Psychological Distress Among Healthcare Professionals Involved in the Covid-19 Emergency: Vulnerability and Resilience Factors

Pandemic Loneliness in Healthcare Workers. Does It Predict Later Psychological Distress?

Increased loneliness associated with the COVID-19 pandemic has been widely reported, with healthcare workers at increased risk compared to the general population. Pre-pandemic research indicates that loneliness has long-term detrimental effects on mental well-being, but the effect of loneliness in the context of COVID-19 is not clear. We conducted an online survey of healthcare workers (HCWs) at a large teaching hospital in Sydney, Australia after the peak of the first wave of the pandemic in 2020. Over one-third experienced loneliness at the peak of the first wave. An observed association with high psychological distress in subsequent months was attenuated after adjusting for status of mental well-being during the peak and before the pandemic. Mental well-being during the peak of the pandemic and, to a lesser extent, mental well-being before the pandemic were the strongest predictors of later distress. Increased conflict at home was also predictive of later distress. The mental health of HCWs is an important consideration at any time and is especially so in the face of crises such as the current global pandemic. Strategies to enhance baseline mental well-being and bolster well-being during crisis situations should assist HCWs cope with unexpected stressors and reduce the associated detrimental psychological consequences.

Linking COVID-19 stress and Chinese nurses' life well-being: The influence of work-family conflict and work centrality

The COVID-19 pandemic has placed enormous stress on health workers, exposing them to high levels of work-family conflict (WFC), which in turn affects their life well-being（LWB). To date, whether WFC is involved in the association between COVID-19 stress and the well-being of life has not been investigated. The purpose of this paper was to explore the connection between COVID-19 stress and LWB in Chinese nurses and to analyse the mediating role of WFC and the moderating effect of work centrality. The link between COVID-19 stress and LWB was examined by performing multiple regression analysis, common method bias analysis, and confirmatory factor analysis on data for 227 nurses.COVID-19 stress exerted a remarkable direct impact on nurses' LWB, and WFC mediated the link between COVID-19 stress and nurses' LWB. Work centrality moderated the link between COVID-19 stress and nurses' WFC. COVID-19 stress decreases nurses' LWB and increases their WFC, which also decreases their LWB. For nurses with higher work centrality, the connection of COVID-19 stress to work-family conflict was stronger. Hospital managers should focus on nurses' work-family balance and pay particular attention to the work-family balance of work-centered nurses to avoid compromising their LWB.

An examination of the effects of family, school, and community resilience on high school students' resilience in China

Introduction

Resilience plays a pivotal role in shaping the academic accomplishments, psychological well-being, and future prospects of high school students. Despite its significance, there is a notable dearth of studies examining the current state and determinants of resilience among high school students in China.

Methods

This research addresses this gap by assessing and exploring levels of resilience and their interconnections across four key domains-individual, family, school, and community-among Chinese high school students. The study also investigates variations in resilience based on factors such as gender, geographical location, and grade levels. A total of 667 high school students participated in the study, responding to four resilience scales.

Results

Chinese high school students exhibited generally low levels of resilience, with family resilience ranking the highest and community resilience the lowest. The study revealed that resilience is positively influenced by resilience levels in school, family, and community settings. Consequently, strategies aimed at fortifying resilience should prioritize interventions in familial, educational, and communal environments.

Discussion

Moreover, the research findings indicate noteworthy disparities in resilience among high school students based on gender, urban-rural divide, and grade levels. Female, urban, and lower-grade students displayed higher resilience compared to their male, rural, and higher-grade counterparts. This highlights the importance of focusing on resilience-building measures tailored to male, rural, and higher-grade high school students, given their increased likelihood of facing significant challenges and stressors in both academic and personal spheres.

Conclusion

This study contributes to the broader understanding of resilience by investigating the correlations between individual, family, school, and community resilience among Chinese high school students. The findings underscore the need for targeted interventions to enhance resilience, particularly in specific demographic groups, thereby advancing the efficacy of resilience-building techniques in high school settings.

Evaluation of the mental health status of community frontline medical workers after the normalized management of COVID-19 in Sichuan, China

Background

During the coronavirus disease 2019 (COVID-19) pandemic, community medical workers, as the primary enforcers of community control measures, undertook many tasks with high exposure risk, resulting in severe psychological pressure, anxiety, depression and other psychological problems. Gender, type of workers, education, marital status, working years and other demographic factors were affect the mental state of medical workers. Community frontline medical workers gradually returned to normal work and life after the normalized management of COVID-19, but heavy work and high psychological pressure may continue to affect them. Thus, our research team used the same psychological questionnaire to investigate the psychological status of community frontline medical workers after the normalized management of COVID-19 compared with the COVID-19 period.

