Analysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the Fight Against COVID-19 in China

The early-stage impacts of shock events on adult sleep: Lessons from the COVID-19 pandemic

The present study aims to estimate the early-stage association of the coronavirus disease 2019 (COVID-19) pandemic with sleep duration, 4 months after the initial outbreak, at a national level. Using the China Family Panel Studies in 2018 and its follow-up in 2020, 16,563 adult participants were analyzed in our study. The first wave transmissibility of the COVID-19 pandemic in mainland China was used as a quasi-natural experiment. The difference in difference method was employed to compare variations across participants interviewed before or after the pandemic and between groups from provinces with different COVID-19 severity. The study observed a decline in workday sleep duration among adults, regardless of their employment status. Specifically, working adults experienced a significant decrease in sleep duration on work days (-1.54, 95% confidence interval -2.16 to -0.92), alongside an increase on work-free days (2.41, 1.56-3.24), leading to a wider sleep discrepancy in sleep patterns (3.95, 3.31-4.59). Noteworthy, working-age adults (-2.00, -2.79 to -1.22) and males (-3.31, -4.31 to -2.30) exhibited greater sleep decreases on work days, whereas females exhibited a more pronounced disparity in sleep patterns (6.18, 4.73-7.63) between work and work-free days. The pandemic is significantly associated with prolonged changes in adults' sleep duration, including sleep decreases on work days and catch-up sleep on work-free days for working adults. To prepare for future global emergencies, the government may need to promote resilience to mitigate the pandemic's adverse impacts on the working population. Guaranteeing adequate sleep among working adults and reducing sleep debt should be prioritized in such efforts.

Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022

Objective

Mental health significantly affects the physical and emotional development of adolescents. The aim of the current study was to examine how physical activity (PA) and mental health among Korean adolescents changed before and after the start of the COVID-19 pandemic.

Methods

We used comparative cross-sectional methods, gathering information from the Korea Disease Control and Prevention Agency databases and conducting Chi-square testing and correlation analysis for evaluation.

Results

The findings indicate that before and during the pandemic, participation in both moderate- and high-intensity PA, as well as strength training, mitigated stress, depression, and suicidal ideation. Furthermore, the findings confirm the beneficial effects of various physical activities on mental well-being.

Conclusions

These insights emphasize the vital role of regular PA in improving mental health among adolescents, particularly during a health crisis such as the pandemic.

COVID-19 and Sleep Problems: A Perspective from Bibliometric Analysis

OBJECTIVES

The Coronavirus Disease 2019 (COVID-19) pandemic and the containment measures for COVID-19 have affected sleep quality in the population. This study explored sleep-related research from a bibliometric perspective to provide an overview of the research outputs in this field.

METHODS

Original and review articles were retrieved from the Web of Science Core Collection (WOSCC) database from December 2019 to 7 Aug 2023. R package "bibliometrix" was used to summarize the number of articles of authors, institutions, and countries; count the citations of the articles, and generate a Three-Fields Plot. VOSviewer software was applied to visualize the collaboration network among authors and institutions, and to conduct a co-occurrence analysis of keywords.

RESULTS

A total of 4,499 articles on COVID-19 and sleep, and 25,883 articles on non-COVID-19 and sleep were included. Sleep related articles were mainly published by authors from China, the USA, and Italy. For COVID-19 and sleep research, Huazhong University of Science was the most productive institution. The Psychiatry Research was the most influential journal across the different subject categories of this field. "Mental health", "anxiety", and "depression" were the most common keywords, while "sleep quality" and "quality of life" were the likely topic areas in terms of future research directions.

CONCLUSIONS

Our findings provide a comprehensive perspective for researchers to understand the wider landscape of both COVID-19 and non-COVID-19 sleep-related research area.

A bibliometric analysis of the knowledge related to mental health during and post COVID-19 pandemic

Objective

COVID-19 led to a horrific global pandemic, with strict lockdowns and prolonged indoor stays increasing the risk of mental health problems, affecting people of different ages, genders, regions, and types of work to varying degrees. This study provides a bibliometric summary of the knowledge map related to mental health during and post COVID-19 pandemic.

Methods

Publications related to mental health during and post COVID-19 pandemic were searched in the Web of Science Core Collection (WoSCC) database through March 19, 2024. After screening the search results, the literature included in the final was first quantitatively analyzed using GraphPad Prism software and then visualized using VOSviewer, CiteSpace, and R (the bibliometrix package).

Results

The 7,047 publications from 110 countries were included, with the highest number of publications from China and the United States, and the number of publications related to mental health during and post the COVID-19 pandemic increased annually until 2023, after which it began to decline. The major institutions were University of Toronto, University of London, Harvard University, King's College London, University College London, University of California System, University of Melbourne, Institut National De La Sante Et De La Recherche Medicale (Inserm), Mcgill University, and University of Ottawa; Frontiers in Psychiatry had the highest number of publications, and the Journal of Affective Disorders had the highest number of co-citations; 36,486 authors included, with Xiang, Yu-Tao, Cheung, Teris, Chung, Seockhoon published the most papers, and World Health Organization, Kroenke K, and Wang CY were the most co-cited; epidemiologically relevant studies on mental health related to COVID-19, and the importance of mental health during normalized epidemic prevention and control are the main directions of this research area, especially focusing on children's mental health; "pandemic," "sars-cov-2," "epidemic," "depression," "coronavirus anxiety," "anxiety," "longitudinal," "child," "coronavirus anxiety," "longitudinal," "child," and "coronavirus" are the top keywords in recent years.

Conclusion

This comprehensive bibliometric study summarizes research trends and advances in mental health during and after the COVID-19 Pandemic. It serves as a reference for mental health research scholars during and after the COVID-19 pandemic, clarifying recent research preoccupations and topical directions.

Impact of COVID-19 pandemic on sleep parameters and characteristics in individuals living with overweight and obesity

Coronavirus disease 2019 (COVID-19) has been very challenging for those living with overweight and obesity. The magnitude of this impact on sleep requires further attention to optimise patient care and outcomes. This study assessed the impact of the COVID-19 lockdown on sleep duration and quality as well as identify predictors of poor sleep quality in individuals with reported diagnoses of obstructive sleep apnoea and those without sleep apnoea. An online survey (June-October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organisations (n = 980). While overall sleep duration did not decline much, there were identifiable groups with reduced or increased sleep. Those with changed sleep habits, especially reduced sleep, had much poorer sleep quality, were younger, gained more weight and were more likely to be female. Poor sleep quality was associated with medical, social and eating concerns as well as mood disturbance. Those with sleep apnoea had poorer quality sleep although this was offset to some degree by use of CPAP. Sleep quality and quantity has been significantly impacted during the early part of the COVID-19 pandemic in those living with overweight and obesity. Predictors of poor sleep and the impact of sleep apnoea with and without CPAP therapy on sleep parameters has been evaluated. Identifying those at increased risk of sleep alterations and its impact requires further clinical consideration.

Associations between Sleep Hygiene and Mental Complaints in a French Healthcare Worker Population during the COVID-19 Crisis: A Cross-Sectional Analysis to Personalize Sleep Health Interventions

Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor sleep hygiene and mental health complaints among healthcare workers and examine their associations. We investigated participants' typical sleep-wake patterns on workdays and free days as indicators of sleep hygiene. Sleep efficiency and social jetlag were calculated as the ratio of mean sleep duration to time spent in bed, while sleep rebound was defined as the difference in mean sleep duration between workdays and free days. Social jetlag was determined as the difference in mid-sleep timing between workdays and free days, with mid-sleep defined as the midpoint between bedtime and wake-up time. Insomnia severity was assessed using the Insomnia Severity Index (ISI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), and symptoms of anxiety and depression using the Patient Health Questionnaire 4 (PHQ-4). Fatigue was measured using a single item inspired by the Maslach Burnout Inventory (MBI). A total of 1562 participants (80.5% women, mean age 40.0 years) were included in the study. The results revealed that 25.9% of participants slept less than 6 h, 24.3% had a sleep efficiency of less than 85%, 27.3% experienced a sleep rebound of more than 2 h, and 11.5% reported a social jetlag exceeding 2 h. Additionally, 33.9% of participants reported insomnia, 45.1% reported excessive daytime sleepiness, 13.1% reported fatigue, 16.5% reported symptoms of depression, and 35.7% reported symptoms of anxiety. After adjustment, mean sleep duration and sleep efficiency were associated with most mental health complaints. Sleep rebound and social jetlag were associated with significant insomnia but not with anxiety or depression symptoms. Our findings underscore the high prevalence of poor sleep hygiene and mental health complaints among healthcare workers, exacerbated by the COVID-19 crisis. We advocate for the promotion of sleep health through behavioral sleep strategies to safeguard the well-being of healthcare professionals.

Psychological capital of petrochemical corporate employees during COVID-19 social isolation: a longitudinal analysis

The COVID-19 pandemic is a major public health emergency and a significant stressor to most people. The objective of this study was to examine the mental health status and social support level of participants from 2019 to 2020. The study aimed to investigate the changes in people's psychological capital state due to the COVID-19 pandemic. A longitudinal study was performed to study the psychosocial predictors of mental health among a sample of 2,999 Chinese employees in 2019, and the follow-up survey was conducted one year later. Regression coefficients were visualized in a heatmap. Path analysis was performed base on the structural equation model (SEM) to measure the associations between study variables. The status of mental health, resilience, and optimism changed significantly during the pandemic (P < 0.05). The level of employee's social support in 2019 could significantly and positively predicted the level of employee's psychological capital in 2020, and the level of employee mental health in 2019 significantly and negatively predicted the level of employee psychological capital in 2020. The mental health of employees played an intermediary role between social support and psychological capital. These results highlight that the COVID-19 pandemic has a strong impact on the psychological capital of company employees. While demanding performance, corporations should ensure timely intervention in the mental health of their employees.

