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Lanzara R, Conti C, Rosa I, Pawłowski T, Malecka M, Rymaszewska J, Porcelli P, Stein B, Waller C, Müller MM. Changes in hospital staff' mental health during the Covid‑19 pandemic: Longitudinal results from the international COPE-CORONA study. PLoS One 2023; 18:e0285296. [PMID: 37972086 PMCID: PMC10653404 DOI: 10.1371/journal.pone.0285296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/17/2023] [Indexed: 11/19/2023] Open
Abstract
This longitudinal study aimed to explore anxiety and depressive symptoms, individual resources, and job demands in a multi-country sample of 612 healthcare workers (HCWs) during the COVID-19 pandemic. Two online surveys were distributed to HCWs in seven countries (Germany, Andorra, Ireland, Spain, Italy, Romania, Iran) during the first (May-October 2020, T1) and the second (February-April 2021, T2) phase of the pandemic, assessing sociodemographic characteristics, contact with COVID-19 patients, anxiety and depressive symptoms, self-compassion, sense of coherence, social support, risk perception, and health and safety at the workplace. HCWs reported a significant increase in depressive and anxiety symptoms. HCWs with high depressive or anxiety symptoms at T1 and T2 reported a history of mental illness and lower self-compassion and sense of coherence over time. Risk perception, self-compassion, sense of coherence, and social support were strong independent predictors of depressive and anxiety symptoms at T2, even after controlling for baseline depressive or anxiety symptoms and sociodemographic variables. These findings pointed out that HCWs during the COVID-19 outbreak experienced a high burden of psychological distress. The mental health and resilience of HCWs should be supported during disease outbreaks by instituting workplace interventions for psychological support.
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Affiliation(s)
- Roberta Lanzara
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Chiara Conti
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Ilenia Rosa
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Tomasz Pawłowski
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Monika Malecka
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Piero Porcelli
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Markus M Müller
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
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Gerbarg PL, Dickson F, Conte VA, Brown RP. Breath-centered virtual mind-body medicine reduces COVID-related stress in women healthcare workers of the Regional Integrated Support for Education in Northern Ireland: a single group study. Front Psychiatry 2023; 14:1199819. [PMID: 37377478 PMCID: PMC10291294 DOI: 10.3389/fpsyt.2023.1199819] [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: 04/04/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Background During the COVID-19 pandemic, healthcare workers endured prolonged stress affecting their psychological well-being. Objectives: (1) Evaluate the effects of the Breath-Body-Mind Introductory Course (BBMIC) on COVID-related stress among employees of the Regional Integrated Support for Education, Northern Ireland, (2) Reduce the risk of adverse effects from COVID-related stress, and (3) Evaluate the effects of BBMIC on indicators of psychophysiological states and the consistency with hypothesized mechanisms of action. Methods In this single group study, a convenience sample of 39 female healthcare workers completed informed consent and baseline measures: Perceived Stress Scale (PSS), Stress Overload Scale-Short (SOS-S), and Exercise-Induced Feelings Inventory (EFI). Following the online BBMIC 4 h/day for 3 days and the 6 week solo (20 min/day) and group practice (45 min weekly), repeat testing plus the Indicators of Psychophysiological State (IPSS) and Program Evaluation were obtained. Results Baseline (T1) mean PSS score was significantly elevated compared to a normative sample: PSS = 18.2 vs. 13.7 (p < 0.001) and improved significantly 11 weeks post-BBMIC (T4). SOS-S mean score declined from 10.7(T1) to 9.7 at 6 week post-test (T3). The SOS-S proportion of High Risk scores found in 22/29 participants (T1), dropped to 7/29 (T3). EFI mean subscale scores improved significantly from T1 to T2 and T3 for Revitalization (p < 0.001); Exhaustion (p < 0.002); and Tranquility (p < 0.001); but not Engagement (p < 0.289). Conclusion Among RISE NI healthcare workers affected by COVID-related stress, participation in the BBMIC significantly reduced scores for Perceived Stress, Stress Overload, and Exhaustion. EFI Revitalization and Tranquility scores significantly improved. More than 60% of participants reported moderate to very strong improvements in 22 indicators of psychophysiological state, e.g., tension, mood, sleep, mental focus, anger, connectedness, awareness, hopefulness, and empathy. These results are consistent with the hypothesized mechanisms of action whereby voluntarily regulated breathing exercises change interoceptive messaging to brain regulatory networks that shift psychophysiological states of distress and defense to states of calmness and connection. These positive findings warrant validation in larger, controlled studies to extend the understanding of how breath-centered Mind-body Medicine practices could mitigate adverse effects of stress.