Methods

This was a cross-sectional study of community frontline medical workers in Sichuan, China, from February 6 to 17, 2023. Symptom Checklist-90 (SCL-90) and a self-designed questionnaire of demographic characteristics were provided to the participants point-to-point through a mobile network platform. Multiple logistic regression was used to analyze influencing factors related to community frontline medical workers' psychology.

Results

A total of 440 valid questionnaires were statistically analyzed, including 192 (43.64%) from doctors and 248 (56.36%) from nurses. There were 222 (50.45%) participants who were SCL-90 positive. The median total SCL-90 score of medical workers was 105.0 (IQR 95.00-123.75), which was higher than that during the COVID-19 period. The doctor's median SCL-90 score was 108.5 (IQR 96.00-136.25), and the positive item score was 16.5; the nurse's median score was 104.0 (IQR 94.00-119.50), and the positive item score was 12.0. Bachelor's degree education, no fixed contract and working years (10-19 years, 20-29 years, 30-39 years) were independent influencing factors for community frontline medical workers' psychology.

Conclusion

After the normalized management of COVID-19, community frontline medical workers still suffered from psychological problems that were even more serious than those during COVID-19. Doctors were more likely to have psychological problems than nurses. In addition, the mental health status of community frontline medical workers was affected by education, type of contract and working years. Managers should pay attention to the mental health of these people.

Alexithymia and Interoceptive Confusion in Covid-19 Pandemic Distress

Objective

Alexithymic traits are associated with the difficulty of perceiving 'non-affective interoceptive signals', and are related to a problematic management of stressful life events (SLEs). The main purpose of this study was to quantify the psychological response of the general population to COVID-19 pandemic stress and to evaluate potential correlations with the presence of 'alexithymic traits' and 'interoceptive confusion' (study protocol # 0077794/2022).

Method

175 subjects from general population were assessed with the Toronto-Alexithymia Scale (TAS-20), the Event-Revised Impact Scale (IES-R), the Interoceptive Accuracy Scale (IAS), and the Interoceptive Confusion Questionnaire (ICQ).

Results

a significant relationship emerged between alexithymic traits (assessed with the TAS-20), the ICQ 'interoceptive confusion', and the domain of 'hyper-arousal' as assessed with IES-R. Logistic regression model showed that ICQ-Total Score and IES-R 'hyper-arousal' domain were significantly correlated with TAS-20 total score, with DR value (R2 corrected) explaining the 36.8% of the variability (standard error: 10.7).

Conclusions

This study, albeit with the limitations of a cross-sectional experimental design with self-evaluation tools in a general population sample, showed a vulnerability to COVID-19 pandemic stress due to high levels of hyper-arousal in subjects with alexithymic traits and interoceptive confusion.

Sense of Coherence (SOC) of Italian healthcare workers during the COVID-19 pandemic: analysis of associated factors

Introduction

The COVID-19 pandemic has posed significant challenges for healthcare workers worldwide, potentially affecting their sense of coherence (SOC) and overall well-being. This study aimed to identify factors associated with different levels of SOC among healthcare workers, exploring demographic characteristics, work-related factors, changes in relationships and social habits, and the overall well-being.

Methods

A cross-sectional study was conducted among 628 healthcare workers. SOC scores were assessed using a standardized questionnaire. Statistical analyses were performed to identify associations between these factors and SOC.

Results

Healthcare workers had a lower average SOC score (mean: 57.1) compared to the national average in Italy (mean: 60.3). Younger age and shorter length of service were associated with a higher risk of low SOC (p < 0.0001). Healthcare workers in the northwestern regions of Italy had an increased risk of low SOC compared to their counterparts in the northeastern regions (p = 0.0336). Adverse pandemic-related experiences and worsening social relationships were also associated with a higher risk of low SOC (p < 0.0001).

Conclusions

This study highlights the unique challenges and stressors faced by healthcare workers during the COVID-19 pandemic and their impact on SOC. Age, length of service, geographic location, and social status were significant factors influencing SOC levels. Targeted interventions are needed to enhance SOC and well-being, particularly for younger and newly employed healthcare workers. Strategies promoting social connections, work-life balance, and psychological support services are crucial to support healthcare workers' resilience and coping abilities.

