Doctors' Mental Health in the Midst of COVID-19 Pandemic: The Roles of Work Demands and Recovery Experiences

Impact mechanism of social-related social media use on the job performance of caregivers of older adults

This study investigated the impact mechanism of social-related social media use on the job performance of caregivers of older adults through mental health and analyzed gender differences. A total of 358 valid questionnaires were collected and analyzed using SPSS and Smart PLS. The results showed that mental health plays an important role in the relationship between social-related social media use and job performance. Such social media use can improve psychological well-being and reduce psychological distress by promoting relaxation experience. Psychological well-being has a significant positive impact on job performance. In addition, significant differences exist in the impact path of social-related social media use on psychological distress among different gender groups. The findings of this study can assist nursing homes in assessing the use of social media within their organizations and provide methodological references for enhancing the job performance of caregivers of older adults.

Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians

BACKGROUND

The COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges.

METHODS

We carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0-100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors.

RESULTS

The average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels.

CONCLUSIONS

Our data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.

Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Background

The COVID-19 pandemic significantly impacted people's mental health significantly. Frontline healthcare workers (HCWs) were arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is important to inform interventions for social and psychological support for future pandemics.

Aim

This study explored the experiences of frontline HCWs in South Africa during the COVID-19 pandemic.

Setting

The sample included HCWs from various professions and health sectors who worked with COVID-19 patients across South Africa.

Methods

An exploratory descriptive qualitative design was used. Semi-structured interviews were conducted with 11 frontline HCWs recruited via purposive sampling. Data were analysed using principles of inductive thematic analysis.

Results

Four major themes were identified in the data: (1) Working during COVID-19 was an emotional rollercoaster; (2) Working during COVID-19 was physically and mentally exhausting; (3) Participants held negative attitudes towards the Department of Health; and (4) COVID-19 had a transformative impact on the daily life of HCWs.

Conclusion

HCWs' experiences were diverse and marked by contradictions. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants. Qualitative methodologies provided depth and insights into the diverse realities of frontline HCWs.

Contribution

This study provides significant insights into the experiences of a diverse group of frontline South African HCWs during COVID-19. It demonstrates a shift in the definition of a 'frontline' HCW and highlights the need for greater psychological support and individualised public health interventions during future pandemics.

Stability and shifts in the combined positive and negative mental health of clergy: A longitudinal latent class and latent transition analysis study of united methodist pastors before and after the onset of COVID-19

COVID-19 and its associated restrictions presented unprecedented challenges for those in the helping professions. In this study, we seek to understand how the mental health of those who belong to one specific helping profession - clergy - changed in the context of COVID-19. Using longitudinal data of a sample of United Methodist pastors from the North Carolina Clergy Health Initiative, we conduct both cross-sectional and person-centered analyses to investigate how the overall mental health of this occupational group changed, as well as how different subgroups of clergy fared within the context of the pandemic, depending on their well-being prior to the onset of COVID-19. We found that the mental health of pastors suffered within the context of the pandemic, but that individual changes in mental health differed based on what the combined positive and negative mental health patterns of clergy were prior to the pandemic, for which we used latent class analysis to identify as Flourishing, Distressed, Languishing, or Burdened but Fulfilled. Of these subgroups, having Flourishing pre-pandemic status was protective of mental health following the onset of COVID-19, whereas the other three subgroups' mental health statuses worsened. This study is the one of the first longitudinal studies of helping professionals which has tracked changes in mental health before and after the onset of COVID-19. Our findings demonstrate the utility of considering positive and negative mental health indicators together, and they point to certain groups that can be targeted with well-being resources during future periods of acute or abnormal stress.

The association between the sense of control and depression during the COVID-19 pandemic: a systematic review and meta-analysis

Introduction

High levels of depression and low sense of control have been reported during the COVID-19 pandemic. The removal of typical freedoms through public health restrictions may have played an important role. The aim of this review was to examine data collected during the pandemic and (1) estimate the strength of the association between sense of control and depression, (2) examine whether the different types of control measures affected the strength of the association, and (3) whether this changed as a function of pandemic indicators.

Methods

We conducted a systematic review and meta-analysis of studies published in English between December 2019 and November 2022. A total of 993 articles were identified, of which 20 were included in the review and 16 in the meta-analysis after conducting a quality assessment using the standard NIH tool.

Results

The control-depression association gave a bias-independent pooled effect size of r = .41, and grew stronger over the 130 weeks covered by this review but did not change as a function of local COVID incidence rates. Subgroup analyses showed that external and overall control were more strongly related to depression than internal control.

Discussion

These findings emphasize that external factors are important to the sense of control and the importance of preserving the sense of control in situations where the removal of personal freedoms is necessary, such as public health emergencies.

Spiritual Intelligence as a Coping Strategy to Manage Job Stress for Midwives in Northern Iran: A Cross-Sectional Study

This study aimed to explore whether spiritual intelligence could help midwives cope with job-related stress. A cross-sectional study was done with 143 midwives in Babol, Iran. The sampling method was non-random and convenience samples were used. Amram and Dreyer's spiritual intelligence and health and safety executive occupational stress questionnaires were used. The response rate of subjects was 90.51%. Results showed that the most predictors of job stress were total spiritual intelligence (β = 0.507, p = 0.001) and the ratio of midwives to patients on the night shift (β =  - 0.224, p = 0.033). High levels of spiritual intelligence were associated with a low level of stress, which could help midwives adapt to job-related challenges.

Efficacy of a Text-Based Mental Health Coaching App in Improving the Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial

BACKGROUND

Stress, anxiety, and depression are major mental health concerns worldwide. A wide variety of digital mental health interventions have demonstrated efficacy in improving one's mental health status, and digital interventions that involve some form of human involvement have been shown to demonstrate greater efficacy than self-guided digital interventions. Studies demonstrating the efficacy of digital mental health interventions within the Asian region are scarce.

OBJECTIVE

This study aimed to investigate the potential efficacy of the digital mental health intervention, ThoughtFullChat, which consists of one-on-one, asynchronous, text-based coaching with certified mental health professionals and self-guided tools, in improving self-reported symptoms of depression, anxiety, and stress. The study also aims to examine the potential differences in efficacy among occupational subgroups and between sexes.