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Affiliation(s)
- Patricia L. Gerbarg
- Department of Psychiatry, New York Medical College, Valhalla, NY, United States
| | - Felicity Dickson
- Regional Integrated Support for Education, Belfast, United Kingdom
| | - Vincent A. Conte
- Management Department, Hofstra University, Hempstead, NY, United States
| | - Richard P. Brown
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
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Sharma VK, Kathrotia R, Barde PB, Sharma G, Chitturi V, Parmar N, Dhruva G, Kavathia G. COVID-19-induced Stress in Health-care Workers: Effect of 8-week Common Yoga Protocol on Autonomic Function and Inflammatory and Oxidative Stress Markers. Int J Yoga 2023; 16:79-89. [PMID: 38204773 PMCID: PMC10775844 DOI: 10.4103/ijoy.ijoy_127_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 01/12/2024] Open
Abstract
Background COVID-19 pandemic posed a huge stress on health-care givers affecting their physical and mental health. Wellness strategies like yoga can improve flexibility, resilience, and outlook. Aim The present study explored the effect of 8-week standard common yoga protocol (CYP) intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers. Materials and Methods It is a randomized controlled trial where 50 nurses underwent CYP and 50 participated as controls. Anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed before and after 8-week CYP. Results Total 88 nurses completed the study with 42 and 46 participants, respectively, in the CYP and control groups. CYP intervention resulted in a significant reduction in cardiovascular parameters systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and rate pressure product (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively), perceived stress score and Depression, Anxiety, and Stress Scale psychological variables of depression, anxiety, and stress, and serum lipid parameters compared to the control group. CYP significantly increased total power, low frequency, high frequency, root mean square of successive differences between adjacent NN intervals, change in successive normal sinus (NN) intervals exceeds 50 ms, and pNN50% (P < 0.001, P = 0.006, P = 0.006, P = 0.039, P < 0.001, and P = 0.013, respectively) suggesting improved resting autonomic modulation and parasympathodominance due to higher vagal efferent activity. There were significant reductions in serum cortisol, tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6 in both the groups. Serum telomerase significantly reduced (P = 0.024) and total antioxidant capacity (P = 0.036) increased in the CYP group post intervention. Conclusion CYP intervention was beneficial in improving psychophysiological, autonomic, and biochemical profile of the nurse group of health-care workers.
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Affiliation(s)
- Vivek Kumar Sharma
- Department of Physiology, All India Institute of Medical Sciences, PDU Medical College, Rajkot, Gujarat, India
| | - Rajesh Kathrotia
- Department of Physiology, All India Institute of Medical Sciences, PDU Medical College, Rajkot, Gujarat, India
| | - Pradip B. Barde
- Department of Physiology, All India Institute of Medical Sciences, PDU Medical College, Rajkot, Gujarat, India
| | - Gaurav Sharma
- Department of Physiology, All India Institute of Medical Sciences, PDU Medical College, Rajkot, Gujarat, India
| | - Vinay Chitturi
- Department of Physiology, All India Institute of Medical Sciences, PDU Medical College, Rajkot, Gujarat, India
| | - Naresh Parmar
- Department of Physiology, All India Institute of Medical Sciences, PDU Medical College, Rajkot, Gujarat, India
| | - Gauravi Dhruva
- Department of Pathology, PDU Medical College, Rajkot, Gujarat, India
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Müller MM, Baillès E, Blanch J, Torres X, Rousaud A, Cañizares S, Cervera Teruel M, Conti C, Dunne PJ, Stanculete MF, Farré JM, Font E, Gayán E, Guagnano MT, König S, Kundinger N, Lanzara R, Lobo A, Nejatisafa AA, Obach A, Offiah G, Peri JM, Rosa I, Schuster SK, Waller C, Stein B. Burnout among hospital staff during the COVID-19 pandemic: Longitudinal results from the international Cope-Corona survey study. J Psychosom Res 2023; 164:111102. [PMID: 36508846 PMCID: PMC9677553 DOI: 10.1016/j.jpsychores.2022.111102] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Long-term changes in burnout and its predictors in hospital staff during the COVID-19 pandemic were investigated in an international study. METHODS Two online surveys were distributed to hospital staff in seven countries (Germany, Andorra, Ireland, Spain, Italy, Romania, Iran) between May and October 2020 (T1) and between February and April 2021 (T2), using the following variables: Burnout (emotional exhaustion and depersonalization), job function, age, gender, and contact with COVID-19 patients; individual resources (self-compassion, sense of coherence, social support) and work-related resources and demands (support at the workplace, risk