Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study

Perceived Autonomy and Anticipated Turnover: The Mediation Role of Burnout Among Critical Care Nurses

Background: Several factors are associated with the nurse anticipated turnover rate, including factors related to the staff, organisation, and management and leadership practices. Nurses in critical care areas (intensive care units and emergency rooms) demonstrated a higher anticipated turnover rate compared to nurses in other healthcare areas. There is evidence that imposing autonomy through managerial intervention is imperative, leading to increased confidence among nurses in terms of decision-making and enhancing their well-being, thus improving their performance, job satisfaction, and job retention. Aim: The aim of this study was to examine the mediating effect of burnout on the association between perceived autonomy and anticipated turnover among critical care nurses. Design: We utilized a cross-sectional descriptive survey design. Methods: We collected data from 134 nurses working in critical care areas using convenient sampling through an online survey. For data analysis, we utilized the Hayes process macro to examine the mediation model. Results: In this study, perceived autonomy was a significant negative predictor of nurses' anticipated turnover, and this association is partially mediated by nurses' emotional exhaustion. Conclusions: Nurse managers and policymakers should strive to support the autonomy and psychological well-being of critical care nurses as they play an important professional role within the healthcare team.

The Optimized Use of a Contact-Free Continuous Monitoring System on Clinical Outcomes During COVID-19

OBJECTIVES

The purpose of this study was to examine the impact of a contact-free continuous monitoring system on clinical outcomes including unplanned intensive care unit (ICU) transfer (primary), length of stay (LOS), code blue, and mortality. A secondary aim was to evaluate the return on investment associated with implementing the contact-free continuous monitoring program during the COVID public health emergency.

METHODS

An interrupted time series evaluation was conducted to examine the association between the use of contact-free continuous monitoring and clinical outcomes. A cost-benefit analysis was planned to evaluate the return on investment.

RESULTS

Use of contact-free continuous monitoring was not significantly associated with unplanned ICU transfers, deaths, ICU LOS, and or rapid response team calls. However, there were significant increases in code blue events ( P  = 0.02) and mean hospital LOS ( P  = 0.01) in the postimplementation period when compared with the preimplementation period. Due to the lack of improvement, costs were calculated but a cost-benefit analysis was not conducted.

CONCLUSIONS

Contact-free continuous monitoring bed use during the COVID-19 public health emergency was not associated with improvements in clinical outcomes, although there was substantial confounding. Future studies should include large randomized controlled trials to control for factors not under direct experimental control including unit staffing, staff turnover, and differences in the patient population related to surges in the COVID-19 pandemic.

Exploring Burnout at the Morgue During the COVID-19 Pandemic: A Three-Phase Analysis of Forensic and Pathology Personnel

Background/Objectives: Burnout is a critical concern among healthcare professionals, particularly during crises such as the COVID-19 pandemic. This study investigated burnout levels among forensic medicine and pathology personnel at three distinct phases: the early pandemic period (Phase 1-September 2020), the peak of the pandemic (Phase 2-October 2021), and the post-pandemic period (Phase 3-October 2024). Methods: A total of 37 participants employed in forensic medicine and pathology departments completed the Maslach Burnout Inventory (MBI). A one-way repeated measures ANOVA was conducted to assess within-subject differences over time. Normality and sphericity were tested using the Shapiro-Wilk test and Mauchly's test, with the Greenhouse-Geisser correction. Post hoc Bonferroni-adjusted comparisons identified significant differences, and partial eta squared (η2) was reported for effect sizes. Results: Results showed significant fluctuations in burnout levels across the three phases. Emotional exhaustion and low personal accomplishment peaked during Phase 2, with slight reductions observed in Phase 3. Gender differences were evident, with females reporting higher EE levels and males exhibiting higher depersonalization across all phases. Marital and parental status also influenced burnout levels, with unmarried individuals and those without children showing higher burnout scores. Medical doctors experienced the highest burnout levels among professional roles, while auxiliary staff showed significant challenges in the PA subscale. Conclusions: The COVID-19 pandemic was pivotal in exacerbating burnout levels due to increased workload, crisis decision-making, and emotional toll. Although the sample size is limited, these findings underscore the importance of implementing targeted interventions to mitigate burnout among forensic and pathology personnel, especially during healthcare emergencies. Gender-based differences in burnout suggest the necessity of specific workplace well-being strategies, while the protective role of family status demonstrates the importance of work-life balance policies. The persistence of psychological distress after a medical crisis calls for long-term monitoring and support programs. There is a need for improved workload distribution, peer support networks, and mental health training to build resilience among forensic and pathology personnel.

The Role of Short-Form Video Apps in Mitigating Occupational Burnout and Enhancing Life Satisfaction Among Healthcare Workers: A Serial Multiple Mediation Model

Background: The intersection of occupational burnout and digital leisure activities has garnered increasing scholarly attention in recent years. However, limited research has examined how Chinese healthcare workers engage with short-form video apps as a stress management tool. Objectives: This study employs a serial multiple mediation model to explore the impact of occupational burnout on the use of short-form video apps and its subsequent effects on a sense of community, intrinsic rewards, and life satisfaction among Chinese healthcare workers aged 18-34. Methods: Data were collected through an online survey, with 362 valid responses, and analyzed using descriptive statistics, hierarchical regression, and mediation analyses, including serial mediation via SPSS 25.0. Results: The results demonstrate a positive direct association between occupational burnout and the use of short-form video apps. Furthermore, the relationship between the use of short-form video apps and life satisfaction was mediated through two distinct pathways, namely, a sense of community and intrinsic rewards. Conclusions: These findings contribute to the expanding body of literature on the role of digital media in stress management and well-being among healthcare workers, as well as highlighting evidence-based digital interventions to support healthcare workers' well-being in high-stress settings.

The relationship between nurses' burnout status and their intention to leave during the COVID-19 pandemic process

AIM

The aim of this research is to determine the relationship between nurses' burnout status and their intention to leave the job during the COVID-19 pandemic.

MATERIALS AND METHODS

The population of the descriptive study, which seeks a relationship, consists of nurses working in State Hospital, the sample consists of 213 nurses who agreed to participate in the research between April 2021 and August 2021. Data were collected using the 'Personal Data Collection Form', 'Burnout Scale' and 'Intention to Leave Scale'. Ethics committee approval was obtained for the study.

RESULTS

Of the participants, 75.6% were women, 91.1% cared for patients with a diagnosis of COVID-19. The participants' Burnout Scale mean score was 4.34 ± 1.10, and the Intention to Leave Scale mean score was 2.94 ± 1.04. The relationship between burnout and age, gender, marital status, income status, unit of work, professional experience, choosing the profession voluntarily, being happy to do the job and caring for a patient with COVID-19 was found to be statistically significant (p < 0.05). It has been concluded that age, income status, unit of work, professional experience, choosing the profession willingly and being happy to do the job affect the intention to leave the job. A positive and significant relationship was found between the mean scores of the Burnout Scale and the mean scores of the Intention to Leave Scale.

CONCLUSION

This study determined that as nurses' burnout level increased, their intention to quit their jobs increased.

High workload and under-appreciation lead to burnout and low job satisfaction among radiographers

INTRODUCTION

Burnout and low job satisfaction in healthcare can impact patient safety and staff retention. This study aims to gain information on the factors influencing burnout and job satisfaction among radiographers in the UK, Ireland and internationally. This can inform strategies for improving the workforce supply and demand imbalance.

METHODS

An online questionnaire was developed, which included demographic questions and two validated instruments, the Maslach Burnout Inventory (MBI) and the Job Satisfaction Survey (JSS). The questionnaire was distributed to diagnostic radiographers through the EFRS Research Hub at the European Congress of Radiology, Vienna, in early March 2023. It was disseminated online through Twitter, Facebook, and email over six weeks.

RESULTS

245 radiographers completed the questionnaire, with the majority (n = 207, 84.5 %) female. Not all respondents responded to all questions. The numbers of respondents for each section were: Pay n = 205, Promotion = 206, supervision = 212, fringe benefits = 211, CR = 212, OC = 214, Co-workers = 213, NoW = 211, Communication = 213 and overall JS = 205. The questionnaire had participants from twenty-one countries, with 66.5 % from Ireland. The mean values for emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) indicate moderate levels of burnout among responding radiographers. 44.2 % of radiographers were dissatisfied, 43.7 % were ambivalent, and 12.1 % were satisfied overall. Workload, under-appreciated work, and time pressures were ranked as the top three factors contributing to burnout. Staff numbers, workload and poor management were the top three factors reducing job satisfaction.

