Factors Influencing Emergency Nurses' Burnout During an Outbreak of Middle East Respiratory Syndrome Coronavirus in Korea

Are pediatric nurses prepared to respond to monkeypox outbreak?

BACKGROUND

Emphasizing the crucial significance of maintaining a national nursing workforce well-prepared with the necessary knowledge, skills, and abilities to respond effectively is the growing frequency of natural and environmental disasters, coupled with public health emergencies such as the COVID-19 pandemic. So, the study aimed to explore pediatric nurses' preparedness to monkeypox outbreak, and their stress during this outbreak in Egypt.

METHODS

A cross-sectional study was conducted on a 416 nurses direct care for children at selected governmental hospitals in Egypt. Demographic form, Questionnaire for Infectious Disease Outbreak Readiness & Preparedness, factors affecting nurses' preparedness, and the generalized anxiety disorders scale-7 were the tools of the study.

RESULTS

(81.5%) of studied nurses had unsatisfactory level of preparedness to monkeypox outbreak. (96.4%) and (95.4%) of them were affected their preparedness by high workload and inconsistent income with the of risk of infection factors. Also, (57.2%) of them had high stress level.

CONCLUSIONS

The study revealed the importance of ensuring adequate supplies of PPE are available and provided, and protocols must be implemented to ensure availability in case of an outbreak. Moreover, nurse staffing levels and workload distribution should be regularly reviewed to create reasonable nurse-patient ratios.

Factors associated with burnout among hospital-based healthcare workers during the COVID-19 pandemic: A cross-sectional CRACoV-HHS study

AIMS

To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID-19.

BACKGROUND

Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID-19 pandemic.

DESIGN

A cross-sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID-19 pandemic between 4 and 19 January 2021.

METHODS

The Maslach Burnout Inventory-Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS-CoV-2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines.

RESULTS

Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = -1.37; 95%CI -2.17 to -0.47) was related to lower EE. HCWs working in wards for patients with COVID-19 reported lower EE (b = -1.39; 95%CI -2.45 to -0.32). HCWs who contracted COVID-19 reported lower DP (b = -0.71, 95%CI -1.30 to -0.12).

CONCLUSIONS

Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout.

RELEVANCE TO CLINICAL PRACTICE

Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff.

Developing hospital resilience domains in facing disruption era in Indonesia: a qualitative study

BACKGROUND

The studies of hospital resilience have been of increasing importance during the last decade due to disasters and pandemics. However, studies in developing the domain and indicators of hospital resilience were limited mainly on disaster response. A few studies of hospital resilience focused on how to deal with disruptions such as environmental turbulence, rapid technological changes, and changes in patient preferences. This study aims to develop domains and indicators of hospital resilience in facing the disruption era.

METHODS

This qualitative study focused on exploring the domains and indicators to face disruptions that have been identified in the first exploratory phase of the studies. Key informants included hospital experts from the government, medical practitioners, and academics. A total of 20 key informants were involved in semi-structured interviews which were conducted face-to-face, via telephone and Zoom. Data was analyzed using a grounded theory approach to discover domains for a resilient hospital.

RESULTS

The study identified a number of domains that are fundamental for a hospital to become a resilient in the face of disruption. These include readiness to face digital transformation, effective leadership, and flexibility in managing resources among others. Situation awareness and resilience ethos, implementation of marketing management, networking, and disaster anticipation are found to be equally important. These domains focused on the hospital's ability to deal with specific shocks from different perspectives as the result of changes from disruptions which are inevitable within the organizational business environment.

CONCLUSIONS

The domains identified in the study are able to respond to the limitations of the concept of hospital resilience, which is currently more focused on hospital disaster resilience. They can be used to measure hospital resilience in the context of the volatility, uncertainty, complexity, and ambiguity (VUCA), which are relevant to the context of the Indonesia hospital industry.

Nursing and Maternity in the Pandemic: A Qualitative Study from Turkey

OBJECTIVES

This study was conducted to examine the experiences and perceived challenges of nurses who are also mothers having a child during the coronavirus disease (COVID-19) pandemic.

METHODS

A descriptive phenomenological design. The study was conducted with 18 nurse mothers working at COVID-19 clinics in Turkey.

RESULTS

Nurse mothers missed their children and are worried about infecting their children. Based on content analysis, the themes of the study were determined as follows: (1) Nursing Care Process, (2) Disruption of Family Processes, (3) Nurse Mother's Perspective: Being a Child in a Pandemic, and (4) Coping with Challenges-"Searching for a solution."

CONCLUSIONS

Necessary conditions should be provided for nurses with children or family members in need of care and protocols should be made with relevant institutions.

Psychological impacts of the COVID-19 on health care providers

BACKGROUND

Psychological distress, functional impairment, reduced quality of life, and subjective well-being were the most common negative psychological effects during the COVID-19 outbreak. The present study was to investigate the impact of job stress, hospital resources, and fear of infection on job burnout of medical staff in Iran during the Covid-19 pandemic.

MATERIALS AND METHODS

In this cross-sectional study, 223 hospital staff from several public and private hospitals in Tehran and Mazandaran provinces, selected through convenience sampling. The questionnaire included the validated "Maslach Burnout Inventory (MBI)", "job stress scale (Parker and DeCotiis, 1983)", and the questions about "hospital resources", and "fear of infection" developed by the researcher wereused to collect data. Data were analyzed by correlation and regression methods using SPSS software.

RESULTS

The results revealed that there was a significant difference in the scores on the burnout scale, in the dimension of emotional exhaustion, but the differences were not significant in the dimensions of depersonalization and self-accomplishment. Also, job stress and fear of infection significantly correlated with job burnout in the dimensions of emotional exhaustion and personal-accomplishment. However, the correlation between the adequacy of hospital resources and job burnout in these two dimensions was not significant. None of the three variables of the study showed a significant correlation with the dimension of depersonalization.

CONCLUSION

It is essential to consider the package of psychological interventions which, primarily includes finding the sources of stress to resolve them through stress management programs, based on education and training in stress coping and management strategies.

Exploring Novice Nurses' Experiences During the First Wave of the COVID-19 Pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic affected how nurses learn and prepare for their future careers. This study explored the experiences of college-prepared, novice nurses pursuing a baccalaureate degree during the first wave of the pandemic.

METHOD

This qualitative descriptive study analyzed students' individual reflective assignments describing the effects of the COVID-19 pandemic on novice nurses' personal, professional, and educational lives.

RESULTS

Three themes emerged: (1) emotions generated in the clinical workplace due to the lack of control and the unknown of working as novice nurses during a pandemic; (2) cognitive dissonance of the nursing role regarding novice nurses' moral distress and their growing empowerment within the scope of practice; and (3) a disconcerted image of nursing with contrasting views of nursing from the public's perspective and a disconnect between frontline workers and decision makers.

CONCLUSION

Novel pedagogical strategies are needed to help novice nurses cope with stress, uncertainty, and role challenges to foster healthy learning in academic and working environments. [J Nurs Educ. 2023;62(8):461-466.].

Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review

BACKGROUND

The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention.

OBJECTIVE

To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East.

METHODS

A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out.

DATA EXTRACTION AND SYNTHESIS

Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach.

RESULTS

The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19.

CONCLUSION

In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation.

TRIAL REGISTRATION

PROSPERO (CRD42022344005).

Use it or lose it? Identifying reasons for the low use of psychosocial support by hospital staff

BACKGROUND

Psychosocial support programs are a way for hospitals to support the mental health of their staff. However, while support is needed, utilization of support by hospital staff remains low. This study aims to identify reasons for non-use and elements that are important to consider when offering psychosocial support.

METHODS

This mixed-method, multiple case study used survey data and in-depth interviews to assess the extent of psychosocial support use, reasons for non-use and perceived important elements regarding the offering of psychosocial support among Dutch hospital staff. The study focused on a time of especially high need, namely the COVID-19 pandemic. Descriptive statistics were used to assess frequency of use among 1514 staff. The constant comparative method was used to analyze answers provided to two open-ended survey questions (n = 274 respondents) and in-depth interviews (n = 37 interviewees).

