Mental health and risk perception among Italian healthcare workers during the second month of the Covid-19 pandemic

Risk Perception and Maternal Prenatal Depressive Symptoms in the Early Stage of COVID-19 Pandemic in China: Role of Negative Emotions and Family Sense of Coherence

BACKGROUND

Prenatal depression is associated with adverse health outcomes for both mothers and their children. The worldwide COVID-19 pandemic has presented new risks and challenges for expectant mothers. The aims of the study were to investigate the underlying mechanism between COVID-19 risk perception of Chinese pregnant women and their prenatal depressive symptoms and potential protective factors such as family sense of coherence (FSOC).

METHOD

A total of 181 Chinese pregnant women (Mage = 31.40 years, SD = 3.67, ranged from 23 to 43) participated in an online survey from April 22 to May 16, 2020. Risk perception and negative emotions (fear and anxiety) related with COVID-19, FSOC, and prenatal depressive symptoms were assessed.

RESULTS

The experience of maternal COVID-19 related negative emotion fully mediated the positive relationship between COVID-19 risk perception and prenatal depressive symptoms of pregnant women (β = 0.12, 95% CI [0.06, 0.19]). When confronting COVID-19 related fear and anxiety, expectant mothers from higher coherent families experienced a significantly lower level of prenatal depressive symptoms.

CONCLUSIONS

Contextual negative emotional experience was demonstrated to explain how risk perception impacts depressive symptoms during severe public health crisis for pregnant women. FSOC may be a psychological resource protecting pregnant women from experiencing adverse psychological outcomes during COVID-19 pandemic.

Experiences of stigma, discrimination and violence and their impact on the mental health of health care workers during the COVID-19 pandemic

Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.

Risk and protection factors of mental stress among medical staff in the third year of the COVID-19 pandemic

Background

The COVID-19 pandemic placed an extraordinary burden on health care workers (HCW), who are reported to suffer from great mental stress. The current study investigates the mental health of HCW in the later phases of the pandemic.

Methods

HCW completed the following questionnaires online (06/2021-02/2022, N=159): demographics (age, gender, profession, ward), Impact of Event Scale (IES-R, posttraumatic stress), State Trait Anxiety Inventory (STAI-S, state anxiety), stress-coping questionnaire (SVF-78), and bespoke corona-specific stress and protective-factor questions (5 items each). We used factor analysis to test scale properties and regression-type methods (t-tests, ANOVA, multiple regression) for hypothesis tests and effect-size estimation.

Results/discussion

Mental stress in HCW is influenced by similar factors as described for earlier phases. However, differences to earlier phases were found in ward affiliation which is no longer a variable of concern for explaining differences in mental health of HCW. Further, even if nurses are the occupational group with the highest mental stress as in prior research, detailed analysis shows that medical specialists with close proximity to patients with a high-level of responsibility are the most burdened sub-group. Unlike nurses, they suffer from high levels of anxiety in addition to high levels of post-traumatic and COVID-specific stress. Analyses showed further that COVID-specific stress is the strongest predictor of mental stress, wherein COVID-specific stress factors remain the same as reported in literature on the early pandemic phases. HCW showed to use still more positive than negative coping strategies. Negative strategies increased as expected mental stress, whereas positive strategies alleviated only anxiety. Additionally, we found that doctors benefited from many protective factors while nurses had access to fewer protective factors like earlier waves.

Conclusion

Data show that HCW still suffer from mental stress in the third year of the pandemic. HCW of all hospital wards may be affected by mental stress and need attention and protective measures. Medical specialists are the most burdened subgroup. Detailed analyses show that properties other than occupation, gender, or ward affiliation are more appropriate to evaluate mental stress of HCW. The findings have implications for developing specialized protection strategies for the post-pandemic phase and future pandemics.

