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Weldetinsae A, Alemu ZA, Tefaye K, Gizaw M, Alemahyehu E, Tayachew A, Derso S, Abate M, Getachew M, Abera D, Mebrhatu A, Kefale H, Habebe S, Assefa T, Mekonnen A, Tollera G, Tessema M. Adherence to infection prevention and control measures and risk of exposure among health-care workers: A cross-sectional study from the early period of COVID-19 pandemic in Addis Ababa, Ethiopia. Health Sci Rep 2023; 6:e1365. [PMID: 37359411 PMCID: PMC10288972 DOI: 10.1002/hsr2.1365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Background and Aim Healthcare workers (HCWs) are considered a high-risk group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, ascribed to the amount of time they spend in health-care facilities (HCFs). This study aimed to assess HCWs' compliance with Infection Prevention and Control (IPC) procedures and the risk of exposure during the early period of the pandemic in Addis Ababa, Ethiopia. Methods A descriptive cross-sectional survey was conducted from June to September 2020. With a response rate of 79.2%, a standardized questionnaire was administered among 247 HCWs, working in eight HCFs. Descriptive and multivariate regression analysis was carried out in STATA version 16. Results About 22.5% (55) of the HCWs had proper adherence to IPC procedures. Of the total participants, 28.2% (69) had proper use of Personal Protective Equipment (PPE), 40% (98) had proper hand hygiene practices, and 33.1% (81) had frequently cleaned their working environment. HCWs who received training on IPC protocols were four times more likely to follow IPC standards than those with no training (adjusted odds ratio [AOR] = 3.93; 95% confidence interval [CI]: 1.46, 10.58). Besides, HCWs working in treatment centers were four times more likely to follow IPC standards than those working in conventional hospitals (AOR = 3.61; 95% CI:1.63, 8.02). Nurses were four times more likely to have adherence to IPC measures than cleaners and runners (AOR = 4.37; 95% CI: 1.38-13.88). Conclusion The nature and magnitude of the pandemic did not introduce the required degree of adherence to IPC procedures, per se does not match the level of diligence needed to halt SARS-CoV-2 transmission. Our finding suggested that providing periodic training of HCWs with particular emphasis on nonclinical staff is commendable. Furthermore, it is necessary to maintain resilent IPC in HCF through continous follow up and safety drills, to assess the readiness of HFCs' adherance to IPC measures under normal circumstances, which could improve prepardeness for an effective response during epidemics.
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Affiliation(s)
| | | | | | - Melaku Gizaw
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | | | | | - Sisay Derso
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | - Moa Abate
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | | | - Daniel Abera
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | | | - Higu Kefale
- Ethiopia Ministry of Health Addis Ababa Ethiopia
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Mardiko AA, Bludau A, Heinemann S, Kaba HEJ, Fenz D, Leha A, von Maltzahn N, Mutters NT, Leistner R, Mattner F, Scheithauer S. Infection control strategies for healthcare workers during COVID-19 pandemic in German hospitals: A cross-sectional study in march-april 2021. Heliyon 2023; 9:e14658. [PMID: 36945349 PMCID: PMC10022461 DOI: 10.1016/j.heliyon.2023.e14658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Background Healthcare workers (HCW) are at risk of getting infected with COVID-19 at work. To prevent such incidents and provide a safe environment in hospitals, comprehensive infection control strategies are necessary. We aimed to collect information on COVID-19 infection control strategies regarding personal protective equipment (PPE), regulations during breaks for HCW and dissemination of pandemic-related information. Methods We invited infection control practitioners from 987 randomly selected German hospitals in March-April 2021 to participate in our cross-sectional online survey. We categorized the hospital based on bed capacity (≤499 beds = small; ≥500 beds = large). Fisher's exact test was performed and p < 0.05 defined as statistically significant. Findings 100 participants completed the questionnaire. Small hospitals were more directive about requiring FFP2 respirators (63%), whereas larger hospitals more often gave their HCW a choice between these and medical masks (67%). For the care of COVID-19 and suspected COVID-19 cases, >90% of the participants recommended the use of gloves. Notably, gloves were recommended beyond COVID-19 in 30% of the hospitals. During meal breaks various strategies were followed. Conclusion Recommendations for PPE varied across hospital sizes, which could be due to different assessments of necessity and safety. Regulations during breaks varied strongly which illustrates the need for clear official guidelines.
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Affiliation(s)
- Amelia A Mardiko
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University, Göttingen, Germany
| | - Anna Bludau
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University, Göttingen, Germany
| | - Stephanie Heinemann
- Local Task Force of the Network University Medicine (NUM), University Medical Center Göttingen (UMG), Göttingen, Germany
- Department of General Practice, University Medical Center Göttingen (UMG), Göttingen, Germany
- Department of Geriatrics, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Hani E J Kaba
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University, Göttingen, Germany
| | - Diana Fenz
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University, Göttingen, Germany
| | - Andreas Leha
- Department of Medical Statistic, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Nicole von Maltzahn
- Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
| | - Nico T Mutters
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Rasmus Leistner
- Institute for Hygiene and Environmental Medicine, Charité University Hospital Berlin, Berlin, Germany
- Division of Gastroenterology, Infectiology and Rheumatology, Medical Department, Charité University Hospital Berlin, Berlin, Germany
| | - Frauke Mattner
- Institute for Hygiene, Cologne Merheim Medical Centre, University Witten-Herdecke, Cologne, Germany
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University, Göttingen, Germany
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Chaiban CG, Maamari O, Issa ST, Asmar MK. The Experience of ER Nurses in Lebanese Hospitals, During the COVID-19 Outbreak: A Qualitative Study. Disaster Med Public Health Prep 2023; 17:e334. [PMID: 36597671 PMCID: PMC10019925 DOI: 10.1017/dmp.2022.304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The increasing number of COVID-19 cases, as well as the overwhelming workload, constitutes a serious occupational health threat to Emergency Room (ER) nurses working on the frontlines. In Lebanon, where unstable socio-economic conditions reign, the Covid-19 outbreak was added to the plethora of daily challenges faced by healthcare workers. The study's objective is to explore how Lebanese ER nurses perceived their duty on the frontlines amid the Covid-19 pandemic. METHODS This study employed a descriptive exploratory qualitative design. 15 Lebanese ER nurses working directly with Covid-19 patients were recruited from 3 university hospitals in Beirut. Interviews were held for data collection until data saturation. Subsequent analysis was done via coding of the transcribed verbatim. RESULTS The findings showed significant gaps related to preparedness, support, and governmental action. Similarly, the frontliners faced serious challenges that increased their stress levels both physically and mentally. Furthermore, some participants were subject to stigma and had to face irresponsible behaviors during triage. Participants emphasized the need to guarantee a safe environment at work, to provide Covid-19 patients with the needed care. CONCLUSIONS ER nurses struggled during this pandemic while working on the frontlines. They described their experience as not satisfying, with high levels of stress, danger, and challenges.
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Affiliation(s)
- Cedric Georges Chaiban
- Institut Supérieur de Santé Publique, Faculté de Médecine, Université Saint Joseph de Beyrouth, Beirut, Lebanon
- Hôtel-Dieu de France, Emergency Department, Beirut, Lebanon
- Corresponding author: Cedric Georges Chaiban,
| | - Olivia Maamari
- Institut Supérieur de Santé Publique, Faculté de Médecine, Université Saint Joseph de Beyrouth, Beirut, Lebanon
| | - Sahar T. Issa
- Department of Environmental Health Sciences, Faculty of Communications, Arts and Sciences, Canadian University of Dubai, Dubai, United Arab Emirates
| | - Michèle Kosremelli Asmar
- Institut Supérieur de Santé Publique, Faculté de Médecine, Université Saint Joseph de Beyrouth, Beirut, Lebanon
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Sun TK, Chu LC, Hui C. The Psychological Impact and Influencing Factors during Different Waves of COVID-19 Pandemic on Healthcare Workers in Central Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710542. [PMID: 36078259 PMCID: PMC9517926 DOI: 10.3390/ijerph191710542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND This study aims to explore differences of psychological impact and influencing factors that affected Taiwanese healthcare workers (HCW) during the first and second wave of COVID-19. METHODS a cross sectional survey of first-line HCW during November 2021 to February 2022: 270 paper questionnaires were issued and the valid response rate was 86% (231). For statistical analysis, descriptive statistics, Pearson correlation, and multivariate linear regression were used. RESULTS regardless of the wave of the pandemic, nearly 70% of HCW had anxiety, nearly 60% felt depressed, half of them suffered from insomnia, and one in three felt insufficient social support, which means a high level of loneliness. With an increased number of infected patients during the second wave, HCW felt significant changes of workload and schedule, with higher concern over risk of infection, and these factors induced higher levels of anxiety, but they manifested better satisfaction over public health policies and information provided by hospitals and governments. Changes of working schedules or duties positively relate to levels of anxiety and insomnia. The risk of infection causes anxiety, depression, and insomnia. Workplace relationships significantly relate to depression and loneliness. A negative family support causes an adverse psychological impact. CONCLUSIONS the pandemic has a negative psychological impact on HCW. Early recognition of significant influencing factors, providing psychological support and therapy, are helpful strategies for reducing the adverse psychological effects.
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Affiliation(s)
- Teh-Kuang Sun
- Department of Internal Medicine, Chung Kang Branch, Cheng Ching Hospital, Taichung City 40764, Taiwan
- Correspondence:
| | - Li-Chuan Chu
- School of Health Policy and Management, Chung Shan Medical University, Taichung City 40201, Taiwan
- Department of Medical Education, Chung Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Chun Hui
- Department of Internal Medicine, Chung Kang Branch, Cheng Ching Hospital, Taichung City 40764, Taiwan
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Santinha G, Forte T, Gomes A. Willingness to Work during Public Health Emergencies: A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10081500. [PMID: 36011158 PMCID: PMC9408569 DOI: 10.3390/healthcare10081500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
The identification of the factors underlying the willingness or lack thereof to respond to public health emergencies is paramount to informing more capable health services. The interest in this topic appears renewed with each surge of threat, either referring to natural disasters, man-made violence, or epidemic and pandemics. However, there is no systematic approach to the research patterns and related main findings concerning individual and contextual determinants. The present article contributes to this theme through a systematic literature review of a sample of 150 articles published in the last 30 years on the subject of willingness and preparedness of health professionals to deal with public health threats. Our findings show that the research is mainly phenomena and contextual driven, responding to whichever emergency threat is more salient in a given period. Geographically, research on this topic is led by USA and China, mostly solely, while European countries invest in collaborations that are more international. Universities, including health institutes and schools, and researchers at hospitals conduct most of the research on the topic. The main research areas are medicine, psychology, and psychiatry. Pandemics, including COVID-19, influenza, and natural disasters, are the phenomena gauging more attention as opposed to terrorism events and biological accidents. The specific role of health professionals within the institution, their belief in ethical duties, preparation training, and concerns regarding infection of self and family are the main variables influencing the willingness and ability to report to work in public health emergencies.
