Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers

Managing nurse redeployment during the Covid-19 pandemic, lessons for future redeployment: A qualitative study

BACKGROUND

The mass redeployment of nurses was critical across countries necessitated by the acute health impact of Covid-19. Knowledge was limited regarding how to manage nurse redeployment or the impact that redeployment might have. Redeployment continues, particularly in response to the current staffing crisis and surges such as winter pressures. This study aims to address these gaps in evidence to inform guidance on how best to manage nurse redeployment in practice.

OBJECTIVES

First, to understand the processes and underpinning decisions made by managers when managing nurse redeployment prior to and during the Covid-19 pandemic. Second, to identify the lessons that can be learned to improve the management of on-going nurse redeployment.

DESIGN

Qualitative study utilising semi-structured interviews and focus groups with nurse managers (ISRCTN: 18172749).

SETTING(S)

Three acute National Health Service (NHS) Trusts in England with geographical and ethnic diversity, and different Covid-19 contexts.

PARTICIPANTS

Thirty-two nurse managers and four Human Resource advisors responsible for redeploying nurses or receiving and supporting redeployed nurses.

METHODS

Participants took part in face-to-face or virtual semi-structured interviews from February 2021 to November 2021 and virtual focus groups from July to December 2021. Qualitative data were analysed using reflexive thematic analysis.

RESULTS

Four themes were evident in the data, capturing four distinctive phases of the redeployment process. There was a fundamental mismatch between how different parts of the nursing and managerial workforce conceived of their decision-making responsibilities across different phases. This led to managers taking inconsistent and sometimes contradictory approaches when redeploying nurses, and a disconnect between nursing staff at all levels of the chain of command. Furthermore, in conjunction with limited guidance in operationalising redeployment and the distressing experiences vocalised by nurses, nurse managers found nurse redeployment logistically and emotionally challenging; and felt 'caught in the middle' of meeting both their managerial and mentoring responsibilities. This became increasingly challenging during subsequent phases of redeployment and remained challenging once the pandemic waned.

CONCLUSIONS

The approach to nurse redeployment in response to the Covid-19 pandemic prioritised nurse staffing numbers over personal well-being. Key principles of good practice relating to nurse redeployment during the Covid-19 pandemic can be applied to improve future redeployment of nurses and support positive outcomes. Having a planned approach for staff redeployment during normal service delivery comprising operational guidance for those tasked with implementing redeployment, that is scalable in a crisis setting, would be beneficial for the nursing workforce.

Physician Posttraumatic Stress Disorder During COVID-19: A Systematic Review and Meta-Analysis

Importance

The COVID-19 pandemic placed many physicians in situations of increased stress and challenging resource allocation decisions. Insight into the prevalence of posttraumatic stress disorder in physicians and its risk factors during the COVID-19 pandemic will guide interventions to prevent its development.

Objective

To determine the prevalence of posttraumatic stress disorder (PTSD) among physicians during the COVID-19 pandemic and examine variations based on factors, such as sex, age, medical specialty, and career stage.

Data Sources

A Preferred Reporting Items for Systematic Reviews and Meta-analyses-compliant systematic review was conducted, searching MEDLINE, Embase, and PsychInfo, from December 2019 to November 2022. Search terms included MeSH (medical subject heading) terms and keywords associated with physicians as the population and PTSD.

Study Selection

Peer-reviewed published studies reporting on PTSD as a probable diagnosis via validated questionnaires or clinician diagnosis were included. The studies were reviewed by 6 reviewers.

Data Extraction and Synthesis

A random-effects meta-analysis was used to pool estimates of PTSD prevalence and calculate odds ratios (ORs) for relevant physician characteristics.

Main Outcomes and Measures

The primary outcome of interest was the prevalence of PTSD in physicians, identified by standardized questionnaires.

Results

Fifty-seven studies with a total of 28 965 participants and 25 countries were included (of those that reported sex: 5917 of 11 239 [52.6%] were male and 5322 of 11 239 [47.4%] were female; of those that reported career stage: 4148 of 11 186 [37.1%] were medical trainees and 7038 of 11 186 [62.9%] were attending physicians). The estimated pooled prevalence of PTSD was 18.3% (95% CI, 15.2%-22.8%; I2 = 97%). Fourteen studies (22.8%) reported sex, and it was found that female physicians were more likely to develop PTSD (OR, 1.93; 95% CI, 1.56-2.39). Of the 10 studies (17.5%) reporting age, younger physicians reported less PTSD. Among the 13 studies (22.8%) reporting specialty, PTSD was most common among emergency department doctors. Among the 16 studies (28.1%) reporting career stage, trainees were more prone to developing PTSD than attendings (OR, 1.33; 95% CI, 1.12-1.57).

Conclusions and Relevance

In this meta-analysis examining PTSD during COVID-19, 18.3% of physicians reported symptoms consistent with PTSD, with a higher risk in female physicians, older physiciansy, and trainees, and with variation by specialty. Targeted interventions to support physician well-being during traumatic events like pandemics are required.

The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

Perceived Stress Among Nurses at a Tertiary Care Teaching Hospital in Saudi Arabia During the COVID-19 Pandemic

BACKGROUND

The stress level of nurses, especially frontline staff, directly impacts their physical and mental health as well as work efficiency. However, few studies have been conducted to understand the stress level of nurses related to the coronavirus disease 2019 (COVID-19) pandemic.

AIM

The aim of this study is to assess the level of perceived stress among nurses at a tertiary care teaching hospital (King Abdulaziz University Hospital, Jeddah) in Saudi Arabia during the COVID-19 pandemic.

METHODS

A cross-sectional survey-based descriptive study involved 1044 nurses working at a tertiary care/teaching hospital in Saudi Arabia. The Perceived Stress Scale (PSS) was used to assess nurses' stress levels. The study was conducted in July 2021 by selecting clinical nurses from different nursing units. Considering the current situation of social isolation, an online cross-sectional survey using Google Forms was used. Data analysis was performed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States).

RESULTS

Out of 1044 nursing professionals, 93 (8.9%) reported experiencing low levels of stress, 915 (87.6%) reported moderate levels of stress, and 36 (3.4%) reported high perceived stress during the COVID-19 pandemic. The study found that gender (p=0.001) and nationality (p=0.016) had significant effects on stress levels. The three major causes of stress identified by the nurses were workload, lack of resources, and fear of contracting COVID-19.

CONCLUSION

Job-related stress continues to be an issue in the nursing workforce. The effects of stress experienced by nurses impact job satisfaction and retention, which, in turn, can affect the quality of patient care. This study highlights that nurses in a tertiary care (COVID care) teaching hospital in our setting often experience stress and anxiety during the pandemic. It is worth noting that this is the first study conducted to understand the level of stress perceived by nursing staff during the COVID-19 pandemic in our current study setting. The findings indicate that a considerable number of nurses experienced moderate levels of stress during COVID-19, which can have implications for patient care. Recognizing and understanding the job-related stressors of nurses can help nurse leaders implement more effective strategies aimed at reducing nurses' stress and subsequently improving patient outcomes.

Examining resilience among child protection professionals during COVID-19: A global comparison across 57 countries

BACKGROUND

The COVID-19 pandemic led to numerous challenges for child protection professionals (CPPs). However, limited research has investigated the interwoven concepts of coping, resilience, and mental distress among CPPs during COVID-19 on a global scale.

OBJECTIVES

This study aimed to explore CPPs' practice, resilience, and mental distress during COVID-19, the relationship between their resilience and mental distress, the global stability of the Multi-System Model of Resilience (MSMR), and how CPPs' resilience varied according to the Human Development Index (HDI).

METHODS

Data were collected from 420 CPPs in 57 countries across five continents between July and September 2021. Participants completed an online questionnaire on demographics, resilience, mental distress, coping, and perceptions of child protection during the pandemic in their native languages. The analyses compared the countries grouped according to HDI using means comparisons, correlations, and multiple linear regressions. A two-path analysis was also performed to identify variables associated with behavioral resilience engagement and mental distress.