Psychological well-being of healthcare workers during COVID-19: Relationship with risk perception and fear in the context of health belief model

This study aimed to evaluate the extent of fear and risk perception related to COVID-19 and their impact on the psychological well-being of healthcare workers. Data were gathered through an online survey, incorporating questions about risk perception utilizing the health belief model, the Fear of COVID-19 Scale, and the General Health Questionnaire-12. A total of 364 HCWs participated in the survey, with 94% of participants identified as being in the high-risk category for mental disorders based on their General Health Questionnaire scores. The assessment of COVID-19-related risk perception within the Health Belief Model demonstrated significant correlations between perceived susceptibility, perceived severity, perceived barriers, and self-efficacy with both the fear scale and General Health Questionnaire scores. Linear regression was employed to identify factors influencing General Health Questionnaire scores, revealing that risk perception, Fear of COVID-19 scores, marital status, and perceived health were significantly associated with General Health Questionnaire scores. These findings underscore the importance of monitoring the psychological well-being of healthcare workers throughout all stages of pandemic preparedness and response.

Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations

BACKGROUND

Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR).

METHODS

We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes.

RESULTS

The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted.

DISCUSSION

PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.

Concern about COVID-19 infection and workload as predictors of psychological distress during the health emergency in Peruvian healthcare personnel

INTRODUCTION

During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing.

OBJECTIVE

To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers.

METHODS

Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale.

RESULTS

It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (P < .01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; P < .001), where concern about COVID-19 (β = -0.436; P < .01) and workload (β = 0.239; P < .01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33).

CONCLUSIONS

Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

The Perception of Workplace Safety and of Risk of Contagion among Preschool Teachers during the COVID-19 Pandemic

The COVID-19 pandemic had a major impact on early childhood educational contexts and on educators' working conditions. This study aims to examine the change over time in personal contribution to workplace safety and perception of risk of infection among preschool teachers after returning to in-person work during the third wave of the pandemic (spring 2021). Teachers' perceptions of workplace safety can influence their quality of work-life and, as a consequence, the quality of service offered to children. Data were collected using two questionnaires: at T0 (January) and at T1 (May). The results showed relations between organizational and personal actions to manage risk and fear of infection at work. Concern about COVID-19 contagion decreased over time (t = 5.53, p = 0.000) and perceptions of personal contribution to workplace safety related to COVID-19 improved: t = -2.18 p = 0.031. The decrease in these concerns illustrates how perceptions of ability to manage contagion and protect workplace safety of preschool teachers improved over time, despite the stability of the pandemic context in the first half of 2021. After the end of the COVID-19 pandemic, this study gives an account of some good practices and their perceived effectiveness in terms of safety for childhood educational contexts.

Lived-in experiences of health care professionals affected with COVID-19

Background and Objective

Healthcare providers (HCPs) were vital during the COVID-19 pandemic. The healthcare providers affected by COVID-19 underwent various life changing events while continuing their profession during the pandemic. This study is aimed to explore the lived-in experiences of HCPs affected by COVID-19 at a tertiary care Mental Health Institute in India.

Materials and Methods

The sampling method was purposive. Twenty two HCPs (eight nursing educators, seven nursing officers, five contractual cleaning workers, and two laboratory technicians) participated in the interviews conducted by the researchers to obtain the lived-in experiences of HCPs who have recovered from COVID-19. Researchers used a sociodemographic form and an interview guide to collect the data. Interviews were audio recorded and analyzed by using Atlas-ti-9 software.

Results

All the participants were female, and they revealed various physical, psychological, and social issues faced by HCPs while balancing home and workplace. Thematic data analysis resulted in the emergence of two themes and 11 subthemes related to life changing events.

Conclusion

The findings concluded that although the healthcare providers had working experience in the field of mental health, they too experienced mild psychological issues like anxiety, depression, and fear of death because of this pandemic situation.