CONCLUSION

Burnout levels were moderate, and overall job satisfaction was very low among radiographers. Workload and under-appreciation were key factors impacting low job satisfaction and high burnout.

IMPLICATIONS FOR PRACTICE

Healthcare policies that address radiographer burnout through wage structure adjustments, targeted human capital investment, and management practices aligned with staff needs are needed. Implementing these strategies is essential for improving healthcare efficiency, staff wellbeing, and patient care outcomes.

Mindfulness Smartphone Application Implementation to Impact Stress and Burnout in Adult Healthcare Professionals

Many healthcare professionals are experiencing increased stress and burnout, worsened by the COVID-19 pandemic, leading to negative individual and organizational outcomes such as mental illness, maladaptive coping, job dissatisfaction, poor patient care, and higher turnover costs. Mindfulness practice is a promising evidence-based approach to impact stress and burnout. This quality improvement pilot project evaluated the impact of a free mindfulness smartphone application on stress and burnout levels in certified or licensed adult healthcare professionals over 6 weeks. Using a quasi-experimental pre- and post-intervention design, the project assessed the Mindfulness Coach application's (app) impact on stress and burnout using the Perceived Stress Scale and the Mini Z 2.0 survey. The results indicated that using the app significantly reduced perceived stress but did not impact burnout symptoms.

Nurses' Experiences and Perceptions of P2/N95 Mask Use During the COVID-19 Pandemic in Australia: A Qualitative Study

Experiencing side effects when wearing N95/P2 masks has negative impacts on health workers and increases exposure to pathogens. While side effects of wearing P2/N95 masks have been reported previously, these masks have never been used as widely as during the COVID-19 pandemic. This study examines Australian hospital nurses' experiences and perceptions of P2/N95 mask usage and its impacts on patient care at a time when P2/N95 masks were widely used. A qualitative exploratory-descriptive design involving semistructured interviews and focus groups was conducted with 12 nurses employed at a public health service in Melbourne, Australia. The data were thematically analyzed. Participants shared experiences resulted in four themes derived from the data: "adverse health impacts," "occupational challenges caused by scarcity of P2/N95 masks," "impact of wearing P2/N95 masks on patient care and work practices," and "adaptive strategies to improve patient care." Nurses experienced notable adverse effects from P2/N95 masks, affecting patient care quality. This study's findings underscore the importance of enhancing training, education, and policies regarding mask usage to uphold high standards of patient care and reduce exposure to pathogens.

Burnout and occupational stress of home care rehabilitation professionals transitioning out of the COVID-19 pandemic in Ontario, Canada

Introduction

The COVID-19 pandemic has significantly impacted the home healthcare industry, with increased rates of burnout and stress among homecare rehabilitation professionals (hcRPs). This study aimed to (1) examine the nature of burnout and occupational stress among homecare rehabilitation professionals at a large home care organization in Ontario, Canada, transitioning out of the pandemic, and (2) assess its impact on work participation and engagement.

Methods

We conducted a cross-sectional survey using the National Institute for Occupational Safety and Health Generic Job Stress Questionnaire and Copenhagen Burnout Inventory to examine burnout and job stress.

Results

One hundred thirty-nine participants identified that work stress and burnout are more likely to occur when one struggles to cope, experiences unexpected circumstances, and feels a lack of control, which can lead to anger and emotional exhaustion. The adjusted odds ratio for emotional exhaustion was 5.46, indicating that the probability of experiencing work stress among homecare rehabilitation professionals increases as emotional exhaustion increases. Significant associations were found between coping with daily tasks and levels of burnout.

Conclusion

Work stress and burnout influence coping, unexpected circumstances in homecare rehabilitation professionals work-life. Furthermore, highlighting the need to provide organizational support and policies that specifically address these issues in the home care sector.

Occupational Risk Factors for Burnout Syndrome Among Healthcare Professionals: A Global Systematic Review and Meta-Analysis

Health professionals are disproportionately affected by burnout compared to other occupational groups. This study aims to systematically review and meta-analyze thirteen occupational risk factors related to burnout syndrome among health professionals globally. A comprehensive literature search was conducted in August 2023. The protocol was registered in The International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42023396081. Using a random-effects model, this meta-analysis assessed the association between occupational risk factors and burnout, reporting odds ratios (ORs) and 95% confidence intervals (CIs). The meta-analysis included 109 studies from diverse global locations. Key factors influencing burnout included workplace bullying, job stress, and poor communication, with protective factors such as supportive work environments, adequate staffing, and individual resilience. All risk factors examined showed a significant positive relationship with burnout incidence. Workplace bullying was strongly associated with increased burnout (OR 4.05-15.01, p < 0.001). Similarly, low job satisfaction and high job stress were strongly associated with burnout, with ORs of 5.05 (95% CI 3.88-6.56, p < 0.001) and 4.21 (95% CI 1.62-10.94, p = 0.003), respectively. The review findings highlight the importance of addressing these risk factors through enhanced supportive work environments and promoting personal resilience strategies.

The relation between humor styles and nurse burnout: a cross-sectional study in China

Background

Nurse burnout is a prevalent issue in healthcare, impacting both nurses' well-being and patient care quality. This cross-sectional study examined the association between humor styles and nurse burnout.

Methods

A total of 244 nurses in China completed an online self-report measure to assess their humor styles and burnout levels using the Humor Styles Questionnaire (HSQ) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Spearman correlation analysis and stepwise regression analysis were conducted.

Results

The results showed that affiliative and self-enhancing humor were moderately used, while aggressive and self-defeating humor were rated low among the nurses. Emotional exhaustion was moderate, depersonalization was severe, and personal accomplishment was low. Correlation analyses uncovered significant relationships between humor styles and burnout dimensions. Self-enhancing humor exhibited negative correlations with emotional exhaustion and depersonalization, while aggressive and self-defeating humor styles displayed positive correlations with these burnout factors. Affiliative humor was also negatively correlated with depersonalization. Additionally, self-enhancing humor was positively correlated with personal accomplishment, whereas aggressive humor showed negative correlations with this dimension of burnout. Stepwise regression analysis revealed that self-defeating humor positively predicted emotional exhaustion while self-enhancing humor negatively predicted it. Aggressive humor positively predicted depersonalization, and affiliative and self-enhancing humor also positively predicted this dimension of burnout. Self-enhancing humor positively predicted personal accomplishment, while aggressive and self-defeating humor negatively predicted this dimension.

Conclusion

The findings highlighted the importance of considering different types of humor in understanding the various dimensions of nurse burnout. The use of self-defeating and aggressive humor appears detrimental, while the use of self-enhancing humor may be beneficial in mitigating burnout among nurses.

Burnout and Personality Profiles Among Chinese Nurses

Although many studies have examined the relationship between the five dimensions of personality and nurse burnout, few studies have examined the relationship between nurse burnout and the overall personality profile. In addition, nurses' demographic characteristics have been found to be related to nurses' burnout level, but the results have been inconsistent. This study aimed to determine personality profiles based on the Big Five personality model in a sample of Chinese nurses then analyze the relationship between burnout and personality profiles and demographics. A total of 1423 nurses were sampled and assessed using the Big Five Inventory and the Oldenburg Burnout Inventory. A k-means cluster analysis was used to divide participants into different personality profiles. Multivariate analysis of variance and binomial logistic regression were used to examine the relationship of burnout with personality profiles and demographics. Cluster analysis identified three personality profiles among nurses: resilient, ordinary, and distressed. For each dimension of the Big Five Inventory and Oldenburg Burnout Inventory, there was a significant difference between different personality profiles, with effect sizes being from 0.37 to 0.57. Nurses with a distressed personality profile were 4.52 times more likely to be diagnosed with burnout than nurses with an ordinary profile, while nurses with a resilient personality profile had a 55% reduction in burnout compared to nurses with an ordinary profile. The results suggested that hospital administrators should focus on nurses with a distressed personality profile to identify potential burnout nurses as early as possible. The findings also enabled hospital administrators to consider the different personality profiles of nurses and the specific requirements of the job to select suitable candidates.

Organizational resilience and its implications for healthcare workers in the COVID-19 pandemic: A literature review

Background

Organizational resilience is crucial in supporting the well-being of healthcare workers and ensuring the quality of healthcare services during crises like the COVID-19 pandemic. This study aims to comprehensively review organizational resilience of healthcare facilities in terms of its conception, measurement, and impacts on healthcare workers during the COVID-19 pandemic.

Methods

A search was conducted in four databases (PubMed, ScienceDirect, PsycINFO, and Web of Science) for empirical articles considering organizational resilience among healthcare facilities during the COVID-19 pandemic from 2019 to 2024. Several keywords from three categories ("COVID-19", "organizational resilience," and "healthcare facilities") were used, and RAYYAN was used to manage references.

