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Zhang Y, Sun J, Wu C, Fei Y, Hu W, Lang H. Comparing the effectiveness of mind-body practices (MBPs) and various psychological methods on occupational stress among healthcare workers: a network meta-analysis of randomized controlled trials. BMC Health Serv Res 2024; 24:962. [PMID: 39169332 PMCID: PMC11337641 DOI: 10.1186/s12913-024-11437-7] [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: 02/18/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVES The purpose of this study is to compare the efficacy of mind-body practices (MBPs) and multiple psychological methods, and identify the optimal method for relieving work-related stress among healthcare workers (HCWs) by network meta-analysis (NMA). METHODS We applied six electronic databases, namely PubMed, Web of Science, Embase, PsycINFO, Cochrane, and Chinese National Knowledge Infrastructure to identify relevant RCTs from inception to September 16, 2023, and implemented a search strategy based on the PICOS principles. Data selection, extraction, and analysis of bias were carried out independently and in duplicate by separate researchers. State 16.0 was used to conduct NMA for comparing the effectiveness of various therapies. RESULTS We identified 23 studies including MBPs and three different psychological therapies, namely mindfulness-related therapy (MRT), psychoeducational therapy (PT), and comprehensive therapy (CT), which were divided into eleven specific techniques, namely yoga, meditation techniques (MT), Qigong, muscle relaxation(MR), biofeedback therapy (BT), mindfulness-based interventions (MBIs), modified mindfulness-based stress reduction (MBSR-M), mindfulness-based interventions combined with others (MBIs-C), mindfulness-based awareness(MBA), PT and CT. Our NMA results of MBPs and three psychological therapies showed MBPs (SMD = -0.90, CrI:-1.26, -0.05, SUCRA = 99%) were effective for occupational stress in HCWs, followed by MRT(SMD = -0.48, CrI:-0.87, -0.08, SUCRA = 66.5%). NMA results of eleven specific techniques showed yoga (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 97.5%) was the most effective technique in relieving the stress of HCWs, followed by MR (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 87.3%). CONCLUSIONS Our study suggested MBPs may be the most effective intervention to improve the occupational stress of HCWs. Furthermore, yoga is likely to be the most optimal of MBPs. Hospital managers should attach importance to yoga in addressing occupational stress among medical workers.
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Affiliation(s)
- Yinjuan Zhang
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, China
- Department of Nursing, Shaanxi University of Chinese Medicine, Qindu District, No. 1 Century Avenue, Xianyang, Shaanxi, 712046, China
| | - Jicheng Sun
- Military Medical Innovation Center, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Chao Wu
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Yue Fei
- Department of Computer Science and Engineering, Xi'an Technological University, No. 4 Jinhua North Road, Xi'an, Shaanxi, 710021, China
| | - Wendong Hu
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, China.
| | - Hongjuan Lang
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, China.
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Zukerman G, Antonovsky A, Shapiro E, Korn L. Sense of coherence and its components under COVID-19: relative associations with personality and psychosocial variables. Glob Health Promot 2024:17579759241248168. [PMID: 38822633 DOI: 10.1177/17579759241248168] [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: 06/03/2024]
Abstract
Sense of Coherence (SOC) is conceptualized as promoting resistance to stress. The study aimed to assess the impact of the Big Five personality traits and Social Capital (SC) on SOC levels during COVID-19, comparing associations with the pre-pandemic period. Another aim was to explore how personality and SC relate differently to SOC domains: Comprehensibility, Manageability, and Meaningfulness, reflecting perceptions of order, resource adequacy, and life's significance, respectively. SOC, Big Five personality traits, SC (using by the 13 items SOC scale, NEO-FFI and PSCS inventories, respectively) and demographic data were obtained from 2717 Israeli participants during the heights of the third COVID-19 wave (November 2020-March 2021). Strong relationships between SOC and personality traits have been found through regression analysis, but these associations differed between SOC domains. Big Five traits demonstrated comparable association with Comprehensibly and Manageability, but different from those with Meaningfulness, particularly in Neuroticism, Openness and Extraversion. Significant SC-SOC associations were observed, though weaker than those reported in the pre-pandemic period. Age and female sex were also associated with stronger SOC. Overall, effect sizes for SOC domains were medium to large for Big Five personality traits and small to medium for demographic variables. SC demonstrated a negligible effect size. Significant interactions of demographic, SC and personality traits were also observed. The study highlights SOC's strong links with personality and demographics, but weaker ties with psychosocial factors. Variations across SOC domains may explain diverse crisis effects.
