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Czepiel D, McCormack C, da Silva AT, Seblova D, Moro MF, Restrepo-Henao A, Martínez AM, Afolabi O, Alnasser L, Alvarado R, Asaoka H, Ayinde O, Balalian A, Ballester D, Barathie JA, Basagoitia A, Basic D, Burrone MS, Carta MG, Durand-Arias S, Eskin M, Fernández-Jiménez E, Frey MIF, Gureje O, Isahakyan A, Jaldo R, Karam EG, Khattech D, Lindert J, Martínez-Alés G, Mascayano F, Mediavilla R, Narvaez Gonzalez JA, Nasser-Karam A, Nishi D, Olaopa O, Ouali U, Puac-Polanco V, Ramírez DE, Ramírez J, Rivera-Segarra E, Rutten BP, Santaella-Tenorio J, Sapag JC, Šeblová J, Soto MTS, Tavares-Cavalcanti M, Valeri L, Sijbrandij M, Susser ES, Hoek HW, van der Ven E. Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic. Glob Ment Health (Camb) 2024; 11:e34. [PMID: 38572248 PMCID: PMC10988139 DOI: 10.1017/gmh.2024.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/15/2024] [Accepted: 02/05/2024] [Indexed: 04/05/2024] Open
Abstract
Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.
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Affiliation(s)
- Diana Czepiel
- Parnassia Psychiatric Institute, Parnassia Groep, The Hague, The Netherlands
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Clare McCormack
- Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, New York, NY, USA
| | - Andréa T.C. da Silva
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine Santa Marcelina, São Paulo, Brazil
| | - Dominika Seblova
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Maria F. Moro
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Alexandra Restrepo-Henao
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellín, Colombia
| | - Adriana M. Martínez
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Oyeyemi Afolabi
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Lubna Alnasser
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Rubén Alvarado
- Department of Public Health, School of Medicine, University of Valparaíso, Valparaiso, Chile
- School of Public Health, University of Chile, Santiago, Chile
| | - Hiroki Asaoka
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Olatunde Ayinde
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Arin Balalian
- Question Driven Design and Analysis Group, New York, NY, USA
| | - Dinarte Ballester
- University Hospital, Federal University of Rio Grande, Rio Grande, Brazil
| | - Josleen A.l. Barathie
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Armando Basagoitia
- Unidad de Investigación, Consultora Salud Global Bolivia, Sucre, Bolivia
| | - Djordje Basic
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - María S. Burrone
- Institute of Health Sciences, Universidad de O’Higgins, Rancagua, Chile
| | - Mauro G. Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sol Durand-Arias
- National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Mehmet Eskin
- Department of Psychology, Koç University, Istanbul, Turkey
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- European University of Madrid, Madrid, Spain
| | - Marcela I. F. Frey
- Social and Community Academic Unit, University of Chubut, Chubut, Argentina
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Anna Isahakyan
- National Institute of Health Named After Academician S. Avdalbekyan, Yerevan, Armenia
| | - Rodrigo Jaldo
- Social and Community Academic Unit, University of Chubut, Chubut, Argentina
| | - Elie G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, University of Balamand,Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Dorra Khattech
- Department Psychiatry A, Razi Hospital La Manouba, Manouba, Tunisia
| | - Jutta Lindert
- Faculty of Health and Social Work, University of Applied Sciences Emden/Leer, Emden, Germany
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
| | - Javier A. Narvaez Gonzalez
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Maestría en Epidemiología, División de Postgrados, El Bosque University, Bogotá, Colombia
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá, Colombia
| | - Aimee Nasser-Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, University of Balamand,Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Olusegun Olaopa
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria
| | - Uta Ouali
- Department Psychiatry A, Razi Hospital La Manouba, Manouba, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Victor Puac-Polanco
- Departments of Health Policy & Management and Epidemiology & Biostatistics, Downstate Health Sciences University, Brooklyn, NY, USA
- Faculty of Medical Sciences, University of San Carlos of Guatemala, Guatemala City, Guatemala
| | - Dorian E. Ramírez
- Faculty of Medical Sciences, University of San Carlos of Guatemala, Guatemala City, Guatemala
| | - Jorge Ramírez
- School of Public Health, University of Chile, Santiago, Chile
| | - Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Bart P.F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julian Santaella-Tenorio
- Department of Clinical Epidemiology and Biostatistics, Pontifical Xavierian University, Bogotá, Colombia
| | - Jaime C. Sapag
- Department of Public Health and Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jana Šeblová
- Emergency Department, Motol University Hospital, Prague, Czech Republic
- Czech Society for Emergency and Disaster Medicine, Czech Medical Association of J. E. Purkyně, Prague, Czech Republic
| | - María T. S. Soto
- Dirección de Investigación Ciencia y Tecnología, Universidad San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Maria Tavares-Cavalcanti
- School of Medicine and Psychiatric Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Linda Valeri
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Marit Sijbrandij
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam, The Netherlands
