Snapshot Impact of COVID-19 on Mental Wellness in Nonphysician Otolaryngology Health Care Workers: A National Study

Prevalence of psychological and mental health symptoms among nursing professionals during the COVID-19 pandemic in the Americas: Systematic review and meta-analysis

To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers.

How SWAT Changed the Conversation: Implementation of a Discharge SWAT Team Improves Morale and Facilitates Communication During the COVID-19 Pandemic

PURPOSE OF STUDY

Hospital overcrowding and delays in discharge are serious issues in the modern health care landscape and can lead to poor patient outcomes and health care personnel (HCP) burnout. The goal of this project was to develop a collaborative forum where HCP representing the entire spectrum of the inpatient care team, including case management team members, could connect to discuss challenges and barriers to patient discharge. The following describes the development, implementation, and outcomes of the discharge SWAT (Solutions, Wins, Actions, and Tactics) team, which is a 30-min virtual daily meeting where discussion is primarily centered around challenges in discharging individual patients and addressing case manager needs. The primary aim of SWAT meetings is fostering a positive atmosphere to address barriers to discharge while prioritizing patient care and outcomes.

PRIMARY PRACTICE SETTING

This study was conducted in a 40-hospital academic health system in the United States.

METHODOLOGY AND SAMPLE

SWAT meetings were first implemented at a representative flagship facility in a health system. HCP at this first facility were surveyed to assess satisfaction with SWAT meetings. SWAT meetings then were implemented at the majority of facilities in a 40-hospital academic health system. During SWAT implementation, average inpatient length of stay (LOS) and patient care transitions were monitored for participating and nonparticipating service lines.

RESULTS

Among surveyed HCP, the majority view SWAT meetings favorably and reported that it was a valuable use of their time and positively impacted their work in the patient discharge space. Nonprovider and case management staff in particular valued the SWAT meetings and found them beneficial. LOS remained stable for patients under the care of participating providers, despite the upheaval of the ongoing COVID-19 pandemic, and the research team also observed a positive impact of SWAT meetings on appropriate inpatient care transitions.

Levels and drivers of burnout during the COVID-19 pandemic among a diverse group of resident physicians

OBJECTIVES

Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases.

METHODS

We examined well-being and burnout among resident physicians in surgical and non-surgical specialties during the peak of the COVID-19 pandemic using the Mayo Physician Well-Being Index (WBI).

RESULTS

Completed surveys were received from 110 residents, 55% of whom were in a surgical training program. 35% of respondents were identified as 'at risk' for burnout. Increased demands from work (adj. OR 3.79, 95% CI 1.50, 9.59, p = 0.005) was associated with an increased likelihood for being 'at risk' compared to those without increased demands. Odds of having increased stress level were higher amongst residents with fear/anxiety of the unknown (adj. OR 4.21, 95% CI 1.63, 10.90, p = 0.003) and more demands outside work (adj. OR 10.54, 95% CI 2.63, 42.16, p = 0.001) but lower amongst residents with more time for studying (OR 0.23, 95% CI 0.09, 0.64, p = 0.005). Risk for burnout was not significantly different between surgical and non-surgical specialties when adjusting for increased demands from work (adj. OR 1.43, 95% CI 0.60, 3.37, p = 0.0.418).

CONCLUSION

Perceived effects of the COVID-19 pandemic upon residents' educational experience was mixed: reduced clinical volume had a negative impact, while increased time for study was perceived favorably. These findings suggest potential strategies and targets to mitigate the stress and burnout of a future crisis, whether large or small, among surgical and non-surgical trainees.

Digitalisation Medical Records: Improving Efficiency and Reducing Burnout in Healthcare

(1) Background: electronic medical record (EMR) systems remain a significant priority for the improvement of healthcare services. However, their implementation may have resulted in a burden on healthcare workers (HCWs). This study aimed to determine the prevalence of burnout symptoms among HCWs who use EMRs at their workplace, as well as burnout-associated factors. (2) Methods: an analytical cross-sectional study was conducted at six public health clinics equipped with an electronic medical record system. The respondents were from a heterogeneity of job descriptions. Consent was obtained before enrolment into the study. A questionnaire was distributed through an online platform. Ethical approval was secured. (3) Results: a total of 161 respondents were included in the final analysis, accounting for a 90.0% response rate. The prevalence of burnout symptoms was 10.7% (n = 17). Three significant predictors were obtained in the final model: experiencing ineffective screen layouts and navigation systems, experiencing physical or verbal abuse by patients, and having a poor relationship with colleagues. (4) Conclusions: the prevalence of burnout symptoms among healthcare workers working with electronic medical record systems was low. Despite several limitations and barriers to implementation, a paradigm shift is needed to equip all health sectors with electronic medical record systems to improve healthcare service delivery. Continuous technical support and financial resources are important to ensure a smooth transition and integration.

Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I² >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I² >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.

Psychological impact, coping behaviors, and traumatic stress among healthcare workers during COVID-19 in Taiwan: An early stage experience

OBJECTIVE

This study investigated the psychological impact on, coping behaviors of, and traumatic stress experienced by healthcare workers during the early stage of the COVID-19 pandemic and formulated effective support strategies that can be implemented by hospitals and government policymakers to help healthcare staff overcome the pandemic.

METHODS

This cross-sectional study recruited clinical healthcare workers at a regional hospital in Nantou County, Taiwan. The questionnaire collected personal characteristics, data on the impact and coping behaviors of the pandemic, and Impact of Event Scale-Revised (IES-R). A total of 354 valid questionnaires were collected. The statistical methods employed were univariate and multivariate stepwise regression, and logistic regression.

RESULTS

Perceived impact and coping behaviors were found to be moderate in degree, and traumatic stress was lower than that in other countries. However, our data identified the following subgroups that require special attention: those with young age, those living with minor children, nurses, those with self-rated poor mental health, and those with insufficient COVID-19-related training.

CONCLUSION

Managers should pay particular attention to helping healthcare workers in high-risk groups, strengthen COVID-19 training, provide adequate protective equipment and shelter, and offer psychological counseling.

No increase in burnout in health care workers during the initial COVID-19 outbreak: Systematic review and meta-analysis

BACKGROUND

For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.

AIM

To literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.

METHODS

We performed a database search of Embase, Google Scholar and PubMed from June to October 2020. We analysed burnout risk factors and protective factors in included studies published in peer-reviewed journals as of January 2020, studying a HCW population during the first COVID-19 wave without any geographic restrictions. Furthermore, we performed a meta-analysis to determine overall burnout levels. We studied the main risk factors and protective factors related to burnout and stress at the individual, institutional and regional levels.

RESULTS

Forty-one studies were included in our final review sample. Most were cross-sectional, observational studies with data collection windows during the first wave of the COVID-19 surge. Of those forty-one, twelve studies were included in the meta-analysis. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). Indeed, exposure to the virus was not a leading factor for burnout. Our meta-analytic estimate of burnout prevalence in the HCW population for a sample of 6784 individuals was 30.05%.

CONCLUSION

There was a significant prevalence of burnout in HCWs during the COVID-19 pandemic, and some of the associated risk factors could be targeted for intervention, both at the individual and organizational levels. Nevertheless, COVID-19 exposure was not a leading factor for burnout, as burnout levels were not notably higher than pre-COVID-19 levels.

Otolaryngology in the face of A pandemic

Although infrequent, pandemics are serious public health concerns with unpredictable courses. The COVID-19 pandemic began over 2 years ago and is far from over. This pandemic has spread rapidly throughout the world and led to several million deaths, making it commonly compared to the deadly Spanish influenza pandemic. Policy and safety measures are constantly being adapted to reduce transmission rates. The pandemic places stress on all healthcare workers, but especially otolaryngology providers due to their direct contact with airway connected cavities. This puts them at high risk for infection and has impacted inpatient and outpatient otolaryngology care, as well as education, research, and mental health.

Initial findings on RESTORE for healthcare workers: an internet-delivered intervention for COVID-19-related mental health symptoms

Many healthcare workers on the frontlines of the COVID-19 pandemic are experiencing clinical levels of mental health symptoms. Evidence-based interventions to address these symptoms are urgently needed. RESTORE (Recovering from Extreme Stressors Through Online Resources and E-health) is an online guided transdiagnostic intervention including cognitive-behavioral interventions. It was specifically designed to improve symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) associated with COVID-19-related traumatic and extreme stressors. The aims of the present study were to assess the feasibility, acceptability, and initial efficacy of RESTORE in healthcare workers on the frontline of the COVID-19 pandemic. We conducted an initial uncontrolled trial of RESTORE in 21 healthcare workers who were exposed to COVID-19-related traumatic or extremely stressful experiences in the context of their work and who screened positive for clinical levels of anxiety, depression, and/or PTSD symptoms. RESTORE was found to be feasible and safe, and led to statistically significant and large effect size improvements in anxiety, depression, and PTSD symptoms over the course of the intervention through follow-up. RESTORE has the potential to become a widely disseminable evidence-based intervention to address mental health symptoms associated with mass traumas.Clinical Trials Registration: This trial was registered with ClinicalTrials.gov ID: NCT04873622.