METHODS

A randomized controlled study was conducted among housemen (trainee physicians), students, faculty members, and corporate staff at International Medical University, Malaysia. A total of 392 participants were enrolled and randomized to the intervention (n=197, 50.3%) and control (n=195, 49.7%) groups. Depression, anxiety, and stress symptoms were measured using the Depression, Anxiety, and Stress Scale-21 items at baseline and after the 3-month intervention period. The Satisfaction with Life Scale and Brief Resilience Scale were also included, along with a questionnaire about demographics.

RESULTS

Significant decrease was observed in depression (P=.02) and anxiety (P=.002) scores in the intervention group. A subgroup (corporate staff) also demonstrated significant decrease in stress (P=.005) alongside depression (P=.006) and anxiety (P=.002). Females showed significant improvements in depression (P=.02) and anxiety (P<.001) when compared with males.

CONCLUSIONS

This study provides evidence that the ThoughtFullChat app is effective in improving the symptoms of depression, anxiety, and stress in individuals, particularly among corporate staff from the educational field. It also supports the notion that mobile mental health apps that connect users to mental health professionals in a discreet and cost-efficient manner can make important contributions to the improvement of mental health outcomes. The differential improvements among occupational subgroups and between sexes in this study indicate the need for future digital mental health app designs to consider an element of personalization focused on systemic components relating to occupation.

TRIAL REGISTRATION

Clinicaltrials.gov NCT04944277; https://classic.clinicaltrials.gov/ct2/show/NCT04944277.

Combined effect of work from home and work during nonwork time on sleep disturbance

Background

Owing to the coronavirus disease 2019 pandemic, being exposed to work from home and work during nonwork time simultaneously can lead to sleep disturbance; however, their combined effect is unclear. We aimed to investigate the combined effect of work from home and work during nonwork time on sleep disturbance.

Methods

This study used data from the Sixth Korean Working Condition Survey and included 27,473 paid workers. Logistic regression analysis was conducted to investigate the relationship between work from home, work during nonwork time, and sleep disturbance according to sex. We re-classified participants into 4 groups based on their working from home (No/Yes) and working during nonwork time (No/Yes). The relative excess risk due to interaction was calculated to examine the effect of exposure to both telecommuting and non-regular work hours on sleep disturbance.

Results

Workers exposed to work from home and work during nonwork time had significantly higher risks of sleep disturbance for all, men, and women workers (OR [95% CI]: 1.71 [1.46-2.02], 1.79 [1.43-2.23], and 1.64 [1.29-2.08] for work from home and 3.04 [2.70-3.42], 3.61 [3.09-4.22], and 2.41 [2.01-2.90] for work during nonwork time, respectively). Compared to those who were not exposed to both factors, when workers had both job factors, the ORs (95% CI) of sleep disturbance for all, men, and women were 3.93 (2.80-5.53), 5.08 (3.21-8.03), and 2.91 (1.74-4.87), respectively. The relative excess risk due to interaction of work from home and work during nonwork time was not significant for sleep disturbance.

Conclusions

Work from home and work during nonwork time were each associated with sleep disturbance, but the interaction between the two factors on sleep disturbance was not observed in both men and women.

Physicians' mental health and coping during the COVID-19 pandemic: One year exploration

Numerous cross-sectional studies have examined physicians' health and coping during the COVID-19 pandemic, while longitudinal studies are lacking. This study explores the progression over one year of physicians' physical and mental health symptoms, their strategies used to cope and discusses coping strategies in relation to physical and mental health symptoms. Two surveys, one year apart, exploring physicians' physical, mental health symptoms and employed coping strategies were sent to all physicians practicing in the province of Saskatchewan, Canada. A total of 117 physicians participated in Round I (RI) (November 2020-January 2021) and 158 participated in Round II (RII) (October 2021-February 2022). Physicians' physical and mental health symptoms remained high, irrespective of their specialty or COVID-19 exposure. COVID-related Post-Traumatic Stress Disorder increased by five times at RII (p = 0.02). In RI anxiety was most prevalent in middle-aged females. In RII depression was most prevalent in physicians with no children. Most coping was adaptive (90%) and included Behavioural, Relational, Cognitive, Spiritual, and Interventional strategies. After one-year, Spiritual coping decreased, while Interventional coping increased by eight times (p = 0.01). Despite efforts to employ adaptive coping, physicians' rates of psychological and physical health difficulties remained high or worsened over one year, offering insight into the protracted health care crisis, and the need for solutions. Our observation of physicians' needs for additional supports, camaraderie and appreciation as well as the shift in coping strategies as the pandemic progressed, offer targets for interventions meant to promote recovery.

Validation of the Recovery Experience Questionnaire in a Lithuanian Healthcare Personnel

Healthcare workers (HCWs) often experience high levels of stress, anxiety, and depression due to high workloads and responsibilities in their professional activities. Therefore, recovery from work-related stress is highly important in HCWs. The Recovery Experience Questionnaire (REQ) is a 16-item self-reported measure covering four stress recovery domains: psychological detachment from work, relaxation, mastery, and control. The current study aimed to test the REQ's psychometric properties in a sample of Lithuanian HCWs. In total, 471 HCWs from various healthcare institutions participated in this study. Confirmatory factor analysis (CFA) was used to test the structure of the REQ. We also used the Brief Patient Health Questionnaire (PHQ-4) and the World Health Organization Psychological Well-Being Index (WHO-5) to assess the mental health of the study participants. The CFA analysis supported the correlated four-factor structure of the REQ. Furthermore, we found significant correlations between the levels of REQ and anxiety, depression, and well-being. We conclude that the REQ is a valid measure that could be a useful tool in research on HCWs' mental health. It could also be used in healthcare settings for the evaluation of well-being among healthcare staff.

Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021

Introduction

Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021.

Methods

This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes.

Results

A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.

What matters most? Network analysis of mental health, recovery experiences, sleep, and fatigue among career firefighters

Firefighters exhibit a higher prevalence of mental health issues than other occupations because they often directly or indirectly experience potentially traumatic events. Previous research has suggested that recovery experiences, sleep, and fatigue may be protective or risk factors for firefighters' mental health. This study conducted regularised partial correlation network analysis to investigate and visualise the complex relationships between these variables. We collected data through an online survey, and 3144 career firefighters from a large east-coast city in China, were included in the analyses. The results of the network analysis showed that: (1) only relaxation and mastery experiences directly correlated with one dimension of the mental health scale, namely, life/social functioning; (2) sleep quality had stronger correlations with mental health issues than sleep quantity; and (3) mental health issues were central nodes of the network. These results indicated that firefighters' mental health was close to other variables in the network and acted as a bridge linking other variables. Therefore, more attention should be paid to the mental health of firefighters to prevent comorbidities. The study's results also indicated that recovery experiences and sleep may be protective factors for firefighters' mental health.

