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

Assessment of psychological health effects of nurses during 2022-2023 of the COVID-19 pandemic: a descriptive study in Southern Taiwan

BACKGROUND

Nurses on the frontlines of the pandemic have increased workloads, burnout, and virus exposure, leading to mental health challenges and a lack of resources for patient care. Mental health support for nurses during the COVID-19 outbreak has become a priority. This study evaluated psychological health outcomes of among nurses during the 2022-2023 COVID-19 pandemic in Taiwan, focusing on personal and work-related fatigue as key contributors to emotional distress.

METHODS

A cross-sectional questionnaire was distributed to 200 nurses in a southern Taiwan hospital between 2022 and 2023. Emotional distress and mental health were assessed using the BSRS-5 (Brief Symptom Rating Scale) and CHQ-12 (Chinese Health Questionnaire). Correlation and regression analyses were conducted to identify factors influencing emotional distress and mental health outcomes.

RESULTS

Nurses aged 40-59 (52.85, p = 0.01), those in emergency departments (56.71, p = 0.001), and those caring for COVID-19 patients (50, p = 0.007) reported higher personal exhaustion. Significant differences in work-related fatigue levels were observed based on working environments (52.78, p < 0.001), no beliefs regarding religion (46.53, p = 0.036), care for COVID-19 patients (47, p < 0.001) and previously diagnosed with COVID-19 (46.58, p = 0.005). Key factors influencing emotional distress included marital status, number of children, and workplace (p < 0.05), while mental health variations were noted  in age, marital status, number of children, workplace, and years of experience (p < 0.05). During the COVID-19 pandemic, nurses' emotional distress and mental health were significantly correlated with specific stressors such as age, workplace, care for confirmed COVID-19 patients, and previous COVID-19 diagnoses (p < 0.001).

CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT

This study highlights the stressors affecting nurses' mental health during the 2022-2023 COVID-19 pandemic, emphasizing the need for stress-specific mental health support. Understanding these stress-specific factors is important for figuring out what nurses need to improve their mental health, which can lead to better care for patients.

Associations of Tai Chi With Depression and Anxiety Among Older Adults: Nationwide Study Findings From a Network Perspective

Within the global population, depression and anxiety are common among older adults. Tai Chi is believed to have a positive impact on these disturbances. This study examined the network structures of depression and anxiety among older Tai Chi practitioners vs non-practitioners. Propensity score matching (PSM) was used to construct a non-practitioner group based on Chinese Longitudinal Healthy Longevity Survey (CLHLS) data. 346 Tai Chi practitioners and 1019 non-practitioners were included. The prevalence and severity rates of depression were significantly lower among Tai Chi practitioners compared to non-practitioners though there was no group difference for anxiety. Network analysis showed that, among Tai Chi practitioners, "Felt sadness", "Uncontrollable worrying" and "Trouble relaxing" were the most central symptoms. In contrast, among non-practitioners, the most central symptoms were "Felt sadness", "Uncontrollable worrying", and "Nervousness". Key bridge symptoms linking depressive and anxiety symptoms were "Worry too much", "Bothered by things" and "Uncontrollable worrying" in Tai Chi practitioners and "Nervousness", "Felt nervous/fearful" and "Sleep quality" in non-practitioners. This study underscored how practising Tai Chi is associated with reduced overall prevalence and severity of depression and different interactions of depressive and anxiety symptoms among older adults. Central and bridge symptoms differed between Tai Chi practitioners and non-practitioners.

Exploring perceptions of work motivation through the experiences of healthcare professionals who provided end-of-life care during the COVID-19 pandemic (PRECA-C project): a qualitative study

BACKGROUND

The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals (HCPs), leading to high rates of burnout and decreased work motivation. Limited ability to provide adequate end-of-life (EOL) care caused moral distress and ethical dilemmas. However, factors that prevent burnout, reduce intent to leave, and enhance professional fulfillment remain underexplored. This study aimed to explore HCPs' perceptions of work motivation during the pandemic, seeking insights to support their continued dedication.

METHODS

A qualitative descriptive study was conducted through online semi-structured interviews (from August to December 2021) with HCPs who provided EOL care, working at intensive care units, specialized COVID-19 wards, and general wards across Japan. Aiming for a diverse sample in terms of gender, occupation, hospital size, and location, interviewees were recruited via the network of the Department of Health Informatics, School of Public Health, Kyoto University. Inductive thematic analysis was applied to interpret the data semantically.

RESULTS

The study participants were 33 HCPs (15 physicians and 18 nurses) from 13 prefectures. The following four main themes with 13 categories were revealed: Developing proficiency in COVID-19 EOL care through HCP experiences, Unity as a multidisciplinary COVID-19 team, Managerial personnel who understand and support staff in fluctuating work, and Social voices from outside of hospitals. These themes uncovered possibilities beyond the personal traits of HCPs and influenced their motivation by incorporating factors associated with healthcare teams, organizations, and wider societal contexts.

CONCLUSION

In this study, four themes, including the importance of organizational management to prevent isolation, maintaining connections among colleagues, and the need for supportive social voices from outside the hospital, emerged from interviews regarding HCPs' work motivation during the pandemic. These findings highlight the complex interplay of individual, organizational, and societal factors in shaping HCPs' motivation during pandemic waves.

Design and Validation of an Instrument to Evaluate Cognitive-Physiological Repercussions and Coping Strategies in a Pandemic Situation

The coronavirus disease (COVID-19) pandemic has significantly affected mental health worldwide, highlighting the need for reliable tools to assess emotional impact (cognitive-psysiological repercusiones) and coping strategies. To validate the psychometric properties of an evaluation instrument with an ad hoc design, called the Evaluation Inventory of Cognitive-Physiological Repercussions and Coping Strategies in a Pandemic Situation (EICPCP), which has two scales: "Cognitive and Physiological repercussions arising from the pandemic due to COVID-19" (RCFPC19-13) and "Coping strategies during the pandemic due to COVID-19" (EAPC19-15). A total of 1,629 participants (students, teachers, and healthcare professionals) from Spain and Colombia completed the instrument. Exploratory and confirmatory factor analyses were conducted to assess their structure and reliability. Both exploratory and confirmatory factor analyses supported the five proposed dimensions: cognitive and physiological impacts on the RCFPC19-13 scale, and adaptation, support, and organization on the EAPC19-15 scale. In addition, satisfactory internal consistency, reliability indices, and temporal stability were obtained for both scales. The EICPCP is a valid and reliable tool for evaluating the cognitive-physiological impact of the pandemic and coping strategies employed. This instrument provides valuable insights for clinical research and psychological interventions in pandemic-related mental-health studies..

Does mild COVID-19 in healthcare workers affect functional capacity and work performance in short term?

BackgroundDisproportionately increased workload is one of the main reasons affecting work performance. Healthcare workers who got infected by COVID-19 were further affected mentally and physically which had an impact on their work performance.ObjectiveIn this study, we aimed to show whether work performance is affected even in people with mild Covid 19 disease or whether it is a part of Post-Acute COVID-19 Syndrome (PACS).MethodsThirty healthcare workers in a tertiary hospital had COVID-19 one month ago and gender and age matched 30 healthy workers without a history of COVID-19 (control group) was enrolled between January 2021 and March 2021. Work performance was assessed on a 7-point Likert scale. Participants performed 1-min sit-to-stand test (1MSTS), 5 times sit-to-stand test (5TSTS), and 6-min walk test (6MWT).ResultsAll participants in the COVID-19 group had a mild (non-hospitalized) form of the disease. 23 patients had ongoing symptoms 4-7 weeks after the initial symptoms of COVID-19 (fatigue/malaise (n = 9), myalgia/arthralgia (n = 7), cough (n = 7), loss of smell/taste (n = 5), headache (n = 5), dyspnea (n = 4), and diarrhea (n = 1). The increase in systolic blood pressure after 6MWT was higher in the COVID group (p = 0.018).ConclusionThe functional status and work performance in healthcare workers with COVID-19 infection were negatively affected in the first month even if the disease severity was mild. It is important to prevent both acute and long-term physical and mental complications of the disease and to ensure that these strategies improve the functional status and work performance of healthcare professionals.

Assessment of the prevalence of stress, anxiety and depression in healthcare workers providing services related to communicable diseases in primary-level health units in Maputo city, Mozambique: an observational cross-sectional study protocol

INTRODUCTION

Mental health is essential for well-being and critical to the quality of care delivered by healthcare professionals. Health workers face increased risks of mental health disorders due to long hours, high emotional and physical demands, and exposure to communicable diseases, which exacerbate stress and anxiety levels. Evidence from low-income countries, including Mozambique, is scarce, yet health professionals in these regions frequently deal with the dual burden of communicable diseases and resource constraints. This study addresses a critical evidence gap by focusing on the mental health of healthcare professionals in Mozambique who are frequently exposed to psychological stress while managing communicable diseases. It aims to assess the prevalence of stress, anxiety and depression among healthcare workers providing services related to communicable diseases in primary-level health units (PHUs) in Maputo City, Mozambique. The study also seeks to identify personal and professional factors associated with these mental health disorders.

METHODS AND ANALYSIS

This is an observational cross-sectional study targeting healthcare workers in PHUs who provide services related to communicable diseases in Maputo City. Using convenience sampling, 382 participants will be recruited, stratified by health unit type. This sample size was calculated manually using the formula by Wang and Ji (2020). Data will be collected through a questionnaire, including demographic and professional information and a validated tool (Depression, Anxiety and Stress Scale, DASS-21), using the Research Electronic Data Capture (REDCap) Software for secure data capture. Descriptive and inferential statistical analyses will be performed using IBM SPSS Statistics to estimate prevalence rates and explore associated factors.

ETHICS AND DISSEMINATION

The study was approved by the Interinstitutional Committee on Bioethics in Health of the Faculty of Medicine/Maputo Central Hospital (CIBS FM&HCM/117/2024). Written informed consent will be obtained, and participants experiencing significant discomfort will be referred for mental health support. Findings will be disseminated via academic theses, peer-reviewed publications, national conferences, and reports shared with the Ministry of Health to inform mental health interventions for healthcare workers.

REGISTRATION

This protocol is registered with the Interinstitutional Committee on Bioethics in Health of the Faculty of Medicine/Maputo Central Hospital (CIBS FM&HCM).

