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Silverman ME, Nag S, Kalishman A, Cox PH, Mitroff SR. Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1466-1472. [PMID: 35658099 DOI: 10.1080/07448481.2022.2080507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The long-term consequences of the COVID-19 pandemic on college students' mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points. PARTICIPANTS Undergraduate college students (N = 524) who volunteered for course credit. METHODS Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts. RESULTS Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility. CONCLUSIONS Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.
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Affiliation(s)
| | - Samoni Nag
- The George Washington University, Washington, DC, USA
| | | | - Patrick H Cox
- The George Washington University, Washington, DC, USA
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2
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Meher K, Mushtaq M, Fatima S. Death Anxiety and WellBeing in Doctors During COVID-19: The Explanatory and Boosting Roles of Sleep Quality and Work Locality. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:667-682. [PMID: 35331036 PMCID: PMC8958309 DOI: 10.1177/00302228221078074] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic, a global public health crisis, has triggered anxiety and fear of death in general public and particularly among health professionals. This study aimed to assess the direct and mediated associations between death anxiety, sleep quality, and subjective wellbeing in doctors working during the pandemic. A secondary aim was tested to analyze the interactive role of workplace locality in these associations. An indirect-effect model was tested on a sample of 244 doctors working during the pandemic. Findings revealed that the association between death anxiety and subjective wellbeing was mediated through sleep quality. Furthermore, death anxiety significantly and negatively predicted subjective wellbeing in doctors working in rural setups compared to those working in urban setups. The theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Komal Meher
- Riphah Institute of Clinical and Professional Psychology, RIPHAH International University, Lahore Campus, Pakistan
| | - Mamoona Mushtaq
- Higher Education Department, Riphah Institute of Clinical and Professional Psychology, RIPHAH International University, Lahore, Pakistan
| | - Shameem Fatima
- Department of Humanities, COMSATS University Islamabad, Lahore
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McCall RK, Al-Sinawi H, Al-Kharusi N, Al Rawahi S, Al Balushi R, Al-Lawati N, Rizzo M, Al-Rasadi K, Al Maniri A. Retrospective study on the emotional status of healthcare workers in a COVID-19 field hospital in Oman. Front Public Health 2024; 12:1339703. [PMID: 38835615 PMCID: PMC11149611 DOI: 10.3389/fpubh.2024.1339703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/30/2024] [Indexed: 06/06/2024] Open
Abstract
Overview To combat the overwhelming demand for medical services and care during the COVID-19 Pandemic, the Sultanate of Oman launched the COVID-19 Field Hospital in 2020, designed to respond and alleviate the burden on the medical infrastructure. Several studies globally and from the Middle East suggested that frontline healthcare workers (HCW) were at risk of developing markers of psychological distress. It was further understood through research findings that HCW were resilient during times of crisis. However, there is a dearth in studies evaluating the emotional status of frontline HCW posted in the COVID-19 field hospitals in Gulf Countries, including Oman. This study attempts to shed light on the emotional status of HCW that were on the frontlines in the field hospital in the Sultanate of Oman. Aim This study aims to quantify and evaluate the emotional status of HCW in the frontline field hospital by screening for symptoms of depression, anxiety, and sleep quality. Method The data was collected by a local private mental healthcare facility as part of digital feedback to design and implement supportive strategies. Data was collected between September 2021 and October 2021 from 121 HCW in the COVID-19 Field hospital in Oman via 'WhatsApp'. Results Chi square and binary logistic regression tests were administered to evaluate the data. The participants comprised of 63.6% females and 79.3% were between 30 and 39 years of age. Majority of the participants (65.2%) described themselves as 'financially unstable' and possess an average of 7.5 years of work experience. Of the participants 73.6% of the HCW were based solely in the field hospital for 6-9 months at the time of the survey. Majority of the participants denied the presence of emotional distress expressed through depression (92.6%), anxiety (92.6%) and poor quality of sleep (59.5%). Conclusion The findings of the present study reflect the HCW ability to cope during challenging situations likely owing to a variety of environmental, social and personal protective factors. The findings of this study can translate into further research on identifying and addressing stressors and targeting the enhancement of protective factors to safeguard the well-being of HCW.
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Affiliation(s)
| | - Hamed Al-Sinawi
- Al Harub Medical Center, Muscat, Oman
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Sulaiman Al Rawahi
- PDO Clinic, Corporate Health & Safety, MSEM, Petroleum Development of Oman, Muscat, Oman
| | | | | | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Palermo, Italy
| | - Khalid Al-Rasadi
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
- Medical Research Centre, Sultan Qaboos University, Muscat, Oman
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Baatiema L, de-Graft Aikins A, Koram KK, Kunfah SMP, Allen LN, Abimbola S, Kruk M. Frontline health workers' experiences of providing care for people living with non-communicable diseases during the COVID-19 pandemic in Ghana: a qualitative study. BMJ Open 2024; 14:e078957. [PMID: 38719303 PMCID: PMC11086292 DOI: 10.1136/bmjopen-2023-078957] [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: 08/17/2023] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted frontline health workers. However, a neglected dimension of this discourse was the extent to which the pandemic impacted frontline healthcare workers providing non-communicable diseases (NCDs) care. This study aims to understand the experiences of healthcare workers with no prior exposure to pandemics who provided care to people living with NCDs (PLWNCDs). METHODS A qualitative study design was employed, using a face-to-face in-depth interviews. Interviews were conducted in primary healthcare facilities in three administrative regions of Ghana, representing the Northern, Southern and Middle Belts. Only frontline health workers with roles in providing care for PLWNCDs were included. Purposive snowballing and convenience sampling methods were employed to select frontline health workers. An open-ended interview guide was used to facilitate data collection, and thematic content analysis was used to analyse the data. RESULTS A total of 47 frontline health workers were interviewed. Overall, these workers experienced diverse patient-driven and organisational challenges. Patient-level challenges included a decline in healthcare utilisation, non-adherence to treatment, a lack of continuity, fear and stigma. At the organisational levels, there was a lack of medical logistics, increased infection of workers and absenteeism, increased workload and burnout, limited motivational packages and inadequate guidelines and protocols. Workers coped and responded to the pandemic by postponing reviews and consultations, reducing inpatient and outpatient visits, changing their prescription practices, using teleconsultation and moving to long-shift systems. CONCLUSION This study has brought to the fore the experiences that adversely affected frontline health workers and, in many ways, affected the care provided to PLWNCDs. Policymakers and health managers should take these experiences into account in plans to mitigate the impact of future pandemics.
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Affiliation(s)
- Leonard Baatiema
- School of Public Health, University of Ghana, Accra-Legon, Ghana
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Kwadwo K Koram
- Epidemiology, University of Ghana Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | - Luke N Allen
- Center for Global Primary Care, University of Oxford, Oxford, UK
| | - Seye Abimbola
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Kruk
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Ferrera D, Galán D, Peláez I, Carpio A, Martín-Buro MC, Mercado F. Long-term findings on working memory neural dynamics in healthcare workers after mild COVID-19. Clin Neurophysiol 2024; 161:40-51. [PMID: 38447493 DOI: 10.1016/j.clinph.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/27/2023] [Accepted: 01/19/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Understanding the long-term impact of Coronavirus Disease 2019 (COVID-19) on cognitive function, even in mild cases, is critical to the well-being of individuals, especially for healthcare workers who are at increased risk of exposure to the virus. To the best of our knowledge, the electrophysiological activity underlying cognitive functioning has not yet been explored. METHODS Seventy-seven healthcare workers took part in the study (43 with mild infection about one year before the study and 34 uninfected). To assess cognitive status, event-related potentials (ERPs) and behavioural responses were recorded while participants performed a working memory task. RESULTS COVID-19 participants exhibited a distinct neural pattern with lower parieto-occipital N1 amplitudes and higher frontal P2 amplitudes as compared to non-infected healthcare workers. We found no behavioural differences (reaction times and error rates) in working memory functioning between groups. CONCLUSIONS This neural pattern suggests the presence of a decrement of processing resources linked to the encoding of sensory information (N1), followed by the enhanced of the P2 response which could be interpreted as the activation of compensation mechanism in COVID-19 participants. SIGNIFICANCE The current findings point out that ERPs could serve as valuable neural indices for detecting distinctive patterns in working memory functioning of COVID-19 participants, even in mild cases. However, further research is required to precisely ascertain the long-term cognitive effects of COVID-19 beyond one-year post-infection.
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Affiliation(s)
- David Ferrera
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Diego Galán
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Irene Peláez
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Alberto Carpio
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - María Carmen Martín-Buro
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Francisco Mercado
- Department of Psychology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain; Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
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Parsons JA, Romanis EC. "All hands on deck": a qualitative study of safeguarding and the transition to telemedical abortion care in England and Wales. Soc Sci Med 2024; 348:116835. [PMID: 38626482 DOI: 10.1016/j.socscimed.2024.116835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/12/2024] [Accepted: 03/25/2024] [Indexed: 04/18/2024]
Abstract
The COVID-19 pandemic raised significant challenges for in-person healthcare provision, leading healthcare providers to embrace digital health like never before. Whilst changes were made as part of a public health response, many have now become permanent fixtures of the healthcare landscape, significantly altering the way care is provided not only for patients, but also for the healthcare professionals that provide care. In abortion care in England and Wales, previously stringent regulations on in-person care provision were relaxed to permit the use of telemedicine and self-administration of medications at home. These changes have since been made permanent. However, there remains opposition to remote abortion care pathways on the basis of safeguarding. Opponents argue that it is not feasible to effectively safeguard patients accessing abortion care remotely. We conducted a qualitative study using semi-structured interviews with abortion care providers in England and Wales. Participants were asked about their views and experiences of the transition to remote care provision, with a particular focus on how they adapted their safeguarding practice. In this article, we present three themes that highlight the changing roles of healthcare professionals in abortion care: (1) a challenging backdrop and resulting apprehension, (2) adaptive practices, and (3) the continued importance of professional curiosity. Across all three themes, participants reflected significantly on how changes were made and what they experienced in the period of transition to telemedicine. In particular, they discussed the changing nature of their professional roles amidst digitalisation. Our findings provide a basis for reflection on the increasing introduction of digital approaches to healthcare provision, highlighting points for caution and emphasising the need to involve professionals in the transition process to ensure vital buy-in. Through this, we articulate two novel understandings of digitalisation: (1) the impact of speed-associated pressures on professional adaptation during digitalisation, and (2) off-proforma safeguarding through telemedicine as a form of invisible non-routine work.
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Affiliation(s)
- Jordan A Parsons
- Birmingham Medical School, University of Birmingham, Birmingham, B15 2TT, UK; Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.
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Bourassa KA, Rohr JC, Bartek N, Miller SM, Jones Wood S, Vasquez NN, Head J, Robert-Ibarra S, Moore K, Marder K, Freeland D, Matthews L, Weinstein BL, Madan A. A Comprehensive Approach to Addressing the Burnout Crisis Among US Health Care Workers: The Houston Methodist Experience. J Psychiatr Pract 2024; 30:192-199. [PMID: 38819243 DOI: 10.1097/pra.0000000000000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Health care workers experience high rates of burnout and psychiatric distress. A large health care system in the southwest United States developed a comprehensive mental health service model for employees. Services offered range from traditional benefits (eg, Employee Assistance Program), resiliency and well-being initiatives, and innovative technology solutions, to access to peer support services for professional practice issues. The latest innovation in services is a free, self-insured outpatient mental health clinic designed exclusively for health care workers and their dependents. In this article, the authors describe the development of expanded mental health programming for health care workers and discuss how this unique service model proactively reduces common barriers to the receipt of high-quality care. This approach to caring for the workforce may serve as a model for other health care organizations across the United States. By providing mental health support to employees, health care organizations are mitigating the risk of burnout and related consequences to the system.