COVID-19 and Breast Cancer: Analysis of Surgical Management of a Large Referral Center during the 2020-2021 Pandemic Period

BACKGROUND

Coronavirus disease-19 (COVID-19) has spread worldwide since December 2019 and was officially declared a pandemic in March 2020. Due to the rapid transmission and the high fatality rate, drastic emergency restrictions were issued, with a negative impact on routine clinical activities. In particular, in Italy, many authors have reported a reduction in the number of breast cancer diagnoses and critical problems in the management of patients who accessed the breast units during the dramatic first months of the pandemic. Our study aims to analyze the global impact of COVID-19 in the two years of the pandemic (2020-2021) on the surgical management of breast cancer by comparing them with the previous two years.

METHODS

In our retrospective study, we analyzed all cases of breast cancer diagnosed and surgically treated at the breast unit of "Città della Salute e della Scienza" in Turin, Italy, making a comparison between the 2018-2019 pre-pandemic period and the 2020-2021 pandemic period.

RESULTS

We included in our analysis 1331 breast cancer cases surgically treated from January 2018 to December 2021. A total of 726 patients were treated in the pre-pandemic years and 605 in the pandemic period (-121 cases, 9%). No significant differences were observed regarding diagnosis (screening vs. no screening) and timing between radiological diagnosis and surgery for both in situ and invasive tumors. There were no variations in the breast surgical approach (mastectomy vs. conservative surgery), while a reduction in axillary dissection compared to the sentinel lymph node in the pandemic period was observed (p-value < 0.001). Regarding the biological characteristics of breast cancers, we observed a greater number of grades 2-3 (p-value = 0.007), pT stage 3-4 breast cancer surgically treated without previous neoadjuvant chemotherapy (p-value = 0.03), and a reduction in luminal B tumors (p-value = 0.007).

CONCLUSIONS

Overall, we report a limited reduction in surgical activity for breast cancer treatment considering the entire pandemic period (2020-2021). These results suggest a prompt resumption of surgical activity similar to the pre-pandemic period.

Risk Perception, Perceived Government Coping Validity, and Individual Response in the Early Stage of the COVID-19 Pandemic in China

As a major crisis event, the COVID-19 pandemic has affected the global economy, threatened the lives of the public, and caused varying degrees of impact on the public. Previous studies have shown that risk perception and government response had different impacts on the public, but they revealed more about the independent impact of risk perception and government response on the public. This study will comprehensively consider the impacts of these two factors on the behavior of the public in the early stage of the epidemic. We analyzed data from an online survey in the early days of the COVID-19 pandemic in China and categorized individual behaviors into three dimensions: entertainment and travel, work, and the stockpile of supplies. In addition, we defined the risk perception variables by two dimensions: knowledge of the epidemic itself and knowledge of the consequences of the epidemic. At the same time, we used an exploratory factor analysis to construct the variable of perceived government coping validity and then adopted the ordinal logit model for analysis. The results showed that in terms of entertainment and travel, people would not be affected even if they fully understood the epidemic itself; once they were aware of the negative social consequences of the epidemic, people would suspend entertainment and travel to prevent the spread of the virus. As for work or employment, people would not stop working or employment even if they realized the infectivity and harmfulness of the disease and its social consequences. Furthermore, fear of COVID-19 and the perception of uncontrolled COVID-19 significantly positively affected people's material stockpiling behavior. These results indicate that different risk perceptions had different effects on individual responses, and individual behaviors reflected different coping logics. In addition, the government's effective response to the epidemic would significantly reduce the negative impacts of the epidemic on the three dimensions of people's responses. These conclusions have certain policy implications for preventing and responding to outbreaks in other countries.

Relationship Between Psychological Distress, Burnout and Work Engagement in Workers During the COVID-19 Pandemic: A Systematic Review

Objective: The psychological distress that the COVID-19 pandemic has produced has generated negative effects on workers, and in one way or another this has affected their work engagement within companies. The aim of this research was to assess the relationship between psychological distress, burnout and work engagement in workers during the COVID-19 pandemic. Methods: A systematic review was carried out following the PRISMA methodology, taking articles from the Scopus, Pubmed, and Web of Science databases from the beginning of the pandemic until November 2022. The methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomised studies. Results: 24 articles were selected. All the articles found an association between psychological distress, burnout or other factors and work engagement. Conclusion: The COVID-19 pandemic has had an impact on work engagement and a negative relationship with psychological distress and burnout, hence the importance of companies taking measures to minimise levels of psychological distress and burnout.

