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Galvin D, O'Reilly B, Greene R, O'Donoghue K, O'Sullivan OE. A national survey on the impact of the coronavirus pandemic on gynecologic surgical training. Int J Gynaecol Obstet 2024. [PMID: 38958460 DOI: 10.1002/ijgo.15761] [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: 12/10/2023] [Revised: 06/04/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE The objective of this study was to assess the impact of the coronavirus pandemic on gynecology surgical training. METHODS A national cross-sectional online survey was distributed to all trainees and trainers in the higher specialist training program for obstetrics and gynecology in Ireland. The survey consisted of questions on topics which included: the volume of surgical procedures performed before and since the pandemic, confidence in performing various gynecologic procedures before and since the pandemic and questions regarding the impact of the pandemic on wellbeing and work practices. RESULTS Trainers and trainees experienced a significant reduction in operative volumes for most procedure types. Analysis showed a significant reduction in the number of minor procedures performed by trainees (z = -2.7, P = 0.007) and a significant reduction in the number of all procedure types performed by trainers (minor procedures z = -3.78, P = <0.001; intermediate procedures z = -4.48, P = < 0.001; major procedures z = -3.69, P = < 0.001). Respondents reported they had less time for research and audit, were less able to attend courses or conferences and worried about the impact of their work on their families. CONCLUSIONS In conclusion, this study has highlighted the current difficulties facing surgical trainees in gynecology because of the COVID-19 pandemic. These challenges have compounded an already challenging training environment for gynecology trainees. Efforts must be made to continue to provide high-quality tailored training to ensure the development of the next generation of gynecologic surgeons.
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Affiliation(s)
- Daniel Galvin
- Department of Obstetrics and Gynecology, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Barry O'Reilly
- Department of Obstetrics and Gynecology, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Richard Greene
- Department of Obstetrics and Gynecology, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynecology, College of Medicine and Health, University College Cork, Cork, Ireland
- INFANT Research Center, University College Cork, Cork, Ireland
| | - Orfhlaith E O'Sullivan
- Department of Obstetrics and Gynecology, College of Medicine and Health, University College Cork, Cork, Ireland
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AbdulHussein A, Butt ZA, Dimitrov S, Cozzarin B. Factors Associated With Worsened Mental Health of Health Care Workers in Canada During the COVID-19 Pandemic: Cross-Sectional Survey Study. Interact J Med Res 2024; 13:e50064. [PMID: 38358785 PMCID: PMC10905361 DOI: 10.2196/50064] [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: 06/18/2023] [Revised: 11/26/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Health care workers (HCWs) in Canada have endured difficult conditions during the COVID-19 pandemic. Many worked long hours while attending to patients in a contagious environment. This introduced an additional burden that may have contributed to worsened mental health conditions. OBJECTIVE In this study, we examine the factors associated with worsened mental health conditions of HCWs as compared to before the start of the pandemic. METHODS We use data from a survey of HCWs by Statistics Canada. A regression model is used to estimate the odds ratios (ORs) of worsened mental health after the start of the pandemic. The estimated odds ratio (OR) is associated with different independent variables that include demographics (age, sex, immigration status, and geographic area), occupational factors (work status, occupational group, and exposure category), and different access levels to personal protective equipment (PPE). RESULTS Of 18,139 eligible participants surveyed, 13,990 (77.1%) provided valid responses. We found that HCWs younger than 35 years old were more likely (OR 1.14, 95% CI 1.03-1.27; P=.01) to exhibit worsened mental health as compared to the reference group (35-44 years old). As for sex, male HCWs were less likely (OR 0.76, 95% CI 0.67-0.86; P<.001) to exhibit worsened mental health as compared to female HCWs. Immigrant HCWs were also less likely (OR 0.57, 95% CI 0.51-0.64; P<.001) to exhibit worsened mental health as compared to nonimmigrant HCWs. Further, HCWs working in Alberta had the highest likelihood of exhibiting worsened mental health as compared to HCWs working elsewhere (Atlantic provinces, Quebec, Manitoba, Saskatchewan, Ontario, British Columbia, and Northern Territories). Frontline workers were more likely (OR 1.26, 95% CI 1.16-1.38; P<.001) to exhibit worsened mental health than nonfrontline HCWs. Part-time HCWs were less likely (OR 0.85, 95% CI 0.76-0.93; P<.001) to exhibit worsened mental health than full-time HCWs. HCWs who reported encountering COVID-19 cases were more likely (OR 1.55, 95% CI 1.41-1.70; P<.001) to exhibit worsened mental health as compared to HCWs who reported no contact with the disease. As for PPE, HCWs who never had access to respirators, eye protection, and face shields are more likely to exhibit worsened mental health by 1.31 (95% CI 1.07-1.62; P<.001), 1.51 (95% CI 1.17-1.96; P<.001), and 1.41 (95% CI 1.05-1.92; P=.02) than those who always had access to the same PPE, respectively. CONCLUSIONS Different HCW groups experienced the pandemic differently based on their demographic and occupational backgrounds as well as access to PPE. Such findings are important to stakeholders involved in the planning of personalized support programs and aid mental health mitigation in future crises. Certain groups require more attention.
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Affiliation(s)
- Ali AbdulHussein
- Department of Management Science, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Zahid Ahmad Butt
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Stanko Dimitrov
- Department of Management Science, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Brian Cozzarin
- Department of Management Science, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
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de Souza Ziegler N, Muller GC, Grossi FS, Pacagnella RDC, Hermel JS, Vettorazzi J. Impact of the covid-19 pandemic on mental health and sexuality of female doctors. PLoS One 2023; 18:e0281321. [PMID: 37428737 PMCID: PMC10332575 DOI: 10.1371/journal.pone.0281321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/19/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND COVID-19 pandemic has changed people's lives around the world due to restrictive measures adopted by governments. The impact of this change on female sexuality needs to be further investigated, particularly between female doctors who are more at risk as they are directly involved with health care services. METHODS An online survey has been filled out by female doctors. The questionnaire evaluates sexual function, depression, anxiety, burnout, sociodemographic and professional data, and it was answered during the peak of COVID-19 pandemic in Brazil. The main outcome is female doctors' sexual function during COVID-19 pandemic, which was evaluated by analyzing FSFI questionnaires. The secondary outcome is related to their mental health, assessed via depression, anxiety and burnout questionnaires. RESULTS A sample of 388 female doctors filled out the questionnaire. The median age was 34.0 (29.0, 43.0) years old. The total FSFI median score was 23.8 [18.9, 26.8] with desire domain median of 5.0 [3.0, 7.0]. In our sample, 231 (59.5%) women had depression and/or anxiety, out of these, 191 (82.7%) had depression and 192 (83.2%), anxiety. From these samples of doctors with depression and/or anxiety, 183 (79.2%) had sexual dysfunction. CONCLUSION This finding suggests that doctors are experiencing a high risk of sexual dysfunction and mental illness during the COVID-19 outbreak. A high index of depression and/or anxiety was shown in the studied population, with almost 80% of them reaching criteria for sexual dysfunction. Working in the frontline is related to worse mental health conditions. Depression and anxiety were found as potential mediators of burnout effect on sexual function.
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Affiliation(s)
- Nadine de Souza Ziegler
- Graduate Program in Health Sciences: Gynecology and Obstetrics, Faculty of Medicine (FAMED), Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Nucleus of Studies and Research in Sexuality of Rio Grande do Sul (NEPeSex), CNPq, Porto Alegre
| | - Gabriel Cardozo Muller
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Santos Grossi
- Graduate Program in Health Sciences: Gynecology and Obstetrics, Faculty of Medicine (FAMED), Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Nucleus of Studies and Research in Sexuality of Rio Grande do Sul (NEPeSex), CNPq, Porto Alegre
| | | | | | - Janete Vettorazzi
- Graduate Program in Health Sciences: Gynecology and Obstetrics, Faculty of Medicine (FAMED), Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Nucleus of Studies and Research in Sexuality of Rio Grande do Sul (NEPeSex), CNPq, Porto Alegre
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Service of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil
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Birowo P, Rasyid N, Mochtar CA, Noegroho BS, Danarto HR, Daryanto B, Hakim L, Parikesit D, Rahman F, Ariwicaksono SC. Daily activities and training experiences of urology residents during the coronavirus disease 2019 pandemic in Indonesia: A nationwide survey. Asian J Urol 2023; 10:119-127. [PMID: 35018283 PMCID: PMC8723788 DOI: 10.1016/j.ajur.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 05/27/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
Objective To explore the impact of the coronavirus disease 2019 (COVID-19) pandemic on the training experiences of urology residents in Indonesia. Methods A cross-sectional study using a web-based questionnaire (SurveyMonkey) involved all registered urology residents in Indonesia. The questionnaire was structured in Bahasa Indonesia, composed of 28 questions, and divided into three sections: demographic characteristics, current daily activities, and opinions regarding training experiences during the COVID-19 outbreak. The survey was distributed to all respondents via chief of residents in each urology center from May 26, 2020 to Jun 2, 2020. Results Of the total 247 registered urology residents, 243 were eligible for the study. The response and completeness rate for this study were 243/243 (100%). The median age of respondents was 30 (range: 24-38) years old, and 92.2% of them were male. Among them, 6 (2.5%) respondents were confirmed as COVID-19 positive. A decrease in residents' involvement in clinical and surgical activities was distinguishable in endourological and open procedures. Most educational activities were switched to web-based video conferences, while others opted for the in-person method. Smart learning methods, such as joining a national or international speaker webinar or watching a recorded video, were used by 93.8% and 80.7% of the respondents, respectively. The respondents thought that educational activities using web-based video conferences and smart learning methods were effective methods of learning. Overall, the respondents felt unsure whether training experiences during the COVID-19 pandemic were comparable to the respective period before. Conclusion The COVID-19 pandemic negatively affected urology residents' training experiences. However, it also opened up new possibilities for incorporating new learning methodologies in the future.
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Affiliation(s)
- Ponco Birowo
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nur Rasyid
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Chaidir A Mochtar
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Bambang S Noegroho
- Department of Urology, Faculty of Medicine, Padjadjaran University, Hasan Sadikin Hospital, Bandung, Indonesia
| | - H R Danarto
- Department of Urology, Faculty of Medicine, Gadjah Mada University, Sardjito Hospital, Yogyakarta, Indonesia
| | - Besut Daryanto
- Department of Urology, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar Hospital, Malang, Indonesia
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Airlangga University, Soetomo Hospital, Surabaya, Indonesia
| | - Dyandra Parikesit
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Universitas Indonesia Hospital, Depok, Indonesia
| | - Fakhri Rahman
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - S Cahyo Ariwicaksono
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Guraya SS, Menezes P, Lawrence IN, Guraya SY, Rashid-Doubell F. Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review. Front Med (Lausanne) 2023; 10:1071537. [PMID: 37056734 PMCID: PMC10086257 DOI: 10.3389/fmed.2023.1071537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundCOVID-19 has endangered healthcare systems at multiple levels worldwide. Published data suggests that moral dilemmas faced during these unprecedented times have placed physicians at the intersections of ethical and unethical considerations. This phenomenon has questioned the physicians' morality and how that has affected their conduct. The purpose of our review is to tap into the spectrum of the transforming optics of patient care during the pandemic and its impact on psychological wellbeing of physicians.MethodsWe adopted the Arksey and O'Malley's framework, defining research questions, identifying relevant studies, selecting the studies using agreed inclusion and exclusion criteria, charting the data, and summarizing and reporting results. Databases of PubMed/Medline, Web of Science, Scopus, Science Direct, CINAHL, and PsycInfo were searched using a predefined search string. The retrieved titles and abstracts were reviewed. Later, a detailed full-text analysis of the studies which matched our inclusion criteria was performed.ResultsOur first search identified 875 titles and abstracts. After excluding duplicates, irrelevant, and incomplete titles, we selected 28 studies for further analysis. The sample size in 28 studies was 15,509 with an average size of 637 per study. Both quantitative and qualitative approaches were used, with cross-sectional surveys being utilized in all 16 quantitative studies. Using the data from semi-structured interviews, several discrete codes were generated, which led to the identification of five main themes; mental health, individual challenges, decision-making, change in patient care, and support services.ConclusionThis scoping review reports an alarming rise in psychological distress, moral injury, cynicism, uncertainty, burnout, and grief among physicians during the pandemic. Decision-making and patient care were mostly regulated by rationing, triaging, age, gender, and life expectancy. Poor professional controls and institutional services potentially led to physicians' crumbling wellbeing. This research calls for the remediation of the deteriorating mental health and a restoration of medical profession's advocacy and equity.
