Professional Quality of Life in Greek Health Professionals Working with Refugees and Migrants

Nurses' strategies for coping with stress in the face of the influx of war refugees from Ukraine to Poland

Introduction

Russian military's incursion into Ukraine sparked the largest refugee crisis in Europe since World War II. As Ukraine's neighboring country, Poland became the primary destination for these refugees. Ukrainians staying in Poland under the EU's Temporary Protection Directive receive humanitarian support similarly to asylum seekers, but the legal pathways, length of stay and integration processes differ significantly as the Directive provides for more immediate, collective protection without the complexity of individual asylum applications. The influx of war refugees generates extremely complex situations that health personnel, especially nurses, must face on a daily basis.

Aim

Identify whether and to what extent the emergence of a large number of patients with war-related experiences constituted a source of stress for nurses, and how Polish nurses coped with this issue.

Materials and method

A cross-sectional study was conducted in December 2022 in Białystok, Poland. It included 473 certified nurses working in hospitals affiliated with the District Chamber of Nurses in Białystok. Perceived Stress Scale (PSS-10) questionnaire and Mini-COPE inventory (Polish version of Carver'a BriefCOPE inventory were used in the study.

Results

The average stress level among nurses was moderate, with nearly equal proportions of nurses experiencing low, medium, and high stress levels. Nurses who had contact with refugees in the last six months and/or helped them, did not present an increased level of stress - on the contrary, this level was lower. Nurses who helped refugees at work more often used a planning strategy in stressful situations, and less frequently reacted to stress using humour, religion, denial or venting.

Conclusions

The greater workload and more frequent contacts between Polish nurses and Ukrainian war refugees were a factor increasing work fatigue, but, paradoxically, at the same time reducing the level of stress in a situation giving the feeling of a duty well fulfilled. Empowering nurses through greater autonomy and fostering supportive work environments, especially in crisis situations like the care of war refugees has a positive impact on coping with stress.

Trauma focused-cognitive behavioral therapy training effectiveness in promoting professional development of psychotherapists working with unaccompanied minors in Greece: a non-blinded randomized control trial

The need to develop psychotherapists' skills to respond to current treatment challenges, such as addressing trauma due to the refugee crisis, is increasing. However, there is a dearth of evidencebased training for psychotherapists who work with refugees, especially in frontline countries. A randomly selected sample of 80 clinicians working with unaccompanied minors (UAMs) in Greek accommodation centers nationwide participated in an intensive trauma-focused cognitive behavioral therapy (TF-CBT) training (n=44) or a control-group (n=36) and completed the Professional Quality of Life Scale, the Work and Meaning Inventory and a questionnaire to assess knowledge and therapeutic skills, in pre-andpost measurements. Clinicians with 1-3 years of experience with refugees reported higher burnout (p=0.012, M=25.78 vs M=22.04) and secondary traumatic stress than those with less than a year (p=0.014, M=22.03 vs M=18.04). Positive meaning at work increased in both groups at post-test (TF-CBT group: p=0.019, M=15 vs M=13.6, and control group: p<0.001, M=15.17 vs M=13.42). The TF-CBT training group outperformed the control group in knowledge and skills (p=0.021, M=10.15 vs M=8.75) and identified a lower number of children with post-traumatic stress disorder symptoms (p=0.009, M=6.94 vs M=4.33) post-training. This study provides preliminary evidence on TF-CBT training effectiveness in equipping psychotherapists to work with UAMs, while their professional quality of life warrants further research.

Quality of work life and associated factors among health professionals working at private and government health institutions in Awi zone, Amhara regional state, Ethiopia, 2022: a comparative cross-sectional study

Background

Quality of work-life issues significantly impact the economic, physical, and psychological well-being of health professionals and their families. Enhancing QWL aims to foster a conducive environment and improve work performance. This study evaluated the quality of work life of health professionals in government and private health institutions in the Awi zone, Ethiopia.

Methods

A comparative cross-sectional approach was employed, with study participants selected via the lottery method in 2022. Socio-demographic and organizational-related data were collected, coded, cleaned, and entered into Epi-Data version 3.1, then analyzed using SPSS version 27. Candidate variables were selected using bivariable logistic regression (p < 0.20). We used multivariable logistic regression to identify factors associated with quality of work life, presenting AOR with a 95% CI at a 5% significance level.

Results

The study included 385 private health professionals and 395 government health professionals, with response rates of 90.38 and 92.72%, respectively. Overall quality of work-life satisfaction was 53.08% (95% CI: 49.2-57.0), with private health institution workers reporting satisfaction at 42.3% (95% CI: 37.4-47.30) and government health professionals at 63.54% (95% CI: 58.78-68.31). The difference between the two groups was 21.2% (95% CI: 14.3, 27.9). Factors significantly associated with quality of work life included type of health institutions (AOR = 2.272; 1.684, 3.065), family size (AOR = 1.536; 1.122, 2.103), personnel protective equipment (AOR = 1.369; 1.006, 1.863), eye protection (AOR = 2.090; 1.514, 2.885), engineering control (AOR = 1.563; 1.140, 2.143), and accessibility of alcohol (AOR = 1.714; 1.219, 2.410).

Conclusion

Health professionals in private health institutions exhibited lower quality of work-life satisfaction than government health institutions. Quality of work life was significantly associated with the type of health institutions, family size, availability of personal protective equipment, eye protection, engineering control, and accessibility of alcohol. Regular monitoring and evaluation of the quality of work life, ensuring the availability of appropriate personal protective equipment, and providing sufficient materials and equipment for both groups were recommended based on the findings.

