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Kroneman M, Williams GA, Winkelmann J, Spreeuwenberg P, Davidovics K, Groenewegen PP. Personal protective equipment for healthcare workers during COVID-19: Developing and applying a questionnaire and assessing associations between infection rates and shortages across 19 countries. Health Policy 2024; 146:105097. [PMID: 38870609 PMCID: PMC11292171 DOI: 10.1016/j.healthpol.2024.105097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/30/2024] [Accepted: 05/24/2024] [Indexed: 06/15/2024]
Abstract
This study aimed to assess the preparedness of European countries regarding personal protective equipment (PPE) for health and care workers (HCWs), the COVID-19 infection rates of HCWs compared to the general working age population, and the association between these. We developed a PPE-preparedness scale based on responses to a questionnaire from experts in the Health Systems and Policy Monitor network, with a response rate of 19 out of 31 countries. COVID-19 infection data were retrieved form the European center for Disease Prevention and Control. Shortages of PPE were found in most countries, in particular in home care and long-term care. HCW infection rates, compared to the general population, varied strongly between countries, influenced by different testing regimes. We found no relationships between HCW infection rates, PPE preparedness and shortages of PPE. Improved surveillance in the population as well as for HCWS are needed to be able to better assess these relationships.
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Affiliation(s)
- Madelon Kroneman
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568 3500, BN, Utrecht, the Netherlands
| | - Gemma A Williams
- London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK; European Observatory on Health Systems and Policies, Place Victor Horta/Victor Hortaplein, 40 bte 30 1060, Brussels, Belgium
| | - Juliane Winkelmann
- European Observatory on Health Systems and Policies, Place Victor Horta/Victor Hortaplein, 40 bte 30 1060, Brussels, Belgium
| | - Peter Spreeuwenberg
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568 3500, BN, Utrecht, the Netherlands
| | - Krisztina Davidovics
- Semmelweis University, Health Services Management Training Centre, Data-Driven Health Division of National Laboratory for Health Security, Kútvölgyi út 2 1125, Budapest, Hungary
| | - Peter P Groenewegen
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568 3500, BN, Utrecht, the Netherlands.
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Liu CW, Jeyakumar N, McArthur E, Sontrop JM, Myran DT, Schwartz KL, Sood MM, Tanuseputro P, Garg AX. COVID-19 vaccine uptake among Ontario physicians: a descriptive population-based retrospective cohort study. BMJ Open 2024; 14:e080461. [PMID: 38858148 PMCID: PMC11168153 DOI: 10.1136/bmjopen-2023-080461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To determine COVID-19 vaccine uptake among physicians in Ontario, Canada from 14 December 2020 to 13 February 2022. DESIGN Population-based retrospective cohort study. SETTING All registered physicians in Ontario, Canada using data from linked provincial administrative healthcare databases. PARTICIPANTS 41 267 physicians (including postgraduate trainees) who were Ontario residents and registered with the College of Physicians and Surgeons of Ontario were included. Physicians who were out of province, had not accessed Ontario Health Insurance Plan-insured services for their own care for ≥5 years and those with missing identifiers were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were the proportions of physicians who were recorded to have received at least one, at least two and three doses of a Health Canada-approved COVID-19 vaccine by study end date. Secondary outcomes were how uptake varied by physician characteristics (including age, sex, specialty and residential location) and time elapsed between doses. RESULTS Of 41 267 physicians, (56% male, mean age 47 years), 39 359 (95.4%) received at least one dose, 39 148 (94.9%) received at least two doses and 35 834 (86.8%) received three doses of a COVID-19 vaccine. Of those who received three doses, the proportions were 90.4% among those aged ≥60 years and 81.2-89.5% among other age groups; 88.7% among family physicians and 89% among specialists. 1908 physicians (4.6%) had no record of vaccination, and this included 3.4% of family physicians and 4.1% of specialists; however, 28% of this group had missing specialty information. CONCLUSIONS In Ontario, within 14 months of COVID-19 vaccine availability, 86.8% of physicians had three doses of a COVID-19 vaccine, compared with 45.6% of the general population. Findings may signify physicians' confidence in the safety and effectiveness of COVID-19 vaccines.