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Affiliation(s)
- Shaista S. Guraya
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
| | - Prianna Menezes
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
| | | | - Salman Yousuf Guraya
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: Salman Yousuf Guraya
| | - Fiza Rashid-Doubell
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
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Fadle AA, Khalifa AA, Mahran DG, Khidr SS, Said HG, Farouk O. Burnout syndrome (BOS) among resident doctors in an Egyptian tertiary care university hospital: Prevalence and determinants during the COVID-19 pandemic. Int J Soc Psychiatry 2023; 69:396-405. [PMID: 35695719 PMCID: PMC10076172 DOI: 10.1177/00207640221104698] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The current study aimed to detect the BOS prevalence and determinants among residents working during the second wave of the COVID-19 pandemic in an Egyptian tertiary university referral hospital. METHODS A cross-sectional study evaluating the working period from June to November 2020 during the COVID-19 pandemic second wave, through a five sections questionnaire evaluating: 1 - sociodemographic characteristics, 2 - job characteristics, 3 - negative thoughts related to their job, 4 - resident's health problems, and 5 - evaluating BOS through Maslach Burnout Inventory (MBI) scale (including emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA] as subscales). RESULTS We included 230 residents with a median age of 27 years. The median MBI sub-scales (IQ Range) values were 30.0 (20, 39), 21.0 (15, 30), and 29.5 (22, 36) for EE, DP, and PA, respectively. About 51.0% and 83.0% of the residents were high in EE and DP, while 8.7% were low in PA. The median EE and DP were higher in younger age (⩽27 years; p = .002 and .024), males (p = .001 and <.001), working >90 hours weekly (p = .016 and <.001), exposure to harassment (p < .001), and having COVID-19 infection (p = .002 and .001). Residents working in surgical departments reported higher DP scores than those in non-surgical departments (p = .03). There was a mild positive correlation between working hours per week and the total scores in EE and DP, r = .24 (p < .001) and r = .23 (p = .001) respectively, while it was found to have a negative correlation with the PA (r = -.133 and p = .044). CONCLUSIONS The BOS is evident and considerably high among the residents working during the COVID-19 pandemic. Younger age, males, working in surgical departments, and those who got COVID-19 infection were most vulnerable.
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Affiliation(s)
- Amr A Fadle
- Orthopaedic Department, Assiut University Hospital, Egypt
| | - Ahmed A Khalifa
- Orthopaedic Department, Assiut University Hospital, Egypt.,Orthopaedic Department, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egypt
| | - Dalia G Mahran
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt
| | | | - Hatem G Said
- Orthopaedic Department, Assiut University Hospital, Egypt
| | - Osama Farouk
- Orthopaedic Department, Assiut University Hospital, Egypt
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Dedeilia A, Papapanou M, Papadopoulos AN, Karela NR, Androutsou A, Mitsopoulou D, Nikolakea M, Konstantinidis C, Papageorgakopoulou M, Sideris M, Johnson EO, Fitzpatrick S, Cometto G, Campbell J, Sotiropoulos MG. Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future-a systematic review and meta-analysis. HUMAN RESOURCES FOR HEALTH 2023; 21:13. [PMID: 36829158 PMCID: PMC9951171 DOI: 10.1186/s12960-023-00799-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This systematic review and meta-analysis identified early evidence quantifying the disruption to the education of health workers by the COVID-19 pandemic, ensuing policy responses and their outcomes. METHODS Following a pre-registered protocol and PRISMA/AMSTAR-2 guidelines, we systematically screened MEDLINE, EMBASE, Web of Science, CENTRAL, clinicaltrials.gov and Google Scholar from January 2020 to July 2022. We pooled proportion estimates via random-effects meta-analyses and explored subgroup differences by gender, occupational group, training stage, WHO regions/continents, and study end-year. We assessed risk of bias (Newcastle-Ottawa scale for observational studies, RοB2 for randomized controlled trials [RCT]) and rated evidence certainty using GRADE. RESULTS Of the 171 489 publications screened, 2 249 were eligible, incorporating 2 212 observational studies and 37 RCTs, representing feedback from 1 109 818 learners and 22 204 faculty. The sample mostly consisted of undergraduates, medical doctors, and studies from institutions in Asia. Perceived training disruption was estimated at 71.1% (95% confidence interval 67.9-74.2) and learner redeployment at 29.2% (25.3-33.2). About one in three learners screened positive for anxiety (32.3%, 28.5-36.2), depression (32.0%, 27.9-36.2), burnout (38.8%, 33.4-44.3) or insomnia (30.9%, 20.8-41.9). Policy responses included shifting to online learning, innovations in assessment, COVID-19-specific courses, volunteerism, and measures for learner safety. For outcomes of policy responses, most of the literature related to perceptions and preferences. More than two-thirds of learners (75.9%, 74.2-77.7) were satisfied with online learning (postgraduates more than undergraduates), while faculty satisfaction rate was slightly lower (71.8%, 66.7-76.7). Learners preferred an in-person component: blended learning 56.0% (51.2-60.7), face-to-face 48.8% (45.4-52.1), and online-only 32.0% (29.3-34.8). They supported continuation of the virtual format as part of a blended system (68.1%, 64.6-71.5). Subgroup differences provided valuable insights despite not resolving the considerable heterogeneity. All outcomes were assessed as very-low-certainty evidence. CONCLUSION The COVID-19 pandemic has severely disrupted health worker education, inflicting a substantial mental health burden on learners. Its impacts on career choices, volunteerism, pedagogical approaches and mental health of learners have implications for educational design, measures to protect and support learners, faculty and health workers, and workforce planning. Online learning may achieve learner satisfaction as part of a short-term solution or integrated into a blended model in the post-pandemic future.
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Affiliation(s)
- Aikaterini Dedeilia
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
| | - Michail Papapanou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Society of Junior Doctors (SJD), Athens, Greece
| | - Andreas N Papadopoulos
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nina-Rafailia Karela
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Androutsou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Mitsopoulou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Melina Nikolakea
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Konstantinidis
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Manthia Papageorgakopoulou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, University of Patras, Patras, Greece
| | - Michail Sideris
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | | | - Giorgio Cometto
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Jim Campbell
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Marinos G Sotiropoulos
- Harvard Medical School, Boston, MA, USA.
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece.
- Department of Neurology, Brigham and Women's Hospital & Massachusetts General Hospital, 55 Fruit Street, WACC721, Boston, MA, 02114, USA.
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Psychological Impact on the Orthodontic Postgraduate Residents and Their Anxiety Level during the COVID-19 Pandemic. Int J Dent 2022; 2022:3143475. [PMID: 36624856 PMCID: PMC9825209 DOI: 10.1155/2022/3143475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/10/2022] [Accepted: 12/20/2022] [Indexed: 01/01/2023] Open
Abstract
Background COVID-19, a viral infection, has negatively impacted the physical and psychological health of the people worldwide. This was a descriptive, cross-sectional study, which aimed to investigate orthodontic postgraduate residents' knowledge regarding COVID-19, its association with anxiety around quality of their training, and performance of routine orthodontic procedures during the pandemic. A questionnaire was circulated online through WhatsApp to the orthodontic residents enrolled in the four-year postgraduate training program across the country which comprised the following sections: demographic data, questions to test knowledge of COVID-19, self-grading of anxiety around performing routine orthodontic procedures, academic aspects of the training program, and residents' thoughts on the current status of their training program in general during the pandemic. The residents were grouped based on their awareness on COVID-19, with >70% score taken as having adequate knowledge and ≤70% as inadequately updated. The association between COVID-19-related knowledge and the anxiety level of the residents experienced during training was assessed. Results were analyzed using SPSS (Statistical Package for Social Sciences) version 23.0. Counts and percentages were reported on baseline characteristics of studied samples. Descriptive methods were used to report the outcomes of this survey on knowledge of COVID-19, anxiety around performing orthodontic procedures, and different academic aspects of training. Statistical significance was set at p < 0.05 using the Pearson chi square test. Results Most of the residents (51.5%) were adequately updated about the COVID-19 virus. Increased awareness was associated with more anxiety about the following: contracting the virus (p < 0.01), performing different orthodontic procedures (p < 0.05), disturbed patients' appointments (p < 0.01), timely completion of their cases (p < 0.01), and exam's preparation (p=0.04). The group with <70% COVID-19 related knowledge opted for extension of their training period (51.8%). Conclusion COVID-19 related knowledge was clearly associated with anxiety experienced by the orthodontic residents during training in the pandemic. Awareness regarding the infection led to more anxiety around working during the pandemic, preparing for postgraduate exams, and concerns about its negative influence on the overall quality of the training program.
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SARS-CoV-Related Pandemic Outbreaks and Mental Disorder Risk. J Nerv Ment Dis 2022; 210:900-911. [PMID: 35687723 PMCID: PMC9741999 DOI: 10.1097/nmd.0000000000001543] [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] [Indexed: 02/04/2023]
Abstract
This study aimed to quantify the association between exposure to pandemic outbreaks and psychological health via a comprehensive meta-analysis. Literature retrieval, study selection, and data extraction were completed independently and in duplicate. Effect-size estimates were expressed as odds ratio (OR) with 95% confidence interval (CI). Data from 22 articles, involving 40,900 persons, were meta-analyzed. Overall analyses revealed a significant association of exposing to SARS-CoV-related pandemics with human mental health (OR, 1.32; 95% CI, 1.24-1.40; p < 0.001). Subgroup analyses showed that anxiety (OR, 1.37; 95% CI, 1.19-1.58; p < 0.001), depression (OR, 1.28; 95% CI, 1.15-1.42; p < 0.001), posttraumatic stress (OR, 1.36; 95% CI, 1.17-1.58; p < 0.001), and psychological distress (OR, 1.25; 95% CI, 1.11-1.40; p < 0.001) were all obviously related to pandemic diseases. In the context of infectious disease outbreaks, the mental health of general populations is clearly vulnerable. Therefore, all of us, especially health care workers, need special attention and psychological counseling to overcome pandemic together.
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Abati E, Nelva Stellio L, Manini A, Moroni F, Azzalini L, Vilca LM. A cross-sectional survey study of the impact of COVID-19 pandemic on the training and quality of life of Italian medical residents in the Lombardy region. Ann Med 2022; 54:2326-2339. [PMID: 36001504 PMCID: PMC9415486 DOI: 10.1080/07853890.2022.2105392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION The reorganization of the healthcare system prompted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has posed unique challenges for Residency Training Programs worldwide. To mitigate its potential negative effects, it is crucial to assess how the pandemic influenced the activity and quality of life of residents. The purpose of this study was to assess the impact of the pandemic on residents' competencies, satisfaction, working load, training patterns and occupational exposure in the clinical, surgical, research and didactic fields and to quantify its effects on quality of life and risk perception. METHODS An online cross-sectional survey was distributed between 1 June 2020 and 31 July 2020 to 1645 residents enrolled in all Residency Programs of four Universities in northern Italy. The survey included questions about clinical, surgical, and research competencies, educational activity, and quality of life pre- and post-pandemic, and on policies and workplace interventions to reduce exposure to SARS-CoV-2. The main outcome measure was the variation in self-perceived clinical, surgical and research competencies and in specialistic training. Data were analysed using the statistical package R Core Team 4.0.0, estimating mean and standard deviation or median and interquartile range for continuous variables. Variables were compared using chi-square test, Fisher exact tests or McNemar test, as appropriate.A multivariate binary logistic regression analysis was performed to test the effect of different factors on the impact of coronavirus disease-2019 (COVID-19) on self-perceived clinical and research competencies and on didactic training. RESULTS A total of 498 residents completed the survey (response rate 30.3%). The mean age of respondents was 28.9 years, 62.9% were women, and 52.4% were enrolled in the first two years of Training Programs. On the first pandemic wave, over 60% of residents reported a negative impact of the pandemic on their specialistic training. In contrast, 40% of residents involved in clinical duties perceived an improvement in their clinical competences, especially those involved in COVID-19 care, and 34.5% perceived an improvement in their research competences, particularly junior residents, while only 3.5% reported an improvement in surgical skills. Most surgical residents (88.5%) reported a decrease in surgical activities, mainly due to reduced hospital bed capacity and reduction of elective surgery. Almost 90% of all residents experienced a reduction in their didactic activities, but 80% stated their Residency Program adopted virtual training methods. A statistically significant reduction in all examined quality of life items post-pandemic vs. pre-pandemic was found. Even though most survey participants reported the availability of personal protective equipment for residents, 44% considered themselves to be at higher risk of exposure compared to senior staff. CONCLUSION COVID-19 pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care. The pandemic had a detrimental effect on all quality of life aspects, and most residents considered themselves at higher risk of SARS-CoV-2 infection compared to other healthcare professionals.Key MessagesCoronavirus disease-2019 (COVID-19) pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care.Most residents experienced a reduction of didactic activities. Although the majority of training programs implemented virtual training methods to counteract the restrictions imposed by the pandemic, only half of the residents were satisfied of them.A vast proportion of residents had a high occupational exposure to SARS-CoV-2 and considered themselves at higher risk of COVID-19 infection compared to senior staff.The survey highlighted a statistically significant reduction in five key quality of life measures (i.e. sleep, mood, familiar relationships and social relationships quality and employment satisfaction) during the first wave, with mood and social relationships being the most affected. Notably, employment satisfaction was significantly higher in medical compared to surgical residents.
