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Hernandez I, Söderström M, Rudman A, Dahlgren A. Under pressure - Nursing staff's perspectives on working hours and recovery during the COVID-19 pandemic: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100225. [PMID: 39139601 PMCID: PMC11321373 DOI: 10.1016/j.ijnsa.2024.100225] [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] [Indexed: 08/15/2024] Open
Abstract
Background The COVID-19 pandemic contributed to increased pressure on healthcare systems. During periods when the demands exceed the capacity of healthcare organizations, adaptive strategies are used to meet these demands. During the COVID-19 pandemic, working hours for nursing staff were reorganized and extended. This has posed challenges for recovery, which may be a key factor for maintaining health and safety under such conditions. Objectives The aim of the study was to bring insights into how nursing staff perceived their working hours and recovery during the COVID-19 pandemic, and if they experienced any changes in their sleep and well-being. Design A qualitative descriptive design was chosen, as it is suitable for gaining insight into perceptions and experiences. Methods Qualitative semi-structured interviews were conducted using an interview guide. The interviews were analyzed using thematic analysis. Sixteen registered nurses and six certified nursing assistants from four Swedish hospitals participated in the study. Results The organization of working hours during the COVID-19 pandemic was considered suboptimal and resulted in more demanding working hours and poor recovery. Nursing staff experienced loss of control as they lost influence over working hours, working hours became more unpredictable and the boundaries between work and leisure became blurred. Nursing staff also experienced a decline in their health and well-being, including extreme fatigue, impaired sleep and physical/mental changes. Conclusion The strategies used by healthcare organizations to meet increasing demands during the COVID-19 pandemic contributed to impaired recovery and well-being of nursing staff, which could generate negative feedback loops contributing to depletion of resources at the organizational level.
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Affiliation(s)
- Isabelle Hernandez
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Marie Söderström
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Ann Rudman
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Anna Dahlgren
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
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Choi YJ, Namgung HI. Still in there-citizens' well-being and PTSD after Seoul Halloween crowd crush in Korea: a cross-sectional study. Sci Rep 2024; 14:20537. [PMID: 39232072 PMCID: PMC11374986 DOI: 10.1038/s41598-024-71631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/28/2024] [Indexed: 09/06/2024] Open
Abstract
The October 29, 2022, Seoul Halloween Crowd Crush (SHCC) caused the loss of 159 lives, making it the deadliest global mass-gathering disaster between 2018 and 2022. Despite the fact that years have passed since the incident, there remains a significant gap in research addressing the mental health of citizens to evaluate their recovery progress. Therefore, in this study, a survey was conducted to assess citizens' anxiety, depression, post-traumatic stress disorder (PTSD), and well-being after the SHCC. The data were analyzed using t-tests, analysis of variance (ANOVA), correlations, a Kruskal-Wallis test, and post hoc tests. The citizens' well-being differed significantly by victimization status, with direct victims showing languishing well-being (p = .036). PTSD severity level was higher in victims and direct witnesses (p < .001). Victims and direct witnesses exhibited worse outcomes in subjective, social, and psychological well-being as well as in PTSD (p < .001). Well-being exhibited a significant negative correlation with PTSD (r = - .247, p < .001). The results of the analysis suggest the SHCC's psychological impact has endured not only for victims and direct witnesses but also for media-exposed citizens. Offering continuous psychological support and fostering positive self-perceptions and social interactions are crucial for their recovery and well-being enhancement.
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Affiliation(s)
- Yun-Jung Choi
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Korea
| | - Hae-In Namgung
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Korea.
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Li CJ, Zheng Y, Gan Y, Du Z, Cai X, Li Y, Wang W, Jiang T, Zhang Q, Niu L, Tao TJ, Hou WK. Mental health of primary health care physicians and nurses following prolonged infection control rules: a national survey in China. Front Public Health 2024; 12:1392845. [PMID: 39247229 PMCID: PMC11377233 DOI: 10.3389/fpubh.2024.1392845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 07/18/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction This study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the post-pandemic period in 2022. Method Region-stratified sampling was conducted to recruit a national sample of 4,246 respondents from 31 July 2022 to 12 August 2022. A total of 692 primary healthcare institutions were identified in 30 provincial-level administrative regions of China. An online questionnaire was used for assessing probable mental health disorders using Symptoms Checklist-90-Revised (SCL-90-R) and PTSD Checklist for DSM-5 (PCL-5), and sleeping problems using Insomnia Severity Index (ISI). Data on demographics and work were also collected. Bivariate analysis and multiple logistic regression were conducted to identify significant correlates of probable mental health disorders. Results A total of 4,246 valid questionnaires were identified. Results showed that relative to the prevalence of probable mental health disorders among health care workers at the early stage of the pandemic in China, there was an overall decreased prevalence except for somatization, PHO, and OCD among the current PHC physicians and nurses. Multiple logistic regressions showed that significant risk factors of common probable mental health disorders, namely psychological distress, SOM, DEP, ANX, PHO, OCD, PTSD, and insomnia, were female gender, multimorbidity, history of psychiatric disorders, quarantine experience, never asking anyone for help, and overtime work. Conclusion Attention should be given to preexisting psychiatric and multimorbid conditions, social support, and work-related stressors. Regular assessment and psychological interventions are needed to enhance the mental health of PHC professionals even after public health crisis.
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Affiliation(s)
- Crystal Jingru Li
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yanling Zheng
- Shouyilu Street Community Health Service Center, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhaohui Du
- Department of Administrative Management, Shanggang Community Health Service Center, Shanghai, China
| | - Xuemin Cai
- Department of Administrative Management, Laoshan Community Health Service Center, Qingdao, Shandong, China
| | - Yongjin Li
- Department of Administrative Management, Jinsong Community Health Service Center, Beijing, China
| | - Wei Wang
- Department of Administrative Management, Xinhua Shaocheng Community Health Service Center, Chengdu, Sichuan, China
| | - Tianwu Jiang
- Department of Administrative Management, Tianshui Wulin Street Community Health Service Center, Hangzhou, Zhejiang, China
| | - Qingyu Zhang
- Department of Administrative Management, Jiexin Village Community Health Service Center, Lanzhou, Gansu, China
| | - Lei Niu
- Department of Administrative Management, Xinglin Street Community Health Service Center, Hefei, Anhui, China
| | - Tiffany Junchen Tao
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Song XD, Gao HX, Tan H, Xie YY, Zhang X, Zhang CM, Wang YL, Dai EH. Prevalence of infection and reinfection among health care workers in a hospital of Northern China between BA.5/BF.7 and XBB.1.5 wave. Am J Infect Control 2024:S0196-6553(24)00643-6. [PMID: 39151826 DOI: 10.1016/j.ajic.2024.08.009] [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: 05/05/2024] [Revised: 08/06/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND To analyze the epidemiological characteristics of the SARS-CoV-2 infection and reinfection associated with the emergence of Omicron variant in Healthcare workers (HCWs). METHODS We enrolled 760 HCWs who received 2-4 vaccination doses of COVID-19 and followed by BA.5/BF.7 and/or XBB.1.5 breakthrough infections between December 2022 and July 2023. Serum sample from each individual were collected approximately 1,3 and 6 months after last exposure. IgM, IgG and Total antibodies against SARS-CoV-2 were measured by chemiluminescent immunoassay. Meanwhile, we created an Enterprise WeChat link for HCWs to self-report SARS-CoV-2 infections, symptoms and post COVID-19 conditions. RESULTS Our study revealed that the reinfection rate among HCWs reached 26.1%. The main symptoms were fever (91.2% vs 60.1%), cough (78.8% vs 58.0%), and sore throat (75.4% vs 59.6%) during infection and reinfection in Omicron BA.5/BF.7 and XBB.1.5 wave, and the interval for reinfection ranged from 91 to 210 days (median 152). Fatigue (23.6%), memory loss (18.8%) and coughing (18.6%) were the most prevalent long COVID symptoms, with a higher prevalence among female HCWs. CONCLUSIONS HCWs reinfection with SARS-CoV-2 causes milder symptoms, but high reinfection rate and short intervals. Strengthen infection prevention and control is crucial to mitigating infection risk and improving health services.
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Affiliation(s)
- Xue-Dong Song
- Department of Clinical Laboratory Medicine, Hebei Medical University, Shijiazhuang, Hebei, China; Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, China
| | - Hui-Xia Gao
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hao Tan
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yan-Yan Xie
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xin Zhang
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chen-Min Zhang
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yu-Ling Wang
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Er-Hei Dai
- Department of Clinical Laboratory Medicine, Hebei Medical University, Shijiazhuang, Hebei, China; Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China.
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5
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Polat A, Demircioğlu Z, Küçükali H. Are we heroes or couriers? A phenomenological study on reappropriation of professional subjectivity and agency among health professionals during COVID-19 contact tracing in Türkiye. Soc Sci Med 2024; 351:116924. [PMID: 38743991 DOI: 10.1016/j.socscimed.2024.116924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/05/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Abstract
During the COVID-19 pandemic, Türkiye implemented a distinctive contact tracing approach involving in-person home visits by medical professionals to individuals who tested positive for the virus. This study examines the experiences of health professionals involved in contact tracing, exploring how they reappropriated their professional subjectivity and agency during their deployment in this role. It is an interpretive phenomenological qualitative study. We conducted 21 semi-structured in-depth interviews, subsequently carried out two separate focus group interviews with an additional 31 participants from various districts in Istanbul. Participants were selected from different medical professions (i.e. doctors, nurses, midwives), career stages, gender and age groups, and hierarchical levels (i.e. officers and directors). Data analysis was conducted collaboratively by the research team from sociology and public health disciplines. Our main finding is that for the majority of health professionals, contact tracing was a novel experience with challenges and ambivalances. Yet, regardless of their perceptions (positive, negative, or mixed), the experience promoted a reaffirmation of professional identity and reappropriation of professional subjectivity and agency, which discloses that professional subjectivity is not firm but dynamic, carrying stability as well as flexibility and adjustment. Four main themes are identified in their reappropriation of professional subjectivity and agency: uncovering professional fulfillment, feeling restrained in professional dissatisfaction, assessing the job, and engaging in professional and bureaucratic negotiations.The profound exploration into the dynamics of contact tracing amidst the pandemic illuminates a multidimensional narrative that transcends the conventional discourse on physical and psychological stress experienced by medical professionals. Contact tracing experience had a transformative impact on meaning and purpose of professional identity. Our findings highlight a need for a balanced approach between centralized decision-making, mobilization of professionals, quantitative evaluation, and professional autonomy and discretion, qualitative assessments, and meaningful engagement.
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Affiliation(s)
- Ayşe Polat
- Istanbul Boğaziçi University, Faculty of Arts and Sciences, Department of Sociology, Istanbul, Türkiye
| | - Zübeyde Demircioğlu
- İstanbul Medeniyet University, Faculty of Arts and Humanities, Department of Sociology, Istanbul, Türkiye
| | - Hüseyin Küçükali
- Queen's University Belfast, Centre for Public Health, Belfast, UK; Istanbul Medipol University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
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6
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McEvoy M, Caccaviello G, Crombie A, Skinner T, Begg SJ, Faulkner P, McEvoy A, Masman K, Bamforth L, Parker C, Stanyer E, Collings A, Li X. Health and Wellbeing of Regional and Rural Australian Healthcare Workers during the COVID-19 Pandemic: Baseline Cross-Sectional Findings from the Loddon Mallee Healthcare Worker COVID-19 Study-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:649. [PMID: 38791863 PMCID: PMC11120829 DOI: 10.3390/ijerph21050649] [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: 04/04/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Coronavirus 19 (COVID-19) has created complex pressures and challenges for healthcare systems worldwide; however, little is known about the impacts COVID-19 has had on regional/rural healthcare workers. The Loddon Mallee Healthcare Worker COVID-19 Study (LMHCWCS) cohort was established to explore and describe the immediate and long-term impacts of the COVID-19 pandemic on regional and rural healthcare workers. METHODS Eligible healthcare workers employed within 23 different healthcare organisations located in the Loddon Mallee region of Victoria, Australia, were included. In this cohort study, a total of 1313 participants were recruited from November 2020-May 2021. Symptoms of depression, anxiety, post-traumatic stress, and burnout were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Impact of Events Scale-6 (IES-6), and Copenhagen Burnout Inventory (CBI), respectively. Resilience and optimism were measured using the Brief Resilience Scale and Life Orientation Test-Revised (LOT-R), respectively. Subjective fear of COVID-19 was measured using the Fear of COVID-19 Scale. RESULTS These cross-sectional baseline findings demonstrate that regional/rural healthcare workers were experiencing moderate/severe depressive symptoms (n = 211, 16.1%), moderate to severe anxiety symptoms (n = 193, 14.7%), and high personal or patient/client burnout with median total scores of 46.4 (IQR = 28.6) and 25.0 (IQR = 29.2), respectively. There was a moderate degree of COVID-19-related fear. However, most participants demonstrated a normal/high degree of resilience (n = 854, 65.0%). Based on self-reporting, 15.4% had a BMI from 18.5 to 24.9 kgm2 and 37.0% have a BMI of 25 kgm2 or over. Overall, 7.3% of participants reported they were current smokers and 20.6% reported alcohol consumption that is considered moderate/high-risk drinking. Only 21.2% of the sample reported consuming four or more serves of vegetables daily and 37.8% reported consuming two or more serves of fruit daily. There were 48.0% the sample who reported having poor sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI). CONCLUSION Regional/rural healthcare workers in Victoria, Australia, were experiencing a moderate to high degree of psychological distress during the early stages of the pandemic. However, most participants demonstrated a normal/high degree of resilience. Findings will be used to inform policy options to support healthcare workers in responding to future pandemics.