Managing the risk of shortages and medication errors with curares during the COVID-19 pandemic: a hospital pharmacy experience

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread rapidly around the world. Like many clinical teams, hospital pharmacies have widely contributed in preventing and containing the COVID-19 pandemic. Pharmacies were thus involved in the management of overuse of specific drugs, medication shortages and risk of medication errors.

OBJECTIVES

To assess the use of curares during the COVID-19 crisis and to highlight the lessons to be learnt from this overuse.

METHODS

The use of curares (Atracurium, Cisatracurium and Rocuronium) was compared with the usual use levels in our hospital. Supply issues have been identified and investigated. The risk of medication errors was clearly established and considered.

RESULTS

Despite an increased demand, our hospital has not experienced any disruption in the supply of curare medications. But the risk of curare shortages has led to the registration of new pharmaceutical forms and dosages never used before. We also observed necessary switches between different curares. All of this has contributed to an increased risk of medication errors.

CONCLUSIONS

During the COVID-19 pandemic, the pharmaceutical management of curare medications has been particularly critical. The risk of medication errors and unsafe medication practices was high. This analysis must lead to a high level of vigilance in the next few months.

Prevalence of Musculoskeletal, Neurological and Physical Disorder After COVID-19 in Saudi Arabia: A Cross Sectional Study

BACKGROUND

The global pandemic of SARS-CoV-2, or COVID-19 continues to attack all human systems. Although COVID-19 is a respiratory disease, various extra-pulmonary manifestations, including musculoskeletal and neuropathies/myopathies was reported. This study aimed to investigates the long-term impacts of COVID-19 infection on physical health, capability of daily life activities, musculoskeletal and neurological functions in the Kingdom of Saudi Arabia (KSA).

METHODS

A total of 499 adults recovered from COVID-19 infection of both sexes, who resided in the KSA were recruited randomly and invited to participate in this cross-sectional web-based survey. A self-administered structured questionnaire was used as an instrument of data collection. All respondents returned the questionnaire. Their responses were recorded, stored into a Microsoft Excel sheet 2010 and analyzed with the Statistical Package for the Social Sciences (SPSS) version 24. Percentages were used to convey descriptive data. The percentages were presented with a 95% confidence interval (CI). For statistical significance, a 0.05 p-value was used.

RESULTS

The overall prevalence of neurological and musculoskeletal disorders as follows: headache (63.1%), muscle ache or weakness (62.3%), vertigo (25%), concentration problems (21.8%), breathing troubles (20.4%), loss of balance (19.4%), seizure (1%), and Guillain-Barre Syndrome (0.6%). The results also revealed a significant association between the influence of COVID-19 infection and daily activities, gender and respiratory disorders.

CONCLUSION

The findings highlighted and concluded that COVID-19 infection had an impact on respiratory, nervous, musculoskeletal systems and affect daily activities.

Sleep Quality, Excessive Daytime Sleepiness, and Physical Activity Level in Health Professionals with and Without COVID-19: a Cross-Sectional Study

Objective  To compare the sleep quality, excessive daytime sleepiness, and physical activity level in health professionals infected and not infected with COVID-19. Methods  Cross-sectional study based on online forms (Google Forms) filled out by health professionals who cared for COVID- 19 patients in hospitals in the Recife metropolitan area, Brazil, between October 2020 and May 2021. Anthropometric, sociodemographic, and occupational data were collected, along with the assessment of excessive daytime sleepiness (with Epworth Sleepiness Scale [ESE]), sleep quality (with Pittsburgh Sleep Quality Index [PSQI]), and physical activity level (with International Physical Activity Questionnaire [IPAQ] - short version). Results  A total of 96 participants were assessed (37 with COVID-19, 59 without COVID-19). There were no differences between the groups regarding physical activity levels classified as sedentary, moderately active, or highly active (p = 0.850), or the weekly energy expenditure (p = 0.522). Infected professionals had a greater workload than non-infected ones, besides poorer sleep quality (10.46 ± 3.75 vs. 7.88 ± 3.75; p = 0.001) and excessive daytime sleepiness (10.19 ± 3.05 vs. 8.44 ± 3.85; p = 0.016). Conclusion  Based on the results, this study shows that professionals infected with COVID-19 have poorer sleep quality, associated with excessive daytime sleepiness, in contrast with non-infected professionals.

Influencing factors of quality of life among front-line nurses who collected nucleic acid samples during COVID-19: a path analysis

Aim

The aim of this study is to investigate the quality of life of nurses who collected nucleic acid samples throughout the COVID-19 epidemic's routine management, as well as the factors that may have influenced it.

Background

After the outbreak of COVID-19, normalized epidemic prevention and control throughout China were implemented. Nucleic acid testing has become an effective measure for the early detection of virus-infected individuals. Nurses collecting nucleic acid samples undertake important tasks. Their quality of life is significant to maintaining team stability and containing the epidemic. However, research on their quality of life is still limited.

Methods

A cross-sectional survey was conducted on 1,292 nurses who collected nucleic acid samples from five tertiary general hospitals in Xi'an through self-reported electronic questionnaires (including general demographic information, the Connor-Davidson Resilience Scale, the Social Support Rating Scale, and the World Health Organization Quality of Life Brief Scale). Descriptive, one-way ANOVA and multiple linear regression were performed using SPSS 26.0. Structural equation modeling was used to analyze the influencing factors.

Results

The nurses collecting nucleic acid samples had a modest level of quality of life. Age, marital status, average daily sleep duration, frequency of exercise, psychological resilience, and social support were all influencing factors of quality of life, according to multiple linear regression analysis. Quality of life was found to be significantly related to psychological resilience and social support.

Conclusion

Demographic characteristics, psychological resilience, and social support are the factors affecting the quality of life of nurses who collect nucleic acid samples. Nursing managers should focus more on these factors to improve the quality of life for nurses.

Relevance to clinical practice

Nursing managers should realize the importance of the quality of life of nurses who collect nucleic acid samples in maintaining a vigorous nursing team and ensuring optimized epidemic control. Social support should also be provided to nurses to improve their psychological resilience, thereby improving their quality of life.

Behind the scenes of the healthcare COVID-19 pandemic crisis: potential affecting factors of healthcare work sustainability in Romania during 2020-2022

Aim

The COVID-19 pandemic represented a great disturbance for medical systems around the world, putting medical personnel on the front lines of the fight against the SARS-Cov2 virus. This fight was particularly impactful in countries with medical systems already facing various challenges, including Romania; where the pandemic unfolded in five waves that severely affected the psychological and physical well-being of medical professionals in terms of overload and continuous exposure to health threats. Against this background, our research aims to identify the mediating role of potential affecting factors of healthcare work sustainability during the change-related uncertainty conditions generated by the COVID 19 crisis. Dynamics and relations of nine carefully selected constructs were tracked along all five pandemic waves in Romania, which span from March 2020 to April 2022. The tested variables and constructs are perception of healthcare workers of their own state of health, their workplace safety, the work-family conflict, the satisfaction of basic needs, the work meaningfulness and work engagement, patient care, pandemic stress and burnout.

Methods

This cross-sectional study is based on an online snowball sampling of 738 health workers from 27 hospitals. Panel research is limited to a maximum of 61 respondents for two successive waves. The analytical part is built on means comparison of analysed variables between all five pandemic waves and an in-depth model to explain the relationships between the variables.

Results

The results indicate statistically significant correlations between the perception of health risks and all selected factors excluding patient care, which seems to be above the own health perception. The factors' dynamics was followed along all five pandemic waves. The developed model identified that one's health status satisfaction is a mediator of the family-work conflict and, together, of work engagement. In turn, work engagement plays a significant role in satisfying basic psychological needs and supporting work meaningfulness. Also, work meaningfulness influences the satisfaction of basic psychological needs.

Discussion

Health workers with higher levels of positive perceived health are better at managing pandemic stress, burnout effects and work-family imbalances. Adaptive behaviors and attitudes towards COVID-19 pandemic threats could be identified in later pandemic waves due to the progress in terms of medical protocols and procedures.

COVID-19 and Sleep Disturbances: A Literature Review of Clinical Evidence

The need for adequate good quality sleep to optimally function is well known. Over years, various physical, psychological, biological, and social factors have been investigated to understand their impact on sleep. However, understanding the etiological processes that are involved in causing sleep disturbances (SD) as impacted by stressful phases such as pandemics has not been well studied. Many such etiological and management strategies have surfaced during the latest "coronavirus disease of 2019 (COVID-19) pandemic. The occurrence of these SD in the infected and uninfected individuals poses a need to investigate factors linked to such occurrence during this phase. Some of such factors include stressful practices such as social distancing, masking, vaccines, and medications availability, changes in routines, and lifestyles. As the status of infection improved, a collective term for all the prolonged effects of COVID-19 after the resolution of the primary infection called the post-COVID-19 syndrome (PCS) surfaced. Apart from impacting sleep during the infectious phase, the aftereffects of this virus left an even greater impact during the PCS. Various mechanisms have been hypothesized to be linked to such SD during the PCS, but the available data are inconclusive. Further, the varied patterns of incidence of these SDs differed by many factors, such as age, gender, and geographical location, making clinical management even more challenging. This review elucidates the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease on sleep health during the various phases of the COVID-19 pandemic. We also investigate different causal relationships, management strategies, and knowledge gaps related to SD during the COVID-19 pandemic.