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Affiliation(s)
- Elena Abati
- Department of Pathophysiology and Transplant (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy
| | - Leonardo Nelva Stellio
- Department of Women, Mothers and Neonates, Buzzi Children's Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Arianna Manini
- Department of Pathophysiology and Transplant (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy
| | - Francesco Moroni
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Luz Maria Vilca
- Unit of Obstetrics and Gynecology, Buzzi Children's Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
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11
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Kimpe V, Sabe M, Sentissi O. No increase in burnout in health care workers during the initial COVID-19 outbreak: Systematic review and meta-analysis. World J Meta-Anal 2022; 10:206-219. [DOI: 10.13105/wjma.v10.i4.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/21/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.
AIM To literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.
METHODS We performed a database search of Embase, Google Scholar and PubMed from June to October 2020. We analysed burnout risk factors and protective factors in included studies published in peer-reviewed journals as of January 2020, studying a HCW population during the first COVID-19 wave without any geographic restrictions. Furthermore, we performed a meta-analysis to determine overall burnout levels. We studied the main risk factors and protective factors related to burnout and stress at the individual, institutional and regional levels.
RESULTS Forty-one studies were included in our final review sample. Most were cross-sectional, observational studies with data collection windows during the first wave of the COVID-19 surge. Of those forty-one, twelve studies were included in the meta-analysis. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). Indeed, exposure to the virus was not a leading factor for burnout. Our meta-analytic estimate of burnout prevalence in the HCW population for a sample of 6784 individuals was 30.05%.
CONCLUSION There was a significant prevalence of burnout in HCWs during the COVID-19 pandemic, and some of the associated risk factors could be targeted for intervention, both at the individual and organizational levels. Nevertheless, COVID-19 exposure was not a leading factor for burnout, as burnout levels were not notably higher than pre-COVID-19 levels.
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Affiliation(s)
- Vincent Kimpe
- Faculty of Medicine, Geneva University, Geneva 1208, Geneva, Switzerland
| | - Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva 1205, Geneva, Switzerland
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva 1205, Geneva, Switzerland
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Goldman C, Pradere B, Mete M, Talso M, Bernardino R, Campi R, Marchalik D. A MULTINATIONAL STUDY OF THE IMPACT OF COVID-19 ON UROLOGIC SURGERY RESIDENCY AND WELLBEING. Urology 2022; 166:87-94. [PMID: 35461917 PMCID: PMC9023370 DOI: 10.1016/j.urology.2022.01.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/06/2021] [Accepted: 01/02/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess changes to the experiences and wellbeing of urology trainees in the United States(US) and European Union (EU) during the COVID-19 pandemic. METHODS A 72-item anonymous online survey was distributed September 2020 to urology residents of Italy, France, Portugal, and the US. The survey assessed burnout, professional fulfillment, loneliness, depression and anxiety as well as 38 COVID specific questions. RESULTS Two hundred twenty-three urology residents responded to the survey. Surgical exposure was the main educational concern for 81% of US and 48% of EU residents. E-learning was utilized by 100% of US and 57% of EU residents with two-thirds finding it equally or more useful than traditional didactics. No significant differences were seen comparing burnout, professional fulfillment, depression, anxiety, or loneliness among US or EU residents, 73% of US and 71% of EU residents reported good to excellent quality of life during the pandemic. In the US and EU, significantly less time was spent in the hospital, clinic, and operating room (p<0.001) and residents spent more time using telehealth and working from home during the pandemic and on research projects, didactic lectures, non-medical hobbies and reading. The majority of residents reported benefit from more schedule flexibility, improved work life balance, and increased time for family, hobbies, education, and research. CONCLUSIONS The COVID-19 pandemic has resulted in significant restructuring of residents' educational experience around the globe. Preservation of beneficial changes such as reduction of work hours and online learning should be pursued within this pandemic and beyond it.
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Affiliation(s)
- Charlotte Goldman
- MedStar Georgetown University Hospital, Department of Urology, 3800 Reservoir Rd NW, Washington, DC, 20007
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Mihriye Mete
- MedStar Health, Office of Physician Wellbeing, 10980 Grantchester Way, Columbia, MD, 21044; MedStar Health Research Institute, Depart of Behavioral Health Research; Georgetown University Medical Center, Department of Psychiatry
| | - Michele Talso
- Department of Urology ASST Fatebenefratelli-Sacco Luigi Sacco University Hospital, Milan, Italy
| | - Rui Bernardino
- Central Lisbon University Hospital Centre, Urology Department, Lisbon
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniel Marchalik
- MedStar Georgetown University Hospital, Department of Urology, 3800 Reservoir Rd NW, Washington, DC, 20007; MedStar Health, Office of Physician Wellbeing, 10980 Grantchester Way, Columbia, MD, 21044.
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13
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Caliandro M, Fabiana G, Surgo A, Carbonara R, Ciliberti MP, Bonaparte I, Caputo S, Fiorentino A. Impact on mental health of the COVID-19 pandemic in a radiation oncology department. Radiol Med 2022; 127:220-224. [PMID: 35034319 PMCID: PMC8761247 DOI: 10.1007/s11547-021-01440-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/03/2021] [Indexed: 01/08/2023]
Abstract
Aim To evaluate the emotional state and organizational well-being of healthcare workers in radiation oncology departments, during the COVID pandemic. Methods A survey was carried out with three questionnaires: Impact of Event Scale—Revised (IES-R); Italian ANAC questionnaire; and Maslach Burnout Inventory (MBI). Comparisons between groups were done by Student’s t test. Results Seventy-eight questionnaires for 26 workers were analyzed. Thirty-three percent of the sample obtained an IES-R high score, such as post-traumatic syndrome. In terms of organizational well-being, younger age and lower working seniority were statistically significant for higher score of ANAC items (p < 0.5). Regarding MBI, 0, 27 and 50% high scores of emotional exhaustion, depersonalization and personal accomplishment were reported, respectively. Low working seniority and male sex were correlated with high score of personal accomplishment (p:0.05; p:0.03). Conclusion Intervention to promote mental health well-being should be implemented in radiation oncology department.
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Affiliation(s)
- Morena Caliandro
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Gregucci Fabiana
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Alessia Surgo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy.
| | - Roberta Carbonara
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Maria Paola Ciliberti
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Ilaria Bonaparte
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Sergio Caputo
- General Regional Hospital F. Miulli, Acquaviva delle fonti (BA), Italy
| | - Alba Fiorentino
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
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14
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Fernández‐Arana A, Olórtegui‐Yzú A, Vega‐Dienstmaier JM, Cuesta MJ. Depression and anxiety symptoms and perceived stress in health professionals in the context of COVID-19: Do adverse childhood experiences have a modulating effect? Brain Behav 2022; 12:e2452. [PMID: 34910383 PMCID: PMC8785635 DOI: 10.1002/brb3.2452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) have a great impact on mental health outcomes of adults. However, little is known whether ACE may act as modulators of the mental health of health professionals caring for patients with COVID-19. METHODS Data were collected through an online cross-sectional survey administered to health professionals in Lima (Peru) between May and July 2020. The survey included standardized self-assessment instruments for anxiety, depression, acute stress (AS) and history of ACE. RESULTS A total of 542 health professionals completed the survey. Caring for patients with COVID-19 was significantly associated with depression and anxiety and when caring for patients with COVID-19 was combined with a history of early sexual abuse, its effect on the risk of anxiety increased (OR = 7.71, p = .010). Mental health problems were associated with female gender in almost all the analyses and with the majority of ACEs. CONCLUSIONS Health workers in the context of the COVID-19 pandemic presented a high risk of mental health disorders. Antecedents of sexual abuse acted as a potentiating factor of anxiety in professionals providing COVID-19 care. These findings suggest that the burden of ACE modulates mental health problems in health professionals during the pandemic.
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Affiliation(s)
| | - Adriel Olórtegui‐Yzú
- Universidad Nacional Mayor de San MarcosFacultad de Medina de San FernandoLimaPeru
- Instituto Nacional Cardiovascular ‐ INCOR ‐ EsSaludLimaPeru
| | | | - Manuel J. Cuesta
- Department of PsychiatryComplejo Hospitalario de NavarraPamplonaSpain
- Navarra Institute for Health Research (IdiSNA)Mental health areaPamplonaSpain
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Moini A, Maajani K, Omranipour R, Zafarghandi MR, Aleyasin A, Oskoie R, Alipour S. Residency training amid the COVID-19 pandemic: exploring the impact on mental health and training, a lesson from Iran. BMC MEDICAL EDUCATION 2021; 21:603. [PMID: 34872551 PMCID: PMC8647502 DOI: 10.1186/s12909-021-03029-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 11/23/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND COVID-19 has affected the training programs and the clinical schedules of surgical wards in many countries, including Iran. Also, the continuous involvement with COVID-19 patients has caused stress in health care workers; among them, residents are on the frontlines of care delivery. Therefore, we designed a study to assess the mental effects of these circumstances, and the effects on General Surgery and Obstetrics & Gynecology residency training in the busiest surgical departments of our university. METHODS Participants of this cross-sectional study were residents of General Surgery and Obstetrics & Gynecology of Tehran University of Medical Sciences, and the conventional sampling method was used. We used a questionnaire consisting of 47 questions (mostly using multiple choice questions and answers on the Likert scale) about personal, familial, and demographic characteristics; training activities, and mental effects of COVID-19. RESULTS The response rate was 63.5%. (127 filled questionnaires). Around 96% of the residents had emotional problems, 85.9% were highly stressed about contracting COVID-19, 81.3% were worried about transferring it to their families; and 78% believed that their residency training had been impaired. CONCLUSION Overall, our study shows the negative impact of COVID-19 on mental health and the training of residents. We propose that appropriate emotional support and suitable planning for compensation of training deficits is provided for residents.
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Affiliation(s)
- Ashraf Moini
- Breast Disease Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Gynecology and Obstetrics, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadije Maajani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramesh Omranipour
- Breast Disease Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Surgical Oncology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad-Reza Zafarghandi
- Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Aleyasin
- Department of Gynecology and Obstetrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Oskoie
- Office of the Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf Alipour
- Breast Disease Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Mansouri A, Sebbani M, Adarmouch L, Mansoury O, Amine M. Perceptions and stress factors among physicians in pre-graduate and post-graduate training in Morocco: COVID-19 pandemic context. J Community Hosp Intern Med Perspect 2021; 11:753-759. [PMID: 34804385 PMCID: PMC8604472 DOI: 10.1080/20009666.2021.1965288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Context: On 30 January, 2020, WHO stated that the global COVID-19 epidemic is a public health emergency. Facing this critical situation, health-care workers were at risk of developing psychological distress and other mental health problems. Aims: This study seeks to explore the feelings, attitudes and perceptions of the COVID-19 pandemic among physicians in pre-graduate and post-graduate training from Marrakesh University Hospital Centre. Methods and Material:We conducted a cross-sectional study with internal and resident-physicians in May 2020. Data collection was based on a self-administered electronic questionnaire. The sociodemographic informations, pandemic impact on the occupational and social fields and stress factors were evaluated. Statistical significance was set at p < 0.05. Results: The number of participants was 74. The sex ratio was 1.4 with an average age of 26.1 ± 3.6 years. Two-thirds were directly involved in the management of patients with SARS-CoV2. The majority reported that their work puts them at high-risk of exposure to SARS-CoV2 and 66% felt stressed at work, female physicians were more stressed than men (p = 0.028). Not knowing when the pandemic will be under control and the risk of developing an infection with SARS-CoV2 were the main sources of stress. About motivators for similar situations, respondents emphasized family support (91.9%) and recognition by management and supervisors for the additional efforts they provide (83.8%). Conclusions: The protection of health-care workers is an important component of public health measures to combat this pandemic. Special interventions to promote health-care workers mental well-being must be implemented immediately.
