Factors influencing the psychosocial impact of COVID-19 pandemic on healthcare workers and their level of satisfaction towards organisational efforts

INTRODUCTION

The Coronavirus Disease 2019 (COVID-19) pandemic has had a dramatic physical, personal, and emotional effect on healthcare workers (HCWs). The main objective of this study was to identify risk factors associated with psychosocial distress among HCWs working in a hospital environment during the pandemic.

MATERIALS AND METHODS

A cross-sectional descriptive survey involving HCWs of a tertiary care hospital was completed using an online survey software (Google Forms). The survey collected respondents' sociodemographic data, perception towards personal protective equipment (PPE) and knowledge about COVID-19, and satisfaction score towards performance of the World Health Organization, the Malaysian police, civil service, healthcare system, and government. Psychosocial distress was assessed using the 12-item version of the General Health Questionnaire (GHQ- 12).

RESULTS

A total of 675 responses were collected. Female gender and doctors were identified to be associated with greater psychosocial impact from the pandemic among the HCWs. Several factors such as self-rated health status, confidence level towards PPE in disease prevention, degree of familiarity in using PPE, knowledge regarding care for COVID-19 patients, and capability in answering questions asked by the public regarding the disease were found to be associated with the degree of psychosocial impact from the pandemic.

CONCLUSION

This study identified the vulnerable groups of HCWs at risk of psychosocial distress and its associated risk factors. These findings highlight the need for strategies to reduce risks and to prioritise psychological support and intervention during the pandemic.

Outcomes of stage I/II follicular lymphoma in the PET era: an international study from the Australian Lymphoma Alliance

Management practices in early-stage (I/II) follicular lymphoma (FL) are variable and include radiation (RT), systemic therapy, or combined modality therapy (CMT). There is a paucity of data regarding maintenance rituximab in this cohort. We conducted an international retrospective study of patients with newly diagnosed early-stage FL staged with positron emission tomography (PET)-computed tomography and bone marrow biopsy. Three hundred sixty-five patients (stage I, n = 221), median age 63 years, treated from 2005-2017 were included, with a median follow-up of 45 months. Management included watchful waiting (WW; n = 85) and active treatment (n = 280). The latter consisted of RT alone (n = 171) or systemic therapy (immunochemotherapy [n = 63] or CMT [n = 46]). Forty-nine systemically treated patients received maintenance rituximab; 72.7% of stage I patients received RT alone, compared to 42.6% with stage II (P < .001). Active therapies yielded comparable overall response rates (P = .87). RT alone and systemic therapy without maintenance rituximab yielded similar progression-free survival (PFS) (hazard ratio [HR], 1.32; 95% confidence interval [CI], 0.77-2.34; P = .96). Maintenance rituximab improved PFS (HR, 0.24; 95% CI, 0.095-0.64; P = .017). The incidence of transformation was lower with systemic therapy compared to RT or WW (HR, 0.20; 95% CI, 0.070-0.61; P = .034). Overall survival was similar among all practices, including WW (P = .40). In the largest comparative assessment of management practices in the modern era, variable practices each resulted in similar excellent outcomes. Randomized studies are required to determine the optimal treatment in early-stage FL.