perception, health and safety at the workplace, altruistic acceptance of risk). Data were analyzed using linear mixed models repeated measures, controlled for age. RESULTS A total of 612 respondents were included (76% women). We found an increase in burnout from T1 to T2. Burnout was high among personnel with high contact with COVID-19 patients. Individual factors (self-compassion, sense of coherence) and work-related factors (support at the workplace, risk perception, health and safety at the workplace) showed associations with burnout. Low health and safety at the workplace at T1 was associated with an increase in emotional exhaustion at T2. Men showed an increase in depersonalization if they had much contact with COVID-19 patients. CONCLUSION Burnout represents a potential problematic consequence of occupational contact with COVID-19 patients. Special attention should be paid to this group in organizational health management. Self-compassion, sense of coherence, support at the workplace, risk perception, and health and safety at the workplace may be important starting points for interventions. REGISTRATION Müller, M. M. (2020, August 30). Cope-Corona: Identifying and strengthening personal resources of hospital staff to cope with the Corona pandemic. Open Science Foundation.
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Affiliation(s)
- Markus M. Müller
- Corresponding author at: Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Prof-Ernst-Nathan-Str. 1, 90418 Nuremberg, Germany
| | - Eva Baillès
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Jordi Blanch
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Xavier Torres
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Araceli Rousaud
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Silvia Cañizares
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Marta Cervera Teruel
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Chiara Conti
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | | | - Mihaela Fadgyas Stanculete
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Josep Maria Farré
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Elena Font
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Elena Gayán
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Maria Teresa Guagnano
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Sarah König
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Nina Kundinger
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Roberta Lanzara
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Antonio Lobo
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Ali-Akbar Nejatisafa
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Amadeu Obach
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Gozie Offiah
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Josep Maria Peri
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Ilenia Rosa
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Sara Katharina Schuster
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Christiane Waller
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
| | - Barbara Stein
- Paracelsus Medical University, General Hospital Nuremberg, Department for Psychosomatic Medicine and Psychotherapy, Nuremberg, Germany.
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Research on the Equity and Influencing Factors of Medical and Health Resources Allocation in the Context of COVID-19: A Case of Taiyuan, China. Healthcare (Basel) 2022; 10:healthcare10071319. [PMID: 35885847 PMCID: PMC9324996 DOI: 10.3390/healthcare10071319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 12/31/2022] Open
Abstract
COVID-19 has killed millions of people worldwide. As a result, medical and health resources continue to be strained, posing a great threat to people’s safety and economic and social development. This paper built the index system of influencing factors of medical and health resources containing the economy, population and society, and then classified Taiyuan into three types of regions by cluster analysis. The Gini coefficient, Theil index and agglomeration degree were then used to analyze the spatial distribution of medical and health resources allocation, and its influencing factors were studied by grey relational analysis. It was found that the population allocation of medical and health resources in Taiyuan was better than area allocation. Population has the greatest influence on the allocation of medical and health resources, followed by society and the economy. The more developed the regional economy, the more diversified the main influencing factors, and the more adjustment and control choices of medical and health resources allocation. Suggestions for optimal allocation were put forward in order to fully utilize the limited medical and health resources, effectively respond to the epidemic needs, promote the sustainable development of resources, protect the health of residents, and improve social benefits.
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