The Impact of the COVID-19 Pandemic on Young Adults with Autism Spectrum Disorder: A Systematic Review

BACKGROUND/OBJECTIVES

The COVID-19 pandemic and related public health measures significantly disrupted daily life, with profound consequences for individuals with Autism Spectrum Disorder (ASD). Young adults with ASD faced unique challenges due to disruptions in routines, employment instability, limited access to essential services, and increased social isolation. While some individuals benefited from reduced social pressures and the adoption of remote work, many experienced heightened anxiety, behavioral difficulties, and declines in autonomy. This systematic review examines the impact of the pandemic on young adults with ASD, focusing on key domains such as autonomy, employment, service accessibility, socialization, emotional regulation, and overall well-being.

METHODS

This review followed the PRISMA 2020 guidelines, and its protocol was pre-registered in the PROSPERO database. A search was conducted in four databases-PubMed, Scous, Web of Science, and PsycInfo-as well as in specialized journals in the field.

RESULTS

Eight studies met the inclusion criteria and were included in the final synthesis. The findings highlight significant disruptions in daily life, increased dependence on caregivers, and difficulties in maintaining structured activities. However, technology-assisted interventions, including virtual therapies and remote work opportunities, played a role in mitigating some adverse effects.

CONCLUSIONS

Despite the heterogeneity in methodologies, this review underscores the urgent need for targeted interventions to support young adults with ASD during crises. Future research should focus on long-term consequences and developing inclusive policies that enhance resilience, access to services, and social integration.

Risk perception of emergency medical technicians in biological disasters: a comparison between COVID-19 and Non-COVID-19 cases

BACKGROUND

Emergency medical technicians (EMTs), positioned at the forefront of medical services, are at greater risk of contracting COVID-19 and passing it on to their families and communities than others. Recognizing the risks associated with this disease can play a crucial role in the care and prevention process. Consequently, this study evaluated the level of risk perception (RP) regarding COVID-19 among EMTs and compared it between those who have contracted the disease and those who have not.

METHODS

This was a cross-sectional descriptive-analytical study conducted in 2021. This study employed simple random sampling to select 200 EMTs affiliated with Birjand University of Medical Sciences. The sample included 100 EMTs who had contracted COVID-19 and 100 who had not. Data were collected through a researcher-designed questionnaire, distributed online via WhatsApp and Telegram groups among the participants. The data were analyzed using SPSS version 16, utilizing descriptive statistical methods (frequency, mean, and standard deviation) along with inferential statistical tests such as independent t-tests, chi-square, and two-way analysis of variance (ANOVA).

RESULTS

The infected EMTs exhibited a moderate perception of the risk of COVID-19, while the non-infected EMTs reported a high level of RP. The independent t-test confirmed that the mean total score for COVID-19 RP was significantly lower in the infected EMTs compared to the non-infected group (mean RP score: infected 150.82 ± 32.24 vs. non-infected 161.54 ± 22.50, P = 0.007). Additionally, ANOVA revealed that none of the demographic variables individually had a significant impact on the level of COVID-19 RP (P > 0.05). Furthermore, the interaction effect between the demographic variables and the groups was also insignificant (P > 0.05).

CONCLUSION

EMTs who contracted COVID-19 had a significantly lower RP compared to their non-infected counterparts. This reduced awareness of COVID-19 risks likely contributed to their infection, highlighting the critical role of RP in disease prevention. Targeted educational programs to enhance RP among EMTs could foster stronger adherence to preventive measures, ultimately reducing infection rates during future biological disasters. Therefore, this study not only contributes to expanding existing knowledge in this field but also assists policymakers and health administrators in improving decision-making to strengthen epidemic preparedness.

Mindfulness-Based Interventions for Mental Health Outcomes in Frontline Healthcare Workers During the COVID-19 Pandemic: A Randomized Controlled Trial

BACKGROUND

The COVID-19 pandemic significantly impacted the mental health of frontline healthcare workers (HCWs), but solid evidence on psychological interventions for HCWs remains limited.

OBJECTIVE

Whether an adjusted therapist-assisted Mindfulness-based Stress Reduction group intervention (adjusted MBSR) is superior to a minimal self-guided mindfulness-based intervention (self-guided MBI) in improving mental health of HCWs during the COVID-19 pandemic.

DESIGN

Randomized controlled trial.

PARTICIPANTS

201 frontline HCWs (47 physicians, 120 nurses, 34 supporting staff); enrollment between June 2020 and September 2021.

INTERVENTIONS

A 4-week adjusted MBSR with eight biweekly 1.5-h sessions; or a 4-week self-guided MBI with 24 mindfulness/compassion exercises.

MEASURES

Primary outcome was the Patient Health Questionnaire - Somatic, Anxiety and Depressive Symptom Scales (PHQ-SADS) at 6-month follow-up. Secondary outcomes included posttraumatic symptoms, insomnia, alcohol use, repetitive negative thinking, mental well-being, posttraumatic growth, mindfulness, and self-compassion at post-intervention and 3- and 6-month follow-up.

KEY RESULTS

At 6-month follow-up, the adjusted MBSR was not superior to the self-guided MBI (mean difference (SE) PHQ-SADS, 0.23 (1.03), P=0.82). Both interventions showed similar within-group improvement in PHQ-SADS (Cohen's d between baseline and 6-month follow-up: adjusted MBSR -0.78 (95% CI -1.07; -0.48), self-guided MBI -0.72 (95% CI -1.01; -0.43)). Secondary outcomes showed that symptom trajectories differed between groups for PHQ-SADS (intervention*time F(3, 420)=3.99, P=0.008), with greater reduction at post-intervention for adjusted MBSR, and posttraumatic growth (intervention*time F(3, 350)=5.32, P=0.001), with exclusive increase post-intervention in adjusted MBSR. Both interventions showed comparable significant within-group improvements on posttraumatic symptoms, insomnia, repetitive negative thinking, mental well-being, mindfulness, and self-compassion.

CONCLUSIONS

The adjusted MSBR was not superior to the self-guided MBI; both were accompanied by significant reductions of depressive, anxiety, and somatic symptoms after 4 weeks of treatment which was sustained at 6-month follow-up. Further research is needed to investigate the possible role of MBIs to support HCWs involved in future healthcare crises.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04720404; onderzoekmetmensen.nl/en NL73793.091.20.

Moral Injury, Mental Disorders, and Suicidal Behavior Among Health Professionals During the COVID-19 Pandemic: A Network Analysis

During extreme conditions such as the COVID-19 pandemic, health professionals were susceptible to mental health issues. A series of network analyses were performed to explore the relationship between moral injury and depressive symptoms, anxiety symptom, PTSD symptom, and suicidal behaviors in 14,993 health professionals. Depressive symptoms were identified as the main pathway through which moral injury led to suicidal behavior, and betrayal was the most significant bridge symptom for moral injury with PTSD, anxiety, and depressive symptoms. The symptom profiles of MI associated with the common mental outcomes included betrayal, self-condemnation, and feeling punished by God. The most central mental symptoms of health professionals were irritability, nervousness, and feeling afraid. It is crucial to implement targeted measures addressing the bridge symptoms of moral injury and the core symptoms of anxiety to prevent and treat mental health consequences among health professionals.

Reproducible feature selection in heterogeneous multicenter datasets via sign-consistency criteria

The identification of risk features associated with disease plays a crucial role in biomedical fields. These features are often used to provide evidence for clinical decision-making. However, in the presence of between-center heterogeneity, covariate effects across data centers may exhibit inconsistent directions, making feature selection challenging. In this work, we propose a novel framework to select reproducible risk features whose underlying effects are consistent across different centers. We quantify the feature reproducibility based on the sign-consistency criterion, which provides an acceptable level of heterogeneity in effect sizes and ensures the reasonable similarity of reproducible signals. Compared with the existing feature selection methods, our proposed method effectively protects data privacy and does not rely on the assumption of data homogeneity. Extensive simulations demonstrated that the proposed method has greater power than existing methods do. We apply the proposed approach to analyze data from the China Health and Retirement Study Longitudinal Study (CHARLS) and identify nine important risk factors that show reproducible associations with depression.

The second victim phenomenon´s impact in male and female healthcare workers: a scoping review

BACKGROUND

The second-victim phenomenon occurs when a healthcare provider experiences trauma after being profoundly affected by a negative medical event. As a work-related phenomenon, it may be influenced by sex and gender-related factors, particularly since women constitute 70% of the health and social sector workforce. This study aims to describe the impact of the second-victim phenomenon on male and female healthcare professionals, identifying differences in their experiences. It also identifies differences in the reactions and behavior of supervisors, colleagues, patients, and their relatives to errors made by male and female healthcare workers.

METHODS

A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines. Comprehensive searches were performed in the electronic databases BDENF, ProQuest, PsycInfo, PubMed, Scopus, and Web of Science, without filters or time limits. Original articles in Portuguese, English, Spanish, or German that mentioned any aspects concerning differences between male and female healthcare workers in relation to the second-victim phenomenon were selected.

RESULTS

Twenty-seven articles were included, most of which were cross-sectional studies from the USA, China, Germany, and Spain, conducted among physicians and nurses. The findings highlighted that women experienced more intense anxiety responses in the aftermath of severe adverse events than men. Male healthcare workers were more resistant to seeking support compared to their female counterparts. Gender-based discrimination against women was identified in both education and practice, further exacerbating the second victim syndrome experienced by female healthcare professionals.

CONCLUSION

Understanding male/female differences is essential for comprehending the second-victim phenomenon and designing effective measures to mitigate its impact. Women may be more psychologically affected by adverse events than men. They are judged more negatively than men after making an error and are more likely to seek help.

Changing Trends in the Mental Health Status of Healthcare Workers at COVID-19 Wards Three Years After the COVID-19 Pandemic Outbreak in Saudi Arabia

Background

The current study aimed to investigate the severity of anxiety and depression symptoms among the healthcare workers of COVID-19 wards three years after the pandemic outbreak in Saudi Arabia.

Methods

An online cross-sectional survey was conducted during the fourth quarter of 2022 and early 2023 at the COVID-19 wards of public primary healthcare hospitals of the AlQassim region of Saudi Arabia. The sample included 323 healthcare workers including physicians, nurses, laboratory, and imaging personnel. The Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) questionnaires were used to collect data using the self-administered approach. The degree of severity of anxiety and depressive symptoms were the main outcome variables. Descriptive and inferential statistics were derived using Statistical Package for Social Science (SPSS) software version 28.0.