Sense of Control and Depression during Public Health Restrictions and the COVID-19 Pandemic

Depression rates have increased significantly since the onset of the COVID-19 pandemic, with a number of factors implicated in this increase, including stress, fear, social isolation and the psychological impact of public health restrictions. The main purpose of the current cross-sectional survey study was to examine the relationship between the experience of public health restrictions, the sense of control and depression, both during and after restrictions were lifted. A survey methodology was chosen, with data collected in the Republic of Ireland at two time points (January 2022 and May 2022). Time 1 participants (n = 314) were invited to repeat the measures 5 months later, with 172 agreeing to be recontacted, and 47 participants completing all measures at two time points. Findings showed that both the sense of control, in relation to perceived constraints, w = 0.43, and the experience of restrictions, w = 0.14, predicted depression at Time 1. Participants were less likely to be depressed at Time 2 and had a stronger sense of control. The Time 1 sense of control through perceived constraints predicted depression at Time 2, w = 0.45. Overall, these data show that public health restrictions and the sense of control are linked and that the sense of control has a powerful and long-lasting effect on depression status in restricted conditions, even once these have been lifted.

Recovery Experiences Protect Emotionally Exhausted White-Collar Workers from Gaming Addiction

Gaming addiction and its negative consequences have attracted public concern, but relatively little is known regarding its impact on adult workers. This study aims to test the association between gaming addiction and emotional exhaustion as well as the protective effect of recovery experiences on such an association among white-collar workers. We recruited 205 working adults (female = 58%) who voluntarily completed an online questionnaire. The results showed that male and younger workers were more vulnerable to gaming addiction. Emotional exhaustion was significantly and positively associated, while two (i.e., relaxation and control) of the four recovery experiences were negatively correlated with gaming addiction. Control experience had an indirect effect on gaming addiction via emotional exhaustion. Moreover, relaxation experience buffered the risk effect of emotional exhaustion on gaming addiction so that the effect is less pronounced at high levels of relaxation. Interventions are suggested to raise workers' awareness of effective recovery experiences (especially for control and relaxation) and to facilitate their recovery opportunities.

The Mental Health of Malaysia’s Northwest Healthcare Workers during the Relaxation of COVID-19 Restrictions and Its Associated Factors

The COVID-19 pandemic has affected people in many ways, including mental health status. Depression, anxiety, and stress (DAS) are terms often used to describe mental health status worldwide. The present study describes the prevalence of DAS and its associated factors among healthcare workers (HCWs) in the northwest region of Malaysia, during the early phase of recovery of movement control order (RMCO), where some restrictions were lifted, and cases are reducing in number. This cross-sectional study used HCW’s mental health surveillance data using the DASS-21 questionnaire. A total of 981 data collected between 1 July and 31 August 2020 were randomly sampled. Socio-demographic factors, occupational characteristics, and health backgrounds were extracted and analyzed using multiple logistic regression. The prevalences of DAS are 8.4% (6.7, 10.3), 17.1% (14.8, 19.6), and 6.4% (5.0, 8.1), respectively. Age is significantly associated with depression (Adjusted Odd Ratio (Adj.OR) 0.96 (0.93, 0.99)) and stress (Adj.OR 0.96 (0.93, 0.997)). Working at the hospital is associated with depression (Adj.OR 1.88 (1.19, 2.97)) as well as anxiety (Adj.OR 1.91 (1.36, 2.68). HCWs with a degree or postgraduate education level are more stressed compared to those with lower educational levels (Adj.OR 8.43 (1.95, 36.37)). Mental health surveillance helps to identify those at risk. Those younger in age, working in hospitals, and with more responsibility in management are the most affected. With the easing of COVID-19 pandemic restrictions, which lead to the release of certain movement control, the mental health status of HCWs was less affected. Those working directly with COVID-19 patients and with more responsibility in management are the most affected.

Anxiety and Stress due to COVID-19 Pandemic and Associated Factors Among Healthcare Workers in West Guji Zone Southern Ethiopia

Background

The COVID-19 pandemic caused a dramatic loss of life around the world and has caused mental and social problems that affect every country in the world. Healthcare workers involved in providing care are at high risk of developing mental health problems as they face heavy workloads, life-and-death decisions, and the risk of infection is high. This study aimed to assess the prevalence of COVID-19-related anxiety and stress and their associated factors among healthcare workers in Southern Ethiopia.

Methods

A cross-sectional survey was conducted in public health facility located in the West Guji district. A simple random sampling technique was used to select 283 study participants. Descriptive, binary, and multiple logistic regression statistics were used. Odds ratios adjusted with 95% CI were used, and statistical significance was declared with a p-value of < 0.05.

Results

A total of 275 participants were included, with a response rate of 97.2%. The prevalence of anxiety and stress were 25.5% and 9.1%, respectively. Factors associated with anxiety symptoms were age, psychoactive drug use, alcohol use, and monthly income, and stress symptoms were alcohol use, medical illness, and knowledge of healthcare workers due to COVID-19 pandemic.

Conclusion

The prevalence of anxiety and stress among healthcare workers due to COVID-19 were an average compared with studies in low-income and high-income countries. Health institutions must focus on the well-being of healthcare workers during the fighting for COVID-19 and comprehensive psychological assistance to support the mental well-being of healthcare workers by giving different training.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40615-022-01335-1.

The Attitude of Turkish Physicians Toward COVID-19 Vaccination and the Effects of Vaccination on Their Mental Health

Background

The study aims to investigate the willingness of physicians for the coronavirus disease 2019 vaccination, factors contributing to their attitude, and the effects of vaccination on their mental health. It is conducted online with physicians between February 17 and March 17, 2021, corresponding to a period of at least 1 month after the first dosage.

Methods

Sociodemographic and professional characteristics are investigated along with coronavirus disease 2019 experiences. The Fear of Coronavirus Disease 2019 Scale, Attitudes Toward the Coronavirus Disease 2019 Vaccine, The Hospital Anxiety and Depression Scale, and Beck Hopelessness Scale are given to evaluate the effects on mental health.