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Affiliation(s)
- Mark McEvoy
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | | | - Angela Crombie
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Timothy Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Stephen J. Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Peter Faulkner
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Anne McEvoy
- Kyabram District Health Service, Kyabram, VIC 3620, Australia;
| | - Kevin Masman
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Laura Bamforth
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Carol Parker
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Evan Stanyer
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Amanda Collings
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, VIC 3550, Australia;
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7
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Maple JL, Whiteside M, Smallwood N, Putland M, Baldwin P, Bismark M, Harrex W, Johnson D, Karimi L, Willis K. Culture, conditions and care support mental health of healthcare workers during crises. Occup Med (Lond) 2024; 74:211-217. [PMID: 38319824 DOI: 10.1093/occmed/kqae002] [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: 02/08/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has presented immense challenges to health systems worldwide and significantly impacted the mental health of frontline healthcare workers. AIMS This study drew on the experiences of frontline healthcare workers to examine organizational strategies needed to support the mental health and well-being of healthcare workers during times of crisis. METHODS Semi-structured focus groups or individual interviews were conducted with healthcare workers to examine their perspectives on organizational strategies for enhancing staff mental health and well-being during crises. Data were analysed thematically. Following this, evidence for the identified strategies was reviewed to assess alignment with participant views and recommendations. RESULTS Thirty-two healthcare workers from diverse disciplines (10 allied health, 11 nursing, 11 medical) participated in the study. Data analysis identified three broad themes contributing to supporting mental health and well-being. These themes can be encapsulated as the 'Three Cs'-culture (building an organizational culture that prioritizes mental health); conditions (implementing proactive organizational strategies during crises) and care (ensuring fit-for-purpose strategies to support mental health and well-being). CONCLUSIONS Study findings underscore the necessity of an integrated and systemic organizational approach to address mental health and well-being in the healthcare workplace. This approach must be long term with the components of the 'Three Cs', particularly cultural change and conditions, viewed as a part of a suite of strategies to ensure crisis preparedness. It is imperative that organizations collaborate with their staff, providing support and fostering a safe and inclusive work environment that ultimately benefits patients, their care and staff well-being.
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Affiliation(s)
- J L Maple
- Institute for Health and Sport, Victoria University, Footscray, Victoria 3011, Australia
| | - M Whiteside
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3000, Australia
| | - N Smallwood
- Department of Respiratory Medicine, The Alfred Hospital, Prahran, Victoria 3004, Australia
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Victoria 3004, Australia
| | - M Putland
- Department of Emergency Medicine, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
- Department of Critical Care, Faculty of Medicine, University of Melbourne, Parkville, Victoria 3010, Australia
| | - P Baldwin
- Black Dog Institute, Randwick, New South Wales 2031, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - M Bismark
- Centre for Health Policy, University of Melbourne, Parkville, Victoria 3010, Australia
| | - W Harrex
- Australasian Faculty of Occupational and Medicine, Royal Australasian College of Physicians, Sydney, New South Wales 2000, Australia
| | - D Johnson
- Department of General Medicine, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
| | - L Karimi
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria 3083, Australia
| | - K Willis
- Institute of Health and Sport, Victoria University, Footscray, Victoria 3011, Australia
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8
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Gamonal B, Quispe-Lizano R, Javier-Murillo N, Lapeyre-Rivera A, Perea-Flórez F, Velásquez-Rimachi V, Alva-Diaz C, Velazco-Gonzales G, Ahmed O, Chung S. Comparison of the Stress and Anxiety to Viral Epidemic-9 and SAVE-6 scales among healthcare workers in Peru. Front Psychiatry 2024; 15:1352896. [PMID: 38751417 PMCID: PMC11094251 DOI: 10.3389/fpsyt.2024.1352896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/29/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Peru is a country that has a high incidence of viral outbreaks and epidemics, which is why it is necessary to validate a scale that measures anxiety and stress in professionals who are on the front lines of these events. Therefore, our objective was to validate the Peruvian-Spanish version of the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) scale and to concurrently compare its validity and internal consistency with the SAVE-6 scale among healthcare workers (HCWs). Materials and methods We conducted a cross-sectional study based on data collected from a self-reported survey in paper-and-pencil format between April and July 2023. A total of 203 HCWs participated in the research. We developed a confirmatory factor analysis (CFA) and item response theory (IRT). We calculated Cronbach's α coefficient and McDonald's ω to assess the internal consistency of the scales. Results The results show that SAVE-9 (a two-factor model) and SAVE-6 (a one-factor model) provided an excellent fit in the confirmatory factor analysis. Both scales demonstrated strong internal consistency (Cronbach's α 0.85 and 0.86, respectively). Significant correlations were found between the SAVE-9 and SAVE-6 scales and Generalized Anxiety Disorder-7 items scale (r = 0.44 and r = 0.38, respectively, p < 0.001) as well as the Patient Health Questionnaire-9 items (r = 0.39 and r = 0.35, respectively, p < 0.001). The optimal cutoff points for SAVE-9 and SAVE-6 were identified for assessing anxiety, aligned with a GAD-7 score ≥5 points. Conclusion The Peruvian-Spanish SAVE-9 and SAVE-6 scales are reliable and valid rating scales to assess the anxiety response of HCWs in response to viral epidemics. Though COVID-19 is diminished, these scales will be useful for other viral epidemics in the future.
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Affiliation(s)
- Bryan Gamonal
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
| | | | - Nair Javier-Murillo
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
| | - André Lapeyre-Rivera
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
- Sociedad Científica de San Fernando, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Francisco Perea-Flórez
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
| | - Víctor Velásquez-Rimachi
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública (NEURONECS), Universidad Científica del Sur, Lima, Peru
| | - Carlos Alva-Diaz
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública (NEURONECS), Universidad Científica del Sur, Lima, Peru
- Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru
| | | | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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9
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Kitto C, Lamb D, Billings J. Responding to the call of the NHS Nightingale, but at what cost? An auto-ethnography of a volunteer frontline mental health trainer's experiences during the COVID-19 pandemic. J Health Psychol 2024; 29:534-551. [PMID: 38083867 DOI: 10.1177/13591053231213478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Healthcare workers, globally, volunteered time and skills to the COVID-19 pandemic frontline response. In March 2020, the predicted high demand for extra critical care beds led to the rapid construction of the UK National Health Service (NHS) Nightingale field hospital, London. I volunteered to develop and deliver psychological preparedness training - coined 'Psychological PPE' - to over 2300 frontline staff over an 8-week period. Existing research has identified broad themes of the impact working on the COVID-19 frontline has on healthcare workers but does not capture in-depth accounts of individuals' experiences. Using autoethnographic enquiry, this research explores my frontline experience at the NHS Nightingale during this time, and the personal impact this had on me. Reflexive thematic analysis explored themes of recognition and sacrifice, emotional lability and fragility, and the impact of transitions. Findings inform personal recovery, as well as future research and policy development pertaining to the sustainable recovery of our NHS people.
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Affiliation(s)
- Chloe Kitto
- UCL, UK
- Royal National Orthopaedic Hospital, UK
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10
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Ogello V, Thuo N, Okello P, Wairimu N, Mwangi P, Maina G, Mwenda H, Mutua P, Kinuthia J, Ongeri L, Mugo N, Ngure K. The Effects of the COVID-19 Pandemic on Healthcare Providers' Mental Health: Experiences at Kenyatta National Hospital, Kenya. Behav Sci (Basel) 2024; 14:351. [PMID: 38785842 PMCID: PMC11118936 DOI: 10.3390/bs14050351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND In 2020, healthcare providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19), putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers. METHODS Between April and August 2021, we conducted in-depth interviews with 60 healthcare providers in the infectious disease unit (IDU) and other units of the hospital (non-IDU). The healthcare providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand the healthcare providers' lived experiences of stress, anxiety, depression, and their associated factors. We transcribed the interviews verbatim and coded and analyzed the transcripts to derive thematic concepts related to mental health experiences. RESULTS The healthcare providers had a median age of 37 years [IQR 20.0-58.0], and 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. The healthcare providers reported increased stress during the pandemic, attributed to the high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that "COVID-19 resulted in death". Testing positive for COVID-19, high exposure to COVID-19 risks, and the death of patients and colleagues reportedly affected the healthcare providers' mental health. Additionally, the healthcare providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling, with privacy and confidentiality concerns. CONCLUSIONS Healthcare providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality.
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Affiliation(s)
- Vallery Ogello
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Nicholas Thuo
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Phelix Okello
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Njeri Wairimu
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Paul Mwangi
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Gakuo Maina
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | | | - Paul Mutua
- Kenyatta National Hospital, Nairobi 20723-00202, Kenya
| | - John Kinuthia
- Kenyatta National Hospital, Nairobi 20723-00202, Kenya
| | - Linnet Ongeri
- Kenya Medical Research Institute, Nairobi 54840-00200, Kenya
| | - Nelly Mugo
- Kenya Medical Research Institute, Nairobi 54840-00200, Kenya
- Department of Global Health, University of Washington, Seattle, WA 98105, USA
| | - Kenneth Ngure
- Department of Global Health, University of Washington, Seattle, WA 98105, USA
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi 62000-00200, Kenya
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11
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He H, Wang J, Yuan Z, Teng M, Wang S. Nurses' mental workload and public health emergency response capacity in COVID-19 pandemic: A cross-sectional study. J Adv Nurs 2024; 80:1429-1439. [PMID: 37937693 DOI: 10.1111/jan.15929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/19/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
AIMS The aim of this study was to assess the level of mental workload of Chinese nurses through a latent profile analysis and to explore its relationship with public health emergency response capacity. DESIGN A cross-sectional design with a convenience sample. METHODS A convenience sample of nurses from five tertiary hospitals in Chengdu between May and December 2022. Demographic, work-related information, Nurse's version of NASA's Task Load Index Scale and Nurse's Public Health Emergency Response Capacity Scale were used in this study. RESULTS The mean scores for mental workload and emergency response capacity for nurses were (57.19 ± 15.67) and (3.58 ± 0.77) respectively. We found that the mental workload of nurses fell into three potential categories. In addition, there were differences in psychological training and supply of epidemic prevention materials in the department among nurses with different mental workload subtypes. There was a moderate negative correlation between nurses' mental workload and public health emergency response capacity. CONCLUSION Our results show that there is still a strong mental workload on a proportion of nurses, and enhanced psychological training and material supply support are beneficial in relieving nurses' mental workload. The better the nurses' capacity to cope with public health emergencies, the lower their mental workload. IMPACT Nursing managers should pay ongoing attention to the mental workload status of nurses in the latter stages of a pandemic and individual differences in nurses' mental workload. In addition, nursing managers should be aware of the impact of public health emergency response capacity on nurses' mental workload. They can intervene in nurses mental workload from a new perspective. PATIENT OR PUBLIC CONTRIBUTION 560 registered nurses participated in this study.
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Affiliation(s)
- Hong He
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Jialin Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Zhongqing Yuan
- Department of Nursing, Sichuan Nursing Vocational College, Deyang City, Sichuan Province, China
| | - Mei Teng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Shuping Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
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12
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Wong KW, Wu X, Dong Y. Interventions to reduce burnout and improve the mental health of nurses during the COVID-19 pandemic: A systematic review of randomised controlled trials with meta-analysis. Int J Ment Health Nurs 2024; 33:324-343. [PMID: 37985559 DOI: 10.1111/inm.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023]
Abstract
This systematic review aims to investigate and determine the effectiveness of interventions on improving mental health (anxiety, depression, stress or mental well-being) and/or reducing burnout of nurses working in hospitals during the COVID-19 pandemic. A search was conducted on studies from conception to December 2022 in databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus and Web of Science and in ProQuest Thesis & Dissertations Global Database, Google Scholar and ClinicalTrials.gov. A total of 17 randomised controlled trials that evaluated different interventions were included. The outcomes were anxiety (n = 11), depression (n = 5), stress (n = 13) mental well-being (n = 7) and burnout (n = 7). Not all interventions led to positive outcomes. Grading of Recommendations Assessment, Development and Evaluation (GRADE) appraisal and risk of bias assessment using the Cochrane tool for randomised controlled trials (RoB 2.0) revealed poor quality of currently available literature, with low to very low certainty. Meta-analysis showed high heterogeneity among the five different outcomes, with subgroup analysis showing greater success in interventions conducted on nurses involved in the care of COVID-19 patients. More well-designed trials are necessary to reinforce current evidence to improve the mental health of nurses, to not only protect their quality of life but also to ensure the quality of patient care.
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Affiliation(s)
- Kang Wei Wong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Xinyao Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Yanhong Dong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
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13
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Zhang Y, Wu C, Ma J, Liu F, Shen C, Sun J, Ma Z, Hu W, Lang H. Relationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis. BMC Nurs 2024; 23:224. [PMID: 38561758 PMCID: PMC10983623 DOI: 10.1186/s12912-024-01867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses. METHOD A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure. RESULTS The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability. CONCLUSION The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.
