Psychological impact of COVID-19 on medical care workers in China

Proactive behaviors and health care workers: A systematic review

BACKGROUND

Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes.

PURPOSE

This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care.

METHODS

Systematic review of articles published to date on proactive behaviors in health care workers.

RESULTS

Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome.

PRACTICE IMPLICATIONS

Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.

Prevalence of mental health symptoms and associated risk factors among healthcare workers in specialized COVID-19 hospitals in Anyang, China: A cross-sectional survey

Background

The novel coronavirus disease 2019 (COVID-19) pandemic spread worldwide and brought unprecedented challenges to healthcare systems. Healthcare workers experienced tremendous pressure and psychological issues.

Methods

A cross-sectional online survey was conducted from January 2022 to April 2022 among healthcare workers in Anyang, Henan Province, China. Insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and problematic internet use (PIU) were evaluated. Logistic regression analyses were used to explore the factors that were associated with mental health problems.

Results

A total of 242 participants (mean [SD] age, 34.7 [6.6] years, 187 female [77.3 %]) were included in the study. The prevalence of symptoms of insomnia, anxiety, depression, PTSD and PIU during the COVID-19 pandemic in China was 53.7 %, 100.0 %, 7.0 %, 20.3 %, and 19.4 %, respectively. Participants who smoked, used sedative-hypnotic drugs and may need psychological assistance were at a higher risk for mental health problems. Respondents who were older than 45 years and were married displayed a lower risk of insomnia and PTSD, respectively.

Conclusions

Mental health symptoms are pervasive among healthcare workers in specialized COVID-19 hospitals during the outbreak. Risk factors include smoking, sedative-hypnotic drug use, and the need for psychological assistance, while protective factors include age and marital status. Developing social media platforms and providing psychological assistance may be effective interventions for healthcare workers.

Psychological status and related factors of resident physicians during the release of COVID-19 pandemic restrictions in China

Background

Resident physicians at the standardized training stage had undergone significant physical and mental stress during the release of the COVID-19 pandemic restrictions at the end of 2022 in China. This study aimed to investigate the psychological status (including anxiety, depression, somatic symptoms, job burnout, and vicarious trauma) of resident physicians and identify its influencing factors under these special periods.

Methods

Survey was conducted one month after the release of the COVID-19 pandemic restrictions on resident training physicians from a tertiary first-class hospital in Zhejiang, China. Resident physicians completed the psychological status questionnaire. Chi-square tests, Mann-Whitney U tests, and logistic regression analyses were used to estimate the group differences and variable associations.

Results

The prevalence of anxiety, depression, and somatic discomfort in this study was 20.88, 28.53, and 41.47%, respectively. Female resident physicians were more likely to experience somatic symptoms [adjusted odds ratio (OR) = 2.36, 95% confidence interval (CI): 1.33-4.18]. Resident physicians with problem-focused coping styles were less prone to psychological health issues [depression (adjusted OR = 0.92, 95% CI: 0.88-0.96), anxiety (adjusted OR = 0.94, 95% CI: 0.90-0.98), somatic symptoms (adjusted OR = 0.93, 95% CI: 0.89-0.97), job burnout (adjusted OR = 0.91, 95% CI: 0.87-0.96) and vicarious trauma (adjusted OR = 0.94, 95% CI: 0.90-0.98)]. Inversely, resident physicians with emotion-focused coping styles and experienced negative life events were more prone to psychological health issues.

Conclusion

Resident training physicians had a high risk of anxiety, depression, and somatic symptoms under the special COVID-19 pandemic restriction release period. Females, with lower training stages, degrees, negative life events, and emotion-focused coping styles had a disadvantaged effect on psychological status. The medical teaching management department needs to monitor and reduce the workload and working hours of resident physicians, ensure sufficient sleep time, and pay attention to the psychological status of resident physicians. By strengthening regular communication and mental health education or intervention, which can help them improve their ability to cope with complex tasks.

Network analysis of posttraumatic stress and posttraumatic growth symptoms among women in subsequent pregnancies following pregnancy loss

BACKGROUND

Pregnant women who have undergone pregnancy loss often display both posttraumatic stress (PTS) and posttraumatic growth (PTG). However, the precise relationship and structure of symptomatic levels of PTS and PTG have not been well understood. This study aimed to assess the associations between PTS and PTG symptoms in women during subsequent pregnancies following a previous pregnancy loss.

METHODS

A total of 406 pregnant women with a history of pregnancy loss were included in this study. The Impact of Events Scale-6 (IES-6) and the Posttraumatic Growth Inventory Short Form (PTGI-SF) were used to assess symptoms of PTS and PTG, respectively. The Graphical Gaussian Model was employed to estimate the network model. Central symptoms and bridge symptoms were identified based on "expected influence" and "bridge expected influence" indices, respectively. The stability and accuracy of the network were examined using the case-dropping procedure and nonparametric bootstrapped procedure.

RESULTS

The network analysis identified PTG3 ("Ability to do better things") as the most central symptom, followed by PTS3 ("Avoidance of thoughts") and PTG6 ("New path for life") in the sample. Additionally, PTS3 ("Avoidance of thoughts") and PTG9 ("Perception of greater personal strength") were bridge symptoms linking PTS and PTG clusters. The network structure was robust in stability and accuracy tests.

CONCLUSIONS

Interventions targeting the central symptoms identified, along with key bridge symptoms, have the potential to alleviate the severity of PTS experienced by women with a history of pregnancy loss and promote their personal growth.

Prevalence and influencing factors of PTSD symptoms among healthcare workers: A multicenter cross-sectional study during the surge period of the COVID-19 pandemic since December 2022 in the Chinese mainland

BACKGROUND

China has experienced a surge period of COVID-19 pandemic since December 2022. Healthcare workers (HCWs) were exposed to huge workload under high risk of being infected, and significant levels of trauma, which might cause Post-traumatic Stress Disorders (PTSD) symptoms in HCWs.

OBJECTIVES

To identify the prevalence of PTSD symptoms among HCWs in the Chinese mainland during the surge period of the COVID-19 pandemic; to explore their psycho-social factors of PTSD symptoms.

METHODS

A multicenter cross-sectional study was conducted among HCWs in Chinese mainland from January 5 to February 9, 2023, covering seven geographical regions. 6552 participants were recruited by convenience sampling. Data were collected on demographic characteristics, work-related factors, and psychological factors by online questionnaires. Univariate analysis and binary logistic regression were used to determine the influencing factors of PTSD symptoms.

RESULTS

The prevalence of PTSD symptoms among HCWs was 37.49 %. A higher level of mindfulness, resilience, and perceived social support were protective factors. Female gender, nurses, higher educational attainment, married status, more working years, higher perceived risk of contracting COVID-19 due to work, and higher perceived work intensity were risk factors.

CONCLUSION

High prevalence of PTSD symptoms among HCWs necessitates psychological interventions. Tailored interventions, designed by professional psychiatrists, should be tailored to address the stressors. A comprehensive approach, incorporating mindfulness, resilience-building, and perceived social support enhancement, is vital to bolster the mental well-being of HCWs exposed to traumatic events, thus mitigating the impact of PTSD effectively. Additionally, it is essential to provide support to HCWs with other potential risk factors.

Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic

INTRODUCTION

In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists' resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS.

RESULTS

A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = - 0.33; p < .001 and Beta = - 0.21; p = .001), mental (Beta = - 0.29; p < .001 and Beta = - 0.18; p = .006) and emotional (Beta = - 0.31; p < .001 and Beta = - 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant.

CONCLUSION

This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists' psychological well-being during crises, offering insights for tailored support and interventions.

