Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic

The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

Physiotherapy services during the COVID-19 pandemic: A mediated model of physiotherapists' self-efficacy, tele-physiotherapy role stressors, and motivation to provide tele-physiotherapy

BACKGROUND

Occupational self-efficacy is a stable predictor for professionals' motivation to engage with new methods and tasks. Yet, the delivery of tele-physiotherapy (Tele-PT) by physiotherapists (PTs) during the coronavirus disease of 2019 (COVID-19) outbreak without advance training may have had the potential to increase work stress and damage their motivation, regardless of their occupational self-efficacy.

OBJECTIVES

The present study examined whether the relations between PTs' overall occupational self-efficacy and motivation to provide Tele-PT was mediated by role stress (i.e. role conflict and ambiguity).

DESIGN AND METHOD

Between February 4 and April 23, 2021, 150 Israeli PTs completed an online survey that measured their overall occupational self-efficacy, their role stress induced by the provision of Tele-PT, their motivation to provide Tele-PT, and their demographic characteristics.

RESULTS

PTs' overall occupational self-efficacy was positively associated with PTs' motivation to provide Tele-PT (r= 0.328, p < .01) and fully mediated by role conflict (0.1757, 95% CI = [0.0231, 0.3797]) and by role ambiguity (0.1845, 95% CI = [0.0196, 0.4184]) (components of role stress) caused by the provision of Tele-PT.

CONCLUSIONS

It is important to investigate the predictors and mediators of the motivation to provide Tele-PT because in the post-COVID-19 era health organizations are likely to adopt many tele-medicine services, and they need to find ways to mitigate perceived challenges.

The COVID-19 pandemic related stress and the associated factors among the healthcare workers in Kota Setar District Health Office, Malaysia

BACKGROUND

The COVID-19 pandemic is the most significant worldwide health catastrophe, with massive impacts observed particularly among the healthcare workers. Stress among healthcare workers is a significant and pervasive issue that can have profound implications for both the well-being of healthcare professionals and the quality of patient care. This study aimed to determine the prevalence of stress related to the COVID-19 pandemic and the associated factors among the healthcare workers (HCWs).

METHODS

A retrospective cross-sectional study was conducted involving 533 HCWs in Kota Setar District Health Office. Related data was collected between January and June 2021. Stress was measured using the Depression Anxiety Depression Scale 21 (DASS-21). Other variables included in this study were sociodemographic and employment factors. The associated factors and predictors were determined by employing chi-square test and multivariate logistic models.

RESULTS

COVID-19 related stress was reported at 10.5%. HCWs who work at the district health offices and those with degree or higher qualifications had 2.3 (AOR = 2.310, 95% CI: 1.177-4.535) and 3 (AOR = 2.899, 95% CI: 1.613-5.211) higher odds of experiencing stress compared to those working in the clinics and had lower qualifications (diploma or less).

CONCLUSIONS

The mental wellbeing of the HCWs participated in this study had been affected negatively by the COVID-19 pandemic, resulting in one in 10th of the HCWs were experiencing stress during the COVID-19 pandemic, with higher risk observed among those working at the district health office and HCWs with higher qualifications or ranking. This is expected since COVID-19 was a new and unprecedented outbreak associated with massive number of mortalities that requires active contact tracing and surveillance which commonly conducted at district health office level. Active intervention needed to cope with the overwhelming stress and working condition to ensure effective rehabilitation are in place and quality of work were not jeopardized.

Network analysis of the comorbidity between post-traumatic stress, depression and anxiety symptoms among frontline healthcare workers during the COVID-19 pandemic

Background

Coronavirus disease 2019 pandemic pointed out significant mental symptoms of frontline healthcare workers (HCWs).

Objective

We aimed to estimate the prevalence and comorbidity of post-traumatic stress symptoms (PTSS), depression and anxiety symptoms in HCWs from Fangcang shelter hospitals during the pandemic.

Design

Demographic information, post-traumatic stress disorder checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) were obtained online based on stratified random sampling design during April 2022, with 284 eligible responses.

Method

Hierarchical regression analyses were applied to investigate independent variables associated with psychological status outcomes (PHQ-9, GAD-7 and PCL-5), and the network analyses were applied to explore the comorbidity using all items of PCL-5, PHQ-9 and GAD-7.

Results

(1) 10.56%, 13.03% and 8.10% of HCWs reported PTSS, depression and anxiety symptoms. Fifty-three (18.66%) HCWs experienced at least one mental health disorder, among which 26.42-37.74% HCWs had comorbidity of two or three mental disorders; (2) several influence factors of mental health were identified, including medical professions, working hours, contacted patients (p < 0.05); (3) prominent bridge symptoms between PTSS and depression were sleep problems, suicide ideation, concentration difficulties and recklessness. Comorbidity between PTSS and anxiety was thought to mainly stem from negative affect, such as afraid, anxious, annoyed and worrying. Depressed mood and worry might be good targets during treatment of comorbidity of depression and anxiety.

Conclusion

Our data suggest mild level of PTSS, depression and anxiety symptoms among HCWs during the pandemic and might give novel insights into assessment and intervention of comorbidity.

Perceived stress, burnout, and resilience among healthcare workers in a multiple disaster-impacted setting during the COVID-19 pandemic

OBJECTIVE

Current literature on coronavirus disease 2019 (COVID-19) research presents gaps and opportunities to investigate the psychological experiences of healthcare workers (HCWs) serving in mass trauma situations. We aimed to measure perceived stress, burnout, and resilience in Kashmiri HCWs and explore the relationship of burnout with sociodemographic, work-related, and pandemic-related factors.

DESIGN, SETTING, AND PARTICIPANTS

This was a cross-sectional descriptive study. Data were collected by circulating a web-based questionnaire among HCWs across primary, secondary, and tertiary healthcare levels in Kashmir, India. The questionnaire consisted of sections on personal, work-related, and pandemic-related variables as well as validated instruments to measure perceived stress, burnout, and resilience.

RESULTS

A total of 514 valid responses were received. More than 80 percent of HCWs had moderate to high perceived stress. The prevalence of personal, work-related, and client-related burnouts was 68, 48.6, and 46 percent, respectively. Resilience was negatively correlated with stress and burnout. Younger (18-28 years), unmarried HCWs, especially junior residents and nurses, had higher burnout levels. Redeployment to deliver COVID-19 duties, unpredictability in work schedule, tested positive for COVID-19, and spending time in isolation/quarantine were also found to be significant risk factors for developing burnout.

CONCLUSIONS

Nearly half of the HCWs suffered from burnout, and more than half had moderate to high perceived stress. In addition to pre-existing risk factors of burnout, the pandemic seems to have introduced more occupational risk factors in this disaster-affected area. Lessons learnt from COVID-19 pandemic may help guide need-based intervention strategies designed for specific target population rather than a one size fits all approach.

Psychological well-being of healthcare workers during COVID-19: Relationship with risk perception and fear in the context of health belief model

This study aimed to evaluate the extent of fear and risk perception related to COVID-19 and their impact on the psychological well-being of healthcare workers. Data were gathered through an online survey, incorporating questions about risk perception utilizing the health belief model, the Fear of COVID-19 Scale, and the General Health Questionnaire-12. A total of 364 HCWs participated in the survey, with 94% of participants identified as being in the high-risk category for mental disorders based on their General Health Questionnaire scores. The assessment of COVID-19-related risk perception within the Health Belief Model demonstrated significant correlations between perceived susceptibility, perceived severity, perceived barriers, and self-efficacy with both the fear scale and General Health Questionnaire scores. Linear regression was employed to identify factors influencing General Health Questionnaire scores, revealing that risk perception, Fear of COVID-19 scores, marital status, and perceived health were significantly associated with General Health Questionnaire scores. These findings underscore the importance of monitoring the psychological well-being of healthcare workers throughout all stages of pandemic preparedness and response.

