Improving Healthcare Worker Resilience and Well-Being During COVID-19 Using a Self-Directed E-Learning Intervention

Resilience in allied health undergraduate education: a scoping review

PURPOSE

Students of allied health disciplines deal with daily challenges. Without methods to mitigate stress, a decline in academic and clinical performance may result. This scoping review aims to examine the current evidence for the efficacy of interventions for enhancing resilience for allied health students.

MATERIALS AND METHODS

Medline, Emcare and Cochrane Library were systematically searched for literature published until October 2022. The search included Quantitative studies which employed a pre-post or controlled study design to evaluate an intervention to improve resilience for university students in medical radiation, pharmacy, optometry, physiotherapy and podiatry. Screening and data extraction was conducted independently by two reviewers. Critical appraisal was conducted using Joanna Briggs Institute (JBI) critical appraisal tools. Seven studies were included.

RESULTS

A range of resilience interventions were discovered in terms of the frequency and duration, method of implementation including didactic and online learning. Statistically significant findings were found in most controlled trials and pre-post studies. Interventions to enhance resilience are effective within allied health curriculum.

CONCLUSIONS

The evidence that resilience can be significantly influenced by an intervention suggests that stakeholders should spend more time on designing and piloting interventions within their context. Future research should look to assess longer term and clinical related outcomes.

The effect of job and personal demands and resources on healthcare workers' wellbeing: A cross-sectional study

The COVID-19 pandemic presented many psychological stressors which affected healthcare worker wellbeing. The aim of this study was to understand the factors that affect the wellbeing of healthcare professionals in the Kingdom of Saudi Arabia using Job-Demand and Resource (JD-R) Model. The proposal model consisted of demand factors (Work load-job demand, loneliness-personal demand), support factors (organizational support-job resource, and resilience-personal resource), mediators (burnout and work engagement), and outcome (wellbeing) A cross-sectional, descriptive study was conducted across 276 healthcare workers from hospitals and primary healthcare centers, including healthcare professionals, health associate professionals, personal care workers, health management and support personnel, and health service providers, and others between February-March 2022. The proposed model was tested using partial least squares structural equation modeling. Among the respondents, the majority were female (198, 71,7%), married (180, 65.2%), healthcare professionals (206, 74.6%), being more than 10 years in the profession (149, 51.6%), and non-Saudi nationality (171, 62.0%). Burnout accounted for a significant effect on wellbeing. Of the demands (workload and loneliness) and the resources (organizational support and resilience), workload had the greatest impact on burnout. Healthcare organizations should invest in reducing workloads and promoting resilience to reduce burnout and increase healthcare worker wellbeing.

Healthcare Professionals' Resilience During the COVID-19 and Organizational Factors That Improve Individual Resilience: A Mixed-Method Study

Healthcare workers are a susceptible population to be psychologically affected during health crises, such as the recent COVID-19 pandemic. Resilience has been pointed out in the literature as a possible protective factor against psychological distress in crisis situations. This can be influenced by internal and external factors, such as individual characteristics and organizational factors. Thus, this study aims to characterize the overall resilience levels among healthcare professionals in Portugal and to understand the perspectives of this healthcare workers regarding organizational factors that improve individual resilience. This is a mixed-method study: a first quantitative study using a cross-sectional design to administer the Resilience Scale for Adults (RSA) to 271 healthcare professionals (Mage 33.90, SD = 9.59 years, 90.80% female), followed by a qualitative study through 10 in-depth interviews. The mean score for the total RSA was 178.17 (SD = 22.44) out of a total of 231. Qualitative analysis showed 4 major themes on factors that enhance resilience: "Professional's Training," "Support and Wellbeing Measures," "Reorganization of Services" and "Professional Acknowledgment." The findings may contribute to the development of targeted interventions and support systems to enhance resilience and well-being among healthcare workers.

Residents' Report of COVID-19 Associated Training Disruptions, Stressors, and Opportunities During the Pandemic-The Singapore Experience

Background

The COVID-19 pandemic has disrupted residency training. Several studies have been performed to investigate the impact of the pandemic on residency training in Accreditation Council for Graduate Medical Education-International (ACGME-I)-accredited institutions. However, these were either limited to certain specialties or failed to consider possible opportunities from the pandemic.

Objective

To determine the stressors on residents as well as the opportunities that arose from the COVID-19 pandemic across multiple specialities in Singapore.

Methods

A cross-sectional survey among SingHealth residents was conducted between July and September 2020. The survey assessed the balance between service and training during hospital postings, the pandemic's influence on examination and teaching, the psychological impact of the pandemic, the level of burnout, and the effect on morale of residents during the pandemic.