Results

Four empirical articles from 172 studies were included, which encompassed a total sample of 6,606 healthcare workers from Switzerland, Saudi Arabia, Iran, and Türkiye. Organizational resilience could influence the individual resilience of healthcare practitioners, enhance crisis management and ensure safety performance. The strategies of enhancing organizational resilience at healthcare worker level included staff training, crisis management protocols, collaboration promotion, and stress management approaches. The ones at health facility level included government intervention, funds for hospital preparedness, competency-based crisis management, and mental health programs for healthcare workers. Our review also suggests a lack of empirical studies, no commonly used measurement instruments, and the heterogeneity of study contexts in the research of organizational resilience in public health.

Conclusions

This review highlights effective strategies to enhance the organizational resilience of healthcare workers and examines their impact during the COVID-19 pandemic. Immediate government action, funding to support hospital preparedness, and the formation of flexible healthcare teams are essential to strengthen organizational resilience among healthcare workers for future crises.

Burnout experience among healthcare workers post third COVID-19 wave in India; findings of a cross-sectional study

Background

The pandemic exacerbated burnout experienced by healthcare personnel, whose mental health had long been a public health concern before COVID-19. This study used the Copenhagen burnout inventory (CBI) tool to assess burnout and identify predictors among Indian healthcare workers managing COVID-19.

Methods

A cross-sectional study was conducted from June to December 2022, after the third pandemic wave. A web-based, fillable Google form was used to recruit COVID-19 management professionals from multiple Jaipur district hospitals. Healthcare professionals provided socio-demographic, work-related, and CBI scores. Multiple linear regression was used to control for model covariant independent variables.

Results

We evaluated the responses of a total of 578 participants with a mean age of 36.59 ± 9.1 years. Based on the CBI cut-off score of 50, 68.1% reported burnout. A total of 67.5%, 56.4%, and 48.6% of healthcare workers reported work-related, personal, and patient-related burnout, respectively. High burnout scores were significantly associated with the nursing profession (β = 7.89, 95% CI; 3.66, 12.11, p < 0.0001). The p-value indicates the probability of observing the data if the null hypothesis is true, and the confidence interval shows the range within which we can be 95% confident that the true effect lies. An independent relationship exists between male gender and higher personal-related burnout scores (β = 4.45, 95% CI 1.9-6.9).

Conclusion

This study identified key indicators that need further emphasis and the need for organizational and individual-level burnout monitoring in healthcare delivery sectors. Health workers continue to experience burnout due to a combination of personal, professional, and patient-related factors. This underscores the need for targeted organizational and individual interventions. The findings also suggest that the CBI tool could identify healthcare worker burnout risk groups.

Practicing During the COVID-19 Pandemic: Experiences of Canadian Hospital-Based Occupational Therapists

Background. The COVID-19 pandemic disrupted hospital operations worldwide, including services delivered by occupational therapists (OTs). Purpose. This study aimed to understand the experiences of OTs at one Canadian, tertiary care hospital during the 2021-2022 period of the pandemic. Method. We used a qualitative descriptive approach to describe the experiences of OTs during the pandemic. Findings. While there were similarities in the 10 participating OTs' experiences, salient differences were largely linked to the method of service delivery. Inpatient OTs benefitted from the support of colleagues and developed coping strategies in response to high levels of workplace stress and anxiety and a perceived lack of support from many levels of society. Clinically, they spent more time on discharge planning with fewer resources. OTs providing virtual/hybrid services experienced unique challenges related to adapting their practice to a virtual platform, including challenges assessing patients. They described benefits associated with virtual/hybrid service delivery and brought up concerns around equity of service provision. Conclusion. OTs in this hospital setting faced challenges in providing patient care and supporting their own wellness during the pandemic. Future research could explore the role of leadership in supporting occupational therapy practice during public health emergencies.

Rural suicide in Newfoundland and Labrador: A qualitative exploration of health care providers' perspectives

INTRODUCTION

Residents of rural regions may have higher and unique suicide risks. Newfoundland and Labrador (NL) is a Canadian province replete with rural regions. Despite an abundance of rural suicide research, heterogeneity in rural regions may preclude amalgamating findings to inform prevention efforts. Thus, exploring the unique needs of NL is needed. Importantly, health care providers (HCP) may afford unique perspectives on the suicide-related needs or concerns of rural life. We asked HCPs of residents of rural NL their perceived suicide risk factors, concerns, and needs for rural NL.

METHOD

Twelve HCPs of rural residents of NL completed virtual semi-structured interviews. Interviews were analysed using reflexive thematic analysis [13,14].

RESULTS

HCPs noted individual, psychological, social, and practical factors linked to rural-suicide risk and subsequent needs. Findings highlight the unique challenges of residing and providing health care in rural NL and inform prevention and intervention efforts.

Effects of Sudarshan Kriya Yoga (SKY) on the stress and self-esteem of medical doctors in a tertiary care hospital: a prospective analytical study

Objectives

Sudarshan Kriya Yoga (SKY) is a unique yoga practice incorporated into the Art of Living course. It is found to have a beneficial effect on different psychiatric disorders. This study was conducted to investigate the impact of SKY practice on stress and self-esteem among medical doctors.

Materials and methods

A prospective study was conducted among medical doctors (interns, residents, and consultants) in a tertiary care center. The Perceived Stress Scale and Rosenberg Self-Esteem Scale were used for the assessment of stress and self-esteem levels, respectively. The parameters were assessed at baseline, 3-day and 40-day follow-up of SKY practice. The statistical analysis was performed using Statistical Package for Social Sciences, version 25.

Results

A total of 58 participants were included in the study. The scores for stress decreased (19.07 to 18.62 to 16.33) and self-esteem levels increased (19.09 to 19.64 to 20.81) after the practice signifying the beneficial impact. It was statistically significant (P<0.05) with considerable effect sizes (Cohen's d 0.2-0.5 and >0.5 for self-esteem and stress levels, respectively). On MANOVA, gender (more in male participants) was significantly associated with stress levels even after the practice of SKY (P=0.042).

Conclusion

Amid the hectic schedule, regular practice of SKY is proven beneficial for medical doctors with its positive impact on stress, and self-esteem levels by our study.

Personality Factors Associated with Burnout in the Nursing Profession during the COVID-19 Pandemic

Background

Occupational burnout in a pandemic situation occurs faster for some people than others. This study aimed to evaluate the relationship between personality traits and occupational burnout in nursing professionals during the COVID-19 pandemic.

Materials and Methods

An observational, cross-sectional study was conducted from February to April 2021. This was carried out on 299 nursing professionals who were taking care of COVID-19 cases. Occupational burnout was measured by the Maslach Burnout Inventory, and personality variables were evaluated using the NEO fivefactor inventory.

Results

Finally, 299 nurses with a mean age of 35.49 ± 8.80 years participated in the study, of which 74.9% were women and 77.3% were married. The mean scores of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) subscales were 20.44 ± 11.52, 8.75 ± 4.10, and 27.66 ± 5.92, respectively. High and medium DP and EE levels were reported in 75.2% and 54.9% of the nurses and high PA level was found in 87.6%. There were significant differences in job satisfaction and work experience for all burnout subscales scores. DP and EE subscales had a positive relationship with neuroticism and a negative correlation with extraversion, openness, agreeableness, and conscientiousness. The PA subscale showed a statistically significant positive relationship with extraversion, openness, agreeableness, and conscientiousness.

Conclusions

The prevalence of burnout among nurses during the COVID-19 pandemic was moderate to high. The five personality characteristics were significantly associated with burnout in nurses and have a key role in developing burnout syndrome.

Understanding COVID-19 Impacts on the Health Workforce: AI-Assisted Open-Source Media Content Analysis

BACKGROUND

To investigate the impacts of the COVID-19 pandemic on the health workforce, we aimed to develop a framework that synergizes natural language processing (NLP) techniques and human-generated analysis to reduce, organize, classify, and analyze a vast volume of publicly available news articles to complement scientific literature and support strategic policy dialogue, advocacy, and decision-making.

OBJECTIVE

This study aimed to explore the possibility of systematically scanning intelligence from media that are usually not captured or best gathered through structured academic channels and inform on the impacts of the COVID-19 pandemic on the health workforce, contributing factors to the pervasiveness of the impacts, and policy responses, as depicted in publicly available news articles. Our focus was to investigate the impacts of the COVID-19 pandemic and, concurrently, assess the feasibility of gathering health workforce insights from open sources rapidly.