Results

Among 578 participants, the total vaccination rate was 91.5% and the main reason for non-vaccination is being already infected by coronavirus disease 2019. Vaccination affected mental health positively in more than half of the participants (59.2% in the vaccinated group). Advanced age (odds ratio = 0.985, P < .05), positive attitude toward vaccination (odds ratio = 0.918, P < .001), and high fear of coronavirus disease 2019 (odds ratio = 0.937, P = .001) were among the predictors of being positively affected by the vaccination. Fear of coronavirus disease 2019 was positively correlated with hopelessness (r = .239, P < .001), depression (r = 0.387, P < .001), and anxiety (r = 0.531, P < .001). The negative thoughts about the vaccination were found to be correlated with hopelessness levels (r = -0.093, P < .05).

Conclusions

Physicians have positive attitudes toward vaccination and vaccination has positive effects on their mental health. As vaccination is a key point during the fight against the coronavirus disease 2019 pandemic, studies on vaccination and its effects on mental health gained importance. The role of physicians in this regard is inevitable.

Investigating Predictors of Psychological Distress for Healthcare Workers in a Major Saudi COVID-19 Center

This study investigated the relationship between fear of COVID-19, previous exposure to COVID-19, perceived vulnerability to disease, sleep quality, and psychological distress among healthcare workers (HCWs) in Taif city in Saudi Arabia, which has a population of 702,000 people. A cross-sectional study design was adopted. HCWs (n = 202) completed a survey containing the Fear of COVID-19 Scale (FCV-19S), Perceived Vulnerability to Disease (PVD), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale (DASS-21). FCV-19S and sleep quality were significant predictors for psychological distress. Female gender was a significant predictor for depression and stress. Single, divorced, and widowed marital status were predictive for anxiety. FCV-19S was weakly correlated with PVD but moderately with depression, anxiety, and stress. Of the two PVD subscales, perceived infectability was weakly correlated with psychological distress. PVD and previous experience with COVID-19 were not significant predictors. Sleep quality and FCV-19S were major predictors of psychological distress. Findings indicated that poor sleep quality was strongly associated with psychological distress, while fear of COVID-19 had a moderate association. Such results support the need to design and implement psychological programs to assist HCWs in dealing with the psychological impact of this ongoing pandemic.

Working as a Healthcare Professional and Wellbeing During the COVID-19 Pandemic: Work Recovery Experiences and Need for Recovery as Mediators

Considering the high impact strain that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has put on medical personnel worldwide, identifying means to alleviate stress on healthcare professionals and to boost their subjective and psychological wellbeing is more relevant than ever. This study investigates the extent to which the relationships between the status of working in healthcare and the subjective and psychological wellbeing are serially mediated by work recovery experiences and the need for recovery. Data were collected from 217 Romanian employees (44 health professionals and 173 employees from other domains) using a cross-sectional design with self-report instruments, during the first stage of the nationwide lockdown. The results of the serial mediation analyses revealed that working in the medical field is indirectly related to subjective and psychological wellbeing through the following: (i) mastery experiences and (ii) mastery experiences as an antecedent of the need for recovery. As such, our findings indicate that (i) working in the medical field is, in fact, linked to healthcare professionals’ subjective and psychological wellbeing, and they provide some input on (ii) how recovery experiences and the need for recovery intervene in these relationships. Based on these findings, theoretical, methodological, and practical implications were suggested, and future research directions were proposed to maximize healthcare professionals’ wellbeing.

Inequalities in recovery or methodological artefact? A comparison of models across physical and mental health functioning

Considerable attention has been paid to inequalities in health. More recently, focus has also turned to inequalities in ‘recovery’; with research, for example, suggesting that lower grade of employment is strongly associated with slower recovery from both poor physical and poor mental health. However, this research has tended to operationalise recovery as ‘return to baseline’, and we know less about patterns and predictors when recovery is situated as a ‘process’. This paper seeks to address this gap. Drawing on data from the UK Household Longitudinal Study, we operationalise recovery as both an ‘outcome’ and as a ‘process’ and compare patterns and predictors across the two models. Our analysis demonstrates that the determinants of recovery from poor health, measured by the SF-12, are robust, regardless of whether recovery is operationalised as an outcome or as a process. For example, being employed and having a higher degree were found to increase the odds of recovery both from poor physical and mental health functioning, when recovery was operationalised as an outcome. These variables were also important in distinguishing health functioning trajectories following a poor health episode. At one and the same time, our analysis does suggest that understandings of inequalities in recovery will depend in part on how we define it. When recovery is operationalised as a simple transition from poor health state to good, it loses sight of the fact that there may be inequalities (i) within a ‘poor health’ state, (ii) in how individuals are able to step into the path of recovery, and (iii) in whether health states are maintained over time. We therefore need to remain alert to the additional nuance in understanding which comes from situating recovery as a process; as well as possible methodological artefacts in population research which come from how recovery is operationalised.

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There is no consensus on what recovery is and how it should be operationalised.

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Understanding of inequalities in recovery across health conditions remains scarce.

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We operationalised recovery both as an outcome and as a process.

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We found robust inequalities in recovery across the two approaches.

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Considering recovery as a process revealed more nuanced patterns in inequalities.

A systematic review and meta-analysis of the mental health symptoms during the Covid-19 pandemic in Southeast Asia

AIMS

The Covid-19 pandemic has had a substantial impact on the mental health of the general public and high-risk groups worldwide. Due to its proximity and close links to China, Southeast Asia was one of the first regions to be affected by the outbreak. The aim of this systematic review was to evaluate the prevalence of anxiety, depression and insomnia in the general adult population and healthcare workers (HCWs) in Southeast Asia during the course of the first year of the pandemic.

METHODS

Several literature databases were systemically searched for articles published up to February 2021 and two reviewers independently evaluated all relevant studies using pre-determined criteria. The prevalence rates of mental health symptoms were calculated using a random-effect meta-analysis model.

RESULTS

In total, 32 samples from 25 studies with 20 352 participants were included. Anxiety was assessed in all 25 studies and depression in 15 studies with pooled prevalence rates of 22% and 16%, respectively. Only two studies assessed insomnia, which was estimated at 19%. The prevalence of anxiety and depression was similar among frontline HCWs (18%), general HCWs (17%), and students (20%) while being noticeably higher in the general population (27%).