Prevalence and determinants of Italian physicians' burnout in the "post-COVID-19" era

PURPOSE

Several studies investigated prevalence and determinants of physicians' burnout during the peak of the COVID-19 pandemic, but only a few during the chronic phase of the pandemic. This study thus aimed to examine this topic referring to the "post-COVID-19 era", defined as a chronic and likely-to-be endemic status quo.

METHODS

A cross-sectional, online survey (November 2021-January 2022) was addressed to physicians in Lombardia (Northern Italy). Besides socio-demographic and COVID-19-related data, measures of personal, work- and patient-related burnout (Copenhagen Burnout Inventory; CBI), depression (Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and self-efficacy (General Self-Efficacy Scale) were collected. Linear/generalized linear models were run to test associations/predictions of interest.

RESULTS

Among the 958 respondents, burnout symptoms were clinically significant in 18.5% of them. Predictive models showed that female sex (OR = 0.73, 95% CI 0.42-1.27), younger age (OR = 0.94, 95% CI 0.59-1.48), shorter job tenure (OR = 1.01, 95% CI 0.62-1.65), trainee status (OR = 1.41, 95% CI 1.16-7.10), higher PHQ-8 (OR = 1.260, 95% CI 1.16-1.37), and GAD-7 scores (OR = 1.19, 95% CI 1.10-1.30) increased the risk to suffer from clinical burnout. COVID-19-related variables were mostly not related/associated to burnout levels.

CONCLUSION

In Italy, physicians' burnout is moderately prevalent also in the chronic phase of the pandemic, with its determinants being more intrinsic than environmental. The development of effective interventions is needed to help physicians cope with the new challenges of their job.

Comparison of the Psychological Impact of COVID-19 on Self-Employed Private Healthcare Workers with Respect to Employed Public Healthcare Workers: Three-Wave Study during the COVID-19 Pandemic in Spain

(1) Background: Coronavirus disease, also called COVID-19, is a worldwide pandemic with a major impact on all aspects of the individual (health status, psychological, and economic aspects, among others). The perception of health professionals in this situation has been influenced by their economic and psychosocial situations. On the economic level, self-employed workers have no state subsidies, with the added disadvantage of not having sufficient means to cope with contagion. This could potentially have an impact on their health and indirectly on their family members, creating additional stress. The aim of this study was to determine whether there are differences in the level of anxiety of health professionals working in private practice compared to healthcare workers working in public institutions during the first three waves of COVID-19. (2) Methods: A cohort study on 517 subjects comparing anxiety between a group of health workers and a group of health professionals working in the public sector at three key moments during the pandemic was performed. (3) Results: Statistically significant differences were found between self-employed private health professionals compared to those working as public health workers. The perception of impact was worse in the self-employed; however, a higher level of anxiety was evident in public employees in all assessed domains (cognitive, physiological, and motor, p = 0.001). (4) Conclusions: There were significant changes when comparing the first phase between both groups; employed public healthcare workers manifested a sense of lower risk of COVID-19 contagion than privately employed professionals, who had a higher level of anxiety. In the second and third waves, negative feelings improved for both groups, and the fear of showing anxiety to the patient decreased over the course of the waves.

Correlation of safety behavior, handover quality, and risk perception: A cross-sectional study among Chinese psychiatric nurses

Background

Nurses' safety behaviors played an important role in patients' safety goal realization, and it varies from person to person. However, less research has explored the safety behavior level of psychiatric nurses and its influencing factors. Thus, this research aimed to assess the level of safety behavior and explore whether risk perception mediated the relationship between handover quality and safety behavior among psychiatric nurses.