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Affiliation(s)
- Yinjuan Zhang
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
- Department of Nursing, Shaanxi University of Chinese Medicine, Shiji Avenue, 712046, Xianyang, Shaanxi, China
| | - Chao Wu
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Jin Ma
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Fang Liu
- Department of Nursing, Shaanxi University of Chinese Medicine, Shiji Avenue, 712046, Xianyang, Shaanxi, China
| | - Chao Shen
- Department of Computer Science and Engineering, Xi'an Technological University, No. 4 Jinhua North Road, 710021, Xi'an, Shaanxi, China
| | - Jicheng Sun
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Zhujing Ma
- Department of Military Medical Psychology, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Wendong Hu
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China.
| | - Hongjuan Lang
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China.
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14
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Bifano SM, Szeglin CJ, Garbers S, Gold MA. Emotional Freedom Techniques (EFT) Tapping for Pediatric Emergency Department Staff During the COVID-19 Pandemic: Evaluation of a Pilot Intervention. Med Acupunct 2024; 36:70-78. [PMID: 38665925 PMCID: PMC11040184 DOI: 10.1089/acu.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Objective Emergency-department (ED) staff may experience psychologic distress due to the stressful nature of their work. The COVID-19 pandemic exacerbated this distress. Emotional Freedom Techniques (EFT) tapping, a somatic psychophysiologic intervention combining vibratory acupressure with elements of cognitive-behavioral and exposure therapies, can reduce psychologic distress. This study tested the short-term effect of 10-minute EFT tapping on the psychologic distress of pediatric ED staff responding to COVID-19. Materials and Methods During the COVID-19 pandemic, diverse staff in the pediatric ED of a New York City teaching hospital participated in this single-group study. A licensed creative arts therapist led participants in 10-minute EFT tapping sessions. A self-report questionnaire with 7 items based on the Trauma Exposure Response framework was administered immediately pre- and postintervention. Standardized mean differences between both timepoints were calculated. Results There were statistically significant reductions for 6 of the 7 items studied, including stress (3.32-2.14), obsessive and intrusive thoughts (2.50-1.85), feelings of pressure (3.20-2.17), loneliness (1.84-1.44), and emotional and physical pain (2.28-1.70); all P < 0.001. No significant changes in professional satisfaction were reported following the intervention. Conclusions Despite the limitations of a single-arm study design, a 10-minute brief EFT tapping session was a promising way to reduce short-term psychologic distress in pediatric ED health care workers. Future studies, including rigorous randomized controlled trials, are needed to evaluate the effectiveness of brief EFT tapping interventions in other settings.
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Affiliation(s)
- Susanne M. Bifano
- Creative Arts Therapy, New York–Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | | | - Samantha Garbers
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melanie A. Gold
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Pediatric, Columbia University Irving Medical Center, New York, NY, USA
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15
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Molnár L, Zana Á, Stauder A. Stress and burnout in the context of workplace psychosocial factors among mental health professionals during the later waves of the COVID-19 pandemic in Hungary. Front Psychiatry 2024; 15:1354612. [PMID: 38600983 PMCID: PMC11004466 DOI: 10.3389/fpsyt.2024.1354612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Background While literature is abundant on the negative mental health impact of the COVID-19 outbreak, few studies focus on the Central and Eastern European region. Objectives We examined stress, burnout, and sleeping troubles among mental health professionals in the context of psychosocial risk factors related to participation in COVID care during the fourth and fifth waves. Materials and methods Mental health professionals (N=268) completed an online cross-sectional survey in Hungary, between November 2021 and April 2022. Of the respondents, 58.2% directly participated in COVID care. The main data collection instrument was the Copenhagen Psychosocial Questionnaire (COPSOQ II), including 20 subscales on work-related psychosocial factors and 3 outcome scales (stress, burnout, and sleeping troubles). We added a question on competence transgression, and items on sociodemographic and professional background. Results Participation in COVID care was associated with higher work pace (59.08 versus 49.78), more role conflicts (55.21 versus 45.93), lower scores on the influence at work (38.18 versus 51.79), predictability (44.71 versus 57.03), reward (55.82 versus 65.03), role clarity (70.19 versus 75.37), social support from supervisor (59.24 versus 65.55), job satisfaction (54.36 versus 62.84), trust regarding management (55.89 versus 67.86), justice and respect (44.51 versus 54.35) scales. Among those involved in COVID care, only the stress score was higher (47.96 vs. 42.35) in the total sample; however, among psychiatrists, both stress (52.16 vs. 38.60) and burnout scores (58.30 vs. 47.06) were higher. Stepwise multiple regression revealed that work-family conflict, emotional demands and workplace commitment were independent predictors of higher stress and burnout scores; furthermore, competence transgression had a significant effect on stress, and being a psychiatric specialist had a significant effect on burnout. These models explained 40.5% of the variance for stress and 39.8% for burnout. Conclusion During the fourth and fifth waves, although COVID care was more well-organized, psychiatrists, as specialist physicians responsible for the quality of the care, were still experiencing challenges regarding their competence and influence at work, which may explain their increased levels of stress and burnout.
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Affiliation(s)
- László Molnár
- Doctoral School of Semmelweis University Budapest, Budapest, Hungary
| | - Ágnes Zana
- Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, Hungary
| | - Adrienne Stauder
- Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, Hungary
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16
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Pool M, Sorsdahl K, Myers B, van der Westhuizen C. The prevalence of and factors associated with depressive and anxiety symptoms during the COVID-19 pandemic among healthcare workers in South Africa. PLoS One 2024; 19:e0299584. [PMID: 38451982 PMCID: PMC10919616 DOI: 10.1371/journal.pone.0299584] [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: 06/26/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Healthcare workers globally have experienced increased social and occupational stressors in their working environments and communities because of COVID-19 which has increased the risk of mental health concerns. This study aimed to explore the prevalence and correlates of depression and anxiety amongst healthcare workers during the COVID-19 pandemic in the Western Cape, South Africa. In addition, role-related stressors and coping strategies were explored. MATERIAL AND METHODS We conducted a cross-sectional survey of doctors and nurses working in public healthcare facilities across the Western Cape, South Africa. Participants completed the Generalized Anxiety Disorder-7 (GAD-7), the Center for Epidemiologic Studies Depression (CES-D), the Professional Quality of Life (PROQL-R-IV), and the Brief Coping Orientation to Problems Experienced (COPE-R) scales. Data were analysed using multivariable logistic regression analysis. RESULTS The sample comprised 416 health workers (303 nurses, 113 doctors). Almost 40% of the sample (n = 161) had CES-D scores suggestive of probable depression, and 45.9% (n = 186) had GAD-7 scores suggestive of anxiety. In the logistic regression model, the odds of probable depression were higher for female participants compared to men (OR = 2.26, 95% CI 1.00-5.10) and for participants who used behavioural disengagement as a coping strategy (OR = 1.50, 95% CI 1.14-1.97). More time spent working with COVID patients was associated with increased odds of having high levels of anxiety [OR = 1.13, 95% CI (1.02-1.25). Substance use (OR = 1.39, 95% CI 1.08-1.81), venting (OR = 1.31, 95% CI 1.01-1.70), and self-blame (OR = 1.42, 95% CI 1.08-1.87) were some of the coping strategies used by healthcare workers. High levels of secondary traumatic stress and burnout were found to increase the odds of both depression and anxiety. CONCLUSION Findings of this study suggest that there is a high prevalence of mental health issues among healthcare workers, and a critical need to focus on workplace mental health interventions to support these frontline workers.
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Affiliation(s)
- Megan Pool
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Katherine Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Bronwyn Myers
- Curtin enAble Institute, Curtin University, Perth, Australia
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Claire van der Westhuizen
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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17
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Rojnic Kuzman M, Padberg F, Amann BL, Schouler-Ocak M, Bajic Z, Melartin T, James A, Beezhold J, Artigue Gómez J, Arango C, Jendricko T, Ismayilov J, Flannery W, Chumakov E, Başar K, Vahip S, Dudek D, Samochowiec J, Mihajlovic G, Rota F, Stoppe G, Dom G, Catthoor K, Chkonia E, Heitor Dos Santos MJ, Telles D, Falkai P, Courtet P, Patarák M, Izakova L, Skugarevski O, Barjaktarov S, Babic D, Racetovic G, Fiorillo A, Carpiniello B, Taube M, Melamed Y, Chihai J, Cozman DCM, Mohr P, Szekeres G, Delic M, Mazaliauskienė R, Tomcuk A, Maruta N, Gorwood P. Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries. Eur Psychiatry 2024; 67:e24. [PMID: 38450651 PMCID: PMC10988156 DOI: 10.1192/j.eurpsy.2024.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.
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Affiliation(s)
- Martina Rojnic Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Benedikt L. Amann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
- Mental Health Institute Hospital del Mar and Hospital del Mar Research Institute, Barcelona, CIBERSAM, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Meryam Schouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital Berlin, Berlin, Germany
| | - Zarko Bajic
- Research Unit “Dr. Mirko Grmek”, Psychiatric Clinic “Sveti Ivan”, Zagreb, Croatia
| | - Tarja Melartin
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Julian Beezhold
- Great Yarmouth Acute Service, Northgate Hospital/Norfolk & Suffolk NHS Foundation Trust, Great Yarmouth, UK
| | | | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | | | | | - William Flannery
- Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Egor Chumakov
- Department of Psychiatry and Addiction, Saint-Petersburg State University, Saint-Petersburg, Russia
| | - Koray Başar
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Simavi Vahip
- Affective Disorders Unit, Department of Psychiatry, Ege University Medicine Faculty, Izmir, Turkey
| | - Dominika Dudek
- Psychiatry and Department of Adult Psychiatry, Collegium Medicum Jagiellonian University, Cracow, Poland
| | | | - Goran Mihajlovic
- Clinic for Psychiatry, University of Kragujevac, Kragujevac, Serbia
| | - Fulvia Rota
- Swiss Society for Psychiatry and Psychotherapy, Switzerland
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Kirsten Catthoor
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Eka Chkonia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Maria João Heitor Dos Santos
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Medicina, Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Diogo Telles
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post Acute Care, Hôspital Lapeyronie, CHU Montpellier,Montpellier, France
| | - Michal Patarák
- Department of Psychiatry, Slovak Medical University, Bratislava, Slovakia
- Roosevelt Teaching Hospital, Banská Bystrica, Slovakia
| | - Lubomira Izakova
- Department of Psychiatry, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Oleg Skugarevski
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Stojan Barjaktarov
- University Clinic of Psychiatry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Dragan Babic
- Psychiatry Clinic, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Goran Racetovic
- Community Mental Health Center, Health Center Prijedor, Prijedor, Bosnia and Herzegovina
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Bernardo Carpiniello
- University of Cagliari and Psychiatry Unit, Section of Psychiatry, Department of Medical Sciences and Public Health, University Hospital, Cagliari, Italy
| | - Maris Taube
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | | | - Jana Chihai
- Department of Mental Health, Medical Psychology and Psychotherapy, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, Kishinev, Moldova
| | | | - Pavel Mohr
- Clinical Department, National Institute of Mental Health, Klecany, Czechia
- Third School of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Ramunė Mazaliauskienė
- Psychiatric Clinic, Lithuanian Health Sciences University Kaunas Hospital, Kaunas, Lithuania
| | | | - Nataliya Maruta
- Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
| | - Philip Gorwood
- Université Paris Cité, INSERM UMR1266, Paris, France
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
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18
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Schaffler Y, Probst T, Pieh C, Haid B, Humer E. Prevalence of mental health symptoms and potential risk factors among Austrian psychotherapists. Sci Rep 2024; 14:3888. [PMID: 38366010 PMCID: PMC10873375 DOI: 10.1038/s41598-024-54372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/12/2024] [Indexed: 02/18/2024] Open
Abstract
This research focused on the intricacies of mental health within the psychotherapist community, a domain currently understudied. A recent study suggests a better overall mental health profile for Austrian psychotherapists compared to the general population. However, a substantial proportion of psychotherapists still exhibited scores beyond the cut-off for clinically significant mental disorders, potentially undermining the efficacy of patient outcomes. A cross-sectional study was conducted between April to June 2023, enrolling a cohort of 502 Austrian psychotherapists (79.7% female; mean age: 53.4 ± 9.26 years). The analysis leveraged indicators for symptoms of depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), stress (PSS-4), and overall well-being (WHO-5). Key correlations were revealed using multivariable logistic regressions incorporating sociodemographic, work-related, and health behavior variables. Mental health symptoms in psychotherapists were associated with lower income, lesser physical activity, employment in outpatient facilities, less experience in the field, and a smaller patient load. Notably, physical activity emerged as a significant protective component, underscoring regular exercise as a vital self-care routine for psychotherapists. Adequate income also presented as a crucial contributor to mental health stability. These findings augment our understanding of the complex dynamics influencing psychotherapists' mental health, potentially enhancing their well-being and optimizing professional output.
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Affiliation(s)
- Yvonne Schaffler
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Thomas Probst
- Division of Psychotherapy, Department of Psychology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Christoph Pieh
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Elke Humer
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria.
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria.