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Affiliation(s)
- Cheng-Wei Liu
- Department of Medicine, Western University, London, Ontario, Canada
| | - Nivethika Jeyakumar
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Eric McArthur
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Jessica M Sontrop
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Daniel T Myran
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kevin L Schwartz
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Manish M Sood
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Amit X Garg
- Department of Medicine, Western University, London, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
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Fukuchi T, Oyama-Manabe N, Sugawara H. Fukuchi-Manabe Score for Infection Control Measures During the Very Early COVID-19 Pandemic Period When Access to Reverse Transcription-Polymerase Chain Reaction Testing Was Poor in Japan: A Single-Center Observational Prospective Cohort Study. Cureus 2024; 16:e54748. [PMID: 38523950 PMCID: PMC10960966 DOI: 10.7759/cureus.54748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND During the early stages of the COVID-19 pandemic in Japan, access to reverse transcription-polymerase chain reaction (RT-PCR) testing was limited. All patients with COVID-19 required hospitalization, and isolation of suspected COVID-19 patients had not yet been implemented. With the recently acquired evidence on COVID-19, it is important to develop a risk stratification system for isolation rooms in the context of limited resources for better resource management. OBJECTIVE This study aimed to develop and validate a COVID-19 risk-scoring strategy, the Fukuchi-Manabe score, to safely stratify and manage isolation rooms, personal protective equipment (PPE), and RT-PCR testing in the context of limited RT-PCR testing and a short supply of PPE. METHODS This single-center prospective study consecutively enrolled suspected COVID-19 adult inpatients between March 1 and August 31, 2020. The primary and secondary outcomes were a positive RT-PCR test and the occurrence of nosocomial infections during the study period, respectively. Factors related to patient history, symptoms, chest computed tomography findings, and laboratory data suggestive of COVID-19 were scored, totaled, and divided into four categories ("probable," "possible," "less likely," and "non-suspicious") based on the likelihood of COVID-19. Sensitivity, specificity, and positive and negative predictive values were evaluated for each probability category. FINDINGS Twenty of 224 inpatients were positive on the RT-PCR test, including 18 "probable" patients (90.0%), one "possible" patient, and one "less likely" patient. The area under the curve (AUC) (95% confidence interval: 0.841-0.977), sensitivity, and specificity were 0.909, 90.0%, and 80.4%, respectively. The positive and negative predictive values and accuracy for the "probable" category were 0.90, 0.80, and 0.82, respectively. The mean and standard deviation of AUCs, validated by bootstrap analysis, were 0.910±0.034. No nosocomial infections were observed. CONCLUSION The Fukuchi-Manabe score will be helpful when other novel pathogens emerge in the future before the availability of genetic testing methods.
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Affiliation(s)
- Takahiko Fukuchi
- Department of Comprehensive Medicine, Division of General Medicine, Jichi Medical University, Saitama Medical Center, Saitama, JPN
| | - Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University, Saitama Medical Center, Saitama, JPN
| | - Hitoshi Sugawara
- Department of Comprehensive Medicine, Division of General Medicine, Jichi Medical University, Saitama Medical Center, Saitama, JPN
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Irfan M, Shaf A, Ali T, Zafar M, Rahman S, I. Hendi MA, M. Baeshen SA, Maghfouri MMM, Alahmari HSM, Shahhar FAI, Shahhar NAI, Halawi AS, Mahnashi FH, Alqhtani SM, Ali M. BT. An intelligent framework to measure the effects of COVID-19 on the mental health of medical staff. PLoS One 2023; 18:e0286155. [PMID: 37289778 PMCID: PMC10249891 DOI: 10.1371/journal.pone.0286155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
The mental and physical well-being of healthcare workers is being affected by global COVID-19. The pandemic has impacted the mental health of medical staff in numerous ways. However, most studies have examined sleep disorders, depression, anxiety, and post-traumatic problems in healthcare workers during and after the outbreak. The study's objective is to evaluate COVID-19's psychological effects on healthcare professionals of Saudi Arabia. Healthcare professionals from tertiary teaching hospitals were invited to participate in the survey. Almost 610 people participated in the survey, of whom 74.3% were female, and 25.7% were male. The survey included the ratio of Saudi and non-Saudi participants. The study has utilized multiple machine learning algorithms and techniques such as Decision Tree (DT), Random Forest (RF), K Nearest Neighbor (KNN), Gradient Boosting (GB), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM). The machine learning models offer 99% accuracy for the credentials added to the dataset. The dataset covers several aspects of medical workers, such as profession, working area, years of experience, nationalities, and sleeping patterns. The study concluded that most of the participants who belonged to the medical department faced varying degrees of anxiety and depression. The results reveal considerable rates of anxiety and depression in Saudi frontline workers.
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Affiliation(s)
- Muhammad Irfan
- Electrical Engineering Department, College of Engineering, Najran University, Najran, Saudi Arabia
| | - Ahmad Shaf
- Department of Computer Science, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan
| | - Tariq Ali
- Department of Computer Science, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan
| | - Maryam Zafar
- Department of Computer Science, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan
| | - Saifur Rahman
- Electrical Engineering Department, College of Engineering, Najran University, Najran, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Samar M. Alqhtani
- Department of Information Systems, College of Computer Science and Information Systems, Najran University, Najran, Saudi Arabia
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Ebrahimi A, Khorasani P, Ahmadi M, Andalib S, Mousavi SMH. The Safe Coping Strategy of Nurses Working in the Care Units of Patients with COVID-19: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:214-219. [PMID: 37332374 PMCID: PMC10275468 DOI: 10.4103/ijnmr.ijnmr_138_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 12/07/2022] [Accepted: 12/26/2022] [Indexed: 06/20/2023]
Abstract
Background Nurses are in direct contact with patients with COVID-19 and have faced much tension with the rapid spread of coronavirus. This study aimed to explore the safe coping strategies of nurses when facing the COVID-19 pandemic. Materials and Methods In this qualitative study, data were collected from September 20 to December 20, 2020, in Isfahan (Iran) through individual semi-structured interviews with 12 nurses working in the five referral centers for patients with COVID-19. Informants were selected via purposeful sampling and interviewed in one or several sessions at the appropriate time and place. The interviews continued until data saturation. All interviews continued until no new data were added to the continuous content analysis. Data analysis was performed using conventional content analysis based on Graneheim and Lundman's approach. We used Guba and Lincoln's criteria (including credibility, transferability, conformability, and dependability) to guarantee trustworthiness and rigor. Results Safe coping strategies for nurses were discovered in two categories of "wise liberation" and "care," and six subcategories. "Wise liberation" consisted of four subcategories: "living in the moment," "accepting the inner and outer world," "life enrichment," and "building opportunities." "Care" contained two subcategories: "caring for others" and "caring for oneself." Conclusions Discovering safe coping strategies for nurses could set the stage for special educational-therapeutic interventions so they can better understand their experiences and take advantage of the best coping strategies.