Prevalence and risk factors of post-traumatic stress disorder symptoms among Chinese health care workers following the COVID-19 pandemic

In December 2019, coronavirus disease 2019 (COVID-19) appeared in Wuhan (Hubei, China) and subsequently swept the globe. In addition to the risk of infection, there is a strong possibility that post-traumatic stress disorder (PTSD) may be a secondary effect of the pandemic. Health care workers (HCWs) participating in the pandemic are highly exposed to and may bear the brunt out of stressful or traumatic events. In this cross-sectional study, we assessed the morbidity and risk factors of PTSD symptoms among Chinese HCWs. A total of 457 HCWs were recruited from March 15, 2020, to Mach 22, 2020, including HCWs in Wuhan and Hubei Province (excluding Wuhan), the areas first and most seriously impacted by COVID-19. The morbidity of PTSD symptoms was assessed by the Event Scale–Revised (IES-R). The risk factors for PTSD symptoms were explored by means of logistic regression analysis. Over 40% of the respondents experienced PTSD symptoms more than one month after the COVID-19 outbreak, and this proportion increased to 57.7% in Wuhan HCWs, especially females and HCWs on the frontline. Thus, rapid mental health assessment and effective psychological interventions need to be developed for frontline HCWs to prevent long-term PTSD-related disabilities. Moreover, Negative coping style and neuroticism personality may be regarded as high risk factors for PTSD symptoms. Improving individual coping strategies to enhance resilience should be the focus of further preventive intervention strategies.

Psychological status of medical staff dedicated to nucleic acid collection in COVID-19 epidemic during closed-loop management: A cross-sectional study

Background

To investigate the depression, anxiety and somnipathy situation occurred in the nucleic acid collection staff during the closed-loop management period of COVID-19. And try to understand the influencing factors of related psychological status.

Methods

A cross-sectional study of 1,014 nucleic acid collection staff from seven Chinese hospitals was conducted. Various investigation methods were involved in the questionnaires to collect data, including 12-items self-made questionnaire survey of basic demographic information, 9-items patient health questionnaire depression scale (PHQ-9), 7-items generalized anxiety disorder scale (GAD-7) and Pittsburgh sleep quality index (PSQI). Data analysis was performed using SPSS version 26.0 and Excel software. Mann-Whitney U-test, Chi-square test, correlation analysis, mono-factor analysis and binary logistic regression were applied accordingly for further analysis.

Results

The positive rate of depression, anxiety and sleep disorder of 1,014 nucleic acid collectors under closed-loop management were 33.5, 27.2, and 50.1%, respectively. Depression was significantly positively correlated with anxiety and sleep (P &lt; 0.05). The scores of depression scale were positively correlated with the age and the fear for infection (r = 0.106, 0.218, both P &lt; 0.05); The scores of anxiety scale were also positively correlated with the age and the fear for infection (r = 0.124, 0.225, both P &lt; 0.05); The length of service, collection time and the degree of worry about infection and was positively correlated with the score of sleep scale (r = 0.077, 0.074, 0.195, both P &lt; 0.05); Education level had a significant negative association with PHQ-9, GAD-7 and PSQI (r = −0.167,−0.172, both P &lt; 0.05). Binary logistic regression analysis showed that age, technical title, education level, collection time, collection frequency, collection location, fear for infection and external environment were important influencing factors of depression, anxiety and sleep disorders.

Conclusion

The results of this study suggested that when carrying out nucleic acid collection mission, managers should intervene to optimize the collection location, control the duration of each collection mission, replace the collection staff in time and pay close attention to the psychological state of the collection staff.

Impacts of COVID-19 Pandemic on Sleep Quality Evaluated by Wrist Actigraphy: A Systematic Review

COVID-19 has probably contributed as a risk factor for sleep disturbance. Actigraphy has been used to evaluate sleep complaints in self-isolated populations and frontline doctors during the COVID-19 pandemic. This systematic review aims to summarize the impact of the COVID-19 pandemic on sleep through wrist actigraphy, estimating sleep latency, total sleep time, awakening-after-sleep onset, and sleep efficiency. Searches were conducted of observational studies on the PubMed, Embase, Scopus, Web of Science, and PEDro databases from 1 December 2019 to 31 December 2022. Ninety articles were found, and given the eligibility criteria, fifteen were selected. Six studies were classified by the National Health and Medical Research Council as evidence level IV, two studies as level III-3, and seven studies as level III-2. According to the ACROBAT-NRSI instrument, three studies were classified as having a "serious" risk of bias, two as having "critical" risk, four as having "moderate" risk, and six as having "low" risk. In the selected publications, various populations were evaluated via actigraphy during the COVID-19 pandemic, with reports of "poor" sleep quality. Actigraphy may be a relevant tool to assess individual day-night rhythms and provide recommendations under enduring pandemic conditions. Moreover, as actigraphy presents objective data for sleep evaluations, it is suggested that this method be used in similar pandemics and that actigraphy be included as part of the sleep hygiene strategy.

Brief Video Intervention to Increase Treatment-Seeking Intention Among U.S. Health Care Workers: A Randomized Controlled Trial

OBJECTIVE

Many health care workers avoid seeking mental health care, despite COVID-19-related increases in risk of psychopathology. This study assessed the effects of two versions (distinguished by the race of the protagonist) of a brief social contact-based video on treatment-seeking intention and stigma toward mental health services among U.S. health care workers.

METHODS

Participants (N=1,402) were randomly assigned to view a 3-minute video in which a Black or White female nurse described struggles with COVID-19-related anxiety and depression, barriers to care, and how therapy helped, or to view a control video unrelated to mental health. Half of the participants receiving the intervention watched the same video (i.e., booster) again 14 days later. Treatment-seeking intention and treatment-related stigma were assessed at baseline, postintervention, and 14- and 30-day follow-ups.

RESULTS

Both intervention videos elicited an immediate increase in treatment-seeking intention in the intervention groups (p<0.001, effect size [ES]=21%), with similar effects among those who watched the booster video (p=0.016, ES=13%) and larger effects among those who had never sought treatment (p<0.001, ES=34%). The increased effects were not sustained 14 days after the initial video or at 30-day follow-up. The results showed an immediate reduction in stigma, but with no booster effect. The race of the protagonist did not influence outcomes.

CONCLUSIONS

This easily administered intervention could increase the likelihood of care seeking by proactively encouraging health care workers with mental health challenges to pursue treatment. Future studies should examine whether the inclusion of linkable referrals to mental health services helps to increase treatment-seeking behavior.

Detecting depression of Chinese microblog users via text analysis: Combining Linguistic Inquiry Word Count (LIWC) with culture and suicide related lexicons

INTRODUCTION

In recent years, research has used psycholinguistic features in public discourse, networking behaviors on social media and profile information to train models for depression detection. However, the most widely adopted approach for the extraction of psycholinguistic features is to use the Linguistic Inquiry Word Count (LIWC) dictionary and various affective lexicons. Other features related to cultural factors and suicide risk have not been explored. Moreover, the use of social networking behavioral features and profile features would limit the generalizability of the model. Therefore, our study aimed at building a prediction model of depression for text-only social media data through a wider range of possible linguistic features related to depression, and illuminate the relationship between linguistic expression and depression.

METHODS

We collected 789 users' depression scores as well as their past posts on Weibo, and extracted a total of 117 lexical features via Simplified Chinese Linguistic Inquiry Word Count, Chinese Suicide Dictionary, Chinese Version of Moral Foundations Dictionary, Chinese Version of Moral Motivation Dictionary, and Chinese Individualism/Collectivism Dictionary.

RESULTS

Results showed that all the dictionaries contributed to the prediction. The best performing model occurred with linear regression, with the Pearson correlation coefficient between predicted values and self-reported values was 0.33, the R-squared was 0.10, and the split-half reliability was 0.75.

DISCUSSION

This study did not only develop a predictive model applicable to text-only social media data, but also demonstrated the importance taking cultural psychological factors and suicide related expressions into consideration in the calculation of word frequency. Our research provided a more comprehensive understanding of how lexicons related to cultural psychology and suicide risk were associated with depression, and could contribute to the recognition of depression.

Evaluation of Cardiovascular Activity and Emotional Experience in Healthcare Workers (HCWs) Operating in COVID-19 Wards

The new 2019 coronavirus or SARS-CoV-2 has been the first biological agent to generate, in this millennium, such a global health emergency as to determine the adoption of public health measures. During this sanitary emergency, the emotional experience of healthcare workers (HCWs) has been hugely tested by several factors. In fact, HCWs have been exposed to greatly tiring physical, psychological and social conditions. The authors investigated the cardiocirculatory activity of a group of HCWs as well as how they perceived stress while working in COVID-19 wards. In particular, every HCW underwent a medical check, an electrocardiographic base exam, systolic and diastolic pressure measurement, and cardio frequency measurement. Furthermore, each HCW was provided with a cardiac Holter device (HoC) and a pressure Holter (Hop). Some psychological factors were considered in order to quantify the stress perceived by each HCW while at work through the administration of two questionnaires: the "Social Stigma towards Patients due to COVID Scale (SSPCS)" and the "Professional Quality of Life Scale (ProQOL)". The HoC and HoP analysis results for HCWs working in COVID-19 OU wards showed significant variations in cardiocirculatory activity. From the analysis of the SSPCS questionnaire answers, it is clear that all of them showed a sense of duty towards their patients. The analysis of the ProQOL questionnaire answers showed that the prevailing attitude is fear; however, HCWs did not absolutely discriminate against those who had COVID-19 nor did they refuse to help those in need. Continuous monitoring of these employees, also carried out through occupational medicine surveillance, allows for the detection of critical conditions and the implementation of actions aimed at preventing chronic processes.

