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Muthumuni N, Sommer JL, El-Gabalawy R, Reynolds KA, Mota NP. Evaluating the mental health status, help-seeking behaviors, and coping strategies of Canadian essential workers versus non-essential workers during COVID-19: a longitudinal study. ANXIETY, STRESS, AND COPING 2024; 37:334-347. [PMID: 37494424 DOI: 10.1080/10615806.2023.2235294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 05/16/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This study examined mental health symptoms, help-seeking, and coping differences between Canadian essential workers (EWs) versus non-EWs, as well as common COVID-related concerns and longitudinal predictors of mental health symptoms among EWs only. DESIGN An online, longitudinal survey (N = 1260; response rate (RR) = 78.5%) assessing mental health and psychosocial domains amongst Canadian adults was administered during the first wave of COVID-19 with a six-month follow-up (N = 821; RR = 53.7%). METHODS Cross tabulations and chi-square analyses examined sociodemographic, mental health, and coping differences between EWs and non-EWs. Frequencies evaluated common COVID-related concerns. Linear regression analyses examined associations between baseline measures with mental health symptoms six months later amongst EWs. RESULTS EWs reported fewer mental health symptoms and avoidance coping than non-EWs, and were most concerned with transmitting COVID-19. Both groups reported similar patterns of help-seeking. Longitudinal correlates of anxiety and perceived stress symptoms among EWs included age, marital status, household income, accessing a psychologist, avoidant coping, and higher COVID-19-related distress. CONCLUSIONS COVID-19 has had a substantial impact on the mental health of Canadian EWs. This research identifies which EWs are at greater risk of developing mental disorders, and may further guide the development of pandemic-related interventions for these workers.
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Affiliation(s)
- Nisali Muthumuni
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Jordana L Sommer
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Kristin A Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Natalie P Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
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Pestana D, Moura K, Moura C, Mouliakis T, D’Aragon F, Tsang JLY, Binnie A. The impact of COVID-19 workload on psychological distress amongst Canadian intensive care unit healthcare workers during the 1st wave of the COVID-19 pandemic: A longitudinal cohort study. PLoS One 2024; 19:e0290749. [PMID: 38452002 PMCID: PMC10919682 DOI: 10.1371/journal.pone.0290749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/15/2023] [Indexed: 03/09/2024] Open
Abstract
Intensive care unit healthcare workers (ICU HCW) are at risk of mental health disorders during emerging disease outbreaks. Numerous cross-sectional studies have reported psychological distress, anxiety, and depression amongst ICU HCW during the COVID-19 pandemic. However, few studies have followed HCW longitudinally, and none of these have examined the association between COVID-19 workload and mental health. We conducted a longitudinal cohort study of 309 Canadian ICU HCW from April 2020 to August 2020, during the 1st wave of the COVID-19 pandemic. Psychological distress was assessed using the General Health Questionnaire 12-item scale (GHQ-12) at 3 timepoints: during the acceleration phase of the 1st wave (T1), the deceleration phase of the 1st wave (T2), and after the 1st wave had passed (T3). Clinically relevant psychological distress, defined as a GHQ-12 score ≥ 3, was identified in 64.7% of participants at T1, 41.0% at T2, and 34.6% at T3. Psychological distress was not associated with COVID-19 workload at T1. At T2, psychological distress was associated with the number of COVID-19 patients in the ICU (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.00, 1.13) while at T3, when COVID-19 patient numbers were low, it was associated with the number of weekly hospital shifts with COVID-19 exposure (OR: 1.33, 95% CI: 1.09, 1.64). When analyzed longitudinally in a mixed effects model, pandemic timepoint was a stronger predictor of psychological distress (OR: 0.24, 95% CI: 0.15, 0.40 for T2 and OR: 0.16, 95% CI: 0.09, 0.27 for T3) than COVID-19 workload. Participants who showed persistent psychological distress at T3 were compared with those who showed recovery at T3. Persistent psychological distress was associated with a higher number of weekly shifts with COVID-19 exposure (OR: 1.97, 95% CI:1.33, 3.09) but not with a higher number of COVID-19 patients in the ICU (OR: 0.86, 95% CI: 0.76, 0.95). In summary, clinically relevant psychological distress was observed in a majority of ICU HCW during the acceleration phase of the 1st wave of the COVID-19 pandemic but decreased rapidly as the 1st wave progressed. Persistent psychological distress was associated with working more weekly shifts with COVID-19 exposure but not with higher numbers of COVID-19 patients in the ICU. In future emerging disease outbreaks, minimizing shifts with direct disease exposure may help alleviate symptoms for individuals with persistent psychological distress.
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Affiliation(s)
- Daniel Pestana
- William Osler Health System, Department of Critical Care, Etobicoke, Ontario, Canada
- Algarve Biomedical Centre Research Institute, Faro, Portugal
| | - Kyra Moura
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Claire Moura
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Taylor Mouliakis
- School of Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Frédérick D’Aragon
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jennifer L. Y. Tsang
- Niagara Health, St. Catharines, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Binnie
- William Osler Health System, Department of Critical Care, Etobicoke, Ontario, Canada
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Gil-Almagro F, García-Hedrera FJ, Carmona-Monge FJ, Peñacoba-Puente C. From Anxiety to Hardiness: The Role of Self-Efficacy in Spanish CCU Nurses in the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:215. [PMID: 38399503 PMCID: PMC10890432 DOI: 10.3390/medicina60020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Evidence shows that throughout the COVID-19 pandemic, nurses suffered from emotional symptoms, yet in spite of this, few studies within "positive psychology" have analyzed the emergence/promotion of positive traits, such as hardiness. In this context, the present study aimed to test a model regarding the mediating role of self-efficacy between anxiety experienced at the beginning of the COVID-19 pandemic and hardiness assessed six months later among nurses in critical care units (CCU) in Spain. Materials and Methods: An observational, descriptive, prospective longitudinal study with two data collection periods: (1) from the 1 to the 21 June 2020 (final phase of the state of alarm declared in Spain on 14 March) in which socio-demographic and occupational variables, anxiety (Depression, Anxiety and Stress Scale, DASS-21), self-efficacy (General Self-Efficacy Scale, GSES) and basal resilience (Resilience Scale-14, RS-14) were assessed, and (2) a follow-up 6 months later (January-March 2021) in which hardiness (Occupational Hardiness Questionnaire, OHQ) was evaluated. To analyze the data, multivariate regressions were performed using the PROCESS macro (simple mediation, model 4). Results: A total of 131 Spanish nurses from CCUs, with a mean age of 40.54 years (88.5% women) participated in the study. Moderate and severe levels of anxiety were observed in 19.1% of the sample. Significant and positive correlations were observed between self-efficacy, hardiness and resilience (all p < 0.001). Significant negative correlations were observed between anxiety and self-efficacy (p < 0.001), hardiness (p = 0.027) and resilience (p = 0.005). The indirect effect of anxiety on hardiness through self-efficacy was significant (Effect (SE) = -0.275 (0.100); LLCI = -0.487, ULCI = -0.097), contributing to 28% of the variance, including resilience (p = 0.015), age (p = 0.784), gender (p = 0.294) and years of experience (p = 0.652) as covariates. A total mediation was observed (non-significant anxiety-hardiness direct effect; Effect (SE) = -0.053 (0.215), t = 0.248, p = 0.804, LLCI = -0.372, ULCI = 0.479). Conclusions: The results suggest that in Spanish CCU nurses, anxiety experienced at the beginning of the COVID-19 pandemic may contribute to the development of hardiness through positive resources such as self-efficacy.