| | - Ezra S. Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Hans W. Hoek
- Parnassia Psychiatric Institute, Parnassia Groep, The Hague, The Netherlands
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Els van der Ven
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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2
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Spencer S, Lukewich J, Marshall EG, Mathews M, Asghari S, Brown JB, Freeman TR, Gill P, Idrees S, McCracken RK, Ranade S, Slade S, Terry AL, Wickett J, Wong E, Buote R, Meredith L, Moritz L, Ryan D, Hedden L. "Family doctors are also people": a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic. HUMAN RESOURCES FOR HEALTH 2024; 22:18. [PMID: 38439084 PMCID: PMC10913223 DOI: 10.1186/s12960-024-00901-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Family physicians (FPs) fill an essential role in public health emergencies yet have frequently been neglected in pandemic response plans. This exclusion harms FPs in their clinical roles and has unintended consequences in the management of concurrent personal responsibilities, many of which were amplified by the pandemic. The objective of our study was to explore the experiences of FPs during the first year of the COVID-19 pandemic to better understand how they managed their competing professional and personal priorities. METHODS We conducted semi-structured interviews with FPs from four Canadian regions between October 2020 and June 2021. Employing a maximum variation sampling approach, we recruited participants until we achieved saturation. Interviews explored FPs' personal and professional roles and responsibilities during the pandemic, the facilitators and barriers that they encountered, and any gender-related experiences. Transcribed interviews were thematically analysed. RESULTS We interviewed 68 FPs during the pandemic and identified four overarching themes in participants' discussion of their personal experiences: personal caregiving responsibilities, COVID-19 risk navigation to protect family members, personal health concerns, and available and desired personal supports for FPs to manage their competing responsibilities. While FPs expressed a variety of ways in which their personal experiences made their professional responsibilities more complicated, rarely did that affect the extent to which they participated in the pandemic response. CONCLUSIONS For FPs to contribute fully to a pandemic response, they must be factored into pandemic plans. Failure to appreciate their unique role and circumstances often leaves FPs feeling unsupported in both their professional and personal lives. Comprehensive planning in anticipation of future pandemics must consider FPs' varied responsibilities, health concerns, and necessary precautions. Having adequate personal and practice supports in place will facilitate the essential role of FPs in responding to a pandemic crisis while continuing to support their patients' primary care needs.
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Affiliation(s)
- Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Emily Gard Marshall
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Shabnam Asghari
- Family Medicine, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Judith B Brown
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Thomas R Freeman
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Paul Gill
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Samina Idrees
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Rita K McCracken
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Sudit Ranade
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Steve Slade
- The College of Family Physicians of Canada, 2630 Skymark Avenue, Mississauga, ON, L4W 5A4, Canada
| | - Amanda L Terry
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Jamie Wickett
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Richard Buote
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Leslie Meredith
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Lauren Moritz
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Dana Ryan
- Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Mateos-Arroyo JA, Zaragoza-García I, Sánchez-Gómez R, Posada-Moreno P, García-Almazán S, Ortuño-Soriano I. Gender Differences among Nurses in Managing Arterial Puncture-Related Pain: A Multicenter Cross-Sectional Study. Healthcare (Basel) 2024; 12:531. [PMID: 38470641 PMCID: PMC10931307 DOI: 10.3390/healthcare12050531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/10/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
There is evidence that healthcare can be executed differentially depending on the gender of patients, researchers, and clinicians. The aim was to analyze the possible existence of nursing gender differences in pain management produced by arterial puncture for blood gas analysis. A cross-sectional, multicenter study designed was conducted in Castilla-la Mancha (Spain). Variables of interest were collected from nurses in the public health system of a European region through a questionnaire. Data were collected for four months; the primary outcome was the use of any intervention to reduce pain and the explanatory variable was the nurse's gender. Bivariate analysis was carried out to assess associations between gender and pain-reducing interventions and a multivariate model was created with those factors that were relevant using logistic regression. A significantly higher proportion of men reported using some form of intervention (45% vs. 30%) and had more specific training (45.9% vs. 32.4%). The adjusted probability of using pain-reducing interventions by men was 71% higher than women. Thus, we found gender differences in the management of pain caused by arterial punctures performed by nurses as the main healthcare providers.