METHODS

We conducted an NLP-assisted media content analysis of open-source news coverage on the COVID-19 pandemic published between January 2020 and June 2022. A data set of 3,299,158 English news articles on the COVID-19 pandemic was extracted from the World Health Organization Epidemic Intelligence through Open Sources (EIOS) system. The data preparation phase included developing rules-based classification, fine-tuning an NLP summarization model, and further data processing. Following relevancy evaluation, a deductive-inductive approach was used for the analysis of the summarizations. This included data extraction, inductive coding, and theme grouping.

RESULTS

After processing and classifying the initial data set comprising 3,299,158 news articles and reports, a data set of 5131 articles with 3,007,693 words was devised. The NLP summarization model allowed for a reduction in the length of each article resulting in 496,209 words that facilitated agile analysis performed by humans. Media content analysis yielded results in 3 sections: areas of COVID-19 impacts and their pervasiveness, contributing factors to COVID-19-related impacts, and responses to the impacts. The results suggest that insufficient remuneration and compensation packages have been key disruptors for the health workforce during the COVID-19 pandemic, leading to industrial actions and mental health burdens. Shortages of personal protective equipment and occupational risks have increased infection and death risks, particularly at the pandemic's onset. Workload and staff shortages became a growing disruption as the pandemic progressed.

CONCLUSIONS

This study demonstrates the capacity of artificial intelligence-assisted media content analysis applied to open-source news articles and reports concerning the health workforce. Adequate remuneration packages and personal protective equipment supplies should be prioritized as preventive measures to reduce the initial impact of future pandemics on the health workforce. Interventions aimed at lessening the emotional toll and workload need to be formulated as a part of reactive measures, enhancing the efficiency and maintainability of health delivery during a pandemic.

Social cohesion among healthcare workers during COVID-19: Qualitative research in Indonesia, Nepal, and Vietnam

Existing literature has portrayed numerous challenges that healthcare workers (HCWs) faced during the COVID-19 pandemic, such as heightened risks of transmission against the scarcity of protective equipment, burgeoning workload, and emotional distress, to name a few. However, most studies explored HCWs' experiences at the individual level rather than examining the collective responses. Exploring these experiences could reveal the social-cultural locality of the pandemic while identifying the system constraints in public health emergencies. As part of a mixed-method study on COVID-19 pandemic impacts, we analysed qualitative interview data with 129 HCWs and health-related staff to explore their experiences during the pandemic between 2020 and 2021 in Vietnam, Indonesia, and Nepal. Using Bahers' sociological framework, Community of Fate, we describe five themes reflecting the formation of a community of HCWs and the social cohesion underlying their efforts to survive hardship. The first three themes characterise the HCW community of fate, including (1) Recognition of extreme work-related danger, (2) physical and figurative closures where HCWs restrict themselves from the outside world, (3) chronic ordeals with overwhelming workload and responsibilities, encompassing recurrent mental health challenges. Against such extreme hardship, cohesive bonding and social resilience are reflected through two additional themes: (4) a mutual sense of moral and professional duty to protect communities, (5) the vertical and horizontal convergence among HCWs across levels and among government departments. We discuss these HCWs' challenges in relation to systemic vulnerabilities while advocating for increasing investment in public health and collaboration across government sectors to prepare for emergency situations.

Determinants of burnout in Canadian health care workers during the COVID-19 pandemic

Background: Health care workers (HCWs) are among the most vulnerable groups to experience burnout during the coronavirus (COVID-19) pandemic. Understanding the risk and protective factors of burnout is crucial in guiding the development of interventions; however, the understanding of burnout determinants in the Canadian HCW population remains limited.Objective: Identify risk and protective factors associated with burnout in Canadian HCWs during the COVID-19 pandemic and evaluate organizational factors as moderators in the relationship between COVID-19 contact and burnout.Methods: Data were drawn from an online longitudinal survey of Canadian HCWs collected between 26 June 2020 and 31 December 2020. Participants completed questions pertaining to their well-being, burnout, workplace support and concerns relating to the COVID-19 pandemic. Baseline data from 1029 HCWs were included in the analysis. Independent samples t-tests and multiple linear regression were used to evaluate factors associated with burnout scores.Results: HCWs in contact with COVID-19 patients showed significantly higher likelihood of probable burnout than HCWs not directly providing care to COVID-19 patients. Fewer years of work experience was associated with a higher likelihood of probable burnout, whereas stronger workplace support, organizational leadership, supervisory leadership, and a favourable ethical climate were associated with a decreased likelihood of probable burnout. Workplace support, organizational leadership, supervisory leadership, and ethical climate did not moderate the associations between contact with COVID-19 patients and burnout.Conclusions: Our findings suggest that HCWs who worked directly with COVID-19 patients, had fewer years of work experience, and perceived poor workplace support, organizational leadership, supervisory leadership and ethical climate were at higher risk of burnout. Ensuring reasonable work hours, adequate support from management, and fostering an ethical work environment are potential organizational-level strategies to maintain HCWs' well-being.

Evaluation of a Pilot Wellness Elective for Master of Public Health Students during the COVID-19 Pandemic

BACKGROUND

Graduate student wellbeing is a public health issue in the United States. The COVID-19 outbreak exacerbated the mental health burden on graduate students worldwide. Culture of Wellness (PH 104) is a 2-week wellbeing elective course that teaches evidence-based wellbeing strategies for graduate students at a university in the United States. Our study aimed to evaluate the impact of this pilot wellbeing elective on Master of Public Health students' mental health and wellness during the COVID-19 pandemic.

METHODS

Participants included 22 Master of Public Health students from the class of 2021 at a university in the United States. We provided a pre-course survey to students that assessed their perception of their own personal wellbeing, their knowledge about various wellbeing strategies, and their confidence in applying 13 wellbeing strategies before taking the course. Post-course students completed the same survey following course completion, as well as a matching evaluation and a five-month follow up survey.

RESULTS

Of the 13 strategies taught, students reported significant improvements in their ability to apply 10 strategies. There was a significant increase in self-reported emotional and physical wellbeing, as well as a significant decrease in burnout. Five months post-course, more than three quarters of respondents used strategies taught in the course on a weekly basis or more.

LIMITATIONS

This pilot study is limited by its small sample size, which may restrict the generalizability of the findings.

CONCLUSIONS

The PH 104 Culture of Wellness course was effective in improving graduate students' wellbeing and confidence in applying wellbeing strategies.

Understanding Ohio X-Waivered Advanced Practice Registered Nurses' Rate of Naltrexone Prescription for Alcohol Use Disordered Patients

BACKGROUND

Alcohol use disorder (AUD) is overrepresented within the United States. Naltrexone, a recommended treatment for AUD, is underutilized. However, the prescribing behaviors of advanced practice registered nurses (APRNs) regarding naltrexone for AUD patients have not been studied. The purpose of our study was to explore the prescriptive practices of a sample of APRNs.

AIMS

To describe and analyze survey responses of a sample of Ohio APRNs with training in medication for addiction treatment (MAT) for substance use disorders (as evidenced by DEA x-waiver receipt) regarding prescribing practices of naltrexone for AUD patients.

METHOD

Public information collected from the first author's Nursing Board (list of APRNs in Ohio) was checked against the public information of x-waivered providers nationally from the Substance Abuse and Mental Health Services Administration's (SAMHSA) website. This generated a potential sample size of 824 APRNs, all of whom were sent email solicitations to complete a Qualtrics survey. After 3 weeks, 55 surveys were completed, and the data were analyzed. Descriptive statistics were generated as well as a logistic regression with five potential predictor variables against the outcome variable (defined as use of naltrexone for AUD patients).

RESULTS

Years practicing as an APRN was found to negatively predict naltrexone prescribing behavior for AUD patients. Practice setting and work experience with an addiction specialist physician were not found to predict naltrexone prescribing behavior for AUD patients.

CONCLUSION

Implications for further study were discussed, with emphasis on regulatory variance between states.

Reported pain at work is a risk factor for vascular surgery trainee burnout

BACKGROUND

Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being.

METHODS

A confidential, voluntary survey was administered after the 2022 Vascular Surgery In-Service Examination to trainees in all Accreditation Council for Graduate Medical Education-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as "no to mild pain" (0-2) vs "moderate to severe pain" (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (eg, burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study.

RESULTS

We included 527 trainees who completed the survey (82.2% response rate); 38% reported moderate to severe pain after a full day of work, of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%; P < .01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (odds ratio, 2.52; 95% confidence interval, 1.48-4.26) and using physiotherapy as pain management (odds ratio, 3.06; 95% confidence interval, 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change after adjustment.

CONCLUSIONS

Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should consider mitigating this occupational hazard by offering ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.

