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Pienkowska A, Ravaut M, Mammadova M, Ang CS, Wang H, Ong QC, Bojic I, Qin VM, Sumsuzzman DM, Ajuebor O, Boniol M, Bustamante JP, Campbell J, Cometto G, Fitzpatrick S, Kane C, Joty S, Car J. Understanding COVID-19 Impacts on the Health Workforce: AI-Assisted Open-Source Media Content Analysis. JMIR Form Res 2024; 8:e53574. [PMID: 38869940 PMCID: PMC11211705 DOI: 10.2196/53574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/29/2024] [Accepted: 03/21/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND To investigate the impacts of the COVID-19 pandemic on the health workforce, we aimed to develop a framework that synergizes natural language processing (NLP) techniques and human-generated analysis to reduce, organize, classify, and analyze a vast volume of publicly available news articles to complement scientific literature and support strategic policy dialogue, advocacy, and decision-making. OBJECTIVE This study aimed to explore the possibility of systematically scanning intelligence from media that are usually not captured or best gathered through structured academic channels and inform on the impacts of the COVID-19 pandemic on the health workforce, contributing factors to the pervasiveness of the impacts, and policy responses, as depicted in publicly available news articles. Our focus was to investigate the impacts of the COVID-19 pandemic and, concurrently, assess the feasibility of gathering health workforce insights from open sources rapidly. METHODS We conducted an NLP-assisted media content analysis of open-source news coverage on the COVID-19 pandemic published between January 2020 and June 2022. A data set of 3,299,158 English news articles on the COVID-19 pandemic was extracted from the World Health Organization Epidemic Intelligence through Open Sources (EIOS) system. The data preparation phase included developing rules-based classification, fine-tuning an NLP summarization model, and further data processing. Following relevancy evaluation, a deductive-inductive approach was used for the analysis of the summarizations. This included data extraction, inductive coding, and theme grouping. RESULTS After processing and classifying the initial data set comprising 3,299,158 news articles and reports, a data set of 5131 articles with 3,007,693 words was devised. The NLP summarization model allowed for a reduction in the length of each article resulting in 496,209 words that facilitated agile analysis performed by humans. Media content analysis yielded results in 3 sections: areas of COVID-19 impacts and their pervasiveness, contributing factors to COVID-19-related impacts, and responses to the impacts. The results suggest that insufficient remuneration and compensation packages have been key disruptors for the health workforce during the COVID-19 pandemic, leading to industrial actions and mental health burdens. Shortages of personal protective equipment and occupational risks have increased infection and death risks, particularly at the pandemic's onset. Workload and staff shortages became a growing disruption as the pandemic progressed. CONCLUSIONS This study demonstrates the capacity of artificial intelligence-assisted media content analysis applied to open-source news articles and reports concerning the health workforce. Adequate remuneration packages and personal protective equipment supplies should be prioritized as preventive measures to reduce the initial impact of future pandemics on the health workforce. Interventions aimed at lessening the emotional toll and workload need to be formulated as a part of reactive measures, enhancing the efficiency and maintainability of health delivery during a pandemic.
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Affiliation(s)
- Anita Pienkowska
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Mathieu Ravaut
- College of Computing and Data Science, Nanyang Technological University, Singapore, Singapore
| | - Maleyka Mammadova
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Chin-Siang Ang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Hanyu Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Qi Chwen Ong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Iva Bojic
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Vicky Mengqi Qin
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Dewan Md Sumsuzzman
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Onyema Ajuebor
- Human Resources for Health Policies and Standards Unit, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Mathieu Boniol
- Data, Evidence and Knowledge Unit, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Juana Paola Bustamante
- Health Labour Market Unit, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - James Campbell
- Director's Office, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Giorgio Cometto
- Human Resources for Health Policies and Standards Unit, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Siobhan Fitzpatrick
- Human Resources for Health Policies and Standards Unit, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Catherine Kane
- Human Resources for Health Policies and Standards Unit, Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Shafiq Joty
- College of Computing and Data Science, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Jeong Y, Jung HS, Baek EM. Effectiveness of cognitive rehearsal programs for the prevention of workplace bullying among hospital nurses: a systematic review and meta-analysis. BMC Public Health 2024; 24:1568. [PMID: 38862940 PMCID: PMC11165786 DOI: 10.1186/s12889-024-18969-x] [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: 08/11/2023] [Accepted: 05/27/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND To solve the problem of workplace bullying among nurses, it is necessary to review the effects of interventions and generalize the findings. We conducted a systematic literature review and meta-analysis to evaluate the effects of cognitive rehearsal programs on workplace bullying among hospital nurses. METHODS Data were collected from March 30 to April 11, 2021, and 11,048 journal articles published in South Korea and internationally were examined across eight databases. Nine articles were selected for inclusion in the systematic literature review; five of the nine studies were included in the meta-analysis. For randomized controlled trials, the risk of bias was evaluated, and for non-randomized controlled trials, the study quality was evaluated using the Risk of Bias for Non-randomized Studies version 2.0. Egger's regression test was performed to determine publication bias. RESULTS Of the nine articles selected for this study, two were randomized controlled trials and seven were non-randomized controlled trials. The I2 value was 18.9%, indicating non-significant heterogeneity. The overall effect size of the cognitive rehearsal programs was -0.40 (95% confidence interval: -0.604 to -0.196; Z = -3.85; p = .0001) in a random-effects model, indicating a large effect size with statistical significance. CONCLUSIONS Therefore, cognitive rehearsal programs that address workplace bullying among hospital nurses are effective. Health policymakers must implement cognitive rehearsal programs in a policy manner to address the problems of bullying in the workplace.
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Affiliation(s)
- Yulliana Jeong
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, South Korea
| | - Hye Sun Jung
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, South Korea.
| | - Eun Mi Baek
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, South Korea.
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3
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Alexandrov N, Scott ES, Janssen MF, Lubetkin EI, Yfantopoulos JN, Bonsel GJ, Haagsma JA. The relationship between healthcare access and change in health-related quality-of-life among the general population of five countries during the COVID-19 pandemic. Qual Life Res 2024:10.1007/s11136-024-03704-1. [PMID: 38861096 DOI: 10.1007/s11136-024-03704-1] [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] [Accepted: 05/28/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries. METHODS An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and HRQoL. The primary outcome was change in HRQoL as measured by the EQ-5D-5L instrument. Specifically, the EQ-5D-5L index and EQ VAS were used. Healthcare access was quantified with regard to the respondent's ease of getting an appointment, waiting time, and opportunity to contact the provider and during analysis dichotomized into "sufficient" versus "insufficient". Linear regression analysis was performed with change in HRQoL as dependent variable and background variables as independent variables. RESULTS In total, 6,765 respondents completed the second questionnaire. 19.8% of total respondents reported insufficient healthcare access. Respondents with insufficient healthcare had both more improved and deteriorated HRQoL compared to respondents with sufficient healthcare, whose HRQoL remained unchanged. We did not find significant interactions between age, gender, SES and/or chronic disease status with healthcare access at onset of the COVID-19 pandemic. CONCLUSION Healthcare access was not associated with cumulative differences in change in HRQoL over a 1-year period in strata of age, gender, SES, and chronic disease status.
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Affiliation(s)
- Nadja Alexandrov
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | | | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York City, NY, USA
| | - John N Yfantopoulos
- Health Department of Economics, National and Kapodistrian University of Athens, Athens, Greece
| | - Gouke J Bonsel
- Department Scientific Support, EuroQol Research Foundation, Rotterdam, The Netherlands
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4
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Mahapatra P, Sahoo KC, Pati S. A longitudinal qualitative study on physician experience in managing multimorbidity across the COVID-19 pandemic in Odisha, India. Sci Rep 2024; 14:12866. [PMID: 38834635 DOI: 10.1038/s41598-024-60473-0] [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: 11/05/2023] [Accepted: 04/23/2024] [Indexed: 06/06/2024] Open
Abstract
While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana's longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises.
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Affiliation(s)
- Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Krushna Chandra Sahoo
- Department of Health Research, Health Technology Assessment in India (HTAIn), Ministry of Health and Family Welfare, New Delhi, 110001, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre Bhubaneswar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India.
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Polat A, Demircioğlu Z, Küçükali H. Are we heroes or couriers? A phenomenological study on reappropriation of professional subjectivity and agency among health professionals during COVID-19 contact tracing in Türkiye. Soc Sci Med 2024; 351:116924. [PMID: 38743991 DOI: 10.1016/j.socscimed.2024.116924] [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: 11/29/2023] [Revised: 04/05/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Abstract
During the COVID-19 pandemic, Türkiye implemented a distinctive contact tracing approach involving in-person home visits by medical professionals to individuals who tested positive for the virus. This study examines the experiences of health professionals involved in contact tracing, exploring how they reappropriated their professional subjectivity and agency during their deployment in this role. It is an interpretive phenomenological qualitative study. We conducted 21 semi-structured in-depth interviews, subsequently carried out two separate focus group interviews with an additional 31 participants from various districts in Istanbul. Participants were selected from different medical professions (i.e. doctors, nurses, midwives), career stages, gender and age groups, and hierarchical levels (i.e. officers and directors). Data analysis was conducted collaboratively by the research team from sociology and public health disciplines. Our main finding is that for the majority of health professionals, contact tracing was a novel experience with challenges and ambivalances. Yet, regardless of their perceptions (positive, negative, or mixed), the experience promoted a reaffirmation of professional identity and reappropriation of professional subjectivity and agency, which discloses that professional subjectivity is not firm but dynamic, carrying stability as well as flexibility and adjustment. Four main themes are identified in their reappropriation of professional subjectivity and agency: uncovering professional fulfillment, feeling restrained in professional dissatisfaction, assessing the job, and engaging in professional and bureaucratic negotiations.The profound exploration into the dynamics of contact tracing amidst the pandemic illuminates a multidimensional narrative that transcends the conventional discourse on physical and psychological stress experienced by medical professionals. Contact tracing experience had a transformative impact on meaning and purpose of professional identity. Our findings highlight a need for a balanced approach between centralized decision-making, mobilization of professionals, quantitative evaluation, and professional autonomy and discretion, qualitative assessments, and meaningful engagement.
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Affiliation(s)
- Ayşe Polat
- Istanbul Boğaziçi University, Faculty of Arts and Sciences, Department of Sociology, Istanbul, Türkiye
| | - Zübeyde Demircioğlu
- İstanbul Medeniyet University, Faculty of Arts and Humanities, Department of Sociology, Istanbul, Türkiye
| | - Hüseyin Küçükali
- Queen's University Belfast, Centre for Public Health, Belfast, UK; Istanbul Medipol University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
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Thanh HN, Sutrisni IA, Rijal S, Pandey A, Tran TP, Dien R, Thi Hong YN, Timoria D, Friska D, Kekalih A, Bogh C, Karkey A, Hamers RL, Chambers M, Lewycka S, Van Nuil JI. Social cohesion among healthcare workers during COVID-19: Qualitative research in Indonesia, Nepal, and Vietnam. SSM. QUALITATIVE RESEARCH IN HEALTH 2024; 5:100404. [PMID: 38911289 PMCID: PMC11190837 DOI: 10.1016/j.ssmqr.2024.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/12/2024] [Accepted: 02/07/2024] [Indexed: 06/25/2024]
Abstract
Existing literature has portrayed numerous challenges that healthcare workers (HCWs) faced during the COVID-19 pandemic, such as heightened risks of transmission against the scarcity of protective equipment, burgeoning workload, and emotional distress, to name a few. However, most studies explored HCWs' experiences at the individual level rather than examining the collective responses. Exploring these experiences could reveal the social-cultural locality of the pandemic while identifying the system constraints in public health emergencies. As part of a mixed-method study on COVID-19 pandemic impacts, we analysed qualitative interview data with 129 HCWs and health-related staff to explore their experiences during the pandemic between 2020 and 2021 in Vietnam, Indonesia, and Nepal. Using Bahers' sociological framework, Community of Fate, we describe five themes reflecting the formation of a community of HCWs and the social cohesion underlying their efforts to survive hardship. The first three themes characterise the HCW community of fate, including (1) Recognition of extreme work-related danger, (2) physical and figurative closures where HCWs restrict themselves from the outside world, (3) chronic ordeals with overwhelming workload and responsibilities, encompassing recurrent mental health challenges. Against such extreme hardship, cohesive bonding and social resilience are reflected through two additional themes: (4) a mutual sense of moral and professional duty to protect communities, (5) the vertical and horizontal convergence among HCWs across levels and among government departments. We discuss these HCWs' challenges in relation to systemic vulnerabilities while advocating for increasing investment in public health and collaboration across government sectors to prepare for emergency situations.