Methods

A total of 186 registered psychiatric nurses in a Chinese hospital were recruited for this study, through the convenience sampling method. Handover quality, risk perception, and safety behavior were measured. Hayes' PROCESS macro was used to evaluate the mediation of risk perception between handover quality and safety behavior.

Results

Scores of psychiatric nurses' safety behaviors were (47.98 ± 7.45), and handover quality and risk perception could predict the variance of nurses' safety behaviors. Risk perception could partially mediate between handover quality and nurses' safety behaviors, and the value of the mediating effect was 49.17%.

Conclusion

Psychiatric nurses' safety behaviors have a large promotion space. Therefore, healthcare professionals should endeavor to improve the handover quality of psychiatric nurses and decrease their risk perception, thereby promoting nurses' safety behaviors.

Experiences of Operating Room Nurses During the COVID-19 Pandemic: A Qualitative Study

PURPOSE

The study was conducted to examine the experiences of operating room nurses during the COVID-19 pandemic.

DESIGN

This study was designed as a phenomenological qualitative research method.

METHODS

This study was conducted with 10 volunteer operating room nurses who met the criteria for participation in the study between February 2021 and March 2021 in a public hospital. Data were collected using a personal information form and a semi-structured interview from using the in-depth interview technique. Two researchers and one expert created the themes and codes using the thematic analysis method.

FINDINGS

As a result of the analysis, four themes and 29 codes were identified. The following codes were created for the theme "Changing systems and practices in the operating room": Personal protective equipment and sterility, workload/time, lack of communication between patient and nurse, decrease in the number of cases, change in the use of emergencies and elective procedures, flexible working methods. On the theme of the impact of the pandemic, anxiety/anxiety, psychological distress, difficulty with personal protective equipment, lack of nurses, longing/distance from family, sleep disturbances, family problems, and difficulty working in another department were noted. On the theme of coping strategies for the pandemic, the codes found were; communication with family, breathing/sporting exercises, spirituality, regular/healthy diet, online shopping, watching TV series/movies, and acceptance of the process. On the theme of "learning from the pandemic," the codes of the importance of life/health, the importance of family, worthlessness of the caring profession, financial injustice, gaining work experience, the importance of personal protection, lack of union support, and job satisfaction were produced.

CONCLUSIONS

The study found that the nursing in the operating room has changed due to the COVID-19 pandemic, that nurses have experienced many positive/negative impacts, and that they have gained many benefits from the pandemic through various coping methods.

Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I² >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I² >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.

Prevalence of Psychopathological Symptoms and Their Determinants in Four Healthcare Workers' Categories during the Second Year of COVID-19 Pandemic

Highly stressful situations, such as the current COVID-19 pandemic, induce constant changes in the mental state of people who experience them. In the present study, we analyzed the prevalence of some psychological symptoms and their determinants in four different categories of healthcare workers during the second year of the pandemic. A total of 265 physicians, 176 nurses, 184 other healthcare professionals, and 48 administrative employees, working in different Italian healthcare contexts, answered a questionnaire including variables about their mental status and experience with the pandemic. The mean scores for anxiety and depressive symptoms measured more than one year after the onset of the pandemic did not reach the pathological threshold. In contrast, post-traumatic and burnout symptoms tended toward the critical threshold, especially in physicians. The main determinant of psychological distress was perceived stress, followed by job satisfaction, the impact of COVID-19 on daily work, and a lack of recreational activities. These results increase the knowledge of which determinants of mental distress would be important to act on when particularly stressful conditions exist in the workplace that persist over time. If well-implemented, specific interventions focused on these determinants could lead to an improvement in employee well-being and in the quality of care provided.

Risk Perception Related to COVID-19 and Future Affective Responses Among Healthcare Workers in Switzerland: A Mixed-Methods Longitudinal Study

Objectives: Whereas early findings suggest that risk perceptions related to COVID-19 affect psychological well-being in healthcare workers (HCWs), the temporal associations between these variables need to be clarified and HCWs lived experience further explored. This study proposes a mixed evaluation of COVID-19-related risk perception and affective responses among HCWs.