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Affiliation(s)
- Adil Mansouri
- Community Medicine and Public Health Department, Research Laboratory, Biosciences and Health, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco.,Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco
| | - Majda Sebbani
- Community Medicine and Public Health Department, Research Laboratory, Biosciences and Health, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco.,Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco
| | - Latifa Adarmouch
- Community Medicine and Public Health Department, Research Laboratory, Biosciences and Health, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco.,Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco
| | - Ouassim Mansoury
- Community Medicine and Public Health Department, Research Laboratory, Biosciences and Health, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco.,Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco
| | - Mohamed Amine
- Community Medicine and Public Health Department, Research Laboratory, Biosciences and Health, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco.,Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco
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Wohlfarth B, Gloor B, Hautz WE. Challenges of students and residents of human medicine in the first four months of the fight against the Covid-19 pandemic - Implications for future waves and scenarios. BMC MEDICAL EDUCATION 2021; 21:554. [PMID: 34717600 PMCID: PMC8556795 DOI: 10.1186/s12909-021-02962-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In the fight against the Covid-19 pandemic, medical students and residents are expected to adapt and contribute in a healthcare environment characterized by ever-changing measures and policies. The aim of this narrative review is to provide a summary of the literature that addresses the challenges of students and residents of human medicine in the first 4 months of the fight against the Covid-19 pandemic in order to identify gaps and find implications for improvement within the current situation and for potential future scenarios. METHODS We performed a systematic literature search and content analysis (CA) of articles available in English language that address the challenges of students and residents of human medicine in the first 4 months of the fight against the Covid-19 pandemic. RESULTS We retrieved 82 articles from a wide range of journals, professional backgrounds and countries. CA identified five recurring subgroup topics: "faculty preparation", «uncertainties and mental health», «clinical knowledge», «rights and obligations» and «(self-) support and supply». Within these subgroups the main concerns of (re-)deployment, interruption of training and career, safety issues, transmission of disease, and restricted social interaction were identified as potential stressors that hold a risk for fatigue, loss of morale and burnout. DISCUSSION Students and residents are willing and able to participate in the fight against Covid-19 when provided with appropriate deployment, legal guidance, safety measures, clinical knowledge, thorough supervision, social integration and mental health support. Preceding interviews to decide on reasonable voluntary deployment, the use of new technology and frequent feedback communication with faculties, educators and policymakers can further help with a successful and sustainable integration of students and residents in the fight against the pandemic. CONCLUSION It is critical that faculties, educators and policymakers have a thorough understanding of the needs and concerns of medical trainees during pandemic times. Leaders should facilitate close communication with students and residents, value their intrinsic creativeness and regularly evaluate their needs in regards to deployment, knowledge aspects, safety measures, legal concerns and overall well-being.
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Affiliation(s)
- Benny Wohlfarth
- Department of Visceral Surgery and Medicine, lnselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland
| | - Beat Gloor
- Department of Visceral Surgery and Medicine, lnselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland
| | - Wolf E. Hautz
- Department of Emergency Medicine, lnselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland
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Yang S, Wang J, Xu X. Psychological health status among thyroid cancer patients during the COVID-19 epidemic in China. Support Care Cancer 2021; 30:2111-2119. [PMID: 34671859 PMCID: PMC8528476 DOI: 10.1007/s00520-021-06624-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/08/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To investigate the psychological health status and explore the impact of different factors among thyroid cancer patients during the peak period of the COVID-19 epidemic in China. METHODS With thyroid cancer patients who had attended Peking Union Medical College Hospital included, we collected their demographic and clinical characteristics, COVID-19-related factors, and outcomes of 4 psychological scales (Insomnia Severity Index [ISI], Generalized Anxiety Disorder Questionnaire [GAD-7], Patient Health Questionnaire [PHQ-9], and Impact of Events Scale-Revised [IES-R]) through an online questionnaire and used multiple linear regression to find independent risk factors for each psychological symptom. RESULTS A total of 219 patients were included. Insomnia, anxiety, depression, and clinically relevant post-traumatic stress symptoms (PTSS) were reported by 69 (31.5%), 87 (39.7%), 74 (33.8%), and 44 (20.1%) patients, respectively. Based on multiple linear regression, being single/divorced/widowed, having a lower level of education, receiving resources of science lectures during the epidemic, and experiencing disruption of routine treatment or follow-up were associated with poorer psychological health among patients with thyroid cancer. CONCLUSIONS High rates of psychological symptoms and potential risk factors were found in thyroid cancer patients during the peak period of COVID-19 in China. Based on these findings, the psychological status of these patients should be a focus, and the psychological support systems need to be strengthened for the prevention of psychological crises during the epidemic.
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Affiliation(s)
- Shijie Yang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinhui Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Qu LG, Perera M, Lawrentschuk N, Umbas R, Klotz L. Scoping review: hotspots for COVID-19 urological research: what is being published and from where? World J Urol 2021; 39:3151-3160. [PMID: 32909171 PMCID: PMC7480207 DOI: 10.1007/s00345-020-03434-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/30/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Contemporary, original research should be utilised to inform guidelines in urology relating to the COVID-19 pandemic. This comprehensive review aimed to: identify all up-to-date original publications relating to urology and COVID-19, characterise where publications were from, and outline what topics were investigated. METHODS This review utilised a search strategy that assessed five electronic databases, additional grey literature, and global trial registries. All current published, in-press, and pre-print manuscripts were included. Eligible studies were required to be original research articles of any study design, reporting on COVID-19 or urology, in any of study population, intervention, comparison, or outcomes. Included studies were reported in a narrative synthesis format. Data were summarised according to primary reported outcome topic. A world heatmap was generated to represent where included studies originated from. RESULTS Of the 6617 search results, 48 studies met final inclusion criteria, including 8 pre-prints and 7 ongoing studies from online registries. These studies originated from ten countries according to first author affiliation. Most studies originated from China (n = 13), followed by Italy (n = 12) and USA (n = 11). Topics of the study included pathophysiological, administrative, and clinical fields: translational (n = 14), COVID-19-related outcomes (n = 5), urology training (n = 4), telemedicine (n = 7), equipment and safety (n = 2), urology in general (n = 4), uro-oncology (n = 3), urolithiasis (n = 1), and kidney transplantation (n = 8). CONCLUSION This review has outlined available original research relevant to COVID-19 and urology from the international community. This summary may serve as a guide for future research priorities in this area.
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Affiliation(s)
- Liang G Qu
- Olivia Newton John Cancer Research Institute, Austin Health, Melbourne, VIC, Australia.
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
- Department of Urology, Austin Health, Heidelberg, VIC, Australia.
| | - Marlon Perera
- Olivia Newton John Cancer Research Institute, Austin Health, Melbourne, VIC, Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Department of Urology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- EJ Whitten Prostate Cancer Research Centre at Epworth, Melbourne, VIC, Australia
| | - Rainy Umbas
- Department of Urology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Laurence Klotz
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Smida M, Khoodoruth MAS, Al‐Nuaimi SK, Al‐Salihy Z, Ghaffar A, Khoodoruth WNC, Mohammed MFH, Ouanes S. Coping strategies, optimism, and resilience factors associated with mental health outcomes among medical residents exposed to coronavirus disease 2019 in Qatar. Brain Behav 2021; 11:e2320. [PMID: 34342152 PMCID: PMC8413747 DOI: 10.1002/brb3.2320] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/17/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The aim of this study is to examine the association between coping strategies, resilience, optimism and different mental health outcomes like stress, anxiety, and depression among the medical residents' during the COVID-19 pandemic, with consideration of different factors like seniority, frontliner, gender, and coping style. METHODS An electronic survey was sent to all medical residents in Qatar. Depression, anxiety, and stress were assessed by the DASS-21. Professional quality of life was measured by the ProQOL scale. The coping mechanisms were assessed with the Brief-COPE, and resilience was measured by the Brief Resilience Scale. RESULTS The most commonly used coping strategies were acceptance, religion, and active coping. The avoidant coping style scores were higher among junior residents (p = .032) and non-COVID-19 frontliners (p = .039). Optimism LOT-R score was higher in senior than in junior residents (p < .001). Lower avoidant coping scores, higher optimism, and higher resilience were associated with lower stress, anxiety, and depressive symptoms. CONCLUSION It seems that avoidant coping styles can exacerbate depressive, anxiety, and stress symptoms in medical residents amidst the COVID-19 pandemic. Strategies promoting optimism, resilience, and approach coping styles can decrease the mental health burden of the pandemic on medical residents.
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Affiliation(s)
- Malek Smida
- Department of PsychiatryHamad Medical CorporationDohaQatar
| | | | | | | | - Adeel Ghaffar
- Graduate Medical EducationHamad Medical CorporationDohaQatar
| | | | | | - Sami Ouanes
- Department of PsychiatryHamad Medical CorporationDohaQatar
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21
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Almufarriji R, Elarjani T, Abdullah J, Alobaid A, Alturki AY, Aldakkan A, Ajlan A, Lary A, Al Jehani H, Algahtany M, Alqahatani S, Alsubaie F. Impact of COVID-19 on Saudi Neurosurgery Residency: Trainers' and Trainees' Perspectives. World Neurosurg 2021; 154:e547-e554. [PMID: 34325024 PMCID: PMC8461645 DOI: 10.1016/j.wneu.2021.07.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022]
Abstract
Introduction After the official announcement of the coronavirus disease-19 pandemic on March 11, 2020, the disease impacted most aspects of health care delivery, especially postgraduate education and training. Method A cross-sectional, online questionnaire-based assessment was performed. The study participants involved neurosurgery residents and program directors (PDs) across the country between May 16 and May 27, 2020. Results Approximately 74 of 95 (77.9%) of the residents experienced an impact on their training calendar. Before the pandemic, 51 residents (53.3%) were involved in 2–3 surgeries per week, but during the pandemic, 66 (69.5%) were attending 0–1 case per week. Fifty-three residents (55.8%) agreed that academic sessions were affected despite the helpful effort of online teaching sessions. Thirty-four (35.8%) residents graded their anxiety during coronavirus disease-19 times as high. Ten PDs (58.8%) confirmed spending 3–5 hours per week on educational activities normally, whereas during the pandemic, 15 PDs (88.2%) reduced their educational hours to 0–2 hours per week. Conclusion Our study showed that educational activities significantly decreased and shifted toward virtual teaching methods. Operative volume showed a substantial reduction for both junior and senior residents. Academic and clinical teaching was the main concern for PDs, and they faced challenges interviewing newly matched residents.
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Affiliation(s)
- Razan Almufarriji
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Turki Elarjani
- Neurosurgery Division, Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Jamal Abdullah
- Neurosurgery Department, Prince Sultan Military Hospital, Riyadh, Saudi Arabia
| | - Abdullah Alobaid
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
| | - Abdulrahman Y Alturki
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Aldakkan
- Neurosurgery Department, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrazag Ajlan
- Neurosurgery Department, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Lary
- Neurosurgery Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hosam Al Jehani
- Neurosurgery Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia
| | - Mubarak Algahtany
- Neurosurgery Division, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Saad Alqahatani
- Neurosurgery Department, King Abdulaziz Medical City, National Guard, Riyadh, Saudi Arabia
| | - Fahd Alsubaie
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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Farooq AR, Iqbal S, Abdulaziz N, O'Brien T, Peters N, Collins DC. Professional and personal opinions of doctors in training during the first wave of the COVID19 pandemic. Ir J Med Sci 2021; 191:1029-1035. [PMID: 34227033 PMCID: PMC8257037 DOI: 10.1007/s11845-021-02698-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The COVID19 pandemic is one of the greatest modern global healthcare crises. The resultant morbidity and mortality of public and healthcare professionals has led to psychological impacts and economic repercussions. We set out to assess the concerns of doctors in training during this crisis. METHODS A questionnaire was developed and delivered via Survey Monkey to doctors in training from 27 March to 6 April 2020, 2 weeks prior to the expected surge in Ireland and UK. The Perceived Stress Scale (PSS) was incorporated to gauge respondent stress as they prepared for the COVID19 impact. RESULTS A total of 285 participants engaged with 197 (69%) completing all questions. Almost 86% of respondents had been trained in donning and doffing personal protective equipment (PPE), and nearly 85% felt confident in the process. Overall, most respondents felt somewhat prepared (60%) or well prepared (20%) to treat COVID19 patients. However, 42% worried that their hospital would struggle, or not cope at all; in particular, 91% highlighted the risk of running out of PPE. Family health (86%), personal health (72%), and social life (47%) topped the list of junior doctor concerns. According to the PSS, the majority of respondents (62%) had moderate stress. CONCLUSIONS This survey is the first to measure the concerns of doctors in training in Ireland as regards the COVID19 pandemic. Worries included PPE exhaustion and personal and family health. A significant majority had moderate stress. Additional supports for doctors in training are essential to aid stress and manage concerns better.