Implementation of a Continuous Patient Monitoring System in the Hospital Setting: A Qualitative Study

BACKGROUND

Technology can improve care delivery, patient outcomes, and staff satisfaction, but integration into the clinical workflow remains challenging. To contribute to this knowledge area, this study examined the implementation continuum of a contact-free, continuous monitoring system (CFCM) in an inpatient setting. CFCM monitors vital signs and uses the information to alert clinicians of important changes, enabling early detection of patient deterioration.

METHODS

Data were collected throughout the entire implementation continuum at a community teaching hospital. Throughout the study, 3 group and 24 individual interviews and five process observations were conducted. Postimplementation alarm response data were collected. Analysis was conducted using triangulation of information sources and two-coder consensus.

RESULTS

Preimplementation perceived barriers were alarm fatigue, questions about accuracy and trust, impact on patient experience, and challenges to the status quo. Stakeholders identified the value of CFCM as preventing deterioration and benefitting patients who are not good candidates for telemetry. Educational materials addressed each barrier and emphasized the shared CFCM values. Mean alarm response times were below the desired target of two minutes. Postimplementation interview analysis themes revealed lessened concerns of alarm fatigue and improved trust in CFCM than anticipated. Postimplementation challenges included insufficient training for secondary users and impact on patient experience.

CONCLUSION

In addition to understanding the preimplementation anticipated barriers to implementation and establishing shared value before implementation, future recommendations include studying strategies for optimal tailoring of education to each user group, identifying and reinforcing positive process changes after implementation, and including patient experience as the overarching element in frameworks for digital tool implementation.

Factors associated with cognitive impairment and the quality-of-life among COVID-19 survivors working as healthcare workers

Prolonged physical and mental health changes, known as post-COVID conditions (PCC), could impair the quality-of-life (QoL) of healthcare workers. The aim of this study was to identify factors that contribute to cognitive impairments and QoL among COVID-19 survivors working as healthcare workers. This cross-sectional study involved healthcare workers at Prof. Dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia. The Montreal Cognitive Assessment (MoCA) was used to assess the cognitive function, while the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF) questionnaire was used to evaluate the QoL. Factors associated with cognitive and QoL status were examined using Mann-Whitney and Chi-squared tests. A total of 100 COVID-19 survivors were included in the study, most of whom were female (74%), aged ≤35 years (95%), and were doctors (62%). Only 22% of the participants had a normal BMI, 93% had a history of mild COVID-19, and 54% had one comorbidity. The Overall MoCA score averaged 24.18±2.86, indicating mild cognitive impairment among the groups. The distribution of MoCA scores had similar patterns with no significant differences based on age, gender, comorbidities, BMI, COVID-19 severity, and frequency of COVID-19 infection. Interestingly, the number of vaccine doses received by the participants had a statistically significant associated with MoCA scores of which those receiving more than two doses had higher cognitive scores than those with only two doses (p=0.008). Based on categorized MoCA scores (normal vs cognitive impairment), none assessed factors were not significantly associated with cognitive outcomes. The WHOQOL-BREF scores ranged from 62.5 to 95.5, with a mean±SD of 83.67±7.03. None of the assessed factors were associated with WHOQOL-BREF scores among COVID-19 survivors. These findings highlight the need for further study to explore the protective role of vaccination frequency in cognitive impairment and the factors underlying the resilience in QoL among survivors.

Investigation of Burnout, Life Engagement and Well-Being in Nurses during the COVID-19 Pandemic

The nurses experience burnout due to COVID-19 and their psychological state is adversely affected by the pandemic. This study aims to examine the relationships between nurses' COVID-19 burnout, life engagement, and well-being perceptions. The study was carried out on 310 nurses working in a university hospital. As a result of the regression analysis, it was determined that the perception of COVID-19 burnout explained 14.7% of the total variance of life engagement and 40.8% of the total variance of well-being. The study also revealed that the perception of well-being explained 25% of the total variance of life engagement.

Effects of Presenteeism on Burnout among Rehabilitation Medical Workers in Korea: Multiple Mediating Effects of Organization and Supervisor Supports

PURPOSES

This study aimed to examine the discriminatory impacts of two major impairment factors-job presenteeism and attention presenteeism (JP and AP)-in presenteeism on burnout and to verify the multiple mediating effects of organizational and supervisory support in their causal relationship to provide theoretical and practical implications for alleviating burnout among rehabilitation medical workers (RMWs).

METHODS

Participants were convenience sampled from 23 hospitals and rehabilitation medical institutions in Korea, and 494 datasets were analyzed using the R packages R-studio, Jamovi, and JASP.

RESULTS

The significant effects of JP and AP on burnout were investigated; AP (0.609) had a much higher effect than JP (0.170) on burnout among RMWs. Moreover, the multiple mediating effects of organizational support and supervisory support were verified in the JP-AP relationship and burnout among RMWs. Additionally, the absolute effect on burnout was more from AP than JP, and organizational support had a far more significant effect than supervisory support in the process of affecting burnout.

CONCLUSIONS

The present study contributes to the literature on burnout by examining the relationships between presenteeism and burnout and by extending the current understanding of burnout and presenteeism to RMWs. And it is practically important to understand that the effect of AP was greater than that of JP between the two key sub-factors of presenteeism affecting burnout among RMWs, and Korean RMWs are more affected by support from the organization system than by personal support from their boss. Related theoretical and practical implications are further elaborated.

Remote assessment and monitoring with advanced wound therapy to optimise clinical outcomes, access and resources

OBJECTIVE

Patients in rural communities may have limited access to wound care; however, this may be mitigated by using a shared care approach. This study assessed the impact of a remote assessment and monitoring tool in combination with adjunctive continuous topical oxygen therapy (cTOT) in patients with diabetes and hard-to-heal wounds.

METHOD

Patients with hard-to-heal wounds (defined as no visible improvement in the previous four weeks) were enrolled to this 12-week pilot study to validate a shared care approach using an Advanced Digital Wound Care Platform-telehealth (ADWCPt) system (eKare Inc., US) coupled with cTOT. Patient and wound assessments were reviewed by the clinician either remotely, via telehealth calls, or at the clinic, and the number of face-to-face clinic visits was recorded. Patient health status scores were captured before and after the study, along with feedback on usability of the remote platform and cTOT device.

RESULTS

The wounds in all eight patients studied reduced in size over 12 weeks (mean percentage area reduction 92.0%), and two wounds were completely re-epithelialised. Another wound almost healed (99.2% wound area reduction). Clinical interactions consisted of self-assessments (n=80, 50.0%), video assessments with the clinician (n=27, 16.9%), and face-to-face interactions in clinic (n=53, 33.1%). Operational efficiencies encompassed a 54.0% increase in the number of clinical interactions, whereas clinical time was reduced by 25.8%. Health status scores improved across all eight patients and feedback on the shared approach and cTOT device was favourable.

CONCLUSION

A shared care model with ADWCPt coupled with an innovative cTOT device saved time and resources, improving patient access and engagement, along with a marked improvement in the wound healing trajectory.

Quality in screening and measuring blood pressure in China's primary health care: a national cross-sectional study using unannounced standardized patients

Background

This study aims to evaluate primary care providers' adherence to the standard of measuring blood pressure for people aged 35 or above during their initial visit, as per Chinese guidelines, and to identify factors affecting their practices.

Methods

We developed 11 standardized patients (SP) cases as tracer conditions to evaluate primary care, and deployed trained SPs for unannounced visits to randomly selected providers in seven provinces of China. The SPs used a checklist based on guidelines to record whether and how blood pressure was measured. Data were analyzed descriptively and regression analysis was performed to examine the association between outcomes and factors such as provider, patient, facility, and clinical case characteristics.

Findings

The SPs conducted 1201 visits and found that less than one-third of USPs ≥35 had their blood pressure measured. Only 26.9% of migraine and 15.4% of diabetes cases received blood pressure measurements. Additionally, these measurements did not follow the proper guidelines and recommended steps. On average, 55.6% of the steps were followed with few providers considering influencing factors before measurement and only 6.0% of patients received both-arm measurements. The use of wrist sphygmomanometers was associated with poor blood pressure measurement.

Interpretation

In China, primary care hypertension screening practices fall short of guidelines, with infrequent initiation of blood pressure measurements and inadequate adherence to proper measurement steps. To address this, priority should be placed on adopting, implementing, and upholding guidelines for hypertension screening and measurement.

Funding

National Natural Science Foundation of China, Swiss Agency for Development and Cooperation, Doctoral Fund Project of Inner Mongolia Medical University, China Postdoctoral Science Foundation.

Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis

BACKGROUND

The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs.