Relationships between psychopathological symptoms, pandemic-related stress, perceived social support, and COVID-19 infection history: a network analysis in Chinese college students

Introduction

Previous coronavirus, 2019 (COVID-19) research has applied network analysis to examine relationships between psychopathological symptoms but rarely extended to potential risk and protective factors or the influence of COVID-19 infection history. This study examined complex inter-relationships between psychopathological symptoms, COVID-19-related stressors, perceived social support, and COVID-19 infection history among Chinese university/college students during the peak of fifth pandemic wave using a network analysis approach.

Methods

A Least Absolute Shrinkage and Selection Operator-regularized partial correlation network using Gaussian graphical model was constructed in 1,395 Chinese university/college students in Hong Kong who completed a survey between 15 March and 3 April, 2022. Depressive, anxiety, and acute/traumatic stress symptoms were measured by Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Impact of Event Scale-6, respectively. COVID-19-related stressors and perceived social support were measured. Network differences by COVID-19 infection history (COVID-network vs. no_COVID-network) and network communities were examined.

Results

Our results showed that the most influential nodes were depressed mood, uncontrollable worries, and uncontrollable thoughts about COVID-19. The main bridging symptoms were concentration problems and psychomotor problems. The COVID-network, comprising participants with a history of COVID-19 infection only, was significantly stronger than the no_COVID-network. Perceived social support and stress from conflicts with family/friends formed a unique community with negative cognition and suicidal idea in the COVID-network only.

Conclusion

Our findings indicate that specific interventions targeting interpersonal conflicts and concentration problems as well as facilitating stress buffering effects of social support may represent effective strategies to reduce psychological distress in university/college students during COVID-19 and should be considered for future pandemic preparedness.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam

OBJECTIVES

The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors.

METHODS

A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale.

RESULTS

In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05).

CONCLUSIONS

Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

A study on the impact of life meaning on occupational identity of nursing students in China:a cross-sectional study

BACKGROUND

With the alterations of the Chinese epidemic prevention policy, China experienced a nationwide wave of the Coronavirus disease 2019 (COVID-19) pandemic from December 2022 to January 2023.The impact of the COVID-19 pandemic extends beyond individual perceptions of the meaning of life and attitudes toward life and death; it also affects the professional identity of nursing students.This study explored nursing students' professional identity and life meaning of affected by the pandemic.

METHODS

An online survey was conducted using the Chinese version of the Nursing Student Career Identity Scale and the Chinese version of the Meaning in Life Questionnaire to assess the current status of nursing students' professional identity and sense of life meaning. Data were also collected on participant gender, education, clinical practice experience, and COVID-19 infection.

RESULTS

The scores for nursing students' sense of professional identity (61.58 ± 16.16) and sense of life meaning (45.29 ± 12.65) were both at an intermediate level. Compared to the scores before the COVID-19 pandemic, Chinese nursing students' professional identity scores increased, while their sense of life meaning scores decreased. Moreover, we found a positive correlation between professional identity and sense of life meaning (p < 0.001); nursing students exhibited a stronger professional identity when they had a relatively higher sense of life meaning than those with a relatively lower sense of life meaning.

CONCLUSION

Enhancing nursing students' sense of meaning in life is crucial for maintaining their professional identity. Attention should be given to life education for nursing students and the development of relevant educational curricula.

Psychological effect of COVID-19 pandemic on healthcare professionals of Yemen and coping strategies

COVID-19 pandemic has triggered psychological stress such as anxiety and depression among people around the globe. Due to the nature of the job, healthcare professionals (HCPs) are at high risk of infection and are facing social stigma as well. This research was conducted with the objective to evaluate the psychological influence of the COVID-19 pandemic among HCPs in Yemen and the coping strategies adopted thereof. A web-based, as well as face-to-face cross-sectional study was carried out from July to December 2021 among HCPs of Yemen. The generalized anxiety disorder (GAD-7), patient health questionnaire (PHQ-9), and Brief-COPE scales were applied for the evaluation of anxiety, depression, and coping strategies. A total of 197 HCPs participated in the study where 28.4% and 43.1% had anxiety and depression respectively. The prevalence of both anxiety and depression in the majority were found of the minimal to none and mild categories (71.6% vs. 56.9% respectively). The respondents who had received training on COVID-19 had statistically significant lower GAD-7 scores than those who did not (6.32 vs. 8.02 respectively). A significant statistical difference was observed between physicians versus nurses regarding depression based on the working area (p < 0.05). The physician and pharmacist had a significant positive association with brief COPE scores at the 50th centile compared to other HCPs. The female respondents had statistically significant higher mean Brief COPE scores than male respondents (78.11 vs. 69.50 respectively). Our findings illustrate the requirement for efficient policies through administrative, clinical, and welfare perspectives from the regulatory body in preparedness and preventive measures towards such a pandemic that aids HCPs to provide service in a stress-free condition and assurance of a better healthcare system..

Mental Health of Healthcare Workers During the Third Wave of the COVID-19 Pandemic: Did We Forget them after the First Wave?

Background

Since December 2019, countries experienced different numbers of COVID-19 pandemic waves. The COVID-19 pandemic led to adverse psychologic problems in the communities and among healthcare workers (HCWs), but the dynamic of these problems through different waves needs to be established more.

Materials and Methods

This cross-sectional study was conducted in October 2020, through the third wave of the COVID-19 pandemic, in Isfahan, Iran. We studied HCWs' depression, anxiety, and stress using Depression, Anxiety, Stress Scale-21 (DASS-21) and insomnia using Insomnia Severity Index (ISI) questionnaires. Multiple linear regression was used to evaluate the association of some characteristic factors with different psychologic symptoms.

Results

Our results showed that about 80% of HCWs had one or more psychological problems. The prevalence of depression, anxiety, stress, and insomnia was 46.0%, 50.2%, 44.6%, and 66.5%, respectively. Female sex, working in ICU, and having a history of chronic disease were predictors of psychological symptoms in our participants.

Conclusion

HCWs' mental health state could be underestimated or neglected. The third pandemic wave negatively affected the mental health of the HCWs. Since mental health problems of HCWs may reduce the quality of care, the potential impact of not addressing this issue should be highlighted.

Post-traumatic stress symptoms in mental healthcare workers during the COVID-19 outbreak

Background

In the context of disease outbreaks, healthcare workers are exposed to multiple physical and psychological stressors, which may result in severe mental health outcomes. Although existing literature explores this impact, it is focused on frontline workers, with limited evidence exploring the mental well-being of mental healthcare workers (MHCWs).

Aim

To explore post-traumatic stress symptoms (PTSS) and associated factors among MHCWs within the context of the coronavirus disease 2019 (COVID-19) pandemic.

Setting

Four academic hospitals in the Gauteng province, South Africa, with specialised psychiatric units.

Methods

A cross-sectional study design was used. Participants were selected using a simple random sampling technique and invited to participate in structured interviews. Measurement tools included a demographic questionnaire, the post-traumatic stress disorder checklist for DSM-5 and the Brief Resilient Coping Scale.

Results

A total of 120 MHCWs participated. The prevalence of PTSS was 11.7%. The MHCWs' profession was a significant predictor of the occurrence of PTSS (p = 0.046), with nurses being the most affected. Other socio-demographic, employment, COVID-19-related factors and coping skills were not predictors of PTSS.

Conclusion

An elevated prevalence of PTSS has been found and was significantly associated with the profession of the MHCW. It is recommended that existing employee wellness programmes be strengthened to promote mental well-being and improve resilience among MHCWs, particularly vulnerable employee groups.

Contribution

This study provides insight into the prevalence of PTSS among MHCWs following the COVID-19 outbreak, as well as associated factors.

Risk factors for healthcare professionals' mental health during the COVID-19 pandemic: a systematic review

The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers' mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.