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23
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Prezotti JA, Henriques JVT, Favorito LA, Canalini AF, Machado MG, Brandão TBV, Barbosa AMV, Moromizato JKM, Anzolch KMJ, Fernandes RDC, Rodrigues FRA, Bellucci CHS, Silva CS, Pompeo ACL, de Bessa J, Gomes CM. Impact of COVID-19 on education, health and lifestyle behaviour of Brazilian urology residents. Int Braz J Urol 2021; 47:753-776. [PMID: 33848067 PMCID: PMC8321480 DOI: 10.1590/s1677-5538.ibju.2021.99.09] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. MATERIALS AND METHODS A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents' concerns, and access to personal protective equipment (PPE). RESULTS Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 -7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P < 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents' concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. CONCLUSIONS COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents' losses.
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Affiliation(s)
- José Antonio Prezotti
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - João Victor T. Henriques
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Luciano A. Favorito
- Universidade do Estado do Rio de Janeiro - UERJUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Alfredo F. Canalini
- Universidade do Estado do Rio de Janeiro - UERJDisciplina de UrologiaRio de JaneiroRJBrasilDisciplina de Urologia, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Marcos G. Machado
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Thulio B. V. Brandão
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Akemi M. V. Barbosa
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Julyana K. M. Moromizato
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Karin M. J. Anzolch
- Hospital Moinhos de VentoServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Roni de C. Fernandes
- Santa Casa de São PauloFaculdade de Ciências MédicasSão PauloSPBrasilFaculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Fransber R. A. Rodrigues
- Universidade de Brasília - UNBDivisão de UrologiaBrasíliaDFBrasilDivisão de Urologia, Universidade de Brasília - UNB, Brasília, DF, Brasil
| | - Carlos H. S. Bellucci
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Caroline S. Silva
- Universidade Estadual de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Antonio Carlos L. Pompeo
- Universidade Federal do ABC - UFABCDisciplina de UrologiaSanto AndréSPBrasilDisciplina de Urologia, Universidade Federal do ABC - UFABC, Santo André, SP, Brasil
| | - Jose de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Cristiano M. Gomes
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
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Baral P. Health Systems and Services During COVID-19: Lessons and Evidence From Previous Crises: A Rapid Scoping Review to Inform the United Nations Research Roadmap for the COVID-19 Recovery. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 51:474-493. [DOI: 10.1177/0020731421997088] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This rapid scoping review has informed the development of the November 2020 United Nations Research Roadmap for the COVID-19 Recovery, by providing a synthesis of available evidence on the impact of pandemics and epidemics on (1) essential services and (2) health systems preparedness and strengthening. Emerging findings point to existing disparities in health systems and services being further exacerbated, with marginalized populations and low- and middle-income countries burdened disproportionately. More broadly, there is a need to further understand short- and long-term impacts of bypassed essential services, quality assurance of services, the role of primary health care in the frontline, and the need for additional mechanisms for effective vaccine messaging and uptake during epidemics. The review also highlights how trust—of institutions, of science, and between communities and health systems—remains central to a successful pandemic response. Finally, previous crises had repeatedly foreshadowed the inability of health systems to handle upcoming pandemics, yet the reactive nature of policies and practices compounded by lack of resources, infrastructure, and political will have resulted in the current failed response to COVID-19. There is therefore an urgent need for investments in implementation science and for strategies to bridge this persistent research–practice gap.
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Affiliation(s)
- Prativa Baral
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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25
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Banerjee S, Lim KHJ, Murali K, Kamposioras K, Punie K, Oing C, O'Connor M, Thorne E, Devnani B, Lambertini M, Westphalen CB, Garrido P, Amaral T, Morgan G, Haanen JBAG, Hardy C. The impact of COVID-19 on oncology professionals: results of the ESMO Resilience Task Force survey collaboration. ESMO Open 2021; 6:100058. [PMID: 33601295 PMCID: PMC7900705 DOI: 10.1016/j.esmoop.2021.100058] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/15/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on well-being has the potential for serious negative consequences on work, home life, and patient care. The European Society for Medical Oncology (ESMO) Resilience Task Force collaboration set out to investigate well-being in oncology over time since COVID-19. METHODS Two online anonymous surveys were conducted (survey I: April/May 2020; survey II: July/August 2020). Statistical analyses were performed to examine group differences, associations, and predictors of key outcomes: (i) well-being/distress [expanded Well-being Index (eWBI; 9 items)]; (ii) burnout (1 item from eWBI); (iii) job performance since COVID-19 (JP-CV; 2 items). RESULTS Responses from survey I (1520 participants from 101 countries) indicate that COVID-19 is impacting oncology professionals; in particular, 25% of participants indicated being at risk of distress (poor well-being, eWBI ≥ 4), 38% reported feeling burnout, and 66% reported not being able to perform their job compared with the pre-COVID-19 period. Higher JP-CV was associated with better well-being and not feeling burnout (P < 0.01). Differences were seen in well-being and JP-CV between countries (P < 0.001) and were related to country COVID-19 crude mortality rate (P < 0.05). Consistent predictors of well-being, burnout, and JP-CV were psychological resilience and changes to work hours. In survey II, among 272 participants who completed both surveys, while JP-CV improved (38% versus 54%, P < 0.001), eWBI scores ≥4 and burnout rates were significantly higher compared with survey I (22% versus 31%, P = 0.01; and 35% versus 49%, P = 0.001, respectively), suggesting well-being and burnout have worsened over a 3-month period during the COVID-19 pandemic. CONCLUSION In the first and largest global survey series, COVID-19 is impacting well-being and job performance of oncology professionals. JP-CV has improved but risk of distress and burnout has increased over time. Urgent measures to address well-being and improve resilience are essential.
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Affiliation(s)
- S Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
| | - K H J Lim
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Department of Immunology and Inflammation, Imperial College London, London, UK
| | - K Murali
- Austin Health, Heidelberg, Australia
| | - K Kamposioras
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - K Punie
- Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - C Oing
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M O'Connor
- University Hospital Waterford, Waterford, Ireland
| | - E Thorne
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - B Devnani
- Department of Radiotherapy and Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - C B Westphalen
- Department of Internal Medicine III, University Hospital, LMU Munich and Comprehensive Cancer Center, Munich, Germany
| | - P Garrido
- Medical Oncology, Hospital Ramón y Cajal, IRYCIS, Alcalá University, Madrid, Spain
| | - T Amaral
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany; Portuguese Air Force Health Care Direction, Lisbon, Portugal
| | - G Morgan
- Department of Medical and Radiation Oncology, Skåne University Hospital, Lund, Sweden
| | - J B A G Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Hardy
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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26
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Kunzler AM, Röthke N, Günthner L, Stoffers-Winterling J, Tüscher O, Coenen M, Rehfuess E, Schwarzer G, Binder H, Schmucker C, Meerpohl JJ, Lieb K. Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses. Global Health 2021; 17:34. [PMID: 33781283 PMCID: PMC8006628 DOI: 10.1186/s12992-021-00670-y] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. METHODS For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. RESULTS Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15-0.65) and depression (SMD 0.67; 95% CI 0.07-1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. CONCLUSIONS This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.
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Affiliation(s)
- Angela M Kunzler
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
| | - Nikolaus Röthke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lukas Günthner
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Jutta Stoffers-Winterling
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health Munich, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health Munich, Munich, Germany
| | - Guido Schwarzer
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christine Schmucker
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
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27
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Calcagnile T, Sighinolfi MC, Sarchi L, Assumma S, Filippi B, Bonfante G, Cassani A, Spandri V, Turri F, Puliatti S, Bozzini G, Moschovas M, Bianchi G, Micali S, Rocco B. COVID-19 and slowdown of residents' activity: Feedback from a novel e-learning event and overview of the literature. Urologia 2021; 88:332-336. [PMID: 33749385 DOI: 10.1177/03915603211001253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the impact of an e-learning online event, created for supporting resident's training during the slowdown of surgical and clinical activities caused by COVID-19 pandemic. An overview of PubMed literature depicting the state of the art of urology residency in the COVID-19 era was performed as well, to contextualize the issue. METHODS An online learning event for residents was set up at the beginning of the pandemic; the faculty consisted of experts in urology who provided on-line lectures and videos on surgical anatomy, procedures, updates in guidelines, technology, training. The audience was composed of 30-500 attendees from Italy, USA, India and Belgium. A questionnaire to analyze relevance, satisfaction and popularity of the lessons was mailed to 30 local residents. RESULTS AND LIMITATIONS Almost all residents defined the web environment suitable to achieve the learning outcomes; the method, the number and the competence of the faculty were appropriate/excellent. Most of the younger residents (81.8%) stated their surgical knowledge would improve after the course; 72.7% declared they would take advantage into routine inpatients clinical activity. Nineteen more expert residents agreed that the course would improve their surgical knowledge and enhance their practical skills; almost all stated that the initiative would change their outpatients and inpatients practice. Overall, 44 articles available in PubMed have addressed the concern of urological learning and training during the pandemic from different standpoints; four of them considered residents' general perception towards web-based learning programs. CONCLUSIONS The paper confirms residents' satisfaction with e-learning methods and, to our knowledge, is the first one focusing on a specific event promptly settled up at the beginning of the outbreak. Web-based educational experience developed during the pandemic may represent the very basis for the implementation of prospective on-site training and overall scientific update of future urologists.
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Affiliation(s)
- Tommaso Calcagnile
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | | | - Luca Sarchi
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Simone Assumma
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Beatrice Filippi
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Giulia Bonfante
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Alessandra Cassani
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Valentina Spandri
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Filippo Turri
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Stefano Puliatti
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Giorgio Bozzini
- Department of Urology, ASST Valle Olona Busto Arsizio, Varese, Italy
| | - Marcio Moschovas
- Department of Urology, Advent Health Global Robotics Institute, Celebration, FL, USA
| | - Giampaolo Bianchi
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Bernardo Rocco
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
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Seifman MA, Fuzzard SK, To H, Nestel D. COVID-19 impact on junior doctor education and training: a scoping review. Postgrad Med J 2021; 98:466-476. [PMID: 33688067 DOI: 10.1136/postgradmedj-2020-139575] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/06/2021] [Indexed: 11/03/2022]
Abstract
COVID-19 has had a significant impact on healthcare resources and the medical workforce. Clinically-based medical education is the principal source of learning, and this has been profoundly impacted by restrictions due to COVID-19. It follows that junior medical staff and their education would be significantly impacted due to the altered volume and breadth of their clinical exposure. Some literature has been published regarding the impact to medical training during COVID-19. This study sought to review junior medical staff perceptions and their reported impact of the COVID-19 pandemic on their education and training.Nine databases (three Ovid MEDLINE databases, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Centre and PsychINFO) were searched for studies published in 1 January 2020 through 24 August 2020. Via a scoping review protocol, an iterative process was used to perform the identification, review and charting analysis of the reported outcomes and themes. Descriptive analysis was performed using quantitative and qualitative methods.Of the 25 343 sources identified, 32 were included in the review. There were studies published from nearly all continents, predominantly in surgical journals, with a wide spread of specialties. Themes identified included the current impact of the pandemic in relation to continuation of and modifications to training programmes, as well as the future impact due to training requirements and career progression.Junior medical staff report that the COVID-19 pandemic has had a significant impact on their education and training. Whether the changes imposed by the pandemic on education are temporary measures or permanent fixtures, and whether standards of competence may be impacted, is not yet known. This scoping review forms a basis for further investigation in the field.
