[COVID-19 Pandemic: Stress Experience of Healthcare Workers - A Short Current Review]

The status quo and correlational analysis of nursing practices, burnout, and social support among nurses from private hospitals in Dazhou, a less developed area of China

OBJECTIVE

To investigate the status quo of nursing practices, job burnout and social support among private hospitals in Dazhou, Sichuan Province, and perform correlational analysis.

METHODS

A cross-sectional study was conducted. A total of 244 nurses were surveyed via convenience sampling from 7 private hospitals, which were randomly selected from Dazhou city. A self-designed demographic sociology questionnaire was applied, and the Chinese versions of the Maslach Burnout Scale and the Social Support scale administered from September to November 2022.

RESULTS

The investigated nurses were relatively young (26.84 ± 4.90 years), had a short duration of service, a low academic background, a low professional title and a low income; however, they were highly satisfied with their working environment and had a low level of burnout, and their level of personal achievement was low. Overtime work, education level and number of children had significant impacts on the level of nurse burnout. The level of social support was high, and various dimensions were negatively correlated with the emotional exhaustion and depersonalization dimensions of burnout (r=-0.438, P < 0.01; r=-0.372, P < 0.01) and positively correlated with personal achievement (r = 0.291, P < 0.01). However, the level of social support was not significantly associated with burnout (r=-0.060, p = 0.354).

CONCLUSIONS

Nursing managers in private hospitals should consider ways of improving nurses' education, professional titles, working environment and increasing nurses' income to stabilize the nursing team. Efforts should be made to relieve the nurses' pressure, and notice the overtime work and professional development of nurses to enhance the personal sense of achievement. More measures should be taken to improve the level of social support, thereby promoting the continuous improvement of nursing quality. Due to the uneven level of social and economic development in different parts of China, the extensibility of the research needs to be confirmed by more studies, but it still has important reference significance for Northeast Sichuan, which represents areas with similar social and economic levels.

Knowledge graph analysis of research on nurses' psychological resilience

In recent years, a surge in literature on psychological nurse resilience, largely driven by the COVID-19 pandemic, has prompted the need for a comprehensive understanding of the current state and emerging trends through reliable methodologies. The purpose of this study was to analyzes the research on nurses' psychological resilience through bibliometrics to understand the current situation, foundation, and hotspot of this research field. The Web of Science core collection database was used as the search source, and CiteSpace analysis software was employed to conduct bibliometric analysis on authors, countries, institutions, keywords, and references of nurse psychological resilience-related literature published from the establishment of the database to July 11, 2023. A total of 1060 articles were included in the final analysis. The study of nurses' psychological resilience had been highly popular and had formed a new and important research basis in recent years. China and the United States led in the number of publications and centrality respectively, with Monash Univ and Curtin Univ as top institutions in the number of publications and centrality respectively. The authors with the highest number of publications and the most frequently cited were Rees and Connor Km respectively. The most frequently cited article was Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 published by Lai, JB, etc. Important key keywords included mental health, resilience, stress, health, outbreak, acute respiratory syndrome, etc. The research topics in this field mainly focused on 4 aspects, including nurses' mental health, post-traumatic stress disorder, job burnout and job satisfaction, and intervention research on psychological resilience. The results of bibliometric analysis provide direct support for future scholars to explore and determine the research direction, hot spots, and find authoritative authors and institutions. At the moment, nurses' psychological resilience research has established a new foundation, primarily focusing on COVID-19-related topics. Given the potential prolonged coexistence of COVID-19 and other diseases, the main research focus remains innovating and validating effective psychological resilience intervention strategies for nurses' overall well-being.

Characteristics and Habits of Psychiatrists and Neurologists With High Occupational Well-Being: A Mixed Methods Study

Objective

To identify the characteristics that distinguish occupationally well outliers (OWO), a subset of academic psychiatrists and neurologists with consistently high professional fulfillment and low burnout, from their counterparts with lower levels of occupational well-being.

Participants and Methods

Participants included faculty physicians practicing psychiatry and neurology in academic medical centers affiliated with the Professional Well-being Academic Consortium. In this prospective, longitudinal study, a mixed qualitative and quantitative approach was used. Quantitative measures were administered to physicians in a longitudinal occupational well-being survey sponsored by the academic organizations where they work. Four organizations participated in the qualitative study. Psychiatrists and neurologists at these organizations who competed survey measures at 2 consecutive time points between 2019 and 2021 were invited to participate in an interview.

Results

Of 410 (213 psychiatrists and 197 neurologists) who completed professional fulfillment and burnout measures at 2 time points, 84 (20.5%) met OWO criteria. Occupationally well outliers psychiatrists and neurologists had more favorable scores on hypothesized determinants of well-being (values alignment, perceived gratitude, supportive leadership, peer support, and control of schedule). Ultimately, 31 psychiatrists (25% of 124 invited) and 33 neurologists (18.5% of 178 invited) agreed to participate in an interview. Qualitatively, OWO physicians differed from all others in 3 thematic domains: development of life grounded in priorities, ability to shape day-to-day work context, and professional relationships that provide joy and support.

Conclusion

A multilevel approach is necessary to promote optimal occupational well-being, targeting individual-level factors, organizational-level factors, and broader system-level factors.

Sociodemographic influences on private and professional contact behaviour during the COVID-19 pandemic in Germany: cross-sectional analysis based on a Regional Blood Donor Cohort

OBJECTIVE

The COVID-19 pandemic has had significant health and socioeconomic impacts worldwide. Extensive measures, including contact restrictions, were implemented to control the spread of the virus. This study aims to examine the factors that influenced private and professional contact behaviour during the COVID-19 pandemic.

RESULTS

We used baseline data (January-April 2021) from the SeMaCo study (Serologische Untersuchungen bei Blutspendern des Großraums Magdeburg auf Antikörper gegen SARS-CoV-2), a longitudinal, regional cohort study assessing COVID-19 seroprevalence in blood donors from Magdeburg and surrounding areas in Germany. In the blood donor cohort (n = 2,195), there was a general reduction in private contacts (by 78.9%) and professional contacts (by 54.4%) after March 18, 2020. Individuals with higher education reduced both private (by 84.1%) and professional (by 70.1%) contacts more than those with lower education levels (private contacts 59.5%; professional contacts 37%). Younger age groups (18-30 years) reduced private contacts more frequently (by 85.4%) than older individuals (61-83 years, by 68.6%) and demonstrated a higher likelihood of private contact reduction compared to older age groups (51-60 years: odds ratio (OR) 0.45 [95% [CI] 0.32-0.65]; 61-83 years: OR 0.33 [95% [CI] 0.22-0.48]).

Motivation to work and attitudes towards retirement among physicians

BACKGROUND

The healthcare system is currently in a state of tension due to a shortage of physicians, the early retirement of health care professionals and an increasing need for care within an (aging) society. Therefore, the aim of the present study was to examine physicians' attitudes towards retirement and possible influencing factors on their motivation to work.

METHOD

Data were collected as part of a baseline survey of a long-term study. The sample includes a variety of physicians (n = 625), working in outpatient or inpatient care, who have not yet reached the retirement age of 67. The primary outcome was to survey attitudes towards retirement using the Motivation to Work scale. Work-related characteristics (e.g., with regard to contract or working hour) as well as job satisfaction, overall health, and burnout were also included in the analyses (correlations and linear regression models).

RESULTS

According to the results, sociodemographic characteristics are not significantly related to motivation to work, whereas the other parameters (satisfaction, health, and burnout) influence attitudes towards retirement significantly.

CONCLUSIONS

The results underline the need to improve the occupational conditions of physicians across different medical settings. More research is needed to understand physicians' decision-making with regard to retirement, especially in terms of work-related characteristics and differences.