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Küppers L, Göbel J, Aretz B, Rieger MA, Weltermann B. Associations between COVID-19 Pandemic-Related Overtime, Perceived Chronic Stress and Burnout Symptoms in German General Practitioners and Practice Personnel-A Prospective Study. Healthcare (Basel) 2024; 12:479. [PMID: 38391854 PMCID: PMC10888352 DOI: 10.3390/healthcare12040479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The mental burdens of general practitioners (GPs) and practice assistants (PrAs) during the COVID-19 pandemic are well investigated. Work-related conditions like overtime are known to contribute to perceived chronic stress and burnout symptoms. However, there is limited evidence regarding the specific mechanisms, which link pandemic-related overtime, chronic stress and burnout symptoms. This study used data from the IMPROVEjob trial to improve psychological well-being in general practice personnel. METHODS This prospective study with 226 German GPs and PrAs used the baseline (pre-pandemic: October 2019 to March 2020) and follow-up data (pandemic: October 2020 to April 2021) of the IMPROVEjob trial. Overtime was self-reported as hours above the regular work time. Perceived chronic stress was assessed using the Trier Inventory for the Assessment of Chronic Stress Screening Scale (TICS-SSCS), while burnout symptoms were evaluated using a short version of the Maslach Burnout Inventory (MBI). A mediation analysis investigated the differences of the three main variables between pre-pandemic and pandemic periods. RESULTS Burnout symptoms increased significantly from baseline to follow-up (p = 0.003). Overtime correlated positively with burnout symptoms (Total Effect: 0.13; 95% CI: 0.03, 0.23). Decomposition of the total effect revealed a significant indirect effect over perceived chronic stress (0.11; 95% CI: 0.06, 0.18) and no significant direct effect (0.02; 95% CI: -0.08, 0.12), indicating a full mediation. CONCLUSION In this large longitudinal study, pandemic-related overtime led to significantly higher levels of burnout symptoms, linked by a pathway through perceived chronic stress. Future prevention strategies need to aim at reducing the likelihood of overtime to ensure the mental well-being of practice personnel.
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Affiliation(s)
- Lucas Küppers
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Julian Göbel
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Benjamin Aretz
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
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20
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Lu L, Liu G, Xu Y, Jiang J, Wei Z. A systematic review of studies on stress during the COVID-19 pandemic by visualizing their structure through COOC, VOS viewer, and Cite Space software. Front Psychiatry 2024; 15:1297112. [PMID: 38333890 PMCID: PMC10850234 DOI: 10.3389/fpsyt.2024.1297112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Background The COVID-19 epidemic generated different forms of stress. From this period, there has been a remarkable increase in the quantity of studies on stress conducted by scholars. However, few used bibliometric analyses to focus on overall trends in the field. Purpose This study sought to understand the current status and trends in stress development during COVID-19, as well as the main research drives and themes in this field. Methods 2719 publications from the Web of Science(WOS) core repository on stress during COVID-19 were analyzed by utilizing Co-Occurrence (COOC), VOS viewer, and Cite Space bibliometric software. The overall features of research on stress during COVID-19 were concluded by analyzing the quantity of publications, keywords, countries, and institutions. Results The results indicated that the United States had the largest number of publications and collaborated closely with other countries with each other. University of Toronto was the most prolific institution worldwide. Visualization and analysis demonstrated that the influence of stress during COVID-19 on the work, life, mental and spiritual dimensions is a hot research topic. Among other things, the frequency of each keyword in research on stress during COVID-19 increased from 2021 to 2022, and the researchers expanded their scope and study population; the range of subjects included children, nurses, and college students, as well as studies focusing on different types of stress, and emphasizing the handling of stress. Conclusion Our findings reveal that the heat of stress research during COVID-19 has declined, and the main research forces come from the United States and China. Additionally, subsequent research should concern more on coping methods with stress, while using more quantitative and qualitative studies in the future.
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Affiliation(s)
- Liyun Lu
- College of Teacher Education, Nanjing Normal University, Nanjing, China
| | - Guiping Liu
- College of Teacher Education, Nanjing Normal University, Nanjing, China
| | - Yanhua Xu
- School of Geography and Environment, Jiangxi Normal University, Nanchang, China
| | - Jinxiu Jiang
- College of Teacher Education, East China Normal University, Shanghai, China
| | - Zizi Wei
- School of Geography and Environment, Jiangxi Normal University, Nanchang, China
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21
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Kalaitzaki A, Theodoratou M, Tsouvelas G, Tamiolaki A, Konstantakopoulos G. Coping profiles and their association with vicarious post-traumatic growth among nurses during the three waves of the COVID-19 pandemic. J Clin Nurs 2024. [PMID: 38225790 DOI: 10.1111/jocn.16988] [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: 04/21/2022] [Revised: 01/16/2023] [Accepted: 12/11/2023] [Indexed: 01/17/2024]
Abstract
AIMS This study aimed to examine (a) changes in coping strategies and vicarious post-traumatic growth (VPTG) across three timepoints of the COVID-19 pandemic among nurses; (b) discrete groups of nurses with unique coping profiles and (c) the association of these coping profiles with VPTG across the timepoints. BACKGROUND Although literature abounds with the negative mental health consequences of the pandemic among healthcare professionals, much less is known about the positive consequences on nurses, the coping strategies that they use, and how these change over time. DESIGN This was a cross-sectional web-based survey at three timepoints during the pandemic. METHODS A sample of 429 nurses completed online the Post-Traumatic Growth Inventory (PTGI) and the Brief Coping Orientation to Problems Experienced Inventory (COPE) to measure vicarious post-traumatic growth (VPTG) and coping strategies, respectively. The STROBE checklist was used to report the present study. RESULTS Significantly higher VPTG scores were observed during the third timepoint. Different coping strategies were employed across the three timepoints. Nurses responded to the pandemic either with an active, an avoidant or a passive coping profile. Significantly higher VPTG levels were reported by the nurses of the active profile compared to those of the passive profile, whereas the difference between active and avoidant profiles was not significant. CONCLUSIONS Notwithstanding the preponderance of the nurses with the active coping profile in achieving high VPTG, the avoidant copers had more gains (VPTG) than the passive copers, suggesting that doing something to cope with the stressor-let it be trying to avoid it-was better than doing nothing. RELEVANCE TO CLINICAL PRACTICE The identification of distinct coping profiles among nurses and their association with VPTG is of particular use to policymakers and practitioners in developing tailored prevention and intervention efforts to help the nurses effectively manage the demands of the pandemic. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution since the study was exclusively conducted by the authors.
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Affiliation(s)
- Argyroula Kalaitzaki
- Department of Social Work, Hellenic Mediterranean University, Heraklion, Greece
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
- Institute of AgriFood and Life Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | - Maria Theodoratou
- School of Humanistic Sciences, Hellenic Open University, Pafos, Cyprus
- School of Health Sciences, Neapolis University of Pafos, Pafos, Cyprus
| | - George Tsouvelas
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
- Department of Nursing, University of West Attica, Thessaloniki, Greece
| | - Alexandra Tamiolaki
- Department of Social Work, Hellenic Mediterranean University, Heraklion, Greece
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | - George Konstantakopoulos
- Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
- Department of Clinical, Education and Health Psychology, University College London, London, UK
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22
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Halms T, Thoma A, Kramer V, Kunz M, Falkai P, Schneider-Axmann T, Hierundar A, Wagner E, Hasan A, Papazova I. Higher Subjective Burden in Psychiatric Compared to Somatic Healthcare Workers in Germany During the first wave of the COVID-19 Pandemic. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024; 92:27-32. [PMID: 37567248 DOI: 10.1055/a-2125-8906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
The COVID-19 pandemic has posed unprecedented challenges for health care workers (HCWs) worldwide. While the adverse effects of the pandemic on the well-being of HCWs in general have now been established, little is known about the impact on HCWs of psychiatric hospitals (PHCWs). PHCWs are of special interest, given that they faced both an increase in infection rates among psychiatric patients as well as in mental strain of the general public due to consequences of the pandemic. The aim of the present study was to investigate how the pandemic affected PHCWs as well as possible differences between PHCWs and other health care workers (OHCWs) in Germany during the first wave of the pandemic. We conducted a country-wide anonymous online survey early during the first pandemic wave between April 15th and May 1st, 2020, to assess different aspects of subjective burden and perceived stress using 5-point Likert-scale questions. We analysed data of 1530 PHCWs and 2114 OHCWs and showed that PHCWs reported higher subjective burden and stress compared to OHCWs (p<0.001). Overall, nurses from both groups of HCWs showed higher ratings in subjective burden and stress than physicians. These higher ratings for subjective burden were even more pronounced for nurses working in psychiatric hospitals. Future research is needed to investigate the causes for PHCWs' increased stress and subjective burden, especially when taking into account the long-term effects of the pandemic, which may lead to further challenges and an ever-increasing workload, especially for PHCWs.
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Affiliation(s)
- Theresa Halms
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Andreas Thoma
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Victoria Kramer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Miriam Kunz
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | | | - Anke Hierundar
- Department of Anaesthesiology, University of Rostock, Rostock, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Irina Papazova
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
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23
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Korošec D, Vrbnjak D, Štiglic G. Prevalence of mental disorders and high rates of absenteeism from work among healthcare professionals in Slovenia: a retrospective study. BMJ Open 2023; 13:e075718. [PMID: 38070887 PMCID: PMC10729225 DOI: 10.1136/bmjopen-2023-075718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence of sick leave and medication prescriptions for treatment of mental health and behavioural disorders from 2015 to 2020. DESIGN Retrospective analysis of nationwide data on absenteeism and prescription of medications for treatment of mental health and behavioural disorders (anxiolytics, antipsychotics, antidepressants). SETTING National databases of the National Institute of Public Health in Slovenia. PARTICIPANTS All employed healthcare workers (35 008 in December 2020): dentists, midwives, nurses, nursing assistants, pharmacists and physicians in Slovenia from 2015 to 2020. RESULTS The most time spent on sick leave by male healthcare workers aged >50 was for 'neoplasms' (71.50 days on average), followed by 'mental health and behavioural disorders' (62.08 days on average). Female healthcare workers under 40 years old spent the most time on sick leave for 'pregnancy, childbirth, and the postpartum period (puerperium)', causing an average of 58.38 days of sick leave. From 2015 to 2020, the highest increase in prescribed medications for treatment of mental health and behavioural disorders was among nursing assistants (an increase of 38.42%), pharmacists (an increase of 29.36%) and nurses (an increase of 26.61%); since the COVID-19 pandemic, an increase of 12.36% was found among dentists, an increase of 11.51% among pharmacists and an increase of 11.36% among nurses. CONCLUSION The prescription of medications for treatment of mental health and behavioural disorders was on the rise from 2015 to 2020. The importance of employee health to individuals and society necessitates the systematisation of effective prevention programmes as well as programmes to assist those in need, especially health workers, whose work contributes significantly to maintaining public health.
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Affiliation(s)
- Darja Korošec
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
- University of Edinburgh, Usher Institute, Edinburgh, UK
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24
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St Marie BJ, Bai J, Knisely MR, Booker SQ, Saravanan A, Sowicz TJ. Experiences of Pain Management Nurses during the COVID-19 Pandemic: A Qualitative Study. Pain Manag Nurs 2023; 24:603-609. [PMID: 37806899 DOI: 10.1016/j.pmn.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The knowledge and skills of pain management nurses positions them well to manage people's pain and provide critical services to patients with COVID-19. AIM To understand the personal and professional experiences and the support pain management nurses received during the COVID-19 pandemic. METHODS Between July 2020 and 2021, data were collected through semi-structured telephone interviews from members of the American Society for Pain Management Nursing. Content analysis was used. RESULTS Eighteen pain management nurses who worked during the early stages of the pandemic were interviewed. Three main categories were identified: experiencing stress and burden, pain management strategies changed, learning to cope with support. Pain management nurses reported fear of exposure, difficulties with staff shortages, the complex social milieu, and how pain management took a backseat to other symptoms of COVID-19. They coped through support from their colleagues, organizational leaders, and community members. Pain management nurses provided recommendations for future care of patients' pain during a pandemic. CONCLUSIONS Pain management nurses shared their professional and personal experiences and the support they received while managing patients' pain during the COVID-19 pandemic. Their experiences provided findings on the importance of pain management and to support nurses during personal and professional vulnerabilities during crises. Key recommendations on the care of patients' pain in future pandemics included developing expertise in pain management and health-related emergencies; engaging nurses in supportive mental health services, infectious disease testing, and vaccine efforts; and planning for surge capacity to reach out to underserved people living with pain.