Results

The response rate was 27.1% (253 of 934). Out of the 253 residents, 136 (53.8%) felt stressed during the pandemic. Concerns about family's health and safety pertaining to potential COVID-19 infection, progression in training, and completion of examinations were the top 3 stressors. One-hundred and three residents (40.7%) had their training disrupted either by being placed in an interim posting not part of their residency requirements or being deployed to care for patients with COVID-19. Although administrative support and information for virtual teaching were sufficient, only 108 (42.7%) agreed it had the same value as face-to-face sessions. Despite the challenges, 179 (70.8%) thought that experiencing this crisis provided more meaning in their career.

Conclusions

The COVID-19 pandemic has brought about challenges and learning opportunities for residents.

Supporting Mental Health and Psychological Resilience Among the Health Care Workforce: Gaps in the Evidence and Urgency for Action

Since the COVID-19 pandemic started, health care workers have faced various challenges to their mental health due to extreme working conditions. Yet these workers have continued to deliver care in the face of stressors and death among their patients, family, and social networks. The pandemic highlighted weaknesses within our health care work environment, especially pertaining to a need to provide increased psychological resilience to clinicians. There has been little research to determine the best practices for psychological health in workplaces and interventions to improve psychological resilience. Although some studies have attempted to provide solutions, there are noteworthy gaps in the literature on effective interventions to use in the time of crisis. The most common include an absence of preintervention data concerning the overall mental well-being of health care workers, inconsistent application of interventions, and a lack of standard assessment tools across studies. There is an urgent need for system-level strategies that not only transform the way workplaces are organized, but also destigmatize, recognize, support, and treat mental health conditions among health care workers. There is also need for more evidence-based resources to improve resilience on the job, and thereby increase clinicians' capacity to address new medical crises. Doing so may mitigate rates of burnout and other psychological conditions in times of crisis among health care workers.

Preventing burnout and substance use disorder among healthcare professionals through breathing exercises, emotion identification, and writing activities

The introduction of the COVID-19 pandemic has placed additional strain on healthcare workers, inducing immense levels of stress and workplace burnout. Health care professionals are acutely susceptible to COVID-19 exposure, ultimately leading to elevated levels of anxiety and mental illness. For example, dental professionals are at high risk due to their close work with the oral cavity. To provide temporary relief to the stress, some may turn toward substance use, especially if that individual has some form of mental illness. To curb the onset of burnout and its byproduct of substance use disorder, it is crucial to be equipped with proper tools and healthy habits that can counteract extreme levels of stress. In this article, a time-effective, 3-step method is introduced, with each activity proven to lessen the symptoms of burnout. When followed, an individual can navigate burnout's symptoms through a healthy mind and body approach. Additionally, resources to find resilience-building and mentorship programs are provided. Common substance use support groups and information regarding group meetings and contact information are listed.

Practical resiliency training for healthcare workers during COVID-19: results from a randomised controlled trial testing the Community Resiliency Model for well-being support

Objective

To introduce the Community Resiliency Model (CRM) as mental well-being support for healthcare workers working through the height of the COVID-19 pandemic.

Design

Randomised controlled trial with a no treatment control group.

Setting

Two large urban health systems in the Southern United States between October 2020 and June 2021.

Participants

Eligible participants were currently employed as healthcare workers within the participating healthcare systems. 275 employees registered and consented electronically in response to email invitations. 253 participants completed the baseline survey necessary to be randomised and included in analyses.

Intervention

Participants were assigned 1:1 to the control or intervention group at the time of registration. Intervention participants were then invited to 1-hour virtual CRM class teaching skills to increase somatic awareness in the context of self and other care.

Main outcome measures

Self-reported data were collected rating somatic awareness, well-being, symptoms of stress, work engagement and interprofessional teamwork.

Results

Baseline data on the total sample of 275 (53% nurses) revealed higher symptoms of stress and lower well-being than the general population. The intervention participants who attended a CRM class (56) provided follow-up survey data at 1 week (44) and 3 months (36). Significant improvement for the intervention group at 3 months was reported for the well-being measures (WHO-5, p<0.0087, d=0.66; Warwick-Edinburgh Mental Well-Being Scale, p<0.0004, d=0.66), teamwork measure (p≤0.0002, d=0.41) and stress (Secondary Traumatic Stress Scale, p=0.0058, d=46).

Conclusion

Baseline results indicate mental health is a concern for healthcare workers. Post intervention findings suggest that CRM is a practical approach to support well-being for healthcare workers during a crisis such as this pandemic. The simple tools that comprise the model can serve as a starting point for or complement self-care strategies to enhance individual resilience and buffer the effects of working in an increasingly stressful work environment.

