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Mehboodi F, Zamanzadeh V, Rahmani A, Dianat I, Shabanloie R. Occupational safety and health of nurses during the COVID-19 pandemic, the missing part of quality care: a qualitative study. BMJ Open 2024; 14:e083863. [PMID: 38858154 PMCID: PMC11168139 DOI: 10.1136/bmjopen-2024-083863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE This study explored the consequences of COVID-19 on the occupational safety and health of nurses. DESIGN Qualitative conventional content analysis. PARTICIPANTS 14 nurses selected by purposeful sampling method. SETTING Five educational and non-educational hospitals in the Northwest of Iran. DATA COLLECTION AND ANALYSIS Semistructured interviews were used for data collection and analysed using conventional content analysis. RESULTS Two main categories have emerged from the data: reduced quality of professional life and post-traumatic growth. Reduced quality of professional life, which has two subcategories including job dissatisfaction and burnout, has a negative nature, and has had many negative effects on the physical, mental and well-being of nursing personnel during the coronavirus era. On the other hand, post-traumatic growth, with two subcategories that include promoting safe behaviour and gaining a positive self-concept, has a positive nature. CONCLUSIONS Maintaining the occupational health and safety of nurses plays an important role in providing quality services to patients. Therefore, it is necessary for managers and policymakers to use the experiences related to the COVID-19 crisis, to prevent negative factors and strengthen positive factors, to maintain the safety and occupational health of nurses, and increase the quality of care.
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Affiliation(s)
- Farkhondeh Mehboodi
- Medical-Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Vahid Zamanzadeh
- Medical-Surgical Nursing, Tabriz University of Medical Sciences, Faculty of Nursing and Midwifery, Tabriz, Iran (the Islamic Republic of)
- Medical-Surgical, Shahid Beheshti University of Medical Sciences School of Nursing and Midwifery, Tehran, Iran (the Islamic Republic of)
| | - Azad Rahmani
- Medical-Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Iman Dianat
- Occupational Health, Tabriz University of Medical Sciences Faculty of Medicine, Tabriz, Iran (the Islamic Republic of)
| | - Reza Shabanloie
- Medical-Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
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Howarth U, Zimmerman PA, van de Mortel TF, Barr N. Paramedics' experiences of barriers to, and enablers of, responding to suspected or confirmed COVID-19 cases: a qualitative study. BMC Health Serv Res 2024; 24:678. [PMID: 38811956 PMCID: PMC11134757 DOI: 10.1186/s12913-024-11120-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: 11/07/2023] [Accepted: 05/19/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Paramedics' work, even pre-pandemic, can be confronting and dangerous. As pandemics add extra stressors, the study explored paramedics' lived experience of the barriers to, and enablers of, responding to suspected or confirmed Coronavirus Disease 2019 (COVID-19) cases. METHODS This exploratory-descriptive qualitative study used semi-structured interviews to investigate Queensland metropolitan paramedics' experiences of responding to cases during the COVID-19 pandemic. Interview transcripts were analysed using thematic analysis. Registered Paramedics were recruited by criterion sampling of staff who experienced the COVID-19 pandemic as active officers. RESULTS Nine registered paramedics participated. Five themes emerged: communication, fear and risk, work-related protective factors, leadership, and change. Unique barriers included impacts on effective communication due to the mobile nature of paramedicine, inconsistent policies/procedures between different healthcare facilities, dispatch of incorrect information to paramedics, assisting people to navigate the changing healthcare system, and wearing personal protective equipment in hot, humid environments. A lower perceived risk from COVID-19, and increased empathy after recovering from COVID-19 were unique enablers. CONCLUSIONS This study uncovered barriers and enablers to attending suspected or confirmed COVID-19 cases unique to paramedicine, often stemming from the mobile nature of prehospital care, and identifies the need for further research in paramedicine post-pandemic to better understand how paramedics can be supported during public health emergencies to ensure uninterrupted ambulance service delivery.
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Affiliation(s)
- Ursula Howarth
- Queensland Ambulance Service, GPO Box 1425, Brisbane, QLD, 4001, Australia
| | - Peta-Anne Zimmerman
- School of Nursing & Midwifery, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia
- Collaborative for the Advancement for Infection Prevention and Control, Gold Coast, QLD, Australia
- Gold Coast Hospital and Health Service, Southport, QLD, Australia
- Menzies Health Institute, Southport, QLD, Australia
| | - Thea F van de Mortel
- School of Nursing & Midwifery, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
| | - Nigel Barr
- University of Sunshine Coast School of Health, Locked Bag 4, Maroochydore, DC, QLD, 4558, Australia
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Temeng E, Hewitt R, Pattinson R, Sydor A, Whybrow D, Watts T, Bundy C. Nurses' coping strategies caring for patients during severe viral pandemics: A mixed-methods systematic review. J Clin Nurs 2024; 33:242-254. [PMID: 37032642 DOI: 10.1111/jocn.16711] [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: 08/19/2022] [Revised: 12/04/2022] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Nurses play an essential role in responding to severe viral disease which bring considerable challenges to their personal and professional well-being. This subsequently can affect the delivery of care and healthcare systems' organisational capacity to respond. Understanding nurses' experiences of these challenges will help inform healthcare policies. AIM To explore the experiences and coping strategies of nurses caring for patients during severe viral disease pandemics. DESIGN A mixed-methods systematic review informed by the Joanna Briggs Institute (JBI) methodology. METHODS A mixed-methods systematic review. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA and Scopus were searched on 4th April 2021. Results were reported in accordance with PRISMA. The findings were analysed and reported in the context of the Self-Regulatory Common-Sense Model. RESULTS In total, 71 peer-review primary research articles describing nurses' experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza or SARS-CoV-2 / COVID-19 published in English from 2003 to 2021 were included. We found links between nurses' perception of the health threats, their emotional reactions, and coping strategies. Perceived health threats were influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, onerous workloads and working hours, unavailability of PPE, and lack of knowledge and training in pandemic management. These impacted nurses' physical, psychological and social well-being. Nurses also reported helpful and unhelpful coping strategies to manage the health threats. CONCLUSIONS It is vital for stakeholders, policymakers, government and healthcare institutions to recognise and monitor the wider impact on healthcare workers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to offset the anticipated impact pre and post pandemics/epidemics is needed. Our findings can inform those strategies for similar future health emergencies. RELEVANCE TO CLINICAL PRACTICE Nurses are often the first point of contact in providing direct care to patients, hence they are at high risk of being infected. The findings from this review can help managers and policymakers in developing programmes to enhance resilience in the nursing workforce. NO PATIENT OR PUBLIC CONTRIBUTION This was a literature review study.
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Affiliation(s)
- Eunice Temeng
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Rachael Hewitt
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Anna Sydor
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Dean Whybrow
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Tessa Watts
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Chris Bundy
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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PHYSICIANS’ MORAL DUTIES DURING PANDEMICS. J Emerg Med 2023. [PMID: 37268477 PMCID: PMC10028360 DOI: 10.1016/j.jemermed.2023.02.009] [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: 03/23/2023]
Abstract
Background Pandemics with devastating morbidity and mortality have occurred repeatedly throughout recorded history. Each new scourge seems to surprise governments, medical experts, and the public. The SARS CoV-2 (COVID-19) pandemic, for example, arrived as an unwelcome surprise to an unprepared world. Discussion Despite humanity's extensive experience with pandemics and their associated ethical dilemmas, no consensus has emerged on preferred normative standards to deal with them. In this article, we consider the ethical dilemmas faced by physicians who work in these risk-prone situations and propose a set of ethical norms for current and future pandemics. As front-line clinicians for critically ill patients during pandemics, emergency physicians will play a substantial role in making and implementing treatment allocation decisions. Conclusion Our proposed ethical norms should help future physicians make morally challenging choices during pandemics.
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RAMDURG SANTOSH, MUDANUR SUBHASHCHANDRAR, BENTOOR SANJEEV, MUDANUR NIKHILS. Mental health status of healthcare providers during the Covid-19 pandemic: A cross-sectional study across India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2022; 35:153-155. [DOI: 10.25259/nmji-35-3-153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background
From the beginning of the Covid-19 pandemic, studies have observed an increased prevalence of psychological symptoms in the general population and healthcare providers. We studied the prevalence of psychological symptoms among the latter.
Methods
We did this study using a self-administered questionnaire among healthcare providers across India who were involved in caring/treating patients. The questionnaire collected information on demographics, Depression, Anxiety and Stress Scales (DASS-21) and semi-structured questions related to the Covid-19 pandemic.