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Affiliation(s)
- Ha Nguyen Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Ida Ayu Sutrisni
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Samita Rijal
- Oxford University Clinical Research Unit, Kathmandu, Nepal
| | - Aakriti Pandey
- Oxford University Clinical Research Unit, Kathmandu, Nepal
| | | | - Ragil Dien
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | - Diana Timoria
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Sumba Foundation, Sumba, Indonesia
| | - Dewi Friska
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Aria Kekalih
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | | | - Raph L. Hamers
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Dept of Medicine, University of Oxford, Oxford, UK
| | - Mary Chambers
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine and Global Health, Nuffield Dept of Medicine, University of Oxford, Oxford, UK
| | - Sonia Lewycka
- Oxford University Clinical Research Unit, Hanoi, Viet Nam
- Centre for Tropical Medicine and Global Health, Nuffield Dept of Medicine, University of Oxford, Oxford, UK
| | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine and Global Health, Nuffield Dept of Medicine, University of Oxford, Oxford, UK
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Yoshida T, Chude-Sokei R, Araji T, Adra S. Impact of COVID-19 Pandemic Surge on Surgical Outcomes: A Retrospective Study. Am Surg 2024; 90:1224-1233. [PMID: 38215308 DOI: 10.1177/00031348241227213] [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] [Indexed: 01/14/2024]
Abstract
BACKGROUND The COVID-19 pandemic posed significant challenges to healthcare systems worldwide, including surgical care. While many studies examined the effect of the pandemic on different patient outcomes, there are none to date examining the impact of the pandemic surge on surgical outcomes. Our aim is to evaluate the impact of the COVID-19 surges on surgical outcomes using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. METHODS A single-center retrospective analysis of 7436 patients who underwent surgery between February 2020 and December 2022 was conducted. Patients were divided into those who underwent surgery during the surge of the pandemic (n = 1217) or outside that period (n = 6219). Primary outcomes were 30-day mortality and morbidity. Secondary outcomes included 30-day mortality, operation time, transfusion, reoperation, and specific postoperative complications. Multivariable logistic regression was used in our analysis. All analyses were conducted using the software "R" version 4.2.1. Statistical significance was set at α = .05 level. RESULTS After adjusting for confounders, we found no significant difference in 30-day mortality and morbidity (OR: 1.06, 95% CI: .89-1.226, P = .5173) or 30-day mortality only (OR: 1.39, 95% CI: .788-2.14, P = .1364) between the two groups. No significant differences were observed in secondary outcomes. Sensitivity analyses yielded similar results to the multivariable logistic regression. CONCLUSION We found no evidence of increased 30-day mortality and morbidity in patients undergoing surgery during the COVID-19 surges compared to those undergoing surgery outside that period. Our results suggest that surgical care was maintained despite the challenges of the pandemic surges.
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Affiliation(s)
- Takuto Yoshida
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Tarek Araji
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Souheil Adra
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Gogoi M, Qureshi I, Chaloner J, Al-Oraibi A, Reilly H, Wobi F, Agbonmwandolor JO, Ekezie W, Hassan O, Lal Z, Kapilashrami A, Nellums L, Pareek M. Discrimination, disadvantage and disempowerment during COVID-19: a qualitative intrasectional analysis of the lived experiences of an ethnically diverse healthcare workforce in the United Kingdom. Int J Equity Health 2024; 23:105. [PMID: 38783292 PMCID: PMC11118759 DOI: 10.1186/s12939-024-02198-0] [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: 06/19/2023] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs' experiences of challenges during the pandemic. METHODS We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants' permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. RESULTS Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs' experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as 'intrasectionalism'. DISCUSSION Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic.
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Affiliation(s)
- Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Irtiza Qureshi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- The Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
| | - Jonathan Chaloner
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Amani Al-Oraibi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Holly Reilly
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Fatimah Wobi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Joy Oghogho Agbonmwandolor
- David Evans Medical Research Centre, Nottingham University Hospital NHS Trust, City Hospital, Nottingham, UK
| | - Winifred Ekezie
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Centre for Ethnic Health Research, University of Leicester, Leicester, UK
| | - Osama Hassan
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Zainab Lal
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Anuj Kapilashrami
- School of Health and Social Care, University of Essex, Colchester, UK
- Centre for Global Health & Intersectional Equity Research, University of Essex, Colchester, UK
| | - Laura Nellums
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- College of Population Health, Health Sciences Centre, University of New Mexico, Albuquerque, NM, USA
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK.
- Development Centre for Population Health, University of Leicester, Leicester, UK.
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
- NIHR Leicester BRC, Leicester, UK.
- NIHR ARC East Midlands, Leicester, UK.
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9
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Konstantinou P, Theofanous V, Karekla M, Kassianos AP. Mapping the needs of healthcare workers caring for COVID-19 patients using the socio-ecological framework: a rapid scoping review. HUMAN RESOURCES FOR HEALTH 2024; 22:29. [PMID: 38773594 PMCID: PMC11110340 DOI: 10.1186/s12960-024-00919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 05/16/2024] [Indexed: 05/24/2024]
Abstract
Undoubtedly, the mental health of healthcare workers (HCWs) was negatively affected because of caring for patients during the COVID-19 pandemic. However, literature is limited on mapping the challenges and needs of HCWs during COVID-19 pandemic. A widely used framework in public health for mapping evidence includes the socio-ecological models, suggesting behavior can be influenced by individual, interpersonal, organizational, and community factors. The aim of this rapid scoping review was to use the socio-ecological model to map and compile lessons learnt from the literature regarding primarily the challenges and needs and secondly available psychological interventions for HCWs caring for COVID-19 patients. PubMed, CINAHL and Scopus databases were searched, with 21 studies finally included examining challenges and needs of HCWs and 18 studies presenting psychological interventions. Organizational-level challenges and needs such as inadequate staff preparation and supplies of protective equipment, flexible work policies and paid rest periods were the most reported. Individual-level challenges and needs included COVID-19-related fears and reduced mental health, whereas interpersonal-related needs included support provision. Community-level challenges included societal stigma. Certain psychological interventions were found to be promising for HCWs, but these were utilized to address only individual-level challenges and needs. Given that well-being entails an interaction of factors, multi-level interventions addressing multiple socio-ecological levels (interpersonal, organizational, community) and that place HCWs in their social context should be administrated to increase and maintain intervention' effects long-term and possibly aid in better coping with future pandemics.
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Affiliation(s)
| | - Vaso Theofanous
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.
- Department of Nursing, Cyprus University of Technology, 3041, Limassol, Cyprus.
- Department of Applied Health Research, UCL, London, United Kingdom.
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Sharma M, Sra H, Painter C, Pan-ngum W, Luangasanatip N, Chauhan A, Prinja S, Singh M. Cost-effectiveness analysis of surgical masks, N95 masks compared to wearing no mask for the prevention of COVID-19 among health care workers: Evidence from the public health care setting in India. PLoS One 2024; 19:e0299309. [PMID: 38768249 PMCID: PMC11104672 DOI: 10.1371/journal.pone.0299309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/08/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Nonpharmacological interventions, such as personal protective equipment for example, surgical masks and respirators, and maintenance of hand hygiene along with COVID-19 vaccines have been recommended to reduce viral transmission in the community and health care settings. There is evidence from the literature that surgical and N95 masks may reduce the initial degree of exposure to the virus. A limited research that has studied the cost-effective analysis of surgical masks and N95 masks among health care workers in the prevention of COVID-19 in India. The objective of this study was to estimate the cost-effectiveness of N95 and surgical mask compared to wearing no mask in public hospital settings for preventing COVID-19 infection among Health care workers (HCWs) from the health care provider's perspective. METHODS A deterministic baseline model, without any mask use, based on Eikenberry et al was used to form the foundation for parameter estimation and to estimate transmission rates among HCWs. Information on mask efficacy, including the overall filtering efficiency of a mask and clinical efficiency, in terms of either inward efficiency(ei) or outward efficiency(e0), was obtained from published literature. Hospitalized HCWs were assumed to be in one of the disease states i.e., mild, moderate, severe, or critical. A total of 10,000 HCWs was considered as representative of the size of a tertiary care institution HCW population. The utility values for the mild, moderate and severe model health states were sourced from the primary data collection on quality-of-life of HCWs COVID-19 survivors. The utility scores for mild, moderate, and severe COVID-19 conditions were 0.88, 0.738 and 0.58, respectively. The cost of treatment for mild sickness (6,500 INR per day), moderate sickness (10,000 INR per day), severe (require ICU facility without ventilation, 15,000 INR per day), and critical (require ICU facility with ventilation per day, 18,000 INR) per day as per government and private COVID-19 treatment costs and capping were considered. One way sensitivity analyses were performed to identify the model inputs which had the largest impact on model results. RESULTS The use of N95 masks compared to using no mask is cost-saving of $1,454,632 (INR 0.106 billion) per 10,000 HCWs in a year. The use of N95 masks compared to using surgical masks is cost-saving of $63,919 (INR 0.005 billion) per 10,000 HCWs in a year. the use of surgical masks compared to using no mask is cost-saving of $1,390,713 (INR 0.102 billion) per 10,000 HCWs in a year. The uncertainty analysis showed that considering fixed transmission rate (1.7), adoption of mask efficiency as 20%, 50% and 80% reduces the cumulative relative mortality to 41%, 79% and 94% respectively. On considering ei = e0 (99%) for N95 and surgical mask with ei = e0 (90%) the cumulative relative mortality was reduced by 97% and the use of N95 masks compared to using surgical masks is cost-saving of $24,361 (INR 0.002 billion) per 10,000 HCWs in a year. DISCUSSION Both considered interventions were dominant compared to no mask based on the model estimates. N95 masks were also dominant compared to surgical masks.
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Affiliation(s)
- Meenakshi Sharma
- Queens University, Belfast, United Kingdom
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harnoor Sra
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Chris Painter
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Wirichada Pan-ngum
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Nantasit Luangasanatip
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Anil Chauhan
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shankar Prinja
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- All India Institute of Medical Sciences, Rishikesh, India
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11
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Muthumuni N, Sommer JL, El-Gabalawy R, Reynolds KA, Mota NP. Evaluating the mental health status, help-seeking behaviors, and coping strategies of Canadian essential workers versus non-essential workers during COVID-19: a longitudinal study. ANXIETY, STRESS, AND COPING 2024; 37:334-347. [PMID: 37494424 DOI: 10.1080/10615806.2023.2235294] [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: 11/26/2022] [Revised: 05/16/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This study examined mental health symptoms, help-seeking, and coping differences between Canadian essential workers (EWs) versus non-EWs, as well as common COVID-related concerns and longitudinal predictors of mental health symptoms among EWs only. DESIGN An online, longitudinal survey (N = 1260; response rate (RR) = 78.5%) assessing mental health and psychosocial domains amongst Canadian adults was administered during the first wave of COVID-19 with a six-month follow-up (N = 821; RR = 53.7%). METHODS Cross tabulations and chi-square analyses examined sociodemographic, mental health, and coping differences between EWs and non-EWs. Frequencies evaluated common COVID-related concerns. Linear regression analyses examined associations between baseline measures with mental health symptoms six months later amongst EWs. RESULTS EWs reported fewer mental health symptoms and avoidance coping than non-EWs, and were most concerned with transmitting COVID-19. Both groups reported similar patterns of help-seeking. Longitudinal correlates of anxiety and perceived stress symptoms among EWs included age, marital status, household income, accessing a psychologist, avoidant coping, and higher COVID-19-related distress. CONCLUSIONS COVID-19 has had a substantial impact on the mental health of Canadian EWs. This research identifies which EWs are at greater risk of developing mental disorders, and may further guide the development of pandemic-related interventions for these workers.
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Affiliation(s)
- Nisali Muthumuni
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Jordana L Sommer
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Kristin A Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Natalie P Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
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12
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Somani R, Muntaner C, Velonis AJ, Smith P, Hillan EM. Factors Contributing to Increased Workplace Violence Against Nurses During COVID-19 in the Healthcare Settings of a Lower Middle-income Country: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:148-158. [PMID: 38697611 DOI: 10.1016/j.anr.2024.04.008] [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: 12/22/2023] [Revised: 04/17/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE The aim of this study was to provide the perceptions of nurses, nursing supervisors, and nursing administrators about factors contributing to increased workplace violence (WPV) against nurses within the healthcare settings in Pakistan during the first wave of the COVID-19 pandemic. METHODS This study used a Descriptive Qualitative design, with a purposive sampling technique. From September to December 2021, In-depth interviews of 45 to 60 minutes, using a semistructured interview guide, we collected data from a private and a public healthcare setting in Pakistan. Given the travel restrictions during the COVID-19 pandemic, these interviews were conducted online, using Zoom audio features. Bedside nurses, nursing supervisors, and nursing administrators with at least six months of work experience participated in this study. RESULTS The qualitative data analysis steps suggested by Braun and Clarke (2013) were used for thematic analysis. The overarching theme emerging from the data was "Factors perceived by nurses that contributed to increased WPV in their work settings during the first wave of COVID-19, in a lower middle-income country" The subthemes from the participants' narrations were (a) highly stressed patients, attendants, and healthcare workers; (b) the financial burden on patients and their families; (c) lack of resources and shortage of staff; (d) restricted visiting policy and a weak security system; (e) lack of awareness about the seriousness of COVID-19; (f) misconceptions about COVID-19 vaccines and nurses' role in disseminating awareness. CONCLUSIONS The current pandemic increased the intensity of WPV against nurses in healthcare settings in Pakistan. Despite any supposed reasons for WPV, exposure to violence should never be an acceptable part of nursing. The healthcare system in Pakistan needs to pay equal attention to funding, resource provision, and ensuring a safe working environment for healthcare workers.