A cross-sectional study on coping strategies of frontline healthcare workers amid the COVID-19 pandemic in a developing country

Objectives

Frontline healthcare workers encountered a heightened susceptibility to negative psychological symptoms and behavioral shifts in light of the coronavirus disease 2019 pandemic. This study determined the coping strategies adopted by frontline healthcare workers in Ghana as well as assessed any differences based on demographics, job title, and ranking in four coronavirus disease 2019-designated centers in the Greater Accra region of Ghana.

Methods

Using a hospital-based, mixed-method approach, the study was conducted between May 2021 and September 2021. A total of 94 frontline healthcare workers were randomly sampled and given a self-administered questionnaire, while 13 healthcare workers took in-depth interviews. Data from the survey were analyzed using both IBM SPSS and IBM AMOS and the interview data were transcribed verbatim and coded using thematic analysis.

Results

The study revealed that coronavirus disease 2019 has affected the psycho-social life of frontline healthcare workers mainly in the form of depression, anxiety, and stress. The three main coping strategies adopted by frontline healthcare workers include personal preventative measures (most dominant), seeking external expert support, and obtaining institutional support. While healthcare workers within the age group 30-39 years were found most compliant with the adoption of personal preventive measures and those below 30 years were found least compliant.

Conclusion

This study concludes that frontline healthcare workers have been affected by a considerable level of anxiety, stress, and depression during the coronavirus disease 2019 pandemic. The study recommends a robust psychological support system at various levels of health care and an Employee Assistance Program with access to a 24-h hotline counseling service for frontline healthcare workers, continuous personal protective equipment provision, regular evidence-based updates on the management of coronavirus disease 2019 patients, and increased commitment from the government in addressing the medical needs of infected frontline healthcare workers.

Effects of Web-Based Mindfulness-Based Interventions on Anxiety, Depression, and Stress Among Frontline Health Care Workers During the COVID-19 Pandemic: Systematic Review and Meta-Analysis

BACKGROUND

Since 2019, the COVID-19 outbreak has spread around the world, and health care workers, as frontline workers, have faced tremendous psychological stress.

OBJECTIVE

The purpose of this study is to explore whether web-based mindfulness-based interventions continue to have a positive impact on anxiety, depression, and stress among health care workers during the COVID-19 pandemic.

METHODS

The inclusion criteria were as follows: (1) participants were frontline health care workers during the COVID-19 pandemic; (2) the experimental group was a web-based mindfulness-based intervention; (3) the control group used either general psychological intervention or no intervention; (4) outcome indicators included scales to assess anxiety, depression, and stress; and (5) the study type was a randomized controlled study. Studies that did not meet the above requirements were excluded. We searched 9 databases, including Web of Science, Embase, PubMed, Cochrane Library, Scopus, ScienceDirect, SinoMed, China National Knowledge Infrastructure (CNKI), and Wanfang Database, for randomized controlled studies on the effects of web-based mindfulness-based interventions on common mental disorder symptoms among health care workers from January 1, 2020, to October 20, 2022. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. The Cochrane risk of bias tool was used to assess the risk of bias. Subgroup analysis was used to look for sources of heterogeneity and to explore whether the results were the same for subgroups under different conditions. Sensitivity analysis was used to verify the stability of the pooled results.

RESULTS

A total of 10 randomized controlled studies with 1311 participants were included. The results showed that web-based mindfulness-based interventions were effective in reducing the symptoms of anxiety (standard mean difference [SMD]=-0.63, 95% CI -0.96 to -0.31, P<.001, I2=87%), depression (SMD=-0.52, 95% CI -0.77 to -0.26, P<.001, I2=75%), and stress (SMD=-0.20, 95% CI -0.35 to -0.05, P=.01, I2=58%) among health care workers during the COVID-19 pandemic, but with wide CIs and high heterogeneity.

CONCLUSIONS

Web-based mindfulness-based interventions may be effective in reducing the symptoms of anxiety, depression, and stress among frontline health care workers during the COVID-19 pandemic. However, this effect is relatively mild and needs to be further explored by better studies in the future.

TRIAL REGISTRATION

PROSPERO CRD42022343727; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343727.

Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study

AIM

To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.

METHODS

This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).

RESULTS

Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.

CONCLUSIONS

TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.

The Perception of Workplace Safety and of Risk of Contagion among Preschool Teachers during the COVID-19 Pandemic

The COVID-19 pandemic had a major impact on early childhood educational contexts and on educators' working conditions. This study aims to examine the change over time in personal contribution to workplace safety and perception of risk of infection among preschool teachers after returning to in-person work during the third wave of the pandemic (spring 2021). Teachers' perceptions of workplace safety can influence their quality of work-life and, as a consequence, the quality of service offered to children. Data were collected using two questionnaires: at T0 (January) and at T1 (May). The results showed relations between organizational and personal actions to manage risk and fear of infection at work. Concern about COVID-19 contagion decreased over time (t = 5.53, p = 0.000) and perceptions of personal contribution to workplace safety related to COVID-19 improved: t = -2.18 p = 0.031. The decrease in these concerns illustrates how perceptions of ability to manage contagion and protect workplace safety of preschool teachers improved over time, despite the stability of the pandemic context in the first half of 2021. After the end of the COVID-19 pandemic, this study gives an account of some good practices and their perceived effectiveness in terms of safety for childhood educational contexts.

Prevalence of anxiety and depression of health care workers during COVID-19 - a systematic review and meta-analysis

Introduction

During the COVID-19 pandemic, the workload of healthcare workers managing the disease, increased significantly. The objective of this review is to determine the anxiety and depression prevalence among healthcare workers during the pandemic period.

Methods

We searched systematically the literature in five electronic databases such as PubMed, CINAHL, ScienceDirect, MEDLINE, and Cochrane COVID-19 study register. The last online research was performed in May 2022. We included only cross-sectional studies and performed a meta-analysis of pooled prevalence. Publication bias was assessed with a funnel plot and Egger's and Begg's tests. A random effect was applied and heterogenicity I2 was calculated. Quality assessment of included studies was performed using the Joanna Briggs Institute tool.

Results

In this review, we included 14 cross-sectional studies comprising 7780 healthcare workers. Participants were from the whole spectrum of healthcare workers. The pooled prevalence of depression was 33.8% (95% CI: 24.6 - 43.6), heterogenicity I2: 98.69%. The pooled prevalence of anxiety was 41.3% (95% CI: 30.2 - 52.9), heterogenicity I2: 99.01%.

Conclusion

One-third of healthcare workers suffered from depression, and more than one-third suffered from anxiety during the COVID-19 pandemic. Increased measures of surveillance of mental health should have been taken, as well as the support of healthcare workers running a high risk of psychological distress during the COVID-19 pandemic.

Network analysis of affect, emotion regulation, psychological capital, and resilience among Chinese males during the late stage of the COVID-19 pandemic

Background

Previous studies have confirmed that both affect and emotion regulation strategies are closely associated with psychological capital (PsyCap) and resilience. These factors are assumed to buffer the effect of the COVID-19 pandemic on mental health, especially among males. However, these interactions have not been closely examined to date. To fill this gap, this paper explores the dimension-level relationships of these psychological constructs among Chinese males during the late stage of the COVID-19 pandemic and identified critical bridge dimensions using network analysis.

Methods

A total of 1,490 Chinese males aged 21–51 years completed self-report scales assessing emotion regulation strategies, affect, PsyCap, and psychological resilience. Two regularized partial correlation networks, namely the affect and emotion regulation-PsyCap network and the affect and emotion regulation-psychological resilience network, were then constructed to examine links between the dimensions of these constructs. The bridge expected influence (BEI) index was also calculated for each node to identify important bridge nodes.

Results

Positive affect, negative affect, cognitive reappraisal, and expressive suppression showed distinct and complex links to various dimensions of PsyCap or psychological resilience. In both networks, positive affect, cognitive reappraisal, and negative affect were identified as critical bridge nodes, with the first two having positive BEI values and the third having a negative value.

