impact on the implementation of a multifaceted intervention to improve quality and teamwork in four hospitals. Notably, COVID led to a diversion of attention and effort away from quality improvement efforts, like RESET, and sites varied in their ability to renew efforts over time. Our findings help explain how COVID adversely affected hospitals’ quality improvement efforts throughout the pandemic and support the need for research to identify elements important for fostering hospital resilience.
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161
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Ibigbami OI, Akinsulore A, Opakunle T, Seun-Fadipe C, Oginni OA, Okorie VO, Oloniniyi I, Olibamoyo O, Aloba OO, Mapayi B, Adewuya A. Psychological Distress, Anxiety, Depression, and Associated Factors Among Nigerian Healthcare Workers During COVID-19 Pandemic: A Cross-Sectional Study. Int J Public Health 2022; 67:1604835. [PMID: 36466008 PMCID: PMC9714461 DOI: 10.3389/ijph.2022.1604835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives: We determined the prevalence of psychological distress, and the associations between sociodemographic factors, anxiety, depression, COVID-19-related experiences, and psychological distress, among nurses and doctors in Nigeria. Methods: The study was a cross-sectional descriptive study, conducted over a month (1st of July-31st of July 2021) among 434 Health Care Workers (HCWs) [225 (51.8%) nurses and 209 (48.2%) doctors] from two tertiary health facilities in southwestern Nigeria. Binary logistic regression was carried out to determine the factors associated with psychological distress (dependent variable), while the independent variables were anxiety, depression, and COVID-19 experience-related factors. Results: The prevalence of moderate and severe psychological distress was 49.1% and 5.8%, respectively. Individuals who had the first degree had significantly lower odds (AOR: 0.43; p = 0.037) of experiencing psychological distress while being a nurse (AOR: 2.03; p = 0.014), higher levels of anxiety (1.28; p < 0.001), and depression (AOR: 1.17; p = 0.005) were associated with significantly higher odds of experiencing moderate to severe levels of psychological distress. Conclusion: There is a high level of psychological distress experienced by these health workers. Hence, they will benefit from strategies to reduce their distress.
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Affiliation(s)
- Olanrewaju Ibikunle Ibigbami
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Adesanmi Akinsulore
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Tolu Opakunle
- State Specialist Hospital, Asubiaro, Oshogbo, Nigeria
| | - Champion Seun-Fadipe
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Olakunle Ayokunmi Oginni
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Victor Ogbonnaya Okorie
- Department of Agricultural Extension and Rural Development, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Ibidunni Oloniniyi
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olushola Olibamoyo
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | - Olutayo Olubunmi Aloba
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Boladale Mapayi
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Abiodun Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
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Affiliation(s)
- Lara Shemtob
- Department of Primary Care and Public Health, Imperial College London, London, UK
- National Institute for Health Research Applied Research Collaboration Northwest London, Imperial College London, London, UK
| | | | - Mark Ferris
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kaveh Asanati
- Department of Primary Care and Public Health, Imperial College London, London, UK
- National Institute for Health Research Applied Research Collaboration Northwest London, Imperial College London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
- National Institute for Health Research Applied Research Collaboration Northwest London, Imperial College London, London, UK
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Otuonye GC, Shenoi N, Wu TD, Guntupalli K, Moukaddam N. " I have nothing more to give": Disparities in burnout and the protective role of immigrant status during the COVID-19 pandemic. Front Public Health 2022; 10:994443. [PMID: 36466537 PMCID: PMC9710614 DOI: 10.3389/fpubh.2022.994443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/17/2022] [Indexed: 11/18/2022] Open
Abstract
Burnout is an epidemic, with deleterious effects on individuals, patient care, and healthcare systems. The Coronavirus Disease 2019 (COVID-19) pandemic may be exacerbating this problem. We aimed to explore socio-cultural and gender norms that modulate burnout development in physicians during the pandemic and analyze any disparities associated with gender, marital and immigration status and work-life balance. We conducted an online cross-sectional survey of physicians (August-November, 2021): The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to measure burnout, combined with a validated survey assessing work-life balance. Demographic data was obtained for each participant. MBI-HSS subscales were measured, along with work and home related changes due to COVID-19. The association between life changes due to COVID-19 and odds of burnout was estimated by logistic regression. Complementary analysis was performed to determine factors most associated with burnout. 352 respondents were analyzed. There was a high prevalence of burnout. Over half of individuals reported a high degree of emotional exhaustion (EE) (56%). 83% of individuals reported at least one life factor changed due to COVID-19. Home-related life changes due to COVID-19 were associated with 143% higher odds of emotional burnout [adjusted odds ratio (aOR) 2.43; 95% confidence interval (CI) 1.49, 3.98] after covariate adjusted analysis. High EE was most evident when there were three or more life changes, suggesting a cumulative effect. First-generation immigrants, older physicians, and trainees were identified as protective factors. Although female gender was identified as a factor related to EE through forward selection, this was not statistically significant (aOR 1.34; 95% CI 0.80, 2.24). Burnout remains pervasive among physicians. We highlight new risk factors for EE (home-life changes due to COVID-19), and protective factors (first-generation immigrants) not previously explored. Understanding burnout and its disparities allows for improved mitigation strategies, decreasing its deleterious effects.
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Affiliation(s)
- Gene Chibuchim Otuonye
- Department of Critical Care, Baylor College of Medicine, Houston, TX, United States,*Correspondence: Gene Chibuchim Otuonye
| | - Nancy Shenoi
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Tianshi David Wu
- Department of Critical Care, Baylor College of Medicine, Houston, TX, United States
| | | | - Nidal Moukaddam
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
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164
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Bartone PT, McDonald K, Hansma BJ, Solomon J. Hardiness moderates the effects of COVID-19 stress on anxiety and depression. J Affect Disord 2022; 317:236-244. [PMID: 36028015 PMCID: PMC9398790 DOI: 10.1016/j.jad.2022.08.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 07/15/2022] [Accepted: 08/20/2022] [Indexed: 12/25/2022]
Abstract
The COVID-19 pandemic has led to sharp increases in mental health problems around the world, most notably in anxiety and depression. The present study examines hardiness and age as potential protective factors against the mental health effects of COVID-related stress. A sample of Canadians balanced across age and gender, completed an online survey including measures of COVID related stressors, hardiness, depression, and anxiety, along with age, gender, and other demographics. Conditional PROCESS analysis showed that COVID stressors led to significant increases in anxiety and depression. Hardiness moderated these relations, with those high in hardiness showing less anxiety and depression. Age was negatively related to anxiety and depression, with highest levels observed among the younger respondents. At the same time, a moderating effect of age was found with respect to depression, with older people showing sharper increases in depression as COVID-related stress goes up. Gender was not a significant factor in any of these relations, meaning that the results apply equally well to both women and men. This study provides evidence that younger people who are also low in hardiness are most vulnerable to developing anxiety and depression while under COVID stress, and so would likely benefit from preventive intervention strategies. While anxiety and depression symptoms are highest among the young, older age groups appear more vulnerable to increasing rates of depression symptoms related to COVID stress. Clinicians and practitioners should thus be especially vigilant for COVID related increases in depression among older people, and those low in psychological hardiness.
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Affiliation(s)
- Paul T. Bartone
- National Defense University, Washington, DC, USA,Dept. of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Corresponding author at: Institute for National Strategic Studies, National Defense University, Fort Lesley J. McNair, 300 5th Ave., SW, Washington, DC 20319, USA
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165
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Schaffler Y, Kaltschik S, Probst T, Jesser A, Pieh C, Humer E. Mental health in Austrian psychotherapists during the COVID-19 pandemic. Front Public Health 2022; 10:1011539. [PMID: 36424964 PMCID: PMC9679414 DOI: 10.3389/fpubh.2022.1011539] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
Although the impact of the COVID-19 pandemic on mental health has been reported in different communities, little is known about the mental health of psychotherapists during the COVID-19 pandemic. This study aimed to assess mental health during the COVID-19 pandemic in Austrian psychotherapists and compare it with the general population. A total of n = 513 psychotherapists (80.5% women; mean age: 53.06 ± 9.94 years) took part in an online survey conducted from April to June 2022. At the same time, a representative sample (N = 1,031) of the Austrian general population was surveyed online. Indicators of mental health were mental wellbeing (WHO-5), depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), and stress (PSS-10). The general population sample was matched according to age and gender with the psychotherapist's data using propensity scores, yielding a final sample of n = 513 (80.5% women; mean age: 52.33 ± 13.39 years). Psychotherapists showed lower odds for exceeding cut-offs for clinically relevant depressive, anxiety, insomnia and stress symptoms (0.34-0.58) compared to the general population. Further studies should elucidate the protective factors underlying these findings.