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Affiliation(s)
- Rozina Somani
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Canada.
| | - Carles Muntaner
- Lawrence S. Bloomberg, Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto, Canada
| | - Alisa J Velonis
- School of Public Health, Division of Community Health Sciences, University of Illinois Chicago, USA
| | - Peter Smith
- Institute for Work & Health, Toronto, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Edith M Hillan
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Canada
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Nantsupawat A, Kutney-Lee A, Abhicharttibutra K, Wichaikhum OA, Poghosyan L. Exploring the relationships between resilience, burnout, work engagement, and intention to leave among nurses in the context of the COVID-19 pandemic: a cross-sectional study. BMC Nurs 2024; 23:290. [PMID: 38685024 PMCID: PMC11057140 DOI: 10.1186/s12912-024-01958-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/21/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Nurses have faced significant personal and professional stressors during the COVID-19 pandemic that have contributed to increased rates of burnout, intention to leave, and poorer work engagement. Resilience has been identified as a critical factor influencing job outcomes; however, the dynamics of this association have not yet been investigated within the context of the Thai workforce. The study objective was to determine the associations between resilience and job outcomes, including burnout, intention to leave, and work engagement among nurses working in Thailand during the COVID-19 pandemic. METHODS This cross-sectional study gathered data from a sample of 394 registered nurses employed across 12 hospitals. The research instruments comprised the Connor-Davidson Resilience Scale (CD-RISC), the Maslach Burnout Inventory-Health Services Survey (MBI-HSS), a questionnaire assessing the intention to leave the job, and the Utrecht Work Engagement Scale (UWES). To determine the associations among the measured variables, multivariate logistic regression analyses were conducted. RESULTS One-third of nurses experienced emotional exhaustion and depersonalization, and about half experienced reduced personal accomplishment; one-tenth of nurses intended to leave their job. Nurses who exhibited higher levels of resilience were found to have a significantly reduced likelihood of experiencing high emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Conversely, these nurses were more likely to report higher levels of work engagement than their less resilience. CONCLUSION The COVID-19 pandemic offers important lessons learned about promoting the well-being of the nursing workforce and protecting against adverse job outcomes. While we identified resilience as a significant predictor of several nurse outcomes, other work environment factors should be considered. Government and hospital administrations should allocate resources for individual and organizational-level interventions to promote resilience among frontline nurses so that hospitals will be better prepared for the next public health emergency and patient and nurse outcomes can be optimized.
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Affiliation(s)
| | - Ann Kutney-Lee
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, USA
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14
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Kirkove D, Willems S, Van Poel E, Dardenne N, Donneau AF, Perrin E, Ponsar C, Mallen C, Stylianou N, Collins C, Gagnayre R, Pétré B. Characteristics of primary care practices associated with patient education during COVID-19: results of the cross-sectional PRICOV-19 study in 38 countries. BMC PRIMARY CARE 2024; 24:285. [PMID: 38637765 PMCID: PMC11027213 DOI: 10.1186/s12875-024-02348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND In response to the COVID-19 pandemic, the World Health Organization established a number of key recommendations such as educational activities especially within primary care practices (PCPs) which are a key component of this strategy. This paper aims to examine the educational activities of PCPs during COVID-19 pandemic and to identify the factors associated with these practices across 38 countries. METHODS A "Patient Education (PE)" score was created based on responses to six items from the self-reported questionnaire among PCPs (n = 3638) compiled by the PRICOV-19 study. Statistical analyses were performed on 3638 cases, with PCPs with missing PE score values were excluded. RESULTS The PE score features a mean of 2.55 (SD = 0.68) and a median of 2.50 (2.16 - 3.00), with a maximum of 4.00, and varies quite widely between countries. Among all PCPs characteristics, these factors significantly increase the PE score: the payment system type (with a capitation payment system or another system compared to the fee for service), the perception of average PCP with patients with chronic conditions and the perception of adequate governmental support. CONCLUSION The model presented in this article is still incomplete and requires further investigation to identify other configuration elements favorable to educational activities. However, the results already highlight certain levers that will enable the development of this educational approach appropriate to primary care.
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Affiliation(s)
- Delphine Kirkove
- Department of Public Health Sciences, University of Liege, B23 / Avenue Hippocrate, n°13, 4000, Liège, Belgium.
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Nadia Dardenne
- Department of Public Health Sciences, University of Liege, B23 / Avenue Hippocrate, n°13, 4000, Liège, Belgium
- Biostatistics and Research Method Center, University of Liege, Liege, Belgium
| | - Anne-Françoise Donneau
- Department of Public Health Sciences, University of Liege, B23 / Avenue Hippocrate, n°13, 4000, Liège, Belgium
- Biostatistics and Research Method Center, University of Liege, Liege, Belgium
| | - Elodie Perrin
- Department of Public Health Sciences, University of Liege, B23 / Avenue Hippocrate, n°13, 4000, Liège, Belgium
| | - Cécile Ponsar
- Institute of Health and Society, Louvain University, Louvain, Belgium
| | | | - Neophytos Stylianou
- International Institute for Compassionate Care, Nicosia, Cyprus
- NS Intelligence Solutions Ltd, Nicosia, Cyprus
| | - Claire Collins
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Research Centre, Irish College of General Practitioners, Dublin, D02XR68, Ireland
| | - Rémi Gagnayre
- Education and Health Practices Laboratory (LEPS), (UR 3412), UFR SMBH, Sorbonne Paris-Nord University, Bobigny, France
| | - Benoit Pétré
- Department of Public Health Sciences, University of Liege, B23 / Avenue Hippocrate, n°13, 4000, Liège, Belgium
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15
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Pereira SCDA, Ribeiro OMPL, Fassarella CS, Santos EJF. The impact of nursing practice environments on patient safety culture in primary health care: a scoping review. BJGP Open 2024; 8:BJGPO.2023.0062. [PMID: 37604581 PMCID: PMC11169981 DOI: 10.3399/bjgpo.2023.0062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Patient safety has in recent decades become a global concern. It is a key priority area of healthcare organisations, and has a direct impact on patient health and wellbeing. Work environments can strongly impact nurses' wellbeing and may ultimately produce different outcomes for both professionals and patients. The adverse events occurrence is an example of how work environments influence outcomes, and there is evidence of this correlation in several studies conducted in recent years. AIM To map the knowledge regarding the impact that nursing practice environments have on safety culture in primary healthcare settings, as primary health care concentrates a significant portion of the population's care. DESIGN & SETTING This review was conducted following the methodology proposed by the Joanna Briggs Institute (JBI) for scoping reviews. METHOD Study selection, data extraction, and synthesis were performed by two independent reviewers. Based on Population (or participants), Concept, and Context (PCC) framework, studies were considered that addressed nurses' practice environment and patient safety culture in primary health care. All studies published or unpublished from 2002 to the present were considered. RESULTS Seven studies were included in this review; however, the existing evidence on the relation between nurses' practice environments and patient safety is still limited in primary healthcare settings. Although clear evidence was not found, several characteristics of nursing practice environments that may impact healthcare safety were found, such as leadership, communication, and organisational culture and policies. CONCLUSION More research directed at primary healthcare nursing practice settings is needed and could be valuable in defining and implementing strategies that promote the safety of care.
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Affiliation(s)
- Soraia Cristina de Abreu Pereira
- PhD student of Nursing Science at Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal, Invited Adjunct Professor at Red Cross Northern School of Health and CINTESIS@RISE, Porto University, Porto, Portugal
| | | | - Cíntia Silva Fassarella
- Adjunct Coordinator and Permanent Professor of the Graduate Program in Nursing, Adjunct Professor at the Faculty of Nursing of the State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo José Ferreira Santos
- Adjunct Professor at Polytechnic University of Viseu, School of Health; Health Sciences Research Unit: Nursing (UICISA: E) and Portugal Centre for Evidence Based Practice (PCEBP): a JBI Centre of Excellence, Coimbra, Portugal
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O'Donnell S, Hayden J, Quigley E, Adamis D, Gavin B, McNicholas F. "We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response. Res Social Adm Pharm 2024; 20:389-400. [PMID: 38350789 DOI: 10.1016/j.sapharm.2023.12.004] [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: 08/17/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future. AIM(S) To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response. METHOD 11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis. RESULTS Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives. CONCLUSIONS The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.
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Affiliation(s)
- Shane O'Donnell
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland.
| | - John Hayden
- RCSI School of Pharmacy and Biomolecular Sciences (PBS), Royal College of Surgeons in Ireland, Ireland
| | - Etain Quigley
- National University of Ireland, Maynooth (Maynooth University) - Department of Law, Ireland
| | | | - Blánaid Gavin
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland
| | - Fiona McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland; Children Health Ireland, Crumlin, Dublin 12, Ireland; Lucena Clinic Rathgar, Dublin 6, Ireland
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Savage NM, Santen SA, Rawls M, Marzano DA, Wong JH, Burrows HL, Hicks RA, Aboff BM, Hemphill RR. Understanding resident wellness: A path analysis of the clinical learning environment at three institutions. MEDICAL TEACHER 2024:1-7. [PMID: 38557254 DOI: 10.1080/0142159x.2024.2331038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE The clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout. MATERIALS AND METHODS Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID. Psychological safety (PS) and perceived organizational support (POS) were used to capture the CLE, and the Mini-Z Scale was used to assess resident job stress and burnout. A total of 2,196 residents received a survey link; 889 responded (40% response rate). Path analysis explored both direct and indirect relationships between PS, POS, resident stress, and resident burnout. RESULTS Both POS and PS had significant negative relationships with experiencing a great deal of job stress; the relationship between PS and stress was noticeably stronger than POS and stress (POS: B= -0.12, p=.025; PS: B= -0.37, p<.001). The relationship between stress and residents' level of burnout was also significant (B = 0.38, p<.001). The overall model explained 25% of the variance in resident burnout. CONCLUSIONS Organizational support and psychological safety of the learning environment is associated with resident burnout. It is important for educational leaders to recognize and mitigate these factors.
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Affiliation(s)
- Nastassia M Savage
- FMP Consulting, Arlington, VA, USA
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Sally A Santen
- Dean's Office, Virginia Commonwealth University, Richmond, VA, USA
- Emergency Medicine and Medical Education, University of Cincinnati, Cincinnati, OH, USA
| | - Meagan Rawls
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Bon Secours Mercy Health, Richmond, VA, USA
| | - David A Marzano
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Jean H Wong
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Heather L Burrows
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Ralph A Hicks
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Brian M Aboff
- Graduate Medical Education, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Robin R Hemphill
- Cincinnati Veterans Association Medical Center, Cincinnati, OH, USA
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Skaffari E, Iirola T, Nordquist H. Patient experience of non-conveyance in the EMS of Southwest Finland: a descriptive survey study. BMC Emerg Med 2024; 24:42. [PMID: 38475735 DOI: 10.1186/s12873-024-00961-8] [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: 11/06/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Emergency Medical Services are dispatched more frequently than before. However, many non-urgent patients do not need ambulance transportation to a healthcare facility after evaluation and treatment on scene. This study explored the experiences of non-conveyed patients. Our research questions were: (1) How have non-conveyed patients experienced the service received from EMS? (2) Does a patient's age, gender, or time of the emergency call impact the patient's experience? METHODS This descriptive survey study examined non-conveyed Emergency Medical Services patients in the Wellbeing Services County of Southwest Finland. The study period was from March 1, 2023, to March 31, 2023. The study population was 1017. They received a questionnaire that was sent by mail. The questionnaire was formed based on questions previously used in four different questionnaires. We received 247 answers (24.3% response rate). Percentages, medians with interquartile ranges, and non-parametric tests were used in the descriptive analyses. RESULTS Non-conveyed patients were very satisfied with the paramedics' expertise and behavior, their ability to meet their individual needs, the sense of safety provided by the paramedics, and the instructions given to the patients. Time to receive help (19% rated 3 or less on a scale from 1 to 5), how paramedics introduced themselves (16.5%), and satisfaction with non-conveyance decisions (14.6%) were more frequently rated lower than other areas. Further, pain management stood out in the less favorable evaluations. Still, patients' experiences of the service were positive. The age group, gender, or time of the emergency call were not associated with patient experience. CONCLUSIONS Patients were very satisfied with the paramedics' interpersonal skills. A more focused approach to pain management and developing EMS to ensure faster patient outreach and clearer explanations of non-conveyance decisions could further enhance the patient experience.
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Affiliation(s)
- Eetu Skaffari
- Centre for Prehospital Emergency Care, Emergency Medical Services, Wellbeing Services County of Pirkanmaa, Satakunnankatu 16, FI-33100, Tampere, Finland
| | - Timo Iirola
- Emergency Medical Services, Turku University Hospital and University of Turku, FI-20521, Turku, PO Box 52, Finland
| | - Hilla Nordquist
- Department of Healthcare and Emergency Care, South-Eastern Finland University of Applied Sciences, Pääskysentie 1, FI-48220, Kotka, Finland.