Results
A total of 612 healthcare providers participated in the study; 254 were doctors of various specialties and 358 were nursing care-providers. According to the DASS-21 assessment, the prevalence of depression was 12.4%, anxiety was 19.1% and stress was 10.8%. The prevalence of psychological problems was more among nursing staff compared to doctors (depression risk ratio [RR] 2.4, anxiety RR 1.73 and stress RR 2.93) and they were equal among both genders (depression RR 1.05, anxiety RR 1.06 and stress RR 1.21).
Conclusions
Our study shows that there is a higher prevalence of depression, anxiety and stress among healthcare providers, particularly among nursing care-providers. We suggest psychological interventions to nursing care-providers and also those who are vulnerable among doctors, to improve their mental health status.
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Affiliation(s)
- SANTOSH RAMDURG
- Department of Psychiatry, Shri B.M. Patil Medical College, Hospital and Research Centre, Bangaramma Sajjan Campus, Solapur Road, Vijayapura 586103, Karnataka, India
| | - SUBHASHCHANDRA R. MUDANUR
- Department of Obstetrics and Gynaecology, Shri B.M. Patil Medical College, Hospital and Research Centre, Bangaramma Sajjan Campus, Solapur Road, Vijayapura 586103, Karnataka, India
| | - SANJEEV BENTOOR
- Department of Medicine, Shri B.M. Patil Medical College, Hospital and Research Centre, Bangaramma Sajjan Campus, Solapur Road, Vijayapura 586103, Karnataka, India
| | - NIKHIL S. MUDANUR
- Department of Obstetrics and Gynaecology, Shri B.M. Patil Medical College, Hospital and Research Centre, Bangaramma Sajjan Campus, Solapur Road, Vijayapura 586103, Karnataka, India
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Yin Q, Shao X, Zhang R, Fan J, Dong W, Deng G. Psychophysical Risk Perceptions and Sleep Quality of Medical Assistance Team Members in Square Cabin Hospitals: A Repeated Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10102048. [PMID: 36292495 PMCID: PMC9602534 DOI: 10.3390/healthcare10102048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/21/2022] Open
Abstract
Objective: This study aimed to evaluate the association between the perceptions of psychophysical risks and sleep quality of Medical Assistance Team Members (MATMs) in Square Cabin Hospitals. Methods: Repeated cross-sectional data collection was conducted in Square Cabin Hospitals during two large-scale lockdowns. The first wave was sampled from MATMs dispatched to Wuhan and the second was from MATMs dispatched to Shanghai. Participants completed online questionnaires comprised of the Risk Perception Questionnaire (RPQ), Positive and negative emotions scale (PANAS), and Sleep Quality Scale (SQS), measuring the psychophysical risk perceptions about the MATMs’ current work, emotional states, and sleep quality. Changes across two waves of data collection were statistically parsed using the exploratory factor analysis and regression models. Results: Data of 220 participants from first-wave samples [S1] and 300 from second-wave samples [S2] were analyzed. Participants reported more worries about physical risks, such as inadequate protection methods and being infected, and S1 rated higher on all risks compared with S2 (as the biggest p-value was 0.021). Across the different situations, the dominant emotional states of MATMs were positive; a higher level of psychophysical risk perceptions, negative emotional states, and poor sleep quality were consistently interrelated. The psychophysical risk perceptions predicted sleep quality. Negative emotions as a state variable intensified the relationship between physical risk perceptions and sleep quality (bindirect effect = 1.084, bootstrapped CI = [0.705, 1.487]). Conclusions: The results provide important evidence that MATMs’ higher level of psychophysical risk perceptions associated with negative emotions could indicate worse sleep quality.
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Affiliation(s)
- Qianlan Yin
- Department of Psychology, Navy Medical University, Shanghai 200433, China
| | - Xiaoqin Shao
- Department of Psychology, Navy Medical University, Shanghai 200433, China
| | - Rong Zhang
- Department of Nursing, No. 989 Hospital of Joint Logistics Support Forces of PLA, Luoyang 471031, China
| | - Jiemei Fan
- Department of Critical Care Medicine, Jinling Hospital, Nanjing 210002, China
| | - Wei Dong
- Department of Psychology, Navy Medical University, Shanghai 200433, China
- Department of Psychology, Fudan University, Shanghai 200011, China
- Correspondence: (W.D.); (G.D.)
| | - Guanghui Deng
- Department of Psychology, Navy Medical University, Shanghai 200433, China
- Correspondence: (W.D.); (G.D.)
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Shahwan S, Yunjue Z, Satghare P, Vaingankar JA, Maniam Y, Janrius GCM, Lin TW, Roystonn K, Subramaniam M. Employer and Co-worker Perspectives on Hiring and Working with People with Mental Health Conditions. Community Ment Health J 2022; 58:1252-1267. [PMID: 35098388 PMCID: PMC9392707 DOI: 10.1007/s10597-021-00934-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to understand perspectives towards hiring and working with people with mental health conditions (PMHC). Semi-structured interviews with 25 employers and 20 co-workers were carried out. Thematic analysis was used to analyse the data. The barriers to hiring and working with PMHC identified through the interviews were concerns about safety, incompetence, PMHC not being able to get along with others, requiring more training and supervision as well as medical costs and reputational risks to the hiring organisation. Employers and co-workers suggested that improving mental health literacy of staff, pairing the PMHC with trained work buddies, having access to mental professionals when needed, and providing incentives for hiring PMHC such as tax rebates are likely to improve attitudes towards hiring and working with PMHC. Their suggestions for the additional supports required should be considered when developing initiatives to promote inclusivity of PMHC in workplaces.
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Affiliation(s)
- Shazana Shahwan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Zhang Yunjue
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yogeswary Maniam
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Goh Chong Min Janrius
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Teh Wen Lin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Morán Pérez AV. Riesgo, incertidumbre y covid-19 entre el personal médico de consultorios adyacentes a farmacias de Oaxaca de Juárez. REVISTA PUEBLOS Y FRONTERAS DIGITAL 2022. [DOI: 10.22201/cimsur.18704115e.2022.v17.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Durante la pandemia de covid-19, el personal médico de los consultorios adyacentes a farmacias (CAF), un servicio de salud privado, desempeñó un rol fundamental en la medida que el 76 % de las personas con síntomas de covid-19 acudieron al sector privado. A partir de un abordaje teórico provisto por la antropología médica, se analiza cómo se configura la percepción del riesgo de médicos(as) de consultorios ubicados en Oaxaca de Juárez. Con base en entrevistas a profundidad realizadas a ocho médicos(as), se muestra que la percepción del riesgo está motivada, entre otros factores, por su condición de vulnerabilidad, la percepción del consultorio como entorno «peligroso» o las conductas de rol definidas por la profesión médica. Además se plantea que, ante la incertidumbre, la reproducción del saber médico se constituye como la práctica de reducción del daño más efectiva.
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El Sharif N, Ahmead M, Imam A. COVID-19 infection prevention and control procedures and institutional trust: Perceptions of Palestinian healthcare workers. Front Public Health 2022; 10:947593. [PMID: 36062099 PMCID: PMC9437519 DOI: 10.3389/fpubh.2022.947593] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/03/2022] [Indexed: 01/21/2023] Open
Abstract
Background Lack of trust in institutional control measures during Coronavirus disease 2019 (COVID-19) outbreaks may affect healthcare workers' (HCWs) levels of stress and wellbeing, and as a consequence, may influence their trust and confidence in their organization. This study aims to understand factors associated with healthcare workers perceptions of trust in organizational preparedness, communication, and infection risk during the COVID-19 pandemic. Methods A cross-sectional study was conducted among HCWs (n = 876) in 16 COVID 19 healthcare facilities between October and December 2020 in Palestine (Gaza Strip, West Bank and East Jerusalem). A stratified purposive sample using an online self-administered Arabic version of a questionnaire was used for data collection. The questionnaire used for this study was adapted from the World Health Organization Blueprint Novel Coronavirus Perceptions of healthcare workers regarding local infection prevention and control procedures for a COVID-19 research protocol.Data were analyzed using Statistical Package for Social Sciences software version 23. In the bivariate analysis, T-test, one-way ANOVA and χ2 test were used at a significant p-value < 0.05. In the multivariable logistic regression analyses, the adjusted odds ratios and its 95% confidence intervals are presented. Results Findings showed that confidence in the systems' ability to manage COVID-19 cases, encouragement and support from senior medical/nursing staff to apply recommended IPC measures, and good levels of mental health increased trust in the organization. Additionally, receiving proper training on IPC procedures for other communicable diseases, having access to clear policies and procedures related to IPC procedures for COVID-19, and providing PPE during the previous clinical shift also increased trust. However, the intention to use recommended PPE when treating patients with suspected or confirmed COVID-19 when having access to it and feeling emotional was negatively correlated with this trust. Conclusions HCWs should be provided with clear, accessible communications about policies and protocols, as well as training about infection prevention and control, personal protective equipment, and support during pandemics to increase their trust in the healthcare system. Additionally, the improvement in HCWs' wellbeing can be attributed to a greater sense of trust in institutions.