Efeitos da pandemia e fatores associados à saúde mental de profissionais de saúde

Objetivo: identificar,na literatura científica, os efeitos da pandemia e fatores associados àsaúde mental de profissionais de saúde que atuam no enfrentamento da COVID-19. Método: revisão integrativa da literatura, através das bases de dados Web of Science, LILACS, Medline e CINAHL, realizada em novembro de 2020.A busca se deu de forma ampla, criteriosa e independente por dois pesquisadores; em casos de divergência, houve a participação de um terceiro pesquisador. Resultados: 12 artigos compuseram a amostra. Ansiedade, depressão e distúrbios do sono foram os efeitos na saúde mental mais prevalentes em profissionais de saúde durante a pandemia de COVID-19. O setor de trabalho, a falta de Equipamentos de Proteção Individual (EPIs) e o aumento da carga horária de trabalho foram os principais fatores desencadeantes desses efeitos. Considerações Finais: faz-se necessária a implantação de estratégias e intervenções eficazes que garantam um suporte psicológico a curto, médio e longo prazo para os profissionais de saúde.

Subjective sleep alterations in healthy subjects worldwide during COVID-19 pandemic: A systematic review, meta-analysis and meta-regression

OBJECTIVE

We conducted a systematic review and meta-analysis to provide an update on sleep quality in different world areas and better characterize subjective sleep alterations during the COVID-19 pandemic. Considering gender distribution and specific pandemic-related parameters, we also intend to identify significant predictors of sleep problems.

METHODS

Six electronic databases were searched from December 2019 to November 2021 for studies investigating sleep during COVID-19 employing the Pittsburgh Sleep Quality Index, the Medical Outcomes Study Sleep, the Insomnia Severity Index or the Epworth Sleepiness Scale. Random-effects models were implemented to estimate the pooled raw means of subjective sleep alterations. Also, we considered the role of several pandemic-related parameters (i.e., days from the first COVID-19 case, government stringency index, new cases for a million people, new deaths for a million people) by means of meta-regression analyses.

RESULTS

A total of 139 studies were selected. The pooled mean of the global Pittsburgh Sleep Quality Index score (PSQIgen) was 6.73 (95% CI, 6.61-6.85). The insomnia severity index score was reported from 50 studies with a pooled mean of 8.44 (95% CI, 7.53-9.26). Subgroup analyses confirmed that most subcategories had poor sleep quality and subclinical insomnia. Meta-regressions showed that PSQIgen was predicted by days from the first COVID-19 case and government restrictions with a negative slope and by female gender with a positive slope. The government stringency index was positively correlated with the direct subjective evaluation of sleep quality.

CONCLUSIONS

We found an overall impaired sleep and widespread subthreshold insomnia during the COVID-19 pandemic. The female percentage seems to be the best predictor of impaired sleep quality, consistently to the available literature. Noteworthy, sleep alterations were inversely associated with governmental restrictions and decreased during the pandemic. Our results give a contribution to critically orienting further studies on sleep since COVID-19 pandemic.

The stress response of intensive care unit medical doctors facing repeated severe emergencies

Objectives

This study assesses the psychopathological distress experienced by doctors working in an Intensive care unit (ICU) during the COVID-19 pandemic. These doctors were the same who faced the consequences of a previous natural disaster, a severe 6.3 magnitude earthquake. A second objective is to evaluate their current mental attitude, professional performances and coping strategies adopted in the pandemic in relation to the conditioning effect of that first emergency, the earthquake.

Methods

Thirty-seven ICU medical doctors were recruited and assessed using Rapid Stress Assessment (RSA) rating scale, Symptom Checklist-90 Revised (SCL-90-R), Zung Self-Rating Anxiety Scale, Beck Depression Inventory, Beck Hopelessness Scale, Millon Clinical Multiaxial Inventory III. Comparison between exposure to the earthquake and COVID pandemic has been made in terms of professional role and psychological burden.

Results

Comparison between 2009 earthquake catastrophe and COVID pandemic conditions evidenced relevant changes in professional role, team, environment, shifts, and work organization.

Conclusion

The doctors, who already experienced the 2009 earthquake reported a feeling of greater insecurity facing this latter catastrophe, the COVID pandemic, as well as perception of greater concern for their family and the global situation. However, having participated in the medical management of another emergency (the 2009 earthquake) appears to have contributed to limiting demoralization and psychological distress. The feeling of having greater decision-making possibilities and participation in the organization of work, strengthen coping skills in the face of the emergency.

Interventions to support the mental health and well-being of front-line healthcare workers in hospitals during pandemics: an evidence review and synthesis

OBJECTIVE

Pandemics negatively impact healthcare workers' (HCW's) mental health and well-being causing additional feelings of anxiety, depression, moral distress and post-traumatic stress. A comprehensive review and evidence synthesis of HCW's mental health and well-being interventions through pandemics reporting mental health outcomes was conducted addressing two questions: (1) What mental health support interventions have been reported in recent pandemics, and have they been effective in improving the mental health and well-being of HCWs? (2) Have any mobile apps been designed and implemented to support HCWs' mental health and well-being during pandemics?

DESIGN

A narrative evidence synthesis was conducted using Cochrane criteria for synthesising and presenting findings when systematic review and pooling data for statistical analysis are not suitable due to the heterogeneity of the studies.

DATA SOURCES

Evidence summary resources, bibliographic databases, grey literature sources, clinical trial registries and protocol registries were searched.

ELIGIBILITY CRITERIA

Subject heading terms and keywords covering three key concepts were searched: SARS-CoV-2 coronavirus (or similar infectious diseases) epidemics, health workforce and mental health support interventions. Searches were limited to English-language items published from 1 January 2000 to 14 June 2022. No publication-type limit was used.

DATA EXTRACTION AND SYNTHESIS

Two authors determined eligibility and extracted data from identified manuscripts. Data was synthesised into tables and refined by coauthors.

RESULTS

2694 studies were identified and 27 papers were included. Interventions were directed at individuals and/or organisations and most were COVID-19 focused. Interventions had some positive impacts on HCW's mental health and well-being, but variable study quality, low sample sizes and lack of control conditions were limitations. Two mobile apps were identified with mixed outcomes.

CONCLUSION

HCW interventions were rapidly designed and implemented with few comprehensively described or evaluated. Tailored interventions that respond to HCWs' needs using experience co-design for mental health and well-being are required with process and outcome evaluation.

Analysis of scores of Symptom Checklist 90 (SCL-90) questionnaire of 182 parents of children with spinal muscular atrophy: a cross-sectional study

BACKGROUND

Spinal muscular atrophy (SMA) is a hereditary disorder characterized by progressive muscle weakness and atrophy in children. However, less attention is paid to psychiatric symptoms of SMA parents. Attention to the psychiatric symptoms of parents of SMA children can improve the comprehensiveness of family support for SMA children, which is beneficial to the rehabilitation of SMA children. Here, we conducted a survey on the psychiatric symptoms of SMA parents and analyzed its relevant factors, with an attempt to inform the psychological support for SMA parents.

METHODS

The Symptom Checklist 90 (SCL-90) and a self-designed basic information (such as parent's gender, household area, place of residence, education background, etc.) questionnaire (in electronic questionnaire) were distributed to parents of SMA children aged 0-18 in a charity WeChat group sponsored by the Meier Advocacy & Support Center for SMA during the period from August 1 to August 31, 2021. Parents completed the electronic questionnaires by mobile phone or computer voluntarily. A total of 188 questionnaires were obtained, of which 182 were valid. Comparisons were performed with the SCL-90 adult norms as the standards. The potential correlations between the general data of SMA parents and children and abnormal factors in the SCL-90 for SMA parents were analyzed.

RESULTS

The SCL-90 factors somatization (1.56±0.80, P=0.002), depression (1.78±0.98, P<0.001), anxiety (1.58±0.87, P=0.007), fear (1.39±0.74, P=0.003), and sleep and eating problems (1.67±0.87, P=0.014) of SMA parents were significantly higher than the national norms. Place of residence was correlated with sleep and eating problems (r=0.158, P=0.033). Increasing age [odds ratio (OR) =1.012, P=0.014] and continuous home-living status (OR =0.360, P=0.031) of SMA children increased the risk of depression in their parents, and the lack of rehabilitation management in SMA children increased the risk of anxiety of their parents (OR =0.409, P=0.038). Non-urban residence (OR =2.602, P=0.017) and poor physical health (OR =0.163, P=0.031) were the relevant factors for the increased risk of sleep and eating problems in SMA parents.

CONCLUSIONS

SMA parents have a higher risk of developing psychiatric symptoms problems compared with the general population. Increasing age and the continuous home-living status of SMA children increase the risk of depression in their parents, and the lack of rehabilitation management increase the risk of anxiety in SMA parents.

Physical activity and mental health in sports university students during the COVID-19 school confinement in Shanghai

Background

In 2022, Shanghai was seriously affected by the coronavirus disease 2019 (COVID-19) pandemic. The government implemented citywide static management for 2 months, as well as all universities in Shanghai, which changed the normal learning and living style of sports students and led to a decline in physical activity level. As the physical activity has a strong correlation with mental health, this study aimed to investigate the current state of physical activity (PA) and mental health of the students in Shanghai University of Sport. It will try to reveal the correlation between PA and depressive symptoms, anxiety symptoms, fear of COVID-19 and smartphone addiction.

Methods

A cross-sectional survey was conducted on a random sample of 400 students who came from six different majors in May 2022 at the Shanghai University of Sport. Respondents completed the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Chinese version of the 9-item Patient Health Questionnaire (PHQ-9), the Chinese version of the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of the COVID-19 Fear Scale (FCV- 19S), and the Smartphone Addiction Scale (SAS-SV). Demographics, PA, depressive symptoms, anxiety symptoms, fear of COVID-19, and smartphone addiction were compared. A binary logistic regression model was used for the further analysis.

Results

A total of 376 college students were included in the final analysis. Binary logistics analysis showed that moderate physical activity (MPA) was negatively correlated with depression (OR = 0.95, 95%CI = 0.93-0.98), anxiety (OR = 0.97, 95%CI = 0.95-0.99), fear of COVID 19(OR = 0.99, 95%CI = 0.98-0.99)and smartphone addiction (OR = 0.94, 95%CI = 0.9-0.98) (all P < 0.05). Sedentary behavior was positively correlated with smartphone addiction (OR = 1.01, P < 0.01, 95%CI = 1.001-1.004).