Methods: A longitudinal mixed-method study was conducted. HCWs (N = 138) completed measures of COVID-19 risk perceptions, depression, anxiety, burnout and secondary traumatic stress (STS) at baseline and 6 months later. A subsample (n = 20) participated in semi-structured interviews exploring both risk perceptions and affective responses.

Results: Main quantitative findings showed positive associations between worry to contaminate others and depression (IRR = 1.04, p < 0.05), anxiety (IRR = 1.03, p < 0.01), STS (b = 0.3, p < 0.05), and perceptions of lacking protection (IRR = 1.04, p < 0.05) with anxiety scores. Four themes emerged from the thematic content analysis: 1) life was turned upside down; 2) skills were put in quarantine; 3) dealing with patient discomfort; 4) balance to be found between protection and restrictions.

Conclusion: These findings emphasize the importance to develop tailored interventions, such as group discussion sessions, to optimize risk perception and help manage uncertainty.

Human Factors and Airway Management in COVID-19 Patients: The Perfect Storm?

The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients’ airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesiologists and intensivists, the main actors of airway management, showed a poor psychological well-being and a high stress and burnout risk. Identifying and better defining the specific main SARS-CoV-2-related stressors can help them deal with and effectively plan a strategy to manage these patients in a more confident and safer way. In this review, we therefore try to analyze the relevance of human factors and non-technical skills when approaching COVID-19 patients. Lessons from the past, such as National Audit Project 4 recommendations, have taught us that safe airway management should be based on preoperative assessment, the planning of an adequate strategy, the optimization of setting and resources and the rigorous evaluation of the scenario. Despite, or thanks to, the critical issues and difficulties, the “take home lesson” that we can translate from SARS-CoV-2 to every airway management is that there can be no more room for improvisation and that creating teamwork must become a priority.

Clinical Characteristics and Potential Risk Factors Associated with the SARS-CoV-2 Infection: Survey on a Health Care Workers (HCWs) Population in Northern Italy

During the two years of the COVID-19 pandemic, more than 400 million cases all over the world have been identified. Health care workers were among the first to deal with this virus and consequently a high incidence of infection was reported in this population. The aim of the survey was to investigate health care workers’ (HCWs) clinical characteristics and potential risk factors associated with the SARS-CoV-2 infection in a referral hospital in Northern Italy after the first and second waves of the pandemic. We administered a questionnaire during the flu vaccination campaign that took place at the end of 2020; among 1386 vaccinated HCWs, data was collected and analyzed for 1065 subjects. 182 HCWs (17%) declared that they had tested positive on at least a molecular or a serological test since the beginning of the pandemic. Comparing the infected vs. not infected HCWs, median age, BMI, smoking habit, presence of hypertension or other comorbidities were not significantly different, while having worked in a COVID ward was associated with the infection (ORadj = 1.54, 95% CI: 1.07–2.20). Respondents declared that more than 70% of contacts occurred in the hospital with patients or colleagues, while about 15% in domestic environments. Among the infected, the most reported symptoms were fever (62.1%), asthenia (60.3%), anosmia/ageusia (53.5%), arthralgia/myalgia (48.3%), headache or other neurological symptoms (46.6%), cough (43.1%) and flu-like syndrome (41.4%). The percentage of subjects who have been infected with SARS-CoV-2 seems to be higher in HCWs than in the general population; hence, in hospitals, protective measures and preventive strategies to avoid the spreading of the contagion remain crucial.

Coping strategies at the frontline of care: Comparisons between Covid-19 and non-Covid-19 units' nurses and the role of moderator variables

INTRODUCTION

Relatively few studies focused on the coping strategies adopted by the healthcare workers during the second phase of the pandemic. The present study compared the coping strategies between Italian nurses working in Covid-19 and in other units and it explored whether socio-demographic and work-related variables moderate the relation between the type of unit and coping strategies.