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Affiliation(s)
- Katelynn A Bourassa
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - Jessica C Rohr
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - Nicole Bartek
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - Susan M Miller
- Houston Methodist Academic Institute, Houston Methodist Research Institute, Department of Medicine, Houston Methodist, Houston, TX
| | | | - Namrata N Vasquez
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - John Head
- Department of Psychiatry and Behavioral Health and Center for Performing Arts Medicine, Houston Methodist, Houston, TX
| | | | - Kula Moore
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - Kate Marder
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - Diana Freeland
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX
| | - Laura Matthews
- Department of Psychiatry and Behavioral Health and Houston Methodist Physician Organization, Houston Methodist, Houston, TX
| | | | - Alok Madan
- Department of Psychiatry and Behavioral Health, Houston Methodist, Houston Methodist Academic Institute, Houston Methodist Research Institute, Houston, TX
- Department of Psychiatry, Weill Cornell Medical College, New York, NY
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Barros C, Baylina P. Disclosing Strain: How Psychosocial Risk Factors Influence Work-Related Musculoskeletal Disorders in Healthcare Workers Preceding and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:564. [PMID: 38791779 PMCID: PMC11121486 DOI: 10.3390/ijerph21050564] [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: 01/24/2024] [Revised: 04/19/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
Healthcare workers, particularly nurses, engage in a daily work routine that takes a toll on their emotional well-being, rendering them vulnerable to psychosocial risk factors. This research seeks to analyse the influence of psychosocial risk factors on the occurrence of work-related musculoskeletal disorders among nurses. An additional analysis was performed to understand the role of age in work-related musculoskeletal disorders and the perception of psychosocial risk factors. The study was conducted during two separate periods-pre-pandemic and pandemic times-involving a sample of 456 nurses from both public and private hospitals in Portugal. The INSAT-Health and Work Survey-was used as measuring instrument. The primary observations indicated a consistency between psychosocial risk factors and the occurrence of work-related musculoskeletal disorders. The findings revealed a significant exposure to psychosocial risk factors, with work pace, intensity, work relationships, and emotional demands exhibiting higher global average percentages during both periods, pre-pandemic and pandemic. Nonetheless, we find that the psychosocial risk factors change when we analyse the pre-pandemic and pandemic results. During the period before the pandemic, the psychosocial risk factors that were most commonly reported included the demanding pace of work, long working hours, and emotional demands. Through the pandemic, the most pronounced psychosocial risk factors were work relationships, employment relationships, and ethical and values conflicts. Therefore, research in this domain is essential to understanding psychosocial risk factors and assessing the less obvious links between work and health.
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Affiliation(s)
- Carla Barros
- Faculty of Human and Social Sciences, University Fernando Pessoa, RISE-UFP, FP-I3ID, 4249-004 Porto, Portugal
| | - Pilar Baylina
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal;
- School of Medicine and Biomedical Sciences, University Fernando Pessoa, 4249-004 Porto, Portugal
- RISE-UFP, University Fernando Pessoa, 4249-004 Porto, Portugal
- I3S—Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal
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Han SJ, Hong HJ, Shin BS. Korean Hospital Nurses' Experiences with COVID-19: A Meta-Synthesis of Qualitative Findings. Healthcare (Basel) 2024; 12:903. [PMID: 38727460 PMCID: PMC11083708 DOI: 10.3390/healthcare12090903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
This study aims to provide a meta-synthesis of qualitative studies examining the perceptions and experiences of nurses who cared for patients in dedicated COVID-19 hospitals in South Korea. We searched key health databases (RISS, KISS, KMbase, NDSL, KoreaMed, DBpia, PubMed, CINAHL, and Cochrane) from September to November 2023. We reviewed and analyzed articles using a thematic synthesis approach. The quality of the studies was ascertained using the Critical Appraisal Skills Program checklist for qualitative research. Ultimately, 13 studies involving 219 nurses were included in the final review. Six major themes and thirteen subthemes emerged. During the unexpected COVID-19 pandemic, nurses were able to overcome difficult situations through their interactions with patients, sense of a professional mission, and commitment to nursing. Most importantly, they persevered through their collaboration and closeness with fellow nurses, despite confusion about their professional identity, the ethical dilemmas they faced in patient care, and the conflicting attitudes of their social support system. To prepare for future infectious disease outbreaks, a multifaceted support system should be established to enable nurses to have positive interactions with their families, colleagues, and patients, which have become central to their resilience.
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Affiliation(s)
- Suk-Jung Han
- College of Nursing, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Hee-Jung Hong
- Department of Nursing, Severance Hospital, Seoul 03722, Republic of Korea
| | - Bok-Soon Shin
- College of Nursing, Inha University, Incheon 22212, Republic of Korea;
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Kiwanuka SN, Babirye Z, Kabwama SN, Tusubira AK, Kizito S, Ndejjo R, Bosonkie M, Egbende L, Bondo B, Mapatano MA, Seck I, Bassoum O, Leye MM, Diallo I, Fawole OI, Bello S, Salawu MM, Bamgboye EA, Dairo MD, Adebowale AS, Afolabi RF, Wanyenze RK. Health workforce incentives and dis-incentives during the COVID-19 pandemic: experiences from Democratic Republic of Congo, Nigeria, Senegal, and Uganda. BMC Health Serv Res 2024; 24:422. [PMID: 38570839 PMCID: PMC10993439 DOI: 10.1186/s12913-024-10822-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic presented a myriad of challenges for the health workforce around the world due to its escalating demand on service delivery. A motivated health workforce is critical to effectual emergency response and in some settings, incentivizing health workers motivates them and ensures continuity in the provision of health services. We describe health workforce experiences with incentives and dis-incentives during the COVID-19 response in the Democratic Republic of Congo (DRC), Senegal, Nigeria, and Uganda. METHODS This is a multi-country qualitative research study involving four African countries namely: DRC, Nigeria, Senegal, and Uganda which assessed the workplace incentives instituted in response to the COVID-19 pandemic. Key informant interviews (n = 60) were conducted with staff at ministries of health, policy makers and health workers. Interviews were virtual using the telephone or Zoom. They were audio recorded, transcribed verbatim, and analyzed thematically. Themes were identified and quotes were used to support findings. RESULTS Health worker incentives included (i) financial rewards in the form of allowances and salary increments. These motivated health workers, sustaining the health system and the health workers' efforts during the COVID-19 response across the four countries. (ii) Non-financial incentives related to COVID-19 management such as provision of medicines/supplies, on the job trainings, medical care for health workers, social welfare including meals, transportation and housing, recognition, health insurance, psychosocial support, and supervision. Improvised determination and distribution of both financial and non-financial incentives were common across the countries. Dis-incentives included the lack of personal protective equipment, lack of transportation to health facilities during lockdown, long working hours, harassment by security forces and perceived unfairness in access to and inadequacy of financial incentives. CONCLUSION Although important for worker motivation, financial and non-financial incentives generated some dis-incentives because of the perceived unfairness in their provision. Financial and non-financial incentives deployed during health emergencies should preferably be pre-determined, equitably and transparently provided because when arbitrarily applied, these same financial and non-financial incentives can potentially become dis-incentives. Moreover, financial incentives are useful only as far as they are administered together with non-financial incentives such as supportive and well-resourced work environments. The potential negative impacts of interventions such as service delivery re-organization and lockdown within already weakened systems need to be anticipated and due precautions exercised to reduce dis-incentives during emergencies.
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Affiliation(s)
- Suzanne N Kiwanuka
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda.
| | - Ziyada Babirye
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
| | - Steven N Kabwama
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
| | - Andrew K Tusubira
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
| | - Susan Kizito
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
| | - Rawlance Ndejjo
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
| | - Marc Bosonkie
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Landry Egbende
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Berthold Bondo
- Barumbu General Referral Hospital, Kinshasa, Democratic Republic of Congo
| | - Mala Ali Mapatano
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Ibrahima Seck
- The Cheikh-Anta-Diop University (UCAD), Dakar, Senegal
| | - Oumar Bassoum
- The Cheikh-Anta-Diop University (UCAD), Dakar, Senegal
| | | | | | - Olufunmilayo I Fawole
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Segun Bello
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mobolaji M Salawu
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Eniola A Bamgboye
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Ayo Steven Adebowale
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rotimi F Afolabi
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rhoda K Wanyenze
- Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
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Abdelaliem SMF, Saed Boswihi HS. Nurses' comfort and well-being: A descriptive study to find out the relationship between nurses' awareness of self-comfort and well-being at long-term care settings in the state of Kuwait. Medicine (Baltimore) 2024; 103:e37479. [PMID: 38518014 PMCID: PMC10957015 DOI: 10.1097/md.0000000000037479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/13/2024] [Indexed: 03/24/2024] Open
Abstract
The study aims to examine out nurses' awareness of self-comfort and well-being in long-term care settings in the state of Kuwait to avoid profession burnout. Nurses are vital resource to health care institutions, the attention on nurses' comfort and well-being should be given valued concerns by top management, as poor staff well-being can pose risks among them and may result in poor performance such as less quality care that is result from less productivity and if the staff well-being ignored the institution performance might be underachieved. A descriptive cross-sectional study design was utilized. The questionnaire assessed participants' socio-demographic data, comfort, and well-being. Data were collected from 260 (86.7% response rate) nurses over the course of 3 months from long-term care facilities in 2 different organizations in Kuwait. The overall nurses' comfort level was moderate with a mean percent score of 67.55 ± 12.50. However, the overall nurses' well-being level was low with a mean percent score of 49.58 ± 6.93. As well as, a strong, positive, and significant correlation was noticed between overall nurses' comfort and its domains with the overall nurses' well-being and its domain. The regression analysis revealed that nurses' perception of their comfort may predict their well-being (P < .001) and explained 34% of the variation in nurses' well-being (R2 = 0.470, β = 0.428, F = 34.762, P < .001). This study emphasized on the importance of creating a healthy, comfortable work environment that promotes nurses' well-being, as well as eliminating discomfort and job dissatisfaction from the organizational culture among nurses as it effects on the organizational performance, productivity, and quality of care.
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Affiliation(s)
- Sally Mohammed Farghaly Abdelaliem
- Nursing Management and Education Department, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Faculty of Nursing, Nursing Administration Department, Alexandria University, Alexandria, Egypt
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12
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Zeraatkhah H, Alavi NM, Ziabakhsh H, Mahdaviasl Z. Prevalence and characters of post-acute COVID-19 syndrome in healthcare workers in Kashan/Iran 2023: a cross-sectional study. BMC Nurs 2024; 23:186. [PMID: 38509550 PMCID: PMC10953126 DOI: 10.1186/s12912-024-01733-2] [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: 08/19/2023] [Accepted: 01/12/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Post-acute COVID-19 syndrome that is called long COVID-19 consists of the symptoms that last more than 12 weeks with no other explanation. The present study aimed to determine the prevalence, frequency of symptoms, and risk factors of long COVID-19 in the healthcare workers (HCWs) of a selected hospital in Kashan/Iran in 2023. METHODS A total of 350 HCWs with a history of COVID-19 infection were randomly recruited to the study from February to May 2023. Participants completed a questionnaire including demographic characteristics, information related to COVID-19 infection, underlying diseases, and a checklist of long COVID-19 symptoms. Mann‒Whitney U test, chi-square test, T‒tests, and binary logistic regression were used for data analysis by SPSS 16. RESULTS The results showed that 75.7% of HCWs experienced symptoms of long COVID-19. The most common symptoms were fatigue (53.1%), cough (43.1%) and muscle weakness (37.1%). In bivariate analysis job title, body mass index (BMI), frequency and number of symptoms of COVID-19 infection, preexisting disease, tobacco use, age, and years of experience showed a significant statistical association with long COVID-19. In binary logistic regression the number of symptoms during COVID-19 infection, nursing occupation, use of corticosteroids, and symptoms of dyspnea and loss of taste could explain the occurrence of long COVID-19. CONCLUSION The long COVID-19 is a prevalent condition among HCWs especially nurses. Symptoms of long COVID-19 such as fatigue and cough can persists over time. This chronic condition has significant associations with different clinical risk factors.
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Affiliation(s)
- Hamidreza Zeraatkhah
- Department of Medical Surgical and Geriatric Nursing, Kashan University of medical Science, Kashan, Iran
| | - Negin Masoudi Alavi
- Trauma Nursing Research Center, Department of Medical Surgical and Geriatric Nursing, Kashan University of medical science, Kashan, Iran.