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Affiliation(s)
- Amrollah Ebrahimi
- Associate Professor, Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan
| | - Parvaneh Khorasani
- PhD in Nursing, Nursing and Midwifery Care Research Center, Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
| | - Mahnaz Ahmadi
- PhD Candidate in Industrial and Organizational Psychology, Department of Psychology, Faculty of Educational Sciences and Psychology, Isfahan University, Isfahan
| | - Sima Andalib
- PhD in Psychology Islamic Azad University Science and Research Branch, Tehran(Esfahan), Isfahan
| | - Seyed Mohamad Hossein Mousavi
- MSc in Health Psychology, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Liu CW, Jeyakumar N, McArthur E, Sontrop JM, Myran DT, Schwartz KL, Sood MM, Tanuseputro P, Garg AX. SARS-CoV-2 testing, infection and outcomes among Ontario physicians: a descriptive population-based cohort study. CMAJ Open 2022; 10:E657-E665. [PMID: 35853660 PMCID: PMC9313000 DOI: 10.9778/cmajo.20210263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Health care workers have a higher risk of acquiring SARS-CoV-2 infection than the general population. Our study reports on SARS-CoV-2 testing, infection and associated outcomes in Ontario physicians before SARS-CoV-2 vaccination became available on Dec. 14, 2020. METHODS We conducted a descriptive, population-based cohort study of physicians in Ontario, Canada, from Jan. 25 to Dec. 31, 2020. We included physicians and postgraduate medical trainees who were residents of Ontario and registrants with the College of Physicians and Surgeons of Ontario during the study period. We examined the proportion of physicians tested for SARS-CoV-2 infection, the proportion who tested positive, and how testing and infections varied by certain physician characteristics. We reported on clinical outcomes associated with infection, including hospital admission and death. RESULTS Of 41 208 physicians (mean age 47 yr; 56.1% male), 19 116 (46.4%) were tested at least once for SARS-CoV-2 infection; 358 tested positive (0.9%). No physicians died within 30 days of testing positive; however, 20/358 (5.6%) were admitted to hospital. By specialty, the proportion tested was highest among postgraduate medical trainees (2531/4125 [61.4%]), emergency physicians (281/478 [58.8%]), infectious disease physicians (33/67 [49.3%]) and family physicians (8857/18 553 [47.7%]). The proportion who tested positive was highest among internal medicine physicians (44/3499 [1.3%]), postgraduate medical trainees (47/4125 [1.1%]) and family physicians (171/18 553 [0.9%]). Of 2290 physicians who worked in long-term care, 1636 (71.4%) were tested and 25 (1.1%) tested positive. INTERPRETATION During the prevaccination period of the COVID-19 pandemic in Ontario, nearly half of all physicians in the province were tested at least once for SARS-CoV-2 infection, 0.9% tested positive and none died. These findings may reflect the public health measures that were implemented in the province during this period.
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Affiliation(s)
- Cheng-Wei Liu
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Nivethika Jeyakumar
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Eric McArthur
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Jessica M Sontrop
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Daniel T Myran
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Kevin L Schwartz
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Manish M Sood
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Peter Tanuseputro
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont
| | - Amit X Garg
- ICES Jeyakumar, McArthur, Garg, Myran, Sood, Tanuseputro, Schwartz, Ont.; Department of Medicine (Liu, Garg), Western University, London, Ont.; Department of Epidemiology & Biostatistics (Sontrop, Garg), Western University, London, Ont.; Clinical Epidemiology Program (Myran, Sood, Tanuseputro), Ottawa Hospital Research Institute, Ottawa, Ont.; Public Health Ontario (Schwartz); Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Sood, Tanuseputro) and Department of Family Medicine (Myran), University of Ottawa, Ottawa, Ont.