The mental health of first- and second-generation migrant vs. native healthcare workers during the COVID-19 pandemic: The VOICE survey of 7,187 employees in the German healthcare sector

The COVID-19 pandemic exacerbated the challenging working conditions of healthcare workers (HCWs) in many regions. A considerable proportion of HCWs in Germany are migrants facing additional migration-related stressors. The aim of this cross-sectional web-based survey was to examine depressive and generalized anxiety symptoms among migrant and native HCWs in Germany during the pandemic. We compared 780 migrant (first- and second-generation) HCWs from different backgrounds with 6,407 native HCWs. Multiple linear regression analyses were used to examine associations between occupational and COVID-19 related variables, controlling for sociodemographics. Migrant HCWs from low-/middle-income countries more frequently had clinically relevant depressive symptoms (PHQ-2 ≥ 3) than did those from high-income countries (29.9% vs. 16.7%, p = .002, ϕ = .156) (all other ϕs/Cramer's Vs ≤ .036). There were no clinically relevant differences in anxiety levels (GAD-2 ≥ 3) between native vs. migrant HCWs, native vs. the individual migrant HCW groups, or between the sexes (all ϕs/Cramer's Vs ≤ .036). After controlling for key sociodemographic characteristics, native HCWs did not differ from the individual migrant HCW groups on depression and anxiety severity (depression: all βs ≤ |.030|, anxiety: all βs ≤ |.014|). A high percentage of HCWs reported distress, with migrants from low-/middle-income countries reporting highest burden. The results indicate the need to establish prevention programmes for HCWs, with special consideration to vulnerable populations including certain migrant groups.

Investigation of the psychiatric factors that determine the fear of COVID-19 in healthcare workers and hospital staff in a university hospital in Turkey

To examine the association of health and hospital workers' fears of coronavirus disease 2019 (COVID-19) with anxiety, anxiety sensitivity, depression, and sociodemographic variables during the COVID-19 pandemic. A total of 527 participants (237 men/289 women) were included, 222 of the participants were doctors, 99 nurses, 22 assistant health personnel, and 182 hospital personnel without health education. Participants filled in the sociodemographic data form, Beck Depression Inventory, Beck Anxiety Inventory, Anxiety Sensitivity Index-3, and Fear of COVID-19 Inventory. In linear regression analysis, independent predictors of the fear of COVID-19 were determined as Beck Anxiety Inventory (p < 0.001), Beck Depression Inventory (p = 0.001), and Anxiety Sensitivity Index-3 Physical subscale (p = 0.001). The fear of COVID-19 is associated with the physical subscale of anxiety, depression, and anxiety sensitivity.

The effectiveness of e-mental health interventions on stress, anxiety, and depression among healthcare professionals: a systematic review and meta-analysis

BACKGROUND

Many healthcare professionals are experiencing psychological distress. Electronic mental health (e-mental health) interventions are convenient and multifunctional. This review aimed to examine the effectiveness of e-mental health interventions in enhancing the well-being of healthcare professionals and to identify moderating factors.

METHODS

A comprehensive and systematic retrieval of randomized controlled trial (RCT) studies was conducted across eight databases. Population, intervention, comparison, and outcome (PICO) were used to define eligibility criteria. Stress, anxiety, and depression were included as the main outcomes. The overall effect was calculated based on the random effect model, and the effect size was presented using the standardized mean difference. The characteristics of the research design, intervention object, and intervention design were further selected as potential moderating factors for subgroup analysis. Meta-regression analyses were finally performed, incorporating intervention duration and sample size as independent variables.

RESULTS

A total of 20 studies were included in the systematic review, and 17 were included in the meta-analysis. A large effect on relieving stress and anxiety and a small-to-medium effect on reducing depression were observed. Subgroup analyses showed that features including mindfulness approaches, online courses, computer use, group interventions, and professional guidance were more favorable in the design of services. Meta-regression revealed that intervention duration only affected anxiety symptoms. Caution should be exercised, as some subgroups had fewer studies and higher heterogeneity. For the secondary outcomes, a large effect on emotional exhaustion and a small-to-medium effect on well-being were observed.

CONCLUSION

In general, e-mental health interventions significantly improve the psychological health of healthcare staff. Future high-quality, large-scale studies targeting healthcare professionals and specific intervention scenarios are warranted.

Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model

BACKGROUND

Healthcare staff in China, especially females, work in a high-pressure, high-load, and high-risk environment, which affects the physical and mental health, the efficiency and quality of work, and increases turnover intention. The present study investigated the relationship between perceived stress and turnover intention in female healthcare staff, and the effects of future-oriented coping and work-family balance on this relationship.

METHODS

Four hundred thirty-five female medical workers were recruited to perform a perceived stress scale, future-oriented coping inventory, work-family balance scale and turnover intention scale. Meanwhile, serial multiple mediation analysis was performed using PROCESS.

RESULTS

1) Perceived stress positively predicted the level of turnover intention in female healthcare staff; 2) Preventive coping and proactive coping showed mediation effects on the relationship between perceived stress and turnover intention, and preventive coping positively related to proactive coping; 3) The work-family balance also showed mediation effects on the relationship between perceived stress and turnover intention; 4) Preventive coping, proactive coping and work-family balance showed a serial multiple mediation on the relationship between perceived stress and turnover intention in female healthcare workers.

CONCLUSIONS

Perceived stress affects the level of turnover intention in female healthcare staff through preventive coping, proactive coping, and work-family balance. In addition, the sequential model of future-oriented coping was validated among female healthcare staff.

Burdens and resources of Austrian clinical psychologists: results of a qualitative study two years into the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic increased the mental health burden in the general population, enhancing the demands placed on mental healthcare professionals.

METHODS

This study aimed to assess the burdens and resources of clinical psychologists that emerged since the beginning of the pandemic. N = 172 Austrian clinical psychologists participated in a cross-sectional online survey between April and May 2022. The burdens and the sources of support that emerged during the pandemic were analyzed using qualitative content analysis.

RESULTS

Mental health-related issues were identified as the greatest burden, followed by work-related themes and restrictions imposed by the government to combat the spreading of the virus. The most important resources mentioned by the clinical psychologists were social contacts and recreational activities. Practising mindfulness and focusing on inner processes and work-related aspects were further important resources mentioned.

CONCLUSION

Overall, it seems that clinical psychologists have a high awareness of mental health-related problems related to the pandemic and use adaptive coping strategies to deal with them.

Can the Reboot coaching programme support critical care nurses in coping with stressful clinical events? A mixed-methods evaluation assessing resilience, burnout, depression and turnover intentions

BACKGROUND

Critical care nurses (CCNs) are routinely exposed to highly stressful situations, and at high-risk of suffering from work-related stress and developing burnout. Thus, supporting CCN wellbeing is crucial. One approach for delivering this support is by preparing CCNs for situations they may encounter, drawing on evidence-based techniques to strengthen psychological coping strategies. The current study tailored a Resilience-boosting psychological coaching programme [Reboot] to CCNs. Other healthcare staff receiving Reboot have reported improvements in confidence in coping with stressful clinical events and increased psychological resilience. The current study tailored Reboot for online, remote delivery to CCNs (as it had not previously been delivered to nurses, or in remote format), to (1) assess the feasibility of delivering Reboot remotely, and to (2) provide a preliminary assessment of whether Reboot could increase resilience, confidence in coping with adverse events and burnout.

METHODS

A single-arm mixed-methods (questionnaires, interviews) before-after feasibility study design was used. Feasibility was measured via demand, recruitment, and retention (recruitment goal: 80 CCNs, retention goal: 70% of recruited CCNs). Potential efficacy was measured via questionnaires at five timepoints; measures included confidence in coping with adverse events (Confidence scale), Resilience (Brief Resilience Scale), depression (PHQ-9) and burnout (Oldenburg-Burnout-Inventory). Intention to leave (current role, nursing more generally) was measured post-intervention. Interviews were analysed using Reflexive Thematic Analysis.

RESULTS

Results suggest that delivering Reboot remotely is feasible and acceptable. Seventy-seven nurses were recruited, 81% of whom completed the 8-week intervention. Thus, the retention rate was over 10% higher than the target. Regarding preliminary efficacy, follow-up measures showed significant increases in resilience, confidence in coping with adverse events and reductions in depression, burnout, and intention to leave. Qualitative analysis suggested that CCNs found the psychological techniques helpful and particularly valued practical exercises that could be translated into everyday practice.

CONCLUSION

This study demonstrates the feasibility of remote delivery of Reboot and potential efficacy for CCNs. Results are limited due to the single-arm feasibility design; thus, a larger trial with a control group is needed.

Medical care services provision and stress experience in urologists during all waves of the COVID-19 pandemic in Germany

Purpose

Urologists' practices reported decreasing medical care provision and increasing stress experience in the first wave of the COVID-19 pandemic. However, long-term effects of the pandemic are unknown.