RESULTS

The findings indicated that CPPs' perceptions of COVID-19's impact on child maltreatment varied in correlation with their country's HDI. There were also significant HDI-based differences regarding the perceived opportunity to engage in resilient behavior and its helpfulness. Years of professional experience, internal resilience, and external resilience were shown to be significant predictors of mental distress among CPPs during the pandemic, and resilience mediated how years of experience predicted mental distress.

CONCLUSIONS

This study emphasized the importance of experience and internal resilience for CPPs' psychological well-being. It also provides empirical evidence to support the MSMR theory on a global scale. Additionally, it demonstrates how the perceived changes in child maltreatment during COVID-19 may be associated with regional HDI. Lastly, the opportunities CPPs had to engage in resilient behavior and how much this helped them was associated with regional HDI, but not in the way originally predicted. Study results also hold implications for how practice and policy may be altered to help CPPs cope better during times of crisis and generally.

Exploring the impact of recovery funding on the well-being and health workforce capability of rural practices during natural disasters and emergencies

INTRODUCTION

This study examines the impact of funding provided to support the well-being of rural health practitioners and their practice staff following the 2019-2022 bushfires.

OBJECTIVE

To assess the benefits and implications of grant funding for rural practices to aid recovery following bushfires in NSW, Australia.

DESIGN

An explanatory sequential mixed method design consisted of a survey and a thematic analysis of semi-structured Interviews.

FINDINGS

Five key themes emerged from analysis: (1) the disasters altered the role of the practice and therapeutic relationships; (2) the funding had a positive impact on access to professional development; (3) the training had a positive impact on staff well-being and resilience; (4) the professional development had a positive impact on rural practitioner's sense of capability; and (5) important elements of future grant opportunities.

DISCUSSION

The findings indicate the importance of recovering funding to facilitate access to professional development for rural health practioners during natural disasters which improved their mental health and wellbeing, capability and support to clients.

CONCLUSION

Recovery funding facilitated improvement in workforce capability, professional resilience, mental health and well-being in the face of natural disasters and emergencies. There was a link between training and maintaining the capability of rural health care practitioners and their practice staff. Capability was an important factor in the well-being and resilience of the health workforce and their ability to support clients.

Mental health status and related factors influencing healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The mental health of healthcare workers during the coronavirus-2019 pandemic was seriously affected, and the risk of mental health problems was high. The present study sought to systematically evaluate the mental health problems of healthcare workers worldwide during the pandemic and to determine the latest global frequency of COVID-19 associated mental health problems.

METHODS

Data in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Elsevier, MEDLINE, PubMed, PsycINFO and the Web of Science before November 11, 2022, were systematically searched. Cohort, case-control and cross-sectional studies were included. The meta-analysis used a random effects model to synthesize the comprehensive prevalence rate of mental health problems. Subgroup analyses were performed based on time of data collection; whether the country was or was not developed; continent; doctors and nurses; doctors/nurses vs. other healthcare workers; and psychological evaluation scale.

RESULTS

A total of 161 studies were included, including 341,014 healthcare workers worldwide, with women accounting for 82.8%. Occupationally, 16.2% of the healthcare workers were doctors, 63.6% were nurses and 13.3% were other medical staff. During the pandemic, 47% (95% confidence interval [CI], 35-60%) of healthcare workers reported job burnout, 38% (95% CI, 35-41%) experienced anxiety, 34% (95% CI 30-38%) reported depression, 30% (95% CI, 29-31%) had acute stress disorder, and 26% (95% CI, 21-31%) had post-traumatic stress disorder.

CONCLUSIONS

The study found that there were common mental health problems among health care workers during the COVID-19 pandemic. The most common was job burnout, followed by anxiety, depression, acute stress and post-traumatic stress disorder. Although the global pandemic has been brought under control, its long-term impact on the mental health of healthcare workers cannot be ignored. Additional research is required to develop measures to prevent, monitor and treat psychological disorders among healthcare workers.

Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island

Introduction

Since the first confirmed case of coronavirus disease 2019 (COVID-19) in China, COVID-19 continues to be a global threat and exerts a significant impact on medical practices. This study aims to investigate the impact of the COVID-19 pandemic on medical practices in Awaji Island, a remote island in Japan.

Methods

First, we conducted a survey on the epidemiological characteristics of COVID-19 on Awaji Island before and during the pandemic. Next, using a questionnaire, we conducted a survey with doctors working full time at Hyogo Prefectural Awaji Medical Center, which is the only designated infectious disease hospital on Awaji Island.

Results

The COVID-19 infection rate of Awaji Island was lower than that of Hyogo Prefecture and of Japan as a whole, although the peaks occurred simultaneously. Outpatient visits as well as hospitalized patients, i.e., inpatients, decreased during the pandemic as a result of restrictions on surgeries and hospitalizations, with no changes in the disease composition ratio. The results of the questionnaire show that during the pandemic, doctors working full time at our hospital worked less and slept more. Furthermore, data obtained from the Medical Affairs Department showed a decrease in overtime hours worked and an increase in the number of days of paid holidays taken.

Conclusions

Epidemiologically, the impact of the COVID-19 pandemic on Awaji Island showed a similar trend to that in Japan, but the results of the survey questionnaire indicated that doctors working full time at our hospital were not necessarily adversely affected.

Half a Century of Research on Posttraumatic Stress Disorder: A Scientometric Analysis

We conducted a scientometric analysis to outline clinical research on posttraumatic stress disorder (PTSD). Our primary objective was to perform a broad-ranging scientometric analysis to evaluate key themes and trends over the past decades. Our secondary objective was to measure research network performance. We conducted a systematic search in the Web of Science Core Collection up to 15 August 2022 for publications on PTSD. We identified 42,170 publications published between 1945 and 2022. We used CiteSpace to retrieve the co-cited reference network (1978-2022) that presented significant modularity and mean silhouette scores, indicating highly credible clusters (Q = 0.915, S = 0.795). Four major trends of research were identified: 'war veterans and refugees', 'treatment of PTSD/neuroimaging', 'evidence syntheses', and 'somatic symptoms of PTSD'. The largest cluster of research concerned evidence synthesis for genetic predisposition and environmental exposures leading to PTSD occurrence. Research on war-related trauma has shifted from battlefield-related in-person exposure trauma to drone operator trauma and is being out published by civilian-related trauma research, such as the 'COVID-19' pandemic impact, 'postpartum', and 'grief disorder'. The focus on the most recent trends in the research revealed a burst in the 'treatment of PTSD' with the development of Mhealth, virtual reality, and psychedelic drugs. The collaboration networks reveal a central place for the USA research network, and although relatively isolated, a recent surge of publications from China was found. Compared to other psychiatric disorders, we found a lack of high-quality randomized controlled trials for pharmacological and nonpharmacological treatments. These results can inform funding agencies and future research.

Comparison of healthcare workers and non-healthcare workers in terms of obsessive-compulsive and depressive symptoms during COVID-19 pandemic: a longitudinal case-controlled study

Objective

The aim of this study was to investigate the obsessive-compulsive and depressive symptoms of healthcare workers in a case-control setting as longitudinal.

Method

In this study included 49 healthcare workers and 47 non-health workers. A sociodemographic data form, the Maudsley Obsessive-Compulsive Inventory (MOCI), the Symptom Checklist-90 (SCL-90), and the Hamilton Depression Rating Scale (HAM-D) were used to assess individuals between June 1, 2020 and June 30, 2021. We assessed the same healthcare workers after 12 months on June 30, 2021 using MOCI, HAM-D, and SCL-90.

Results

MOCI and SCL-90 obsessive-compulsive subscale scores were significantly higher in the healthcare workers than in the non-health workers. When we assessed MOCI, HAM-D, and SCL-90 obsessive-compulsive subscale scores after 12 months, there was a statistically significant decrease in the scores of all three scales among the healthcare workers.