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Efeoğlu İE, Kılınçarslan Ö. Pandemic experiences of family physicians infected with the COVID-19: a qualitative study. BMJ Open 2022; 12:e052955. [PMID: 35365518 PMCID: PMC8977460 DOI: 10.1136/bmjopen-2021-052955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Family physicians are usually patients' first point of contact with primary healthcare. This study aims to understand the experiences of family physicians who were infected with the COVID-19 and started working again. STUDY DESIGN AND SETTING This qualitative study was conducted on 18 different family health centres in Adana. Data collection was performed through 18 interviews, each lasting an average of 46.6 min. The data were analysed using the qualitative content analysis method. PARTICIPANTS The study included 18 family physicians (9 women and 9 men), and there were no significant differences between them by gender or seniority. RESULTS The results of the study have shown that family physicians who were infected with the COVID-19 and started working again have experienced high levels of anxiety at work. In addition, due to the fear of being reinfected, family physicians' social relations with their colleagues have decreased. The results are discussed under two themes: anxieties and social relationships. CONCLUSION In primary healthcare services, family physicians play a vital role during the pandemic. Many family physicians either lost their lives or got infected with the virus, recovered and worked in difficult conditions for a long time. Understanding the experiences of family physicians during the pandemic when they underwent COVID-19 and after they recovered could help to protect their psychological health and improve their work conditions.
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Affiliation(s)
- İbrahim Efe Efeoğlu
- Business Administration, Adana Alparslan Türkeş Science and Technology University, Adana, Turkey
| | - Ömür Kılınçarslan
- Business Administration, Adana Alparslan Türkeş Science and Technology University, Adana, Turkey
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Mausz J, Jackson NA, Lapalme C, Piquette D, Wakely D, Cheskes S. Protected 911: Development, Implementation, and Evaluation of a Prehospital COVID-19 High-Risk Response Team. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053004. [PMID: 35270696 PMCID: PMC8910754 DOI: 10.3390/ijerph19053004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023]
Abstract
Patients with COVID-19 who require aerosol-generating medical procedures (such as endotracheal intubation) are challenging for paramedic services. Although potentially lifesaving for patients, aerosolizing procedures carry an increased risk of infection for paramedics, owing to the resource limitations and complexities of the pre-hospital setting. In this paper, we describe the development, implementation, and evaluation of a novel pre-hospital COVID-19 High-Risk Response Team (HRRT) in Peel Region in Ontario, Canada. The mandate of the HRRT was to attend calls for patients likely to require aerosolizing procedures, with the twofold goal of mitigating against COVID-19 infections in the service while continuing to provide skilled resuscitative care to patients. Modelled after in-hospital 'protected code blue' teams, operationalizing the HRRT required several significant changes to standard paramedic practice, including the use of a three-person crew configuration, dedicated safety officer, call-response checklists, multiple redundant safety procedures, and enhanced personal protective equipment. Less than three weeks after the mandate was given, the HRRT was operational for a 12-week period during the first wave of COVID-19 in Ontario. HRRT members attended ~70% of calls requiring high risk procedures and were associated with improved quality of care indicators. No paramedics in the service contracted COVID-19 during the program.
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Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (N.A.J.); (C.L.); (D.P.); (D.W.)
- Correspondence:
| | - Nicholas A. Jackson
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (N.A.J.); (C.L.); (D.P.); (D.W.)
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West Room HSC-2C1, Hamilton, ON L8S 4K1, Canada
| | - Corey Lapalme
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (N.A.J.); (C.L.); (D.P.); (D.W.)
| | - Dan Piquette
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (N.A.J.); (C.L.); (D.P.); (D.W.)
| | - Dave Wakely
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (N.A.J.); (C.L.); (D.P.); (D.W.)
| | - Sheldon Cheskes
- Sunnybrook Centre for Prehospital Medicine, 77 Brown’s Line, Suite 100, Toronto, ON M8W 3S2, Canada;
- Division of Emergency Medicine, University of Toronto, 6 Queen’s Park Cres. W., Toronto, ON M5S 3H2, Canada
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Beverly E, Hommema L, Coates K, Duncan G, Gable B, Gutman T, Love M, Love C, Pershing M, Stevens N. A tranquil virtual reality experience to reduce subjective stress among COVID-19 frontline healthcare workers. PLoS One 2022; 17:e0262703. [PMID: 35139092 PMCID: PMC8827469 DOI: 10.1371/journal.pone.0262703] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/01/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The novel coronavirus-19 (COVID-19) has taken an immense physical, social, and emotional toll on frontline healthcare workers. Research has documented higher levels of anxiety, depression, and burnout among healthcare workers during the pandemic. Thus, creative interventions are needed now more than ever to provide brief, accessible support to frontline workers. Virtual reality is a rapidly growing technology with potential psychological applications. In this study, we piloted a three-minute Tranquil Cinematic-VR simulation of a nature scene to lower subjective stress among frontline healthcare workers in COVID-19 treatment units. We chose to film a nature scene because of the extensive empirical literature documenting the benefits of nature exposure and health. METHODS A convenience sample of frontline healthcare workers, including direct care providers, indirect care providers, and support or administrative services, were recruited from three COVID-19 units located in the United States. Inclusion criteria for participation included adults aged 18 years and older