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Affiliation(s)
- Fernanda Gil-Almagro
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, Spain;
| | | | | | - Cecilia Peñacoba-Puente
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
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Rouleau G, Wu K, Parry M, Richard L, Desveaux L. Providing compassionate care in a virtual context: Qualitative exploration of Canadian primary care nurses' experiences. Digit Health 2024; 10:20552076231224072. [PMID: 38205037 PMCID: PMC10777765 DOI: 10.1177/20552076231224072] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Objective Virtual care presents a promising opportunity to create new communication channels and increase access to healthcare. However, concerns have been raised around the potential for unintended emotional distances created through virtual care environments that could strain patient-provider relationships. While compassionate care is an enabler of emotional connectivity and a core tenant of nursing, little is known about whether or how nurses have adapted their compassion skills into virtual interactions. These concerns are particularly relevant in primary care, where there is a focus on relational continuity (i.e. relationship-based, longitudinal care) and a broad uptake of virtual care. The aim of this study was to explore the meaning of compassionate virtual care and to uncover how nurses operationalized compassionate care through virtual interactions in primary care. Methods We used a qualitative interpretive descriptive lens to conduct semistructured interviews with primary care nurses (Ontario, Canada) who had provided virtual care (i.e. video visits, remote patient monitoring, or asynchronous messaging). We used a thematic approach to analyze the data. Results We interviewed 18 nurse practitioners and two registered nurses. Participants described how: (1) compassionate care was central to nursing practice, (2) compassionate care was evolving through virtual nurse-patient interaction, and (3) nurses balanced practice with patients' expectations while providing virtual compassionate care. Conclusions There is an opportunity to better align nurses' understanding and operationalization of compassionate care in virtual primary care contexts. Exploring how compassionate care is operationalized in primary care settings is a necessary first step to building compassionate competencies across the nursing profession to support the continued virtual evolution of health service delivery.
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Affiliation(s)
- Geneviève Rouleau
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Kelly Wu
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
| | - Monica Parry
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Lauralie Richard
- Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Laura Desveaux
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Boucher VG, Haight BL, Léger C, Deslauriers F, Bacon SL, Lavoie KL, Puterman EM. Canadian healthcare workers' mental health and health behaviours during the COVID-19 pandemic: results from nine representative samples between April 2020 and February 2022. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:823-839. [PMID: 37548891 PMCID: PMC10485207 DOI: 10.17269/s41997-023-00807-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/16/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE In the context of COVID-19, Canadian healthcare workers (HCWs) worked long hours, both to respond to the pandemic and to compensate for colleagues who were not able to work due to infection and burnout. This may have had detrimental effects on HCWs' mental health, as well as engagement in health-promoting behaviours. This study aimed to identify changes in mental health outcomes and health behaviours experienced by Canadian HCWs throughout the COVID-19 pandemic. METHODS Nine representative samples (Ntotal = 1615 HCWs) completed the iCARE survey using an online polling firm between April 2020 (Time 1) and February 2022 (Time 9). Participants were asked about the psychological effects of COVID-19 (e.g., feeling anxious) and about changes in their health behaviours (e.g., alcohol use, physical activity). RESULTS A majority of the HCWs identified as female (65%), were younger than 44 years old (66%), and had a university degree (55%). Female HCWs were more likely than male HCWs to report feeling anxious (OR = 2.68 [1.75, 4.12]), depressed (OR = 1.63 [1.02, 2.59]), and irritable (OR = 1.61 [1.08, 2.40]) throughout the first two years of the pandemic. Female HCWs were more likely than their male counterparts to report eating more unhealthy diets (OR = 1.54 [1.02, 2.31]). Significant differences were also revealed by age, education level, income, parental status, health status, and over time. CONCLUSION Results demonstrate that the impacts of COVID-19 on HCWs' mental health and health behaviours were significant, and varied by sociodemographic characteristics (e.g., sex, age, income).
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Affiliation(s)
| | - Brook L Haight
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Camille Léger
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Montreal, QC, Canada
| | - Frédérique Deslauriers
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Montreal, QC, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Montreal, QC, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Kim L Lavoie
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Montreal, QC, Canada
| | - Eli M Puterman
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
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Turner BJ, Welch BE, Legg NK, Phiri P, Rathod S, Paterson TSE. Psychological Impacts of the COVID-19 Pandemic on Canadian Healthcare Workers: A Case Control Comparison From Three Cross Sectional Surveys. J Occup Environ Med 2023; 65:e580-e586. [PMID: 37340692 DOI: 10.1097/jom.0000000000002913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVE The aim of the study is to describe mental health impacts of the COVID-19 pandemic and identify roles that predict distress among Canadian healthcare workers (HCWs). METHODS Using data from three cross-sectional Canadian surveys, we compared 799 HCWs to demographically matched controls and compared HCWs with and without COVID-19 patient contact. Participants completed validated measures of depression, anxiety, trauma-related stress, alcohol problems, coping self-efficacy, and sleep quality. RESULTS Non-HCWs reported more depression and anxiety in Fall 2020 and more alcohol problems in Fall/Winter 2021 than HCWs. In Winter 2020-2021, HCWs reported more trauma-related stress than non-HCWs. As of early 2021, HCWs with direct patient contact reported worse symptoms across nearly all measures than HCWs without. CONCLUSIONS Although Canadian HCWs did not report worse mental health than demographically similar peers, mental health supports are needed for HCWs providing direct patient care.