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Affiliation(s)
- Gonçalo Santinha
- GOVCOPP, Department of Social, Political and Territorial, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
| | - Teresa Forte
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ariana Gomes
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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Curtin M, Richards HL, Fortune DG. Resilience among health care workers while working during a pandemic: A systematic review and meta synthesis of qualitative studies. Clin Psychol Rev 2022; 95:102173. [PMID: 35636130 PMCID: PMC9126830 DOI: 10.1016/j.cpr.2022.102173] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022]
Abstract
Background Aim Method Results Conclusion
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Affiliation(s)
- Mariah Curtin
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland
| | - Helen L Richards
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland; Department of Clinical Health Psychology, Mercy University Hospital, Cork T12 WE28, Ireland
| | - Donal G Fortune
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland; Clinical Psychology, Health Service Executive, CHO3 Mid West, Ireland.
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Yeung NCY, Wong ELY, Cheung AWL, Leung CSY, Yeoh EK, Wong SYS. Finding the positives from the COVID-19 pandemic: factors associated with posttraumatic growth among nurses in Hong Kong. Eur J Psychotraumatol 2022; 13:2005346. [PMID: 35145608 PMCID: PMC8823681 DOI: 10.1080/20008198.2021.2005346] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Due to active involvement with patients for COVID-19 treatments, nurses are susceptible to adverse psychological outcomes amid the COVID-19 pandemic. Despite the distress, studies have suggested that nurses are able to experience positive changes (i.e. posttraumatic growth; PTG) during the pandemic. Research on other populations has also indicated that COVID-19-specific worries and work-related coping resources are associated with people's positive changes during the pandemic. OBJECTIVE This study examined how socio-demographic characteristics, COVID-19-related worries, and work-related variables (satisfaction with work and workplace pandemic guidelines) were associated with PTG among nurses in Hong Kong. METHODS Nurses (N = 1510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between 8 August 2020 and 22 September 2020. They were invited to complete a cross-sectional survey measuring their sociodemographic characteristics, COVID-19 worries, and satisfaction with work and workplace pandemic-control measures. RESULTS Results from hierarchical regressions found that those working non-full-time (β = -0.06), affiliating with a religion (β = 0.24), having higher COVID-19-related worries and psychological distress (βs ranging from 0.12-0.15), and having higher work satisfaction (β = 0.14) were associated with higher PTG (ps < .05). Moreover, a significant interaction between psychological distress and satisfaction with workplace pandemic control guidelines emerged in explaining PTG (β = 0.08, p < .05), such that guideline satisfaction was only associated with higher PTG among those with higher distress (β = 0.09, p = .03), but not those with lower distress (β = -0.05, p > .05). CONCLUSIONS Nurses in Hong Kong did report positive changes amid the COVID-19 pandemic. Future studies could focus on the contributing factors of PTG to design for effective strategies to enhance resources for nurses to promote positive psychosocial outcomes.
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Affiliation(s)
- Nelson Chun-Yiu Yeung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cecilia Shih-Ya Leung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Duffy CC, Bass GA, Fitzpatrick G, Doherty EM. What Can We Learn From the Past? Pandemic Health Care Workers' Fears, Concerns, and Needs: A Review. J Patient Saf 2022; 18:52-57. [PMID: 33337596 DOI: 10.1097/pts.0000000000000803] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Health care workers (HCWs) have been engaged in fighting dangerous epidemics for hundreds of years, more recently in severe acute respiratory syndrome, H1N1, Middle East respiratory syndrome, and now coronavirus disease 2019. A consistent feature of epidemic disease results is that health care systems and HCWs are placed under immense strain. METHODS A focused narrative review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to examine the main concerns and anxieties faced by HCWs during recent epidemics and to determine the supports deemed most important to those HCWs to keep them at the frontline. PubMed, Web of Science, and the Cochrane Library were searched in March 2020 using terms "Healthcare" OR "Medical" AND "Staff" OR "Workers" OR "Front line" AND "Concerns" OR "Anxiety" OR "Stress" AND "Pandemic" Or "Epidemic." RESULTS Twenty-five studies that reported the concerns and expectations of an estimated 13,793 HCWs in 10 countries (Canada, China, Greece, Hong Kong, Japan, Liberia, Netherlands, Saudi Arabia, Singapore and Taiwan) during pandemic situations were identified. Health care workers identified personal and family safety, appreciation, and the provision of personal protective equipment and adequate rest as primary concerns. Informal psychological supports were favored over formal employment-based group interventions. DISCUSSION Despite being hailed by the media as heroes, HCWs face social stigmatization and experienced high levels of anxiety and fear regarding personal safety and the health of their colleagues and family. Health care workers are more likely to seek peer-to-peer psychological support but also benefit from knowing that formal psychological supports are available to them.
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Affiliation(s)
| | | | | | - Eva M Doherty
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin
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9
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Abstract
Quarantine is an essential practice during pandemics but it could have negative effects. There are currently no studies on the experiences of health care workers (HCWs) in quarantine during the coronavirus disease pandemic. The aim of this study was to assess the psychosocial effects of quarantine on tertiary hospital HCWs who were exposed to coronavirus. A cross-sectional study on the psychological wellbeing, needs and resources of HCWs during quarantine was conducted using an online survey in a large tertiary hospital. In total, 148 quarantined HCWs participated in this study. Overall self-reported psychological wellbeing scores were high (5.22 ± 1.11). Physicians had higher psychological wellbeing compared to nurses (5.58 ± 1.05 and 4.83 ± 1.21, respectively). Being a nurse, separation from family during quarantine, experiencing public shaming and longer quarantine period were associated with lower psychological wellbeing and higher needs. Working from home and confidence in safety at work was associated with fewer needs during quarantine. Nurses might be a risk group for the negative influences of quarantine. The ability to remain connected to work by working from home could have a protective effect on HCWs’ psychological wellbeing. More efforts should be implemented in order to support HCWs in quarantine and after their return to work. During the COVID-19 crisis, health care workers (HCWs) were at the frontline of this pandemic and therefore were exposed to its risks and negative impact. One of the challenges during this time was the frequent quarantines of HCWs as a result of their exposure to patients. Although quarantine is important to stop the infection, it may effect mental and physical health. This study examined HCWs’ experience during quarantine, their well-being and ways of coping. We sent HCWs who are working in a tertiary hospital an online questionnaire and 148 replied. We found that the average well-being of HCWs in quarantine was high, with physicians having the highest reported well-being and nurses having the lowest. HCWs who reported low sense of well-being also reported on having more difficulties coping with the quarantine and reported more public shaming due to being in quarantine. We also found that HCWs who were working from home during quarantine and those who reported they felt safe in their place of work reported less difficulties coping with the quarantine. Our study suggests that nurses are more vulnerable to the negative impact of quarantine. It also suggests that being connected to work during quarantine can improve well-being. It is important to address stigma toward quarantined individuals and to provide more resources to support HCWs in quarantine and after their return to work.
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Affiliation(s)
- Neta HaGani
- Social Work Department, Rambam Health Care Campus, Haifa, Israel
- Corresponding author. E-mail:
| | - Yael Eilon
- Internal Auditor Office, Rambam Health Care Campus, Haifa, Israel
| | - Sagit Zeevi
- Social Work Department, Rambam Health Care Campus, Haifa, Israel
| | - Liat Vaknin
- Occupational and Environmental Clinic (Personnel Clinic), Rambam Health Care Campus, Haifa, Israel
| | - Hagar Baruch
- Nursing Administration, Rambam Health Care Campus, Haifa, Israel
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Chahley ER, Reel RM, Taylor S. The lived experience of healthcare professionals working frontline during the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic: A qualitative systematic review. SSM - QUALITATIVE RESEARCH IN HEALTH 2021; 1:100026. [PMID: 34901922 PMCID: PMC8645281 DOI: 10.1016/j.ssmqr.2021.100026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/06/2021] [Accepted: 12/02/2021] [Indexed: 12/23/2022]
Abstract
Objective To synthesize qualitative literature exploring the lived experience of healthcare workers (HCWs) who cared for patients during the following infectious disease outbreaks (IDOs): the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic. We aim to reveal the collective experience of HCWs during these four IDOs and to create a reference for comparison of current and future IDOs. Methods Three electronic databases were searched, yielding 823 results after duplicates were removed. Forty qualitative and mixed-methods studies met the criteria for full file review. Fourteen studies met the inclusion and exclusion criteria. The data from the Results or Findings sections were manually coded and themes were conceptualized using thematic analysis. Results Of the 14 studies, 28.6% focused on SARS, 21.4% on H1N1, 21.4% on MERS, and 28.6% on EVD. Studies occurred in six different countries and included physicians, nurses, paramedics, and emergency medical technicians as participants. Five themes were conceptualized: Uncertainty, Adapting to Change, Commitment, Sacrifice, and Resilience. Conclusion This review identified the collective experience of HCWs caring for patients during four 21st century IDOs. This qualitative systematic review offers a reference to compare similarities and differences of other IDOs, including the COVID-19 pandemic.
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Affiliation(s)
- Erin R Chahley
- Island Medical Program, University of British Columbia, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Riley M Reel
- Island Medical Program, University of British Columbia, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Steven Taylor
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
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Zipf AL, Polifroni EC, Beck CT. The experience of the nurse during the COVID-19 pandemic: A global meta-synthesis in the year of the nurse. J Nurs Scholarsh 2021; 54:92-103. [PMID: 34738314 PMCID: PMC8662101 DOI: 10.1111/jnu.12706] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/15/2021] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Purpose From its beginnings in China in December of 2019, the novel coronavirus COVID‐19 spread and quickly became the center of nursing care and conversation across the globe (WHO, 2020). This meta‐ethnographic study was conducted in order to provide the profession of nursing interpretative explanations of a common experience during the care of patients with COVID‐19. Design and method A literature review focused on the experience of the nurse during the COVID‐19 pandemic revealed a total of 13 qualitative studies conducted in China, Spain, Turkey, Iran, Brazil, and the United States. A meta‐ethnographic review of these qualitative works, using the method of Noblit and Hare, was then conducted which revealed the experience of the nurse across the globe during the COVID‐19 pandemic. Findings The review revealed strong similarities between the experiences of the nurse across the 13 studies. Given this reciprocal relationship, translations were constructed and synthesized until four new themes emerged outlining the global experience of the nurse during the COVID‐19 pandemic. Conclusions Despite the differences between the structures of healthcare and government of the six countries represented in this meta‐ethnography, the experience of the nurse emerged into a narrative shared by those represented in this study. As the profession of nursing continues to work through ongoing waves of COVID‐19, these results will help guide the resources and training provided to nurses on the frontline of care. Clinical relevance Despite great personal risk, nurses across the globe stepped up to the challenge of upholding and improving the health of the world's people during the COVID‐19 pandemic. As health policy, education, and system leaders, we must listen to the common experience revealed in this meta‐synthesis and respond by providing the resources needed to improve nursing practice and care.