who could read and speak in English and were currently employed by the healthcare system. Participants viewed a 360-degree video capture of a lush, green nature preserve in an Oculus Go or Pico G2 4K head-mounted display. Prior to viewing the simulation, participants completed a brief demographic questionnaire and the visual analogue scale to rate their subjective stress on a 10-point scale, with 1 = 'Not at all stressed' to 10 = 'Extremely stressed.' We conducted paired t-tests to examine pre- and post-simulation changes in subjective stress as well as Kruskal-Wallis tests and Mann-Whitney U tests to examine differences by demographic variables. All analyses were conducted in SPSS statistical software version 28.0. We defined statistical significance as a p-value less than .05. RESULTS A total of 102 individuals consented to participate in the study. Eighty-four (82.4%) participants reported providing direct patient care, 73 (71.6%) identified as women, 49 (48.0%) were between the ages of 25-34 years old, and 35 (34.3%) had prior experience with VR. The pre-simulation mean stress score was 5.5±2.2, with a range of 1 to 10. Thirty-three (32.4%) participants met the 6.8 cutoff for high stress pre-simulation. Pre-simulation stress scores did not differ by any demographic variables. Post-simulation, we observed a significant reduction in subjective stress scores from pre- to post-simulation (mean change = -2.2±1.7, t = 12.749, p < .001), with a Cohen's d of 1.08, indicating a very large effect. Further, only four (3.9%) participants met the cutoff for high stress after the simulation. Post-simulations scores did not differ by provider type, age range, gender, or prior experience with virtual reality. CONCLUSIONS Findings from this pilot study suggest that the application of this Tranquil Cinematic-VR simulation was effective in reducing subjective stress among frontline healthcare workers in the short-term. More research is needed to compare the Tranquil Cinematic-VR simulation to a control condition and assess subjective and objective measures of stress over time.
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Affiliation(s)
- Elizabeth Beverly
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, United States of America
- Ohio University Diabetes Institute, Athens, Ohio, United States of America
- * E-mail:
| | - Laurie Hommema
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, United States of America
- OhioHealth Riverside Methodist Hospital, Columbus, Ohio, United States of America
| | - Kara Coates
- OhioHealth Healthcare Organization, Columbus, Ohio, United States of America
| | - Gary Duncan
- OhioHealth Riverside Methodist Hospital, Columbus, Ohio, United States of America
- OhioHealth Healthcare Organization, Columbus, Ohio, United States of America
- OhioHealth Center for Medical Education & Innovation, Columbus, Ohio, United States of America
| | - Brad Gable
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, United States of America
- OhioHealth Healthcare Organization, Columbus, Ohio, United States of America
- OhioHealth Center for Medical Education & Innovation, Columbus, Ohio, United States of America
| | - Thomas Gutman
- OhioHealth Healthcare Organization, Columbus, Ohio, United States of America
- OhioHealth Center for Medical Education & Innovation, Columbus, Ohio, United States of America
| | - Matthew Love
- Ohio University J. Warren McClure School of Emerging Communication Technologies, Athens, Ohio, United States of America
- Ohio University Game Research and Immersive Design (GRID) Lab, Athens, Ohio, United States of America
| | - Carrie Love
- Ohio University Game Research and Immersive Design (GRID) Lab, Athens, Ohio, United States of America
- Hocking College, Nelsonville, Ohio, United States of America
| | - Michelle Pershing
- OhioHealth Research Institute, Columbus, Ohio, United States of America
| | - Nancy Stevens
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, United States of America
- Ohio University Museum Complex, Athens, Ohio, United States of America
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10
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Sundararajan K, Bi P, Milazzo A, Poole A, Reddi B, Mahmood MA. Preparedness and response to COVID-19 in a quaternary intensive care unit in Australia: perspectives and insights from frontline critical care clinicians. BMJ Open 2022; 12:e051982. [PMID: 35121600 PMCID: PMC8819546 DOI: 10.1136/bmjopen-2021-051982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This study was conducted to explore the perspectives and opinions of intensive care unit (ICU) nurses and doctors at a COVID-19-designated pandemic hospital concerning the preparedness and response to COVID-19 and to consolidate the lessons learnt for crisis/disaster management in the future. DESIGN A qualitative study using in-depth interviews (IDIs) and focus group discussions (FGDs). Purposeful sampling was conducted to identify participants. A semistructured guide was used to facilitate IDIs with individual participants. Two FGDs were conducted, one with the ICU doctors and another with the ICU nurses. Thematic analysis identified themes and subthemes informing about the level of preparedness, response measures, processes, and factors that were either facilitators or those that triggered challenges. SETTING ICU in a quaternary referral centre affiliated to a university teaching COVID-19-designated pandemic hospital, in Adelaide, South Australia. PARTICIPANTS The participants included eight ICU doctors and eight ICU nurses for the IDIs. Another 16 clinicians participated in FGDs. RESULTS The study identified six themes relevant to preparedness for, and responses to, COVID-19. The themes included: (1) staff competence and planning, (2) information transfer and communication, (3) education and skills for the safe use of personal protective equipment, (4) team dynamics and clinical practice, (5) leadership, and (6) managing end-of-life situations and expectations of caregivers. CONCLUSION Findings highlight that preparedness and response to the COVID-19 crisis were proportionate to the situation's gravity. More enablers than barriers were identified. However, opportunities for improvement were recognised in the domains of planning, logistics, self-sufficiency with equipment, operational and strategic oversight, communication and managing end-of-life care.