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Affiliation(s)
| | - Ignacio Zaragoza-García
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, University Complutense of Madrid, 28040 Madrid, Spain; (R.S.-G.); (P.P.-M.); (I.O.-S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), InveCuid Group, 28041 Madrid, Spain
| | - Rubén Sánchez-Gómez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, University Complutense of Madrid, 28040 Madrid, Spain; (R.S.-G.); (P.P.-M.); (I.O.-S.)
- Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (FIBHCSC), Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Paloma Posada-Moreno
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, University Complutense of Madrid, 28040 Madrid, Spain; (R.S.-G.); (P.P.-M.); (I.O.-S.)
- Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (FIBHCSC), Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Sara García-Almazán
- Intensive Care Unit, Hospital General Nuestra Señora del Prado, 45600 Talavera de la Reina, Spain;
| | - Ismael Ortuño-Soriano
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, University Complutense of Madrid, 28040 Madrid, Spain; (R.S.-G.); (P.P.-M.); (I.O.-S.)
- Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (FIBHCSC), Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Moreno Martínez M, Feijoo-Cid M, Fernández-Cano MI, Llorens-Serrano C, Navarro-Giné A. Psychosocial risk in healthcare workers after one year of COVID-19. Occup Med (Lond) 2024; 74:37-44. [PMID: 36583909 DOI: 10.1093/occmed/kqac121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic overwhelmed the capacity of the healthcare system, affecting the volume of demands and the care tasks of healthcare workers. AIMS To examine the health indicators and exposure to psychosocial risks of Spanish healthcare workers 1 year into the COVID-19 pandemic and compare them with the results of the first wave. METHODS We conducted a cross-sectional study using an online questionnaire (April-May 2020 and 2021). The data stem from the COTS 1 project database, corresponding to the first wave of COVID-19 (n = 1989) and COTS 2 (n = 1716) corresponding to 1 year later. The samples were independent. The prevalence of exposure to psychosocial risks and adverse health indicators was estimated for every occupational group, segregating the data by sex. RESULTS Professionals of all types presented worse perception of health. In general, the results were worse for women, while geriatric assistants presented the greatest exposure to psychosocial risk in COTS 2 compared to COTS 1. Sleep problems, high quantitative demands and high concern about becoming infected and spreading COVID-19 were cross-disciplinary in COTS 1, while worse perception of health, high pace of work, high work-life conflict and low development opportunities stood out in COTS 2. CONCLUSIONS Exposure to psychosocial risks was already high during the first wave and a significant decline in working conditions was observed. The prolongation of the pandemic exacerbated these results and seems to have multiplied the pre-existing inequalities between the axes of segregation in the labour market.