- Kashan Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Ghotb Ravandi Highway, Kashan, Iran.
| | - Hanieh Ziabakhsh
- Department of Medical Surgical and Geriatric Nursing, Kashan University of medical Science, Kashan, Iran
| | - Zahra Mahdaviasl
- Department of Medical Surgical and Geriatric Nursing, Kashan University of medical Science, Kashan, Iran
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13
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Almutairi AF, Hamdan NA, Altheyabi S, Alsaeed EA, Alammari FS, BaniMustafa A. The Prevalence and Associated Factors of Occupational Stress in Healthcare Providers in Saudi Arabia. Int J Gen Med 2024; 17:809-816. [PMID: 38476624 PMCID: PMC10929258 DOI: 10.2147/ijgm.s446410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/31/2024] [Indexed: 03/14/2024] Open
Abstract
Background Occupational stress is a negative physical and emotional response to job requirements, which might be caused by various factors that can harm the emotional and physical well-being of the employee. We aimed to investigate the factors and conditions associated with occupational stress. Study Design The study was cross-sectional, conducted with the Perceived Stress Scale ten item version. Results The majority of the participants reported moderate stress 223 (71%) and a small proportion (n=38, 12.2%) a high stress level. Several factors associated with higher risk of stress level for example being single were associated with higher risk of stress level in 135 (74.6%), moderate and high stress level was also reported in the group without enough income, 96 (75%) and 20 (15.6%), respectively. Conclusion A group of sociodemographic factors were consistently associated with occupational stress, including gender, income, comorbidity and marital status. However, some factors remained complex and multifaceted. Recommendation It is important to focus on reducing stress levels for all employees, regardless of their work experience or income. To prevent losing control of the healthcare worker's stress and to prevent an escalation to anxiety or depression, stress-management programs are necessary, specifically for those who are experiencing high stress levels.
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Affiliation(s)
- Adel F Almutairi
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Saud Altheyabi
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Faisal S Alammari
- College of Dentistry, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ala’a BaniMustafa
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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14
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Mulondo M, Ndlovu S, Ndirangu J, Tsoka-Gwegweni J. Mental health impact of COVID-19 on healthcare workers versus adults in Africa. Afr J Prim Health Care Fam Med 2024; 16:e1-e6. [PMID: 38426784 PMCID: PMC10913132 DOI: 10.4102/phcfm.v16i1.4175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND This review mapped the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of healthcare workers (HCWs) and the adult general population in Africa. AIM The study focussed on anxiety, depression, post-traumatic stress disorder and suicide cases to determine the impact of COVID-19 on the mental health of the selected population. METHOD A scoping review was conducted on relevant database and search engines. The search resulted in 143 studies. Five studies met the inclusion criteria for synthesis. RESULTS Results indicated anxiety was more prevalent among HCWs as opposed to the adult general population, which was in the rise of suicide cases. Among HCWs, mental health was negatively impacted by the loss of their infected patients and concerns over infecting family members. The adult general population was impacted because of isolation and their fear of contracting the virus. CONCLUSION The COVID-19 pandemic led to the increase of mental health issues among HCWs as evidenced by a high prevalence of anxiety compared to that of the adult general population. There was, however, a rise in depression and suicide cases among the adult general population.Contribution: This study will assist in adding more knowledge to build a robust and responsive strategy to mental health problems during and post-pandemics like COVID-19. Strategies that have appeared effective in combatting the impact of COVID-19 on mental health include support packages established for frontline HCWs such as social media online chat groups.
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Affiliation(s)
- Mutshidzi Mulondo
- Department of Public Health, Faculty of Health Sciences, University of the Free State, Bloemfontein.
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15
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Dilokpattanamongkol P, Yan C, Jayanama K, Ngamjanyaporn P, Sungkanuparph S, Rotjanapan P. Impact of vitamin D supplementation on the clinical outcomes of COVID-19 pneumonia patients: a single-center randomized controlled trial. BMC Complement Med Ther 2024; 24:97. [PMID: 38383361 PMCID: PMC10880207 DOI: 10.1186/s12906-024-04393-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Vitamin D supplementation for infectious diseases has been discussed, but its role in COVID-19 is unclear. Therefore, this study examined the clinical outcomes of COVID-19 pneumonia patients who received vitamin D supplementation. METHODS This prospective, open-label, randomized controlled trial was conducted in a university hospital between July 2020 and March 2022. The inclusion criteria were patients aged ≥ 18 years with COVID-19 pneumonia patients. The patients were randomized into two groups: an intervention group receiving vitamin D supplementation (alfacalcidol, two mcg orally daily) until discharge and a control group. The clinical outcomes were pneumonia treatment duration, length of hospital stay, and change in pneumonia severity index between enrollment and discharge. Subgroup analysis was conducted for supplemental oxygen use, high-dose corticosteroid administration, evidence of lymphopenia, C-reactive protein concentration, and total serum vitamin D concentration. Adverse events were monitored. RESULTS Two hundred ninety-four patients were recruited (147 per group). The two groups did not differ in pneumonia treatment duration to discharge (p = 0.788) or length of hospital stay (p = 0.614). The reduction in the pneumonia severity index between enrollment and discharge was more significant in the intervention group (p = 0.007); a significant decrease was also observed among patients who had C-reactive protein > 30 mg/L (p < 0.001). No adverse reactions were recorded. CONCLUSIONS Adding active vitamin D to standard treatment may benefit COVID-19 pneumonia patients who require supplemental oxygen or high-dose corticosteroid therapy or who have high C-reactive protein concentrations (> 30 mg/L) upon treatment initiation. TRIAL REGISTRATION Thai Clinical Trials Registry TCTR20210906005 (retrospectively registered, 6 September 2021).
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Affiliation(s)
| | - Chadakan Yan
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kulapong Jayanama
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Pintip Ngamjanyaporn
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Somnuek Sungkanuparph
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Porpon Rotjanapan
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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16
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Ramlagan S, Sewpaul R, Shean Y, Schmidt T, North A, Reddy SP. Psychological distress among South African healthcare workers during the COVID-19 pandemic. Curationis 2024; 47:e1-e12. [PMID: 38426792 PMCID: PMC10912894 DOI: 10.4102/curationis.v47i1.2477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). OBJECTIVES This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. METHOD The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. RESULTS A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. CONCLUSION Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs.Contribution: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.
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Affiliation(s)
- Shandir Ramlagan
- Department of Human and Social Capabilities, Human Sciences Research Council, Pretoria.
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17
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Zhang M, Bo M, Wang H, Fan W, Kong L, Zhou C, Zhang Z. Prevalence and influencing factors of post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1323111. [PMID: 38425999 PMCID: PMC10902088 DOI: 10.3389/fpsyt.2024.1323111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic. Aims To estimate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among Chinese healthcare workers during COVID-19. Methods Search of Chinese and English literature in PubMed, EMbase, Web of Science, Medline, Elsevier, SpringerLink, China Biomedical Literature Database, CNKI, Wan-fang, and CQVIP for the period from December 2019 to August 2023. Stata 14.0 software was used for data analysis. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the Random-effects model. Publication bias was evaluated using Egger's test and Begg's test. Results Twenty-one studies included 11841 Chinese healthcare workers in this review. First, the overall prevalence of Post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic was 29.2% (95% CI: 20.7% to 33.7%). Twelve factors included in the meta-analysis were found to be protective against PTSD among Chinese healthcare workers: female, nurse, married, front-line work, less work experience, family or friend diagnosed with COVID-19, history of chronic disease and fear of COVID-19. Conversely, outside Hubei, higher education, social support and psychological resilience are protective factors. Conclusion These recent findings increase our understanding of the psychological status of Chinese healthcare workers and encourage that long-term monitoring and long-term interventions should be implemented to improve the mental health of Chinese healthcare workers in the aftermath of the COVID-19.
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Affiliation(s)
- Min Zhang
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Mingyu Bo
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Huixin Wang
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Wenyi Fan
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Lingling Kong
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong, China
| | - Chunjie Zhou
- School of Information and Electrical Engineering, Ludong University, Yantai, Shandong, China
| | - Zhenxing Zhang
- School of Information and Electrical Engineering, Ludong University, Yantai, Shandong, China
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D’Alessandro-Lowe AM, Patel H, Easterbrook B, Ritchie K, Brown A, Xue Y, Karram M, Millman H, Sullo E, Pichtikova M, Nicholson A, Heber A, Malain A, O’Connor C, Schielke H, Rodrigues S, Hosseiny F, McCabe RE, Lanius RA, McKinnon MC. The independent and combined impact of moral injury and moral distress on post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic. Eur J Psychotraumatol 2024; 15:2299661. [PMID: 38334706 PMCID: PMC10860446 DOI: 10.1080/20008066.2023.2299661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/04/2023] [Indexed: 02/10/2024] Open
Abstract
Background: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its relation to PTSD among HCWs. This study examined the independent and combined impact of MI and MD on PTSD symptoms in Canadian HCWs during the pandemic.Methods: HCWs participated in an online survey between February and December 2021, with questions regarding sociodemographics, mental health and trauma history (e.g. MI, MD, PTSD, dissociation, depression, anxiety, stress, childhood adversity). Structural equation modelling was used to analyze the independent and combined impact of MI and MD on PTSD symptoms (including dissociation) among the sample when controlling for sex, age, depression, anxiety, stress, and childhood adversity.Results: A structural equation model independently regressing both MI and MD onto PTSD accounted for 74.4% of the variance in PTSD symptoms. Here, MI was strongly and significantly associated with PTSD symptoms (β = .412, p < .0001) to a higher degree than MD (β = .187, p < .0001), after controlling for age, sex, depression, anxiety, stress and childhood adversity. A model regressing a combined MD and MI construct onto PTSD predicted approximately 87% of the variance in PTSD symptoms (r2 = .87, p < .0001), with MD/MI strongly and significantly associated with PTSD (β = .813, p < .0001), after controlling for age, sex, depression, anxiety, stress, and childhood adversity.Conclusion: Our results support a relation between MI and PTSD among HCWs and suggest that a combined MD and MI construct is most strongly associated with PTSD symptoms. Further research is needed better understand the mechanisms through which MD/MI are associated with PTSD.
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Affiliation(s)
| | - Herry Patel
- McMaster University, Hamilton, Ontario, Canada
| | | | - Kim Ritchie
- McMaster University, Hamilton, Ontario, Canada
- Trent University, Peterborough, Ontario, Canada
| | | | - Yuanxin Xue
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Mauda Karram
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | - Emily Sullo
- McMaster University, Hamilton, Ontario, Canada
| | - Mina Pichtikova
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Andrew Nicholson
- McMaster University, Hamilton, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- University of Western Ontario, London, Ontario, Canada
| | - Alex Heber
- McMaster University, Hamilton, Ontario, Canada
- Canadian Institute for Pandemic Health Education and Response, Regina, Saskatchewan, Canada
| | - Ann Malain
- Homewood Health Centre, Guelph, Ontario, Canada
| | | | | | - Sarah Rodrigues
- University of Ottawa, Ottawa, Ontario, Canada
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
| | - Fardous Hosseiny
- University of Ottawa, Ottawa, Ontario, Canada
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
| | - Randi E. McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Ruth A. Lanius
- University of Western Ontario, London, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | - Margaret C. McKinnon
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
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Mo D, Gluck R, Jiang F, Tao R, Geng F, Liu T, Liu Y, Liu H, Yi-Lang Tang. The association between mental health symptoms and alcohol use among Chinese psychiatrists during the early stage of the COVID-19 pandemic. Alcohol 2024; 114:1-7. [PMID: 37604320 DOI: 10.1016/j.alcohol.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/15/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023]
Abstract
AIM To investigate the association between mental health symptoms, alcohol use, and alcohol misuse among psychiatrists in China during the early stage of the COVID-19 pandemic. METHODS We conducted an online survey to collect data regarding mental health symptoms and alcohol use among psychiatrists in early 2020. The Depression Anxiety Stress Scale-Chinese Version (DASS-21) was used to assess depression, anxiety, and stress symptoms, and the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to assess alcohol use. RESULTS In total, 3774 psychiatrists completed the survey. AUDIT-C scores were positively correlated with DASS total and depression, anxiety, and stress subscales (total: r = 0.015, depression: r = 0.121, anxiety: r = 0.103, and stress: r = 0.096, all p < 0.05). Alcohol misuse was associated with male sex (OR = 4.754), cigarette smoking (OR = 2.441), administrative position (OR = 1.811), depression (OR = 1.489), and stress (OR = 1.504). Those who reported increased alcohol use during the pandemic were more likely to be male (OR = 2.174), endorse anxiety symptoms (OR = 2.386), or increased stress (OR = 2.402). CONCLUSIONS Mental health symptoms were common among psychiatrists during the COVID-19 pandemic. Depression and stress symptoms were significantly associated with alcohol misuse. Anxiety and stress symptoms were associated with reported increases in alcohol use. Though a causal relationship cannot be inferred, our findings suggest that strategies promoting healthcare professionals' mental well-being should include alcohol use.
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Affiliation(s)
- Daming Mo
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, Hefei Fourth People's Hospital, 316 Huangshan Road, Shushan District, Hefei, 230022, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Rachel Gluck
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Tao
- Department of Psychiatry, Hefei Fourth People's Hospital, 316 Huangshan Road, Shushan District, Hefei, 230022, China
| | - Feng Geng
- Department of Psychiatry, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA; Atlanta Veterans Affairs Medical Center, Decatur, GA, USA.
