A qualitative analysis of psychosocial stressors and health impacts of the COVID-19 pandemic on frontline healthcare personnel in the United States

Impact of COVID-19 on celebration of death, mortuary, and funerary customs in Bangladesh: A qualitative study

Introduction

During the COVID-19 pandemic, restrictions significantly impacted religious activities related to death celebrations, mortuary practices, and funerary rituals in Bangladesh. Bereaved families faced a harsh reality, unable to perform the full rituals for their loved ones due to the pandemic outbreak. This study explores the adjustments and modifications made in cultural rituals and how they affected bereaved families and close relatives.

Objective

This study aims to explore how the COVID-19 pandemic impacted the observance of death rituals in Bangladesh and the effects on bereaved families and close relatives.

Methods

This study employed a qualitative approach and gathered data through 3 key informant interviews (KIIs) and 58 in-depth interviews (IDIs) conducted between December 2020 and January 2021. Purposive sampling was employed to recruit participants from three distinct groups: (1) individuals who had experienced the death of a relative during the pandemic, (2) caregivers who provided support to those experiencing loss, and (3) volunteers actively involved with funeral and burial services. This selection strategy ensured a diverse range of perspectives on the impact of the pandemic on death rituals.

Results

The pandemic forced people to observe funerals or make significant sacrifices to traditional practices reluctantly. Disruptions to long-standing traditions and widespread emotional toll were as various segments of society struggled to find closure in saying goodbye to loved ones. Due to the severity of the pandemic, people became heavily reliant on priests, crematorium workers, and funeral volunteers for mortuary services. Both Hindu and Muslim religions discouraged family gatherings during post-burial rituals. The fear of contracting the virus further limited bereaved families' ability to bid farewell to their deceased loved ones properly.

Conclusion

This research highlights the profound impact of the pandemic on death rituals and the resulting emotional distress for bereaved families in Bangladesh. The findings are pivotal in guiding the development of concrete policies for future pandemic preparedness and response. Such policies might encompass guidelines for safe and culturally sensitive mortuary practices, psychosocial support and grief counseling initiatives for affected communities, and strategies to mitigate religious anxieties during public health emergencies.

Availability and use of institutional support programs for emergency department healthcare personnel during the COVID-19 pandemic

OBJECTIVES

The COVID-19 pandemic placed health care personnel (HCP) at risk for stress, anxiety, burnout, and post-traumatic stress disorder (PTSD). To address this, hospitals developed programs to mitigate risk. The objectives of the current study were to measure the availability and use of these programs in a cohort of academic emergency departments (EDs) in the United States early in the pandemic and identify factors associated with program use.

METHODS

Cross-sectional survey of ED HCP in 21 academic EDs in 15 states between June and September 2020. Site investigators provided data on the availability of 28 programs grouped into 9 categories. Individual support programs included: financial, workload mitigation, individual COVID-19 testing, emotional (e.g., mental health hotline), and instrumental (e.g., childcare) Clinical work support programs included: COVID-19 team communication (e.g., debriefing critical incident), patient-family communication facilitation, patient services (e.g., social work, ethics consultation), and system-level exposure reduction. Participants provided corresponding data on whether they used the programs. We used generalized linear mixed models clustered on site to measure the association between demographic and facility characteristics and program use.

RESULTS

We received 1,541 survey responses (96% response rate) from emergency physicians or advanced practice providers, nurses, and nonclinical staff. Program availability in each of the 9 categories was high (>95% of hospitals). Program use was variable, with clinical work support programs used more frequently (28-50% of eligible HCP across categories) than individual employee support programs (6-13% of eligible HCP across categories). Fifty-seven percent of respondents reported that the COVID-19 pandemic had affected their stress and anxiety, and 12% were at elevated risk for PTSD. Program use did not significantly differ for HCP who reported symptoms of anxiety and/or stress compared to those who did not.

CONCLUSIONS

Early in the pandemic, support programs were widely available to ED HCP, but program use was low. Future work will focus on identifying barriers and facilitators to use and specific programs most likely to be effective during periods of highest occupational stress.