The effect of the COVID-19 pandemic on health care workers' anxiety levels: a meta-analysis

Background

The COVID-19 pandemic has been declared a public health emergency of international concern, causing excessive anxiety among health care workers. Additionally, publication bias and low-quality publications have become widespread, which can result in the dissemination of unreliable information. A meta-analysis was performed for this study with the following two aims: (1) to examine the prevalence of anxiety among health care workers and determine whether it has increased owing to the COVID-19 pandemic and (2) to investigate whether there has been an increase in publication bias.

Methods

All relevant studies published between 2015 and 2020 were searched in electronic databases (namely Web of Science, PubMed, Embase, PsycInfo, PsyArXiv, and medRxiv). The heterogeneity of the studies was assessed using the I 2 statistic. The effect size (prevalence rate of anxiety) and 95% CI for each study were also calculated. We used moderator analysis to test for the effect of the COVID-19 pandemic on health care workers' anxiety levels and to detect publication bias in COVID-19 studies. We assessed publication bias using funnel plots and Egger's regression.

Results

A total of 122 studies with 118,025 participants met the inclusion criteria. Eighty-eight articles (75,066 participants) were related to COVID-19, 13 articles (9,222 participants) were unrelated to COVID-19 (i.e., articles related to other outbreaks, which were excluded), and 21 preprints (33,737 participants) were related to COVID-19. The pooled meta-analysis prevalence was 33.6% (95% CI [30.5-36.8]; 95% PI [6.5-76.3]). Moderator analysis revealed no significant differences between articles related to COVID-19 and those unrelated to COVID-19 (p = 0.824). Moreover, no significant differences were found between articles and preprints related to COVID-19 (p = 0.843). Significant heterogeneity was observed in each subgroup. An Egger's test revealed publication bias in both articles and preprints related to COVID-19 (p < 0.001).

Conclusions

Determining whether the anxiety state of health care workers is altered by the COVID-19 pandemic is currently difficult. However, there is evidence that their anxiety levels may always be high, which suggests that more attention should be paid to their mental health. Furthermore, we found a substantial publication bias; however, the quality of the studies was relatively stable and reliable.

The Impact of the COVID-19 Pandemic on Burnout, Compassion Fatigue, and Compassion Satisfaction in Healthcare Personnel: A Systematic Review of the Literature Published during the First Year of the Pandemic

This literature review aimed to determine the level of burnout, compassion fatigue, and compassion satisfaction, as well as their associated risks and protective factors, in healthcare professionals during the first year of the COVID-19 pandemic. We reviewed 2858 records obtained from the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, and Web of Science databases, and finally included 76 in this review. The main results we found showed an increase in the rate of burnout, dimensions of emotional exhaustion, depersonalization, and compassion fatigue; a reduction in personal accomplishment; and levels of compassion satisfaction similar to those before the pandemic. The main risk factors associated with burnout were anxiety, depression, and insomnia, along with some sociodemographic variables such as being a woman or a nurse or working directly with COVID-19 patients. Comparable results were found for compassion fatigue, but information regarding compassion satisfaction was lacking. The main protective factors were resilience and social support.

Impact of Mental Health on Wellness in Adult Workers

Wellness in adult workers is intimately associated with better quality of life in individuals, as well as in the family, community, workplace, and country. This study aimed to examine the status of wellness in adult workers and to identify the factors that influence wellness. A descriptive survey was conducted with 260 adult workers. T- test and one-way ANOVA with post-hoc Scheffe test were used to analyze the data. Multiple regression analysis was performed on stress, depression, anxiety, well-being, self-efficacy, and perceived health status. The regression model for wellness in adult workers was significant (F = 42.21, p < 0.001), with an explanatory power of 0.558. Depression (β = −0.306) was identified as the most influential factor for wellness in adult workers, followed by self-efficacy (β = 0.280) and well-being (β = 0.264). Depression, stress, and anxiety negatively influenced wellness, whereas self-efficacy, well-being, and perceived health status positively influenced wellness. Study findings suggest the need to develop intervention programs for workers that decrease stress, depression, and anxiety, and incorporate self-efficacy strategies.