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Affiliation(s)
- M Moreno Martínez
- Medicine Department, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
| | - M Feijoo-Cid
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
- Multidisciplinari Research Group in Health and Society (GREMSAS), (2017 SGR 917), 08303 Barcelona, Spain
| | - M I Fernández-Cano
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
- Multidisciplinari Research Group in Health and Society (GREMSAS), (2017 SGR 917), 08303 Barcelona, Spain
| | - C Llorens-Serrano
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
- Union Institute of Work, Environment and Health (ISTAS), Reference Centre on Work Organisation and Health, 08003 Barcelona, Spain
- Sociology Department, Faculty of Sociology and Political Sciences, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
| | - A Navarro-Giné
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
- Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain
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Trojak RM, Lenger M, Birner A, Maget A, Dalkner N, Lang JN, Fellendorf FT, Ratzenhofer M, Schönthaler EMD, Fleischmann E, Bengesser SA, Queissner R, Platzer M, Tmava-Berisha A, Reininghaus EZ. Impact of the COVID-19 Pandemic on Productivity of Workers in the Health Sector between Working in a Hospital and from Home. J Clin Med 2023; 12:5129. [PMID: 37568530 PMCID: PMC10420162 DOI: 10.3390/jcm12155129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Due to the COVID-19 pandemic, workplaces in the medical field experienced changes. Non-frontline workers in the health sector (WHS) were in many cases allowed to work from home (WFH). Changes in work locations have affected the perception of productivity during the COVID-19 pandemic compared to the pre-pandemic perception. Studies regarding this research field are rare for WHS. The aim of the present study was to investigate the perception of productivity and its impact on symptoms of depression during the COVID-19 pandemic. The second objective was to assess the implications for post-pandemic work settings such as WFH or work scenarios in hospitals during pandemics. METHODS At three points in time during the COVID-19 pandemic (t1; n = 161: April 2020, t2; n = 1598 winter 2020/2021, t3; n = 1879 winter 2021/2022), an online survey of WHS (e.g., medical doctors, nurses, scientific staff) in Austria concerning their productivity in their current workplace (pre- and post-pandemic) was conducted. The online survey included questions about the perceptions of productivity changes (i.e., perceptions of lower, equal, and higher productivity, before and during the COVID-19 pandemic) in different work settings (e.g., working in a hospital or working from home), as well as standardized questionnaires like the Patient Health Questionnaire (PHQ-9), assessing symptoms of depression in WHS. RESULTS χ2 tests showed that WHS working in hospitals experienced significantly fewer fluctuations in their perceptions of productivity than WHS working from home. An analysis of variance (ANOVA) indicated that WHS with a lower perception of productivity tended to have higher self-assessed depressive symptoms. CONCLUSION The possibility of remaining working in the hospital in stressful scenarios like the COVID-19 pandemic might stabilize the feeling of productivity. Moreover, productivity is associated with self-assessed depressive symptoms. Hence, looking into the reasons behind this discrepancy between WHS in hospitals and those working from home might help to improve the home office modality and to create better structures, which are related to symptoms of depression.
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Affiliation(s)
| | - Melanie Lenger
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (R.M.T.); (A.B.); (A.M.); (N.D.); (J.N.L.); (F.T.F.); (M.R.); (E.M.D.S.); (E.F.); (S.A.B.); (R.Q.); (M.P.); (A.T.-B.); (E.Z.R.)
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Sangpoom S, Adesina F, Kaewchandee C, Sikanna K, Noppapak N, Maneerattanasak S, Shohaimi S, Suwanbamrung C. Levels and Predictors of Proactive Practical Experience to Solve COVID-19 among Public Health Officers in Primary Care Units in the Upper Southern Region, Thailand: An Explanatory Mixed Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6487. [PMID: 37569027 PMCID: PMC10419067 DOI: 10.3390/ijerph20156487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/10/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
Public Health Officers (PHOs)' experiences in reaction to the COVID-19 pandemic can be based on whether the PHO is active or passive regarding five experience aspects, including knowledge, understanding, opinion, participation, and practice. Therefore, this study's objectives are to identify the types of experiences and analyse the predictors of proactive practical experiences in addressing the COVID-19 pandemic among PHOs in the southern region of Thailand. METHODS An explanatory mixed methods approach was used to collect data, through questionnaires and online in-depth interviews. This study was conducted from 4 August 2020 to 3 August 2021. RESULTS The results include 60 PHOs from 60 Primary Care Units in six provinces, with 41 (68.3%) females and an average age of 35.57 years (SD = 11.61). The PHOs' knowledge, understanding, and participation experience aspects were mostly proactive rather than passive. The factors that significantly predicted proactive practical experiences included sex (ORadj = 1.52, 95% CI = 1.04-2.21), age (ORadj = 1.69, 95% CI = 1.16-2.48), married status (ORadj = 1.69, 95% CI = 1.16-2.48), education level (ORadj = 1.50, 95% CI = 1.02-2.20), and position for work (ORadj = 1.69, 95% CI = 1.16-2.48). The results of quantitative method were confirmed by 12 sub-themes of 8 PHOs' experiences from qualitative method. CONCLUSIONS The PHOs' knowledge, understanding, opinion, and participation experiences were significant predictors of practical experience. Primary health care systems should promote proactive experiences in all four aspects to increase proactive practical experiences.
