Psychological Distress in South African Healthcare Workers Early in the COVID-19 Pandemic: An Analysis of Associations and Mitigating Factors

Prevalence of anxiety, depression, stress and insomnia among healthcare professionals during COVID-19 in Africa: umbrella review of existing meta-analyses

Introduction

In Africa, healthcare professionals experienced various mental health problems during COVID-19. However, very little was done on the extensive evidence regarding mental disorders. The purpose of this umbrella review is to provide comprehensive data on the prevalence of anxiety, depression, stress, and insomnia among healthcare professionals during the COVID-19 pandemic in Africa.

Materials and Methods

Systematic searches of databases African Journals Online, MedRxiv, PubMed, and Google Scholar were used to identify studies from the occurrence of COVID-19 from December 2019 to March 2023 were included. To pool the gathered data for results with a 95% confidence interval (CI), DerSimonian-Laird random effects meta-analysis was used. For heterogeneity examination, I2 was used. The quality assessment was evaluated by using the Joanna Briggs Institute (JBI) critical appraisal checklist.

Results

A total of five studies reported the prevalence of depression, the pooled prevalence was 53.75% (95% CI [40.80-66.70], I2 = 63.6%, p = 0.027). In a total of four studies, the pooled prevalence of anxiety was 49.97% (95% CI [34.71-65.23], I2 = 71.26%, p = 0.014). From a total of two studies, the pooled prevalence of stress was 57.27% (95% CI [42.28-72.25], I2 = 58.9%, p = 0.119). From a total of four studies, the pooled prevalence of insomnia was 45.16% (95% CI [32.94-57.39], I2 = 50.8%, p = 0.107).

Conclusions

The COVID-19 pandemic highly affects the mental health of healthcare professionals in Africa. Stress, depression, anxiety, and insomnia symptoms were representing the most common based on evidences from existing meta-analyses. This evidence can help experts when executing specific interventions that address mental health problems among healthcare professionals during future public health crises.

Psychological distress and attitudes toward seeking professional psychological help among Omani nurses: Strategies for nursing practice

BACKGROUND

This study investigated the psychological distress and attitudes toward seeking professional psychological help among Oman's nurses, highlighting the importance of changing negative attitudes toward mental health among healthcare professionals. Nurses face difficult circumstances and serve as role models. Creating supportive environments can improve treatment quality and public awareness and reduce social stigma, ultimately contributing to better care and quality of life.

MATERIALS AND METHODS

This study used a cross-sectional design with a convenience sampling approach. A sample of 205 nurses working in Oman completed the study questionnaires, including a sociodemographic questionnaire, the attitude toward seeking professional psychological distress scale, and the Kessler Psychological Distress Scale. The survey was distributed between May and June 2023.

RESULT

The study found that most participants had moderate psychological distress (43.22%, n = 67) and a low attitude toward seeking professional psychological help (66.67%, n = 48). There were significant differences in distress based on gender (P < 0.001), marital status (P < 0.001), and working department (F = 3.140, P = 0.004), while attitude had significant differences based on gender (P < 0.001) and marital status (P < 0.001). The study also found no significant correlation between psychological distress and attitudes toward seeking help among Oman's nurses (T (1, 204) = 0.019, P = 0.985), with a r2 of 0.005.

CONCLUSION

Nurses must be trained to handle stress and job strain from terminally ill patients, complex cases, and difficult situations. They should prioritize psychological assistance as a sign of strength and self-awareness as it demonstrates stability and self-awareness in nursing. This can be promoted by obtaining education, enhancing healthcare accessibility, and providing a support system.

Lived experiences of South African rehabilitation practitioners during coronavirus disease 2019

Background

In South Africa, the sharp rise in people with severe illness because of coronavirus disease 2019 (COVID-19) in early 2020, meant that health systems needed to adapt services and operations, including rehabilitation services. Important insights into the lived experiences of rehabilitation personnel enacting these adaptations in an African context are limited.

Objectives

The aim of this study was to explore the lived experiences of rehabilitation practitioners working in the public sector in South Africa during the COVID-19 pandemic.

Method

A phenomenological approach and a duo-ethnographic design were used. A recruitment letter was circulated requesting volunteers. Maximum variation sampling was used to select the 12 participants of this study. Data were collected through interviews via Zoom, and critical conversations were facilitated by a non-rehabilitation partner who is known for challenging health inequities. The interviews were audio-recorded and transcribed verbatim. Data were analysed through elements of qualitative content and thematic analysis. Data were coded, categorised, clustered into concepts and formulated into themes.