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Spencer S, Lukewich J, Marshall EG, Mathews M, Asghari S, Brown JB, Freeman TR, Gill P, Idrees S, McCracken RK, Ranade S, Slade S, Terry AL, Wickett J, Wong E, Buote R, Meredith L, Moritz L, Ryan D, Hedden L. "Family doctors are also people": a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic. HUMAN RESOURCES FOR HEALTH 2024; 22:18. [PMID: 38439084 PMCID: PMC10913223 DOI: 10.1186/s12960-024-00901-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Family physicians (FPs) fill an essential role in public health emergencies yet have frequently been neglected in pandemic response plans. This exclusion harms FPs in their clinical roles and has unintended consequences in the management of concurrent personal responsibilities, many of which were amplified by the pandemic. The objective of our study was to explore the experiences of FPs during the first year of the COVID-19 pandemic to better understand how they managed their competing professional and personal priorities. METHODS We conducted semi-structured interviews with FPs from four Canadian regions between October 2020 and June 2021. Employing a maximum variation sampling approach, we recruited participants until we achieved saturation. Interviews explored FPs' personal and professional roles and responsibilities during the pandemic, the facilitators and barriers that they encountered, and any gender-related experiences. Transcribed interviews were thematically analysed. RESULTS We interviewed 68 FPs during the pandemic and identified four overarching themes in participants' discussion of their personal experiences: personal caregiving responsibilities, COVID-19 risk navigation to protect family members, personal health concerns, and available and desired personal supports for FPs to manage their competing responsibilities. While FPs expressed a variety of ways in which their personal experiences made their professional responsibilities more complicated, rarely did that affect the extent to which they participated in the pandemic response. CONCLUSIONS For FPs to contribute fully to a pandemic response, they must be factored into pandemic plans. Failure to appreciate their unique role and circumstances often leaves FPs feeling unsupported in both their professional and personal lives. Comprehensive planning in anticipation of future pandemics must consider FPs' varied responsibilities, health concerns, and necessary precautions. Having adequate personal and practice supports in place will facilitate the essential role of FPs in responding to a pandemic crisis while continuing to support their patients' primary care needs.
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Affiliation(s)
- Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Emily Gard Marshall
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Shabnam Asghari
- Family Medicine, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Judith B Brown
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Thomas R Freeman
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Paul Gill
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Samina Idrees
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Rita K McCracken
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Sudit Ranade
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Steve Slade
- The College of Family Physicians of Canada, 2630 Skymark Avenue, Mississauga, ON, L4W 5A4, Canada
| | - Amanda L Terry
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Jamie Wickett
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Richard Buote
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Leslie Meredith
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Lauren Moritz
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Halifax, NS, B3J 3T4, Canada
| | - Dana Ryan
- Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Jennifer A J, Vandenboer E, Anderson B, Lordly D, Macdonald B, Ann F. Changing Roles and Responsibilities of Dietitians from Diverse Settings During the First Three Waves of the COVID-19 Pandemic in Nova Scotia. CAN J DIET PRACT RES 2024; 85:12-19. [PMID: 38377041 DOI: 10.3148/cjdpr-2023-030] [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] [Indexed: 02/22/2024]
Abstract
Purpose: To explore the impact of the COVID-19 pandemic on Nova Scotian dietitian's roles, responsibilities, and professional development needs.Methods: We conducted a province-wide, online, exploratory survey with registered dietitians during the initial waves of the COVID-19 pandemic. Differences were explored with descriptive statistics by work sector (hospital/acute care; primary health/community or public health (PH); long-term care [LTC]; other [e.g., private practice, retail]).Results: Dietitians (n = 122) reported being most frequently challenged by stress and anxiety, changing work expectations, and rapidly evolving safety protocols during the pandemic. Those working in PH, primary health, and LTC reported experiencing more work responsibilities, more change, and perceived less employer support than dietitians in other sectors. Despite the identified challenges, most participants (70.7%) felt their education and training were sufficient to take on these new work roles. Primary and PH dietitians, however, more frequently perceived their skill sets to be under-utilized than other sectors. Key learnings from practice identified as being important for dietetic education included qualities such as resilience, problem-solving, flexibility, and self-care.Conclusion: These findings will be of interest to health administrators, professional bodies, and academic institutions to inform strategies for strengthening dietetic practice, building resilience, and preparing for future emergencies.
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Affiliation(s)
- Jamieson Jennifer A
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
| | - Erik Vandenboer
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Barbara Anderson
- School of Nutrition & Dietetics, Acadia University, Wolfville, NS
| | - Daphne Lordly
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Brenda Macdonald
- Nutrition and Food Services, Nova Scotia Health Authority, Halifax, NS
| | - Fox Ann
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
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21
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Buchberger B, Weishaar H, Evans M, Böttcher R, Umlauf R, Muminow S, Montt Maray E, Muller N, Chemali S, Geurts B, Fischer HT, El Bcheraoui C. Listening to the Voices of Health Care Workers During the COVID-19 Pandemic: A Qualitative Study Providing In-Depth Insights Into Ethical and Individual Challenges. QUALITATIVE HEALTH RESEARCH 2024:10497323241231521. [PMID: 38406882 DOI: 10.1177/10497323241231521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
In their daily practice, health care workers (HCWs) experience the effects of tensions between professional ethos and work realities, which can lead to ethical dilemmas. We aim to explore the ethical dilemmas that affected HCWs in Germany during the COVID-19 pandemic and to understand these in the context of the German health system. Between April and December 2022, we interviewed HCWs from various levels of care and key informants responsible for decisions related to HCWs in Germany. Three themes were identified in the data analyzed from 78 participants. The first highlighted the potency of pre-existing health system problems during the COVID-19 pandemic. The second captured the ethical dilemmas that were described as having arisen due to the tension between professional ethos and structural constraints. The third included factors related to increasing or diminishing the implications of ethical dilemmas. A lack of opportunities for HCWs to participate in political and managerial decisions was suggested to result in policies that do not meet the needs of HCWs and patients. Positive interpersonal interactions were described as helpful when coping with dilemmatic decision-making situations. In order to avoid negative consequences caused by unresolved ethical dilemmas, including moral distress, among HCWs, staff shortages and decision-making in the German health system urgently need to be addressed. HCWs' working conditions regularly evoke ethical dilemmas, particularly during public health emergencies. Together with HCWs, decision-makers must develop new models for working in health care settings that are in line with HCWs' professional ethos.
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Affiliation(s)
- Barbara Buchberger
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Heide Weishaar
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Megan Evans
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Rike Böttcher
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - René Umlauf
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Swetlana Muminow
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Eloisa Montt Maray
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Nadine Muller
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Souaad Chemali
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Brogan Geurts
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Hanna-Tina Fischer
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Charbel El Bcheraoui
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
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22
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Hernandez-Pineda E, Amaya CA, González-Uribe C, Herrera A, Velasco N. Covid-19 vaccination: a mixed methods analysis of health system resilience in Latin America. Int J Equity Health 2024; 23:27. [PMID: 38347545 PMCID: PMC10863163 DOI: 10.1186/s12939-023-02073-4] [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: 07/28/2023] [Accepted: 12/01/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND This paper discusses the stages of health system resilience (HSR) and the factors underlying differences in HSR during the covid-19 pandemic, especially the vaccination challenge. We studied the relationship between vaccination strategies and macro-context backgrounds in 21 Latin American countries. Our objective was to capture the impact of those aspects in the SR and identify potential improvements for future crises and for vaccination programs in general. METHODS The study uses mixed-methods research to provide insights into how the countries' backgrounds and vaccination strategies impact the HSR. Particularly, we used explanatory sequential mixed methods, which entails a quantitative-qualitative two-phase sequence. The quantitative phase was conducted using cluster and variance analysis, in which the HSR was measured using as a proxy the covid-19 vaccination outcomes in three cut-offs of reaching 25%, 50%, and 75% of population coverage. This approach allows us to discriminate covid-19 vaccination progress by stages and contrast it to the qualitative stage, in which we performed a country-case analysis of the background conditions and the changes in vaccination strategies that occurred during the corresponding dates. RESULTS The paper provides a rich comparative case analysis of countries, classifying them by early, prompt, and delayed performers. The results show that differences in vaccination performance are due to flexibility in adapting strategies, cooperation, and the ability to design multilevel solutions that consider the needs of various actors in the health ecosystem. These differences vary depending on the vaccination stage, which suggests the importance of acknowledging learning, diffusion, and feedback processes at the regional level. CONCLUSIONS We identified the importance of societal well-being as an ideal country antecedent for high and sustained levels of performance in covid-19 vaccination. Whereas in other countries where the set-up and beginning phases were rough, the value of the operational decisions and the learning on the move regarding their own and their peers' trajectories were crucial and were reflected in performance improvement. A contribution of this study is that the above-mentioned analysis was done using vaccination coverage cut-off points that allow a performance view that takes into consideration the stages of the vaccination progress and the learning process that goes with it. As well as framing this into the HSR shock cycles that allow to differentiate the stages of resilience on which countries must act.
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Affiliation(s)
| | - Ciro-Alberto Amaya
- School of Engineering, Universidad de Los Andes, Cra 1 E ste N° 19A - 40, Bogotá, 111711, Colombia
| | - Catalina González-Uribe
- School of Medicine, Universidad de Los Andes, Carrera 1 No 18 A - 10 42 Bloque Q Piso 8, Bogotá, 111711, Colombia
| | - Andrea Herrera
- School of Engineering, Universidad de Los Andes, Cra 1 E ste N° 19A - 40, Bogotá, 111711, Colombia
| | - Nubia Velasco
- School of Management, Universidad de Los Andes, Calle 21 # 1-20, Bogotá, 111711, Colombia
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Obina WF, Ndibazza J, Kabanda R, Musana J, Nanyingi M. Factors associated with perceived work-life balance among health workers in Gulu District, Northern Uganda: a health facility-based cross-sectional study. BMC Public Health 2024; 24:278. [PMID: 38263074 PMCID: PMC10807176 DOI: 10.1186/s12889-024-17776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION Work-life balance (WLB) plays a significant role in improving career satisfaction and reducing burnout. While health workers' productivity is considered a key factor in client care, there is limited effort put into examining how health workers perceive the balance of their jobs with family and other societal responsibilities (PWLB), especially in low-income countries where the number of health workers in active patient care is low. The purpose of this study was to assess factors associated with perceived work-life balance (PWLB) among health workers in the rural district of Gulu, Northern Uganda. METHODS A health facility-based cross-sectional analytical study was conducted. A simple random sampling technique was used to select 384 study participants from the three main hospitals in Gulu District. Data were collected from health workers using a self-administered semi-structured questionnaire and analyzed using STATA version 15. Factors associated with PWLB were determined at a multivariable level using a modified Poisson regression with robust variance with a 95% confidence level and 5% statistical significance. Adjusted prevalent ratios (APR) were used to report the Factors associated with PWLB. RESULTS Only 157/384 (40.9%) of the health workers reported a positive perceived work-life balance. Multivariable modified Poisson regression analysis showed positive statistical association with PWLB of a laboratory worker(APR = 1.74, 95% CI: 1.10-2.75); a midwife(APR = 1.82, 95% CI:1.13-2.93) or a nurse (APR = 2.19, 95% CI = 1.45-3.30); working in the inpatient department (APR = 1.97, 95% CI: 1.31-2.96) or laboratory (APR = 2.09, 95%CI: 1.34-3.28); and having a flexible work schedule (APR = 28.32, 95%CI:14.52-55.22); feeling satisfied at work (APR = 1.58; 95% CI:1.17-2.10), and belonging to an association in the community (APR = 32.71, 95% Cl:11.91-89.88). On the other hand, employment tenure of 1-4 years (APR = 0.63,95% CI:0.40-0.99) was negatively associated with perceived work-life balance. CONCLUSION Only four in every 10 health workers experienced a positive perceived work-life balance. The type of profession, duty station, flexibility in work schedule, satisfaction with work, and availability of social support systems, were independent determinants of perceived WLB. Therefore, nurturing a system of reviews of the scheduling of health workers, allowing internal staff rotation, and fostering support systems around the health workers could be beneficial for WLB.
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Affiliation(s)
- Wilfred Felicity Obina
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
- Department of Health, Catholic Medical Services, Gulu District, Kampala, Uganda
| | - Juliet Ndibazza
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
| | - Richard Kabanda
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
| | - Jonathan Musana
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
| | - Miisa Nanyingi
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda.
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Taleb S, Vahedian-Azimi A, Karimi L, Salim S, Mohammad F, Samhadaneh D, Singh K, Hussein NR, Ait Hssain A. Evaluation of psychological distress, burnout and structural empowerment status of healthcare workers during the outbreak of coronavirus disease (COVID-19): a cross-sectional questionnaire-based study. BMC Psychiatry 2024; 24:61. [PMID: 38254016 PMCID: PMC10804486 DOI: 10.1186/s12888-023-05088-x] [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: 12/16/2022] [Accepted: 08/08/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors. METHODS This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis. RESULTS Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences. CONCLUSION Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.
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Affiliation(s)
- Sara Taleb
- Division of Genomics and Translational Biomedicine, College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar
- Proteomics Core, Research department, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Leila Karimi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Safa Salim
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Farhan Mohammad
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Kalpana Singh
- Nursing Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar.
- College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar.