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Affiliation(s)
- Suttida Sangpoom
- Excellent Center for Dengue and Community Public Health: EC for DACH, School of Science, Walailak University, Thasala District, Nakhon Si Thammarat 80160, Thailand;
| | - Femi Adesina
- Department of Biology, Federal University of Technology Akure, Akura 340110, Nigeria;
| | - Chuthamat Kaewchandee
- Community Health Program, Faculty of Liberal Art and Science, Sisaket Rajabhat University, Muang 33000, Thailand;
| | - Kannika Sikanna
- School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand; (K.S.); (N.N.)
| | - Natchima Noppapak
- School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand; (K.S.); (N.N.)
| | - Sarunya Maneerattanasak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia;
| | - Charuai Suwanbamrung
- Master and PhD. Program in Public Health Research, Excellent Center for Dengue and Community Public Health: EC for DACH, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
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7
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Saunders NR, Stukel TA, Strauss R, Fu L, Guan J, Cohen E, Vigod S, Guttmann A, Kurdyak P, Toulany A. Association between physician characteristics and practice-level uptake of paediatric virtual mental healthcare: a population-based study. BMJ Open 2023; 13:e070172. [PMID: 37451721 PMCID: PMC10350908 DOI: 10.1136/bmjopen-2022-070172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVE To examine physician factors associated with practice-level uptake of virtual mental healthcare for children and adolescents. DESIGN, SETTING AND PARTICIPANTS A population-based data linkage study of a cohort of all physicians (n=12 054) providing outpatient mental healthcare to children and adolescents (aged 3-17 years, n=303 185) in a single-payer provincial health system in Ontario, Canada from 1 July 2020 to 31 July 2021. EXPOSURES Physician characteristics including gender, age, specialty, location of training, practice region, practice size and overall and mental health practice size. MAIN OUTCOMES Practice-level proportion of outpatient virtual care provided: (1) mostly in-person (<25% virtual care), (2) hybrid (25%-99% virtual care) or (3) exclusively virtual (100% virtual care). Multinomial logistic regression models tested the association between practice-level virtual care provided and physician characteristics. RESULTS Among physicians, 1589 (13.2%) provided mostly in-person mental healthcare with 8714 (67.8%) providing hybrid care, and 2291 (19.0%) providing exclusively virtual care. The provision of exclusive virtual care (vs mostly in-person) was associated with female sex (adjusted OR (aOR) 1.97, 95% CI 1.70 to 2.27 (ref: male)), foreign training (aOR 1.27, 95% CI 1.07 to 1.50 (ref: Canadian-trained)), family physicians (aOR 2.05, 95% CI 1.56 to 2.69 (ref: psychiatrist)) and reversely associated with large practice size (aOR 0.32, 95% CI 0.25 to 0.40 (ref smallest quintile)). Mostly in-person care was associated with older age physicians (71+ years) and practice outside the Toronto region. CONCLUSIONS AND RELEVANCE In a single-payer universal healthcare system that remunerates physicians using the same fee structure for in-person and virtual outpatient care, there is heterogeneity in utilisation of virtual care that is associated with provider factors. This practice variation, with limited evidence on effectiveness and appropriate contexts for virtual care use, suggests there may be opportunity for further outcomes research and guidance on appropriate context for paediatric virtual mental healthcare delivery.