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van Hout D, Hutchinson P, Wanat M, Pilbeam C, Goossens H, Anthierens S, Tonkin-Crine S, Gobat N. The experience of European hospital-based health care workers on following infection prevention and control procedures and their wellbeing during the first wave of the COVID-19 pandemic. PLoS One 2022; 17:e0245182. [PMID: 35130294 PMCID: PMC8820620 DOI: 10.1371/journal.pone.0245182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 01/14/2022] [Indexed: 01/10/2023] Open
Abstract
Background Working under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. A better understanding of HCWs’ experiences of following local infection prevention and control (IPC) procedures during COVID-19 is urgently needed to inform strategies for protecting the psychical and psychological health of HCWs. The objective of this study was therefore to capture the perceptions of hospital HCWs on local IPC procedures and the impact on their emotional wellbeing during the first wave of the COVID-19 pandemic in Europe. Methods Participants were recruited in two sampling rounds of an international cross-sectional survey. Sampling took place between 31 March and 17 April 2020 via existing research networks and between 14 May and 31 August 2020 via online convenience sampling. Main outcome measures were behavioural determinants of HCWs’ adherence to IPC guidelines and the WHO-5 Well-Being Index, a validated scale of 0–100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression. Results 2289 HCWs from 40 countries in Europe participated. Mean age was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n = 1699) of HCWs were directly treating patients with COVID-19, of which 32% (n = 527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This feeling was more common among junior than senior HCWs (46% versus 38%, P value < .01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2–1.8). Conclusions In Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.
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Affiliation(s)
- Denise van Hout
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - Paul Hutchinson
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Caitlin Pilbeam
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, United Kingdom
| | - Nina Gobat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Frenkel MO, Pollak KM, Schilling O, Voigt L, Fritzsching B, Wrzus C, Egger-Lampl S, Merle U, Weigand MA, Mohr S. Stressors faced by healthcare professionals and coping strategies during the early stage of the COVID-19 pandemic in Germany. PLoS One 2022; 17:e0261502. [PMID: 35041679 PMCID: PMC8765664 DOI: 10.1371/journal.pone.0261502] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has exerted great pressure on national health systems, which have aimed to ensure comprehensive healthcare at all times. Healthcare professionals working with COVID-19 patients are on the frontline and thereby confronted with enormous demands. Although early reports exist on the psychological impact of the pandemic on frontline medical staff working in Asia, little is known about its impact on healthcare professionals in other countries and across various work sectors. The present cross-sectional, online survey sought to investigate common work stressors among healthcare professionals, their psychological stress as well as coping resources during the pandemic. METHODS A sample of 575 healthcare professionals (57% male) in three different sectors (hospital, prehospital emergency care, and outpatient service) reported their experiences concerning work and private stressors, psychological stress, and coping strategies between April 17, 2020 and June 5, 2020. To capture pandemic-specific answers, most of the items were adapted or newly developed. Exploratory factor analyses (EFA) were conducted to detect underlying latent factors relating to COVID-specific work stressors. In a next step, the effects of these latent stressors across various work sectors on psychological stress (perceived stress, fatigue, and mood) were examined by means of structural equation models (SEM). To add lived experience to the findings, responses to open-ended questions about healthcare professionals' stressors, effective crisis measures and prevention, and individual coping strategies were coded inductively, and emergent themes were identified. RESULTS The EFA revealed that the examined work stressors can be grouped into four latent factors: "fear of transmission", "interference of workload with private life", "uncertainty/lack of knowledge", and "concerns about the team". The SEM results showed that "interference of workload with private life" represented the pivotal predictor of psychological stress. "Concerns about the team" had stress-reducing effects. The latent stressors had an equal effect on psychological stress across work sectors. On average, psychological stress levels were moderate, yet differed significantly between sectors (all p < .001); the outpatient group experienced reduced calmness and more stress than the other two sectors, while the prehospital group reported lower fatigue than the other two sectors. The prehospital group reported significantly higher concerns about the team than the hospital group (p < .001). In their reports, healthcare professionals highlighted regulations such as social distancing and the use of compulsory masks, training, experience and knowledge exchange, and social support as effective coping strategies during the pandemic. The hospital group mainly mentioned organizational measures such as visiting bans as effective crisis measures, whereas the prehospital sector most frequently named governmental measures such as contact restrictions. CONCLUSION The study demonstrated the need for sector-specific crisis measures to effectively address the specific work stressors faced by the outpatient sector in particular. The results on pandemic-specific work stressors reveal that healthcare professionals might benefit from coping strategies that facilitate the utilization of social support. At the workplace, team commitment and knowledge exchange might buffer against adverse psychological stress responses. Schedules during pandemics should give healthcare workers the opportunity to interact with families and friends in ways that facilitate social support outside work. Future studies should investigate cross-sector stressors using a longitudinal design to identify both sector- and time-specific measures. Ultimately, an international comparison of stressors and measures in different sectors of healthcare systems is desirable.
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Affiliation(s)
| | | | - Oliver Schilling
- Psychological Institute, Heidelberg University, Heidelberg, Germany
| | - Laura Voigt
- Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Benedikt Fritzsching
- Corona specialized physician practice, Heidelberg, Germany
- Head of outpatient service for pediatric patients with fever, Heidelberg, Germany
| | - Cornelia Wrzus
- Psychological Institute, Heidelberg University, Heidelberg, Germany
| | - Sebastian Egger-Lampl
- Center for Technology Experience, Austrian Institute of Technology (AIT) GmbH, Seibersdorf, Austria
| | - Uta Merle
- Department for Gastroenterology, Infectious diseases and Intoxication, University Hospital Heidelberg, Germany
| | | | - Stefan Mohr
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
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Fernandez DFD, Phoon YL, Soon MML, Tiow Shen C. Exploration of Factors Influencing Nurses’ Preparedness and Response to the COVID-19 Outbreak. SAGE Open Nurs 2022; 8:23779608221142159. [DOI: 10.1177/23779608221142159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction and Objective Nurses as the core of the health care workforce affect an organization's preparedness and response. This study explores the factors and unique determinants influencing nurses’ preparedness and response to the coronavirus disease 2019 (COVID-19) outbreak in Singapore. Methods This qualitative phenomenological study utilized purposive sampling and in-depth interviews with 10 registered nurses and two enrolled nurses who had worked or were still working in an infectious disease (ID) hospital during the COVID-19 outbreak at the point of recruitment. The data were collected from September 2020 to December 2020. Results (1) Before the outbreak: Factors such as knowledge, skills, and experiences that enhanced nurses’ adaptability and response through training and exposure prior to the outbreak influenced preparedness. In addition, the importance of nurses’ knowing their purpose and the role of their institute during the outbreak also influenced preparedness. (2) The COVID-19 phase: Factors such as the novelty of the disease, communication, load and demand, and coping mechanisms affected participants’ working response to the outbreak. (3) Learning and looking forth: Lessons learnt to enhance preparedness and response to future outbreaks, and positive sentiments as part of the nation's effort to combat the disease. Conclusion Ground nurses should be actively involved in outbreak planning to gain a better view of their responsibilities and unpredictable events that may occur. A transparent and bidirectional communication among management and nurses is crucial amidst rapid changes in an outbreak to strike a balance between the needs of nurses and leadership and to enhance nurses’ resilience throughout this challenging journey.