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25
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Romero-Cabrera AB, Lindo-Cavero A, Villarreal-Zegarra D, Rodriguez V, Luna-Matos ML, Rojas-Mendoza WN, Huarcaya-Victoria J, Cuzcano-Gonzales KV, Gonzales-Gavancho C, Alarcon-Ruiz CA. Perception of personal protective equipment availability and mental health outcomes in workers from two national hospitals during the COVID-19 pandemic. Heliyon 2024; 10:e23327. [PMID: 38148804 PMCID: PMC10750142 DOI: 10.1016/j.heliyon.2023.e23327] [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: 03/10/2023] [Revised: 11/18/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023] Open
Abstract
Background During the first wave of the pandemic, a constant concern of healthcare workers, who are more vulnerable to contagion, is their personal safety. This is directly related to the availability of adequate PPE, which led to a perception of dissatisfaction and inequality with government responses. We aim t o determines whether perception of adequate PPE availability is associated with depressive, anxiety, and stress symptoms in different types of healthcare workers. Methods Analytical cross-sectional study surveyed clinical and non-clinical healthcare workers in two third-level hospitals in Lima, Peru. An online self-survey assessed the perception of adequate PPE availability, using a Likert scale question, which was then dichotomized for the analysis. In addition, we assessed the depressive, anxiety, and stress symptoms using validated questionnaires. Results 563 participants were included. In general, there is no association between perception of PPE availability and three mental health outcomes. However, in the subgroup analysis, physicians with better perception of PPE availability had less moderate-severe outcomes in mental health; in contrast, nurses had higher moderate-severe outcomes. The type of profession in healthcare workers may modify the effect of this association. Conclusion The association between perception of PPE availability and mental health outcomes is complex in healthcare workers from two third-level hospitals. This association can vary according to the type of work.
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Affiliation(s)
| | | | - David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Escuela de Psicología, Universidad Continental, Lima, Peru
| | - Vilma Rodriguez
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
| | - Matilde L. Luna-Matos
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
| | | | - Jeff Huarcaya-Victoria
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
- Escuela Professional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Peru
| | - K. Vanesa Cuzcano-Gonzales
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Filial Norte, Chiclayo, Peru
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26
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Jose S, Geller G, Bollinger J, Mathews D, Kahn J, Garibaldi BT. The ethics of using COVID-19 host genomic information for clinical and public health decision-making: A survey of US health professionals. HGG ADVANCES 2024; 5:100255. [PMID: 37978805 PMCID: PMC10746522 DOI: 10.1016/j.xhgg.2023.100255] [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: 07/12/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
Several genetic variants linked to COVID-19 have been identified by host genomics researchers. Further advances in this research will likely play a role in the clinical management and public health control of future infectious disease outbreaks. The implementation of genetic testing to identify host genomic risk factors associated with infectious diseases raises several ethical, legal, and social implications (ELSIs). As an important stakeholder group, health professionals can provide key insights into these ELSI issues. In 2021, a cross-sectional online survey was fielded to US health professionals. The survey explored how they view the value and ethical acceptability of using COVID-19 host genomic information in three main decision-making settings: (1) clinical, (2) public health, and (3) workforce. The survey also assessed participants' personal and professional experience with genomics and infectious diseases and collected key demographic data. A total of 603 participants completed the survey. A majority (84%) of participants agreed that it is ethically acceptable to use host genomics to make decisions about clinical care and 73% agreed that genetic screening has an important role to play in the public health control of COVID-19. However, more than 90% disagreed that it is ethically acceptable to use host genomics to deny resources or admission to individuals when hospital resources are scarce. Understanding stakeholder perspectives and anticipating ELSI issues will help inform policies for hospitals and public health departments to evaluate and perhaps adopt host genomic technologies in an ethically and socially responsible manner during future infectious disease outbreaks.
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Affiliation(s)
- Sheethal Jose
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Gail Geller
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Juli Bollinger
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Debra Mathews
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Jeffrey Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Brian T Garibaldi
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Chabrol F, Traverson L, Hou R, Chotard L, Lucet JC, Peiffer-Smadja N, Bendjelloul G, Lescure FX, Yazdanpanah Y, Zinszer K, Ridde V. Adaptation and Response of a Major Parisian Referral Hospital to the COVID-19 Surge: A Qualitative Study. Health Syst Reform 2023; 9:2165429. [PMID: 36803567 DOI: 10.1080/23288604.2023.2165429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, few studies have focused on crisis management of multiple services within one hospital over several waves of the pandemic. The purpose of this study was to provide an overview of the COVID-19 crisis response of a Parisian referral hospital which managed the first three COVID cases in France and to analyze its resilience capacities. Between March 2020 and June 2021, we conducted observations, semi-structured interviews, focus groups, and lessons learned workshops. Data analysis was supported by an original framework on health system resilience. Three configurations emerged from the empirical data: 1) reorganization of services and spaces; 2) management of professionals' and patients' contamination risk; and 3) mobilization of human resources and work adaptation. The hospital and its staff mitigated the effects of the pandemic by implementing multiple and varied strategies, which the staff perceived as having positive and/or negative consequences. We observed an unprecedented mobilization of the hospital and its staff to absorb the crisis. Often the mobilization fell on the shoulders of the professionals, adding to their exhaustion. Our study demonstrates the capacity of the hospital and its staff to absorb the COVID-19 shock by putting in place mechanisms for continuous adaptation. More time and insight will be needed to observe whether these strategies and adaptations will be sustainable over the coming months and years and to assess the overall transformative capacities of the hospital.
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Affiliation(s)
- Fanny Chabrol
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
| | - Lola Traverson
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
| | - Renyou Hou
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
| | - Lisa Chotard
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
| | - Jean-Christophe Lucet
- Equipe de Prévention du Risque Infectieux, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Cité, Inserm, IAME, F-75006 Paris, France
| | - Nathan Peiffer-Smadja
- Service des Maladies Infectieuses et Tropicales, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Cité, Inserm, IAME, F-75006 Paris, France
| | - Gisèle Bendjelloul
- Equipe de Prévention du Risque Infectieux, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François-Xavier Lescure
- Service des Maladies Infectieuses et Tropicales, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Cité, Inserm, IAME, F-75006 Paris, France
| | - Yazdan Yazdanpanah
- Service des Maladies Infectieuses et Tropicales, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Cité, Inserm, IAME, F-75006 Paris, France
| | - Kate Zinszer
- Ecole de Santé publique de l'Université de Montréal, Centre de recherche en santé publique, Université de Montréal, Québec, Canada
| | - Valéry Ridde
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
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Tani K, Osetinsky B, Mhalu G, Mtenga S, Fink G, Tediosi F. Healthcare workers' experiences with COVID-19-related prevention and control measures in Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002678. [PMID: 38051721 PMCID: PMC10697532 DOI: 10.1371/journal.pgph.0002678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023]
Abstract
The ability of a health system to withstand shocks such as a pandemic depends largely on the availability and preparedness of health-care workers (HCWs), who are at the frontline of disease management and prevention. Despite the heavy burden placed on HCWs during the COVID-19 pandemic, little is known regarding their experiences in low-income countries. We conducted a web-based survey with HCWs in randomly selected districts of Tanzania to explore their experiences with COVID-19-related prevention and control measures. The survey assessed implementation of COVID-19 control guidelines in health facilities, HCW perceptions of safety, well-being and ability to provide COVID-19 care, and challenges faced by frontline workers during the pandemic. We used multivariate regression analysis to examine the association between HCW and health facility characteristics, a score of guideline implementation, and challenges faced by HCWs. 6,884 Tanzanian HCWs participated in the survey between December 2021 to March 2022. The majority of respondents were aware of the COVID-19 guidelines and reported implementing preventive measures, including masking of both HCWs and patients. However, HCWs faced several challenges during the pandemic, including increased stress, concerns about infection, and inadequate personal protective equipment. In particular, female HCWs were more likely to report exhaustion from wearing protective equipment and emotional distress, while physicians were more likely to experience all challenges. While most HCWs reported feeling supported by facility management, they also reported that their concerns about COVID-19 treatment were not fully addressed. Notably, perceptions of protection and well-being varied widely among different HCW cadres, highlighting the need for targeted interventions based on level of exposure. In addition, various factors such as HCW cadre, facility ownership and COVID-19 designation status influenced HCWs' opinions about the health system's response to COVID-19. These findings highlight the importance of consistent implementation of guidelines and social and emotional support for HCWs.
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Affiliation(s)
- Kassimu Tani
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Brianna Osetinsky
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Grace Mhalu
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Sally Mtenga
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Lertchaisataporn K, Boonsathorn W. Factors affecting the work passion of physicians during the COVID-19 pandemic: a qualitative study in Thailand. Int J Qual Stud Health Well-being 2023; 18:2235126. [PMID: 37454347 DOI: 10.1080/17482631.2023.2235126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
PURPOSE This qualitative study explores the factors influencing physicians' work passion during the COVID-19 pandemic in the Thai medical context. METHODS Using an appreciative inquiry (AI) approach, we conducted qualitative interviews with 30 physicians from a public hospital in Thailand to investigate the factors that influence passion for their professional work (work passion). RESULTS Our analysis revealed 12 codes influencing physician work passion, which were grouped into four themes: job factors (meaningful work, challenging tasks, task accomplishment, autonomy, work-life balance); organizational factors (fairness, positive environment); relationship factors (having a role model, psychological support, collaboration, recognition and respect); and individual factors (spiritual drive). CONCLUSION These findings contribute to developing knowledge about work passion among physicians and provide information to develop effective strategies to harness and manage work passion, thus improving clinical practice and healthcare outcomes. This qualitative study sheds light on the factors that influence physician work passion during the COVID-19 pandemic in Thailand, providing valuable information for future research and guiding the development of strategies to optimize work passion and its impact on clinical practice.
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Affiliation(s)
| | - Wasita Boonsathorn
- School of Human Resource Development, National Institution of Development Administration, Bangkok, Thailand
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You W, Cusack L, Donnelly F. A global comparison of nursing and midwifery's and medical efficacy in preventing COVID-19 deaths 2019-2022. Int Nurs Rev 2023; 70:552-559. [PMID: 37718556 DOI: 10.1111/inr.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 08/26/2023] [Indexed: 09/19/2023]
Abstract
AIM Compare roles of nurses and midwives and physicians in reducing COVID-19 deaths measured with a case fatality ratio. BACKGROUND The roles and responsibilities of different health disciplines to the COVID-19 pandemic vary. While more difficult to measure, objective assessments of discipline contributions of nurses and midwives and physicians can be viewed through statistical analysis. METHODS Population-level data are analysed with scatter plots, bivariate correlations, partial correlation and multiple linear regression models to illustrate the contributions of nurses and midwives and physicians in reducing COVID-19 deaths. The role of nurses and midwives and physicians in protecting the community against COVID-19 deaths is explored and compared using competing effects of affluence, age and urbanization. Data analysis software programs include Excel v.2016, SPSS v.28 and Fisher r-to-z transformation. RESULTS Nurses and midwives reduce COVID-19 deaths significantly more than physicians. This difference remains while controlling for physician care, economic affluence, median age and urbanization individually or in combination. In contrast, the role of physicians in reducing COVID-19 deaths is less independent than nurses and midwives. Linear regression results insinuate when nursing and physician care are collated together with other predicting factors, physicians' contribution to community protection against COVID-19 case fatality ratio is statistically explained by nursing and midwifery care. DISCUSSION Unlike physicians, the nursing and midwifery workforce is bigger and located throughout all healthcare system levels and, therefore, is more accessible to the community. This is an important point in explaining the contribution of nurses and midwives to reducing COVID-19 deaths when compared with physicians. CONCLUSION This study suggests that, worldwide, the nursing and midwifery workforce may play a more significant role in protecting the community against COVID-19 deaths than physicians. IMPLICATIONS FOR HEALTH POLICY, NURSING AND MIDWIFERY PRACTICE The findings from this study offer a unique perspective for health authorities to further understand the complementary and independent role of the nursing and midwifery workforce in respect of the healthcare team. This study suggests the importance of a broader range of healthcare services, especially during the pandemic, for example, COVID-19. With the permission of health authorities, the nursing and midwifery workforce should have further extension of their scope of practice in situations such as pandemics due to their broader access to the community.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
- Acute and Urgent Care, Royal Adelaide Hospital, Adelaide, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Lynette Cusack
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Frank Donnelly
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
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Ahmed SMJ, Miskeen E, Awadelgeed BA, Al Faifi JA. The psychological impact of the ongoing COVID-19 pandemic on health-care workers in primary health-care centers in resource-poor settings. J Family Med Prim Care 2023; 12:2840-2847. [PMID: 38186781 PMCID: PMC10771213 DOI: 10.4103/jfmpc.jfmpc_2416_22] [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: 12/13/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 01/09/2024] Open
Abstract
Background Health-care workers' psychological status is essential to Preventive control measures in a weak and unstable health system with poor infrastructural constraints. This study examines the psychological impact of the ongoing coronavirus disease 2019 (COVID-19) pandemic on the health-care providers working in primary health-care settings in Sudan. Materials and Methods This is a health facility-based cross-sectional study conducted in primary health-care units in White Nile State, Sudan. The psychological impact of stress and anxiety was determined using the Depression Anxiety Stress Scale 21 (DASS-21). A self-administered questionnaire measured depression, anxiety, and stress. The population of this study included health professionals working in health centers, including physicians, nurses, technicians, pharmacists, and other support staff. Results A total of 167 health professionals were systematically recruited. The mean anxiety score in the study population was 8.26 & 9.0 (corresponding to mild anxiety). Participants without anxiety constituted 26.35% (n = 44) of the participants. Women were significantly more likely to be affected than men (P = 0.0). Age (21-40 years), female nurses, and other health-care workers (anesthesiology, public health, health education, occupational health, psychiatry, etc.) could be strong predictors of psychological disorders (P-value of 0.0). Conclusion This study provided evidence for primary health care at its preparatory levels, as they are the first line of protection against the COVID-19 pandemic. Addressing the high-risk population is a high priority in the preliminary phase.