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Affiliation(s)
- Brianna J Turner
- From the Department of Psychology, University of Victoria, Victoria, Canada (B.J.T., B.E.W., N.K.L., T.S.E.P.); Southern Health NHS Foundation Trust, Southampton, United Kingdom (P.P., S.R.); School of Primary Care, Population Sciences, and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (P.P.); and Faculty of Science, University of Portsmouth, Portsmouth, United Kingdom (S.R.)
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7
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Odero SA, Mwangi P, Odhiambo R, Mumbua Nzioka B, Shumba C, Ndirangu-Mugo E, Abubakar A. Psychometric evaluation of PHQ-9 and GAD-7 among community health volunteers and nurses/midwives in Kenya following a nation-wide telephonic survey. Front Psychiatry 2023; 14:1123839. [PMID: 37324823 PMCID: PMC10264862 DOI: 10.3389/fpsyt.2023.1123839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
Background Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya. Methods Between June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach's alpha and MacDonalds' omega were used to evaluate the scale's internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools' divergent and convergent validity. Results The internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were significantly negatively correlated with resilience and work engagement, supporting divergent validity. The PHQ-9 and GAD-7 were also significantly positively correlated with resilience and work engagement, supporting divergent validity. Conclusion The PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.
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Affiliation(s)
| | - Paul Mwangi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | - Constance Shumba
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
| | | | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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Ménard AD, Soucie K, Ralph J, Chang YY, Morassutti O, Foulon A, Jones M, Desjardins L, Freeman L. One-year follow-up of hospital nurses' work experiences during the COVID-19 pandemic: A qualitative study. J Adv Nurs 2023. [PMID: 36825468 DOI: 10.1111/jan.15599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/09/2023] [Accepted: 02/05/2023] [Indexed: 02/25/2023]
Abstract
AIM To follow up on the experiences of Registered Nurses (RNs) working after 1 year of the COVID-19 pandemic in Canadian and American hospitals. DESIGN Semi-structured interviews were conducted, and transcripts were analysed through a reflexive thematic analysis (RTA). METHODS RNs (n = 19) first interviewed in the spring of 2020 were re-interviewed 1 year after their original interviews (May 25, 2021-June 25, 2021). Participants consisted of nurses residing in Canada and working in Ontario (n = 12) or American hospitals (n = 7), i.e., both local and cross-border nurses. RESULTS Five themes were identified: (1) "You call us heroes, but you forgot us": Nurses described experiences of disrespect and stigma from their communities, their government, and their workplaces. (2) "A whole new level of busy": Nurses reported stressors both at home and at work that had increased exponentially throughout the pandemic. (3) "Running on empty": Nurses described burnout and mental health struggles including depression, irritation, and suicidal ideation; they coped using both adaptive and maladaptive strategies. (4) "The job of nursing is painful": Ongoing pandemic issues led nurses to re-evaluate their commitments to their units, their hospitals and the profession itself. (5) "Surviving an un-survivable day": Nurses shared positive moments at work and home that helped give them the strength to carry on. CONCLUSION Significant investments will be required from hospital organizations and governments to ensure that healthcare systems continue to function safely for patients, their families and nurses. IMPACT The purpose of this study was to understand and describe nurses' experiences after 1 year of working during the COVID-19 pandemic. Nurses reported feeling disrespected, overwhelmed, and burned out; many were looking to leave the profession. These findings will be of interest to nurses working on the frontline of the pandemic as well as hospital managers and policy makers. NO PATIENT OR PUBLIC CONTRIBUTION In this investigation, nurses were the participants.
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Affiliation(s)
- A Dana Ménard
- Faculty of Arts, Humanities and Social Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Kendall Soucie
- Faculty of Arts, Humanities and Social Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Jody Ralph
- Faculty of Nursing, University of Windsor, Windsor, Ontario, Canada
| | - Yiu-Yin Chang
- Faculty of Arts, Humanities and Social Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Olivia Morassutti
- Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
| | - Alanna Foulon
- Faculty of Arts, Humanities and Social Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Madison Jones
- Faculty of Arts, Humanities and Social Sciences, University of Windsor, Windsor, Ontario, Canada
| | | | - Laurie Freeman
- Faculty of Nursing, University of Windsor, Windsor, Ontario, Canada
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Bouaddi O, Abdallahi NM, Fadel Abdi CM, Hassouni K, Jallal M, Benjelloun R, Belrhiti Z, Nejjari C, Khalis M. Anxiety, Stress, and Depression Among Healthcare Professionals During the COVID-19 Pandemic: A Cross-Sectional Study in Morocco. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580221147377. [PMID: 36708313 PMCID: PMC9892525 DOI: 10.1177/00469580221147377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The COVID-19 pandemic has caused an enormous psychological impact worldwide. This study aimed to assess anxiety, depression, stress, and compensatory behaviors among Moroccan healthcare workers (HCWs) during COVID-19. This descriptive cross-sectional study was conducted using a snowball sampling strategy. This descriptive cross-sectional study was conducted using a snowball sampling strategy. Online surveys were sent to groups of HCWs working in Casablanca and Fez cities. Post-traumatic stress disorder (PTSD) was measured using the Impact of Event Scale revised (IES-R) scale, and the DASS-21 was used to measure anxiety, depression, and stress among participants. Compensatory behaviors used by HCWs to manage these symptoms were also investigated. The majority of participants (72.5%) experienced moderate to severe distress during the COVID-19 pandemic. The majority of participants (53.1%) reported symptoms of mild to extremely severe depression. Overall, nurses, female, and frontline HCWs experienced more stress, anxiety, and depression (P < .001). Leisure activities (29%), sport (19%), and drinking tea/coffee (19%) were the most common compensatory behaviors. Our findings suggest that psychological support and interventions targeting high-risk HCWs with heavy psychological distress are needed. It is of paramount importance to improve the psychological endurance and safeguard the mental and physical well-being of HCWs, who find themselves on the frontline of health and humanitarian crises, when they are needed the most.