Psychological Consequences Among Residents and Fellows During the COVID-19 Pandemic in New York City: Implications for Targeted Interventions

PURPOSE

To examine the psychological impact of the COVID-19 pandemic on medical trainees (residents and fellows) working at Mount Sinai Hospital (MSH) in New York City (NYC), the initial epicenter of the United States pandemic.

METHOD

The authors administered a survey to 991 trainees in frontline specialties working at MSH in NYC between April and May 2020. The instrument assessed symptoms of major depressive disorder, generalized anxiety disorder, COVID-19-related posttraumatic stress disorder, and burnout. Psychiatric screens were aggregated into 1 composite measure, and meeting criteria on any of the 3 scales was considered a positive screen for psychiatric symptoms. The survey also assessed COVID-19-related exposures, worries, coping strategies, and desired interventions. Multivariable logistic regressions were conducted to identify factors associated with psychiatric symptoms and burnout.

RESULTS

Of the 560 respondents (56.6% response rate), 29.7% screened positive for psychiatric symptoms and 35.8% screened positive for burnout. History of a mental illness, COVID-19-related duties and personal/career worries, and coping by substance use were associated with increased likelihood of screening positive for psychiatric symptoms. Positive emotion-focused coping and feeling valued by supervisors were associated with decreased likelihood. Internal medicine and surgical specialties, a history of mental illness, increased duty hours, duty-related worries, personal/career worries, coping via self-blame and venting, and coping via substance use were associated with higher odds of burnout. Feeling valued by supervisors was associated with decreased burnout odds. The most common crisis-related needs included access to personal protective equipment, food provisions, and financial support.

CONCLUSIONS

Psychological distress and burnout affected approximately one-third of trainees sampled during the height of the pandemic in NYC. As the pandemic surged beyond NYC, these findings suggest that interventions should include addressing basic needs, promoting leadership affirmation, moderating duty hours, supporting trainees financially, and enhancing mental health support.

Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: A systematic review and meta-analysis

BACKGROUND

Healthcare workers are at high risk of developing mental health issues during the coronavirus disease 2019 (COVID-19) pandemic. However, there is a need for a full picture of mental health problems with comprehensive analysis among healthcare workers during the COVID-19 pandemic.

OBJECTIVE

This review aimed to systematically identify the mental health problems among healthcare workers in various countries during the COVID-19 pandemic.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic literature search was performed of the following databases: PubMed, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, MEDLINE Complete, and SocINDEX. The last date of our search was November 2, 2020. We included all cohort, case-control and cross-sectional studies and used the Joanna Briggs Institute tool to assess their quality. A meta-analysis was performed to synthesize the pooled prevalence of mental health problems using a random-effects model. Heterogeneity was measured using the I² statistic and Egger's test was used to assess publication bias.

RESULTS

A total of 38 studies were identified that reported the mental health problems of healthcare workers during the COVID-19 pandemic. The distribution of healthcare workers analyzed in this review included 27.9% doctors, 43.7% nurses, and 7.0% allied health workers. The pooled prevalence of mental health problems for post-traumatic stress disorder, anxiety, depression, and distress was 49% (95% confidence interval [CI]: 22-75%), 40% (95% CI: 29-52%), 37% (95% CI: 29-45%), and 37% (95% CI: 25-50%), respectively.

CONCLUSION

This review yielded evidence that estimated the global prevalence of mental health problems among healthcare workers during the COVID-19 pandemic. Post-traumatic stress disorder was the most common mental health disorder reported by healthcare workers during the COVID-19 pandemic, followed by anxiety, depression, and distress. Additional studies remain necessary to assess the appropriate management strategies for treating and preventing mental health disorders among healthcare workers during the pandemic.

The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis

Objective: The COVID-19 epidemic has generated great stress throughout healthcare workers (HCWs). The situation of HCWs should be fully and timely understood. The aim of this meta-analysis is to determine the psychological impact of COVID-19 pandemic on health care workers.

Method: We searched the original literatures published from 1 Nov 2019 to 20 Sep 2020 in electronic databases of PUBMED, EMBASE and WEB OF SCIENCE. Forty-seven studies were included in the meta-analysis with a combined total of 81,277 participants.