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Affiliation(s)
| | - Elhadi Miskeen
- Department of Obstetrics and Gynaecology, College of Medicine, University of Bisha, Bisha, Saudi Arabia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Gezira, Sudan
| | | | - Jaber Ahmed Al Faifi
- Department of Paediatrics, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Orhierhor M, Pringle W, Halperin D, Parsons J, Halperin SA, Bettinger JA. Lessons learned from the experiences and perspectives of frontline healthcare workers on the COVID-19 response: a qualitative descriptive study. BMC Health Serv Res 2023; 23:1074. [PMID: 37805603 PMCID: PMC10559616 DOI: 10.1186/s12913-023-10062-0] [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: 06/06/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, healthcare systems and healthcare workers (HCWs) faced significant demands and unique challenges. In this qualitative study, we explore the effects of the COVID-19 public health policies on British Columbia's frontline HCWs, describe what worked in the management of the pandemic, and elucidate the lessons learned that could be applied to future pandemic preparedness, recovery and response. METHODS This qualitative descriptive study is part of a larger, national multi-case study on pandemic policy communication and uptake. Semi-structured interviews were conducted from November 2020- June 2021 with fourteen HCWs working in long-term care (LTC), acute care and public health settings. Data were inductively coded, and analyzed following a resilience framework for public health emergency preparedness, which emphasizes the essential elements of a public health system, vital to all phases of health emergency management, readiness, response and recovery. RESULTS HCWs experienced confusion, frustration, uncertainty, anxiety, fatigue and stress, during the pandemic and detailed challenges that affected policy implementation. This included communication and coordination inconsistencies between the province and regional health authorities; lack of involvement of frontline staff in pandemic planning; inadequate training and support; inadequate personal protective equipment resource capacity and mobilization; and staffing shortages. HCWs recommended increased collaboration between frontline staff and policy makers, investment in preparing and practicing pandemic plans, and the need for training in emergency management and infection prevention and control. CONCLUSIONS Pandemic planning, response and recovery should include inputs from actors/key stakeholders at the provincial, regional and local levels, to facilitate better coordination, communication and outcomes. Also, given the critical roles of frontline HCWs in policy implementation, they should be adequately supported and consideration must be given to how they interpret and act on policies. Bi-directional communication channels should be incorporated between policymakers and frontline HCWs to verify the appropriate adoption of policies, reflective learning, and to ensure policy limitations are being communicated and acted upon by policy makers.
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Affiliation(s)
- Marian Orhierhor
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, A5-950 West 28th Street, Vancouver, BC, V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Wendy Pringle
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, A5-950 West 28th Street, Vancouver, BC, V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Donna Halperin
- Rankin School of Nursing, St. Francis Xavier University, 4130 University Ave, Antigonish, Nova Scotia, B2G 2W5, Canada
- Canadian Center for Vaccinology, Dalhousie University, IWK Health, Nova Scotia Health, Halifax, Nova Scotia, B3K 6R8, Canada
| | - Janet Parsons
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, M5B 1W8, Canada
- Department of Occupational Science & Occupational Therapy, Department of Physical Therapy, and the Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health, Nova Scotia Health, Halifax, Nova Scotia, B3K 6R8, Canada
- Departments of Pediatrics and Microbiology & Immunology, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, A5-950 West 28th Street, Vancouver, BC, V5Z 4H4, Canada.
- Department of Pediatrics, University of British Columbia, Vancouver, Canada.
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Cavalcante de Oliveira AP, Lopes Galante M, Senna Maia L, Craveiro I, Pereira da Silva A, Fronteira I, Chança R, Ferrinho P, Dal Poz M. Policies and Management Interventions to Enhance Health and Care Workforce Capacity for Addressing the COVID-19 Pandemic: Protocol for a Living Systematic Review. JMIR Res Protoc 2023; 12:e50306. [PMID: 37796568 PMCID: PMC10587809 DOI: 10.2196/50306] [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: 06/27/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Countries and health systems have had to make challenging resource allocation and capacity-building decisions to promote proper patient care and ensure health and care workers' safety and well-being, so that they can effectively address the present COVID-19 pandemic as well as upcoming public health problems and natural catastrophes. As innovations are already in place and updated evidence is published daily, more information is required to inform the development and implementation of policies and interventions to improve health and care workforce capacity to address the COVID-19 pandemic response. OBJECTIVE The objective of this protocol review is to identify countries' range of experiences with policies and management interventions that can improve health and care workers' capacity to address the COVID-19 pandemic response and synthesize evidence on the effectiveness of the interventions. METHODS We will conduct a living systematic review of quantitative, qualitative, and mixed methods studies and gray literature (technical and political documents) published in English, French, Hindi, Portuguese, Italian, and Spanish between January 1, 2000, and March 1, 2022. The databases to be searched are MEDLINE (PubMed), Embase, SCOPUS, and Latin American and Caribbean Health Sciences Literature. In addition, the World Health Organization's COVID-19 Research Database and the websites of international organizations (International Labour Organization, Economic Co-operation and Development, and The Health System Response Monitor) will be searched for unpublished studies and gray literature. Data will be extracted from the selected documents using an electronic form adapted from the Joanna Briggs Institute quantitative and qualitative tools for data extraction. A convergent integrated approach to synthesis and integration will be used. The risk of bias will be assessed with Joanna Briggs Institute critical appraisal tools, and the certainty of the evidence in the presented outcomes will be assessed with the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS The database and gray literature search retrieved 3378 documents. Data are being analyzed by 2 independent reviewers. The study is expected to be published by the end of 2023 in a peer-reviewed journal. CONCLUSIONS This review will allow us to identify and describe the policies and strategies implemented by countries and their effectiveness, as well as identify gaps in the evidence. TRIAL REGISTRATION PROSPERO CRD42022327041; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327041. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/50306.
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Affiliation(s)
| | - Mariana Lopes Galante
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leila Senna Maia
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Lisbon, Portugal
| | | | - Ines Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Lisbon, Portugal
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Lisbon, Portugal
| | - Mario Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Mirbahaeddin E, Chreim S. Work-life boundary management of peer support workers when engaging in virtual mental health support during the COVID-19 pandemic: a qualitative case study. BMC Public Health 2023; 23:1623. [PMID: 37620816 PMCID: PMC10463757 DOI: 10.1186/s12889-023-16488-9] [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: 01/03/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Mental health care needs have increased since the COVID-19 pandemic was declared. Peer support workers (PSWs) and the organizations that employ them have strived to provide services to meet increasing needs. During pandemic lockdowns in Ontario, Canada, these services moved online and were provided by PSWs from their homes. There is paucity of research that examines how providing mental health support by employees working from home influences their work-life boundaries. This research closes the gap by examining experiences of work-life boundary challenges and boundary management strategies of PSWs. METHODS A qualitative case study approach was adopted. Interviews with PSWs who held formal, paid positions in a peer support organization were conducted. Data was analyzed thematically using both inductive and deductive approaches. Descriptive coding that closely utilized participants' words was followed by inferential coding that grouped related themes into conceptual categories informed by boundary theory. Member checking was conducted. RESULTS PSWs provided accounts of work-life boundary challenges that we grouped into three categories: temporal (work schedule encroachments, continuous online presence), physical (minimal workspace segregation, co-presence of household members and pets) and task-related (intersecting work-home activities). Strategies used by PSWs to manage the boundaries consisted of segmenting the work-life domains by creating separate timescapes, spaces and tasks; and integrating domains by allowing some permeability between the areas of work and life. CONCLUSION The findings from this study can help inform management, practices, future research and policy on health care workforce. The study highlights the need to attend to the consequences of greater work-life integration for mental health workers since their successful practice is largely dependent on maintaining self-care. Training regarding work-life boundary management is highlighted as one of the ways to approach situations where work from home is required.
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Affiliation(s)
- Elmira Mirbahaeddin
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, Ontario K1N 6N5 Canada
| | - Samia Chreim
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, Ontario K1N 6N5 Canada
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Misnaniarti, Nugraheni WP, Nantabah ZK, Restuningtyas FR, Hartono RK, Rachmawati T, Mubasyiroh R, Kusnali A. Smoking behavior and hypertension among health workers during the COVID-19 pandemic: a case study in Java and Bali-Indonesia. Front Cardiovasc Med 2023; 10:1146859. [PMID: 37645521 PMCID: PMC10462451 DOI: 10.3389/fcvm.2023.1146859] [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: 01/18/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023] Open
Abstract
Background Health workers who should be role models for the community not to smoke and live a healthy life are still consuming cigarettes. Java and Bali (especially Java) are the biggest contributors to health worker deaths due to COVID-19 in Indonesia. This study aims to determine the association of smoking behavior and hypertension among health workers in Java and Bali. The researchers conducted this study in 2021 and designed it with a cross-sectional design. Data was collected online using the Lime Survey as a data collection tool. The data analysis used was logistic regression to determine the association of smoking and hypertension. Result A number of 7.6% of health workers were still smoking and 10.4% were suffering from hypertension during the COVID-19 pandemic. This study shows that the proportion of health workers with hypertension is two times that of smokers (18.0%) compared to non-smokers (9.8%). Logistic regression showed that smoking has a 20% higher risk of developing hypertension (OR = 1.97; 95%CI = 1.01-1.41; p = 0.034). Conclusion Among health workers on the islands of Java and Bali, there are still many who smoke, and this puts them at a higher risk of experiencing hypertension.
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Affiliation(s)
- Misnaniarti
- Public Health Faculty, Sriwijaya University, Kota Palembang, Indonesia
| | - Wahyu Pudji Nugraheni
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Indonesia
| | - Zainul Khaqiqi Nantabah
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Indonesia
| | | | | | - Tety Rachmawati
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Indonesia
| | - Rofingatul Mubasyiroh
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Indonesia
| | - Asep Kusnali
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Indonesia
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Lohmann J, Diallo M, De Allegri M, Koulidiati JL, Martinez-Alvarez M. Stress and coping in the face of COVID-19: a qualitative inquiry into early pandemic experiences and psychological well-being of health workers in Burkina Faso, Senegal and The Gambia. Health Policy Plan 2023; 38:777-788. [PMID: 37036713 PMCID: PMC10394495 DOI: 10.1093/heapol/czad023] [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: 01/17/2023] [Revised: 03/30/2023] [Accepted: 04/08/2023] [Indexed: 04/11/2023] Open
Abstract
COVID-19 represented an unprecedented challenge for health workers around the world, resulting in strong concerns about impacts on their psychological well-being. To inform on-going support and future preparedness activities, this study documented health workers' experiences, well-being and coping throughout the first wave of the pandemic, in Burkina Faso, Senegal and The Gambia. We collected data from 68 primarily clinical staff from the COVID-19 treatment, maternity and emergency departments in 13 purposely hospitals and laboratories across the three countries. Following in-depth interviews via Zoom (mid-May to September 2020), we regularly followed up via WhatsApp until the end of 2020. We used a mixed deductive and inductive coding approach and a framework matrix to organize and analyse the material. All respondents initially assessed the situation as stressful and threatening. Major emotional reactions included fear of own infection, fear of being a risk to loved ones, guilt, compassion, and anxiety regarding the future. Many suffered from feeling left alone with the emerging crisis and feeling unvalued and unappreciated, particularly by their governments and ministries of health. Conversely, health workers drew much strength from support and valuation by direct supervisors and team members and, in part, also by patients, friends and family. We observed important heterogeneity between places of work and individual backgrounds. Respondents coped with the situation in various ways, particularly with strategies to manage adverse emotions, to minimize infection risk, to fortify health and to find meaning in the adverse circumstances. Coping strategies were primarily grounded in own resources rather than institutional support. Over time, the situation normalized and fears diminished for most respondents. With a view towards emergency preparedness, our findings underline the value of participation and transparent communication, institutional support and routine training to foster health workers' psychological preparedness, coping skill set and resilience more generally.