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Affiliation(s)
- Amy L Zipf
- School of Nursing, The University of Connecticut, Storrs, Connecticut, USA
| | - E Carol Polifroni
- School of Nursing, The University of Connecticut, Storrs, Connecticut, USA
| | - Cheryl Tatano Beck
- School of Nursing, The University of Connecticut, Storrs, Connecticut, USA
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Zhang L, Flike KL, Gakumo CA, Shi L, Leveille SG, Thompson LS. Frontline healthcare workers' mental distress, top concerns, and assessment on hierarchy of controls in response to COVID-19: a cross-sectional survey study. HUMAN RESOURCES FOR HEALTH 2021; 19:118. [PMID: 34565407 PMCID: PMC8474834 DOI: 10.1186/s12960-021-00661-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 09/16/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND The existing studies showed that frontline healthcare workers during an epidemic experienced unusual stressors and mental distress which even lasted for years after the crisis. It is important to learn about their concerns early to mitigate the negative impact as well as to evaluate disease control from experiences on the front lines for improving responses to the outbreak. The study aimed to provide insights on how to strengthen public health responses to protect healthcare workers both physically and mentally, and effectively control the disease in light of hierarchy of controls. METHODS A cross-sectional survey was distributed online via Qualtrics to frontline healthcare workers during the COVID-19 through a university's nursing program and received 267 valid responses from 103 certificated nursing assistants, 125 nurses, and 39 other health professionals. A descriptive data analysis with a Chi-square test at a two-sided 0.05 level of significance was performed on factors that potentially affected mental health of healthcare workers and effectiveness of disease control at workplace in five domains. The themes were summarized on open-ended questions. RESULTS About 30% of the respondents showed the symptom of depression and needed a further investigation. The influencing factors in five domains were examined. Engineering and administrative controls, as well as PPE were widely used in response to COVID-19. The respondents assessed the state and workplace responses to COVID-19 better than the federal government responses. The workplace responses were considered most effective. Multiple factors with a statistically significant correlation with effectiveness of the disease control at workplace were identified. CONCLUSIONS The study suggested that timely responses at policy level will be more effective than other measures in early prevention and control of the pandemic, mental distress should be addressed in addition to PPE, and nursing programs should consider providing a situation-specific career coaching or counseling for students. A longitudinal study at a larger scale is warranted to capture the variation of time change with the disease control evolvement and across geographic regions.
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Affiliation(s)
- Lingling Zhang
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125-3393 USA
| | - Kimberlee L. Flike
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125-3393 USA
| | - C. Ann Gakumo
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125-3393 USA
| | - Ling Shi
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125-3393 USA
| | - Suzanne G. Leveille
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125-3393 USA
| | - Linda S. Thompson
- Westfield State University, 577 Western Avenue, Westfield, MA 01086 USA
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Nguyen TT, Zeger WG, Wadman MC, Barksdale AN. Accuracy and Acceptance of a Self-Collection Model for Respiratory Tract Infection Diagnostics: A Concise Clinical Literature Review. J Emerg Nurs 2021; 47:798-806. [PMID: 34530972 PMCID: PMC8238690 DOI: 10.1016/j.jen.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/06/2021] [Accepted: 04/21/2021] [Indexed: 11/15/2022]
Abstract
Background Nurses are the primary clinicians who collect specimens for respiratory tract infection testing. The specimen collection procedure is time and resource-consuming, but more importantly, it places nurses at risk for potential infection. The practice of allowing patients to self-collect their diagnostic specimens may provide an alternative testing model for the current COVID-19 outbreaks. The objective of this paper was to evaluate the accuracy and patient perception of self-collected specimens for respiratory tract infection diagnostics. Methods A concise clinical review of the recently published literature was conducted. Results A total of 11 articles were included the review synthesis. The concept of self-collected specimens has a high patient acceptance rate of 83-99%. Self-collected nasal-swab specimens demonstrated strong diagnostic fidelity for respiratory tract infections with a sensitivity between 80-100%, this is higher than the 76% sensitivity observed with self-collected throat specimens. In a comparative study evaluating a professionally collected to a self-collected specimen for COVID-19 testing, a high degree of agreement (k = 0.89) was observed between the two methods. Conclusion As we continue to explore for testing models to combat the COVID-19 pandemic, self-collected specimens is a practical alternative to nurse specimen collection.
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14
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Billings J, Ching BCF, Gkofa V, Greene T, Bloomfield M. Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis. BMC Health Serv Res 2021; 21:923. [PMID: 34488733 PMCID: PMC8419805 DOI: 10.1186/s12913-021-06917-z] [Citation(s) in RCA: 197] [Impact Index Per Article: 65.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers' own perspectives or what their views are about support. METHODS We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers' experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. RESULTS This review identified 46 qualitative studies which explored healthcare workers' experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others' physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers' relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress. CONCLUSIONS The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Brian Chi Fung Ching
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Vasiliki Gkofa
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Talya Greene
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Michael Bloomfield
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Traumatic Stress Clinic, Camden & Islington NHS Foundation Trust, London, UK
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
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15
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Rathnayake S, Dasanayake D, Maithreepala SD, Ekanayake R, Basnayake PL. Nurses' perspectives of taking care of patients with Coronavirus disease 2019: A phenomenological study. PLoS One 2021; 16:e0257064. [PMID: 34478482 PMCID: PMC8415609 DOI: 10.1371/journal.pone.0257064] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/21/2021] [Indexed: 12/02/2022] Open
Abstract
The pandemic of Coronavirus disease 2019 (COVID-19) has brought significant pressure on nurses globally as they are the frontline of care. This study aimed to explore the experiences and challenges of nurses who worked with hospitalised patients with COVID-19. In this qualitative study, a purposive sample of 14 nurses participated in in-depth telephone interviews. Data were analysed using Colaizzi’s phenomenological method. Five key themes emerged: (1) physical and psychological distress of nurses, (2) willingness to work, (3) the essential role of support mechanisms, (4) educational and informational needs of nurses and (5) the role of modern technology in COVID-19 care. Although the provision of care led to physical and psychological distress among nurses, with their commitment and professional obligation, it is a new experience that leads to personal satisfaction. Guilty feeling related to inefficiency of care, witnessing the suffering of patients, discomfort associated with wearing personal protective equipment (PPE), work-related issues (e.g., long hour shifts), negative impact to the family and rejection by others are the leading distress factors. Religious beliefs, including keeping trust in good and bad merits, have become a strong coping mechanism. Addressing distress among nurses is essential. The reported learning needs of nurses included skills related to donning and doffing PPE, skills in performing nursing procedures and breaking bad news. Nurse managers need to pay special attention to expanding training opportunities as well as support mechanisms, for example, welfare, appreciations and counselling services for nurses. Modern technology, particularly robots and telecommunication, can perform an essential role in COVID-19 care. The establishment of timely policies and strategies to protect health workers during a national disaster like COVID-19 is needed.
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Affiliation(s)
- Sarath Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- * E-mail:
| | - Damayanthi Dasanayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Ramya Ekanayake
- Department of Paediatrics, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Brooks SK, Greenberg N, Wessely S, Rubin GJ. Factors affecting healthcare workers' compliance with social and behavioural infection control measures during emerging infectious disease outbreaks: rapid evidence review. BMJ Open 2021; 11:e049857. [PMID: 34400459 PMCID: PMC8370838 DOI: 10.1136/bmjopen-2021-049857] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The 2019-2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission. This review's aim was to explore the existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with infection control measures among healthcare staff. METHODS A rapid evidence review for primary studies relevant to healthcare workers' compliance with infection control measures. RESULTS Fifty-six papers were reviewed. Staff working in emergency or intensive care settings or with contact with confirmed cases appeared more likely to comply with recommendations. There was some evidence that anxiety and concern about the risk of infection were more associated with compliance, and that monitoring from superiors could improve compliance. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability, perceived difficulty and effectiveness, inconvenience, discomfort and a negative impact on patient care. There were many issues regarding the communication and ease of understanding of infection control guidance. CONCLUSION We recommend provision of training and education tailored for different occupational roles within the healthcare setting, managerial staff 'leading by example', ensuring adequate resources for infection control and timely provision of practical evidence-based infection control guidelines.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
| | - N Greenberg
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - G J Rubin
- Department of Psychological Medicine, King's College London, London, UK
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17
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The perceived social stigma, self-esteem, and its determinants among the health care professionals working in India during COVID 19 pandemic. Med J Armed Forces India 2021; 77:S450-S458. [PMID: 34393330 DOI: 10.1016/j.mjafi.2021.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 01/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background Health conditions perceived as contagious, dangerous, or incurable are associated with some facets of social stigma. Methods A cross-sectional survey was conducted from May 9, 2020 to June 9, 2020, among frontline healthcare workers (HCWs) in India to understand their perceived stigmatizing experiences (SE) and self-esteem during the COVID-19 pandemic. Google forms, an online forms tool, was used to create the survey, and samples were recruited through snowball sampling. Data comprised baseline characteristics of HCWs and their responses to the modified version of the Inventory of Stigmatizing Experiences and the Rosenberg Self-Esteem Scale. Results Of the 600 participants (mean age: 30.9 ± 6.7 years), 76% comprised of nurses. Most participants were residing in urban areas and working in government sectors in clinical areas. Approximately 66.3% HCWs had at least 1 SE, and 51.7% reported a high impact of stigma (SI) across their various life domains, viz. quality of life, social contacts, self-esteem, and family relations, but 73% had normal self-esteem. The SI was more at the family level than at the individual level. The prevalence of SE (69.5% vs. 56.6%) and psychosocial SI (54.5% vs. 44.1%) was higher among nurses than among doctors. Being a nurse and working in clinical areas were statistically significant (P < 0.05 and < 0.01, respectively) for predicting SE likelihood. Conclusion Although HCWs have their own apprehensions, they do have high self-esteem and continue to deliver professional duties despite their SE. The government should frame guidelines to stop such discrimination and hail the saviors.