Conclusion

There was an association between the presence of MPA and depressive symptoms, anxiety symptoms, fear of COVID-19, smartphone addiction, and sedentary behavior associated with smartphone addiction levels. Clarifying the causal relationship between PA and mental health will require further research.

The impact of eating behaviors during COVID-19 in health-care workers: A conditional process analysis of eating, affective disorders, and PTSD

Objective

The incidence of post-traumatic stress disorder (PTSD) increased among healthcare workers (HCWs) during the outbreak of COVID-19. The purpose of this study was to examine the relationship between eating behavior and PTSD, considering the mediation effect of anxiety, depression and sleep.

Methods

A total of 101 HCWs completed a survey. The Food-Frequency Questionnaires (FFQ) were used to evaluate the diet. A special survey was conducted on the eating time of each shift mode. The PTSD Checklist-Civilian Version (PCL-C), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and Morning-Evening Questionnaire (MEQ) were utilized to assess clinical symptoms.

Results

There was a statistically significant correlation between the night shift eat midpoint (NEMP) and PTSD symptoms, anxiety and depression as significant mediators. The last meal jet lag between night shift and day shift (NDLM) was related to PTSD symptoms significantly, and sleep and anxiety were significant mediators. The relationship between animal-based protein pattern and PTSD symptoms was statistically significant, and anxiety was the significant mediator.

Conclusions

The earlier the HCWs eat in the night shift, the lighter the symptoms of PTSD. This is mediated by improving anxiety, depression and sleep disorder. Furthermore, the consumption of animal protein could reduce symptoms of PTSD by improving anxiety.

The path of depression among frontline nurses during COVID-19 pandemic: A fuzzy-set qualitative comparative analysis

This study aimed to explore the combination of different conditional variables that led to depressive symptoms among frontline nurses who were fought against COVID-19 during the outbreak in Wuhan City, Hubei Province of China. The study was conducted in August 2020, which included 331 frontline clinical nurses who supported Wuhan's fight against COVID-19. The age range was 21-57 years and included 315 female nurses and 16 male nurses. This study used the fuzzy-set qualitative comparative analysis research method to explore the path of depression among frontline nurses. This study generated nine different configurations for the path of depression among frontline nurses, and had a detailed demonstration for each configuration. Each configuration distinguishes the different effects of influencing factors. For example, in the first configuration, gender, sleep disorder and PTSD exist as core conditions, while social support exists as a core condition lack. This study was presented results which was different what linear regression model reports. It takes into consideration the combined effect of each conditional variable on the development of depression. Nurse managers should pay attention to the combination of multiple influencing factors, instead of focus on single factors.

Prevalence Of Sleep Disorders Among Physicians And Nurses During COVID-19 Pandemic

The objective of our review was to analyze studies of prevalence sleep disorders among medical workers during COVID-19 pandemic. Material and Methods — Overall, during the analyzed period, studying domestic and foreign databases, we identified 94 publications on the development of sleep disorders among medical personnel working during COVID–19 pandemic in 2000-2021. However, only 88 of these publications complied with the objective of the review. We included 75 full-text publications in this review. Results — Physicians and nurses during COVID-19 pandemic do not have the opportunity to take therapy aimed at combating the symptoms of sleep disorders, due to the need to maintain sufficient attention and the risk of developing excessive drowsiness while on duty in a COVID -19 hospital. The latter can have a negative impact on their professional activities. Thus, this problem certainly requires professional psychotherapeutic correction. Unfortunately, not all medical institutions have such specialists. Conclusion — Based on the literature review, we found out that health care workers have a high risk of developing sleep disorders. This can include violations of the circadian rhythm, a decrease in the quality and duration of night sleep, daytime hypersomnia caused by shift work in a hospital. An additional factor affecting the frequency and severity of sleep disorders in healthcare workers (physicians and nurses) is chronic stress, the importance of which has increased during the COVID-19 pandemic. Currently, the above problem has not been completely solved and requires research in this area and the development of new programs to help medical personnel.

Pandeminin Gölgesinde Tıp Öğrencisi Olmak: Tıp Öğrencilerinin COVİD-19 Pandemisine Karşı Psikolojik Tepkileri ve Uzaktan Eğitim ile İlgili Görüşleri

Amaç: Bu çalışmada, preklinik dönem tıp öğrencilerinin COVİD-19 Pandemisine karşı psikolojik tepkilerinin ve öğrencilerin uzaktan eğitimle ilgili görüşlerinin araştırılması amaçlanmıştır. Metod: Gönüllü 722 öğrenci ile kesitsel bir çalışma yapıldı. Veriler 20-27 Aralık 2020 tarihleri arasında, çevrimiçi bir anket yolu ile toplandı. Veri toplama aracı olarak sosyodemografik bilgiler ve uzaktan eğitimle ilgili görüşlere yönelik bir soru formu ile Revize Olayların Etkisi Ölçeği ve Uykusuzluk Şiddeti ölçekleri kullanıldı. Bulgular: Katılımcıların yaş ortalaması 20.7±1.6 ve 393’ü (54.4%) kadındı. Öğrencilerin 699’u (96.8%) eğitimleri ile ilgili olarak kaygılanmakta, 181’i (25.1%) travma sonrası stress, 171’i (23.6%) uykusuzluk yaşamaktaydı. Travma sonrası stres olasılığı kadınlarda erkeklere göre (OR=1.489, 95% CI=1.02-2.16; p=0.038), COVİD-19’a yakalanan akrabası olanlarda olmayanlara göre (OR=1.489, 95% CI=1.02-2.16; p=0.038), yakınlarına COVİD-19 bulaşma korkusu fazla olanlarda az olan veya olmayanlara göre (OR=0.523, 95% CI=0.339-0.807; p=0.003), COVİD-19 ile ilgili haberleri sosyal medyadan takip edenlerde diğer kaynaklardan takip edenlere göre (OR=0.662, 95% CI=0.461-0.951; p

Associations between Physical Activity Level and Mental Health in the Spanish Population: A Cross-Sectional Study

Physical inactivity and sedentary lifestyles appear to be critical factors in developing mental health problems, including depression, anxiety, and other diseases in developed societies. This study analysed the associations between physical activity level (PAL) and mental health using the Goldberg General Health Questionnaire (GHQ12) in the Spanish population before the COVID-19 pandemic. A cross-sectional design, based on data from the Spanish National Health Survey (ENSE 2017), the last health survey before the pandemic, was carried out with 17,641 participants. Data did not follow a normal distribution, so non-parametric tests were used to analyse intergroup differences, differences at baseline and post hoc, and correlations between variables. Associations were found between the PAL, mental health and all its dimensions. The groups that performed moderate and intense PAL showed lower values in the GHQ12 questionnaire than those who walked or were inactive. Thus, higher PAL was associated with better mental health indicators, including successful coping, self-esteem and stress. This study provides a framework to compare outcomes between the pre- and post-pandemic periods, as the ENSE is performed every five years.

Sleep Disorders and Mental Stress of Healthcare Workers during the Two First Waves of COVID-19 Pandemic: Separate Analysis for Primary Care

Background: During the recent pandemic, Healthcare Professionals (HCPs) presented a significant prevalence of psychological health problems and sleep disturbances. The aim of this study was to assess the impact of COVID-19 on HCPs’ sleep and mental stress with a separate analysis for primary care HCPs. Methods: A cross-sectional observational study with an online anonymized, self-reported questionnaire was conducted in May 2020 (1st wave) and repeated in December 2020 (2nd wave). Patient health questionnaire-4 (PHQ-4), dimensions of anger reactions-5 (DAR-5) scale, 3-item UCLA loneliness scale (LS) and sleep condition indicator (SCI) were used. Results: Overall, 574 participants were included from the 1st wave, 514 from the 2nd and 469 were followed during both. Anxiety and depression were significantly higher during the 2nd wave vs. the 1st (32.8% vs. 12.7%, p < 0.001 and 37.7% vs. 15.8%, p < 0.001). During the 2nd wave, HCPs scored significantly higher in DAR-5 (9.23 ± 3.82 vs. 7.3 ± 3.3, p < 0.001) and LS (5.88 ± 1.90 vs. 4.9 ± 1.9, p < 0.001) with worse sleep quality SCI (23.7 ± 6.6 vs. 25.4 ± 3.2, p < 0.001). This was more evident in primary care HCPs. Significant correlations were found between SCI and PHQ4, DAR5 and LS. Conclusion: There is a need to support HCPs’ mental health and sleep, especially in those working in primary care.

Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis

BACKGROUND

Healthcare workers are leading the way in treating patients with coronavirus disease 2019 (COVID-19). Due to the high levels of psychological stress, this group is more likely to experience psychological issues. These psychological problems in healthcare providers include depression, anxiety, insomnia, stress and post-traumatic stress disorder (PTSD). The goal of this systematic review and meta-analysis was to find out how common these problems were in the face of COVID-19.

METHODS

On 20 February 2022, systematic searches were conducted in the PubMed, Cochrane Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases. Two authors selected articles based on search keywords. As a last step, articles about the prevalence of psychological problems among healthcare workers in the face of COVID-19 were looked at and analysed for five different outcomes.

RESULTS

The initial search yielded 18,609 articles. After reviewing the titles, abstracts and full texts of the articles, 44 were chosen for the final analysis and 29 were subjected to a meta-analysis. Insomnia, anxiety, depression, PTSD and stress are among the psychological issues faced by healthcare workers. Furthermore, the highest pooled prevalence of depression, anxiety, insomnia, PTSD and stress was 36% (95% confidence interval (CI) 24-50%), 47% (95% CI 22-74%), 49% (95% CI 28-70%), 37% (95% CI 19-59%) and 27% (95% CI 6-69%).