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Affiliation(s)
- Oumnia Bouaddi
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco,Knowledge for Health Policies Center, Casablanca, Morocco,Mohammed VI Center for Research and Innovation,Oumnia Bouaddi, Mohammed VI University of Health Sciences, Avenue Mohamed Taieb Naciri, Casablanca 82 403, Morocco.
| | | | | | - Kenza Hassouni
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Manar Jallal
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Roukaya Benjelloun
- Psychiatry Department, Cheikh Khalifa International University Hospital, Mohammed VӀ University of Health Sciences, Casablanca, Morocco
| | - Zakaria Belrhiti
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco,Knowledge for Health Policies Center, Casablanca, Morocco
| | - Chakib Nejjari
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mohamed Khalis
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco,Knowledge for Health Policies Center, Casablanca, Morocco,Mohammed VI Center for Research and Innovation,Higher Institute of Nursing Professions and Health Technology, Rabat, Morocco
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Anaraki NR, Mukhopadhyay M, Karaivanov Y, Wilson M, Asghari S. Living and working in rural healthcare during the COVID-19 pandemic: a qualitative study of rural family physicians' lived experiences. BMC PRIMARY CARE 2022; 23:335. [PMID: 36550406 PMCID: PMC9773678 DOI: 10.1186/s12875-022-01942-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic has been pervasive in its impact on all aspects of Canadian society. Along with its pervasiveness, the disease provided unprecedented complexity to the Canadian healthcare infrastructure, eliciting varying responses from the afflicted healthcare systems in Canada. However, insights into the various parameters and complexities endured by Canadian rural physicians and rural healthcare institutions during the pandemic have been scarce. OBJECTIVE This paper explores the conditions and complexity of living and working of Rural Family Physicians (RFPs) in rural healthcare in Canada during the pandemic. METHODS Community-based participatory research was utilized as a collaborative and partnership approach, equitably engaged community members in all aspects of research, ranging from designing the research question to analyzing data. Participants of this study include RFPs with at least one year of experience working in rural Canada. Data were collected through telephone interviews and analyzed according to the six-phase guide for the data's inductive thematic analysis. Data collection halted upon saturation. RESULTS Five significant compiled categories reflect the lived experiences of Rural Family Physicians. 1- virtual care as a challenge or forward progress; 2- canceling in-person visits and interrupting the routine; 3- shortage of health care providers and supporting staff; 4-ongoing coping process with the pandemic guidelines; 5-COVID-19 combat fatigue. DISCUSSION The inception of COVID-19 has significantly impacted rural physicians across several interconnected issues. This study illuminates the lesser-known effects of the COVID-19 pandemic, which heavily impacts rural healthcare.
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Affiliation(s)
- Nahid Rahimipour Anaraki
- grid.25055.370000 0000 9130 6822Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Meghraj Mukhopadhyay
- grid.25055.370000 0000 9130 6822Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Yordan Karaivanov
- grid.25055.370000 0000 9130 6822Labrador‐Grenfell Health, Memorial University of Newfoundland, Newfoundland, Canada
| | - Margo Wilson
- grid.25055.370000 0000 9130 6822Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Shabnam Asghari
- grid.25055.370000 0000 9130 6822Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada ,grid.25055.370000 0000 9130 6822Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, Faculty of Medicine Building
- Room M5M107, 300 Prince Philip Drive, St. John’s, Newfoundland, A1B 3V6 Canada
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11
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Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers. Curr Opin Crit Care 2022; 28:686-694. [PMID: 36302198 DOI: 10.1097/mcc.0000000000000994] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW We aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. RECENT FINDINGS The pandemic has resulted in a multitude of closely intertwined professional and personal challenges for ICU HCW. High rates of posttraumatic stress disorder (14-47%), burnout (45-85%), anxiety (31-60%), and depression (16-65%) have been reported, and these mental health symptoms are often interrelated. Most studies suggest that nurses and female HCW are at highest risk for developing mental health symptoms. The main personal concerns associated with reporting mental health symptoms among ICU HCW were worries about transmitting COVID-19 to their families, worries about their own health, witnessing colleagues contract the disease, and experiencing stigma from their communities. Major modifiable work-related risk factors were experiencing poor communication from supervisors, perceived lack of support from administrative leadership, and concerns about insufficient access to personal protective equipment, inability to rest, witnessing hasty end-of-life decisions, and restriction of family visitation policies. SUMMARY The COVID-19 pandemic has severely impacted ICU HCW worldwide. The psychological trauma, manifesting as posttraumatic stress disorder, burnout, anxiety, and depression, is substantial and concerning. Urgent action by lawmakers and healthcare administrators is required to protect ICU HCW and sustain a healthy workforce.
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Wang T, Abrantes ACM, Liu Y. Intensive care units nurses' burnout, organizational commitment, turnover intention and hospital workplace violence: A cross-sectional study. Nurs Open 2022; 10:1102-1115. [PMID: 36126210 PMCID: PMC9834521 DOI: 10.1002/nop2.1378] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/31/2022] [Accepted: 09/04/2022] [Indexed: 01/16/2023] Open
Abstract
AIMS This study aimed to (1) assess the relationship between intensive care unit (ICU) nurses' burnout, organizational commitment and turnover intention, (2) examine the moderating effect of the organizational commitment on the relationship between ICU nurses' burnout and turnover intention, and (3) explore the prevalence and influencing factors of hospital workplace violence among ICU nurses. DESIGN Cross-sectional study design. METHODS Data were collected from August to October 2020 and a convenience sample of registered nurses was recruited. To control common method biases, one-month temporal separation, Harman's single-factor analysis and method of latent variables were adopted. The moderating effect was tested by SPSS Hayes PROCESS Macro. Chi-square and logistic regression were used to examine workplace violence data. RESULTS Organizational commitment (β = -.23, 95% confidence interval -.45 to -.03) and continuance commitment (β = -.15, 95% confidence interval -.24 to -.16) have negative moderation effects on the relationship between emotional exhaustion and turnover intention. 77.7% of ICU nurses experienced workplace violence, male and staff nurses, and nurses with lower professional titles and shorter working years have greater odds of experiencing this violence.