RESULTS

The use of psychosocial support decreased from 8.4% in December 2020 to 3.6% by September 2021. We identified four main reasons for non-use of support: deeming support unnecessary, deeming support unsuitable, being unaware of the availability, or feeling undeserving of support. Furthermore, we uncovered four important elements: offer support structurally after the crisis, adjust support to diverse needs, ensure accessibility and awareness, and an active role for supervisors.

CONCLUSIONS

Our results show that the low use of psychosocial support by hospital staff is shaped by individual, organizational, and support-specific factors. These factors can be targeted to increase use of psychosocial support, whereby it is important to also focus on the wider hospital workforce in addition to frontline staff.

Experiences of healthcare workers following occupational exposure to COVID-19 at the early stages of the pandemic: A phenomenological qualitative study

AIM

To explore the experiences of healthcare workers (HCWs) following occupational exposure to coronavirus disease 2019 (COVID-19) during the early stage of the pandemic.

DESIGN

A Husserl descriptive phenomenological study design was employed.

METHODS

Convenient and snowball sampling was used. In-depth semi-structured telephone interviews were conducted from February to March 2020 with the frontline HCWs who were exposed to COVID-19 during work. Data analysis was conducted following the 7-step analysis method developed by Colaizzi.

RESULTS

Fifteen HCWs participated in the study. Four themes were identified, including (1) traumatic experiences since the occupational exposure; (2) getting through the hard time; (3) struggling to return to work; (4) reflections on occupational exposures.

CONCLUSION

The HCWs had traumatic and painful experiences after the occupational exposure. But they returned to work with strong resilience, professional obligation and social support. Training and supervision, and adequate supply of personal protective equipment are suggested to prevent professional exposure. Social and organizational support should be provided for the exposed HCWs.

Stress management protocol for nurses working in the COVID-19 wards

Purpose

Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences.

Methods

This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion.

Results

Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items.

Conclusion

This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.

Qualitative study of challenges facing emergency departments nurses in Jordan

Worldwide, nurses employed in the Emergency Department (ED) face many challenges that negatively influence their well-being and ability to provide high-quality patient care. Previous researchers have investigated these challenges regarding their causes, consequences, and how to deal with them. However, most of the previous research addressed these challenges using quantitative research. The current study is the first qualitative study that examined these challenges in the Jordanian context. A descriptive naturalistic qualitative design was used to explore the most critical challenges facing nurses employed in the ED and described the suggested solutions for these challenges from nurses' perspectives. Ten registered nurses employed in the most prominent ED in Jordan were selected through purposive sampling. Semi-structured interviews were used to collect data. Thematic analysis technique was used to analyze data. Six main themes emerged: the definition of challenge, challenges facing registered nurses in the emergency department (five sub-themes), preventive measurements, possible solutions (five sub-themes), effects of the challenges (two sub-themes), and future challenges. The outcomes of this study could be integrated into the educational curricula to prepare new nurses to deal with these challenges in the future after graduation and contribute to finding solutions and solving some significant problems facing registered nurses in the ED. The hospital administrators and the policymakers should develop effective interventions to overcome the challenges facing nurses in the ED to ensure a better work environment and high-quality patient care.

Factors influencing emergency nurses' infection control practices related to coronavirus disease 2019 in Korea

BACKGROUND

When an infectious disease breaks out, emergency nurses are the front-line specialists. Infection control by emergency nurses is important to minimize the risk of infectious disease and to improve the infection control practices of emergency nurses. Therefore, it is crucial to identify the factors influencing infection control practice related to COVID-19.

METHODS

For this cross-sectional study design used survey methods for data collection, a questionnaire survey was conducted with 161 emergency nurses working in five hospitals selected through convenience sampling. Data were collected from November 10 to November 26 in 2020.

RESULTS

Infection control practice related to COVID-19 was affected by the infection prevention environment (β = 0.24, p = .002), monitoring of wearing Personal Protective Equipment (β = 0.19, p = .006), knowledge about COVID-19 (β = 0.18, p = .009), perceived severity related to COVID-19 (β = 0.18, p = .010), and perceived barrier related to COVID-19 (β = -0.15, p = .033).

CONCLUSION

Creating safe infection prevention measures and revitalizing personal protective equipment monitoring are necessary to improve infection control practices. A systematic infection control education program is needed to improve knowledge about COVID-19, emphasize its perceived severity, and identify and eliminate perceived barriers.

The Lived Experiences of Nurses Caring for Patients With COVID-19 in Arabian Gulf Countries: A Multisite Descriptive Phenomenological Study

Since the beginning of the COVID-19 pandemic, several studies worldwide have explored nurses' experiences of caring for COVID-19 patients in various healthcare settings. However, these studies were conducted in context, culture, and healthcare systems that differ greatly from the Arabian Gulf context. This descriptive phenomenological study aimed to understand nurses' lived experiences caring for patients diagnosed with COVID-19 in Arabian Gulf countries. Individual virtual interviews were conducted with 36 nurses from five countries and were analyzed using Giorgi's methodology. Four main themes were identified: (1) living with doubts, (2) living through the chaos of challenges, (3) moving toward professional resilience, and (4) reaching the maximum level of potential. The findings from this study hopefully will guide health organizations in this region in developing strategies and policies to support and prepare nurses for future outbreaks.

Risk factors and the psychological impacts of the COVID-19 outbreak: perspectives and experiences of Iranian healthcare workers on the frontline

Frontline healthcare workers (HCWs) looking after COVID-19 patients are at high risk of developing mental health problems. Both preventive and interventional initiatives are essential, therefore, to maintain and improve the mental health of HCWs and ultimately to enhance the quality of care that they provide. This qualitative content analysis study, conducted in Iran between September 2020 and February 2021, involved the gathering of data on the issue through face-to-face interviews with 22 HCWs working directly with COVID-19 patients. Data analysis led to the generation of 163 codes, 45 categories (16 risk factors and 29 consequences), and 9 themes. Overall, the results suggest that caring for a patient with COVID-19 is associated with positive and negative psychological impacts. Measures such as increasing sensitivity to crisis situations, self-adjustment skills training, and identifying signs of job burnout owing to moral conflicts can reduce or eliminate the risk of negative psychological consequences among HCWs.

The prevalence and associated factors of depression, anxiety, and PTSD among Moroccan medical doctors in the COVID-19 pandemic: a national study

COVID-19 pandemic is facing healthcare professionals with unprecedented challenges, which might alter their mental health. We targeted assessing depression, generalized anxiety, and post-traumatic stress disorder (PTSD) of Moroccan medical doctors during the COVID-19 pandemic; this would allow identifying the associated factors. A cross-sectional national study was carried out on 1267 exposed and unexposed public health medical doctors to COVID-19 patients. The study was conducted between May 15 and 15 June 2020. An anonymous self-administered questionnaire was completed online voluntarily and randomly. We used the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), and the PTSD Checklist for DSM‑5 (PCL-5) to assess depression, generalized anxiety, and PTSD, respectively. The respondents' rate was 63.3%. The mean age was 30.97 ± 6.65 years old, and 59.3% (N = 751) were females with a sex ratio M/F of 0.68. The sample included 43.0% (N = 545) of COVID-19 frontline doctors. Among all participants, 31.5% (N = 400) had depression, 29.2% (N = 370) had generalized anxiety, and 21.7% (N = 276) had PTSD. The average scores of the PHQ-9, the GAD-7, and the PCL-5 were 7.79 (± 5.54), 6.12 (±5.72), and 18.58 (±17.62), respectively. The multivariate logistic regression showed that working in primary and secondary hospitals, moderate and high-stress perceptions, a chronic physical illness, and a family history of psychiatric disorder were independently associated factors of depression, generalized anxiety, and PTSD. The females expressed significantly more anxiety. Doctors living in a family consisting of member with chronic disease showed a significantly higher risk of PTSD. The security sense of contamination risk and low threat perception of COVID-19 were significantly protective factors of depression, anxiety, and PTSD. Moroccan medical doctors are in psychological distress. It is essential to preserve medical doctors' mental well-being health for a better fight against the COVID-19 pandemic through effective and targeted health policies.