Dispositional mindfulness and mental health among Chinese college students during the COVID-19 lockdown: The mediating role of self-compassion and the moderating role of gender

College students' mental health has been seriously impacted during the global COVID-19 lockdown. There is evidence that dispositional mindfulness is beneficial to mental health. However, few studies have looked at the relationship between dispositional mindfulness and mental health from the standpoint of self-compassion. Furthermore, it is unclear under what circumstances dispositional mindfulness is linked to mental health during COVID-19 lockdown. To fill this gap, the current study investigated self-compassion as a possible mediating factor and gender as a possible moderating effect between dispositional mindfulness and mental health. The sample included 1,018 Chinese university students during the COVID-19 lockdown (M age = 20.12; SD age = 1.17) who had completed self-report questionnaires on dispositional mindfulness, self-compassion, and mental health. According to the findings of mediation analysis, self-compassion partially mediated the relationship between dispositional mindfulness and mental health. The moderating analysis also revealed significant moderating effects of dispositional mindfulness, self-compassion, and mental health. Male college students' mental health was significantly better protected, and the buffering effects of dispositional mindfulness and self-compassion on their mental health were significantly stronger than those of female college students. These findings advance our understanding of the process and mechanism between dispositional mindfulness and mental health, broadened and deepened the understanding of the relationship between dispositional mindfulness and mental health, as well as the mediating role of self-compassion and the moderating role of gender, and offer practical guidance for improving college students' mental health during the COVID-19 lockdown.

The Prevalence and Predictors of Depressive, Anxiety, and Stress Symptoms Among Tepi Town Residents During the COVID-19 Pandemic Lockdown in Ethiopia

BACKGROUND

As a result of the coronavirus disease 2019 (COVID-19) outbreak, many countries have imposed movement restrictions and implemented lockdowns. However, evidence from a variety of nations showed that the COVID-19 outbreak and its associated quarantine measures triggered a wide range of psychological problems, such as anxiety, depression, and stress in the general population. As a result, the purpose of this study was to determine the prevalence and predictors of depression, anxiety, and stress symptoms among Tepi town residents during the pandemic lockdown.

METHODOLOGY

A community-based cross-sectional survey was conducted among residents of Tepi town from September 15 through September 25, 2020, and residents who have lived in Tepi town for at least 6 months were included. We have employed the depression, anxiety, and stress scale 21 (DASS-21) to evaluate depression, anxiety, and stress. The Chi-squared test of association and logistic regression were used to identify factors associated with depression, anxiety, and stress among residents of Tepi town. For all statistical analysis, we used (IBM) SPSS version 25.

RESULTS

According to the current study, the prevalence of depression, anxiety, and stress symptoms were 37.7%, 39.0%, and 44.2%, respectively, among residents of Tepi town. Estimated odds of having depression, anxiety, and stress were as follows: for being female 6.315, 4.591, and 3.155; smoking 1.787, 1.883, and 1.787; sleep problem 2.613, 2.254, and 1.721; chewing Khat 2.156, 2.053, and 2.110; quarantine for 14 days 2.251, 1.902, and 1.960; and frequent use of social media 3.126, 1.849, and 3.126 times more likely as compared to their corresponding reference group respectively. The odds of developing depression and anxiety respectively were as follows: for alcohol consumption 2.438 and 1.797 times higher than their corresponding reference group respectively. Those exposed to COVID-19 were 3.870 times more likely to develop depression symptoms. Estimated odds of having anxiety and stress symptoms for fear of COVID-19 were 1.776 and 1.835; social interactions altered were 3.197 and 2.069, moderate levels of hope were 2.687 and 2.849 respectively. The odds ratio for those taking traditional preventive medicine, and having family members infected with COVID-19 were 2.475 and 1.837 times more likely to experience anxiety symptoms respectively.

CONCLUSION

In this study, the prevalence of depression, anxiety, and stress symptoms was found to be high among residences in Tepi town. Being female, chewing Khat, smoking, being quarantined for 14 days, frequently using social media, and having sleeping problems were all found to be significantly associated with an increased risk of developing depression, anxiety, and stress symptoms, whereas alcohol consumption and family members infected by COVID-19 were considerably linked to depression and anxiety symptoms. Fear of COVID-19, influence on social interaction and having a moderate level of hope were substantially related to stress and anxiety symptoms, while taking preventive medicine was found to be a significant factor in anxiety symptoms among Tepi town residences. Interventions should be made to improve the mental health of Tepi residents.