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Affiliation(s)
- Marc Adam Seifman
- Plastic, Reconstructive and Hand Surgery Unit, Peninsula Health, Frankston, Victoria, Australia .,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sibon K Fuzzard
- Plastic, Reconstructive and Hand Surgery Unit, Peninsula Health, Frankston, Victoria, Australia
| | - Henry To
- Northern Health Research and Education, Epping, Victoria, Australia
| | - Debra Nestel
- Surgery-Austin Health Precinct, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
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Lange M, Joo S, Couette PA, Le Bas F, Humbert X. Impact on mental health of the COVID-19 outbreak among general practitioners during the sanitary lockdown period. Ir J Med Sci 2021; 191:93-96. [PMID: 33660115 PMCID: PMC7929901 DOI: 10.1007/s11845-021-02513-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/10/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND COVID-19 outbreak can impact mental health including health care workers. AIM The aim of this study was to assess the mental health impact of COVID-19 in French General Practitioners (GPs). METHODS We carried out a postal-based survey during the first lockdown. Four psychological validated self-report questionnaires were used to assess stress,post-traumatic stress symptoms, burnout and self-efficacy (Perceived Stress scale, Impact of Event Scale-revised, Maslach Burnout Inventory and General Self-Efficacy scale). RESULTS The sample consists of 332 general practitioners (43.50% women, mean age = 50.74 ± 11.91). General practitioners working in high epidemic location represented 27.71% of the sample (n = 92). Thirty four GPs reported significant post-traumatic stress symptoms (10.59%). High burnout symptoms were found in 79 (24.46%), 137 (42.41%) and 17 (5.26%) participants. Only General Self-Efficacy scores were significantly different according to epidemic location status with lower scores in GPs working in high epidemic location (33.37 ± 4.64 vs. 32.06 ± 5.43; P = 0.04). Women reported more stress and burnout symptoms than men (P = 0.01). CONCLUSIONS This study showed the psychological impact of COVID-19 in GPs during the sanitary lockdown period including burnout and post-traumatic stress symptoms. Up to 42% of GPs reported psychological disturbances. Interventions to promote mental health well-being of healthcare workers need to be developing.
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Affiliation(s)
- Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France.,Normandie University, UNICAEN, INSERM, ANTICIPE, 14000, Caen, France
| | - Sarah Joo
- Family Medicine Department, Normandie University, UNICAEN, UFR Santé, 2, rue des Rochambelles, 14000, Caen, France.,EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, Normandie University, 14000, Caen, France
| | - Pierre-André Couette
- Family Medicine Department, Normandie University, UNICAEN, UFR Santé, 2, rue des Rochambelles, 14000, Caen, France.,EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, Normandie University, 14000, Caen, France
| | - François Le Bas
- Family Medicine Department, Normandie University, UNICAEN, UFR Santé, 2, rue des Rochambelles, 14000, Caen, France.,EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, Normandie University, 14000, Caen, France
| | - Xavier Humbert
- Family Medicine Department, Normandie University, UNICAEN, UFR Santé, 2, rue des Rochambelles, 14000, Caen, France. .,EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, Normandie University, 14000, Caen, France.
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Rassweiler JJ, Pini G, Liatsikos F, Georgiev M, Roupret M, Breda A, Knoll T, Micali S, Stenzl A, Goezen AS, Yanev K, Rassweiler-Seyfried MC. [COVID-19 in european urology : Which lessons have we learned?]. Urologe A 2021; 60:306-317. [PMID: 33559012 PMCID: PMC7869769 DOI: 10.1007/s00120-021-01450-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 11/30/2022]
Abstract
The coronavirus has challenged all medical systems worldwide. Herein both waves of COVID-19 (coronavirus disease 2019) in spring and autumn 2020 differ principally. Whereas Europe was hit by the first wave more or less unprepared, which was aggravated by the high virulence of COVID-19, the second wave is characterized by a much higher contagiosity of the virus with very high incidences. On the other hand the virus has attenuated, which is reflected by the significantly lower incidence-related mortality rate. However, the overall increasing number of infected patients represents again a great challenge for the medical management of the disease. France and Spain are doing better in comparison to Germany and Italy this time. The absolute number of deaths per week is higher than during the peak of the first wave. However, urologists in these countries have also experienced greater restrictions in their activities in the second shutdown than in Germany, where there is only a reduction of beds to between 75 and 90%. Mostly all levels are operated. Of importance for Germany, however, is the plateau on a high level for several weeks probably due to the reduced efficacy of a light lock-down. This finally resulted in a total lock-down in mid-December 2020. Subsequently in Germany some hospitals are also reaching their limits with similar consequences for the departments of urology facing a 50% reduction of beds and operating only level III and IV indications. Nevertheless, the management of urologic patients during the COVID-19 pandemic is carried out in Europa on a high standard. Therefor the risk of secondary harm to our patients is expected to be rather minimal in the long run.
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Affiliation(s)
- J J Rassweiler
- Klinik für Urologie und Kinderurologie SLK Kliniken Heilbronn, Akademisches Lehrkrankenhaus der Universität Heidelberg, Heidelberg, Deutschland.
- Urologische Klinik, SLK Kliniken Heilbronn, Am Gesundbrunnen 20, 74074, Heilbronn, Deutschland.
| | - G Pini
- IRCSS San Raffaele Hospital, 20132, Mailand, Lombardei, Italien
| | - F Liatsikos
- Department of Urology, University of Patras, Patras, Griechenland
| | - M Georgiev
- Department of Urology, Medical University Sofia, Sofia, Bulgarien
| | - M Roupret
- GRC 5 Predictive ONCO-URO, AP-HP, Urology, Pitié-Salpetrière Hospital, Sorbonne University, Paris, Frankreich
| | - A Breda
- Department of Uro-oncology and Transplantation, Fundacio Puigvert, Barcelona, Spanien
| | - T Knoll
- Urologische Klinik, Klinikum Sindelfingen-Böblingen, Klinikverbund-Südwest, Sindelfingen-Böblingen, Deutschland
| | - S Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italien
| | - A Stenzl
- Urologische Universitätsklinik Tübingen, Tübingen, Deutschland
| | - A S Goezen
- Klinik für Urologie und Kinderurologie SLK Kliniken Heilbronn, Akademisches Lehrkrankenhaus der Universität Heidelberg, Heidelberg, Deutschland
| | - K Yanev
- Department of Urology, Medical University Sofia, Sofia, Bulgarien
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Khoodoruth MAS, Al-Nuaimi SK, Al-Salihy Z, Ghaffar A, Khoodoruth WNCK, Ouanes S. Factors associated with mental health outcomes among medical residents exposed to COVID-19. BJPsych Open 2021; 7:e52. [PMID: 33583483 PMCID: PMC8058844 DOI: 10.1192/bjo.2021.12] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak has caused challenges for healthcare systems worldwide. Recent data indicates that the psychological impact has differed with respect to occupation. In many countries, medical residents have been on the front line of this pandemic. However, data on the psychological impact of infectious disease outbreaks, and COVID-19 in particular, on medical residents are relatively lacking. AIMS The aim of our study was to assess the psychological impact of the COVID-19 pandemic on medical residents working on the front and second line. METHOD An electronic survey was sent to all medical residents in Qatar. Depression, anxiety and stress were assessed by the Depression, Anxiety and Stress Scale - 21 Items. Professional quality of life was measured by the Professional Quality of Life measure. RESULTS Of the 640 medical residents contacted, 127 (20%) responded. A considerable proportion of residents reported symptoms of depression (42.5%), anxiety (41.7%) and stress (30.7%). Multivariate analysis of variance showed significant effects of seniority in residency, with junior residents having poorer outcomes. In addition, there was a statistically significant interaction effect with moderate effect sizes between gender and working on the front line, as well as gender, working on the front line and seniority, on mental health outcomes. CONCLUSIONS The COVID-19 pandemic may have a negative impact on junior residents' mental health. Preventive measures to reduce stress levels and easy access to professional mental health services are crucial.
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Affiliation(s)
| | | | | | - Adeel Ghaffar
- Medical Education Department, Hamad Medical Corporation, Qatar
| | | | - Sami Ouanes
- Department of Psychiatry, Hamad Medical Corporation, Qatar
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Macía-Rodríguez C, Alejandre de Oña Á, Martín-Iglesias D, Barrera-López L, Pérez-Sanz MT, Moreno-Diaz J, González-Munera A. Burn-out syndrome in Spanish internists during the COVID-19 outbreak and associated factors: a cross-sectional survey. BMJ Open 2021; 11:e042966. [PMID: 33574150 PMCID: PMC7880089 DOI: 10.1136/bmjopen-2020-042966] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The objective of this study is to evaluate the impact of the COVID-19 outbreak on mental health and burn-out syndrome in Spanish internists and the factors that could be related to its appearance. DESIGN We performed an observational, cross-sectional, descriptive study for which we designed a survey that was distributed in May 2020. SETTING We included internists who worked in Spain during the COVID-19 outbreak. PARTICIPANTS A total of 1015 internists responded to the survey. Of those 62.9% were women. RESULTS Of 1015 people, 58.3% presented with high emotional exhaustion, 61.5% had a high level of depersonalisation and 67.6% reported low personal fulfilment. 40.1% presented with the 3 criteria described, and therefore burn-out syndrome.Burn-out syndrome was independently related to the management of patients with SARS-CoV-2 (HR: 2.26; 95% CI 1.15 to 4.45), the lack of availability of personal protective equipment (HR: 1.41; 95% CI 1.05 to 1.91), increased responsibility (HR: 2.13; 95% CI 1.51 to 3.01), not having received financial compensation for overtime work (HR: 0.43; 95% CI 0.31 to 0.62), not having rested after 24-hour shifts (HR: 1.61; 95% CI 1.09 to 2.38), not having had holidays in the previous 6 months (HR: 1.36; 95% CI 1.01 to 1.84), consumption of sleeping pills (HR: 1.83; 95% CI 1.28 to 2.63) and higher alcohol intake (HR: 1.95; 95% CI 1.39 to 2.73). CONCLUSIONS During the COVID-19 outbreak, 40.1% of Internal Medicine physicians in Spain presented with burn-out syndrome, which was independently related to the assistance of patients with SARS-CoV-2, overworking without any compensation and the fear of being contagious to their relatives. Therefore, it is imperative to initiate programmes to prevent and treat burn-out in front-line physicians during the COVID-19 outbreak.
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Affiliation(s)
- Cristina Macía-Rodríguez
- Department of Internal Medicine, POVISA Hospital-Ribera Salud Group, Vigo, Spain
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
| | - Álvaro Alejandre de Oña
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Daniel Martín-Iglesias
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Spain
| | - Lucía Barrera-López
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
- Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - María Teresa Pérez-Sanz
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Moreno-Diaz
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
- Chief Medical Officer, Hospital Real Nuestra Señora de Gracia, Zaragoza, Spain
| | - Adriana González-Munera
- Formation Work Group of the Spanish Society of Internal Medicine, Madrid, Spain
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Fiest KM, Parsons Leigh J, Krewulak KD, Plotnikoff KM, Kemp LG, Ng-Kamstra J, Stelfox HT. Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review. BMC Psychiatry 2021; 21:91. [PMID: 33568141 PMCID: PMC7875435 DOI: 10.1186/s12888-021-03090-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prior to the COVID-19 pandemic, physicians experienced unprecedented levels of burnout. The uncertainty of the ongoing COVID-19 pandemic along with increased workload and difficult medical triage decisions may lead to a further decline in physician psychological health. METHODS We searched Medline, EMBASE, and PsycINFO for primary research from database inception (Medline [1946], EMBASE [1974], PsycINFO [1806]) to November 17, 2020. Titles and abstracts were screened by one of three reviewers and full-text article screening and data abstraction were conducted independently, and in duplicate, by three reviewers. RESULTS From 6223 unique citations, 480 articles were reviewed in full-text, with 193 studies (of 90,499 physicians) included in the final review. Studies reported on physician psychological symptoms and management during seven infectious disease outbreaks (severe acute respiratory syndrome [SARS], three strains of Influenza A virus [H1N1, H5N1, H7N9], Ebola, Middle East respiratory syndrome [MERS], and COVID-19) in 57 countries. Psychological symptoms of anxiety (14.3-92.3%), stress (11.9-93.7%), depression (17-80.5%), post-traumatic stress disorder (13.2-75.2%) and burnout (14.7-76%) were commonly reported among physicians, regardless of infectious disease outbreak or country. Younger, female (vs. male), single (vs. married), early career physicians, and those providing direct care to infected patients were associated with worse psychological symptoms. INTERPRETATION Physicians should be aware that psychological symptoms of anxiety, depression, fear and distress are common, manifest differently and self-management strategies to improve psychological well-being exist. Health systems should implement short and long-term psychological supports for physicians caring for patients with COVID-19.
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Affiliation(s)
- Kirsten M Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary & Alberta Health Services, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada.
