Factors Associated With Psychological Outcomes Among Vaccinated and Unvaccinated Health Care Workers Against COVID-19 Infection in Bangladesh

Exploring healthcare workers' immunisation behaviour towards COVID-19 vaccines through psychological patterns

BACKGROUND

 The psychological approach can provide valuable insights into vaccination behaviour, especially in high-risk contexts. It offers new perspectives for effective interventions to improve vaccination behaviour.

AIM

 To investigate key factors influencing stress related to vaccination in emergency situations among healthcare professionals.

SETTING

 Eastern region of Morocco.

METHODS

 We conducted a descriptive and analytical cross-sectional study involving 221 healthcare professionals in the Eastern region of Morocco. A snowball sampling method was used to select the participants who were administered a questionnaire. Logistic regression analysis was performed with p  0.05 being the level of statistical significance.

RESULTS

 The participants had a median age of 25.5 years (30-34.5) and were predominantly females (68.3%). Vaccination coverage stood at 84.6%, with a positive perception of 77.8%. The analysis of the Perceived Stress Scale (PSS) revealed that 51.6% (n = 114) of healthcare professionals experienced stress towards vaccination. Females were almost two times more susceptible to experiencing vaccination stress (p = 0.03). Furthermore, the analysis showed that vaccination profile (p = 0.02), accepting the vaccine for any reason other than its accessibility (p = 0.03) and having a previous coronavirus disease 2019 infection (p = 0.03), were significantly associated with stress. In contrast, healthcare professionals based at the university hospital had a significantly lower stress level (p = 0.01).

CONCLUSION

 Moroccan healthcare professionals exhibited high vaccine acceptance and positive perceptions, particularly among vaccinated individuals despite notable stress around immunisation.Contribution: These insights can guide governments and policymakers in developing strategies to enhance healthcare workers' awareness and understanding of vaccination.

The association of perceived social support, resilience, and posttraumatic stress symptoms among coronavirus disease patients in the United States

BACKGROUND

Posttraumatic stress disorder (PTSD) has become a main psychological consequence of COVID-19. This study assessed the association between social support, psychological resilience, and probable COVID-19-related PTSD.

METHODS

The PTSD Checklist for DSM-5, Medical Outcomes Study Social Support Survey, and Connor-Davidson Resilience Scale (CD-RISC) were used to assess for PTSD symptoms, social support, and resilience among COVID-19 patients treated at a large medical system in New York City between July 2020 and July 2023. Logistic regression evaluated the association between social support and resilience with PTSD. We further investigated whether associations differed across age, gender, site of acute care, vaccination status, and pre-existing mental disorders.

RESULTS

Among the 1484 participants, 16.6 % had probable COVID-19-related PTSD. Higher scores on measures of resilience (OR: 0.68, 95 % CI: 0.61-0.75) and social support (OR: 0.96, 95 % CI: 0.93-0.99) were associated with lower odds of probable COVID-19-related PTSD. The association between resilience and PTSD was moderated by sex (p for interaction = 0.001), with resilience showing a stronger negative association with PTSD among men relative to women. Associations between resilience, social support, and COVID-19-related PTSD did not differ by age, sites of acute care, vaccination status, and pre-existing mental disorders.

LIMITATIONS

Cross-sectional design precludes establishing causal relationships; assessment timing was not considered; the short CD-RISC may limit measurement precision; single-center study may not be fully generalizable.

CONCLUSIONS

These findings suggest that individuals with low social support and resilience may be at higher risk of PTSD and should be screened and be the target of preventive interventions.

When and how does the practice environment most benefit the job outcomes of newly graduated nurses?

BACKGROUND

Providing a favourable practice environment has been regarded as an essential to improve the job outcomes of newly graduated nurses (NGNs). However, little is known about how and when NGNs can best utilize their practice environment to produce optimal job outcomes.

AIM

The aim of this study, which is based on the Conservation of Resources Theory and the Social Cognitive Model of Career Self-Management, is to investigate whether NGNs who have a higher level of personal growth initiative are more likely to benefit from their practice environment and achieve better job outcomes by increasing their occupational self-efficacy.