CONCLUSIONS

This is the first systematic review to investigate the mental health impact of the Covid-19 pandemic in Southeast Asia. A considerable proportion of the general population and HCWs reported mild to moderate symptoms of anxiety and depression; the pooled prevalence rater, however, remain significantly lower than those reported in other areas such as China and Europe.

Emotional Health Status of Postgraduate Students of Periodontics in India During COVID Health Crisis-A Questionnaire-Based Study

Dental students, especially postgraduate students present a higher risk of getting infected because of their close contact with the patients during this pandemic. The objectives of the study include (a) the reasons for postgraduate students’ altered emotional status during coronavirus (COVID-19) infection. (b) To assess the kind of infection protocols adopted. (c) To assess the impacts of postgraduate students’ emotional status on treating patients with periodontal problems during the COVID-19 lockdown period from March 2020 to December 2020. The emotional status of postgraduate students was assessed in 2 phases that are at the initial phase of COVID infection and lockdown and the second phase when the lockdown was prolonged. Questionnaires were distributed to the Postgraduate students of periodontics all over India to assess their level of awareness of COVID infection, type of infection control measures followed during the pandemic period, as well as the outpatient turnout during the lockdown period. Results of this study stated that more than 80% of students addressed the decline in the number of patients to surgical clinics, 76.3% of postgraduates were worried about themselves and their families due to the pandemic situation. Surprisingly, 74.3% of them even worried about losing their expertize or skills due to a long lockdown period. Dental postgraduates all over India are willing to treat their patients during the period of a pandemic but in strict compliance with infection control guidelines. This study assessed the emotional responses of the postgraduates during the pandemic through the questionnaire and concluded that all the professionals are ready to resume their clinical activities with adequate guidelines provided.

Stress, anxiety, depression and burnout in frontline healthcare workers during two peaks of COVID-19 pandemic in Russia

PURPOSE

In this study we aimed to assess the range of psychopathological symptoms (anxiety, stress, depression, burnout) and risk factors in frontline HCWs during spring and autumn outbreaks of the new coronavirus infection in Russian Federation.

METHODS

We conducted two independent, cross-sectional hospital-based online surveys. Data of 2195 HCWs were collected between May 19th and May 26th 2020 and between October 10th and October 17th 2020. Stress, anxiety, depression, burnout and perceived stress were assessed using the Russian versions of SAVE-9 and GAD-7, PHQ-9, MBI and PSS-10 scales. Logistic regression analysis was performed to determine the influence of different variables.

RESULTS

The study revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7%,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The rate of anxiety was higher in October 2020 compared with May 2020. Revealed risk factors included: female gender, younger age, being a physician, working for over a week, living outside of Moscow or Saint Petersburg, being vaccinated against COVID-19.

CONCLUSION

These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups and its increasing importance over time.

Levels and predictors of anxiety, depression, and stress during COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020: A multicenter cross-sectional study

INTRODUCTION

The provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. However, healthcare providers as the frontline caregivers dealing with infected patients, are more vulnerable to mental health problems. Despite this fact, there is scarce information regarding the mental health impact of COVID-19 among frontline health care providers in South-West Ethiopia.

OBJECTIVE

This study aimed to determine the levels and predictors of anxiety, depression, and stress during the COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020.

METHODS

An institutional-based cross-sectional study was conducted among 322 health care providers from November 10-25, 2020 in Gurage zonal health institutions. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection technique. The data were entered into the Epi-data version 3.01 and exported to SPSS version 25.0 for analysis. Both descriptive statistics and inferential statistics (chi-square tests) were presented Bivariable and Multivariable logistic regression analyses were made to identify variables having a significant association with the dependent variables.

RESULTS

The results of this study had shown that the overall prevalence of anxiety, depression and stress among health care providers during the COVID-19 pandemic was 36%, [95% CI = (30.7%- 41.3%)], 25.8% [95% CI = (21.1%- 30.4%)] and 31.4% [95% CI = (26.4%- 36.0%)] respectively. Age, Adjusted Odds Ratio [AOR = 7.9], Educational status, [AOR = 3.2], low monthly income [AOR = 1.87], and presence of infected family members [AOR = 3.3] were statistically associated with anxiety. Besides this, gender, [AOR = 1.9], masters [AOR = 10.8], and degree holder [AOR = 2.2], living with spouse [AOR = 5.8], and family [AOR = 3.9], being pharmacists [AOR = 4.5], and physician [AOR = (0.19)], were found to be statistically significant predictors of depression among health care providers. Our study finding also showed that working at general [AOR = 4.8], and referral hospitals [AOR = 3.2], and low monthly income [AOR = 2.3] were found to be statistically significant predictors of stress among health care providers.

CONCLUSION

Based on our finding significant numbers of healthcare providers were suffered from anxiety, depression, and stress during the COVID-19 outbreak. So, the Government and other stakeholders should be involved and closely work and monitor the mental wellbeing of health care providers.

How Do Teleworkers and Organizations Manage the COVID-19 Crisis in Brazil? The Role of Flexibility I-Deals and Work Recovery in Maintaining Sustainable Well-Being at Work

The COVID-19 pandemic has impacted the economic market and labor contexts worldwide. Brazil has suffered one of the worst social and governmental managements of the COVID-19 crisis, forcing workers and organizations to develop coping strategies. This environment can affect both well-being and performance at work. Sustainable well-being at work refers to different patterns of relationships between performance and well-being. It may include eudaimonic (e.g., Meaning of Work-MOW) or hedonic (e.g., emotions) forms of well-being. This study tests the moderating role of recovery from work stress in the relationship between flexibility i-deals and patterns of sustainable well-being at work in Brazilian teleworkers. We relied on two studies to achieve this objective. In Study 1, conducted during the pandemic's first outbreak in Brazil (N = 386), recovery experiences moderated the relationship between i-deals and clusters formed by performance and MOW (eudaimonic happiness). In Study 2, conducted during the second outbreak (N = 281), we identified relationships between clusters of emotions (hedonic happiness) and MOW (eudaimonic) with performance. The results supported the idea that recovery experiences moderated the relationship between i-deals and patterns of sustainable well-being at work differently. Our findings have implications for Human Resource Management and teleworkers, especially for employee behaviors to deal with stress.

Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis

INTRODUCTION

COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic.

MATERIAL AND METHODS

We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI.