Results: The pooled prevalence of anxiety is 37% (95% CI 0.31–0.42, I² = 99.9%) from 44 studies. Depression is estimated in 39 studies, and the pooled prevalence of depression is 36% (95% CI 0.31–0.41, I² = 99.6%). There are 10 studies reported the prevalence of insomnia, and the overall prevalence of insomnia is 32% (95% CI 0.23–0.42, I² = 99.5%). The subgroup analysis showed a higher incidence of anxiety and depression among women and the frontline HCWs compared to men and non-frontline HCWs respectively.

Conclusions: The COVID-19 pandemic has caused heavy psychological impact among healthcare professionals especially women and frontline workers. Timely psychological counseling and intervention ought to be implemented for HCWs in order to alleviate their anxiety and improve their general mental health.

The global prevalence of depression, anxiety, stress, and, insomnia and its changes among health professionals during COVID-19 pandemic: A rapid systematic review and meta-analysis

BACKGROUND

During the COVID-19 pandemic, the health professionals who are at the frontline of this crisis have been facing extreme psychological disorders. This research aims to provide an overall scenario of the prevalence of depression, anxiety, stress, as well as insomnia and to inspect the changes in these prevalence over time by analyzing the existing evidence during this COVID-19 pandemic.

METHODS

A systematic search was performed on March 30, 2021, in PubMed, MEDLINE, Google Scholar databases, and Web of Science. To assess the heterogeneity, Q-test,I 2 statistics, and Meta regression and to search for the publication bias, Eggers's test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity.

RESULTS

Among eighty-three eligible studies in the final synthesis, 69 studies (n = 144649) assessed the depression prevalence of 37.12% (95% CI: 31.80-42.43), 75 studies (n = 147435) reported the anxiety prevalence of 41.42% (95% CI: 36.17-46.54), 41 studies (n = 82783) assessed the stress prevalence of 44.86% (95% CI: 36.98-52.74), 21 studies (n = 33370) enunciated the insomnia prevalence of 43.76% (95% CI: 35.83-51.68). The severity of the mental health problems among health professionals increased over the time during January 2020 to September 2020.

LIMITATIONS

A significant level of heterogeneity was found among psychological measurement tools and across studies.

CONCLUSIONS

Therefore, it is an emergency to develop psychological interventions that can protect the mental health of vulnerable groups like health professionals.

The psychological impact of COVID-19 on health care workers working in a unique environment under the umbrella of Qatar Red Crescent Society

OBJECTIVES

to determine the levels of depression, anxiety, and stress among healthcare workers (HCWs) working in a unique male-dominated environment under the umbrella of Qatar Red Crescent, and to explore the associated factors during COVID-19 pandemic in Qatar.

METHODS

a cross-sectional study utilizing a web-based survey was conducted in the period between 15 November 2020 and 22 December 2020. Depression, anxiety, and stress were determined using the 9-items patient health questionnaire (PHQ-9), the 7-item generalized anxiety disorder (GAD-7) scale, and the 22- item impact of event scale revised (IES-R), respectively. We conducted multivariable logistic regression analysis to determine the predictors of mental health outcomes among HCWs.

RESULTS

the proportions of the participants reporting symptoms of depression, anxiety, and stress were 12.4 (95%CI: 9.3-16.1), 14.2 (95%CI: 10.9-18.1), and 18.5% (95%CI: 14.8-22.7) respectively. Arabs had significantly more severe anxiety levels than non-Arabs (p = 0.031), HCWs with high COVID-19 risk perception experienced more severe mental health outcomes (p < 0.001). The multivariable logistic regression showed that high risk perception was independently associated with depression (adjusted OR 4.62, 95%CI: 2.00-10.68), anxiety (adjusted OR 4.90, 95%CI: 2.24-10.68), and stress (adjusted OR 3.067, 95%CI: 1.62-5.79) with p < 0.001. Compared to nurses, technicians and paramedics were more likely to report anxiety symptoms with (adjusted OR 2.97, 95%CI: 1.23-7.17, p = 0.015), and (adjusted OR 5.48, 95%CI: 1.86-16.12, p = 0.002) respectively. Having a relative or a friend died of COVID-19 infection was significantly associated with depression symptoms (adjusted OR 2.54, 95%CI: 1.21-5.36, p = 0.014). Not living with family was significantly associated with the presence of different mental health outcomes.