Risk and prediction of job burnout in responding nurses to public health emergencies

BACKGROUND

In public health emergencies, nurses are vulnerable to adverse reactions, especially job burnout. It is critical to identify nurses at risk of burnout early and implement interventions as early as possible.

METHODS

A cross-sectional survey of the hospitals in Xiangyang City was conducted in January, 2023 using stratified cluster sampling. Anonymized data were collected from 1584 working nurses. The Impact of Events Scale-Revised (IES-R) and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) were used to evaluate the post-traumatic stress disorder (PTSD) and burnout of nurses in public health emergencies. Logistic regression analysis was established to screen for risk factors of burnout, and a nomogram was developed to predict the risk of burnout. A calibration curve and the area under the receiver operating characteristic (ROC) curve were used to validate the nomogram internally.

RESULTS

This study showed that only 3.7% of nurses were completely free of PTSD during a public health emergency. We found that PTSD varied by age, marital status, procreation status, length of service, employee status, and whether working in the ICU. The nurses aged 30 ~ 40 years old, single, married without children, non-regular employees, worked for less than three years or worked in the ICU had higher levels of PTSD. Regarding the prevalence of burnout, 27.4%, 48.5%, and 18.6% of nurses had a high level of emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA), respectively. There, 31.1% of nurses had more than two types of job burnout. The number of night shifts, the type of hospital, marital status, and the severity of PTSD were all associated with higher rates of exhaustion among nurses. As a graphical representation of the model, a nomogram was created and demonstrated excellent calibration and discrimination in both sets (AUC = 0.787).

CONCLUSIONS

This study confirmed the PTSD and burnout are common problems for in-service nurses during public health emergencies and screened out the high-risk groups of job burnout. It is necessary to pay more attention nurses who are single and working in general hospitals with many night shifts, especially nurses with severe PTSD. Hospitals can set up nurses' personal health records to give timely warnings to nurses with health problems, and carry out support interventions to relieve occupational stress.

Assessing airborne transmission risks in COVID-19 hospitals by systematically monitoring SARS-CoV-2 in the air

IMPORTANCE

Risk management and control of airborne transmission in hospitals is crucial in response to a respiratory virus pandemic. However, the formulation of these infection control measures is often based on epidemiological investigations, which are an indirect way of analyzing the transmission route of viruses. This can lead to careless omissions in infection prevention and control or excessively restrictive measures that increase the burden on healthcare workers. The study provides a starting point for standardizing transmission risk management in designated hospitals by systemically monitoring viruses in the air of typical spaces in COVID-19 hospitals. The negative results of 359 air samples in the clean and emergency zones demonstrated the existing measures to interrupt airborne transmission in a designated COVID-19 hospital. Some positive cases in the corridor of the contaminant zone during rounds and meal delivery highlighted the importance of monitoring airborne viruses for interrupting nosocomial infection.

Risk factors for post-traumatic stress disorder in nurses from the regional medical alliance during the COVID-19 epidemic: A prospective cross-sectional study

Mental health issues among nursing professionals have been increasingly reported during the coronavirus disease (COVID-19) pandemic. However, there is a paucity of research on post-traumatic stress disorder (PTSD) among nurses working in Medical Alliances. In this study, we aimed to investigate the risk factors associated with PTSD in the Regional Medical Alliance (MA) in Shantou (China) during the COVID-19 pandemic. A total of 1286 nurses from four MA hospitals participated in the study from February to March 2020. Our findings revealed that the incidences of PTSD, depression, anxiety, and sleep disorders among nurses from MA were 15.6%, 35.5%, 18.3%, and 36.4%, respectively. Moreover, PTSD was positively correlated with depression, anxiety, and sleep disorders. In addition, the results of logistic regression analysis showed that working in a tertiary hospital, older age, more severe depression, more severe anxiety, and prevalent sleep disorders were independent risk factors for PTSD among nurses. Therefore, mental health interventions targeting high-risk nurses in MA with an incidence of PTSD are urgently needed.

Research on the psychological status of medical staff during the COVID-19 epidemic in China: A longitudinal study

An online questionnaire, including the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), was used to assess the psychological status of medical staff in Wuhan during the COVID-19 epidemic. Lasso-Logistic regression analysis was performed to analyze the risk factors of abnormal psychological status (anxiety or depression). 36.6% of the study subjects experienced anxiety, and 41.5% experienced depression. Female (OR [odds ratio] = 7.22, 95% CI [confidence interval]: 0.58-89.33), basic diseases (OR = 17.95, 95% CI: 1.59-202.49), suspected exposure history (OR = 9.63, 95% CI: 1.40-66.29), smoking (OR = 6.07, 95% CI: 0.38-96.78) were risk factors for anxiety. Female (OR = 5.00, 95% CI: 0.45-55.91), basic diseases (OR = 37.19, 95% CI: 2.70-512.73), suspected exposure history (OR = 5.10, 95% CI: 0.78-33.10), drinking wine (OR = 6.27, 95% CI: 0.38-103.85) were risk factors for depression. The results of the re-sampling evaluation after 2 years showed that some medical staff still showed anxiety (42.4%) and depression (27.3%), and the proportion of females was higher. Early intervention should be carried out, and short-term and long-term intervention plans should be formulated.

Depression in healthcare workers during COVID-19 pandemic: results from Czech arm of HEROES Study

The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant´s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.

The trends of psychosomatic symptoms and perceived stress among healthcare workers during the COVID-19 pandemic in China: Four cross-sectional nationwide surveys, 2020-2023

An unseen wave of vast infection was detected in China in December 2022, and healthcare workers faced inevitable challenges and heavy stress. We aimed to present a dynamic mental health map and, most importantly, provide a timely report of the current situation in healthcare workers. The current study conducted four national cross-sectional online surveys from February and March 2020, Apr 2022, and Jan 2023. The Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10) were used to assess psychosomatic symptoms and perceived stress. Fourteen thousand nine hundred forty-five participants (8578 healthcare workers and 6367 others) participated in the surveys. The prevalence of psychosomatic syndrome, reflected by PSSS, was 19.3% (Wave1), 22.9% (Wave2), 36.4% (Wave3), and 60.7% (Wave4) among healthcare workers, compared to 24.0% (Wave1), 35.7% (Wave2), 34.2% (Wave3) and 50.5% (Wave4) among the others. In addition, healthcare workers exhibited lower PSSS total scores at the beginning but higher in later waves. Despite their infection status, they now suffer from more severe psychosomatic symptoms than the rest of society. Our findings suggest that healthcare workers in China have now experienced severe psychosomatic symptoms and tremendous stress. Therefore, there is an urgent need to utilize social support for them.

Prevalence and factors associated with depression, anxiety and stress in Malaysia during COVID-19 pandemic: A systematic review

BACKGROUND

The COVID-19 pandemic has had severe impacts on mental health status worldwide. Several studies have investigated the prevalence and factors associated with depression, anxiety, and stress in different countries, however, a systematic review on the research topic during COVID-19 is presently lacking in Malaysia's context. To fill this gap, electronic databases including PubMed, Scopus, Science Direct, Sagepub, CINAHL, Psychology, and Behavioral Sciences Collection were searched for relevant studies. A total of 16 studies were included in the systematic review.

METHODS

To fill this gap, electronic databases including PubMed, Scopus, Science Direct, Sagepub, CINAHL, Psychology, and Behavioral Sciences Collection were searched for relevant studies. A total of 16 studies were included in the systematic review.