Results

Three years following the outbreak of the pandemic, a transition toward a high prevalence of mild symptoms of anxiety and depression was noted. The present study reported 85.1%, 8.4%, and 6.5% mild, moderate, or moderately severe depression and 90.7%, 6.8%, and 2.5% anxiety, respectively. Depression was more common in men (t=3.009; p=0.003). Phlebotomists, x-ray and imaging personnel, and paramedics showed a strong association with symptoms of depression (t=8.36; p< 0.001) and anxiety (t= 10.325; p<0.001). Sleep deprivation, fatigue, loss of interest, and changes in eating behavior were depressive symptoms with a high degree of severity. Anxiety symptoms that showed a high degree of severity were having trouble relaxing and getting annoyed quickly. An overall depressive and anxiety score of 16.5 and 12.8 was obtained.

Conclusion

The long-term impact of the pandemic on healthcare workers in COVID-19 wards includes the persistence of depression and anxiety symptoms. These findings highlight the need for implementing mental health wellness programs and coping strategies that reduce work stress and improve the quality of life.

Psychological Care in Spanish Nurses at the Frontline of the COVID-19 Pandemic: A Prospective Study on Symptoms, Burnout and Psychological Variables

(1) Background: Previous studies have highlighted the emotional symptoms experienced throughout the COVID-19 pandemic by nurses and their consequences. It would be of interest to analyze the extent to which healthcare workers (HCWs), in the context of the psychological health crisis, have sought (and received) psychological care. Likewise, it would be highly relevant to analyze the profile of these professionals, both in terms of the sociodemographic and occupational characteristics as well as the emotional symptoms they presented, and the percentage of nurses who requested psychological help during the COVID-19 pandemic, their sociodemographic and occupational characteristics as well as their levels of associated symptoms. Additionally, one could study the associated psychological personality variables, including both risk factors and protective variables, as this is of special interest for the design of appropriate interventions. (2) Methods: An observational, descriptive, prospective longitudinal study with three data collection periods was carried out. At the first time point, anxiety, insomnia, self-efficacy, resilience and social support were assessed. Anxiety, insomnia, fear of COVID-19, cognitive fusion and burnout syndrome were assessed at the second time point. Finally, at the third time point, we assessed anxiety, insomnia and burnout syndrome. During the second and third time points, the nurses' requests for psychological help were assessed. (3) Results: Overall, 33.1% of the final sample requested psychological support, and 20.5% of them had sought psychological support by the first time point, of which 7.3% continued to in the final time measure. The request for psychological help was significantly related to higher means for anxiety (p = 0.003), insomnia (p = 0.001) and burnout (p < 0.05), as well as high levels of cognitive fusion (p = 0.001) and low levels of resilience (p = 0.009). Requests for psychological help were not significantly related to social support (p = 0.222) or fear of COVID-19 (p = 0.625). (4) Conclusions: The data suggest the need to promote measures for the implementation of psychological help among nurses aimed not only at reducing the consequences of the psycho-emotional affectation derived from a stressful work situation but also strengthening health-promoting traits such as self-efficacy or resilience.

Community health volunteers' experiences during the COVID-19 pandemic in Kiambu county, Kenya: A qualitative study

BACKGROUND

For already overburdened health systems in low- and middle-income countries (LMICs), the COVID-19 pandemic presented an almost impossible challenge. In Kenya, efforts to mitigate the impact of the pandemic included the mobilization of community health volunteers (CHVs), a cadre that has been historically understaffed and under-resourced. These volunteers were required to sustain the delivery of routine community-based health services while also taking on additional responsibilities related to COVID-19 mitigation. This study explored the challenges faced by CHVs during the COVID-19 response in Kiambu County; focusing on their experiences with control measures, impacts on community-level healthcare delivery, and perspectives on the government's pandemic response within the community health framework.

METHODS

This study employed a phenomenological exploratory qualitative design. Due to logistical constraints, only two focus group discussions could be conducted with 24 CHVs, representing 48% of eligible participants who met the inclusion criteria: a minimum of five years of experience, active involvement in the pandemic response, and availability for the interview. Data were digitally recorded, transcribed, translated, and coded for thematic analysis.

RESULTS

Specific themes from the experiences of the CHVs during the COVID-19 lockdown were: (1) dedication and commitment to serving the community; (2) overcoming demoralization; and (3) community barriers to health care delivery and access. In regards to the community perspectives of COVID-19, the CHVs relayed widespread misinformation among community members, with experiences of stigma due to COVID-19 misconceptions. They also gave second-person accounts of the economic strife the community went through as a result of mitigation measures. The CHVs were skeptical in the county's preparedness in dealing with both the COVID-19 and future pandemics.

CONCLUSION

Despite facing stigma, misinformation, limited resources, and economic hardships, CHVs demonstrated commitment to their roles. Their efforts not only underscored their resilience but also revealed critical gaps in preparedness and resource allocation within the healthcare system. However, the small number of FGDs and insufficent data saturation should be considered when interpreting the findings. Nonetheless, our study provides a starting point for further research and comparative analysis across other counties in Kenya.

The impact of COVID-19 quarantine on college students' mental health

BACKGROUND

The COVID-19 pandemic is a global public health crisis. The quarantine measures for COVID-19 have caused harm to the mental health of college students, and it is of great significance to continue focusing on the impact of COVID-19 on mental health.

METHODS

The data comes from the research group on the impact of COVID-19 on college students' mental health. A total of 2,033 Chinese college students participated in this study, including 1,285 female and 748 male students, with an average age of 19.81 years (SD = 1.22). Using the ordered logistic regression model, the study analyzed the mechanisms of academic stress, employment pressure, and sleep quality to investigate the impact of COVID-19 quarantine on college students' mental health.

RESULTS

Quarantine due to the COVID-19 pandemic has a significant impact on college students' mental health. The impact of quarantine on college students' mental health is economically stratified, with lower family income students experiencing greater effects and higher family income students experiencing lesser effects. Academic stress, employment pressure, and sleep quality are important mechanisms through which quarantine affects college students' mental health.

CONCLUSION

This study provides new insights into the relationship between quarantine and mental health among college students during the COVID-19 pandemic, helping to offer targeted interventions for college students' mental health.

Trend of psychological symptoms from pregnancy to postpartum: a prospective study during COVID-19 pandemic

Psychological symptoms during pregnancy and the postpartum period require special attention, particularly in the context of the COVID-19 pandemic. This study aims to evaluate the trajectory of psychiatric symptoms from pregnancy to the postpartum period during the COVID-19 pandemic. This prospective study was conducted at Babol University of Medical Sciences from February 2020 to September 2021. A total of 252 pregnant women completed the Symptom Checklist 25 (SCL-25), the Corona Disease Anxiety Scale, and the Post-Traumatic Stress Diagnostic Scale at both prenatal and postpartum time points. Results indicated that the mean total score of psychological symptoms decreased modestly from pregnancy to postpartum (39.61 ± 11.67 vs. 32.78 ± 12.15, p < 0.001). Additionally, symptoms of somatization, depression, anxiety, and phobia significantly declined from pregnancy to postpartum (p < 0.05). However, levels of depression, anxiety, and phobia remained significantly higher among women with a positive history of COVID-19 infection compared to those without, during both pregnancy and postpartum. While the overall mean score of psychological symptoms showed a slight reduction from pregnancy to postpartum, many symptoms persisted, particularly in individuals with a COVID-19 infection history or post-traumatic stress symptoms. The study recommends that healthcare providers, including obstetricians, nurses, and midwives, implement timely screening and treatment for psychological symptoms from pregnancy through postpartum.

Characterizing Mental Health in an LMIC Context: Measuring Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Health Care Providers in Ecuador During COVID-19 with the ProQOL V5 Questionnaire

OBJECTIVES

This study assessed compassion satisfaction, compassion fatigue, and burnout in health care providers from public health care institutions in Ecuador during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted in 2022, involving 111 different public health care institutions in 23 provinces in Ecuador, with 2873 participants recruited via convenience sampling. The survey instrument was the revised Stamm's Professional Quality of Life Scale Version-5 tool, designed to measure self-reported compassion fatigue, work satisfaction, and burnout among providers. Kruskall-Wallis test assessed subscale score differences by gender, professional role, region, and health care facility level. Dunn's test was then applied to determine whether groups differed from each other.

RESULTS

On average, health care providers from all facilities had a high rate of compassion satisfaction (84.9%). However, the majority presented moderate levels of burnout (57.1%), and moderate levels of secondary traumatic stress (59.6%). Higher burnout levels were observed in the Amazon regions compared to Coastal regions.

CONCLUSIONS

Despite high compassion satisfaction, most surveyed health care providers from Ecuador's public health institutions experienced moderate burnout and secondary traumatic stress, with higher burnout levels in the Amazon region. Ecuador, similarly to other LMICs, requires mental health policy and legislation targeted to the mental health workforce and these needs. More research is needed on burnout factors among health care providers in resource-challenged low- and middle-income countries.

Conceptualising wellbeing among health-care workers during the Covid-19 pandemic

Since 2020 health workers everywhere have been challenged by the ongoing ramifications of the Covid-19 pandemic. This virus impacted all aspects of life but health-related workplaces particularly, were transformed virtually overnight. Demands were heightened and customary supports came under pressure presenting a huge crisis for health systems. The goal of this study was to explore how this catastrophic pandemic event impacted the wellbeing of healthcare professionals (HCPs) working through this time. Interviews with 57 HCPs from multiple countries and specialty areas were explored utilising inductive content analysis (ICA). Resulting data were then categorised into themes and deductively analysed utilising a method informed by Capability Theory. These were secondary data as the interviews were part of a larger set collected primarily for the purpose of a documentary being made about this experience. This study found that illbeing experiences were prevalent among HCPs. However, significant sources of wellbeing were also evident, and were instrumental in maintaining HCP resilience. Wellbeing was enhanced when HCPs experienced a small number of key capabilities that enabled a broad range of functionings. The capabilities were for (a) participation in positive relationships, (b) a sense of identity, purpose, meaning and value in relation to one's work and (c) ability to provide an appropriate level of medical treatment, care and other role related support. These capabilities were central to HCP wellbeing irrespective of the individual's location and specialty area, however the ability to realise these capabilities in desired functionings was differentially impacted by each individual's unique circumstances.