Emergency Stress, Hardiness, Coping Strategies and Burnout in Health Care and Emergency Response Workers During the COVID-19 Pandemic

Objective

Stress is a growing problem in the general population, but most especially for workers responding to the COVID-19 crisis. The present study examines stress and Burnout in Health Care workers and Emergency Responders during the third COVID wave in Italy. In addition, we explore the value of psychological Hardiness and positive coping strategies as protective factors against the ill-effects of stress.

Methods

Over a 5-month period in 2021, surveys were administered across all Italian regions to several groups including Health Care workers (N = 220), Emergency Responders (firefighters, civil protection, ambulance personnel; N = 121), volunteer Italian Red Cross workers (N = 328), and a comparison group (N = 400) drawn from the General Population of Italy.

Results

Results showed that among the groups, Health Care workers had the highest levels of Emergency Stress, while the Red Cross volunteers had relatively lower stress levels. Hardiness and positive coping levels were highest among Red Cross workers, and lowest in the General Population sample. The biggest impact on Burnout was seen among health care workers, especially on Emotional Exhaustion and Depersonalization. Multiple regression results showed that Hardiness operates as a moderator of the effects of Emergency Stress on Emotional Exhaustion and Depersonalization aspects of Burnout, while problem focused coping and Stopping Negative Thoughts-Emotions also showed moderating effects.

Conclusion

These results suggest that Health Care workers and Emergency Responders would benefit from additional training in hardiness and positive coping skills.

Relationship between Risk Perception of COVID-19 and Job Withdrawal among Chinese Nurses: The Effect of Work-Family Conflict and Job Autonomy

Aim

The aim of this study was to examine the mediating role of work–family conflict and the moderating role of job autonomy on the association between risk perception of COVID‐19 and job withdrawal among Chinese nurses during the initial disease outbreak.

Background

Nurses' job withdrawal can not only reduce the quality and efficiency of care but also give rise to turnover during the COVID‐19 pandemic. Thus, it is essential to clarify how and when the risk perception of COVID‐19 influences the job withdrawal behaviours of nurses and to provide guidelines for reducing nurses' job withdrawal.

Methods

A two‐wave study was conducted among 287 Chinese nurses from 11 COVID‐19‐designated hospitals during the initial outbreak of the disease from March through April 2020. Data on the risk perception of COVID‐19, job autonomy and work–family conflict were collected at time 1, and 1 month later, job withdrawal data were collected at time 2. Model 4 and Model 14 from SPSS macro PROCESS were used to test the mediating effect of work–family conflict and the moderating effect of job autonomy, respectively.

Results

Work–family conflict mediated 60.54% of the relationship between risk perception of COVID‐19 and job withdrawal. Job autonomy positively moderated the relation between work–family conflict and job withdrawal (β = 0.12, P < 0.01).

Conclusion

Risk perception of COVID‐19 influenced nurses' job withdrawal through work–family conflict. Job autonomy exaggerated the association between work–family conflict and job withdrawal.

Implications for Nursing Management

Managers should provide more supportive resources to help nurses cope with the risk of COVID‐19 to decrease work–family conflict and job withdrawal, and they should strengthen supervision over the work processes of nurses.

Suicidal Behaviours During Covid-19 Pandemic: A Review

Objective

Novel COVID-19 disease has become a major concern worldwide, and a recent line of research warned that the context of the COVID-19 pandemic may be a major risk factor for developing severe suicidal behaviors. A broad systematic review is needed to cover the studies that have already assessed the potential underlying factors for suicidal behaviors in the context of the COVID-19 outbreak.

Method

A total of 52 studies met the inclusion criteria, and data were then described according to the subsequent categories: (1) countries where the studies were carried out; (2) factors impacting suicidal behaviors during the COVID-19 outbreak; and (3) examination of the observed populations.

Results

Findings of the current systematic review suggest that there is a certain amount of heterogeneity in factors impacting suicidal behaviors during the COVID-19 outbreak, with economic downturn, psychiatric vulnerability, isolation and quarantine, health concerns, and relational difficulties being the most prominent reasons for developing suicidal behaviors during the COVID-19 outbreak.