Exploring the experiences of frontline nurses during the first 6 months of the COVID-19 pandemic: An integrated literature review

AIM

The aim of this study was to explore the experiences of frontline nurses caring for patients during the first 6 months of the COVID-19 pandemic.

DESIGN

The JBI manual for evidence synthesis and the PRISMA guidelines for reporting.

DATA SOURCES

CINAHL Complete, MEDLINE, PsycINFO (EBSCO) and Scopus (Elsevier).

REVIEW METHODS

The JBI Mixed Methods Data Extraction Tool following a Convergent Integrated Approach.

RESULTS

Nineteen studies were included in the review, comprising eight countries and 2525 frontline nurses. Six themes emerged encompassing frontline nurses' COVID-19 experiences including emotional experiences, physical symptoms, ethical and moral challenges, professional impact, risk factors for negative emotional experiences and protective factors for future pandemic events.

CONCLUSION

Frontline nurses have faced numerous challenges during the COVID-19 pandemic. Providing frontline nurses with the required resources and support to perform their roles in global healthcare crises allows for an empowered and resilient workforce ensuring nurses remain in their chosen profession.

Causes of Stress among Healthcare Professionals and Successful Hospital Management Approaches to Mitigate It during the COVID-19 Pandemic: A Cross-Sectional Study

The outbreak of the COVID-19 pandemic posed an immediate challenge to the management of hospitals in Germany and elsewhere. The risk of stress for front-line healthcare professionals forced occupational health and safety units to adopt a variety of protective measures, not all of which have been thoroughly validated. The main objective of the present analysis is to assess what the most important sources of stress were and which of the protective measures applied to counteract stress among healthcare staff had the greatest impact. A better understanding of these factors will improve hospital management and worker safety in a future health crisis situation and may also prove to be beneficial in non-crisis situations. For this purpose, in 2020, an exploratory, cross-sectional and quantitative study using a questionnaire created for this purpose was carried out on a total of 198 professionals-133 nurses and 65 physicians-at the Klinikum Mittelbaden Balg hospital in Baden-Baden, Germany, during the first wave of the pandemic. Statistical analyses showed that nurses suffer more stress than physicians and that stress is higher among professionals in critical care and emergency units than in units that are less exposed to infected patients. It was also found that measures such as salary incentives, encouragement of work in well-integrated teams, and perceived support from hospital management mitigate stress. These findings highlight the importance of support measures from management and superiors. Knowing the actual effectiveness of the measures applied by management and the factors mentioned above could help to protect healthcare professionals in the event of another pandemic or similar situations and may still be of value in dealing with the continuing COVID-19 pandemic.

Burnout status of healthcare workers in the world during the peak period of the COVID-19 pandemic

During the COVID-19 pandemic, healthcare workers have a high workload and have been exposed to various psychosocial stressors. This study aimed to evaluate health workers during the COVID-19 pandemic in the world. The method used in this research is qualitative with a literature review approach. The data sources in this study were taken from the Scopus database using the keywords "health workers," "burnout," AND "coronavirus" from the time range of 2020 to April 25, 2022. From the determination of the time range, 150 documents emerged. This study revealed that the Pearson correlation between total burnout scale scores on healthcare workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact indicated that overall burnout scores were associated with depression and anxiety. Stress symptoms had correlation values ranging from 0.84 to 0.73. Job burnout had a significant relationship with exhaustion at 0.89; depression r = 0.73), impacting a score of 0.66. At the same time, the fulfillment of professional and interpersonal disengagement showed a Pearson correlation between the total burnout scale scores on health workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact. Overall, the participants in health care workers worldwide experienced high levels of psychological distress. We also found that health workers dealing with COVID-19 pandemic patients were more likely to experience depression, stress, and burnout than health staff who were not personally involved in medical work. Furthermore, this study will be a follow-up study using the Work Ability Index (WAI) to measure work ability and work satisfaction.

No increase in burnout in health care workers during the initial COVID-19 outbreak: Systematic review and meta-analysis

BACKGROUND

For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.

AIM

To literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.

METHODS

We performed a database search of Embase, Google Scholar and PubMed from June to October 2020. We analysed burnout risk factors and protective factors in included studies published in peer-reviewed journals as of January 2020, studying a HCW population during the first COVID-19 wave without any geographic restrictions. Furthermore, we performed a meta-analysis to determine overall burnout levels. We studied the main risk factors and protective factors related to burnout and stress at the individual, institutional and regional levels.

RESULTS

Forty-one studies were included in our final review sample. Most were cross-sectional, observational studies with data collection windows during the first wave of the COVID-19 surge. Of those forty-one, twelve studies were included in the meta-analysis. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). Indeed, exposure to the virus was not a leading factor for burnout. Our meta-analytic estimate of burnout prevalence in the HCW population for a sample of 6784 individuals was 30.05%.

CONCLUSION

There was a significant prevalence of burnout in HCWs during the COVID-19 pandemic, and some of the associated risk factors could be targeted for intervention, both at the individual and organizational levels. Nevertheless, COVID-19 exposure was not a leading factor for burnout, as burnout levels were not notably higher than pre-COVID-19 levels.

The Psychological Impact and Influencing Factors during Different Waves of COVID-19 Pandemic on Healthcare Workers in Central Taiwan

BACKGROUND

This study aims to explore differences of psychological impact and influencing factors that affected Taiwanese healthcare workers (HCW) during the first and second wave of COVID-19.

METHODS

a cross sectional survey of first-line HCW during November 2021 to February 2022: 270 paper questionnaires were issued and the valid response rate was 86% (231). For statistical analysis, descriptive statistics, Pearson correlation, and multivariate linear regression were used.

RESULTS

regardless of the wave of the pandemic, nearly 70% of HCW had anxiety, nearly 60% felt depressed, half of them suffered from insomnia, and one in three felt insufficient social support, which means a high level of loneliness. With an increased number of infected patients during the second wave, HCW felt significant changes of workload and schedule, with higher concern over risk of infection, and these factors induced higher levels of anxiety, but they manifested better satisfaction over public health policies and information provided by hospitals and governments. Changes of working schedules or duties positively relate to levels of anxiety and insomnia. The risk of infection causes anxiety, depression, and insomnia. Workplace relationships significantly relate to depression and loneliness. A negative family support causes an adverse psychological impact.

CONCLUSIONS

the pandemic has a negative psychological impact on HCW. Early recognition of significant influencing factors, providing psychological support and therapy, are helpful strategies for reducing the adverse psychological effects.

Work Stress and Willingness of Nursing Aides during the COVID-19 Pandemic

Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, nursing aides (NAs) experienced greater work stress than they do typically because they worked in highly contagious environments. This may have influenced their work morale and willingness to work, which can reduce patient satisfaction, influence their physical and mental health, and even endanger patient safety or cause medical system collapse. Design: A cross-sectional survey with a structured self-report questionnaire was conducted. Setting and Participants: 144 NAs from a medical center in Central Taiwan participated. Methods: We recruited NAs through convenience sampling to discuss their work stress, willingness to work, and patients’ satisfaction with them during the COVID-19 pandemic. Result: Of the 144 recruited NAs, 115 (79.9%) were women and 29 (20.1%) were men, and 89 (61.8%) had completed COVID-19 training courses. NAs with different work tenure lengths exhibited significant differences in work stress (p = 0.022), willingness to work (p = 0.029), and patient satisfaction (p = 0.029) scores during the pandemic. Conclusion: The study findings provide crucial data for the management of NAs during pandemics to prevent them from neglecting patients due to excessive work stress or losing their willingness to work, which may cause the medical system to collapse.