CONCLUSION

relatively lower rates of mental health outcomes in this study compared to others could have several explanations related to the unique characteristics of our target population and their working environment. Ensuring proper mental health support for HCWs is highly recommended.

Multinational Study to Assess Stress Levels Among the Health Care Workers of Radiation Oncology Community at the Outset of the COVID-19 Pandemic

PURPOSE

To evaluate stress levels among the health care workers (HCWs) of the radiation oncology community in Asian countries.

METHODS

HCWs of the radiation oncology departments from 29 tertiary cancer care centers of Bangladesh, India, Indonesia and Nepal were studied from May 2020 to July 2020. A total of 758 eligible HCWs were identified. The 7-Item Generalized Anxiety Disorder, 9-Item Patient Health Questionnaire, and 22-Item Impact of Events Scale-Revised were used for assessing anxiety, depression, and post-traumatic stress disorder. Univariate and multivariate analysis was done to identify the causative factors affecting mental health.

RESULTS

A total of 758 participants from 794 HCWs were analyzed. The median age was 31 years (IQR, 27-28). The incidence of moderate to severe levels of anxiety, depression, and stress was 34.8%, 31.2%, and 18.2%, respectively. Severe personal concerns were noticed by 60.9% of the staff. On multivariate analysis, the presence of commonly reported symptoms of COVID-19 during the previous 2 weeks, contact history (harzard ratio [HR], 2.04; CI, 1.15 to 3.63), and compliance with precautionary measures (HR, 1.69; CI, 1.19 to 2.45) for COVID-19 significantly predicted for increasing anxiety (HR, 2.67; CI, 1.93 to 3.70), depression (HR, 3.38; CI 2.36 to 4.84), and stress (HR, 2.89; CI, 1.88 to 4.43) (P < .001). A significant regional variation was also noticed for anxiety, stress, and personal concerns.

CONCLUSION

This survey conducted during the COVID-19 pandemic revealed that a significant proportion of HCWs in the radiation oncology community experiences moderate to severe levels of anxiety, depression, and stress. This trend is alarming and it is important to identify and intervene at the right time to improve the mental health of HCWs to avoid any long-term impacts.

Prevalence of anxiety in health care professionals during the COVID-19 pandemic: A rapid systematic review (on published articles in Medline) with meta-analysis

During the COVID-19, healthcare workers are exposed to a higher risk of mental health problems, especially anxiety symptoms. The current work aims at contributing to an update of anxiety prevalence in this population by conducting a rapid systematic review and meta-analysis. Medline and Pubmed were searched for studies on the prevalence of anxiety in health care workers published from December 1, 2019 to September 15, 2020. In total, 71 studies were included in this study. The pooled prevalence of anxiety in healthcare workers was 25% (95% CI: 21%-29%), 27% in nurses (95% CI: 20%-34%), 17% in medical doctors (95% CI: 12%-22%) and 43% in frontline healthcare workers (95% CI: 25%-62%). Our results suggest that healthcare workers are experiencing significant levels of anxiety during the COVID-19 pandemic, especially those on the frontline and nurses. However, international longitudinal studies are needed to fully understand the impact of the pandemic on healthcare workers' mental health, especially those working at the frontline.

Women in healthcare experiencing occupational stress and burnout during COVID-19: a rapid review

Context

COVID-19 has had an unprecedent impact on physicians, nurses and other health professionals around the world, and a serious healthcare burnout crisis is emerging as a result of this pandemic.

Objectives

We aim to identify the causes of occupational stress and burnout in women in medicine, nursing and other health professions during the COVID-19 pandemic and interventions that can support female health professionals deal with this crisis through a rapid review.

Methods

We searched MEDLINE, Embase, CINAHL, PsycINFO and ERIC from December 2019 to 30 September 2020. The review protocol was registered in PROSPERO and is available online. We selected all empirical studies that discussed stress and burnout in women healthcare workers during the COVID-19 pandemic.

Results

The literature search identified 6148 citations. A review of abstracts led to the retrieval of 721 full-text articles for assessment, of which 47 articles were included for review. Our findings show that concerns of safety (65%), staff and resource adequacy (43%), workload and compensation (37%) and job roles and security (41%) appeared as common triggers of stress in the literature.

Conclusions and relevance

The current literature primarily focuses on self-focused initiatives such as wellness activities, coping strategies, reliance of family, friends and work colleagues to organisational-led initiatives such as access to psychological support and training. Very limited evidence exists about the organisational interventions such as work modification, financial security and systems improvement.