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Galletta M, Piras I, Finco G, Meloni F, D'Aloja E, Contu P, Campagna M, Portoghese I. Worries, Preparedness, and Perceived Impact of Covid-19 Pandemic on Nurses' Mental Health. Front Public Health 2021; 9:566700. [PMID: 34123979 PMCID: PMC8187773 DOI: 10.3389/fpubh.2021.566700] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 04/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background: In times of global public health emergency, such as the COVID-19 pandemic, nurses stand at the front line, working in close contact with infected individuals. Being actively engaged in fighting against COVID-19 exposes nurses to a high risk of being infected but can also have a serious impact on their mental health, as they are faced with excessive workload and emotional burden in many front-line operating contexts. Purpose: The aim of the study is to analyze how risk factors such as perceived impact, preparedness to the pandemic, and worries were associated with mental health outcomes (crying, rumination and stress) in nurses. Methods: A cross-sectional study design was performed via an online questionnaire survey. Participants included 894 registered nurses from Italy. Participation was voluntary and anonymous. Multiple binary logistic regression was carried out to analyze the relationship between risk factors and health outcomes. Results: Increased job stress was related to higher levels of rumination about the pandemic (OR = 4.04, p < 0.001), job demand (OR = 2.00, p < 0.001), impact on job role (OR = 2.56, p < 0.001), watching coworkers crying at work (OR = 1.50, p < 0.05), non-work-related concerns (OR = 2.28, p < 0.001), and fear of getting infected (OR = 2.05, p < 0.001). Job stress (OR = 2.52, p < 0.01), rumination (OR = 2.28, p < 0.001), and watching colleagues crying (OR = 7.92, p < 0.001) were associated with crying at work. Rumination was associated with caring for patients who died of COVID-19 (OR = 1.54, p < 0.05), job demand (OR = 1.70, p < 0.01), watching colleagues crying (OR = 1.81, p < 0.001), non-work-related worries (OR = 1.57, p < 0.05), and fear of getting infected (OR = 2.02, p < 0.001). Conclusions: The psychological impact that this pandemic may cause in the medium/long term could be greater than the economical one. This is the main challenge that health organizations will have to face in the future. This study highlights that the perceived impact and worries about the pandemic affect nurses' mental health and can impact on their overall effectiveness during the pandemic. Measures to enhance nurses' protection and to lessen the risk of depressive symptoms and post-traumatic stress should be planned promptly.
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Affiliation(s)
- Maura Galletta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ilenia Piras
- PhD School in Biomedical Sciences (Public Health), University of Sassari, Sassari, Italy.,Emergency Department SS. Trinità Hospital, Azienda Tutela Salute Sardegna, Cagliari, Italy
| | - Gabriele Finco
- Pain Therapy Service, University of Cagliari, Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ernesto D'Aloja
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paolo Contu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Igor Portoghese
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Zaghini F, Fiorini J, Livigni L, Carrabs G, Sili A. A mixed methods study of an organization's approach to the COVID-19 health care crisis. Nurs Outlook 2021; 69:793-804. [PMID: 34176670 PMCID: PMC8114768 DOI: 10.1016/j.outlook.2021.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/11/2021] [Accepted: 05/01/2021] [Indexed: 11/26/2022]
Abstract
Background Healthcare emergency can increase work-related stress and reduce nurses’ job satisfaction and quality of life. Managerial decisions and proactive interventions implemented to react to the emergency ensure the best patient outcomes. Purpose The purpose of this study was to verify whether a proactive organizational approach can limit nurses’ work-related stress and help preserve their job satisfaction and quality of life during a health emergency. Methods A longitudinal mixed methods study was conducted. Data were collected before and after the transformation into a SARS-CoV-2 Hospital and the implementation of organizational interventions. Focus groups were conducted to investigate quantitative data. Findings After the implementation of interventions and as the pandemic progressed, work-related stress decreased and job satisfaction and quality of life increased. Discussion Through proactive organization, even during an emergency, nurses are prepared for working, and work-related stress due to changes is reduced. Nurses are motivated and satisfied with their organization and management, and quality of life increases.
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Affiliation(s)
- Francesco Zaghini
- Department of Nursing Professions, University Hospital of Rome Tor Vergata, Rome, Italy.
| | - Jacopo Fiorini
- Department of Nursing Professions, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Lucilla Livigni
- Occupational Health Service, University of Rome Tor Vergata, Rome, Italy
| | - Gemma Carrabs
- Occupational Health Service, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Sili
- Department of Nursing Professions, University Hospital of Rome Tor Vergata, Rome, Italy
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20
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Nurses’ Intention to Work during the COVID-19 Outbreak in West Sumatra, Indonesia. NURSE MEDIA JOURNAL OF NURSING 2021. [DOI: 10.14710/nmjn.v11i1.34093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Nurses who work on the front-line and are involved in caring for COVID-19 patients have a high risk of transmission. The increase in the number of confirmed and suspected cases, followed by an increase in workload, a limitation of personal protection equipment, a lack of effective treatment, and inadequate emotional support may contribute to the work intention during a pandemic.Purpose: This study aimed to describe nurses’ intention to work and provide care when people may be at risk of the COVID-19 and examine its relating factors. Methods: This was a cross-sectional and survey-based study that collected the respondents' characteristics and the intention to work measurements from 238 nurses in 36 hospitals in West Sumatera, Indonesia. Data analysis was performed using descriptive statistics, T-tests, and ANOVA.Results: The mean and standard deviation scores of nurses’ intention to work during the COVID-19 outbreak were 42.49±5.92. The isolation experience, the presence of authorized beds for COVID-19, and sufficient protection equipment supply, were correlated to the intention to work (p=0.016, p=0.035, p=0.000). Nurse respondents expected that hospital managers should provide more attention to nurses who agreed to attend to work during the COVID-19 outbreak. Conclusion: Nurses showed preserved intention to work during the COVID-19 outbreak. The factors correlated with intention to work were isolation experience, the presence of authorized beds for COVID-19, and protection equipment supply. The government and hospital management should ensure strategies and regulations to provide adequate hospital protective equipment supplies. They should also support compensations to nurses who actively care for patients during the COVID-19 outbreak.
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21
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Abstract
Doctors experience high levels of work stress even under normal circumstances, but many would be reluctant to disclose mental health difficulties or seek help for them, with stigma an often-cited reason. The coronavirus disease 2019 (COVID-19) crisis places additional pressure on doctors and on the healthcare system in general and research shows that such pressure brings a greater risk of psychological distress for doctors. For this reason, we argue that the authorities and healthcare executives must show strong leadership and support for doctors and their families during the COVID-19 outbreak and call for efforts to reduce mental health stigma in clinical workplaces. This can be facilitated by deliberately adding 'healthcare staff mental health support process' as an ongoing agenda item to high-level management planning meetings.
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Affiliation(s)
| | - David Boyda
- Department of Psychology, University of Wolverhampton, UK
| | | | - Tariq Hassan
- Department of Psychiatry, Queen's University, Providence Care Hospital, Kingston, Ontario, Canada
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22
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Portoghese I, Meloni F, Galletta M, Piras I, D'Aloja E, Finco G, Campagna M. Concerns, Perceived Impact, Preparedness in Coronavirus Disease (COVID-19) Pandemic and Health Outcomes among Italian Physicians: A Cross-Sectional Study. J Prim Care Community Health 2021; 12:21501327211000245. [PMID: 33733901 PMCID: PMC7983480 DOI: 10.1177/21501327211000245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) are among the professionals at serious risk for the impact of the COVID-19 pandemic on their mental health. In this sense, the next public health challenge globally will be to preserving healthy HCWs during this pandemic. AIM The present study has the aim of investigating the relationship among concerns, perceived impact, preparedness for the COVID-19 pandemic and the mental health of Italian physicians. METHODS From March 29th to April 15th 2020, we conducted an online survey using snowball sampling techniques through Limesurvey platform. Data were analyzed using descriptive statistics and multiple binary logistic regressions. RESULTS Multivariate analysis showed that the risk factors for perceived job stress were concerns about catching COVID-19 (OR = 3.18 [95% CI = 2.00-5.05] P < .001), perceived impact on job demands (OR = 1.63 [95% CI = 1.05-2.52] P < .05), perceived impact on job role (OR = 2.50 [95% CI = 1.60-3.90] P < .001), and non-working concerns (OR = 1.86 [95% CI = 1.15-3.03] P < .05). With respect to the risk factors for rumination about the pandemic emerged concerns about catching COVID-19 (OR 1.74, [95% CI = 1.12-2.71] P < .05), perceived impact on job role (OR = 1.68 [95% CI = 1.12-2.52] P < .05), and impact on personal life (OR = 2.04 [95% CI = 1.08-3.86] P < .05). Finally, the risk factors for crying at work were perceived impact on job role (OR = 2.47, [95% CI = 1.20-5.09] P < .05), rumination about the pandemic (OR = 3.027 [95% CI = 1.27-7.19] P < .01), watching colleagues crying at work (OR = 3.82 [95% CI = 1.88-7.77] P < .01), and perceived job stress (OR = 3.53 [95% CI = 1.24-10.07] P < .05). CONCLUSION In general, our results highlighted that being concerned about being infected/infecting other people, carrying out new and unusual tasks, and witnessing colleagues crying at work were important risk factors for physicians' well-being. Additional data are necessary to advance understanding of these risk factors in a long-term perspective.
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Affiliation(s)
| | | | - Maura Galletta
- Università degli Studi di Cagliari, Monserrato (Ca), Italy
| | - Ilenia Piras
- Università degli Studi di Cagliari, Monserrato (Ca), Italy.,University of Sassari, Sassari (SS), Italy
| | | | - Gabriele Finco
- Università degli Studi di Cagliari, Monserrato (Ca), Italy
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Abstract
Objective: This study evaluates the personal and professional experiences of physician mothers during the coronavirus disease 2019 (COVID-19) pandemic and the impact of the pandemic on the lives of physician mothers. Methods: Using social media to reach a broad range of physicians, a convenience sample of physician mothers completed an on-line survey posted between April 27 and May 11. Members were encouraged to repost on social media and share with personal contacts resulting in a passive snowball sampling effect. Results: A total of 2709 physician mothers from 48 states, Puerto Rico, and 19 countries representing more than 25 medical specialties completed the survey. Most were between 30 and 39 y of age, 67% self-identified as white, 17% as Asian, 4% as African American. Most had been working for 11-16 y. A total of 91% had a spouse/partner of the opposite sex. Over half were practicing in an area they identified as high COVID-19 density, while 50% had personally cared for a person with COVID-19. Physician mothers were most concerned about exposing their children to COVID-19 and about the morale and safety of their staff. Conclusions: This is one of the first studies to explore the personal and professional challenges facing physician mothers during a pandemic. Physician mothers were most concerned about exposing their families to COVID-19. Mothers continued to work and at times increased their work, despite having domestic, childcare, and schooling responsibilities.