Investigation of the Level and Factors Influencing Emergency Department Nurses Fatigue: A Case Study of the Saudi Arabian Context

Background: Work-related fatigue is a common health problem among nurses which can affect their performance and decision making. Significance and Aim: The study explores the levels of fatigue and its associated factors among emergency department (ED) nurses in Saudi Arabia. Methods: The study was developed through a cross-sectional quantitative study design. This included the collection of primary quantitative data with a questionnaire prepared and published on REDCap. The study questionnaire was adapted from two tools, namely the OFER 15 and the Copenhagen II tools, respectively. Results: The study established that the Saudi Arabian ED nurses have high acute fatigue (OFER 15 score = 81.11), moderate-high chronic fatigue (OFER 15 score = 74.17), and a high inter-shift recovery index (OFER 15 score = 78.01). In terms of the predictor factors, the study established that for the demographic factors, gender has an impact on chronic and acute fatigue, while work experience impacted acute fatigue and the number of dependents impacted on inter-shift recovery index. On the psycho-social factors, chronic fatigue is influenced by emotional demand (which is a variable used to evaluate the levels to which the nurse is invested, gaining education/skills thus increases job satisfaction) (−0.289), influence at work (−0.310), commitment at the workplace (0.376), rewards (−0.187), stress (0.420), and burnout (0.293), respectively. Acute fatigue is influenced by the emotional demands (0.336), role clarity (−0.128), and the nurses’ well-being and health (−0.034). Finally, the inter-shift recovery index is influenced by the ED nurses’ burnout levels (−0.877). Conclusions: The study indicates a high level of nursing fatigue among the Saudi Arabian ED nurses.

Explaining the challenges and adaptation strategies of nurses in caring for patients with COVID-19: a qualitative study in Iran

Background

Nurses, as the primary human resource in the fight against COVID-19, encounter several obstacles and concerns. As a result, the current study used a qualitative method to describe the problems and adaptation techniques of nurses caring for COVID-19 patients.

Methods

The current study used a qualitative conventional content analysis technique with 30 nurses working in COVID-19 wards in Tehran hospitals. Purposive sampling, snowball sampling, and semi-structured interviews were used to get access to participants and gather data. The data was examined using conventional qualitative content analysis and the MAXQDA-18 program. To assess the quality of study findings, Guba and Lincoln’s trustworthiness criteria were fulfilled.

Results

The data analysis revealed two main categories and sixteen subcategories: (1) experiences and challenges (lack of protective equipment, high work pressure, marginalized physical health, problems related to the use of protective equipment, being excluded, a lack of a supportive work environment, problems related to patients, psychological problems, fear, marginalized personal and family life, and the challenge of communicating with patients’ families); and (2) adaptation strategies for work conditions (performing religious-spiritual activities, creating an empathetic atmosphere in the workplace, spiritualizing their work, trying to convince the family and gaining their support, and strengthening their sense of self-worth and responsibility).

Conclusion

Nurses’ working conditions can be improved by providing adequate protective equipment, a suitable work environment, and more social and financial support; paying more attention to nurses’ physical and mental health; and considering appropriate communication mechanisms for nurses to communicate with their families and patients’ families.

Factors Contributing to Burnout among Healthcare Workers during COVID-19 in Sabah (East Malaysia)

The third wave of COVID-19 in Malaysia has significantly strained the healthcare system of the country and increased the level of burnout among the healthcare workers (HCWs) in the country. Therefore, this study aimed to identify the various factors associated with burnout among HCWs. A cross-sectional study was conducted among 150 HWCs in Kota Kinabalu, Sabah, Malaysia. An online survey was administered using the Copenhagen Burnout Inventory, Multidimensional Scale of Perceived Social Support, Brief COPE, and Fear of COVID-19 scales. Pearson correlations were assessed amongst all variables. Subsequently, a multiple linear regression analysis was performed using burnout dimensions as dependent variables. Multiple linear regression results showed: (a) lower work-related burnout (β = −0.217, p < 0.01) among married HCWs; (b) higher personal-related burnout (β = 0.228, p < 0.01), work-related burnout (β = 0.425, p < 0.01), and client-related burnout (β = 0.359, p < 0.01) among doctors; (c) fear towards COVID-19 was significantly associated with client-related burnout (β = 0.243, p < 0.01); (d) an avoidant coping strategy was significantly associated with personal-related burnout (β = 0.322, p < 0.01); (e) social support from family was significantly associated with personal-related burnout (β = −0.264, p < 0.01), work-related burnout (β = −0.186, p < 0.05), and client-related burnout (β = −0.326, p < 0.01);(f) and social support from friends was significantly associated with work-related burnout (β = −0.202, p < 0.05). This study demonstrated significant theoretical contributions and clinical implications in the healthcare system in Sabah by addressing the impact of various factors on burnout among HWCs.

Sociodemographic and Psychological Predictors of Resilience Among Frontline Nurses Fighting the COVID-19 Pandemic

OBJECTIVE

According to a WHO report, the number of patients with coronavirus disease 2019 (COVID-19) has reached 456,797,217 worldwide as of 15 March, 2022. In Wuhan, China, large teams of health-care personnel were dispatched to respond to the COVID-19 emergency. This study aimed to determine the sociodemographic and psychological predictors of resilience among frontline nurses fighting the current pandemic.

METHODS

A total of 143 nurses were recruited from February 15 to February 20, 2020, to participate in this study. The 10-item Connor-Davidson Resilience Scale and the 21-item Depression Anxiety Stress Scale were used to estimate the participants' resilience and mental wellbeing.

RESULTS

Results showed that the nurses displayed a moderate resilience level. Their median depression, anxiety, and stress scores were 1, 2, and 3, respectively, which were negatively correlated with resilience. Female gender, being dispatched to Wuhan, and depression levels were the significant predictors of resilience.

CONCLUSIONS

The results suggest that particular attention should be given to nurses who were dispatched to Wuhan and who exhibited depression symptoms, and appropriate measures should be taken to boost their resilience.

The Work Environment during Coronavirus Epidemics and Pandemics: A Systematic Review of Studies Using Quantitative, Qualitative, and Mixed-Methods Designs

We aimed to provide an overview of how work environment and occupational health are affected, and describe interventions designed to improve the work environment during epidemics and pandemics. The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) were followed. The databases Cinahl, Medline, PsycInfo, and Web of Science were searched for population: working population; exposure: coronavirus epidemic or pandemic; and outcome: work environment, in articles published until October 2020. Quality assessment was based on a modified version of the Mixed Methods Appraisal Tool (MMAT). After deduplication 3711 articles remained, of which 530 were selected for full-text screening and 119 for quality assessment. After the exclusion of studies that were low quality, 95 remained, of which 85 focused on healthcare personnel and 10 on employees in other industries; 73 used quantitative methods and 22 used qualitative or mixed methods; the majority were based on cross-sectional data. Healthcare staff experienced increased job demands, poor leadership, and lack of resources (personal protective equipment, personnel, and competence). High demands and work with infected patients were associated with negative mental health outcomes. There was a lack of studies assessing interventions, studies from industries other than healthcare, and studies of high quality.

Mental health impact of the Middle East respiratory syndrome, SARS, and COVID-19: A comparative systematic review and meta-analysis

BACKGROUND

Over the last few decades, 3 pathogenic pandemics have impacted the global population; severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2. The global disease burden has attributed to millions of deaths and morbidities, with the majority being attributed to SARS-CoV-2. As such, the evaluation of the mental health (MH) impact across healthcare professionals (HCPs), patients and the general public would be an important facet to evaluate to better understand short, medium and long-term exposures.

AIM

To identify and report: (1) MH conditions commonly observed across all 3 pandemics; (2) Impact of MH outcomes across HCPs, patients and the general public associated with all 3 pandemics; and (3) The prevalence of the MH impact and clinical epidemiological significance.

METHODS

A systematic methodology was developed and published on PROSPERO (CRD42021228697). The databases PubMed, EMBASE, ScienceDirect and the Cochrane Central Register of Controlled Trials were used as part of the data extraction process, and publications from January 1, 1990 to August 1, 2021 were searched. MeSH terms and keywords used included Mood disorders, PTSD, Anxiety, Depression, Psychological stress, Psychosis, Bipolar, Mental Health, Unipolar, Self-harm, BAME, Psychiatry disorders and Psychological distress. The terms were expanded with a ‘snowballing’ method. Cox-regression and the Monte-Carlo simulation method was used in addition to I² and Egger’s tests to determine heterogeneity and publication bias.

RESULTS

In comparison to MERS and SARS-CoV, it is evident SAR-CoV-2 has an ongoing MH impact, with emphasis on depression, anxiety and post-traumatic stress disorder.