RESULTS

The analyses showed that the prevalence of depression, anxiety, and stress ranged from 14.3% to 81.7%, 8.0% to 81.7%, and 0.9% to 56.5% respectively. Adult populations demonstrated the highest prevalence of depression, whereas university students reported the highest prevalence of anxiety and stress. Several factors were associated with mental health conditions including age, gender, family income, and perception of COVID-19.

CONCLUSION

Differentials in mental health screening practices call for standardised screening practices. Mental health intervention should be targeted at high-risk populations with effective risk communication.

Hendi MA, M. Baeshen SA, Maghfouri MMM, Alahmari HSM, Shahhar FAI, Shahhar NAI, Halawi AS, Mahnashi FH, Alqhtani SM, Ali M. BT. An intelligent framework to measure the effects of COVID-19 on the mental health of medical staff

The mental and physical well-being of healthcare workers is being affected by global COVID-19. The pandemic has impacted the mental health of medical staff in numerous ways. However, most studies have examined sleep disorders, depression, anxiety, and post-traumatic problems in healthcare workers during and after the outbreak. The study's objective is to evaluate COVID-19's psychological effects on healthcare professionals of Saudi Arabia. Healthcare professionals from tertiary teaching hospitals were invited to participate in the survey. Almost 610 people participated in the survey, of whom 74.3% were female, and 25.7% were male. The survey included the ratio of Saudi and non-Saudi participants. The study has utilized multiple machine learning algorithms and techniques such as Decision Tree (DT), Random Forest (RF), K Nearest Neighbor (KNN), Gradient Boosting (GB), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM). The machine learning models offer 99% accuracy for the credentials added to the dataset. The dataset covers several aspects of medical workers, such as profession, working area, years of experience, nationalities, and sleeping patterns. The study concluded that most of the participants who belonged to the medical department faced varying degrees of anxiety and depression. The results reveal considerable rates of anxiety and depression in Saudi frontline workers.

Anxiety during the COVID-19 pandemic in hospital staff: systematic review plus meta-analysis

BACKGROUND

This study was conducted to systematically review the existing literature examining the prevalence of anxiety among hospital staff and identifying the contributing factors to address the complications of this disorder and develop effective programmes for reducing the complications of this mental health problem.

METHODS

We searched the electronic databases including PubMed, EMBASE, Scopus, Web of Science and Google Scholar from January 2020 to February 2021. To perform meta-analysis, the random effects model was used. To assess the statistical heterogeneity of the included studies, the I2 index was used, and 95% CI was estimated. Data analysis was performed by R software.

RESULTS

In the final analysis, 46 articles with the total sample size of 61 551 hospital staff members were included. Accordingly, anxiety prevalence among healthcare workers (HCWs) was 26.1% (95% CI 19% to 34.6%). The prevalence rates of anxiety in health technicians and medical students were 39% (95% CI 13% to 73%) and 36% (95% CI 15% to 65%), respectively, indicating a much higher prevalence than other hospital staff members. Furthermore, a positive significant relationship between prevalence of anxiety among HCWs and their age was approved (p<0.001). The prevalence rate of anxiety was higher among women 37.7% (95% CI 25.4% to 51.8%) than men 27.2% (95% CI 18.2% to 38.6%).

CONCLUSION

The findings show a moderately high prevalence rate of anxiety in hospital staff. Due to the high prevalence of this mental health problem in health technicians, medical students and frontline health workers, it is highly suggested that healthcare institutions offer mental health programmes for these working groups in order to appropriately manage anxiety during the COVID-19 pandemic.

Psychological symptoms and correlates of Chinese healthcare professionals in the intensive care unit before and after the COVID-19 outbreak: A comparison of two cross-sectional studies

BACKGROUND

The outbreak of COVID-19 disarranged lives across mainland China. No study has examined changes in psychological symptoms of healthcare professionals in the intensive care unit (ICU) before and after the outbreak of COVID-19. The aim of this study was to estimate changes in psychological symptoms of ICU healthcare professionals before and after the COVID-19 outbreak, and to analyze factors related to psychological symptoms.

METHODS

Two waves' administrations were implemented between December 13 and December 14, 2018, and between April 5 and April 7, 2020, respectively. The symptom checklist-90 (SCL-90) were used to evaluate psychological symptoms. Multiple logistical regression was used to reveal the risk of psychological symptoms.

RESULTS

A total of 3902 and 3908 ICU healthcare professionals took part in the first and second surveys. The mean total score of the SCL-90 was 179.27 (70.02) at wave 1 and 147.75 (58.40) at wave 2, respectively. The proportion of psychological symptoms was 55.6 % (95%CI = 54.0-57.1) at wave 1. But rates of psychological symptoms decreased to 36.6 % (95%CI = 35.1-38.2) at wave 2. ICU healthcare professionals with western economic belt and 6-10 years of work were more likely to develop psychological symptoms, while ICU healthcare professionals with the later survey and doctoral degree were less likely to develop psychological symptoms.

CONCLUSION

Although COVID-19 period benefited psychological symptoms of ICU healthcare professionals, psychological symptoms still had a related high prevalence. Regular screening and appropriate interventions should still be implemented to decrease the risk for psychological symptoms among Chinese ICU healthcare professionals.

Mediator role of resilience in the relationship between neuroticism and psychological symptoms: COVID-19 Pandemic and supermarket employees

The current research aimed to examine the relationship between personality traits, resilience, and psychological symptom levels of front-line supermarket employees during the COVID-19 pandemic. Three-hundred and ten (310) supermarket employees participated in the research between March and May 2021. Participants filled out the questionnaire sets online The Demographic Information Form, Symptom Checklist, Five Factor Inventory and Resilience Scale for Adults were presented as questionnaire sets. Pearson Correlation Analyses were conducted to determine the relationships between variables, Multiple Regression and mediation analyses were conducted to discover the predictors of symptom level. It was found that personality traits, resilience and psychological symptom levels are related to each other. Conscientiousness, neuroticism, openness and resilience are significant predictors of psychological symptom level. In addition, resilience plays a mediating role in the relationship between neuroticism and psychological symptom levels. The findings were discussed within the framework of the relevant literature and COVID-19 research findings.

The psychological impact of the COVID-19 pandemic in the elderly in southwest China: A longitudinal study based on generalized estimating equations

The objectives of this study were to assess the trends in anxiety and depression levels in older adults nearly 10 months after the outbreak of coronavirus disease 2019 (COVID-19) and explore its determinants. A longitudinal study was performed between October 2019 and December 2020. The Patient Health Questionnaire 9-Item Scale and the Generalized Anxiety Disorder 7-Item Scale were used to assess depression and anxiety. Data were collected before (wave 1), during (wave 2), and 10 months after the COVID-19 outbreak (wave 3). The prevalence of depressive symptoms in the elderly was found to be 18.9%, 28.1%, and 35.9% at wave 1, wave 2, and wave 3 respectively. The prevalence of depressive symptoms at wave 1 was lower than that at wave 2 (χ ²  = 15.544, P < 0.001) and wave 3 (χ ² = 44.878, P < 0.001). There was no significant change in the prevalence of anxious symptoms (wave 1, 28.5%, wave 2, 30.3%, and wave 3, 30.3%). Older adults who were single/divorced/widowed had higher levels of anxiety compared with those who were married (OR = 2.306 95%CI 1.358-3.914, P = 0.002). The pandemic appeared to be associated with increases in depressive symptoms in older persons. Targeted interventions could be carried out among those with higher risk of maladjustment.

Association between COVID-19-related Stress and Self-Directed Learning Ability among Korean Nursing Students

Purpose

Traditional face-to-face classes for nursing students due to the COVID (Coronavirus Disease)-19 pandemic around the world made it inevitable to operate education delivery method using remote/hybrid fashion. This study was aimed to validate the Korean version of the Student Stress Inventory-Stress Manifestations (SSI-SM) and assess the association between COVID-19 pandemic related stress level and self-directed learning ability competence in nursing students.