Conclusion

The results of the study showed that healthcare workers were more likely to have obsessive-compulsive symptoms than non-health workers in the early part of the pandemic on June 1, 2020, as shown by their scores on MOCI and the obsessive-compulsive subscale of SCL-90. When we assessed the same participants after 12 months (June 30, 2021), both MOCI and SCL-90 obsessive-compulsive subscale scores had decreased significantly. In contrast to these results, HAM-D scores significantly increased.

Factors associated with the quality of life and persistent dyspnea severity in COVID-19 survivors: A cross-sectional study among healthcare workers

The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on global health. The alterations in quality of life (QoL) and the persistent symptoms of dyspnea have been the healthcare workers' challenges during and after the pandemic. The aim of this study was to assess factors associated with the QoL and persistent dyspnea experienced by COVID-19 survivors, particularly among healthcare workers. A cross-sectional study was conducted among healthcare workers at H. Adam Malik General Hospital, Medan, Indonesia, using direct interviews to collect the data. The EuroQol 5-dimensional 5-level (EQ-5D-5L) and the self-assessment EuroQol-visual analog scale (EQ-VAS) were employed to assess the QoL of the healthcare workers; and persistent dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Several possible risk factors such as demographic characteristics (gender and age), clinical characteristics (comorbidities, history of hospitalization, oxygen usage, history of COVID-19 vaccination, the severity of previous COVID-19, existence of post-COVID syndrome) and the symptoms of the post-COVID syndrome were collected. Chi-squared test or Fisher's exact test was used to identify the risk factors associated with the QoL and persistent dyspnea. A total of 100 healthcare workers were included in the study. The EQ-5D-5L assessment found that 2% of healthcare workers experienced pain/discomfort and 4% experienced anxiety/depression. The average healthcare worker's EQ-VAS score was 87.6±8.1. There was no significant association between studied demographics and clinical characteristics with QoL dimensions. However, post-COVID symptoms of activity limitation (p=0.004), sore throat (p=0.026), headache (p=0.012), myalgia (p=0.006), and arthralgia (p=0.001) were associated with pain/discomfort dimension of QoL. In addition, there was a significant association between activity limitation (p=0.012), headache (p=0.020), myalgia (p=0.015) and arthralgia (p=0.032) with anxiety/depression dimension of QoL. Our data suggested that the presence of post-COVID syndrome (p=0.006) and the presence of post-COVID syndrome symptoms of cough (p=0.021) and fatigue (p=0.015) were associated with persistent dyspnea. In conclusion, this study suggests that the presence of post-COVID syndrome and its symptoms are associated with low quality of health-related QoL and persistent dyspnea. Therefore, cautions are needed for such patients to prevent low QoL in the future.

Risk factors of developing psychological problems among frontline healthcare professionals working in the COVID-19 pandemic era: a meta-analysis

BACKGROUND

This study sought to evaluate the risk factors behind developing psychological problems as per specific mental health assessment instruments. This study focuses specifically on frontline healthcare professionals of the COVID-19 pandemic era, and evaluated the psychological assessment of frontline healthcare professionals.

METHODS

Studies reporting on the psychological assessment of frontline healthcare professionals were retrieved from the PubMed, Embase, Web of Science, Ovid, EBSCO, and Cochrane Library databases. The recommended method was used to assess the risk of bias of the included studies. The random-effects method was applied when significant heterogeneity was observed.

RESULTS

The combined results from the 20 included articles indicated that frontline healthcare professionals had a higher risk of developing anxiety in comparison with non-frontline healthcare workers, with similar levels of depression scoring were observed. Healthcare providers aged > 40 years had a lower probability of developing anxiety and seemed to experience minimal depression. Conversely, frontline workers had a higher incidence of anxiety than that of depression. Being single (not in a relationship) could influence the PHQ-9 scores instead of those concerning the GAD-7. The gender gap was not proven to be significantly wide between healthcare professionals with or without anxiety; however, being male was proven to be positively correlated with depression.

CONCLUSION

In general, the risk factors for susceptibility to psychological problems among frontline healthcare professionals during the COVID-19 pandemic concerned those of a lower age, being single, being male, and being engage in frontline healthcare work.

Factors associated with depression among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis

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.

Psychological distress and musculoskeletal pain in manual therapists during the second wave of the COVID-19 pandemic in Sweden: a cross-sectional study

BACKGROUND

The COVID-19 pandemic had an unprecedented impact on healthcare, and the health of healthcare workers has been subject of much research. However, studies of health-related factors in manual therapists during the COVID-19 pandemic are scarce. Research in this field can provide valuable insights for future crises policy and guidelines, including in regions where the public health response to COVID-19 contrasts with that of most other international jurisdictions. The aim was to describe the prevalence of psychological distress and musculoskeletal pain, and to investigate factors potentially associated with high psychological distress and activity-limiting musculoskeletal pain in clinically active chiropractors and naprapaths during the second wave of the COVID-19 pandemic in Sweden.

METHODS

A cross-sectional survey was distributed to a representative sample of Swedish manual therapists, between November 2020 and January 2021. High psychological distress and activity-limiting musculoskeletal pain were investigated regarding associations with residing in a municipality with a high spread of infection, a previous/ongoing SARS-CoV-2 infection, clinical interferences and economic consequences associated with the pandemic. Generalized Linear Models with log link and binomial distribution were used, computing prevalence ratios (PR) with 95% confidence intervals (95% CI).

RESULTS

A total of 762 participants were included, representing 46% of the source population. The prevalence of depressive, anxiety, and stress symptoms was 17%, 7%, and 12%, respectively. Neck (50%), low back (46%), upper back (40%), and shoulders (39%) were the most prevalent musculoskeletal pain areas. Economic consequences due to the pandemic were associated with high psychological distress (PR = 2.30, 95% CI: 1.48-3.53).

CONCLUSIONS

During the second wave of the COVID-19 pandemic in Sweden, manual therapists primarily suffered from musculoskeletal pain related to the back and shoulders, while depressive symptoms were the most common symptom of psychological distress. Owners of businesses that suffered economic consequences had a higher prevalence of high psychological distress, which may call for targeted support of this group in future similar contexts. Future longitudinal studies during the pandemic are warranted to assess these associations further.

PTSD of Chinese nurses in the normalisation of COVID-19 pandemic prevention and control: Prevalence and correlates

Background

Though the severe prevention and control measures faced by Chinese nurses had changed during the normalisation stage of the coronavirus 2019 (COVID-19) pandemic, they still worked under great stress. Due to a lack of related evidence, we aimed to investigate the prevalence and correlates of post-traumatic stress disorder (PTSD) among Chinese nurses during the normalisation of COVID-19 pandemic prevention and control measures.

Methods

Using convenience sampling, we recruited 784 nurses in Jiangsu province, China to complete a survey via their mobile devices. We used a demographic questionnaire, the Perceived Social Support Scale, the Connor-Davidson Resilience Scale, the General Self-Efficacy Scale, and The Impact of Event Scale-Revised to collect data and applied binary logistic regression analysis to identify factors associated with PTSD.

Results

The prevalence of PTSD was 26.4%. Married nurses were less likely to experience PTSD than unmarried ones (odds ratio (OR) = 0.573; 95% confidence interval (CI) = 0.33-0.99, P = 0.046). Social support (OR = 0.96; 95% CI = 0.94-0.98, P = 0.000) and resilience (OR = 0.98; 95% CI = 0.97-0.99, P = 0.004) were significant predictors of PTSD.

Conclusions

PTSD remained prevalent among Chinese nurses as COVID-19 pandemic prevention and control measures became normalised, with an incidence rate of 26.4%. Resilience, social support, and marital status were factors associated with PTSD. Chinese hospital management must intervene to improve resilience and social support for nurses to reduce symptoms of PTSD.

Physical Activity Reduces Depression among Healthcare Workers during the COVID-19 Pandemic in Jordan

Aims

This study aimed to assess mental health status by measuring depression and investigating the effect of physical activity in lessening the mental health burden among HCWs during the COVID-19 pandemic in Jordan.

Background

The COVID-19 pandemic has caused distress and depression among healthcare workers and drastic disruptions in social, economic, and health systems worldwide.