DESIGN

A cross-sectional study.

METHODS

From 1 September 2022, to 30 September 2022, 279 NGNs from five Chinese state-owned hospitals were recruited for this study. The participants completed measures of practice environment, personal growth initiative, occupational self-efficacy, job stress, job satisfaction, turnover intention and quality of care. A descriptive analysis and a moderated mediation model were computed. Reporting adhered to the STROBE statement.

RESULTS

The influence of the practice environment on job outcomes was significantly mediated by occupational self-efficacy, with personal growth initiative acting as a moderator of this mediation effect.

CONCLUSIONS

NGNs who exhibited a higher degree of personal growth initiative were more likely to derive benefits from their practice environment and attain positive job outcomes by enhancing their occupational self-efficacy. To boost NGNs' occupational self-efficacy and achieve optimal job outcomes, hospital administrators may not only provide a supportive practice environment for them but also conduct interventions that promote their personal growth initiative.

NO PATIENT OR PUBLIC CONTRIBUTION

This study was designed to examine the psychosocial factors associated with NGNs' job outcomes. The study was not conducted using suggestions from the patient groups or the public.

IMPACTS

Our findings indicate that favourable practise contexts may not always benefit the nursing job outcome if NGNs do not exhibit a high level of personal growth initiative and produce increased occupational self-efficacy. Therefore, hospital administrators should consider implementing an intervention to improve the personal growth initiative of NGNs so that they can take full advantage of the practice environment and gain resources at work to create optimal job outcomes.

SARS-CoV-2 vaccination may improve anxious, insomnia and depressive symptoms among Chinese population aged 18-75 years during the COVID-19 pandemic

Previous studies have reported significant decreases in the incidence of mental health problems following SARS-CoV-2 vaccination. However, less relevant studies are published in China. We conducted a cross-sectional study involving Chinese adults aged 18-75 years with no known psychiatric diseases. The study used data from mental health of SARS-CoV-2 vaccinated and unvaccinated participants from May 2020 to July 2021.Three standardized scales, namely, the Generalized Anxiety Disorder-7 (GAD-7) for anxious symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and Athens Insomnia Score-8 (AIS-8) for insomnia symptoms, as well as basic demographic questions were used. The hierarchical regression method was used for multivariate logistic regression analysis to explore the effects of SARS-CoV-2 vaccination on anxious, insomnia, and depressive symptoms. The results confirmed first that vaccinated participants experienced significantly lower anxious, insomnia, and depressive symptoms scores (P < 0.001) compared with unvaccinated participants. Second that vaccinated participants had a lower prevalence of anxious, insomnia, and depressive symptoms (P < 0.001). Third, after adjusting for potential confounders, we still observed a good correlation between vaccination and a reduced risk of anxious, insomnia, and depressive symptoms. The current study showed that SARS-CoV-2 vaccination may be helpful in improving anxious, insomnia, and depressive symptoms.

Anxiety and Health Concerns among Healthcare Personnel Working with COVID-19 Patients: A Self-Assessment Study

BACKGROUND Anxiety disorders are currently among the most common psychiatric diagnoses. This study aimed to analyze self-assessment of anxiety disorders, depression, and quality of life among healthcare personnel working during the COVID-19 pandemic, with a focus on sociodemographic sources and psychological indicators. MATERIAL AND METHODS The study covered a group of 318 healthcare professionals from Poland. The study used a self-created questionnaire, Beck Depression Inventory, WHOQOL-BREF, Generalised Anxiety Disorder Questionnaire (GAD-7), and Leibowitz Social Anxiety Scale. RESULTS In the study group, 71.1% of the respondents had coronavirus infection, and only 3.5% were not vaccinated. Almost half (45.6%) of the respondents in this group made independent decisions about performing work (45.6%), and 93.4% were satisfied with their work. Less than half of respondents (46.5%) felt work-related anxiety during the pandemic, 54.7% of respondents reported symptoms of depression, and 57% had a good quality of life. Nearly half (47.2%) of the respondents rated their health as good, but 53.1% feared deterioration after performing the aforementioned work, while 87.1% constantly or periodically felt anxious about their work. CONCLUSIONS Although the respondents usually made their own decisions about working with coronavirus-infected patients, most of them experienced anxiety related to their work during the pandemic and were afraid of damaging their health and contracting COVID-19. In self-assessment using standardized questionnaires, most respondents did not show an increase in generalized or social anxiety, but to a greater or lesser extent were diagnosed with a depressive episode. The majority of respondents had a good quality of life: the highest aspect regarded physical functioning and the lowest regarded social functioning.

