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Bolsewicz KT, White J, Murray P, Vidler M, Durrheim DN. "COVID-19 - A Perfect Storm": A Qualitative Exploration of Residential Care Facility Managers Perspectives on the Psychosocial Impacts of COVID-19. J Appl Gerontol 2024; 43:1503-1513. [PMID: 38587987 DOI: 10.1177/07334648241238920] [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] [Indexed: 04/10/2024] Open
Abstract
Growing evidence highlights the negative impact of managing the COVID-19 pandemic on the wellbeing of the healthcare workforce, including in the aged care sector. We undertook a qualitative study during the pandemic's third year to explore the psychosocial impacts on nine managers of residential care facilities (RCFs) across metropolitan and rural New South Wales, the largest state in Australia. Four themes were identified: (1) Increased pressure on maintaining aged care services, (2) Increased responsibility on RCF managers, (3) Psychosocial impacts due to accumulating pressures, and (4) Experience of beneficial supports. COVID-19 compounded pre-pandemic sector challenges and added new stressors. While resilient and resourceful, RCF managers experienced workplace stress and burnout, which may affect quality of resident care and impact on staff retention. There is a need for more investment to effectively support staff, and research to identify optimal psychosocial and management supports.
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Affiliation(s)
- Katarzyna T Bolsewicz
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Jennifer White
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Peter Murray
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Megan Vidler
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - David N Durrheim
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
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Smith J, Tiwana MH, Murage A, Samji H, Morgan R, Delgado-Ron JA. Moral distress related to paid and unpaid care among healthcare workers during the COVID-19 pandemic. PLoS One 2024; 19:e0310132. [PMID: 39255257 PMCID: PMC11386464 DOI: 10.1371/journal.pone.0310132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/23/2024] [Indexed: 09/12/2024] Open
Abstract
While there is growing literature on experiences of healthcare workers and those providing unpaid care during COVID-19, little research considers the relationships between paid and unpaid care burdens and contributions. We administered a moral distress survey to healthcare workers in Canada, in 2022, collecting data on both paid and unpaid care. There were no significant differences in the proportion of participants providing unpaid care by gender, with both genders equally affected by certain responsibilities such as reduced contact with family/loved ones. However, men were significantly more distressed about specific unpaid care responsibilities. Unpaid care was not significantly associated with differences in intention to leave work. At work, women were significantly more concerned about patients unable to see family, while men were distressed by others mistreating COVID patients. This study enhances understanding of paid and unpaid care relationships, particularly during crises, and proposes an innovative method for assessing unpaid care burdens.
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Affiliation(s)
- Julia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | - Alice Murage
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Rosemary Morgan
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
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Musolino C, Baum F, Flavel J, Freeman T, McKee M, Chi C, Giugliani C, Falcão MZ, De Ceukelaire W, Howden-Chapman P, Huong NT, Serag H, Kim S, Dardet CA, Gesesew HA, London L, Popay J, Paremoer L, Tangcharoensathien V, Sundararaman T, Nandi S, Villar E. Caring During COVID-19: A Study of Intersectionality and Inequities in the Care Economy in 16 Countries. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024:27551938241269198. [PMID: 39129232 DOI: 10.1177/27551938241269198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Carers were disproportionately harmed in the COVID-19 pandemic. Despite facing an increased risk of contracting the virus, they continued in frontline roles in care services and acted as "shock absorbers" for their families and communities. In this article, we apply an intersectional lens to examine care work and the structural factors disadvantaging carers during COVID-19 through a comparative case study analysis of 16 low-, middle-, and high-income countries. Data on each country was collected through a qualitative framework during 2021-2022. We found that while carers everywhere were predominantly women with low incomes and precarious employment, other factors were at play in shaping their experiences. Moreover, government responses to mitigate the direct impact of the pandemic have created local and global disparities affecting those working in this sector. Our findings reveal how oppressive social structures such as race, class, caste, and migration status converged in contextually specific ways to shape the gendered nature of care within and between different countries. We call for a better understanding of the multiple axes of inequalities experienced by carers to inform crisis mitigations, coupled with long-term strategies to address social inequities in the care economy and to promote gender equality.
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Affiliation(s)
- Connie Musolino
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Fran Baum
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Joanne Flavel
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Toby Freeman
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, WC1H 9SH, UK
| | - Chunhuei Chi
- Center for Global Health, Oregon State University, Corvallis, OR 7331, USA
| | - Camila Giugliani
- Social Medicine Department, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2400 CEP 90035-003, Porto Alegre, Brazil
| | - Matheus Zuliane Falcão
- Health Law Research Centre, University of São Paulo, Av. Dr. Arnaldo, 715 - 211 - Cerqueira César, São Paulo, SP 01246- 904, Brazil
| | | | | | - Nguyen Thanh Huong
- Faculty of Social Science and Behavior, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Hani Serag
- Department of Internal Medicine, University of Texas Medical Branch (UTMB), 301 University Blvd., Galveston, Texas, 77555, USA
| | - Sun Kim
- People's Health Movement South Korea, Seoul, South Korea
| | - Carlos Alvarez Dardet
- CIBERESP, Center for Research in Epidemiology and Public Health, Public Health Research Group University of Alicante, Madrid, Spain
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Leslie London
- School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Jennie Popay
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - Lauren Paremoer
- Political Studies, University of Cape Town, Cape Town, South Africa
| | | | | | - Sulakshana Nandi
- Public Health Researcher, Ebertsgade 6, 2300 Copenhagen, Denmark
| | - Eugenio Villar
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, San Martín de Porres 15102, Peru
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Akoo C, Price S, McMillan K, Ingraham K, Ayoub A, Rolle Sands S, Shankland M, Bourgeault I. Nurses Navigating Mental Health During Uncharted Times: Self, Others, Systems (S.O.S)! Can J Nurs Res 2024:8445621241266291. [PMID: 39054953 DOI: 10.1177/08445621241266291] [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: 07/27/2024] Open
Abstract
STUDY BACKGROUND The nursing profession is facing a multiplicity of stressors that have both predated and been exacerbated by the Covid-19 pandemic. The emotional and physical demands entailed in nursing predispose nurses to suboptimal mental health and burnout. PURPOSE This paper draws upon the narrative interviews of 53 Canadian nurses as part of a larger pan-Canadian, cross disciplinary study that examined the gendered experiences of mental health, leaves of absence, and return to work of 7 professions. METHODS Thorne's interpretive descriptive guided Iterative and thematic analysis which identified three predominant themes within the nursing dataset, this paper focuses on the substantive theme of 'Navigating it Alone,'. RESULTS Nurses expressed a profound sense of isolation at 3 particular levels: at home, at work, and in systems - while simultaneously balancing uniquely gendered familial responsibilities and workplace demands. CONCLUSIONS These results illuminate instrumental pathways for stakeholders to attenuate the personal and professional pressures that continue to be disproportionately carried by nurses as they navigate these particularly challenging times.
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Affiliation(s)
- Chaman Akoo
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Sheri Price
- School of Nursing, Dalhousie University, Nova Scotia, Canada
| | | | | | - Abby Ayoub
- School of Nursing, University of Ottawa, Ottawa, Canada
| | | | - Mylène Shankland
- Institute of Feminist and Gender Studies, University of Ottawa, Ottawa, Canada
| | - Ivy Bourgeault
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, Canada
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Gittings L, Ncube N, Ronan A, Chimatira I, Hatane L. Empowering and supporting frontline providers in the paediatric-adolescent HIV response: results from participatory priority-setting and group discussions in twenty-four sites in twelve high HIV-burden African countries. AIDS Care 2024; 36:60-75. [PMID: 38315800 DOI: 10.1080/09540121.2024.2308023] [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: 08/18/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024]
Abstract
Children and adolescents living with HIV in Africa experience poor outcomes across the HIV cascade of care. Paediatric and adolescent-friendly services are crucial to their well-being, and recent years have seen a call for urgent service improvements. While frontline health workers are responsible for these services, less attention has been given to their contextual realities, and what constitutes an enabling service delivery environment. We engaged participatory priority-setting and group discussions across twenty-four sites in twelve high HIV-burden African countries in November 2022 with 801 frontline paediatric-adolescent providers. Data were analysed using thematic analysis and priority mapping. We constructed a socio-ecological model for supportive and empowering service delivery environments for frontline paediatric-adolescent HIV services. Individual-level themes related to well-being, self-care and mental health. Interpersonal themes included supportive supervision/mentorship, teamwork and acknowledgement. At the organisational level, resources, physical infrastructure and confidential spaces were included. The community level included feeling appreciated and positive stakeholder relationships. The structural level included funding, discriminatory SRHR policies and guidelines. Results provide insight into priorities, challenges and needs of frontline providers in the paediatric-adolescent HIV response. Improving the well-being of HIV-affected children and adolescents requires greater investment and attention to creating more caring, supportive environments for their frontline providers.