Conclusions

Timely interventions are needed to prevent suicidal behaviors in both the clinical and general populations, and in this regard, the creation of standard procedures may speed up the process.

The role of resilience and coping among Italian healthcare workers during the COVID-19 pandemic

Objective:

To evaluate the psychological state of healthcare workers (HCWs) in the field of rehabilitation during the COVID-19 pandemic.

Methods:

Cross-sectional observational study. Sample of 334 HCWs including: nurses, medical doctors, therapists, scientists, and clerical workers working at the IRCCS San Raffaele Roma rehabilitation hospital during the second wave of the COVID-19 pandemic. Anonymous web-based questionnaire included 14-item Resilience Scale, Brief-COPE, Hospital Anxiety Depression Scale, Fear of COVID-19 Scale. Occupational and sociodemographic characteristics.

Results:

High levels of resilience, low levels of anxiety, depression, and fear were observed in the study population; the most frequently used coping strategies in the Brief-COPE were acceptance, planning, and active coping. Specifically, 87% of the participants reported a moderate to high level of resilience, with the highest level observed in nurses while physicians show the lowest level. HCWs showed symptoms of anxiety (29%), depressive symptoms (10%), and fear caused by the COVID-19 pandemic (44%). Statistically significant differences were observed between different occupations for fear (p <0.05) and resilience (p <0.01). Levels of anxiety and fear appeared to be higher in female and younger workers. The latter group - who also reported higher levels of depression - showed lower levels of resilience.

Conclusions:

In our study hospital and non-hospital workers show different emotional, cognitive, and behavioural resources when facing stressful situations, like in the case of the SARS-CoV-2 pandemics. Our results support the role of resilience and the proper use of problem-focused and emotion-focused coping strategies as protective factors from psychological distress.

Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review

Background: Several data suggest that coronavirus disease 2019 (COVID-19) pandemic may exacerbate or trigger eating disorders (EDs). The aim of this paper was to summarize current literature studies on COVID pandemic and EDs. Methods: Literature search, study selection, methods, and quality evaluation were performed according to the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Results: A systematic search allowed the initial selection of 172 papers; 21 (12.2%) papers were eligible and included in the review. In selected studies, a total number of 29,108 subjects were enrolled (range: 10-11,391; mean/SD: 1,386 ± 2,800), 6,216 were men (21.4%), 22,703 were women (77.9%), and 189 (0.7%) were gender fluid or not declared. The mean age/SD of subjects was 30.2 ± 7.7. About 12 studies (57.1%) were online surveys, 4 (19.0%) were retrospective studies, 2 (9.5%) were qualitative studies, 2 (9.5%) were longitudinal cohort studies, and 1 was a social media survey (4.8%). Their analysis revealed five main findings: (1) changes in the routines of physical activities were related to the worsening of preoccupation on weight/body shape; (2) food access limitation during pandemic represented the risk factors for both triggering and exacerbating EDs; (3) restriction in healthcare facilities contributed to increase anxiety levels and to modify treatment compliance; (4) social isolation was related to the exacerbation of symptoms in patients with EDs who are home-confined with family members; and (5) conflicts and difficulties in relationships with "no way out" were the maintenance factors for ED symptoms, especially in adolescents and young adults. Conclusion: The COVID-19 pandemic had a negative impact on EDs that might be triggered by the exceptional conditions derived from COVID-19-related stress in predisposed subjects. Patients who were already affected by EDs experienced the worsening of their clinical conditions and related quality of life (QoL).

Psychological Problems in a Sample of Jordanian Healthcare Workers Involved in Caring for Patients With COVID-19: A Cross-Sectional Study