CONCLUSION

It was evident MH studies during MERS and SARS-CoV was limited in comparison to SARS-CoV-2, with much emphasis on reporting symptoms of depression, anxiety, stress and sleep disturbances. The lack of comprehensive studies conducted during previous pandemics have introduced limitations to the “know-how” for clinicians and researchers to better support patients and deliver care with limited healthcare resources.

The Effect of Mindfulness-Based Breathing and Music Therapy Practice on Nurses' Stress, Work-Related Strain, and Psychological Well-being During the COVID-19 Pandemic: A Randomized Controlled Trial

Infectious diseases cause psychological problems for health care workers and especially nurses. Nurses who provided coronavirus disease-2019 (COVID-19) patients with care experience negative feelings such as stress, work-related strain, discomfort, and helplessness related to their high-intensity work. The aims of this study are to investigate the effect of the mindfulness-based breathing and music therapy practice on stress, work-related strain, and psychological well-being levels of nurses who provided COVID-19 patients with care. This randomized controlled trial was conducted in a COVID-19 department at a university hospital in Turkey. Nurses who care for patients infected with COVID-19 were randomly divided into an intervention group (n = 52) and a no-treatment control group (n = 52). The intervention group received mindfulness-based breathing and music therapy. In data collection, the Personal Information Form, State Anxiety Inventory, Work-Related Strain Scale, and Psychological Well-Being Scale were used. The data from the study showed that mindfulness-based breathing and music therapy decreased stress and work-related strain (P < .05) and increased psychological well-being (P < .05). The control group showed no statistically significant changes on these measures (P > .05). The mindfulness-based breathing and music therapy practice reduced nurses' stress and work-related strain and increased psychological well-being during the COVID-19 pandemic.

Stress, Depression, Anxiety, and Burnout among Healthcare Workers during the COVID-19 Pandemic: A Cross-sectional Study in a Tertiary Centre

Background:

Healthcare workers have been known to suffer from depression, anxiety, and other mental health issues as a result of their profession. Healthcare professionals were already vulnerable to mental health issues prior to the COVID-19 pandemic, but now they are even more prone to stress and frustration.

Objective:

The study aimed to assess stress, depression, anxiety, and burnout among healthcare workers during the COVID-19 pandemic. Moreover, it assessed the relationship between stress, depression, anxiety, burnout, and COVID-19 related stress.

Methods:

A cross-sectional, descriptive, and correlative design was adopted to assess stress, depression, anxiety, and burnout among healthcare workers and determine the relationship among these variables during the COVID-19 pandemic.

Results:

The response rate was 87.6% (831 out of 949), the majority of the participants were nurses (87.4%), and 38.4% were working in inpatient settings. The means of COVID-19 related anxiety (17.38 ± 4.95) and burnout (20.16 ± 6.33) were high and tended to be in the upper portion of the total scores. Participants reported moderate to extremely severe levels of stress (26.5%), anxiety (55.8%), and depression (37.2%). Males reported a higher level of stress (16.59 ± 10.21 vs. 13.42 ± 9.98, p = 0.002) and depression (14.97 ± 10.98 vs. 11.42 ± 10.56, p = 0.001). COVID-19 related anxiety was significantly correlated with participants’ professions (p = 0.004). Burnout (p = 0.003) and depression (p = 0.044) were significantly correlated with the participants’ working area. Significant positive correlations were found between stress, depression, anxiety, burnout, and COVID-19 related stress.

Conclusion:

Healthcare workers may experience considerable psychologic distress as a result of the COVID-19 pandemic due to providing direct patient care, quarantine, or self-isolation. Healthcare workers who were at high risk of contracting COVID-19 appeared to have psychological distress, burnout, and probably, chronic psychopathology. Frontline staff, especially nurses, were at higher risk of showing higher levels of psychological and mental health issues in the long term.

"I love the job…" Thriving in nursing: A qualitative interview study with framework analysis

BACKGROUND

Burnout is a well-known issue among nurses in critical care settings, including emergency nurses. There are decades of research indicating that emergency nurses experience burnout in their work. However, many nurses have long careers in emergency settings, which suggests that burnout is not the only outcome for nurses. Thriving may also be part of nurses' experiences. The Model of Thriving at Work includes external factors (autonomy, climate of trust and respect, and information sharing) and internal factors (knowledge, personal outlook, and relationships). Thriving is characterized by the concepts of vitality and ongoing learning. Previous researchers suggest that thriving fits with some nurses' experiences, based on validated questionnaires. However, thriving has not been investigated among nurses using interview approaches.

AIMS

This article explores nurses' experiences of thriving and assesses the fit of Spreitzer et al.'s Model of Thriving at Work with nurses' experiences.

STUDY DESIGN

Qualitative interview study, using framework analysis.

METHODS

Eleven nurses, from a single site, completed semi-structured interviews. These interviews explored nurses' workplace experiences, both positive and negative.

RESULTS

Participants reported experiences that fit with the Model of Thriving at Work, consisting of vitality, ongoing learning, and external and internal factors. Nurses hesitated to describe themselves in positive ways, referring instead to being 'not burnt out'. Nurses could, however, readily identify qualities of thriving in others, and viewed those nurses as aspirational. In addition to the Model, participants highlighted their emotional burden, workload, and ethical issues as important contributors to thriving. The Model could potentially be expanded to include these factors.

CONCLUSIONS

Thriving at work could be part of a range of emergency nurses' workplace outcomes. External and internal factors contribute to thriving. Healthcare leaders could support thriving among emergency nurses by fostering a positive work environment.

The impact of the COVID-19 pandemic on pediatric developmental services: a cross-sectional study on overall burden and mental health status

BACKGROUND

The COVID-19 outbreak has taken a heavy toll on the mental well-being of healthcare workers, even those who have not been directly involved in the care of acutely ill patients. The aims of this study were to identify the overall burden and mental health status of healthcare workers in pediatric developmental services under the influence of the COVID-19 pandemic, and to identify the risk and protective factors associated with mental health.

METHODS

This cross-sectional web-based study was part of a large multicenter VOICE study conducted among employees ((neuro-)pediatricians, psychologists, speech therapists, occupational therapists, etc.) from various pediatric developmental services between June and July 2020. A total of 1291 questionnaires regarding overall burden, mental health status (depression, generalized anxiety disorder and emotional exhaustion) and risk and protective factors for mental health (working conditions, potential problems during the COVID-19 pandemic and psychological resources) were analyzed. Descriptive statistics and multiple linear regression were used for data analysis.

RESULTS

A total of 44.5% (574/1291) participants felt a high or very high overall burden during the COVID-19 pandemic. Of all the participants, 14.6% (171/1173) reported clinically significant levels of depressive symptoms, 17.0% (199/1173) reported generalized anxiety disorder symptoms and 44.6% (532/1192) reported emotional exhaustion. Multiple linear regression analyses identified several common risk and protective factors for mental health status variables. The burden of an increase in the quantity of work, fear of work and fear of becoming infected showed the strongest negative associations, whereas psychological resources and sufficient relaxation in leisure time exhibited the strongest positive associations.

CONCLUSION

Employees who were not directly involved in the care of acutely ill patients were also exposed to considerable stress, some of which was not different from that experienced by professionals who were directly affected. These employees should not be lost sight of and must be offered appropriate support.

Role of resilient leadership and psychological capital in employee engagement with special reference to COVID-19

Purpose

The spread of the COVID-19 pandemic has led to an unseen crisis lately, which has put organizational leadership and employee engagement (EE) to test. Resilient leadership (RL) helps an organization survive and keep employees engaged in the risky environment. Similarly, psychological capital (PsyCap) is known to exert an influence on EE, but PsyCap and EE have not been investigated together during the period of crisis. To address this gap, the present study aims to outline the importance of RL and PsyCap to keep the employees engaged in the information technology (IT) industry.

Design/methodology/approach

In total, 265 samples of IT professionals were collected by using an online survey questionnaire pan India. The collected data was analyzed using regression analysis, structural equation modeling along with bootstrapping technique for mediation analysis and model fit indices analysis.

Findings

The results of the analysis confirm the positive impact of RL on EE and the partial mediation impact of PsyCap on the RL–EE relationship, and the findings exhibit that employees with a higher level of PsyCap contribute favorably to EE during the COVID-19 pandemic.