OBJECTIVE

This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program.

METHODS

A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework.

RESULTS

A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness.

CONCLUSIONS

Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879.

Evaluation of psychological distress, burnout and structural empowerment status of healthcare workers during the outbreak of coronavirus disease (COVID-19): a cross-sectional questionnaire-based study

BACKGROUND

In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors.

METHODS

This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis.

RESULTS

Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences.

CONCLUSION

Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.

Re-examining provider perceptions of best pre-war practices: what elements can help opiate agonist therapy programs in Ukraine successfully survive the crisis?

Purpose

This paper seeks to explore and understand what constitutes successful opioid agonist therapy (OAT) programs from the views of Ukrainian OAT providers in their context-specific accounts. Prior to the ongoing war the Ukrainian addiction treatment system made great strides to expand its OAT program and increase the number of patients. Since the beginning of the war there has been much alarm that those hard-earned successes will be destroyed. However, emerging evidence suggests that the Ukrainian OAT programs have shown signs of resilience in the face of adversity albeit at great cost. What aspects of the OAT programs developed prior to the crisis have been helpful to allow them to weather the storm? Using the data from 24 addiction treatment providers, this paper describes the essential elements of the OAT programs that preceded the current crisis which made them robust over time. By examining the narratives of the participants interviewed pre-war and pre-COVID-19 the paper reveals structural and cultural elements of the OAT programs before the perfect storm that are likely to endure. To the best of our knowledge, no one else has investigated OAT providers perspectives in Ukraine prior to the crisis which makes this paper extremely salient to understand both the robustness and the vulnerability of MAT programs in Ukraine during the war and going forward.

Methodology

The data come from qualitative semi-structured interviews with 24 OAT providers throughout 5 regions of Ukraine. Participants included front-line clinicians, head narcologists, and chief doctors from TB clinics, district hospitals and drug addiction centers. Using a coding scheme of 103 inductively developed categories we explored participants' perceptions of their OAT program.

Findings

In the stories shared by clinicians pre crisis, three major interconnected themes focused on economic uncertainty at the institutional level (leading to under-staffing), structural capacity of the program, and clinicians' professional identity, shaping differing views on application of rules for administrative discharge, take-home dosing, and the potential for scale-up. Knowing the data collection was completely unbiased to the current crisis, interpreting the findings helps us understand that OAT clinicians have had "years" of training under conditions of duress in Ukraine to overcome barriers, find creative solutions and form a support network that became indispensable in surviving the current humanitarian catastrophe.

Conclusion

In the discussion we point out that the current crisis magnified the pre-existing challenges as the providers approach toward overcoming them was already largely present before the crisis (just on a different scale). The underlying fragility of resources was a constant since OAT inception in Ukraine. Historically, providers in Ukraine operated in a system that was under-funded in the absence of solid governmental funding for OAT programs, yet they came up with solutions which required ingenuity that they took pride in. This gives hope that addiction treatment in Ukraine and OAT programs will not be casualties of this humanitarian crisis and providers and their patients will persevere.

Examination of Burnout Levels and Social Support Resources of Healthcare Workers in Filiation Teams During COVID-19 Pandemic in Turkey

This study aims to examine the level of burnout and social support of healthcare workers in filiation teams during the period of COVID-19 in Turkey. A total of 1028 healthcare workers have been reached. The sociodemographic questionnaire, Maslach Burnout Inventory (MBI), and Multidimensional Scale of Perceived Social Support (MSPSS) have been used. SPSS was used to analyze the data. Descriptive statistics were created, and independent t-tests and Pearson correlation tests were performed. 69.5% of the participants were females. The participants consisted of midwives (21.2%), nurses (15.5%), doctors (14.1%), psychologists (10.8%), and dentists (10.7%). The MSPSS scale scores of the participants were 62.66 ± 16.96; family 22.87 ± 5.85, friends 21.14 ± 6.30, and significant other person 18.65 ± 7.95. MBI scale scores are 54.05 ± 10.77, emotional exhaustion 18.12 ± 8.36, depersonalization 4.53 ± 3.45, and personal achievement 31.40 ± 7.04. The study showed that females have higher levels of emotional exhaustion and, as education levels, the population of the region, daily working hours, patient burden, and death of coronavirus-infected colleagues increase, and burnout levels increase.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam

OBJECTIVES

The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors.

METHODS

A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale.

RESULTS

In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05).

CONCLUSIONS

Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

Cross-Sectional Study of the Professional Quality of Life of Palliative Care Professionals during the COVID-19 Pandemic

BACKGROUND

The display of compassionate care by palliative care professionals is of the utmost importance to the patients, their families, and even to their own professional well-being. Lately and, especially due to the emergence of the COVID-19 pandemic, palliative care professionals have been subjected to greater pressures stemming from their work environment, organizational standpoint, and emotional sense of view. Not only have these factors made it harder for professionals to deliver compassionate care to their patients, but they have also decreased their overall well-being. The aim is to study how sociodemographics, workplace characteristics, internal resources, and the COVID-19 pandemic-derived pressures have affected the professionals' capacity to perform compassionate care and their well-being while at the same time exploring the relationship between compassionate care and well-being.

METHODS

This study used a cross-sectional design with data gathered from Spanish palliative care professionals. The final sample was formed by 241 participants. They were surveyed about compassion, professional quality of life, well-being, sociodemographic data, working conditions, self-care, and coping with death competence, and the impact of the COVID-19 pandemic. The analyses used were descriptive statistics, bivariate tests, and the construction of a structural equation model.

RESULTS

Compassion was predicted by the ability to control their workload and the ability to cope with death. Burnout was predicted by age, workload, workload control, self-care, material resources, and changes in teamwork. Moreover, compassion, age, workload control, and changes in teamwork and self-care were shown to significantly predict compassion satisfaction. When it comes to compassion fatigue, different variables were shown to predict it, those being compassion, control over the workload, social self-care, and the ability to cope with death.

CONCLUSIONS

Having a healthy lifestyle and an adequate social support system is key to maintaining professional well-being in the case of palliative care professionals. Inner resources such as the ability to perform self-care and the capacity to cope with death are of vital importance to taking care of these professionals. Thus, it would be beneficial to establish training programs focused on these aspects in the myriad of sanitary centers that perform these tasks, as these abilities are necessary to withstand the work-related pressures and, at the same time, be able to provide compassionate care for patients.

Evaluation of burnout and stress perception levels of Turkish dental laboratory technicians according to affecting factors during the COVID-19 pandemic

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic has caused healthcare professionals to face unequal acute workplace stress and burnout. This study aimed to analyze the potential impact of COVID-19 on the burnout and associated emotional stress conditions of Turkish dental technicians.

METHODS

A 20-question demographic scale, Maslach Burnout Inventory (MBI), Sense of Coherence-13 (SoC-13), and Perceived Stress Scale-10 (PSS-10) were used to obtain data. A total of 152 participants answered these surveys directly and reported their stress burnout levels during the COVID-19 pandemic.

RESULTS

Of all participants who agreed to participate in the survey, 39.5% were females and 60.5% were males. Regardless of demographic variables, the MBI-total (37.2 ± 11.71), SoC-13 total (53.81 ± 10.29), and PSS-10 total (21.25 ± 5.5) scores indicated moderate burnout, SoC, and perceived stress levels. According to sub-scores of the MBI; mean emotional exhaustion and depersonalization indicate low-level burnout, and mean personal accomplishment indicates moderate burnout. Long working hours increase burnout. No significant differences were observed according to demographic variables, except for work experience. A positive correlation was found between perceived stress and burnout.

CONCLUSIONS

The findings showed that dental technicians working during the COVID-19 pandemic are influenced by emotional stress due to the outcomes of the pandemic. One reason for this situation might be the long working hours. Working arrangements, under-controlled disease risk factors, and lifestyle changes may improve stress levels.Key MessagesCOVID-19 outbreak exposed psychological returns to the general population, and especially to healthcare workers.Questionnaire method was applied to evaluate the burnout and stress levels among dental laboratory technicians during COVID-19 outbreak.Moderate levels of burnout and stress perception were detected. Long working time was one of the effective factors.