Evaluating the impact of lavender aromatherapy and music therapy on reducing stress, anxiety, and depression in female nurses during the COVID-19 pandemic

PURPOSE

Nurses often experience high levels of physical and psychological stress due to frequent exposure to emergency and critical situations, which can adversely affect their professional performance. This study aimed to evaluate and compare the short- and long-term impacts of combining aromatherapy with music therapy versus using aromatherapy alone on the physical and psychological well-being of nurses during the COVID-19 pandemic.

METHOD

This study employed a quasi-experimental design without non-intervention control group and recruited 60 nurses from a regional teaching hospital in central Taiwan between February and November 2023. Participants were randomly assigned to two groups: one group received aromatherapy, and the other group received a combination of aromatherapy and music therapy. The aromatherapy intervention involved inhaling gas infused with lavender essential oil. The intervention was conducted once a week during the lunch break for 20 min over a six-week period. Physiological and psychological indicators were compared before and after the intervention. Physiological indicators included systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR). Psychological indicators included scores on the Nursing Stress Scale (NSS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI), which measured stress, anxiety, and depression, respectively.

RESULTS

Overall, after each aromatherapy intervention, the physiological and psychological measures of the nurses in both groups showed significant reductions (p < 0.05) based on paired t-tests. After six measurements, a one-way repeated measures ANOVA was conducted, revealing that most physiological and psychological measures of the nurses in the aromatherapy-only group were significantly reduced (p < 0.05), although no significant differences were found for diastolic blood pressure and pulse rate. In the group receiving aromatherapy combined with music therapy, all physiological and psychological measures showed significant reductions in repeated measures tests (p < 0.05). These results suggest that aromatherapy combined with music therapy not only improved physical and psychological symptoms immediately but also had lasting effects for at least six weeks.

CONCLUSIONS

This study found that aromatherapy effectively reduced the physical and psychological stress of nurses, with even greater benefits when combined with music therapy. This approach not only provided immediate effects but also were associated with lasting benefits for an extended duration.

Perceived stress and performance of daily activities among emergency healthcare workers during the COVID-19 pandemic

BackgroundDuring the COVID-19 pandemic, healthcare workers were exposed to intense stress in the emergency departments and sudden changes in their daily lives.ObjectiveThe study aimed to investigate the impact of the pandemic on performance and participation in the activities of daily living, personal lives, and overall well-being of the healthcare workers in an emergency department.MethodsSeventy-eight people working in an emergency department of a university hospital (100% of those eligible) participated in the study during June-July 2022. A self-report survey, cross-sectional design was used to collect data. Participants completed the Perceived Stress Scale-10 (PSS) and the Canadian Occupational Performance Measure (COPM). Independent sample t-tests, Pearson correlation, and multiple regression analysis were used for statistical analysis.ResultsThere was a significant negative correlation between PSS and COPM Performance (r = -0.524) as well as between PSS and COPM Satisfaction (r = -0.508), indicating that higher levels of stress were associated with lower performance and satisfaction. In addition, work-related factors, including working experience, daily working hours, and time available for rest at work, were significantly associated with PSS, COPM Performance, and Satisfaction (p < 0.05). The strongest multivariate associations (p = 0.001) were found between lacking time to rest at work and PSS (direct) and COPM Performance and Satisfaction (inverse).ConclusionThe stress experienced by emergency healthcare workers during COVID-19 negatively impacted their performance, daily activities, personal lives, and well-being. A potential implication is that policy-makers addressing work-related factors and implementing regulations could improve the well-being of these workers in their professional practices.

Should I stay or should I go-Medical assistants´ experiences and coping with patient demand and lack of appreciation during the Covid-19 pandemic

BACKGROUND

This article explores the psychological burden experienced by medical assistants (MAs) in General Practices during the Covid-19 pandemic (Corona virus disease 2019 (SARS-CoV-2)) in Germany. The study aims on demanding patient behavior, increased workload, and the perceived lack of appreciation and discuss their potential impact on the MAs´ well-being and career decisions.

METHODS

A qualitative approach was utilized. MAs were included via a regional practice network as well as professional associations and newsletters. In total, 21 interviews with MAs from various federal states in Germany were conducted between April and September 2021. The semi-structured interview guideline focused on daily work challenges during the pandemic and its consequences. Interviews were recorded, transcribed, and analyzed using qualitative content analysis according to Kuckartz.

RESULTS

The findings highlight core challenges, including demanding communication with patients, lack of appreciation in the media, a high workload, resilience versus career migration, and the needs and wishes of MAs in their everyday work. Abusive language, insults, and theft of materials by patients added significant stress. The interviews reveal how important teamwork and a supportive working environment are for overcoming these challenges.

CONCLUSIONS

The study underlines the urgent need for societal and political awareness regarding the challenges faced by MAs, especially during public health crises. The perceived social egoism in patient behavior, coupled with a lack of recognition and appreciation, contributed to a challenging work atmosphere and potential burnout risk. Recommendations include enhancing support for MAs, recognizing their contributions in the media, and fostering collaborative efforts between practitioners and policymakers to address the unique challenges in general practices.

TRIAL REGISTRATION

German Register of Clinical Studies (DRKS) DRKS00032402; https://drks.de/search/de/trial/DRKS00032402 (Registration Date: 14.08.2023).

Limited Moderating Effect of Podcast Listening on Work Stress and Emotional Exhaustion Among Nurses During the COVID-19 Pandemic: Cross-Sectional Study

BACKGROUND

The COVID-19 pandemic placed unprecedented pressure on health care systems worldwide, significantly impacting frontline health care workers, especially nurses. These professionals faced considerable psychological stress from caring for patients with COVID-19 and the fear of spreading the virus to their families. Studies report that more than 60% (132/220) of nurses experience anxiety, depression, and emotional exhaustion, which adversely affect their mental health and the quality of care they provide.

OBJECTIVE

This study aimed to investigate the relationship between work-related stress and emotional exhaustion among nurses and to assess whether listening to podcasts moderates this association.

METHODS

A cross-sectional online survey was conducted between March 1, 2023, and March 31, 2023. A total of 271 clinical nurses, aged 20 years to 65 years, were recruited for the study. Participants were divided into 2 groups: experimental group consisting of regular podcast listeners (n=173) and control group comprising nonlisteners (n=98). Ethical approval for this study was obtained from the local ethics committee (IRB number YGHIRB20230421B). Validated scales were used to measure work stress, emotional dissonance, and emotional exhaustion. Data analysis included descriptive statistics, independent t tests, and structural equation modeling to examine the relationships between variables.

RESULTS

No statistically significant differences were found between the experimental and control groups in terms of overall work stress (mean difference=-0.09, 95% CI -0.31 to 0.13; P=.42) or emotional exhaustion (mean difference=0.07, 95% CI -0.15 to 0.29; P=.53). Emotional dissonance emerged as a significant predictor of emotional exhaustion in both the experimental (β=0.476, P<.001) and control (β=0.321, P=.01) groups. Nurses reporting higher workloads had significantly higher emotional exhaustion levels (experimental group: β=0.302, P<.001; control group: β=0.327, P=.002). Podcast listening demonstrated only a slight, nonsignificant moderating effect.

CONCLUSIONS

Although podcasts alone may not significantly reduce work stress or emotional exhaustion among nurses, there was a potential, albeit limited, moderating effect of podcasts on emotional well-being. They could serve as a supplementary tool for emotional support. However, broader and more comprehensive interventions are required to address the underlying causes of stress and emotional exhaustion in this population. More in-depth exploration and recommendations are possible by analyzing the content and patterns of listening. Further research is needed to examine the long-term benefits of integrating podcasts with other digital tools for holistic stress management in health care settings.

Mitigating Burnout: The Role of Healthcare Organizations

Even before the coronavirus disease (COVID-19) pandemic, burnout in healthcare providers had reached crisis levels, with up to 50% of nurses and 40% of physicians experiencing symptoms of burnout. Because of the immense work-related stress during the pandemic, healthcare providers' burnout dramatically escalated, with percentages reaching as high as 70-90%, and many healthcare providers started to leave their profession. As a result, patients are beginning to experience the deleterious impact of extreme staffing shortages in healthcare facilities. Burnout interventions are defined as either organizational or individually focused. Organizational interventions address problems such as electronic medical records, documentation, or billing systems. Individual interventions provide the necessary skills to address specific job-related stressors. Ideally, the most effective interventions would combine these two categories by teaching healthcare providers to cope with job-related stressors in a safe community that is supported by the healthcare organization. The adoption of combined organizational and individual programs will improve healthcare providers' job satisfaction, decrease burnout and other forms of psychological distress, enhance job retention, and return joy to health care. The resulting decreased turnover rates would also reduce some of the skyrocketing healthcare costs, as turnover is expensive for healthcare organizations. Ultimately, enhancing healthcare providers' well-being would improve the care we deliver to our patients. In this article, I explain why it is a critical time in health care and highlight four general principles that frame the development of specific well-being interventions. Finally, I discuss several interventions that could enhance the well-being of healthcare providers and ultimately transform the culture of health care.

Prevalence and associated factors of obsessive compulsive symptoms among under graduate medical and health science students in Dilla university, Ethiopia: a cross-sectional study

BACKGROUND

Obsessive-Compulsive Disorder (OCD) is a debilitating mental health condition characterized by recurrent, intrusive thoughts and repetitive behaviors that significantly disrupt daily life. Medical students may be uniquely susceptible to obsessive compulsive symptoms due to their constant exposure to potential contaminants and infectious diseases during their training. Obsessive Compulsive symptoms among medical students are often overlooked, which can significantly impact their academic performance, well-being, and future career prospects. The prevalence and factors of obsessive compulsive symptom is not widely studied in low and middle income countries and there are limited studies in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of obsessive compulsive symptoms among medical students.

METHODS

This was a cross-sectional study conducted among 370 students. The outcome variable was assessed using the Obsessive-Compulsive Inventory-Revised scale (OCI-R). The collected data were entered using kobo collect tool box version 1.3 and analyzed using SPSS version 25. Bivariable and multivariable logistic analysis was conducted to identify factors associated with Obsessive Compulsive symptoms and variables with P-values less than 0.05 were considered to have significant association with 95% confidence interval.