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Affiliation(s)
- Krishnaswamy Sundararajan
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Discipline of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Adriana Milazzo
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Alexis Poole
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Discipline of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Benjamin Reddi
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Discipline of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mohammad Afzal Mahmood
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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11
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Seluch M, Volchansky M, Safronov R. Dependence of emotional burnout on personality typology in the COVID-19 pandemic. Work 2021; 70:713-721. [PMID: 34719460 DOI: 10.3233/wor-210428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Under the conditions of the COVID-19 pandemic, the problem of emotional burnout syndrome among nurses working under extremely stressful conditions has become particularly acute. It is therefore necessary to examine the characteristics of emotional burnout syndrome in nurses during the COVID-19 pandemic to develop effective measures to prevent and enhance their mental health. OBJECTIVE The study aimed to establish the features of emotional burnout syndrome and its connection with typological characteristics of the personality in nurses working with COVID-19 patients. METHODS A total of 120 female nurses who worked with COVID-19 patients were surveyed, of whom 60 (50.0%) worked in outpatient settings along with general practitioners and 60 (50.0%) worked in the intensive care unit. The average age of the participants was 40.86±3.20 years, and the average length of medical service was 13.64±1.73 years. RESULTS A burnout syndrome of varying severity was present in 50.0%of outpatient nurses and 73.3%of intensive care nurses (OR = 2.44, 95%CI [1.16-5.16]; p < 0.05). The tension phase predominated in outpatient nurses (53.3%), and the resistance phase was more typical for intensive care nurses (63.3%). CONCLUSIONS The practice of nurses under COVID-19 pandemic conditions is characterized by the high prevalence of emotional burnout syndrome.
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Affiliation(s)
- Marina Seluch
- Amur State University, Blagoveshchensk, RussianFederation
| | | | - Roman Safronov
- I.M. Sechenov FirstMoscow State Medical University (Sechenov University), Moscow, Russian Federation
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12
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Linde K, Bergmaier C, Torge M, Barth N, Schneider A, Hapfelmeier A. The diversity of opinion among general practitioners regarding the threat and measures against COVID-19 - Cross-sectional survey. Eur J Gen Pract 2021; 27:176-183. [PMID: 34319199 PMCID: PMC8330783 DOI: 10.1080/13814788.2021.1954155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND After the 'first wave' in spring 2020, opinions regarding the threat and measures against COVID-19 seemed to vary among German general practitioners (GPs). OBJECTIVES To systematically investigate opinions and to identify subgroups of GPs sharing similar views. METHODS A questionnaire was sent to all 210 practices accredited for undergraduate teaching of family medicine at the Medical Faculty of the Technical University of Munich. Questions addressed personal opinions regarding risks, dilemmas, restrictions and their relaxation associated with COVID-19, and personal fears, symptoms of depression and anxiety. Patterns of strong opinions ('archetypes') were identified using archetypal analysis, a statistical method seeking extremal points in the multidimensional data. RESULTS One hundred and sixty-one GPs sent back a questionnaire (response rate 77%); 143 (68%) with complete data for all 38 relevant variables could be included in the analysis. We identified four archetypes with subgroups of GPs tending in the direction of these archetypes: a small group of 'Sceptics' (n = 12/8%) considering threats of COVID-19 as overrated and measures taken as exaggerated; 'Hardliners' (n = 34/24%) considering threats high and supporting strong measures; 'Balancers' (n = 77/54%) who also rated the threats high but were more critical about potentially impairing the quality of life of elderly people and children; and 'Anxious' GPs (n = 20/14%) tending to report more fear, depressive and anxiety symptoms. CONCLUSION Among the participants in this survey, opinions regarding the threat and the measures taken against COVID-19 during the 'first wave' in Germany in spring 2020 varied greatly.