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Affiliation(s)
| | | | | | | | | | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
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166
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Linzer M, Jin JO, Shah P, Stillman M, Brown R, Poplau S, Nankivil N, Cappelucci K, Sinsky CA. Trends in Clinician Burnout With Associated Mitigating and Aggravating Factors During the COVID-19 Pandemic. JAMA HEALTH FORUM 2022; 3:e224163. [PMID: 36416816 PMCID: PMC9685483 DOI: 10.1001/jamahealthforum.2022.4163] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/25/2022] [Indexed: 11/24/2022] Open
Abstract
Importance The COVID-19 pandemic has affected clinician health and retention. Objective To describe trends in burnout from 2019 through 2021 with associated mitigating and aggravating factors. Design, Setting, and Participants Cross-sectional surveys were sent to physicians and advanced practice clinicians throughout 120 large US health care organizations between February 2019 and December 2021. From 56 090 surveys, there were 20 627 respondents. Exposures Work conditions and COVID-19. Main Outcomes and Measures Surveys measured time pressure, chaos, work control, teamwork, electronic health record use, values alignment, satisfaction, burnout, intent to leave, and in 2021, feeling valued. Multivariate regressions controlling for gender, race and ethnicity, years in practice, and role determined burnout, satisfaction, and intent-to-leave correlates. Results Of the 20 627 respondents (median response rate, 58% [IQR, 34%-86%; difference, 52%]), 67% were physicians, 51% female, and 66% White. Burnout was 45% in 2019, 40% to 45% in early 2020, 50% in late 2020, and 60% in late 2021. Intent to leave increased from 24% in 2019 to more than 40% as job satisfaction decreased. Higher burnout was seen in chaotic workplaces (odds ratio [OR], 1.51; 95% CI, 1.38-1.66; P < .001) and with low work control (OR, 2.10; 95% CI, 1.91-2.30; P < .001). Higher burnout was associated with poor teamwork (OR, 2.08; 95% CI, 1.78-2.43; P < .001), while feeling valued was associated with lower burnout (OR, 0.22; 95% CI, 0.18-0.27; P < .001). In time trends, burnout was consistently higher with chaos and poor work control. For example, in the fourth quarter of 2021 burnout was 36% (95% CI, 31%-42%) in calm environments vs 78% (95% CI, 73%-84%) if chaotic (absolute difference, 42%; 95% CI, 34%-49%; P < .001), and 39% (95% CI, 33%-44%) with good work control vs 75% (95% CI, 69%-81%) if poor (absolute difference, 36%; 95% CI, 27%-44%; P < .001). Good teamwork was associated with lower burnout rates (49%; 95% CI, 44%-54%) vs poor teamwork (88%; 95% CI, 80%-97%; absolute difference, 39%; 95% CI, 29%-48%; P < .001), as was feeling valued (37%; 95% CI, 31%-44%) vs not feeling valued (69%; 95% CI, 63%-74%; absolute difference, 32%; 95% CI, 22%-39%; P < .001). Conclusions and Relevance Results of this survey study show that in 2020 through 2021, burnout and intent to leave gradually increased, rose sharply in late 2021, and varied by chaos, work control, teamwork, and feeling valued. Monitoring these variables could provide mechanisms for worker protection.
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Affiliation(s)
- Mark Linzer
- Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - Jill O. Jin
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Purva Shah
- American Medical Association, Chicago, Illinois
| | - Martin Stillman
- Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - Roger Brown
- University of Wisconsin School of Nursing, Madison
| | - Sara Poplau
- Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
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Kelly PJA, Pilla J, Otor A, Hoadley A, Bauerle Bass S. "We figured it out as we went along": Staff perspectives of COVID-19 response efforts at a large North American syringe services programme. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4605-e4616. [PMID: 35702040 PMCID: PMC9350032 DOI: 10.1111/hsc.13864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/05/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Syringe services programmes face operational challenges to provide life-sustaining services to people who use substances and those who have substance use disorders. COVID-19 has disrupted operations at these programmes and is a threat to people with substance use disorder because of severe poverty, de-prioritisation of COVID-19 safety and high prevalence of comorbidities. This phenomenological qualitative study describes 16 in-depth interviews with staff of one of the largest syringe services programme in North America-Prevention Point Philadelphia, located in the Kensington neighbourhood of Philadelphia, Pennsylvania. Interviews were conducted from December 2020 to February 2021, audio-recorded, transcribed and coded to develop a thematic framework. Participants were mostly white (71.4%) and female (68.8%) with a median age of 31.5. Three main and four sub-themes related to the impact of COVID-19 on the syringe services programme were identified: (1) COVID-19 altered services provision (sub-theme: select service changes should be retained); (2) unclear or absent COVID-19 response guidance which compromised mitigation (sub-themes: COVID-19 messaging was difficult to translate to practice, learn-as-we-go); and (3) staff and clients experienced elevated mental anguish during the pandemic (sub-theme: already limited resources were further strained). COVID-19 presented complex challenges to an organisation normally strained in pre-pandemic times. A staff culture of resourcefulness and resiliency aided the syringe services programme to balance client needs and staff safety. However, staff experienced a serious psychological impact, largely attributable to being unable to find reprieve from the stressors of COVID-19 and the difficulties associated with navigating and acting-on contradictory public health messaging. Staff also shared a belief that the relaxing of some pre-pandemic barriers allowed staff to link clients more readily with services. Syringe services programmes should embrace the potential for lasting changes to health services delivery brought about by wide-scale changes in service provisions because of COVID-19.
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Affiliation(s)
- Patrick J. A. Kelly
- Risk Communication LaboratoryTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
| | - Jenine Pilla
- Risk Communication LaboratoryTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
- Department of Social and Behavioral SciencesTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
| | - AnnaMarie Otor
- Risk Communication LaboratoryTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
- Department of Social and Behavioral SciencesTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
| | - Ariel Hoadley
- Risk Communication LaboratoryTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
- Department of Social and Behavioral SciencesTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
| | - Sarah Bauerle Bass
- Risk Communication LaboratoryTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
- Department of Social and Behavioral SciencesTemple University College of Public HealthPhiladelphiaPennsylvaniaUSA
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168
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Catanzano T, Verma N, Sarkany D, Mohammed TL, Slanetz PJ. The Midcareer Syndrome: Reflection and Repositioning for Better Career Engagement. Acad Radiol 2022; 29:1619-1622. [PMID: 36192268 DOI: 10.1016/j.acra.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Tara Catanzano
- Department of Radiology, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
| | - Nupur Verma
- Department of Radiology, University of Florida, Gainesville, Florida
| | - David Sarkany
- Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York
| | | | - Priscilla J Slanetz
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts
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169
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Andhavarapu S, Yardi I, Bzhilyanskaya V, Lurie T, Bhinder M, Patel P, Pourmand A, Tran QK. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114890. [PMID: 36260970 PMCID: PMC9573911 DOI: 10.1016/j.psychres.2022.114890] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
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Affiliation(s)
- Sanketh Andhavarapu
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Isha Yardi
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Vera Bzhilyanskaya
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Tucker Lurie
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mujtaba Bhinder
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Priya Patel
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, 22 South Greene Street, Suite T3N45, Baltimore, MD 21043, United States; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
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170
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Ringenberg KJ, Fremming BA, Berky KC, Roberts EK, Schulte TE. Operating Room Utilization – How the Pandemic Affected Resulting Case Volume. PERIOPERATIVE CARE AND OPERATING ROOM MANAGEMENT 2022; 29:100296. [PMCID: PMC9637284 DOI: 10.1016/j.pcorm.2022.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/04/2022] [Indexed: 11/08/2022]
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Sharma A, Kumar R. Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID-19 pandemic. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:331. [PMID: 36567992 PMCID: PMC9768745 DOI: 10.4103/jehp.jehp_1140_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/06/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Coronavirus disease (COVID-19) causes significant psychological distress among nursing students. College-bound nursing students might have preferred different types of coping strategies to deal with psychological distress. This study aims to measure the psychological distress and role of coping styles to mediate the stress level among the baccalaureate nursing students amid the COVID-19 pandemic. MATERIAL AND METHODS A cross-sectional online survey was conducted in December 2020 at a nursing college attached to a tertiary care teaching hospital, North India. Nearly 251 baccalaureate nursing students completed the Impact of Event Scale-Revised (IES-R) and Coping Orientation to Problems Experienced Inventory (Brief-COPE) scale to report their psychological distress and coping styles, respectively. Chi-square test, independent sample t-test followed by binary and multivariable regression were used to identify the factors associated with distress in students during the pandemic. RESULTS Students' mean age was 22.22 ± 1.24 years. The mean IES-R was 19.59 ± 12.45 in nursing students. Psychological distress found a significant association with age (P = 0.022), academic class (P = 0.016), travel history (P = 0.034), and being positive reverse transcription-polymerase chain reaction (RT-PCR) for COVID-19 status of self (P = 0.018) and family members in the medical profession (P = 0.013). In binary logistic regression, stress level found a significant association with first-year academic level (OR: 3.250, 95% CI: 1.429-7.390, P = 0.005) and family members in the medical profession (OR: 4.44, 95% CI: 1.019-19.382, P = 0.047). Adaptive coping styles were more frequently preferred than maladaptive coping styles (54% vs 41%). Adaptive (r = 0.295, P < 0.001) and maladaptive coping (r = 0.403, P < 0.001) shows a significant positive relationship with stress in students, respectively. CONCLUSIONS Coronavirus pandemic causes significant distress among nursing students. Students were able to manage stress using acceptance and religious/spiritual coping strategies. During the pandemic, stress management to support mental health is highly recommended.