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Affiliation(s)
- Lesley Gittings
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Nokuzola Ncube
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
| | - Agnes Ronan
- Paediatric-Adolescent Treatment Africa (PATA), Cape Town, South Africa
| | | | - Luann Hatane
- Paediatric-Adolescent Treatment Africa (PATA), Cape Town, South Africa
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6
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Roncero C, Díaz-Trejo S, Álvarez-Lamas E, García-Ullán LL, Bersabé-Pérez M, Benito-Sánchez JA, González-Sánchez A. Follow-up of telemedicine mental health interventions amid COVID-19 pandemic. Sci Rep 2024; 14:14921. [PMID: 38942891 PMCID: PMC11213890 DOI: 10.1038/s41598-024-65382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/19/2024] [Indexed: 06/30/2024] Open
Abstract
The initiation of the program Mental Health Support Program for Coronavirus Infection addressed the increased demand for mental health services in the province of Salamanca, resulting from the COVID-19 pandemic. The psychiatry service provided care for COVID-19 patients, their families, and healthcare workers who treated them, as these groups were identified as being at risk. This study aims to describe the assistance provided, including personnel and resources utilized, types of interventions carried out, and to assess the demand for mental health care and predominant symptoms and emotions experienced by patients. Billboards and the complex's intranet publicized the program. Specific clinical approach using telemedicine were provide from March 2020 to December 2021 to COVID-19 patients, their relatives, and healthcare workers. 216 patients were included with a mean age of 53.2 years, with women comprising 77.3% of this group. All the groups received treatment in similar proportions. Over a period of 730 h, a total of 1376 interventions were performed, with an average duration of 31.8 min per intervention. The program could treat 79.6% of these patients without requiring referrals to other services. When the program concluded, only 21 participants (9.7%) were discharged to the local mental health network to continue their mental health treatment. The program effectively reduced the burden on regular mental health services due to its ability to treat most patients without requiring referrals. The program was able to attend to most mental health requests with minimal involvement of the regular mental health service.
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Affiliation(s)
- Carlos Roncero
- Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain.
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Virgen de la Vega, 10ª Planta, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.
| | - Sara Díaz-Trejo
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007, Salamanca, Spain
| | - Esther Álvarez-Lamas
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Virgen de la Vega, 10ª Planta, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007, Salamanca, Spain
| | - LLanyra García-Ullán
- Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Virgen de la Vega, 10ª Planta, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007, Salamanca, Spain
| | - Miriam Bersabé-Pérez
- Psiquiatric Service, Hospital Infantil Universitario Niño Jesús, Av. de Menéndez Pelayo, 65, Retiro, 28009, Madrid, Spain
| | - José Antonio Benito-Sánchez
- Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Virgen de la Vega, 10ª Planta, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007, Salamanca, Spain
| | - Armando González-Sánchez
- Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Virgen de la Vega, 10ª Planta, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
- Facultad de Psicología, Universidad Pontificia de Salamanca (UPSA), C/ Compañía, 5, 37002, Salamanca, Spain
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Zee MS, Onwuteaka-Philipsen BD, Witkamp E, Heessels B, Goossensen A, Korfage IJ, Becqué YN, Nierop-van Baalen C, van der Heide A, Pasman HR. Distress among healthcare providers who provided end-of-life care during the COVID-19 pandemic: a longitudinal survey study (the CO-LIVE study). BMC Palliat Care 2024; 23:134. [PMID: 38802776 PMCID: PMC11131237 DOI: 10.1186/s12904-024-01446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/28/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic had a significant impact on care at the end-of-life due to restrictions and other circumstances such as high workload and uncertainty about the disease. The objective of this study is to describe the degree of various signs experienced by healthcare providers throughout the first 18 months of the pandemic and to assess what provider's characteristics and care circumstances related to COVID-19 are associated with distress. METHODS A longitudinal survey study among healthcare providers from different healthcare settings who provided end-of-life care during the pandemic's first 18 months. Data of four time periods were analyzed using descriptive statistics, logistic regression analysis and Generalized Estimating Equation. RESULTS Of the respondents (n=302) the majority had a nursing background (71.8%) and most worked in a hospital (30.3%). Although reported distress was highest in the first period, during the first wave of COVID-19 pandemic, healthcare providers reported signs of distress in all four time periods. Being more stressed than usual and being regularly exhausted were the most common signs of distress. Healthcare providers working in nursing homes and hospitals were more likely to experience signs of distress, compared to healthcare providers working in hospice facilities, during the whole period of 1.5 years. When HCPs were restricted in providing post-death care, they were more likely to feel more stressed than usual and find their work more often emotionally demanding. CONCLUSION A substantial amount of healthcare providers reported signs of distress during the first 1.5 years of the COVID-19 pandemic. A cause of distress appears to be that healthcare providers cannot provide the care they desire due the pandemic. Even though the pandemic is over, this remains an important and relevant finding, as high workload can sometimes force healthcare providers to make choices about how they provide care. Given that this can cause prolonged stress and this can lead to burnout (and HCPs leaving their current positions), it is now especially important to continue observing the long term developments of the well-being of our healthcare providers in palliative care and provide timely and adequate support where needed.
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Affiliation(s)
- Masha S Zee
- Department of Public and Occupational Health, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Erica Witkamp
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Benthe Heessels
- Department of Public and Occupational Health, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | | | - Ida J Korfage
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Yvonne N Becqué
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Corine Nierop-van Baalen
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Agnes van der Heide
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - H Roeline Pasman
- Department of Public and Occupational Health, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Gamonal B, Quispe-Lizano R, Javier-Murillo N, Lapeyre-Rivera A, Perea-Flórez F, Velásquez-Rimachi V, Alva-Diaz C, Velazco-Gonzales G, Ahmed O, Chung S. Comparison of the Stress and Anxiety to Viral Epidemic-9 and SAVE-6 scales among healthcare workers in Peru. Front Psychiatry 2024; 15:1352896. [PMID: 38751417 PMCID: PMC11094251 DOI: 10.3389/fpsyt.2024.1352896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/29/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Peru is a country that has a high incidence of viral outbreaks and epidemics, which is why it is necessary to validate a scale that measures anxiety and stress in professionals who are on the front lines of these events. Therefore, our objective was to validate the Peruvian-Spanish version of the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) scale and to concurrently compare its validity and internal consistency with the SAVE-6 scale among healthcare workers (HCWs). Materials and methods We conducted a cross-sectional study based on data collected from a self-reported survey in paper-and-pencil format between April and July 2023. A total of 203 HCWs participated in the research. We developed a confirmatory factor analysis (CFA) and item response theory (IRT). We calculated Cronbach's α coefficient and McDonald's ω to assess the internal consistency of the scales. Results The results show that SAVE-9 (a two-factor model) and SAVE-6 (a one-factor model) provided an excellent fit in the confirmatory factor analysis. Both scales demonstrated strong internal consistency (Cronbach's α 0.85 and 0.86, respectively). Significant correlations were found between the SAVE-9 and SAVE-6 scales and Generalized Anxiety Disorder-7 items scale (r = 0.44 and r = 0.38, respectively, p < 0.001) as well as the Patient Health Questionnaire-9 items (r = 0.39 and r = 0.35, respectively, p < 0.001). The optimal cutoff points for SAVE-9 and SAVE-6 were identified for assessing anxiety, aligned with a GAD-7 score ≥5 points. Conclusion The Peruvian-Spanish SAVE-9 and SAVE-6 scales are reliable and valid rating scales to assess the anxiety response of HCWs in response to viral epidemics. Though COVID-19 is diminished, these scales will be useful for other viral epidemics in the future.
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Affiliation(s)
- Bryan Gamonal
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
| | | | - Nair Javier-Murillo
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
| | - André Lapeyre-Rivera
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
- Sociedad Científica de San Fernando, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Francisco Perea-Flórez
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
| | - Víctor Velásquez-Rimachi
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública (NEURONECS), Universidad Científica del Sur, Lima, Peru
| | - Carlos Alva-Diaz
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública (NEURONECS), Universidad Científica del Sur, Lima, Peru
- Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru
| | | | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kuhlmann E, Falkenbach M, Brînzac MG, Correia T, Panagioti M, Ungureanu MI. The mental health needs of healthcare workers: When evidence does not guide policy. A comparative assessment of selected European countries. Int J Health Plann Manage 2024; 39:614-636. [PMID: 38193752 DOI: 10.1002/hpm.3752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The healthcare workforce (HCWF) globally is facing high stress levels and deteriorating mental health due to workplace, labour market and policy deficiencies that further exacerbate the existing crisis. However, comprehensive and effective action is missing. AIMS We adopt a health system and governance perspective to address the mental health needs of healthcare workers (HCWs), considering the nature of interventions and the levels and actors involved in governance. The aim is to move the debate forward by identifying governance gaps hampering the implementation of health workforce policies and exploring strategies to effectively increase mental health support. MATERIAL AND METHODS A qualitative comparative methodology is applied based on a case study design utilising a multi-level intersectoral governance matrix. We conducted a rapid assessment of HCWF developments in the European context (Germany, Portugal, Romania, Switzerland and the United Kingdom), drawing on secondary sources and country experts. RESULTS AND DISCUSSION Awareness of mental health threats among HCWs increased, but policy discourse is driven by service delivery and labour market demands. The attention to HCWs' needs is stronger on the international level and weakest at national/regional levels. Although organisations and professions demonstrate varying degrees of activity, their efforts are scattered and lack sustainability. Similar challenges were identified across healthcare systems, including limited action, disconnected actors, missing coordination, and a lack of attention to governance gaps and system weaknesses. CONCLUSION Adopting a health system approach is important but not sufficient. Successful mental health policy implementation needs multi-level governance and coherent coordination mechanisms.