Purpose: To explore the psychological problems (stress, depression, and anxiety) and the level of resilience among frontline healthcare workers (HCWs) who provide care for patients with coronavirus disease 2019 (COVID-19). Additionally, the current study identified the correlation among these problems, resilience, and demographics of participants. The study explored the main predictors of stress, depression, anxiety, and resilience. Methods: Both the descriptive cross-sectional correlational design and convenience sample technique were used to collect data from active Jordanian HCWs who directly deal with patients suspected or confirmed to be infected with COVID-19 and work at healthcare facilities in Jordan. Data were collected by using online questionnaires about the demographics, stress, anxiety, depression, and resilience of the participants. Results: Data were collected from 225 HCWs. Their mean age was 31.17 years (SD = 6.8). All the participants perceived different levels of stress, with most perceiving exposure to a high level of stress (distress) (46.2% with low level and 53.8% with high level of stress); approximately half of them (52.9%; n = 119) reported a high level of anxiety, and more than half (66.2%; n = 149) had a high level of depression. Additionally, an increased anxiety and depression level was significantly associated with the decreased resilience and increased stress level. Increased age and experience of HCWs are significantly correlated with increased stress levels. The participants having personal protection equipment (PPE) reduced anxiety and depression and increased resilience (p > 0.05). The predictors of the main variables were varied in the study. Conclusion: Frontline HCWs involved in treating the patients with COVID-19 are liable to have a high level of stress that is associated with increased anxiety and depression levels. These high levels affect their mental well-being and resilience. Healthcare institutions in Jordan must tailor appropriate psychological interventions and support that are congruent with the needs of HCWs during and after caring for patients with COVID-19.

Mental Health Support in the Time of Crisis: Are We Prepared? Experiences With the COVID-19 Counselling Programme in Hungary

The Coronavirus disease 2019 (COVID-19) posed unexpected global economic and societal challenges. These include a heavy impact on mental health due to fast changing lockdown and quarantine measures, uncertainty about health and safety and the prospect of new waves of infections. To provide crisis mental health support during the pandemic, Eötvös Loránd University in Hungary launched a specialist online counselling programme, consisting of one to three sessions. The programme was available to all university members between 4th March and 25th May 2020. Overall, 47 clients received support. In this paper we discuss challenges reported by clients, key features of providing a brief mental health intervention online, reflect on counsellor experiences and give recommendations on how mental health services could be developed in the time of crisis. Most clients had challenges with developing a daily routine under quarantine; and many had hardship related to finances, housing, and distance learning. Common mental health consequences included fear from the virus and stress, anxiety, and fatigue due to the interruption to everyday life. In some cases, more complex conditions were triggered by the pandemic. Examples include addictive behaviours and symptoms of depression or psychosis. However, referring cases beyond the competency of counselling proved to be a challenge due to the closure of specialist services. Counsellors observed three key features to the online delivery of a brief crisis mental health intervention: [1] an explicit problem-oriented approach to counselling; [2] challenges of building rapport online; and [3] frames of online counselling. Counsellor experiences often overlapped with those of clients and included challenges of working from home and adjusting to online counselling methods. The possibility of online counselling allowed that mental health care could take place at all during the pandemic. Client experiences reflect findings from previous literature. Like other mental health initiatives launched to tackle COVID-19, the intervention's effectiveness was not measured given the unexpected context and short time frame for programme development. We recommend the use of impact measurement tools to develop mental health services in crises. Meanwhile, the pandemic brought to attention the need to better understand online delivery models. Counsellors should have access to training opportunities on online counselling and managing work-life balance in a remote setting. The COVID-19 counselling programme in Eötvös Loránd University, Hungary is an example of providing online mental health counselling in the time of crisis. Clearly, more studies are needed discussing delivery models and effectiveness of mental health interventions during the pandemic. Experience and knowledge sharing across practitioners should be encouraged to improve how the field reacts to unexpected, high risk events and crises.

Impacts on Children and Adolescents' Lifestyle, Social Support and Their Association with Negative Impacts of the COVID-19 Pandemic

The impacts of the COVID-19 pandemic on physical and mental health-related behaviors among children and adolescents are likely to be profound and long-lasting. This study aimed to investigate the changes in lifestyle and social support and their associations with negative impacts due to the pandemic. A classroom survey using stratified random sampling and structured questionnaire was conducted among Hong Kong primary and secondary school students. The paper-and-pen survey, administered by well-trained research assistants, was completed by 2863 participants aged 9-17 years old (M = 12.6, SD = 1.3) at a brief school reopening six months after the outbreak of the COVID-19 pandemic. About 48% and 37% of the participants stated that they paid increased attention to physical and mental health, respectively. About 20% to 40% stated that they found more support from their friends and family members; only a small percentage reported decreased social support. Around 25% to 50% spent more time to rest, relax, and exercise. The aforementioned changes varied among genders, education groups, and socio-economic status. In general, higher perceived vulnerability, feeling more stressed, apprehensive, and helpless were associated with more reported positive lifestyle changes, including more social/family support, increased mental health awareness, and a positive lifestyle. These positive changes serve as important cushions against the negative impacts of COVID-19.