An investigation of the level of burnout and resilience among hospital based nurse managers after COVID 19 - A cross-sectional questionnaire-based study

AIM

We aim to investigate burnout and resilience among hospital based nurse managers post COVID-19 in order to suggest appropriate person-centred leadership support.

BACKGROUND

Nurse leaders are central to establishing safe and caring environments for patients and staff. Therefore, their own wellbeing is crucial, particular in times of crisis where they must provide support and guidance.

METHODS

Cross-sectional questionnaire included ward managers. Data collected were burnout inventory, brief resilience score and demographic data. To analyse data, we used descriptive statistics.

RESULTS

51.2% answered the questionnaire. Of those, 32.3% displayed symptoms of high personal burnout and 29% of work-related burnout. 6.5% showed signs of high employee-related burnout. As a group, ward managers showed moderate to high resilience.

CONCLUSION

Personal and work-related burnout was highly prevalent among ward managers. Results suggest that the cause of their burnout symptoms cannot be attributed to low individual resilience. We thus suggest a shift in focus from strengthening individual leadership resilience to the establishment of healthful and resilient cultures in accordance with person-centred leadership.

IMPLICATIONS FOR NURSING MANAGEMENT

Person-centred leadership has the potential to shift the focus from the resilience of individual leaders to that of collective responsibility for creating a healthful and resilient culture.

Bibliometric visualisation of industrial and organisational psychology during COVID-19 pandemic: Insight for future research

Orientation

Industrial and organisational psychology (IOP) researchers have shown their contribution to solving COVID-19 pandemic in the workplace through the enormous number of studies.

Research purpose

This study intended to map IOP research related to the COVID-19 crisis to provide the research issues that have emerged and potential for future research.

Motivation for the study

All the IOP levels (worker, team and organisation) were impacted by COVID-19, and they continuously change. Researchers must be careful in directing their research and avoid focusing on certain levels or problems.

Research approach/design and method

A bibliometric visualisation analysis method was adopted in this study.

Main findings

The bibliometric results showed that the prominent keywords in IOP research-related COVID-19 are ‘human(s)’, ‘COVID-19’, keywords related to subject characteristics and mental health. Six clusters on the map showed the prominent themes: mental health, health care workers as the research subject, specific workplace issues, digital technology, methodologies used, and country. Furthermore, in every cluster, the depth overview of study results is presented. The top issues were at the worker-level, while the organisational-level issues gained limited attention.

Practical/managerial implications

For practitioners and managers, this study provides a complete picture of emerging issues during COVID-19 crisis ranging from causes, risk factors and solutions. For researchers, this study can provide insight for further research.

Contribution/value-add

This study provides a comprehensive overview of the IOP issues related-COVID-19 that will be beneficial as the basis for policymaking and recommendations for future potential areas.

COVID-19-Related Trajectories of Psychological Health of Acute Care Healthcare Professionals: A 12-Month Longitudinal Observational Study

The COVID-19 pandemic hit healthcare professionals (HCPs) hard, potentially leading to mental health deterioration. This longitudinal study investigated the 1-year evolution of psychological health of acute care HCPs during the COVID-19 pandemic and explored possible differences between high and low resilient HCPs. From April 2020 to April 2021, a convenience sample of 520 multinational HCPs completed an online survey every 3 months, up to five times. We used mixed linear models to examine the association between resilience and the variation of COVID-19-related anxiety, depressiveness, perceived vulnerability, and psychological trauma symptomatology. We demonstrated "u-shaped" trajectories for all mental health symptoms. We also explored differences in the abovementioned variables between front-line and second-line acute care HCPs. In contrast to HCP.s with lower levels of resilience (-1SD), those with higher levels of resilience (+1SD) showed increased COVID-19 anxiety and perceived vulnerability over time. Front-line and second-line HCPs differed in their depressiveness and psychological trauma variation during the 1-year analysis. High and average resilient second-line HCPs showed steeper depressiveness increases with time than high and average resilient front-line HCPs. Acute care HCPs reported their most elevated clinical symptoms of depressiveness (5-7%) and psychological trauma symptomatology (26-46%) in April 2020. During the first year of the COVID-19 pandemic, second-line HCPs with more resilience showed a steeper worsening of their depressiveness than more resilient front-line HCPs. HCPs with low resilience may benefit from interventions at the beginning of a pandemic, whereas HCPs with high resilience might benefit from resilience-enhancing interventions at later phases.

Trial Registration

The study protocol was pre-registered with the International Standard Randomised Controlled Trial Number (ISRCTN13694948) published (Fuchs et al., 2020).