CONCLUSIONS

In this meta-analysis, insomnia was found to be the most common mental health problem, followed by anxiety, PTSD, depression and stress in healthcare workers in the face of the COVID-19 pandemic. Generally, the pooled prevalence of these mental health problems was higher among physicians, nurses and older staff in the subgroup analysis. As a result, health policymakers and managers of the health care system should think about effective interventions to promote mental health, paying particular attention to these two groups.Key pointsStudies conducted in China reported more mental problems than in other countries.Health policymakers and health system managers should hold training programs to promote healthcare workers' mental health with a particular focus on more vulnerable groups.The prevalence of PTSD, stress, anxiety, depression and insomnia were higher among physicians, nurses and older staff.Health systems at both national and local levels have to take older physicians, nurses and healthcare providers into consideration while designing interventions.

The Impact of COVID-19 on the Physical Well-being of Nursing and Medical Personnel: An Integrative Review

Objective: To highlight the impact of responding to COVID-19 on the physical well-being of nursing and medical personnel. Method: This integrative literature review includes Spanish, English, and Portuguese articles. From July 10 to 16, 2020, the search was carried out in the Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, Web of Science, SciVerse Scopus, and National Library of Medicine databases. Twenty-five studies were analyzed, and the results are presented descriptively and in tables. Results: Of the total number of articles, 52 % addressed coronavirus infection and related factors as an impact on nursing and medical personnel’s physical well-being resulting from responding to COVID-19, 28 % addressed sleep quality and predictors, and 20 % addressed damage stemming from the use of personal protective equipment or other preventive measures. Conclusions: Responding to COVID-19 has been conducive to coronavirus infection among personnel due to the work process and prevention measures, poor sleep quality due to mental disorders and lack of social support, and physical harm, such as headaches and skin injuries, due to the use of protective equipment and hand disinfection.

The pooled prevalence of the mental problems of Chinese medical staff during the COVID-19 outbreak: A meta-analysis

BACKGROUND

The COVID-19 pandemic has had a great impact on the mental health of the medical staff in China, especially those on the first-line (frontline) of the pandemic. But the profile of the mental problem of nationwide Chinese medical staff is still unclear, especially about the sleep problems.

METHODS

There are five databases (PubMed, Embase, CNKI, Wanfang Database and Web of Science) searched to identify the published studies on the mental health of the medical staff in China during the COVID-19 outbreak. The pooled prevalence of mental problems of Chinese medical staff during the pandemic were calculated, especially for the first-line medical staff. Subgroup analysis and meta-regression analysis were performed to identify the potential impact factors.

RESULTS

A total of 71 articles including 98,533 participants are included in this meta-analysis. The results showed that the pooled prevalence of the mental problems was as follows: anxiety problem 27%, depression problem 29%, sleep problem 40%. Subgroup analysis showed that there were significant differences in the prevalence of anxiety and depression problems between first-line and non-first-line medical staff (p < 0.01). Sex had a significant impact on the sleep of first-line medical staff (p < 0.01).

LIMITATIONS

There may be heterogeneity among the included studies. The analysis of potential influencing factors remains limited.

CONCLUSIONS

The prevalence of adverse mental problems among medical staff is high during the COVID-19 outbreak. We need to pay special attention to the mental health of first-line medical staff, especially the sleep problems of female first-line workers.

Investigating Predictors of Psychological Distress for Healthcare Workers in a Major Saudi COVID-19 Center

This study investigated the relationship between fear of COVID-19, previous exposure to COVID-19, perceived vulnerability to disease, sleep quality, and psychological distress among healthcare workers (HCWs) in Taif city in Saudi Arabia, which has a population of 702,000 people. A cross-sectional study design was adopted. HCWs (n = 202) completed a survey containing the Fear of COVID-19 Scale (FCV-19S), Perceived Vulnerability to Disease (PVD), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale (DASS-21). FCV-19S and sleep quality were significant predictors for psychological distress. Female gender was a significant predictor for depression and stress. Single, divorced, and widowed marital status were predictive for anxiety. FCV-19S was weakly correlated with PVD but moderately with depression, anxiety, and stress. Of the two PVD subscales, perceived infectability was weakly correlated with psychological distress. PVD and previous experience with COVID-19 were not significant predictors. Sleep quality and FCV-19S were major predictors of psychological distress. Findings indicated that poor sleep quality was strongly associated with psychological distress, while fear of COVID-19 had a moderate association. Such results support the need to design and implement psychological programs to assist HCWs in dealing with the psychological impact of this ongoing pandemic.

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

This systematic review and meta-analysis evaluated the extent of sleep disturbances during the COVID-19 pandemic. Eleven databases and six preprint repositories were searched for the period from November 1, 2019, to July 15, 2021. The DerSimonian and Laird method was used to develop random-effect meta-analyses. Two hundred and fifty studies comprising 493,475 participants from 49 countries were included. During COVID-19, the estimated global prevalence of sleep disturbances was 40.49% [37.56; 43.48%]. Bayesian meta-analysis revealed an odds of 0.68 [0.59; 0.77] which translates to a rate of approximately 41%. This provides reassurance that the estimated rate using classical meta-analysis is robust. Six major populations were identified; the estimated prevalence of sleep problem was 52.39% [41.69; 62.88%] among patients infected with COVID-19, 45.96% [36.90; 55.30%] among children and adolescents, 42.47% [37.95; 47.12%] among healthcare workers, 41.50% [32.98; 50.56%] among special populations with healthcare needs, 41.16% [28.76; 54.79%] among university students, and 36.73% [32.32; 41.38%] among the general population. Sleep disturbances were higher during lockdown compared to no lockdown, 42.49% versus 37.97%. Four in every ten individuals reported a sleep problem during the COVID-19 pandemic. Patients infected with the disease, children, and adolescents appeared to be the most affected groups.

The Mental Health Impact of the COVID-19 Pandemic Among Physicians, Nurses, and Other Health Care Providers in Alberta: Cross-sectional Survey

BACKGROUND

During the COVID-19 pandemic, threats to mental health, psychological safety, and well-being are evident, particularly among the first responders and the health care staff.

OBJECTIVE

This study aims to examine the prevalence and potential predictors of the likely stress, generalized anxiety disorder, and major depressive disorder among health care workers (HCWs).

METHODS

A cross-sectional survey was used through a survey link sent to gather demographic information and responses on several self-report scales, including the Perceived Stress Scale, the Generalized Anxiety Disorder 7-item scale, and the Patient Health Questionnaire-9 among HCWs enrolled in the Text4Hope program.

RESULTS

The result from this study suggests that during the COVID-19 pandemic, HCWs reported a high likelihood of moderate-to-high perceived stress (n=840, 81.2%), moderate-to-severe anxiety (n=369, 38.6%), and depression (n=317, 32.7%) symptoms. Nurses and other HCWs were significantly more likely to report depressive symptoms compared to physicians (F(2, 159.47)=15.89, 95% CI -5.05 to -2.04). Younger age groups of HCWs (≤30 years) were more prone to report likely stress, anxiety, and depressive symptoms compared to HCWs 41-50 and >50 years old (odds ratio [OR] 1.82-3.03). Similarly, females and those who reported a lack of social support (separated/divorced and single) among HCWs had a higher likelihood to report likely stress and depressive symptoms, respectively (OR 1.8 and 1.6, respectively).

CONCLUSIONS

This cross-sectional study explored a high level of mental health burdens during the COVID-19 pandemic among HCWs in Alberta. Levels of psychological symptoms were more noticeable in the female gender and the nursing profession.

Interventional Response of Hospital and Health Services to the Mental Health Effects of Viral Outbreaks on Health Professionals

The aim of this integrative review was to examine the impact of past viral epidemics on staff mental health interventional responses, with a specific focus on healthcare provider response in the context of the COVID-19 pandemic. Following PRISMA methodology, databases were searched for relevant articles. A total of 55 articles with a range of methodologies (e.g., commentary papers, cohort studies, qualitative studies) were included to ensure broad coverage of this rapidly emerging research area. The literature showed that many healthcare providers implemented a variety of wellbeing initiatives to support their staff during a viral outbreak. Most of these interventions, however, were not formally evaluated. Interventions included leadership/team support; online psychoeducational resources and updated information on the pandemic; respite spaces; peer support outreach; staff resilience training; telephone hotline support; staff support groups; and individual counseling. Staff were generally supportive of the initiatives offered by hospital and health services, with certain interventions being more appreciated (e.g., staff respite areas). Rapid, locally, and culturally appropriate workplace-based responses may counter the negative mental health impact on staff; but a stepped response is required for a smaller number of staff at risk of mental illness, or those with pre-existing mental illness. Systematic Review Registration: Unique Identifier: CRD42020222761.

COVID-19, sex, and gender in China: a scoping review

Background

During the course of the COVID-19 pandemic, states were called upon by the World Health Organization to introduce and prioritise the collection of sex-disaggregated data. The collection of sex-disaggregated data on COVID-19 testing, infection rates, hospital admissions, and deaths, when available, has informed our understanding of the biology of the infectious disease. The collection of sex-disaggregated data should also better inform our understanding of the gendered impacts that contribute to risk of exposure to COVID-19. In China, the country with the longest history of fighting the COVID-19 infection, what research was available on the gender-differential impacts of COVID-19 in the first 6 months of the COVID-19 pandemic?

Methods

In this scoping review, we examine the first 6 months (January–June 2020) of peer-reviewed publications (n = 451) on sex and gender experiences related to COVID-19 in China. We conducted an exhaustive search of published Chinese and English language research papers on COVID-19 in mainland China. We used a COVID-19 Gender Matrix informed by the JPHIEGO gender analysis toolkit to examine and illuminate research into the gendered impacts of COVID-19 within China.