RESULT

The probable prevalence of obsessive-compulsive disorder among medical and health science students was 28% with (95% CI: 26.4-32.7). Being female [AOR = 1.33(95%CI: 1.09, 2.18)], Depressive symptoms [AOR = 2.12(95%CI: 1.95, 4.06)], Maladaptive coping mechanism [AOR = 1.74 (95%CI: 1.23, 2.50)], and Poor sleep quality [(AOR = 1.48(95%CI: 1.08, 2.24)] were significantly associated with obsessive compulsive symptoms.

CONCLUSION

Obsessive Compulsive Symptom has a high probable prevalence among medical and health science students. Being female, experiencing depressive symptoms, employing maladaptive coping mechanisms, and having poor sleep quality were significantly associated with obsessive-compulsive disorder. Therefore, early detection, screening, and appropriate intervention for obsessive-compulsive symptoms in medical students are crucial.

Exploring the magnitude and predictors of the long-term psychological impact of COVID-19 on frontline healthcare workers in Vietnam: a multi-center, cross-sectional study

BACKGROUND

The detrimental impacts of COVID-19 on the mental well-being of frontline healthcare workers (HCWs) have been well studied. However, the long-term trajectory of their mental well-being remains relatively unexplored. We examined the magnitude and predictors of the psychological impact of COVID-19 on frontline HCWs during the transition into the "new normal" phase.

METHODS

A cross-sectional survey was performed on frontline HCWs at two largest designated COVID-19 hospitals in Ho Chi Minh City between May and November 2022. A self-administered questionnaire captured participants' demographic characteristics and psychological distress including depression, anxiety, and insomnia. Multivariable logistic regression models were used to examine factors associated with psychological distress.

RESULTS

Among 462 HCWs, 85.3% self-reported having good, very good, or excellent mental health before their COVID-19 deployment, compared to 40.7% during the deployment and 55.6% at the time of the study. The prevalence of moderate-to-severe depression was 26.8%, anxiety (20.8%), insomnia (23.4%), and overall psychological distress (73.2%). Predictors for depression included pre-existing physical (adjusted odds ratio [aOR] = 2.09, 95%CI 1.03-4.22, P = 0.04) and mental health (aOR = 3.59, 95%CI 1.31-9.84, P = 0.01) conditions and being deployed during the 3rd (aOR = 6.28, 95%CI 1.12-35.08, P = 0.04) and 4th (aOR = 5.01, 95%CI 1.08-23.16, P = 0.04) COVID-19 wave. Those with mental health conditions before the deployment (aOR = 3.95, 95%CI 1.42-11.0, P = 0.008) were more likely to report anxiety symptoms. Predictors for insomnia included physical health conditions before the deployment (aOR = 2.73, 95%CI 1.37-5.44, P = 0.004), working at field hospitals (aOR = 2.44, 95%CI 1.43-4.16, P = 0.001), and currently being deployed to respond to COVID-19 (aOR = 0.35, 95%CI 0.19-0.67, P = 0.001).

CONCLUSIONS

Given the substantial impact of COVID-19 deployment on HCWs' long-term mental well-being, comprehensive mental health support strategies are urgently needed. As HCWs may overlook their mental health issues, a screening program with psychological support services should accompany them early in future pandemics. Further nationwide studies with longer follow-ups are necessary to understand the full extent of psychological distress among frontline HCWs in Vietnam.

Emotional Processing and Psychological Well-Being of Healthcare Workers During the COVID-19 Pandemic

Objectives: The present cross-sectional web-based survey study aimed to examine the impact of gender and frontline/non-frontline condition on psychological health (depression and peritraumatic distress) of a sample of Italian healthcare workers, and to explore the mediating effects of emotional processing in these relationships. Methods: Emotional processing styles and depressive and peritraumatic distress symptoms were assessed between March and December 2021, a period which in Italy corresponds to the third and the start of the fourth wave of COVID-19, along with gender, frontline versus non-frontline role in the pandemic emergency, and other sociodemographic and background variables. Results: Results showed that emotional processing mediated the relationship between gender and frontline/non-frontline role with depressive and peritraumatic distress symptomatology. Being a woman, working on the frontlines, and having a maladaptive emotional processing style increased the negative effects of stress during the pandemic. Conclusions: The obtained results strengthen the importance of providing useful psychological support for health professionals to facilitate the expression and management of emotions as well as the learning of healthy and functional styles of emotional processing.

Emotional distress during the first year of the COVID-19 pandemic-large sample serbian study

The COVID-19 pandemic has significantly impacted mental health, with healthcare professionals being particularly vulnerable. This study explores the emotional distress experienced in Serbia, focusing on factors that contribute to symptoms of depression, anxiety, and stress. A total of 3328 participants from the general and healthcare populations were surveyed using the Depression Anxiety Stress Scales-Short Form (DASS-21). The analysis revealed that certain groups, such as women, non-psychiatrist doctors, individuals with a history of mental disorders, and those dissatisfied with their financial, familial, and living circumstances, were more likely to experience heightened levels of emotional stress. Moreover, healthcare professionals, especially those working in challenging conditions, may be at increased risk for mental health issues. These findings underscore the need for targeted interventions and ongoing support for those most affected, particularly within the healthcare sector, to mitigate the long-term mental health impacts of the pandemic.

The best approaches and doses of exercise for improving sleep quality: a network meta-analysis and dose-response relationship study

BACKGROUND

Poor sleep quality not only diminishes people's quality of life and work efficiency but is also closely associated with various diseases. A reasonable exercise regimen can improve sleep quality to some extent, but there is a lack of comparative studies on the effects of different types of exercise, especially varying exercise doses, on sleep quality.

OBJECTIVE

To systematically evaluate the effects of different exercise modalities and doses on sleep quality.

METHODS

A search was conducted in PubMed, Web of Science, EBSCO, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases for randomized controlled trials (RCTs) on the effects of different exercise modalities on sleep quality, from database inception to November 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Network meta-analysis and dose-response analysis were performed using Stata 16.0 and R software with a random-effects model.

RESULTS

A total of 86 RCTs involving 7,276 participants were included. Six types of interventions were assessed: Aerobic Exercise (AE), Resistance Training (RT), Combined Aerobic and Resistance training (AE + RT), Yoga, Pilates, and Traditional Chinese Sports (TCS). The network meta-analysis results showed that compared to the control group, AE (SMD = -1.21, 95% CI: -1.50, -0.91, P < 0.01), RT (SMD = -1.12, 95% CI: -1.80, -0.44, P < 0.01), AE + RT (SMD = -1.11, 95% CI: -1.56, -0.66, P < 0.01), YOGA (SMD = -0.82, 95% CI: -1.22, -0.42, P < 0.01), Pilates (SMD = -1.65, 95% CI: -2.42, -0.88, P < 0.01), and TCS (SMD = -0.94, 95% CI: -1.28, -0.60, P < 0.01) all significantly improved sleep quality. The cumulative ranking probability (SUCRA) ranking showed that Pilates (91.7%) was the most effective, followed by AE (69.7%), AE + RT (59.4%), RT (58.6%), TCS (40.5%), and YOGA (30.1%). Additionally, the relationship between exercise dose and sleep quality was nonlinear, following a U-shaped curve. The overall optimal exercise dose for improving sleep quality was 920 MET-min/week. The optimal doses varied across exercise types, ranging from 390 MET-min/week for Pilates to 1,100 MET-min/week for aerobic exercise.

CONCLUSION

This study provides strong support for non-pharmacological interventions to improve sleep quality. For individuals aiming to improve their sleep through exercise, Pilates and aerobic exercise are recommended as the preferred options. Additionally, controlling the exercise dose within the optimal range (e.g., 920 MET-min/week) can significantly enhance the intervention effect.

CLINICAL TRIAL NUMBER

Not applicable.

Psychological distress in health care workers during the beginning, the middle, and the last part of the COVID-19 pandemic

The COVID-19 pandemic placed significant psychological strain on healthcare workers. Our study tracked health care workers in the Czech Republic throughout the pandemic to examine the impact of stressors on psychological distress over time and explore gender differences in these associations. We studied health care workers from the Czech arm of the international COVID-19 HEROES Study who took part in all three waves of data collection in 2020, 2021 and 2022 (n = 264). We employed a path model to examine the relationships among six stressors (low trust in workplace, assignment of new tasks, prioritization of patients, experience of death due to COVID-19, experience of discrimination or violence, contact with COVID-19 patients), psychological distress (measured by General Health Questionnaire), and covariates (age, gender, occupation). We incorporated autoregressive paths and interactions to assess the longitudinal impact of stressors. Prior levels of distress predicted subsequent distress, with significant carry-over effects observed between each wave. Stressors had direct association to distress in the same wave of data collection (2020 and 2021), but not in subsequent waves, and stressors in 2022 did not have a significant direct effect to distress. Men reported lower distress in 2020 and 2021, but not in 2022. Furthermore, no significant interactions between stressors and gender were found. Age and occupation were not related to distress levels. There is a need for adaptable mental health support that addresses current stressors through targeted interventions, while also providing ongoing monitoring beyond crises, particularly for individuals with high distress levels.

Psychological status of healthcare workers in the post-COVID 19 period in China: a retrospective multicentric cross-sectional study

Objective

This study aimed to assess the depression, anxiety, sleep disorders, and post-traumatic stress disorder (PTSD) among healthcare workers (HCWs) in Huizhou in the post-pandemic period.

Methods

A retrospective multicentric cross-sectional study was conducted from April 25 to May 25, 2023, involving 4,618 HCWs from 46 hospitals in Guangdong Province, China. Psychological well-being was measured using the PHQ-9, GAD-7, Insomnia Severity Index (ISI), and PTSD scales. Chi-square test and multivariable logistic regression were used to identify factors associated with depression, anxiety, insomnia and PTSD.

Results

The rates of anxiety, depression, insomnia, and PTSD were 45.0%, 59.4%, 40.5%, and 10.5%, respectively. HCWs who did not experience negative events were more likely to show anxiety (OR=2.082, 95%CI:1.734-2.499), depression (OR=2.013, 95%CI:1.647-2.460) and insomnia (OR=2.013, 95%CI:1.683-2.409).

Conclusion

There was a high prevalence of anxiety, depression, insomnia, and PTSD in the HCWs after the COVID-19 pandemic.