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Affiliation(s)
- Ellen Kuhlmann
- Institute for Economics, Labour and Culture, Goethe-University Frankfurt, Frankfurt, Germany
- WHO Collaborating Center for Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - Michelle Falkenbach
- European Observatory on Health Systems and Policies, Brussels, Belgium
- Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Monica-Georgiana Brînzac
- Faculty of Political, Administrative and Communication Sciences, Department of Public Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Faculty of Political, Administrative and Communication Sciences, Center for Health Workforce Research and Policy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Tiago Correia
- WHO Collaborating Center for Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
- Global Health and Tropical Medicine, Associate Laboratory in Translation and Innovation Towards Global Health, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Maria Panagioti
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Marius-Ionut Ungureanu
- WHO Collaborating Center for Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
- Faculty of Political, Administrative and Communication Sciences, Department of Public Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Faculty of Political, Administrative and Communication Sciences, Center for Health Workforce Research and Policy, Babeș-Bolyai University, Cluj-Napoca, Romania
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Romulo SG, Urbano RC. Women and Care: Reflections on the Lived Experience of COVID-19 Sufferers. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:243-252. [PMID: 36912132 PMCID: PMC10014448 DOI: 10.1177/2752535x231163029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Women play a crucial role in the care and response to the COVID-19 pandemic, whether in paid or unpaid work. This article looks into the lived experience of some of these women infected by COVID-19 while doing their job as care providers. We selected nine women from Cebu City, Philippines. We presented their lived experience through van Manen's phenomenology of practice. Themes of the lived experience reveal pain and separation, suffering and caring, stigma of discrimination, caring response, and supportive relationship in the midst of a health crisis. Our reflections reveal that even in serious vulnerability and sustained domestic burden, women remained steadfast in their caring character. Their caring attitude has turned the quarantine facility into a liveable space where empathy, reciprocity, and relationality dwell and thus help everyone survive the COVID-19 ordeal.
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Affiliation(s)
| | - Ryan C. Urbano
- College of Arts and Sciences, Cebu Technological University, Cebu City, Philippines
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Spencer S, Lukewich J, Marshall EG, Mathews M, Asghari S, Brown JB, Freeman TR, Gill P, Idrees S, McCracken RK, Ranade S, Slade S, Terry AL, Wickett J, Wong E, Buote R, Meredith L, Moritz L, Ryan D, Hedden L. "Family doctors are also people": a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic. HUMAN RESOURCES FOR HEALTH 2024; 22:18. [PMID: 38439084 PMCID: PMC10913223 DOI: 10.1186/s12960-024-00901-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Family physicians (FPs) fill an essential role in public health emergencies yet have frequently been neglected in pandemic response plans. This exclusion harms FPs in their clinical roles and has unintended consequences in the management of concurrent personal responsibilities, many of which were amplified by the pandemic. The objective of our study was to explore the experiences of FPs during the first year of the COVID-19 pandemic to better understand how they managed their competing professional and personal priorities. METHODS We conducted semi-structured interviews with FPs from four Canadian regions between October 2020 and June 2021. Employing a maximum variation sampling approach, we recruited participants until we achieved saturation. Interviews explored FPs' personal and professional roles and responsibilities during the pandemic, the facilitators and barriers that they encountered, and any gender-related experiences. Transcribed interviews were thematically analysed. RESULTS We interviewed 68 FPs during the pandemic and identified four overarching themes in participants' discussion of their personal experiences: personal caregiving responsibilities, COVID-19 risk navigation to protect family members, personal health concerns, and available and desired personal supports for FPs to manage their competing responsibilities. While FPs expressed a variety of ways in which their personal experiences made their professional responsibilities more complicated, rarely did that affect the extent to which they participated in the pandemic response. CONCLUSIONS For FPs to contribute fully to a pandemic response, they must be factored into pandemic plans. Failure to appreciate their unique role and circumstances often leaves FPs feeling unsupported in both their professional and personal lives. Comprehensive planning in anticipation of future pandemics must consider FPs' varied responsibilities, health concerns, and necessary precautions. Having adequate personal and practice supports in place will facilitate the essential role of FPs in responding to a pandemic crisis while continuing to support their patients' primary care needs.
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Affiliation(s)
- Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Emily Gard Marshall
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Shabnam Asghari
- Family Medicine, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Judith B Brown
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Thomas R Freeman
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Paul Gill
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Samina Idrees
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Rita K McCracken
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Sudit Ranade
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Steve Slade
- The College of Family Physicians of Canada, 2630 Skymark Avenue, Mississauga, ON, L4W 5A4, Canada
| | - Amanda L Terry
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Jamie Wickett
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Richard Buote
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Leslie Meredith
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Lauren Moritz
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Dana Ryan
- Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Langat EC, Mazoya BY, Oginga P, Okwaro F, Matheka N, Kibara I, Otieno R, Mantel M, Lorway R, du Plessis E, Temmerman M, Avery L. Women in Health and their Economic, Equity and Livelihood statuses during Emergency Preparedness and Response (WHEELER) protocol: a mixed methods study in Kenya. BMJ Open 2024; 14:e077778. [PMID: 38418233 PMCID: PMC10910466 DOI: 10.1136/bmjopen-2023-077778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/13/2024] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Kenya reported its first COVID-19 case on 13 March 2020. Pandemic-driven health system changes followed and unforeseen societal, economic and health effects reported. This protocol aims to describe the methods used to identify the gender equality and health equity gaps and possible disproportional health and socioeconomic impacts experienced by paid and unpaid (community health volunteer) female healthcare providers in Kilifi and Mombasa Counties, Kenya during the COVID-19 pandemic. METHODS AND ANALYSIS Participatory mixed methods framed by gender analysis and human-centred design will be used. Research implementation will follow four of the five phases of the human-centred design approach. Community research advisory groups and local advisory boards will be established to ensure integration and the sustainability of participatory research design. ETHICS AND DISSEMINATION Ethical approval was obtained from the Institutional Scientific and Ethics Review Committee at the Aga Khan University and the University of Manitoba.This study will generate evidence on root cultural, structural, socioeconomic and political factors that perpetuate gender inequities and female disadvantage in the paid and unpaid health sectors. It will also identify evidence-based policy options for future safeguarding of the unpaid and paid female health workforce during emergency preparedness, response and recovery periods.
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Affiliation(s)
- Evaline Chepchichir Langat
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
- Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | | | - Pauline Oginga
- Department of Health, County Government of Mombasa, Mombasa, Kenya
| | - Ferdinand Okwaro
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
| | - Norah Matheka
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
| | - Irene Kibara
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
| | - Rhoda Otieno
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
| | - Michaela Mantel
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
| | - Robert Lorway
- Institute for Centre for Global Public Health, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Elsabe du Plessis
- Institute for Centre for Global Public Health, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, The Aga Khan University-Kenya, Nairobi, Kenya
| | - Lisa Avery
- Institute for Centre for Global Public Health, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
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Li M, Raven J, Liu X. Feminization of the health workforce in China: exploring gendered composition from 2002 to 2020. HUMAN RESOURCES FOR HEALTH 2024; 22:15. [PMID: 38373975 PMCID: PMC10877893 DOI: 10.1186/s12960-024-00898-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Feminization of health workforce has been globally documented, but it has not been investigated in China. This study aims to analyze changes in the gendered composition of health workforce and explore the trend in different types of health workforce, health organizations and majors within China's health system. METHODS The data were collected from China Health Statistical Yearbook from 2002 to 2020. We focused on health professionals including doctors, nurses, and pharmacists in health organizations. Trend analysis was employed to examine the change in the ratio of female health workforce over 18 years. The estimated average annual percent change (AAPC) was estimated, and the reciprocals of variances for the female ratios were used as weights. RESULTS In China, health professionals increased from 4.7 million in 2002 to 10.68 million in 2020. Health professionals per 1000 population increased from 3.41 in 2002 to 7.57 in 2020. The ratio of female health professionals significantly increased from 63.85% in 2002 to 72.4% in 2020 (AAPC = 1.04%, 95% CI 0.96-1.11%, P < 0.001). Female doctors and pharmacists increased 4.7 and 7.9 percentage points from 2002 to 2020. Female health workers at township health centers, village clinics, centers for disease control and prevention had higher annual increase rate (AAPC = 1.67%, 2.25% and 1.33%, respectively) than those at hospital (0.70%) and community health center (0.5%). Female doctors in traditional Chinese medicine, dentistry and public health had higher annual increase rate (AAPC = 1.82%, 1.53% and 1.91%, respectively) than female clinical doctor (0.64%). CONCLUSIONS More women are participating in the healthcare sector in China. However, socially lower-ranked positions have been feminizing faster, which could be due to the inherent and structural gender norms restricting women's career. More collective and comprehensive system-level actions will be needed to foster a gender-equitable environment for health workforce at all levels.
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Affiliation(s)
- Mingyue Li
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, People's Republic of China
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
- Division of Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - Joanna Raven
- Department of Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Xiaoyun Liu
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China.
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Fronteira I, Mathews V, Dos Santos RLB, Matsumoto K, Amde W, Pereira A, de Oliveira APC, Craveiro I, Chança R, Boniol M, Ferrinho P, Poz MRD. Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations. HUMAN RESOURCES FOR HEALTH 2024; 22:10. [PMID: 38273317 PMCID: PMC10809470 DOI: 10.1186/s12960-024-00892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). METHODS We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. RESULTS The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. DISCUSSION PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Verona Mathews
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Ranailla Lima Bandeira Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Osvaldo Cruz, Rua Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, Brazil
| | - Karen Matsumoto
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Woldekidan Amde
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Rahmani F, Ranjbar F, Asghari E, Gholizadeh L. The impact of psychological distress, socio-demographic and work-related factors on coping strategies used by nurses during the COVID-19 pandemic: A cross-sectional study. Nurs Open 2024; 11:e2053. [PMID: 38268272 PMCID: PMC10697121 DOI: 10.1002/nop2.2053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/28/2023] [Accepted: 11/14/2023] [Indexed: 01/26/2024] Open
Abstract
AIM This study aimed to determine factors associated with coping strategies used by nursing staff during the COVID-19 pandemic in Iran. DESIGN Cross-sectional study. METHODS A convenience sample of 365 nurses were selected from referral hospitals for COVID-19 patients in Tabriz, Iran between February 2022 and July 2022. An online self-administered questionnaire was distributed through social media platforms, including WhatsApp and Instagram. The survey package included a modified Brief COPE scale, socio-demographic and work-related questions, and a measure of psychological distress. Multiple regression analysis examined associated factors with coping strategies in SPSS. The study adhered to the STROBE guidelines for reporting. RESULTS The mean age of participants was 31.2 (7.3) years old. Of the 365 participants, 209 (58.9%) used maladaptive coping strategies, and 214 (57.6%) reported experiencing psychological distress. Psychological distress was the strongest predictor of maladaptive coping strategies (β = 4.473, p < 0.001). Female nurses (β = 3.259, p < 0.05), nurses who were under 35 years of age (β = 3.214, p < 0.05), nurses with fewer than ten years of experience (β = 2.416, p < 0.001), those who worked in COVID-19 ICUs (β = 4.321, p < 0.001), floor nurses (β = 2.344, p < 0.001), and those who worked two or more years in COVID-19 settings (β = 3.293, p < 0.001) had higher mean scores in maladaptive coping strategies. PATIENT OR PUBLIC CONTRIBUTION No patient or public contributions.