Design

This research was a cross-sectional study design.

Methods

The study was conducted from December 2020 to January 2021, with a convenience sample of 172 nursing students in the 3rd and 4th grades in South Korea. The Korean version of SSI-SM(K-SSI-SM) was translated and adapted according to standard guideline, and tested construct validity and reliability. In addition, a multiple linear regression analysis was used to examine the associations between the COVID-19 related stress level and the self-directed learning ability.

Results

An exploratory analysis showed that K-SSI-SM composed of 13-item in three factors (uncertainty, non-sociability, and somatization) accounted for 68.73% of the total variance after it was modified. The internal consistency was good with 0.91. Multiple linear regression analysis revealed that higher self-directed learning ability was associated with lower stress levels (β=-0.19, p=0.008), positive toward online learning (β=0.41, p=0.003) and scored higher in theory (β=0.30, p<0.001) in nursing students.

Conclusion

The K-SSI-SM is an acceptable instrument for assessing stress levels in Korean-nursing students. And nursing faculties need to pay attention to related factors of self-directed learning ability, in order to achieve the course's self-directed learning goal in students attending online classes.

Use of virtual meeting and survey technology to assess Covid-19-related mental well-being of healthcare workers

Background and aims

Healthcare workers (HCWs) throughout the world have been exposed to economic and existential stress during the Covid-19 pandemic. The American Medical Association (AMA) has documented that increased healthcare burden correlates with increased stress, burnout, and psychological burden in HCWs. However, limits on personnel, time, and in person interactions make it challenging to assess mental health outcomes during a pandemic. This pilot study used virtual technology to efficiently assess these outcomes.

Setting

Data were collected based on voluntary participation in the Coping with Covid-19 for Caregivers Survey created by AMA. The survey was sent out to approximately 300 participants who included local physicians, medical residents, medical students, and allied health professionals and students who attended a virtual Mental Health Summit.

Methods

The AMA developed survey included questions about demographics, overall stress, fear of infection and transmission of the virus, perceived anxiety or depression due to Covid-19, work overload, childcare issues, and sense of meaning and purpose. The AMA allows for up to five additional questions to be added to their survey, therefore five questions regarding support service utilization, perseverance, and resilience during the Covid-19 pandemic, and two items to further understand students' areas of medical interest. The survey was administered using an online platform through the AMA. The data were analyzed using descriptive statistics.

Results

There were 81 survey respondents. Based on the results of the survey, "high stress" was found in 52 (64%) participants. 66 (81%) were afraid (moderately or to a great extent) of exposure or transmission, 61 (75%) described high levels of anxiety or depression, and 67 (84%) noted work overload. Despite this increase in stress, most respondents (77%) said they were not likely to reduce their devoted hours to clinical care or research in the next 12 months, and 81% answered that they would not leave their practice or research within two years.

Conclusion

Covid-19 has negatively affected the well-being of HCWs. This is a similar trend seen during other times of healthcare strain. Mental health support, work modulation, and various provisions should be explored as means to reduce Covid-19-related negative impacts. The use of an online summit and online data collection methods were appropriate for collecting data on the impact of the Covid-19 pandemic on mental health. This pilot study supports the larger scale implementation of this technology for health informatics research.

Psychosocial impact of COVID-19 2 years after outbreak on mental health of medical workers in Iran

Background

The COVID-19 pandemic had a substantial influence on the mental health of healthcare workers. This study investigated general health status, the prevalence, and the severity of depressive spectrum and anxiety-related disorders. It evaluated the association between various factors and depression, anxiety, and stress among healthcare workers in the Khatam-Alanbia Hospital in Iran, after 2 years since the corona virus disease 2019 (COVID-19) pandemic.

Results

In this online cross-sectional study, 409 participants were selected and given a questionnaire about demographic, personal, and clinical characteristics as well as stressors related to COVID-19. The participants completed the General Health Questionnaire (GHQ-28) and the 42-item Depression, Anxiety, and Stress Scale (DASS-42) to report depression, anxiety, and stress/tension levels. We found that the overall incidence of depression, anxiety and stress among health care workers during the COVID-19 pandemic was 44.25%, 50.62%, and 43.76%, respectively. Participants with severe to very severe depression, anxiety and stress accounted for 19.2%, 26.6%, and 18.2% of the sample, respectively. Being female was associated with higher odds of depression, anxiety, and stress.

Conclusions

Two years after the COVID-19 outbreak, health workers are still showing a significant level of depression, anxiety, stress, and remarkable signs of psychological distress. The situation of a health care worker is worrying. The long-term psychological implications of infectious diseases should not be ignored. Mental health services could play an essential role in rehabilitation.

Analysis of the mental health status of hospital staff during the COVID-19 pandemic

BACKGROUND

Medical work is a complex and interpersonally sensitive job; clinicians interact with patients, colleagues and society-at-large daily, and they are under pressure from a variety of sources. The doctor-patient relationship is of particular concern.

OBJECTIVE

To investigate the current mental health status of hospital staff and related influencing factors during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

The Symptom Checklist-90 (SCL-90) and Generalized Anxiety Disorder Scale-7 (GAD-7) were used to survey the current mental health status of hospital employees. The resulting qualitative data was described in the form of frequency and percentage (%), and the quantitative data were expressed as mean±standard deviation (X¯±S).

RESULTS

A total of 1,074 employees of The Third Xiangya Hospital of Central South University participated in the mental health survey, of whom 77.47% were women. The SCL-90 score was 133.89±48.87, and the three highest scoring factors were depression, somatisation and obsessions, with factor scores of 19.10±8.14, 16.78±6.21 and 16.27±6.39, respectively. The GAD-7 score was 3.74±4.17 for women and 2.14±3.55 for men. The number of women with anxiety disorders was higher compared with men.

CONCLUSION

The mental health status of hospital workers with different demographic characteristics varied greatly during the COVID-19 pandemic. Active attention needs to be paid to the mental health status of hospital staff.

Lessons From Early COVID-19: Associations With Undergraduate Students' Academic Performance, Social Life, and Mental Health in the United States

Objectives: This study aims to explore the influence of COVID-19 on undergraduate students' academic performance, social life, and mental health during the pandemic's early stage, and evaluate potential correlates of stress, anxiety, and depression in relation to COVID-19. Methods: Participant data was collected as part of a survey that consisted of demographic questions, a DASS-21 questionnaire, and an open-ended question. The final sample consisted of 1077 full-time students in the United States. Results: 19%, 20%, and 28% of participants met the cutoff for "severe" and "extremely severe" levels of stress, anxiety, and depression according to DASS-21. During COVID-19, a significant increase in hours of sleep, and decrease in hours spent on extracurriculars and studying were observed. While talking to family was significantly associated with stress, anxiety, and depression, engaging in hobbies was only associated with depression. Conclusion: With the continued spread of COVID-19, it is critical for universities to adapt to the mental health needs of their students. Future institutional advancements should create treatment programs to ensure better academic and social outcomes.

Effects of the COVID-19 pandemic on the mental health of rehabilitation area professionals: A systematic review

Background

The role of the physiotherapist is vital in the recovery of post-COVID-19 patients, but fear of contagion is a possible feeling among healthcare professionals. The objective of this study is to assess the mental health effects that COVID-19 has had on healthcare workers, including rehabilitation care, in times of pandemic.

Methods

A systematic review was conducted using the PRISMA format in the Pubmed, SCOPUS, and Web of Science databases between July and September 2022. Keywords included were "healthcare providers," "COVID-19," "Mental Health," and "Psychological Distress." Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools.