"Having Support at Work 'Is Different' and Important": A Qualitative Study of Virtual Peer Discussion Groups With Medical School Faculty

PURPOSE

In response to the need to support health care professionals during the COVID-19 pandemic, an innovative, peer-led discussion group program for medical school faculty, called CIRCLE (Colleague Involved in Reaching Colleagues through Listening and Empathy), was developed at Rutgers Health. This article describes results of a qualitative analysis of the participants' experiences, explores virtual communication platform use during this peer support program, and identifies the program's beneficial elements.

METHOD

CIRCLE was inaugurated in October 2020 at Rutgers New Jersey Medical School and Rutgers Robert Wood Johnson Medical School using evidence-informed topics. The inaugural CIRCLE peer-led discussion groups included 50 physicians who met twice monthly in groups of 5 to 8 between October 2020 and April 2021. Deidentified transcript data were iteratively reviewed using conventional content analysis, including familiarization, thematic framework creation, indexing, charting, mapping, and interpretation. Themes were grouped into 4 conceptual framework categories based on social support theory in context of work-related stress: emotional, appraisal, informational, and instrumental support.

RESULTS

Themes emerged based on the framework: emotional support (connecting on a deeper level, importance of support at work, COVID-19 made virtual connections needed and relevant), appraisal support (feeling "not alone," safe space to connect and share), informational support (sharing self-care strategies), and instrumental support (incentives to join are helpful but connection leads to engagement, some structure but "not too much" is important, virtual modalities are convenient and conducive to connection).

CONCLUSIONS

Benefits of peer discussion groups include deeper connections at work, reduced isolation, safe sharing, and exchange of information on self-care. Connection and balancing structure and autonomy were important to engagement. Virtual modalities were viewed as feasible, convenient, and conducive to connection. This article highlights the benefits and convenience of virtual peer-led discussion groups for medical school clinical faculty and provides evidence for content development of these programs.

Psychological health of healthcare workers during Shanghai lockdown: Prevalence and associated factors

The 2022 Shanghai COVID-19 lockdown may lead to mental health issues among healthcare workers (HCWs). A cross-sectional study was conducted to investigate psychological health and its associated factors among HCWs. A total of 253 hCWs were recruited in Shanghai, China, through convenience sampling method. Demographic Questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and The Impact of Event Scale-Revised were used to assess demographic information, anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD), respectively. The associated factors of psychological health were identified by binary logistic regression analysis. The prevalence of anxiety, depression, insomnia, and PTSD was 6.3%, 10.3%, 9.9% and 17.8%, respectively. Female HCWs were more likely to report anxiety (OR = 5.50, 95%CI = [1.45-20.82], p < 0.05) and PTSD (OR = 3.20, 95%CI= [1.23-8.28], p < 0.05). Besides, being a nurse was associated with a lower level of PTSD symptoms (OR = 0.23, 95%CI = [0.07-0.76], p < 0.05). Symptoms of psychological health were screened positive in HCWs during the 2022 Shanghai COVID-19 lockdown. Gender and occupation were associated with psychological health. The hospital authorities of Shanghai need to pay special attention to female HCWs.

Unraveling the fear of COVID-19 reinfection: insights from frontline doctors in China

Considering the end of global emergency status of Coronavirus-19 (COVID-19) and the persistent risk of reinfection for healthcare workers (HCWs), it is important to evaluate the attitude of the HCWs toward reinfecting with COVID-19. To gather information about participants' concerns regarding reinfection with COVID-19, a comprehensive online questionnaire was administered to all individuals involved in the study. DASS-21 was used to assess their mental health. Logistic regression was used to evaluate the factors associated with fear of reinfection. A total of 982 questionnaires were collected for this study, with only 503 questionnaires included in the final analysis. Of the 503 respondents, 201 (39.96%) feared reinfection with COVID-19. Three factors emerged as significantly associated with the fear of reinfection: (a) having been infected with COVID-19 before, (b) feeling that COVID-19 had a lasting effect on one's life, and (c) experiencing anxiety. The most common factors reported by those who feared reinfection were: concern about the negative effects of reinfection on their physical health, worry about the possible long-term complications of reinfection, and belief that reinfection would not have a big impact. And the mental state of HCWs has improved and become more optimistic. Although the morale of HCWs has improved, it remains evident that a significant portion of them still have concerns about reinfection and continue to experience anxiety. Moving forward, it is crucial to provide timely psychological care and support to HCWs, alongside reinforcing efforts in epidemic management.

Perceived Trauma Among Nurses During the COVID-19 Pandemic: A Qualitative Descriptive Study

The COVID-19 pandemic has caused disruption to healthcare services worldwide, and although the pandemic was declared over, nurses continue to experience burnout and mental health implications because of events experienced since 2020. The aim of this study was to explore the experiences of trauma among nurses during the COVID-19 pandemic, using a qualitative descriptive study design. This paper used secondary analysis of qualitative, semi-structured interviews conducted with 55 Australian nurses exploring their alcohol consumption, due to the frequent narratives of trauma and traumatic events arising during this process. Data were analysed using structural coding and reported in accordance with the Consolidated Checklist for Reporting Qualitative Data (CORE-Q guidelines). Four themes emerged during data analysis: managing the traumatic stress of the clinical environment in COVID ('it doesn't feel like it's gone away'), post-pandemic trauma ('it was like war, wasn't it?'), bonding over shared trauma ('I was not expecting the camaraderie that developed') and managing trauma after the event ('If something bad happens whilst you're on shift, you just have to pretend like it hasn't happened'). Participants in this study described lasting mental health effects from working clinically during the COVID-19 pandemic that they described as trauma. These effects have lasted since governments worldwide have announced an end to the pandemic, and although participants described bonding over these shared experiences, they continue to have a detrimental impact on workforce well-being and sustainability.

Post COVID-19 infection and quality of life of healthcare workers at Sahloul University Hospital of Sousse in Tunisia

BACKGROUND

Since the COVID-19 pandemic, health care workers (HCWs) faced an enormous physical and mental burden, sometimes altering their quality of life due mainly to persistent challenges stemming from their frontline position.

AIMS

Todetermine the prevalence of post-COVID-19 syndrome, and its impact on the Health-Related Quality of Life (HRQoL) among HCWs.

METHODS

This is an exhaustive cross-sectional study with analytical scope, conducted among all HCWs of the University Hospital Sahloul of Sousse, Tunisia, who have contracted COVID-19 between September 2020 and 30 March 2021 (N=529 cases).The post-covid medical check-up was carried out three months after the acute phase of the COVID-19 infection (December 2020 to June 2021). HRQoL was assessed using the SF-12 (12-item Short Form Health Survey) questionnaire. Bivariate study and multiple linear regressions were performed to identify the different factors influencing the quality of life of HCWs.

RESULTS

During the study period, 529 HCWs were diagnosed with SARS CoV-2 infection, out of them 249 participants were included (47% participation rate). Post covid-19 syndrome was reported in 65% of cases. A low overall quality of life (QoL) score was reported in 28.6% of cases. Low physical and mental composite scores were reported in 34.3% and 29.4% of cases respectively. In the multiple linear regression analysis, gender, post COVID-19 syndrome and time off work were significantly associated with SF12 scores.

CONCLUSION

In our study, HCWs experienced a significant deterioration in HRQoL after COVID-19 with a high incidence of post-COVID-19 syndrome. The need of long-term follow-up after SARS-CoV-2 infection remains essential to support HCWs and mitigate long-term impacts.

Psychometric Properties and Gender Invariance of the Positive Mental Health Scale in Spanish Nurses During the COVID-19 Pandemic

AIM

Positive mental health (PMH) can be considered a key aspect of mental health in the face of potentially stressful healthcare situations such as the COVID-19 pandemic. The aim of this study was to analyse the psychometric properties of the Spanish version of the Positive Mental Health Scale (PMS) in Spanish nurses during the COVID-19 pandemic.

DESIGN

Descriptive analysis, confirmatory factor analysis, gender invariance analysis and convergent and divergent analyses were performed, and reliability indices were calculated.

METHODS

A total of 661 nurses (425 women and 236 men) participated in the study. They completed various questionnaires during August-October 2021.

RESULTS

Factor analysis demonstrated a unidimensional structure with very good indices of model fit, high positive convergent validity, especially with social support, self-efficacy and resilience to suicide attempts, and high divergent validity with anxiety and, to a lesser extent, with depression. There was also strong invariance between genders and high reliability indices. In conclusion, the data show that the PMS has adequate validity and reliability in nurses. Furthermore, this study allows us to confirm gender invariance, which has not been examined in other studies. The data show that PMS is a suitable measure for assessing the mental health of healthcare professionals exposed to high-stress situations.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contributions.

Prevalence of the symptoms of post-traumatic stress disorder (PTSD) and burnout syndrome (BOS) among intensive care unit (ICU) healthcare workers during the COVID-19 pandemic

Pandemic COronaVIrus Disease-19 (COVID-19) was a traumatic event that had a significant impact on the mental health of healthcare workers (HCWs), especially intensive care units (ICUs). Months of exposure and the threat of death can lead to post-traumatic stress disorder (PTSD), and high physical and emotional strain can lead to burnout syndrome (BOS). The purpose of this study was to assess the prevalence of PTSD and BOS among ICU HCWs during the COVID-19 pandemic. A case-control study was conducted in 2022 using a diagnostic survey method with 148 hCWs from two intensive care units: a temporary intensive care unit (tICU, n = 93) and a general intensive care unit (gICU, n = 55) in Cracow, Poland. The Impact of Events Scale (IES-R), Oldenburg Burnout Inventory (OLBI) and a proprietary questionnaire were used. The results obtained indicate that 46.62% (69) of HCWs had pronounced PTSD symptoms. In the tICU HCWs, 47.31% (44) had severe symptoms of PTSD, and in the gICU HCWs, 45.45% (25) were affected. HCWs in the tICU reported the highest score in the Hyperarousal domain (x = 1.52; SD = 0.87), while HCWs from the gICU reported higher scores in the Avoidance domain (xx = 1.45 SD = 0.81). HCWs presented moderate levels of job BOS in the domains of exhaustion (50.68%; 75) and lack of commitment (64.86%; 96). It was shown that lack of commitment to work was significantly more frequent in the tICU group than in the gICU group (p = 0.022). It was shown that the greater the level of exhaustion or withdrawal, the greater the severity of each PTSD symptom. Activity responsibility and fatigue were found to be the most stressful in the workplace. PTSD symptoms co-occurred with BOS. It is necessary to provide employees with targeted psychological support in dealing with the post-pandemic emotional crisis and support the retention of nurses in the profession.