Psychological benefits of the COVID-19 vaccination: A Bangladeshi comparative study

Background and Aims

Despite evidence that COVID-19 vaccination can strengthen mental health, there is limited evidence about this in Bangladesh. Thus, this comparative study assessed the prevalence and factors associated with mental health problems between vaccine receivers and nonreceivers.

Methods

Using a snowball sampling technique, a web-based cross-sectional study was conducted among a total of 459 participants. The survey questionnaire included sociodemographic information, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), and the Trauma Screening Questionnaire (TSQ-10).

Results

The study found that mental health problems were nonsignificantly prevalent in the vaccine nonreceivers than those who received it (i.e., 24.79% vs. 20.60% for depression, 21.20% vs. 16.60% for anxiety, and 15.30% vs. 12.60% for posttraumatic stress disorder). Female gender, chronic condition, smoking status, and alcohol consumption were the risk factors for mental health problems.

Conclusion

This study's findings suggest that the COVID-19 vaccination necessarily improves mental health outcomes. However, the study had limitations in terms of its design and sampling technique, and further research is needed to establish a cause-effect relationship between vaccination and mental health problems.

Physician stress in the era of COVID-19 vaccine disparity: a multi-institutional survey

CONTEXT

Healthcare workers are at a high risk of infection during infectious disease outbreaks, such as the COVID-19 pandemic. Despite the availability of several vaccines against COVID-19, the absence of vaccination in patients and colleagues remains a continuous source of stress in healthcare workers. We conducted a survey of physician preceptors, both MDs and DOs, to explore the impact of differences in the patients' and colleagues' vaccination status on their well-being, stress, and burnout.

OBJECTIVES

The objective of this study is to determine whether exposure to unvaccinated patients and/or colleagues increases stress and burnout in physician preceptors by utilizing a self-reported survey.

METHODS

This multi-institutional study was carried out in the United States in 2022. An online survey questionnaire was utilized to collect data from physicians working as preceptors for multiple academic institutions. The anonymous Qualtrics^® survey utilized a modified version of the questionnaire from the expanded Physician Well-being Index (ePWBI) designed by MedEd Web Solutions (MEWS). Statistical analysis on both descriptive and qualitative data were performed. Utilizing a threshold of p≤0.05, data analysis revealed many statistically significant relationships between the variables.

RESULTS

A total of 218 physician preceptors completed the survey. The survey results showed that physicians overwhelmingly (p < 0.001) felt that all patients (and healthcare workers) should be vaccinated. The results also indicated that physicians experienced more stress when working with unvaccinated patients (p<0.001), and these stressors were often associated with the physician's gender and age. Furthermore, physicians stated that both their assessment and treatment plans were significantly different for vaccinated vs unvaccinated patients (p=0.039 and p=0.0167, respectively). Most importantly, stress levels (p<0.001) and burnout characteristics (p=0.024) were noted by physicians, both in themselves and in their colleagues.

CONCLUSIONS

Findings suggest that physician stress and burnout is a common theme due to the differences in vaccination status of patients admitted to COVID-19 clinics. Due to a more rapid progression of COVID-19 in unvaccinated patients, treatment plans for vaccinated vs unvaccinated patients were also considerably different.