Conclusion

The findings elucidate the specific role of the dimensions of emotion regulation or affect in relation to PsyCap and psychological resilience, which facilitates further understanding of the mechanisms underlying these interrelationships. These findings also provide implications for developing effective intervention strategies to increase PsyCap and psychological resilience.

Mental well-being of intensive care unit nurses after the second surge of the COVID-19 pandemic: A cross-sectional and longitudinal study

OBJECTIVES

To determine the impact of the second surge of the COVID-19 pandemic (October 2020 to June 2021) on mental well-being of intensive care unit nurses and factors associated with mental health outcomes.

METHODS

An online survey was available for Dutch intensive care unit nurses in October 2021, measuring mental health symptoms; anxiety, depression (Hospital Anxiety and Depression Scale), and post-traumatic stress disorder (Impact of Event Scale-6). Additionally, work-related fatigue was measured using the Need For Recovery-11 questionnaire. Previous data from the first surge (March until June 2020) were used to study mental well-being longitudinally in a subgroup of intensive care unit nurses. Logistic regression analyses were performed to determine factors associated with mental health symptoms.

RESULTS

In total, 589 nurses (mean age 44.8 [SD, 11.9], 430 [73.8 %] females) participated, of whom 164 also completed the questionnaire in 2020. After the second surge, 225/589 (38.2 %) nurses experienced one or more mental health symptoms and 294/589 (49.9 %) experienced work-related fatigue. Compared to the first measurement, the occurrence of mental health symptoms remained high (55/164 [33.5 %] vs 63/164 [38.4 %], p = 0.36) and work-related fatigue was significantly higher (66/164 [40.2 %] vs 83/164 [50.6 %], p = 0.02). Granted holidays as requested (aOR, 0.54; 95 % CI, 0.37-0.79), being more confident about the future (aOR, 0.59; 95 % CI, 0.37-0.93) and a better perceived work-life balance (aOR, 0.42; 95 % CI, 0.27-0.65) were significantly associated with less symptoms.

CONCLUSION

The second surge of the COVID-19 pandemic further drained the mental reserves of intensive care unit nurses, resulting in more work-related fatigue.

Mental Health of Healthcare Workers during COVID-19 Pandemic in Taiwan: The First Wave Outbreak Occurred 1 Year Later Than in Other Countries

We probed the psychological influence exerted on traumatic stress endured by healthcare workers (HCWs) and the coping behaviors adopted during the first wave of COVID-19 in Taiwan, which occurred one year later than in other countries. Clinical HCWs from two branches of a hospital network in Taichung, Taiwan, were recruited for this cross-sectional study. The participants were administered a questionnaire on sociodemographic and work-related characteristics, perceived influence exerted by COVID-19, coping behaviors in relation to COVID-19, and Impact of Event Scale-Revised scores. We obtained 769 valid questionnaires. A chi-square test, generalized linear modeling, and multivariate stepwise regression analyses were performed. Although the first wave of COVID-19 occurred one year later in Taiwan than in other countries, the traumatic stress experienced by Taiwanese HCWs was noted to be comparable to that of those in other countries. Factors for increased traumatic stress included caring for more patients with COVID-19, fair or poor self-rated mental health, higher perceived influence of COVID-19, vulnerable household income, and more negative coping behaviors. Positive coping behaviors such as exposure reduction and protection measures decreased traumatic stress. Accordingly, managers should strengthen protective measures, enhance COVID-19-related training, and provide psychological support and counseling for high-risk employees.

Implications of nursing performance in coping with COVID-19: emotional exhaustion and strategies used

Abstract Objective to analyze the self-perceived implications and strategies used by Nursing workers from COVID-19 and non-COVID-19 units regarding professional performance in coping with the pandemic. Method a multicenter and descriptive-exploratory study with a qualitative approach, developed at four hospitals in southern Brazil between January and May 2021. 19 workers from the Nursing team were interviewed, 10 of which were assigned to COVID-19 units and 9 to non-COVID-19 units. Thematic content analysis was performed. Results two categories emerged: (1) Emotional exhaustion and its impact on work, due to severity of the patients and high number of deaths in COVID-19 units and organizational changes and work overload in non-COVID units; and (2) Coping strategies used, similar in the units in terms of self-care, leisure, physical activity and spirituality, but different in terms of professional fulfillment, present in the COVID-19 units. Conclusion and implications for the practice The pandemic increased exhaustion in the Nursing workers who used mitigating strategies, highlighting the difference in understanding the cause of exhaustion and in carrying out the work felt by workers in COVID-19 units. The need to monitor the health of Nursing workers that were active during the pandemic is highlighted.

Implicações da atuação da enfermagem no enfrentamento da COVID-19: exaustão emocional e estratégias utilizadas

Resumo Objetivo analisar as implicações autopercebidas e as estratégias utilizadas por trabalhadores de enfermagem de unidades dedicadas e não dedicadas à COVID-19 acerca da atuação profissional no enfrentamento da pandemia. Método estudo multicêntrico, descritivo-exploratório, com abordagem qualitativa, desenvolvido em quatro hospitais do sul do Brasil, entre janeiro e maio de 2021. Foram entrevistados 19 trabalhadores da equipe de enfermagem, sendo 10 lotados em unidades dedicadas à COVID-19 e 9 em unidades não dedicadas. Fez-se análise de conteúdo do tipo temática. Resultados emergiram duas categorias: (1) Exaustão emocional e seu impacto no trabalho, devido à gravidade dos pacientes e ao elevado número de óbitos nas unidades dedicadas e às mudanças organizacionais e à sobrecarga de trabalho nas não dedicadas; e (2) Estratégias de enfrentamento utilizadas, semelhantes nas unidades quanto ao autocuidado, lazer, atividade física e espiritualidade, mas diferente quanto a realização profissional, presente nas unidades dedicadas à COVID-19. Conclusão e Implicações para a Prática a pandemia incrementou a exaustão dos trabalhadores da enfermagem que utilizaram estratégias atenuantes, com destaque para a diferença na compreensão da origem da exaustão e na realização com o trabalho sentido pelos trabalhadores das unidades dedicadas. Evidencia a necessidade de acompanhamento à saúde dos trabalhadores de enfermagem atuantes na pandemia.

The psychological impact of the COVID-19 pandemic on the Sudanese healthcare workers in quarantine centers: a cross-sectional study 2020–2021

Background

After its emergence in Wuhan in December 2019, the COVID-19 virus disseminated around the globe creating an incredible panic and outweighing the healthcare system’s capacities. As a result of this hazardous situation, healthcare workers were placed at an unprecedented challenge making them vulnerable to a wide spectrum of mental health issues including anxiety and depression. This was a cross-sectional health facility-based study aiming to explore the psychological impact of the COVID-19 pandemic on Sudanese healthcare workers in COVID-19 treatment centers. Convenience sampling was applied. And two-part self-administered online questionnaire was used: the first part consisted of the demographic data and concerns related to COVID-19, and the second part consisted of the Hospital Anxiety and Depression Scale (HADS) standardized questionnaire. Ethical clearance was obtained from the Ministry of Health.

Results

One-hundred thirty-three healthcare workers of different job titles were enrolled in this study. A total of 54% were females, and 46% were males. Most of the participants had borderline depression (44%) or anxiety scores (47%). Females had significantly a higher mean anxiety score than males. There was no significant difference between participants with and without chronic disease on both anxiety and depression scores.

Conclusions

Healthcare workers at the forefront of the fight against COVID-19 pandemic are facing critical mental health challenges. An immediate intervention from the decision-makers is needed to mitigate this deleterious impact and to strengthen the healthcare system’s capacity in the face of healthcare emergencies in general.