Methods

Medical record data of n = 127 urologists were used to assess changes in healthcare provision, comparing the pandemic with the pre-pandemic period. An online survey among n = 101 urologists was conducted to assess the physicians' perceptions of the identified healthcare provision and organizational changes and experiences of anxiety, stress, and support needs during the pandemic waves. Urologists consultations, specialists' referrals, hospital admissions, documented cancer diagnoses, urologists' perceptions of causes for these changes and experienced stress, anxiety and support needs. Results were demonstrated using descriptive statistics.

Results

Over the first two years of the pandemic, there was a slight decline in consultations (-0,94%), but more intensive reduction in hospital admissions (-13,6%) and identified cancer diagnoses (-6,2%). Although patients' behavior was seen as the main reason for the changes, 71 and 61% of consultations of high-risk patients or urgent surgeries were canceled. Telemedical approaches were implemented by 58% of urologists, and 88% stated that the reduced cancer detection rate would negatively affect patients' outcomes. Urologists reported higher anxiety, stress, and need for support during all waves of the pandemic than other disciplines, especially females.

Conclusion

The pandemic tremendously affects urologists' health care provision and stress experience, possibly causing long-term consequences for patients and physicians.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam

OBJECTIVES

The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors.

METHODS

A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale.

RESULTS

In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05).

CONCLUSIONS

Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

Cross-Sectional Study of the Psychological Well-Being of Healthcare Workers in a Large European University Hospital after the COVID-19 Initial Wave

BACKGROUND

The SARS-CoV-2 pandemic greatly impacted healthcare workers (HCWs) dedicated to caring for COVID-19 patients. The study was conducted in a large European hospital to study the psychological distress of HCWs engaged in COVID-19 wards in the early phase of the pandemic.

METHODS

A questionnaire was sent to 1229 HCWs aimed at collecting the following information: 1) sociodemographic data; 2) depression, anxiety, and stress scales (DASS-21); 3) event impact scale (IES-R); 4) perceived stress scale (PSS); and 5) work interface analysis. The responses were collected through Google® forms and then statistically analyzed. Regardless of the outcome of the questionnaire, all subjects were offered psychological support voluntarily.

RESULTS

Approximately two-thirds of the workers reported no symptoms according to the DASS-21 scales, while the IES-R and PSS scales showed 36% and 43%, respectively. There were no statistically significant differences in the levels of depression investigated through the different scales in the various occupational categories. Symptoms of anxiety, stress, and depression were more pronounced in women, while the highest stress levels were observed in the younger age groups. The highest scores were observed on the DAS-21 scales of anxiety and IES-R but not on the others. Only 51 workers, most of them with previous SARS-CoV-2 infection, sought clinical psychological counseling, and more than half received subsequent psychological support.

CONCLUSIONS

Our results agree with most of the literature data that anxiety, depression, and stress are associated with gender (female), age (18-44 vs. over 55), and having cared for patients with COVID-19.

Mental health and work-related factors in healthcare workers in a pandemic - meta-analysis

Due to the SARS-CoV-2 pandemic, healthcare workers worldwide faced major challenges in the form of psychological stress. The aim of this systematic literature review and meta-analysis is to identify mental health consequences and associated work-related factors in healthcare workers during a pandemic and to quantify the influence of associated work-related factors on mental health consequences. A systematic literature search according to PRISMA was conducted on 5 August 2021 using the databases PubMed Central and APA PsychInfo. The included studies investigated the mental health consequences and associated work-related factors in healthcare workers in a pandemic. In addition, we performed a risk of bias analysis to assess the study quality of the included studies using the JBI checklists. Random-effect models and pooled effect estimators were used for the meta-analysis. The Chi2 and I2 statistics were used to identify the statistical heterogeneity. Additional sensitivity analysis was performed. From a total of 3,910 publications, 43 studies met the inclusion criteria. These studies provided 15 stress consequences and 20 stress factors. The most frequently reported stress factors were 'contact with COVID-19 patients', 'no education or training in handling infectious diseases' and 'insufficient protective equipment'. Anxiety, stress, and depression were the most common outcomes identified. Analyses showed an increase in anxiety scores among HCWs who cared for COVID-19 patients, as well as a rise in depressive symptoms due to inadequate or no personal protective equipment. In this review, various pandemic-associated stress factors and stress consequences of healthcare workers were observed. With the results, criteria for effective measures and interventions can be developed to minimize the risk of stress consequences.

[Team-specific impacts of the corona pandemic on intensive care medicine personnel of a maximum care hospital]

The ongoing strain on personnel in the healthcare system during the COVID-19 pandemic is considerable and poses major emotional and psychological challenges for the personnel. In a team evaluation (physicians and nurses), team-specific stress, possible relief strategies, positive and negative experiences, and wishes for improvement of the situation in an intensive care unit were collected. While both occupational groups perceived equally high emotional stress intensities, nursing additionally perceived high stress intensities in the organizational and physical areas. Thus, the occupational group of nurses proves to be the most stressed by the COVID-19 pandemic. The findings presented here can be used to derive instructions for future actions.

Nurses' Burnout, Resilience, and Its Associated Factors in Sichuan, China, During the Peak of Coronavirus Disease 2019 Infection

AIM

To investigate the level of burnout and resilience, and the associated factors when the coronavirus disease 2019 infection hit a peak in the community in Sichuan, China.

METHOD

This was a descriptive cross-sectional design study. Data were collected from 25 to 31 December 2022, at six hospitals in Sichuan province. Using convenience sampling, a total of 717 participants were recruited, using the revised version of the Maslach Burnout InventoryGeneral Survey, and the Resilience Assessment Scale for healthcare workers.

RESULTS

More than half of nurses reported a moderate level of emotional exhaustion (66.50%, n = 484), cynicism (68.20%, n = 489), and personal accomplishment (68.76%, n = 493); nearly one-third and one-fourth of nurses experienced a high level of emotional exhaustion (27.48%, n = 197) and cynicism (20.78%, n = 149), respectively. In resilience, the highest scoring dimension was interpersonal connectedness, followed by decisional coping, flexible self-adaptation, and rational thinking. Satisfaction with work income, patient-nurse conflict, frequency of overtime work, age, and marital status were significant factors influencing burnout among nurses (p < .05).

CONCLUSION

The findings of the study enlighten nursing administrators on the level of burnout and resilience and associated factors among nurses during the peak of coronavirus disease 2019 infection in China. This would be of immense help in planning a welfare program to support the nurses.

Insomnia and common mental disorder among patients with pre-existing chronic non-communicable diseases in southern Ethiopia: a survey during COVID-19 pandemic

Background

COVID-19 has been causing significant mental health problems and other health-related issues. Despite the fact that COVID-19 has a significant impact on chronic disease patients, there is scant research on insomnia, common mental health disorders (CMD), and their associated factors among chronic disease patients.

Objective

The purpose of this study was to assess the prevalence of insomnia and common mental disorders (CMD) and their associated factors among patients with pre-existing chronic NCDs in Sidama, southern Ethiopia.

Methods

A multicenter cross-sectional study was undertaken between June 1 and September 1, 2021. The study included 633 participants. CMD and insomnia were assessed using a 20-item Self-Reported Questionnaire (SRQ-20) and a 7-item Insomnia Severity Index (ISI) scale, respectively. To describe the various variables, descriptive statistics were used. We performed multivariable logistic regression analysis to identify independent factors associated with CMD and insomnia. A value of p < 0.05 was considered statistically significant at a 95% confidence interval.

Results

The prevalence of insomnia and CMD was found to be 39.3% and 46.8%, respectively. Being merchant (AOR = 0.33; 95% CI = 0.13, 0.82), having a diagnosis of diabetes mellitus (AOR = 1.89; 95% CI = 1.04, 3.46), comorbid diagnosis (AOR = 3.96; 95% CI = 2.27, 6.89), low social support (poor (AOR = 3.37; 95% CI = 1.51, 7.57) and moderate (AOR = 3.13; 95% CI = 1.46, 6.69)), symptoms of insomnia (AOR = 12.08; 95% CI = 7.41, 19.72) and poor quality of life (QOL) (AOR = 1.67; 95% CI = 1.04, 2.72) were independent predictors of CMD. We also found out that, having cardiovascular disorders (CVDs) (AOR = 2.48; 95% CI = 1.18, 5.19), CMD (AOR = 12.09; 95% CI = 7.46, 19.61), and poor QOL (AOR = 2.04; 95% CI = 1.27, 3.26) were significantly associated with insomnia symptoms.