Compassion fatigue in healthcare providers: a scoping review

The detrimental impacts of COVID-19 on healthcare providers' psychological health and well-being continue to affect their professional roles and activities, leading to compassion fatigue. The purpose of this review was to identify and summarize published literature on compassion fatigue among healthcare providers and its impact on patient care. Six databases were searched: MEDLINE (Ovid), PsycINFO (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science, for studies on compassion fatigue in healthcare providers, published in English from the peak of the pandemic in 2020 to 2023. To expand the search, reference lists of included studies were hand searched to locate additional relevant studies. The studies primarily focused on nurses, physicians, and other allied health professionals. This scoping review was registered on Open Science Framework (OSF), using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension to scoping review. From 11,715 search results, 24 met the inclusion criteria. Findings are presented using four themes: prevalence of compassion fatigue; antecedents of compassion fatigue; consequences of compassion fatigue; and interventions to address compassion fatigue. The potential antecedents of compassion fatigue are grouped under individual-, organization-, and systems-level factors. Our findings suggest that healthcare providers differ in risk for developing compassion fatigue in a country-dependent manner. Interventions such as increasing available personnel helped to minimize the occurrence of compassion fatigue. This scoping review offers important insight on the common causes and potential risks for compassion fatigue among healthcare providers and identifies potential strategies to support healthcare providers' psychological health and well-being.

Burnout, employee engagement, and changing organizational contexts in VA primary care during the early COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic involved a rapid change to the working conditions of all healthcare workers (HCW), including those in primary care. Organizational responses to the pandemic, including a shift to virtual care, changes in staffing, and reassignments to testing-related work, may have shifted more burden to these HCWs, increasing their burnout and turnover intent, despite their engagement to their organization. Our objectives were (1) to examine changes in burnout and intent to leave rates in VA primary care from 2017-2020 (before and during the pandemic), and (2) to analyze how individual protective factors and organizational context affected burnout and turnover intent among VA primary care HCWs during the early months of the pandemic.

METHODS

We analyzed individual- and healthcare system-level data from 19,894 primary care HCWs in 139 healthcare systems in 2020. We modeled potential relationships between individual-level burnout and turnover intent as outcomes, and individual-level employee engagement, perceptions of workload, leadership, and workgroups. At healthcare system-level, we assessed prior-year levels of burnout and turnover intent, COVID-19 burden (number of tests and deaths), and the extent of virtual care use as potential determinants. We conducted multivariable analyses using logistic regression with standard errors clustered by healthcare system controlled for individual-level demographics and healthcare system complexity.

RESULTS

In 2020, 37% of primary care HCWs reported burnout, and 31% reported turnover intent. Highly engaged employees were less burned out (OR = 0.57; 95% CI 0.52-0.63) and had lower turnover intent (OR = 0.62; 95% CI 0.57-0.68). Pre-pandemic healthcare system-level burnout was a major predictor of individual-level pandemic burnout (p = 0.014). Perceptions of reasonable workload, trustworthy leadership, and strong workgroups were also related to lower burnout and turnover intent (p < 0.05 for all). COVID-19 burden, virtual care use, and prior year turnover were not associated with either outcome.

CONCLUSIONS

Employee engagement was associated with a lower likelihood of primary care HCW burnout and turnover intent during the pandemic, suggesting it may have a protective effect during stressful times. COVID-19 burden and virtual care use were not related to either outcome. Future research should focus on understanding the relationship between engagement and burnout and improving well-being in primary care.

Prevalence and correlates of burn-out among Nigerian medical doctors during the COVID-19 pandemic: a cross-sectional study

INTRODUCTION

Physician burn-out was an issue before the pandemic. Medical personnel have faced several clinical and non-clinical challenges because of the novel coronavirus (SARS-CoV-2) pandemic, which predisposes them to burn-out. There is a paucity of studies that shed light on the level of burn-out and its association with work-related factors for Nigerian medical doctors. This study aims to examine the level of burn-out among Nigerian medical doctors during the COVID-19 pandemic and explore possible associations between burn-out and sociodemographic, work-related and COVID-19-related factors.

METHODOLOGY

A cross-sectional study was conducted among 251 medical doctors in a tertiary hospital in Nigeria. A questionnaire was used to obtain sociodemographic history, work-associated factors, COVID-19-related parameters and burn-out history. Personal, work-related and patient-related burn-out were evaluated with the use of the Copenhagen Burnout Inventory.

RESULTS

The number of doctors enrolled in this study was 251 with a median age of 34; 51.4% were males. The percentage of doctors who had personal, work-related and patient-related burn-out were 62.2%, 52.2 % and 27.5%, respectively. The univariate analysis revealed a correlation between burn-out scores and cadre, age, sex, years of experience, marital status, weekly work hours and number of calls. After multiple regression, female gender (p=0.012), those with less than 6 years of work experience (p=0.004) and those working for at least 71 hours in a week (p=0.0001) remained correlated with higher burn-out scores. Additionally, physicians who had a person with COVID-19 in their immediate environment had an independent correlation with higher work-related burn-out scores (p=0.043).

CONCLUSION

The prevalence of burn-out is high among Nigerian doctors and is linked to some sociodemographic, work-related and COVID-19-related factors. Due to the adverse effects of burn-out on physician well-being and patient care, strategies need to be put in place to identify and mitigate burn-out among Nigerian physicians.

Evaluation of experiences of the patients discharged from the COVID-19 intensive care unit: a qualitative research

Making arrangements by learning how intensive care patients feel due to a disease called as fatal worldwide can make it easier for patients to cope with the disease. For this reason, it is important for healthcare professionals to understand the patients who have been infected and discharged during the COVID-19 pandemic. The experiences of the patients may affect the perspective of the disease and cause different changes in the perception of it. This study, which was conducted based on this idea, aimed to examine the intensive care experiences of patients discharged from the COVID-19 intensive care unit. This study used a phenomenological qualitative approach. A semi-structured interview form was used to interview 23 patients discharged from the COVID-19 intensive care unit. The findings were reported on the basis of consolidated criteria for reporting qualitative research. In line with the data obtained from the interviews, five main themes and eight subthemes were created. The main themes were classified as emotional expressions (positive/negative) related to intensive care experience, coping methods, analogies (for COVID-19 and nurses) and attitudes towards the care provided (respiration, nutrition, excretion and privacy, sleep, communication). In this study, the participants experienced negative emotions such as fear of death/anxiety, sadness, loneliness, and helplessness during their intensive care experiences. Most of them stated that they tried to cope with prayer and communication. The participants compared COVID-19with deadly and respiratory-inhibiting tools and diseases. They expressed difficulties in breathing, nutrition, excretion and privacy, sleep and communication related to the care provided. In this process, they made positive analogies for the nurses who spent the most time with them, such as angels and family members.

"Beating Your Head Against the Wall": Burnout on the Rise Among Local Health Department Communication Officials

The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals globally. Despite the varied challenges encountered by frontline healthcare professionals, the difficulties faced by public health communication officials in particular has remained an underexplored area of research. This study examined the specific challenges experienced by communication officials during the COVID-19 pandemic in the United States. A qualitative research design was used to conduct in-depth interviews with communication officials working in local health departments (LHDs) in 2022. A total of 14 participants were recruited through purposive sampling, coupled with a data saturation strategy, from LHDs situated in Kansas, Missouri, and Oklahoma. Thematic analysis revealed 3 key themes: (1) main challenges faced by LHDs during the COVID-19 pandemic, (2) challenges related to information dissemination on social media, and (3) burnout experienced by communication officials. This study's findings suggest that communication officials should be provided with the necessary resources and training to effectively handle misinformation, toxic behaviors, and bullying on social media while prioritizing their mental health. In addition, federal, state, and local health agencies should provide timely, clear, and accurate information to address the challenges faced by communication officials in their bid to disseminate information effectively.

Emotional intelligence, workplace conflict and job burn-out among critical care physicians: a mediation analysis with a cross-sectional study design in Egypt

OBJECTIVES

This study aimed to examine the association between the effect of emotional intelligence on job burn-out and the mediating effect of workplace conflict management among critical care physicians.

DESIGN AND SETTING

A cross-sectional study design was deployed.

PARTICIPANTS

The studied sample comprised 144 critical care physicians working at two Egyptian tertiary care public hospitals.

MEASURES

The participants' responses to three questionnaires were studied, including the Maslach Burnout Inventory, the Emotional Intelligence Questionnaire and the Conflict Management Formative Questionnaire, in addition to assessing coenzyme Q10 (CoQ10) levels.

RESULTS

Among the anaesthesiologists and critical care specialists examined, burn-out was reported by 63.9% of them. The findings of this study indicated that emotional intelligence played a notable role in predicting job burn-out, with a negative impact. Further analysis revealed that workplace conflict management acted as a mediator between emotional intelligence and the three components of job burn-out. Additionally, age and years of experience were found to have a negative correlation with burn-out and a positive correlation with conflict management. Furthermore, CoQ10 levels showed a negative correlation with burn-out, while displaying positive correlations with emotional intelligence and conflict management.