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Affiliation(s)
| | - Yan Ling Phoon
- Department of Nursing, National Centre for Infectious Diseases, Singapore
| | | | - Chua Tiow Shen
- Department of Nursing, National Centre for Infectious Diseases, Singapore
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Özçevik Subaşi D, Akça Sümengen A, Şimşek E, Ocakçı AF. Healthcare workers' anxieties and coping strategies during the COVID-19 pandemic in Turkey. Perspect Psychiatr Care 2021; 57:1820-1828. [PMID: 33650693 PMCID: PMC8013878 DOI: 10.1111/ppc.12755] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/31/2020] [Accepted: 02/09/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This study aimed to investigate the anxiety levels of healthcare workers and the coping strategies they used for stress during the COVID-19 pandemic. DESIGN AND METHODS This descriptive cross-sectional study was carried out in April 2020 in Turkey with 444 healthcare workers via three online questionnaires: A participant information form, the State Anxiety Inventory (SAI), and the Ways of Coping Questionnaire. FINDINGS: Healthcare workers might be considered to experience more anxiety during the pandemic than shown in the studies conducted before the pandemic. Significant differences in SAI score were found in terms of age, gender, and education status. PRACTICE IMPLICATIONS Age, gender, and some variables related to the pandemic affected the anxiety levels and coping strategies of healthcare workers.
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Affiliation(s)
- Damla Özçevik Subaşi
- PhD student in Nursing, Department of Pediatric Nursing, Graduate School of Health Sciences, Koç University, İstanbul, Turkey
| | - Aylin Akça Sümengen
- Department of Pediatric Nursing, Graduate School of Health Sciences, Koç University, İstanbul, Turkey
| | - Enes Şimşek
- Master's student in Nursing, Department of Pediatric Nursing, Graduate School of Health Sciences, Koç University, İstanbul, Turkey
| | - Ayşe Ferda Ocakçı
- Department of Pediatric Nursing, School of Nursing, Koç University, İstanbul, Turkey
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Household Preparedness and Perceptions of Workforce Preparedness During Pandemics: A Health Care Employee Survey at the US Department of Veterans Affairs. Disaster Med Public Health Prep 2021; 16:1953-1958. [PMID: 34396946 DOI: 10.1017/dmp.2021.198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the effects of household preparedness on perceptions of workplace preparedness during a pandemic among all employees at the US Department of Veterans Affairs (VA) medical facilities. METHODS The VA Preparedness Survey (October-December 2018, Los Angeles, CA) used a stratified simple random, web-based survey. Multivariate statistical analyses examined the effect of household preparedness on perceptions of workforce preparedness during a pandemic: institutional readiness; desire for additional training; and understanding their role and its importance. RESULTS VA employees totaling 4026 participated. For a pandemic, 55% were confident in their VA medical facility's ability to respond, 63% would like additional training, 49% understood their role during a response, and 68% reported their role as important. Only 23% reported being "well prepared" at home during major disasters. After controlling for study-relevant factors, household preparedness was positively associated with perceptions of workforce preparedness during a pandemic. CONCLUSIONS Efforts to increase household preparedness for health care employees could bolster workforce preparedness during pandemics. Organizations should consider robust policies and strategies, such as flexible work arrangements, in order to mitigate factors that may serve as barriers to household preparedness.
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15
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Meng Y, Khan A, Bibi S, Wu H, Lee Y, Chen W. The Effects of COVID-19 Risk Perception on Travel Intention: Evidence From Chinese Travelers. Front Psychol 2021; 12:655860. [PMID: 34335367 PMCID: PMC8322978 DOI: 10.3389/fpsyg.2021.655860] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
This study attempts to assess the relationship between risk perception, risk knowledge, and travel intentions of Chinese leisure travelers during the COVID-19 pandemic in the framework of social contagion and risk communication theories by analyzing a sample of 1,209 travelers through structural equation modeling (SEM) and path analysis. We used the process macro of Hayes to analyze the moderation effects of age, gender, and education between risk perception, media and interpersonal communication, and risk knowledge. It was found that travelers were more concerned about self-efficacy than severity. Risk perception of travelers predicts the information-seeking process of tourists. This process helps travelers to accumulate risk information that influences their travel intentions. Travelers give more importance to interpersonal (contagion) communication in making a traveling decision. Demographic factors influence traveling decision-making; women travelers were found to be more risk resilient than men. Young travelers seek information at low- and old travelers at high-risk levels. Marketing implications also provided.
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Affiliation(s)
- Yue Meng
- College of Tourism, Sichuan Agricultural University, Chengdu, China
| | - Asif Khan
- Department of Tourism and Hotel Management, School of Management, Zhejiang University, Hangzhou, China.,Department of Tourism and Hospitality, Hazara University, Mansehra, Pakistan
| | - Sughra Bibi
- Guanghua Law School Zhejiang University, Hangzhou, China
| | - Haoyue Wu
- College of Tourism, Sichuan Agricultural University, Chengdu, China
| | - Yao Lee
- Department of Tourism and Hotel Management, School of Management, Zhejiang University, Hangzhou, China
| | - Wenkuan Chen
- College of Tourism, Sichuan Agricultural University, Chengdu, China
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16
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Seddighi H, Salmani I, Baharmand H, Seddighi S, Sharifi Sedeh M. Rapid Assessment of COVID-19 Screening Program for Travelers in Iran: A Qualitative Study. Disaster Med Public Health Prep 2021; 16:1-5. [PMID: 34250890 PMCID: PMC8438510 DOI: 10.1017/dmp.2021.219] [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: 05/29/2020] [Revised: 03/21/2021] [Accepted: 06/20/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) screening stations set up by Iranian Red Crescent Society have been available for 17 d with the aim of identifying and treating people with coronavirus, reducing road trips, and sensitizing people to the problem. This study aims to investigate the challenges of the procedure. METHODS A qualitative study was used to find the challenges of the COVID-19 screening centers. Volunteers, branch managers, and headquarter managers of the Iranian Red Crescent Society participated in this study applying snowball sampling. Data were collected by means of in-depth semi-structured telephone interviews in April 2020 after completion of the fever screening plan. All interviews were recorded and transcribed verbatim, always with prior permission of interviewees. RESULTS The interviews with 20 participants in the plan indicated 6 relevant challenges, including logistics, lack of planning, lack of coordination, legal challenges, mental health, and ethical challenges. CONCLUSIONS The results indicated that, although establishing fever detection centers in Iran was a rapid response to COVID-19, it had significant flaws in the structure and adversely affected volunteers' and staff's health and financial resources. Therefore, well-structured protocols are required for similar responses in the future.
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Affiliation(s)
- Hamed Seddighi
- Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ibrahim Salmani
- Department of Health in Disaster and Emergency, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Murray EJ, Mason M, Sparke V, Zimmerman PAP. Factors Influencing Health Care Workers' Willingness to Respond to Duty during Infectious Disease Outbreaks and Bioterrorist Events: An Integrative Review. Prehosp Disaster Med 2021; 36:321-337. [PMID: 33618789 PMCID: PMC7948100 DOI: 10.1017/s1049023x21000248] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/16/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond. AIM The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events. METHODS An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool. RESULTS A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics. CONCLUSIONS By comprehensively identifying the facilitators and barriers to HCWs' WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety.
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Affiliation(s)
- Eleanor J. Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, MassachusettsUSA
| | - Matt Mason
- School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
- Collaborative for the Advancement of Infection Prevention and Control, Queensland, Australia
| | - Vanessa Sparke
- Collaborative for the Advancement of Infection Prevention and Control, Queensland, Australia
- Discipline of Nursing and Midwifery, James Cook University, Cairns, Queensland, Australia
| | - Peta-Anne P. Zimmerman
- Collaborative for the Advancement of Infection Prevention and Control, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
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18
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Fetansa G, Etana B, Tolossa T, Garuma M, Tesfaye Bekuma T, Wakuma B, Etafa W, Fekadu G, Mosisa A. Knowledge, attitude, and practice of health professionals in Ethiopia toward COVID-19 prevention at early phase. SAGE Open Med 2021; 9:20503121211012220. [PMID: 33996080 PMCID: PMC8083007 DOI: 10.1177/20503121211012220] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/30/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Coronavirus disease (COVID-19) is a potentially lethal disease having significant public health concerns. As the disease is new, nothing has been intervened yet. Therefore, here we show the health worker's knowledge, attitude, and practice toward COVID-19. METHODS The online cross-sectional study design was conducted from April to May 2020, among Ethiopia health workers. The data were collected online, downloaded by an Excel sheet, and transferred to IBM SPSS version 24. Using questionnaire containing four parts sociodemographic, knowledge, attitude, and practice assessing. Linear logistic regression and binary logistic regression were performed to test the association between the dependent and the independent variables. We reported the 95% confidence intervals of adjusted odds ratios with a statistical significance level at less than 0.05 p-values. RESULTS AND CONCLUSION A total of 441 health workers were included in this study. The majority of participants were from urban (88.7%), nurses (53.1%), male (88.4%), and have a degree educational level (66.7%). The mean knowledge level of respondents was 10.13 ± 0.057 standard deviation. The majority of respondents had a positive attitude toward control of COVID-19, 88%, and 77% of respondents had confidence that Ethiopia will control COVID-19. Similarly, male (2.746, 95% confidence interval (1.23, 6.02)) and good knowledge level (1.98, 95% confidence interval (1.01, 3.09)) were found to be a determinant for attitude regarding control of COVID-19. Good knowledge level 1.6 (1.02, 2.6), male sex 2.2 (1.07, 4.6), masters 2.33 (1.06, 5.08), and medical doctors 5.99 (1.76, 20.4) to practice wearing a mask when going out of the home. Knowledge, attitude, and practice of the participant health workers are considerable, but may not be enough to control the disease. Sex, age, and profession of the health workers were determinant factors for knowledge about COVID-19. Therefore, training has to be considered for updating health care workers on COVID-19 prevention and controlled at the national level.