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Affiliation(s)
- Klaus Linde
- Institute of General Practice and Health Services Research, Technical University Munich, Munich, Germany
| | - Christian Bergmaier
- Institute of General Practice and Health Services Research, Technical University Munich, Munich, Germany
| | - Marion Torge
- Institute of General Practice and Health Services Research, Technical University Munich, Munich, Germany
| | - Niklas Barth
- Institute of General Practice and Health Services Research, Technical University Munich, Munich, Germany
| | - Antonius Schneider
- Institute of General Practice and Health Services Research, Technical University Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, Technical University Munich, Munich, Germany
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13
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Barret M, Gronier O, Chaussade S. COVID-19 Transmission among Gastrointestinal Endoscopists. Gastroenterology 2021; 160:1432-1433. [PMID: 32565017 PMCID: PMC7301138 DOI: 10.1053/j.gastro.2020.05.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/23/2020] [Indexed: 01/10/2023]
Affiliation(s)
| | | | - Stanislas Chaussade
- Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris and, University of Paris, Paris, France
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14
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Guglielmetti L, Kontsevaya I, Leoni MC, Ferrante P, Fronti E, Gerna L, Valdatta C, Donisi A, Faggi A, Paolillo F, Ratti G, Ruggieri A, Scotti M, Sacchini D, Taliani G, Codeluppi M. Severe COVID-19 pneumonia in Piacenza, Italy - A cohort study of the first pandemic wave. J Infect Public Health 2021; 14:263-270. [PMID: 33497876 PMCID: PMC7723761 DOI: 10.1016/j.jiph.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Piacenza is the closest city to the first coronavirus disease 2019 (COVID-19) cluster in Italy and has the highest national COVID-19 death rates per population. The objective of this study is to present characteristics and outcomes of patients admitted to medical departments of the Hospital of Piacenza during the first wave of the epidemic. METHODS A total of 218 patients with confirmed or suspect COVID-19 and severe pneumonia were included from February 21st to May 15th, 2020. Routinely-collected clinical and laboratory data were retrospectively retrieved from electronic medical files. A Cox proportional-hazards model was fit to assess the association of treatment and other variables with death. RESULTS Median age of patients was 68 years; 150 patients (69%) had comorbidities, mainly hypertension (107, 49%). Overall, 185 (85%) patients had acute respiratory distress syndrome (ARDS) on admission, including 103 (47%) with moderate or severe ARDS. Chest computed tomography scan showed bilateral disease in 201 (98%) and extensive lung involvement in 79 (50%) patients. Most patients received antiviral treatment (187, 86%) and corticosteroids (134, 61%). All patients received respiratory support and 64 (29%) were admitted to intensive care unit. As of June 30th, 100 patients (46%) died, 109 patients (50%) were discharged, and 9 patients (4%) were still hospitalized. In multivariable Cox analysis, age above 65 years, having more than one comorbidity, severe ARDS, low platelet counts, and high LDH levels at admission were associated with mortality, while having diarrhea at admission was associated with survival. The use of antivirals or corticosteroids was not associated with survival. CONCLUSIONS Overall case fatality rates were high and associated with comorbidities, extensive lung involvement, ARDS at admission, and advanced age. The use of antivirals was not associated with increased survival.
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Affiliation(s)
- Lorenzo Guglielmetti
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, équipe 13, Paris, France; APHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France; Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Irina Kontsevaya
- Research Center Borstel, Borstel, Germany; German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems, Borstel, Germany; International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany.
| | - Maria C Leoni
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Patrizia Ferrante
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy; Institute for Cross-Disciplinary Physics and Complex Systems IFISC (UIB-CSIC), Campus Universitat Illes Balears, E-07122 Palma de Mallorca, Spain.
| | - Elisa Fronti
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Laura Gerna
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | | | - Alessandra Donisi
- Migration Health Unit, Primary Health Care Department, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
| | - Alberto Faggi
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Franco Paolillo
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Giovanna Ratti
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | | | - Marta Scotti
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Daria Sacchini
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
| | - Gloria Taliani
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy; Infectious and Tropical Disease Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy; Anti-COVID Task Force of the Italian Civil Protection.
| | - Mauro Codeluppi
- Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy.
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15
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Iyengar KP, Ish P, Upadhyaya GK, Malhotra N, Vaishya R, Jain VK. COVID-19 and mortality in doctors. Diabetes Metab Syndr 2020; 14:1743-1746. [PMID: 32920494 PMCID: PMC7470789 DOI: 10.1016/j.dsx.2020.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS COVID-19 disease appear to have been associated with significant mortality amongst doctors and health care workers globally. We explore the various risk factors associated with this occupational risk, especially focusing on India. This may elucidate lessons to protect these frontline workers during the COVID-19 pandemic. METHODS We carried out a comprehensive review of the literature using suitable keywords such as 'COVID-19', 'pandemics', 'physicians' 'mortality' and 'health personnel' on the search engines of PubMed, SCOPUS, Google Scholar and ResearchGate in the month of July 2020 during the current COVID-19 pandemic and assessed mortality data. RESULTS Mortality in health care professionals has been on the rise. The countries which faced the pandemic in the early months of 2020 have had a huge surge in mortality amongst doctors due to COVID-19. India continues to show a rising trend in COVID-19 cases, however although compared to the western world India has seen a comparatively favourable statistic. Male gender, elderly doctors and those belonging to Black, Asian, and Minority Ethnic (BAME) community seem to be predisposing factors in the western world. CONCLUSION COVID-19 has been associated with an increased mortality in doctors and health care workers. Until an effective cure/vaccine is developed, risk assessments at work, mitigating confounding factors, adequate supply of personal protective equipment (PPE) and enhanced protection against infection are necessary to protect health care professionals on the coronavirus frontline. Otherwise this occupational risk can lead to further untimely mortality and become another unintended consequence of the COVID-19 pandemic.