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Affiliation(s)
| | - Jinbing Bai
- Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA
| | | | - Staja Q Booker
- University of Florida, College of Nursing, Gainesville, FL
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25
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Hennein R, Tiako MJN, Bonumwezi J, Tineo P, Boatright D, Crusto C, Lowe SR. Vicarious Racism, Direct Racism, and Mental Health Among Racialized Minority Healthcare Workers. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01844-7. [PMID: 37935947 DOI: 10.1007/s40615-023-01844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Racism-related stress is a root cause of racial and ethnic disparities in mental health outcomes. An individual may be exposed to racism directly or vicariously by hearing about or observing people of the same racial and/or ethnic group experience racism. Although the healthcare setting is a venue by which healthcare workers experience both direct and vicarious racism, few studies have assessed the associations between direct and vicarious racism and mental health outcomes among healthcare workers. METHODS In this cross-sectional study, we assessed the relationships between direct and vicarious racism and symptoms of posttraumatic stress, depression, and anxiety among healthcare workers in the USA in 2022. RESULTS Our sample consisted of 259 healthcare workers identifying as a racialized minority, including 68 (26.3%) who identified as mixed-race, 61 (23.6%) East Asian, 36 (13.9%) Black, 33 (12.7%) South Asian, 22 (8.5%) Southeast Asian, 21 (8.1%) Middle Eastern/North African, and 18 (6.9%) another race. The mean age was 37.9 years (SD 10.1). In multivariable linear regression models that adjusted for demographics, work stressors, and social stressors, we found that increased reporting of vicarious racism was associated with greater symptoms of anxiety (B = 0.066, standard error = 0.034, p = .049). We did not identify significant relationships between vicarious and direct racism and symptoms of posttraumatic stress or depression in the fully adjusted models. CONCLUSIONS Our findings should be considered by academic health systems to mitigate the negative impact of racism on healthcare workers' mental health.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, USA.
- Yale School of Medicine, New Haven, CT, USA.
| | | | - Jessica Bonumwezi
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Petty Tineo
- Department of Psychology, Montclair State University, Montclair, NJ, USA
| | - Dowin Boatright
- Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Cindy Crusto
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, University of Pretoria, Pretoria, South Africa
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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26
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Loureiro SR, Zuardi AW, Silveira ILM, Crippa JADS, Hallak JEC, Osório FDL. Progression of the COVID-19 pandemic, Brazilian healthcare workers' emotional burden and the effects on professional fulfillment at the end of the third wave: a longitudinal study. Front Psychiatry 2023; 14:1237123. [PMID: 38025454 PMCID: PMC10657209 DOI: 10.3389/fpsyt.2023.1237123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Even though the long-term effects of the COVID-19 pandemic on healthcare workers' mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies. Objectives To assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths). Methods The sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment). Results Brazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased. Conclusion The lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic's chronic effects and the need for organizations to monitor these workers' mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.
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Affiliation(s)
- Sonia Regina Loureiro
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Antônio Waldo Zuardi
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | | | - José Alexandre de Souza Crippa
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Jaime Eduardo Cecílio Hallak
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Flávia de Lima Osório
- Ribeirão Preto Medical SchoolUniversity of São Paulo, Ribeirão Preto, Brazil
- National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
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27
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Zhang L, Gagné T, McMunn A. Changes in economic activity and mental distress among young adults during the COVID-19 pandemic: Differences between the first and second infection waves in the UK. PLoS One 2023; 18:e0292540. [PMID: 37851662 PMCID: PMC10584092 DOI: 10.1371/journal.pone.0292540] [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: 08/17/2022] [Accepted: 09/24/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND While infection rates, lockdown policies, and labor market conditions substantially varied across COVID-19 waves, the majority of evidence on young adults' mental health remains focused on initial responses in early 2020. The variability of the relationship between economic activity and mental health over time therefore remains poorly understood in this age group. METHODS Using linear mixed models, we investigated the relationship between current activity and changes in activity and mental distress (GHQ-12) among 1,390 young adults aged 16-34 via the UK Household Longitudinal Study COVID-19 survey. The association was explored in the first (from April to July 2020) and second (from September 2020 to March 2021) infection waves. Current activity was defined as "not working", "working <17.5 hours/week", "17.5-35 hours/week", and "> = 35 hours/week". Changes in activity were derived from current and pre-pandemic working hours and divided into four categories: "working with no reduced hours", "working fewer hours", "no longer working", and "did not work before the pandemic". RESULTS During the first wave, no association reached statistical significance. During the second wave: 1) compared to "currently not working", working 35 or more hours was associated with decreased distress (b = -1.54; 95%CI -2.39, -0.69) and working less than 17.5 hours was not (b = -0.62; 95%CI -1.66, 0.41); 2) compared to "working with no reduced hours compared with before the outbreak", no longer working was associated with increased distress (b = 1.58, 95%CI 0.61, 2.55) and working with reduced hours was not (b = 0.47, 95%CI -0.24, 1.17). CONCLUSION Above the mental health inequalities experienced at the start of the pandemic, full-time work-even with variation in work hours-continued to be a protective factor against mental distress among young adults during the second wave in the UK. Stable, full-time work can better support this age group's mental well-being over time.
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Affiliation(s)
- Linruo Zhang
- ESRC International Centre for Life Course Studies in Society & Health, Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Thierry Gagné
- ESRC International Centre for Life Course Studies in Society & Health, Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Anne McMunn
- ESRC International Centre for Life Course Studies in Society & Health, Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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28
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Bautista TG, Roman G, Khan M, Lee M, Sahbaz S, Duthely LM, Knippenberg A, Macias-Burgos MA, Davidson A, Scaramutti C, Gabrilove J, Pusek S, Mehta D, Bredella MA. What is well-being? A scoping review of the conceptual and operational definitions of occupational well-being. J Clin Transl Sci 2023; 7:e227. [PMID: 38028344 PMCID: PMC10643923 DOI: 10.1017/cts.2023.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Well-being is a multifaceted construct that is used across disciplines to portray a state of wellness, health, and happiness. While aspects of well-being seem universal, how it is depicted in the literature has substantial variation. The aim of this scoping review was to identify conceptual and operational definitions of well-being within the field of occupational health. Broad search terms were used related to well-being and scale/assessment. Inclusion criteria were (1) peer-reviewed articles, (2) published in English, (3) included a measure of well-being in the methods and results section of the article, and (4) empirical paper. The searches resulted in 4394 articles, 3733 articles were excluded by reading the abstract, 661 articles received a full review, and 273 articles were excluded after a full review, leaving 388 articles that met our inclusion criteria and were used to extract well-being assessment information. Many studies did not define well-being or link their conceptual definition to the operational assessment tool being used. There were 158 assessments of well-being represented across studies. Results highlight the lack of a consistent definitions of well-being and standardized measurements.
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Affiliation(s)
| | - Gretchen Roman
- University of Rochester Medical Center, Rochester, NY, USA
| | - Munziba Khan
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - Michele Lee
- Northern Arizona University, Flagstaff, AZ, USA
| | | | | | | | | | | | | | | | - Susan Pusek
- University of North Carolina School of Medicine, St. Chapel Hill, NC, USA
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van Diepen C, Vestjens L, Nieboer AP, Scheepers R. Nursing home staff perceptions of well-being during the COVID-19 pandemic: A qualitative study. J Adv Nurs 2023; 79:3866-3875. [PMID: 37309050 DOI: 10.1111/jan.15730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/25/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
AIMS To explore how nursing home staff perceived their work environment during the COVID-19 pandemic and how this impacted their well-being. DESIGN A qualitative interview study. METHODS Interviews were held with twenty-two registered nurses and assistant nurses from five nursing homes in the Netherlands between April 2021 and July 2021. The interviews were analysed using qualitative content analysis. The Standards for Reporting Qualitative Research (SRQR) were followed. RESULTS Five themes emerged from the interviews and indicated that working during the COVID-19 pandemic impacted perceived well-being of nursing home staff. Three themes concerned experiences at work: eroding care, additional roles and workplace support. Specifically, the increased workload with additional tasks, the constant stream of new guidelines and constrictive personal protective equipment caused discomfort and anxiety. Two other themes concerned experiences outside of work: work-life interference and social interactions and status. The nurses reported that when they returned home after work, they were tired and worried about spreading the virus while facing limited social interactions and support. CONCLUSION The social distancing measures due to the COVID-19 pandemic negatively impacted nursing home staff well-being by increasing demands in the absence of adequate resources. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The well-being needs of nurses should receive continued attention to ensure the sustainability of healthcare during future crises. PATIENT OR PUBLIC CONTRIBUTION The nursing home managers participated in recommending the topics to be covered during interviews. IMPACT What problem did the study address? The pressure of stressful working conditions on the well-being of nurses during the pandemic. What were the main findings? Nurses created strategies to cope with declining well-being. However, the available resources did not alleviate the increased demands caused by the pandemic. Where and on whom will the research have an impact? This study is important for healthcare organizations to understand how the COVID-19 pandemic affected nurses so that they may better prepare for future crises.
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Affiliation(s)
- Cornelia van Diepen
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Lotte Vestjens
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
- De Zorggroep Noord- en Midden-Limburg, Venlo-Blerick, the Netherlands
| | - Anna P Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Renée Scheepers
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Tian H, Qiao T, Teng J, Kang C, Ke J, Shan L, Li M, Shen C, Han Y. Factors associated with depression among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Psychol Med 2023:1-10. [PMID: 37712399 DOI: 10.1017/s0033291723002271] [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] [Indexed: 09/16/2023]
Abstract
The COVID-19 pandemic has had a profound impact on the mental health of healthcare workers (HCWs). We aimed to identify the factors associated with depression among HCWs during the pandemic. We conducted literature search using eight electronic databases up to July 27 2022. Observational studies with more than 200 participants investigating correlates of depression in HCWs after COVID-19 outbreak were included. We used fixed- and random-effects models to pool odds ratios (ORs) across studies, and Cochran's chi-squared test and I 2 statistics to assess study heterogeneity. Publication bias was evaluated by funnel plots. Thirty-five studies involving 44,362 HCWs met the inclusion criteria. Female (OR=1.50, 95% CI [1.23,1.84]), single (OR=1.36, 95% CI [1.21,1.54]), nurse (OR=1.69, 95% CI [1.28,2.25]), history of mental diseases (OR=2.53, 95% CI [1.78,3.58]), frontline (OR=1.79, 95% CI [1.38,2.32]), health anxiety due to COVID-19 (OR=1.88, 95% CI [1.29,2.76]), working in isolation wards (OR=1.98, 95% CI [1.38,2.84]), and insufficient personal protective equipment (OR=1.49, 95% CI [1.33,1.67]) were associated with increased risk of depression. Instead, HCWs with a positive professional prospect (OR=0.34, 95% CI [0.24,0.49]) were less likely to be depressed. This meta-analysis provides up-to-date evidence on the factors linked to depression among HCWs during the COVID-19 pandemic. Given the persistent threats posed by COVID-19, early screening is crucial for the intervention and prevention of depression in HCWs.
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Affiliation(s)
- Haoyu Tian
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tianci Qiao
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Teng
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chen Kang
- Second Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jia Ke
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lili Shan
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengting Li
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun Shen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Yan Han
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Baldassini Rodriguez S, Bardacci Y, El Aoufy K, Bazzini M, Caruso C, Giusti GD, Mezzetti A, Lucchini A, Iozzo P, Guazzini A, Magi CE, Iovino P, Longobucco Y, Rasero L, Bambi S. Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic. NURSING REPORTS 2023; 13:1203-1215. [PMID: 37755346 PMCID: PMC10538004 DOI: 10.3390/nursrep13030103] [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: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. MATERIALS AND METHODS A descriptive-exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State-Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). RESULTS a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = -0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. DISCUSSION AND CONCLUSION Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.
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Affiliation(s)
- Samuele Baldassini Rodriguez
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, 50134 Florence, Italy; (S.B.R.); (Y.B.); (M.B.)
| | - Yari Bardacci
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, 50134 Florence, Italy; (S.B.R.); (Y.B.); (M.B.)
| | - Khadija El Aoufy
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marco Bazzini
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, 50134 Florence, Italy; (S.B.R.); (Y.B.); (M.B.)
| | - Christian Caruso
- Emergency Medical System—AUSL Toscana Centro, 50122 Florence, Italy; (C.C.); (A.M.)
| | - Gian Domenico Giusti
- Medicine and Surgery Department, University of Perugia, 06100 Perugia, Italy;
- Teaching and Quality Department, Perugia University Hospital, 06100 Perugia, Italy
| | - Andrea Mezzetti
- Emergency Medical System—AUSL Toscana Centro, 50122 Florence, Italy; (C.C.); (A.M.)
| | - Alberto Lucchini
- UOS Terapia Intensiva Generale e UOSD Emergenza Intraospedaliera e Trauma Team, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Pasquale Iozzo
- Emergency Department, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, 90100 Palermo, Italy;
| | - Andrea Guazzini
- Department of Education, Languages, Intercultural Studies, Literatures and Psychology, University of Florence, 50135 Florence, Italy;
- Center for the Study of Complex Dynamics (CSDC), University of Florence, 50134 Florence, Italy
| | - Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
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Oyama N, Seki M, Nakai M, Miyamoto K, Nagao K, Morimitsu R. Depressive symptoms, burnout, resilience, and psychosocial support in healthcare workers during the COVID-19 pandemic: A nationwide study in Japan. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e136. [PMID: 38867835 PMCID: PMC11114275 DOI: 10.1002/pcn5.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 06/14/2024]
Abstract
Aim The coronavirus disease 2019 pandemic has significantly impacted the mental health of healthcare workers. This study aimed to assess the mental health of healthcare workers and identify risk and protective factors. Methods We surveyed 48,031 healthcare workers at 63 Japanese Red Cross hospitals from December 15, 2022 to January 15, 2023. Mental health was assessed using the Center for Epidemiologic Studies Depression Scale, the Japanese Burnout Scale, and 10-item Connor-Davidson Resilience Scale. Furthermore, we inquired about the psychosocial support activities provided to the healthcare workers within their workplaces. Results This study included 3815 healthcare workers (250 doctors, 32 residents, 2588 nurses, 504 co-medical staff, and 441 administrative staff). Symptoms of depression were noted in 31.5% of all participants and 46.9% of resident doctors. Women and those who were young, lived alone, had a nonmanagement position, had contact with coronavirus disease 2019 patients, or had passive motivation to coronavirus disease 2019 work had a significantly higher total Center for Epidemiologic Studies Depression Scale score than in the corresponding groups with the opposite characteristics. High emotional exhaustion and depersonalization scores on the Japanese Burnout Scale were risk factors for depressive symptoms, while living with family was a protective factor. Moreover, interventions such as job performance support (skills, knowledge, information, and safety), peer support, and organizational support (infection control team, patient care rotation systems) were effective. Conclusion The impact of the prolonged coronavirus pandemic on mental health among healthcare workers is clear, and organized psychosocial support is needed.