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Affiliation(s)
- Getahun Fetansa
- Department of Nursing, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Belachew Etana
- Department of Public Health, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Tadesse Tolossa
- Department of Public Health, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Melkamu Garuma
- Nekemte Public Health Research and Referral Laboratory, Nekemte, Ethiopia
| | - Tariku Tesfaye Bekuma
- Department of Public Health, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- Department of Nursing, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Werku Etafa
- Department of Nursing, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of pharmacy, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New territory, Hong Kong
| | - Alemnesh Mosisa
- Department of Nursing, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
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19
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Garbóczy S, Szemán-Nagy A, Ahmad MS, Harsányi S, Ocsenás D, Rekenyi V, Al-Tammemi AB, Kolozsvári LR. Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19. BMC Psychol 2021; 9:53. [PMID: 33823945 PMCID: PMC8022303 DOI: 10.1186/s40359-021-00560-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/26/2021] [Indexed: 12/23/2022] Open
Abstract
Background In the case of people who carry an increased number of anxiety traits and maladaptive coping strategies, psychosocial stressors may further increase the level of perceived stress they experience. In our research study, we aimed to examine the levels of perceived stress and health anxiety as well as coping styles among university students amid the COVID-19 pandemic. Methods A cross-sectional study was conducted using an online-based survey at the University of Debrecen during the official lockdown in Hungary when dormitories were closed, and teaching was conducted remotely. Our questionnaire solicited data using three assessment tools, namely, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WCQ), and the Short Health Anxiety Inventory (SHAI). Results A total of 1320 students have participated in our study and 31 non-eligible responses were excluded. Among the remaining 1289 participants, 948 (73.5%) and 341 (26.5%) were Hungarian and international students, respectively. Female students predominated the overall sample with 920 participants (71.4%). In general, there was a statistically significant positive relationship between perceived stress and health anxiety. Health anxiety and perceived stress levels were significantly higher among international students compared to domestic ones. Regarding coping, wishful thinking was associated with higher levels of stress and anxiety among international students, while being a goal-oriented person acted the opposite way. Among the domestic students, cognitive restructuring as a coping strategy was associated with lower levels of stress and anxiety. Concerning health anxiety, female students (domestic and international) had significantly higher levels of health anxiety compared to males. Moreover, female students had significantly higher levels of perceived stress compared to males in the international group, however, there was no significant difference in perceived stress between males and females in the domestic group. Conclusion The elevated perceived stress levels during major life events can be further deepened by disengagement from home (being away/abroad from country or family) and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping methods, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety could be mitigated.
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Affiliation(s)
- Szabolcs Garbóczy
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.,Department of Psychiatry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anita Szemán-Nagy
- Department of Personality and Clinical Psychology, Institute of Psychology, University of Debrecen, Debrecen, Hungary
| | - Mohamed S Ahmad
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Szilvia Harsányi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Dorottya Ocsenás
- Department of Social and Work Psychology, Institute of Psychology, University of Debrecen, Debrecen, Hungary.,Doctoral School of Human Sciences, University of Debrecen, Debrecen, Hungary
| | - Viktor Rekenyi
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ala'a B Al-Tammemi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.,Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Móricz Zs. krt. 22, Debrecen, 4032, Hungary
| | - László Róbert Kolozsvári
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary. .,Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Móricz Zs. krt. 22, Debrecen, 4032, Hungary.
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DENİZ ÖZTURAN D, KELEŞ ŞAHİN A. Levels of anxiety and coping with stress in healthcare workers during coronavirus disease 2019 (COVID-19) pandemic. FAMILY PRACTICE AND PALLIATIVE CARE 2021. [DOI: 10.22391/fppc.789890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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21
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Munawar K, Choudhry FR. Exploring stress coping strategies of frontline emergency health workers dealing Covid-19 in Pakistan: A qualitative inquiry. Am J Infect Control 2021; 49:286-292. [PMID: 32649990 PMCID: PMC7340021 DOI: 10.1016/j.ajic.2020.06.214] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/30/2022]
Abstract
Background The COVID-19 outbreak has gravely impacted the physical and psychological health of people. As the outbreak is ongoing, it is crucial to equip the emergency healthcare workers (HCWs) to be medically and psychologically prepared. Objective To examine the psychological impact of COVID-19 on emergency HCWs and to understand how they are dealing with COVID-19 pandemic, their stress coping strategies or protective factors, and challenges while dealing with COVID-19 patients. Methods Using a framework thematic analysis approach, 15 frontline emergency HCWs directly dealing with COVID-19 patients from April 2, 2020 to April 25, 2020. The semi-structured interviews were conducted face-to-face or by telephone. Data were analyzed using thematic analysis. Results Findings highlighted first major theme of stress coping, including, limiting media exposure, limited sharing of Covid-19 duty details, religious coping, just another emergency approach, altruism, and second major theme of Challenges includes, psychological response and noncompliance of public/denial by religious scholar. Conclusions Participants practiced and recommended various coping strategies to deal with stress and anxiety emerging from COVID-19 pandemic. Media was reported to be a principal source of raising stress and anxiety among the public. Religious coping as well as their passion to serve humanity and country were the commonly employed coping strategies.
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Ismail TI, Shehata SF, Mahrous RSS. Occupational stress and burnout among frontline Egyptian anesthesiologists during COVID-19 outbreak in Egypt. EGYPTIAN JOURNAL OF ANAESTHESIA 2021. [DOI: 10.1080/11101849.2021.1891704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Tarek I. Ismail
- Lecturer of Anaesthesia, Department of Anaesthesia and Surgical Intensive Care, Helwan University, Cairo, Egypt
| | - Shehata F. Shehata
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia
- Lecturer of Statistics, High Institute of Public Health, Alexandria University, Helwan, Egypt
| | - Rabab S. S Mahrous
- Assistant Professor of Anesthesia, Department of Anaesthesia and Surgical Intensive Care, Alexandria University, Alexandria, Egypt
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Goldfarb N, Grinstein-Cohen O, Shamian J, Schwartz D, Zilber R, Hazan-Hazoref R, Goldberg S, Cohen O. Nurses' perceptions of the role of health organisations in building professional commitment: Insights from an israeli cross-sectional study during the COVID-19 pandemic. J Nurs Manag 2021; 29:1102-1110. [PMID: 33411376 DOI: 10.1111/jonm.13248] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/10/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
AIMS To reveal the factors associated with nurses' professional commitment during the COVID-19 pandemic. BACKGROUND During the first wave of the COVID-19 pandemic, the Nursing Division at the Israeli Ministry of Health and partners conducted a study to examine the nurses' perceptions towards a set of personal and professional circumstances that may affect their performance. METHOD A cross-sectional Web-based study was conducted in Israel. Study' participants included 817 community and hospital nurses. The Occupational Commitment Scale for Health Professionals during pandemic (PanHP-OCS) was used to gather data. Univariate and multivariate analyses explored associations between the PanHP-OCS score and demographic and professional variables. RESULTS About 40% of 817 respondents reported having managerial roles (n = 320). Those who received specific pandemic-focused training had significantly better PanHP-OCS scores (p < .001). Most respondents expected their organisation to provide them emotional support. Linear regression explored the organisational commitment factor as the greatest contributor to nurses' professional commitment (β = 0.284, p < .001). CONCLUSION To enhance the nurses' professional commitment during the COVID-19 pandemic, training and emotional support must be emphasized in all types of nurses' workplaces. IMPLICATIONS FOR NURSING MANAGEMENT In a pandemic, health organisations must provide dedicated pandemic training, including proactive emotional support for nurses. Special attention should be given to community care.