Results

Three themes were identified: (1) 'Management became the enemy', (2) 'Tired of being resilient' and (3) 'Think out of the box…think on our feet'.

Conclusion

The results of this study highlighted new ways of practice, innovative adaptations, and usage of resources and platforms.

Contribution

This study highlights the re-imagining of accessible rehabilitation services that could lead to deeper onto-epistemological shifts amongst the rehabilitation practitioners.

Psychological distress in healthcare workers during COVID-19 pandemic: A systematic review

OBJECTIVES

Healthcare workers serving during the COVID-19 pandemic may have been exposed to high work overload, which may have had an impact on their physical, mental, and social health. The aim of this study was to assess the risk factors associated with psychological distress among healthcare workers serving during the COVID-19 pandemic from January 2020 to December 2022.

METHODS

A systematic review was conducted based on the 2020 PRISMA statement. Articles were searched in the Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO databases.

RESULTS

A total of 59 articles were included in this systematic review. It was observed that the prevalence of psychological distress during the COVID-19 pandemic was high. Female sex, being a nurse, being young, living alone/being single, and having a chronic disease or psychiatric disorder history are the main risk factors at the personal level. Other occupational and pandemic-related factors such as having many years of work experience, the presence of COVID-19 symptoms and contact history, not enough sleep, having lower family support and limited social relationships, fear of infecting friends and family, having a reduced perception of protection by personal protective equipment, working on the frontline, and having longer service duration were found to be factors influencing the development of psychological distress during the COVID-19 pandemic.

CONCLUSIONS

There are personal, interpersonal, and organizational risk factors that can lead to the occurrence of psychological distress among healthcare staff working during the COVID-19 pandemic.

Mental health problems among healthcare professionals during COVID-19 in Africa: a protocol for umbrella review

INTRODUCTION

COVID-19 pandemic is a global health problem. In Africa, healthcare professionals face mental health problems due to COVID-19. But little was done on the prevalence of mental disorders among healthcare professionals during COVID-19 in Africa. This umbrella review of meta-analysis aimed to provide the pooled prevalence of anxiety, depression, stress, suicide, demoralisation and insomnia during COVID-19 pandemic in Africa.

METHODS AND ANALYSIS

We will search the African Journals Online, MedRxiv, PubMed and Google Scholar to identify studies published from the occurrence of the pandemic to March 2023. Systematic review and meta-analysis studies assessing mental health problems among healthcare professionals in Africa will be considered. The outcomes of interest include prevalence of mental health problems on healthcare professionals following COVID-19. Two researchers will extract data and execute quality assessment independently. The Joanna Briggs Institute critical appraisal checklist will be used to assess the quality of studies. Stata V.16.0 software will be used for statistical analysis. The I² and Cochran's Q-statistics will be used for analysis of heterogeneity. Publication bias will be examined by DOI plot and Luis Furuya Kanamori (LFK) index.

ETHICS AND DISSEMINATION

Ethical approval and informed consent are not required as this is a literature review. The final results will be published in a peer-reviewed journal and presented at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42022383939.

Factors affecting job stress among physical therapists during the COVID-19 pandemic in Saudi Arabia

<b>Background:</b> Physical therapists (PTs), like other healthcare professionals, are susceptible to job stress when involved in patient care, and several factors contribute to it. Therefore, this study aims to assess PTs’ knowledge, attitude, and practices (KAP) adopted by PTs during the COVID-19 pandemic and its impact on their job stress.<br /> <b>Methods:</b> A cross-sectional design was used. 300 PTs from the government and private healthcare organizations in Saudi Arabia were randomly picked and invited to participate. Data were collected using a pre-tested content-validated KAP tool using a Google Form between January and March 2022. Data were analyzed quantitively through SPSS 24.0.<br /> <b>Results:</b> The findings revealed that 85% of PTs whose job involves direct contact with the patients are susceptible to higher stress (perceived stress score [PSS]=22.82) than others. Specifically, female and unmarried PTs are prone to more job stress than others (p&lt;0.05). In addition, PTs who were apprehensive about managing COVID-19 patients and worried about acquiring COVID-19 disease are prone to more job stress. Lastly, 89% of PTs who adopted the practice of wearing N-95 masks and proper handwashing techniques (&gt;80%) experience less stress than others (p&lt;0.05).<br /> <b>Conclusion:</b> The KAP of PTs influences job stress during the COVID-19 pandemic. PTs with sufficient knowledge about measures to adopt, show a positive attitude, and practice wearing proper PPEs, handwashing procedures, and waste disposal systems during patient care are prone to less job stress than others.