Methods

A cross-sectional online study through google forms involved HCWs across Jordan for two months. The 10-item short form of the Center for Epidemiological Studies Depression Scale Revised (CESD-R10) was used to assess depressive symptoms.

Results

The total sample was 295, females were 50.5% with mean age of 33.1 (>80% less than 40 years old), married 51.9%, 63% were physicians, 88.1% had contact with patients, and 64.7% were smokers. Depression symptoms were perceived by 59.3% of the total samples (53.1).

Conclusion

During the COVID-19-induced nationwide lockdown in Jordan, HCWs who engaged in enough physical exercise reported fewer depressive symptoms. Promoting physical exercise among HCWs may lead to better results for their mental health. Various clinical implications support promoting designated time and space for physical activity at work.

Impact of COVID-19 Pandemic on Mental Health among the Population in Jordan

BACKGROUND

Mental health is a key indicator for public health measures. Jordan is one of the countries that has a high prevalence of mental illness and disorders. The COVID-19 pandemic has affected all health services in the country with a high refugee population. The aim of this review is to assess the impact of the pandemic on mental health in Jordan and identify key factors affecting it, in addition to addressing lessons learned from the pandemic.

METHODS

A systematic search was conducted on Medline Plus, Embase, Web of Science, EBSCOHost Psycinfo and Cinhal, following the PRISMA guidelines. Articles were selected based on predefined inclusion and exclusion criteria. Data were extracted and synthesized using narrative descriptive analysis.

RESULTS

The pandemic had a significant impact on PTSD, psychological distress, anxiety, depression and stress. Predictors of a higher impact on mental health were related to gender, socio-economic status and comorbidities. The healthcare workers group was the most affected by mental disorders.

CONCLUSIONS

The COVID-19 pandemic's impact on mental health was associated with high levels of PTSD, anxiety, depression and stress. In a country with a high prevalence of mental disorders, prompt and quick measures are needed to support the health system to absorb the effect of the pandemic and be responsive to dealing with the existing high prevalence.

Post-Traumatic Stress Disorder among Polish Healthcare Staff in the Era of the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic has brought many adverse phenomena, particularly in the area of health for both individuals and society as a whole. Healthcare staff also suffered dire consequences.

AIM

The aim of this study was to assess whether the COVID-19 pandemic increased the risk of post-traumatic stress disorder among healthcare professionals in Poland.

MATERIAL AND METHOD

The survey was conducted between 4 April 2022 and 4 May 2022. The study applied the Computer Assisted Web Interview (CAWI) technique using the standardised Peritraumatic Distress Inventory (PDI) questionnaire.

RESULTS

The average score obtained by the respondents on the PDI was 21.24 ± 8.97. There was a statistically significant difference between the average PDI score obtained based on the gender of the subject (Z = 3.873, p = 0.0001.) The score obtained amongst nurses was statistically significantly higher compared to the paramedic group (H = 6.998, p = 0.030). There was no statistically significant difference between the average PDI score obtained based on the age of the participants (F = 1.282, p = 0.281), nor with their length of service (F = 0.934, p = 0.424). A total of 82.44% of the respondents received 14 PDI points, the cut-off point indicating the risk of PTSD that was adopted in the study. It was concluded that 6.12% of respondents did not require intervention (<7 PDI score); 74.28% of respondents needed further follow-up for PTSD and a reassessment of the PDI approximately 6 weeks after the initial testing; and 19.59% required coverage for PTSD prevention and mitigation (>28 PDI score).

CONCLUSIONS

The study has shown a high risk of post-traumatic stress disorder among healthcare professionals in Poland. This risk is related to the gender of the respondents, with an indication of a higher risk of PTSD among women. The results have also shown a correlation between increased risk of post-traumatic stress disorder and occupation, with nurses being the most affected group. In contrast, no association has been found in terms of age and length of service for an increase in the risk of PTSD, following exposure to trauma in relation to healthcare services during the COVID-19 pandemic.

Work-Family Conflict and Mental Health among Chinese Female Healthcare Workers during the COVID-19 Pandemic: The Moderating Effects of Resilience

(1) Background: The mental health of female healthcare workers is at greater risk during the COVID-19 pandemic due to increased psychological stress and heightened work-family conflict. This study investigated whether resilience, as a protective factor for mental health, can safeguard the well-being of female healthcare workers. This study assessed the mental health of female healthcare workers (n = 431) from a small inland city in Central China, explored the impact of work-family conflict on their mental health, and examined the moderating role of resilience. (2) Methods: The main variables were measured using standard tools administered via an online survey. A one-sample t-test, ANOVA, Pearson correlation analysis, and multiple regression were performed with SPSS. A simple slope test was conducted based on the multiple regression results. (3) Results: The analysis revealed that the mental health level of the surveyed female healthcare workers was significantly lower than the national norm (t = 16.36, p < 0.001). Work-family conflict had a significant negative impact on mental health (β = 0.39, p < 0.001), while the interaction effect of resilience and work-family conflict was significant (β = -0.13, p < 0.05), suggesting a moderating effect. (4) Conclusions: Female healthcare workers exhibited poor mental health during the COVID-19 pandemic, but resilience remained a protective factor, mitigating the negative impact of work-family conflict on female healthcare workers' mental health.

Machine learning-based analytics of the impact of the Covid-19 pandemic on alcohol consumption habit changes among United States healthcare workers

The COVID-19 pandemic is a global health concern that has spread around the globe. Machine Learning is promising in the fight against the COVID-19 pandemic. Machine learning and artificial intelligence have been employed by various healthcare providers, scientists, and clinicians in medical industries in the fight against COVID-19 disease. In this paper, we discuss the impact of the Covid-19 pandemic on alcohol consumption habit changes among healthcare workers in the United States during the first wave of the Covid-19 pandemic. We utilize multiple supervised and unsupervised machine learning methods and models such as decision trees, logistic regression, support vector machines, multilayer perceptron, XGBoost, CatBoost, LightGBM, AdaBoost, Chi-Squared Test, mutual information, KModes clustering and the synthetic minority oversampling technique on a mental health survey data obtained from the University of Michigan Inter-University Consortium for Political and Social Research to investigate the links between COVID-19-related deleterious effects and changes in alcohol consumption habits among healthcare workers. Through the interpretation of the supervised and unsupervised methods, we have concluded that healthcare workers whose children stayed home during the first wave in the US consumed more alcohol. We also found that the work schedule changes due to the Covid-19 pandemic led to a change in alcohol use habits. Changes in food consumption, age, gender, geographical characteristics, changes in sleep habits, the amount of news consumption, and screen time are also important predictors of an increase in alcohol use among healthcare workers in the United States.

Linguistic Predictors of Psychological Adjustment in Healthcare Workers during the COVID-19 Pandemic

COVID-19 broke out in China in December 2019 and rapidly became a worldwide pandemic that demanded an extraordinary response from healthcare workers (HCWs). Studies conducted during the pandemic observed severe depression and PTSD in HCWs. Identifying early predictors of mental health disorders in this population is key to informing effective treatment and prevention. The aim of this study was to investigate the power of language-based variables to predict PTSD and depression symptoms in HCWs. One hundred thirty-five HCWs (mean age = 46.34; SD = 10.96) were randomly assigned to one of two writing conditions: expressive writing (EW n = 73) or neutral writing (NW n = 62) and completed three writing sessions. PTSD and depression symptoms were assessed both pre- and post-writing. LIWC was used to analyze linguistic markers of four trauma-related variables (cognitive elaboration, emotional elaboration, perceived threat to life, and self-immersed processing). Changes in PTSD and depression were regressed onto the linguistic markers in hierarchical multiple regression models. The EW group displayed greater changes on the psychological measures and in terms of narrative categories deployed than the NW group. Changes in PTSD symptoms were predicted by cognitive elaboration, emotional elaboration, and perceived threat to life; changes in depression symptoms were predicted by self-immersed processing and cognitive elaboration. Linguistic markers can facilitate the early identification of vulnerability to mental disorders in HCWs involved in public health emergencies. We discuss the clinical implications of these findings.