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Affiliation(s)
- Netali Goldfarb
- Nursing Department, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Orli Grinstein-Cohen
- Nursing Department, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Judith Shamian
- International Council of Nurses ICN President Emerita, FAAN, Toronto, ON, Canada
| | - Dagan Schwartz
- Emergency Medicine Department, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rama Zilber
- Nursing Division, Ministry of Health, Jerusalem, Israel
| | | | | | - Odeya Cohen
- Nursing Department, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Balut MD, Der-Martirosian C, Dobalian A. Determinants of Workforce Preparedness during Pandemics Among Healthcare Workers at the U.S. Department of Veterans Affairs. J Prim Care Community Health 2021; 12:21501327211004738. [PMID: 33759623 PMCID: PMC8010801 DOI: 10.1177/21501327211004738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE An infectious disease outbreak can place a significant burden on healthcare systems, however, our understanding of the broader healthcare workforce's preparedness during a pandemic is limited. This study examines factors that influence perceived workforce preparedness at the U.S. Department of Veterans Affairs (VA) during a pandemic. METHODS The VA Preparedness Survey was a random, anonymous, web-based survey fielded nationwide October to December 2018. Multivariate statistical analyses examined the effects of study relevant factors (sociodemographic, work-related, general health, and household-related characteristics of VA employees) on perceptions of workforce preparedness, including institutional readiness and understanding of individual roles during a pandemic. RESULTS Four thousand and twenty-six VA employees responded. Overall, 55% were confident in their VA medical facility's ability to respond; 49% understood their role; and 68% reported their role to be important during a pandemic. After controlling for study-relevant factors, household preparedness, having plans that address the health care needs of family members, and higher self-reported health status were associated with all 3 workforce preparedness variables. Clinical staff (compared to non-clinical staff) were less likely (OR:0.80, 95% CI:0.68-0.94, P < .01) to have confidence in their medical facility's ability to respond but more likely (OR:1.77, 95% CI:1.49-2.10, P < .001) to believe their role was important. Employees who have been at the VA longer (OR:1.07, 95% CI:1.01-1.14, P < .05) or have experienced a disaster while working at the VA (OR:1.29, 95% CI:1.04-1.59, P < .05) were more likely to understand their role during a pandemic. CONCLUSION The findings from this study suggest the need for identifying ways to increase VA employees' confidence in their medical facility's ability to respond to a pandemic; develop trainings to improve understanding of their different yet critical roles, for both clinical and non-clinical staff, during a pandemic; create different workforce trainings for newly hired employees; and identify ways to improve household preparedness for a pandemic outbreak.
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Affiliation(s)
- Michelle D. Balut
- Veterans Emergency Management Evaluation Center, North Hills, CA, USA
| | | | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, North Hills, CA, USA
- University of Memphis School of Public Health, Memphis, TN, USA
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Karimi Dehkordi N, Abbasi AF, Radmard Lord M, Soleimanpour S, Goharinezhad S. Interventions to Improve the Willingness to Work Among Health care Professionals in Times of Disaster: A Scoping Review. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211059959. [PMID: 34903077 PMCID: PMC8679035 DOI: 10.1177/00469580211059959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The critical role of the health workforce in the function of the health care system is undeniable. In times of disaster and public health emergency, the importance of this valuable resource for the organization multiplies. This scoping review was conducted to identify, analyze, and categorize interventions to improve willingness to work in times of disaster as well as the existing knowledge gaps in the topic. For this purpose, four databases were searched. These included Scopus, PubMed, WOS, and World Health Organization observatory, and they were searched for papers published from July 2000 to September 2020. Studies of the English language that described strategies to improve human resources for health willingness to work during times of disaster/public health emergency were included. Full-text papers were screened by authors and data extraction was done according to self-designed form. Framework analysis identified key interventions based on human resources for health action framework. From 6246 search results, 52 articles were included, a great portion of which was published in 2020 probably due to the COVID-19 pandemic. Northern America was the region with most studies. From 52 included studies, 21 papers have reported the interventions to improve willingness to work and 31 papers have explored factors that affected a willingness to work. The interventions used in the studies were categorized into five themes as Leadership, Partnership, Financing, Education, and Organizational policies. The most and least interventions were financial and partnership respectively. The review identified a wide range of feasible strategies and interventions to improve human resources for health's willingness to work at times of disaster that are expected to be effective. Organizations should let the staff know these decisions and as a necessary step in every organizational intervention remember to evaluate the impacts.
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Affiliation(s)
- Negin Karimi Dehkordi
- Student Research Committee, School
of Medicine, Iran University of Medical
Sciences, Tehran, Iran
| | - Amir Farhang Abbasi
- Student Research Committee, School
of Medicine, Iran University of Medical
Sciences, Tehran, Iran
| | - Mostafa Radmard Lord
- Student Research Committee, School
of Medicine, Iran University of Medical
Sciences, Tehran, Iran
| | - Samira Soleimanpour
- Department of Medical Library and
Information Sciences, School of Health Management and Information Sciences, Iran University of Medical
Sciences, Tehran, Iran
| | - Salime Goharinezhad
- Preventive Medicine and Public
Health Research Center, Psychosocial Health Research Institute, Iran University of Medical
Sciences, Tehran, Iran
- Health Management and Economics
Research Center, Health Management Research Institute, Iran University of Medical
Sciences, Tehran, Iran
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Sultan MAS, Løwe Sørensen J, Carlström E, Mortelmans L, Khorram-Manesh A. Emergency Healthcare Providers' Perceptions of Preparedness and Willingness to Work during Disasters and Public Health Emergencies. Healthcare (Basel) 2020; 8:healthcare8040442. [PMID: 33138164 PMCID: PMC7712235 DOI: 10.3390/healthcare8040442] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022] Open
Abstract
This study evaluates the perceptions of preparedness and willingness to work during disasters and public health emergencies among 213 healthcare workers at hospitals in the southern region of Saudi Arabia by using a quantitative survey (Fight or Flight). The results showed that participants’ willingness to work unconditionally during disasters and emergencies varied based on the type of condition: natural disasters (61.97%), seasonal influenza pandemic (52.58%), smallpox pandemic (47.89%), SARS/COVID-19 pandemic (43.56%), special flu pandemic (36.15%), mass shooting (37.56%), chemical incident and bombing threats (31.92%), biological events (28.17%), Ebola outbreaks (27.7%), and nuclear incident (24.88%). A lack of confidence and the absence of safety assurance for healthcare workers and their family members were the most important reasons cited. The co-variation between age and education versus risk and danger by Spearman’s rho confirmed a small negative correlation between education and danger at a 95% level of significance, meaning that educated healthcare workers have less fear to work under dangerous events. Although the causes of unsuccessful management of disasters and emergencies may vary, individuals’ characteristics, such as lack of confidence and emotional distractions because of uncertainty about the safety issues, may also play a significant role. Besides educational initiatives, other measures, which guarantee the safety of healthcare providers and their family members, should be established and implemented.