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24
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Arcadi P, Simonetti V, Ambrosca R, Cicolini G, Simeone S, Pucciarelli G, Alvaro R, Vellone E, Durante A. Nursing during the COVID-19 outbreak: A phenomenological study. J Nurs Manag 2021; 29:1111-1119. [PMID: 33421209 PMCID: PMC8014333 DOI: 10.1111/jonm.13249] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/24/2020] [Accepted: 12/31/2020] [Indexed: 01/01/2023]
Abstract
Aim The aim of this study was to explore the experience of Italian nurses engaged in caring for patients with COVID‐19. Background COVID‐19 found the health care world unprepared to face an emergency of such magnitude. Italy was one of the most affected European countries, with more than 250,000 cases. Understanding the impact of events of this magnitude on nurses provides a framework of knowledge on which educational training could be based to face similar situations in the future to prevent further breakdown. Methods The hermeneutic approach by Cohen was used. Semi‐structured interviews were conducted using a voice‐over Internet protocol. Interviews were transcribed, read in depth and analysed. Results Twenty nurses were interviewed. Four themes were extracted: uncertainty and fear, alteration of perceptions of time and space, change in the meaning of ‘to care’ and changes in roles and relationships. Conclusions Psychological support in association with emergency training prevents stress and helps tackle compassion fatigue. Implications for nursing management Policies to improve nursing science should be developed to ensure better quality of care, a higher number of professionals and, consequently, an increase in the safety of patients.
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Affiliation(s)
- Paola Arcadi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Simonetti
- Politecnica delle Marche Facoltà di Medicina e Chirurgia, Università Politecnica delle Marche, Ancona, Italy.,ASUR Marche, AV5 Ascoli Piceno Hospital, Ascoli Piceno, Italy
| | - Rossella Ambrosca
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giancarlo Cicolini
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Faculty of Medicine, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Durante
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Chia JMX, Goh ZZS, Chua ZY, Ng KYY, Ishak D, Fung SM, Ngeow JYY, Griva K. Managing cancer in context of pandemic: a qualitative study to explore the emotional and behavioural responses of patients with cancer and their caregivers to COVID-19. BMJ Open 2021; 11:e041070. [PMID: 33518518 PMCID: PMC7852065 DOI: 10.1136/bmjopen-2020-041070] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Having to access life-sustaining treatment during the emerging COVID-19 outbreak has placed patients with cancer at an especially vulnerable position notwithstanding their immunocompromised condition. The present study aimed to elucidate cancer patients' and their caregivers' experiences during this outbreak. DESIGN Face-to-face semistructured interviews were conducted. SETTING A tertiary cancer care facility. PARTICIPANTS 16 patients with cancer and 14 caregivers. Inclusions criteria were: (A) diagnosed with cancer, (B) receiving active treatment or follow-ups, (C) aged 21 years and above and (D) fluent in English or Mandarin. RESULTS Thematic analysis was conducted. Five themes were identified: heightened sense of threat, impact on healthcare experience, responsibility falls on oneself, striving for normalcy and sense of safety and trust. Heightened threat of COVID-19 was more pronounced in patients and linked to vulnerability and fear, uncertainty and actions of socially irresponsible others. Dominant in their healthcare experience was prioritising cancer and treatment amidst heightened threat and anticipatory worry about treatment disruptions. Both noted on the importance of taking responsibility for one's health, with caregivers reporting a reinforced sense of duty towards patients. They strived to maintain normalcy by viewing COVID-19 as beyond personal control, downplaying and living life as usual. Their resolve was supported by a sense of safety from the actions of authorities, hospitals and trust towards healthcare providers. CONCLUSIONS Cancer intensifies threat and the emotional impact of COVID-19 and may trigger specific concerns related to treatment. Psychoeducation interventions led by healthcare providers over digital platforms could help address cancer-specific concerns and support patients and caregivers during the pandemic.
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Affiliation(s)
- Jace Ming Xuan Chia
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Zack Zhong Sheng Goh
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Zi Yang Chua
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Kennedy Yao Yi Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Diana Ishak
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Si Ming Fung
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Joanne Yuen Yie Ngeow
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Konstadina Griva
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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Bell V, Wade D. Mental health of clinical staff working in high-risk epidemic and pandemic health emergencies a rapid review of the evidence and living meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1-11. [PMID: 33245379 PMCID: PMC7691696 DOI: 10.1007/s00127-020-01990-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE The SARS-CoV-2 / COVID-19 pandemic has raised concerns about the potential mental health impact on frontline clinical staff. However, given that poor mental health is common in acute medical staff, we aimed to estimate the additional burden of work involving high exposure to infected patients. METHODS We report a rapid review, meta-analysis, and living meta-analysis of studies using validated measures from outbreaks of COVID-19, Ebola, H1N1 influenza, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS). RESULTS A random effects meta-analysis found that high-exposure work is not associated with an increased prevalence of above cut-off scoring (anxiety: RR = 1.30, 95% CI 0.87-1.93, Total N = 12,473; PTSD symptoms: RR = 1.16, 95% CI 0.75-1.78, Total N = 6604; depression: RR = 1.50, 95% CI 0.57-3.95, Total N = 12,224). For continuous scoring, high-exposure work was associated with only a small additional burden of acute mental health problems compared to low-exposure work (anxiety: SMD = 0.16, 95% CI 0.02-0.31, Total N = 6493; PTSD symptoms: SMD = 0.20, 95% CI 0.01-0.40, Total N = 5122; depression: SMD = 0.13, 95% CI -0.04-0.31, Total N = 4022). There was no evidence of publication bias. CONCLUSION Although epidemic and pandemic response work may add only a small additional burden, improving mental health through service management and provision of mental health services should be a priority given that baseline rates of poor mental health are already very high. As new studies emerge, they are being added to a living meta-analysis where all analysis code and data have been made freely available: https://osf.io/zs7ne/ .
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Affiliation(s)
- Vaughan Bell
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
| | - Dorothy Wade
- University College London Hospitals Critical Care Department, London, UK
- Research Department of Behavioural Science and Health, University College London, London, UK
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Bendau A, Ströhle A, Petzold MB. Mental Health in Health Professionals in the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:737-757. [PMID: 33973209 DOI: 10.1007/978-3-030-63761-3_41] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed enormous challenges to the healthcare systems worldwide, which are mainly shouldered by healthcare workers from all professions. This chapter outlines the potential stressors of the COVID-19 pandemic for health professionals and describes possible consequences for their mental health as well as potential interventions and coping strategies. The chapter is based on preliminary research on the psychosocial implications of the COVID-19 pandemic in health professionals and is complemented by findings from previous outbreaks of high-risk infectious diseases. High proportions of healthcare workers report acute symptoms of anxiety, depression, high psychological stress, and insomnia in the context of the COVID-19 pandemic. Coping strategies and self-care on an individual level, interventions on an institutional level such as specific training and institutional support, as well as social and psychological support can help to mitigate psychological strain. Further reliable and prospective studies regarding the mental health of health professionals, as well as further measures to protect their short- and long-term mental health, are required.
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Affiliation(s)
- Antonia Bendau
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Moritz Bruno Petzold
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
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Magill E, Siegel Z, Pike KM. The Mental Health of Frontline Health Care Providers During Pandemics: A Rapid Review of the Literature. Psychiatr Serv 2020; 71:1260-1269. [PMID: 33019857 DOI: 10.1176/appi.ps.202000274] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This rapid review addresses two key questions posed by the COVID-19 pandemic: What are the anticipated mental health sequelae for frontline health workers? and What are best practices during health emergencies to address the mental health needs of these workers? METHODS This review synthesized the literature on the mental health sequelae for health workers during major pandemics and epidemics that occurred in the 21st century (severe acute respiratory syndrome, Middle East respiratory syndrome, Ebola virus disease, and swine flu) and interventions used to address related mental health sequelae. PubMed, MEDLINE, and PsycINFO were searched with terms related to these epidemics/pandemics. RESULTS Of 3,876 articles retrieved, 94 were included in this review. Across these studies, most health workers exhibited some adverse psychological experiences during outbreaks, with stress and anxiety being most common. Psychological distress decreased over time. Some studies reported insomnia, burnout, and posttraumatic stress for a subset of individuals up to 3 years after the disease outbreak. Few interventions have been implemented to address providers' mental health needs, and these strategies have not been evaluated systematically. CONCLUSIONS Systems-level interventions may alleviate distress for most providers without the need for specialized mental health intervention. Psychotherapeutic support and referral to specialty care should be available to health workers with severe and intense adverse psychological outcomes during and beyond the COVID-19 pandemic. Evidence-based interventions are urgently needed to better serve health workers both during and following epidemics/pandemics.
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Affiliation(s)
- Elizabeth Magill
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York
| | - Zoe Siegel
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York
| | - Kathleen M Pike
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York
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Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, Ellwood L. Implications for COVID-19: A systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic. Int J Nurs Stud 2020; 111:103637. [PMID: 32919358 PMCID: PMC7206441 DOI: 10.1016/j.ijnurstu.2020.103637] [Citation(s) in RCA: 379] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. OBJECTIVES To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. DESIGN This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. DATA SOURCES A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. REVIEW METHODS All studies describing nurses' experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. RESULTS Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. CONCLUSIONS Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses' require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Heidi Lord
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Laura Ellwood
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia.
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Jemal K, Gashaw K, Kinati T, Bedada W, Getahun B. Clean and Safe Healthcare Environment: Knowledge, Attitude, and Practice of Infection Prevention and Control among Health Workforce at North Showa Zone Oromiya Region. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:6021870. [PMID: 33178291 PMCID: PMC7648680 DOI: 10.1155/2020/6021870] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/06/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Abstract
Background Infection prevention and control practice (IPCP) is essential for healthcare safety and quality service delivery. The Ethiopian government has already put in place programs and initiatives for clean and safe healthcare facilities. However, in the North Showa Zone of the Oromiya Region, the infection prevention and control practice level was not well understood. Therefore, this study aimed to assess the knowledge, attitude, and practice of infection prevention and control practice among the health workforce (HWF) in North Shoa healthcare facilities (NSHCFs) environment. Methods Healthcare facility-based cross-sectional study design was employed. Structured and pretested self-administered questionnaires were distributed for 373 health workforce. Three hospitals and six health centers were randomly selected, and the study participants were selected by systematic sampling technique. Data were entered into Epi-data version 3.5.2 and then exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to determine the associated factors with infection prevention practice, and a p value of less than 0.05 was considered statistically significant. Results A total of 361 (96.8%) health workforce responded to self-administered questionnaires. About 55.70% of study participants had good knowledge, 59.3% of them had a positive attitude, and 46.8% had a good infection prevention practice. Age category of 20-29(AOR = 4.08, 95%, CI = (1.97, 8.49)), female participants (AOR = 3.87, 95%, CI = (1.91, 7.86)), single participants (AOR = 3.89, 95%, CI = (1.92, 7.87)), having greater than ten years of working experience (AOR = 3.10, 95% CI = (1.19, 8.10)), positive attitude (AOR = 10.07, 95% CI = (4.82, 21.05)), and availability of water at working area (AOR = 2.27, 95% CI = (1.18, 4.35)) were significantly associated with good infection prevention practice. Conclusion In this study, a significant number of health workers had low knowledge, negative attitudes, and poor infection prevention practices. Female participants, higher work experience, a positive attitude, and water availability in the healthcare facilities were positively associated with infection prevention and control practice. Healthcare facilities should be continued capacitating the health workforce on infection prevention and control measures and equipping health facilities with infection prevention materials.
