Severe Burnout and Poor Mental Health Among Healthcare Workers 6 Months After COVID-19 Pandemic Declaration: What Can We Learn for Future Emergencies?

Predictors of poor psychological functioning of healthcare workers based in Greece during the COVID-19 pandemic

Background

Poor psychological functioning during the COVID-19 pandemic has been reported in several studies of healthcare workers from around the world. Factors that might predict this have yet to be established.

Objectives

First, to ascertain which factors were associated with poor psychological functioning in a cohort of healthcare workers during the COVID-19 pandemic. Second, to characterize key sociodemographic aspects of this cohort. Third, to determine the degree to which any predictors of poor psychological functioning were associated with each other.

Methods

A questionnaire-based cross-sectional study was conducted of 144 healthcare workers in Patras, Greece, during the COVID-19 pandemic. The questionnaire consisted of: (1) demographic survey questions; (2) the Psychological Consequences Questionnaire scale; (3) the Kessler Psychological Distress scale; and (4) Toulouse's scale for coping strategies. The data were analyzed using general linear modeling.

Results

The statistical model (p < 10-10) indicated that smoking or taking drugs to calm anxiety, feeling ashamed, and being overwhelmed by one's feelings were all predictors of poor psychological functioning. Conversely, income was a protective factor. A post hoc network analysis showed that smoking or taking drugs to calm anxiety was relatively strongly associated with feeling ashamed; the latter was also associated with feeling overwhelmed. There was a weak negative association between income and feeling ashamed.

Conclusion

This study highlights the critical importance of psychological functioning in shaping the mental well-being of healthcare professionals during pandemics. Prioritizing the mental health of frontline workers is crucial for their well-being and for the overall functioning of healthcare systems.

Compassion fatigue and compassion satisfaction in pediatric and neonatal care nurses during the COVID-19 pandemic in Sweden

PURPOSE

Quality of care and the mental and physical health of nurses are interlinked. The COVID-19 pandemic has imposed an extremely high burden on health care. This study aimed to: 1) describe professional quality of life of registered nurses (RN) working in the pediatric and neonatal care units during the COVID-19 pandemic in Sweden, 2) compare professional quality of life between RNs with and without a Master's degree in specialist nursing pediatric care (MSc), and 3) compare differences in professional quality of life associated with the nursing experience (years).

DESIGN AND METHODS

This study adopted a cross-sectional survey design. The PROQoL®-5-questionnaire was administered as a web survey to 160 RNs at four pediatric wards and two neonatal units of two hospitals in Sweden.

RESULTS

Seventy-one RNs responded to the survey. Overall, they reported a sufficient professional quality of life. RNs with an MSc suffered significantly lower secondary traumatic stress levels. Experienced RNs reported significantly higher compassion satisfaction and lower occupational burnout.

CONCLUSION

Higher education and longer experience are beneficial for nurses' professional quality of life when working in pediatric care units.

PRACTICAL IMPLICATIONS

Results from this study highlights the importance of offering RN education in pediatric care at master level and supporting novice nurses, to prevent negative professional well-being outcomes in pediatric care, because the health of nurses is of utterly importance when crisis such as a pandemic hits the world. The findings also suggest that the conditions for professional quality of life could improve through activities such as self-care, time for reflection, better working hours, competence-adjusted salary, and educational opportunities.

Mixed-methods study protocol for exploring the perception of nurses' resilience in the COVID-19 pandemic: Designing, implementing and evaluation of intervention

BACKGROUND

While the necessity for interventions to build resilient nurses in the COVID-19 pandemic is recognized, there is disagreement about the effective methods for achieving this.

AIM

We present our research protocol that describes plans to design and test an interventional program for promoting nurses' resilience.

DESIGN

This sequential exploratory interventional mixed-methods study is conducted in three phases (qualitative, intervention design, and quantitative).

METHODS

It was funded from May 2021 for 24 months. In phase 1, we explored strategies for promoting resilience in the COVID-19 pandemic from nurses' perspectives (through semi-structured interviews). In phase 2, we will design an interventional program for promoting nurses' resilience (using the qualitative phase and literature review results). We will assess the program's effectiveness on nurses' resilience in a randomized controlled trial in phase 3.

DISCUSSION

Given the different experiences of nurses of resilience in COVID-19, our innovative program can guide future research to enhance nurses' resilience based on specific situations.

Assessment of Resilience Training for Hospital Employees in the Era of COVID-19

IMPORTANCE

Health care workers face serious mental health challenges as a result of ongoing work stress. The COVID-19 pandemic exacerbated that stress, resulting in high rates of anxiety, depression, and burnout. To date, few evidence-based programs targeting mental health outcomes in health care workers have been described.