Psychological impact of COVID-19 on healthcare leaders: a cross-sectional survey in Friuli-Venezia Giulia, Italy

INTRODUCTION

Although several studies highlighted the psychological burden of 2019 coronavirus disease (COVID-19) pandemic, no data are available regarding professionals leading healthcare organisations. This study aims to assess the psychological impact of COVID-19 on healthcare leaders (HeLs), along with the leadership skills and coping strategies needed for successful leadership.

METHODS

A cross-sectional survey was conducted in Friuli-Venezia Giulia (Italy) between October and November 2020. We assessed the presence of depressive symptoms (DS), anxiety symptoms (AS), perceived stress (PS) and insomnia using internationally validated tools. Coping strategies and skills needed to overcome the crisis were examined, along with the most challenging phases.

RESULTS

A total of 48 HeLs participated. The prevalence of DS and AS was 14.6% and 12.5%, respectively. Moderate and severe insomnia was found in 12.5% and 6.3% of them, respectively. Leaders showed moderate (45.8%) and high 4,2%) level of PS. The two most challenging phases were recognised in early recognition (45.2%) and peak phase (31.0%). Concerning healthcare leaders' skills required to manage with pandemic, the most reported were communication (35.1%) and decision-making (25.5%).

CONCLUSION

The high level of PS, insomnia, DS and AS experienced by healthcare leaders shows the COVID-19 pandemic's psychological impact. The two most challenging phases identified enhances the importance of public health surveillance and monitoring systems, and communication appeared a critical success skill for healthcare leaders. Given the key role these professional play in addressing the current crisis in healthcare organisations, their mental health and well-being deserve greater attention.

Influence of empathy on work alienation among Chinese nurses during the COVID-19 pandemic: The mediating effect of ego depletion

Background

Nurses' work alienation has become increasingly serious due to the increase in workload and risk during the coronavirus disease 2019 (COVID-19). However, no studies have investigated the link between empathy, ego depletion, and work alienation among Chinese nurses. The present study aimed to evaluate Chinese nurses' empathy, ego depletion, and work alienation and to examine whether nurses' ego depletion mediates the relationship between empathy and work alienation.

Methods

This was a descriptive, cross-sectional study involving 353 nurses from Shaanxi. The Jefferson Scale of Empathy-Health Professionals, Self-Regulating Fatigue Scale and Work Alienation Questionnaire were used to collect data through an online survey. Structural equation modeling was conducted to analyze the mediating model.

Results

Work alienation was negatively correlated with empathy (r = -0.305, p < 0.01) and positively correlated with ego depletion (r = 0.652, p < 0.01). Empathy was negatively correlated with ego depletion (r = -0.325, p < 0.01). Empathy can directly predict work alienation (β = -0.263, p < 0.01), while ego depletion has a mediating effect between empathy and work alienation (β = -0.309, p < 0.01), and the mediating effect accounts for 54.02% of the total effect.

Conclusion

Nurses' work alienation was at a moderate-to-high level. Improving empathy can reduce work alienation through less ego depletion. Nursing managers should discover nurses' work alienation as soon as possible. Interventions to improve empathy can help replenish nurses' psychological resources, thereby reducing ego depletion and work alienation.

Mental Health of Healthcare Workers during COVID-19 Pandemic in Taiwan: The First Wave Outbreak Occurred 1 Year Later Than in Other Countries

We probed the psychological influence exerted on traumatic stress endured by healthcare workers (HCWs) and the coping behaviors adopted during the first wave of COVID-19 in Taiwan, which occurred one year later than in other countries. Clinical HCWs from two branches of a hospital network in Taichung, Taiwan, were recruited for this cross-sectional study. The participants were administered a questionnaire on sociodemographic and work-related characteristics, perceived influence exerted by COVID-19, coping behaviors in relation to COVID-19, and Impact of Event Scale-Revised scores. We obtained 769 valid questionnaires. A chi-square test, generalized linear modeling, and multivariate stepwise regression analyses were performed. Although the first wave of COVID-19 occurred one year later in Taiwan than in other countries, the traumatic stress experienced by Taiwanese HCWs was noted to be comparable to that of those in other countries. Factors for increased traumatic stress included caring for more patients with COVID-19, fair or poor self-rated mental health, higher perceived influence of COVID-19, vulnerable household income, and more negative coping behaviors. Positive coping behaviors such as exposure reduction and protection measures decreased traumatic stress. Accordingly, managers should strengthen protective measures, enhance COVID-19-related training, and provide psychological support and counseling for high-risk employees.

The impact of the Covid-19 pandemic and previous natural disasters on the mental health of healthcare workers in Puerto Rico

The objective of this study was to assess the impact of COVID-19 pandemic worries (e.g., fear of contagion) and previous exposure to natural disasters (e.g., hurricanes) on Healthcare Workers (HCWs) mental health in Puerto Rico. Participants completed a self-administered online survey including items on sociodemographic information, working conditions, fears, and worries about the COVID-19 pandemic, past natural disaster experiences, depressive symptoms, and resilience. Logistic regressions models were performed to explain the relationship between depressive symptomatology and COVID-19 experiences and worries. 40.9% (n = 107) of the sample were classified as having some level (mild to severe) of depressive symptomatology (PHQ-8 ≥5). Results reflect normal to high levels of psychological resilience (BRS; M = 3.7, SD = 0.7). A significant association was found between depressive symptomatology and psychological resilience (OR = 0.44, 95% CI: 0.25-0.77). The odds of having depressive symptomatology were almost five times higher (OR = 4.79, 95% CI: 1.71-13.44) among those who reported emotional coping difficulties during the pandemic after experiencing a natural disaster compared to those that did not, when adjusting for psychological resilience and residence region. Despite normal to high psychological resilience levels, HCWs who reported emotional coping difficulties due to previous disasters were at risk of developing depressive symptomatology. Results suggest interventions to address the mental health of HCWs could benefit from considering other individual and environmental factors beyond resilience. Findings could inform future interventions to promote HCWs' well-being before, during, and after a natural disaster or pandemic outbreak.

Comparison of the Psychological Impact of COVID-19 on Self-Employed Private Healthcare Workers with Respect to Employed Public Healthcare Workers: Three-Wave Study during the COVID-19 Pandemic in Spain

(1) Background: Coronavirus disease, also called COVID-19, is a worldwide pandemic with a major impact on all aspects of the individual (health status, psychological, and economic aspects, among others). The perception of health professionals in this situation has been influenced by their economic and psychosocial situations. On the economic level, self-employed workers have no state subsidies, with the added disadvantage of not having sufficient means to cope with contagion. This could potentially have an impact on their health and indirectly on their family members, creating additional stress. The aim of this study was to determine whether there are differences in the level of anxiety of health professionals working in private practice compared to healthcare workers working in public institutions during the first three waves of COVID-19. (2) Methods: A cohort study on 517 subjects comparing anxiety between a group of health workers and a group of health professionals working in the public sector at three key moments during the pandemic was performed. (3) Results: Statistically significant differences were found between self-employed private health professionals compared to those working as public health workers. The perception of impact was worse in the self-employed; however, a higher level of anxiety was evident in public employees in all assessed domains (cognitive, physiological, and motor, p = 0.001). (4) Conclusions: There were significant changes when comparing the first phase between both groups; employed public healthcare workers manifested a sense of lower risk of COVID-19 contagion than privately employed professionals, who had a higher level of anxiety. In the second and third waves, negative feelings improved for both groups, and the fear of showing anxiety to the patient decreased over the course of the waves.

Post-traumatic stress disorders and coping strategies of health professionals during COVID-19 pandemic in Bangladesh: Findings of a countrywide cross-sectional study

Background

COVID-19 pandemic imposed a devastating effect on the psychological health of health professionals as they worked nonstop to withstand the hardship of the pandemic. The present study intended to determine the post-traumatic stress disorders (PTSD) and coping strategies among health professionals during the COVID-19 pandemic in Bangladesh.