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Affiliation(s)
- Kemal Jemal
- Salale University, College of Health Sciences, Department of Nursing, Fitche, Ethiopia
| | - Ketema Gashaw
- Salale University, College of Health Sciences, Department of Public Health, Fitche, Ethiopia
| | - Tadele Kinati
- Salale University, College of Health Sciences, Department of Nursing, Fitche, Ethiopia
| | | | - Belete Getahun
- Canadian Physicians for Aid and Relief, Addis Ababa, Ethiopia
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31
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Zhang MM, Niu N, Zhi XX, Zhu P, Wu B, Wu BN, Meng AF, Zhao Y. Nurses' psychological changes and coping strategies during home isolation for the 2019 novel coronavirus in China: A qualitative study. J Adv Nurs 2020; 77:308-317. [PMID: 33068024 DOI: 10.1111/jan.14572] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/23/2020] [Accepted: 08/19/2020] [Indexed: 01/01/2023]
Abstract
AIMS To explore the psychological changes of nurses during home isolation, the factors that related with these changes, and coping strategies in home isolation during the epidemic of COVID-19 in China. DESIGN A qualitative study based on grounded theory. METHODS Individual semi-structured telephone interviews were conducted from January 2020-February 2020 with 10 nurses who were isolated at home sharing the experiences of the epidemic of COVID-19. All interviews were audio recorded, transcribed, and analysed using constant comparative data analysis. RESULTS Analyses of the collected data reveal that the psychological changes of nurses during home isolation reflect a complex, dynamic, and gradually adaptive process that was affected by many factors. Nurses had many negative emotional reactions in the early stages of isolation and positive emotions gradually increased during home isolation. After release from home isolation, they become more confident and calm after. Six categories of coping strategies were identified, including reasoned cognition; autosuggestion; develop healthy protective behaviours; shifting attention; social support; and the power of a role model. CONCLUSIONS The study provides a better understanding of the psychological changes and the coping strategies used among nurses isolated at home. It is necessary to pay more attention to negative emotions in the early stages of home isolation to help nurses adjust quickly. The coping strategies used by nurses are likely to help those in home isolation reduce negative psychological changes and experience more optimal self-adjustment. IMPACT This study explored the psychological changes and coping strategies of home isolation among nurses, providing useful advice for psychologists to develop psychological crisis interventions to help individuals reduce negative psychological and have more actively coping strategies when faced sudden stressful infectious diseases.
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Affiliation(s)
- Mao-Mao Zhang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Niu Niu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Xiao-Xu Zhi
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Ping Zhu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Bing Wu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Bai-Nv Wu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Ai-Feng Meng
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Yun Zhao
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
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Risk and Resilience Factors For Psychosocial Impact In Healthcare Workers During COVID-19 Pandemic: A Systematic Review. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.783596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sheng Q, Zhang X, Wang X, Cai C. The influence of experiences of involvement in the COVID-19 rescue task on the professional identity among Chinese nurses: A qualitative study. J Nurs Manag 2020; 28:1662-1669. [PMID: 32770772 PMCID: PMC7436396 DOI: 10.1111/jonm.13122] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 11/29/2022]
Abstract
Aims To explore the influence of experiences of involvement in the COVID‐19 rescue task on professional identity among Chinese nurses from a qualitative method perspective. Background Professional identity of nurses is not static and easily affected by many factors. The COVID‐19 epidemic brings the tremendous physical and psychological challenges for rescue nurses. At present, there are limited data on the influence of rescue experiences on the nurses’ professional identity. Methods This study used a face‐to‐face interview with semi‐structured questions to learn about the influence of rescue experiences on the professional identity of nurses. Purposeful sampling was used to collect participants (n = 14), and interview data were analysed following the Colaizzi's phenomenological analysis. Results The ‘impression of exhaustion and fear’, ‘feeling the unfairness’, ‘perceiving incompetence in rescue task’ and ‘unexpected professional benefits’ were the main factors affecting the professional identity of rescue nurses. Conclusion The present study showed that special attention and targeted support measures should be provided to improve the professional identity of rescue nurses. Implications for Nursing Management Nurse managers should make a post‐epidemic recovery plan to help nurses to improve the professional identity. Designed education programmes and complete disaster response system should be developed to deal with infection disease in the future.
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Affiliation(s)
- Qingqing Sheng
- School of Health Sciences, Wuhan University, Wuchang, China
| | - Xi Zhang
- School of Health Sciences, Wuhan University, Wuchang, China
| | - Xinyu Wang
- School of Health Sciences, Wuhan University, Wuchang, China
| | - Chunfeng Cai
- School of Health Sciences, Wuhan University, Wuchang, China
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Luo WY, Sun JW, Zhang WL, Li Q, Ni P, Zhao LB, Tian JH, Zhang YQ, Lu H. Management in the paediatric wards facing novel coronavirus infection: a rapid review of guidelines and consensuses. BMJ Open 2020; 10:e039897. [PMID: 32788192 PMCID: PMC7422658 DOI: 10.1136/bmjopen-2020-039897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Relevant guidelines and consensuses for COVID-19 contain recommendations aimed at optimising the management in paediatric wards. The goal of this study was to determine the quality of those recommendations and provide suggestions to hospital managers for the adjustment of existing hospital prevention and control strategies, and also to offer recommendations for further research. DESIGN A rapid review of the guidelines and consensuses for the management in paediatric wards facing COVID-19. METHODS PubMed, EMBASE, the Cochrane Library, UpToDate, China National Knowledge Infrastructure, the Wanfang database and relevant websites such as medlive.cn, dxy.cn, the National Health and Health Commission and the China Center for Disease Control and Prevention were systematically searched through late May 2020. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was then used to assess the quality of the selected articles and summarise the relevant evidence concerning management in paediatric wards. RESULTS A total of 35 articles were included, composed of 3 consensus guidelines, 25 expert consensuses and 7 expert opinions. Of the 35 papers, 24 were from China, 2 from the USA, 1 from Spain, 1 from Brazil, 1 from Saudi Arabia and 6 from multinational cooperative studies. Scores for the six domains of the AGREE II tool (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) were 98.57%, 53.57%, 17.92%, 69.62%, 26.96% and 50.35%, respectively. Recommendations for nosocomial infection and control, human resource management as well as management of paediatric patients and their families were summarised. CONCLUSIONS Due to the outbreak of COVID-19, the quality of rapid guidelines and consensuses for the management in paediatric wards affected by COVID-19 is unsatisfactory. In the future, it will be necessary to develop more high-quality guidelines or consensuses for the management in paediatric wards to deal with nosocomial outbreaks in order to fully prepare for emergency medical and health problems.
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Affiliation(s)
- Wen-Yi Luo
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Ji-Wen Sun
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Lan Zhang
- Pediatric Intensive Care Unit, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Li
- Department of General Surgical, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Ni
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lie-Bin Zhao
- Dean's Office, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin-Hui Tian
- Evidence-Based Medicine Center, Lanzhou University School of Basic Medical Sciences, Lanzhou, Gansu, China
| | - Ya-Qing Zhang
- Editorial Department of Journal of Shanghai Jiao Tong University (Medical Science), Shanghai Jiao Tong University, Shanghai, China
| | - Hong Lu
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Benhamou K, Piedra A. CBT-Informed Interventions for Essential Workers During the COVID-19 Pandemic. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020; 50:275-283. [PMID: 32836379 PMCID: PMC7367784 DOI: 10.1007/s10879-020-09467-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Essential workers during the COVID-19 pandemic face heightened levels of anxiety and depression due to increased work demands, lack of adequate personal protective equipment, fear of contracting the virus, and fear of spreading it to loved ones. This is a time of urgent need for mental health support for workers affected by the pandemic crisis. Clinicians may employ empirically supported interventions derived from cognitive behavioral therapy (CBT) and related therapies. Psychological First Aid, an evidence-based crisis intervention, may be utilized to emphasize basic needs and support, but is intended as an acute disaster intervention. Given that a pandemic is an ongoing and prolonged stressor, additional CBT-informed interventions are likely needed to fully support essential workers during these times. It is recommended that clinicians help essential worker clients meet their basic needs by modifying health and sleep habits where possible and helping them advocate for their needs using interpersonal effectiveness skills. Empathic listening, validation of the crisis at hand, and values clarification can aid the therapeutic relationship, help them feel a renewed sense of purpose and meaning in their careers and with their families, and facilitate behavior change consistent with chosen values. Self-monitoring through a daily diary can help clients focus their thoughts and recognize maladaptive patterns in their thoughts and behaviors. In tandem with these techniques, behavioral activation and coping strategies including relaxation, distress tolerance, and acceptance promote engaging in positive and adaptive activities. Finally, therapists can help clients reduce anxiety related to the pandemic by helping them limit information intake.
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Affiliation(s)
- Kathy Benhamou
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road, Cleveland, OH 44106 USA
| | - Alexandra Piedra
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road, Cleveland, OH 44106 USA
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Hou Y, Zhou Q, Li D, Guo Y, Fan J, Wang J. Preparedness of Our Emergency Department During the Coronavirus Disease Outbreak from the Nurses' Perspectives: A Qualitative Research Study. J Emerg Nurs 2020; 46:848-861.e1. [PMID: 32962844 PMCID: PMC7359786 DOI: 10.1016/j.jen.2020.07.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 11/29/2022]
Abstract
Introduction This study explores the preparedness of our emergency department during the COVID-19 outbreak from the nurses’ perspectives, providing a reference and basis for our emergency department’s response to public health emergencies. Methods Using qualitative research methods, semistructured interviews were conducted with 12 emergency nurses who met the inclusion criteria, and Colaizzi analysis was used for data analysis, summary, and induction. Results A cluster of 4 themes that involved preparedness of the emergency department during the COVID-19 outbreak was extracted: organizational preparedness, personal preparedness, patient and family preparedness, and deficiencies and challenges. Discussion Organizations, individuals, patients, and family members were actively prepared to respond to novel coronavirus pneumonia outbreak in the emergency department. The emergency nurses said that the trusted organization guaranteed personal preparedness, and the active cooperation from patients and families was a motivator for personal preparedness. In addition, our study showed that there were deficiencies in both multidisciplinary collaboration efforts and efforts to rapidly diagnose and treat patients with fever in critical condition.