Results

A total of 14 studies were included in this review. The study population was healthcare professionals including the rehabilitation services. In total, 4 studies reported exclusively on anxiety and stress levels in physiotherapists providing care during the pandemic.

Conclusions

The mental health of healthcare professionals has been compromised during the pandemic. However, initially, research was only focused on physicians and nurses, so the need arises to include those professionals, such as physiotherapists, who are also in direct contact with COVID-19 patients.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367664, identifier: CRD42022367664.

The challenge of community mental health interventions with patients, relatives, and health professionals during the COVID-19 pandemic: a real-world 9-month follow-up study

Since the beginning of the COVID-19 pandemic, the need to implement protocols that respond to the mental health demands of the population has been demonstrated. The PASMICOR programme started in March 2020, involving a total of 210 requests for treatment. Out of those subjects, the intervention was performed in 53 patients with COVID-19 without history of past psychiatric illness, 57 relatives and 60 health professionals, all of them within the area of Salamanca (Spain). Interventions were carried out by professionals of the public mental health service mostly by telephone. Depending on clinical severity, patients received basic (level I) or complex psychotherapeutic care combined with psychiatric care (level II). The majority of attended subjects were women (76.5%). Anxious-depressive symptoms were predominant, although sadness was more frequent in patients, insomnia in relatives and anxiety and fear in health professionals. 80% of the sample, particularly most of the health professionals, required a high-intensity intervention (level II). Nearly 50% of the people treated were discharged after an average of 5 interventions. Providing early care to COVID-19 patients, relatives and professionals by using community mental health resources can help to reduce the negative impact of crises, such as the pandemic, on the most affected population groups.

How stressful was the COVID-19 pandemic for residents specializing in family practice? A study of stressors and psychological well-being of physicians in further training specializing in family practice (GP trainees) within a pandemic context

BACKGROUND

The coronavirus pandemic poses many challenges for medical personnel. During the first phase of the pandemic, psychological stress became increasingly apparent. This was a complex and difficult situation, especially for physician residents specializing in family practice (GP trainees), who were not yet able to draw on years of practical experience. In this context, the Kompetenzzentrum Weiterbildung Allgemeinmedizin Sachsen (Competence Center for Continuing Education in General Medicine Saxony) (KWA^Sa) developed a survey on how to deal with the concerns and challenges perceived at the time. The purpose of the study was to obtain information on psychological well-being in the pandemic context, as well as on expectations, fears, and protective measures in everyday work. The aim was to identify stress factors for general practice (GP) trainees during a pandemic situation to be able to consider the support needs in the design of future residency training programs, especially for GP trainees.

METHODS

An online questionnaire was distributed from May 5, 2020 to June 4, 2020 among GP trainees enrolled in KWA^Sa since 2018. The questionnaire consisted of standardized items, which were evaluated descriptively, and open-ended items with free-text answers, which were evaluated according to the principle of qualitative content analysis.

RESULTS

The results show the relevance of the topic as 61% of respondents indicated that they were concerned about the coronavirus. Most GP trainees also gave an affirmative response regarding emotional challenges. In this context, various stressors could be identified within both the professional and personal environments. There were four particularly salient factors: (1) the fear of infecting one's family as well as patients with the SARS-CoV-2 virus; (2) missing or insufficiently existing protective measures; (3) an increased need for consultation due to unpredictable patient behavior as well as uncertainties in patient treatment; and (4) communication difficulties within the collegial environment.

CONCLUSIONS

The study aimed to identify the support needs of GP trainees in crisis situations such as the COVID-19 pandemic. The results of the survey can be used for the development of suitable continuing education programs for physicians in further training.

Acute stress, worry, and impairment in health care and non-health care essential workers during the COVID-19 pandemic

OBJECTIVE

Health care and non-health care essential workers working in face-to-face interactions during the coronavirus disease 2019 (COVID-19) pandemic may be vulnerable to psychosocial distress. Limited empirical research on COVID-19-related psychosocial outcomes has utilized probability-based samples including both health care and non-health care essential workers.

METHOD

We surveyed a sample of 1,821 United States self-identified essential workers, collected using probability-based methods, working in face-to-face interactions during the early phase of the COVID-19 outbreak (March 18, 2020 through April 18, 2020), in three consecutive 10-day cohorts. We assessed acute stress, health-related worries, and functional impairment. Demographics, secondary stressors (lack of childcare or health care, lost wages), and pre-COVID-19 mental and physical health were examined as predictors of psychological outcomes.

RESULTS

Acute stress (β = .08, p = .001), health-related worries (β = .09, p = .001), and functional impairment (β = .05, p = .034) increased over time in the early weeks of the outbreak. Health care essential workers reported lower functional impairment (β = -.06, p = .009) and acute stress (β = -.06, p = .015) compared with non-health care essential workers. Across the sample, prior mental and physical health ailments, inability to obtain health care, lost wages, younger age, female gender, and Hispanic ethnicity were associated with acute stress (βs = -.14 to .15, ps ≤ .001), health-related worries (βs = -.09 to .14, ps ≤ .001), and functional impairment (βs = -.08 to .16, ps ≤ .006). Lack of childcare (β = .09, p < .001) was positively associated with acute stress.

CONCLUSION

Non-health care essential workers may be vulnerable to negative psychosocial outcomes. Targeted training and support may help facilitate coping with the effects of working in-person during the ongoing COVID-19 pandemic. Findings may help inform intervention efforts, critical as COVID-19 becomes endemic and society must learn to live with its evolving variants. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychosocial outcomes of COVID-19 pandemic on healthcare workers in maternity services

AIM

We investigated the effects of the COVID-19 outbreak on social support and anxiety levels in healthcare professionals working in maternity services situated in Trabzon, Turkey.

MATERIALS AND METHODS

Our study was designed retrospectively and observationally. Social support to the participants was measured using a scale called the multidimensional scale of perceived social support (MSPSS). State anxiety scale (STAI TX-1) and trait anxiety scale (STAI TX-2) were used to determine the level of anxiety. All scales were measured before and during the pandemic. Independent t-test and one-way ANOVA were used to analyze the data where p < 0.05 was considered significant.

RESULTS

The participants' demographic data (n = 96) included the mean age of doctors (n = 30), midwives (n = 34), and nurses (n = 32) which were 41.38 ± 4.16/38.58 ± 1.79/37.34 ± 2.19, respectively. Mean gravida was 1.69 ± 2.87/2.23 ± 0.12/2.31 ± 0.14, respectively. Mean BMI was 24.69 ± 2.87/26.04 ± 0.8/25.69 ± 1.98 in the same order (p > 0.05). The total mean values of the MSPSS, STAI TX-1, STAI TX-2 scales before and during the pandemic were found as 66.55 ± 6.63 - 55.25 ± 4.76, 36.71 ± 10.04 - 50.08 ± 11.65, 37.33 ± 8.09 - 53.32 ± 9.94, respectively. A significant difference was found for the mean of all scales amongst the groups (p < 0.05).

CONCLUSION

During the COVID-19 pandemic, a significant number of healthcare workers were deprived of social support and their anxiety levels increased.

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

BACKGROUND

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

An investigation into managerial support for the psychological wellbeing of national health service doctors during the Covid-19 pandemic: A cross sectional study

AIM

This study investigates the psychological wellbeing of United Kingdom National Health Service doctors during the Covid-19 pandemic and evaluates how they have been supported managerially.

METHOD

A mixed-method sequential study design of online surveys and semi-structured interviews was employed between July-August 2020, with a response rate of 273/300 and 4/4 respectively. The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and Health and Safety Executive Management Standards (HSE MS) were used as measuring tools. The Jobs Demands Resource (JD-R) model and its relation to psychological wellbeing was determined. Survey findings informed semi-structured interviews, coded using thematic analysis.