Originality/value

This study aims to assist IT practitioners in effectively incorporating RL to plan mitigation strategies. EE is an outcome of enhanced PsyCap of employees. To develop necessary skills and coping mechanisms to combat disruptions of such massive outbreaks, RL and PsyCap are crucial.

Perceived Stress and Intention to Work during the COVID-19 Pandemic among Nurses in West Sumatra Indonesia

BACKGROUND: Nurses are at high risk of experiencing stress when treating patients with COVID-19. The presence of an outbreak could also result in burnout among nurses due to job stress, poor hospital resources for the treatment, and inadequate support from family and friends. All of these related obstacles might be interfered with the intention of nurses to work during a pandemic. AIM: The objective of the study was to identify perceived stress and intention to work during the COVID-19 pandemic among nurses. METHODS: An online-based cross-sectional study was conducted among nurses in Indonesia. There were 238 responses received. Multiple regression analysis was used to examine for data analysis. RESULTS: There was a significant correlation between perceived stress and intention to work (p < 0.001). The regression model showed the variance in the perceived stress with other main predictors. CONCLUSIONS: To maintain an adequate workforce during the pandemic, hospital management should ensure adequate hospital goods supply and deploy retention strategies to retain clinically experienced nurses.

Nurse Adaptability and Post-traumatic Stress Disorder Symptoms During the COVID-19 Pandemic: The Effects of Family and Perceived Organizational Support

Objective

To examine the effect of family and perceived organizational support on the relationship between nurse adaptability and their experience with COVID-related PTSD (post-traumatic stress disorder) symptoms in frontline nurses working on COVID-19 units.

Background

Proximity to and survival of life-threatening events contribute to a diagnosis of PTSD, which is characterized by avoidance of reminders of trauma, intrusive thoughts, flashbacks of events, sleep disturbances, and hypervigilance. Using the job-demands and resource model, we examined the effect of adaptability, family support, and perceived organizational support on PTSD symptoms for nurses during the COVID-19 pandemic. Specifically, we tested whether perceptions of environmental supports-i.e., family and organizational support-moderated the relationship between nurse adaptability and COVID-related PTSD symptoms.

Methods

A sample of frontline nurses working on COVID-19 units during the COVID-19 pandemic in Texas (N = 277) participated in this cross-sectional, observational study. Frontline Nurses reported demographic information and completed surveys designed to measure adaptability, perceived organizational support, family support, and COVID-related PTSD symptoms.

Results

Adaptability was significantly positively correlated (medium effects) to perceived organizational and family support (r = 0.51 and 0.56, respectively, p < 0.01). Adaptability and perceived organizational support were also negatively correlated with COVID-related PTSD symptoms (medium effects). Adaptability was negatively correlated with COVID-related PTSD symptoms, supporting Hypothesis 1 (r = -0.43, p < 0.01). Perceived organizational support was also significantly negatively correlated with COVID-19-related PTSD symptoms (r = -0.30, p < 0.01). Family support was not significantly correlated with COVID-related PTSD but was positively related to experiencing COVID-related PTSD after other variables were accounted for.

Conclusion

Findings suggest that individual adaptability and organizational support may reduce PTSD severity in frontline nurses working during a crisis; however, family support may increase PTSD symptoms. We provide suggestions for strengthening individual adaptability and healthcare leadership including remaining highly engaged to show support by providing rapid communication, remaining calm during difficult circumstances, and maintaining a consistent, physical presence during difficult times. Moreover, our results suggest additional support for nurses with families to adapt to crisis.

Lived experiences of frontline nurses and physicians infected by COVID-19 during their activities: A phenomenological study

We analyzed the lived experiences of frontline nurses and physicians who were affected by COVID-19 through a phenomenological approach, using Cohen's methodology with interview data. The participants were enrolled in the study in May 2020 during the COVID-19 pandemic in Italy. The inclusion criteria were (i) being a nurse or physician employed full time caring for COVID-19 patients before falling ill; (ii) contracting SARS-CoV-2 between February 2020 to May 2020; (iii) having recovered before enrollment; and (iv) providing informed consent to participate. Sixteen participants (60% nurses) with an average age of 45 years were included. The following main themes were extrapolated from our data analysis: "fear of diagnosis," "loneliness (as isolation)," "touch of nurses," and "feeling guilty of abandonment." Several aspects emerging from our study highlight the strong emotional impact of COVID on nurses and physicians infected during their activities, such as feelings of fear and loneliness on the one hand, and of impotence and guilt for not being able to help on the other.

Interventions for adapting health care providers to new situations in the workplace during the COVID-19 pandemic: A scoping review for developing a policy brief

The rapid change in the conditions of health care centers following the sudden onset of the COVID-19 pandemic led to work challenges and role changes and the transfer of staff to new and unfamiliar workplaces. This study aimed to develop policy interventions to adapt health care providers to the new situation in the workplace during the COVID-19 pandemic. A systematic literature review was carried out using international databases to identify English-language studies to identify policy interventions. The viewpoints resulting from the observations of the research team and seven health system experts were used to categorize the interventions. Three main policy interventions were identified: creating a flexible and efficient system through modifying personnel roles, adequate training of health care personnel about work conditions when treating COVID-19 patients, and creating a supportive and motivating work environment.

Factors associated with burnout among Chinese nurses during COVID-19 epidemic: a cross-sectional study

BACKGROUND

The coronavirus disease 2019 (COVID-19) epidemic has broken out and even spread globally. The healthcare system worldwide faces enormous challenges, and nurses are at the highest risk as one of the leading forces. It's worth paying attention to nurses' anxiety and job burnout. This study aimed to investigate nurses' levels of burnout and anxiety during the epidemic of COVID-19 and to analyze influencing factors of burnout.

METHODS

A cross-sectional survey was conducted from 19 to 25 February 2020. Questionnaires such as the basic information questionnaire, Maslach Burnout Inventory-General Survey (MBI-GS), and State-Trait Anxiety Inventory (STAI) were used among 1011 nurses in Wuhan tertiary hospitals via the online survey. The final number of valid questionnaires was 885. The effective response rate was 87.5%.

RESULTS

The average score of MBI-GS was 11.50, 6.02, 24.47, respectively. The average score for state anxiety was 45.52 and trait anxiety, 43.78. Anxiety was positively associated with emotional exhaustion and cynicism, and negatively related to personal accomplishment. The protective factors of burnout were personnel agency, five years or less work experience, living in hospital dormitory, Wuhan medical team, working time exceeding 9 h, and the best knowledge of COVID-19. The absence of siblings, median job title, working in isolation wards, three or more night shifts per week, living in hotels, and being surrounded by confirmed or suspected medical staff were all negative factors.

CONCLUSIONS

Nurses had high anxiety levels during the COVID-19 period, but the level of burnout was mild to moderate. Managers should continue to pay attention to nurses' psychological state and related factors and intervene to stabilize the nursing team.

Experiences of health professionals diagnosed with COVID-19 in coping with the disease

Aim

This study evaluates the experiences of health professionals diagnosed with Coronavirus Disease 2019 (COVID‐19) in coping with the disease.

Background

During the COVID‐19 pandemic, health professionals faced various physical and psychological difficulties. Many of them were also infected with COVID‐19.

Methods

This study used a descriptive phenomenological approach and was conducted between May and June 2020. The participants were 24 health professionals who were diagnosed with COVID‐19. Data were collected by phone using semistructured and in‐depth interviews. Data were analyzed using Colaizzi's seven‐step method with the support of MAXQDA software.

Results

After the data analysis, the primary codes were extracted, and subthemes were created by categorizing these codes. The subthemes were organized, and themes were created. From the perspective of the participants, four main themes emerged: effects of the disease process on the participants, feelings of the disease process, differences in being infected with COVID‐19 as a health professional, and ways to cope with the disease.

Conclusion

The reactions of the people around them, their feelings and experiences, and their environmental and institutional support systems affected the ways health professionals coped with COVID‐19.

Implications for health policy and nursing

Health managers should provide medical, psychosocial, and legal resources as soon as possible so that health professionals diagnosed with COVID‐19 can receive the treatment and care that they need. COVID‐19 should be considered an occupational disease by health professionals all over the world.