OBJECTIVE

To assess the feasibility, acceptability, and preliminary outcomes of a skills-based coaching program designed to reduce stress and build resilience.

DESIGN, SETTING, AND PARTICIPANTS

A pilot cohort study was conducted between September 2020 and April 2021 using preprogram and postprogram assessments and a mixed-methods analysis. Duration of follow-up was 7 weeks. The coaching program was delivered via video conferencing. Participants were health care workers and staff from a large urban health system.

INTERVENTION

The Promoting Resilience in Stress Management (PRISM) program, a manualized, skills-based coaching program originally developed for adolescents and young adults with serious/chronic illness, was adapted to support health care workers and staff ("PRISM at Work"). It included 6 weekly 1-hour group sessions.

MAIN OUTCOMES AND MEASURES

Feasibility was defined a priori as 70% completion rates. Acceptability was defined quantitatively (satisfaction scores) and qualitatively (open-ended questions regarding experience with program). Preliminary outcomes were assessed with preprogram and post program assessments of self-reported resilience, stress, anxiety, and burnout using validated instruments. Descriptive statistics summarized demographic variables and feasibility and acceptability. Linear mixed effects regression models examined preliminary outcomes, controlling for relevant covariates.

RESULTS

A total of 153 participants (median [SD] age, 40.6 [10.1] years; 142 [92%] were female; 128 [84%] identified as having White race; 81 [53%] were in patient-facing roles) enrolled. Of the 132 health care workers who provided follow-up surveys, 120 (91%) had completed the program, and 116 (88%) reported being satisfied. Answers to open-ended questions suggested that participants wanted more PRISM either with longer or additional sessions. Participant-reported resilience (β = 1.74; 95% CI, 1.00-2.48), stress (β = -2.40; 95% CI, -3.28 to -1.51), anxiety (β = -2.04; 95% CI, -2.74 to -1.34), and burnout-exhaustion (β = -0.37; 95% CI, -0.56 to -0.18) improved after the program.

CONCLUSIONS AND RELEVANCE

Results of this study suggest that PRISM at Work may have utility for health care workers and staff in that the program was found to be feasible, acceptable, and associated with improved outcomes.

A Comparison of the 2023 Magnet® Manual and the 2020-2030 Future of Nursing Report

The Magnet Recognition Program® completed a crosswalk between the National Academy of Medicine (NAM) recommendations in the 2020-2030 Future of Nursing report and the recently released 2023 Magnet Application Manual. In comparing the 2 documents, it was determined the Magnet® framework aligns with several of the NAM recommendations. Both the NAM and Magnet program emphasize health equity and diversity in patient care, education, and nurse wellness. In this column, one can learn how both documents establish guidelines for empowering the nursing profession as the primary means to improving health equity and outcomes for the 21st century.

Nurses' mental health from early COVID-19 pandemic to vaccination

AIMS

The influence of the COVID-19 vaccine and the evolution of the pandemic over time on nurses' mental health have not been thoroughly examined. This study aimed to explore the changes in nurses' mental health from the early pandemic to the early vaccination period over a 1-year time span and examine vaccination and coping mechanisms as predictors of nurses' poor mental health and burnout.

METHODS

Three cross-sectional surveys were conducted: Early-pandemic (n = 320), pre-vaccination (n = 228), and early-vaccination cohorts (n = 292).

FINDINGS

About 72% of nurses in the early-vaccination cohort were fully vaccinated with two doses of mRNA COVID-19 vaccines. There were significant decreases in moderate/severe anxiety and moderate/severe depression for the early-vaccination cohort compared to the other cohorts. In multivariate analyses, vaccination had almost three-fold higher odds of moderate/severe anxiety (Odds Ratio [OR] = 2.87; 95% Confidence Interval [CI] = 1.28-6.44). High resilience, family functioning, and spirituality were associated with two- to five-fold lower odds of poor mental health and burnout.

CONCLUSIONS

Although nurses in the early-vaccination cohort had lower anxiety and depression than earlier cohorts, COVID-19 vaccination had minimal associations with nurses' mental health. Coping mechanisms and organizational support appear to be important predictors of nurses' poor mental health and burnout.

CLINICAL RELEVANCE

The evidence gathered over 1 year of the pandemic may be helpful for a better understanding of the challenges facing frontline nurses and preparing for future healthcare crises. As a part of the preparedness plan for the future, evidence-based interventions that raise frontline nurses' resilience, as well as family and spiritual support, should be considered.