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Schwatka NV, Burden M, Dyrbye LN. An Organizational Leadership Development Approach to Support Health Worker Mental Health. Am J Public Health 2024; 114:142-147. [PMID: 38354347 PMCID: PMC10916722 DOI: 10.2105/ajph.2023.307407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 02/16/2024]
Affiliation(s)
- Natalie V Schwatka
- Natalie V. Schwatka is with the Center for Health, Work & Environment, Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora. Marisha Burden is with the Division of Hospital Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora. Liselotte N. Dyrbye is the senior associate dean of faculty and chief well-being officer, professor of medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Marisha Burden
- Natalie V. Schwatka is with the Center for Health, Work & Environment, Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora. Marisha Burden is with the Division of Hospital Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora. Liselotte N. Dyrbye is the senior associate dean of faculty and chief well-being officer, professor of medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Liselotte N Dyrbye
- Natalie V. Schwatka is with the Center for Health, Work & Environment, Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora. Marisha Burden is with the Division of Hospital Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora. Liselotte N. Dyrbye is the senior associate dean of faculty and chief well-being officer, professor of medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
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21
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Černe M, Aleksić D. Hidden work, frustration and multiple layers of occupational health in emergency situations: a longitudinal study during the COVID-19 pandemic. Front Psychol 2024; 14:1042397. [PMID: 38274681 PMCID: PMC10808337 DOI: 10.3389/fpsyg.2023.1042397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
This study examines the effects of the COVID-19 pandemic over time. Specifically, we derive from the organizational model of frustration to propose and test a model of pandemic-induced hidden work affecting employees' emotional responses of frustration along with behavioral responses and outcomes with respect to occupational health. We thereby develop a concept of multiple layers of occupational health that spans across stress, satisfaction with work-life balance (SWLB), burnout, subjective well-being, and physical health. Based on a longitudinal web-based survey of 198 working professionals conducted at seven points in time (1,143 data points, with 118 fully completed responses across all time points) for a wide range of industries in 2020, the study tests the proposed relationships using random coefficient modeling. The results show that COVID-19-situation-induced hidden work invokes emotional responses of frustration, which in turn influence outcomes referring to multiple layers of occupational health-positively affecting stress and burnout, and negatively influencing SWLB, subjective well-being, and physical health. Implications for research and practice are discussed.
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Affiliation(s)
| | - Darija Aleksić
- School of Economics and Business, University of Ljubljana, Ljubljana, Slovenia
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Dixit P, Srivastava SP, Tiwari SK, Chauhan S, Bishnoi R. Compassion satisfaction, burnout, and secondary traumatic stress among nurses after the second wave of the COVID-19 pandemic. Ind Psychiatry J 2024; 33:54-61. [PMID: 38853793 PMCID: PMC11155655 DOI: 10.4103/ipj.ipj_45_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 06/11/2024] Open
Abstract
Background Nurses frequently experience compassion fatigue and burnout, which impact their personal lives and patient care. The COVID-19 pandemic additionally caused stress, uncertainty, and fear of death among healthcare professionals. Aim To assess professional quality of life (ProQoL) among nurses after the second wave of the COVID-19 pandemic. Material and Methods A web-based cross-sectional study was conducted among 203 nurses using a purposive sampling technique in the month of September to December 2021. Data were collected using a self-administered ProQoL scale version 5. Statistical Analysis Descriptive and inferential statistics were used. Kolmogorov-Smirnov test, Mann-Whitney U, and Kruskal-Wallis H test were used. Bivariate correlations were used to correlate the main variables. Multiple linear regression analysis was also performed. Results The majority of the nurses reported a moderate level of compassion satisfaction (CS) (62.6%), burnout (BO) (66.0%), and secondary traumatic stress (STS) (63.1%). Residence and education emerged as a factor whether the nurses experienced BO or STS, respectively. Additionally, CS negatively correlated with BO (r = -0.732: P < 0.001) and STS (r = -0.141: p-0.04). Conclusions The majority of the nurses experienced moderate levels of CS, BO, and STS after the second wave of the COVID-19 crisis and nurse patient-ratio emerged as a significant factor to predict CS, BO, or STS. Hence, effective measures need to be implemented by hospital administration to enhance the nurses' satisfaction and reduce fatigue and burnout.
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Affiliation(s)
- Priyanshi Dixit
- Department of Nursing Services, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | | | - Surya Kant Tiwari
- Nursing Tutor, Yatharth Nursing College and Paramedical Institute, Chandauli, Uttar Pradesh, India
| | - Soni Chauhan
- Nursing Tutor, Yatharth Nursing College and Paramedical Institute, Chandauli, Uttar Pradesh, India
| | - Ravi Bishnoi
- Department of Nursing Services, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
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Agyapong-Opoku G, Agyapong B, Obuobi-Donkor G, Eboreime E. Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature. Behav Sci (Basel) 2023; 13:1002. [PMID: 38131858 PMCID: PMC10740739 DOI: 10.3390/bs13121002] [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: 11/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.
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Affiliation(s)
- Gerald Agyapong-Opoku
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Gloria Obuobi-Donkor
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada (E.E.)
| | - Ejemai Eboreime
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada (E.E.)
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Ljungberg Persson C, Nordén Hägg A, Södergård B. A survey of pharmacists' perception of the work environment and patient safety in community pharmacies during the COVID-19 pandemic. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100327. [PMID: 37780549 PMCID: PMC10534261 DOI: 10.1016/j.rcsop.2023.100327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/19/2023] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Background Community pharmacies have changed during the COVID-19 pandemic, and new routines have been introduced to address the needs of customers and staff and to reduce the risk of spreading infection. Burnout has been described among staff possibly due to a changed working climate. However, little research has focused on the pandemic's effect on patient safety in community pharmacies. Objective To examine pharmacists' perceptions of the impact of the COVID-19 pandemic on workload, working environment, and patient safety in community pharmacies. Methods A survey was distributed to all Swedish community pharmacists, constituting a census study. Questions regarding the pharmacists' perception of the impact of the pandemic on workload, working environment, and patient safety were included. Respondents were asked to provide comments on their working situation. Quantitative results were analysed using descriptive statistics, and comments were analysed using qualitative content analysis. Results The response rate was 41% (2034 responses). Most pharmacists (62%) considered the workload to be increased during the pandemic while work environment deteriorated (physical work environment was considered worse by 47% of respondents while psychosocial work environment was considered worse by 59%). Despite this, many respondents (55%) believed that patient safety was not affected. Neither having had COVID-19 nor being afraid of contracting it, influenced these perceptions in any substantial way. Findings were consistent regardless of education, professional role, number of years in community pharmacies, or special assignments in the pharmacies. According to the respondents, the communication within pharmacy companies during the pandemic was inadequate. Conclusions The impact of the pandemic on working conditions is in line with previous findings but the effect on patient safety needs further studies. The respondents felt the management had a limited understanding of the conditions during the pandemic, which stresses the importance of good and clear communication during a crisis.
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Affiliation(s)
- C. Ljungberg Persson
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - B. Södergård
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Finland
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25
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Nelson O, Greenwood E, Simpao AF, Matava CT. Refocusing on work-based hazards for the anaesthesiologist in a post-pandemic era. BJA OPEN 2023; 8:100234. [PMID: 37942056 PMCID: PMC10630594 DOI: 10.1016/j.bjao.2023.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023]
Abstract
The coronavirus pandemic has raised public awareness of one of the many hazards that healthcare workers face daily: exposure to harmful pathogens. The anaesthesia workplace encompasses the operating room, interventional radiology suite, and other sites that contain many other potential occupational and environmental hazards. This review article highlights the work-based hazards that anaesthesiologists and other clinicians may encounter in the anaesthesia workplace: ergonomic design, physical, chemical, fire, biological, or psychological hazards. As the anaesthesia work environment enters a post-COVID-19 pandemic phase, anaesthesiologists will do well to review and consider these hazards. The current review includes proposed solutions to some hazards and identifies opportunities for future research.
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Affiliation(s)
- Olivia Nelson
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Eric Greenwood
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Allan F. Simpao
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Clyde T. Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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26
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Williams V, Vos-Seda AG, Calnan M, Mdluli-Dlamini L, Haumba S, Grobbee DE, Klipstein-Grobusch K, Otwombe K. Tuberculosis services during the COVID-19 pandemic: A qualitative study on the impact of COVID-19 and practices for continued services delivery in Eswatini. PUBLIC HEALTH IN PRACTICE 2023; 6:100405. [PMID: 38099086 PMCID: PMC10719405 DOI: 10.1016/j.puhip.2023.100405] [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: 01/13/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 12/17/2023] Open
Abstract
Objectives To describe the impact of the COVID-19 pandemic on tuberculosis services and the different approaches healthcare workers adopted to ensure continued tuberculosis service delivery in Eswatini. Study design This is a qualitative study with a cross-sectional design. Methods Thirteen nurses and 9 doctors who provide tuberculosis care from 10 health facilities participated in an in-depth interview to describe how the COVID-19 pandemic affected tuberculosis services and the approaches adopted to ensure continued patient care. Twenty in-person and 2 telephone interviews were conducted. The participating facilities were selected based on a ranking criterion of the number of patients seen. Data were analyzed using thematic content analysis. NVivo 12 software was used for qualitative analysis, and the Consolidated Criteria guided the study for Reporting Qualitative research (COREQ). Results Two major themes emerged: COVID-19 impacted services delivery and access; and best practices that ensured healthcare services delivery. Six sub-themes describe how COVID-19 impacted services: all attention focused on COVID-19; COVID worsened the health system challenges; COVID hindered patients from accessing care; patients defaulted due to the lockdown; COVID impacted the quality of care and increased the risk of infection among healthcare workers. Five sub-themes describe best practices that ensure continued service delivery: Home-based care, Patient support, Patient Education, Integrated Services, and Staff rotation. Conclusion While various strategies were adopted globally to mitigate the impact of the COVID-19 pandemic, these strategies need contextualization to be effective and sustainably incorporated into routine care to ensure continuity of and access to TB and other healthcare services.
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Affiliation(s)
- Victor Williams
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- National Tuberculosis Control Program, Manzini, Eswatini
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alinda G. Vos-Seda
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Samson Haumba
- Center for Global Health Practice and Impact, Georgetown University Medical Center, Washington, DC, USA
| | - Diederick E. Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Kennedy Otwombe
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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27
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Rosamond RL, Giarratano G, Orlando S, Sumner J, Devier D, McDaniel LS, Wardell DW. Healing Touch: A Strategy for Acute Care Nurses' Stress Reduction. J Holist Nurs 2023; 41:347-359. [PMID: 36714962 DOI: 10.1177/08980101221142193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of the study is to determine whether administering healing touch (HT) is more effective than deep breathing (DB) for reducing acute care nurses' stress during a shift. A randomized cluster trial assessed 150 nurses' vital signs and Visual Analog Scale for Stress (VASS) levels pre, post, and at follow-up to achieve a power of .7 and medium affect size. Open-ended questions following the intervention enriched quantitative findings describing the experience, facilitators, and barriers to potential use in nursing. The generalized estimating equation 1 (GEE1) comparisons of mean change over time, found that nurses in the HT intervention, had significantly lower VASS stress scores at posttreatment (-0.95, p = .0002) and at follow-up (-0.73, p = .0144) than the DB group, and the respiratory rate (RR) rate differences were nearly significant at post-intervention and significant at follow-up, respectively (1.36, p = .0568 and -2.28, p = .0011), indicating lower RR after HT. These findings support the use of HT as an effective stress reduction strategy as a relevant strategy to sustain a viable nurse work force post-COVID-19.