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Affiliation(s)
- Ankita Sharma
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Rajesh Kumar
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
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172
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Sims H, Alvarez C, Grant K, Walczak J, Cooper LA, Ibe CA. Frontline healthcare workers experiences and challenges with in-person and remote work during the COVID-19 pandemic: A qualitative study. Front Public Health 2022; 10:983414. [PMID: 36203659 PMCID: PMC9531651 DOI: 10.3389/fpubh.2022.983414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction The COVID-19 pandemic created new and exacerbated existing stressors for frontline healthcare workers. Despite being disproportionately affected by COVID-19, little is known about the experiences of frontline healthcare workers serving marginalized populations in community settings. Design We used qualitative descriptive methods to understand the experiences of 12 frontline healthcare workers (HCWs) supporting primarily underserved populations in outpatient settings during COVID-19. Interviews were conducted from March to April 2021. Methods Interviews were held virtually via Zoom using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and uploaded into NVivo 12 qualitative data analysis software. The transcripts were dually coded by members of the research team and a thematic analysis was conducted. Results Four major themes from the interviews were identified: stressors and burnout, coping strategies, organizational support, and recommendations. HCWs described how the early adjustment period to the pandemic created new challenges as they attempted to navigate changes in the workplace and altered responsibilities at home. HCWs felt largely unsupported by their organizations as they attempted to cope with stressors. Organizational support programs and resources often did not meet frontline workers' needs, and sentiments of unappreciation from leadership contributed to feelings of burnout and frustration as pandemic-related challenges persisted and evolved. Conclusion Despite encountering numerous stressors at work and home, resulting from pandemic-related disruptions, frontline HCWs continued to provide care for their clients while navigating emerging challenges. Health organizations should include HCWs in decision-making processes when implementing support systems for workers during times of crisis.
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Affiliation(s)
- Holly Sims
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Carmen Alvarez
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States
| | - Kimesha Grant
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Jessica Walczak
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Lisa A. Cooper
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Chidinma A. Ibe
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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173
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Krishnan PS, Daggumati S, Widmeyer J, Quinn KJ, Yu C, Vahidi N, Kamdar R, Kandl C. The Lasting Impact of the COVID-19 Pandemic on Surgical Key Indicator Cases for Otolaryngology Residency Education. Ann Otol Rhinol Laryngol 2022:34894221123121. [PMID: 36123958 DOI: 10.1177/00034894221123121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Early on during the COVID-19 pandemic, the US Centers for Medicare & Medicaid Services (CMS) and other government as well as medical institutions recommended that surgeons postpone nonessential surgeries. The aim of our study is to examine the impact of the COVID-19 pandemic on otolaryngology surgical training by evaluating changes in surgical volumes through various time points relative to the height of the pandemic. METHODS We performed a retrospective review of all surgical cases performed by the Otolaryngology-Head and Neck Surgery department at a tertiary care academic center from 3 time periods: July 1st, 2018, to June 30th, 2019; July 1st, 2019, to June 30th, 2020; and July 1st, 2020, to June 30th, 2021. RESULTS From the 2018-19 period to the 2020-21 period, the total number of overall cases decreased by 9.9%, from 2386 to 2148 cases. During this same time duration, the number of key indicator cases decreased by 13.4%, from 1715 to 1486 cases. Relative to other cases, ethmoidectomy, rhinoplasty, and stapes/OCR cases decreased the most during the 2019-20 period by 41.9%, 41.8%, and 29.5%, respectively. From the 2018-19 period to the 2020-21 period, thyroid/parathyroid cases decreased the most by 35.4%. Only ethmoidectomy and oral cavity cases showed increases during this period at 9.7% and 24.4%, respectively. CONCLUSIONS Although case volumes have stayed relatively constant, key indicator case volumes at the present tertiary care academic center have not yet fully recovered from the COVID-19 pandemic. Efforts must be made to determine how this has impacted residency surgical education.
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Affiliation(s)
- Pavan S Krishnan
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Srihari Daggumati
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Jonathan Widmeyer
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Kevin J Quinn
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Cheryl Yu
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Nima Vahidi
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Rushabh Kamdar
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Christopher Kandl
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
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174
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Najjar-Debbiny R, Chazan B, Lobl R, Greene MT, Ratz D, Saint S, Carmeli Y, Schwaber MJ, Ben-David D, Shitrit P, Paz A, Brosh-Nissimov T, Mor M, Regev-Yochay G, Ciobotaro P, Yinnon AM, Mar-Chaim D, Rubinovitch B, Hussein K, Benenson S. Healthcare-associated infection prevention and control practices in Israel: results of a national survey. BMC Infect Dis 2022; 22:739. [PMID: 36114529 PMCID: PMC9482296 DOI: 10.1186/s12879-022-07721-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Healthcare-associated infection (HAI) is a common and largely preventable cause of morbidity and mortality. The COVID-19 pandemic has presented unprecedented challenges to health systems. We conducted a national survey to ascertain hospital characteristics and the use of HAI prevention measures in Israel.
Methods We e-mailed surveys to infection prevention and control (IPC) leads of acute care hospitals in Israel. The survey included questions about the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). The survey also assessed COVID-19 impact and healthcare worker well-being. Results IPC leads from 15 of 24 invited hospitals (63%) completed the survey. Only one-third of respondents reported strong support for IPC from hospital leadership. Although several prevention practices were used by all hospitals (e.g., maximum sterile barrier precautions for CLABSI and real-time assessment of environmental cleaning for CDI), use of other practices was suboptimal—particularly for CAUTI and VAP. COVID-19 had a profound impact on Israeli hospitals, with all hospitals reporting opening of new units to care for COVID patients and most reporting moderate to extreme financial hardship. All hospitals reported highly successful plans to vaccinate all staff and felt confident that the vaccine is safe and effective.
Conclusion We provide a status report of the IPC characteristics and practices Israeli hospitals are currently using to prevent HAIs during the COVID-19 era. While many globally accepted IPC practices are widely implemented, opportunities to increase the use of certain IPC practices in Israeli hospitals exist. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07721-8.
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Mann A, Fainstad T, Shah P, Dieujuste N, Thurmon K, Dunbar K, Jones C. "We're all going through it": impact of an online group coaching program for medical trainees: a qualitative analysis. BMC MEDICAL EDUCATION 2022; 22:675. [PMID: 36100880 PMCID: PMC9468533 DOI: 10.1186/s12909-022-03729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Trainees in graduate medical education are affected by burnout at disproportionate rates. Trainees experience tremendous growth in clinical skills and reasoning, however little time is dedicated to metacognition to process their experiences or deliberate identity formation to create individualized definitions of success and wellbeing. The purpose of this study was to understand the perspectives and experiences of trainees who participated in a 6-month, web-based, group coaching program for women residents in training. METHODS Better Together Physician Coaching is a six-month, self-paced, online, asynchronous, coaching program with multiple components including live coaching calls, unlimited written coaching, and self-study modules. Semi-structured interviews of seventeen participants of Better Together from twelve GME programs within a single institution in Colorado were conducted from May to June of 2021. All identified as women and had participated in a 6-month coaching program. Both inductive and deductive methods were used in collecting and analyzing the data with an aim to understand learners' perceptions of the coaching program, including "how and why" the coaching program affected training experiences and wellbeing. RESULTS Three main themes emerged as benefits to the coaching program from the data: 1) practicing metacognition as a tool for healthy coping 2) building a sense of community, and 3) the value of a customizable experience. CONCLUSIONS Female trainees who participated in a group coaching program expressed that they found value in learning how to cope with stressors through metacognition-focused coaching. They also described that building a community and being able to customize the experience were positive aspects of the program. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05280964 . Date of registration: March 15th 2022. Retrospectively registered. URL of trial registry record.