Traumatic stress in Egyptian doctors during COVID-19 pandemic

COVID-19 pandemic has heavily burdened healthcare systems throughout the world, causing substantial mental distress to medical professionals. We aim to investigate the associated traumatic stress in a sample of practicing physicians in Egypt during the COVID-19 pandemic. This cross-sectional study assessed depression, and Post-traumatic stress disorder (PTSD) among a sample of Egyptian physicians using an electronic survey. It included demographic and practice-related data, PTSD Checklist - Civilian Version (PCL-C) and the nine-item Patient Health Questionnaire (PHQ-9). Of the 124 respondents, 66.9% were at high risk for depression and 37.9% met criteria for diagnosis of PTSD. Female gender and perceived work-related stress were significantly associated with PTSD. PTSD and depression severity scores were positively correlated. These findings highlight the importance of timely mental support and intervention for medical workers.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Post-Traumatic Stress Disorder among Frontline Nurses during the COVID-19 Pandemic and Its Relationship with Occupational Burnout

Objective: This study aimed to determine the level of post-traumatic stress disorder (PTSD) among nurses and its relationship with occupational burnout. Method : This online cross-sectional survey was conducted from late November to early January 2020 in six hospitals in Iran. 309 frontline nurses in COVID-19 wards were selected via stratified random sampling and asked to complete a sociodemographic questionnaire, the Impact of Event Scale-revised version (IES-R), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) in an anonymous online survey. Data management and analysis were performed in SPSS 25.0 using descriptive and inferential statistics, including Pearson's correlation coefficient, independent samples t-test, ANOVA, and linear regression. Results: The majority of the participants were women (81.6%) with a mean ± SD age of 31.56 ± 6.42 years. The mean ± SD of the total PTSD score was 39.2 ± 16.44 years, indicating severe PTSD among nurses. The mean ± SD of the total occupational burnout score was 82.77 ± 19.38, expressing moderate burnout. The findings also demonstrated a significant moderate correlation between PTSD and occupational burnout (r = 0.363, P < 0.001). Univariate analysis revealed a significant relationship of occupational burnout with PTSD, work experience, number of night shifts per month, and employment status (P < 0.05). However, in multivariate analysis, only PTSD had a positive and significant relationship with occupational burnout (P < 0.001; R2 = 160; β = 0.339) and was a predicting factor for it. Conclusion: We found that both PTSD and burnout are common among nurses. Given the role of PTSD especially as a predictor of burnout and the significant impact of these disorders on occupational and non-occupational activities, immediate and appropriate measures are necessary to monitor and reduce their effects on the nurses who are at the forefront of fighting the pandemic.

Nurses' Experiences of Caring for Patients with COVID-19: A Qualitative Study

The purpose of this study was to explore nurses' experiences, abilities, and willingness to care for patients with Coronavirus Disease 2019 (COVID-19). A descriptive qualitative study was conducted among 12 nurses working with patients with COVID-19. Purposive sampling was used to recruit participants from two national hospitals in Jordan. Semi-structured interviews (45-90 minutes each) with open-ended questions were held via Zoom to collect data. Four major themes emerged from the data analysis. The first theme, uncertainty, consisted of two subthemes: new experience and lack of training. The second theme was related to social stigma by society and other staff members. The third theme of front-line fighters consisted of two subthemes: empowering the main health caregiver and community acknowledgment. The fourth theme was related to challenges and consisted of two subthemes: physical and psychological challenges. At the beginning of the outbreak of COVID-19, the nurses had experienced a lack of certainty, physical and psychological challenges, and social stigmatization, which had negatively affected their willingness and ability to fight the outbreak. However, the nurses reported growing professionally and psychologically with time and becoming more knowledgeable, skillful, powerful, and confident care providers during the pandemic. Being able to fulfill their responsibilities and being acknowledged by others gave the nurses a sense of achievement. Early education and training about COVID-19, clear infection control protocols and guidelines, psychological counseling, and adequate social support are essential steps for enhancing nurses' mental well-being and willingness and ability to fight COVID-19.

Impact of the COVID-19 pandemic on nurses mental health status in Iraq

BACKGROUND

The COVID-19 pandemic is a major health crisis that has changed the life of millions globally. Coronaviruses are viruses' group that can contract animals and humans and the cause of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19. Nurses are the primary service providers in the health care; nurses who are in close contact with infectious patients need to get their mental health checked and supervised on a regular basis, particularly with regard to stress, anxiety, and suicidal ideation, so that they can provide optimal quality of life and healthy mental health to have good care for patients to assess the impact of the pandemic on mental health status for nurses in Iraq.

MATERIALS AND METHODS

A total of sample study (1000) nurses in Iraq completed an online questionnaire between March and May 2021. Psychological impact was assessed using the depression anxiety stress scale (DASS21).

RESULTS

The study revealed impact COVID-19 on mental health status (anxiety stress) and no impact COVID-19 on mental health status (depression) for nurses was (P value = 0.040 and P value = 0.045, respectively).

CONCLUSION

The impact COVID-19 on mental health status for nurses. Protecting the nursing staff from chronic stress, anxiety, and depression, which constitutes a psychological burden on health during the outbreak of the COVID-19 pandemic, by clarifying the disease and how to prevent it, as well as providing the personal protective equipment to decrease stress, anxiety, and depression during the pandemic.

How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health

AIM

To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship.

BACKGROUND

Workplace violence has emerged as a crucial determinant of turnover intention for health care workers.

METHODS

A cross-sectional survey was conducted among Chinese health care workers (N = 1,063) between 13 and 20 February 2020. Mediation effects were tested using structural equation modelling with weighted least squares mean and variance adjusted (WLSMV) estimator.

RESULTS

Workplace violence had both direct and indirect effects on turnover intention among Chinese health care workers. Specifically, perceived social support, mental health and perceived social support together with mental health partially mediated the relationship between workplace violence and turnover intention.

CONCLUSIONS

Chinese health care workers experiencing violence during the COVID-19 outbreak were more likely to report turnover intention. Enhancing social support and reducing mental health problems would be beneficial in decreasing the detrimental effects of workplace violence on turnover intention.

IMPLICATIONS FOR NURSING MANAGEMENT

Ensuring health care workers' health and safety is vital in reducing turnover intention, which in turn ascertains continuity of health care delivery. Health care managers should develop targeted interventions to improve social support and prevent post-violence mental health problems.

A Multi-Center Study on the Negative Psychological Impact and Associated Factors in Chinese Healthcare Workers 1 Year After the COVID-19 Initial Outbreak

Objectives: The study aimed at analyzing the prevalence of five psychological outcomes (depression, anxiety, stress, post-traumatic stress disorder (PTSD), and suicidal ideation) among Chinese healthcare workers (HCWs), and measured the total possible negative psychological impact 1 year after the COVID-19 initial outbreak. Methods: A cross-sectional nationwide multi-center study was performed between November 2020 and March 2021 in China. A self-report questionnaire was applied, and three psychological scales were used. Binary logistic regression was performed to analyze the risk factors associated with each psychological outcome. Results: The findings demonstrated that the COVID-19 pandemic had a negative psychological impact on HCWs, which was still evident 1 year after the initial outbreak. Nurses showed higher depression and anxiety than other HCWs. Female gender, passive coping, long working hours, having a chronic disease, and experiencing violence, among other factors, were all risk factors for psychological impairment. Conclusion: Developing and promoting programs to improve mental health among HCWs, and identifying those who might need psychological support is still relevant 1 year after the initial outbreak.

Prevalence and risk factors associated with self-reported psychological distress among college students during the omicron outbreak in Shanghai

Background

More and more attention has been paid to the mental health of students in higher education. The Omicron outbreak has brought renewed attention to this vulnerable group.

Objective

To understand the prevalence and influencing factors of anxiety symptoms and depression symptoms of college students in a closed state.