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Wang H, Liu Y, Hu K, Zhang M, Du M, Huang H, Yue X. Healthcare workers' stress when caring for COVID-19 patients: An altruistic perspective. Nurs Ethics 2020; 27:1490-1500. [PMID: 32662326 DOI: 10.1177/0969733020934146] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND When the contagious COVID-19 spread worldwide, the frontline staff faced unprecedented excessive work pressure and expectations of all of the society. OBJECTIVE The aim was to explore healthcare workers' stress and influencing factors when caring for COVID-19 patients from an altruistic perspective. METHODS A cross-sectional, descriptive study was conducted in a tertiary hospital during the outbreak of COVID-19 between February and March 2020 in Wuhan, the capital city of Hubei province in China. Data were collected from 1208 healthcare workers. Descriptive statistics and multiple linear regression were used to analyze the data. ETHICAL CONSIDERATIONS Research ethics approval (with the code of TJ-IRB20200379) was obtained from Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology. Written informed consent was also received from participants. RESULTS Less than 60% of participants chose moderate or severe stress on all stressors, indicating a low stress level among healthcare workers. The main source of stress among frontline healthcare workers caring for COVID-19 patients came from the fear of being infected, the fear of family members being infected, and the discomfort caused by protective equipment. Frontline staff who were nurses, were married, and had worked more than 20 days suffered higher stress, whereas rescue staff showed lower stress. CONCLUSION The healthcare workers caring for patients with COVID-19 had low stress level, although they still had the fear of being infected or uncomfortable feeling caused by personal protective equipment. A low stress level among healthcare workers indicated their professional devotion and altruism during COVID-19 epidemic. Medical institutions and the government should continue to strengthen infection prevention measures and provide more comprehensive care involving families of frontline healthcare workers, especially nurses and married staff. It will be a lesson to other countries that awaking healthcare workers' inside motivation and providing necessary support from government and society were significant.
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Affiliation(s)
- Hui Wang
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Yu Liu
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Kaili Hu
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Meng Zhang
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Meichen Du
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Haishan Huang
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Xiao Yue
- 66375Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, P.R. China
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[Caring for the caregiver: The emotional impact of the coronavirus epidemic on nurses and other health professionals]. ENFERMERIA CLINICA 2020; 31:S35-S39. [PMID: 32425487 PMCID: PMC7229967 DOI: 10.1016/j.enfcli.2020.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 12/21/2022]
Abstract
La crisis sanitaria provocada por la pandemia del virus COVID-19 ha vuelto a destacar el papel de los profesionales sanitarios como elemento clave para su contención, que sufren una alta tensión marcada por la presión asistencial y la falta de medios de protección. Ante esta tensión, resulta relevante analizar el impacto emocional en los profesionales sanitarios de la pandemia de coronavirus y los recursos de afrontamiento para disminuir o atenuar este impacto. Destacan el estrés, los trastornos del sueño y los síntomas depresivos. Se ofrecen algunas estrategias que han sido utilizados por profesionales que anteriormente han sufrido la presión del COVID-19 y les han sido de utilidad. Por último, se señalan algunas recomendaciones cuya eficacia es conocida para el manejo del impacto emocional.
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Houghton C, Meskell P, Delaney H, Smalle M, Glenton C, Booth A, Chan XHS, Devane D, Biesty LM. Barriers and facilitators to healthcare workers' adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database Syst Rev 2020; 4:CD013582. [PMID: 32315451 PMCID: PMC7173761 DOI: 10.1002/14651858.cd013582] [Citation(s) in RCA: 257] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This review is one of a series of rapid reviews that Cochrane contributors have prepared to inform the 2020 COVID-19 pandemic. When new respiratory infectious diseases become widespread, such as during the COVID-19 pandemic, healthcare workers' adherence to infection prevention and control (IPC) guidelines becomes even more important. Strategies in these guidelines include the use of personal protective equipment (PPE) such as masks, face shields, gloves and gowns; the separation of patients with respiratory infections from others; and stricter cleaning routines. These strategies can be difficult and time-consuming to adhere to in practice. Authorities and healthcare facilities therefore need to consider how best to support healthcare workers to implement them. OBJECTIVES To identify barriers and facilitators to healthcare workers' adherence to IPC guidelines for respiratory infectious diseases. SEARCH METHODS We searched OVID MEDLINE on 26 March 2020. As we searched only one database due to time constraints, we also undertook a rigorous and comprehensive scoping exercise and search of the reference lists of key papers. We did not apply any date limit or language limits. SELECTION CRITERIA We included qualitative and mixed-methods studies (with a distinct qualitative component) that focused on the experiences and perceptions of healthcare workers towards factors that impact on their ability to adhere to IPC guidelines for respiratory infectious diseases. We included studies of any type of healthcare worker with responsibility for patient care. We included studies that focused on IPC guidelines (local, national or international) for respiratory infectious diseases in any healthcare setting. These selection criteria were framed by an understanding of the needs of health workers during the COVID-19 pandemic. DATA COLLECTION AND ANALYSIS Four review authors independently assessed the titles, abstracts and full texts identified by our search. We used a prespecified sampling frame to sample from the eligible studies, aiming to capture a range of respiratory infectious disease types, geographical spread and data-rich studies. We extracted data using a data extraction form designed for this synthesis. We assessed methodological limitations using an adapted version of the Critical Skills Appraisal Programme (CASP) tool. We used a 'best fit framework approach' to analyse and synthesise the evidence. This provided upfront analytical categories, with scope for further thematic analysis. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and developed implications for practice. MAIN RESULTS We found 36 relevant studies and sampled 20 of these studies for our analysis. Ten of these studies were from Asia, four from Africa, four from Central and North America and two from Australia. The studies explored the views and experiences of nurses, doctors and other healthcare workers when dealing with severe acute respiratory syndrome (SARS), H1N1, MERS (Middle East respiratory syndrome), tuberculosis (TB), or seasonal influenza. Most of these healthcare workers worked in hospitals; others worked in primary and community care settings. Our review points to several barriers and facilitators that influenced healthcare workers' ability to adhere to IPC guidelines. The following factors are based on findings assessed as of moderate to high confidence. Healthcare workers felt unsure as to how to adhere to local guidelines when they were long and ambiguous or did not reflect national or international guidelines. They could feel overwhelmed because local guidelines were constantly changing. They also described how IPC strategies led to increased workloads and fatigue, for instance because they had to use PPE and take on additional cleaning. Healthcare workers described how their responses to IPC guidelines were influenced by the level of support they felt that they received from their management team. Clear communication about IPC guidelines was seen as vital. But healthcare workers pointed to a lack of training about the infection itself and about how to use PPE. They also thought it was a problem when training was not mandatory. Sufficient space to isolate patients was also seen as vital. A lack of isolation rooms, anterooms and shower facilities was a problem. Other important practical measures described by healthcare workers included minimising overcrowding, fast-tracking infected patients, restricting visitors, and providing easy access to handwashing facilities. A lack of PPE, and equipment that was of poor quality, was a serious concern for healthcare workers and managers. They also pointed to the need to adjust the volume of supplies as infection outbreaks continued. Healthcare workers believed that they followed IPC guidance more closely when they saw the value of it. Some healthcare workers felt motivated to follow the guidance because of fear of infecting themselves or their families, or because they felt responsible for their patients. Some healthcare workers found it difficult to use masks and other equipment when it made patients feel isolated, frightened or stigmatised. Healthcare workers also found masks and other equipment uncomfortable to use. The workplace culture could also influence whether healthcare workers followed IPC guidelines or not. Across many of the findings, healthcare workers pointed to the importance of including all staff, including cleaning staff, porters, kitchen staff and other support staff when implementing IPC guidelines. AUTHORS' CONCLUSIONS Healthcare workers point to several factors that influence their ability and willingness to follow IPC guidelines when managing respiratory infectious diseases. These include factors tied to the guideline itself and how it is communicated, support from managers, workplace culture, training, physical space, access to and trust in personal protective equipment, and a desire to deliver good patient care. The review also highlights the importance of including all facility staff, including support staff, when implementing IPC guidelines.
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Affiliation(s)
- Catherine Houghton
- National University of Ireland Galway, School of Nursing and Midwifery, Áras Moyola, NUI Galway, Galway, Ireland
| | - Pauline Meskell
- University of Limerick, Department of Nursing and Midwifery, Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Hannah Delaney
- National University of Ireland Galway and Trinity College Dublin, School of Nursing and Midwifery, Dublin, Ireland
| | - Mike Smalle
- National University of Ireland Galway, James Hardiman Library, Galway, Ireland
| | - Claire Glenton
- Norwegian Institute of Public Health, PO Box 7004 St Olavs plass, Oslo, Norway, N-0130
| | - Andrew Booth
- University of Sheffield, ScHARR, School of Health and Related Research, Regent Court, 30 Regent Street, Sheffield, UK, S1 4DA
| | - Xin Hui S Chan
- John Radcliffe Hospital, Headley Way, Headington, Oxford, Oxfordshire, UK, OX3 9DU
| | - Declan Devane
- National University of Ireland Galway, School of Nursing and Midwifery, Áras Moyola, NUI Galway, Galway, Ireland
| | - Linda M Biesty
- National University of Ireland Galway, School of Nursing and Midwifery, Áras Moyola, NUI Galway, Galway, Ireland
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Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, Du H, Li R, Kang L, Su M, Zhang J, Liu Z, Zhang B. Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak. Front Psychiatry 2020; 11:306. [PMID: 32346373 PMCID: PMC7171048 DOI: 10.3389/fpsyt.2020.00306] [Citation(s) in RCA: 403] [Impact Index Per Article: 100.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/27/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The outbreak of the 2019 novel coronavirus disease (COVID-19) not only caused particularly large public health problems, but also caused great psychological distress, especially for medical staff. We aimed to investigate the prevalence rate of insomnia and to confirm the related social psychological factors among medical staff in hospitals during the COVID-19 outbreak. METHOD Medical staff members in China were recruited, including frontline medical workers. The questionnaire, administered through the WeChat program, obtained demographic data and asked self-design questions related to the COVID-19 outbreak, insomnia/depressive/anxiety symptoms, and stress-related symptoms. We used a logistic regression analysis to examine the associations between sociodemographic factors and insomnia symptoms. RESULT There were a total of 1,563 participants in our study. Five-hundred-and-sixty-four (36.1%) participants had insomnia symptoms according to the Insomnia Severity Index (ISI) (total score ≥ 8). A multiple binary logistic regression model revealed that insomnia symptoms were associated with an education level of high school or below (OR = 2.69, p = 0.042, 95% CI = 1.0-7.0), being a doctor (OR = 0.44, p = 0.007, 95% CI = 0.2-0.8), currently working in an isolation unit (OR = 1.71, p = 0.038, 95% CI = 1.0-2.8), is worried about being infected (OR = 2.30, p < 0.001, 95% CI = 1.6-3.4), perceived lack of helpfulness in terms of psychological support from news or social media with regard to COVID-19 (OR = 2.10, p = 0.001, 95% CI = 1.3-3.3), and having very strong uncertainty regarding effective disease control (OR = 3.30, p = 0.013, 95% CI = 1.3-8.5). CONCLUSION Our study found that more than one-third of the medical staff suffered insomnia symptoms during the COVID-19 outbreak. The related factors included education level, an isolation environment, psychological worries about the COVID-19 outbreak, and being a doctor. Interventions for insomnia among medical staff are needed considering the various sociopsychological factors at play in this situation.