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Affiliation(s)
- Farnaz Rahmani
- Social Determinants of Health Research CenterTabriz University of Medical SciencesTabrizIran
| | - Fatemeh Ranjbar
- Research Center of Psychiatry and Behavioral SciencesTabriz University of Medical SciencesTabrizIran
| | - Elnaz Asghari
- Department of Medical‐Surgical Nursing, Nursing and Midwifery FacultyTabriz University of Medical SciencesTabrizIran
| | - Leila Gholizadeh
- Faculty of HealthUniversity of TechnologySydneyNew South WalesAustralia
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Phillips G, Kendino M, Brolan CE, Herron LM, Kὃrver S, Motofaga S, Cox M. Women on the frontline: exploring the gendered experience for Pacific healthcare workers during the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100961. [PMID: 38022711 PMCID: PMC10658397 DOI: 10.1016/j.lanwpc.2023.100961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/24/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
Background Women comprise 90% of patient-facing global healthcare workers (HCWs), yet remain underpaid, undervalued, and under-represented in leadership and decision-making positions, particularly across the Pacific region. The COVID-19 pandemic has exacerbated these health workplace inequalities. We sought to understand Pacific women HCWs experience from the COVID-19 frontline to contribute to policies aimed at addressing gendered gaps in regional health systems. Methods Our interpretative phenomenological study used critical feminist and social theory, and a gendered health systems analytical framework. Data were collected using online focus groups and in-depth interviews with 36 Pacific regional participants between March 2020 and July 2021. Gender-specific content and women's voices were privileged for inductive analysis by Pacific and Australian women researchers with COVID-19 frontline lived experience. Findings Pacific women HCWs have authority and responsibility resulting from their familial, biological, and cultural status, but are often subordinate to men. They were emancipatory leaders during COVID-19, and as HCWs demonstrated compassion, situational awareness, and concern for staff welfare. Pacific women HCWs also faced ethical challenges to prioritise family or work responsibilities, safely negotiate childbearing, and maintain economic security. Interpretation Despite enhanced gendered power differentials during COVID-19, Pacific women HCWs used their symbolic capital to positively influence health system performance. Gender-transformative policies are urgently required to address disproportionate clinical and community care burdens and to protect and support the Pacific female health workforce. Funding Epidemic Ethics/World Health Organization (WHO), Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.
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Affiliation(s)
- Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Kὃrver
- TB Elimination, and Implementation Science, Burnet Institute, Papua New Guinea and Australia
| | - Silina Motofaga
- Clinical Services Program, Public Health Division, Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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Smart S, Imms D, Brewer M. Virtual nourishment: Paediatric feeding disorder management with telepractice amidst COVID-19: An allied health perspective. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-11. [PMID: 37933463 DOI: 10.1080/17549507.2023.2264550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
PURPOSE The rapid adoption of telepractice services by health professionals was necessary to maintain service continuity for children with paediatric feeding disorders during the COVID-19 pandemic, during periods where in-person therapy was restricted. The aim of this study was to explore clinical perspectives and reflections on the use of telepractice for managing paediatric feeding disorders during the pandemic. METHOD A post-positivist qualitative approach using thematic analysis was adopted. This study seeks to understand participants' experiences and thoughts from allied health professionals from speech-language pathology, occupational therapy, and dietetics working with paediatric feeding in Western Australia. All participants delivered at least 10 telepractice sessions to children from birth to 12 years with a paediatric feeding disorder. Braun and Clarke's six-step thematic analysis process was used to analyse the data inductively. RESULT Eleven allied health professionals representing eight clinical settings in Western Australia, including speech-language pathology, occupational therapy, and dietetics, working with paediatric feeding were recruited. The results revealed four themes: families becoming the catalyst of change, clinician comfort over confidence, insights into authentic mealtimes, and the paradox of choice. CONCLUSION This study highlighted the need to build clinicians' confidence and competence, and the provision of service guidelines and training. Although many clinicians had positive experiences with telepractice, most returned to in-person delivery once COVID-19 restrictions were lifted, emphasising the importance of comfort in service delivery selection. We recognise that the findings of this study are constrained by the fact that it was conducted in a single geographical region and utilised a small qualitative sample. While telepractice was successful in managing paediatric feeding disorders, further development and implementation of telepractice guidelines are needed for telepractice to be a viable service delivery option for families and children with feeding disorders.
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Bahar-Özvarış Ş, Yıldırımkaya G, Ağduk M, Erdost T. Women healthcare professionals' experiences and needs regarding the COVID-19 pandemic from a gender perspective. Int J Health Plann Manage 2023; 38:1833-1850. [PMID: 37684709 DOI: 10.1002/hpm.3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 07/11/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Accounting for 70% of healthcare workers worldwide, and 56% in Turkey, women continue to be the frontline fighters in the battle against the COVID-19 pandemic. Their needs may be overlooked as a result of their growing responsibilities both in their professional and private lives. This descriptive study aimed at identifying the gendered needs and experiences of women healthcare workers in Turkey throughout the pandemic. METHOD This study consists of 1082 healthcare professionals' responses of various positions across several provinces and facilities, collected through a web-based survey of 50 questions. RESULTS Almost all participants (94%) expressed feeling anxious over the pandemic regardless of their working units. Four out of ten (38%) respondents noted working for 41 h or more on average weekly, and most of the participants who worked for long hours were assigned in COVID-19 units. Non-clinical personnel reported less difficulty in work/life balance. 64% of the respondents reported not having gone through any training on COVID-19, and eight out of ten (81%) said they had information needs. Research findings suggest that 92% of participants' needs remained unmet. While 74% of the respondents pointed out not having an income that is worthwhile, 72% referred to the need for psychosocial support, 58% need for support in domestic work and 37% support for child care as their primary needs. CONCLUSION Results of the research highlighted the gendered needs of women healthcare professionals during the COVID-19 pandemic, and disseminate protective and preventive health policies and practices through a gender responsive approach.
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Affiliation(s)
- Şevkat Bahar-Özvarış
- Director of Hacettepe University Women's Research and Implementation Center (HUWRIC) and Hacettepe University Institute of Public Health, Ankara, Turkey
| | - Gökhan Yıldırımkaya
- Reproductive Health Program Coordinator/Population and Development Program Coordinator, United Nations Population Fund (UNFPA) Turkey Country Office, Ankara, Turkey
| | - Meltem Ağduk
- Gender & GBV Technical Specialist, United Nations Population Fund (UNFPA), Addis Ababa, Ethiopia
| | - Türküler Erdost
- Hacettepe University Women's Research and Implementation Center (HUWRIC), Ankara, Turkey
- Hacettepe Üniversitesi Kadın Sorunları Araştırma ve Uygulama Merkezi (HÜKSAM), Ankara, Turkey
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Cavalcante de Oliveira AP, Galante ML, Maia LS, Craveiro I, da Silva AP, Fronteira I, Chança R, Cometto G, Ferrinho P, Dal Poz M. Implementation of policy and management interventions to improve health and care workforce capacity to address the COVID-19 pandemic response: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:80. [PMID: 37817165 PMCID: PMC10563305 DOI: 10.1186/s12960-023-00856-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/14/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic highlighted pre-existing weaknesses in health and care systems and services and shortages of health and care workers (HCWs). As a result, policymakers needed to adopt measures to improve the health and care workforce (HCWF) capacity. This review aims to identify countries' range of policies and management interventions implemented to improve HCWs' capacity to address the COVID-19 pandemic response, synthesize their evidence on effectiveness, and identify gaps in the evidence. METHODS The literature was searched in PubMed, Embase, Scopus, LILACS-BVS, WHO's COVID-19 Research Database and the ILO, OECD and HSRM websites for literature and documents published between January 2020 and March 2022. Eligibility criteria were HCWs as participants and policy and management interventions aiming to improve HCWF capacity to address the COVID-19 pandemic response. Risk of bias was assessed with Joanna Briggs Institute (JBI) Critical Appraisal Tools (CAT) and certainty of the evidence in presented outcomes with GRADE. RESULTS The searches retrieved 3378 documents. A total of 69 were included, but only 8 presented outcomes of interventions implemented. Most of the selected documents described at least one intervention implemented by countries at the organizational environment level to increase the flexibility and capacity of the HCWF to respond to the pandemic, followed by interventions to attract and retain HCWs in safe and decent working environments. There was a lack of studies addressing social protection, human resources for health information systems, and regarding the role of community health workers and other community-based providers. Regarding the risk of bias, most of documents were rated as medium or high quality (JBI's CAT), while the evidence presented for the outcomes of interventions was classified as mostly low-certainty evidence (GRADE). CONCLUSIONS Countries have implemented various interventions, some innovative, in response to the pandemic, and others had their processes started earlier and accelerated by the pandemic. The evidence regarding the impact and efficacy of the strategies used by countries during the pandemic still requires further research.