Results

In China, only a small portion of the COVID-19-related research focused on gender experiences and differences. Near the end of the six-month literature review period, a small number of research items emerged on women healthcare workers, women’s mental health, and pregnant women’s access to care. There was an absence of research on the gendered impact of COVID-19 amongst populations. There was minimal consideration of the economic, social and security factors, including gender stereotypes and expectations, that affected different populations’ experiences of infection, treatment, and lockdown during the period of review.

Conclusion

At the outset of health emergencies in China, gender research needs to be prioritised during the first stage of an outbreak to assist with evaluation of the most effective public health measures, identifying access to healthcare and social welfare barriers amongst priority communities. Gender stereotypes and gendered differences lead to different patterns of exposure and treatment. The exclusion of this knowledge in real time affects the design of effective prevention and recovery.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-022-00804-w.

Reliability and validity of the Pittsburgh Sleep Quality Index among frontline COVID-19 health care workers using classical test theory and item response theory

STUDY OBJECTIVES

The applicability of sleep-related scales to frontline medical staff for the COVID-19 pandemic has not been fully proved, so sleep survey results lack credibility and accuracy, creating difficulties for the guidance and treatment of frontline medical staff with sleep disorders, which is not conducive to the prevention and control of COVID-19. This study sought to analyze the reliability and validity of the Pittsburgh Sleep Quality Index (PSQI) among frontline medical staff fighting the COVID-19 pandemic.

METHODS

A network questionnaire survey was used to investigate the PSQI among frontline medical staff who fought COVID-19 in Wuhan, China from March 19 to April 15, 2020. Combined with classical test theory and item response theory, the content validity, internal consistency, construct validity, and other aspects of the PSQI were evaluated.

RESULTS

According to classical test theory, content validity, criterion validity, and construct validity of the PSQI were good. But the internal consistency was better after the deletion of the "daytime dysfunction" subscale. With regard to item response theory, difficulty, the differential item function, and the Wright map performed well.

CONCLUSIONS

The original PSQI showed acceptable applicability in frontline COVID-19 medical staff, and its characteristics moderately improved after the "daytime dysfunction" subscale was removed.

CITATION

Wang L, Wu Y-X, Lin Y-Q, et al. Reliability and validity of the Pittsburgh Sleep Quality Index among frontline COVID-19 health care workers using classical test theory and item response theory. J Clin Sleep Med. 2022;18(2):541-551.

Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals

STUDY OBJECTIVES

To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on insomnia and other sleep disturbances in health care professionals.

METHODS

A survey was distributed using social media and organizational emails to Brazilian active health care professionals during the COVID-19 outbreak. We explored potential associated factors including age, sex, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths, anxiety, and burnout. We evaluated new-onset/previous insomnia worsening episodes (primary outcome), new pharmacological treatments, sleep quality, duration, nightmares, and snoring (secondary outcomes).

RESULTS

A total of 4,384 health professionals from all regions of the country were included in the analysis (44 ± 12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. The primary outcome occurred in 32.9% of respondents in parallel to 13% new pharmacological treatments for insomnia. The sleep quality worsened for 61.4%, while 43.5% and 22.8% reported ≥ 1-hour sleep duration reduction and worsening or new-onset nightmares, respectively. Multivariate analyses showed that age (odds ratio [OR]: 1.008; 95% confidence interval [CI] 1.001-1.015), females (OR: 1.590; 95% CI 1.335-1.900), weight change (decrease: OR: 1.772; 95% CI 1.453-2.161; increase: OR: 1.468; 95% CI 1.249-1.728), prevalent anxiety (OR: 3.414; 95% CI 2.954-3.948), new-onset burnout (OR: 1.761; 95% CI 1.489-2.083), family income reduction > 30% (OR: 1.288; 95% CI 1.069-1.553), and assisting patients with COVID-19 (OR: 1.275; 95% CI 1.081-1.506) were independently associated with new-onset or worsening of previous insomnia episodes.

CONCLUSIONS

We observed a huge burden of insomnia episodes and other sleep disturbances in health care professionals during the COVID-19 pandemic.

CITATION

Drager LF, Pachito DV, Moreno CRC, et al. Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals. J Clin Sleep Med. 2022;18(2):373-382.

The association between sleep and psychological distress among New York City healthcare workers during the COVID-19 pandemic

BACKGROUND

Healthcare workers (HCWs) treating patients with COVID-19 report psychological distress. We examined whether disturbed sleep was associated with psychological distress in New York City (NYC) HCWs during the initial peak of the COVID-19 pandemic (April-May 2020).

METHODS

HCWs completed a survey screening for acute stress (4-item Primary Care PTSD screen), depressive (Patient Health Questionaire-2), and anxiety (2-item Generalized Anxiety Disorder scale) symptoms. Insomnia symptoms (modified item from the Insomnia Severity Index) and short sleep (SS, sleep duration <6 h/day) were assessed. Poisson regression analyses predicting psychological distress from SS and insomnia symptoms, adjusting for demographics, clinical role/setting, redeployment status, shifts worked, and multiple comparisons were performed.

RESULTS

Among 813 HCWs (80.6% female, 59.0% white) mean sleep duration was 5.8 ± 1.2 h/night. Prevalence of SS, insomnia, acute stress, depressive, and anxiety symptoms were 38.8%, 72.8%, 57.9%, 33.8%, and 48.2%, respectively. Insomnia symptoms was associated with acute stress (adjusted prevalence ratio [PR]: 1.51, 95% CI: 1.35, 1.69), depressive (PR: 2.04, 95% CI: 1.78, 2.33), and anxiety (PR: 1.74, 95% CI: 1.55, 1.94) symptoms. SS was also associated with acute stress (PR: 1.17, 95% CI: 1.07, 1.29), depressive (PR: 1.36, 95% CI: 1.233, 1.51), and anxiety (PR: 1.38, 95% CI: 1.26, 1.50) symptoms.

LIMITATIONS

Our cross-sectional analysis may preclude the identification of temporal associations and limit causal claims.

CONCLUSIONS

In our study, SS and insomnia were associated with psychological distress symptoms in NYC HCWs during the COVID-19 pandemic. Sleep may be a target for interventions to decrease psychological distress among HCWs.

The occurrence and risk factors associated with post-traumatic stress disorder among discharged COVID-19 patients in Tianjin, China

BACKGROUND

Post-traumatic stress disorder (PTSD) is a serious mental health condition that is triggered by a terrifying event. We aimed to investigate the occurrence and risk factors of PTSD among discharged COVID-19 patients.

METHODS

This study included 144 discharged COVID-19 patients. PTSD was assessed by using validated cut-offs of the impact of event scale-revised (IES-R, score ≥25). All patients completed a detailed questionnaire survey, and clinical parameters were routinely measured in the hospital. Binary logistic regression models were applied to identify factors associated with PTSD.

RESULTS

Of the 144 participants with laboratory-confirmed COVID-19, the occurrence of PTSD was 16.0%. In multivariable analyses, age above 40 years (adjusted OR [95% CI], 5.19 [2.17-12.32]), female sex (adjusted OR [95% CI], 7.82 [3.18-18.21]), current smoker (adjusted OR [95% CI], 6.72 [3.23-15.26]), and ≥3 involved pulmonary lobes (adjusted OR [95% CI], 5.76 [1.19-15.71]) were significantly associated with a higher risk of PTSD. Conversely, history of hypertension and serum hemoglobin levels were significantly associated with a lower risk of PTSD with adjusted ORs (95% CI) of 0.37 (0.12-0.87) and 0.91 (0.82-0.96), respectively.

CONCLUSION

Old age, gender (being female), current smoking, bacterial pneumonia, and ≥3 involved pulmonary lobes were associated with an increased occurrence of PTSD among discharged COVID-19 patients.

COVID-19 pandemic-related mortality, infection, symptoms, complications, comorbidities, and other aspects of physical health among healthcare workers globally: An umbrella review

Background

The COVID-19 pandemic has continued to cause unprecedented concern across the globe since the beginning of the outbreak. Healthcare workers, particularly those working on the front line, remain one of the most affected groups. Various studies have investigated different aspects of the physical health of healthcare workers; however, limited evidence on the overall physical health of healthcare workers has been collectively examined.

Aim

To examine the various aspects of physical health and well-being of healthcare workers during the COVID-19 pandemic.

Design

An umbrella review.

Methods

We conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library and MEDLINE and supplemented the search with Google Scholar. Key terms related to ‘COVID-19’, ‘physical health’, ‘healthcare worker’ and ‘systematic review’ were used in the search. Systematic reviews with or without meta-analyses were included if they were published in the English language, could be obtained in full-text format, and assessed the physical health impacts of the COVID-19 pandemic on healthcare workers were included. The methodological quality of eligible studies was assessed using the Joanna Briggs Institute's checklist for systematic reviews. The data were narratively synthesised in line with the ‘Synthesis Without Meta-analysis’ guideline.

Results

Thirteen systematic reviews (represented as K = 13) that synthesized data from 1230 primary studies/reports and 1,040,336 participants met the inclusion criteria. The findings indicate a death rate of between 0.3 and 54.2 per 100 infections (K = 4). The overall case-fatality rate was estimated to be 0.87% (approximately 9 deaths per 1000 infections, K = 3). The overall infection rate among healthcare workers ranged from 3.9% to 11% (K = 5), with the highest rate associated with healthcare workers involved in screening. Considering geographic regions, the highest number of infections was reported in Europe (78.2% of 152,888 infected healthcare workers, K = 1). More nurses and female healthcare workers were infected, while deaths occurred mainly among men and medical doctors. The commonly reported symptoms included cough (56–80%, K = 3), fever (57–85%, K = 3), and headache (7–81%, K = 3), while hypertension was the most prevalent comorbidity (7%, K = 1). Additionally, a high prevalence of poor sleep quality (41–43%, K = 2), work-related stress (33–44.86%, K = 5) and personal protective equipment-associated skin injuries (48.2–97%, K = 2) affected the healthcare workers. The most reported preventive measures included laboratory testing, clinical diagnosis, adequate personal protective equipment, self-isolation, and training/orientation for infection control.