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Affiliation(s)
- Nene Oyama
- Psychosocial Support Unit, Disaster Management Research InstituteJapanese Red Cross College of Nursing
| | - Mayumi Seki
- Psychosocial Support Unit, Disaster Management Research InstituteJapanese Red Cross College of Nursing
| | - Mari Nakai
- Psychosocial Support Unit, Disaster Management Research InstituteJapanese Red Cross College of Nursing
| | - Kyoko Miyamoto
- Psychosocial Support Unit, Disaster Management Research InstituteJapanese Red Cross College of Nursing
| | - Kayoko Nagao
- Psychosocial Support Unit, Disaster Management Research InstituteJapanese Red Cross College of Nursing
| | - Reo Morimitsu
- Psychosocial Support Unit, Disaster Management Research InstituteJapanese Red Cross College of Nursing
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Tsang VWL, Ragazan DC, Kryskow P, Walsh Z, Dames S. A Pilot Study Comparing a Community of Practice Program with and without Concurrent Ketamine-Assisted Therapy. J Psychoactive Drugs 2023:1-10. [PMID: 37655532 DOI: 10.1080/02791072.2023.2253798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/21/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023]
Abstract
The prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) has increased among healthcare providers, while the effectiveness of conventional treatments remains limited. Ketamine-assisted therapy offers a promising alternative; however, few have integrated ketamine with a group-based therapeutic modality. We report a retrospective, secondary analysis of a 12-week pilot of a Community of Practice (CoP) oriented group therapy program with optional, adjunct ketamine for depression, anxiety, and PTSD in a sample of 57 healthcare providers. All participants moved through the treatment as one group, with 38 electing to also receive three adjunct ketamine sessions in addition to the weekly CoP. Symptoms were assessed at baseline and pilot completion with the PHQ-9 for depression, GAD-7 for anxiety, and PCL-5 for PTSD. We observed significant reductions in the mean change among all participants, suggesting that benefit was derived from the CoP component, with or without ketamine as an adjunct. PHQ-9 scores decreased by 6.79 (95% CI: 5.09-8.49, p < .001), GAD-7 scores decreased by 5.57 (CI: 4.12-7.00, p < .001), and PCL-5 scores decreased by 14.83 (CI: 10.27-19.38, p < .001). Reductions were larger, but statistically nonsignificant, among those receiving ketamine. Further research is required to assess the impact of ketamine as an adjunct in group-based therapies.
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Affiliation(s)
- Vivian W L Tsang
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Dragos C Ragazan
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Pamela Kryskow
- Health and Human Services, Vancouver Island University, Nanaimo, BC, Canada
- Department of Family Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zach Walsh
- Department of Psychology, University of British Columbia, Kelowna, BC, Canada
| | - Shannon Dames
- Health and Human Services, Vancouver Island University, Nanaimo, BC, Canada
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Smallwood N, Bismark M, Willis K. Burn-out in the health workforce during the COVID-19 pandemic: opportunities for workplace and leadership approaches to improve well-being. BMJ LEADER 2023; 7:178-181. [PMID: 37192091 DOI: 10.1136/leader-2022-000687] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/25/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Burn-out is a long-standing problem among healthcare workers (HCWs) and leads to poorer quality and less safe patient care, lower patient satisfaction, absenteeism and reduced workforce retention. Crises such as the pandemic not only generate new challenges but also intensify existing workplace stresses and chronic workforce shortages. As the COVID-19 pandemic continues, the global health workforce is burnt-out and under immense pressure, with multiple individual, organisational and healthcare system drivers. METHOD In this article, we examine how key organisational and leadership approaches can facilitate mental health support for HCWs and identify strategies to support HCWs that are critical for supporting workforce well-being during the pandemic. RESULTS We identified 12 key approaches at the organisational and individual levels for healthcare leadership to support workforce well-being during the COVID-19 crisis. These approaches may inform leadership responses to future crises. CONCLUSION Governments, healthcare organisations and leaders must invest and deliver long-term measures to value, support and retain the health workforce to preserve high-quality healthcare.
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Affiliation(s)
- Natasha Smallwood
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
- Respiratory Research@Alfred, Central Clinical School, The Alfred Hospital, Monash University, Clayton, Victoria, Australia
| | - Marie Bismark
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Karen Willis
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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Laza R, Lustrea A, Lazureanu VE, Marinescu AR, Nicolescu N, Herlo A, Cut TG, Porosnicu TM, Papava I, Romosan RS, Romosan AM, Bondrescu M, Dimeny CZ, Nica-Bacaiteanu CB, Andor M, Dehelean L. Untangling the Professional Web: Understanding the Impact of Work-Related Factors on the Mental Health of Healthcare Professionals During the Late Stages of Covid-19 Pandemic. J Multidiscip Healthc 2023; 16:2391-2404. [PMID: 37609050 PMCID: PMC10441651 DOI: 10.2147/jmdh.s424563] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose The COVID-19 pandemic has determined an extraordinary challenge to healthcare systems worldwide. The extraordinary circumstances, characterized by elevated stress levels, prolonged working hours, new medical procedures, media attention, and high population expectations, have created an extremely stressful situation for healthcare professionals. This period has offered a unique opportunity to examine the medical system and the responses of healthcare practitioners to stress. This research aimed to identify the work-related factors that significantly impact the mental health of healthcare professionals. Patients and Methods Three mental health variables were assessed: anxiety, depression and stress. The work-related factors considered were professional degree, type of medical unit (COVID or non-COVID), the number of hours spent at work in a single shift, type of shifts, monthly on-call frequency, and number of COVID-19 treated patients per month. In the spring of 2022, three inventories and a demographic survey were distributed and completed online by 300 healthcare professionals from Timisoara's public hospitals in Romania. Results Among the respondents, 47.7% reported mild symptoms of anxiety, 65.3% reported moderate levels of stress, and 33% of the participants reported mild symptoms of depression. The intensity of anxious, depressive, and stress symptoms varied significantly depending on the professional degree, number of on-calls per month, the type of medical unit where the participants worked, and the number of SARS CoV-2 patients treated in the previous month. Conclusion Current data underlines the urgency of implementing effective strategies to reduce the stress and anxiety of medical practitioners who work with COVID-19 patients. Possible interventions encompass a variety of approaches, such as improving working conditions, reducing working hours where possible, increasing access to mental health services, and promoting team-building activities to enhance social support among colleagues. Digital mental health interventions, including online counseling and stress management programs, have also shown promise in these challenging times. Sustaining the mental health of medical practitioners is vital to support the continued provision of first-rate care to patients and to build a resilient healthcare workforce capable of navigating future health crises.
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Affiliation(s)
- Ruxandra Laza
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Anca Lustrea
- Department of Educational Sciences, University Clinic of Therapies and Psycho-Pedagogical Counseling, West University of Timisoara, Timisoara, Romania
| | - Voichita Elena Lazureanu
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Adelina Raluca Marinescu
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Narcisa Nicolescu
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Alexandra Herlo
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Talida Georgiana Cut
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Doctoral School Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Tamara Mirela Porosnicu
- Doctoral School Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Intensive Care Unit, Victor Babes Clinical Hospital of Infectious Diseases and Pneumophtisiology Timisoara, Timisoara, Romania
| | - Ion Papava
- Department of Neurosciences-Psychiatry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Radu Stefan Romosan
- Department of Neurosciences-Psychiatry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Ana-Maria Romosan
- Department of Neurosciences-Psychiatry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Mariana Bondrescu
- Doctoral School Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Department of Neurosciences-Psychiatry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Cristian Zoltan Dimeny
- Department of Psychiatry, Timis County Emergency Clinical Hospital Pius Brinzeu, Timisoara, Romania
| | | | - Minodora Andor
- Department of Medical Semiology II, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Multidisciplinary Heart Research Center, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Liana Dehelean
- Department of Neurosciences-Psychiatry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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Navario PS, Upadhaya N, Hall BJ, Yang LH. Editorial: Global mental health among marginalized communities in pandemic emergencies. Front Public Health 2023; 11:1249575. [PMID: 37546296 PMCID: PMC10402728 DOI: 10.3389/fpubh.2023.1249575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Affiliation(s)
- Peter S. Navario
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, United States
- HealthRight International, New York, NY, United States
| | | | - Brian J. Hall
- New York University School of Global Public Health, New York, NY, United States
- NYU Shanghai Center for Global Health Equity, Shanghai, China
| | - Lawrence H. Yang
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
- Columbia University Mailman School of Public Health, New York, NY, United States
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Hennein R, Poulin R, Gorman H, Lowe SR. Gender Discrimination and Mental Health Among Health Care Workers: Findings from a Mixed Methods Study. J Womens Health (Larchmt) 2023; 32:823-835. [PMID: 37256783 PMCID: PMC10354310 DOI: 10.1089/jwh.2022.0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Background: Gender discrimination among healthcare workers (HCWs) negatively impacts their mental health and career development; however, few studies have explored how experiences of gender discrimination change during times of health system strain. Methods: This survey-based study assesses the associations between gender discrimination and four stress-related mental health outcomes (posttraumatic stress, depression, anxiety, and burnout), as well as the qualitative experiences of gender discrimination in healthcare during the COVID-19 pandemic. Results: Among women, increased gender discrimination was associated with heightened symptoms of posttraumatic stress, depression, anxiety, and burnout after adjusting for demographics and pandemic-related stressors; however, among men, increased gender discrimination was only associated with heightened symptoms of depression. Using thematic analysis, we identified five themes that describe experiences of gender discrimination faced by women in healthcare, including differential valuing of work and contributions, gendered roles and assumptions about roles, maternal discrimination, objectification, and "old boys club." We also identified two themes describing how men perceived gender discrimination, including instances of symbolic discrimination and woman provider preference. Conclusion: These findings suggest that experiences of gender discrimination persist during times of health system strain and negatively impact women HCWs' mental health.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Rhayna Poulin
- Yale College, Yale University, New Haven, Connecticut, USA
| | - Hannah Gorman
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Sarah R. Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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Watanuki S, Kayama M. Foreseeing the unforeseen: Towards mental health and gerontic nursing perspectives. Glob Health Med 2023; 5:125-127. [PMID: 37397951 PMCID: PMC10311672 DOI: 10.35772/ghm.2023.01068] [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: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
With the theme of "Foreseeing the Unforeseen: Towards a New Era of Nursing", this special issue on nursing includes a variety of articles from different countries and institutions. Several key features of this issue include: i) the impact and responses/countermeasures to the coronavirus disease (COVID-19) pandemic; ii) innovative nursing practice, management, education, research, and policy in response to the issues raised; iii) nursing toward a low fertility and a super-aged society, internationalization, or cultural diversity; and iv) human resource development, systems development, and policy recommendations for health, medical care, and welfare in the next era. In this Editorial article, we summarize the issues during the COVID-19 pandemic and the implications for the next era, particularly in the fields of mental health and gerontic nursing. We also provide several perspectives on mental health issues in the general population and for nurses, as well as gerontic nursing issues related to older adults.
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Affiliation(s)
- Shigeaki Watanuki
- Address correspondence to:Shigeaki Watanuki and Mami Kayama, National College of Nursing, Japan, 1-2-1 Umezono, Kiyose-City, Tokyo 204-8575, Japan. E-mail: (SW), . ac.jp (MK)
| | - Mami Kayama
- Address correspondence to:Shigeaki Watanuki and Mami Kayama, National College of Nursing, Japan, 1-2-1 Umezono, Kiyose-City, Tokyo 204-8575, Japan. E-mail: (SW), . ac.jp (MK)
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Kuznetsova E, Moskvicheva N, Zinovyeva E, Kostromina S. Coping Strategies During the COVID-19 Pandemic and Self-Determination: A Review of Russian Studies. PSYCHOLOGY IN RUSSIA: STATE OF ART 2023; 16:3-21. [PMID: 37818342 PMCID: PMC10561783 DOI: 10.11621/pir.2023.0201] [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: 05/04/2023] [Accepted: 06/06/2023] [Indexed: 10/12/2023] Open
Abstract
Background The COVID-19 pandemic is a multifaceted stressor. Its impact suggests long-term psychological effects. Self-determination promotes flexibility of goals and actions and helps to overcome the difficulties caused by stress. Objective To analyze coping strategies during the COVID-19 pandemic presented in Russian scientific studies (RQ1), and their relationship with self-determination (RQ2). Design Relevant studies (2020-2022) were selected from the Russian citation index (RSCI) database. Strict selection criteria were used. Twenty-four articles were selected for the final review. For dynamic analysis, four stages of the pandemic were identified. Results Prevailing coping strategies have changed over time. At the beginning of the pandemic, respondents used familiar coping mechanisms. Six months later, active coping strategies were more often used, but deprivation and avoidance strategies increased. A year later, there was an increase in denial and avoidance strategies. Using non-constructive coping strategies may indicate that, due to the long course of the pandemic, meeting basic psychological needs became increasingly frustrated, leading to helplessness, alienation, and lack of control. Later dynamics reflect the growth of effective coping strategies and confirm that when basic needs are blocked for a long time, people seek alternative ways to satisfy them. Conclusion The dynamics of coping strategies during the pandemic reflected their close relationship with basic psychological needs, as described in the theory of self-determination. The results confirmed the importance of self-determination as a dispositional variable in predicting coping mechanisms.