RESULTS

Overall mean WEMWBS, 43.2 (SD = 9.44), was low as was mean managerial support, 2.38 (SD = 0.78). Overall mean clinical demand score was high (2.6 on reverse scale). First year female trainee respondents from frontline specialties were found to have low psychological wellbeing scores. Key correlations were found between high managerial support, low clinical demands and low psychological wellbeing (r > 0.6). Core themes emerged: (1) breakdown of leadership, (2) vulnerability of wellbeing without support, (3) suboptimal navigation through change and (4) poor physical and human resource management.

CONCLUSION

Maintaining the psychological wellbeing of doctors requires physical and psychological resources to meet clinical demands and the enhancement of fundamental managerial principles of control, communication, change management and leadership through adversity.

What did Chinese Social Workers Do at the Worst Moment? --A Research Based on Social Workers' Participation in the Fight against COVID-19 at Guangzhou

The prevention and control of COVID-19 was the first time that Chinese professional social workers formally demonstrated their unique ability and role in public health emergencies. To explore the contribution of Chinese social workers in fighting against COVID-19, this study has surveyed the practical experience of 179 Chinese social workers who participated in public health emergencies for the first time. According to the findings of the investigation, the prevention and control from social workers were active and timely. As a professional group, social workers have played many roles in the pandemic which further helped form coupling effects with other professional departments and build a solid pandemic prevention network. In this process, social workers have retrieved their sociality by taking root in the grass-roots units to build social support networks, link resources and help the vulnerable groups. Meanwhile, social workers still worked based on the national conditions of China's statism and collectivism. They have taken on the roles of coadjutant and propagandist as well as embedded their work in the discourse system with Chinese characteristics when completing the work of policy propaganda, national and social mobilization, and ideological construction. Besides discussing the above content, this exploratory study also points out some difficulties in the aspects of policy support and the practice of China's social work in public health emergencies.

Prevalence and Determinants of COVID-19 Vaccine Acceptance Among Healthcare Workers: A Systematic Review

COVID-19 is a major public health problem that has been seriously affecting the global community. Healthcare workers (HCWs) are at high risk of infection due to being directly involved in diagnosing and taking care of patients. Due to this, they were prioritized to receive the initial supply of vaccines. However, vaccine hesitancy has been identified as a major global public health threat. Therefore, this review aimed to synthesize pieces of evidence on the prevalence of COVID-19 vaccine acceptance and determinate factors among HCWs. A systematic search of published articles was identified using PubMed, Science Direct, Web of Science, and Google Scholar for relevant studies of vaccine acceptance and determinant factors among HCWs. Published articles were identified using abstracts and titles of the articles, and articles were assessed for eligibility criteria. The review process was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). An electronic database search identified 365 articles, from which 33 full-text articles were included in the systematic review. In this review, the highest rate of vaccine acceptance was reported at 95% and the lowest rate of vaccine acceptance was found at 21%. Factors such as sex (male), age, profession (medical doctors), and previous influenza vaccination were the main positive predictors for COVID-19 vaccine acceptance among HCWs. Concerns about vaccine safety, efficacy, and effectiveness were the main barriers and drivers for vaccine hesitancy. Therefore, to improve the COVID-19 vaccine acceptance among HCWs, governments, public health authorities, and private healthcare systems should work together to provide continuous professional development and training on the safety and effectiveness of the COVID-19 vaccine.

Factors Affecting the Psychological Well-Being of Health Care Workers During the COVID-19 Crisis

Background

Health care workers (HCWs) are a group that especially suffered during the COVID-19 pandemic. In addition to facing the stress of dealing with patients and social isolation, they had to worry about being infected themselves and transmitting the infection to their families. This study evaluated the fear, anxiety, and depression experienced by HCWs during the COVID-19 crisis.

Subjects and Methods

The sample size was 541 HCWs. Data collection was done using an online validated questionnaire through Google Docs, sent to HCWs by email and WhatsApp groups. We assessed depression and anxiety with the 4-item Patient Health Questionnaire-4 (PHQ-4), while evaluating fear with the Fear of COVID-19 Scale (FCV-19S).

Results

A statistically significant difference was found in the perception of fear between married and unmarried people, and between those with colleagues who had died from COVID-19 infection and those without. There was a significant relation between HCWs’ anxiety and a history of death from COVID-19 infection, either of friends or of close relatives. The prevalence of depression was 18.48% in the tested sample of HCWs. Participants who had close relatives or friends infected with COVID-19 showed a significantly higher degree of depression. The age group <30 and those working 20 to 30 hours weekly showed higher degrees of anxiety and depression.

Conclusion

Sociodemographic variables such as age, marital status, and working area had a significant impact on the mental and psychological health of HCWs during the COVID-19 crisis. HCWs who lost patients due to COVID-19 had a significantly higher prevalence of fear, depression, and anxiety.

Perceived Risk of COVID-19 and Employee Decision-Making: How Psychological Distress during the Pandemic Increases Negative Performance Outcomes among Healthcare Workers

In this research, we examined how COVID-19 impacts employee decision-making and performance, knowing that this virus has negatively affected public health, crippled economies, and transformed social and business environments across the globe. To quantitatively test our specific hypotheses regarding the effects of employees’ perceived risk of COVID-19 and psychological distress on negative performance outcomes, we surveyed 443 healthcare workers who were employed by a group of private hospitals in Zimbabwe. These essential workers were delivering day-to-day frontline services with high exposure to COVID-19 during the pandemic. We find that employees’ perceived risk of COVID-19 increases their disengagement, turnover intention, burnout, and low morale at a p < 0.05 significance level. These latter relationships are mediated by employees’ psychological distress at a p < 0.05 significance level. Our findings shed light on how the COVID-19 pandemic is affecting the cognitions and behaviors of the frontline workers who are vulnerable to this contagious disease. Turnover intentions are amplified among healthcare employees, due to their perceived risk of COVID-19 and the resulting psychological distress. Similarly, burnout becomes predominant as these workers worry about contracting the coronavirus due to the poor working conditions they face. As such, our research confirms that the pandemic has intensified the precariousness of work and challenge of managing employee performance, especially for frontline healthcare workers.

Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis

Background

This systematic review aims to 1) summarize the prevalence of anxiety, depression, distress, insomnia, and PTSD in the adult population during the first year of the COVID pandemic in developing countries and 2) uncover and highlight the uneven distribution of research on mental health in all developing countries across regions.

Methods

Several literature databases were systemically searched for meta-analyses published by September 22, 2021, on the prevalence rates of mental health symptoms in developing countries worldwide. We meta-analysed the raw data of the individual empirical results from the previous meta-analysis papers in developing countries in different regions.

Results

The prevalence rates of mental health symptoms were summarized based on 341 empirical studies with a total of 1 704 072 participants from 40 out of 167 developing countries in Africa, Asia (East, Southeast, South, and West), Europe, and Latin America. Comparatively, Africa (39%) and West Asia (35%) had the worse overall mental health symptoms, followed by Latin America (32%). The prevalence rates of overall mental health symptoms of medical students (38%), general adult students (30%), and frontline health care workers (HCWs) (27%) were higher than those of general HCWs (25%) and general populations (23%). Among five mental health symptoms, distress (29%) and depression (27%) were the most prevalent. Interestingly, people in the least developing countries suffered less than those in emergent and other developing countries. The various instruments employed lead to result heterogeneity, demonstrating the importance of using the well-established instruments with the standard cut-off points (eg, GAD-7, GAD-2, and DASS-21 for anxiety, PHQ-9 and DASS-21 for depression, and ISI for insomnia).