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Affiliation(s)
- Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524-7º andar, Blocos D e E-Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil.
| | - Mariana Lopes Galante
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524-7º andar, Blocos D e E-Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Leila Senna Maia
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524-7º andar, Blocos D e E-Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Alessandra Pereira da Silva
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524-7º andar, Blocos D e E-Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ines Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Giorgio Cometto
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524-7º andar, Blocos D e E-Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Trommer M, Adams A, Bürkle C, Brunner S, Grandoch A, Geffroy A, Franklin C, Gassa A, Meißner AK, Mellinghoff S, Sharma SJ, Schrittenlocher S, Witte L, Marnitz S. Impact of the COVID-19 pandemic on training conditions and education in oncologic disciplines: a survey-based analysis. Strahlenther Onkol 2023; 199:806-819. [PMID: 37540263 PMCID: PMC10449661 DOI: 10.1007/s00066-023-02121-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE The COVID-19 pandemic has led to changes in global health care. Medical societies had to update guidelines and enhance new services such as video consultations. Cancer treatment had to be modified. The aim of this study is to ensure optimal care for cancer patients with the help of high-quality training even in times of crisis. We therefore conducted a nationwide survey of physicians in training in oncological disciplines during the pandemic to assess the impact on their education. METHODS The survey was sent to tumour centres, hospitals, specialist societies, and working and junior research groups and distributed via newsletters and homepages. Interim results and a call for participation were published as a poster (DEGRO) [26] and in the German Cancer Society (DKG) journal FORUM [42]. The survey contained 53 questions on conditions of education and training and on clinical and scientific work. Statistics were carried out with LimeSurvey and SPSS (IBM Corp., Armonk, NY, USA). RESULTS Between February and November 2022, 450 participants answered the survey, with radio-oncologists being the largest group (28%). Most colleagues (63%) had access to digital training methods. Virtual sessions were rated as a good alternative, especially as multidisciplinary meetings (54%) as well as in-house and external training programs (48%, 47%). The time spent by training supervisors on education was rated as less than before the pandemic by 57%. Half of all participants perceived communication (54%), motivation (44%) and atmosphere (50%) in the team as bad. The participants felt strongly burdened by extra work (55%) and by a changed team atmosphere (49%). One third felt a change in the quality of training during the pandemic and rated it as negative (35%). According to 37% of the participants, this had little influence on their own quality of work. Additional subgroup analyses revealed significant differences in gender, specialty and education level. CONCLUSION In order to improve oncology training in times of crisis, access to digital training options and meetings should be ensured. Participants wish for regular team meetings in person to enable good team spirit, compensation for overtime work and sufficient time for training supervisors for discussion and feedback.
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Affiliation(s)
- Maike Trommer
- Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Cologne, Germany.
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany.
- Center for Molecular Medicine Cologne, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany.
| | - Anne Adams
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät, Universität zu Köln, Cologne, Germany
| | - Carolin Bürkle
- Medizinische Klinik und Poliklinik III, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - Stefanie Brunner
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Center for Molecular Medicine Cologne, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Andrea Grandoch
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Klinik für Poliklinik für Mund-Kiefer- und Plastische Gesichtschirurgie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Alexandra Geffroy
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg im Breisgau, Medizinische Fakultät, Universität Freiburg, Freiburg im Breisgau, Germany
| | - Cindy Franklin
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Klinik und Poliklinik für Dermatologie und Venerologie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Asmae Gassa
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Klinik und Poliklinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie, Herzzentrum an der Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Anna-Katharina Meißner
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Sibylle Mellinghoff
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Medizinische Klinik I, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Shachi Jenny Sharma
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Center for Molecular Medicine Cologne, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf und Halschirurgie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Silvia Schrittenlocher
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
| | - Luisa Witte
- Urologische Klinik, Bundeswehrkrankenhaus Ulm, Ulm, Germany
| | - Simone Marnitz
- Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Cologne, Germany
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Kuhlmann E, Ungureanu MI, Behrens GMN, Cossmann A, Fehr LM, Klawitter S, Mikuteit M, Müller F, Thilo N, Brînzac MG, Dopfer-Jablonka A. Migrant healthcare workers during COVID-19: bringing an intersectional health system-related approach into pandemic protection. A German case study. Front Public Health 2023; 11:1152862. [PMID: 37533524 PMCID: PMC10393282 DOI: 10.3389/fpubh.2023.1152862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/26/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction Migrant healthcare workers played an important role during the COVID-19 pandemic, but data are lacking especially for high-resourced European healthcare systems. This study aims to research migrant healthcare workers through an intersectional health system-related approach, using Germany as a case study. Methods An intersectional research framework was created and a rapid scoping study performed. Secondary analysis of selected items taken from two COVID-19 surveys was undertaken to compare perceptions of national and foreign-born healthcare workers, using descriptive statistics. Results Available research is focused on worst-case pandemic scenarios of Brazil and the United Kingdom, highlighting racialised discrimination and higher risks of migrant healthcare workers. The German data did not reveal significant differences between national-born and foreign-born healthcare workers for items related to health status including SARS-CoV-2 infection and vaccination, and perception of infection risk, protective workplace measures, and government measures, but items related to social participation and work conditions with higher infection risk indicate a higher burden of migrant healthcare workers. Conclusions COVID-19 pandemic policy must include migrant healthcare workers, but simply adding the migration status is not enough. We introduce an intersectional health systems-related approach to understand how pandemic policies create social inequalities and how the protection of migrant healthcare workers may be improved.
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Affiliation(s)
- Ellen Kuhlmann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Marius-Ionut Ungureanu
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania
- Center for Health Workforce Research and Policy, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj Napoca, Romania
| | - Georg M. N. Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner-Site Hannover-Braunschweig, Hannover, Germany
| | - Anne Cossmann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Leonie Mac Fehr
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Sandra Klawitter
- Department of Computer Science, Ostfalia University of Applied Science, Wolfenbüttel, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Nancy Thilo
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Monica Georgina Brînzac
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania
- Center for Health Workforce Research and Policy, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj Napoca, Romania
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner-Site Hannover-Braunschweig, Hannover, Germany
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22
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Shams M, Nasreen M. Socio-economic impacts of Covid-19 through gender lens: A situational assessment in Dhaka city, Bangladesh. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 93:103698. [PMID: 37273284 PMCID: PMC10147447 DOI: 10.1016/j.ijdrr.2023.103698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 04/16/2023] [Accepted: 04/16/2023] [Indexed: 06/06/2023]
Abstract
Global trends showed that men were somehow, more inclined to the infection and death by Covid-19 than women, which showed no exception in Bangladesh. This paper aims to focus on major socio-economic impacts (economic, education, health, gender power relation) and Covid-19-induced response measures in urban context, through gender lens. Qualitative and quantitative methods were blended for the study. A significant relationship was identified between respondent's gender and maintaining social distancing (χ2 (1, N = 110) = 12.2037, p = 0.000477), also in case of going in crowded places during the first wave of Covid-19 (χ2 (4, N = 110) = 18.8001, p = 0.00086), using chi-square test. Concerned with socio-economic impacts, the gender of respondents was found to have a moderate impact on domestic abuse (χ2 (1, N = 110) = 1.8442, p = 0.174454). As for other impacts, null hypotheses failed to be rejected. Regarding response and awareness level, researcher found that 71.6% of women were more skilled in isolation management, and food stocking, in contrast with 64% of men. Entrenched social prejudices and unequal gender-specific treatments toward women, could stimulate the gender-sensitive disproportion in preparedness, impact, and response phase since the Covid-19 emergence.
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Affiliation(s)
- Mayesha Shams
- Institute of Disaster Management and Vulnerability Studies (IDMVS), University of Dhaka; Nilkhet Road, Dhaka-1000, Bangladesh
| | - Mahbuba Nasreen
- Institute of Disaster Management and Vulnerability Studies (IDMVS), University of Dhaka; Nilkhet Road, Dhaka-1000, Bangladesh
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23
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Meese KA, Boitet LM, Sweeney KL, Nassetta L, Mugavero M, Hidalgo B, Reamey R, Rogers DA. Still Exhausted: The Role of Residual Caregiving Fatigue on Women in Medicine and Science Across the Pipeline. J Med Internet Res 2023; 25:e47629. [PMID: 37314842 DOI: 10.2196/47629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/15/2023] Open
Abstract
Understanding the impact of caregiving responsibilities on women in medicine is crucial for ensuring a healthy and intact workforce, as caregiving responsibilities have the potential to affect the careers of women in health care along the entire pipeline, from students and trainees to physicians, physician-scientists, and biomedical researchers.