METHODS

A web-based questionnaire that included sociodemographic and work-related questions and the Coping Orientation to Problem Experienced-New Italian Version-25 item was administered. Moderation effects between variables and coping strategies were analyzed using generalized linear models.

RESULTS

253 nurses participated. Nurses who worked in a Covid-19 unit had significantly lower scores on Avoidance Strategies subscale and higher scores on Positive Attitude and Social Support subscales than nurses working in other units.

DISCUSSION

Gender differences emerged only on the social support coping dimension, with women being more likely to adopt social support than men. No association between the type of unit and the other coping strategies was found.

CONCLUSION

Nurses working in Covid-19 units showed better coping strategies than their colleagues: this suggests that support interventions aimed to promote coping strategies should be offered also to Covid-19-free units' nurses.

The Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers

Due to the unprecedented impact of the COVID-19 pandemic on health care systems, there has been great interest in the mental wellbeing of healthcare workers. While most studies investigated mental health outcomes among frontline vs. non-frontline healthcare workers, little is known about the impact of various work-related variables. The present study aimed to examine the association between work-related [i.e., having contact with COVID-19 patients, being redeployed due to the pandemic and availability of sufficient personal protective equipment (PPE)] and subjective (i.e., worries about getting infected or infecting others) exposures and self-reported mental health outcomes (i.e., psychological distress, depressive symptoms, and posttraumatic stress symptoms). Between February and May 2021, 994 healthcare workers employed at a variety of healthcare settings in the Netherlands filled out an online survey as part of the COVID-19 HEalth caRe wOrkErS (HEROES) study. Mental health outcomes were measured using the General Health Questionnaire-12, the Patient Health Questionnaire-9, and the Primary Care PTSD Screen for DSM-5. Approximately 13% reported depressive symptoms, 37% experienced psychological distress, and 20% reported posttraumatic stress symptoms. Multilevel linear models consisted of three levels: individual (work-related and subjective exposures), healthcare center (aggregated redeployment and availability of sufficient PPE), and regional (cumulative COVID-19 infection and death rates). Worries about infection were associated with all three mental health outcomes, whereas insufficient PPE was associated with psychological distress and depressive symptoms. There were no differences in outcomes between healthcare centers or provinces with different COVID-19 infection and death rates. Our findings highlight the importance of adequate PPE provision and the subjective experience of the COVID-19 pandemic. These factors should be part of interventions aimed at mitigating adverse mental health outcomes among healthcare workers during the COVID-19 pandemic.

Nursing care during COVID-19 at non-COVID-19 hospital units: A qualitative study

The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses’ experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care.

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

Aim

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

Background

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

Methods

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

Results

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

Conclusion

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

Implications for Nursing Management

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

Risk Perception towards COVID-19: A Systematic Review and Qualitative Synthesis

Several studies have attempted to identify how people's risk perceptions differ in regard to containing COVID-19 infections. The aim of the present review was to illustrate how risk awareness towards COVID-19 predicts people's preventive behaviors and to understand which features are associated with it. For the review, 77 articles found in six different databases (ProQuest, PsycInfo, PubMed, Science Direct, SCOPUS, and Web of Science) were considered, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was followed, and data synthesis was conducted using a mixed-methods approach. The results indicate that a high-risk perception towards COVID-19 predicts, in general, compliance with preventive behaviors and social distancing measures. Additionally, risk awareness was found to be associated with four other key themes: demographic factors, individual factors, geographical factors, and timing. Therefore, gaining a greater understanding of individual and cultural differences as well as how people behave could be the basis of an effective strategy for raising public risk awareness and for countering COVID-19.