Methods

This large cross-sectional study using data from a survey on the mental health of college students in Shanghai (China), conducted by using a stratified cluster random sampling method between March 15th and April 15th, 2022. To estimate results related to regional location, only data from students with Internet protocol addresses and current addresses in Shanghai were included. The main outcome was self-reported psychological distress (including depressive symptoms, anxiety symptoms, and self-assessment of health), measured using the epidemiologic studies depression scale (CES-D), the Spielberger state-trait anxiety inventory (STAI) and self-rated mental health (SRMH), respectively. Moreover, the Simplified Coping Style Scale (SCSS) was also used to assess how participants coped with negative emotions.

Results

Among 13,000 college students who completed the survey, 12,124 students were included in the final analysis, and the total effective rate was 93.3%. The prevalence of depressive symptoms and anxiety symptoms were 14.1 and 9.8%, respectively. By using Multivariate logistics regression analysis, we found that being male and negative coping were risk factors for depressive symptoms and anxiety symptoms, while positive coping, such as study or learning, were protective factors. Moreover, linear regression analysis showed that learning or study improved the overall mental health index by improving anxiety or depressive symptoms, and played a partial mediating role.

Conclusions

These findings suggest that a significant number of college students, especially boys, will experience emotional problems during the course of closed schools. Therefore, we need to give them proper attention and advise them to adopt positive coping strategies, such as learning or study, to resist bad emotions.

Anxiety and Stress Seem Temporary during the Pneumonia COVID-19 Pandemic: A Survey on the Mental Health Status of Healthcare Workers

Objective

To evaluate the presence/severity of depression, anxiety, and stress among health care workers (HCWs) who work on the specially allocated COVID-19 ward (Group A) and HCWs on the other wards (Group B).

Methods

This questionnaire-based study was conducted from January 25 to February 28, 2021. The mental status was assessed using the Persian version of the 42-item Depression, Anxiety, and Stress score (DASS-42). Gathered data was analyzed using SPSS version 25. The independent T-test and Chi-square tests were used to compare quantitative and qualitative variables.

Results

Two-hundred and twenty two questionnaires were eligible for analysis. Group A consisted of 33 HCWs, and 189 (85.1%) individuals were working on the other wards. No statistically significant differences were seen regarding the Socio-demographic features except for the marital status (p=0.005). The depressions' mean score was comparable between group A and B (p=0.102). The mean scores of anxiety and stress were significantly lower in group A than group B (p=0.006), although the frequency of DASS-42 parameters did not differ between these two groups (p>0.05).

Conclusion

Contrary to our assumptions, this study showed that the DASS-42 parameters were not higher in HCWs working on the COVID-19 wards. This might be justified by developing coping mechanisms, being on the honeymoon phase of the disaster, compassion satisfaction, promising vaccine news, and working on the less impacted hospital.

COVID-19 Posttraumatic Stress Disorder in Clinical Nurse Specialists

The purpose of this study was to examine if a relationship exists between the coronavirus 2019 pandemic and posttraumatic stress disorder in clinical nurse specialists.

Psychological Distress and Work-Related Quality of Life Among Oncology Nurses During the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

Oncology nurses are at disproportionate risk for psychological distress because they often encounter ethical challenges and deaths while providing care. Exposures to emergent suffering during the COVID-19 pandemic compound their chronic distress, which likely increased their vulnerability to psychological distress and may increase their risk for reduced work-related quality of life (WRQOL).

OBJECTIVES

This study examined the association between psychological distress and WRQOL among oncology nurses during the COVID-19 pandemic.

METHODS

A cross-sectional analysis of psychological distress and WRQOL among oncology nurses (N = 63) was conducted.

FINDINGS

The mean Depression, Anxiety and Stress Scale score was 33.4, showing low depression levels, mild anxiety, and mild stress. The mean PTSD score was 29.3, and the mean WRQOL Scale score was 78.8. Depression, anxiety, and stress were strongly correlated to PTSD, and WRQOL was negatively correlated to PTSD, depression, anxiety, and stress.

Associations between COVID-19 Work-Related Stressors and Posttraumatic Stress Symptoms among Chinese Doctors and Nurses: Application of Stress-Coping Theory

Healthcare workers are vulnerable to posttraumatic stress symptoms (PTSS) due to stressful work during the COVID-19 pandemic. This study aimed to investigate whether the associations between COVID-19 work-related stressors and PTSS would be mediated by maladaptive and adaptive coping strategies and moderated by perceived family support based on stress-coping theory. An anonymous online survey was conducted among 1449 doctors and nurses in five hospitals in China between October and November 2020 during the “post-outbreak” period. The prevalence of PTSS assessed by the Posttraumatic Symptom Scale Self-Report was 42%. Logistic regression analysis revealed that worries about being infected with COVID-19, perceived difficulties in family caregiving, coping strategies of rumination, catastrophizing, acceptance, and perceived family support were independently associated with PTSS. Furthermore, maladaptive and adaptive coping partially mediated the association between COVID-19 work-related stressors and PTSS.The results of multi-group analyses showed that perceived family support tended to intensify the associations between COVID-19 work-related stressors and adaptive coping and between adaptive coping and PTSS, whereas perceived family support attenuated the positive association between COVID-19 work-related stressors and PTSS. The findings suggest tailor-made health interventions with respect to alleviation of work-related stressors and coping skill training to reduce the risk of PTSS among healthcare workers, especially for those with lower perceived family support.

Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China

Vaccine uptake rate is crucial for herd immunity. Medical care workers (MCWs) can serve as ambassadors of COVID-19 vaccine acceptance. This study aimed to assess MCWs’ willingness to receive the COVID-19 vaccine, and to explore the factors affecting COVID-19 vaccination acceptance. A multicenter study among medical care workers was conducted in seven selected hospitals from seven geographical territories of China, and data were collected on sociodemographic characteristics, vaccine hesitancy, and health beliefs on COVID-19 vaccination among participants. Univariate and multivariate logistic regression models were performed to explore the correlations between individual factors and the acceptance of the COVID-19 vaccine. Among the 2681 subjects, 82.5% of the participants were willing to accept the COVID-19 vaccination. Multivariate regression analyses revealed that individuals with more cues to action about the vaccination, higher level of confidence about the vaccine, and higher level of trust in the recommendations of COVID-19 vaccine from the government and the healthcare system were more likely to get the COVID-19 vaccine. In contrast, subjects with higher level of perceived barriers and complacency were less likely to accept the COVID-19 vaccine. Overall, MCWs in China showed a high willingness to get the COVID-19 vaccine. The governmental recommendation is an important driver and lead of vaccination. Relevant institutions could increase MCWs’ willingness to COVID-19 vaccines by increasing MCWs’ perception of confidence about COVID-19 vaccines and cues to action through various strategies and channels. Meanwhile, it can also provide evidence in similar circumstances in the future to develop vaccine promotion strategies.

Psychological responses of medical staff during COVID-19 and the adjustment effect of brief mindfulness meditation

Background

COVID-19 has posed an unprecedented threat to public health and remains a critical challenge for medical staff, especially those who have been fighting against the virus in Wuhan, China. Limited data have been reported regarding the psychological status of these medical staff members. Therefore, we conducted this study to explore the mental health status of medical staff and the efficacy of brief mindfulness meditation (BMM) in improving their mental health.

Methods

A survey was conducted between April 18 and May 3, 2020. Upon completing the pre-test, participants in the treatment group received a 15-min BMM intervention every day at 8 p.m. Post-test questionnaires were completed after 16 days of therapy. The questionnaire comprised demographic data and psychological measurement scales. The levels of pre and post-test depression, anxiety, stress, and insomnia were assessed using the 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, Perceived Stress Scale, and Athens Insomnia Scale, respectively.