Structural Factors Contributing to Compassion Fatigue, Burnout, and Secondary Traumatic Stress Among Hospital-Based Healthcare Professionals During the COVID-19 Pandemic

High levels of burnout among healthcare providers (HCPs) have been a widely documented phenomenon, which have been exacerbated during the COVID-19 pandemic. In the United States, qualitative studies that are inclusive of HCPs in diverse professional roles have been limited. Therefore, we utilized a qualitative-quantitative design to examine professional quality of life in terms of compassion fatigue, burnout, and secondary traumatic stress among hospital-based HCPs, including social workers, hospitalists, residents, and palliative care team members during COVID-19. HCPs (n = 26) participated in virtual semi-structured focus groups or individual interviews and online surveys (n = 30) including the Professional Quality of Life (ProQOL) Scale. While ProQOL scores indicated low levels of compassion fatigue, burnout, and secondary traumatic stress, thematic analysis of our qualitative data included rich descriptions of compassion fatigue, burnout, and secondary traumatic stress. Safety concerns and value misalignment characterized structural stressors perceived to contribute to HCP compassion fatigue, burnout, and secondary traumatic stress. The discrepancy between our qualitative and quantitative findings may be indication that modifications to current screenings are warranted. These findings also suggest a need to identify and implement structural and policy changes that increase HCPs' physical and emotional safety and promote better alignment of institutional interests with HCP values.

The influence of hospital leadership support on burnout, psychological safety, and safety climate for US infection preventionists during the coronavirus disease 2019 (COVID-19) pandemic

OBJECTIVE

To explore infection preventionists' perceptions of hospital leadership support for infection prevention and control programs during the coronavirus disease 2019 (COVID-19) pandemic and relationships with individual perceptions of burnout, psychological safety, and safety climate.

DESIGN

Cross-sectional survey, administered April through December 2021.

SETTING

Random sample of non-federal acute-care hospitals in the United States.

PARTICIPANTS

Lead infection preventionists.

RESULTS

We received responses from 415 of 881 infection preventionists, representing a response rate of 47%. Among respondents, 64% reported very good to excellent hospital leadership support for their infection prevention and control program. However, 49% reported feeling burned out from their work. Also, ∼30% responded positively for all 7 psychological safety questions and were deemed to have "high psychological safety," and 76% responded positively to the 2 safety climate questions and were deemed to have a "high safety climate." Our results indicate an association between strong hospital leadership support and lower burnout (IRR, 0.61; 95% CI, 0.50-0.74), higher perceptions of psychological safety (IRR, 3.20; 95% CI, 2.00-5.10), and a corresponding 1.2 increase in safety climate on an ascending Likert scale from 1 to 10 (β, 1.21; 95% CI, 0.93-1.49).

CONCLUSIONS

Our national survey provides evidence that hospital leadership support may have helped infection preventionists avoid burnout and increase perceptions of psychological safety and safety climate during the COVID-19 pandemic. These findings aid in identifying factors that promote the well-being of infection preventionists and enhance the quality and safety of patient care.

Exhausting care: On the collateral realities of caring in the early days of the Covid-19 pandemic

We explore care as a site of multiplicity and tension. Working with the qualitative interview accounts of nineteen health care workers in Colombia, we trace a narrative of 'exhausting care' in the early days of the Covid-19 pandemic. Accounts relate exhausting care to working without break in response to extraordinary demand, heightened contagion concern, the pressures of caring in the face of anticipated death, and efforts to carry on caring in the face of constraint. We bring together the work of John Law (2010, 2011) on 'collateral realities' with Lauren Berlant's (2011) thesis of 'cruel optimism' to explore care as a site of practice in which the promise of the good can also become materialised as harm, given structural conditions. Through the reflexive narrative of 'carrying on' in the face of being 'worn down' by care, a narrative which runs through health care worker accounts, we draw attention to the collateral realities of exhausting care as personal and political, at once a practice of endurance and extraction. We argue that the exhausting care that relates to the extraordinariness of the Covid-19 pandemic also resides in the ordinariness, and slower violence, of the everyday. The cruel optimism of care is a relation in which the labour of care reproduces a harmful situation.