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Affiliation(s)
| | | | - Susan Orlando
- Louisiana State University Health NOLA School of Nursing, LA, USA
| | - Jane Sumner
- Louisiana State University Health NOLA School of Nursing, LA, USA
| | - Diedre Devier
- Louisiana State University Health NOLA School of Nursing, LA, USA
| | - Lee S McDaniel
- Louisiana State University Health NOLA School of Nursing, LA, USA
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Ross T, de Maria de Albuquerque C, Chaves J, Carneiro Rolim KM, Albuquerque Frota M, Surkan PJ. COVID-19 threatens the progress of humanised childbirth: a qualitative study of giving birth during the pandemic in Brazil. Sex Reprod Health Matters 2023; 31:2152548. [PMID: 36825627 PMCID: PMC9970195 DOI: 10.1080/26410397.2022.2152548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
The stressful nature of the early months of the COVID-19 pandemic severely impacted the quality of maternity care. The purpose of this study was to understand and explore the labour and delivery experiences for women who were diagnosed with COVID-19 in Brazil during this time. Between July and October 2020, we conducted 28 semi-structured interviews with postpartum women who tested positive for COVID-19 prior to delivering at a tertiary hospital in Fortaleza, Brazil. Interview transcripts were coded, and we carried out a thematic analysis using three domains of the World Health Organization's model of intrapartum care for a positive childbirth experience as a framework. During labour and delivery, women experienced varying levels of respect, with many women reporting feeling mistreated by their healthcare team because of their COVID-19 diagnosis. Due to COVID-19 hospital protocols that denied companions or visitors, women reported feeling unsupported and isolated, especially during the mandatory quarantine. Women also experienced varying levels of effective communication, with some women citing they felt the staff were often fearful, and either avoidant or disrespectful. A minority of women reported that the staff appeared to be respectful and receptive to their needs. Our findings provide preliminary evidence that the strain of the COVID-19 pandemic on health professionals potentially results in ineffective communication and mistreatment during labour and delivery. Embedding respectful and humanised childbirth principles into emergency maternal healthcare protocols may improve the childbirth experience for women with COVID-19, as well as for women during future public health emergencies.
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Affiliation(s)
- Tamia Ross
- MSPH Student, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Conceição de Maria de Albuquerque
- PhD Student, Centro de Ciências de Saúde, Programa de Pós-graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
| | - Jessica Chaves
- MS Student, Centro de Ciências de Saúde, Programa de Pós-graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
| | - Karla Maria Carneiro Rolim
- Professor, Centro de Ciências de Saúde, Programa de Pós-graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
| | - Mirna Albuquerque Frota
- Professor, Centro de Ciências de Saúde, Programa de Pós-graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
| | - Pamela J. Surkan
- Professor, Social and Behavioral Intervention Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E5523, Baltimore, MD, USA. Correspondence:
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Shenkman R, Diewald L, Murray MB, Oliver TL. Unveiling Lived Experiences: Exploring the Health and Lifestyle Effects of COVID-19 on Healthcare Workers. Nutrients 2023; 15:4857. [PMID: 38068716 PMCID: PMC10708279 DOI: 10.3390/nu15234857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
The COVID-19 pandemic brought about significant life disruptions among healthcare workers (HCWs), including changes in weight, eating habits, and physical activity. This qualitative study sought to evaluate the initial and longitudinal effects of health habits among HCWs throughout the pandemic. Data were collected through Qualtrics surveys at three points over a 2-year period with questions asking participants (n = 234) to describe whether they experienced changes in weight, eating behaviors, and physical activity and why they believe these changes occurred. The open-ended responses were analyzed following the summative content analysis approach. Four key themes emerged: (1) problematic eating patterns and habits, (2) disruptions in physical activity, (3) alterations in work environment and schedule, and (4) declines in mental health. Respondent reflections highlight the immediate and long-term pandemic-related effects on weight status for some, attributed to alterations in routines and health habits. Other HCWs reported a "reset" or indicated their habits may have been initially disrupted but normalized or improved over the 2-year time span. Findings underscore the need for strategies that support the physical and mental health of healthcare workers.
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Affiliation(s)
- Rebecca Shenkman
- MacDonald Center for Nutrition Education and Research, M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA;
| | - Lisa Diewald
- MacDonald Center for Nutrition Education and Research, M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA;
| | - Mary Beth Murray
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA; (M.B.M.); (T.L.O.)
| | - Tracy L. Oliver
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA; (M.B.M.); (T.L.O.)
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He C, Igwe N, Damian C, Feder A, Feingold J, Ripp J, Pietrzak R, Peccoralo L, Hurtado A, Chan C. Racial & ethnic differences in mental health outcomes and risk factors among frontline healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry 2023; 85:1-7. [PMID: 37716020 DOI: 10.1016/j.genhosppsych.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/06/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To examine racial/ethnic differences in mental health outcomes and risk factors during the COVID-19 pandemic among frontline healthcare workers (FHCWs). METHODS A survey was conducted on FHCWs at a large metropolitan hospital during winter 2021. Depression, anxiety, and post-traumatic stress symptoms, demographic characteristics, and COVID-19-related occupational factors were assessed. Multivariable logistic regression examined factors associated with screening positive for psychiatric symptoms and their interactions with race/ethnicity. RESULTS Of 1437 FHCWs, 762 (53.0%) self-identified as white, 451 (31.4%) as Asian, 118 (8.2%) as Black, and 106 (7.4%) as Latinx. Black FHCWs had a higher prevalence of screening positive for depression (18.6%) than other groups (6.6%-11.7%, p < .05). Significant risk factors by race/ethnicity interactions indicated that having cared for patients who died from COVID-19 increased risk of psychiatric symptoms among white and Black individuals, having to make difficult decisions prioritizing patients increased risk most significantly among white and Asian individuals, and working more hours increased risk most significantly among Latinx individuals. CONCLUSION Results suggest that occupational stressors may have differential impacts on mental health among racial/ethnic groups of FHCWs. Findings provide insight on subgroups with increased vulnerability to certain risk factors and inform interventions to improve mental health in diverse FHCWs.
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Affiliation(s)
- Celestine He
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA.
| | - Nnamdi Igwe
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA
| | - Candida Damian
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Jordyn Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Jonathan Ripp
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, NY, NY 10029, USA
| | - Robert Pietrzak
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Lauren Peccoralo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, NY, NY 10029, USA
| | - Alicia Hurtado
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Chi Chan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
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Abd Wahab AT, Mohd Hairon S, Shafei MN, Ibrahim MI, Mahmud N. Exploring Job Stress Among Public Health Workforce in Northeastern Malaysia. Cureus 2023; 15:e49083. [PMID: 38125210 PMCID: PMC10731145 DOI: 10.7759/cureus.49083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Job stress is recognized as a significant concern across various occupational settings which have profound implications for both individuals and organizations. During the COVID-19 pandemic, job stress among the public health workforce (PHW) has been a significant concern, as they face a significantly increased risk of infection and mortality due to excessive COVID-19 exposure. This study presents a descriptive exploration of key job stress-related factors among PHW in Terengganu, Malaysia. Methodology This is a cross-sectional study conducted from May 2022 to April 2023, encompassing all eight District Health Offices (DHO) and government health clinics in Terengganu. Data collection involved a Malay version of the Job Content Questionnaire (M-JCQ), which assesses job characteristics based on Karasek's demand-control-support model and consists of four main domains: decision latitude, psychological job demands, physical job demands, and social support. Data was collected from 1044 participants, and statistical analysis was performed using SPSS version 27 (IBM Corp., Armonk, NY, USA). Findings Of the 1044 participants, 18.9% experienced job stress. The highest percentage of job stress was observed among nurses (24.3%), followed by medical assistants (18.3%) and physicians (16.0%). In contrast, the public health assistant (PKA) group had the lowest rate of job stress. Job types based on Karasek's model also showed variations, with doctors having the highest percentage of active jobs (46.4%), while medical assistants had the highest percentage of low job strain (17.9%), and PKAs had the highest percentage of passive job types (44.7%). Conclusion This study offers significant insights into the work-related challenges faced by the public health workforce in Terengganu, Malaysia, especially during the COVID-19 pandemic. Job stress is a substantial concern, and understanding its underlying factors is essential for improving the well-being of PHWs. Decision latitude, job demands, and social support play critical roles in shaping job stress among PHWs. Strategies and interventions are needed to mitigate job stress, improve working conditions, and enhance the effectiveness of PHWs in public health initiatives. This study highlights the importance of addressing job stress in this sector, with potential benefits for both the mental and physical health of PHW.
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Affiliation(s)
- Amer Taufek Abd Wahab
- Department of Community Medicine, School of Medicine, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medicine, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Mohd Nazri Shafei
- Department of Community Medicine, School of Medicine, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medicine, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Noriah Mahmud
- Environmental and Occupational Health Unit, Terengganu State Health Department, Ministry of Health Malaysia, Kuala Terengganu, MYS
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Lee SJ, Yun Y, Hwang J, Jong S. Impact of COVID-19 on occupational injuries and illnesses among nursing care facility workers: Analysis of California workers' compensation data, 2019-2021. Am J Ind Med 2023; 66:965-976. [PMID: 37635641 DOI: 10.1002/ajim.23531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic greatly affected healthcare workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California nursing care facility workers during 2019-2021, to assess the impact of the pandemic on occupational injury risk. METHODS This study used data from the California Workers' Compensation Information System. WC claims in prepandemic and pandemic periods were described and compared between nursing care facilities and other settings. Nursing facility cases were described by demographic, job, and injury characteristics. RESULTS In 2019-2021, we identified 41,134 claims as nursing facility cases in California. Annual claims increased by 64.6% from 2019 to 2020 and then decreased in 2021, returning to levels similar to pre-COVID. In contrast, non-healthcare settings had decreases in claims during the pandemic. COVID-related claims accounted for 50.5% of claims in nursing facilities in 2020-2021; this proportion was much higher compared with other healthcare (35.7%) or nonhealthcare settings (14.3%). Non-COVID claims decreased during the pandemic but mental disorder or stress claims increased in nursing facilities, particularly in 2020 (+42.5%). CONCLUSIONS Our findings show that nursing care facilities were more severely affected by the pandemic than other settings. We did not find evidence of an increased risk of occupational injuries during the pandemic, except for increased claims for stress or mental disorders. Our findings indicate a clear need to address psychological stress and mental health among nursing facility workers during a pandemic.
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Affiliation(s)
- Soo-Jeong Lee
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Younghee Yun
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Jeehyun Hwang
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Soson Jong
- Laguna Honda Hospital and Rehabilitation Center, San Francisco, California, USA
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Sarigül A, Kaya A, Aziz IA, Yıldırım M, Özok HI, Chirico F, Zaffina S. General work stress and suicide cognitions in health-care workers: mediating effect of hopelessness and job satisfaction. Front Public Health 2023; 11:1254331. [PMID: 37942250 PMCID: PMC10629234 DOI: 10.3389/fpubh.2023.1254331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/02/2023] [Indexed: 11/10/2023] Open
Abstract
Individuals with a satisfactory level of job satisfaction are much less likely to feel hopeless about their future and are more likely to perform efficiently in the workplace. General work stress (i.e., the work-related stress subjectively experienced) is a significant predictor of suicide cognitions. Furthermore, it has been posited that satisfaction and hope are fundamental to life from an existential perspective. We, therefore, tested a hypothetical model of general work stress, suicide cognitions, hopelessness, and job satisfaction. The data were collected from 416 health-care workers through a convenience sampling method. The mediation analysis results revealed significant negative and positive relationships among general work stress, suicide conceptions, hopelessness, and job satisfaction. The findings indicate that hopelessness and job satisfaction have a parallel mediating effect in the relationship between general work stress and suicide cognitions. The result of the study is of great importance, which suggests that interventions to alleviate hopelessness and work stress and to boost the job satisfaction of medical staff may help prevent suicide cognitions.
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Affiliation(s)
- Abdulselami Sarigül
- Department of Therapy and Rehabilitation, Ağrı İbrahim Çeçen University, Ağrı, Türkiye
| | - Alican Kaya
- Department of Guidance and Psychological Counselling, Ağrı İbrahim Çeçen University, Ağrı, Türkiye
| | - Izaddin Ahmad Aziz
- Special Education Department, College of Education, Salahaddin University, Erbil, Iraq
- Department of English, College of Education, Bayan University, Erbil, Iraq
| | - Murat Yıldırım
- Faculty of Science and Letters, Department of Psychology, Ağrı İbrahim Çeçen University, Ağrı, Türkiye
- Graduate Studies and Research, Lebanese American University, Beyrut, Lebanon
| | - Halil Ibrahim Özok
- Department of Measurement and Assessment, Van Yüzüncü Yıl University, Van, Türkiye
| | - Francesco Chirico
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy
| | - Salvatore Zaffina
- Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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An H, Kim K, Lee J, Won S. Experiences of Caring for Cohort-Isolated Patients among Nurses in Locked Psychiatric Units. Healthcare (Basel) 2023; 11:2650. [PMID: 37830687 PMCID: PMC10573048 DOI: 10.3390/healthcare11192650] [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: 08/28/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
The aim of this study was to gain an understanding of the experiences of caring for cohorts of patients isolated due to coronavirus disease (COVID-19) among nurses in locked psychiatric units. A phenomenological approach was used to analyze data collected from 10 nurses with a minimum of one year of experience as a mental health nurse working in locked psychiatric units that were cohort-isolated due to COVID-19. Data collected using semi-structured one-to-one in-depth interviews were analyzed based on steps outlined by Colaizzi. Five themes and thirteen subthemes emerged. The five themes were as follows: "Challenges intensified by the nature of mental disorders", "Concerns regarding limited mental health care", "Escalating stress", "Bolstered identity as a mental health nurse", "Witnessing changes that have begun". Environmental and institutional measures need to be implemented to identify the potential phenomena that may affect locked psychiatric units during an infectious disease epidemic and ensure the safety of health care professionals and patients from the infectious disease.