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Affiliation(s)
- Adrienne Mann
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Veterans Health Administration, Aurora, CO, USA.
- Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St., Aurora, CO, 80045, USA.
| | - Tyra Fainstad
- Department of Medicine, Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Lowry Internal Medicine, 8101 E Lowry Blvd Ste 120, Denver, CO, 80230, USA.
| | - Pari Shah
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Nathalie Dieujuste
- Adult & Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado, School of Medicine, Aurora, CO, USA
| | - Kerri Thurmon
- Department of Surgery, Division of Urology, Denver Health, Denver, USA
| | - Kimiko Dunbar
- Department of Pediatrics, Division of Hospital Medicine, Children's Hospital, Aurora, USA
| | - Christine Jones
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Veterans Health Administration, Aurora, CO, USA
- Veterans Health Administration, Eastern CO Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Aurora, CO, USA
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Lawton R, Thomas EJ. Overcoming the ‘self-limiting’ nature of QI: can we improve the quality of patient care while caring for staff? BMJ Qual Saf 2022; 31:857-859. [DOI: 10.1136/bmjqs-2022-015272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 11/03/2022]
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Shaikh CF, Palmer Kelly E, Paro A, Cloyd J, Ejaz A, Beal EW, Pawlik TM. Burnout Assessment Among Surgeons and Surgical Trainees During the COVID-19 Pandemic: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:1206-1220. [PMID: 35659443 PMCID: PMC9091165 DOI: 10.1016/j.jsurg.2022.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The objective of the current study was to summarize current research on burnout among surgical trainees and surgeons during the COVID-19 pandemic. METHODS PubMed, SCOPUS, Embase, and Psych INFO were systematically searched for studies that evaluated burnout during the COVID-19 pandemic among surgical trainees and surgeons. RESULTS A total of 29 articles met inclusion criteria, most of which originated from the United States (n = 18, 62.1%). Rates of burnout ranged from 6.0% to 86.0%. Personal factors responsible for burnout were fear of contracting/transmitting COVID-19 (8 studies, 27.6%), female gender (8, 27.6%), and younger age (5, 17.2%). Professional factors contributing to burnout included increased COVID-19 patient clinical load (6, 20.7%), limited work experience (6, 20.7%), reduction in operative cases (5, 17.2%) and redeployment to COVID-19 wards (4, 13.8%). The COVID-19 pandemic negatively impacted surgical education due to reduced number of operative cases (11, 37.9%), decreased hands-on experience (4, 13.8%), and not being able to complete case requirements (3, 10.34%). The shift of didactics to virtual formats (3, 10.3%), increased use of telemedicine (2, 6.9%), and improved camaraderie among residents (1, 3.4%) were viewed as positive consequences. CONCLUSION COVID-19 related burnout was reported in as many as 1 in 2 surgical trainees and attending surgeons. Intrinsic- (i.e., gender, age), family- (i.e., family/being married/having children or being single/not having children), as well as work-related extrinsic- (i.e., work-force deployment, risk of infection/spread, changes in educational format) factors were strongly associated with risk of burnout. These factors should be considered when designing interventions to ameliorate burnout among surgical trainees and surgeons.
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Affiliation(s)
- Chanza Fahim Shaikh
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Elizabeth Palmer Kelly
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Alessandro Paro
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Jordan Cloyd
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Aslam Ejaz
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Eliza W Beal
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio.
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Winslow BD, Kwasinski R, Hullfish J, Ruble M, Lynch A, Rogers T, Nofziger D, Brim W, Woodworth C. Automated stress detection using mobile application and wearable sensors improves symptoms of mental health disorders in military personnel. Front Digit Health 2022; 4:919626. [PMID: 36082233 PMCID: PMC9445306 DOI: 10.3389/fdgth.2022.919626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Leading causes in global health-related burden include stress, depression, anger, fatigue, insomnia, substance abuse, and increased suicidality. While all individuals are at risk, certain career fields such as military service are at an elevated risk. Cognitive behavioral therapy (CBT) is highly effective at treating mental health disorders but suffers from low compliance and high dropout rates in military environments. The current study conducted a randomized controlled trial with military personnel to assess outcomes for an asymptomatic group (n = 10) not receiving mental health treatment, a symptomatic group (n = 10) using a mHealth application capable of monitoring physiological stress via a commercial wearable alerting users to the presence of stress, guiding them through stress reduction techniques, and communicating information to providers, and a symptomatic control group (n = 10) of military personnel undergoing CBT. Fifty percent of symptomatic controls dropped out of CBT early and the group maintained baseline symptoms. In contrast, those who used the mHealth application completed therapy and showed a significant reduction in symptoms of depression, anxiety, stress, and anger. The results from this study demonstrate the feasibility of pairing data-driven mobile applications with CBT in vulnerable populations, leading to an improvement in therapy compliance and a reduction in symptoms compared to CBT treatment alone. Future work is focused on the inclusion of passive sensing modalities and the integration of additional data sources to provide better insights and inform clinical decisions to improve personalized support.
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Affiliation(s)
- Brent D. Winslow
- Design Interactive, Inc., Orlando, FL, United States
- Correspondence: Brent D. Winslow
| | | | | | | | - Adam Lynch
- Design Interactive, Inc., Orlando, FL, United States
| | - Timothy Rogers
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Debra Nofziger
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - William Brim
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Craig Woodworth
- Department of Behavioral Health, Brook Army Medical Center, Fort Sam Houston, TX, United States
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Zarei S, Fooladvand K. Mediating effect of sleep disturbance and rumination on work-related burnout of nurses treating patients with coronavirus disease. BMC Psychol 2022; 10:197. [PMID: 35962404 PMCID: PMC9372524 DOI: 10.1186/s40359-022-00905-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background COVID-19 has created significant and unprecedented psychological distress on nurses working with COVID-19 patients. Nurses dealing with such psychological distress are prone to burnout. This study examined the mediating role of sleep disturbance and rumination in the association between psychological distress and work-related burnout of nurses treating COVID-19 patients. Methods A cross-sectional study was conducted from 26th February to 16th March 2021, on a sample of 250 nurses who were actively working during the COVID-19 pandemic in five referral hospitals in Tehran, Iran. The Oldenburg Burnout Inventory, Kessler Psychological Distress Scale (K10), Pittsburgh Sleep Quality Index, and Ruminative Responses Scale were used to collect data. Data analysis was based on pearson’ correlation analysis and path analysis. Results Psychological distress has a significant effect on job burnout. When sleep disturbances were modeled as a mediator, path coefficients of psychological distress showed a significant effect on job burnout. Also, according to the findings, rumination poses a significant mediating effect on the association between psychological distress and job burnout. Conclusion This study demonstrated the importance of designing psychological interventions intended to reduce sleep disturbances and rumination when experiencing stressful events to avoid job burnout among nurses.
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Affiliation(s)
- Salman Zarei
- Psychology Department, Lorestan University, Khorramabad, Iran.
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Balton S, Vallabhjee AL, Pillay SC. When uncertainty becomes the norm: The Chris Hani Baragwanath Academic Hospital’s Speech Therapy and Audiology Department’s response to the COVID-19 pandemic. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e11. [PMID: 36073072 PMCID: PMC9452927 DOI: 10.4102/sajcd.v69i2.913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022] Open
Abstract
Background In March 2020 the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. Management of this pandemic had significant implications for clinical departments across the world. Healthcare systems were urgently required to reorganise and redesign patient care as well as repurpose staff. Objectives We will share the lived experience of our response as speech therapy and audiology (STA) clinicians to the COVID-19 pandemic. Method This study adopted an autoethnographic approach within Bronfenbrenner’s bioecological model to describe STA clinicians’ response to the COVID-19 pandemic. Results Adaptations to practice were made to continue service provision whilst adhering to COVID-19 regulations. We assisted in other areas to meet the immediate needs of the hospital. Service delivery strategies consisted of a review of clinical and quality assurance protocols. We developed a telehealth service package which included a hybrid approach, within a context of digital poverty. We created resources to ensure continuity of care. Collaboration within our systems facilitated innovative solutions. Mental health and well-being of staff members were key to the response developed. Conclusion South African healthcare systems’ inequalities were highlighted by the pandemic. The response showed that the needs of vulnerable populations were not accounted for when developing this public health response. Lessons learnt included the importance of adaptability, becoming comfortable with uncertainty and maintaining open and transparent communication. Consultation and collaboration within various levels of our healthcare system were critical in responding to the needs of patients. Commitment to compassionate leadership and staff well-being were crucial.