Impacts of the COVID-19 pandemic on health and social professionals working with people with disabilities: A qualitative study

BACKGROUND

Since the beginning of the COVID-19 pandemic, protection and isolation measures established by the Canadian and Quebec governments have directly affected the work of health and social professionals (HSPs). These measures have added pressure on HSPs, complexified their work and added tasks to their already busy workload. However, few studies have explored in depth the impacts of the pandemic on HSPs working with people with disabilities.

OBJECTIVE

The objective of this study was to qualitatively explore the experiences of HSPs working among people with disabilities in the province of Quebec, Canada, during the COVID-19 pandemic (January and February 2021), including the impact on their work, the relationships with their colleagues, and on their immediate social and familial environment.

METHODS

HSPs participated in a semi-structured interview. A mixed thematic analysis approach, combining inductive and deductive coding, was carried out using N'Vivo 12.

RESULTS

Fifty-five HSPs participated in the interviews (mean [SD] age, 42 [9]). They mostly identified as women (91%). Three main themes representing the impacts of the pandemic were identified, including 1) Health and Well-being; 2) Family and social networks including the subthemes; 2.1) Fear of being a vector of contamination for their loved ones; 2.2) Work-family balance; 2.3) Social Network, and finally 3) Work, highlighting, including 3.1) Workload and adaptative strategies developed; 3.2) Relationship with colleagues; 3.3) Perceived support received at work, and 3.4) Services offered to patients.

CONCLUSIONS

These findings highlight the importance of closely tracking and supporting the well-being of HSPs.

Healthcare practitioners' construction of occupational risk during the COVID-19 pandemic

RATIONALE AND OBJECTIVE

In the pandemic's first year, frontline healthcare practitioners (HCPs) experienced a disproportionate burden of COVID-19's negative effects, including infection, death, trauma and burnout. Qualitative research is needed to understand practitioners' experiences to address the unique challenges they face. To this end, this article investigates occupational factors identified by practitioners as relevant to their risk perceptions. By positioning HCPs as a distinctive risk group in the hierarchical space of risk group prioritization, this analysis extends thinking about such classifications within medicine.

METHODS

Remote interviews were conducted between 2020 and 2022 with 45 U.S. practitioners, including physicians, nurse practitioners, physician associates, registered nurses and technicians. Interviews were audio recorded, transcribed, and coded using NVivo to analyze how practitioners understood their occupational risk.

RESULTS

Participants' risk perceptions focused on three concerns. First, working within spatial concentrations of COVID-19 required adapting procedures and reimagining their bodies as potentially hazardous. Second, the limitations of protective measures elevated concerns about healthcare work, and were perceived as pitting practitioners' health against patient care and administrative needs. Third, managing the many uncertainties about COVID-19 meant HCPs risked both its known and unknown effects.

CONCLUSION

This study examines frontline practitioners' perceptions of occupational risk during the pandemic. It argues two tensions underlie practitioners' risk perceptions. First, like other essential workers, HCPs constituted a unique risk group that distinguished them from other vulnerable populations - due to risks arising from occupational rather than biomedical factors. Second, unlike other essential workers, practitioners were directly exposed to infectious patients that posed risks to their health. These elements each highlight a perceived gap between practitioners' and administrators' risk perceptions that facilitated HCP cynicism about guidelines. Future research may fruitfully investigate if these themes persist outside the U.S. and across healthcare systems.