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Affiliation(s)
- Hyeran An
- Department of Nursing, College of Nursing, Daegu Catholic University, Daegu 42472, Republic of Korea;
| | - Kyungmi Kim
- Department of Nursing, Gangdong University, Eumseong-gun 27690, Republic of Korea;
| | - Jongeun Lee
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju-si 28644, Republic of Korea
| | - Sunhwa Won
- Graduate School, Chungnam National University, Daejeon 34134, Republic of Korea;
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Rachubińska K, Panczyk M, Sygut M, Ustianowski P, Grochans E, Cybulska AM. Exploring factors influencing depression among Polish nurses during the COVID-19 pandemic. Front Public Health 2023; 11:1272082. [PMID: 37780422 PMCID: PMC10538971 DOI: 10.3389/fpubh.2023.1272082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives The COVID-19 pandemic has been recognized as an international public health emergency. The aim of our study was to identify contributors to nurses' depression. Methods This survey-based study was conducted in the Pomeranian Medical University Hospital no. 1 in Szczecin and involved 207 nurses. The following standardized research instruments were applied: the World Assumptions Scale, the Athens Insomnia Scale, the Impact of Event Scale - Revised, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder, the Perceived Stress Scale, and a questionnaire of our own authorship. Results The study showed that 72.95% of the subjects experienced severe stress, and 40.58% suffered from insomnia. In addition, 65.7% of the respondents had anxiety symptoms of varying degrees of severity, and 62.8% had depressive symptoms of mild to severe severity. The mean score on the IES-R scale, reflecting a psychological impact of the COVID-19 pandemic, was 34.25. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. Anxiety levels and insomnia significantly affect the prevalence of depression among nurses. Conclusion The COVID-19 pandemic has been recognized as an international public health emergency. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. It is important to conduct further research after the COVID-19 pandemic has ended.
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Affiliation(s)
- Kamila Rachubińska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Sygut
- Department of Social Medicine and Public Health, Chair of Social Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Przemysław Ustianowski
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anna Maria Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Hummel S, Michelsen I, Zafar A, Moritz S, Benoy C, Lemogne C, Almeida R, Losada R, Ribeiro O, Frisardi V, Tarricone I, Ferrari S, Dechent F, Huber CG, Weidt S, Mayer G, Schultz JH. Unmet Psychosocial Needs of Health Care Professionals in Europe During the COVID-19 Pandemic: Mixed Methods Approach. JMIR Public Health Surveill 2023; 9:e45664. [PMID: 37672320 PMCID: PMC10484324 DOI: 10.2196/45664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/18/2023] [Accepted: 06/26/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic severely affected everyday life and working conditions for most Europeans, particularly health care professionals (HCPs). Over the past 3 years, various policies have been implemented in various European countries. Studies have reported on the worsening of mental health, work-related stress, and helpful coping strategies. However, having a closer look is still necessary to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff. OBJECTIVE This study aimed to obtain quantitative information on job-related stressors of physicians and nurses and the coping strategies of HCPs and nonmedical staff at 2 periods of the COVID-19 pandemic. By further analyzing qualitative comments, we wanted to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff on different levels of experience. METHODS A cross-sectional survey was conducted at 2 time points during the COVID-19 pandemic in several European countries. The first study period (T1) lasted between April 1 and June 20, 2020, and the second study period (T2) lasted between November 25, 2021, and February 28, 2022. On a quantitative level, we used a questionnaire on stressors for physicians and nurses and a questionnaire on coping strategies for HCPs and nonmedical staff. Quantitative data were descriptively analyzed for mean values and differences in stressors and coping strategies. Qualitative data of free-text boxes of HCPs and nonmedical staff were analyzed via thematic analysis to explore the experiences of the individuals. RESULTS T1 comprised 609 participants, and T2 comprised 1398 participants. Overall, 296 participants made 438 qualitative comments. The uncertainty about when the pandemic would be controlled (T1: mean 2.28, SD 0.85; T2: mean 2.08, SD 0.90) and the fear of infecting the family (T1: mean 2.26, SD 0.98; T2: mean 2.02, SD 1.02) were the most severe stressors identified by physicians and nurses in both periods. Overall, the use of protective measures (T1: mean 2.66, SD 0.60; T2: mean 2.66, SD 0.60) and acquiring information about COVID-19 (T1: mean 2.29, SD 0.82; T2: mean 1.99, SD 0.89) were identified as the most common coping strategies for the entire study population. Using thematic analysis, we identified 8 themes of personal experiences on the micro, meso, and macro levels. Measures, working conditions, feelings and emotions, and social climate were frequently mentioned topics of the participants. In T1, feelings of isolation and uncertainty were prominent. In T2, feelings of exhaustion were expressed and vaccination was frequently discussed. Moreover, unmet psychosocial needs were identified. CONCLUSIONS There is a need for improvement in pandemic preparedness. Targeted vocational education measures and setting up of web-based mental health support could be useful to bridge gaps in psychosocial support needs in future crises.
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Affiliation(s)
- Svenja Hummel
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ina Michelsen
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Zafar
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Charles Benoy
- Centre Hospitalier Neuro-Psychiatrique Luxembourg, Ettelbrück, Luxembourg
| | - Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Rosa Almeida
- INTRAS Research, Innovation and Knowledge Unit, Intras Foundation, Valladolid, Spain
| | - Raquel Losada
- INTRAS Research, Innovation and Knowledge Unit, Intras Foundation, Valladolid, Spain
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS) at the Associate Laboratory RISE - Health Research Network, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Vincenza Frisardi
- Geriatric Unit, IRCCS-AOU BO, Policlinico San't Orsola, Bologna, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna University, Bologna, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Frieder Dechent
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Christian G Huber
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Steffi Weidt
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gwendolyn Mayer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
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Berglund AM, Raugh IM, Macdonald KI, James SH, Bartolomeo LA, Knippenberg AR, Strauss GP. The effects of the COVID-19 pandemic on hallucinations and delusions in youth at clinical high-risk for psychosis and outpatients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023; 273:1329-1338. [PMID: 36680609 PMCID: PMC9862234 DOI: 10.1007/s00406-023-01551-8] [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: 08/10/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
Although the COVID-19 pandemic has had detrimental effects on mental health in the general population, the impact on those with schizophrenia-spectrum disorders has received relatively little attention. Assessing pandemic-related changes in positive symptoms is particularly critical to inform treatment protocols and determine whether fluctuations in hallucinations and delusions are related to telehealth utilization and treatment adherence. In the current longitudinal study, we evaluated changes in the frequency of hallucinations and delusions and distress resulting from them across three-time points. Participants included: (1) outpatients with chronic schizophrenia (SZ: n = 32) and healthy controls (CN: n = 31); (2) individuals at clinically high risk for psychosis (CHR: n = 25) and CN (n = 30). A series of questionnaires were administered to assess hallucination and delusion severity, medication adherence, telehealth utilization, and protective factors during the pandemic. While there were no significant increases in the frequency of hallucinations and delusions in SZ and CHR, distress increased from pre-pandemic to early pandemic in both groups and then decreased at the third time point. Additionally, changes in positive symptom severity in SZ were related to psychiatric medication adherence. Findings suggest that positive symptoms are a critical treatment target during the pandemic and that ongoing medication services will be beneficial.
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Affiliation(s)
- Alysia M Berglund
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Ian M Raugh
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Kelsey I Macdonald
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Sydney H James
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Lisa A Bartolomeo
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Anna R Knippenberg
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA.
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Mak HW, Bu F, Fancourt D. Mental health and wellbeing among people with informal caring responsibilities across different time points during the COVID-19 pandemic: a population-based propensity score matching analysis. Perspect Public Health 2023; 143:275-284. [PMID: 35787706 PMCID: PMC10576404 DOI: 10.1177/17579139221104973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Due to a prolonged period of national and regional lockdown measures during the coronavirus (COVID-19) pandemic, there has been an increase reliance on informal care for informal carers. In light of this, the current study compared the experiences of carers and non-carers on various mental health and wellbeing measures across six key time points during the pandemic. METHODS Data analysed were from the University College London (UCL) COVID -19 Social Study. Our study focused on six time points in England: (1) the first national lockdown (March-April 2020); (2) the beginning of first lockdown rules easing (May 2020); (3) the second national lockdown (November 2020); (4) the third national lockdown (January 2021); (5) the easing of the third lockdown (March 2021); and (6) the end of restrictions (July-August 2021). We considered five mental health and wellbeing measures: depressive symptoms, anxiety symptoms, loneliness, life satisfaction, and sense of being worthwhile. Propensity score matching was applied for the analyses. RESULTS We found that informal carers experienced higher levels of depressive and anxiety symptoms than non-carers across much of the pandemic. During the first national lockdown, carers also experienced a higher sense of life being worthwhile. No association was found between informal caring responsibilities and levels of loneliness and life satisfaction. CONCLUSION Given that carers are an essential national healthcare support, especially during a pandemic, it is crucial to integrate carers' needs into healthcare planning and delivery. These results highlight that there is a pressing need to provide adequate and targeted mental health support for carers during and following this pandemic.
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Affiliation(s)
- Hei Wan Mak
- Department of Behavioural Science and Health, University College London, London, UK
| | - Feifei Bu
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, 1–19 Torrington Place, London WC1E 7HB, UK
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Espeleta HC, Litvitskiy NS, Higgins K, Ridings LE, Bravoco O, Jones S, Ruggiero KJ, Davidson T. Implementation of a stepped care program to address posttraumatic stress disorder and depression in a Level II trauma center. Injury 2023; 54:110922. [PMID: 37422365 PMCID: PMC10528678 DOI: 10.1016/j.injury.2023.110922] [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: 10/25/2022] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND The Trauma Resilience and Recovery Program (TRRP) is a technology enhanced model of care that includes education, screening, and service referrals to address posttraumatic stress disorder and depression following traumatic injury. TRRP has shown high rates of engagement at a Level I trauma center, but Level II centers have fewer resources and face more challenges to addressing patients' mental health needs. METHODS We utilized clinical administrative data to examine engagement in TRRP in a Level II trauma center with 816 adult trauma activation patients. RESULTS Most patients (86%) enrolled in TRRP, but only 30% completed screens during a 30-day follow-up call. Three-quarters of patients who endorsed clinically significant symptoms accepted treatment recommendations/referrals. CONCLUSIONS Engagement at each step of the model was lower than previously reported in a Level I center. Differences likely correspond to lower rates of mental health symptoms in the trauma patients at this setting. We discuss program adaptations that may be needed to improve patient engagement.
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Affiliation(s)
- Hannah C Espeleta
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA.
| | - Nicole S Litvitskiy
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Kristen Higgins
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Leigh E Ridings
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Olivia Bravoco
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Seon Jones
- Trident Medical Center, 9291 Medical Plaza Dr. Suite B, Charleston, SC 29406, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Tatiana Davidson
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street Charleston, SC 29425, USA
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Mahfouz MS, Osman SA, Mohamed BA, Saeed EAM, Ismaeil MIH, Elkhider RAA, Orsud MA. Healthcare Professionals' Experiences During the COVID-19 Pandemic in Sudan: A Cross-Sectional Survey Assessing Quality of Life, Mental Health, and Work-Life-Balance. Int J Public Health 2023; 68:1605991. [PMID: 37711157 PMCID: PMC10497743 DOI: 10.3389/ijph.2023.1605991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/26/2023] [Indexed: 09/16/2023] Open
Abstract
Objectives: The main objective of this research was to investigate the Work-life balance (WLB), mental health, and quality of life and their associated factors among Healthcare Professionals (HCPs) in Sudan during the peak of the COVID-19 pandemic during 2021. Methods: An observational cross-sectional web-based survey was conducted during August-December 2021 among a sample of 430 HCPs working in the hospitals of four Sudanese states. The study used the WHOQoLBREF scale, Work-Life Balance Scale, and General Anxiety Disorder (GAD-7). Results: HCPs reporting a poor quality of life made up 33.5% (95% CI 29.1-38.0), while those reporting worse WLB made up 52.6% (95% CI 47.8-57.2). HCPs reporting moderate to severe anxiety symptoms accounted for 35.8% (95% CI 31.4-40.5). The Multiple Regression model indicated that an increase in the anxiety scores is associated with a decrease in Health-related Quality of Life (HRQoL) (β= 0.831, p < 0.05). Female HCPs exhibited 4.53-fold lower HRQoL scores than their male colleagues (p < 0.05). Conclusion: Approximately one-third of the HCPs in Sudan reported low HRQoL and suffered from moderate to severe anxiety, while a large portion of them had an unequal work-life balance during COVID-19. Health policies addressing these factors are needed to improve the quality of health of HCPs.