Resilience, Coping Self-Efficacy, and Posttraumatic Stress Symptoms among Healthcare Workers Who Work with Refugees and Asylum Seekers in Greece

Due to occupational exposure to potentially traumatic events, health care workers (HCWs) may be at risk of developing posttraumatic stress (PTS) symptoms or probable posttraumatic stress disorder (PTSD). This study examined probable PTSD, coping, and resilience among national HCWs working in Greece. A total of 17.9% of the sample of participants (N = 112) met the screening criteria for probable PTSD. Logistic regression models were constructed to assess if trauma coping self-efficacy (CSE) and resilience predicted probable PTSD, and the results indicated that lower trauma CSE significantly predicted probable PTSD in unadjusted models (OR = 0.89, 95% CI, 0.82, 0.96, p < 0.01) and adjusted models (OR = 0.90, 95% CI, 0.83, 0.97, p < 0.01). Our study findings suggest that organizations that employ HCWs may support their workers through ongoing screening, assessment, and training that enhances coping self-efficacy.

The Experience of Staff Working in Migrants' Reception Project: Phenomenological Study in a Multicultural Context

Introduction

Migrants and refugees belong to the most marginalized groups in the world. Barriers related to the determinants of health can often preclude access to basic human rights, and have a negative impact on health. Therefore, it is essential to understand how to properly interface with people with different perceptions of health and disease and how to design programs based on available resources.

Aim

To explore the experience of socio-health workers who work in the context of a reception project in Italy related to taking care of the health needs of a migrant population in a multicultural context.

Methods

This research was a qualitative phenomenological study with an interpretive approach adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines. The conversations were audio-recorded, transcribed, and read in depth. Reflexive analysis was used to analyze the data.

Results

Sixteen health and social workers were interviewed. Three main themes were extracted: (1) nature of needs and their facets; (2) interconnection between skills and in relationships; (3) struggles against shortages. The results highlight the participants' attribution of meaning to the needs and requirements of migrants, their experience in the relationship with the team and the migrants, and the difficulties in carrying out their role.

Discussion

What the study found underscores the importance of designing interventions that consider the unique perceptions and experiences of professionals who engage with migrants in daily practice. The complex health needs, experiences, and different cultural representations of health and illness must be read and approached with a culturally competent vision.

Conclusion

The study reveals how much the strengths of taking care of migrants' health lie in the ability to interconnect various competencies. This study gives elements for professionals and health organizations to understand the complexity of caring for the migrant population.

The Impact of Work-Related Barriers on Job Satisfaction of Practitioners Working with Migrants

The work environment of practitioners working with migrants may be very demanding as they are frequently exposed to the sad narratives of such a vulnerable population, the lack of professional support, or the frequent change of policies towards refugees and asylum seekers. Little research has been conducted to explore the job satisfaction of practitioners working with migrants and the organizational characteristics that can hinder or promote such satisfaction. The present study investigated the relationship between work-related barriers (i.e., intra-organizational, legal, and interaction-related barriers) and job satisfaction of practitioners working with migrants, also testing if perceived organizational efficacy is mediating this relation. This study was part of a larger European funded project, and participants were 428 First-Line Practitioners working with migrants in various sectors (e.g., social and health services, immigration and asylum services, or border guards) and working in several European countries. Data were collected through an online survey in the period between October and December 2020. Results showed that intra-organizational and legal barriers had a negative impact on job satisfaction, while interaction-related barriers did not have any. Perceived organizational efficacy mediated the relationship between two work-related barriers (intra-organizational and interaction-related barriers) and job satisfaction. These findings suggest that organizations working with migrants should focus on addressing intra-organizational and legal barriers, and on implementing actions aimed at building employees’ collective efficacy beliefs to improve their job satisfaction.

BURNOUT AND DEPRESSION OF GREEK HEALTHCARE PROFESSIONALS WORKING IN REFUGEES' RECEPTION CENTERS AND ACCOMMODATION PROGRAMS

OBJECTIVE

Aim: The investigation of health professionals' burnout and depression, working in refugees' reception centers and their possible intercorrelation.

PATIENTS AND METHODS

Materials and methods: A descriptive correlation study was carried out in health professionals, who worked in refugees' reception centers and accommodation programs throughout Greece. Data were collected using an anonymous questionnaire through online Google Forms. The questionnaire contained demographics, the Copenhagen Burnout Questionnaire (CBI-Gr) and the Patient Health Questionnaire (PHQ-9). The SPSS 22.00 was used for the statistical analysis and the significance level was set at 0.05.

RESULTS

Results: The sample consisted of 125 healthcare professionals working in refugees' reception centers and accommodation programs, the majority of tchem were women (62.4%), aged between 30-39 years (39.2%) nurses (24.8%) and with a master's degree (28%). A strong linear positive correlation was found between depression and burnout (r=0.542, p=0.000). A statistically significant correlation was also recorded between burnout and female gender (p=0.001), the age group of 30-39 (p=0.042) and nursing profession (p=0.003).

CONCLUSION

Conclusions: A strong linear relationship between burnout and depression was revealed, a finding indicating that it is imperative to implement interventions to strengthen the resilience of health professionals working in refugees' reception centers.