Prevalence and risk factors of depression and anxiety among Chinese adults who received SARS-CoV-2 vaccine - A cross-sectional survey

BACKGROUND

Direct data reflecting the psychological problems during the nationwide SARS-CoV-2 vaccination campaign are scarce in China. The aim of this study was to assess the prevalence of depression and anxiety and investigate the associated risk factors after vaccination against SARS-CoV-2 among Chinese adults.

METHODS

We conducted a web-based cross-sectional survey from June to July 2021. A structured questionnaire including the Patient Health Questionnaire-9(PHQ-9) and Generalized Anxiety Disorder-7(GAD-7) was used to investigated depression and anxiety symptoms. After excluding 223 ineligible records, a total of 6984 participants were included in our final analysis. Multivariable logistic regression analysis was used to examined the potential factors associated with depression or anxiety.

RESULTS

Our data indicated that the overall prevalence of depression and anxiety was assessed at 19.39 % and 9.74 %, respectively. Participants who had vaccinated the second dose were more likely to have depressive symptoms (20.95 % vs.16.40 %) and anxiety symptoms (10.38 % vs. 8.51 %) than who had vaccinated the first dose. Multivariable logistic regression analysis indicated female gender, being healthcare worker, college or above and planning a pregnancy were all independently linked to depression or anxiety.

LIMITATIONS

The present study was based on an online survey.

CONCLUSION

The present study confirmed the presence of depression and anxiety among Chinese adults who received SARS-COV-2 vaccine, as well as the potential influencing factors. Additional attention and psychological support should be directed at these high-risk groups during SARS-CoV-2 vaccination campaign.

Comparison of General Anxiety among Healthcare Professionals before and after COVID-19 Vaccination

Vaccination plays a crucial role in controlling the rate of coronavirus transmission and infectivity. Healthcare professionals are, in fact, at the greatest risk of contracting coronavirus due to their proximity and prolonged exposure to infected patients; this certitude alone enhances the stress and anxiety among patients and professionals alike. In this study, we aimed to assess the levels of anxiety experienced by healthcare professionals in their practices before and after getting vaccinated. This cross-sectional study was carried out in 2021. An electronic survey was distributed among the non-vaccinated and vaccinated healthcare workers. The survey consisted of the following parts: demographic characteristics, coronavirus-related questions, questions related to the specific field of healthcare professions, general anxiety questions, and working-hour-related questions. The Modified General Anxiety Scale (GAD-7) was used along with the paired t-test, Mann-Whitney U test, and Spearmen's test for comparison. p ≤ 0.05 was considered statistically significant. A total of 798 healthcare professionals participated in the study. In this study, the majority of participants were females, with 598 (74.9%) being between the ages of 21 and 30, and 646 (80.9%) participants were graduates, with the majority being dentists. Non-vaccinated healthcare professionals had severe anxiety (30.9%), whereas, in vaccinated participants, anxiety levels were minimal (56.9%). A statistically significant correlation was discovered when comparing the scores of the vaccinated and non-vaccinated individuals as well as when comparing the professions of vaccinated participants, whereas no association was found with the gender and education level of participants. Vaccination is necessary for all entitled individuals to control the spread of coronavirus. It was discovered that there was an increase in anxiety levels before the vaccination was introduced. The anxiousness was greatly lessened following mass immunizations. Our research will help to raise public awareness of stigmatized mental health disorders in the healthcare industry.

Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic

COVID-19 vaccination acceptance among healthcare workers (HCWs) is very important to control the pandemic and to ensure the safety of HCWs and patients. As psychological factors may affect the decision to be vaccinated, the aim of this study was to investigate the influence of psychological factors on vaccination acceptance in different phases of the COVID-19 pandemic. A cross-sectional study using a web-based survey was conducted among HCWs in Slovenia at the beginning of the pandemic (N = 851), one month later (N = 86), and one year later (N = 145) when vaccines were already available. The results showed that the influence of psychological factors (anxiety, psychological burden, perceived infectability, and germ aversion) was specific for each survey period. At the beginning of the pandemic, vaccination intention was positively associated with anxiety. In the third survey period, anxiety was not exposed as a predictive factor for vaccination intention. However, comparison of vaccination status among groups with different levels of anxiety revealed an interesting distinction within those in favour of vaccination; in the group with minimal levels of anxiety, there was a relatively high share of respondents that were already vaccinated, whereas in the group with severe anxiety, most individuals intended to be vaccinated but hesitated to take action.