RESULTS

We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8-41.3), anxiety 39.7(95%CI: 34.3-45.1), stress 36.4% (95%CI: 23.2-49.7), fear 71.3% (95%CI: 54.6-88.0), burnout 68.3% (95%CI: 54.0-82.5), and low resilience was 16.1% (95%CI: 12.8-19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30-1.68) and nurses (OR = 1.21; 95%CI = 1.02-1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49-1.85), (Nurse: OR = 1.36; 95%CI = 1.16-1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28-1.97).

CONCLUSION

In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.

Depressive symptoms among frontline and non-frontline healthcare providers in response to the COVID-19 pandemic in Kelantan, Malaysia: A cross sectional study

Background

Healthcare providers are vulnerable in the fight against COVID-19 and may experience significant psychological and mental health consequences. This study aimed to compare the levels of depressive symptoms among frontline and non-frontline healthcare providers in response to the COVID-19 pandemic.

Methods

A comparative cross-sectional study was conducted in two government hospitals managing COVID-19-related cases in Kelantan, Malaysia from May to July 2020 to identify and compared depressive symptoms levels of frontline and non-frontline healthcare providers. Convenient sampling was applied in the selection of eligible participants and those diagnosed as having any psychiatric illnesses were excluded. The self-administered questionnaires for the Malay versions of the Hospital Anxiety and Depression Scale to measure depressive symptoms score and the Medical Outcome Study Social Support Survey to measure social support score as an important confounder. A descriptive analysis, independent t-test and ANCOVA were performed using SPSS version 26.

Results

A total of 306 respondents from healthcare providers were recruited which 160 were frontline healthcare providers and 146 were non-frontline healthcare providers. The level of depressive symptoms (HADS score >8) was 27.5% for the frontline healthcare providers and 37.7% for the non-frontline healthcare providers. The mean depressive symptoms score for the non-frontline healthcare providers was 0.75 points higher than that of the frontline healthcare providers after adjusting for gender, duration of employment and social support.

Conclusion

Non-frontline healthcare providers are also experiencing psychological distress during the COVID-19 pandemic even though they do not have direct contact with COVID-19 patients.

Prevalence of Psychological Impacts on Healthcare Providers during COVID-19 Pandemic in Asia

COVID-19 has impacted people psychologically globally, including healthcare providers. Anxiety, depression, and stress are the most common impacts that have affected these people. Thus, this study was aimed to ascertain the estimated prevalence of psychological impacts among healthcare providers in the Asian region. A systematic search was performed in the MEDLINE, CINAHL, and Scopus databases for original research articles published between 2020 and April 2021. Only studies published in English were included. The quality of data was assessed using the Joanna Briggs Institute Meta-Analysis, and the analysis was performed using generic inverse variance with a random-effects model by Review Manager software. A total of 80 studies across 18 countries in Asia region were pooled to assess the data prevalence on anxiety (34.81% (95% CI: 30.80%, 38.83%)), depression (34.61% (95% CI: 30.87%, 38.36%)), stress (31.72% (95% CI: 21.25%, 42.18%)), insomnia (37.89% (95% CI: 25.43%, 50.35%)), and post-traumatic stress disorder (15.29% (95% CI: 11.43%, 19.15%)). Subgroup analyses were conducted across regions, type of healthcare providers, sex, and occupation. This review has identified a high prevalence of anxiety, depression, stress, and insomnia but a low prevalence of post-traumatic stress disorder among healthcare providers in Asia regions. Effective intervention support programs are urgently needed to improve psychological health of healthcare providers and maintaining the health system.

Coping with job stress for hospital nurses during the COVID-19 crisis: The joint roles of micro-breaks and psychological detachment

AIM

To examine a mediated moderation of the effects of micro-break activity and psychological detachment on the relationship between job stress and work engagement among hospital nurses.

BACKGROUND

Nursing burnout, compassion fatigue and job stress have been relatively constant issues in nursing for at least the past decade-and the pervasiveness of the COVID-19 pandemic is intensifying them, which may lead to new challenges to work engagement.

METHODS

We tested our model using a time-lagged design to collect data from supervisor-subordinate dyads in seven public hospitals located in southern China, and 263 nurses and 58 head nurses in this survey. Confirmatory factor analysis, Pearson's correlation and hierarchical multiple regression were carried out.

RESULTS

The results showed that the adverse impact of job stress on work engagement disappeared when nurses engaged in high levels of micro-break activity. Moreover, the moderating role of micro-break activity was mediated by psychological detachment.

CONCLUSIONS

Micro-break activity and psychological detachment play joint roles in helping nurses to cope with job stress.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should change their negative attitude toward micro-break activity (if it exists) and help nurses find opportunities for detachment under high-pressure environment.

Prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in Southern Ethiopia

OBJECTIVES

Globally, novel coronavirus disease 2019 (COVID-19) has spread rapidly since it was first identified and challenging the provision of essential services for low-resource countries. Healthcare workers involved in providing care are at high risk of developing mental health problems. The aim of this was to determine the prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in the West Guji zone in public health facilities, southern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted in public health facilities found in the West Guji zone. A simple random sampling technique was employed to select 283 study subjects. This study was used to assess the prevalence of depression symptoms using Depression, Anxiety and Stress Scale-21, a depression subscale. Descriptive statistics, binary and multiple logistic regressions were used. Adjusted odds ratios (AORs) with 95% confidence interval will be estimated to assess the strength of associations and statistical significance will be declared at a p-value < 0.05.

RESULTS

Out of 283 eligible healthcare workers, 275 respondents had participated in this study with a 97.2% response rate. The prevalence of depressive symptoms was 21.5%. The independent predictors associated with depressive symptoms due to COVID-19 were age (adjusted odds ratio = 2.35, 95% confidence interval = 1.126-3.95), family size (adjusted odds ratio = 3.56, 95% confidence interval = 1.09-11.62), alcohol use (adjusted odds ratio = 4.31, 95% confidence interval = 1.76-10.55), medical illness (adjusted odds ratio = 9.56, 95% confidence interval = 3.71-24.59), having training on COVID-19 (adjusted odds ratio = 0.37, 95% confidence interval = 0.17-0.81), and lack of knowledge on COVID-19 (adjusted odds ratio = 15.34, 95% confidence interval = 6.32-37.21).

CONCLUSION

The prevalence of depressive symptoms among healthcare workers due to COVID-19 was high. Factors associated with depressive symptoms were age, family size, alcohol use, medical illness, having training on COVID-19, and lack of knowledge on COVID-19.