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Affiliation(s)
- Chenxi Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Lulu Yang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Simeng Ma
- Department of Psychiatry, RenMin Hospital of Wuhan University, Wuhan, China
| | - Ying Wang
- Department of Psychiatry, RenMin Hospital of Wuhan University, Wuhan, China
| | - Zhongxiang Cai
- Department of Psychiatry, RenMin Hospital of Wuhan University, Wuhan, China
| | - Hui Du
- Department of Psychiatry, Jing Men No. 2 People's Hospital, Jingmen, China
| | - Ruiting Li
- Department of Psychiatry, RenMin Hospital of Wuhan University, Wuhan, China
| | - Lijun Kang
- Department of Psychiatry, RenMin Hospital of Wuhan University, Wuhan, China
| | - Meilei Su
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Jihui Zhang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhongchun Liu
- Department of Psychiatry, RenMin Hospital of Wuhan University, Wuhan, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
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Jindal M, Jambunathan P, Patra P, Madhusudan T. COVID-warriors: Psychological impact of the severe acute respiratory syndrome coronavirus 2 pandemic on health-care professionals. JOURNAL OF MARINE MEDICAL SOCIETY 2020. [DOI: 10.4103/jmms.jmms_44_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Deciding to work during the Ebola outbreak: The voices and experiences of nurses and midwives in Liberia. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2017. [DOI: 10.1016/j.ijans.2017.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Lam SK, Kwong EW, Hung MS, Pang SM. Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses. J Clin Nurs 2016; 25:2895-905. [PMID: 27507678 PMCID: PMC7166687 DOI: 10.1111/jocn.13343] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the difficulties and strategies regarding guideline implementation among emergency nurses. BACKGROUND Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps. DESIGN A qualitative descriptive design was used. METHODS Semi-structured, face-to-face, individual interviews were conducted between November 2013-May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach. RESULTS Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established. CONCLUSIONS The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines. RELEVANCE TO CLINICAL PRACTICE It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important component for effective guideline implementation.
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Affiliation(s)
- Stanley Kk Lam
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
| | - Enid Wy Kwong
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Maria Sy Hung
- School of Nursing, Tung Wah College, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Samantha Mc Pang
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
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Chen SL, Chen KL, Lee LH, Yang CI. Working in a danger zone: A qualitative study of Taiwanese nurses' work experiences in a negative pressure isolation ward. Am J Infect Control 2016; 44:809-14. [PMID: 26944003 DOI: 10.1016/j.ajic.2016.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/31/2015] [Accepted: 01/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hospital nurses are frontline health care workers in controlling the spread of infectious diseases. It is not known if nurses working in negative pressure isolation wards (NPIWs) are better prepared than before to safely care for patients with common infectious diseases. METHODS For this qualitative descriptive study, 10 nurses were interviewed in depth about their experiences caring for patients in an NPIW. Tape recordings were transcribed verbatim and analyzed by qualitative content analysis. RESULTS The following 5 themes were identified: (1) complexity of patient care, (2) dissatisfaction with the quantity and quality of protective equipment, (3) shortage of nursing staff, (4) continued worries about being infected, and (5) sensitivity to self-protection. Our participants' anxiety and uncertainty about being infected in the NPIW were increased by the complexity of patients' health problems and organizational factors. To protect themselves against infection before and during patient care, participants also developed sensitivity to, concepts about, and strategies to improve self-protection. CONCLUSIONS NPIW administrators should pay more attention to nurses' concerns about improving the NPIW working environment, supply good quality protective equipment, and provide appropriate psychologic support and ongoing education to ensure that nurses feel safe while working. This ongoing education should refresh and update nurses' knowledge about disease transmission, therefore decreasing unnecessary anxiety based on misunderstandings about becoming infected.
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Affiliation(s)
- Shu-Ling Chen
- Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Kuei-Ling Chen
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Hung Lee
- Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Cheng-I Yang
- Department of Nursing, HungKuang University, Taichung, Taiwan.
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Accounting for personal and professional choices for pandemic influenza vaccination amongst English healthcare workers. Vaccine 2015; 33:2267-2272. [PMID: 25820062 DOI: 10.1016/j.vaccine.2015.03.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 03/05/2015] [Accepted: 03/11/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are encouraged to get vaccinated during influenza pandemics to reduce their own, and patients', risk of infection, and to encourage their patients to get immunised. Despite extensive research on HCWs' receipt of vaccination, little is known about how HCWs articulate pandemic influenza vaccination advice to patients. AIMS To explore HCWs' uptake of the A/H1N1 vaccine during the pandemic of 2009-2010, their recommendations to patients at the time, and their anticipated choices around influenza vaccination under different pandemic scenarios. METHOD We conducted semi-structured interviews and focus groups with eight vaccinated and seventeen non-vaccinated HCWs from primary care practices in England. The data was analysed using thematic analysis. RESULTS The HCWs constructed their receipt of vaccination as a personal choice informed by personal health history and perceptions of vaccine safety, while they viewed patients' vaccination as choices made following informed consent and medical guidelines. Some HCWs received the A/H1N1 vaccine under the influence of their local practice organizational norms and values. While non-vaccinated HCWs regarded patients' vaccination as patients' choice, some vaccinated HCWs saw it also as a public health issue. The non-vaccinated HCWs emphasised that they would not allow their personal choices to influence the advice they gave to patients, whereas some vaccinated HCWs believed that by getting vaccinated themselves they could provide a reassuring example to patients, particularly those who have concerns about influenza vaccination. All HCWs indicated they would accept vaccination under the severe pandemic scenario. However, most non-vaccinated HCWs expressed reticence to vaccinate under the mild pandemic scenario. CONCLUSIONS Providing evidence-based arguments about the safety of new vaccines and the priority of public health over personal choice, and creating strong social norms for influenza vaccination as part of the organizational culture, should increase uptake of influenza vaccination among primary care HCWs and their patients.
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Freitas BCG, Trujillo CA, Carromeu C, Yusupova M, Herai RH, Muotri AR. Stem cells and modeling of autism spectrum disorders. Exp Neurol 2012; 260:33-43. [PMID: 23036599 DOI: 10.1016/j.expneurol.2012.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 09/24/2012] [Indexed: 01/21/2023]
Abstract
Human neurons, generated from reprogrammed somatic cells isolated from live patients, bring a new perspective on the understanding of Autism Spectrum Disorders (ASD). The new technology can nicely complement other models for basic research and the development of therapeutic compounds aiming to revert or ameliorate the condition. Here, we discuss recent advances on the use of stem cells and other models to study ASDs, as well as their limitations, implications and future perspectives.
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Affiliation(s)
- Beatriz C G Freitas
- University of California San Diego, School of Medicine, Department of Pediatrics/Rady Children's Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, CA 92093, MC 0695, USA
| | - Cleber A Trujillo
- University of California San Diego, School of Medicine, Department of Pediatrics/Rady Children's Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, CA 92093, MC 0695, USA
| | - Cassiano Carromeu
- University of California San Diego, School of Medicine, Department of Pediatrics/Rady Children's Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, CA 92093, MC 0695, USA
| | - Marianna Yusupova
- University of California San Diego, School of Medicine, Department of Pediatrics/Rady Children's Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, CA 92093, MC 0695, USA
| | - Roberto H Herai
- University of California San Diego, School of Medicine, Department of Pediatrics/Rady Children's Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, CA 92093, MC 0695, USA
| | - Alysson R Muotri
- University of California San Diego, School of Medicine, Department of Pediatrics/Rady Children's Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, CA 92093, MC 0695, USA.
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Wu P, Cowling BJ, Wu JT, Lau EHY, Ip DKM, Nishiura H. The epidemiological and public health research response to 2009 pandemic influenza A(H1N1): experiences from Hong Kong. Influenza Other Respir Viruses 2012; 7:367-82. [PMID: 22883352 PMCID: PMC3705741 DOI: 10.1111/j.1750-2659.2012.00420.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In recent years, Hong Kong has invested in research infrastructure to appropriately respond to novel infectious disease epidemics. Research from Hong Kong made a strong contribution to the international response to the 2009 influenza A (H1N1) pandemic (pH1N1). Summarizing, describing, and reviewing Hong Kong’s response to the 2009 pandemic, this article aimed to identify key elements of a real‐time research response. A systematic search in PubMed and EMBASE for research into the infection dynamics and natural history, impact, or control of pH1N1 in Hong Kong. Eligible articles were analyzed according to their scope. Fifty‐five articles were included in the review. Transmissibility of pH1N1 was similar in Hong Kong to elsewhere, and only a small fraction of infections were associated with severe disease. School closures were effective in reducing pH1N1 transmission, oseltamivir was effective for treatment of severe cases while convalescent plasma therapy has the potential to mitigate future pandemics. There was a rapid and comprehensive research response to pH1N1 in Hong Kong, providing important information on the epidemiology of the novel virus with relevance internationally as well as locally. The scientific knowledge gained through these detailed studies of pH1N1 is now being used to revise and update pandemic plans. The experiences of the research response in Hong Kong could provide a template for the research response to future emerging and reemerging disease epidemics.
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Affiliation(s)
- Peng Wu
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
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