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Affiliation(s)
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
| | - Gaurav Kumar Upadhyaya
- Department of Orthopaedics, All India Institute of Medical Sciences, Rae Bareli, UP, India.
| | - Nipun Malhotra
- Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India.
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India.
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16
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Titov N, Staples L, Kayrouz R, Cross S, Karin E, Ryan K, Dear B, Nielssen O. Rapid report: Early demand, profiles and concerns of mental health users during the coronavirus (COVID-19) pandemic. Internet Interv 2020; 21:100327. [PMID: 32537424 PMCID: PMC7262525 DOI: 10.1016/j.invent.2020.100327] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Trends in contact with a high volume national digital mental health service (DMHS), the MindSpot Clinic, provide a unique opportunity to assess the mental health effects of the COVID-19 pandemic. METHODS Three methods were used to assess changes in responses to COVID-19. First, website visits and call centre traffic were compared across two time periods: the "comparison period" (1 to 28 September 2019), and during the early weeks of the "COVID-19 pandemic" (19 March to 15 April 2020). Second, demographic and symptom data were compared across all patients who started an assessment during the comparison (n = 1650) and the COVID-19 period (n = 1668). Third, responses to questions about the impact of COVID-19 introduced to the assessment from 19 March 2020, and reports from treating therapists were examined. RESULTS There was an 89% increase in website visits and a 90% increase in telephone calls to the clinic in the early COVID-19 period compared to the comparison period. There was a higher proportion of females in the COVID-19 sample (76.9% vs. 72.9%), and a lower proportion reported being in employment (52.8% vs. 60.8%). There was a small but significant increase in the severity of anxiety symptoms, and an increase in the number of people reporting recent onset of anxiety and depression. However, there were no differences between groups in severity of symptoms of distress or depression. Most people (94%) reported concern about the impact of COVID-19, and 88% reported making changes in lifestyle. Older adults had higher levels of concern about COVID-19. Therapists reported that patients were concerned about how to access testing, manage quarantine, financial security and the effect of social isolation. CONCLUSIONS COVID-19 has resulted in a significant increase in contact with an established DMHS, but we have not yet detected increases in baseline symptom severity. With the prospect of prolonged restriction of movement, DMHS such as MindSpot could play an important role in both providing clinical services and monitoring the mental health of the population.
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Affiliation(s)
- Nickolai Titov
- MindSpot Clinic, Macquarie University, Australia
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Rony Kayrouz
- MindSpot Clinic, Macquarie University, Australia
| | - Shane Cross
- MindSpot Clinic, Macquarie University, Australia
| | - Eyal Karin
- MindSpot Clinic, Macquarie University, Australia
| | - Katie Ryan
- MindSpot Clinic, Macquarie University, Australia
| | - Blake Dear
- MindSpot Clinic, Macquarie University, Australia
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Olav Nielssen
- MindSpot Clinic, Macquarie University, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Australia
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17
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Giusti EM, Pedroli E, D'Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, Stramba Badiale M, Riva G, Castelnuovo G, Molinari E. The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front Psychol 2020; 11:1684. [PMID: 32754102 PMCID: PMC7366071 DOI: 10.3389/fpsyg.2020.01684] [Citation(s) in RCA: 266] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background: The COVID-19 pandemic had a massive impact on health care systems, increasing the risks of psychological distress in health professionals. This study aims at assessing the prevalence of burnout and psychopathological conditions in health professionals working in a health institution in the Northern Italy, and to identify socio-demographic, work-related and psychological predictors of burnout. Methods: Health professionals working in the hospitals of the Istituto Auxologico Italiano were asked to participate to an online anonymous survey investigating socio-demographic data, COVID-19 emergency-related work and psychological factors, state anxiety, psychological distress, post-traumatic symptoms and burnout. Predictors of the three components of burnout were assessed using elastic net regression models. Results: Three hundred and thirty health professionals participated to the online survey. Two hundred and thirty-five health professionals (71.2%) had scores of state anxiety above the clinical cutoff, 88 (26.8%) had clinical levels of depression, 103 (31.3%) of anxiety, 113 (34.3%) of stress, 121 (36.7%) of post-traumatic stress. Regarding burnout, 107 (35.7%) had moderate and 105 (31.9%) severe levels of emotional exhaustion; 46 (14.0%) had moderate and 40 (12.1%) severe levels of depersonalization; 132 (40.1%) had moderate and 113 (34.3%) severe levels of reduced personal accomplishment. Predictors of all the three components of burnout were work hours, psychological comorbidities, fear of infection and perceived support by friends. Predictors of both emotional exhaustion and depersonalization were female gender, being a nurse, working in the hospital, being in contact with COVID-19 patients. Reduced personal accomplishment was also predicted by age. Conclusions: Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.
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Affiliation(s)
- Emanuele Maria Giusti
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, eCampus University, Novedrate, Italy
| | - Guido E D'Aniello
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Chiara Stramba Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Chiara Manna
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Marco Stramba Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Enrico Molinari
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
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