Conclusions

The research effort on mental health in developing countries during COVID-19 has been highly uneven in the scope of countries and mental health outcomes. This meta-analysis, the largest on this topic to date, shows that the mental health symptoms are highly prevalent yet differ across regions. The accumulated systematic evidence from this study can help enable the prioritization of mental health assistance efforts to allocate attention and resources across countries and regions.

Mental health among healthcare workers during COVID-19 pandemic in Thailand

Objectives

This study aimed to measure the prevalence of burnout syndrome, anxiety, depression, and post-traumatic disorders (PTSD), as well as examine their associated factors among Thai healthcare workers (HCWs) during COVID-19 outbreak.

Method

We employed a multiple-method design at a tertiary-care hospital in Bangkok between May 22, 2021 and June 30, 2021 by using an online survey. The information included demographic characteristics, work details, perceived support, PTSD symptoms, Maslach Burnout Inventory: General Survey (MBI-GS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-2 and PHQ-9), and narrative response to an open-ended question. The associated factors of mental health problems were analysed by multiple logistic regression analyses. The qualitative data were analysed by the content analysis method.

Results

A total of 986 HCWs (89.1% female; mean age = 34.89 ± 11.05 years) responded to the survey. 16.3%,16%, and 53.5% of respondents had a high level of emotional exhaustion, depersonalisation, and diminished personal achievement, respectively. 33.1%, 13.8%, and 2.3% of respondents had anxiety, depression, and PTSD. Risk factors of emotional exhaustion were male sex (OR_adj = 2.29), nurses (OR_adj = 3.04), doctors (OR_adj = 4.29), working at COVID-19 inpatient unit (OR_adj = 2.97), and working at COVID-19 intensive care unit (OR_adj = 3.00). Additionally, preexisting mental illness was associated with anxiety (OR_adj = 2.89), depression (OR_adj = 3.47), and PTSD (OR_adj = 4.06). From qualitative analysis, participants reported that these factors would improve their mental health: supportive and respectful colleagues, appropriate financial compensation, reduced workload, clarity of policy and communication channel, and adequate personal protective equipment.

Conclusions

Thai HCWs experienced negative mental health outcomes during the COVID-19 pandemic substantially. This issue needs attention and actions should be implemented to support them.

Association of the time spent on social media news with depression and suicidal ideation among a sample of Lebanese adults during the COVID-19 pandemic and the Lebanese economic crisis

The main objectives were to associate between social media news consumption during these unstable times and depression, as well as suicidal ideation among a sample of Lebanese adults, in addition to associate between fear of Covid-19, depression and suicidal ideation. Secondary objectives aimed to check the mediating effect of depression in the association between time spent on social media to get the news and the presence of suicidal ideation. This is a cross-sectional study executed between April and May 2021. It involved 402 Lebanese citizens aged 18 years and above, selected randomly from all Lebanese districts. Having cancer (Beta = 0.20) or lung disease (Beta = 0.27), more fear of COVID-19 (Beta = 0.16), a higher time spent on social media for news (Beta = 0.13) and a higher household crowding index (Beta = 0.29) were significantly associated with more depression, whereas having a pet in the house (Beta = -0.13) and working in the medical field (Beta = -0.17) were significantly associated with less depression. Higher depression (aOR = 1.19) was significantly associated with higher odds of having suicidal ideation, whereas more fear of COVID-19 (aOR = 0.84) and older age (aOR = 0.96) were significantly associated with less odds of having suicidal ideation. Depression did not mediate the association between time spent on social media to get the news and suicidal ideation. This study showed that more time spent on social media reading the news is associated with higher depression but not suicidal ideation. Fear of Covid-19 is associated with more depression, but less suicidal ideation. Further studies are needed to identify the causality between social media news consumption, depression and suicidal ideation. Moreover, awareness campaigns should be organized to teach people how to consume social media news in a responsible way, without letting it affect their emotions directly, which may cause psychological disorders.

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

Background

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

Methods

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

Results

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

Conclusions

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

Mental health and health-related quality of life among healthcare workers in Indonesia during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

Healthcare workers (HCWs) are the front lines during the COVID-19 pandemic. They are more exposed to COVID-19 than other professions. Studies from other countries have shown that the mental health and health-related quality of life (HRQoL) of HCWs were affected during this pandemic. However, studies on mental health in Indonesia remain scarce and no study has evaluated the HRQoL among HCWs. Thus, this study was designed to explore the mental health status and HRQoL among HCWs in Indonesia.

DESIGN

This was a cross-sectional study.

SETTING

This was an open online survey in Indonesia conducted from December 2020 to February 2021.

PARTICIPANTS

This study involved HCWs who worked during the COVID-19 pandemic. Of the 502 respondents who accessed the online questionnaire, 392 were included in the analysis.

OUTCOMES

Mental health status was measured using the 21-item Depression, Anxiety and Stress Scale and HRQoL was measured using the second version of the 12-item Short-Form Health Survey (SF12v2).

RESULTS

The prevalence of depression, anxiety and stress among HCWs was 29.4%, 44.9% and 31.8%, respectively. Using the SF12v2 questionnaire, 354 (90.3%) HCWs were found to have impaired physical component and 156 (39.8%) HCWs have impaired mental component.

CONCLUSION

The prevalence of mental health problems among HCWs was high in Indonesia. HRQoL, particularly the physical component, was affected in most HCWs. Thus, policymakers should give more attention to the mental health and HRQoL of HCWs during the COVID-19 pandemic.

Planning and Implementing the Protocol for Psychosocial Interventions by Social Workers in Iranian Healthcare Centers against COVID-19

The present study aims to plan the protocol for providing psychosocial support by social workers in Iranian healthcare centers and reaching consensus in terms of implementing and offering comprehensive service to individuals dealing with the COVID-19 pandemic. This qualitative study consists of four phases. The first phase, the literature review involved studying valid databases, while the second and third phases consisted of collecting data through the Focus Group Discussions with 23 specialists and experts in the field of social work and mental health. Having been designed, the protocol was then applied and assessed for two months in all the state health centers around Iran (633 hospitals). In the present study, Interventions used by the social workers were divided into 9 types: psychosocial assessment, counseling, training, working with the family, intervention in the crisis, intra- and extra-organizational support-seeking, referral and safe discharge. Interventions used by social workers were also divided based on the health center (psychosocial support for the target groups and bereavement intervention for the survivors) and the services offered in convalescent care facilities. This protocol leading social workers into the fields of bereavement interventions, inter-organizational interventions, working with families and working with the medical staff.

Bereavement Needs Assessment in Nurses: Elaboration and Content Validation of a Professional Traumatic Grief Scale

The COVID-19 pandemic has caused a series of biopsychosocial repercussions among nursing professionals. The impossibility of anticipating the events, the numerous deaths, the excessive workload, the lack of personal health and the necessary means of protection made it difficult to regulate the impact and the elaboration of grief to the point of becoming, on many occasions, a traumatic grief whose physical and psychological manifestations are becoming more and more evident. The main objective of this research was to develop a scale for a group of symptoms based on professional traumatic grief. The development consisted of two phases: (I) instrument design through a literature review and focus groups of bereavement experts and healthcare professionals who experience the grief process in their work; and (II) validation of the content of the instrument. A total of 25 final items were established as suitable for inclusion in the instrument. It is expected that the experiences and results obtained through the development and validation of a scale of specific symptomatology of professional traumatic grief in health professionals will allow the assessment and detection of symptomatology in order to develop programs and strategies for early intervention and prevention.