Mental health during the Covid-19 pandemic: An international comparison of gender-related home and work-related responsibilities, and social support

PURPOSE  : To assess gender differences in COVID-19 related changes in home and work responsibilities longitudinally, and determine whether these differences, together with other potential risk and protective factors, are associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptomatology.

METHOD

Symptoms of depression, anxiety, and PTSD were measured using an online survey instrument, between May 2020 and April 2021, in four waves completed at 3-monthly intervals. Analyses were based on data from the COvid MEntal healTh (COMET) survey which investigated the mental health effects of the COVID-19 outbreak spanning 13 countries on five continents in N = 7,909 participants.

RESULTS

From the first to the last wave, women reported a greater increase in home and work responsibilities, and had higher depression, anxiety and PTSD scores compared to men. Women who reported a reduction in income due to the pandemic had higher depression scores. Working harder and experiencing a reduction in income were also associated with higher anxiety scores in women but not in men. Women were more likely to score above the cut-off for depression (32.5% vs 23.6%, p < .001), anxiety (21.2% vs 14.4%, p < .001) and PTSD (21.2% vs 14.4%, p < .001) than men during the first wave. Stronger reliance on socially supported coping mechanisms was a risk factor for depression, anxiety and PTSD in men and women.

CONCLUSION

Women were more likely to report mental health problems which may be related to the gender disproportionate increase in home and work responsibilities but not necessarily due to COVID-19 stressors.

The relationship between young adults' time use, occupational diversity, and occupational balance

BACKGROUND

Research has shown that work-life balance is not only about job satisfaction and performance. It is also related to a good occupational balance. In this way, a balanced working pattern can improve health. The impact of smartphones, which have become ubiquitous in contemporary society, on this balance is a topic of ongoing debate.

OBJECTIVE

This study aims to investigate the relationship between time use, smartphone use, occupational balance, and occupational self-competence among working young people and university students. The findings of this study may contribute to the development of effective strategies to improve the work-life balance of young people who are either working or about to start their working life.

METHODS

The study involved 158 healthy young adults. The research instruments used included a socio-demographic information form, the Modified Occupational Questionnaire, the Occupational Self-Assessment, and the Turkish Occupational Balance Questionnaire. The results were then analyzed using SPSS 24.0.

RESULTS

A significant relationship was found between the time allocated to sleep and occupational balance (p = 0.009), as well as between the time allocated to work and productive activities and occupational self-competence (p = 0.010). Furthermore, a statistically significant relationship was found between the duration of smartphone usage and occupational balance (p = 0.04).

CONCLUSION

The study emphasizes occupational balance as an important concept for identifying and addressing time use problems among young workers and university students. The study suggests that achieving work-life balance requires consideration of the positive effects of time allocated sleep and the negative effects of smartphone use.

Mental Health Status and the Intention to Leave the Profession of Nurses Employed Across Catalonia, Spain: A Cross-Sectional Study

INTRODUCTION

The relationship between nurses' mental well-being and intention to leave the profession remains a pressing issue.

AIM

To determine the mental health status and the intention to leave the profession of nurses employed across diverse healthcare sectors in Catalonia, Spain.

METHODS

This cross-sectional study included 1051 Registered Nurses in Catalonia, Spain, using convenience sampling through social media platforms and personal contacts. Participants completed four standardised instruments online to measure anxiety, insomnia, depression and posttraumatic stress disorder, along with an ad hoc sociodemographic questionnaire. The methodology of this study was guided by the STROBE checklist.

RESULTS

The analysis revealed that a significant proportion of participants exhibited mental health issues: 44% showed moderate to severe anxiety, 31% experienced moderate to severe insomnia, 40% suffered from moderate to severe depression and 42% had moderate to severe posttraumatic stress disorder. Participants who had worked in COVID hospital units were 1.38 times more likely to experience poor mental health status. Although not all associations were statistically significant, nurses working in primary healthcare, intensive care units and nursing homes had increased odds of poor mental health. Additionally, 53% of participants had reconsidered their working status, with 69% of them expressing an intention to leave the nursing profession.

LIMITATIONS

The evolving nature of the pandemic and the adaptation of healthcare workers to the new scenario may have influenced their experiences during data collection.

IMPLICATIONS

Highlights the increase in mental health-related needs and high rates of psychiatric symptoms among nurses nowadays.

RECOMMENDATIONS

Addressing mental health needs is crucial to mitigate the intention of nurses to abandon the profession.

Presenting a model of a healthy lifestyle in the post-COVID-19 era: A qualitative study

BACKGROUND

The pandemic disease of coronavirus disease 2019 (COVID-19) has caused extensive changes in people's lifestyles with its widespread spread. The current research was conducted with the aim of designing a healthy lifestyle model in the post-COVID-19 era.

MATERIALS AND METHODS

The current research is a qualitative study of the grounded theory type, which was performed by the theoretical sampling method in 2022. Data were collected using semi-structured interviews. The researcher reached theoretical saturation by the end of the 15th interview. Data analysis was performed using the coding obtained from interviews with experts, using MAXQDA software 2020.

RESULTS

A total of 189 initial codes were extracted by the researcher, and after removing those repetitive concepts, 154 final concepts were obtained. The result of the axial coding stage was the identification of 36 main categories, which were placed in the six main categories of the paradigmatic model in the selective coding stage. The results of the research led to the presentation of a healthy lifestyle model in the post-COVID-19 era. According to the paradigm model, a healthy lifestyle in the post-COVID-19 era includes five causal factors, 10 contextual factors, seven interventional factors, 10 strategic factors, and finally five outcomes of social health, mental health, physical health, life expectancy, and movement toward development.

CONCLUSION

To achieve a healthy lifestyle, appropriate behaviors based on this model must be promoted at the community level by health policymakers. Additionally, it is important to give special attention to public health and the prevalence of infectious diseases for the practical implementation of this model.

Prediction models for sleep quality among frontline medical personnel during the COVID-19 pandemic: cross-sectional study based on internet new media

Background

The factors associated with sleep quality among medical personnel providing support on the frontline during the height of the COVID-19 pandemic remain unclear, and appropriate predictive and screening tools are lacking. This study was designed and conducted to investigate whether factors such as weight change, job title, and tea consumption influence the sleep quality of these workers. Additionally, the study aims to develop predictive models to analyze the sleep problems experienced by healthcare workers during periods of epidemic instability, and to provide relevant data and tools to support effective intervention and prevention strategies.

Methods

A cross-sectional study was conducted from June 25 to July 14, 2022, using a self-administered general information questionnaire and the Pittsburgh Sleep Quality Index (PSQI) to investigate the sleep quality of medical personnel providing aid in Shanghai. The relevant influencing factors were obtained via univariate analysis and multivariate stepwise logistic regression analysis, and 80% of the data were used in the training-test set (n = 1,060) and 20% were used in the independent validation set (n = 266). We used snowball sampling to establish the six models of logistics (LG), deep learning (DL), naïve Bayes (NB), artificial neural networks (ANN), random forest (RF), and gradient-boosted trees (GBT) and perform model testing.

Results

Among the participants, 75.8% were female. Those under 35 years of age comprised 53.7% of the medical staff, while those over 35 years accounted for 46.3%. The educational background of the participants included 402 individuals with an associate degree (30.3%), 713 with a bachelor's degree (53.8%), and 211 with a master's degree or higher (15.9%).Weight, job title, and tea consumption during the aid period were the main factors influencing the sleep quality of medical personnel during the aid period. The areas under the curve (AUC) of LG, DL, NB, ANN, RF, and GBT were 0.645, 0.656, 0.626, 0.640, 0.551, and 0.582, respectively. The DL model has the best prediction performance (specificity = 86.1%, sensitivity = 45.5%) of all the models.

Conclusion

During the height of the COVID-19 pandemic, the sleep quality of frontline medical personnel providing aid in Shanghai was influenced by multiple factors, and the DL model was found to have the strongest overall predictive efficacy for sleep quality.

Psychometric properties and validity of inventory of symptoms of professional traumatic grief among nursing professionals

BACKGROUND

Traumatic grief can exert a considerable influence on the mental and physical well-being of nurses, potentially altering their ability to provide high quality care. This impact is most pronounced in specific contexts such as health emergencies, palliative care and paediatric intensive care units. In the context of the Covid-19 pandemic, health professionals have faced an unprecedented increase in loss and trauma, and this situation is seen as an exacerbating factor in complicated bereavement. Despite the availability of instruments for the assessment of prolonged or pathological grief, there is a pressing need for additional studies that allow for a more accurate understanding and measurement of this phenomenon, filling certain existing methodological gaps. The main purpose of this research is to evaluate the psychometric properties of the Inventory of Symptoms of Professional Traumatic Grief (ISDUTYP), with a view to improving assessment tools in this field.

METHOD

Construct validity, reliability, criterion validity, convergent validity and discriminant validity were assessed. The scale's psychometric properties were tested with 930 nursing professionals. The data were collected between September 2022 and January 2023.

RESULTS

A total of 930 people took part in the study. The factorial analysis of ISDUTYP showed that, according to eigenvalues and the scree plot, the optimal number of factors was 2. These factors consisted of 13 and 12 items, respectively, and had clinical significance. Factor 1 could be termed "Behavioural Symptoms," while Factor 2 could be termed "Emotional Symptoms." Cronbach's alpha values demonstrated excellent reliability for all scores. In particular, Cronbach's alpha was 0.964 for the overall score, 0.950 for the behavioural symptoms subscale, and 0.950 for the emotional symptoms subscale. Regarding criterion validity, all expected correlations were statistically significant. Finally, almost all hypotheses defined of convergent and discriminant validity were fulfilled.

CONCLUSIONS

The high reliability and validity of the scale supports its use in research and clinical practice to assess the impact of professional traumatic grief and enhance its treatment. The validated scale for measuring nurses' grief has significant implications in clinical practice, allowing for the identification and management of nurses' grief, fostering a healthy work environment, and improving patient care quality.