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Affiliation(s)
- Sadna Balton
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg.
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Schiff M, Chow A, Noi GS. Riding the waves of the pandemic from West to East: The social workers' experience an International collaboration on study of social workers during COVID-19. SOCIAL WORK IN HEALTH CARE 2022; 61:185-198. [PMID: 35929856 DOI: 10.1080/00981389.2022.2108569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Miriam Schiff
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University, Israel
| | - Amy Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Goh Soon Noi
- Medical Social Services, Changi General Hospital, Singapore
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Kunno J, Supawattanabodee B, Sumanasrethakul C, Wiriyasirivaj B, Yubonpunt P. Burnout prevalence and contributing factors among healthcare workers during the COVID-19 pandemic: A cross-sectional survey study in an urban community in Thailand. PLoS One 2022; 17:e0269421. [PMID: 35926013 PMCID: PMC9352097 DOI: 10.1371/journal.pone.0269421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 05/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background Burnout is associated with an increased risk for severe COVID-19. Few studies have examined burnout prevalence related to healthcare workers during the pandemic. This study investigated the burnout prevalence and contributing factors among HCWs, including medical staff and support staff, during the COVID-19 pandemic in an urban community in Thailand. Methods A cross-sectional online survey was distributed among HCWs in Bangkok, Thailand, from July–August 2021. The independent t-test and one-way analysis of variance (ANOVA) were used to compare the contributing factors and burnout items. Variable factors associated with burnout among HCWs were used in multiple linear regression models. Results A total of 517 HCWs’ survey responses were received. Most participants were medical staff (55.3%), female (83.4%), and over the age of 35 (59.4%); most participants (65.6%) did not have any diseases but had family members that did (63.6%). The prevalence of overall burnout presented among medical staff (25.9%). The results of the multiple linear regression models found that female (vs. male, β 0.088; 95% CI 0.033, 6.614) was higher associated with overall burnout score. In addition, hours of sleep as > 6 hr./day (vs. ≤ 6 hr./day, β -0.120; 95% CI -6.012, -0.969) was lower associated with overall burnout score. Conclusion This study highlights the importance of addressing burnout among HCWs, in which female medical staff who slept less than six hours per day were associated with burnout. Our study further suggested that both intervention and identification are needed of frontline HCWs to prevent and reduce the risk of burnout, as the proportion of females compared to males is high. Thus, the government should provide support in these areas to prevent a humanitarian crisis.
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Affiliation(s)
- Jadsada Kunno
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Busaba Supawattanabodee
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Chavanant Sumanasrethakul
- Department of Urban Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Budsaba Wiriyasirivaj
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Pataraporn Yubonpunt
- Department of Public Health, Faculty of Public and Environmental Health, Huachiew Chalermprakiet University, Samutprakan, Thailand
- * E-mail:
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Work Stress and Willingness of Nursing Aides during the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10081446. [PMID: 36011103 PMCID: PMC9407857 DOI: 10.3390/healthcare10081446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, nursing aides (NAs) experienced greater work stress than they do typically because they worked in highly contagious environments. This may have influenced their work morale and willingness to work, which can reduce patient satisfaction, influence their physical and mental health, and even endanger patient safety or cause medical system collapse. Design: A cross-sectional survey with a structured self-report questionnaire was conducted. Setting and Participants: 144 NAs from a medical center in Central Taiwan participated. Methods: We recruited NAs through convenience sampling to discuss their work stress, willingness to work, and patients’ satisfaction with them during the COVID-19 pandemic. Result: Of the 144 recruited NAs, 115 (79.9%) were women and 29 (20.1%) were men, and 89 (61.8%) had completed COVID-19 training courses. NAs with different work tenure lengths exhibited significant differences in work stress (p = 0.022), willingness to work (p = 0.029), and patient satisfaction (p = 0.029) scores during the pandemic. Conclusion: The study findings provide crucial data for the management of NAs during pandemics to prevent them from neglecting patients due to excessive work stress or losing their willingness to work, which may cause the medical system to collapse.
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Abstract
The measures put in place to contain the rapid spread of COVID-19 infection, such as quarantine, self-isolation, and lockdown, were supportive but have significantly affected the mental wellbeing of individuals. The primary goal of this study was to review the impact of COVID-19 on mental health. An intensive literature search was conducted using PsycINFO, PsyciatryOnline, PubMed, and the China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and June 2022 were retrieved and appraised. Reviews and retrospective studies were excluded. One hundred and twenty-two (122) relevant articles that fulfilled the inclusion criteria were finally selected. A high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorders was reported. Alcohol and substance abuse, domestic violence, stigmatization, and suicidal tendencies have all been identified as direct consequences of lockdown. The eminent risk factors for mental health disorders identified during COVID-19 include fear of infection, history of mental illness, poor financial status, female gender, and alcohol drinking. The protective factors for mental health include higher income levels, public awareness, psychological counseling, social and government support. Overall, the COVID-19 pandemic has caused a number of mental disorders in addition to economic hardship. This strongly suggests the need to monitor the long-term impact of the COVID-19 pandemic on mental health.
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Tekkas Kerman K, Albayrak S, Arkan G, Ozabrahamyan S, Beser A. The effect of the COVID-19 social distancing measures on Turkish women's mental well-being and burnout levels: A cross-sectional study. Int J Ment Health Nurs 2022; 31:985-1001. [PMID: 35466490 PMCID: PMC9111787 DOI: 10.1111/inm.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2022] [Indexed: 11/30/2022]
Abstract
Lockdown and social distancing measures during the COVID-19 pandemic increase women's responsibilities and influence their mental health. This study aimed to assess the effect of COVID-19 social distancing measures on mental well-being and burnout levels of women using an online cross-sectional survey in Turkey. The Warwick-Edinburgh Mental Well-being Scale, The Burnout Measure, and Sociodemographic form were used in this study. All analyses were performed on a sample of 438 women aged between 18 and 65. The mean score of mental well-being was 47.86 (SD = 10.04) and the mean score of burnout was 3.86 (SD = 1.16). Being younger than 30 years old (t = 2.14, P = 0.033), having undergraduate education or above (F = 5.09, P = 0.007), part-time working (F = 5.39, P = 0.005), attending to school (t = 2.68, P = 0.008), having COVID-19 symptoms (t = 6.01, P < 0.001), and perceiving spousal emotional support (F = 3.47, P = 0.016) were the factors associated with high burnout. Being older than 30 years old (z = -3.11, P = 0.002), full time working (H = 11.96, P = 0.003), not attending to school (z = -2.09, P = 0.036), perceiving spousal emotional (H = 13.22, P = 0.004), or social (H = 13.11, P = 0.004) support were the factors associated with higher mental well-being. Age (β = -0.03, P = 0.001), having two or more children (β = 0.42, P = 0.015), and perceiving COVID-19 symptoms (β = -0.73, P < 0.001) were the predictors of women's burnout. This study shows that mental well-being and burnout levels of women in Turkey have been considerably affected as a result of social distancing measures taken with the first wave of the pandemic. Findings signal the immediate need for targeted mental health nursing interventions. Therefore, technology-based mental health support programmes are recommended to be designed and utilized by mental health nurses.