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Affiliation(s)
- Gil Zukerman
- Department of Communication Disorders, School of Health Sciences, Ariel University, Ariel, Israel
| | - Avishai Antonovsky
- Department of Health and Well-Being, Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Ephraim Shapiro
- Department of Health Management Systems, School of Health Sciences, Ariel University, Ariel, Israel
| | - Liat Korn
- Department of Health Management Systems, School of Health Sciences, Ariel University, Ariel, Israel
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Xiong NN, Fan TT, Liu Q, Fritzsche K, Leonhart R, Stein B, Waller C, Müller MM. Burnout, emotional distress and sleep quality among Chinese psychiatric healthcare workers during the COVID-19 pandemic: a follow-up study. Front Public Health 2023; 11:1272074. [PMID: 38179557 PMCID: PMC10764523 DOI: 10.3389/fpubh.2023.1272074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Background Different from the very early stages of the COVID-19 pandemic, burnout and chronic mental health problems among health care workers (HCWs) has become a challenge. Research is lacking on the relationship between burnout, stress, emotional distress and sleep quality. Methods The Chinese center has been involved in the Cope-Corona project since the second survey (T2). Named after the project, a total of three cross-sectional surveys were distributed: T2 (February 16-20, 2021), T3 (May 10-14, 2022), and T4 (December 20-24, 2022). Burnout, depression, anxiety, sleep quality, workplace factors and individual resources were measured. Using the T4 data, we conducted structural equation model (SEM) to examine the mediating role of burnout in predicting emotional distress and sleep quality. Results 96, 124, and 270 HCWs were enrolled at T2, T3, and T4, respectively. In line with the epidemic trends, the level of perceived COVID-19 related risks was significantly higher at T4, while the feeling of health and safety decreased significantly. At T4, the percentages of participants with clinically significant levels of depression and anxiety symptoms were 18.9% (51/270) and 9.3% (25/270), respectively, while 30.4% (82/270) of them reported poor or very poor sleep quality. According to the SEM, individual resources and workplace factors mainly had an indirect effect in predicting depression and anxiety via burnout. However, neither burnout nor stress was a mediator or predictor of sleep quality. Instead, individual resources, positive workplace factors, and younger age had a direct effect in predicting good sleep quality. Conclusion Measures designed to enhance workplace factors and individual resources should be implemented to improve psychosomatic wellbeing of HCWs.
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Affiliation(s)
- Na-na Xiong
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Teng-teng Fan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Qi Liu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Mental Health, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Department for Social Psychology and Methodology, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Markus M. Müller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
- Social and Organizational Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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Herbst R, Sump C, Riddle S. Staying in bounds: A framework for setting workplace boundaries to promote physician wellness. J Hosp Med 2023; 18:1139-1143. [PMID: 37035935 DOI: 10.1002/jhm.13102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Rachel Herbst
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
| | - Courtney Sump
- Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio, USA
| | - Sarah Riddle
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio, USA
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Loureiro SR, Zuardi AW, Silveira ILM, Crippa JADS, Hallak JEC, Osório FDL. Progression of the COVID-19 pandemic, Brazilian healthcare workers' emotional burden and the effects on professional fulfillment at the end of the third wave: a longitudinal study. Front Psychiatry 2023; 14:1237123. [PMID: 38025454 PMCID: PMC10657209 DOI: 10.3389/fpsyt.2023.1237123] [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: 06/08/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Even though the long-term effects of the COVID-19 pandemic on healthcare workers' mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies. Objectives To assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths). Methods The sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment). Results Brazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased. Conclusion The lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic's chronic effects and the need for organizations to monitor these workers' mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.