The impact of an educational video about the role of an emergency nurse, viewed by emergency nurses' support systems, on emergency nurses' wellbeing

BACKGROUND

High stress daily events contribute to burnout in emergency nurses. Strong and informed support systems are essential in ensuring emergency nurses are actively dealing with their workplace-generated stress, through informal social support.

METHODS

A pre and post intervention design over a 6-month period in a single ED. A video was created by emergency nurses to orientate their support system to their role and work environment. Its impact on nurse well-being was assessed.

RESULTS

More than half of the participants considered their spouse/partner to be their main support system (n = 52, 58%). The majority of participants found their support system: (i) had a greater understanding of their everyday work (n = 79, 88%), (ii) were more engaged when talking about work (n = 72, 80%), (iii) asked more questions about work (n = 63, 70%), and (iv) reported they had an improved ability to debrief with their support system (n = 67, 74%). The median total World Health Organization wellbeing score improved by two points (7%, p < 0.001).

CONCLUSION

Emergency nurses' support systems had a greater understanding of the emergency nurse's role and work environment following exposure to the video. This in turn improved the emergency nurses' ability to debrief at home, experience of support, and ultimately their wellbeing.

Burnout and psychological distress among Pakistani nurses providing care to COVID-19 patients: A cross-sectional study

AIM

The aim of this study is to assess the burden of burnout and psychological distress and its association among Pakistani nurses providing care to patients with COVID-19.

BACKGROUND

Nurses may experience an elevated risk of burnout and psychological distress during epidemics.

METHODS

A cross-sectional study was conducted using a convenience sample of 288 nurses. Maslach Burnout Inventory was administered to measure burnout and its domains of emotional exhaustion, depersonalization, and personal accomplishment. Screening Tool for Psychological Distress was administered to measure depression, anxiety, stress, anger, and low social support.

RESULTS

Burnout was present in 48.6% of nurses, severe emotional exhaustion in 37.2%, severe depersonalization in 36.8%, and low personal accomplishment in 46.9% of nurses. Psychological distress was present in 45% of nurses. Burnout and psychological distress were significantly higher in nurses who: were working in public hospitals, did not receive training for COVID-19 prevention, and were dealing with increased patient load. Burnout and its domains were significantly associated with depression, anxiety, stress, anger, and low social support.

CONCLUSION

Nurses are experiencing high levels of burnout and psychological distress during the COVID-19 pandemic with a significant moderate-to-strong association between these conditions. These findings accentuate the need for institution-based interventions to mitigate burnout and preserve the mental health of nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospitals must screen nurses frequently for the presence of significant burnout and psychological distress and offer supportive interventions to protect their mental health and well-being.

Psychological impact of coronavirus disease on nurses exposed and non-exposed to disease

Introduction

Nurses who have direct contact with patients with coronavirus disease 19 (COVID-19) and are involved in diagnosis, treatment, and care are at risk for serious psychological health problems.

Purpose

To examine the psychological impact of COVID-19 on nurses who are in direct contact with COVID-19 patients and compared them with other nurses, not in direct contact with COVID-19 patients.

Methods

A descriptive comparative cross-sectional was conducted on a convenience sample of 364 nurses working at three hospitals in Jordan to collect their socio-demographic data and scores on the Depression, Anxiety Stress Scale, 22-item Impact of Event Scale-Revised, and Insomnia Severity Index via Google form questionnaires. Descriptive analysis, Kruskal-Wallis test, independent t-test, and multivariable logistic regression with a significance level of p-value < 0.05 were used to analyze the study data.

Results

Overall, the prevalence rates of depression, anxiety, stress, insomnia, and post-traumatic stress symptoms were 34.1%, 48.9%, 44%, 33.8%, and 67.3%, respectively. Depression, anxiety, stress, and insomnia were significantly more prevalent in the exposed group of nurses than in the non-exposed ones. However, no significant difference was found between the groups regarding post-traumatic stress symptoms. Exposure to COVID-19 and the existence of comorbidities were associated with an increased risk of anxiety, depression, insomnia, and stress.

Conclusion

Nurses who have direct contact with COVID-19 patients have a higher risk of psychological disorders than nurses who do not. Psychological interventions need to be implemented to enhance nurses' psychological well-being.

Emotional Exhaustion of Burnout Among Medical Staff and Its Association With Mindfulness and Social Support: A Single Center Study During the COVID-19 Pandemic in Japan

BACKGROUND

Although higher rates of burnout have been reported during the COVID-19 pandemic, the contribution of the modifiable factors is lesser-known. We investigated how the risk of emotional exhaustion was associated with mindfulness skills and social support in a single medical center in Japan.

METHODS

We conducted a cross-sectional web survey on mental health for all staff of a national medical hospital from February to March 2021. We examined the association between self-rated emotional exhaustion and levels of mindfulness and social support using multivariate logistic regression.

RESULTS

Of the 830 participants, signs of emotional exhaustion were observed in 261 (31%) individuals. Among those highly exposed to the virus at work, individuals with low levels of mindfulness and social support had significantly higher odds of emotional exhaustion [OR 3.46 (95% CI; 1.48-8.09), OR; 3.08 (95% CI; 1.33-7.13), respectively] compared to those with high levels. However, among those not highly exposed to the virus, individuals with both low and moderate levels of mindfulness had significantly higher odds of emotional exhaustion. [OR 3.33 (95% CI; 2.22-5.00), OR; 2.61 (95% CI; 1.73-3.94), respectively].

CONCLUSION

We found that factors associated with emotional exhaustion differed by exposure to SARS-CoV-2. Building mindfulness skills can help reduce the high burden placed on the staff. Additionally, increasing social support may be useful especially for workers highly exposed to SARS-CoV-2.

Evaluation of a digital programme for final year nursing students during COVID-19

Aim

The aim of this study was to evaluate a digital programme aimed to address COVID-19 related anxiety of final year undergraduate nursing students on returning to the clinical practice during the pandemic in South Africa.

Background

In South Africa, concern about the physical and psychological safety of nursing students resulted in the planning of a psychological first aid program to facilitate nursing students return to clinical practice.

Design

A survey was conducted in September 2020 following the August 2020 return of final year nursing students to clinical facilities.

Methods

All final year nursing students were invited to participate in the study (N = 196). An online survey was circulated via WhatsApp asking respondents to rate their anxiety and fear of COVID-19 before and after return to practice following an intervention (eCOVID). Related pair analysis was done on the main outcome measures of anxiety, COVID-19 fears and concerns using Related Samples Wilcoxon Signed Rank tests.

Results

After the programme, the respondents reported a significant reduction in anxiety (W = 2.92, p =.004) and COVID fear (W=0.3.1, p =.001), specifically related to infecting family, being exposed to COVID-19 at work, propagating infection at work and lacking access to COVID-19 information and communication.

Conclusion

The implementation of a dedicated digital programme, underpinned by a sound theory base of psychological first aid, may have decreased anxiety and fear in nursing students during clinical practice in the pandemic.Contribution: The study contributes to evidence on psychological first aid support of nursing students during the COVID-19 pandemic.

Mental well-being and social support perceptions of nurses working in a Covid-19 pandemic hospital

PURPOSE

This study was conducted to determine the mental well-being and social support perceptions of nurses working in a Covid-19 pandemic hospital.

DESIGN AND METHODS

This study used a cross sectional design. The sample included 333 volunteer nurses.

FINDINGS

Based on the marital and income statuses of the nurses, there was a significant difference between the multidimensional scale of perceived social support family subscale (p < 0.05). There was a positive, weakly significant relationship between the nurses' mental well-being and their perception of social support (r = 0.381; p < 0.05).

PRACTICE IMPLICATIONS

In conclusion, protective measures must be increased and social networks must be promoted to increase the mental well-being and social support levels of nurses.

Experiences and perceptions of Turkish intensive care nurses providing care to Covid-19 patients: A qualitative study

AIM

To describe the experiences of intensive care nurses who provided care to Covid-19 patients and their perceptions towards the disease and their work conditions during the pandemic.

