Stresses and anxieties in the time of the COVID-19 pandemic - what we can learn

Positive Vibes are Not Always Easy: Examining the Association Between Covid-19 Stress and Mental Well-Being

The virus known as Covid-19 caused a global pandemic in 2019 and was found to have a devastating impact on mental well-being. Individuals around the world had difficulty retaining positive emotions such as gratitude, mindfulness, and hope in the face of this disaster. These feelings diminished their sense of mental well-being. This study examined the mediational model of gratitude, mindfulness, and hope as parallel mediators of the relationship between Covid-19 stress and mental well-being. In total, 289 adults from the general population completed the scales of Covid stress, gratitude, mindfulness, hope, and mental well-being. Results indicated that Covid-19 stress was related to mental well-being, with mindfulness and hope acting as mediators. Gratitude, on the other hand, did not mediate the relationship. The study provides evidence that targeting gratitude, mindfulness, and hope may have a meaningful effect on Covid-19 stress as a related symptom and potentially have a negative impact on mental well-being during the pandemic.

Burnout syndrome, doctor-patient relationship and family support of pediatric medical staff during a COVID-19 Local outbreak in Shanghai China: A cross-sectional survey study

OBJECTIVES

To explore burnout syndrome (BOS) incidence, doctor-patient relationship, and family support on pediatric medical staff in Shanghai comprehensive hospitals during a COVID-19 local outbreak.

METHODS

A cross-sectional survey of pediatric medical staff from 7 comprehensive hospitals across Shanghai was conducted from March to July 2022. The survey included BOS, doctor-patient relationships, family support, and the related factors of COVID-19. The T-test, variance, the LSD-t test, Pearson's r correlation coefficient, and multiple regression analyses examined the data.

RESULTS

Using Maslach Burnout Inventory-General Survey (MBI-GS), 81.67% of pediatric medical staff had moderate BOS, and 13.75% were severe. The difficult doctor-patient relationship was positively correlated with emotional exhaustion(EE), cynicism(Cy), and negatively with personal accomplishment(PA). When medical staff need help, the greater the support provided by the family, the lower the EE and CY, and the higher the PA.

CONCLUSION

"In our study, the pediatric medical staff in Shanghai comprehensive hospitals had significant BOS during a COVID-19 local outbreak." We provided the potential steps that can be taken to reduce the increasing rate of BOS in pandemics. These measures include increased job satisfaction, psychological support, maintaining good health, increased salary, lower intent to leave the profession, regularly carrying out COVID-19 prevention training, improving doctor-patient relations, and strengthening family support.

NURSE: Five Micropractices to Reduce Stress

The Coronavirus pandemic affected patients' health and heightened stress among the frontline caregivers, especially radiology nurses. Although there is literature on the effects of stress on nurses, there is a gap on interventions to mitigate the impact of stress. There are evidence-based mindful interventions to maintain balance in stressful situations and reduce perceived stress in sports, neuroscience, and positive psychology. Studies show that even brief periods of self-care reduce stress and cortisol levels. Nurses work long hours and have personal, family, and community responsibilities. Nurses may not have the luxury of extra time to devote to self-care. Therefore, this essay summarizes what stress does to the body; the tangible and intangible costs associated with unmanaged stress among nurses. Five self-care micropractices requiring no additional time called NURSE are offered. When practiced consistently, these micropractices can enhance nurses' well-being, leading to the retention of nursing talent and improved patient care.

Depression and anxiety symptoms and perceived stress in health professionals in the context of COVID-19: Do adverse childhood experiences have a modulating effect?

BACKGROUND

Adverse childhood experiences (ACE) have a great impact on mental health outcomes of adults. However, little is known whether ACE may act as modulators of the mental health of health professionals caring for patients with COVID-19.

METHODS

Data were collected through an online cross-sectional survey administered to health professionals in Lima (Peru) between May and July 2020. The survey included standardized self-assessment instruments for anxiety, depression, acute stress (AS) and history of ACE.

RESULTS

A total of 542 health professionals completed the survey. Caring for patients with COVID-19 was significantly associated with depression and anxiety and when caring for patients with COVID-19 was combined with a history of early sexual abuse, its effect on the risk of anxiety increased (OR = 7.71, p = .010). Mental health problems were associated with female gender in almost all the analyses and with the majority of ACEs.

CONCLUSIONS

Health workers in the context of the COVID-19 pandemic presented a high risk of mental health disorders. Antecedents of sexual abuse acted as a potentiating factor of anxiety in professionals providing COVID-19 care. These findings suggest that the burden of ACE modulates mental health problems in health professionals during the pandemic.

Leveraging diversity, equity and inclusion for promoting wellness in the radiology workplace

Over the last decade, health care professionals in the field of radiology have experienced increasing rates of burnout. A study in 2017 showed high prevalence of burnout in pediatric radiology, and other studies have identified several drivers for burnout. An important factor in promoting wellness and mitigating burnout is leveraging diversity, equity and inclusion in the workplace. This manuscript highlights the importance of diversity in high-functioning teams as well as the critical role of equity and inclusion in the workplace to help create an organization where people belong and can effectively succeed.