Conclusion

Healthcare workers experienced considerable COVID-19-related physical health issues, including mortalities. This requires targeted interventions and health policies to support healthcare workers worldwide to ensure timely management of the pandemic.

Tweetable abstract: This umbrella review highlights the global mortalities, infections, and other aspects of physical health of healthcare workers during the COVID-19 pandemic.

Factors causing stress in postgraduate dental students during COVID-19 pandemic: A cross-sectional survey

Background:

COVID-19 pandemic has impacted the academic and clinical training of postgraduate dental students. This study aimed to assess various factors causing psychological stress in them, and the extent of stress perception during pandemic.

Materials and Methods:

In this cross-sectional study, 250 postgraduate students from nine dental colleges of Haryana and National Capital Region, India, responded to an online questionnaire sent electronically to them in September 2020, which included modified dental environment stress (DES) score, Perceived Stress Scale (PSS), and questions regarding COVID-associated stress (CAS). Students already diagnosed with any psychiatric disorder or having a history of any major adverse event during the last 6 months likely to affect their psychological health were excluded from this study. The data obtained were analyzed using Chi-square test, Independent t-test, univariate ANOVA with post hoc tests, Pearson moment correlation, and multiple hierarchical regression tests. P < 0.05 was considered statistically significant.

Results:

DES score was moderate for 48.8% and high for 34.4% of the participants. PSS was moderate for 69.2% and high for 18.8% of the participants. The most stressful factor in dental environment was the pattern of university examination, while the most stressful factor specific to COVID-19 was the fear of family members contracting the infection. PSS score was significantly higher in female participants. DES and CAS scores were significantly higher in students staying in hostels. Multiple hierarchical regression model depicted gender, mean health, and DES score as significant predictors of PSS.

Conclusion:

Postgraduate dental students reported the adverse impact of COVID-19 pandemic upon their training and prospects as a reason for the increase in stress.

The psychological impact of COVID-19 on Chinese healthcare workers: a systematic review and meta-analysis

PURPOSE

This study aimed at investigating five dimensions of the psychological impact (post-traumatic stress symptoms (PTSS), anxiety, depression, sleep disturbance or profession-related burnout) of COVID-19 on healthcare workers (HCW) in China.

METHODS

Studies that evaluated at least one of the five target dimensions of the psychological impact of COVID-19 on HCW in China were included. Studies with no data of our interest were excluded. Relevant Databases were searched from inception up to June 10, 2020. Preprint articles were also included. The methodological quality was assessed using the checklist recommended by AHRQ. Both the rate of prevalence and the severity of symptoms were pooled. The protocol was registered in PROSPERO (CRD42020197126) on July 09, 2020.

RESULTS

We included 44 studies with a total of 65,706 HCW participants. Pooled prevalence rates of moderate to severe PTSS, anxiety, depression, and sleep disturbances were 27% (95% CI 16%-38%), 17% (13-21%), 15% (13-16%), and 15% (7-23%), respectively; while the prevalence of mild to severe level of PTSS, anxiety, and depression was estimated as 31% (25-37%), 37% (32-42%) and 39% (25-52%). Due to the lack of data, no analysis of profession-related burnout was pooled. Subgroup analyses indicated higher prevalence of moderate to severe psychological impact in frontline HCW, female HCW, nurses, and HCW in Wuhan.

CONCLUSION

About a third of HCW in China showed at least one dimension of psychological symptoms during the COVID-19 pandemic, whereas the prevalence of moderate and severe syndromes was relatively low. Studies on profession-related burnout, long-term impact, and the post-stress growth are still needed.

Sleep Difficulties Among COVID-19 Frontline Healthcare Workers

OBJECTIVE

To identify COVID-19 work-related stressors and experiences associated with sleep difficulties in HCW, and to assess the role of depression and traumatic stress in this association.

METHODS

A cross-sectional study of HCW using self-report questionnaires, during the first peak of the pandemic in Israel (April 2020), conducted in a large tertiary medical center in Israel. Study population included 189 physicians and nurses working in designated COVID-19 wards and a comparison group of 643 HCW. Mean age of the total sample was 41.7 ± 11.1, 67% were female, 42.1% physicians, with overall mean number of years of professional experience 14.2 ± 20. The exposure was working in COVID-19 wards and related specific stressors and negative experiences. Primary outcome measurement was the Insomnia Severity Index (ISI). Secondary outcomes included the Primary Care-Post Traumatic Stress Disorder Screen (PC-PTSD-5); the Patient Health Questionnaire-9 (PHQ-9) for depression; the anxiety module of the Patient-Reported Outcomes Measurement Information System (PROMIS); Pandemic-Related Stress Factors (PRSF) and witnessing patient suffering and death.

RESULTS

Compared with non-COVID-19 HCW, COVID-19 HCW were more likely to be male (41.3% vs. 30.7%) and younger (36.91 ± 8.81 vs. 43.14 ± 11.35 years). COVID-19 HCW reported higher prevalence of sleep difficulties: 63% vs. 50.7% in the non-COVID group (OR 1.62, 95% CI 1.15-2.29, p = 0.006), mostly difficulty maintaining sleep: 26.5% vs. 18.5% (OR 1.65, 95% CI 1.11-2.44, p = 0.012). Negative COVID-19 work-related experiences, specifically witnessing patient physical suffering and death, partially explained the association. Although past psychological problems and current depression and PTSD were associated with difficulty maintaining sleep, the main association remained robust also after controlling for those conditions in the full model.

CONCLUSION AND RELEVANCE

COVID-19 frontline HCW were more likely to report sleep difficulties, mainly difficulty maintaining sleep, as compared with non-COVID-19 HCW working at the same hospital. Negative patient-care related experiences likely mediated the increased probability for those difficulties. Future research is needed to elucidate the long-term trajectories of sleep difficulties among HCW during large scale outbreaks, and to identify risk factors for their persistence.

Video intervention to increase treatment-seeking by healthcare workers during the COVID-19 pandemic: randomised controlled trial

BACKGROUND

Many healthcare workers do not seek help, despite their enormous stress and greater risk for anxiety, depression and post-traumatic stress disorder (PTSD).

AIMS

This study screened for psychopathology and evaluated the efficacy of a brief, social contact-based video intervention in increasing treatment-seeking intentions among healthcare workers (trial registration: NCT04497415). We anticipated finding high rates of psychopathology and greater treatment-seeking intentions post-intervention.

METHOD

Healthcare workers (n = 350) were randomised to (a) a brief video-based intervention at day 1, coupled with a booster video at day 14; (b) the video at day 1 only; or (c) a non-intervention control. In the 3 min video, a female nurse described difficulty coping with stress, her anxieties and depression, barriers to care and how therapy helped her. Assessments were conducted pre- and post-intervention and at 14- and 30-day follow-ups.

RESULTS

Of the 350 healthcare workers, 281 (80%) reported probable anxiety, depression and/or PTSD. Participants were principally nurses (n = 237; 68%), physicians (n = 52; 15%) and emergency medical technicians (n = 30; 9%). The brief video-based intervention yielded greater increases in treatment-seeking intentions than the control condition, particularly among participants in the repeat-video group. Exploratory analysis revealed that in both video groups, we found greater effect among nurses than non-nurses.

CONCLUSIONS

A brief video-based intervention increased treatment-seeking intention, possibly through identification and emotional engagement with the video protagonist. A booster video magnified that effect. This easily disseminated intervention could increase the likelihood of seeking care and offer employers a proactive approach to encourage employees to search for help if needed.

Association between sleep disturbance and mental health of healthcare workers: A systematic review and meta-analysis

OBJECTIVES

Sleep disturbance and mental health are challenges for healthcare workers (HCWs). Especially during the COVID-19 pandemic, they experienced more severe sleep and mental health problems. However, the association between sleep disturbance and the mental health of HCWs is still controversial. This study aimed to systematically review the relationship by conducting a systematic review and meta-analysis.

METHOD

Two researchers retrieved the literature from Web of Science, PubMed, EMBASE, CINAHL, Psyclnfo, and Cochrane Library from the establishment of the databases until November 20, 2021. We used the New Castle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ) to evaluate the risk of bias in prospective research and cross-sectional research, respectively. The major exposure was HCWs' sleep disturbance, and the major outcome was mental health. The correlation coefficients (r), regression coefficients (β) and odds ratios (OR) of the included studies were integrated.

RESULT

Fifty-nine studies were included for qualitative analysis, of which 30 studies could be combined and entered into quantitative analysis. There were 23 studies during the COVID-19 pandemic among the 59 included studies. The results of the meta-analysis showed that the correlation coefficient between sleep disturbance and mental health was 0.43 (95% CI: 0.39-0.47). HCWs with sleep disturbance had a 3.74 (95% CI: 2.76-5.07) times higher risk of mental health problems than those without sleep disturbance. The correlation coefficient during the COVID-19 epidemic was 0.45 (95% CI: 0.37-0.53), while it was 0.40 (95% CI: 0.36-0.44) during the non-epidemic period. Subgroup analysis compared the OR results in epidemic and non-epidemic periods of COVID-19, which were 4.48 (95% CI: 2.75-5.07) and 3.74 (95% CI: 2.74-7.32), respectively.

CONCLUSION

Sleep disturbance and mental health problems were positively correlated among HCWs. Particularly in the COVID-19 pandemic, more attention should be given to this issue.