Results

A total of 134 completed questionnaires were received. Of the medical staff, 6.7%, 1.5%, and 26.7% reported symptoms of depression, anxiety, and insomnia, respectively. Public officials from military hospitals reported experiencing greater pressure than private officials (t = 2.39, p = 0.018, d = 0.50). Additionally, BMM treatment appeared to effectively alleviate insomnia (t = 2.27, p = 0.027, d = 0.28).

Conclusions

The medical staff suffered negative psychological effects during the COVID-19 pandemic. BMM interventions are advantageous in supporting the mental health of medical staff.

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

Background

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

Methods

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

Results

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

Conclusions

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

Bienestar psicológico en enfermeras que realizan terapia de reemplazo renal en tiempos de COVID-19

Introducción: La pandemia por COVID-19 ha generado deterioro de la salud mental en los profesionales del sector salud, siendo desconocida su situación en las enfermeras al cuidado de pacientes con enfermedad renal crónica. Objetivo: Identificar el bienestar psicológico y sus diferencias de acuerdo a las variables demográficas y profesionales en enfermeras que realizan hemodiálisis en tiempos de COVID-19. Material y Método: Estudio cuantitativo, descriptivo transversal, realizado en 52 enfermeras que realizan terapia de reemplazo renal en unidades de cuidado intensivo y de terapia renal en tiempos de COVID-19. Fueron obtenidas variables de tipo sociodemográfico, académico, laboral y se empleó la escala PGWBI para establecer los niveles de bienestar psicológico. Se utilizó el test de Mann-Whitney y Kruskall-Wallis realizando el post test de Dunn para comparar diferencias entre las variables estudiadas. Resultados: La edad promedio fue de 36,56±6,95 años. Los niveles de bienestar psicológico fueron positivos en todas las categorías de la escala, con excepción de la ansiedad y la depresión. De igual forma, se encontró que las variables género, estado civil, estabilidad, antigüedad laboral, remuneración salarial y formación académica, muestran comportamiento diferenciado en las categorías que evalúa el instrumento. Conclusiones: Se identificaron altos niveles de bienestar psicológico en enfermeras que prestan cuidados en pacientes en terapia de reemplazo renal en tiempos de pandemia por COVID-19, donde factores como el estado civil, formación post gradual y tener estabilidad laboral con mejores ingresos salariales, influencian positivamente las categorías que contribuyeron a los resultados de bienestar psicológico de las enfermeras evaluadas.

Psychological impact of the COVID-19 pandemic on medical and rehabilitation sciences university students in Saudi Arabia

BACKGROUND: The COVID-19 pandemic has been associated with increased stressful impact among different populations that are at an increased risk of mental health problems, such as university students. OBJECTIVES: To investigate the psychological effects of the COVID-19 pandemic on medical and rehabilitation sciences university students, explore the factors affecting them, and provide helpful recommendations for better mental health. METHODS: An online survey was conducted with a sample of medical and rehabilitation sciences students. The anxiety visual analogue scale, the perceived stress scale (PSS), and the impact of events scale-revised (IES-R) were applied. RESULTS: A total of 244 students completed the survey (60.7% were female). The mean scores of total anxiety, PSS and IES-R were significantly higher in females than males. 34.5% and 29.4% of the students reported that their sleep and appetite were respectively disturbed during the pandemic. Students with adequate knowledge about the COVID-19 pandemic reported a significant decrease in anxiety level (p = 0.01), perceived stress (p = 0.00), and less negative impacts of the pandemic (p = 0.01). CONCLUSION: This study shed light on factors that play a major role in anxiety, perceived stress and stressful impact of COVID-19 pandemic among medical and health sciences students, such as gender, knowledge, educational level, presence of chronic condition, and family financial status. Developing proper mental health management guidelines and providing psychological support are recommended and should be considered.

Factors Associated to Psychological Distress During the COVID-19 Pandemic Among Healthcare Workers in Ecuador

Objective: The global COVID-19 pandemic has challenged health systems. Healthcare professionals had to face harsh conditions that have caused psycho-emotional consequences. Ecuador has been one of the countries hit hardest by the pandemic in Latin America. The objective of this study was to analyse the levels of psychological distress among healthcare workers in Ecuador during the COVID-19 pandemic.

Methods: A cross-sectional descriptive study was conducted with a convenience sample of 1,056 healthcare professionals, assessing their psychological distress, physical symptoms of COVID-19, state of health, the preventive measures adopted, and the history of contact with people infected with the SARS-CoV2 virus.

Results: showed that 66.0% of the participants manifested psychological distress, with significantly higher levels in women with symptoms of COVID-19 and previous contact with infected people or objects (p < 0.001). However, adherence to preventive measures and perception of health were associated with less psychological distress (p < 0.001).

Conclusions: The importance of monitoring the mental health of healthcare workers during the COVID-19 pandemic was confirmed, having identified factors associated with the development of psychological distress among professionals in Ecuador.

The impact of the COVID-19 pandemic on the mental health of medical staff considering the interplay of pandemic burden and psychosocial resources-A rapid systematic review

BACKGROUND

In times of the global corona pandemic health care workers (HCWs) fight the disease at the frontline of healthcare services and are confronted with an exacerbated load of pandemic burden. Psychosocial resources are thought to buffer adverse effects of pandemic stressors on mental health. This rapid review summarizes evidence on the specific interplay of pandemic burden and psychosocial resources with regard to the mental health of HCWs during the COVID-19 pandemic. The goal was to derive potential starting points for supportive interventions.

METHODS

We conducted a rapid systematic review following the recommendations of the Cochrane Rapid Reviews Methods Group. We searched 7 databases in February 2021 and included peer-reviewed quantitative studies, that reported related data on pandemic stressors, psychosocial resources, and mental health of HCWs.

RESULTS

46 reports were finally included in the review and reported data on all three outcomes at hand. Most studies (n = 41) applied a cross-sectional design. Our results suggest that there are several statistically significant pandemic risk factors for mental health problems in HCWs such as high risk and fear of infection, while resilience, active and emotion-focused coping strategies as well as social support can be considered beneficial when protecting different aspects of mental health in HCWs during the COVID-19 pandemic. Evidence for patterns of interaction between outcomes were found in the context of coping style when facing specific pandemic stressors.

CONCLUSIONS

Our results indicate that several psychosocial resources may play an important role in buffering adverse effects of pandemic burden on the mental health of HCWs in the context of the COVID-19 pandemic. Nevertheless, causal interpretations of mentioned associations are inadequate due to the overall low study quality and the dominance of cross-sectional study designs. Prospective longitudinal studies are required to elucidate the missing links.

Cross-sectional study of traumatic stress disorder in frontline nurses 6 mo after the outbreak of the COVID-19 in Wuhan

BACKGROUND

Frontline nurses in Wuhan directly fighting severe acute respiratory syndrome coronavirus-2 diseases are at a high risk of infection and are extremely susceptible to psychological stress, especially due to the global coronavirus disease 2019 (COVID-19) pandemic. The psychological after-effects of this public health emergency on frontline nurses will last for years.

AIM

To assess factors influencing post-traumatic stress disorder (PTSD) among frontline nurses in Wuhan 6 mo after the COVID-19 pandemic began.

METHODS

A total of 757 frontline nurses from five hospitals in Wuhan, China, participated in an online survey from July 27 to August 13, 2020. This cross-sectional online study used a demographic information questionnaire, the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, the Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-4. The chi-square test and logistic regression were used to analyze the association of demographics, COVID-19-related variables, and PTSD. Logistic regression was also conducted to investigate which variables were associated with PTSD outcomes.

RESULTS

A total of 13.5%, 24.3%, and 21.4% of the frontline nurses showed symptoms of PTSD, depression, and anxiety, respectively. The multivariate logistic regression analysis showed that the following factors were strongly associated with PTSD: Having a relative, friend, or colleague who died of COVID-19; experiencing stigma; or having psychological assistance needs, depressive symptoms or anxiety. Showing resilience and receiving praise after the COVID-19 outbreak were protective factors.