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Affiliation(s)
- Tiemei Wang
- Hepato Pancreato Biliary Surgery, Department of General SurgeryThe Third People’s Hospital of Chengdu &The Affiliated Hospital of Southwest Jiaotong UniversityChengduSichuanChina
| | | | - Yan Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanChina
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Stafseth SK, Skogstad L, Ræder J, Hovland IS, Hovde H, Ekeberg Ø, Lie I. Symptoms of Anxiety, Depression, and Post-Traumatic Stress Disorder in Health Care Personnel in Norwegian ICUs during the First Wave of the COVID-19 Pandemic, a Prospective, Observational Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7010. [PMID: 35742259 PMCID: PMC9222786 DOI: 10.3390/ijerph19127010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 11/25/2022]
Abstract
Background: The COVID-19 pandemic has induced demanding work situations in intensive care units (ICU). The objective of our study was to survey psychological reactions, the disturbance of social life, work effort, and support in ICU nurses, physicians, and leaders. Methods: From May to July 2020, this cross-sectional study included 484 ICU professionals from 27 hospitals throughout Norway. Symptoms of anxiety and depression were measured on Hopkins Symptom Checklist-10 (HSCL-10). Symptoms of post-traumatic stress disorder (PTSD) were measured on the PCL-5. Results: The study population were highly educated and experienced professionals, well prepared for working with COVID-ICU patients. However, 53% felt socially isolated and 67% reported a fear of infecting others. Probable cases of anxiety and depression were found in 12.5% of the registered nurses, 11.6% of the physicians, and 4.1% of the leaders. Younger age and <5 years previous work experiences were predictors for high HSCL-10 scores. Reported symptom-defined PTSD for nurses 7.1%; the leaders, 4.1%; and 2.3% of physicians. Conclusions: ICU health care professionals experienced talking with colleagues as the most helpful source of support. The COVID-ICU leaders reported a significantly higher mean score than physicians and nurses in terms of pushing themselves toward producing high work effort.
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Affiliation(s)
- Siv Karlsson Stafseth
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
- MEVU, Lovisenberg Diaconal University College, 0456 Oslo, Norway
| | - Laila Skogstad
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway;
| | - Johan Ræder
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway;
- Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway
| | - Ingvild Strand Hovland
- Department of Acute Medicine, Division of Medicine, Oslo University Hospital, 0424 Oslo, Norway;
| | - Haakon Hovde
- The Norwegian Association for Critical Care Nurses, 0152 Oslo, Norway;
| | - Øivind Ekeberg
- Psychosomatic and Consultation-Liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway;
| | - Irene Lie
- Centre for Patient-Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, 0424 Oslo, Norway;
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 2815 Gjøvik, Norway
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Mehta S, Yarnell C, Shah S, Dodek P, Parsons-Leigh J, Maunder R, Kayitesi J, Eta-Ndu C, Priestap F, LeBlanc D, Chen J, Honarmand K. The impact of the COVID-19 pandemic on intensive care unit workers: a nationwide survey. Can J Anaesth 2022; 69:472-484. [PMID: 34940952 PMCID: PMC8697539 DOI: 10.1007/s12630-021-02175-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To evaluate the impact of the COVID-19 pandemic on Canadian intensive care unit (ICU) workers. METHODS Between June and August 2020, we distributed a cross-sectional online survey of ICU workers evaluating the impact of the pandemic, coping strategies, symptoms of post-traumatic stress disorder (PTSD; Impact of Events Scale-Revised), and psychological distress, anxiety, and depression (Kessler Psychological Distress Scale). We performed regression analyses to determine the predictors of psychological symptoms. RESULTS We analyzed responses from 455 ICU workers (80% women; 67% from Ontario; 279 nurses, 69 physicians, and 107 other healthcare professionals). Respondents felt that their job put them at great risk of exposure (60%), were concerned about transmitting COVID-19 to family members (76%), felt more stressed at work (67%), and considered leaving their job (37%). Overall, 25% had probable PTSD and 18% had minimal or greater psychological distress. Nurses were more likely to report PTSD symptoms (33%) and psychological distress (23%) than physicians (5% for both) and other health disciplines professionals (19% and 14%). Variables associated with PTSD and psychological distress included female sex (beta-coefficient [B], 1.59; 95% confidence interval [CI], 1.20 to 2.10 and B, 3.79; 95% CI, 1.79 to 5.78, respectively; P < 0.001 for differences in scores across groups) and perceived increased risk due to PPE shortage or inadequate PPE training (B, 1.87; 95% CI, 1.51 to 2.31 and B, 4.88; 95% CI, 3.34 to 6.43, respectively). Coping strategies included talking to friends/family/colleagues (80%), learning about COVID-19 (78%), and physical exercise (68%). Over half endorsed the following workplace strategies as valuable: hospital-provided scrubs, clear communication and protocols by hospitals, knowing their voice is heard, subsidized parking, and gestures of appreciation from leadership. CONCLUSIONS This survey study shows that ICU workers have been impacted by the COVID-19 pandemic with high levels of stress and psychological burden. Respondents endorsed communication, protocols, and appreciation from leadership as helpful mitigating strategies.