Adaptation and Preliminary Validation of the Fear of Coronavirus Vaccination Scale in the Prospective Study among a Representative Sample of Polish, Israeli, Slovenian, and German Adults during the COVID-19 Pandemic

Although concerns about harm and side effects are among the most important factors determining vaccine hesitancy, research on the fear of vaccination is sparse. The purpose of this study is a validation the Fear of Coronavirus Vaccination Scale (FoCVVS), adapted from the Fear of COVID-19 Scale. A representative sample of 1723 young adults aged 20-40 from Poland, Israel, Slovenia, and Germany participated during two time-points of the third COVID-19 pandemic wave. The online survey included demographic variables and several well-being dimensions, including gender, vaccination status, fear of coronavirus (FoCV-19S), physical health (GSRH), life satisfaction (SWLS), and perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Exploratory factor analysis (EFA) was performed at T1, and confirmatory analysis (CFA) at T2. The second-order two-factor structure demonstrated the best fit and very good discriminant and convergent validation. The general factor of the FoCVVS included two subscales assessing the emotional and physiological symptoms of fear of vaccination. Unvaccinated people showed higher levels of fear of vaccination than those vaccinated. A vaccination status, fear of vaccination T1, and fear of COVID-19 T1 were significant predictors of fear of vaccination T2. Vaccination-promoting programs should be focused on decreasing fear and enhancing the beneficial effects of vaccination.

Network Analysis of Well-Being Dimensions in Vaccinated and Unvaccinated Samples of University Students from Poland during the Fourth Wave of the COVID-19 Pandemic

Although numerous studies investigated the predictors of vaccination intention and decision, little is known about the relationship between vaccination and well-being. This study compares the physical and mental health dimensions among vaccinated and unvaccinated people. In a cross-sectional online survey, 706 university students from Poland (mean age of 23 years, 76% of women) participated in this study during the fourth pandemic wave (November–December 2021). Standardized questionnaires with a Likert response scale were included in the survey to measure spirituality, exposure to the COVID-19 pandemic, perceived physical health, stress, coronavirus-related PTSD, fear of COVID-19, anxiety, depression, and life satisfaction. Consistent with the fuzzy-trace theory, the unvaccinated sample was younger and scored significantly lower than the vaccinated group in exposure to COVID-19, perceived physical health, stress, coronavirus-related PTSD, fear of COVID-19, and depression, while higher in life satisfaction. The network analysis showed that mental health plays a crucial role in both groups, with the central influence of anxiety and stress on depression and life satisfaction. The message on vaccination to university students should focus on the benefits of vaccination in maintaining the status quo of good health and well-being. Campus prevention programs should primarily aim to reduce anxiety, stress, and negative emotions by teaching students coping strategies, relaxation techniques, and mindfulness.

Psychological effects and associated factors among vaccinated and unvaccinated general population against COVID-19 infection in Bangladesh

Background

The global effort to develop herd immunity in the general public against the COVID-19 pandemic is currently ongoing. However, to the best of our knowledge, there have been no studies on how the COVID-19 vaccine affects mental health in the context of the COVID-19 pandemic in Bangladesh. The present study investigated the psychological effects and associated factors among vaccinated and unvaccinated general populations against COVID-19 infection in Bangladesh.

Methods

A nationwide online cross-sectional survey was conducted in Bangladesh from June 23 to December 25, 2021. The frequency of symptoms of psychological distress, depression, anxiety, stress, post-traumatic stress disorder (PTSD), insomnia, and fear was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and FCV-19S scales, respectively.