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Affiliation(s)
- Julia Lohmann
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
| | - Marème Diallo
- MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 273, Banjul, The Gambia
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, 4 Rue 2 D1 Pole Urbain de Diamniado BP 7325, Dakar, Sénégal
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
| | - Jean-Louis Koulidiati
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso
| | - Melisa Martinez-Alvarez
- MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 273, Banjul, The Gambia
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, 4 Rue 2 D1 Pole Urbain de Diamniado BP 7325, Dakar, Sénégal
- Université Cheikh Anta Diop, Fann Campus, Dakar BP 5005, Sénégal
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Kuhlmann E, Ungureanu MI, Behrens GMN, Cossmann A, Fehr LM, Klawitter S, Mikuteit M, Müller F, Thilo N, Brînzac MG, Dopfer-Jablonka A. Migrant healthcare workers during COVID-19: bringing an intersectional health system-related approach into pandemic protection. A German case study. Front Public Health 2023; 11:1152862. [PMID: 37533524 PMCID: PMC10393282 DOI: 10.3389/fpubh.2023.1152862] [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: 01/28/2023] [Accepted: 06/26/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction Migrant healthcare workers played an important role during the COVID-19 pandemic, but data are lacking especially for high-resourced European healthcare systems. This study aims to research migrant healthcare workers through an intersectional health system-related approach, using Germany as a case study. Methods An intersectional research framework was created and a rapid scoping study performed. Secondary analysis of selected items taken from two COVID-19 surveys was undertaken to compare perceptions of national and foreign-born healthcare workers, using descriptive statistics. Results Available research is focused on worst-case pandemic scenarios of Brazil and the United Kingdom, highlighting racialised discrimination and higher risks of migrant healthcare workers. The German data did not reveal significant differences between national-born and foreign-born healthcare workers for items related to health status including SARS-CoV-2 infection and vaccination, and perception of infection risk, protective workplace measures, and government measures, but items related to social participation and work conditions with higher infection risk indicate a higher burden of migrant healthcare workers. Conclusions COVID-19 pandemic policy must include migrant healthcare workers, but simply adding the migration status is not enough. We introduce an intersectional health systems-related approach to understand how pandemic policies create social inequalities and how the protection of migrant healthcare workers may be improved.
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Affiliation(s)
- Ellen Kuhlmann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Marius-Ionut Ungureanu
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania
- Center for Health Workforce Research and Policy, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj Napoca, Romania
| | - Georg M. N. Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner-Site Hannover-Braunschweig, Hannover, Germany
| | - Anne Cossmann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Leonie Mac Fehr
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Sandra Klawitter
- Department of Computer Science, Ostfalia University of Applied Science, Wolfenbüttel, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Nancy Thilo
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Monica Georgina Brînzac
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania
- Center for Health Workforce Research and Policy, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, Cluj Napoca, Romania
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner-Site Hannover-Braunschweig, Hannover, Germany
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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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van de Baan F, Poesen L, Westra D, Fleuren B, Ruwaard D, Zijlstra F, Gifford R. Use it or lose it? Identifying reasons for the low use of psychosocial support by hospital staff. HUMAN RESOURCES FOR HEALTH 2023; 21:44. [PMID: 37296431 DOI: 10.1186/s12960-023-00830-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/28/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Psychosocial support programs are a way for hospitals to support the mental health of their staff. However, while support is needed, utilization of support by hospital staff remains low. This study aims to identify reasons for non-use and elements that are important to consider when offering psychosocial support. METHODS This mixed-method, multiple case study used survey data and in-depth interviews to assess the extent of psychosocial support use, reasons for non-use and perceived important elements regarding the offering of psychosocial support among Dutch hospital staff. The study focused on a time of especially high need, namely the COVID-19 pandemic. Descriptive statistics were used to assess frequency of use among 1514 staff. The constant comparative method was used to analyze answers provided to two open-ended survey questions (n = 274 respondents) and in-depth interviews (n = 37 interviewees). RESULTS The use of psychosocial support decreased from 8.4% in December 2020 to 3.6% by September 2021. We identified four main reasons for non-use of support: deeming support unnecessary, deeming support unsuitable, being unaware of the availability, or feeling undeserving of support. Furthermore, we uncovered four important elements: offer support structurally after the crisis, adjust support to diverse needs, ensure accessibility and awareness, and an active role for supervisors. CONCLUSIONS Our results show that the low use of psychosocial support by hospital staff is shaped by individual, organizational, and support-specific factors. These factors can be targeted to increase use of psychosocial support, whereby it is important to also focus on the wider hospital workforce in addition to frontline staff.
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Affiliation(s)
- Frank van de Baan
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT, Maastricht, The Netherlands.
| | - Lieze Poesen
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER, Maastricht, The Netherlands
| | - Daan Westra
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT, Maastricht, The Netherlands
| | - Bram Fleuren
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER, Maastricht, The Netherlands
| | - Dirk Ruwaard
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT, Maastricht, The Netherlands
| | - Fred Zijlstra
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER, Maastricht, The Netherlands
| | - Rachel Gifford
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT, Maastricht, The Netherlands
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Brøderud L, Pedersen R, Magelssen M. Balancing burdens of infection control: Norwegian district medical officers' ethical challenges during the COVID-19 pandemic. BMC Health Serv Res 2023; 23:590. [PMID: 37286998 DOI: 10.1186/s12913-023-09573-7] [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: 01/22/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND In several countries, district medical officers (DMOs) are public health experts with duties including infection control measures. The Norwegian DMOs have been key actors in the local handling of the COVID-19 pandemic. METHODS The aim of the study was to explore the ethical challenges experienced by Norwegian DMOs during the COVID-19 pandemic, and how the DMOs have handled these challenges. 15 in-depth individual research interviews were performed and analyzed with a manifest approach. RESULTS Norwegian DMOs have had to handle a large range of significant ethical problems during the COVID-19 pandemic. Often, a common denominator has been the need to balance burdens of the contagion control measures for different individuals and groups. In another large set of issues, the challenge was to achieve a balance between safety understood as effective contagion prevention on the one hand, and freedom, autonomy and quality of life for the same individuals on the other. CONCLUSIONS The DMOs have a central role in the municipality's handling of the pandemic, and they wield significant influence. Thus, there is a need for support in decision-making, both from national authorities and regulations, and from discussions with colleagues.
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Affiliation(s)
- Linn Brøderud
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Pb. 1130 Blindern, Oslo, N-0318, Norway
| | - Reidar Pedersen
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Pb. 1130 Blindern, Oslo, N-0318, Norway
| | - Morten Magelssen
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Pb. 1130 Blindern, Oslo, N-0318, Norway.
- MF Norwegian School of Theology, Religion and Society Oslo, Oslo, Norway.
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Kim Y, Yang SC, Jang J, Park SY, Kim SS, Kim C, Kwon D, Lee SW. COVID-19 Cases and Deaths among Healthcare Personnel with the Progression of the Pandemic in Korea from March 2020 to February 2022. Trop Med Infect Dis 2023; 8:308. [PMID: 37368726 DOI: 10.3390/tropicalmed8060308] [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: 05/04/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Healthcare personnel (HCP) are vulnerable to COVID-19 infection due to their higher risk of contact with infected persons. The numbers of cases and deaths among HCP in Korea were divided into four periods associated with different major variants of SARS-CoV-2: GH clade, Alpha, Delta, and Omicron. To evaluate the implication of HCP infection in Korea, we overviewed the pandemic status in Korea and in other countries: the cases, deaths, excess mortality, and vaccination rates in Germany, Israel, Italy, Japan, the United Kingdom, and the United States. In about two years, there were 10,670 HCP cases among all COVID-19 cases (1.15% of 925,975 cases). HCP cases had a lower death rate (%) compared to that for all cases (0.14 versus 0.75). Nurses were the most infected (55.3%), followed by HCP of other categories (28.8%) and doctors (15.9%), while deaths were mostly reported among doctors (9 out of 15, 60%). Cases among HCP gradually increased, but the death rate decreased as the pandemic progressed. Compared to five of the other countries examined, Korea had a higher incidence of cases but a lower mortality, lower excess mortality, and a higher vaccination rate.
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Affiliation(s)
- Yeonju Kim
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
| | - Sung-Chan Yang
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
| | - Jinhwa Jang
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
| | - Shin Young Park
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
| | - Seong Sun Kim
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
| | - Chansoo Kim
- AI/R Lab, AI-Robot Department, University of Science and Technology, Seoul 02792, Republic of Korea
- AI/R Lab, Computational Science Center & ASSIST, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - Donghyok Kwon
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
- Division of Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
| | - Sang-Won Lee
- Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency (KDCA), Cheongju 28159, Republic of Korea
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Ehrenzeller S, Kuehl R, Durovic A, Martinez AE, Battegay M, von Rotz M, Fringer A, Tschudin-Sutter S. A qualitative study on the perception of infection prevention and control measures among healthcare workers without patient contact during the SARS-CoV-2 pandemic. Antimicrob Resist Infect Control 2023; 12:43. [PMID: 37122021 PMCID: PMC10149153 DOI: 10.1186/s13756-023-01246-8] [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: 01/23/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023] Open
Abstract
We conducted a qualitative interview-based study to examine the perception of infection prevention and control (IPC) measures implemented during the COVID-19 pandemic among healthcare workers (HCWs) without patient contact in a tertiary academic care center. We compared these findings to those derived from interviews of HCWs with patient contact from the same institution using the same study design. The following main four themes were identified: (1) As for HCWs with patient contact, transparent communication strongly contributes to employees' sense of security. (2) Information on personal protective equipment (PPE) usage needs to be stratified according to different educational backgrounds and professions. (3) Consistency of IPC measures was positively perceived yet a desire for constant reminders to counteract the fatigue effect played a more significant role for HCWs without patient contact. (4) As compared to HCWs with patient contact, HCWs without patient contact preferred uniform digital training resources rather than more face-to-face training. This study shows that the needs of HCWs with and without patient contact differ and need to be considered in pandemic management.
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Affiliation(s)
- Selina Ehrenzeller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Richard Kuehl
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ana Durovic
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Aurélien Emmanuel Martinez
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias von Rotz
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - André Fringer
- School of Health Professions, Institute of Nursing, Zürich University of Applied Sciences ZHAW, Winterthur, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
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Soubra K, Tamworth C, Kamal Z, Brook C, Langdon D, Billings J. Health and social care workers experiences of coping while working in the frontline during the COVID-19 pandemic: One year on. PLoS One 2023; 18:e0284306. [PMID: 37043526 PMCID: PMC10096225 DOI: 10.1371/journal.pone.0284306] [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: 12/19/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The unprecedented pressure of working on the frontline during the Covid-19 pandemic had a demonstrable impact on the mental health and wellbeing of health and social care workers in the early stages of the pandemic, however, less research has focused on workers' experiences over the longer course of the pandemic. AIMS We set out to develop an explanatory model of the processes that helped and hindered the coping of HSCWs working over the course of the Covid-19 pandemic. METHOD Twenty HSCWs based in the UK took part in the study. They completed semi-structured interviews 12-18 months after the peak of the first wave in the UK. Interviews were transcribed and analysed using grounded theory methodology. RESULTS The analysis identified eleven theoretical codes: personal context, organisational resources, organisational response, management, colleagues, decision-making and responsibilities, internal impacts, external impactors, safety, barriers to accessing support and temporal factors. The findings suggest that factors related to the individual themselves, their personal context, the organisation they work in, their managers, the support structures around them and their sense of safety impacted on HSCWs; ability to cope. Some factors changed over time throughout the first year of the pandemic, such as workload and staff illness, which further impacted HSCWs' coping. There were many barriers to accessing support that also impacted coping, including availability, awareness and time. The relationship between the factors that impacted coping are represented in an explanatory model. CONCLUSIONS The findings extend previous studies on the mental health impact on frontline HSCWs working during Covid-19, providing novel insight by developing an explanatory model illustrating the underlying factors that impacted their coping experiences over the course of the pandemic in the UK. The findings from this study may assist in the development of improved and more effective support for HSCWs going forwards.
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Affiliation(s)
- Karina Soubra
- Department of Psychology, Royal Holloway University of London, London, United Kingdom
| | - Camilla Tamworth
- Division of Psychiatry, University College London, London, United Kingdom
| | - Zeast Kamal
- Division of Psychiatry, University College London, London, United Kingdom
| | - Clare Brook
- Acorn Group Practice, Twickenham, United Kingdom
| | - Dawn Langdon
- Department of Psychology, Royal Holloway University of London, London, United Kingdom
| | - Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
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Reid S, Nana M, Abrahams T, Hussey N, Okun-Netter R, Ras T, von Pressentin K. Tackling the First COVID-19 Wave at the Cape Town Hospital of Hope: Why Was It Such a Positive Experience for Staff? Healthcare (Basel) 2023; 11:healthcare11070981. [PMID: 37046908 PMCID: PMC10094382 DOI: 10.3390/healthcare11070981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/05/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Background: In contrast to alarming reports of exhaustion and burnout amongst healthcare workers in the first wave of the COVID-19 pandemic, we noticed surprisingly positive staff experiences of working in a COVID-19 field hospital in South Africa. The 862-bed “Hospital of Hope” was established at the Cape Town International Convention Centre specifically to cope with the effects of the first wave of the COVID-19 pandemic in Cape Town. Methods: We aimed to systematically describe and assess the effects on staff and the local health system. A cross-sectional descriptive study design was employed using mixed methods including record reviews and interviews with key informants. Results: Quantitative results confirmed high job satisfaction and low staff infection rates. The emerging themes from the qualitative data are grouped around a “bull’s eye” of the common purpose of person-centeredness, from both patient and staff perspectives, and include staff safety and support, rapid communication, continuous learning and adaptability, underpinned by excellent teamwork. The explanations for the positive feedback included good disaster planning, adequate resources, and an extraordinary responsiveness to the need. Conclusions: The “Hospital of Hope” staff experience produced valuable lessons for designing and managing routine health services outside of a disaster. The adaptability and responsiveness of the facility and its staff were largely a product of the unprecedented nature of the pandemic, but such approaches could benefit routine health services enormously, as individual hospitals and health facilities realize their place in a system that is “more than the sum of its parts”.