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Affiliation(s)
- Sangeeta Mehta
- Department of Medicine, Sinai Health; and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
| | - Christopher Yarnell
- Department of Medicine, Sinai Health; and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Sumesh Shah
- Department of Medicine, Sinai Health; and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Dodek
- Center for Health Evaluation and Outcome Sciences and Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeanna Parsons-Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Robert Maunder
- Department of Psychiatry, Sinai Health and University of Toronto, Toronto, ON, Canada
| | | | | | - Fran Priestap
- Department of Surgery, Trauma Program, London Health Sciences Centre, London, ON, Canada
| | - Danielle LeBlanc
- Department of Medicine, Division of Critical Care, Western University, London, ON, Canada
| | - Jennifer Chen
- Department of Medical Biophysics, Western University, London, ON, Canada
| | - Kimia Honarmand
- Department of Medicine, Division of Critical Care, Western University, London, ON, Canada
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Ethical Lessons from an Intensivist's Perspective. J Clin Med 2022; 11:jcm11061613. [PMID: 35329939 PMCID: PMC8949962 DOI: 10.3390/jcm11061613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022] Open
Abstract
Intensive care units (ICUs) around the world have been hugely impacted by the SARS-CoV-2 pandemic and the vast numbers of patients admitted with COVID-19, requiring respiratory support and prolonged stays. This pressure, with resulting shortages of ICU beds, equipment, and staff has raised ethical dilemmas as physicians have had to determine how best to allocate the sparse resources. Here, we reflect on some of the major ethical aspects of the COVID-19 pandemic, including resource allocation and rationing, end-of-life decision-making, and communication and staff support. Importantly, these issues are regularly faced in non-pandemic ICU patient management and useful lessons can be learned from the discussions that have occurred as a result of the COVID-19 situation.
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16
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Côté J, Aita M, Chouinard MC, Houle J, Lavoie-Tremblay M, Lessard L, Rouleau G, Gélinas C. Psychological distress, depression symptoms and fatigue among Quebec nursing staff during the COVID-19 pandemic: A cross-sectional study. Nurs Open 2022; 9:1744-1756. [PMID: 35199497 PMCID: PMC8994967 DOI: 10.1002/nop2.1199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/12/2022] [Accepted: 01/30/2022] [Indexed: 01/05/2023] Open
Abstract
Aim To describe the state of health of Quebec nursing staff during the pandemic according to their exposure to COVID‐19, work‐related characteristics and sociodemographic factors (gender, generational age group). State of health was captured essentially by assessing psychological distress, depression symptoms and fatigue. Design and methods A large‐scale cross‐sectional study was conducted with 1,708 nurses and licenced practical nurses in Quebec (87% women, mean age of 41 ± 11 years). The survey included several questionnaires and validated health‐related scales (psychological distress, depression symptoms and fatigue). The STROBE guidelines were followed in reporting the study's findings. Results Results showed that the prevalence of psychological distress and depression symptoms was moderate to severe. Women, generation Xers and Yers, nurses who cared for COVID‐19 patients and those with a colleague who was infected with COVID‐19 at work scored higher for fatigue, psychological distress and depression.
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Affiliation(s)
- José Côté
- Faculté des Sciences Infirmières, Université de Montréal, Montreal, QC, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Research Chair in Innovative Nursing Practices, Centre Hospitalier de l'Université de Montréal Centre de Recherche, Montreal, QC, Canada
| | - Marilyn Aita
- Faculté des Sciences Infirmières, Université de Montréal, Montreal, QC, Canada.,Sainte-Justine Hospital Pediatric Research Centre, Montreal, QC, Canada
| | | | - Julie Houle
- Nursing Department, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada.,Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, Trois-Rivières, QC, Canada
| | - Mélanie Lavoie-Tremblay
- McGill University Ingram School of Nursing, Montreal, QC, Canada.,Centre of Research, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Lily Lessard
- Université du Québec à Rimouski - Sciences de la santé, Rimouski, QC, Canada.,Interdisciplinary Chair in Health and Social Services for Rural Populations, Université du Québec à Rimouski, Rimouski, QC, Canada.,Centre de recherche du CISSS de Chaudière-Appalaches, Sainte-Marie, QC, Canada
| | - Geneviève Rouleau
- Research Chair in Innovative Nursing Practices, Centre Hospitalier de l'Université de Montréal Centre de Recherche, Montreal, QC, Canada.,Women's College Hospital, Toronto, Ontario, Canada
| | - Céline Gélinas
- McGill University Ingram School of Nursing, Montreal, QC, Canada.,Centre intégré universitaire de santé et de services sociaux du l'Ouest-de-l'Île-de-Montréal du Québec, Centre for Nursing Research, Jewish General Hospital, Montreal, QC, Canada
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Vinicius Santinelli Pestana D, Raglione D, Junior LD, Liberatti CDSP, Braga EC, Ezequiel VADL, Alves ADS, Mauro JG, Dias JODA, Moreira PTF, Madureira BDB, Paiva LP, de Lucena BMN, Junior JMS, Malbouisson LMS. Stress and substance abuse among workers during the COVID-19 pandemic in an intensive care unit: A cross-sectional study. PLoS One 2022; 17:e0263892. [PMID: 35143590 PMCID: PMC8830709 DOI: 10.1371/journal.pone.0263892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 01/28/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Professionals working in intensive care units (ICUs) during the COVID-19 pandemic have been exposed to stressful situations and increased workload. The association between symptoms of traumatic stress disorders, substance abuse and personal/occupational characteristics of Brazilian COVID-19-ICU workers is still to be addressed. Our aim was to evaluate the prevalence of those conditions and to find if those associations exist. METHODS In this observational, single-center, cross-sectional study, all professionals working in a COVID-19 ICU were invited to fill an anonymous form containing screening tools for traumatic stress disorders and substance abuse, and a section with questions regarding personal and occupational information. RESULTS Three hundred seventy-six ICU professionals participated. Direct exposure to patients infected by COVID-19, history of relatives infected by COVID-19, and sex (female) were significantly associated with signs and symptoms of traumatic stress disorders. 76.5% of the participants had scores compatible with a diagnosis of traumatic stress disorders. Moreover, the prevalence of scores suggestive of Tobacco and Alcohol abuse were 11.7% and 24.7%, respectively. CONCLUSION ICU workers had significantly elevated scores on both screening forms. Providing psycho-social support to ICU professionals may prevent future problems with traumatic stress disorders or substance abuse.