Anxiety Linked to COVID-19: A Systematic Review Comparing Anxiety Rates in Different Populations

The COVID-19 pandemic has incited a rise in anxiety, with uncertainty regarding the specific impacts and risk factors across multiple populations. A qualitative systematic review was conducted to investigate the prevalence and associations of anxiety in different sample populations in relation to the COVID-19 pandemic. Four databases were utilised in the search (Medline, EMBASE, CINAHL, and PsycINFO). The review period commenced in April 2021 and was finalised on 5 July 2021. A total of 3537 studies were identified of which 87 were included in the review (sample size: 755,180). Healthcare workers had the highest prevalence of anxiety (36%), followed by university students (34.7%), the general population (34%), teachers (27.2%), parents (23.3%), pregnant women (19.5%), and police (8.79%). Risk factors such as being female, having pre-existing mental conditions, lower socioeconomic status, increased exposure to infection, and being younger all contributed to worsened anxiety. The review included studies published before July 2021; due to the ongoing nature of the COVID-19 pandemic, this may have excluded relevant papers. Restriction to only English papers and a sample size > 1000 may have also limited the range of papers included. These findings identify groups who are most vulnerable to developing anxiety in a pandemic and what specific risk factors are most common across multiple populations.

＜Editors' Choice＞ Developing online lectures using text mining reduces health workers' anxiety in non-epicenter areas of COVID-19

COVID-19 is indirectly associated with various mental disorders such as anxiety, insomnia, and depression, and healthcare professionals who treat COVID-19 patients are particularly prone to severe anxiety. However, neither the anxiety of healthcare workers in non-epicenter areas nor the effects of knowledge support have been examined thus far. Participants were 458 staff working at the Toyota Regional Medical Center who completed a preliminary questionnaire of their knowledge and anxiety regarding COVID-19. Based on text mining of the questionnaire responses, participants were offered an online lecture. The effect of the lecture was analyzed using a pre- and post-lecture rating of anxiety and knowledge confidence, and quantitative text mining. The response rates were 45.6% pre- and 62.9% post-lecture. Open-ended responses regarding anxiety and knowledge were classified into seven clusters using a co-occurrence network. Before the lecture, 28.2%, 27.2%, and 20.3% of participants were interested in and anxious about "infection prevention and our hospital's response," "infection and impact on myself, family, and neighbors," and "general knowledge of COVID-19," respectively. As a result of the lecture, Likert-scale ratings for anxiety of COVID-19 decreased significantly and knowledge confidence increased significantly. These changes were confirmed by analyses of open-ended responses about anxiety, lifestyle changes, and knowledge. Positive changes were strongly linked to the topics focused on in the lecture, especially infection prevention. The anxieties about COVID-19 of healthcare workers in non-epicenter areas can be effectively reduced through questionnaire surveys and online lectures using text mining.

A systematic review and meta-analysis of the mental health symptoms during the Covid-19 pandemic in Southeast Asia

AIMS

The Covid-19 pandemic has had a substantial impact on the mental health of the general public and high-risk groups worldwide. Due to its proximity and close links to China, Southeast Asia was one of the first regions to be affected by the outbreak. The aim of this systematic review was to evaluate the prevalence of anxiety, depression and insomnia in the general adult population and healthcare workers (HCWs) in Southeast Asia during the course of the first year of the pandemic.

METHODS

Several literature databases were systemically searched for articles published up to February 2021 and two reviewers independently evaluated all relevant studies using pre-determined criteria. The prevalence rates of mental health symptoms were calculated using a random-effect meta-analysis model.

RESULTS

In total, 32 samples from 25 studies with 20 352 participants were included. Anxiety was assessed in all 25 studies and depression in 15 studies with pooled prevalence rates of 22% and 16%, respectively. Only two studies assessed insomnia, which was estimated at 19%. The prevalence of anxiety and depression was similar among frontline HCWs (18%), general HCWs (17%), and students (20%) while being noticeably higher in the general population (27%).

CONCLUSIONS

This is the first systematic review to investigate the mental health impact of the Covid-19 pandemic in Southeast Asia. A considerable proportion of the general population and HCWs reported mild to moderate symptoms of anxiety and depression; the pooled prevalence rater, however, remain significantly lower than those reported in other areas such as China and Europe.

Narrative review of the COVID-19, healthcare and healthcarers thematic series

This review covers the thematic series of 22 papers selected from among manuscripts published by BJPsych Open concerning coronavirus disease 2019 (COVID-19) and healthcare. We report nine papers that cover concepts and epidemiology relating to the public and patients. We review 11 papers about the impact of COVID-19 on healthcare services and their staff in 15 countries. Two papers consider the psychosocial impact on staff working in mental health services in the UK. Most papers report cross-sectional analyses of data collected from convenience samples by self-reported surveys conducted at single times. They have limitations of generalisability, do not enable conclusions about diagnosis or causality, and many are likely to have attendant bias and noise. BJPsych Open published these papers to meet requirements for early indications of the mental health impact of COVID-19 on the public and on healthcare staff. They claim high prevalence of symptoms of anxiety, depression and post-traumatic stress. We contrast these findings with selected reports of studies with different methodologies published elsewhere. We emphasise the need for longitudinal clinical studies with refined sampling and methodological rigour. We identify several longitudinal research programmes; two in this series. We advocate tuning advice offered about caring for the public and healthcare staff to the realities of their circumstances and their perceptions of need in the context of findings from further longitudinal studies. We draw attention to the importance of the social, relationship and environmental circumstances of the public and healthcare staff in order to understand their distress and their risks of developing mental health disorders.

Impact of COVID-19 pandemic on psychological health of a sample of the health care workers in the western region of Kingdom of Saudi Arabia

Background

The coronavirus disease 2019 pandemic has shown a significant impact on the psychological well-being of health care workers. The aim of the study was to evaluate the impact of the COVID-19 pandemic on the psychological health of health care workers in the Kingdom of Saudi Arabia. During the months of November and December, 283 health care workers completed a survey containing measures of depression, anxiety and stress (using Depression Anxiety and Stress-21 scale [DASS-21]) and questions regarding potential predictors such as the role of COVID-19 perception, availability of mental health support and work-related factors. Pearson X² test revealed factors associated with the presence of significant psychiatric symptoms.

Result

Among the participants, 17.3% screened positive for depression, 26.2% for anxiety and 17.3% for stress. Nurses reported significantly more depression, anxiety and stress than doctors. Those who received mental health support reported significantly lesser depression, anxiety and stress. Those who felt that quality of life was heavily impacted due to COVID-19 reported significantly high depression, anxiety and stress.

Conclusions

Poor psychological well-being was prevalent in health care workers; however, mental health measures have been shown to significantly reduce the mental health burden in health care workers.

Psychosocial responses to COVID-19 among nurses in two hospitals: a mixed method study at Eastern Nepal

BACKGROUND

Most documented studies have focused on mental health status of health care workers during the pandemic but there are very few studies, focusing on mitigation of mental health problems among nurses.

AIM

To study psychosocial responses to COVID-19 and the effectiveness of intervention among nurses.

MATERIALS AND METHODS

A mixed-method study was conducted, including 278 nurses from two COVID-19 hospitals of the province by purposive sampling. Depression, anxiety and stress and a composite measure of personal financial burden scales for quantitative; and interview guide for qualitative data were used. A psychosocial strengthening session was introduced and the effectiveness of the program was assessed after 4-5 weeks of intervention.

RESULTS

Mild, moderate and severe depression was found among 13.7%, 9.4% and 1.1% of the participants correspondingly. Mild, moderate, severe and extremely severe anxiety was found among 21.2%, 8.6%, 3.2% and 2.2% of the participants respectively. Stress was mild among 9% and moderate in 1.4% of the participants. Lack of PPE and fear of transmitting infection were found as frequent causes of problems. Mean scores of depression, anxiety and stress were significantly decreased after the psychosocial strengthening program.

CONCLUSION

Depression, anxiety and stress are common issues of nurses. Common causes of problems were lack of resources, fear of being infected and fear of transmitting to family members. The psychosocial strengthening program was effective in reducing the problems.