Fear of COVID-19 and COVID-19 Stress and Association with Sociodemographic and Psychological Process Factors in Cases under Surveillance in a Frontline Worker Population in Borneo

COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was a cross-sectional study using a sociodemographic questionnaire incorporating two specific epidemiological risk variables, namely specific questions about COVID-19 surveillance status (persons under investigation (PUI), persons under surveillance (PUS), and positive cases) and the nature of frontline worker status. Furthermore, five other instruments were used, with three measuring psychopathology (namely depression, anxiety and stress, fear of COVID-19, and stress due to COVID-19) and two psychological process variables (namely psychological flexibility and mindfulness). Kruskal-Wallis and Mann-Whitney tests were performed to assess if there were significant differences in psychopathology and psychological process variables between sociodemographic and epidemiological risk variables. Hierarchical multiple regression was further performed, with depression, anxiety, and stress as dependent variables. There were significant differences in the fear of COVID-19 between positive cases, PUI, and PUS. The fear of COVID-19 scores were higher in positive cases compared to in PUS and PUI groups. Upon hierarchical multiple regression, mindfulness and psychological flexibility were significant predictors of depression, anxiety, and stress after controlling for sociodemographic and epidemiological risk factors. This study demonstrates that exposure to COVID-19 as persons under investigation or surveillance significantly increases the fear of COVID-19, and brief psychological interventions that can positively influence mindfulness and psychological flexibility should be prioritized for these at-risk groups to prevent undue psychological morbidity in the long run.

Risk Factors for Anxiety and Depressive Symptoms in Doctors During the Coronavirus Disease 2019 Pandemic

Background: The purpose of our study was to investigate the prevalence of anxiety and depressive symptoms and their risk factors among doctors during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A hospital-based survey study was conducted. Anxiety symptoms were assessed using the Self-Rating Anxiety Scale (SAS), and depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Multivariable logistic regression was used to analyze anxiety and depressive symptoms across independent variables. Results: A total of 1,521 doctors were included; 11.11% (169/1,521) of the doctors had anxiety symptoms, and 16.90% (257/1,521) had depressive symptoms. Female sex [adjusted odds ratio (aOR), 1.69; 95% confidence interval (CI), 1.21-2.34; P = 0.002] and having a minor child (aOR, 2.31; 95% CI, 1.50-3.56; P < 0.001) were associated with an increased risk of anxiety symptoms. Female sex (aOR, 1.56; 95% CI, 1.18-2.06; P = 0.002) and having a minor child (aOR, 1.48; 95% CI, 1.06-2.01; P = 0.022) were associated with an increased risk of depressive symptoms. Older age (aOR, 0.97; 95% CI, 0.98-0.99; P = 0.008) was associated with a decreased risk of depressive symptoms. Conclusions: Anxiety and depressive symptoms have been common mental health problems in doctors during the COVID-19 pandemic. We found that female sex, having a minor child, and younger age were major risk factors for the development of anxiety and depressive symptoms among doctors during the COVID-19 pandemic.

Subjective Feelings of Polish Doctors after Receiving the COVID-19 Vaccine

The COVID-19 pandemic has caused enormous confusion around the world in our daily existence. The security measures taken, such as physical distance, wearing a mask, quarantine or closing shopping malls, and even isolating large groups of the population, did not contribute to the complete overcoming of the problem. Information on the positive results of research into the COVID-19 vaccine and, finally, its administration offered hope that the pandemic would be overcome. The undertaken problem of research concerning the subjective analysis of the feelings of doctors in Poland after receiving the COVID-19 vaccine shows an important area of the medical world, which is directly responsible for their own health and the patients entrusted to them. In addition, 149 people participated in the study (8-13 February 2021), including 57% of women and 43% of men. The minimum and maximum age of the respondents are 26 and 69 years old. Furthermore, 85% of respondents took two doses of the vaccine and 15% took one. The authorial questionnaire was completed by the participants in the study online in February 2021. The results obtained indicate that the COVID-19 vaccine generates hope for stopping the pandemic. In addition, 96% of research participants think so. Doctors in middle and mature age are the most optimistic, while the youngest ones are less optimistic. In addition, 57% of respondents do not worry about side effects after taking the vaccine. Fear at the time of vaccination was experienced by over 9% of doctors. The most frequently reported post-vaccination reactions are injection site pain, fatigue and headache. Increased temperature occurred in older female respondents. From a psychosocial perspective, men are more likely to fear being infected personally with the virus, and women are more likely to be infected with their loved ones. The presented subjective assessment presents the physicians' view captured at the moment in terms of existential and emotional. The presented feelings of the research participants reflect their personal satisfaction, responsibility for their own health, care for their relatives and patients.

Psychological impact of COVID-19 pandemic on healthcare workers in China Xi'an central hospital

OBJECTIVE

COVID-19 significantly altered our routine, lifestyle, and stress level across the globe. This study investigated the psychological impact of COVID-19 on healthcare workers in China Xi'an Center hospital.

METHODS

A modified online questionnaire of Psychological Status and the General Health Questionnaire (GHQ-12) was provided to 1,967 healthcare workers during the COVID-19 pandemic. Participation was voluntary, and the responses were anonymous. The survey lasted for 2 weeks, and the GHQ-12 was completed every other day. The data were collected automatically and electronically and then statistically analyzed.

RESULTS

The 431 (21.9%) responders included 214 nurses (49.7%), 146 clinicians (33.9%), 29 pharmacists (6.7%), 15 medical technicians (3.5%), 17 administrative staff (3.9%), and 10 other departments (2.3%). Of these, 46.2% had 10 years of work experiences or more and 78.2% were married. Work experience increased emotional stress as 23% of participants with 10 years or more of experience exhibited higher stress compared to those with fewer than 3 years of work experience (7.5%). Moreover, 33.3% of participants who worked in or were exposed to the affected areas of the pandemic experienced psychological stress. Overall, this study identified four factors that were significantly associated with psychological stress: (a) work experience (OR 2.99; 95% CI: 1.06 to 8.41); (b) change in job position (OR 1.99; 95% CI: 1.10 to 3.59); (c) change in lifestyle (OR 4.06; 95% CI: 1.81 to 9.10); and (d) need for psychological counseling (OR 3.07; 95% CI: 1.62 to 5.82).