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Affiliation(s)
- Katherine A Meese
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Laurence M Boitet
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Katherine L Sweeney
- UAB Medicine, Birmingham, AL, United States
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lauren Nassetta
- UAB Medicine, Birmingham, AL, United States
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rebecca Reamey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Doan LP, Dam VAT, Boyer L, Auquier P, Fond G, Tran B, Vu TMT, Do HT, Latkin CA, Zhang MWB, Ho RCM, Ho CSH. Impacts of COVID-19 on career choices in health professionals and medical students. BMC MEDICAL EDUCATION 2023; 23:387. [PMID: 37237404 DOI: 10.1186/s12909-023-04328-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUNDS The COVID-19 pandemic has resulted in not only significant mortalities in Vietnam but has had an impact on its economy. Previous studies have highlighted how the pandemic has had a marginal impact on Vietnamese healthcare workers working at the frontlines. To date, there have been several other studies examining the impact of COVID-19 on intentions to transition between jobs among healthcare professionals, but this has yet to be explored amongst Vietnamese healthcare workers. METHODS To achieve the study's objectives an online cross-sectional study was conducted between September to November 2021. Snowball sampling methodology was adopted for the recruitment of participants. The questionnaire that was used for this study comprised of the following sections: (a) socio-demographic information; (b) impact of COVID-19 on work; (c) risk of exposure to COVID-19; (d) career choices/intentions to change job, and (e) motivation at work. RESULTS There were 5727 completed the entire survey. 17.2% of the respondents have had increased job satisfaction, 26.4% reported increased motivation to work, and 40.9% reported decreased motivation to work. Whilst there were changes in the daily work intensity and the level of work-related stress, more than 60% of respondents we sampled did not intend to switch careers. Demographic variables like gender, whether one was a student or an existing healthcare worker, and income related to work motivation. The community's stigma was a negative factor that declined intrinsic motivation as well as decreased work retention. CONCLUSIONS Our study is instrumental in identifying the impact of COVID-19 on career choices amongst Vietnamese healthcare workers. The factors identified have clear implications for policymaking.
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Affiliation(s)
- Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Vu Anh Trong Dam
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Laurent Boyer
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Pascal Auquier
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Guillaume Fond
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Bach Tran
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Thuc Minh Thi Vu
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Hoa Thi Do
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Melvyn W B Zhang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119077, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
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25
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Sikaras C, Tsironi M, Zyga S, Panagiotou A. Anxiety, insomnia and family support in nurses, two years after the onset of the pandemic crisis. AIMS Public Health 2023; 10:252-267. [PMID: 37304592 PMCID: PMC10251058 DOI: 10.3934/publichealth.2023019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/09/2023] [Accepted: 04/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction The Covid-19 pandemic continues to cause serious physical and mental problems for health professionals, particularly nurses. Aim To estimate the prevalence of anxiety and insomnia and to evaluate their possible association with family support received by nurses two years after the onset of the pandemic. Materials and methods In total, the study participants were 404 nurses (335 females and 69 males) with a mean age of 42.88 (SD = 10.9) years and a mean of 17.96 (SD = 12) years working as nurses. Nurses from five tertiary hospitals in Athens constituted the study population who completed the questionnaires State-Trait Anxiety Inventory (STAI), Athens Insomnia Scale (AIS) and Family Support Scale (FSS), in the months of November and December 2021. Regarding demographic and occupational characteristics, gender, age and years of experience as nurses were recorded. Results 60.1% of the nurses showed abnormal scores in state anxiety, with 46.8% in trait anxiety, and 61.4% showed insomnia. Women showed higher scores on the two subscales of anxiety and the insomnia scale compared to men (p < 0.01 and p < 0.05 respectively), while they showed a lower score on the FSS without statistical significance (p > 0.05). Positive correlations (p < 0.01) were found between the State Anxiety Inventory, Trait Anxiety Inventory and AIS, while all of them showed a high negative correlation with FSS (p < 0.01). Age showed a negative correlation with Trait Anxiety Inventory (p < 0.05). As shown by the mediation analysis, the relationship between state anxiety and insomnia was mediated by trait anxiety, whereas state anxiety appeared to be dependent on family support. Conclusions Nurses continue to experience high levels of anxiety and insomnia and feel less supported by their families than in the first year of the pandemic. Insomnia appears to be dependent on state anxiety, with a significant indirect effect of trait anxiety, while family support seems to affect state anxiety.
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Affiliation(s)
- Christos Sikaras
- University of the Peloponnese, Department of Nursing, 22100, Tripoli, Greece
- Sotiria Thoracic Diseases Hospital of Athens, Nursing Department, 11527, Athens, Greece
| | - Maria Tsironi
- University of the Peloponnese, Department of Nursing, 22100, Tripoli, Greece
| | - Sofia Zyga
- University of the Peloponnese, Department of Nursing, 22100, Tripoli, Greece
| | - Aspasia Panagiotou
- University of the Peloponnese, Department of Nursing, 22100, Tripoli, Greece
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Kuhlmann E, Denis JL, Côté N, Lotta G, Neri S. Comparing Health Workforce Policy during a Major Global Health Crisis: A Critical Conceptual Debate and International Empirical Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5035. [PMID: 36981946 PMCID: PMC10049040 DOI: 10.3390/ijerph20065035] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The health workforce is central to healthcare systems and population health, but marginal in comparative health policy. This study aims to highlight the crucial relevance of the health workforce and contribute comparative evidence to help improve the protection of healthcare workers and prevention of inequalities during a major public health crisis. METHODS Our integrated governance framework considers system, sector, organizational and socio-cultural dimensions of health workforce policy. The COVID-19 pandemic serves as the policy field and Brazil, Canada, Italy, and Germany as illustrative cases. We draw on secondary sources (literature, document analysis, public statistics, reports) and country expert information with a focus on the first COVID-19 waves until the summer of 2021. RESULTS Our comparative investigation illustrates the benefits of a multi-level governance approach beyond health system typologies. In the selected countries, we found similar problems and governance gaps concerning increased workplace stress, lack of mental health support, and gender and racial inequalities. Health policy across countries failed to adequately respond to the needs of HCWs, thus exacerbating inequalities during a major global health crisis. CONCLUSIONS Comparative health workforce policy research may contribute new knowledge to improve health system resilience and population health during a crisis.
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Affiliation(s)
- Ellen Kuhlmann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30265 Hannover, Germany
- Sociology of Health and Health Systems, Faculty I, University of Siegen, Adolf-Reichwein-Strasse 1, 57068 Siegen, Germany
| | - Jean-Louis Denis
- Département de Gestion, D’évaluation et de Politique de Santé École de Santé Publique, Université de Montréal, C.P. 6128 Succursale A, Montréal, QC H3C 3J7, Canada
| | - Nancy Côté
- Département de Sociologie, Université Laval, Pavillon Charles-De Koninck, 1030, Avenue des Sciences-Humaines, Bureau 3469, Québec, QC G1V 0A6, Canada
| | - Gabriela Lotta
- Department of Public Administration, Getulio Vargas Foundation, Av Nove de Julho 2029, São Paulo 01313-902, Brazil
- Center of Metropolitan Studies, Cidade Universitária, 109, São Paulo 05508-060, Brazil
| | - Stefano Neri
- Department of Social and Political Sciences, University of Milan, Via Conservatorio 7, 20122 Milan, Italy
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Shroff FMC. Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans. Front Glob Womens Health 2023; 4:1126934. [PMID: 36860346 PMCID: PMC9968936 DOI: 10.3389/fgwh.2023.1126934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023] Open
Abstract
COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.
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Affiliation(s)
- Farah Mahrukh Coomi Shroff
- Department of Family Practice and School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Maternal and Infant Health Canada, Vancouver, BC, Canada
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Smith J, Korzuchowski A, Memmott C, Oveisi N, Tan HL, Morgan R. Double distress: women healthcare providers and moral distress during COVID-19. Nurs Ethics 2023; 30:46-57. [PMID: 36260872 PMCID: PMC9582741 DOI: 10.1177/09697330221114329] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: COVID-19 pandemic has led to heightened moral distress among healthcare providers. Despite evidence of gendered differences in experiences, there is limited feminist analysis of moral distress.Objectives: To identify types of moral distress among women healthcare providers during the COVID-19 pandemic; to explore how feminist political economy might be integrated into the study of moral distress.Research Design: This research draws on interviews and focus groups, the transcripts of which were analyzed using framework analysis.Research Participants and Context: 88 healthcare providers, based in British Columbia Canada, participated virtually.Ethical Considerations: The study received ethical approval from Simon Fraser University.Findings: Healthcare providers experienced moral dilemmas related to ability to provide quality and compassionate care while maintaining COVID-19 protocols. Moral constraints were exacerbated by staffing shortages and lack of access to PPE. Moral conflicts emerged when women tried to engage decision-makers to improve care, and moral uncertainty resulted from lack of clear and consistent information. At home, women experienced moral constraints related to inability to support children's education and wellbeing. Moral conflicts related to lack of flexible work environments and moral dilemmas developed between unpaid care responsibilities and COVID-19 risks. Women healthcare providers resisted moral residue and structural constraints by organizing for better working conditions, childcare, and access to PPE, engaging mental health support and drawing on professional pride.Discussion: COVID-19 has led to new and heightened experiences of moral distress among HCP in response to both paid and unpaid care work. While many of the experiences of moral distress at work were not explicitly gendered, implicit gender norms structured moral events. Women HCP had to take it upon themselves to organize, seek out resources, and resist moral residue.Conclusion: A feminist political economy lens illuminates how women healthcare providers faced and resisted a double layering of moral distress during the pandemic.