Results

The study included 3,013 persons from all eight divisions of Bangladesh, with 1,272 (42.2%) being vaccinated and 1,741 (57.8%) being unvaccinated. Compared with unvaccinated populations, vaccinated populations had significantly lower prevalence rates of psychological distress (36.4 vs. 51.5%), depression (21.1 vs. 37.9%), anxiety (25.1 vs. 44.9%), stress (19.4 vs. 30.4%), PTSD (29.4 vs. 38.3%), insomnia (18.7 vs. 39.4%), and fear symptoms (16.1 vs. 27.5%). Among vaccinated populations, respondents who lived in nuclear families were significantly associated with higher risk of psychological distress (AOR, 1.38; 95% CI, 1.09-1.78), depression (AOR, 1.49; 95% CI, 1.11-1.98), anxiety (AOR, 1.77; 95% CI, 1.21-1.98), and fear (AOR, 1.43; 95% CI, 1.11-1.83) symptoms. Participants who lost family members, friends, or colleagues due to the COVID-19 pandemic had significantly higher risk of symptoms of psychological distress (AOR, 1.35; 95% CI, 1.02-1.79), anxiety (AOR, 1.41; 95% CI, 1.11-1.87), and PTSD (AOR, 1.76; 95% CI, 1.24-2.19). On the other hand, unvaccinated populations who lived in the Dhaka division were significantly associated with an increased risk of depression (AOR, 2.06; 95% CI, 1.40-2.52), anxiety (AOR, 1.86; 95% CI, 1.15-2.47), stress (AOR, 1.92; 95% CI, 1.12-2.88), and insomnia (AOR, 1.88; 95% CI, 1.20-2.94) symptoms. Except for PTSD and fear symptoms, unemployed participants had considerably higher rates of psychological distress, depression, anxiety, stress, and insomnia symptoms (e.g., psychological distress: AOR, 1.83; 95% CI, 1.10-2.62; depression: AOR, 1.74; 95% CI, 1.37-2.19).

Conclusions

This study recommends immunizing unvaccinated populations as soon as possible to prevent infection and boost mental health. Vulnerable people needed special care, health-related education, and psychological assistance.

Mental health outcomes and associated factors among vaccinated and unvaccinated teachers against COVID-19 infection in Bangladesh

Background

Vaccination of teachers is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their students, as well as to encourage their parents to get immunized. The present study investigated the mental health outcomes and associated factors among vaccinated and unvaccinated teachers against COVID-19 infection in Bangladesh.

Methods

A cross-sectional survey was conducted in Bangladesh from March 4 to September 9, 2021. The frequency of symptoms of psychological distress, depression, anxiety, stress, post-traumatic stress disorder (PTSD), insomnia, and fear was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and FCV-19S scales, respectively.

Results

A total of 1,527 Bangladeshi teachers completed the questionnaire, with 678 (44.4%) being vaccinated and 849 (55.6%) being unvaccinated. Compared with unvaccinated teachers, vaccinated teachers had a statistically significant lower prevalence of psychological distress (35.8 vs. 42.9%), depression (37.6 vs. 46.4%), anxiety (31.9 vs. 45.1%), stress (18.3 vs. 32.0%), PTSD (33.0 vs. 43.8%), insomnia (25.2 vs. 36.9%), and fear symptoms (23.3 vs. 29.6%). Among vaccinated teachers, participants with master's or lower degree levels had significantly higher symptoms of depression, stress, and fear than other education levels. Respondents with children had a significantly higher risk of depression, anxiety, stress, and fear symptoms than those who did not have children. Participants who lost family members, friends, or colleagues due to the COVID-19 pandemic had a significantly higher chance of experiencing symptoms of anxiety, PTSD, and fear than those who did not. On the other hand, unvaccinated male teachers were significantly associated with a higher risk of all mental health outcomes except psychological distress and PTSD symptoms compared to female teachers. Participants who were smokers had a significantly higher chance of anxiety, stress, and fear symptoms than non-smokers. Compared to participants with strong social support, those with poor social support had a higher risk of all mental health outcomes except PTSD symptoms.

Conclusion

This study suggests emphasizing the vaccinated to unvaccinated teachers as soon as possible to control the infection and improve mental health outcomes. Vulnerable teachers also required special attention, health-related education, and psychological support.