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Paromita P, Mundnich K, Nadarajan A, Booth BM, Narayanan SS, Chaspari T. Modeling inter-individual differences in ambulatory-based multimodal signals via metric learning: a case study of personalized well-being estimation of healthcare workers. Front Digit Health 2023; 5:1195795. [PMID: 37363272 PMCID: PMC10289192 DOI: 10.3389/fdgth.2023.1195795] [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: 03/28/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Intelligent ambulatory tracking can assist in the automatic detection of psychological and emotional states relevant to the mental health changes of professionals with high-stakes job responsibilities, such as healthcare workers. However, well-known differences in the variability of ambulatory data across individuals challenge many existing automated approaches seeking to learn a generalizable means of well-being estimation. This paper proposes a novel metric learning technique that improves the accuracy and generalizability of automated well-being estimation by reducing inter-individual variability while preserving the variability pertaining to the behavioral construct. Methods The metric learning technique implemented in this paper entails learning a transformed multimodal feature space from pairwise similarity information between (dis)similar samples per participant via a Siamese neural network. Improved accuracy via personalization is further achieved by considering the trait characteristics of each individual as additional input to the metric learning models, as well as individual trait base cluster criteria to group participants followed by training a metric learning model for each group. Results The outcomes of the proposed models demonstrate significant improvement over the other inter-individual variability reduction and deep neural baseline methods for stress, anxiety, positive affect, and negative affect. Discussion This study lays the foundation for accurate estimation of psychological and emotional states in realistic and ambulatory environments leading to early diagnosis of mental health changes and enabling just-in-time adaptive interventions.
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Affiliation(s)
- Projna Paromita
- HUman Bio-Behavioral Signals Lab, Texas A & M University, College Station, TX, United States
| | - Karel Mundnich
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Amrutha Nadarajan
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Brandon M. Booth
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Shrikanth S. Narayanan
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Theodora Chaspari
- HUman Bio-Behavioral Signals Lab, Texas A & M University, College Station, TX, United States
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Marchand V, Watt MH, Minja LM, Barabara ML, Mlay J, Stephens MJ, Hanson O, Mmbaga BT, Cohen SR. Burnout among labor and birth providers in northern Tanzania: A mixed-method study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.28.23290395. [PMID: 37398023 PMCID: PMC10312826 DOI: 10.1101/2023.05.28.23290395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of accomplishment, is a serious problem among healthcare workers. Burnout negatively impacts provider well-being, patient outcomes, and healthcare systems globally, and is especially worrisome in settings with a shortage of healthcare workers and resources. The goal of this study is to explore the experience of burnout in a population of labor and delivery (L&D) providers in Tanzania. We examined burnout using three data sources. A structured assessment of burnout was collected at four time points from a sample of 60 L&D providers in six clinics. The same providers participated in an interactive group activity from which we drew observational data on burnout prevalence. Finally, we conducted in-depth interviews (IDIs) with a subset of 15 providers to further explore their experience of burnout. At baseline, prior to any introduction to the concept, 18% of respondents met criteria for burnout. Immediately after a discussion and activity on burnout, 62% of providers met criteria. One- and three- months later, 29% and 33% of providers met criteria, respectively. In IDIs, participants saw the lack of understanding of burnout as the cause for low baseline rates and attributed the subsequent decrease in burnout to newly acquired coping strategies. The activity helped providers realize they were not alone in their experience of burnout. High patient load, low staffing, limited resources, and low pay emerged as contributing factors. Burnout was prevalent among a sample of L&D providers in northern Tanzania. However, a lack of exposure to the concept of burnout leads to providers being unaware of the issue as a collective burden. Therefore, burnout remains rarely discussed and not addressed, thus continuing to impact provider and patient health. Previously validated burnout measures cannot adequately assess burnout without a discussion of the context.
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Affiliation(s)
| | - Melissa H Watt
- University of Utah, Department of Population Health Sciences, Salt Lake City, Utah, USA
| | - Linda M Minja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | - Janeth Mlay
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Maya J Stephens
- University of Utah, Department of Population Health Sciences, Salt Lake City, Utah, USA
| | - Olivia Hanson
- University of Utah, Department of Population Health Sciences, Salt Lake City, Utah, USA
| | | | - Susanna R Cohen
- University of Utah, Department of Obstetrics and Gynecology, Salt Lake City, Utah, USA
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Roulston A, Ross J, Dobrikova P, Piccione T, Reigada C, Mackova M, Wasner M. The impact of COVID-19 on palliative care social work: An online survey by a European Association of Palliative Care Task Force. Palliat Med 2023; 37:884-892. [PMID: 37038744 PMCID: PMC10186133 DOI: 10.1177/02692163231167938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND The SARS-Cov-2 (COVID-19) pandemic affected the delivery of health and social care services globally. However, little is known about how palliative care social work services were impacted. AIM The aim of this study was to capture and analyse data from palliative care social workers who provided professional support in a range of settings across 21 countries during the COVID-19 pandemic. DESIGN A cross-sectional survey-based design was used for this empirical study and this paper primarily focuses on the quantitative responses. SETTING/PARTICIPANTS Participants, palliative care social workers, were drawn internationally via members of the EAPC Social Work Task Force and the World Hospice Palliative Care Social Work network. RESULTS We received 362 survey responses from 21 countries. Most (79%) respondents worked with adults in in-patient units or hospitals. The number of referrals during COVID-19 increased more in non-European countries, compared to European countries. The full range of social work services could no longer be delivered, existing services changed and 65.3% of participants reported higher levels of pressure during the pandemic, which was linked to higher levels of staff absence and additional duties. For many respondents (40.8%), this included facilitating online communication between patients and their families. CONCLUSIONS Our findings indicate that restrictions to limit the spread of COVID-19 resulted in adaptations to service delivery, increased pressure on staff and moral distress, like other health and social care professions. All members of the palliative team need support and supervision to ensure effective interdisciplinary working and team cohesion.
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Affiliation(s)
- Audrey Roulston
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Northern Ireland, UK
| | - Jana Ross
- Queen’s University Belfast and Ulster University, Northern Ireland, UK
| | | | | | - Carla Reigada
- Global Observatory of Palliative Care, University of Navarra, Pamplona, Spain
| | - Marie Mackova
- Department of Social Sciences, PRIGO University, Havířov, Czech Republic
| | - Maria Wasner
- Katholische Stiftungshochschule München, München, Germany
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Holton S, Wynter K, Peeters A, Georgalas A, Yeomanson A, Rasmussen B. Psychological wellbeing of Australian community health service staff during the COVID-19 pandemic: a longitudinal cohort study. BMC Health Serv Res 2023; 23:405. [PMID: 37101142 DOI: 10.1186/s12913-023-09382-y] [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: 06/08/2022] [Accepted: 04/09/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Hospital clinical staff have reported poor psychosocial wellbeing during the COVID-19 pandemic. Little is known about community health service staff who undertake various roles including education, advocacy and clinical services, and work with a range of clients. Few studies have collected longitudinal data. The aim of this study was to assess the psychological wellbeing of community health service staff in Australia during the COVID-19 pandemic at two time points in 2021. METHODS A prospective cohort design with an anonymous cross-sectional online survey administered at two time points (March/April 2021; n = 681 and September/October 2021; n = 479). Staff (clinical and non-clinical roles) were recruited from eight community health services in Victoria, Australia. Psychological wellbeing was assessed using the Depression, Anxiety and Stress Scale (DASS-21) and resilience using the Brief Resilience Scale (BRS). General linear models were used to measure the effects of survey time point, professional role and geographic location on DASS-21 subscale scores, adjusting for selected sociodemographic and health characteristics. RESULTS There were no significant differences in respondent sociodemographic characteristics between the two surveys. Staff's mental health declined as the pandemic continued. Adjusting for dependent children, professional role, general health status, geographic location, COVID-19 contact status and country of birth; depression, anxiety and stress scores were significantly higher for respondents in the second survey than the first (all p < 0.001). Professional role and geographic location were not statistically significantly associated with scores on any of the DASS-21 subscales. Higher levels of depression, anxiety and stress were reported among respondents who were younger, and had less resilience or poorer general health. CONCLUSIONS The psychological wellbeing of community health staff was significantly worse at the time of the second survey than the first. The findings indicate that the COVID-19 pandemic has had an ongoing and cumulative negative impact on staff wellbeing. Staff would benefit from continued wellbeing support.
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Affiliation(s)
- Sara Holton
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia.
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation, Deakin University - Western Health Partnership, St Albans, VIC, 3021, Australia.
| | - Karen Wynter
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation, Deakin University - Western Health Partnership, St Albans, VIC, 3021, Australia
| | - Anna Peeters
- Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | | | - Ann Yeomanson
- Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Copenhagen, Denmark
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation, Deakin University - Western Health Partnership, St Albans, VIC, 3021, Australia
- Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Qin Z, He Z, Yang Q, Meng Z, Lei Q, Wen J, Shi X, Liu J, Wang Z. Prevalence and correlators of burnout among health professionals during different stages of the COVID-19 pandemic in China. Front Psychiatry 2023; 14:1156313. [PMID: 37181868 PMCID: PMC10169669 DOI: 10.3389/fpsyt.2023.1156313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/24/2023] [Indexed: 05/16/2023] Open
Abstract
Background Persistently increased workload and stress occurred in health professionals (HPs) during the past 3 years as the COVID-19 pandemic continued. The current study seeks to explore the prevalence of and correlators of HPs' burnout during different stages of the pandemic. Methods Three repeated online studies were conducted in different stages of the COVID-19 pandemic: wave 1: after the first peak of the pandemic, wave 2: the early period of the zero-COVID policy, and wave 3: the second peak of the pandemic in China. Two dimensions of burnout, emotional exhaustion (EE) and declined personal accomplishment (DPA), were assessed using Human Services Survey for Medical Personnel (MBI-HSMP), a 9-item Patient Health Questionnaire (PHQ-9), and a 7-item Generalized Anxiety Disorder (GAD-7) to assess mental health conditions. An unconditional logistic regression model was employed to discern the correlators. Results There was an overall prevalence of depression (34.9%), anxiety (22.5%), EE (44.6%), and DPA (36.5%) in the participants; the highest prevalence of EE and DPA was discovered in the first wave (47.4% and 36.5%, respectively), then the second wave (44.9% and 34.0%), and the third wave had the lowest prevalence of 42.3% and 32.2%. Depressive symptoms and anxiety were persistently correlated with a higher prevalence risk of both EE and DPA. Workplace violence led to a higher prevalence risk of EE (wave 1: OR = 1.37, 95% CI: 1.16-1.63), and women (wave 1: OR = 1.19, 95% CI: 1.00-1.42; wave 3: OR =1.20, 95% CI:1.01-1.44) and those living in a central area (wave 2: OR = 1.66, 95% CI: 1.20-2.31) or west area (wave 2: OR = 1.54, 95% CI: 1.26-1.87) also had a higher prevalence risk of EE. In contrast, those over 50 years of age (wave 1: OR = 0.61, 95% CI: 0.39-0.96; wave 3: OR = 0.60, 95% CI: 0.38-0.95) and who provided care to patients with COVID-19 (wave 2: OR = 0.73, 95% CI: 0.57-0.92) had a lower risk of EE. Working in the psychiatry section (wave 1: OR = 1.38, 95% CI: 1.01-1.89) and being minorities (wave 2: OR = 1.28, 95% CI: 1.04-1.58) had a higher risk of DPA, while those over 50 years of age had a lower risk of DPA (wave 3: OR = 0.56, 95% CI: 0.36-0.88). Conclusion This three-wave cross-sectional study revealed that the prevalence of burnout among health professionals was at a high level persistently during the different stages of the pandemic. The results suggest that functional impairment prevention resources and programs may be inadequate and, as such, continuous monitoring of these variables could provide evidence for developing optimal strategies for saving human resources in the coming post-pandemic era.