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Affiliation(s)
- Mohammed Ali Salem Sultan
- Directorate of Health Affairs in Najran, Najran 66255, Saudi Arabia
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, 413 46 Gothenburg, Sweden;
- Correspondence: ; Tel.: +966-5661-23313
| | - Jarle Løwe Sørensen
- USN School of Business, Campus Vestfold, University of South-Eastern Norway, 3603 Kongsberg, Norway;
| | - Eric Carlström
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, 413 46 Gothenburg, Sweden;
- USN School of Business, Campus Vestfold, University of South-Eastern Norway, 3603 Kongsberg, Norway;
| | - Luc Mortelmans
- Center for Research and Education in Emergency Care, University of Leuven, 3000 Leuven, Belgium;
- Regedim, VUB, Brussels and dept of Emergency Medicine, ZNA, Stuivenberg, 2060 Antwerp, Belgium
| | - Amir Khorram-Manesh
- Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 90 Gothenburg, Sweden;
- Department of Research and Development, Swedish Armed Forces Centre for Defence Medicine, 426 76 Gothenburg, Sweden
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All for One and One for All: Voluntary Physicians in the Intensive Medicine Units During the COVID-19 Outbreak in Spain. Disaster Med Public Health Prep 2020; 16:612-618. [PMID: 33040768 PMCID: PMC7737119 DOI: 10.1017/dmp.2020.375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Our purpose was to determine the intensive care units' (ICU's) medical staff surge capacity during the coronavirus disease 2019 (COVID-19) outbreak in Spring 2020 in Spain. METHODS A multicenter retrospective survey was performed addressing the medical specialties present in the ICUs and the increase in bed capacity during this period. RESULTS Sixty-seven centers (62.04%) answered the questionnaire. The ICU bed capacity during the pandemic outbreak increased by 160% (95% confidence interval [CI], 128.97-191.03%). The average number of beds per intensive care medicine (ICM) specialist was 1.5 ± 0.60 and 3.71 ± 2.44 beds/specialist before and during the COVID-19 outbreak, respectively. Non-ICM specialists and residents were present in 50 (74.63%) and 23 (34.3%) ICUs during the outbreak, respectively. The number of physicians (ICM and non-ICM residents and specialists) in the ICU increased by 89.40% (95% CI, 64.26114.53%). The increase in ICM specialists was, however, 4.94% (95% CI, -1.35-11.23%). Most non-ICM physicians were anesthetists, followed by pediatricians and cardiologists. CONCLUSIONS The majority of ICUs in our study were able to rapidly expand critical care capacity by adapting areas outside of the normal ICU to manage critically ill patients, and by extending the critical care staff with noncritical care physicians working as force multipliers.
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Stephens EH, Dearani JA, Guleserian KJ. Courage, Fortitude, and Effective Leadership of Surgical Teams During COVID-19. World J Pediatr Congenit Heart Surg 2020; 11:675-679. [PMID: 32648522 PMCID: PMC7355204 DOI: 10.1177/2150135120938330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 02/06/2023]
Abstract
The world as we once knew it has been drastically altered secondary to coronavirus disease 2019 (COVID-19). The impact of these changes, particularly for those practicing in the medical profession, extends beyond the physical to the psychological, emotional, and spiritual. We discuss the factors that contribute to these stresses, way to manage them, and how we as leaders of our teams can inspire resilience and help our colleagues endure these most difficult times.
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Affiliation(s)
| | - Joseph A. Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kristine J. Guleserian
- Department of Congenital Heart Surgery, Medical City Children’s
Hospital, Dallas, TX, USA
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Bavinger JC, Shantha JG, Yeh S. Ebola, COVID-19, and emerging infectious disease: lessons learned and future preparedness. Curr Opin Ophthalmol 2020; 31:416-422. [PMID: 32740063 PMCID: PMC7755289 DOI: 10.1097/icu.0000000000000683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To highlight the lessons learned from the Ebola outbreak that may inform our approach to the COVID-19 pandemic, particularly related to the widespread disruption of healthcare, ophthalmic disease manifestations, and vision health systems strengthening for future outbreaks. RECENT FINDINGS Coronavirus disease 2019 (COVID-19), first detected in China in December 2019, has become a worldwide health emergency, with significant disruption of all aspects of society, including travel, business, and medical care. Although this pandemic has had unprecedented effects on healthcare delivery in the United States, experiences from recent Ebola virus disease (EVD) outbreaks in Africa provide insight and inform our approach to COVID-19 and outbreak preparedness. Like COVID-19, the rapid emergence of Ebola required new clinical and surgical approaches to understand its associated spectrum of ophthalmic complications and the potential for Ebola viral persistence within the eye and in tear film. Recent reports of ophthalmic findings associated with COVID-19 include conjunctivitis, retinopathy, and molecular evidence of virus within the tear film in a minority of cases. Yet, more rigorous approaches to understand ophthalmic disease and transmission risk associated with COVID-19 are needed. Gaps also remain in our understanding of eye disease associated with other high priority emerging infectious diseases including Nipah, Lassa fever, Marburg virus, and others. SUMMARY Thoroughly understanding the ophthalmic findings and transmission risk associated with COVID-19 is paramount during this pandemic, providing additional measures of safety while resuming ophthalmic care for all patients. Vision health systems preparedness measures developed during recent EVD outbreaks and the current pandemic provide models for ophthalmic clinical practice, research, and education, as we continue to address COVID-19 and future emerging infectious disease threats.
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Affiliation(s)
| | | | - Steven Yeh
- Department of Ophthalmology, Emory University
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Cai Y, Jiam NT, Wai KC, Shuman EA, Roland LT, Chang JL. Otolaryngology Resident Practices and Perceptions in the Initial Phase of the U.S. COVID-19 Pandemic. Laryngoscope 2020; 130:2550-2557. [PMID: 32368800 PMCID: PMC7267342 DOI: 10.1002/lary.28733] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The coronavirus 2019 (COVID-19) pandemic has had widespread implications on clinical practice at U.S. hospitals. These changes are particularly relevant to otolaryngology-head and neck surgery (OHNS) residents because reports suggest an increased risk of contracting COVID-19 for otolaryngologists. The objectives of this study were to evaluate OHNS residency program practice changes and characterize resident perceptions during the initial phase of the pandemic. STUDY DESIGN A cross-sectional survey of U.S. OHNS residents at 81 programs was conducted between March 23, 2020, and March 29, 2020. RESULTS Eighty-two residents from 51 institutions (63% of invited programs) responded. At the time of survey, 98% of programs had enacted policy changes to minimize COVID-19 spread. These included filtered respirator use for aerosol-generating procedures even in COVID-19-negative patients (85%), decreased resident staffing of surgeries (70%), and reduced frequency of tracheotomy care (61%). The majority of residents (66%) perceived that residents were at higher risk of contracting COVID-19 compared to attendings. Residents were most concerned about protective equipment shortage (93%) and transmitting COVID-19 to patients (90%). The majority of residents (73%) were satisfied with their department's COVID-19 response. Resident satisfaction correlated with comfort level in discussing concerns with attendings (r = 0.72, P < .00001) and inversely correlated with perceptions of increased risk compared to attendings (r = -0.52, P < .00001). CONCLUSION U.S. OHNS residency programs implemented policy changes quickly in response to the COVID-19 pandemic. Sources of resident anxieties demonstrate the importance of open communication and an integrated team approach to facilitate optimal patient and provider care during this unprecedented crisis. LEVEL OF EVIDENCE 4. Laryngoscope, 130:2550-2557, 2020.
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Affiliation(s)
- Yi Cai
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Nicole T Jiam
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Katherine C Wai
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Elizabeth A Shuman
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Lauren T Roland
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A
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31
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Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, Zhuang Q. Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID‑19) in Hubei, China. Med Sci Monit 2020; 26:e924171. [PMID: 32291383 PMCID: PMC7177038 DOI: 10.12659/msm.924171] [Citation(s) in RCA: 382] [Impact Index Per Article: 95.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Throughout China, during the recent epidemic in Hubei province, frontline medical staff have been responsible for tracing contacts of patients infected with coronavirus disease 2019 (COVID-19). This study aimed to investigate the psychological impact and coping strategies of frontline medical staff in Hunan province, adjacent to Hubei province, during the COVID-19 outbreak between January and March 2020. Material/Methods A cross-sectional observational study included doctors, nurses, and other hospital staff throughout Hunan province between January and March 2020. The study questionnaire included five sections and 67 questions (scores, 0–3). The chi-squared χ2 test was used to compare the responses between professional groups, age-groups, and gender. Results Study questionnaires were completed by 534 frontline medical staff. The responses showed that they believed they had a social and professional obligation to continue working long hours. Medical staff were anxious regarding their safety and the safety of their families and reported psychological effects from reports of mortality from COVID-19 infection. The availability of strict infection control guidelines, specialized equipment, recognition of their efforts by hospital management and the government, and reduction in reported cases of COVID-19 provided psychological benefit. Conclusions The COVID-19 outbreak in Hubei resulted in increased stress for medical staff in adjacent Hunan province. Continued acknowledgment of the medical staff by hospital management and the government, provision of infection control guidelines, specialized equipment and facilities for the management of COVID-19 infection should be recognized as factors that may encourage medical staff to work during future epidemics.