A model for occupational stress amongst paediatric and adult critical care staff during COVID-19 pandemic

Purpose

The coronavirus 2019 pandemic has placed all intensive care unit (ICU) staff at increased risk of psychological distress. To date, measurement of this distress has largely been by means of validated assessment tools. We believe that qualitative data may provide a richer view of staff experiences during this pandemic.

Methods

We conducted a cross-sectional, observational study using online and written questionnaires to all ICU staff which consisted of validated tools to measure psychological distress (quantitative findings) and open-ended questions with free-text boxes (qualitative findings). Here, we report our qualitative findings. We asked four questions to explore causes of stress, need for supports and barriers to accessing supports. A conventional content analysis was undertaken.

Results

In total, 269 of the 408 respondents (65.9%) gave at least one response to a free-text question. Seven overarching themes were found, which contribute to our proposed model for occupational stress amongst critical care staff. The work environment played an important role in influencing the perceived psychological impact on healthcare workers. Extra-organisational factors, which we termed the “home-work interface” and uncertainty about the future, manifested as anticipatory anxiety, had a proportionally larger influence on worker well-being than would be expected in non-pandemic conditions.

Conclusion

Our findings have important implications for appropriate allocation of resources and ensuring well-being of the ICU multidisciplinary team for this and future pandemics.

Protective and Risk Factors of Italian Healthcare Professionals during the COVID-19 Pandemic Outbreak: A Qualitative Study

The COVID-19 pandemic put the Italian health system under great stress. The sudden reorganization of work practices and the emotional impact of the large number of the victims had many consequences on the well-being of the healthcare professionals (HCPs) involved in managing the crisis. In the available literature, most studies have focused on the risk aspects while only few studies also take into account protective factors. For this reason, it was decided to conduct, within psycho-sociological perspective, a qualitative study with the aim to explore in depth the protective and risk factors as experienced by HCPs who worked in the Italian healthcare system during the COVID-19 outbreak. A total of 19 semi-structured interviews were conducted with HCPs-9 nurses and 10 physicians (7M and 12F) with an average age of 43 (SD = 13.4)-selected using snowball sampling. Considering three different levels of analysis the results highlight the protective and risk factors: personal history level (intrinsic/ethical motivation and flexible role versus extrinsic motivation and static role), interpersonal level (perception of supportive relationships with colleagues, patients, and family versus bad relationships), and organizational level (good leadership and sustainable work purpose versus absence of support from management and undefined or confused tasks).

Sense of coherence, engagement, and work environment as precursors of psychological distress among non-health workers during the COVID-19 pandemic in Spain

BACKGROUND

The interrelationship between the sense of coherence, work environment, work engagement, and psychological distress have particular interest in non-health workers who carried out essential activities during the COVID-19 pandemic.

OBJECTIVE

To assess the effects of the COVID-19 on the physical and mental health of non-health workers.

DESIGN

Observational descriptive cross-sectional study.

DATA SOURCES

1089 questionnaires have been analysed. Engagement (UWES-9), sense of coherence (SOC-13), mental health (Goldberg GHQ-12), demographic data, perception of health and stress and work environment were assessed.

RESULTS

At low levels of engagement, the percentage of distress is higher (77.9%). Low levels of sense of coherence correspond to the highest percentages of distress (86.3%). The 94.1% believe it necessary for professionals and volunteers involved in COVID-19 to receive psychological support. Low comprehensibility is mediated by the perception of stress; if the perception is low, comprehensibility is modulated by the level of significance; if it is low, it generates 95.9% of distress.

CONCLUSION

The interrelationship between the sense of coherence, work environment, work engagement, and psychological distress have particular interest in non-health workers who carried out essential activities during the COVID-19 pandemic. Almost all respondents believed that professionals and volunteers involved in COVID-19 should receive psychological support. This may be an indicator of the effect of the COVID-19 pandemic on workers' mental health.

Emotional Impact of COVID-19 Lockdown Among the Spanish Population

BACKGROUND

The COVID-19 pandemic has resulted in some populations being confined to their homes as part of infection control measures. This situation can be hard to cope with due to separation from loved ones, prohibition of regular activities, fear of infection, loss of freedom, and so on. These negative impacts cause considerable psychological stress, and all the more so when the situation continues for an extended period, as was the case in Spain. The present study was aimed at investigating the effects of COVID-19 quarantine on the emotional functioning of confined Spanish individuals after 8 weeks of lockdown by means of a cross-sectional study. The possible associations between changes in emotional functioning and demographic variables (age and sex), health habits (physical exercise, following a routine, and smoking), social support, and resilience were also analyzed.