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, Alberta, T2N4Z6, Canada.
| | - Jeanna Parsons Leigh
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, Alberta, T2N4Z6, Canada
- School of Health Administration, Faculty of Health and Department of Critical Care Medicine, Faculty of Medicine, Dalhousie University, 5850 College Street, Halifax, Nova Scotia, B3H4R2, Canada
| | - Karla D Krewulak
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary & Alberta Health Services, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada
| | - Kara M Plotnikoff
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary & Alberta Health Services, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada
| | - Laryssa G Kemp
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary & Alberta Health Services, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada
| | - Joshua Ng-Kamstra
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary & Alberta Health Services, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary & Alberta Health Services, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, T2N4Z6, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, Alberta, T2N4Z6, Canada
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Abstract
Background Coronavirus disease (COVID-19) has caused global disruption to health care. Non-urgent elective surgical cases have been cancelled, outpatient clinics have reduced and there has been a reduction in the number of patients presenting as an emergency. These factors will drastically affect the training opportunities of surgical trainees. The aim of this systematic review is to describe the impact of COVID-19 on surgical training globally. Methods The review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched. Results The searches identified 499 articles, 29 of which were included in the review. This contained data from more than 20 countries with 5260 trainees and 339 programme directors. Redeployment to non-surgical roles varied across studies from 6% to 35.1%. According to all of the studies, operative experience has been reduced. Knowledge learning had been switched to online platforms across 17 of the studies and 7 reported trainees had increased time to devote to educational/academic activities. All of the studies reporting on mental health report negative associations with increased stress, ranging from 54.9% to 91.6% of trainees. Conclusions The impact of COVID-19 on surgical trainees has been experienced globally and across all specialities. Negative effects are not limited to operative and clinical experience, but also the mental health and wellbeing of trainees. Delivery of surgical training will need to move away from traditional models of learning to ensure trainees are competent and well supported. Supplementary Information The online version contains supplementary material available at 10.1007/s10151-020-02404-5.
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Flateau C, Noël C, Bonnafoux A, Fuentes E, de Pontfarcy A, Diamantis S. Psychological impact of the SARS-CoV-2 outbreak on the staff of a French hospital. Infect Dis Now 2021; 51:187-193. [PMID: 33495766 PMCID: PMC7816966 DOI: 10.1016/j.idnow.2021.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/04/2021] [Accepted: 01/11/2021] [Indexed: 12/24/2022]
Abstract
Background The outbreak of SARS-CoV-2 has resulted in anxiety, depression and post-traumatic stress disorder (PTSD) among hospital staff. The factors associated with this psychological impact remain to be determined. Methods A cross-sectional study using an online questionnaire completed by the staff of a French hospital, two months after the SARS-CoV-2 outbreak. Results Among the 353 participants (of whom 67% were healthcare professionals), 32% had symptoms of anxiety, 16% of depression and 16% of PTSD. Eleven per cent had initiated or increased treatment with sleeping pills, and 6% with anxiolytics. In a multivariate analysis, factors independently associated with anxiety were: change of professional team, having a relative infected by SARS-CoV-2 and a new/increased treatment with sleeping pills or anxiolytics. The only factor associated with depression was the feeling of risk during professional practice. The factors associated with PTSD were: having a relative infected by SARS-CoV-2, the feeling of risk during professional practice, the increase in smoking and treatment with sleeping pills. The observance of transmission preventive measures (TPM) was not associated with the psychological impact of SARS-CoV-2. A personal history of SARS-CoV-2 infection and age < 36 years were associated with insufficient use of protective equipment. Age < 36 years, and being a healthcare professional were associated with the non-observance of social distancing. Conclusion The hospital staff displayed psychological consequences, resulting in the use of anxiolytics and sleeping pills. Belonging to a group with low-risk of severe disease was associated with lower observance of TPM.
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Affiliation(s)
- C Flateau
- Service des maladies infectieuses, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - C Noël
- Équipe mobile opérationnelle d'hygiène, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - A Bonnafoux
- Pôle médecine, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - E Fuentes
- Pôle médecine, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - A de Pontfarcy
- Service des maladies infectieuses, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - S Diamantis
- Service des maladies infectieuses, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
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Ngoo KS, Fadzli AN, Amponin MOCSE, Cho SY, Chuang Y, Horiguchi A, Karthikeyan VS, Morshed MS, Situmorang GR, Tan TC, Teoh JY, Thaidumrong T, Ong T. COVID
‐19 pandemic impact on urology residencies in
Asia
‐ An observational study. SURGICAL PRACTICE 2021. [DOI: 10.1111/1744-1633.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kay Seong Ngoo
- Department of Surgery Hospital Angkatan Tentera Tuanku Mizan Kuala Lumpur Malaysia
| | - Ahmad Nazran Fadzli
- Urology Unit, Department of Surgery University of Malaya Medical Center Kuala Lumpur Malaysia
| | | | - Sung Yong Cho
- Department of Urology Seoul National University Hospital Seoul South Korea
| | - Yao‐Chi Chuang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Akio Horiguchi
- Department of Urology National Defense Medical College Saitama Japan
| | | | - Md Selim Morshed
- Department of Urology Dhaka Medical College Hospital Dhaka Bangladesh
| | - Gerhard Reinaldi Situmorang
- Department of Urology, Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Tinh Chung Tan
- Urology C Department Binh Dan Hospital Ho Chi Minh City Vietnam
| | - Jeremy Yuen‐Chun Teoh
- Department of Surgery, Faculty of Medicine The Chinese University of Hong Kong Shatin Hong Kong
| | - Tanet Thaidumrong
- Division of Urology, Department of Surgery Rajavithi Hospital Bangkok Thailand
| | - Teng‐Aik Ong
- Urology Unit, Department of Surgery University of Malaya Medical Center Kuala Lumpur Malaysia
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Teixeira BL, Cabral J, Mendes G, Madanelo M, Rocha MA, Mesquita S, Correia J, Tavares C, Marques-Pinto A, Fraga A. How the COVID-19 pandemic changed urology residency - a nationwide survey from the Portuguese resident's perspective. Cent European J Urol 2021; 74:121-127. [PMID: 33976927 PMCID: PMC8097653 DOI: 10.5173/ceju.2021.0278.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION The aim of this article was to evaluate the impact of the COVID-19 pandemic on urology residency. MATERIAL AND METHODS A 30 question online survey was sent to all urology residents in Portugal between the 25th of April and the 25th of May 2020. Reduction in different areas of clinical activity during the COVID-19 period were evaluated and their perceived impact on their residency program was quantified. RESULTS Forty-three (54.4%) Portuguese urology residents responded to our inquiry. Eighty-one percent report having supressed their activity by more than 75% in the outpatient clinic; 48.8% in diagnostic procedures; 29.3% in endoscopic surgery; 67.5% in laparoscopic/robotic surgery and 17.5% in major open surgery. There were no differences in clinical activity reduction across residency years. Considering the impact of COVID-19 on urology training programs, 32.6% plan on prolonging residency. During the COVID-19 period, a larger number of residents report having spent more time developing research projects or on continuing medical education, as compared with the pre-COVID-19 period (p = 0.012). CONCLUSIONS COVID-19 had a major impact on Urology residency in Portugal, with major short- and long-term consequences. A large proportion of residents are considering prolonging their residency as a result.
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Affiliation(s)
| | - João Cabral
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | - Gonçalo Mendes
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | - Mariana Madanelo
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | | | - Sofia Mesquita
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | - Jorge Correia
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | - Catarina Tavares
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | - André Marques-Pinto
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
| | - Avelino Fraga
- Centro Hospitalar Universitário do Porto, Department of Urology, Porto, Portugal
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Thapa BB, Shrestha D, Bista S, Thapa S, Niranjan V. Urology during COVID-19 Pandemic Crisis: A Systematic Review. Surg J (N Y) 2021; 7:e3-e10. [PMID: 33469564 PMCID: PMC7810570 DOI: 10.1055/s-0040-1722341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/14/2020] [Indexed: 12/05/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude. The health care system is facing a tremendous challenge to provide ethical and quality care. The transformation of the patient-based care to population-based care during the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is to explore the consensus in modified standard urology care, that can be adopted and applied during COVID-19 and similar pandemic. Methods We adopted an exploratory study design using secondary data. The data were extracted from a web-based medical library using keywords "COVID-19," "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)," and "urology." We identify and extrapolate (screening, eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic standard urology care under four main themes: (1) general urology care, (2) choice of surgical modality, (3) triage, and (4) urology training. Result We identified 63 academic papers related to our research question. The majority are expert opinions and perspectives on urology care. The common consensus is triage-based urology care and surgeries. Life or organ threatening conditions need immediate attention. Universal protective measures (personal protective equipment, safe operative environment) and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection. Conservation of the resources and its rational distribution provide an ethical basis for population-based health care during a pandemic. Informed decision making serves best to patients, families, and society during the public health crisis. Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard population-based care. The consensus in crisis is drawn from evolving pieces of medical evidence and public health ethics. The provision of urology care during a pandemic is based on the availability of resources; severity of the disease, consequences of deferment of service, and dynamics of the pandemic.
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Affiliation(s)
- Bikash Bikram Thapa
- Department of Surgery, College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Dhan Shrestha
- Department of Emergency Medicine, Mangalbare Hospital, Morang, Nepal
| | - Sanjeeb Bista
- Department of Surgery, College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Suresh Thapa
- Department of Surgery, College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Vikram Niranjan
- Health Research Institute/Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Pathak M, Thakur B. Burden of predominant psychological reactions among the healthcare workers and general population during COVID-19 pandemic phase: A systematic review and meta-analysis. Indian J Community Med 2021; 46:600-605. [PMID: 35068717 PMCID: PMC8729270 DOI: 10.4103/ijcm.ijcm_1007_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 06/17/2021] [Indexed: 12/23/2022] Open
Abstract
Aim: Material and Methods: Results: Conclusion:
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Mheidly N, Fares MY, Fares J. Coping With Stress and Burnout Associated With Telecommunication and Online Learning. Front Public Health 2020; 8:574969. [PMID: 33262967 PMCID: PMC7686031 DOI: 10.3389/fpubh.2020.574969] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic substantially impacted the field of telecommunication. It increased the use of media applications that enable teleconferencing, telecommuting, online learning, and social relations. Prolonged time facing screens, tablets, and smart devices increases stress and anxiety. Mental health stressors associated with telecommunication can add to other stressors related to quarantine time and lockdown to eventually lead to exhaustion and burnout. In this review, the effects of the COVID-19 pandemic on communication and education are explored. In addition, the relationship between prolonged exposure to digital devices and mental health is studied. Finally, coping strategies are offered to help relieve the tele-burdens of pandemics.
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Affiliation(s)
- Nour Mheidly
- Faculty of Information, Lebanese University, Beirut, Lebanon
| | - Mohamad Y. Fares
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- College of Medical Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jawad Fares
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland SØ, Stroobants S, Van de Velde S, Vist GE. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res 2020; 293:113441. [PMID: 32898840 PMCID: PMC7462563 DOI: 10.1016/j.psychres.2020.113441] [Citation(s) in RCA: 468] [Impact Index Per Article: 117.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 12/20/2022]
Abstract
The covid-19 pandemic has heavily burdened healthcare systems throughout the world. We performed a rapid systematic review to identify, assess and summarize research on the mental health impact of the covid-19 pandemic on HCWs (healthcare workers). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence on 11 May and included 59 studies. Six reported on implementing interventions, but none reported on effects of the interventions. HCWs reported low interest in professional help, and greater reliance on social support and contact. Exposure to covid-19 was the most commonly reported correlate of mental health problems, followed by female gender, and worry about infection or about infecting others. Social support correlated with less mental health problems. HCWs reported anxiety, depression, sleep problems, and distress during the covid-19 pandemic. We assessed the certainty of the estimates of prevalence of these symptoms as very low using GRADE. Most studies did not report comparative data on mental health symptoms before the pandemic or in the general population. There seems to be a mismatch between risk factors for adverse mental health outcomes among HCWs in the current pandemic, their needs and preferences, and the individual psychopathology focus of current interventions.
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Affiliation(s)
| | | | | | | | | | - Synne Øien Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies, Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
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Impact on mental health of the COVID-19 outbreak among community pharmacists during the sanitary lockdown period. ANNALES PHARMACEUTIQUES FRANÇAISES 2020; 78:459-463. [PMID: 33038309 PMCID: PMC7539790 DOI: 10.1016/j.pharma.2020.09.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 01/11/2023]
Abstract
This study showed the psychological impact of COVID-19 in community pharmacists. Up to 35% of pharmacists reported psychological disturbances. Interventions to promote mental well-being of healthcare workers need to be developing.
Objectives COVID-19 outbreak can impact mental health including health care workers. The aim of this study was to assess the psychological impact of COVID-19 in French community pharmacists. Material and methods We carried out a postal-based survey to assess the psychological impact of COVID-19 in French owner community pharmacists based on three validated self-report questionnaires: Perceived Stress scale, Impact of Event Scale-revised and Maslach Burnout Inventory. Results The sample consists of 135 community pharmacists. Twenty-three pharmacists reported significant post-traumatic stress symptoms (17%). High burnout symptoms were found in 33 (25%), 46 (34.9%) and 4 (3%) participants. Females scored higher than males for all questionnaires (P = 0.01). Conclusions This study is the first study which showed the psychological impact of COVID-19 in community pharmacists. Based on validated self-report questionnaires, up to 35% of pharmacists reported psychological disturbances. Interventions to promote psychological well-being of healthcare workers need to be developing.