CONCLUSIONS

The COVID-19 pandemic has increased psychological stress among healthcare workers with 10 years or more work experiences and who recently experienced a career position change.

"We All Really Need to just Take a Breath": Composite Narratives of Hospital Doctors' Well-Being during the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the spread of the virus and prioritize healthcare for those who contracted it. This study interviewed 48 hospital doctors who worked in Ireland during the first wave of the pandemic and investigated their conceptualizations of their own well-being during that time (March-May 2020). Doctors were interviewed via Zoom™ or telephone. Interview transcripts were analyzed using structured thematic analysis. Five composite narratives are presented which have been crafted to illustrate themes and experiences emerging from the data. This study found that despite the risks of contracting COVID-19, many doctors saw some improvements to their physical well-being in the first wave of the pandemic. However, most also experienced a decline in their mental well-being due to anxiety, emotional exhaustion, guilt, isolation and poor support. These findings shed light on doctor well-being during COVID-19, and the ways in which they have been affected by the pandemic, both professionally and personally. The paper concludes by highlighting how doctors' work life and well-being can be better supported during and after the COVID-19 pandemic.

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

Objective: Health-care workers (HCW) are at risk for psychological distress during an infectious disease outbreak, such as the coronavirus pandemic, due to the demands of dealing with a public health emergency. This rapid systematic review examined the factors associated with psychological distress among HCW during an outbreak. Method: We systematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCW during an outbreak (COVID-19, SARS, MERS, H1N1, H7N9, and Ebola). Four electronic databases were searched (2000 to 15 November 2020) for relevant peer-reviewed research according to a pre-registered protocol. A narrative synthesis was conducted to identify fixed, modifiable, and infection-related factors linked to distress and psychiatric morbidity. Results: From the 4,621 records identified, 138 with data from 143,246 HCW in 139 studies were included. All but two studies were cross-sectional. The majority of the studies were conducted during COVID-19 (k = 107, N = 34,334) and SARS (k = 21, N = 18,096). Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk of contact with infected patients, and experiencing quarantine, were risk factors for psychological distress among HCW. Personal and organizational social support, perceiving control, positive work attitudes, sufficient information about the outbreak and proper protection, training, and resources, were associated with less psychological distress. Conclusions: This review highlights the key factors to the identify HCW who are most at risk for psychological distress during an outbreak and modifying factors to reduce distress and improve resilience. Recommendations are that HCW at risk for increased distress receive early interventions and ongoing monitoring because there is evidence that HCW distress can persist for up to 3 years after an outbreak. Further research needs to track the associations of risk and resilience factors with distress over time and the extent to which certain factors are inter-related and contribute to sustained or transient distress.

COVID-19-Related Fear and Anxiety: Spiritual-Religious Coping in Healthcare Workers in Portugal

The COVID-19 pandemic has negatively affected the mental health of the general population, and for healthcare workers (HCWs) it has been no different. Religiosity and spirituality are known coping strategies for mental illnesses, especially in stressful times. This study aimed to describe the role of spiritual-religious coping regarding fear and anxiety in relation to COVID-19 in HCWs in Portugal. A cross-sectional quantitative online survey was performed. Socio-demographic and health data were collected as well as the Duke University Religion Index, Spirituality Scale, Fear of COVID-19 Scale, and Coronavirus Anxiety Scale. Two hundred and twenty-two HCWs participated in the study, 74.3% were female and 81.1% were physicians. The median age was 37 years (Q1, Q3: 31, 51.3). Religiosity was neither a significant factor for coronavirus-related anxiety nor it was for fear of COVID-19. Participants with higher levels in the hope/optimism dimension of the Spirituality Scale showed less coronavirus-related anxiety. Female HCWs, non-physicians, and the ones with a previous history of anxiety presented higher levels of fear and/or anxiety related to COVID-19. HCWs' levels of distress should be identified and reduced, so their work is not impaired.

Emotional Experience and Feelings during First COVID-19 Outbreak Perceived by Physical Therapists: A Qualitative Study in Madrid, Spain

Knowing the experiences and feelings of health professionals who have actively worked on the first-line during the first COVID-19 outbreak could help for identifying specific professional duties focused on health assistance objectives. No qualitative study has been published describing the emotion/feelings of physical therapists during the first COVID-19 outbreak. This study describes and explores the emotional experiences and feelings of thirty physical therapists working at the first-line at eleven public health hospitals in Madrid (Spain) during the first COVID-19 outbreak (March–May 2020). A qualitative exploratory study was conducted based on an interpretive framework. Participants were recruited by purposeful sampling and snow-ball techniques between May and June 2020. In-depth interviews and researchers’ field notes were used to collect the data. An inductive thematic analysis was conducted to identify significant emerging themes from verbatim transcription. After identifying 2135 codes and 9 categories, three themes emerged to describe their emotional experiences and feelings. First, “Critical events”, with negative and positive critical events. Second theme, “Emotional Roller Coaster”, with emotions, feelings, and coping strategies. Third theme: “Last words: Conclusions of the COVID-19 outbreak experience”, with the meaning of the COVID-19 outbreak from a personal and professional perspective. Comprehensive support for all first-line healthcare professionals is needed.

Prevalence of Stress in Healthcare Professionals during the COVID-19 Pandemic in Northeast Mexico: A Remote, Fast Survey Evaluation, Using an Adapted COVID-19 Stress Scales

The world is currently subjected to the worst health crisis documented in modern history: an epidemic led by the novel coronavirus disease 2019 (COVID-19). At the epicenter of this crisis, healthcare professionals continue working to safeguard our well-being. To the regular high levels of stress, COVID-19 adds even more so to healthcare professionals in particular, depending on their area, specialty, and type of work. Here we investigated what are the tendencies or areas most affected. Through an adaptation of the original COVID-stress scales, we developed a remote, fast test designed for healthcare professionals in the northeastern part of Mexico, an important part of the country with economic and cultural ties to the United States. Our results showed four key correlations as highly dependent: work area-xenophobia (p < 0.045), work with COVID patients-traumatic stress (p < 0.001), total number of COVID patients per day-traumatic stress (p < 0.027), and total number of COVID patients-compulsive checking and reassurance. Overall, we concluded that normal levels of stress have increased (mild-moderate). Additionally, we determine that the fear of being an asymptomatic patient (potential to spread without knowing) continues being a concern.