INTRODUCTION

Identification of experiences and perceptions of intensive care nurses towards disease, care and their workplace conditions when providing care to Covid-19 patients will inform decision-makers about improvements that can be implemented.

BACKGROUND

The Covid-19 pandemic has led to increased strain and workplace-related health risks to intensive care nurses, but it has also provided a unique experience and opportunities for learning and development.

METHODS

A descriptive qualitative study was conducted with 10 intensive care unit nurses working in seven hospitals in Istanbul, Turkey. Snowball sampling method was used, and the data were collected by semistructured online interviews. A thematic analysis was performed. The Consolidated Criteria for Reporting Qualitative Research were followed.

FINDINGS

Five major themes were identified: 'death and fear of death', 'impact on family and social lives', 'nursing care of Covid-19 patients', 'changing perceptions of their own profession: empowerment and dissatisfaction', and 'experiences and perceptions of personal protective equipment and other control measures'.

DISCUSSION

Intensive care nurses experience an increased risk of infection and psychological burden, and they lack a sense of professional satisfaction. Improvements to working conditions are needed to support nurses caring for patients during the pandemic.

CONCLUSION

The pandemic increased the workload and responsibilities of intensive care nurses and led to increases in their work-related health risks and challenges with care. However, it also increased nurses' awareness about the importance of their professional roles.

IMPLICATIONS FOR NURSING PRACTICE AND POLICIES

There is a need to improve working conditions and develop nursing standards for the care of Covid-19 patients in intensive care units.

A multidisciplinary, cross-sectional survey of burnout and wellbeing in emergency department staff during COVID-19

Background

Emergency department (ED) staff are at-risk of burnout, poor wellbeing and increased stress that can impact patient satisfaction, staff morale and retention. The aim of this survey was to determine level of burnout, stress and satisfaction with current employment role in ED during COVID-19.

Methods

A multisite cross-sectional survey captured ED employment data, wellbeing, burnout (Maslach Burnout Inventory), stress (Health Professions Stress Inventory), work environment (WES-10) and Caring for COVID-19 Patients questions.

Results

The response rate of 44.2% (n = 177) represented all healthcare disciplines. Only 58.8% (n = 104) of participants were happy in their role, satisfaction was low, burnout was high (M 71.0, SD 17.1) as was level of stress (M 90.6, SD 16.5). Nurses and allied health staff were more stressed than their medical or support staff colleagues. Participants perceived discriminatory behaviours from friends and family in caring for suspected or infected COVID-19 patients.

Conclusions

ED staff are a vulnerable group. Programmes to promote wellbeing, personal resilience, and self-care together with personal and professional growth are needed to build individual capability and a culture of organisational resilience, particularly in the context of the COVID pandemic.

Development of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) Scale for Assessing Work-related Stress and Anxiety in Healthcare Workers in Response to Viral Epidemics

BACKGROUND

The coronavirus disease 2019, or COVID-19, has had a major psychological impact on healthcare workers. However, very few scales are available to specifically assess work-related stress and anxiety in healthcare workers responding to a viral epidemic. This study developed a new assessment tool, the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) and aimed to validate it among healthcare workers directly affected by COVID-19 in Korea.

METHODS

A total of 1,019 healthcare workers responded through anonymous questionnaires during April 20-30, 2020. Exploratory factor analysis (EFA) was conducted to explore the construct validity, and the reliability was assessed using internal consistency measures of Cronbach's alpha coefficients. Receiver operating characteristic analysis was conducted to define the most appropriate cut-off point of SAVE-9 using the Generalized Anxiety Disorder-7 scale (GAD-7; ≥ 5). Second, Spearman's rank correlation coefficient was used to establish convergent validity for the SAVE-9 questionnaire with GAD-7 and the Patient Health Questionnaire-9.

RESULTS

The nine-item scale had satisfactory internal consistency (Cronbach's α = 0.795). It adopted a two-factor structure: 1) anxiety regarding viral epidemics and 2) work-related stress associated with viral epidemics. A cut-off score of 22 for the SAVE-9 ascertained levels of stress and anxiety in response to a viral epidemic in healthcare workers that warranted clinical attention. Correlations between the SAVE-9 and the other scales were statistically significant (P < 0.05).

CONCLUSION

The results suggest that the SAVE-9 is a useful, reliable, and valid tool to evaluate stress and anxiety responses in healthcare workers during viral epidemics.

Impact of the COVID-19 pandemic on mental health of nursing students in Japan: protocol for a cross-sectional study

INTRODUCTION

The COVID-19 pandemic is spreading globally with a high risk of mortality. It is also significantly affecting mental health. For nursing students, the impact of COVID-19 on mental health is predicted to be significant; however, sufficient data have not been obtained. Therefore, this study will aim to assess the mental health of nursing students and evaluate the related factors.

METHODS AND ANALYSIS

This proposed study is a cross-sectional survey using a self-report questionnaire. An online questionnaire will be distributed among all nursing students of eight universities in Japan. The survey questionnaire will consist of questions related to demography, life satisfaction, fear of COVID-19, mental health and physical activities. The target sample size is 1300 nursing students. We will calculate descriptive statistics for each measurement item and perform univariate and logistic regression analyses to evaluate the potential risk factors for anxiety, depression and insomnia symptoms in nursing students. The strength of association will be assessed using the OR and its 95% CIs. Statistical significance will be set at a p<0.05.

ETHICS AND DISSEMINATION

The protocol was approved by the Institutional Review Board (IRB) of the University of Hyogo on 22 March 2021 (ID: 2020F29). In addition, all of the participating facilities required ethical approval from their local IRBs. The findings will be disseminated through peer-reviewed publications and conference presentations. We believe that the proposed large-scale investigation of the mental health of nursing students during the COVID-19 pandemic and the relationship between mental health and fear of COVID-19 are novel and will be a strength of this study.

The lived experience of healthcare professionals working frontline during the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic: A qualitative systematic review

Objective

To synthesize qualitative literature exploring the lived experience of healthcare workers (HCWs) who cared for patients during the following infectious disease outbreaks (IDOs): the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic. We aim to reveal the collective experience of HCWs during these four IDOs and to create a reference for comparison of current and future IDOs.

Methods

Three electronic databases were searched, yielding 823 results after duplicates were removed. Forty qualitative and mixed-methods studies met the criteria for full file review. Fourteen studies met the inclusion and exclusion criteria. The data from the Results or Findings sections were manually coded and themes were conceptualized using thematic analysis.

Results

Of the 14 studies, 28.6% focused on SARS, 21.4% on H1N1, 21.4% on MERS, and 28.6% on EVD. Studies occurred in six different countries and included physicians, nurses, paramedics, and emergency medical technicians as participants. Five themes were conceptualized: Uncertainty, Adapting to Change, Commitment, Sacrifice, and Resilience.

Conclusion

This review identified the collective experience of HCWs caring for patients during four 21st century IDOs. This qualitative systematic review offers a reference to compare similarities and differences of other IDOs, including the COVID-19 pandemic.

Challenges faced by nurses while caring for COVID-19 patients: A qualitative study

INTRODUCTION

In the COVID-19 crisis, nurses are directly involved in patient care, so they face many challenges. This study was performed to determine the challenges faced by nurses while caring for COVID-19 patients in Iran in 2020.

MATERIALS AND METHODS

This qualitative, content analysis was conducted in Iran on ten nurses directly involved in the fight against the corona epidemic, selected through a purposeful sampling strategy. Data were collected through deep interviews consisting of open questions. All the interviews were recorded, and immediately after each interview, it was transcribed into written form. The data were analyzed using MAXQDA software.

RESULTS

All the challenges could be classified into three main categories and 17 subcategories. The main categories were miss-management in controlling corona conditions, mental and physical complications and challenges in corona work conditions, and lack of sufficient workforce.

CONCLUSION

Hospital managers and authorities play a significant role in meeting the financial needs and requirements of nurses, and can minimize the job discrimination prevalent at medical centers through providing financial and nonfinancial incentives for nurses. Moreover, the findings of the present study can help hospital managers and authorities to gain a better understanding of the experiences of nurses, and to take the necessary measures to obviate the challenges faced by nurses in public health emergencies.