"I Carry the Trauma and Can Vividly Remember": Mental Health Impacts of the COVID-19 Pandemic on Frontline Health Care Workers in South Africa

We know from research that pandemics and disease outbreaks expose HCWs to an increased risk of short and long-term psychosocial and occupational impacts. We conducted qualitative research among 44 frontline health care workers (FHCWs) practicing in seven South African hospitals and clinics. FHCWs were interviewed on their experiences of working during the first-wave of the COVID-19 pandemic and its perceived impact on their wellness. In this study, FHCWs included the non-medical and medical professionals in direct contact with COVID-19 patients, providing health care and treatment services during the COVID-19 pandemic. Most of the FHCWs reported stressful and traumatic experiences relating to being exposed to a deadly virus and working in an emotionally taxing environment. They reported depression, anxiety, traumatic stress symptoms, demoralization, sleep difficulties, poor functioning, increased irritability and fear of being infected or dying from COVID-19. The mental health impacts of COVID-19 on HCWs were also associated with increased poor physical wellbeing, including fatigue, burnout, headache, and chest-pains. FHCWs reported professional commitment and their faith as critical intrinsic motivators that fostered adaptive coping while working on the frontline during the first-wave of the COVID-19 pandemic. Many alluded to gaps in workplace psychosocial support which they perceived as crucial for coping mentally. The findings point to a need to prioritize interventions to promote mental wellness among FHCWs to ensure the delivery of quality healthcare to patients during pandemics or deadly disease outbreaks.

Protecting healthcare workers during a pandemic: what can a WHO collaborating centre research partnership contribute?

Objectives

To ascertain whether and how working as a partnership of two World Health Organization collaborating centres (WHOCCs), based respectively in the Global North and Global South, can add insights on "what works to protect healthcare workers (HCWs) during a pandemic, in what contexts, using what mechanism, to achieve what outcome".

Methods

A realist synthesis of seven projects in this research program was carried out to characterize context (C) (including researcher positionality), mechanism (M) (including service relationships) and outcome (O) in each project. An assessment was then conducted of the role of the WHOCC partnership in each study and overall.

Results

The research found that lower-resourced countries with higher economic disparity, including South Africa, incurred greater occupational health risk and had less acceptable measures to protect HCWs at the onset of the COVID-19 pandemic than higher-income more-equal counterpart countries. It showed that rigorously adopting occupational health measures can indeed protect the healthcare workforce; training and preventive initiatives can reduce workplace stress; information systems are valued; and HCWs most at-risk (including care aides in the Canadian setting) can be readily identified to trigger adoption of protective actions. The C-M-O analysis showed that various ways of working through a WHOCC partnership not only enabled knowledge sharing, but allowed for triangulating results and, ultimately, initiatives for worker protection.

Conclusions

The value of an international partnership on a North-South axis especially lies in providing contextualized global evidence regarding protecting HCWs as a pandemic emerges, particularly with bi-directional cross-jurisdiction participation by researchers working with practitioners.

A Parallel Mediation Analysis on the Effects of Pandemic Accentuated Occupational Stress on Hospitality Industry Staff Turnover Intentions in COVID-19 Context

The purpose of this research was to analyze how different effects of the COVID pandemic, expressed through pandemic accentuated occupational stress, perceived job insecurity, occupational safety and health perception and perceived organizational effectiveness, may impact turnover intentions of the personnel in the hospitality industry. Our research team designed an online questionnaire which was analyzed with network analysis to depict the relationship between factors, and, then, a confirmatory factor analysis was employed to confirm the distribution of the items to the envisaged five factors. Based on a sample of 324 randomized Romanian hospitality industry staff, the results of our cross-sectional study revealed that occupational safety and health perception, perceived organizational effectiveness and perceived job insecurity in the pandemic accentuated occupational stress to indirectly and significantly impact hospitality industry staff turnover intentions (TI). The results indicated that, while the total effect of PAOS on TI was significant, the direct effect was still significant, while all three mediators remained significant predictors. Overall, mediators partially mediated the relationship between PAOS and TI, indicating that employees with low scores on occupational safety and health perception (OSHP), and perceived organizational effectiveness (POE) and high scores on perceived job insecurity (PJI) were more likely to have higher levels of TI turnover intentions.