Conclusion

Our study suggests that substantially high prevalence of CMD and insomnia. Significant association between CMD and occupation, diagnosis, comorbidity, social support, insomnia, and QOL were found. We also revealed that having CVDs, CMD, and poor QOL were significantly associated with insomnia symptoms. Therefore, dealing with the mental health problems of patients with chronic NCDs is an essential component of public health intervention during the COVID-19 pandemic.

Exploring factors influencing depression among Polish nurses during the COVID-19 pandemic

Objectives

The COVID-19 pandemic has been recognized as an international public health emergency. The aim of our study was to identify contributors to nurses' depression.

Methods

This survey-based study was conducted in the Pomeranian Medical University Hospital no. 1 in Szczecin and involved 207 nurses. The following standardized research instruments were applied: the World Assumptions Scale, the Athens Insomnia Scale, the Impact of Event Scale - Revised, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder, the Perceived Stress Scale, and a questionnaire of our own authorship.

Results

The study showed that 72.95% of the subjects experienced severe stress, and 40.58% suffered from insomnia. In addition, 65.7% of the respondents had anxiety symptoms of varying degrees of severity, and 62.8% had depressive symptoms of mild to severe severity. The mean score on the IES-R scale, reflecting a psychological impact of the COVID-19 pandemic, was 34.25. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. Anxiety levels and insomnia significantly affect the prevalence of depression among nurses.

Conclusion

The COVID-19 pandemic has been recognized as an international public health emergency. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. It is important to conduct further research after the COVID-19 pandemic has ended.

The experiences of nurses during the COVID-19 crisis in India and the role of the state: A qualitative analysis

OBJECTIVES

The study documents the lived experience of nurses coping with the double burden of external demands and internal stressors while providing care during the COVID-19 pandemic in India.

METHODS

This qualitative study interviewed 18 female nurses who worked in the COVID wards of a major hospital in India. The one-on-one telephonic interviews were conducted with respondents based on three broad open-ended questions. Thematic analysis was conducted.

RESULTS

Three themes were identified: (i) external demands such as availability, utilization, and management of resources; (ii) internal psychological stressors, such as emotional exhaustion, moral anguish, and social isolation; and (iii) promotive factors such as the roles of the state and society, and of patients and attendants CONCLUSIONS: Findings suggest that despite limited resources and facilities, nurses ploughed through the pandemic with their resilience and the state's and society's promotive factors. To improve health care delivery in this crisis, the role of the state and healthcare system has become important to prevent the workforce from crumbling. The sustained attention of the state and society is required to reinstate motivation among nurses by raising the collective value of their contribution and capability.

A Comparison of the Impact of COVID-19-Related Restrictions on Physical Activity Among Public Employees

OBJECTIVES

This article compares the impact of COVID-19-related restrictions on the level of physical activity, performed by public servants, in April and November 2020.

METHODS

The survey examined the amount (in minutes per week) and the energy expenditure (in metabolic equivalent of task in minutes per week [METmin/week]) of physical activity for both before and during contact restrictions in April and November 2020, respectively.

RESULTS

Especially for sports activity difference was determined by the medians before (April/November: median [Mdn] = 180.0 min/wk) and during (April: Mdn = 130 minutes, November: Mdn = 60 min/wk) restrictions ( P < 0.05).Also for energy consumption (METmin/wk), the medians before and during the contact restrictions declined for both periods.

CONCLUSIONS

Measures against the coronavirus have led to a reduction in activity levels among public employees, regardless of their work environment. The decrease in participation in sport activities seemed to be even more noticeable within the second restriction period.

[ECMO support during the first two waves of the corona pandemic-a survey of high case volume centers in Germany]

BACKGROUND

At the onset of the coronavirus pandemic, concerns were raised about sufficiency of available intensive care resources. In many places, routine interventions were postponed and criteria for the allocation of scarce resources were formulated. In Germany, some hospitals were at times seriously burdened during the course of the pandemic. Intensive care units in particular experienced a shortage of resources, which may have led to a restriction of services and a stricter indication setting for resource-intensive measures such as extracorporeal membrane oxygenation (ECMO). The aim of this work is to provide an overview of how these pressures were managed at large ECMO centers in Germany.

METHODS

One representative of each major ECMO referral center in Germany was invited to participate in an online survey in spring 2021.

RESULTS

Of 34 invitations that were sent out, the survey was answered by 23 participants. In all centers, routine procedures were postponed during the pandemic. Half of the centers increased the number of beds on which ECMO procedures could be offered. Nevertheless, in one-third of the centers, the start of at least one ECMO support was delayed because of a feared resource shortage. In 17% of centers, at least one patient was denied ECMO that he or she would have most likely received under prepandemic conditions.

CONCLUSION

The results of this online survey indicate that the experienced pressures and resource constraints led some centers to be cautious about ECMO indications.

Understanding pandemic resilience: a mixed-methods exploration of burdens, resources, and determinants of good or poor well-being among Austrian psychotherapists

Introduction

The COVID-19 pandemic has exacerbated the mental health burden on the general population, resulting in increased demands on mental healthcare professionals, including psychotherapists. This cross-sectional study assessed the challenges and resources encountered by 513 psychotherapists based on an online survey conducted between April and May 2022.

Methods

Qualitative methods content analysis of written reports was employed to investigate the emerging challenges and sources of support during the pandemic. A comparative analysis of burdens, resources, sociodemographic factors and daily physical activity was conducted to discern patterns of good and poor well-being.

Results

The predominant burden identified was mental health-related issues, followed by global crises and government-imposed restrictions to mitigate virus transmission. Essential resources encompassed social connections, mindfulness, work satisfaction, and internal processes. Notably, psychotherapists demonstrating good well-being were older, more physically active, had a lower proportion of females, were employed in private practices rather than in institutionalized settings, had more years of professional experience and treated more patients weekly than their counterparts with poor well-being. Furthermore, they exhibited greater optimism, health focus, and satisfaction with their coping methods.

Discussion

These findings can help develop support systems, policies, and educational programs to better support mental health professionals during global crises and offer strategies for individual practitioners to maintain their well-being.

The prevalence of effort-reward imbalance and its associations with working conditions, psychosocial resources and burden among health care workers during the COVID-19 pandemic: Results of the egePan-Voice study

OBJECTIVE

The association between a measure of effort-reward imbalance (ERI) and profession as well as gender in a sample of health care workers (HCW) during the first wave of the COVID-19 pandemic in Germany using the egePan-Voice study. In addition, we examined, which factors are associated with an effort-reward imbalance ratio (ERI ratio) >1.

METHODS

In a large sample of HCW (N = 6174) we assessed occupational stress with the short version of the effort-reward imbalance (ERI) questionnaire, working conditions, COVID-19-related problems and psychosocial resources (ENRICHD Social Support Inventory, ESSI; Sense of Coherence Scale, SOC-3 and optimism, SOP2).

RESULTS

The prevalence of a ERI ratio >1 among HCW was 50.9%. The prevalence's of an ERI ratio >1 were statistically significant different between gender as well as the occupational profession. The proportion of women (51.8%) with ERI ratio >1 was significantly higher than among men (47.8%). The highest ERI imbalance was found among nurses (62.8%), followed by medical technical assistants (MTA) (58.8%), while psychologists/psychotherapists revealed the lowest value (37.8%), followed by physicians (41.8%). In the total sample, most essential factors reported at this time for increased ERI ratio were: insufficient staff for the current work load, insufficient recovery, feeling insufficiently protected by measures taken by the hospital/the employer, high occupancy rate of the wards, insufficient trust in colleagues and being a nurse as compared with being a physician.

CONCLUSION

The findings indicate a high proportion of HCW with effort-reward imbalance and substantial profession-related differences. Preventive interventions should be offered to vulnerable groups among the HCW to decrease the imbalance measured by work stress.

Counseling and support services for healthcare workers in German university hospitals during the pandemic-descriptive results of a Germany-wide cross-sectional survey

Background

Due to the SARS-CoV-2 pandemic, healthcare workers (HCWs) are experiencing tremendous levels of emotional and physical stress. Hospitals are trying to help personnel cope with work-related pressure. The aim of this study was to assess HCWs' awareness and utilization of counseling and support services during the pandemic, HCWs' unmet counseling and support needs, and the type and content of these services.