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Affiliation(s)
- Diego Vinicius Santinelli Pestana
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Dante Raglione
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Dalfior Junior
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Caroline de Souza Pereira Liberatti
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Elisangela Camargo Braga
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vitor Augusto de Lima Ezequiel
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Adriana da Silva Alves
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Juliana Gil Mauro
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - José Omar de Araújo Dias
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Thadeu Fantinato Moreira
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Del Bianco Madureira
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Lilian Petroni Paiva
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Melo Nóbrega de Lucena
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - João Manoel Silva Junior
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Marcelo Sá Malbouisson
- Department of Anesthesiology, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Damasceno KSM, Oliveira GM, Beltrame M, Coelho JMF, Pimentel RFW, Merces MCD. Efetividade da auriculoterapia na redução de estresse em trabalhadores de saúde: ensaio clínico controlado randomizado. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5992.3772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Resumo Objetivo: avaliar a efetividade da auriculoterapia na redução do estresse ocupacional em trabalhadores de saúde da Estratégia de Saúde da Família durante a pandemia da COVID-19. Método: ensaio clínico controlado randomizado em dois grupos: grupo auriculoterapia para o estresse e grupo placebo. Foi utilizado o teste de Shapiro-Wilk para avaliar a normalidade dos dados. O teste ANOVA de medidas repetidas e o teste post-hoc Tukey foram aplicados para o grupo com amostras normais. Já o teste de Friedman e de Durbin-Conover foram utilizados no grupo com distribuição não normal. Para o tamanho do efeito da terapia, foi calculado o índice d de Cohen. Considerou-se o nível de significância de 95% e valor p<0,05. Resultados: o grupo auriculoterapia apresentou redução do estresse ocupacional de 16,3 e 23,7% após a terceira e sexta sessões de auriculoterapia, com índices d de Cohen de 1,12 (grande efeito) e 1,82 (efeito muito grande), respectivamente. Conclusão: a auriculoterapia mostrou-se efetiva na redução do estresse ocupacional em trabalhadores de saúde da Estratégia Saúde da Família durante a pandemia da COVID-19. Sugere-se que novos estudos sejam desenvolvidos durante e após a pandemia de maneira a melhorar a qualidade de vida dos trabalhadores de saúde. Registro ReBEC: RBR - 38hjyt3.
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Damasceno KSM, Oliveira GM, Beltrame M, Coelho JMF, Pimentel RFW, Merces MCD. Efectividad de la auriculoterapia para la reducción del estrés de trabajadores de la salud: ensayo clínico controlado aleatorizado. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5992.3770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumen Objetivo: evaluar la efectividad de la auriculoterapia para la reducción del estrés laboral en trabajadores de salud de la Estrategia Salud de la Familia durante la pandemia de COVID-19. Método: ensayo clínico controlado aleatorizado en dos grupos: grupo auriculoterapia para el estrés y grupo placebo. Se utilizó la prueba de Shapiro-Wilk para evaluar la normalidad de los datos. Al grupo con muestras normales se les aplicó la prueba ANOVA de medidas repetidas y la prueba post-hoc de Tukey. Se utilizaron las pruebas de Friedman y Durbin-Conover en el grupo con distribución no normal. Para el tamaño del efecto de la terapia se calculó el índice d de Cohen. Se consideró un nivel de significación del 95% y un valor de p <0,05. Resultados: el grupo auriculoterapia mostró una reducción del estrés laboral de 16,3 y 23,7% después de la tercera y sexta sesión de auriculoterapia, con índices d de Cohen de 1,12 (efecto grande) y 1,82 (efecto muy grande), respectivamente. Conclusión: la auriculoterapia demostró ser eficaz para la reducción del estrés laboral en trabajadores de la salud de la Estrategia Salud de la Familia durante la pandemia de COVID-19. Se sugiere desarrollar nuevos estudios durante y después de la pandemia con el fin de mejorar la calidad de vida de los trabajadores de la salud. Registro ReBEC: RBR - 38hjyt3.
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Damasceno KSM, Oliveira GM, Beltrame M, Coelho JMF, Pimentel RFW, Merces MCD. Effectiveness of auriculotherapy on stress reduction in health workers: a controlled randomized clinical trial. Rev Lat Am Enfermagem 2022; 30:e3771. [PMID: 36629728 PMCID: PMC9818249 DOI: 10.1590/1518-8345.5992.3771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE to assess the effectiveness of auriculotherapy in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. METHOD a controlled randomized clinical trial divided into two groups, namely: auriculotherapy for stress group and placebo group. The Shapiro-Wilk test was used to assess data normality. The ANOVA test for repeated measures and the Tukey post-hoc test were applied to the group with normal samples. In turn, the Friedman and Durbin-Conover tests were employed in the group with non-normal distribution. Cohen's d index was calculated for the therapy effect size. A 95% significance level and p<0.05 were considered. RESULTS the auriculotherapy group presented 16.3% and 23.7% reductions in occupational stress after the third and sixth auriculotherapy sessions, with Cohen's d indices of 1.12 (large effect) and 1.82 (very large effect), respectively. CONCLUSION auriculotherapy proved to be effective in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. It is suggested that new studies are developed both during and after the pandemic in order to improve health workers' Quality of Life. ReBEC registration: RBR - 38hjyt3.
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Affiliation(s)
| | | | - Mônica Beltrame
- Universidade do Estado da Bahia, Departamento de Ciências da Vida, Salvador, BA, Brazil
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21
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Berkhout SG, Billings J, Abou Seif N, Singleton D, Stein H, Hegarty S, Ondruskova T, Soulios E, Bloomfield MAP, Greene T, Seto A, Abbey S, Sheehan K. Shared sources and mechanisms of healthcare worker distress in COVID-19: a comparative qualitative study in Canada and the UK. Eur J Psychotraumatol 2022; 13:2107810. [PMID: 35979505 PMCID: PMC9377263 DOI: 10.1080/20008066.2022.2107810] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: COVID-19 has had a significant impact on the wellbeing of healthcare workers, with quantitative studies identifying increased stress, anxiety, depression, insomnia, and PTSD in a wide range of settings. Limited qualitative data so far has offered in-depth details concerning what underlies these challenges, but none provide comprehensive comparison across different healthcare systems. Objective: To explore qualitative findings relating to healthcare worker distress from two different countries to understand the nuanced similarities and differences with respect to the sources and impact of distress relating to COVID-19. Method: A comparative interpretive thematic analysis was carried out between two qualitative data sets examining healthcare workers' experiences of distress during the COVID-19 pandemic. Data from Canada and the UK were collected in parallel and analyzed in an iterative, collaborative process. Results: A number of sources of distress cut across both study settings including concerns about safety and patient care, challenges at home or in one's personal life, communication issues, work environment, media and public perception, and government responses to the pandemic. These sit on a spectrum from individual to institutional sources and were mutually reinforcing. Our analysis also suggested that common mechanisms such as exacerbations in uncertainty, hypervigilance, and moral injury underpinned these sources, which contributed to how they were experienced as distressing. Conclusion: This is the first international collaboration utilising qualitative data to examine this pressing issue. Despite differences in the political, social, health service, and pandemic-related context, the sources and mechanisms of distress experienced by healthcare workers in Canada and the UK were remarkably similar. HIGHLIGHTS This international comparative qualitative study explores how mechanisms that lead to distress are shared across different geographies and cultures, even as the local context shapes the sources of distress themselves.