A Survey of Living Conditions and Psychological Distress in Japanese University Freshmen during the COVID-19 Pandemic

Since the novel coronavirus disease 2019 (COVID-19) pandemic, educational institutions have implemented measures such as school closures, raising concerns regarding the increase in psychological distress among university students. The purpose of this study is to identify factors that have influenced psychological distress among college freshmen during the COVID-19 pandemic. A questionnaire survey was conducted at the conclusion of the sixth wave of COVID-19 in Japan. Psychological distress was measured using the six-item Kessler Psychological Distress Scale (K6). Factors affecting psychological distress were calculated using regression analysis. Of the 2536 participants, 1841 (72.6%) reported having no psychological distress, while 695 (27.4%) reported having psychological distress. Factors that were identified to contribute to psychological distress were lack of sleep, weight gain or loss, worsening of interpersonal relationships, and physical symptoms and illnesses. A willingness to join an athletic club and having an environment in which it is easy to discuss worries and anxieties with others were factors that were identified to hinder psychological distress. It is necessary for universities to offer enhanced supports for physical and interpersonal activities. Additionally, it is imperative to encourage students to look after their physical health and to actively utilize university-based consultation systems.

Tolerance for three commonly administered COVID-19 vaccines by healthcare professionals

Importance

Most healthcare institutions require employees to be vaccinated against SARS-CoV-2 and many also require at least one booster.

Objective

We determine the impact of vaccine type, demographics, and health conditions on COVID-19 vaccine side effects in healthcare professionals.

Design

A COVID-19 immunity study was performed at the 2021 American Association for Clinical Chemistry Annual Scientific meeting. As part of this study, a REDCap survey with cascading questions was administered from September 9, 2021 to October 20, 2021. General questions included participant demographics, past and present health conditions, smoking, exercise, and medications. COVID-19 specific questions asked about SARS-CoV-2 vaccine status and type, vaccine-associated side effects after each dose including any boosters, previous infection with COVID-19, diagnostic testing performed, and type and severity symptoms of COVID-19.

Results

There were 975 participants (47.1% male, median age of 50 years) who completed the survey. Pfizer was the most commonly administered vaccine (56.4%) followed by Moderna (32.0%) and Johnson & Johnson (7.1%). There were no significant differences in vaccine type received by age, health conditions, smoking, exercise, or type or number of prescription medications. Side effects were reported more frequently after second dose (e.g., Moderna or Pfizer) (54.1%) or single/only dose of Johnson & Johnson (47.8%). Males were significantly more likely to report no side effects (p < 0.001), while females were significantly more likely to report injection site reactions (p < 0.001), fatigue (p < 0.001), headache (p < 0.001), muscle pain (p < 0.001), chills (p = 0.001), fever (p = 0.007), and nausea (p < 0.001). There was a significant upward trend in participants reporting no side effects with increasing age (p < 0.001). There were no significant trends in side effects among different races, ethnicities, health conditions, medications, smoking status or exercise. In multivariate logistic regressions analyses, the second dose of Moderna was associated with a significantly higher risk of side effects than both the second dose of Pfizer and the single dose of Johnson & Johnson.

Conclusions and relevance

Younger people, females, and those receiving the second dose of Moderna had more COVID-19 vaccine side effects that per self-report led to moderate to severe limitations. As reported in other studies, the increase in side effects from Moderna may be explained by higher viral mRNA concentrations but be associated with additional protective immunity.

Analysis of Sustainable Communication Patterns during the Telework Period in Western Romanian Corporations

The research was conducted in a particular context, the recent pandemic. It is a comparative study of the methods and quality of communication in global companies between 2021 and 2022. The corporations involved in the research are important providers of flexible production, quality, and logistics solutions that cover customers' real needs. They are active in the automotive industry and units involved in mass production in the electronics industry, household appliances, and cosmetics industries. In their case, it was noted that to achieve operational objectives such as developing employee skills, using advanced technologies, and exceeding customer expectations, it is important to use innovative methods and tools such as single platforms, which allow access to the most important information from a distance, anywhere, anytime. It is significant that, according to the research, the preferred method of communication by employees, regardless of the existing conditions, is face-to-face. Primarily, this method is chosen because it provides an open area of interpersonal interaction. The participants observe non-verbal attitudes or can perceive emotions and feelings. Their personality can be identified through unintentional contact to obtain constructive feedback through guidance and counseling. Moreover, it can be formed and develop productive, intentional connections. Stakeholders' efficient and effective open dialogs are encouraged in this sense.