CONCLUSION

Frontline nurses still experienced PTSD (13.5%) six months after the COVID-19 outbreak began. Peer support, social support, official recognition, reward mechanisms, exercise, better sleep, and timely provision of information (such as vaccine research progress) by the government via social media, and adequate protective supplies could mitigate the level of PTSD among nurses responding to COVID-19. Stigmatization, depression, and anxiety might be associated with a greater risk of PTSD among nurses.

Interventions to reduce post-traumatic stress disorder symptoms in health care professionals from 2011 to 2021: a scoping review

OBJECTIVES

This scoping review aimed to describe available interventions for decreasing (post-traumatic stress disorder) PTSD symptoms among healthcare professionals in hospital care.

METHOD

A scoping review was conducted following Arksey and O'Malley's framework. PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest were searched for original research published in English from 2011 to 2021, on 8 July 2021. We included studies that described interventions that focused on reducing the PTSD symptoms of healthcare professionals. A narrative synthesis was adopted to synthesise the data.

RESULTS

A total of eight studies out of 2558 articles were identified. Six used a quantitative study design and two adopted qualitative methods. cognitive behavioural therapy and mindfulness-based interventions were the most commonly adopted. Most studies used a combination of different intervention strategies. Trauma-related knowledge, emotion regulation and relaxation skill training, and psychological support from peers and psychologists were three core intervention components. The duration ranged from 2 weeks to 6 months. Healthcare professionals who participated in training programmes reported both positive experiences and suggestions for the improvement of PTSD-reducing interventions in their qualitative feedback.

CONCLUSIONS

The scoping review provides a practical summary of the intervention characteristics for reducing the PTSD symptoms of healthcare professionals. Hospitals and managers could use the overview of interventions to assist healthcare professionals with PTSD symptoms. More research investigating the effects of PTSD symptom-reducing interventions for healthcare professionals with appropriate follow-up assessments is needed in the future.

Factors associated with peritraumatic stress symptoms among the frontline healthcare workers during the outbreak of COVID-19 in China

OBJECTIVES

This study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China.

DESIGN AND SETTING

An online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19.

OUTCOMES MEASURES

PTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs' PTSS scores.

RESULTS

A total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores.

CONCLUSIONS

During the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.

Estimation of Prevalence and Comparing the Levels of Stress, Anxiety, Depression, and Psychological Impact Before and After COVID-19 Lockdown Among Front Line Health Care Workers

The main objective of the study is to estimate the prevalence and compare the levels of psychological impact, anxiety, depression, and stress experienced by the frontline health care workers (HCWs) during the lockdown and post lockdown periods at Apollo Institute of Medical Sciences and Research, Hyderabad, India. All participants involved in the study were evaluated by using depression, anxiety and stress scale 21, the impact of event scale revised scale for post-traumatic stress disorder (PTSD), and a standardized questionnaire. During the lockdown period, the score for depression was observed mean scores to be more in front desk people (2.70) followed by pharmacists and technicians (2.60) and security (2.28) in the lockdown period. During the lockdown, the highest levels of anxiety were seen in security staff (4.72) and housekeeping (4.8), with a considerable increase after the lockdown situation. During the lockdown period, the mean score of pharmacists and technicians (10.33) were more stressed than other HCWs, and the second-highest levels of stress were observed in security (10.11) and front desk workers (10.09), respectively. Our results show that there was a worsening of the psychological impact of the pandemic and an increase in PTSD, stress, anxiety, and depression among HCWs. Female gender, pharmacists, and technicians were the most vulnerable group to develop psychiatric comorbidities.

Relationship Between Self-Acceptance and Intention to Stay at Work Among Clinical Nurses in China: A Cross-Sectional Online Survey

BACKGROUND

During the pandemic and with the growing shortage of nurses, the problem of how to retain existing nurses was of paramount importance. However, there is limited evidence on the relationship between nurses' self-acceptance and intention to stay.

OBJECTIVES

This study aimed to investigate the factors influencing nurses' intention to stay at work, and explore the relationship between self-acceptance and their intention to stay.

METHODS

Convenience sampling was conducted to select nurses who worked in a clinical environment during June 2020, in hospitals in Shandong Province, China. Self-designed basic information and two questionnaires, namely, the "self-acceptance questionnaire" and "intention to stay" were adopted. Mean, median, related analysis, and regression analysis were adopted to describe the relationship of self-acceptance and intention to stay on part of Chinese nurses.

RESULTS

A total of 1,015 clinical nurses participated in the survey. The mean score of intention to stay among participants was 22.00. The multiple regression analysis revealed various factors, such as age, family support the work, interest in work, job suitability, type of employment, professional level, weekly working hours, working department and self-acceptance influenced the nurse's intention to stay (β range from -1.506 to 2.249).

CONCLUSION

Our findings identified several factors that are significantly related to and impact the level of intention to stay among clinical nurses.

A mental health survey among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China

BACKGROUND

The sporadic coronavirus disease (COVID-19) epidemic has placed enormous psychological stress on people, especially clinicians. The objective of this study was to examine depression, anxiety, quality of life (QOL), and related social psychological factors among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China and to provide a reference for formulating reasonable countermeasures.

METHODS

In this cross-sectional study, demographic information, COVID-19-related questions, anxiety (Generalized Anxiety Disorder-7, GAD-7), depression (Patient Health Questionnaire-9, PHQ-9), insomnia (Insomnia Severity Index, ISI), stress (Perceived Stress Scale-10, PSS-10), and QOL (World Health Organization Quality of Life-brief version, WHOQOL-BREF) were collected. Binary logistic regression analysis was used to test the relationships between anxiety and/or depression and other related problems. Multiple linear regression analysis was used to test the relationships among factors influencing QOL.

RESULTS

A total of 146 young front-line clinicians were included. The prevalence rates of depression, anxiety, and anxiety-depression comorbidity were 37.7% (95% CI = 29.7-45.6%), 26.0% (95% CI = 18.8-33.2%), and 24.0% (95% CI = 17.0-31.0%), respectively. Severe stress (OR = 1.258, 95% CI = 1.098-1.442, P < 0.01) and insomnia (OR = 1.282, 95% CI = 1.135-1.447, P < 0.01) were positively correlated with depression. Severe stress (OR = 1.487, 95% CI = 1.213-1.823, P < 0.01) and insomnia (OR = 1.131, 95% CI = 1.003-1.274, P < 0.05) were positively correlated with anxiety. Severe stress (OR = 1.532, 95% CI = 1.228-1.912, P < 0.01) was positively correlated with anxiety-depression comorbidity. However, insomnia (OR = 1.081, 95% CI = 0.963-1.214, P > 0.05) was not correlated with anxiety-depression comorbidity. The belief that the vaccine will stop the COVID-19 pandemic (OR = 0.099, 95% CI = 0.014-0.715, P < 0.05) was negatively correlated with anxiety and anxiety-depression comorbidity (OR = 0.101, 95% CI = 0.014-0.744, P < 0.05). Severe stress (B = -0.068, 95% CI = -0.129 to -0.007, P < 0.05) and insomnia (B = -0.127, 95% CI = -0.188 to -0.067, P < 0.01) were negatively correlated with QOL. The belief that the vaccine could provide protection (B = 1.442, 95% CI = 0.253-2.631, P < 0.05) was positively correlated with QOL.

CONCLUSIONS

The prevalence of depression, anxiety, and even anxiety-depression comorbidity was high among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China. Various biological and psychological factors as well as COVID-19-related factors were associated with mental health issues and QOL. Psychological intervention should evaluate these related factors and formulate measures for these high-risk groups.