Methods

This country-wide cross-sectional study was conducted from July to December 2021 among 1394 health professionals (596 physicians, 713 nurses, 85 medical technologists) who served COVID-19 patients at the secondary, tertiary, and specialized government healthcare facilities in Bangladesh and completed at least one month after exposure to COVID-19 patient-care. Data were collected through face-to-face interviews using a semi-structured questionnaire and analyzed by SPSS software. All the ethical issues were maintained strictly.

Findings

Most of the participants, 877(62∙9%) [95% CI: 60∙3-65∙5], were female, and 327(23∙5%) [95% CI: 21∙3-25∙8] developed PTSD. Females (AOR:1∙42 [95% CI: 1∙083-1∙868] p=0∙011), having an elderly family member (AOR:1∙515 [95% CI: 1∙173-1∙956] p=0∙0014), working in specialized hospitals (AOR:2∙685 [95% CI: 1∙928-3∙739] p<0∙001), and working ≥8 hours/day (AOR:1∙897 [95% CI: 1∙350-2∙666] p=0∙0002) had higher odds of developing PTSD. Most of the participants adopted spiritual approaches 96(29∙4%) [24∙5-34∙6] and distraction by watching TV/YouTube 59(18∙0%) [14∙0-22∙6] as coping strategies.

Interpretation

The study findings would be helpful for health policymakers and managers to develop comprehensive measures for restoring the mental well-being of health professionals by alleviating PTSD induced by a pandemic like COVID-19.

Funding

The study got funding from the Directorate General of Medical Education under the Ministry of Health and Family Welfare, Bangladesh.

Effects of the COVID-19 pandemic on the mental health of rehabilitation area professionals: A systematic review

Background

The role of the physiotherapist is vital in the recovery of post-COVID-19 patients, but fear of contagion is a possible feeling among healthcare professionals. The objective of this study is to assess the mental health effects that COVID-19 has had on healthcare workers, including rehabilitation care, in times of pandemic.

Methods

A systematic review was conducted using the PRISMA format in the Pubmed, SCOPUS, and Web of Science databases between July and September 2022. Keywords included were "healthcare providers," "COVID-19," "Mental Health," and "Psychological Distress." Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools.

Results

A total of 14 studies were included in this review. The study population was healthcare professionals including the rehabilitation services. In total, 4 studies reported exclusively on anxiety and stress levels in physiotherapists providing care during the pandemic.

Conclusions

The mental health of healthcare professionals has been compromised during the pandemic. However, initially, research was only focused on physicians and nurses, so the need arises to include those professionals, such as physiotherapists, who are also in direct contact with COVID-19 patients.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367664, identifier: CRD42022367664.

How are Medical Institutions Supporting the Well-being of Undergraduate Students? A Scoping Review

INTRODUCTION

Medical students experience significant stress and impacts on mood due to multiple factors. Unmitigated stress impacts both physical and mental health while increasing the risk of unethical behavior. It is important for medical institutions to identify strategies that effectively reduce perceived stress and improve the well-being of their students.

METHODS

The authors undertook a scoping review of the literature to identify strategies implemented by medical educational programs to improve the well-being of medical students.

RESULTS

Of 1068 articles identified, 19 studies met the inclusion criteria. Interventions were categorized as mindfulness-based programs, reflection groups, curriculum changes, and 'miscellaneous.' All studies assessed outcomes of student stress/resilience, as well as additional domains including academic performance, mental health, and interpersonal skills. Some also assessed the acceptability of the intervention to students.

CONCLUSIONS

Despite the heterogeneity of interventions and outcome measures, a clear theme emerged that institutionally-provided strategies to promote student well-being tend to be effective when students opt into the program. It was noted that adding mandatory content or activities to a medical program without creating adequate space or support for it can have the opposite effect. Further high quality intervention studies involving randomization, blinding and rigorous controls are warranted.

The Mediating Role of Cumulative Fatigue on the Association between Occupational Stress and Depressive Symptoms: A Cross-Sectional Study among 1327 Chinese Primary Healthcare Professionals

Occupational stress and depressive symptoms are common among professionals in the primary healthcare system, and the former can lead to a more severe level of the latter. However, there are few studies on the mediating effect of occupational stress on depressive symptoms using cumulative fatigue as a mediating variable. The Core Occupational Stress Scale, the Self Diagnosis Scale of Workers' Cumulative Fatigue, and the Patient Health Questionnaire were used in the proposed study. To analyze and test the mediating effect, the hierarchical regression analysis method and the Bootstrap method were applied. Our results showed that occupational stress was positively correlated with the level of cumulative fatigue (p < 0.01) and depressive symptoms (p < 0.01). Cumulative fatigue played a partial, mediating role between the four dimensions of occupational stress and depressive symptoms, and the effect size of occupational stress and each dimension was 0.116 (95% CI: 0.096-0.135, p < 0.001), -0.204 (95% CI: -0.245--0.166, p < 0.001), 0.179 (95% CI: 0.143-0.218, p < 0.001), 0.333 (95% CI: 0.283-0.385, p < 0.001), and -0.210 (95% CI: -0.292--0.132, p < 0.001), respectively, while the percentages of the mediating effects were 43.56%, 44.46%, 48.58%, 71.26%, and 45.80%, respectively. Occupational stress can directly or indirectly affect depressive symptoms through the mediating effect of cumulative fatigue. Therefore, primary healthcare professionals can reduce occupational stress, which in turn relieves depressive symptoms, and thus reduce cumulative fatigue levels.

Insights on COVID-19 Vaccination in Portugal: A Qualitative Study among Health Professionals and Teachers

BACKGROUND

Vaccination against COVID-19 has had a major impact over the course of the pandemic, leading to a reduced number of hospitalizations and deaths. However, the mass vaccination process has been accompanied by skepticism and hesitancy since its beginning. As health professionals and teachers are important public health actors who can strongly intervene to reduce vaccination hesitancy among their patients and students, respectively, this study aimed to assess their main perceptions towards COVID-19 vaccination.

METHODS

Two focus group sessions, one with health professionals and the other with teachers, were conducted according to the COREQ checklist. Qualitative data were analyzed through theoretical thematic analysis.

RESULTS

In general, none of the groups showed vaccine hesitancy, although both groups had concerns regarding the safety and efficacy of the vaccines. The main concerns of health professionals were mostly related to the long-term impact of the COVID-19 pandemic, while teachers were more worried about the lack of access to reliable information about the COVID-19 vaccination.

CONCLUSIONS

It is plausible to conclude that it is imperative to provide clear and accurate information for the population in order to avoid vaccination hesitancy.

Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I² >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I² >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.

The impact of the COVID-19 pandemic on job satisfaction among professionally active nurses in five European countries

The COVID-19 pandemic has negatively affected the work of many medical professionals, including the group of nurses. This study aimed at assessing the impact of the COVID-19 pandemic on job satisfaction of nursing staff in five European countries. The study was conducted using the Job Satisfaction Scale (SSP) and original questions on the job satisfaction. The cross-sectional online study was conducted with a sample of 1,012 professionally active nurses working in Poland, Germany, Italy, Great Britain and Sweden, who assessed their job satisfaction before (retrospectively) and during the pandemic. The results showed a significant decrease in job satisfaction due to the need to perform it during the pandemic caused by the SARS-CoV-2 virus. In 8 out of 10 examined parameters of job satisfaction, a statistically significant decrease in job satisfaction was observed at the level of p < 0.05. Among the examined factors influencing job satisfaction, the highest decrease was recorded based on the assessment of working conditions (1,480). A high level of satisfaction with the work of nurses has a significant impact on providing better patient care as well as reducing the risk of professional burnout of nurses.