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Affiliation(s)
- Natasha Ruth Saunders
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Therese A Stukel
- ICES, Toronto, Ontario, Canada
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Eyal Cohen
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Simone Vigod
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital and Women's College Research Institute, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Alene Toulany
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Insitute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
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8
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Meese KA, Boitet LM, Sweeney KL, Nassetta L, Mugavero M, Hidalgo B, Reamey R, Rogers DA. Still Exhausted: The Role of Residual Caregiving Fatigue on Women in Medicine and Science Across the Pipeline. J Med Internet Res 2023; 25:e47629. [PMID: 37314842 DOI: 10.2196/47629] [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: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/15/2023] Open
Abstract
Understanding the impact of caregiving responsibilities on women in medicine is crucial for ensuring a healthy and intact workforce, as caregiving responsibilities have the potential to affect the careers of women in health care along the entire pipeline, from students and trainees to physicians, physician-scientists, and biomedical researchers.
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Affiliation(s)
- Katherine A Meese
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Laurence M Boitet
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Katherine L Sweeney
- UAB Medicine, Birmingham, AL, United States
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lauren Nassetta
- UAB Medicine, Birmingham, AL, United States
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rebecca Reamey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Raparelli V, Santilli F, Marra AM, Romiti GF, Succurro E, Licata A, Buzzetti E, Piano S, Masala M, Suppressa P, Becattini C, Muiesan ML, Russo G, Cogliati C, Proietti M, Basili S. The SIMI Gender '5 Ws' Rule for the integration of sex and gender-related variables in clinical studies towards internal medicine equitable research. Intern Emerg Med 2022; 17:1969-1976. [PMID: 35932381 PMCID: PMC9522660 DOI: 10.1007/s11739-022-03049-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/01/2022] [Indexed: 12/02/2022]
Abstract
Biological sex and sociocultural gender matter when it comes to health and diseases. They have been both proposed as the undeniable gateways towards a personalized approach in care delivery. The Gender Working Group of the Italian Society of Internal Medicine (SIMI) was funded in 2019 with the aim of promoting good practice in the integration of sex and gender domains in clinical studies. Starting from a narrative literature review and based on regular meetings which led to a shared virtual discussion during the national SIMI congress in 2021, the members of the WG provided a core operational framework to be applied by internal medicine (IM) specialists to understand and implement their daily activity as researchers and clinicians. The SIMI Gender '5 Ws' Rule for clinical studies has been conceptualized as follows: Who (Clinical Internal Medicine Scientists and Practitioners), What (Gender-related Variables-Gender Core Dataset), Where (Clinical Studies/Translational Research), When (Every Time It Makes Sense) and Why (Explanatory Power of Gender and Opportunities). In particular, the gender core dataset was identified by the following domains (variables to collect accordingly): relations (marital status, social support, discrimination); roles (occupation, caregiver status, household responsibility, primary earner, household dimension); institutionalized gender (education level, personal income, living in rural vs urban areas); and gender identity (validated questionnaires on personality traits). The SIMI Gender '5 Ws' Rule is a simple and easy conceptual framework that will guide IM for the design and analysis of clinical studies.
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Affiliation(s)
- Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Via dei Borsari 46, 44121, Ferrara, Italy.
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy.
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
| | - Francesca Santilli
- Department of Medicine and Aging, and Center for Advanced Studies and Technology (CAST), University of Chieti, Chieti, Italy
| | - Alberto Maria Marra
- Department of Translational Medical Sciences, Italy and Center for Pulmonary Hypertension, Thoraxklinic, Member of the German Center for Lung Research (DZL), "Federico II" University of Naples, University Hospital Heidelberg, Heidelberg, Germany
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Anna Licata
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo Medical School, Palermo, Italy
| | - Elena Buzzetti
- Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Piano
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine-DIMED, University and Hospital of Padua, Padua, Italy
| | - Maristella Masala
- Department of Internal Medicine, University of Sassari, Sassari, Italy
| | - Patrizia Suppressa
- Department of Internal Medicine and Rare Disease Centre "C. Frugoni" University Hospital of Bari, Bari, Italy
| | - Cecilia Becattini
- Internal and Cardiovascular Medicine-Stroke Unit, University of Perugia, Perugia, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giuseppina Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Chiara Cogliati
- Internal Medicine, Department of Biomedical and Clinical Sciences, L.Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milano, Milan, Italy
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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10
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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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