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Mrklas K, Shalaby R, Hrabok M, Gusnowski A, Vuong W, Surood S, Urichuk L, Li D, Li XM, Greenshaw AJ, Agyapong VIO. Prevalence of Perceived Stress, Anxiety, Depression, and Obsessive-Compulsive Symptoms in Health Care Workers and Other Workers in Alberta During the COVID-19 Pandemic: Cross-Sectional Survey. JMIR Ment Health 2020; 7:e22408. [PMID: 32915764 PMCID: PMC7527165 DOI: 10.2196/22408] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During pandemics, effective containment and mitigation measures may also negatively influence psychological stability. As knowledge about COVID-19 rapidly evolves, global implementation of containment and mitigation measures has varied greatly, with impacts to mental wellness. Assessing the impact of COVID-19 on the mental health needs of health care workers and other workers may help mitigate mental health impacts and secure sustained delivery of health care and other essential goods and services. OBJECTIVE This study assessed the self-reported prevalence of stress, anxiety, depression, and obsessive-compulsive symptoms in health care workers and other workers seeking support through Text4Hope, an evidence-based SMS text messaging service supporting the mental health of residents of Alberta, Canada, during the COVID-19 pandemic. METHODS An online cross-sectional survey gathered demographic (age, gender, ethnicity, education, relationship, housing and employment status, employment type, and isolation status) and clinical characteristics using validated tools (self-reported stress, anxiety, depression, and contamination/hand hygiene obsessive-compulsive symptoms). Descriptive statistics and chi-square analysis were used to compare the clinical characteristics of health care workers and other workers. Post hoc analysis was conducted on variables with >3 response categories using adjusted residuals. Logistic regression determined associations between worker type and likelihood of self-reported symptoms of moderate or high stress, generalized anxiety disorder, and major depressive disorder, while controlling for other variables. RESULTS Overall, 8267 surveys were submitted by 44,992 Text4Hope subscribers (19.39%). Of these, 5990 respondents were employed (72.5%), 958 (11.6%) were unemployed, 454 (5.5%) were students, 559 (6.8%) were retired, 234 (2.8%) selected "other," and 72 (0.9%) did not indicate their employment status. Most employed survey respondents were female (n=4621, 86.2%). In the general sample, the 6-week prevalence rates for moderate or high stress, anxiety, and depression symptoms were 85.6%, 47.0%, and 44.0%, respectively. Self-reported symptoms of moderate or high stress, anxiety, and depression were all statistically significantly higher in other workers than in health care workers (P<.001). Other workers reported higher obsessive-compulsive symptoms (worry about contamination and compulsive handwashing behavior) after the onset of the pandemic (P<.001), while health care worker symptoms were statistically significantly higher before and during the COVID-19 pandemic (P<.001). This finding should be interpreted with caution, as it is unclear the extent to which the adaptive behavior of health care workers or the other workers might be misclassified by validated tools during a pandemic. CONCLUSIONS Assessing symptoms of prevalent stress, anxiety, depression, and obsessive-compulsive behavior in health care workers and other workers may enhance our understanding of COVID-19 mental health needs. Research is needed to understand more fully the relationship between worker type, outbreak phase, and mental health changes over time, as well as the utility of validated tools in health care workers and other workers during pandemics. Our findings underscore the importance of anticipating and mitigating the mental health effects of pandemics using integrated implementation strategies. Finally, we demonstrate the ease of safely and rapidly assessing mental health needs using an SMS text messaging platform during a pandemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19292.
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Affiliation(s)
- Kelly Mrklas
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Marianne Hrabok
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - April Gusnowski
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Liana Urichuk
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Daniel Li
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew James Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Degraeve A, Lejeune S, Muilwijk T, Poelaert F, Piraprez M, Svistakov I, Roumeguère T. When residents work less, they feel better: Lessons learned from an unprecedent context of lockdown. Prog Urol 2020; 30:1060-1066. [PMID: 32917488 PMCID: PMC7833413 DOI: 10.1016/j.purol.2020.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/20/2022]
Abstract
Introduction With the COVID-19 outbreak activities of urology departments have been limited to non-deferrable procedures impacting the daily program of residents in urology. We assessed the psychological impact of the lockdown on Belgian residents in urology and their resounding on the quality of the training. Material and Methods A self-administered anonymous questionnaire assessing the risk of burnout in a pandemic situation and its impact on the quality of the training was e-mailed to the members of the European Society of Residents in Urology of Belgium (ESRU-B). We used the Copenhagen Burnout Inventory score which assesses the different dimensions of burnout (personal (CBIP), professional (CBIPro), relational (CBIR)). Several questions evaluating impact on residents’ health and apprehension of the future were included. The survey lasted for 5 days. Comparison of parameters before and during the coronavirus crisis was made using paired samples t-test or Chi2 test were. Results Fifty percent (62/126) of the ESRU-B members replied to the questionnaire. If 93% of the responders reported a negative impact on the quality of their practical training (CI95 = [0.07–1.10]; P = 0.83), 56% and 61.7% reported a positive impact of the crisis on their life and on their theoretical training respectively. Burnout risk scores were significantly reduced (P < 0.001) for each dimension 7.26 to 3.40 (CBIP), 9.02 to 4.35 (CBIPro) and 4.42 to 3.03 (CBIR) respectively. Conclusion Despite a negative impact on the daily work quality, the decrease in activity induced by the lockdown did not have a negative psychological impact on Belgian residents in urology but stress the opportunity to review the current training system to be better balanced between practice and theoretical formation.
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Affiliation(s)
- A Degraeve
- Department of Urology, Saint-Luc University Clinics, Université Catholique de Louvain, Brussels, Belgium.
| | - S Lejeune
- Institut de Recherche Expérimentale et Clinique (IREC), Saint-Luc University Clinics, Université Catholique de Louvain, Brussels, Belgium
| | - T Muilwijk
- Department of Urology and Department of Development and Regeneration, University Clinics of Leuven, Catholic University of Leuven, Leuven, Belgium
| | - F Poelaert
- Department of Urology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - M Piraprez
- Department of Urology, CHR de la Citadelle, Université de Liège, Liège, Belgium
| | - I Svistakov
- Department of Urology, University Clinics of Brussels, Erasme hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - T Roumeguère
- Department of Urology, University Clinics of Brussels, Erasme hospital, Université Libre de Bruxelles, Brussels, Belgium
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Da Cunha de Sá-Caputo D, Sonza A, Bachur JA, Bernardo-Filho M. Development, validation and reliabilty of a questionnaire to evaluate the changes on the level of physical exercises and in daily life habits due to COVID-19 pandemic social distancing. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020004. [PMID: 32921702 PMCID: PMC7717004 DOI: 10.23750/abm.v91i3.9888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/18/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIM Physical inactivity is expected to happen during the COVID-19 pandemic through home quarantine measures. The aim of this study was to develop, validate and perform the reliability of the questionnaire "Physical exercise (PE) level before and during social isolation (PEF-COVID19)" to evaluate the level of PE during the social distancing due to the COVID-19 pandemic and to try to identify changes in the daily life of the individuals. METHODS This transversal study was developed to measure psychometric properties of the questionnaire PEF-COVID19. The survey was divided into 4 sections including subjects' characterization, social isolation update and physical exercise performed, pain, anxiety and stress before and during COVID-19 pandemic. After the survey construction in Portuguese language (Brazil), the survey was transferred to an online digital platform (Google® forms). The Construct, Clarity and Relevance Validation strategy was judged by a panel of experts and the validity index (VI) were calculated. The reliability was evaluated through the test-retest interrater reliability and measured through the intraclass correlation coefficient (ICC) and Kappa coefficient (KC). RESULTS Twenty-five experts participated of the survey validity and 34 respondents from the target population participated of the test-retest reliability. The general average measures for VI were all above 0.84 and test-retest ICC and KC were 0.89 and 0.88, respectively. CONCLUSIONS This survey was considered valid and reliable to be applied to the general population over 18 years-old to investigate the PE practice and psychological aspects during the social distancing due to the COVID-19 pandemic, a public health problem.
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Affiliation(s)
- Danúbia Da Cunha de Sá-Caputo
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Departamento de biofísica e biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil .
| | - Anelise Sonza
- Laboratório de Desenvolvimento e Controle Postural, Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.
| | | | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Departamento de biofísica e biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil .
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O'Kelly F, Sparks S, Seideman C, Gargollo P, Granberg C, Ko J, Malhotra N, Hecht S, Swords K, Rowe C, Whittam B, Spinoit AF, Dudley A, Ellison J, Chu D, Routh J, Cannon G, Kokorowski P, Koyle M, Silay MS. A survey and panel discussion of the effects of the COVID-19 pandemic on paediatric urological productivity, guideline adherence and provider stress. J Pediatr Urol 2020; 16:492.e1-492.e9. [PMID: 32680626 PMCID: PMC7334656 DOI: 10.1016/j.jpurol.2020.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/12/2020] [Accepted: 06/19/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has led to an unprecedented need to re-organise and re-align priorities for all surgical specialties. Despite the current declining numbers globally, the direct effects of the pandemic on institutional practices and on personal stress and coping mechanisms remains unknown. The aims of this study were to assess the effect of the pandemic on daily scheduling and work balances, its effects on stress, and to determine compliance with guidelines and to assess whether quarantining has led to other areas of increased productivity. METHODS A trans-Atlantic convenience sample of paediatric urologists was created in which panellists (Zoom) discussed the direct effects of the COVID-19 pandemic on individual units, as well as creating a questionnaire using a mini-Delphi method to provide current semi-quantitative data regarding practice, and adherence levels to recently published risk stratification guidelines. They also filled out a Perceived Stress Scale (PSS) questionnaire to assess contemporary pandemic stress levels. RESULTS There was an 86% response rate from paediatric urologists. The majority of respondents reported near complete disruption to planned operations (70%), and trainee education (70%). They were also worried about the effects of altered home-lives on productivity (≤90%), as well as a lack of personal protective equipment (57%). The baseline stress rate was measured at a very high level (PSS) during the pandemic. Adherence to recent operative guidelines for urgent cases was 100%. CONCLUSION This study represents a panel discussion of a number of practical implications for paediatric urologists, and is one of the few papers to assess more pragmatic effects and combines opinions from both sides of the Atlantic. The impact of the pandemic has been very significant for paediatric urologists and includes a decrease in the number of patients seen and operated on, decreased salary, increased self-reported stress levels, substantially increased telemedicine usage, increased free time for various activities, and good compliance with guidelines and hospital management decisions.
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Affiliation(s)
- Fardod O'Kelly
- Division of Paediatric Urology, The Hospital for Sick Children, Toronto, Canada.
| | - Scott Sparks
- Division of Pediatric Urology, Children's Hospital of Los Angeles, CA, USA
| | - Casey Seideman
- Division of Pediatric Urology, OHSU Doernbecher Children's Hospital, Portland, OR, USA
| | | | | | - Joan Ko
- Division of Pediatric Urology, Children's Hospital of Los Angeles, CA, USA
| | | | - Sarah Hecht
- Division of Pediatric Urology, Children's Hospital Colorado, USA
| | - Kelly Swords
- Division of Pediatric Urology, Rady Children's Hospital, San Diego, CA, USA
| | - Courtney Rowe
- Division of Pediatric Urology, Connecticut Children's Hospital, USA
| | - Ben Whittam
- Division of Pediatric Urology, Riley Children's, Indianapolis, IN, USA
| | | | - Anne Dudley
- Division of Pediatric Urology, Connecticut Children's Hospital, USA
| | | | - David Chu
- Division of Pediatric Urology, Lurie Children's Chicago, IL, USA
| | - Jonathan Routh
- Division of Urologic Surgery, Duke University Medical Centre, NC, USA
| | - Glenn Cannon
- Division of Pediatric Urology, University of Pittsburgh Medical Centre, PA, USA
| | - Paul Kokorowski
- Division of Pediatric Urology, Children's Hospital of Los Angeles, CA, USA
| | - Martin Koyle
- Division of Paediatric Urology, The Hospital for Sick Children, Toronto, Canada
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Adebayo O, Obazenu L, Eze U, Hassan F, Olalekan TR. Counting the effects of COVID-19 on early career doctors and call for sustained mitigation. NIGERIAN JOURNAL OF MEDICINE 2020. [DOI: 10.4103/njm.njm_189_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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