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Affiliation(s)
| | | | - Gulcihan Arkan
- Faculty of Health Sciences, Izmir Demokrasi University, Izmir, Turkey
| | | | - Ayse Beser
- Koç University School of Nursing, Istanbul, Turkey
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Linzer M, McLoughlin C, Poplau S, Goelz E, Brown R, Sinsky C. The Mini Z Worklife and Burnout Reduction Instrument: Psychometrics and Clinical Implications. J Gen Intern Med 2022; 37:2876-2878. [PMID: 35048290 PMCID: PMC9411313 DOI: 10.1007/s11606-021-07278-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/10/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Mark Linzer
- Department of Medicine and Institute for Professional Worklife, Hennepin Healthcare System, 701 Park Avenue (G5), Minneapolis, MN, 55415, USA.
| | | | - Sara Poplau
- Department of Medicine and Institute for Professional Worklife, Hennepin Healthcare System, 701 Park Avenue (G5), Minneapolis, MN, 55415, USA
| | - Elizabeth Goelz
- Department of Medicine and Institute for Professional Worklife, Hennepin Healthcare System, 701 Park Avenue (G5), Minneapolis, MN, 55415, USA
| | - Roger Brown
- University of Wisconsin School of Nursing, Madison, WI, USA
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Perry H, Narayan A, Phillips J, Sheth MM, Slanetz PJ. Tips for Successful Career Transitions in Breast Imaging. JOURNAL OF BREAST IMAGING 2022; 4:423-429. [PMID: 38416984 DOI: 10.1093/jbi/wbac039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Indexed: 03/01/2024]
Abstract
Whether beginning a new career in breast imaging or switching into a different breast imaging practice for personal or professional advancement, a leadership opportunity, a need to relocate geographically, or simply a better opportunity, it is critical to transition between positions as smoothly as possible. Thoroughly reflecting on your career priorities and goals is essential prior to undertaking any career transition. Once the decision has been made to move to a new position, it is imperative to learn about the dynamics of the new practice and practice environment. Here, we provide suggestions on how to hit the ground running when joining a new breast imaging practice.
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Affiliation(s)
- Hannah Perry
- University of Vermont Medical Center and Larner College of Medicine at the University of Vermont, Department of Radiology, Burlington, VT, USA
| | - Anand Narayan
- University of Wisconsin-Madison, Department of Radiology, Madison, WI, USA
| | - Jordana Phillips
- Boston University Medical Center and Boston University School of Medicine, Department of Radiology, Boston, MA, USA
| | - Monica M Sheth
- NYU Langone-Long Island Hospital and NYU Grossman School of Medicine, Department of Radiology, Mineola, NY, USA
| | - Priscilla J Slanetz
- Boston University Medical Center and Boston University School of Medicine, Department of Radiology, Boston, MA, USA
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The Link between Job Demands, Burnout, and the Self-Undermining of Healthcare Employees during the COVID-19 Pandemic: An Underestimated Threat? Healthcare (Basel) 2022; 10:healthcare10081408. [PMID: 36011065 PMCID: PMC9408603 DOI: 10.3390/healthcare10081408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/18/2022] [Accepted: 07/23/2022] [Indexed: 11/24/2022] Open
Abstract
Previous studies have shown an association between job demands and burnout in medical staff during the pandemic. However, these studies have ignored the possibility of loss cycle occurrence during the crisis. In order to address this gap, the aim of this study was to test the mediating role of burnout in the positive relationship between job demands and the self-undermining of healthcare employees during the COVID-19 pandemic. Self-undermining represents the set of behaviors that generate obstacles and diminish performance (e.g., careless mistakes, generating interpersonal conflicts, poor communication), and it has been suggested that this variable could explain the loss cycle between demands and burnout (the phenomenon in which demands increase burnout, which in turn leads to even greater demands). A total of 523 healthcare workers from two Romanian hospitals (e.g., physicians, nurses, stretcher-bearers) completed a self-report questionnaire during the COVID-19 outbreak that included three job demands, burnout, and self-undermining. Burnout mediated the positive relationship between two demands (work–family conflict; lack of equipment and supplies) and self-undermining. These results may provide a preliminary indication for the existence of loss cycles, supporting the assumptions of the job demands-resources theory. Moreover, the results highlight the risk of loss cycle occurrences for healthcare employees during outbreaks.
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Hange N, Agoli AM, Pormento MKL, Sharma A, Somagutta MR, Paikkattil N, Jadhav A, Bethineedi D, Pisude P. Impact of COVID-19 response on public health literacy and communication. Health Promot Perspect 2022; 12:1-9. [PMID: 35854843 PMCID: PMC9277294 DOI: 10.34172/hpp.2022.01] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/06/2022] [Indexed: 11/21/2022] Open
Abstract
With unaddressed challenges of pandemic with re-emergence of coronavirus disease 2019 (COVID-19) waves, public health literacy and communication have proved to be a prerequisite for effective communication as part of the control strategy. Hence this article addressed the impact of COVID-19 response policies on public health literacy. Considering the rapid transmission of COVID-19, taking lives needs urgent attention from the population›s perspective to be more vigilant about health information and incorporate that into their daily routines. To be responsible and resilient globally, governments and states are formulating different health policies and related plans to prevent and control the spread of the pandemic. This article has recommended short-term measures, including smart focused IEC targeted on vaccination and motivational sessions for health care workers and front line workers. Targeted Long-term measures included healthcare system reforms inclusive of resources, workforce, capacity building with particular focus on lifestyle measures addressing non-communicable disease prevention.
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Affiliation(s)
- Namrata Hange
- Division of Research, Eurasian Cancer Research Council (ECRC), Chembur, Mumbai, Maharashtra, India
| | - Arjola Musta Agoli
- Tirana University of Medicine, Dept of Obstetrics & Gynecology, Rruga e Dibrës, Tirana, Albania
| | - Maria Kezia Lourdes Pormento
- Ateneo School of Medicine and Public Health, Don Eugenio Lopez Sr. Medical Complex, Ortigas Ave, Pasig, 1604 Metro Manila, Philippines
| | - Amrit Sharma
- Department of Community Health, Christian Medical College, Christian Medical College, Vellore, Tamil Nadu, India
| | - Manoj Reddy Somagutta
- Avalon University School of Medicine, 212 Churchill Hubbard Road Youngstown, OH, USA
| | | | - Amol Jadhav
- Medical Operations, JV Gokal Charity Trust, Kasturi Building, 2nd Floor, 171/172, J Tata Road, Mumbai, Maharashtra, India
| | - Deepak Bethineedi
- Andhra Medical College, Road King George Hospital, opp. Collector Office, Maharani Peta, Visakhapatnam, Andhra Pradesh 530002, India
| | - Pravin Pisude
- ESIC Medical College and Hospital and SS Hospital, Sanath Naga Sanath Nagar Hyderabad, Telangana, India
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191
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Tucker K, Sullivan S, Deal AM, Allman K, Cuaboy L, McCabe SD, Gehrig PA. A prospective randomized trial of standard versus multimedia-supplemented counseling in patients undergoing endometrial cancer staging surgery. Gynecol Oncol 2022; 166:397-402. [PMID: 35863993 DOI: 10.1016/j.ygyno.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A patient's understanding of surgery is often limited, especially in the setting of complex oncologic procedures. The use of supplemental materials can improve patients' knowledge of their procedure and satisfaction with decision making. We sought to determine if a multimedia-supplemented approach in patients undergoing robotic endometrial cancer staging improves satisfaction with preoperative counseling. Secondary objectives were patient comprehension, physician satisfaction, and visit length. METHODS From 2018 to 2019, patients were randomized to standard physician education (SPE) or multimedia-based education (MBE), which included watching two novel videos followed by focused physician counseling. Basic demographic information was collected. Patient satisfaction was assessed using the Client Satisfaction Questionnaire-8 (CSQ-8, a validated satisfaction survey, scored 8-32) and a global satisfaction score (GGS, 10-point scale). Physician satisfaction was assessed using a GGS. Comprehension was assessed with a study-specific 9-question survey at three time points. t-tests and linear mixed models were used to compare groups. RESULTS Of the 75 patients included in the analysis, the majority were white (70%), 50-70 years old (72%), and had at least some college education (74%). The MBE group reported higher satisfaction on the CSQ-8 (31.69 vs 30.69, p < 0.01) and global satisfaction score (9.95 vs 9.74, p = 0.04). There was no difference in comprehension scores over time (p = 0.84) or between groups (p = 0.23). Visit lengths were significantly longer in the MBE group (90.36 vs 80.46 min, p = 0.04). CONCLUSIONS Patients had high satisfaction and comprehension with both SPE and MBE. Multimedia education may be implemented in preoperative counseling based on provider preference and consideration should be made for further study of satisfaction, both patient and physician, and visit length after the initial implementation period.