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Affiliation(s)
- Mohamed Salih Mahfouz
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Sara Amir Osman
- Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum, Sudan
| | | | | | | | | | - Merdi Ahmed Orsud
- Mathematics Department, College of Science, Jazan University, Jazan, Saudi Arabia
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Misra P, Mandal S, Sharma G, Kant S, Rai S, Yadav K, Sangral M, Kardam P. Effect of Structured Yoga Program on Stress and Well-being Among Frontline Healthcare Workers During COVID-19 Pandemic. Cureus 2023; 15:e43081. [PMID: 37680404 PMCID: PMC10482358 DOI: 10.7759/cureus.43081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
CONTEXT Frontline healthcare workers are at risk of developing psychological distress during a pandemic. Yoga, a form of mind-body medicine can reduce body stress and increases well-being. AIMS To assess the effect of yoga on the stress and well-being of healthcare workers during the COVID-19 pandemic. SETTINGS AND DESIGN This single-arm pre-post study was conducted among frontline health workers (support staff, paramedics, and medics) posted at a secondary care hospital in a North Indian district. METHODS AND MATERIALS Basic demographic details, blood pressure, anthropometric variables like height, weight, and biochemical variables like glycosylated hemoglobin (Hb1Ac), fasting and post-prandial blood sugar, lipid profile, serum cortisol, and C-reactive protein were measured. Stress levels were assessed using the depression anxiety and stress scale (DASS)-21 while well-being was assessed using the World Health Organization (WHO)-5 well-being scale. Twelve weeks of supervised yoga session was provided for 1 hour per session, 3 times per week. STATISTICAL ANALYSIS The mean value was compared from baseline to post-intervention with paired t-test/Wilcoxon signed rank test. RESULT A total of 89 participants were enrolled, 53 (59.5%) being male. Two-thirds of the participants were aged 20-39 years. During follow-up, 80 participants completed 12 weeks of yoga sessions. Post-intervention DASS-21 score decreased and WHO-5 increased significantly. The glycosylated hemoglobin (HbA1c) level and cholesterol-HDL ratio decreased significantly. Other variables didn't change significantly. No adverse effects were reported by the participants. CONCLUSION Supervised structured yoga sessions helped decrease stress, depression, and anxiety and improved well-being. Therefore, it can be a feasible strategy to manage workplace-related stress and phycological morbidities.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Suprakash Mandal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Gautam Sharma
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, IND
| | - Shashi Kant
- Centre for Community Medcine, All India Institute of Medical Sciences, New Delhi, IND
| | - Sanjay Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Meenu Sangral
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Priyanka Kardam
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
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Namikawa H, Tochino Y, Okada A, Ota K, Okada Y, Yamada K, Watanabe T, Mizobata Y, Kakeya H, Kuwatsuru Y, Shibata T, Shuto T. Mental health complaints among healthcare workers engaged in the care of COVID-19 patients: A prospective cohort study from Japan. J Gen Fam Med 2023; 24:240-246. [PMID: 37484128 PMCID: PMC10357096 DOI: 10.1002/jgf2.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 07/25/2023] Open
Abstract
Background Healthcare workers (HCWs) caring for patients with coronavirus disease-2019 (COVID-19) can experience physical and mental health burdens. It is imperative that hospitals reduce such burdens on frontline HCWs, protect them, and support their healthcare. This study aimed to investigate the association between occupation and the manifestation of physical or psychological symptoms among HCWs during the current COVID-19 pandemic. Methods A twice-weekly survey using questionnaires targeting HCWs who care for COVID-19 patients was performed at Osaka Metropolitan University Hospital (tertiary hospital). The demographic characteristics of the participants, exposure level, and physical and psychological complaints were evaluated. Results Seventy-one HCWs participated in this study, of whom 27 (38.0%) were doctors, 25 (35.2%) were nurses, and 19 (26.8%) were technicians. Among the HCWs, the proportions of those who experienced any physical or psychological symptoms were 28.2% and 31.0%, respectively. The frequency of depression and anxiety was obviously higher among the nurses than that among the doctors (both p < 0.01). Multivariate analysis revealed that being a nurse (odds ratio 4.90; p = 0.04) and having physical complaints (odds ratio 4.66; p = 0.02) might be independent predictors of the manifestation of psychological symptoms. Conclusion Our results indicate that the follow-up of HCWs experiencing physical symptoms, especially nurses engaged in the care of COVID-19 patients, may require more careful management to improve the psychological outcomes. We believe that this study is the first step toward establishing a psychological health management strategy for HCWs caring for COVID-19 patients.
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Affiliation(s)
- Hiroki Namikawa
- Department of Medical Education and General PracticeOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
| | - Yoshihiro Tochino
- Department of Medical Education and General PracticeOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
- Office of Institutional ResearchOsaka Metropolitan University, Faculty of MedicineOsakaJapan
| | - Akiko Okada
- Office of Institutional ResearchOsaka Metropolitan University, Faculty of MedicineOsakaJapan
| | - Keiko Ota
- Center for Clinical Research and InnovationOsaka Metropolitan University HospitalOsakaJapan
| | - Yasuyo Okada
- Department of Infection Control and PreventionOsaka Metropolitan University HospitalOsakaJapan
| | - Koichi Yamada
- Department of Infection Control and PreventionOsaka Metropolitan University HospitalOsakaJapan
- Department of Infection Control ScienceOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
| | - Tetsuya Watanabe
- Department of Respiratory MedicineOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
| | - Yasumitsu Mizobata
- Department of Traumatology and Critical Care MedicineOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
| | - Hiroshi Kakeya
- Department of Infection Control and PreventionOsaka Metropolitan University HospitalOsakaJapan
- Department of Infection Control ScienceOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
| | - Yumiko Kuwatsuru
- Department of NursingOsaka Metropolitan University HospitalOsakaJapan
| | - Toshihiko Shibata
- Department of Cardiovascular SurgeryOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
| | - Taichi Shuto
- Department of Medical Education and General PracticeOsaka Metropolitan University, Graduate School of MedicineOsakaJapan
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Shamon S, Gill A, Meadows L, Kruizinga J, Kaasalainen S, Pereira J. Providing palliative and end-of-life care in long-term care during the COVID-19 pandemic: a qualitative study of clinicians' lived experiences. CMAJ Open 2023; 11:E745-E753. [PMID: 37607749 PMCID: PMC10449019 DOI: 10.9778/cmajo.20220238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND A disproportionate number of COVID-19-related deaths in Canada occurred in long-term care homes, affecting residents, families and staff alike. This study explored the experiences of long-term care clinicians with respect to providing palliative and end-of-life care during the COVID-19 pandemic. METHODS We used a qualitative research approach. Long-term care physicians and nurse practitioners (NPs) in Ontario, Canada, participated in semistructured interviews between August and September of 2021. Interviews were undertaken virtually, and results were analyzed using thematic analysis. RESULTS Twelve clinicians (7 physicians and 5 NPs) were interviewed. We identified 5 themes, each with several subthemes: providing a palliative approach to care, increased work demands and changing roles, communication and collaboration, impact of isolation and visitation restrictions, and impact on the providers' personal lives. Clinicians described facing several concurrent challenges, including the uncertainty of COVID-19 illness, staffing and supply shortages, witnessing many deaths, and distress caused by isolation. These resulted in burnout and feelings of moral distress. Previous training and integration of the palliative care approach in the long-term care home, access to resources, increased communication and interprofessional collaboration, and strong leadership mitigated the impact and led to improved palliative care and a sense of pride while facing these challenges. INTERPRETATION The pandemic had a considerable impact on clinicians caring for residents in long-term care homes at the end of life. It is important to address these lived experiences and use the lessons learned to identify strategies to improve palliative care in long-term care homes and reduce the impact of future pandemics with respect to palliative care.
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Affiliation(s)
- Sandy Shamon
- Division of Palliative Care (Shamon, Gill, Pereira), Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Community Health Sciences, Cumming School of Medicine (Meadows), University of Calgary, Calgary, Alta.; School of Nursing (Kruizinga, Kaasalainen), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Pallium Canada (Pereira), Ottawa, Ont.
| | - Ashlinder Gill
- Division of Palliative Care (Shamon, Gill, Pereira), Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Community Health Sciences, Cumming School of Medicine (Meadows), University of Calgary, Calgary, Alta.; School of Nursing (Kruizinga, Kaasalainen), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Pallium Canada (Pereira), Ottawa, Ont
| | - Lynn Meadows
- Division of Palliative Care (Shamon, Gill, Pereira), Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Community Health Sciences, Cumming School of Medicine (Meadows), University of Calgary, Calgary, Alta.; School of Nursing (Kruizinga, Kaasalainen), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Pallium Canada (Pereira), Ottawa, Ont
| | - Julia Kruizinga
- Division of Palliative Care (Shamon, Gill, Pereira), Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Community Health Sciences, Cumming School of Medicine (Meadows), University of Calgary, Calgary, Alta.; School of Nursing (Kruizinga, Kaasalainen), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Pallium Canada (Pereira), Ottawa, Ont
| | - Sharon Kaasalainen
- Division of Palliative Care (Shamon, Gill, Pereira), Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Community Health Sciences, Cumming School of Medicine (Meadows), University of Calgary, Calgary, Alta.; School of Nursing (Kruizinga, Kaasalainen), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Pallium Canada (Pereira), Ottawa, Ont
| | - José Pereira
- Division of Palliative Care (Shamon, Gill, Pereira), Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Community Health Sciences, Cumming School of Medicine (Meadows), University of Calgary, Calgary, Alta.; School of Nursing (Kruizinga, Kaasalainen), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Pallium Canada (Pereira), Ottawa, Ont
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Byrne JP, Humphries N, McMurray R, Scotter C. COVID-19 and healthcare worker mental well-being: Comparative case studies on interventions in six countries. Health Policy 2023; 135:104863. [PMID: 37399678 PMCID: PMC10292916 DOI: 10.1016/j.healthpol.2023.104863] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
Healthcare worker (HCW) mental well-being has become a global public health priority as health systems seek to strengthen their resilience in the face of the COVID-19 pandemic. Analysing data from the Health System Response Monitor, we present six case studies (Denmark, Italy, Kyrgyzstan, Lithuania, Romania, and the United Kingdom) as a comparative review of policy interventions supporting HCW mental health during the pandemic. The results illustrate a wide range of interventions. While Denmark and the United Kingdom built on pre-existing structures to support HCW mental wellbeing during the pandemic, the other countries required new interventions. Across all cases, there was a reliance on self-care resources, online training tools, and remote professional support. Based on our analysis, we develop four policy recommendations for the future of HCW mental health supports. First, HCW mental health should be seen as a core facet of health workforce capacity. Second, effective mental health supports requires an integrated psychosocial approach that acknowledges the importance of harm prevention strategies and organisational resources (psychological first aid) alongside targeted professional interventions. Third, personal, professional and practical obstacles to take-up of mental health supports should be addressed. Fourth, any specific support or intervention targeting HCW's mental health is connected to, and dependent on, wider structural and employment factors (e.g. system resourcing and organisation) that determine the working conditions of HCWs.