Methods

A cross-sectional online survey was conducted from January to June 2021 through the German national research organization Network University Medicine (NUM). All participating hospitals (6 in total) were asked to inform their employees about the study.

Results

A total of 1,495 HCWs were included in the analysis. Of these, 42.8% (n = 637) were frontline HCWs (who had contact with COVID-19 patients), 23.1% (n = 344) were second-line HCWs (who only had contact with non-COVID-19 patients) and 34.1% (n = 508) had no contact with any patients. Participating hospitals offer various counseling and support services for their staff. The percentage of respondents who were unaware of available counseling and support services ranged from 5.0 to 42.0%. Depending on the type of counseling and support services, 23.0-53.6% of the respondents indicated that counseling and support services were provided but not used, while 1.7-11.6% indicated that, despite the need for them, such services were not available. HCWs' overall satisfaction with the provided counseling and support services and their unmet support needs differed by patient contact: Frontline HCWs reported more unmet needs for counseling and support than second-line HCWs, while second-line HCWs reported more unmet needs than HCWs without patient contact.

Conclusion

The results indicate that hospitals should make more efforts to inform HCWs about available counseling and support services. Hospitals could also create networks where HCWs could share information about the type and content of services and their experiences with various counseling and support services. These steps would enable hospitals to respond more quickly and effectively to the problems facing HCWs during pandemics.

Evaluation of a Telehealth-Enabled Pilot Program to Address Intensive Care Unit Health Care Worker Mental Health Distress

Introduction

Health care workers (HCWs) are at heightened risk of adverse mental health events (AMHEs) and burnout with resultant impact on health care staffing, outcomes, and costs. We piloted a telehealth-enabled mental health screening and support platform among HCWs in the intensive care unit (ICU) setting at a tertiary care center.

Methods

A survey consisting of validated screening tools was electronically disseminated to a potential cohort of 178 ICU HCWs. Participants were given real-time feedback on their results and those at risk were provided invitations to meet with resiliency clinicians. Participants were further invited to engage in a 3-month longitudinal assessment of their well-being through repeat surveys and a weekly text-based check-in coupled with self-help tips. Programmatic engagement was evaluated and associations between at-risk scores and engagement were assessed. Qualitative input regarding programmatic uptake and acceptance was gathered through key informant interviews.

Results

Fifty (28%) HCWs participated in the program. Half of the participants identified as female, and most participants were white (74%) and under the age of 50 years (93%). Nurses (38%), physicians-in-training (24%), and faculty-level physicians (20%) engaged most frequently. There were 19 (38%) requests for an appointment with a resiliency clinician. The incidence of clinically significant symptoms of AMHEs and burnout was high but not clearly associated with engagement. Additional programmatic tailoring was encouraged by key informants while time was identified as a barrier to program engagement.

Discussion

A telehealth-enabled platform is a feasible approach to screening at-risk HCWs for AMHEs and can facilitate engagement with support services.

A predictive model of perceived stress during the first wave of the COVID-19 pandemic in university students Ecuadorians

Background and objectives

The situation caused by the confinement due to the COVID-19 pandemic and the mobility restriction implemented by governments worldwide had a significant impact on people's routines. Stressors are known to increase emotional imbalance, uncertainty, and frustration in the general population. This study explores the factors that predispose to the risk of perceived stress from COVID-19 and determines the underlying mediating mechanisms in the Ecuadorian population.

Method

The cross-sectional study an incidental non-probabilistic sample of n = 977 participating student volunteers from the four regions of the Republic of Ecuador (68.6% women and 31.4% men). Data on emotional regulation (ERQ), perceived stress (PSS), active procrastination (APS), diagnosis and symptoms related to COVID-19, social isolation, coexistence, and a sociodemographic questionnaire (biological sex, marital status, and age) were recruited. Statistical analysis was based on a structural equation model.

Results

The risk of suffering perceived stress in the COVID-19 pandemic was higher for single women who have lived longer in social isolation, have lived with more people, have poor emotional regulation and high rates of procrastination. This structural model is similar in all Ecuadorian regions χ² = 21.54 (p = 0.760), RMSEA = 0.001 (95%CI, 0.00-0.02), CFI = 0.998; TLI = 0.999; SRMR = 0.020.

Discussion

Although our findings are consistent and revealing for the scientific community, the lack of discrimination of the data due to strict isolation measures, taken at different periods by the Ecuadorian government against positive cases of COVID-19, is discussed. The research was applied to the university population, it would be representative to extend the study to schools and colleges.

Conclusion

We consider this work as a starting point for the creation of preventive models against perceived stress in the university environment in the event of health emergencies.

Factors affecting job stress among physical therapists during the COVID-19 pandemic in Saudi Arabia

<b>Background:</b> Physical therapists (PTs), like other healthcare professionals, are susceptible to job stress when involved in patient care, and several factors contribute to it. Therefore, this study aims to assess PTs’ knowledge, attitude, and practices (KAP) adopted by PTs during the COVID-19 pandemic and its impact on their job stress.<br /> <b>Methods:</b> A cross-sectional design was used. 300 PTs from the government and private healthcare organizations in Saudi Arabia were randomly picked and invited to participate. Data were collected using a pre-tested content-validated KAP tool using a Google Form between January and March 2022. Data were analyzed quantitively through SPSS 24.0.<br /> <b>Results:</b> The findings revealed that 85% of PTs whose job involves direct contact with the patients are susceptible to higher stress (perceived stress score [PSS]=22.82) than others. Specifically, female and unmarried PTs are prone to more job stress than others (p&lt;0.05). In addition, PTs who were apprehensive about managing COVID-19 patients and worried about acquiring COVID-19 disease are prone to more job stress. Lastly, 89% of PTs who adopted the practice of wearing N-95 masks and proper handwashing techniques (&gt;80%) experience less stress than others (p&lt;0.05).<br /> <b>Conclusion:</b> The KAP of PTs influences job stress during the COVID-19 pandemic. PTs with sufficient knowledge about measures to adopt, show a positive attitude, and practice wearing proper PPEs, handwashing procedures, and waste disposal systems during patient care are prone to less job stress than others.

Comparison of mental health indicators in clinical psychologists with the general population during the COVID-19 pandemic

Mental healthcare professionals face diverse challenges during the COVID-19 pandemic, which may augment their risk of experiencing adverse mental health outcomes themselves. We aimed to compare depressive, anxiety, insomnia, and stress symptoms in Austrian clinical psychologists during the COVID-19 pandemic with the Austrian general population. A total of N = 172 Austrian clinical psychologists (91.9% women; mean age: 44.90 ± 7.97 years) participated in an online survey in spring 2022. A representative sample (N = 1011) of the Austrian general population was surveyed simultaneously. Symptoms of depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), and stress (PSS-10) were assessed. Differences in the prevalence of clinically relevant symptoms were analyzed using univariate (Chi-squared tests) and multivariable (binary logistic regression including covariates age and gender) analyses. Clinical psychologists showed lower adjusted odds for exceeding the cut-offs for clinically relevant depression (aOR 0.37), anxiety (aOR 0.50), and moderate to high stress levels (aOR 0.31) compared to the general population (p < 0.01). No difference was observed for insomnia (aOR 0.92; p = 0.79). In conclusion, clinical psychologists experience better mental health than the general population during the COVID-19 pandemic. Future studies are needed to analyze the underlying reasons.

Mental health of healthcare professionals during the ongoing COVID-19 pandemic: a comparative investigation from the first and second pandemic years

Healthcare staff have been facing particular mental health challenges during the COVID-19-pandemic. Building on a first study at the beginning of the pandemic in March 2020, we aimed to investigate among healthcare professionals in Germany and Austria (1) how mental health may have changed in professionals over the course of the ongoing pandemic, (2) whether there are differences between different professional groups regarding mental health, (3) which stress factors may explain these mental health outcomes and (4) whether help-seeking behaviour is related to caretaker self-image or team climate. Between March and June 2021, N=639 healthcare professionals completed an online survey including the ICD-10 Symptom Rating checklist, event-sampling questions on pandemic-related stressors and self-formulated questions on help-seeking behaviour and team climate. Findings were analysed using t-tests, regressions and comparisons to a sample of healthcare professionals assessed in 2020 as well as to norm samples. Results show that mental health symptoms, particularly for depression and anxiety, persist among healthcare staff in the second pandemic year, that symptom prevalence rates are higher among nursing staff compared with physicians and paramedics and that team climate is associated with mental health outcomes. Implications of these findings in relation to the persisting pandemic and its aftermath are discussed.