METHODS

A total of 906 Spanish adults completed an online survey to gather information about their prevailing mood and affects (before and after 8 weeks of lockdown), using the Positive and Negative Affect Schedule (PANAS) (Watson et al., 1988), and other variables related to their habits and protective factors.

FINDINGS

As expected, the data indicated an increase in negative affects (e.g., "upset," "afraid," "distressed") and a decrease in positive affects after 8 weeks under lockdown, as well as a general decline in overall mood. The largest increases in negative affects were observed in young adults (18-35 years) and women. We did not find any differences between people who were or were not diagnosed with COVID-19. Adhering to a routine, maintaining the same weight, and moderate physical exercise were associated with fewer negative affects, which indicates they are important protective factors, as are perceived social support and resilience.

CONCLUSION

In order to mitigate the psychological impact of confinement, it is important to develop psychoeducational measures that encourage subjects to adhere to health habits and promote social support and resilience as protective factors. A special preventive focus should be placed on the most vulnerable population groups, namely women and young adults. For a public health lockdown to succeed, its negative consequences must be minimized insofar as possible through adequate knowledge of the risk factors and protective factors, and by means of prevention-oriented organization.

Traumatic Stress in Healthcare Workers During COVID-19 Pandemic: A Review of the Immediate Impact

The disease caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 resulted in a pandemic that has demanded extraordinary physical and mental effort from healthcare workers. This review provides an overview of studies that have explored traumatic stress in healthcare workers and associated factors between January and May 2020. The focus is on the most relevant literature investigating the prevalence of trauma- and stressor-related symptoms. Articles were selected from PubMed and PsycINFO databases using the search terms, "healthcare workers," "COVID-19," and "posttraumatic stress" in different combinations and with various synonyms. Among the seven studies that fulfilled our criteria, five assessed traumatic stress response, one assessed acute stress symptoms, and one focused on vicarious traumatization. Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms. Future studies should clarify the long-term effects of the COVID-19 pandemic on the mental health of healthcare workers, with particular focus on posttraumatic stress disorder.

Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic

OBJECTIVE

Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

METHODS

An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

RESULTS

Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = -0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = -0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

DISCUSSION

Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review

Health care professionals (HCPs) are a population at risk for high levels of burnout and compassion fatigue. The aim of the present systematic review was to give an overview on recent literature about mindfulness and compassion characteristics of HCPs, while exploring the effectiveness of techniques, involving the two aspects, such as MBSR or mindfulness intervention and compassion fatigue-related programs. A search of databases, including PubMed and PsycINFO, was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the methodological quality for this systematic review was appraised using AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews-2). The number of articles that met the inclusion criteria was 58 (4 RCTs, 24 studies with pre-post measurements, 12 cross-sectional studies, 11 cohort studies and 7 qualitative studies). MBSR intervention was effective at improving, and maintaining, mindfulness and self-compassion levels and to improve burnout, depression, anxiety, stress. The most frequently employed interventional strategies were mindfulness-related trainings that were effective at improving mindfulness and self-compassion, but not compassion fatigue, levels. Compassion-related interventions have been shown to improve self-compassion, mindfulness and interpersonal conflict levels. Mindfulness was effective at improving negative affect and compassion fatigue, while compassion satisfaction may be related to cultivation of positive affect. This systematic review summarized the evidence regarding mindfulness- and compassion-related qualities of HCPs as well as potential effects of MBSR, mindfulness-related and compassion-related interventions on professionals' psychological variables like mindfulness, self-compassion and quality of life. Combining structured mindfulness and compassion cultivation trainings may enhance the effects of interventions, limit the variability of intervention protocols and improve data comparability of future research.

Children and the Covid-19 Transition: Psychological Reflections and Suggestions on Adapting to the Emergency

The current period of transition due to COVID-19 emergency may negatively affect the psychological functioning of children and require resources aimed at supporting post-transition adaptation. Few contributions exist which specifically focus on what to do in such circumstances in order to assist the mental health of both children and parents. It seems therefore critical to provide strategies, which support the adjustment of children during the pre-existing and post-transition periods. Furthermore, screening projects are required in order to identify those children with increased levels of emotional and behavioural issues, beyond the COVID-19 transition, in order to plan specific interventions.