Nurses' burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis

AIMS

To examine the nurses' burnout and associated risk factors during the COVID-19 pandemic.

DESIGN

We followed the Cochrane criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis.

DATA SOURCES

PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, CINAHL and pre-print services (medRχiv and PsyArXiv) were searched from January 1 to November 15, 2020 and we removed duplicates.

REVIEW METHODS

We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high.

RESULTS

Sixteen studies, including 18,935 nurses met the inclusion criteria. The overall prevalence of emotional exhaustion was 34.1%, of depersonalization was 12.6% and of lack of personal accomplishment was 15.2%. The main risk factors that increased nurses' burnout were the following: younger age, decreased social support, low family and colleagues readiness to cope with COVID-19 outbreak, increased perceived threat of Covid-19, longer working time in quarantine areas, working in a high-risk environment, working in hospitals with inadequate and insufficient material and human resources, increased workload and lower level of specialized training regarding COVID-19.

CONCLUSION

Nurses experience high levels of burnout during the COVID-19 pandemic, while several sociodemographic, social and occupational factors affect this burnout.

IMPACT

We found that burnout among nurses is a crucial issue during the COVID-19 pandemic. There is an urgent need to prepare nurses to cope better with COVID-19 pandemic. Identification of risk factors for burnout could be a significant weapon giving nurses and health care systems the ability to response in a better way against the following COVID-19 waves in the near future.

Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The new coronavirus disease's (COVID-19) high risk of infection can increase the workload of healthcare workers, especially nurses, as they are most of the healthcare workforce. These problems can lead to psychological problems. Therefore, the aim of this systematic review and meta-analysis to ascertain the present impact of the COVID-19 outbreak on the prevalence of stress, anxiety, depression and sleep disturbance among nurses.

METHODS

A systematic review and meta-analysis were conducted. The following databases were searched: PubMed, CHINAL, MEDLINE, EMBASE, PsycINFO, MedRxiv and Google Scholar, from January 2020 up to 26th October 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics.

RESULTS

A total of 93 studies (n = 93,112), published between January 2020 and September 2020, met the inclusion criteria. The overall prevalence of stress was assessed in 40 studies which accounted for 43% (95% CI 37-49). The pooled prevalence of anxiety was 37% (95% CI 32-41) in 73 studies. Depression was assessed in 62 studies, with a pooled prevalence of 35% (95% CI 31-39). Finally, 18 studies assessed sleep disturbance and the pooled prevalence was 43% (95% CI 36-50).

CONCLUSION

This meta-analysis found that approximately one third of nurses working during the COVID-19 epidemic were suffering from psychological symptoms. This highlights the importance of providing comprehensive support strategies to reduce the psychological impact of the COVID-19 outbreak among nurses under pandemic conditions. Further longitudinal study is needed to distinguish of psychological symptoms during and after the infectious disease outbreaks.

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

Objective: Health-care workers (HCW) are at risk for psychological distress during an infectious disease outbreak, such as the coronavirus pandemic, due to the demands of dealing with a public health emergency. This rapid systematic review examined the factors associated with psychological distress among HCW during an outbreak. Method: We systematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCW during an outbreak (COVID-19, SARS, MERS, H1N1, H7N9, and Ebola). Four electronic databases were searched (2000 to 15 November 2020) for relevant peer-reviewed research according to a pre-registered protocol. A narrative synthesis was conducted to identify fixed, modifiable, and infection-related factors linked to distress and psychiatric morbidity. Results: From the 4,621 records identified, 138 with data from 143,246 HCW in 139 studies were included. All but two studies were cross-sectional. The majority of the studies were conducted during COVID-19 (k = 107, N = 34,334) and SARS (k = 21, N = 18,096). Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk of contact with infected patients, and experiencing quarantine, were risk factors for psychological distress among HCW. Personal and organizational social support, perceiving control, positive work attitudes, sufficient information about the outbreak and proper protection, training, and resources, were associated with less psychological distress. Conclusions: This review highlights the key factors to the identify HCW who are most at risk for psychological distress during an outbreak and modifying factors to reduce distress and improve resilience. Recommendations are that HCW at risk for increased distress receive early interventions and ongoing monitoring because there is evidence that HCW distress can persist for up to 3 years after an outbreak. Further research needs to track the associations of risk and resilience factors with distress over time and the extent to which certain factors are inter-related and contribute to sustained or transient distress.