The different impacts of COVID-19 on the mental health of distinct health care worker categories

The present study sought to explore the factors associated with the odds of having probable depression and posttraumatic stress disorder (PTSD) related to traumatic COVID-19 experiences and their impact on health care workers in distinct categories. In this cross-sectional study, 1843 health care workers (nurses, nurse technicians, physicians, physical therapists, and other healthcare workers) were recruited via convenience sampling. A survey was administered to obtain information regarding sociodemographic, occupational, and mental health status. Descriptive statistics and multivariable logistic regression were used for the analyses. Being a nurse technician was associated with an odds ratio of 1.76 for probable PTSD. No relation was observed between health care worker categories and the odds of probable depression. Additionally, being female and not receiving adequate PPE were related to greater odds of having probable PTSD and depression.

The effect of COVID-19 on employees' mental health

Long lockdowns, food shortages, and the inability to receive basic primary healthcare have aggravated the effects of pandemics. However, most studies have focused on the health problems of the infected people or the measures employed to keep the disease under control. This cross-sectional study focused primarily on the mental health issues of employees. By employing a convenient sampling method, we reached 237 respondents (135 with coronavirus history) to assess the impact of the pandemic on employees. Multivariate causal relationships were assessed with Structural Equation Modeling (SEM). The predictors included internal entrapment (INT) and difficulty identifying feelings (DIF), which are significant predictors of depression (DEPR). DIF was found to be a significant predictor of INT and EXT feelings, while FEAR was found to be a significant predictor of INT, DIF, and DEPR. Quality of life (QoL) was found to be a significant predictor of DIF and DDF, DEPR, EXT and INT, and FEAR. The results also showed that DIF mainly manifested its effect on depression through INT. The DEPR level of employees working only from home was higher than that of other employees. The depression levels of women, young employees, and those whose QoL was adversely affected by the coronavirus were higher than the rest.

Work-Related Traumatic Stress Response in Nurses Employed in COVID-19 Settings

Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17-85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1-10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1-10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.

Resilience and its impact on the mental health of physiotherapists during the COVID-19 pandemic in São Paulo, Brazil

OBJECTIVE

To analyze whether resilience modulates the levels of depression, anxiety, stress and the impact of events in physiotherapists who work with COVID-19 patients with those who do not.

METHODS

A cross-sectional study was conducted from August 2020 up to October 2020. A total of 519 physiotherapists were enrolled and divided according to resilience and whether they worked with COVID-19 patients. Volunteers answered sociodemographic questionnaires, rating their depression, anxiety, and stress on a scale (DASS-21). The impact of event scale revised (IES-R) and 14-item resilience scale (14-RS) were also used.

RESULTS

Physiotherapists with low resilience present scores significantly high of depression, anxiety, stress and impact of event compared to the high resilience group (P < .001). Additionally, working with COVID-19 patients also resulted in increased levels of depression, anxiety, stress, and impact of event compared with the NO COVID-19 group (P < .001). These responses were modulated by age, sex, number of absences from work, whether or not personal protective equipment was received, host leadership, and the practice and maintenance of regular physical activity.

LIMITATIONS

The responses to the questionnaires were anonymous and self-administered. We cannot assess whether these people had a previous diagnosis of depression, anxiety and stress.

CONCLUSIONS

Low resilience and work with COVID-19 patients were associated with high levels of depression, anxiety, and stress and worse psychological impacts of events. Several aspects modulate these responses and can contribute to improving the resilience and mental health of physiotherapists who are responsible for the care of COVID-19 patients.

COVID-19 Posttraumatic Stress Disorder in Clinical Nurse Specialists

The purpose of this study was to examine if a relationship exists between the coronavirus 2019 pandemic and posttraumatic stress disorder in clinical nurse specialists.

Investigating Frontline Nurse Stress: Perceptions of Job Demands, Organizational Support, and Social Support During the Current COVID-19 Pandemic

Background

While frontline nurses employ coping alternatives to help deal with occupational stress resulting from unprecedented challenges during the COVID-19 pandemic, their access to necessary resources is unclear.

Objective

This study aims to explore nurses' mental health in Alabama hospitals during the COVID-19 outbreak and investigate the impact of organizational and community support on nurse stressor levels, physio-psychosocial responses, and coping strategies employed.

Methods

A cross-sectional survey was developed to bridge our understanding of stress, support, and coping mechanisms and distributed to nurses working with COVID-19-infected patients in hospital settings in Alabama. A total of 232 frontline nurses responded to 79 items in four domains (stressors, physio-psychosocial symptoms, coping, and support) between May 6, 2020, and June 30, 2020. A two-way ANOVA, regression analysis, and mediation of effects were used to analyze the data.

Results

This study found that both social support and use of coping strategies contributed to the reduction of physio-psychosocial symptoms. Differences were found in how older frontline nurses perceived the efficacy of social support and certain coping strategies. This study provides further evidence of the importance of organizational support in addressing the harmful physio-psychosocial symptoms experienced by nurses.

A machine learning approach to predict resilience and sickness absence in the healthcare workforce during the COVID-19 pandemic

During the COVID-19 pandemic, healthcare workers (HCWs) have faced unprecedented workloads and personal health risks leading to mental disorders and surges in sickness absence. Previous work has shown that interindividual differences in psychological resilience might explain why only some individuals are vulnerable to these consequences. However, no prognostic tools to predict individual HCW resilience during the pandemic have been developed. We deployed machine learning (ML) to predict psychological resilience during the pandemic. The models were trained in HCWs of the largest Finnish hospital, Helsinki University Hospital (HUS, N = 487), with a six-month follow-up, and prognostic generalizability was evaluated in two independent HCW validation samples (Social and Health Services in Kymenlaakso: Kymsote, N = 77 and the City of Helsinki, N = 322) with similar follow-ups never used for training the models. Using the most predictive items to predict future psychological resilience resulted in a balanced accuracy (BAC) of 72.7–74.3% in the HUS sample. Similar performances (BAC = 67–77%) were observed in the two independent validation samples. The models' predictions translated to a high probability of sickness absence during the pandemic. Our results provide the first evidence that ML techniques could be harnessed for the early detection of COVID-19-related distress among HCWs, thereby providing an avenue for potential targeted interventions.

Anthropomorphic Robotic Eyes: Structural Design and Non-Verbal Communication Effectiveness

This paper shows the structure of a mechanical system with 9 DOFs for driving robot eyes, as well as the system’s ability to produce facial expressions. It consists of three subsystems which enable the motion of the eyeballs, eyelids, and eyebrows independently to the rest of the face. Due to its structure, the mechanical system of the eyeballs is able to reproduce all of the motions human eyes are capable of, which is an important condition for the realization of binocular function of the artificial robot eyes, as well as stereovision. From a kinematic standpoint, the mechanical systems of the eyeballs, eyelids, and eyebrows are highly capable of generating the movements of the human eye. The structure of a control system is proposed with the goal of realizing the desired motion of the output links of the mechanical systems. The success of the mechanical system is also rated on how well it enables the robot to generate non-verbal emotional content, which is why an experiment was conducted. Due to this, the face of the human-like robot MARKO was used, covered with a face mask to aid in focusing the participants on the eye region. The participants evaluated the efficiency of the robot’s non-verbal communication, with certain emotions achieving a high rate of recognition.

Premorbid traumatic stress and veteran responses to the COVID-19 pandemic

The COVID-19 pandemic has had unprecedented effects on lifestyle stability and physical and mental health. We examined the impact of preexisting posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression on biopsychosocial responses to the pandemic, including psychiatric symptoms, COVID-19 exposure, and housing/financial stability, among 101 U.S. military veterans enrolled in a longitudinal study of PTSD, a population of particular interest given veterans' trauma histories and defense-readiness training. Participants (83.2% male, 79.2% White, M_age  = 59.28 years) completed prepandemic, clinician-administered psychiatric diagnostic interviews and a phone-based assessment between May and September 2020 using a new measure, the Rapid Assessment of COVID-19-Related Experiences (RACE), which was used to assess pandemic responses and its effects on mental and physical health; COVID-19 diagnosis and testing were also extracted from electronic medical records. Multivariate regressions showed that, controlling for demographic characteristics, prepandemic PTSD, β = .332; p = .003, and AUD symptoms, β = .228; p = .028, were associated with increased pandemic-related PTSD symptoms. Prepandemic AUD was associated with increased substance use during the pandemic, β = .391; p < .001, and higher rates of self-reported or medical record-based COVID-19 diagnosis, β = .264; p = .019. Minority race was associated with pandemic-related housing/financial instability, β = -.372; p < .001, raising concerns of population inequities. The results suggest that preexisting PTSD and AUD are markers for adverse pandemic-related psychiatric outcomes and COVID-19 illness. These findings carry implications for the importance of targeting prevention and treatment efforts for the highest-risk individuals.