Experiences of New Zealand registered nurses of Chinese ethnicity during the COVID-19 pandemic

AIMS

This study aimed to investigate the experiences and challenges of New Zealand registered nurses of Chinese ethnicity who have been working during the COVID-19 pandemic.

BACKGROUND

New Zealand's nursing workforce is becoming increasingly multicultural as foreign nurses make up an essential part of the New Zealand health workforce. The ongoing COVID-19 pandemic has highlighted the contributions that nurses have made in providing front-line services to the public. However, little has been documented about challenges and experiences of this minority ethnic group-Chinese nurses-who have been working as registered nurses in New Zealand during the COVID-19 pandemic.

METHODS

This study used an anonymous online questionnaire and a thematic approach to establishing understandings of the experiences of New Zealand registered nurses of Chinese ethnicity in working through the COVID-19 pandemic. A total of 51 Chinese nurses completed this survey. A self-explanatory checklist for reporting results of Internet e-surveys (CHERRIES) was used for the purpose of the quality of this online survey.

RESULTS

The result showed that 47.06% participants (n = 24) reported negative experiences including racial discrimination, workplace bullying and judgement, while 52.94% (n = 27) participants reported positive working experiences including supports received in the workplace and positive recognition by the pubic in New Zealand.

CONCLUSION

Ethnic minority nurses are key assets to the New Zealand health system. It is important to understand their experiences and challenges, particularly during the COVID-19 pandemic to make sure they are supported and protected from any physical and emotional injury.

RELEVANCE TO CLINICAL PRACTICE

COVID-19 has brought additional challenges and concerns to nurses who are working on the front line of health services. Having knowledge of nurses' working experiences will help with their job satisfaction and has potential implications for the sustainability of the New Zealand nursing workforce and retention strategies to address nursing workforce shortages which is foreseeable in New Zealand.

Evaluation of stress and anxiety caused by the coronavirus disease 2019 (COVID-19) pandemic in pediatric radiology

BACKGROUND

Work-related stress and burnout were documented to be high among pediatric radiologists prior to the coronavirus disease 2019 (COVID-19) pandemic. New challenges arose from the COVID-19 pandemic, potentially introducing new stressors and anxieties.

OBJECTIVE

To evaluate potential sources of stress and anxiety for pediatric radiology faculty during the early phase of the COVID-19 pandemic.

MATERIALS AND METHODS

We conducted a survey of attending physician members of the Society for Pediatric Radiology in North America from April 27, 2020, to May 22, 2020. The response rate was 21% (251/1,206). Survey questions included demographic information and questions regarding working remotely, personal protective equipment, redeployment, personal wellness, wellness resources and financial concerns. A psychometrician reviewed the questions to ensure minimal risk of misinterpretation.

RESULTS

Median age of respondents was 48 years (range 33-70 years) with median number of years in practice of 14 (range 1-45 years). Fifty-three percent of respondents were women and 46% were men. Because of an increase in remote work, 69% of respondents endorsed feeling more isolated from a lack of regular interaction with colleagues. Fifty-three percent of respondents indicated that it is challenging to work remotely while overseeing home schooling for children. In comparison to men, women reported overall higher work-related stress and anxiety (P=0.02), higher feelings of guilt from radiology staff (i.e. technologists and nurses) being more exposed to COVID-19 (P=0.02) and higher levels of stress providing for dependents (P=0.04). Most respondents thought that departmental leadership was effective and respondents were not concerned about meeting financial obligations or job loss.

CONCLUSION

The early phase of the COVID-19 pandemic caused additional stress and anxiety for pediatric radiology faculty and disproportionally affected women. Given the continuously evolving state of the COVID-19 pandemic, these results could aid in planning and implementation of future strategies to combat burnout in radiology. Specific attention should be directed to different stressors experienced by female versus male radiologists, especially in regard to dependent care.

Impact of COVID-19 Pandemic on Patients’ Perceptions of Safety and Need for Elective Foot and Ankle Surgery in the United States

Background:

With the development of the COVID-19 pandemic, elective foot and ankle surgeries were delayed throughout the United States to divert health care resources and limit exposure. Little is known about the impact of COVID-19 on patient’s willingness to proceed with elective procedures once restrictions are lifted and factors contributing to such decision.

Methods:

Patients across 6 US orthopedic institutions who had their elective foot and ankle surgeries cancelled secondary to the pandemic were given a questionnaire. Specifically, patients were asked about their willingness to move forward with surgery once restrictions were lifted and if not why. Pain-level and pain medication use were also assessed. Univariate analysis was used to identify factors that contribute to patient’s decisions.

Results:

A total of 150 patients participated in this study. Twenty-one (14%) opted not to proceed with surgery once restrictions were lifted. Forty-three percent (n = 9) listed concern for COVID infection as the reason; however, 14% of them would proceed if procedures were performed in surgery center. Twenty-nine (19% of the total cohort) patients had increased pain and 11% of patients were taking more pain meds because of the delay to their procedure. Patients who decided not to proceed with surgery reported pain reduction (3% vs 14%) and lower increase in pain medication used (5% vs 12%).

Conclusion:

COVID-19 has made a significant impact on the health care system. Delay of elective foot and ankle procedures impact patient quality of life and outcomes. Access to surgery centers may provide a partial solution during the pandemic

Level of Evidence:

Level III.