CONCLUSION

Conflict management acted as a mediator in reducing burn-out by demonstrating a significant negative relationship between emotional intelligence and burn-out. Initial findings indicated that possessing good emotional intelligence and conflict management skills had a positive influence on the immune system, as evidenced by higher CoQ10 levels. However, burn-out had the opposite effect, depleting the body's CoQ10 stores and negatively impacting immune-protective mechanisms. Therefore, it is crucial to implement emotional management educational programmes and update educational policies and pedagogical practices to enhance the emotional capabilities of healthcare providers, especially in demanding fields like critical care, to effectively address conflicts.

The mediation effect analysis of nurse's mental health status and burnout under COVID-19 epidemic

Aim

The objective of this study is to investigate the mental health status of nurses during the outbreak of novel coronavirus pneumonia. Additionally, we aim to analyze the relationship between anxiety, depression, and burnout among nurses. The findings will provide a scientific basis for promoting the psychological health of nurses.

Methods

Using a cross-sectional study, nurses in Quanzhou in May 2020 completed a general information questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the Maslach Burnout Inventory (MBI). Data analysis was conducted using structural equation model.

Results

372 questionnaires were returned, with a response rate of 92.5%. The prevalence of anxiety and depression among the participants were 45.2 and 41.4%, respectively. The prevalence of severe burnout among nurses was found to be 7.3%. There was a correlation between nurses' anxiety, depression, and job burnout. The correlation coefficients between anxiety and job burnout, depression and job burnout, and anxiety and depression were found to be statistically significant (p < 0.001). Depression plays a mediating role between anxiety and jod burnout (0.584/1.413, 41.3%).

Conclusion

The COVID-19 epidemic has resulted in moderate to high levels of job burnout among nurses. In this context, depression has been found to play a mediating role in the relationship between anxiety and job burnout. It is imperative for hospital administrators to prioritize the mental health of nurses and the provide necessary support to ensure their well-being.

Hidden and Understaffed: Exploring Canadian Medical Laboratory Technologists' Pandemic Stressors and Lessons Learned

(1) Background: The COVID-19 pandemic has highlighted the critical role of medical laboratory technologists (MLTs) in the healthcare system. Little is known about the challenges MLTs faced in keeping up with the unprecedented demands posed by the pandemic, which contributed to the notable staff shortage in the profession. This study aims to identify and understand the stressors of MLTs in Canada and the lessons learned through their lived experiences during the pandemic. (2) Methods: In this descriptive qualitative study, we conducted five semi-structured focus groups with MLTs working during the pandemic. The focus group sessions were audio-recorded and then transcribed verbatim. Thematic analysis was used to inductively code data and identify themes. (3) Results: A total of 27 MLTs across Canada participated in the study. Findings highlighted four key themes: (i) unexpected challenges navigating through the uncertainties of an ever-evolving pandemic; (ii) implications of staff shortage for the well-being of MLTs and quality of patient care; (iii) revealing the realities of the hidden, yet indispensable role of MLTs in predominantly non-patient-facing roles; and (iv) leveraging insights from the COVID-19 pandemic to enhance healthcare practices and preparedness. (4) Conclusion: The study provides in-depth insight into the experiences of MLTs across Canada during the pandemic. Based on our findings, we provide recommendations to enhance the sustainability of the laboratory workforce and ensure preparedness and resiliency among MLTs for future public health emergencies, as well as considerations as to combating the critical staff shortage.

"Flying a plane and building it at the same time": Lessons learned from the dynamic implementation of mass vaccination clinics in the Region of Waterloo, Ontario, Canada

BACKGROUND

Vaccination plays a critical role during pandemics, and mass vaccination clinics are often an imperative public health measure. These clinics usually consist of multi-disciplinary teams, which can pose significant coordination challenges, yet also present an opportunity for collectively contributing towards mitigating the impact of infection within communities. This study explores the coordination dynamics of the Region of Waterloo's coronavirus disease of 2019 (COVID-19) mass vaccination clinics in Ontario, Canada, between July 2021 and April 2022.

METHODS

This qualitative study included 16 purposively selected participants working in mass vaccination clinics. Participants were individually interviewed for 40-60 min. An inductive and iterative thematic analysis was undertaken, including open coding, grouping, labelling, regrouping and making sense of the themes.

RESULTS

Three interrelated themes were created: (1) unpredictable work environment, which was comprised of changing clinic processes and the impact of clinic adjustments to the running of the clinics; (2) clinic cohesion challenges, which included staff role disparities, limited job preparation and clinic system silos; and (3) adaptable and supportive work environment, which was comprised of staff adaptability, dispositional flexibility and a supportive work environment. While the first two themes created a precarious situation in the clinics, the third countered it, leading to a largely successful clinic implementation.

CONCLUSIONS

The rapid evolution and high transmissibility of COVID-19 in communities required a public health response that felt like flying and building a plane simultaneously - a seemingly impossible yet necessary task. However, an adaptable and supportive work environment was critical for establishing an atmosphere that can overcome challenges from a constantly changing pandemic and the guidance of public health officials. Such lessons gained from understanding the dynamic experiences in mass vaccination clinics are essential for improving the development and operation of future immunization campaigns.

Development and validation of the COVID-19 Impact Scale in Australia

OBJECTIVE

The COVID-19 pandemic significantly impacted and continues to impact the health and well-being of Australian adults. However, there has been no instrument validated to comprehensively measure how the COVID-19 pandemic impacted adults in Australia across several domains (e.g. fear of COVID-19, attitudes towards vaccination, psychosocial impact of lockdowns).The current study conducted a rigorous psychometric process to develop and validate an instrument to measure the impact of the COVID-19 pandemic in Australia, the COVID-19 Impact Scale (CIS).

METHOD

Data was obtained from the Australian population. Participants (N = 563) aged between 19 and 91 years (M = 54.50, SD = 16.16) provided online responses between June, 2021 and May, 2022. The majority of participants were female (60.9%), employed either full-time (37.7%) or part-time (22.0%), and had completed an undergraduate degree or higher (70.1%). An initial pool of 30 items was developed based on a review of the literature and input from a panel of experts including psychologists, epidemiologists, and public health experts, among others. The study used network psychometrics to examine the psychometric properties of: (1) item score distributions; (2) item redundancy; (3) dimensionality; (4) model fit; (5) measurement invariance; (6) reliability; and (7) criterion validity.

RESULTS

Following an evaluation of items for ceiling/floor effects and redundancy, the final CIS network model included eighteen nodes and displayed a three-dimensional structure. The three communities of "Fear" (consisting of three nodes; ω = 0.82), "Attitudes" (consisting of ten nodes; ω = 0.89), and "Ill-being" (consisting of five nodes; ω = 0.79) displayed adequate reliability. The evaluation of model fit indicated a good fit of the network model (RMSEA = 0.047; CFI =0.98).

CONCLUSION

The instrument is available to be used by Australian researchers and implemented to evaluate public policies, adapted for future pandemics, or used internationally.

Effects of work-family conflict on turnover intention among primary medical staff in Huaihai Economic Zone: a mediation model through burnout

Background

Countries worldwide face the challenge of how medical personnel manage conflicts between work and family. Especially after the challenge of the COVID-19 epidemic, it is necessary to explore the possible mechanisms of work-family conflict, burnout, and turnover intention among primary medical staff.

Objectives

This study aims to observe the turnover intention of Chinese primary medical staff and explore the relationship between work-family conflict, burnout, and turnover intention.

Methods

A cross-sectional study included a turnover intention questionnaire, the Maslach Burnout Inventory-General Survey (MBI-GS), and the Work-Family Conflict Scale (WFCS) to understand turnover intention, burnout, and work-family conflict among primary medical staff in four cities (Xuzhou, Linyi, Huaibei, and Shangqiu cities) within the Huaihai Economic Zone. Spearman correlation analysis and hierarchical multiple regression analysis were used to examine the related factors of turnover intention. Structural equation modeling (SEM) was used to study the mediating role of burnout between work-family conflict and turnover intention.

Results

In this study, there is a positive correlation between work-family conflict and turnover intention (P < 0.01). Demographic characteristics, work-family conflict, and burnout explained 2.3%, 20.3%, and 8.8% of the incremental variances, respectively. Burnout mediated the association between work-family conflict and turnover intention.

Conclusions

Burnout can be regarded as a mediator between two different variables: work-family conflict and turnover intention. Improving work-family conflict and alleviating burnout may play a key role in reducing the willingness of primary medical staff to resign. Corresponding measures can be taken to balance the conflict between work and family, alleviate burnout, reduce turnover rates, and build a primary medical staff team with higher medical service quality and stability.