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Affiliation(s)
- Julia Smith
- Julia Smith, Faculty of Health Sciences, Simon Fraser University, 11806 Blusson Hall, 8888 University Drive West, Burnaby, BC V5A 1S6, CA.
| | | | - Christina Memmott
- Bloomberg School of Public Health, 1466Johns Hopkins University, Baltimore, ML, USA
| | - Niki Oveisi
- Pharmaceutical Studies, 8166University of British Columbia, Vancouver, BC, CA
| | - Heang-Lee Tan
- Bloomberg School of Public Health, 1466Johns Hopkins University, Baltimore, ML, USA
| | - Rosemary Morgan
- Bloomberg School of Public Health, 1466Johns Hopkins University, Baltimore, ML, USA
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The Impact of the COVID-19 Pandemic on Mental Health and Quality of Life in COVID-19 Department Healthcare Workers in Central Greece. J Pers Med 2023; 13:jpm13020250. [PMID: 36836484 PMCID: PMC9967900 DOI: 10.3390/jpm13020250] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The pandemic crisis created conditions of insecurity and threat and brought about changes in social contacts and everyday life. Frontline healthcare workers (HCW) were mostly affected. We aimed to evaluate the quality of life and negative emotions in COVID-19 HCW and searched for factors influencing the above. METHODS The present study was conducted among three different academic hospitals in central Greece (04/2020-03/2021). Demographics, attitude towards COVID-19, quality of life, depression, anxiety, stress (using the WHOQOL-BREF and DASS21 questionnaire) and the fear of COVID-19 were assessed. Factors affecting the reported quality of life were also assessed. RESULTS The study involved 170 HCW in COVID-19 dedicated departments. Moderate levels of quality of life (62.4%), satisfaction with social relations (42.4%), working environment (55.9%) and mental health (59.4%) were reported. Stress was present in 30.6% of HCW; 20.6% reported fear for COVID-19, depression (10.6%) and anxiety (8.2%). HCW in the tertiary hospital were more satisfied with social relations and working environment and had less anxiety. Personal Protective Equipment (PPE) availability affected the quality of life, satisfaction in the work environment and the presence of anxiety and stress. Feeling safe during work influenced social relations and fear of COVID-19 Conclusion: The HCW quality of life is affected in the pandemic. Feelings of safety during work related to the reported quality of life.
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Psychosoziale Belastung und psychosoziale Unterstützung für Fachkräfte im Gesundheitswesen während der COVID-19-Pandemie. DIE PSYCHOTHERAPIE 2023. [PMCID: PMC9878479 DOI: 10.1007/s00278-022-00642-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Zusammenfassung
Hintergrund
Ausgangspunkt der Studie ist die hohe psychosoziale Belastung von Fachkräften im Gesundheitswesen bei gleichzeitig geringer Inanspruchnahme eines Beratungs- und Unterstützungsangebots für Mitarbeiter*innen einer Universitätsklinik während der COVID-19-Pandemie.
Ziel der Arbeit
Die vorliegende Studie untersucht den Grad des psychosozialen Belastungserlebens von Fachkräften im Gesundheitswesen (n = 859) einer Universitätsklinik sowie Kenntnis, Inanspruchnahme und Bewertung innerbetrieblicher psychosozialer Versorgungsstrukturen.
Material und Methoden
Im Rahmen einer Online-Befragung (21.07.–19.10.2021) wurden die subjektiv empfundene Belastung durch die COVID-19-Pandemie, Depressivität (PHQ-8) des Personals sowie Kenntnis, Inanspruchnahme und Bewertung möglicher Versorgungsangebote der Universitätsklinik erhoben. Zusätzlich wurden qualitative Daten zu Informationsquelle, -vermittlung sowie Art der Kontaktaufnahme der innerbetrieblichen Versorgungsstrukturen erhoben.
Ergebnisse
Trotz hoher psychosozialer Belastung und überwiegender Kenntnis der Existenz innerbetrieblicher psychosozialer Versorgungsangebote ist deren Inanspruchnahme bei Fachkräften im Gesundheitswesen gering. Insbesondere der Kontakt zu Patient*innen stellte einen Risikofaktor für das psychosoziale Belastungserleben dar. Die qualitative Analyse zeigt, dass die Mitarbeiter*innen mehr über E‑Mails und Newsletters informiert werden möchten sowie eine übersichtliche Darstellung der Angebote vermissen.
Diskussion
Eine Überarbeitung der Angebotsdarstellung und Kontaktwege gemäß den Wünschen des Personals könnte die Inanspruchnahme innerbetrieblicher Angebote verbessern.
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Rahmani F, Hosseinzadeh M, Gholizadeh L. Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:73. [PMID: 36703151 PMCID: PMC9879561 DOI: 10.1186/s12888-023-04562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. METHODS This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. RESULTS A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. CONCLUSION Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.
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Affiliation(s)
- Farnaz Rahmani
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mina Hosseinzadeh
- grid.412888.f0000 0001 2174 8913Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Gholizadeh
- grid.117476.20000 0004 1936 7611Faculty of Health, University of Technology, Sydney, NSW Australia
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Tawse J, Demou E. Qualitative study to explore UK medical students' and junior doctors' experiences of occupational stress and mental health during the COVID-19 pandemic. BMJ Open 2022; 12:e065639. [PMID: 36523252 PMCID: PMC9748513 DOI: 10.1136/bmjopen-2022-065639] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This qualitative study aimed to explore the occupational experiences of medical students and junior doctors working during the COVID-19 pandemic. In particular, the research sought to identify factors which mediated work stress, barriers to disclosing mental health problems and levels of support medical students and junior doctors received during the pandemic. DESIGN This study was a form of thematic analysis and adopted an inductive, 'bottom-up' approach, in which coded categories were derived from rich, descriptive data. SETTING Semistructured interviews were conducted online with UK-based medical students and junior doctors. Interviews were recorded, and analysis was done by coding salient quotes into themes. PARTICIPANTS The final sample consisted of seven junior doctors and eight medical students, during the summer of 2021. RESULTS High levels of occupational stress were identified, which were exacerbated by COVID-19. A number of organisational difficulties associated with the pandemic compounded participants' experiences of work stress. Participants recognised progress towards promoting and managing mental health within the profession but may still be reluctant to access support services. Barriers to disclosure included fear of stigmatisation, concerns about adding to colleagues' workloads, lack of clarity about career implications and mistrust of occupational health services. CONCLUSIONS While attitudes towards mental health have improved, medical students and junior doctors may avoid seeking help. Given the immense pressures faced by health services, it is imperative that extra measures are implemented to minimise work-stress, encourage help-seeking behaviours and promote supportive work cultures.
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Affiliation(s)
- James Tawse
- University of Glasgow College of Social Sciences, Glasgow, UK
- Staff Advice and Liaison Service, Alder Hey Children's Hospital, Liverpool, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, UK
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Laskaris Z, Fleischer NL, Burgard S, Eisenberg JN. Personal and work-related factors associated with mental health among auto workers during the COVID-19 pandemic in the United States. Prev Med Rep 2022; 30:102001. [PMID: 36189126 PMCID: PMC9512522 DOI: 10.1016/j.pmedr.2022.102001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Little is known about the psychological impact of the COVID-19 pandemic on non-healthcare workers, especially among those who weathered unemployment related to shutdowns and supply-chain disruptions. We administered a cross-sectional survey (May - October 2021) to understand patterns between personal and work-related predictors and mental health symptoms among in-person auto workers in the United States (N = 1,165). The Generalized Anxiety Disorder-2 and the Patient Health Questionnaire-2 measured the presence of anxiety and depressive symptoms, respectively. Predictors included the presence of financial/family stressors, fear of SARS-CoV-2 exposure, perceptions of safety climate/culture, and clarity of workplace COVID-19 protocols. We used multinomial logistic regression to examine associations between the predictors and anxiety symptoms alone, depressive symptoms alone, and both anxiety and depressive symptoms compared to no symptoms, adjusting for socio-demographic characteristics, employee type, COVID-19 infection history, and preexisting psychological or psychiatric disorders. Experiencing financial/family stressors (adjusted odds ratio (AOR): 2.65, 95 % CI: 1.86-3.78) and feeling very concerned over SARS-CoV-2 exposure (AOR: 2.12, 95 % CI: 1.47-3.06) increased the odds of having both anxiety and depressive symptoms in comparison to experiencing no stressors, and feeling less than very concerned over exposure, respectively. Positive perceptions of safety climate/culture (AOR = 0.79, 95 % CI: 0.75-0.84) and strong clarity of COVID-19 protocols (AOR = 0.91, 95 %CI: 0.84-0.99) were associated with lower odds of both anxiety and depressive symptoms. These findings highlight the importance of job security and feeling safe at work in affecting the psychological impact of the pandemic on workers. Considerations for COVID-19 prevention in the workplace and mental health should go hand-in-hand.
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Affiliation(s)
- Zoey Laskaris
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Nancy L. Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Sarah Burgard
- Department of Sociology, University of Michigan, 500 State Street, Ann Arbor, MI 48109, United States
| | - Joseph N. Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States
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Podgorica N, Zenzmaier C, Rungg C, Bertini B, Perkhofer S. Facing the unknown COVID-19 pandemic: A qualitative study with nurses and nursing assistants in three European countries. Front Public Health 2022; 10:985702. [PMID: 36523579 PMCID: PMC9744762 DOI: 10.3389/fpubh.2022.985702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background The coronavirus disease (COVID-19) is now a worldwide public health emergency. As essential and central parts of the COVID-19 patient care team, nurses and nurse assistants are facing all kinds of challenges caused by the disease and the pandemic. Understanding these challenges and the way nurses and nurse assistants handle and cope with them provides important knowledge on how to improve management of future pandemics and endemic situations. Thus, the present study explored the challenges faced by nurses and nurse asssitants who cared for COVID-19 patients in hospitals and long term care facilities in Italy, Austria and Germany. Methods The study employed a qualitative design. Purposive sampling was used to select the participants consisting on nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5) from hospitals (n = 32) and long-term care facilities (n = 9) in Austria, Germany, and Italy. Data were collected between August and December 2020 through semi-structured interviews. The collected data were analyzed using qualitative content analysis. Results The analysis of the data revealed three main themes with twelve sub-categories: (i) Knowledge, skills, and training (lack of knowledge; skills; organizational issues; training); (ii) resources and risk (lack of protective equipment; difficulties with protective equipment; risk and infection; feelings and isolation); (iii) coping strategies (humor; adaption; team effort; self-care; family and friends). Conclusion Nurses and nurse assistants who participated in this study faced many personal and professional challenges, and used different coping strategies to manage the situation. Some of these strategies can be applied to reduce these challenges and create better working conditions for nurses and nurse assistants in similar events. Further research, training of staff, and adaptation of institutional policies may help develop new strategies to face future pandemics successfully.