Clinical Psychology and the COVID-19 Pandemic: A Mixed Methods Survey Among Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT)

Background

The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challenging. The current study investigates European clinical psychologists and psychotherapists' views on the changes and impact on mental health care that occurred due to the COVID-19 pandemic. It further aims to explore individual and organizational processes that assist clinical psychologists' and psychotherapists' in their new working conditions, and understand their needs and priorities.

Method

Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT) were invited (N = 698) to participate in a survey with closed and open questions covering their experiences during the first wave of the pandemic from June to September 2020. Participants (n = 92) from 19 European countries, mostly employed in universities or hospitals, completed the online survey.

Results

Results of qualitative and quantitative analyses showed that clinical psychologists and psychotherapists throughout the first wave of the COVID-19 pandemic managed to continue to provide treatments for patients who were experiencing emotional distress. The challenges (e.g., maintaining a working relationship through video treatment) and opportunities (e.g., more flexible working hours) of working through this time were identified.

Conclusions

Recommendations for mental health policies and professional organizations are identified, such as clear guidelines regarding data security and workshops on conducting video therapy.

A study on the relationship between sociodemographic characteristics and job stress and satisfaction among healthcare workers in Turkey during the COVID-19 pandemic

The aim of this study was to determine the sociodemographic characteristics that affect job stress and job satisfaction in 454 healthcare workers (physicians, nurses, midwives, technicians, and other healthcare personnel) working with COVID-19 patients in primary healthcare institutions in Turkey with a cross-sectional, web-based survey between 9 and 30 August 2021. The survey included a personal information form, a standard job stress scale, and the Minnesota Satisfaction Questionnaire. The levels of job stress and job satisfaction did not differ between male and female respondents. Singles reported lower job stress and higher job satisfaction than the married respondents. Job stress did not differ between departments, but respondents on the front line who worked in a COVID-19 intensive care unit (ICU) (at any point and/or at the time of the study) or the emergency department reported lower job satisfaction than those working in other departments. Similarly, while stress did not differ by educational status, satisfaction of respondents with bachelor's or master's degree was lower than that of the rest. Our findings also suggest that working in a COVID-19 ICU and age are significant predictors of higher stress, whereas lower education, working in a COVID-19 ICU, and being married are good predictors of lower satisfaction. Further research should include other sociodemographic variables that may affect stress and satisfaction at work, and similar studies should follow up to see what was left in the wake of the pandemic.

Burnout and occupational stress among Hungarian radiographers working in emergency and non-emergency departments during COVID-19 pandemic

INTRODUCTION

The increased workload caused by the coronavirus pandemic may have had a significant impact on the mental health of radiographers. The aim of our study was to investigate burnout and occupational stress in radiographers working in emergency departments (ED) and non-emergency departments (NED).

METHODS

Quantitative, cross-sectional, descriptive research was carried out among radiographers working in the public health sector in Hungary. Due to the cross-sectional nature of our survey, there was no overlap between the ED and NED groups. For data collection, we used simultaneously the Maslach Burnout Inventory (MBI), the Effort-Reward Imbalance questionnaire (ERI), and our self-designed questionnaire.

RESULTS

We excluded incomplete questionnaires from our survey; finally, 439 responses were evaluated. Significantly higher scores for depersonalisation (DP; 8.43 (SD = 6.69) vs. 5.63 (SD = 4.21) and emotional exhaustion (EE; 25.07 (SD = 11.41) vs. 19.72 (SD = 11.72)) were observed in radiographers working in ED (p = 0.001; p = 0.001) when compared to NED. Male radiographers working in ED aged 20-29 and 30-39 years with experience of 1-9 years were more affected by DP (p ≤ 0.05). Worrying about one's own health had a negative effect on DP and EE (p ≤ 0.05). Having close friend with a COVID-19 infection had a negative effect on EE (p ≤ 0.05); not being infected with coronavirus, not being quarantined and relocating within the workplace had a positive effect on personal accomplishment (PA); radiographers who were 50 years or older with 20-29 years of experience were more affected by depersonalisation (DP); and those who worried about their health had significantly higher stress scores (p ≤ 0.05) in both ED and NED settings.

CONCLUSION

Male radiographers at the beginning of their careers were more affected by burnout. Employment in EDs had a negative impact on DP and EE.

IMPLICATIONS FOR PRACTICE

Our results support the implementation of interventions to counter the effects of occupational stress and burnout among radiographers working in ED.

Impact of local COVID-19 alert levels on rhegmatogenous retinal detachment

PURPOSE

To investigate the impact of the local alert levels regarding coronavirus disease 2019 (COVID-19) on the clinical patterns of rhegmatogenous retinal detachment (RRD) in Japan.

STUDY DESIGN

Retrospective, single-center, consecutive case series.

METHODS

We compared two groups of RRD patients, a COVID-19 pandemic group and a control group. Based on the local alert levels in Nagano, five periods during the COVID-19 pandemic were further analyzed: epidemic 1 (state of emergency), inter-epidemic 1, epidemic 2 (second epidemic duration), inter-epidemic 2, and epidemic 3 (third epidemic duration). Patients' characteristics, including symptoms' duration before visiting our hospital, macula status, and retinal detachment (RD) recurrence rate in each period, were compared with those in a control group.

RESULTS

There were 78 patients in the pandemic group and 208 in the control group. The pandemic group had a longer duration of symptoms than the control group (12.0 ± 13.5 days vs. 8.9 ± 14.7 days, P = 0.0045). During the epidemic 1 period, patients had a higher rate of macula-off RRD (71.4% vs. 48.6%) and RD recurrence (28.6% vs. 4.8%) than the control group. This period also demonstrated the highest rates compared to all other periods in the pandemic group.

CONCLUSION

During the COVID-19 pandemic, RRD patients significantly delayed visiting a surgical facility. They showed a higher rate of macula-off and recurrence compared to the control group during the state of emergency than during other periods of the COVID-19 pandemic, although the difference was not statistically significant due to the small sample size.

Perception of Work-Related Stress and Quality of Life among Nurses during COVID-19 Pandemic-An International, Multicenter Prospective Study

The major focus of the study was the impact of the COVID-19 pandemic on healthcare workers' mental health. Nurses are the workers who were exposed to pandemic-related stress, being the most affected. The present cross-sectional study was focused on finding out the differences of the level of work-related stress and quality of life in nurses of the three Central European states, specifically the Czech Republic, the Slovak Republic, and Poland. A structured anonymous online questionnaire was created, and then the link was distributed to the target population through executives. Data analysis was performed by using the R programme-version 4.1.3. The study found that nurses from the Czech Republic achieved lower stress levels and had a higher quality of life than nurses from Poland and Slovakia.

Psychotherapists' experiences of telepsychotherapy during the COVID-19 pandemic in Argentina: impact on therapy setting, therapeutic relationship and burden

In order to prevent the spread of the coronavirus in Argentina, quarantine and distancing measures were adopted. This has led to a large increase in the use of online psychotherapy. Several international studies have already examined the transition from face-to-face therapy to telepsychotherapy during the COVID-19 pandemic from a therapist perspective, but within these studies, the Latin American context is not represented. To fill this research gap, this qualitative study explored the Argentinean psychotherapists' experiences with online psychotherapy during the COVID-19 pandemic by means of in-depth interviews and content analysis. Based on the international literature, an interview guideline was created which covered three main topics: setting, therapeutic relationship, and burden among therapists. For the analysis of the therapists' answers, a detailed codebook was developed. Effects were identified in all three areas investigated. The nine interviewed psychotherapists described unfavorable therapy conditions which affected the therapeutic setting, the psychotherapeutic methods and contents. Positive effects in the therapeutic relationship included patients being more open, but also negative effects such as discontinuation of therapies were reported. Therapists experienced telepsychotherapy as more exhausting than in-person psychotherapy, but they considered it a valuable tool during the pandemic, and the transition an enriching experience. These results, which are partially consistent with international findings, have practical implications for the practice of telepsychotherapy in Argentina. Technical conditions should be improved and patients' privacy during the session should be ensured. Treatment techniques and diagnostics need to be adapted for their use in telepsychotherapy.