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Affiliation(s)
- Suze G Berkhout
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| | - Nada Abou Seif
- Division of Psychiatry, University College London, London, UK
| | - David Singleton
- Division of Psychiatry, University College London, London, UK
| | - Hilarie Stein
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Siobhan Hegarty
- Division of Psychiatry, University College London, London, UK
| | | | - Emilia Soulios
- Division of Psychiatry, University College London, London, UK
| | | | - Talya Greene
- Division of Psychiatry, University College London, London, UK.,Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Susan Abbey
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
| | - Kathleen Sheehan
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
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22
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Yang X, Miao J, Fan W, Wang L, Sun S, Li H, Wang N, Wang X, Lin M, He R. Analysis of Psychological Trends and Policy Recommendations of Medical Staff in Northern China in the Latter Stages of the COVID-19 Pandemic. Front Psychol 2021; 12:747557. [PMID: 34744923 PMCID: PMC8564395 DOI: 10.3389/fpsyg.2021.747557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022] Open
Abstract
Aim: Since the 2019 coronavirus disease (COVID-19) outbreak, medical staff have faced greater psychological stress and are prone to psychological problems such as anxiety and depression, as confirmed by several studies. This study further clarifies the psychological status of Chinese medical staff during the stable phase of the pandemic through a cross-sectional investigation in a large population sample in northern China. Methods: Subjects: Clinical frontline medical staff from seven hospitals in Liaoning Province were recruited from November 2020 to February 2021. Research Tools: The research tools used were the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Simplified Coping Style Questionnaire (SCSQ), and General Status Questionnaire. Statistical Analysis: SPSS 22.0, ANOVA variance analysis, and multiple logistics regression were used for statistical analysis. P-values of <0.05 indicated significant statistical differences. Results: A total of 3,144 medical staff completed the survey (599 men [19.1%] and 2,545 women [80.9%]; 1,020 doctors [32.4%] and 2,124 nurses [67.6%]). Among all subjects, the rates of anxiety and depression were 21.1% (663/3, 144) and 43.9% (1,381/3,144), respectively. Multiple logistic comparative analysis revealed that age (OR = 1.272, 95% CI = 1.036–1.561, P = 0.022), the need for psychological counseling (OR = 1.566, 95% CI = 1.339–1.830, P < 0.001), and the coexistence of depression (OR = 0.050, 95% CI = 0.038–0.066, P < 0.001) were significantly associated with anxiety. Coexisting anxiety was also associated with the occurrence of depression (OR = 0.050, 95% CI = 0.038–0.065, P < 0.001). Conclusions: In the later stages of the pandemic in China, the occurrence rates of anxiety and depression among medical staff remain high. In addition to age, there is little correlation between anxiety or depression and general factors such as gender and profession. As a special group, medical staff show different psychological changes at various times during a stressful event. Concerning for the psychological needs of medical staff and different psychologically oriented policy implementation are needed.
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Affiliation(s)
- Xueping Yang
- Department of Psychology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Junxiao Miao
- Department of Psychology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Weizhong Fan
- Department of Public Places, The Health Supervision Center of Liaoning Province, Shenyang, China
| | - Lili Wang
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Shuning Sun
- Department of Neurology, Jinqiu Hospital of Liaoning Province, Shenyang, China
| | - Hongshi Li
- Department of Oncology and Medical Affair Department, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Na Wang
- Department of Neurorehabilitation, Second Affiliated Hospital of Zhenzhou University, Zhenzhou, China
| | - Xuesong Wang
- Department of Urinary Surgery, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Muhui Lin
- Department of Neurology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Ru He
- Department of Psychology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
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23
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Psychosocial Impact of the COVID-19 Pandemic on Healthcare Workers and Initial Areas of Action for Intervention and Prevention-The egePan/VOICE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910531. [PMID: 34639831 PMCID: PMC8508196 DOI: 10.3390/ijerph181910531] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/15/2022]
Abstract
Introduction: Epidemics lead to an increase in occupational stress and psychological strain among healthcare workers. However, the impact of a pandemic outbreak on healthcare systems is yet to be clearly defined. Therefore, this work aims to describe and analyze specific areas of workload among different groups of healthcare workers during the first wave of the COVID-19 pandemic. Methods: A sample of N = 8088 persons working in the German-speaking healthcare sector participated in the VOICE/egePan online survey, which addressed the impact of the COVID-19 pandemic during the second quarter of 2020. We used 15 self-constructed items, based on the work of Matsuishi et al. (2012), to identify potential COVID-19-specific topics. Results: N = 7542 records of healthcare workers were analyzed. Of these, 60.80% reported, retrospectively, an increase in stress since the outbreak of the pandemic. Problem areas tended to be indicated more frequently by the women surveyed than by the men. Nurses, paramedics and medical technicians reported the highest fear of infecting others while physicians reported the highest fear of physical or mental exhaustion. With respect to age, older respondents indicated less fear and felt more protected. Men and people living alone were more likely to use dysfunctional coping strategies. Migrants reported a higher fear of becoming infected or infecting others as well as they reported about increased levels of smoking. Discussion: Retrospectively, the COVID-19 pandemic led to an increase in stress among healthcare workers. Problem areas have different focuses with regard to different living situations, environmental conditions and professions. In order to lay the best basis for healthy and efficient work, it seems necessary to take measures especially tailored to the needs of different groups of healthcare workers.
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