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Affiliation(s)
- John-Paul Byrne
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland.
| | - Niamh Humphries
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland
| | - Robert McMurray
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland
| | - Cris Scotter
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland
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Nguyen HT, Le TH, Nguyen CC, Le TD, Nguyen TV. COVID-19 infection and decline in outdoor activities associated with depression in older adults: A multicenter study in Vietnam. PLoS One 2023; 18:e0286367. [PMID: 37352257 PMCID: PMC10289328 DOI: 10.1371/journal.pone.0286367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/15/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has caused a serious global communicable disease burden. Although COVID-19 and its policy responses have significantly influenced older adults, the impact of COVID-19 on depression in the older population is not fully understood. We aimed to investigate whether a history of COVID-19 infection and a decline in outdoor activities during the COVID-19 pandemic were associated with depression among older adults in Vietnam. METHODS This multicenter cross-sectional study was conducted on 1,004 outpatients (aged ≥60 years; mean age 70.8 ± 7.3 years; men, 33.0%) visiting three hospitals for a comprehensive geriatric assessment between November 2021 and July 2022. Depression over the past week was evaluated using the 15-item Geriatric Depression Scale. History of COVID-19 infection and decline in outdoor activities were included as binary variables. We adjusted these two factors with sociodemographic and geriatric variables and comorbidities using a logistic regression analysis in separate models. RESULTS A total of 156 participants (15.5%) experienced depression. The proportion of mild, moderate, and severe depressive symptoms was 14.1%, 44.9%, and 41.0%, respectively. In the multivariate model, decline in outdoor activities (odds ratio [OR] 17.2, 95% confidence interval [CI] 9.15-32.2, p <0.001) and history of COVID-19 infection (OR 2.22, 95% CI 1.28-3.84, p = 0.004) were associated with depression. Additionally, we found that age ≥ 75 years, female sex, being underweight, limitations in functional status, poor sleep quality, and stroke were associated with depression. Of the associated factors, decline in outdoor activities had a moderate strength of association with depression (r = 0.419), while each of the remaining factors had a weak strength of association. CONCLUSIONS COVID-19 had a direct and indirect impact on depression in older adults, reflecting an association between both a history of COVID-19 infection and a decline in outdoor activities during the COVID-19 pandemic and depression in the older population.
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Affiliation(s)
- Huan Thanh Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam
- Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Thien Hoang Le
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam
| | - Chanh Cong Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam
| | - Thanh Dinh Le
- Thong Nhat Hospital, Ho Chi Minh City, Vietnam
- Department of Geriatrics and Gerontology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tan Van Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam
- Thong Nhat Hospital, Ho Chi Minh City, Vietnam
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Whelan J, Hillenaar M, Fraser P, Allender S, Jackson M, Strugnell C, Bell C. Perceived impacts of COVID-19 and bushfires on the implementation of an obesity prevention trial in Northeast Victoria, Australia. PLoS One 2023; 18:e0287468. [PMID: 37339115 DOI: 10.1371/journal.pone.0287468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 06/06/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Calls for the adoption of a systems approach to chronic disease prevention date back at least ten years because of the potential to empower communities to identify and address the complex causes of overnutrition, undernutrition and climate change. Australia, like many countries, has high levels of obesity and extreme climate events. The Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND) trial aims to prevent unhealthy weight gain in children in 10 intervention and two pilot communities in north-east Victoria, Australia using community-based participatory approaches informed by systems science. Intervention activities co-designed in 2019 were disrupted by COVID-19 and bushfires. This paper explores the impacts of these 'shocks' on the local prevention workforce to implement actions within communities. METHODS A case study design involving one-hour online focus groups and an on-line survey (November 2021-February 2022). Purposive sampling was used to achieve diverse representation from RESPOND stakeholders including local council, health services, primary care partnerships and department of health. The focus group interview schedule and survey questions were based on Durlak and DuPre's implementation factors. RESULTS Twenty-nine participants from seven different communities participated in at least one of nine focus groups to discuss the impacts of COVID-19 and bushfires on localised implementation. Twenty-eight participants (97% of focus group sample) also completed the on-line survey. Implementation of RESPOND stalled or stopped in most communities due to bushfires and/or COVID-19. These shocks resulted in organisational priorities changing, loss of momentum for implementation, redeployment of human resources, culminating in fatigue and exhaustion. Participants reported adaptation of RESPOND, but implementation was slowed due to limited resources. CONCLUSION Further research is needed to advance risk management strategies and protect resources within health promotion. System shocks such as bushfires and COVID-19 are inevitable, and despite multiple adaptation opportunities, this intervention approach was not 'shock proof'.
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Affiliation(s)
- Jillian Whelan
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Monique Hillenaar
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Penny Fraser
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Michelle Jackson
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Claudia Strugnell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
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Hasen AA, Seid AA, Mohammed AA. Mental health problems among healthcare professionals during COVID-19 in Africa: a protocol for umbrella review. BMJ Open 2023; 13:e072337. [PMID: 37336531 DOI: 10.1136/bmjopen-2023-072337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION COVID-19 pandemic is a global health problem. In Africa, healthcare professionals face mental health problems due to COVID-19. But little was done on the prevalence of mental disorders among healthcare professionals during COVID-19 in Africa. This umbrella review of meta-analysis aimed to provide the pooled prevalence of anxiety, depression, stress, suicide, demoralisation and insomnia during COVID-19 pandemic in Africa. METHODS AND ANALYSIS We will search the African Journals Online, MedRxiv, PubMed and Google Scholar to identify studies published from the occurrence of the pandemic to March 2023. Systematic review and meta-analysis studies assessing mental health problems among healthcare professionals in Africa will be considered. The outcomes of interest include prevalence of mental health problems on healthcare professionals following COVID-19. Two researchers will extract data and execute quality assessment independently. The Joanna Briggs Institute critical appraisal checklist will be used to assess the quality of studies. Stata V.16.0 software will be used for statistical analysis. The I² and Cochran's Q-statistics will be used for analysis of heterogeneity. Publication bias will be examined by DOI plot and Luis Furuya Kanamori (LFK) index. ETHICS AND DISSEMINATION Ethical approval and informed consent are not required as this is a literature review. The final results will be published in a peer-reviewed journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42022383939.
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Affiliation(s)
- Aragaw Asfaw Hasen
- Department of Statistics, College of Natural and Computational Sciences, Samara University, Semera, Ethiopia
| | - Abubeker Alebachew Seid
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Semera, Ethiopia
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Semera, Ethiopia
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Przyłęcki P, Wieczorkowska M, Pawlak-Kałuzińska A, Cedrowska-Adamus W, Gulczyńska E. The COVID-19 pandemic impact on the Polish medical personnel work: a survey and in-depth interviews study. Front Public Health 2023; 11:1187312. [PMID: 37383273 PMCID: PMC10293619 DOI: 10.3389/fpubh.2023.1187312] [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: 03/15/2023] [Accepted: 05/19/2023] [Indexed: 06/30/2023] Open
Abstract
Objective The objective of the study was to examine the impact of the COVID-19 pandemic on the work of medical personnel in terms of: task scope, preparation to perform medical tasks related to the pandemic, team collaboration, involvement in tasks performed, concerns about performing tasks related to the pandemic, stress levels. Methods The mixed-method approach was applied to this cross-sectional study. The online questionnaire which included 40 questions was completed via Google among medical personnel in Poland. Eight semi-structured, in-depth interviews were conducted to deepen the data obtained with the questionnaires. Participants The questionnaire was completed by 215 healthcare professionals, with the largest group being nurses (56.3%) followed by physicians (22.3%), midwives (11.6%) and other healthcare professionals (e.g., physiotherapists, paramedics, nutritionists - 9.8%). Among the respondents were people who worked in the hospital in the so-called "covid wards" (31.2%) and other hospital wards (60%) as well as people who were employed outside the hospital (8.8%). Results The pandemic affected the nature and range of tasks performed by health professionals. Initially, respondents felt unprepared to work under pandemic conditions, but over time their ratings increased in all areas studied. More than half of respondents reported no change in interpersonal relationship within the team, but nearly 35% noted a worsening and only one in 10 claimed improvement. Study participants rated their own commitment to tasks slightly higher than that of their colleagues (mean 4.9 and 4.4 respectively) but the overall rating was high. The mean self-rating of work stress increased from 3.7 before the pandemic to 5.1 during the pandemic. Most of the respondents were afraid of transmission of the infection to their relatives. Other fears included the possibility of making a medical error, not being able to help the patient, not having enough personal protective equipment (PPE) and contracting SARS-CoV-2. Conclusion The conducted study revealed that the organization of medical care in the initial period of the pandemic, especially the hospital care of patients infected with SARS-CoV-2, was quite chaotic. The most affected were the people who were transferred to work in the covid wards. Not all medical professionals were prepared to work with the COVID-19 patients, as they lacked experience working in such facilities, especially in intensive care units (ICU). Working under time pressure and under new conditions led mainly to an increase in perceived stress and conflicts between staff.
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Affiliation(s)
- Paweł Przyłęcki
- Department of Humanistic Sciences, Faculty of Health Sciences, Medical University of Lodz, Łódź, Poland
| | - Magdalena Wieczorkowska
- Department of Humanistic Sciences, Faculty of Health Sciences, Medical University of Lodz, Łódź, Poland
| | | | - Wioletta Cedrowska-Adamus
- Department of Neonatology, Intensive Care and Pathology of Neonate, Institute of the Polish Mother’s Health Center, Łódź, Poland
| | - Ewa Gulczyńska
- Department of Neonatology, Intensive Care and Pathology of Neonate, Institute of the Polish Mother’s Health Center, Łódź, Poland
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Bjørge H, Gunnheim N, Bachke A, Anker-Rasch C, Sheikoleslami Oleslami R, Finstad AK, Karterud D, Halvorsrud L, Lohne V, Sæterstrand TM. The solitary and uncertain learning process: A qualitative study of nursing students' experiences in the initial phase of the COVID-19 pandemic. TEACHING AND LEARNING IN NURSING : OFFICIAL JOURNAL OF THE NATIONAL ORGANIZATION FOR ASSCIATE DEGREE NURSING 2023:S1557-3087(23)00093-8. [PMID: 37360266 PMCID: PMC10243095 DOI: 10.1016/j.teln.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/28/2023]
Abstract
When the Coronavirus disease 2019 (COVID-19) pandemic broke out, the nursing students clinical practice period was abruptly interrupted by the lock down. The present study aimed to investigate the nursing students' learning experiences during the initial phase of the pandemic. A qualitative study was conducted investigating nursing students' written assignments (n = 48) of reflections according to their learning process. The qualitative data analysis revealed three main themes, namely the solitary and uncertain learning process; from collective learning process to digital devices; additional learning outcomes. The students' anxiety about the virus affected their motivation to study, but they also expressed enthusiasm and gratitude for having the opportunity to learn about the health system in a time of crisis. These results point towards the health care authorities can rely on nursing students' ability to take part and cover important emergency functions. The use of technology helped the students to achieve their learning objectives.
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Affiliation(s)
- Heidi Bjørge
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Niklas Gunnheim
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - André Bachke
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Celina Anker-Rasch
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Ann-Kristin Finstad
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Dag Karterud
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Liv Halvorsrud
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Vibeke Lohne
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Torill Margaret Sæterstrand
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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50
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Doan LP, Dam VAT, Boyer L, Auquier P, Fond G, Tran B, Vu TMT, Do HT, Latkin CA, Zhang MWB, Ho RCM, Ho CSH. Impacts of COVID-19 on career choices in health professionals and medical students. BMC MEDICAL EDUCATION 2023; 23:387. [PMID: 37237404 DOI: 10.1186/s12909-023-04328-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUNDS The COVID-19 pandemic has resulted in not only significant mortalities in Vietnam but has had an impact on its economy. Previous studies have highlighted how the pandemic has had a marginal impact on Vietnamese healthcare workers working at the frontlines. To date, there have been several other studies examining the impact of COVID-19 on intentions to transition between jobs among healthcare professionals, but this has yet to be explored amongst Vietnamese healthcare workers. METHODS To achieve the study's objectives an online cross-sectional study was conducted between September to November 2021. Snowball sampling methodology was adopted for the recruitment of participants. The questionnaire that was used for this study comprised of the following sections: (a) socio-demographic information; (b) impact of COVID-19 on work; (c) risk of exposure to COVID-19; (d) career choices/intentions to change job, and (e) motivation at work. RESULTS There were 5727 completed the entire survey. 17.2% of the respondents have had increased job satisfaction, 26.4% reported increased motivation to work, and 40.9% reported decreased motivation to work. Whilst there were changes in the daily work intensity and the level of work-related stress, more than 60% of respondents we sampled did not intend to switch careers. Demographic variables like gender, whether one was a student or an existing healthcare worker, and income related to work motivation. The community's stigma was a negative factor that declined intrinsic motivation as well as decreased work retention. CONCLUSIONS Our study is instrumental in identifying the impact of COVID-19 on career choices amongst Vietnamese healthcare workers. The factors identified have clear implications for policymaking.
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Affiliation(s)
- Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Vu Anh Trong Dam
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Laurent Boyer
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Pascal Auquier
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Guillaume Fond
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Bach Tran
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, boulevard Jean-Moulin, Marseille cedex 05, 13385, France
| | - Thuc Minh Thi Vu
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Hoa Thi Do
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Melvyn W B Zhang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119077, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
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