Psychosoziale Belastung und psychosoziale Unterstützung für Fachkräfte im Gesundheitswesen während der COVID-19-Pandemie

Hintergrund

Ausgangspunkt der Studie ist die hohe psychosoziale Belastung von Fachkräften im Gesundheitswesen bei gleichzeitig geringer Inanspruchnahme eines Beratungs- und Unterstützungsangebots für Mitarbeiter*innen einer Universitätsklinik während der COVID-19-Pandemie.

Ziel der Arbeit

Die vorliegende Studie untersucht den Grad des psychosozialen Belastungserlebens von Fachkräften im Gesundheitswesen (n = 859) einer Universitätsklinik sowie Kenntnis, Inanspruchnahme und Bewertung innerbetrieblicher psychosozialer Versorgungsstrukturen.

Material und Methoden

Im Rahmen einer Online-Befragung (21.07.–19.10.2021) wurden die subjektiv empfundene Belastung durch die COVID-19-Pandemie, Depressivität (PHQ-8) des Personals sowie Kenntnis, Inanspruchnahme und Bewertung möglicher Versorgungsangebote der Universitätsklinik erhoben. Zusätzlich wurden qualitative Daten zu Informationsquelle, -vermittlung sowie Art der Kontaktaufnahme der innerbetrieblichen Versorgungsstrukturen erhoben.

Ergebnisse

Trotz hoher psychosozialer Belastung und überwiegender Kenntnis der Existenz innerbetrieblicher psychosozialer Versorgungsangebote ist deren Inanspruchnahme bei Fachkräften im Gesundheitswesen gering. Insbesondere der Kontakt zu Patient*innen stellte einen Risikofaktor für das psychosoziale Belastungserleben dar. Die qualitative Analyse zeigt, dass die Mitarbeiter*innen mehr über E‑Mails und Newsletters informiert werden möchten sowie eine übersichtliche Darstellung der Angebote vermissen.

Diskussion

Eine Überarbeitung der Angebotsdarstellung und Kontaktwege gemäß den Wünschen des Personals könnte die Inanspruchnahme innerbetrieblicher Angebote verbessern.

Job-demand and family business resources in pandemic context: How they influence burnout and job satisfaction

This research aims to explore how work demands and resource variables affect the burnout and satisfaction of employees of family businesses in the context of the pandemic (COVID-19) and the moderation effect of fear of COVID-19 on this relationship. A sample of 214 Chilean family business employees is used for hypotheses testing. Results indicate that the demands and resources partially explain the burnout and satisfaction of employees of family firms during the pandemic. Employees' fear of COVID-19 moderates the relationship between resources-demands and burnout-job satisfaction in family firms. This work contributes to understanding how these organizations can manage adverse scenarios to survive and continue operations.

[Influence of the contact restrictions against SARS-CoV-2 on physical activity among public sector employees.]

Objective

Preliminary results from activity surveys conducted in spring 2020 suggest that athletic activity may have decreased within the contact restrictions against the spread of coronavirus. The coronavirus pandemic poses many challenges to the workforce in the healthcare system. Therefore, this study investigated whether the measures to limit the pandemic have an influence on the activity behavior of employees in the public sector.

Method

A retrospective cross-sectional survey was conducted to collate the activity behavior among employees of three institutions in the public sector before and during the measures against the coronavirus in April 2020. An online version of the Freiburg Activity Questionnaire was used. Using Wilcoxon tests on connected samples with a significance level of p < 0.05, the activity behavior was examined for differences before compared to during the contact restrictions in min/week and MET-min./week.

Results

A total of 1797 public sector employees in Freiburg (36.0% male, 63.9% female, and 0.1% diverse) participated in the survey. For sports activity, a relevant difference (p < 0.05) was measured in the medians (Mdn) of activities per week before (Mdn = 180 min) and during (Mdn = 120 min) the relevant contact restrictions. Similarly, for energy expenditure through exercise, the median value within the contact restrictions decreased from Mdn = 1022 MET-min/week to Mdn = 750 MET-min./week.

Conclusion

Measures to limit the spread of the coronavirus have led to a reduction in activity levels among public sector employees. In particular, fewer employees engaged in sports. This could be related to the closure of fitness studios as these activities were particularly reduced. Decreased physical activity can lead to unfavorable individual risk profiles, which must be compensated for in the future.

Depression, anxiety and stress levels of operating room workers during the COVID-19 pandemic period

Purpose: The objective of this study was to determine the depression, anxiety, and stress levels of operating room workers during the COVID-19 pandemic. Materials and Methods: The data were collected using the “Personal Information Form” and "Depression Anxiety Stress-21 (DASS-21)" scale. The personal information form consisted of eight questions including age, gender, profession, professional seniority, status of being diagnosed with COVID-19, being afraid of developing COVID-19, presence of chronic diseases and change in weight during the pandemic period. DASS-21 scale is a 4-point Likert type (never=0; always=3) scale and consists of seven questions with each predicting "depression, stress and anxiety dimensions". Results: A total of 253 volunteers with 161 (63.6%) being female and 92 (36.4%) male were included in this observational screening study. Anxiety score of female participants (5.65±4.44) was found to be statistically significantly higher compared to the male participants (3.94±4.68). Depression (5.97±4.41), anxiety (5.48±4.53) and stress (6.94±4.59) scores were significantly higher in the participants who were afraid of developing COVID-19. Depression, anxiety and stress scores were significantly higher in the participants with chronic diseases than in those without chronic diseases. Conclusion: The findings of our study indicate that the mean depression, anxiety and stress scores of the operating room personnel were mild.

Impact of fear & anxiety of COVID-19 and perceived job insecurity on the mental health of the bankers: evidence from Bangladesh

The study examined the impact on bankers' mental health in terms of fear and anxiety and perceived job insecurity during COVID-19. It also evaluated the effectiveness of combating steps against COVID-19 taken by government and employers to reduce bankers' mental stress. Data were collected from 252 banking professionals in Bangladesh through questionnaire survey. Goodness of fit has been analyzed using Structural Equation Modeling (SEM). Furthermore, Exploratory and confirmatory factor analyses were applied for reliability test. The sampling adequacy was tested using KMO and Bartlett's Test, and the results showed the sample is significant. Cronbach's alpha and composite reliability (C.R) results indicate that the construct is reliable. The results showed fear & anxiety and perceived job insecurity have significant and positive impact on bankers' mental health implying their increase deteriorates bankers' mental health. It is observed that the study and its concerned subject matter absolutely unleashed the inner scenario of banking professionals in Bangladesh. According to this study, lockdown limitations should be used more wisely, and the mental health of the bankers should receive more immediate and consistent attention. In the event that workforce reduction measures are required to address the financial crisis, it is advised that banking sector give furloughs preference over layoffs.

Physiological and psychological stress responses to labor and delivery during COVID-19 pandemic: a cohort study

OBJECTIVE

To evaluate objective (saliva cortisol) and subjective (questionnaire) stress levels during the Coronavirus disease (COVID-19) pandemic compared to before the pandemic and their effects on obstetric and neonatal outcomes.

METHODS

This cohort study included 36 women with low-risk, singleton, term deliveries at a tertiary academic center during the COVID-19 pandemic and 49 who delivered before. Physiological stress was evaluated with salivary cortisol measurements, and emotional stress with stress scale questionnaires (0-10) during active and full dilation stages of labor, and 2-min postpartum. Cord blood cortisol and pH were obtained. Delivery mode, complications, and neonatal outcomes were evaluated.

RESULTS

Psychological stress was higher for the COVID-19 group compared to controls during full dilation (6.2 ± 3.4 vs. 4.2 ± 3, p = .009). The COVID-19 group had significantly lower cord cortisol levels (7.3 vs. 13.6 mcg/dl, p = .001). No differences were found regarding salivary cortisol level assessments at active, full dilation and 2-min post-delivery (p = .584, p = .254, p = .829, respectively). No differences were found regarding pH < 7.1 (p = .487), 1- and 5-min Apgar scores < 7 (p = .179) and neonatal weight (p = .958).

CONCLUSIONS

Women who delivered during COVID-19 pandemic had higher stress levels at full dilation and lower cord cortisol levels, as may be expected after exposure to a chronic stressor.

Home care nurses' perception of the challenges they faced during the COVID-19 pandemic: a qualitative study

BACKGROUND

Despite the significant role they play in the whole health care system, home care nurses are not paid the attention they deserve. Besides highlighting their significant role in the health care system, the COVID-19 pandemic also posed several challenges for home care nurses.