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Affiliation(s)
- Nertila Podgorica
- Health University of Applied Sciences Tyrol, Innsbruck, Austria,*Correspondence: Nertila Podgorica
| | - Christoph Zenzmaier
- Health University of Applied Sciences Tyrol, Innsbruck, Austria,Christoph Zenzmaier
| | - Christine Rungg
- Health University of Applied Sciences Tyrol, Innsbruck, Austria
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Peñaranda A, Moreno-López S, Peñaranda D, Pérez-Herrera LC. Effect of the COVID-19 pandemic on the mental health, daily and occupational activities of pediatric otolaryngologists in Latin America. Front Public Health 2022; 10:735073. [PMID: 36339173 PMCID: PMC9630938 DOI: 10.3389/fpubh.2022.735073] [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] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/04/2022] [Indexed: 01/21/2023] Open
Abstract
Background Otolaryngologists have a higher risk of physical/psychological problems due to their frequent exposure to SARS-CoV-2. There is no information about the impact of COVID-19 on the mental health of these specialists in low/middle-income countries from Latin America. This study aimed to assess the frequency of anxiety, depression, and stress, as well as the changes in occupational and daily activities due to the COVID-19 pandemic in a group of pediatric otolaryngologists in Latin America. Methods Observational, cross-sectional study conducted between October and December 2020. Mental health tools such as the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10 were applied. Fear to COVID-19 scale and questionnaires about occupational and daily activities were also applied. Results Among 55 pediatric otolaryngologists, the frequency of anxiety, depression, and stress were 67.3%, 45.5, and 40%, respectively. Up to 27.3% of the specialists reported moderate to severe symptoms of anxiety, while 7.3 and 40% presented moderate depression and stress symptoms. The specialists reported a reduction of 58.3% of their consultations, as well as a 51.7% reduction in their monthly income compared to the same period before the pandemic. Up to 14.6% of the specialists expect to incorporate long-term (>1 year) drastic changes in their daily activities due to the pandemic. Conclusions The frequency of anxiety, depression, and stress was high among pediatric otolaryngologists in Latin America compared to previous studies performed in high-income countries. Further research on these psychological outcomes is needed to achieve early mental health strategies.
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Affiliation(s)
- Augusto Peñaranda
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Department of Otolaringology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sergio Moreno-López
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel Peñaranda
- Department of Otolaryngology, Fundación Universitaria de Ciencias de la Salud-Hospital de San José, Bogotá, Colombia
| | - Lucía C. Pérez-Herrera
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
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Cezar-Vaz MR, Xavier DM, Bonow CA, Vaz JC, Cardoso LS, Sant’Anna CF, da Costa VZ. Domains of Physical and Mental Workload in Health Work and Unpaid Domestic Work by Gender Division: A Study with Primary Health Care Workers in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9816. [PMID: 36011463 PMCID: PMC9407714 DOI: 10.3390/ijerph19169816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Various studies indicate that workload metrics can be used to assess inequities in the division of labor according to gender and in the mental health of health care professionals. In most studies, the workload is portrayed in a way that does not integrate the different fields of work, that is, work in health services and unpaid domestic work. The objective was to determine the effects of the workload domains of health work and unpaid domestic work according to the gender division of health professionals working in primary health care (PHC), and to analyze the workload as an inducer of anxiety disorders and episodes of depression. This cross-sectional study consisted of 342 health care professionals recruited for interview at primary health care units in the extreme south of Rio Grande do Sul, Brazil. Sociodemographic and occupational variables, workload in PHC and unpaid domestic work, and dichotomies of anxiety disorders and episodes of depression were considered. Poisson and multivariate linear regression models were used for data analysis. Cohen's standardized effect size was used to assess the magnitude of the difference between women and men in terms of workload. The female professionals presented higher scores in terms of PHC work and unpaid domestic work and higher proportions of episodes of depression and anxiety disorders compared to males. The male professionals showed that anxiety disorders presented a medium standardized effect size on domestic workload and the level of frustration with family involvement was higher in those with episodes of depression. The results illustrate that the workload metric is an important indicator of female vulnerability to working conditions in PHC and in the family environment.
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Affiliation(s)
| | | | - Clarice Alves Bonow
- Faculty of Nursing, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | - Jordana Cezar Vaz
- Institute of Dermatology Professor Rubem David Azulalay (Medical Residency), Rio de Janeiro 20020-020, Brazil
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Meysamie A, Ghasemi E, Moshksar S, Askarian M. "Intention to receive COVID-19 vaccine among healthcare workers: a comparison between two surveys". BMC Health Serv Res 2022; 22:982. [PMID: 35915483 PMCID: PMC9342594 DOI: 10.1186/s12913-022-08379-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considering the importance of intention to receive COVID-19 vaccine among healthcare workers and its role in maintaining their health and inhibiting the epidemic spread of Covid-19, the present study was done to identify the changes in intention to receive COVID-19 vaccine rate in two different time points and it's determinants based on the dimensions of the health belief model among healthcare workers in Iran. METHODS Two cross-sectional surveys performed to investigate COVID-19 vaccination intent and associated factors based on the health belief model. The first conducted on 1244 participants from August 18 to 23, 2020, and the second on 1514 participants from February 5 to April 29, 2021, both using a questionnaire of intent to accept COVID-19 vaccination. The questionnaire distribution platform in both surveys was similarly, WhatsApp and Telegram social and working virtual groups of HCWs. Data were analyzed with SPSS-16 software for descriptive and analytical statistics. RESULTS In the first survey, 58.4% (95% CI: 0.55-0.61%) of healthcare workers intended to receive the COVID-19 vaccine, the rate dropped to 45.7% (95% CI: 0.43-0.48%) in the second survey (P < 0.001). The regression analysis indicated six factors that were significantly associated with higher intention to receive COVID-19 vaccine: being a female (OR = 1.84, 95% CI (1.11-3.03)), history of Covid-19 infection (OR = 1.54, 95% CI (1.09-2.18), perceptions of Covid-19 disease (OR = 1.13, 95% CI (1.01-1.28)), perceived benefits of COVID-19 vaccine (OR = 1.34, 95% CI (1.22-1.47)), prosocial norms for COVID-19 vaccination (OR = 1.25, 95% CI (1.21-1.29)), and COVID-19 vaccine safety/cost concerns (OR = 1.25, 95% CI (1.17-1.33)). CONCLUSIONS Present study showed an undesirable rate of intention to receive COVID-19 vaccine among healthcare workers, especially decreasing over the time, emphasize the need of interventions to promote healthcare workers' intention to receive the vaccine and reduce the spread of COVID-19 disease.
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Affiliation(s)
- Alipasha Meysamie
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ghasemi
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Moshksar
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Karimkhan-e Zand Avenue, Shiraz, 7134845794 Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Karimkhan-e Zand Avenue, Shiraz, 7134845794 Iran
- Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kelly J, Gittings L, Laurenzi C, Glinski CD, Mangqalaza H, Ralayo N, Langwenya N, Sidloyi L, Mbiko A, Taleni B, Saliwe B, Toska E. HIV and SRH healthcare delivery experiences of South African healthcare workers and adolescents and young people during COVID-19. PSYCHOL HEALTH MED 2022; 27:155-166. [PMID: 36004413 DOI: 10.1080/13548506.2022.2108080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While substantial research has emerged from the frontlines of the COVID-19 pandemic, as well as from studies with adolescent populations, there has been a dearth of research focused in South Africa on the context-specific experiences of healthcare workers (HCWs) and the adolescents and young people (AYP) to whom they provide services. This article documents the experiences of provision and receipt of HIV and sexual and reproductive health (SRH) services during the COVID-19 pandemic from the perspective of South African HCWs (n = 13) and AYP (n = 41, ages 17-29). Findings highlight several barriers to accessing comprehensive HIV and SRH services during the pandemic including lockdown-related mobility restrictions (reported by HCWs), prioritisation of COVID-19 above other healthcare needs, longer health facility waiting times, poor treatment by HCWs (reported by AYP), discomfort and perceived stigma from having to queue outside health facilities, and fear of contracting COVID-19 (reported by both groups). While HCWs reported that HIV and SRH services continued to be available during the pandemic, AYP described seeking these services - such as long-acting reversible contraception, check-ups for their babies and medical refills - and being told that because they were not considered emergency cases, they should return on a different date. By capturing diverse experiences and perspectives from both groups, our findings reiterate the growing call for health system investments to strengthen the delivery of adolescent services, including investing in appropriate channels of communication between young people and their healthcare providers (for example, through adolescent peer supporters or community healthcare workers) and differentiated models of service delivery (for example, multi-month ART refills and community pick-ups). Closing the gap between the experiences and needs of adolescents and the healthcare workers who serve them may support young people and HCWs in buffering against changes brought about by the COVID-19 pandemic.
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Affiliation(s)
- Jane Kelly
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Lesley Gittings
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Christina Laurenzi
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa.,Institute for Life Course Health Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Charné Dee Glinski
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa.,Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Hlokoma Mangqalaza
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Nokubonga Ralayo
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | | | - Lulama Sidloyi
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Amanda Mbiko
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Babalwa Taleni
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Bongiwe Saliwe
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
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