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Affiliation(s)
- Steve Reid
- Primary Health Care Directorate, University of Cape Town, Cape Town 7700, South Africa
- Correspondence:
| | - Mitan Nana
- Dean’s Office, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Theo Abrahams
- Western Cape Department of Health, Cape Town 8000, South Africa
| | - Nadia Hussey
- Western Cape Department of Health, Cape Town 8000, South Africa
| | | | - Tasleem Ras
- Division of Family Medicine, University of Cape Town, Cape Town 7700, South Africa
| | - Klaus von Pressentin
- Division of Family Medicine, University of Cape Town, Cape Town 7700, South Africa
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Albulescu AC. Exploring the links between flood events and the COVID-19 infection cases in Romania in the new multi-hazard-prone era. NATURAL HAZARDS (DORDRECHT, NETHERLANDS) 2023; 117:1611-1631. [PMID: 37251346 PMCID: PMC10032624 DOI: 10.1007/s11069-023-05918-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/09/2023] [Indexed: 05/31/2023]
Abstract
The occurrence of flood events amid the COVID-19 pandemic represents a prominent part of the emerging multi-hazard landscape, as floods are one of the most frequent and destructive natural hazards. This spatial and temporal overlap of hydrological and epidemiological hazards translates into compounded negative effects, causing a shift in the hazard management paradigm, in which hazard interaction takes centre stage. This paper calls into question whether the river flood events that occurred during the COVID-19 pandemic in Romania and the way that they were managed had an impact on the infection with the SARS-CoV-2 virus at county scale. To this end, hazard management data concerning the flood events that were severe enough to impose the evacuation of the population were corroborated with COVID-19 confirmed cases data. A definite link between the flood events and the dynamics of COVID-19 cases registered in the selected counties is difficult to identify, but the analysis shows that all flood events were followed by various size increases in the COVID-19 confirmed cases at the end of the incubation time range. The findings are critically interpreted by providing viral load and social-related contexts, allowing a proper understanding of the interactions between concurrent hazards.
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Affiliation(s)
- Andra-Cosmina Albulescu
- Tulnici Research Station via RECENT AIR, “Alexandru Ioan Cuza” University of Iasi, Bd. Carol I, No. 11 700506, Iasi, Romania
- Faculty of Geography and Geology, Alexandru Ioan Cuza University of Iasi, Iasi, Romania
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46
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McChesney C, Powis ML, Espin-Garcia O, Hack S, Morley L, Krzyzanowska MK. Staff Experiences With Remote Work in a Comprehensive Cancer Center During the COVID-19 Pandemic and Recommendations for Long-Term Adoption. JCO Oncol Pract 2023; 19:e732-e744. [PMID: 36812455 DOI: 10.1200/op.22.00649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic led to the rapid implementation of remote work, but few studies have examined the impact. We evaluated clinical staff experience with working remotely at a large, urban comprehensive cancer center in Toronto, Canada. METHODS An electronic survey was disseminated between June 2021, and August 2021, via e-mail to staff who had completed at least some remote work during the COVID-19 pandemic. Factors associated with a negative experience were examined with binary logistic regression. Barriers were derived from a thematic analysis of open-text fields. RESULTS Most respondents (N = 333; response rate, 33.2%) were age 40-69 years (46.2%), female (61.3%), and physicians (24.6%). Although the majority of respondents wished to continue remote work (85.6%), relative to administrative staff (admin), physicians (odds ratio [OR], 16.6; 95% CI, 1.45 to 190.14) and pharmacists (OR, 12.6; 95% CI, 1.0 to 158.9) were more likely to want to return on-site. Physicians were approximately eight times more likely to report dissatisfaction with remote work (OR, 8.4; 95% CI, 1.4 to 51.6) and 24 times more likely to report that remote work negatively affected efficiency (OR, 24.0; 95% CI, 2.7 to 213.0); nurses were approximately seven times more likely to report the need for additional resources (OR, 6.5; 95% CI, 1.71 to 24.48) and/or training (OR, 7.02; 95% CI, 1.78 to 27.62). The most common barriers were the absence of fair processes for allocation of remote work, poor integration of digital applications and connectivity, and poor role clarity. CONCLUSION Although overall satisfaction with working remotely was high, work is needed to overcome barriers to implementation of remote and hybrid work models in the health care setting.
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Affiliation(s)
- Christopher McChesney
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Melanie Lynn Powis
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Osvaldo Espin-Garcia
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Epidemiology and Biostatistics, Western University, London, ON, Canada.,Dalla Lana School of Public Health and Statistical Sciences, University of Toronto, Toronto, ON, Canada
| | - Saidah Hack
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Epidemiology and Biostatistics, Western University, London, ON, Canada.,Dalla Lana School of Public Health and Statistical Sciences, University of Toronto, Toronto, ON, Canada
| | - Lyndon Morley
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Epidemiology and Biostatistics, Western University, London, ON, Canada.,Dalla Lana School of Public Health and Statistical Sciences, University of Toronto, Toronto, ON, Canada
| | - Monika K Krzyzanowska
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Epidemiology and Biostatistics, Western University, London, ON, Canada.,Dalla Lana School of Public Health and Statistical Sciences, University of Toronto, Toronto, ON, Canada
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Cousin Cabrolier L, Di Beo V, Marcellin F, Rousset Torrente O, Mahe V, Valderas JM, Chassany O, Carrieri PM, Duracinsky M. Negative representations of night-shift work and mental health of public hospital healthcare workers in the COVID-19 era (Aladdin survey). BMC Health Serv Res 2023; 23:187. [PMID: 36814276 PMCID: PMC9946706 DOI: 10.1186/s12913-023-09101-7] [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: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Many risk factors impact the health of hospital night workers, which can lead to physical and mental health disorders. During the recent period, night hospital workers have been particularly stressed. This study therefore aims to: (i) To document the prevalence of depression, anxiety, sleep disorders, and symptoms suggestive of post-traumatic stress disorder in night shift workers (NSHW) working in Parisian public hospitals after France's first COVID-19 wave ended; (ii) To estimate the effect of negative representations and perceptions of night shift work on these mental health outcomes. METHODS An observational cross-sectional online survey of NSHW (June to September 2020) in 39 public hospitals in Paris, France. Standard scales were used to measure mental health outcomes. Weighted multinomial logistic regression models supported the identification of predictors of depression (score > 10 on the Hospital Anxiety and Depression Scale, HADS, for depression), anxiety (score > 10 on the HADS for anxiety), severe insomnia (score > 21 on the Insomnia Severity Index, ISI) and symptoms suggestive of post-traumatic stress disorder (score > 36 on the Impact of Event Scale-Revised, IES-R). RESULTS The weighted prevalence rates [95% confidence interval] of depression, anxiety, severe insomnia, and symptoms of post-traumatic stress disorder were, respectively, 18.9% [16.5-21.2], 7.6% [6.0-9.1], 8.6% [6.9-10.2] and 11.7% [9.7-13.6]. After multiple adjustment, organizational changes in NSHW professional lives due to the COVID-19 pandemic (such as moving to another hospital department and modified schedules) and NSHW-perceived negative representations of night work were significantly associated with all studied mental health outcomes. CONCLUSION Our findings confirm the importance of monitoring mental health and sleep quality among NSHW in Parisian public hospitals, even more during health crises. Multilevel interventions aiming at reducing negative representations and improving work organization are urgently needed to improve overall health of this frontline healthcare providers group.
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Affiliation(s)
- Lorraine Cousin Cabrolier
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France ,grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Vincent Di Beo
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Fabienne Marcellin
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Olivia Rousset Torrente
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France
| | - Véronique Mahe
- Service de Santé Au Travail, Hôpitaux Lariboisière-Fernand Widal, AP-HP Nord, Paris, France
| | - José Maria Valderas
- grid.4280.e0000 0001 2180 6431Department of Medicine, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Olivier Chassany
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France
| | - Patrizia Maria Carrieri
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004, Paris, France. .,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010, France. .,Département de Médecine Interne Et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, 94275, Kremlin Bicêtre, France.
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48
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Wałowska K, Domaradzki J. Superheroes or Super Spreaders? The Impact of the COVID-19 Pandemic on Social Attitudes towards Nurses: A Qualitative Study from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2912. [PMID: 36833609 PMCID: PMC9957068 DOI: 10.3390/ijerph20042912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The social perception of the nursing profession in Poland is profoundly affected by social stereotypes that may discourage young people from entering the profession and lead to prejudice towards nurses. During the COVID-19 pandemic, nurses gained visibility, which caused the social image of nurses to likewise grow. In this study, we explore nurses' experiences with respect to how the COVID-19 pandemic influenced the social image of nursing. Semi-structured interviews were conducted with fifteen hospital nurses. Three major themes emerged: (1) social attitudes towards nurses during the pandemic, (2) nurses' perception of the impact of the pandemic on the social image of the nursing profession and (3) the impact of the pandemic on nurses' mental health. Although the pandemic promoted the image of nursing to the general public, nurses were disappointed that in the face of the healthcare crisis and the constant threat, they had to struggle with difficult working conditions and professional, social and economic recognition. This study therefore stresses the duty of policy makers to undertake a systemic approach to improving the organisation of health care and increase nurses' safety by providing them with a safe working environment and prepare them better for the next health crisis.
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Affiliation(s)
- Katarzyna Wałowska
- Department of Gastroenterology, Metabolic Diseases, Internal Medicine and Dietetics, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Jan Domaradzki
- Laboratory of Health Sociology and Social Pathology, Department of Social Sciences and Humanities, Poznań University of Medical Sciences, 60-806 Poznań, Poland
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49
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Wałowska K, Domaradzki J. Superheroes or Super Spreaders? The Impact of the COVID-19 Pandemic on Social Attitudes towards Nurses: A Qualitative Study from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2912. [DOI: https:/doi.org/10.3390/ijerph20042912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
The social perception of the nursing profession in Poland is profoundly affected by social stereotypes that may discourage young people from entering the profession and lead to prejudice towards nurses. During the COVID-19 pandemic, nurses gained visibility, which caused the social image of nurses to likewise grow. In this study, we explore nurses’ experiences with respect to how the COVID-19 pandemic influenced the social image of nursing. Semi-structured interviews were conducted with fifteen hospital nurses. Three major themes emerged: (1) social attitudes towards nurses during the pandemic, (2) nurses’ perception of the impact of the pandemic on the social image of the nursing profession and (3) the impact of the pandemic on nurses’ mental health. Although the pandemic promoted the image of nursing to the general public, nurses were disappointed that in the face of the healthcare crisis and the constant threat, they had to struggle with difficult working conditions and professional, social and economic recognition. This study therefore stresses the duty of policy makers to undertake a systemic approach to improving the organisation of health care and increase nurses’ safety by providing them with a safe working environment and prepare them better for the next health crisis.
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Affiliation(s)
- Katarzyna Wałowska
- Department of Gastroenterology, Metabolic Diseases, Internal Medicine and Dietetics, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Jan Domaradzki
- Laboratory of Health Sociology and Social Pathology, Department of Social Sciences and Humanities, Poznań University of Medical Sciences, 60-806 Poznań, Poland
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50
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Otero-García L, Mateos JT, Esperato A, Llubes-Arrià L, Regulez-Campo V, Muntaner C, Legido-Quigley H. Austerity Measures and Underfunding of the Spanish Health System during the COVID-19 Pandemic-Perception of Healthcare Staff in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2594. [PMID: 36767958 PMCID: PMC9914961 DOI: 10.3390/ijerph20032594] [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: 12/28/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Insufficient pandemic preparedness and underfunding of human and economic resources have conditioned the response to COVID-19 in Spain. This underfunding has continued since the austerity measures introduced during the 2008 financial crisis. This study aims to understand the perceptions of healthcare staff in Spain on the relationship between the funding of the health system and its capacity to respond to the COVID-19 pandemic. To this end, we carried out a thematic content analysis, based on 79 online semi-structured interviews with healthcare staff across the regions most affected by the COVID-19 first wave. Participants reported a lack of material resources, which had compromised the capacity of the health system before the pandemic. The lack of human resources was to be addressed by staff reorganisation, such as reinforcing hospital units to the detriment of primary health care. Staff shortages continued straining the COVID-19 response, even after material scarcities were later partially alleviated. Personnel shortages need to be adequately addressed in order to adequately respond to future health crises.
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Affiliation(s)
- Laura Otero-García
- CIBER Epidemiology and Public Health (CIBERESP-ISCIII), 28029 Madrid, Spain
- Nursing Department, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - José Tomás Mateos
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain
- Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRB Lleida), 25198 Lleida, Spain
| | | | - Laia Llubes-Arrià
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain
- Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRB Lleida), 25198 Lleida, Spain
| | - Vanesa Regulez-Campo
- Osakidetza, Nursing Teaching Unit, Cruces University Hospital, 48903 Baracaldo, Spain
| | - Carles Muntaner
- Faculty of Nursing, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Helena Legido-Quigley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
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