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Affiliation(s)
- Haozheng Cai
- Transplantation Center, The 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Baoren Tu
- Transplantation Center, The 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Engineering and Technology Research Center of National Health Ministry for Transplantation Medicine, Changsha, Hunan, China (mainland).,The Center on Behavior Health, The Faculty of Social Science, The University of Hong Kong, Hong Kong, China (mainland)
| | - Jing Ma
- Department of Infectious Diseases, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Limin Chen
- Department of Infectious Diseases, The 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Lei Fu
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Yongfang Jiang
- Department of Infectious Diseases, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Quan Zhuang
- Transplantation Center, The 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Engineering and Technology Research Center of National Health Ministry for Transplantation Medicine, Changsha, Hunan, China (mainland)
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Abstract
As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives?With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel struggle with acute shortages of equipment-both to treat patients and protect themselves. With their personal and possibly their family's lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks-including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers' risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal.
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Affiliation(s)
- Kenneth V Iserson
- University of Arizona, Department of Emergency Medicine, Tucson, Arizona
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Jang WM, Kim UN, Jang DH, Jung H, Cho S, Eun SJ, Lee JY. Influence of trust on two different risk perceptions as an affective and cognitive dimension during Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea: serial cross-sectional surveys. BMJ Open 2020; 10:e033026. [PMID: 32139484 PMCID: PMC7059523 DOI: 10.1136/bmjopen-2019-033026] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES This study aimed to assess the affective and cognitive risk perceptions in the general population of Middle East respiratory syndrome (MERS) during the 2015 MERS coronavirus (MERS-CoV) outbreak in South Korea and the influencing factors. DESIGN Serial cross-sectional design with four consecutive surveys. SETTING Nationwide general population in South Korea. PARTICIPANTS Overall 4010 respondents (aged 19 years and over) from the general population during the MERS-CoV epidemic were included. PRIMARY AND SECONDARY OUTCOME MEASURES The main outcome measures were (1) affective risk perception, (2) cognitive risk perception, and (3) trust in the government. Multivariate logistic regression models were used to identify factors (demographic, socioeconomic, area and political orientation) associated with risk perceptions. RESULTS Both affective and cognitive risk perceptions decreased as the MERS-CoV epidemic progressed. Proportions of affective risk perception were higher in all surveys and slowly decreased compared with cognitive risk perception over time. Females (adjusted OR (aOR) 1.72-2.00; 95% CI 1.14 to 2.86) and lower self-reported household economic status respondents were more likely to perceive the affective risk. The older the adults, the higher the affective risk perception, but the lower the cognitive risk perception compared with younger adults. The respondents who had low trust in the government had higher affective (aOR 2.19-3.11; 95 CI 1.44 to 4.67) and cognitive (aOR 3.55-5.41; 95 CI 1.44 to 9.01) risk perceptions. CONCLUSIONS This study suggests that even if cognitive risk perception is dissolved, affective risk perception can continue during MERS-CoV epidemic. Risk perception associating factors (ie, gender, age and self-reported household economic status) appear to be noticeably different between affective and cognitive dimensions. It also indicates that trust in the government influences affective risk perception and cognitive risk perception. There is a need for further efforts to understand the mechanism regarding the general public's risk perception for effective risk communication.
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Affiliation(s)
- Won Mo Jang
- Health Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, South Korea
| | - Un-Na Kim
- Division of Suicide Prevention Policy, Ministry of Health and Welfare, Sejong, South Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
| | - Deok Hyun Jang
- Research Analytics and Communications, Gallup Korea, Seoul, South Korea
| | - Hyemin Jung
- Health Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, South Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
| | - Sanghyun Cho
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Jun Eun
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Jin Yong Lee
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
- Department of Public Health and Community Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, South Korea
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Holmgren J, Paillard‐Borg S, Saaristo P, von Strauss E. Nurses' experiences of health concerns, teamwork, leadership and knowledge transfer during an Ebola outbreak in West Africa. Nurs Open 2019; 6:824-833. [PMID: 31367405 PMCID: PMC6650671 DOI: 10.1002/nop2.258] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/04/2019] [Accepted: 02/05/2019] [Indexed: 12/20/2022] Open
Abstract
AIM To describe nurses' experiences of health concerns, teamwork, leadership and management and knowledge transfer during an Ebola outbreak in West Africa. DESIGN The study has a qualitative descriptive design. METHODS The 44 nurses who had worked in an Ebola Treatment Centre in Kenema in 2014 and 2015 were invited by email to respond to a questionnaire. The qualitative, open-ended answers were analysed using a thematic analysis. Data have been coded systematically, with the identification of semantic patterns presented in four themes. RESULTS The themes are as follows: personal health management-a way to feel safe and secure for delegates and affiliates; pre-deployment training-crucial for a joint value base and future collaboration; the importance of a professional democratic approach and being a good role model; and the value of timely in-depth knowledge transfer of experienced former delegates.
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Affiliation(s)
| | | | - Panu Saaristo
- The International Federation of the Red Cross and Red Crescent Societies (IFRC)GenevaSwitzerland
| | - Eva von Strauss
- The Swedish Red Cross University College (SRCUC)HuddingeSweden
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Taylor HA, Rutkow L, Barnett DJ. Local Preparedness for Infectious Disease Outbreaks: A Qualitative Exploration of Willingness and Ability to Respond. Health Secur 2019; 16:311-319. [PMID: 30339094 PMCID: PMC6207156 DOI: 10.1089/hs.2018.0046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/21/2018] [Accepted: 09/01/2018] [Indexed: 11/13/2022] Open
Abstract
As ecologic, social, and economic conditions continue to facilitate the emergence and transmission of infectious diseases, local health department workers' willingness to respond will remain vital to the United States' ability to recognize and respond to new and emerging disease threats. As demonstrated by heavy occupational morbidity and mortality associated with the 2014 Ebola outbreak, infectious disease response can pose serious risks to the health workforce and presents many ethical and logistical challenges. To explore willingness to respond to an infectious disease outbreak among local health departments-the hub of the public health emergency preparedness system-we conducted focus groups with 46 local health department staff attending 2 national conferences. We examined perspectives from our participants on how local health department employees learn about and articulate their professional commitment to the department, the ways in which local health department leaders support local health department employees in responding to an outbreak, and how local health department staff articulate their responsibilities to their families. We conclude with a proposal for how a web of ethical commitments likely influences willingness to respond. These commitments and their relationship to willingness to respond should be explored further.
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Affiliation(s)
- Holly A. Taylor
- Holly A. Taylor, PhD, MPH, is an Associate Professor, Department of Health Policy and Management; Lainie Rutkow, PhD, JD, is a Professor, Department of Health Policy and Management; and Daniel J. Barnett, MD, MPH, is an Associate Professor, Department of Environmental Health and Engineering; all in the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lainie Rutkow
- Holly A. Taylor, PhD, MPH, is an Associate Professor, Department of Health Policy and Management; Lainie Rutkow, PhD, JD, is a Professor, Department of Health Policy and Management; and Daniel J. Barnett, MD, MPH, is an Associate Professor, Department of Environmental Health and Engineering; all in the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel J. Barnett
- Holly A. Taylor, PhD, MPH, is an Associate Professor, Department of Health Policy and Management; Lainie Rutkow, PhD, JD, is a Professor, Department of Health Policy and Management; and Daniel J. Barnett, MD, MPH, is an Associate Professor, Department of Environmental Health and Engineering; all in the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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36
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Iserson KV. Must I Respond if My Health is at Risk? J Emerg Med 2018; 55:288-293. [PMID: 29773480 PMCID: PMC7134772 DOI: 10.1016/j.jemermed.2018.04.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/31/2018] [Accepted: 04/10/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. DISCUSSION It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community. Despite numerous medical ethical codes, nothing-either morally or legally-requires a response to risk-prone situations from civilian clinicians; it remains a personal decision. The most important questions are: What will encourage us to respond to these situations? And will we respond? These questions are necessary, not only for physicians and other direct health care providers, but also for vital health care system support personnel. Those who provide care in the face of perceived risk demonstrate heroic bravery, but the choice to do so has varied throughout history. To improve individual response rates, disaster planners and managers must communicate the risks clearly to all members of the health care system and help mitigate their risks by providing them with as much support and security as possible. CONCLUSIONS The decision to remain in or to leave a risky health care situation will ultimately depend on the provider's own risk assessment and value system. If history is any guide, we can rest assured that most clinicians will choose to stay, following the heroic example established through the centuries and continuing today.
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Affiliation(s)
- Kenneth V Iserson
- International Federation for Emergency Medicine and Department of Emergency Medicine, The University of Arizona, Tucson, Arizona
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