AI Chatbots for Psychological Health for Health Professionals: Scoping Review

Background

Health professionals face significant psychological burdens including burnout, anxiety, and depression. These can negatively impact their well-being and patient care. Traditional psychological health interventions often encounter limitations such as a lack of accessibility and privacy. Artificial intelligence (AI) chatbots are being explored as potential solutions to these challenges, offering available and immediate support. Therefore, it is necessary to systematically evaluate the characteristics and effectiveness of AI chatbots designed specifically for health professionals.

Objective

This scoping review aims to evaluate the existing literature on the use of AI chatbots for psychological health support among health professionals.

Methods

Following Arksey and O'Malley's framework, a comprehensive literature search was conducted across eight databases, covering studies published before 2024, including backward and forward citation tracking and manual searching from the included studies. Studies were screened for relevance based on inclusion and exclusion criteria, among 2465 studies retrieved, 10 studies met the criteria for review.

Results

Among the 10 studies, six chatbots were delivered via mobile platforms, and four via web-based platforms, all enabling one-on-one interactions. Natural language processing algorithms were used in six studies and cognitive behavioral therapy techniques were applied to psychological health in four studies. Usability was evaluated in six studies through participant feedback and engagement metrics. Improvements in anxiety, depression, and burnout were observed in four studies, although one reported an increase in depressive symptoms.

Conclusions

AI chatbots show potential tools to support the psychological health of health professionals by offering personalized and accessible interventions. Nonetheless, further research is required to establish standardized protocols and validate the effectiveness of these interventions. Future studies should focus on refining chatbot designs and assessing their impact on diverse health professionals.

An innovative approach based on health surveillance for the prevention and early detection of cardiovascular diseases in a large cohort of healthcare workers

The aim of our three-year retrospective observational study on 6000 healthcare workers, all subjected to mandatory health surveillance, is to determine the risk factors and prevalence of cardiovascular diseases (CVDs) and to analyze the results of an ad hoc designated preventive health surveillance protocol. A risk assessment was performed and a preventive health surveillance protocol was implemented, including clinical-instrumental and laboratory tests aimed at the early detection of any sign of CVD. As a result, n = 442 new diagnoses of CVDs were made and the prevalence of CVDs increased from 12 to 16.1%. The higher prevalence was observed in physicians (P = 57.8%; p < 0.0001). The main risk factors for CVDs were age, male sex and family history of CVDs. The analysis of CVDs determinants highlighted an unexpected protective role of shift work (aOR = 0.64; p < 0.0001). Our preventive health surveillance protocol allowed to reveal a high prevalence of undiagnosed CVDs, laying the foundations for future primary prevention and counseling interventions as part of the health promotion and TOTAL WORKER HEALTH programs. Further studies are needed to create solid scientific evidence that can guide public health decisions regarding new prevention models and health promotion programs also in the general population.

Predictors of post-traumatic stress disorder among healthcare workers during the COVID-19 pandemic in Poland

The COVID-19 pandemic has significantly impacted the mental health of healthcare workers globally. Given the critical role these professionals play, understanding the prevalence and predictors of post-traumatic stress disorder (PTSD) among healthcare workers is crucial for developing targeted interventions. Comprehensive data on the predictors of PTSD symptoms within this population remain limited. This cross-sectional study surveyed 852 healthcare workers across 4 Polish regions between 2021 and 2022. Data were collected using the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), which was culturally adapted and validated for Polish respondents. To identify key predictors of PTSD symptoms, researchers employed various statistical methods: Descriptive Statistics summarized key variables (e.g. age, job tenure) to provide an overview of data distribution and sample characteristics. Pearson Correlations examined linear relationships among variables like age, work experience, and PTSD severity, ensuring no multicollinearity through variance inflation factor checks. t-Tests and Mann-Whitney U tests compared PTSD symptom severity across demographic and professional subgroups, accounting for normality using the Kolmogorov-Smirnov test. And Hierarchical Regression Analysis identified significant predictors, incorporating demographic factors first and work-related variables (e.g. fear for personal health) in a second step. A total of 88.1% of participants were female, and 82.6% were nurses. The overall prevalence of PTSD symptoms was high, with a mean total PTSD score of 37.87. Gender differences were significant, with women reporting higher scores across the PTSD subscales, including avoidance and hyperarousal. Nurses had significantly higher intrusion symptoms compared to other professionals. Fear for personal health was the strongest predictor of PTSD symptoms (β = 0.15, P < .001), explaining 11% of the variance in the final regression model (R2 = 0.11, P < .001). The findings underscore the urgent need for targeted mental health interventions, particularly for women and nurses, who are disproportionately affected by PTSD during the pandemic. Predictive models should guide the development of support programs to mitigate the long-term psychological impact of COVID-19 and ensure better preparedness for future pandemics. The significant influence of fear for personal health on PTSD outcomes highlights the importance of protective measures and psychological support for frontline healthcare workers.

Influence of the pandemic on the mental health of professional workers

BACKGROUND

This study focuses on the influence of the pandemic on professional workers from an explicitly comparative perspective. High levels of stress and burnout have been reported among professional workers pre-pandemic, but the pandemic has had unique consequences for certain professional workers. Gender has emerged as a particularly important factor. While the existing research yields important insights of mental health concerns among professional workers, there is a need for more research that examines these impacts empirically, explicitly from a comparative perspective across professions taking gender more fully into consideration.

METHODS

This paper undertakes a secondary data analysis of two different pan Canadian sources to address the pandemic impact on professional workers: The Canadian Community Health Survey (2020, 2021) administered by Statistics Canada and the Healthy Professional Worker survey (2021). Across the two datasets, we focused on the following professional workers - academics, accountants, dentists, nurses, physicians and teachers - representing a range of work settings and gender composition. Inferential statistics analyses were conducted to provide prevalence rates of self-perceived worsened mental health since the pandemic and to examine the inter-group differences.

RESULTS

Statistical analysis of these two data sources revealed a significant effect of the pandemic on the mental health of professional workers, that there were differences across professional workers and that gender had a notable effect both at the individual and professional level. This included significant differences in self-reported mental health, distress, burnout and presenteeism prior to and during the pandemic, as well as the overall impact of the pandemic on mental health. The high levels of distress and burnout during the pandemic were particularly evident in nursing, teaching, and midwifery - professions where women predominate.

CONCLUSIONS

Interventions to address the mental health consequences of the pandemic, including their unique gendered and professional dimensions, should consider the intersecting influences and differences revealed through our analysis. In addition to being gender sensitive, interventions need to take into account the unique circumstances of each profession to better respond to the mental health needs of all genders within each professional group.

Workers' Psychological Distress During the Early Months of the COVID-19 Pandemic in Brazil: A Cross-Sectional Study

The COVID-19 pandemic significantly impacted the mental health of workers. This study aimed to assess the prevalence of psychological distress among Brazilian workers during the early months of the pandemic and explore its associated factors. A cross-sectional study was conducted using an online questionnaire administered to 2903 Brazilian workers, including 1752 non-healthcare workers (NHCWs) and 1151 healthcare workers (HCWs), between April and May 2020. Snowball sampling was employed for participant recruitment, and the research questionnaire was adapted for use with the Brazilian population through a process of translation and cultural adaptation, based on an instrument initially created and validated for use in Spain. Differences between NHCWs and HCWs were tested using the chi-square or Fisher's Exact test and Mann-Whitney test followed by effect size measurement. Multiple linear regression models were used to analyze the association between psychological distress and the predictor variables. Psychological distress was observed in 72.6% (95% CI 70.1-74.2%) of the participants, with no significant difference observed between NHCWs and HCWs. Although 32 variables showed statistically significant differences between NHCWs and HCWs, only 7 demonstrated clinical-epidemiological relevance, primarily related to occupational factors. Work-related stress was positively associated with psychological distress, but this relationship diminished in the absence of family members infected with COVID-19. Conversely, a higher sense of coherence was protective against psychological distress, although this effect weakened in the absence of family members infected with COVID-19. The study highlights the high prevalence of psychological distress among Brazilian workers during the pandemic's early months. Work stress played a significant role, while sense of coherence appeared to mitigate mental health challenges. These findings highlight the need for targeted mental health interventions, particularly for workers facing both professional and family-related stressors during crises.

Compassion fatigue and satisfaction among frontline staff in long term care facilities: psychometric properties of the Serbian version of the professional quality of life scale

Introduction

This study explored the complex relationship between anxiety, depression, compassion fatigue, and satisfaction among long-term care (LTC) workers following the COVID-19 pandemic. In addition, the study assessed psychometric properties of the Professional Quality of Life (ProQOL) scale, to ensure a reliable and valid instrument for identifying compassion fatigue and satisfaction in the Serbian healthcare system.

Methods

A cross-sectional study was conducted across LTC facilities in the Republic of Serbia. A ProQOL was administered to physicians, nurses, and aids, to measure compassion fatigue (including burnout and secondary traumatic stress) and compassion satisfaction. The following standardized instruments were also distributed: Secondary Traumatic Stress Scale (STSS), Depression Anxiety and Stress Scale 21 (DASS-21) and 12-Item Short-Form Health 36 Survey (SF-12).

Results

A total of 300 LTC workers participated, mostly women (86.3%), with an average age of 45.4 ± 10.5 years and a median work experience of 15 years (range: 1 to 42 years). The study reported a significant presence of anxiety and depression symptoms (53.3% and 43.3%, respectively), with LTC workers experiencing moderate levels of compassion fatigue, as indicated by burnout (58.3%) and stress (57.3%) subscales, and moderate or high levels of compassion satisfaction (49.0% and 50.0%, respectively). The study demonstrated that anxiety impacts depression both directly and indirectly (p<0.05). Specifically, burnout and compassion satisfaction mediated the positive effect of anxiety on depression, indicating that increased anxiety led to higher burnout and lower compassion satisfaction, which resulted in greater depression (p<0.05). The three-factor structure of the ProQOL was validated (IFI, TLI, and CFI were above the cut-off of ≥0.95, and the RMSEA was below the suggested value of ≤ 0.06). The Cronbach α of the three subscales was above 0.8, indicating good scale reliability.

Conclusion

This study contributes to the broader literature on LTC workers wellbeing by examining the complex interplay between professional quality of life, anxiety, and depression. The findings should guide decision-makers in developing targeted interventions and policies that promote the psychological resilience and well-being of LTC workers, thereby enhancing both individual and organizational outcomes in the healthcare sector.