Safety Management and Wellbeing during COVID-19: A Pilot Study in the Manufactory Sector

Background: The rapid spread of COVID-19 has generated anxiety and concerns among the whole population, by also affecting people’s working life quality. Although several studies underlined the impact of the COVID-19 pandemic in the healthcare sector, very few studies investigated the consequences in the occupational sectors with low risk of contagion. Method: 220 full-time in-presence workers of the manufacturing sector agreed to participate in a study of cross-sectional design during September and October 2020. Data were collected by means of a self-reported questionnaire conceived to investigate the constructs of the COVID-19 concerns, both the personal contribution and the supervisor support to workplace safety, the organizational commitment to safety, and finally, the level of workers’ exhaustion. Results: This study highlights that COVID-19 concerns represent a significant source of stress since it is significantly associated to higher levels of exhaustion among workers. Furthermore, the findings show the relevance of resources related to employee’s personal contribution to safety management as well as the role of climate variables. Conclusions: These results promote knowledge on the role of COVID-19 concerns in affecting psychological wellbeing at work, as well as the impact of both individual and job-related resources that may prevent exhaustion at work. Finally, the present findings also have implications for organizations and the maintenance of their commitment to safety.

Impact of COVID-19 on Mental Health Care Practitioners

Many mental health practitioners, including psychiatrists, have suffered multiple social and mental health impacts from COVID-19. A range of actions are described that health care organizations and individuals can take to mitigate these impacts. There will likely be substantial positive short- and long-term outcomes for psychiatrists individually and as a profession post-COVID-19. These include improved professional well-being and more efficient practice modalities through the development of hybrid care clinical approaches integrating technologies into practice, and a greater focus on providing better care for diverse racial and ethnic communities.

The COVID-19/Tuberculosis Syndemic and Potential Antibody Therapy for TB Based on the Lessons Learnt From the Pandemic

2020 will be marked in history for the dreadful implications of the COVID-19 pandemic that shook the world globally. The pandemic has reshaped the normality of life and affected mankind in the aspects of mental and physical health, financial, economy, growth, and development. The focus shift to COVID-19 has indirectly impacted an existing air-borne disease, Tuberculosis. In addition to the decrease in TB diagnosis, the emergence of the TB/COVID-19 syndemic and its serious implications (possible reactivation of latent TB post-COVID-19, aggravation of an existing active TB condition, or escalation of the severity of a COVID-19 during TB-COVID-19 coinfection), serve as primary reasons to equally prioritize TB. On a different note, the valuable lessons learnt for the COVID-19 pandemic provide useful knowledge for enhancing TB diagnostics and therapeutics. In this review, the crucial need to focus on TB amid the COVID-19 pandemic has been discussed. Besides, a general comparison between COVID-19 and TB in the aspects of pathogenesis, diagnostics, symptoms, and treatment options with importance given to antibody therapy were presented. Lastly, the lessons learnt from the COVID-19 pandemic and how it is applicable to enhance the antibody-based immunotherapy for TB have been presented.

Stress and depressive symptoms among Italian mental health nurses during the COVID-19 pandemic, a cross-sectional study

This study used the cross-sectional web survey methodology to assess how the COVID-19 pandemic affected Italian psychiatric nurses in terms of stress levels and depressive symptoms. A total of 266 nurses belonging to the Italian Mental Health Departments were interviewed and they were subjected to two validated scales respectively PSS-10 (for the evaluation of stress) and PHQ-9 (for the evaluation of depressive symptoms). Statistical analysis showed moderate stress levels and a prevalence of sub-threshold (borderline) depressive symptoms among responding nurses. Logistic regression analysis reported that frontline nurses on COVID-19 positive patients are at greater risk of reporting higher levels of stress and major depressive symptoms, as are female nurses and juvenile nurses. age. Monitoring and managing the psychological well-being of nursing staff are to be considered among the priorities of mental health service managers and are part of a process that aims to increase individual and organizational well-being but above all to improve the outcomes resulting from assistance.

Mindfulness as a Protective Factor Against Increased Tobacco and Alcohol Use in Hospital Workers Following the First COVID-19-Related Lockdown: a Study in Southern France

COVID-19-related national lockdowns worldwide have had repercussions on people's well-being and have led to increased substance use. Mindfulness has previously been associated with reduced psychological distress and benefits in terms of addictive behaviors. We aimed to assess whether dispositional mindfulness protected against increased tobacco and alcohol use in hospital workers after France's first lockdown started. All workers in two French hospitals were contacted by email to participate in an online survey. Three hundred eighty-five workers answered. We ran two separate logistic regression models to test for associations between the level of dispositional mindfulness and both increased tobacco and alcohol use, after adjusting for affect deterioration. Dispositional mindfulness was associated with a lower likelihood of increased tobacco (adjusted odds ratio (AOR) [95% CI] 0.71 [0.51; 0.99], p = 0.046) and alcohol (0.66 [0.50; 0.87], p = 0.004) use. The effect of mindfulness on tobacco use was partially mediated by affect deterioration. Dispositional mindfulness appeared to be a protective factor against lockdown-related tobacco and alcohol use increases in French hospital workers.

Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors

COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic.

Adesão ao isolamento social na pandemia de Covid-19 entre professores da educação básica de Minas Gerais, Brasil

RESUMO Este estudo teve por objetivo estimar a prevalência da adesão ao isolamento social e verificar os fatores associados, durante a pandemia de Covid-19, entre professores de Minas Gerais, Brasil. Trata- se de um estudo transversal realizado com uma amostra de 15.641 docentes. Aplicou-se um formulário digital para a coleta dos dados. Foram conduzidas análises descritivas das variáveis, que incluíram adesão ao isolamento social, características sociodemográficas, fatores ocupacionais e condições de saúde au- torrelatadas. Utilizou-se o modelo de regressão de Poisson com variância robusta e se estimaram Razões de Prevalências (RP) com intervalos de 95% de confiança. A prevalência de adesão ao isolamento social foi estimada em 79,8%, cujos fatores associados foram: sexo feminino; faixa etária igual ou superior a 60 anos; viver com o(a) cônjuge; maior carga horária de trabalho; dificuldades no sono; sentimento de tristeza; além de patologias como hipertensão arterial sistêmica, diabetes mellitus, obesidade e doenças respiratórias. Evidenciou-se expressiva prevalência de adesão às medidas de isolamento social entre os docentes, e que a adesão está associada a características sociodemográficas, fatores ocupacionais e condições de saúde dos profissionais da educação.

Adherence to social isolation in the Covid-19 pandemic among primary school teachers in Minas Gerais, Brazil

ABSTRACT This study aimed to estimate the prevalence of adherence to social isolation and to inves- tigate associated factors during the Covid-19 pandemic among teachers in Minas Gerais, Brazil. This is a cross-sectional study carried out with a sample of 15,641 teachers. A digital form was applied for data collection. Descriptive analyses of the variables were conducted, which included adherence to social isolation, sociodemographic characteristics, occupational factors, and self-reported health conditions. The Poisson regression model with robust variance was used and Prevalence Ratios (PR) were estimated, with 95% confidence intervals. The prevalence of adherence to social isolation was estimated at 79.8%, and the associated factors were: female gender; 60 years old or older; living with a spouse; longer working hours; sleeping difficulty; feeling sad; and pathologies such as hypertension, diabetes mellitus, obesity, and respiratory diseases. There was a significant prevalence of adherence to social isolation measures among teachers, and that adherence is associated with sociodemographic characteristics, occupational factors, and health conditions of education professionals.