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Affiliation(s)
- Katherine Tucker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, United States of America.
| | - Stephanie Sullivan
- Division of Gynecologic Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Allison M Deal
- Senior Biostatistician, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America
| | - Kathryn Allman
- Nurse Practitioner, Palliative Care Program, University of North Carolina, Chapel Hill, NC, United States of America
| | - Luz Cuaboy
- Lead Study Coordinator, Office of Clinical & Translational Research, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America
| | - Sean D McCabe
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Paola A Gehrig
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, United States of America
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192
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Jow S, Doshi S, Desale S, Malmut L. Mental health impact of COVID-19 pandemic on therapists at an inpatient rehabilitation facility. PM R 2022; 15:168-175. [PMID: 35666036 PMCID: PMC9347797 DOI: 10.1002/pmrj.12860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/25/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Healthcare workers have faced extraordinary work-related stress in the face of the COVID-19 pandemic. Physical therapy, occupational therapy, and speech-language pathology providers at inpatient rehabilitation facilities may represent a distinct at-risk subgroup for work-related stress during the pandemic due to the usual nature of their job duties, including close physical contact and extended treatment times. OBJECTIVE To evaluate the impact of the COVID-19 pandemic on work-related stress and occurrence of depression and anxiety in physical therapists, occupational therapists, and speech-language pathologists during the first surge of COVID-19 hospitalizations. DESIGN Cross-sectional survey. SETTING Academic, freestanding inpatient rehabilitation facility. PARTICIPANTS Survey responses were collected from 38 therapists. INTERVENTION A 26-item electronic questionnaire containing a mix of multiple-choice and open-ended questions. MAIN OUTCOME MEASURES Positive screens for depression or anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder 7-item (GAD-7) scale, respectively. RESULTS Seven individuals (19%) scored at or above the clinically significant cutoff of 10 on each the PHQ-9 and GAD-7, corresponding to increased risk for depression and anxiety. Therapists younger than 30 years old had significantly higher GAD-7 scores compared to therapists between 30-39 years old (p < .05). Occupational stress was attributed to a number of causes including concerns for health and safety, unpredictable changes in hospital protocols and work assignments, acquisition of additional work duties, concerns about the ability to provide high-quality patient care in a restricted environment, and the psychological toll of caring for patients with or recovering from COVID-19. CONCLUSION This cross-sectional survey highlights the impact of the COVID-19 pandemic on occupational stress and mental health of therapists working at an inpatient rehabilitation facility during the first surge of COVID-19 hospitalizations. This research may help institutions identify at-risk individuals who may benefit from support and guide policy changes to resolve potentially modifiable factors at a systems level.
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Affiliation(s)
- Steven Jow
- Department of Physical Medicine and RehabilitationMedStar National Rehabilitation HospitalWashingtonDistrict of ColumbiaUSA,Department of Physical Medicine and RehabilitationGeorgetown University School of MedicineWashingtonDistrict of ColumbiaUSA
| | - Saumil Doshi
- Department of Physical Medicine and RehabilitationGeorgetown University School of MedicineWashingtonDistrict of ColumbiaUSA,Department of Physical Medicine and RehabilitationMedStar Washington Hospital CenterWashingtonDistrict of ColumbiaUSA
| | - Sameer Desale
- Department of Physical Medicine and RehabilitationMedStar Health Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Laura Malmut
- Department of Physical Medicine and RehabilitationMedStar National Rehabilitation HospitalWashingtonDistrict of ColumbiaUSA,Department of Physical Medicine and RehabilitationGeorgetown University School of MedicineWashingtonDistrict of ColumbiaUSA
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193
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Burnout Reduction in Acute Care Surgeons: Impact of Faculty Schedule Change at a Level 1 Trauma and Tertiary Care Center. J Trauma Acute Care Surg 2022; 93:439-445. [PMID: 35788582 DOI: 10.1097/ta.0000000000003736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Acute care surgeons are prone to burnout due to heavy workload, concurrent clinical responsibilities, and busy in-house call. Modifiable burnout factors have been identified, but few studies have looked for longitudinal effects after change is implemented. We hypothesized that optimizing faculty workflow could decrease burnout without compromising productivity. METHODS We streamlined the faculty schedule at our institution to eliminate 24-hour call by creating weekly blocks of 12-hour day and night call, free from other clinical obligations. Protected academic time was added. The Maslach Burnout Inventory (MBI) and Areas of Worklife Survey (AWS) for health care providers were given to faculty, as well as close friends or family, at baseline, 6, and 12 months. MBI and AWS proprietary formulas were used to assess change in factors contributing to burnout. Our primary outcome measure was the presence of factors contributing to burnout. Chart delinquency, RVUs, and academic projects were secondary outcome measures assessing clinical productivity change. RESULTS Survey completion rates were 92% for faculty and 80% for family. All burnout risk factors improved at 6 and 12 months. In surgeon and family groups, the following improvements were noted in the mean scores of risk factors at one year: workload (74%, 68%), control (38%, 16%), reward (14%, 24%), fairness (69%, 22%), emotional exhaustion (27.5%, 24%), depersonalization (37.5%, 14%), personal accomplishment (12.5%, 2%), community (3%, 5%), values (10%, 15%), and over-all burnout (12.5%, 23.3%). There was a reduction in charts reaching delinquent status. RVU production did not decrease. CONCLUSIONS This study demonstrates that implementing a weekly, 12-hour call schedule can improve factors leading to burnout. Improvements were noted in surgeon and family groups alike, signifying both subjective improvements and observed change in the surgeons' behavior, without compromising clinical productivity. LEVEL OF EVIDENCE Level III, Care Management.
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194
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Mombelli JMR, Barbosa GC, Claro HG, Boska GDA, Oliveira MAFD. Predictors burden in mental health workers during the COVID-19 pandemic. Rev Bras Enferm 2022; 75Suppl 3:e20210762. [PMID: 35766748 DOI: 10.1590/0034-7167-2021-0762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/21/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze burden predictors in mental health workers during the COVID-19 pandemic. METHODS a quantitative study, collected between October and December 2020 through a sociodemographic questionnaire and Mental Health Service Burden Assessment Scale, in four services in a municipality in the state of São Paulo, Brazil, with 108 workers. Descriptive analysis and multiple linear regression of ordinary least squares were performed, in search of predictors for variation in the scale score. RESULTS it showed median work burden (2.03). Predictors: psychological or psychiatric follow-up; normal performance of activities during the pandemic; direct action with suspected or confirmed cases of COVID-19; and belonging to the risk group (people over 60 years of age, diabetics, hypertensive, cardiac, respiratory problems) (p<0.05). CONCLUSIONS working conditions observed during the pandemic, simultaneously with workers' mental health care needs predict burden at work in health.
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195
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Sullivan EE, McKinstry D, Adamson J, Hunt L, Phillips RS, Linzer M. Burnout Among Missouri Primary Care Clinicians in 2021: Roadmap for Recovery? MISSOURI MEDICINE 2022; 119:397-400. [PMID: 36118800 PMCID: PMC9462904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Rates of burnout among clinicians have been exacerbated by the COVID-19 (COVID)pandemic. A survey of Missouri primary care professionals at federally qualified health centers was conducted during a COVID surge in August 2021 to assess burnout, stress, and job satisfaction as well as if respondents had sought assistance for burnout or attended resiliency training. Despite respondents reporting rates of burnout (56%) that exceed those reported nationally (48%), only 17% sought help for burnout. Most (81%) had not attended resiliency training; of those who did, 16% said sessions "make me feel less alone," while an equivalent number found sessions not useful, identifying an absence of resources within their organization. Comments focused on the need for dedicated time to receive support, including time to seek assistance during working hours, time to take breaks, and time for self-care. The data suggest one path forward to remediate burnout: provide the workforce with time to access support.