OBJECTIVE

The purpose of this study is to explain the nurses' perception of the challenges of home care during the Covid-19 pandemic.

METHODS

The present study was a qualitative study with a conventional content analysis approach conducted from November 2020 to September 2021. Participants included 16 home care nurses who were purposefully selected based on the eligibility criteria. After obtaining ethical authorization, the data were collected through semi-structured interviews. MAXQDA Version 10 software was used for data mangement. Data analysis was performed using the Granheim and Lundman five-step method. Guba and Lincoln criteria were utilized for trustworthiness.

FINDINGS

The seven main categories obtained in this study included "the onset of a new chapter: from avoidance to relapse", "burnout", "vortex of moral distress", "social stigma", "difficulty in breaking the transmission chain", "care inhibitors related to the patient and family" and "support deficiency: the crisis of home care nursing agencies during the crisis".

CONCLUSION

The results showed that nurses working in home care during the Covid-19 pandemic experienced several challenges in various fields. This study captured the nurses' perception of the challenges of home care during the Covid-19 pandemic, a period of unprecedented change and difficulty. These challenges included lack of support, psychological problems, and dealing with new experiences. Identifying these challenges can help improve the quality of home care nursing and planning in this area.

Coping strategies used by health-care workers during the SARS-COV2 crisis. A real-world analysis

The aim of this paper is to analyze the main coping strategies used by frontline teams during the first days of the COVID pandemic confinement in Spain. This information could be necessary in order to carry out training programs that allow a better handling of future emergency situations, as well as acting more effectively and with less negative emotional impact. A questionnaire was used to identify different psychological profiles for coping, and in turn, other relevant variables were analyzed. The most used strategies by health professionals were problem solving, desiderative thinking and social support. Emotional expression and social support were used more by women. Significantly different behaviors were found in desiderative thinking (lower in people of 35-50 years old, and social support, higher in people 35 years old). The symptoms most commonly experienced by medical personnel were: sleep disorders, anxiety, tension, depressive symptoms, gastrointestinal symptoms and general somatic muscular symptoms. A relationship could be determined between the age/gender of the workers and the participants' overall assessment of their ability to cope with the COVID-19 stress situation they had experienced (men 50 years old and women between 35 and 50 years old, who felt able or very able to cope with the stress caused by the health emergency. However, women <35 years old and >50 years old believed they were able to cope poorly with the circumstances. The advantage of specific training plans in order to help with some stress symptoms could be suggested, aimed at the acquisition of tools based on problem solving, and emotional management in stressful and emergency situations.

The implications of COVID-19 on health and social care personnel in long-term care facilities for older people: An international scoping review

This scoping review mapped out the existing literature pertaining to health and social care personnel experiences during the coronavirus disease-2019 (COVID-19) pandemic and their work in a long-term care setting for older people. This review identified the gaps in the implications of health and social care personnel's own health and well-being during the pandemic as well as the ethical dilemmas inherent in providing care during the COVID-19 pandemic. The authors utilised the PRISMA checklist for undertaking scoping reviews. The Databases Medline, PsychINFO, CINAHL, SCOPUS, Web of Science and Google Scholar were searched for relevant articles in English that were published between March 28, 2020 and June 1, 2022. This time period was selected to focus specifically on the COVID-19 pandemic. In the context of this review, long-term care facilities were defined to include institutions such as nursing homes, skilled nursing facilities, retirement homes and residential care homes. The gaps identified were a paucity of research on the experiences of health and social care personnel in long-term care facilities, the impact on their mental health, and the wider challenges experienced during the COVID-19 pandemic is discussed. The findings of this scoping review indicate a need for adequate preparedness during a pandemic within the health and social care sector to protect health and social care personnel and the individuals they care for.

Consequences of the Corona crisis on outpatient oncological care - a qualitative study among nurses and medical assistants

Introduction

The Covid-19 pandemic has caused great personal stress for medical staff. To ensure adequate outpatient care for cancer patients, extensive safety and hygiene measures must be taken. This interview-based study examines the effects–both personal and professional–of the pandemic on the work routine of outpatient hematology/oncology nurses and medical assistants.

Patients, materials and methods

Half a year after the outbreak of Covid-19 and the introduction of infection control regulations in three outpatient hematological/oncological centers, the affected medical staff (n = 15) were surveyed about the consequences for patient care and clinical work using audio-recorded telephone interviews. The interviews were transcribed and analyzed using a qualitative content analysis.

Results

The Covid-19 pandemic has complicated the medical care of cancer patients, but only a slight deterioration of medical and psycho-oncological care was observed. The level of stress experienced by medical staff is moderate, with hygiene and safety measures at the workplace helping to reduce stress.

Conclusion

From the point of view of medical staff, the Covid-19 pandemic has had a moderate impact on the outpatient care of cancer patients. Safety measures against Covid-19 are decisive for ensuring the continuation of therapy and for motivating employees.

COVID-19 stress and wellbeing: A phenomenological qualitative study of Pakistani Medical Doctors

The COVID-19 stress and increased job pressure have largely affected healthcare professionals’ various life domains. This study particularly explores the effect of stress caused by treating COVID-19 patients on medical doctors’ wellbeing. To explore this phenomenon, we interviewed 12 doctors treating COVID-19 patients in hospitals of metropolitan cities in Pakistan. The thematic analysis using NVivo V.12 Plus software of interviews resulted in four major themes, COVID-19 Stressors, Effects of Stress, Nature and Personality, Stress Relievers, and Stress Coping Strategies. Physicians were physically and emotionally stressed as a result of the intense work. Although they were carrying a lot of pain and hurt on their insides, participants demonstrated a sense of professional determination to overcome obstacles. Physicians are currently dealing with their emotional issues, and they should have access to complete professional help to ensure their wellbeing. The COVID-19 pandemic’s mental health effects are anticipated to last far longer than the physical health effects. This study is well-positioned to investigate frontline physicians’ opinions and attitudes concerning the COVID-19 and its impact on their daily lives and mental health. This research will help implement context-specific innovative mental health solutions to help the frontline workers.

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

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

[egePan-VOICE study on the psychosocial burden of the Covid-19 pandemic among - medical technical assistants]

egePan-VOICE study on the psychosocial burden of the Covid-19 pandemic among - medical technical assistants Objectives: The Covid-19 pandemic is associated with increased demands on healthcare workers. A previously neglected occupational group is medical technical assistants (MTA). The aim is therefore to identify stress factors among MTA in Germany during the pandemic. Methods: A cross-sectional online survey of medical staff was conducted in spring 2020 (N = 8088). Results: N = 1483 records of MTA were analyzed. Retrospectively, the stress increased under the pandemic, and 60.1 % of MTA suffered from work stress (ERI). Staff shortages and extra work were associated with an increase in work stress. Problems of work-life balance and contact with contaminated material/infected persons favored stressful experiences. Conclusions: Some working conditions in the pandemic pose a potential health risk to MTA. It seems necessary to create improvements in the general conditions that enable healthily and effective work.

Construction process and development stages of pandemic emotions questionnaire in cancer patients (PEQ-CP)

BACKGROUND

Despite the numerous tools built ad hoc to investigate the effects of the CoViD-19 pandemic on people, to date there are no known questionnaires that investigate the emotional experiences of cancer patients. This work aims to start a process of construction and validation of a tool that captures these aspects (Pandemic Emotions Questionnaire in Cancer Patients-PEQ-CP).

METHOD

A mixed method approach was used through three phases, each on a different sample: Phase 1: creation of items and checking of internal validity, through unstructured interviews and verification of the validity of content by "peers" and "experts"; Phase 2: exploration of the factorial structure of the scale through an exploratory factor analysis (EFA); Phase 3: confirmation of the factorial structure of the scale through a confirmatory factor analysis (CFA).

RESULTS

Phase 1 revealed 26 items that can be grouped into 4 theoretical dimensions. "Peers" and "experts" rated all items as understandable and relevant except one, which was reformulated. The EFA in the Phase 2 revealed a factorial structure with 14 items and three dimensions (Emotional Understanding, Communication of Emotions, Feelings the same as others), confirmed by the CFA in Phase 3.

CONCLUSION

Although further validation steps are required, the PEQ-CP showed good psychometric properties.