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Affiliation(s)
- Sonia Regina Loureiro
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Antônio Waldo Zuardi
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | | | - José Alexandre de Souza Crippa
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Jaime Eduardo Cecílio Hallak
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Flávia de Lima Osório
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
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Maunder RG, Rosen B, Heeney ND, Jeffs LP, Merkley J, Wilkinson K, Hunter JJ, Johnstone J, Greenberg RA, Wiesenfeld LA. Relationship between three aspects of resilience-adaptive characteristics, withstanding stress, and bouncing back-in hospital workers exposed to prolonged occupational stress during the COVID-19 pandemic: a longitudinal study. BMC Health Serv Res 2023; 23:703. [PMID: 37380994 DOI: 10.1186/s12913-023-09731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND The term resilience is used to refer to multiple related phenomena, including: (i) characteristics that promote adaptation to stressful circumstances, (ii) withstanding stress, and (iii) bouncing back quickly. There is little evidence to understand how these components of resilience are related to one another. Skills-based adaptive characteristics that can respond to training (as opposed to personality traits) have been proposed to include living authentically, finding work that aligns with purpose and values, maintaining perspective in the face of adversity, managing stress, interacting cooperatively, staying healthy, and building supportive networks. While these characteristics can be measured at a single time-point, observing responses to stress (withstanding and bouncing back) require multiple, longitudinal observations. This study's aim is to determine the relationship between these three aspects of resilience in hospital workers during the prolonged, severe stress of the COVID-19 pandemic. METHODS We conducted a longitudinal survey of a cohort of 538 hospital workers at seven time-points between the fall of 2020 and the spring of 2022. The survey included a baseline measurement of skills-based adaptive characteristics and repeated measures of adverse outcomes (burnout, psychological distress, and posttraumatic symptoms). Mixed effects linear regression assessed the relationship between baseline adaptive characteristics and the subsequent course of adverse outcomes. RESULTS The results showed significant main effects of adaptive characteristics and of time on each adverse outcome (all p < .001). The size of the effect of adaptive characteristics on outcomes was clinically significant. There was no significant relationship between adaptive characteristics and the rate of change of adverse outcomes over time (i.e., no contribution of these characteristics to bouncing back). CONCLUSIONS We conclude that training aimed at improving adaptive skills may help individuals to withstand prolonged, extreme occupational stress. However, the speed of recovery from the effects of stress depends on other factors, which may be organizational or environmental.
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Affiliation(s)
- Robert G Maunder
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Benjamin Rosen
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Lianne P Jeffs
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Jane Merkley
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
| | - Kate Wilkinson
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
| | - Jonathan J Hunter
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jennie Johnstone
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | | | - Lesley A Wiesenfeld
- Sinai Health, 600 University Ave., Toronto, M5G 1X5, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Zhao Y, Tao Y, Bao X, Ding Q, Han C, Luo T, Zhang W, Sun J, Shi J. A study on differences about the influencing factors of depressive symptoms between medical staff and residents during 2022 city-wide temporary static management period to fighting against COVID-19 pandemic in Shanghai. Front Public Health 2023; 10:1083144. [PMID: 36699891 PMCID: PMC9868696 DOI: 10.3389/fpubh.2022.1083144] [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: 10/28/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Objectives Our study aimed to identify the latent class of depressive symptoms in the Shanghai population during the city-wide temporary static management period and compare differences in the factors influencing depressive symptoms between medical staff and residents. Methods An online cross-sectional survey was conducted with 840 participants using questionnaires, including Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and self-compiled questionnaire (demographic characteristics and internet usage time). Latent class analysis (LCA) was performed based on participants' depressive symptoms. The latent class subgroups were compared using the chi-square test and t-test. Logistic regression was used in our study to analyze the factors influencing depressive symptoms within the medical staff group and residents group and then compare their differences. Results Two distinct subgroups were identified based on the LCA: the group with low-depressive symptoms and the group with high-depressive symptoms. There were significant differences between the two groups (P < 0.05) on age, education level, marital status, internet usage time, identity characteristics (medical staff or residents), family income level, living style, overall quality of sleep, and anxiety levels. Furthermore, logistic regression analysis results showed that compared with the residents group, the participants in the group of medical staff with "increasing internet usage time" and the "daytime dysfunction" would have nearly two times the possibility of getting serious depressive symptoms. Conclusions There are differences in the factors influencing depression symptoms between medical staff and residents during the 2022 city-wide temporary static management period to fighting against the COVID-19 pandemic in Shanghai. We should pay special attention to those with increasing internet usage time and daytime dysfunction in medical staff working in a special environment such as the COVID-19 pandemic.
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Affiliation(s)
- Ying Zhao
- Department of Psychological Medicine, Children's Hospital of Fudan University, Shanghai, China
| | - Yiran Tao
- Department of General Medicine, Zhoupu Health Service Center, Pudong New Area, Shanghai, China
| | - Xiwen Bao
- Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Qiang Ding
- Department of Psychological Medicine, Children's Hospital of Fudan University, Shanghai, China
| | - Changyan Han
- Department of General Medicine, Zhoupu Health Service Center, Pudong New Area, Shanghai, China
| | - Tingkun Luo
- Department of General Medicine, Zhoupu Health Service Center, Pudong New Area, Shanghai, China
| | - Weijia Zhang
- Department of General Medicine, Zhoupu Health Service Center, Pudong New Area, Shanghai, China
| | - Jinhua Sun
- Department of Psychological Medicine, Children's Hospital of Fudan University, Shanghai, China,*Correspondence: Jinhua Sun ✉
| | - Jiali Shi
- Department of Psychiatry, Tongji University Affiliated Shanghai Pudong New Area Mental Health Center, Shanghai, China,Jiali Shi ✉
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