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Affiliation(s)
- Erin E Sullivan
- Sawyer School of Business, Suffolk University, Boston, Massachusetts, and Harvard Medical School, Center for Primary Care, Harvard University, Boston, Massachusetts
| | | | - Joni Adamson
- Missouri Primary Care Association, Jefferson City, Missouri
| | - Lindsay Hunt
- Harvard Medical School, Center for Primary Care, Harvard University, Boston, Massachusetts
| | - Russell S Phillips
- Harvard Medical School, Center for Primary Care, Harvard University, Boston, Massachusetts and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Mark Linzer
- Department of Medicine and Institute for Professional Worklife, Hennepin Healthcare System, Minneapolis, Minnesota
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196
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Harry EM, Carlasare LE, Sinsky CA, Brown RL, Goelz E, Nankivil N, Linzer M. Childcare Stress, Burnout, and Intent to Reduce Hours or Leave the Job During the COVID-19 Pandemic Among US Health Care Workers. JAMA Netw Open 2022; 5:e2221776. [PMID: 35849398 PMCID: PMC9294994 DOI: 10.1001/jamanetworkopen.2022.21776] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Childcare stress (CCS) is high during the COVID-19 pandemic because of remote learning and fear of illness transmission in health care workers (HCWs). Associations between CCS and burnout, intent to reduce (ITR) hours, and intent to leave (ITL) are not known. OBJECTIVE To determine associations between CCS, anxiety and depression, burnout, ITR in 1 year, and ITL in 2 years. DESIGN, SETTING, AND PARTICIPANTS This survey study, Coping with COVID, a brief work-life and wellness survey of US HCWs, was conducted between April and December 2020, assessing CCS, burnout, anxiety, depression, workload, and work intentions. The survey was distributed to clinicians and staff in participating health care organizations with more than 100 physicians. Data were analyzed from October 2021 to May 2022. MAIN OUTCOMES AND MEASURES The survey asked, "due to…COVID-19, I am experiencing concerns about childcare," and the presence of CCS was considered as a score of 3 or 4 on a scale from 1, not at all, to 4, a great extent. The survey also asked about fear of exposure or transmission, anxiety, depression, workload, and single-item measures of burnout, ITR, and ITL. RESULTS In 208 organizations, 58 408 HCWs (15 766 physicians [26.9%], 11 409 nurses [19.5%], 39 218 women [67.1%], and 33 817 White participants [57.9%]) responded with a median organizational response rate of 32%. CCS was present in 21% (12 197 respondents) of HCWs. CCS was more frequent among racial and ethnic minority individuals and those not identifying race or ethnicity vs White respondents (5028 respondents [25.2%] vs 6356 respondents [18.8%]; P < .001; proportional difference, -7.1; 95% CI, -7.8 to -6.3) and among women vs men (8281 respondents [21.1%] vs 2573 respondents [17.9%]; odds ratio [OR], 1.22; 95% CI, 1.17 to 1.29). Those with CCS had 115% greater odds of anxiety or depression (OR, 2.15; 95% CI, 2.04-2.26; P < .001), and 80% greater odds of burnout (OR, 1.80; 95% CI, 1.70-1.90; P < .001) vs indidivuals without CCS. High CCS was associated with 91% greater odds of ITR (OR, 1.91; 95% CI, 1.76 to 2.08; P < .001) and 28% greater odds of ITL (OR, 1.28; 95% CI, 1.17 to 1.40; P < .001). CONCLUSIONS AND RELEVANCE In this survey study, CCS was disproportionately described across different subgroups of HCWs and was associated with anxiety, depression, burnout, ITR, and ITL. Addressing CCS may improve HCWs' quality of life and HCW retention and work participation.
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Affiliation(s)
- Elizabeth M. Harry
- University of Colorado School of Medicine, UCHealth, Aurora
- UCHealth, Aurora, Colorado
| | | | | | - Roger L. Brown
- School of Nursing, University of Wisconsin, Madison
- School of Medicine and Public Health, University of Wisconsin, Madison
| | - Elizabeth Goelz
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis
| | | | - Mark Linzer
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis
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197
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Abstract
Despite evidence to support the safety and efficacy of COVID-19 vaccination in pregnancy, and clear recommendations from professional organizations and the Centers for Disease Control and Prevention (CDC) for pregnant people to get vaccinated, COVID-19 vaccine hesitancy in pregnancy remains a significant public health problem. The emergence of the highly transmissible B.1.617.2 (Delta) variant among primarily unvaccinated people has exposed the cost of vaccine hesitancy. In this commentary, we explore factors contributing to COVID-19 vaccine hesitancy in pregnancy and potential solutions to overcome them. KEY POINTS: · Low COVID-19 vaccination coverage in pregnant people is a major public health problem in the United States.. · COVID-19 vaccine hesitancy in pregnancy is multifactorial.. · The "4 Cs" framework may be useful in countering COVID-19 vaccine hesitancy..
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Affiliation(s)
- Lydia L. Shook
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA, United States
| | - Thomas P. Kishkovich
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Andrea G. Edlow
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA, United States
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198
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Impact of the Early Phase of the COVID-19 Pandemic on Medical Student Well-Being: a Multisite Survey. J Gen Intern Med 2022; 37:2156-2164. [PMID: 35710675 PMCID: PMC9202979 DOI: 10.1007/s11606-022-07497-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 03/23/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND The COVID-19 pandemic drastically impacted medical student experiences. Little is known about the impact of the pandemic on student well-being and protective factors for burnout. OBJECTIVE Assess US medical student burnout, stress, and loneliness during the initial phase of the pandemic, compare results to pre-pandemic data, and identify risk factors for distress and protective factors to inform support interventions. DESIGN Cross-sectional survey of medical students conducted between May and July 2020. PARTICIPANTS 3826 students from 22 medical schools. MAIN MEASURES Burnout (MBI-HSS), stress (PSS-10), loneliness (UCLA scale), and student experiences. Compared burnout and stress to pre-pandemic studies (2010-2020). KEY RESULTS Of 12,389 students, 3826 responded (31%). Compared to pre-pandemic studies, burnout was lower (50% vs. 52%, P = 0.03) while mean stress was higher (18.9 vs. 16.0, P < 0.001). Half (1609/3247) reported high (≥ 6/9) loneliness scores. Significant differences were found in burnout and stress by class year (P = 0.002 and P < 0.001) and race (P = 0.004 and P < 0.001), with the highest levels in second- and third-year students and Black, Asian, or other racial minority students. Students experiencing financial strain or racism had higher burnout and stress (P < 0.001 for all). Respondents with COVID-19 diagnoses in themselves or family members had higher stress (P < 0.001). Nearly half (1756/3569) volunteered during the pandemic, with volunteers reporting lower burnout [48% (782/1639) vs. 52% (853/1656), P = 0.03]. CONCLUSIONS While stress was higher compared to pre-pandemic data, burnout was significantly lower. Higher burnout and stress among Black, Asian, and other racial minority students and those who experienced financial strain, racism, or COVID-19 diagnoses likely reflect underlying racial and socioeconomic inequalities exacerbated by the pandemic and concurrent national racial injustice events. Volunteer engagement may be protective against burnout. Schools should proactively support vulnerable students during periods of stress.
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199
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Butow P, Havard PE, Butt Z, Juraskova, Sharpe L, Dhillon H, Beatty L, Beale P, Cigolini M, Kelly B, Chan RJ, Kirsten L, Best M, Shaw J. The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study. PATIENT EDUCATION AND COUNSELING 2022; 105:2397-2403. [PMID: 35120797 PMCID: PMC8801619 DOI: 10.1016/j.pec.2022.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged. METHODS In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety and Stress Scale (carers and HPs) to assess emotional morbidity. Thematic analysis was undertaken on qualitative data. RESULTS 32 patients, 16 carers and 29 HPs participated. Qualitative analysis yielded three shared themes: fear and death anxiety, isolation, and uncertainty. For HPs, uncertainty incorporated the potential for moral distress and work-stress. Patients and carers scoring high on anxiety/depression measures were more likely to have advanced disease, expressed greater death anxiety, talked about taking more extreme precautionary measures, and felt more impacted by isolation. CONCLUSION Cancer and COVID-19 can have compounding psychological impacts on all those receiving or giving care. PRACTICE IMPLICATIONS Screening for distress in patients, and burnout in HPs, is recommended. Increased compassionate access and provision of creative alternatives to face-to-face support are warrented.
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Affiliation(s)
- P Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia.
| | - P E Havard
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - Z Butt
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - Juraskova
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - L Sharpe
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - H Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - L Beatty
- Flinders University, Órama Institute, College of Education, Psychology & Social Work, Adelaide, Australia
| | - P Beale
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW 2006 Australia
| | - M Cigolini
- Department of Palliative Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - B Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan NSW 2308, Australia
| | - R J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
| | - L Kirsten
- Nepean Cancer Care Centre, Penrith, NSW 2751, Australia
| | - M Best
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW 2007, Australia
| | - J Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
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200
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Bezner TL, Sivaraman M. COVID-19 Pandemic and Its Impact on Sleep Health: A Rapid Review. MISSOURI MEDICINE 2022; 119:385-389. [PMID: 36118813 PMCID: PMC9462915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This rapid review aims to elucidate the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease-both in the acute phase and the "long-hauler" syndrome-on sleep health. Literature regarding the direct physiologic impact of COVID disease on sleep is sparse but has illuminated a toxic synergy between the immune response to COVID disease and the pro-inflammatory state brought on by obstructive sleep apnea (OSA). Primary care physicians and sleep medicine specialists should aggressively screen for OSA in COVID patients.
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Affiliation(s)
- Tracy L Bezner
- Department of Neurology, University of Missouri - Columbia School of Medicine, Columbia, Missouri
| | - Manjamalai Sivaraman
- Associate Professor of Neurology, University of Missouri - Columbia School of Medicine, Columbia, Missouri
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