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Affiliation(s)
- Zhengshan Qin
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
| | - Qinglin Yang
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zeyu Meng
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
| | - Jing Wen
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jun Liu
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
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Huang CLC. Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians: Determinants, challenges, and the impact of the COVID-19 pandemic. World J Psychiatry 2023; 13:131-140. [PMID: 37123097 PMCID: PMC10130963 DOI: 10.5498/wjp.v13.i4.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/12/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Medical practitioners’ duties are highly stressful and performed in a particularly challenging and competitive work environment. Stress and burnout among physicians have emerged as a worldwide public health problem in recent years. A high level of distress and burnout can lead to clinically significant behavioral health problems, such as stress-related psychiatric disorders. Mounting evidence shows that physicians have higher risks of insomnia, anxiety, and depression than the general population, especially during the coronavirus disease 2019 pandemic. However, the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated. In this mini-review, we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among phy-sicians and their healthcare-seeking behaviors. We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.
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Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 710, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Cohen M, Cruz LN, Cardoso RB, Albuquerque MDFPMD, Montarroyos UR, de Souza WV, Ludermir AB, de Carvalho MR, da Silva Vicente JD, Viegas Filho MP, Cortes FJM, de Siqueira Silva MT, Almeida CMC, Lima LNGC, Veras MADSM, Kendall C, Kerr LRFS, Martelli CMT, Camey SA. Impact of the COVID-19 pandemic on the mental health of frontline healthcare workers in a highly affected region in Brazil. BMC Psychiatry 2023; 23:255. [PMID: 37069533 PMCID: PMC10107551 DOI: 10.1186/s12888-023-04702-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic had a major impact on the mental health of healthcare workers (HCWs), especially in low and middle-income countries, which had to face additional political, social, and economic challenges. We thus aimed to assess the prevalence of mental health outcomes and the associated factors in HCWs treating COVID-19 patients in one of the most affected regions in Brazil. METHODS We used the Respondent-Driven Sampling method to assess the risks of COVID-19 infection and symptoms of mental disorders in nurses, nursing technicians, and physicians who worked on the frontline in the metropolitan region of Recife. 865 healthcare workers completed a survey regarding sociodemographic data, work-related risks, and symptoms of mental disorders - SRQ-20 for common mental disorders (CMD); AUDIT-C for problematic alcohol use; GAD-7 for anxiety; PHQ-9 for depression; PCL-5 for post-traumatic stress disorder (PTSD). Gile's successive sampling estimator was used to produce the weighted estimates by professional category. A Poisson regression model with robust variance was used to analyze factors associated with a positive screening for CMD. We will present the results of a cross-sectional analysis of the mental health outcomes after the first peak of COVID-19 - from August 2020 to February 2021. RESULTS The prevalence ratios for a positive screening for CMD were 34.9% (95% CI: 27.8-41.9) in nurses, 28.6% (95% CI: 21.3-36.0) in physicians, and 26.6% (95% CI: 16.8-36.5) in nursing technicians. Nurses presented a higher prevalence of depressive symptoms (23%). Positive screening for problematic alcohol use (10.5 to14.0%), anxiety (10.4 to 13.3%), and PTSD (3.3 to 4.4%) were similar between the professional categories. The main factors associated with CMD in nurses and physicians were related to an intrinsic susceptibility to mental illness, such as previous or family history of psychiatric disorder, and female sex. Among nurse technicians, work-related factors, such as accidents with biological material, presented the strongest association with CMD. CONCLUSION The mental health of HCWs fighting COVID-19 in Recife was severely affected. It is crucial that healthcare services provide adequate working conditions and psychological support, investing in programs to promote and protect HCWs mental health.
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Affiliation(s)
- Mírian Cohen
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil.
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Luciane Nascimento Cruz
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
- Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo Bertoglio Cardoso
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | | | | | | | - Fanny Julia Mireille Cortes
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Carl Kendall
- Department of Community Health, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | | | - Suzi Alves Camey
- Statistics Department, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Workneh F, Worku A, Assefa N, Berhane Y. Change in depression during the COVID-19 pandemic among healthcare providers in Addis Ababa, Ethiopia. PeerJ 2023; 11:e15053. [PMID: 37065689 PMCID: PMC10100826 DOI: 10.7717/peerj.15053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/21/2023] [Indexed: 04/18/2023] Open
Abstract
Background The COVID-19 pandemic has increased mental health problems among healthcare workers globally. However, studies from low- and middle-income countries on this matter were minimal. This study assessed the change in depression prevalence during the first year of the COVID-19 pandemic and associated factors among healthcare providers in Addis Ababa, Ethiopia. Methods We conducted surveys among healthcare workers in Addis Ababa at two-time points, September 2020 and October 2021. A total of 577 study participants were randomly selected based on registers obtained from professional associations. Computer-assisted telephone interviewing technique was used for data collection. The Patient Health Questionnaire (PHQ-9) was used to screen for depression. Multivariable logistic regression analysis was performed to identify potential factors associated with depression. Result The prevalence of depression among healthcare workers was 2.3% (95% CI [1.1-4.8]) in Time 1 and 6.5% (95% CI [4.1-10.1]) in Time 2; nearly a three-fold increase in Time 2 compared to Time 1. The most frequently reported symptoms at both times based on the PHQ-9 item were having poor energy, sleep problem, and anhedonia, while reported suicidal ideation was less than 5%. Depression showed a positive and significant association with a positive COVID-19 test result (AOR 7.25 95% CI [1.32-39.4]) in Time 1, and with being a female healthcare provider (AOR 3.96 95% CI [1.08-14.51]) and lack of COVID-19 related policy or guidelines at the workplace (AOR 3.22 95% CI [1.11-9.35]) in Time 2. Conclusion The prevalence of depression among healthcare workers tripled during the first year of the COVID-19 pandemic. Panic reaction to positive COVID-19 test result seems to have a negative effect at the beginning while lack of disease-specific prevention guidelines and comprehensive psychological interventions for healthcare providers had an adverse effect on the mental health of health workers.
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Affiliation(s)
- Firehiwot Workneh
- Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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McGuinness SL, Eades O, Grantham KL, Zhong S, Johnson J, Cameron PA, Forbes AB, Fisher JR, Hodgson CL, Kasza J, Kelsall H, Kirkman M, Russell GM, Russo PL, Sim MR, Singh K, Skouteris H, Smith K, Stuart RL, Trauer JM, Udy A, Zoungas S, Leder K. Mental health and wellbeing of health and aged care workers in Australia, May 2021 - June 2022: a longitudinal cohort study. Med J Aust 2023; 218:361-367. [PMID: 37032118 DOI: 10.5694/mja2.51918] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 04/11/2023]
Abstract
OBJECTIVES To assess the mental health and wellbeing of health and aged care workers in Australia during the second and third years of the coronavirus disease 2019 (COVID-19) pandemic, overall and by occupation group. DESIGN, SETTING, PARTICIPANTS Longitudinal cohort study of health and aged care workers (ambulance, hospitals, primary care, residential aged care) in Victoria: May-July 2021 (survey 1), October-December 2021 (survey 2), and May-June 2022 (survey 3). MAIN OUTCOME MEASURES Proportions of respondents (adjusted for age, gender, socio-economic status) reporting moderate to severe symptoms of depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder scale, GAD-7), or post-traumatic stress (Impact of Event Scale-6, IES-6), burnout (abbreviated Maslach Burnout Inventory, aMBI), or high optimism (10-point visual analogue scale); mean scores (adjusted for age, gender, socio-economic status) for wellbeing (Personal Wellbeing Index-Adult, PWI-A) and resilience (Connor Davidson Resilience Scale 2, CD-RISC-2). RESULTS A total of 1667 people responded to at least one survey (survey 1, 989; survey 2, 1153; survey 3, 993; response rate, 3.3%). Overall, 1211 survey responses were from women (72.6%); most respondents were hospital workers (1289, 77.3%) or ambulance staff (315, 18.9%). The adjusted proportions of respondents who reported moderate to severe symptoms of depression (survey 1, 16.4%; survey 2, 22.6%; survey 3, 19.2%), anxiety (survey 1, 8.8%; survey 2, 16.0%; survey 3, 11.0%), or post-traumatic stress (survey 1, 14.6%; survey 2, 35.1%; survey 3, 14.9%) were each largest for survey 2. The adjusted proportions of participants who reported moderate to severe symptoms of burnout were higher in surveys 2 and 3 than in survey 1, and the proportions who reported high optimism were smaller in surveys 2 and 3 than in survey 1. Adjusted mean scores for wellbeing and resilience were similar at surveys 2 and 3 and lower than at survey 1. The magnitude but not the patterns of change differed by occupation group. CONCLUSION Burnout was more frequently reported and mean wellbeing and resilience scores were lower in mid-2022 than in mid-2021 for Victorian health and aged care workers who participated in our study. Evidence-based mental health and wellbeing programs for workers in health care organisations are needed. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12621000533897 (observational study; retrospective).
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Affiliation(s)
| | - Owen Eades
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | | | - Shannon Zhong
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | - Josphin Johnson
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | - Peter A Cameron
- Monash University, Melbourne, VIC
- The Alfred Emergency and Trauma Centre, Alfred Health, Melbourne, VIC
| | | | | | - Carol L Hodgson
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | | | | | | | | | - Philip L Russo
- Monash University, Melbourne, VIC
- Cabrini Health, Melbourne, VIC
| | | | - Kasha Singh
- The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
- Peninsula Health, Melbourne, VIC
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC
| | - Karen Smith
- Monash University, Melbourne, VIC
- Ambulance Service of Victoria, Melbourne, VIC
| | - Rhonda L Stuart
- Monash University, Melbourne, VIC
- Monash Health, Melbourne, VIC
| | | | - Andrew Udy
- Alfred Health, Melbourne, VIC
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC
| | | | - Karin Leder
- Monash University, Melbourne, VIC
- Royal Melbourne Hospital, Melbourne, VIC
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Watermeyer J, Madonsela S, Beukes J. The mental health and wellbeing of healthcare workers during COVID-19 in South Africa. Health SA 2023; 28:2159. [PMID: 37064645 PMCID: PMC10090965 DOI: 10.4102/hsag.v28i0.2159] [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: 09/05/2022] [Accepted: 01/31/2023] [Indexed: 04/05/2023] Open
Abstract
Background Little is known about the experiences and impact of coronavirus disease 2019 (COVID-19) on the mental health and wellbeing of healthcare workers (HCWs), particularly in Global South contexts. Aim The authors aimed to explore the experiences of HCWs at different points during the COVID-19 pandemic in South Africa. Setting This study's sample included 621 HCWs from various professions and health sectors who completed the survey during the pandemic peaks of waves I, II and III in South Africa. Methods The authors used a qualitative survey design exploring participants' general work, life, mental health and wellbeing experiences, and their support mechanisms or strategies. Data were analysed using thematic analysis. Results The authors identified three overarching themes in the data, namely stress, adjustment to work during COVID-19, and support experiences and needs. These themes were common across all three survey waves, with some minor differences noted across the waves. Conclusion An overarching thread of uncertainty seems central to HCWs' experiences of working during COVID-19, related to pressures in the South African healthcare system that have been aggravated by the pandemic. Contribution These findings have the potential to inform the development of contextually relevant approaches to support the mental health and wellbeing needs of HCWs during and after a pandemic. In particular, workplaces need to actively offer psychological support to all HCWs, not just to workers traditionally defined as frontline.
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Affiliation(s)
- Jennifer Watermeyer
- Health Communication Research Unit, School of Human and Community Development, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonto Madonsela
- Health Communication Research Unit, School of Human and Community Development, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna Beukes
- Health Communication Research Unit, School of Human and Community Development, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
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50
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Halms T, Strasser M, Papazova I, Reicherts P, Zerbini G, Grundey S, Täumer E, Ohmer-Kluge M, Kunz M, Hasan A. What do healthcare workers need? A qualitative study on support strategies to protect mental health of healthcare workers during the SARS-CoV-2 pandemic. BMC Psychiatry 2023; 23:195. [PMID: 36964558 PMCID: PMC10038365 DOI: 10.1186/s12888-023-04686-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND To support healthcare workers (HCWs) during the increased burden caused by the SARS-CoV-2 pandemic, numerous recommendations for action and possible interventions have been developed. However, the actual protective factors, needs and desires of those affected, as well as potential barriers to implementing psychological interventions, have been insufficiently examined. This study addresses this research gap and captures HCWs' experiences and views. METHODS Medical personnel including nursing staff and physicians were recruited for a qualitative study regarding protective factors as well as barriers to the implementation of support services. We conducted 21 individual, semi-structured interviews with members of the medical staff at tertiary care center in Germany. The collected data were analyzed using a qualitative content analysis. RESULTS The analyses showed that social interaction in the professional and private context was rated as helpful in coping with the challenges of everyday work amplified by the SARS-CoV-2 pandemic. The results also suggest that the available support services, despite being highly valued, were rarely accessed. Possible barriers included the fear of negative consequences when asking for support. It could be deduced that the fear and shame of admitting one's own mistakes as well as the work-related tradition of showing no weakness could be the underlying factors for this fear. RESULTS The results of this study suggest that medical staff need a more extensive range of low-threshold support services, which should be adapted to the respective needs of the professional groups. The study also provides indications that the norms and expectations represented in the hospital system require critical reflection.
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Affiliation(s)
- Theresa Halms
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany.
| | - Martina Strasser
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
| | - Irina Papazova
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
| | - Philipp Reicherts
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Giulia Zerbini
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | | | - Esther Täumer
- Department of Psychiatry and Psychotherapy, University Hospital, Klinikum der Universität München, Ludwig-Maximilians University Munich, Munich, Germany
| | | | - Miriam Kunz
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
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