Sources of anxiety among health care workers in Tehran during the COVID-19 pandemic

By applying multivariate regression to 2020 survey data from four Tehran hospitals, we measure eight recognized sources of Coronavirus disease 2019 (COVID-19) pandemic-related anxiety among 723 healthcare workers (HCWs) with diverse sociodemographic characteristics employed across different hospital areas and positions. The most prominent anxiety source identified is the risk of workplace COVID-19 contraction and transmission to family, followed by uncertainty about organizational support for personal and family needs in the event of worker infection. A supplemental qualitative analysis of 68 respondents in the largest hospital identifies four additional anxiety sources, namely, health, finances, workload, and leadership. This evidence of the multifaceted nature of anxiety sources among HCWs highlights the differentiated approaches that hospital policymakers must take to combat anxiety.

Burnout and well-being of healthcare workers in the post-pandemic period of COVID-19: a perspective from the job demands-resources model

Background

The present study aimed 1) to examine the effects of epidemic-related job stressors, perceived social support and organizational support on the burnout and well-being of Chinese healthcare workers in the period of COVID-19 regular epidemic prevention and control and 2) to investigate the moderating effects of social support and organizational support on the relationship between job stressors and burnout and well-being within the theoretical framework of the Job Demands-Resources (JD-R) model.

Methods

A sample of healthcare workers (N = 3477) from 22 hospitals in Beijing, China participated in the cross-sectional investigation in October 2020 and reported epidemic-related job stressors, perceived social support, organizational support, burnout, anxiety and depression symptoms.

Results

1) Medical doctors, females, people aged from 30 to 50, and those who worked in the second line during the pandemic reported higher scores of psychological symptoms and burnout in the period of regular epidemic prevention and control; 2) Epidemic-related job stressors positively predicted burnout, anxiety, and depression among healthcare workers; 3) Perceived social support and organizational support were negatively related to reported burnout, anxiety and depression symptoms; 4) Social support reduced the adverse effects of epidemic-related job stressors on anxiety and depression but enhanced the association between stressors and burnout; 5) Organizational support mitigated the adverse effects of epidemic-related job stressors on depression.

Conclusion

The results shed light on preventing burnout and enhancing the psychological well-being of healthcare workers under epidemic prevention and control measures by reducing epidemic-related job stressors and strengthening personal and organizational support systems.

Return to Work during the COVID-19 Outbreak: A Study on the Role of Job Demands, Job Resources, and Personal Resources upon the Administrative Staff of Italian Public Universities

Background: Compared to healthcare workers and teleworkers, occupational wellbeing of employees who continued or suddenly returned to work during the COVID-19 pandemic have received less attention thus far. Using the Job Demand–Resource model as a framework, the present study aimed at evaluating the role of job demands and job and personal resources in affecting emotional exhaustion among university administrative staff. Methods: This cross-sectional study analyzed data collected through an online questionnaire completed by 364 administrative employees that continued working in presence (WP) and 1578 that continued working blended (WB), namely, partly remotely and partly in presence. Results: Among job demands, quantitative job demand overloads and perceived risk of being infected were positively associated with higher levels of emotional exhaustion. Among job resources, colleague support was significantly associated with lower emotional exhaustion for both WB and WP, whereas supervisor support and fatigue management were salient only for WB. Among personal resources, personal contribution in managing COVID-19-related risk at work emerged as a protective factor for emotional exhaustion. Conclusion: Insights for the development of targeted preventive measure for a more psychologically safe and productive return to work can be derived from these results.

The experience of European hospital-based health care workers on following infection prevention and control procedures and their wellbeing during the first wave of the COVID-19 pandemic

Background

Working under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. A better understanding of HCWs’ experiences of following local infection prevention and control (IPC) procedures during COVID-19 is urgently needed to inform strategies for protecting the psychical and psychological health of HCWs. The objective of this study was therefore to capture the perceptions of hospital HCWs on local IPC procedures and the impact on their emotional wellbeing during the first wave of the COVID-19 pandemic in Europe.

Methods

Participants were recruited in two sampling rounds of an international cross-sectional survey. Sampling took place between 31 March and 17 April 2020 via existing research networks and between 14 May and 31 August 2020 via online convenience sampling. Main outcome measures were behavioural determinants of HCWs’ adherence to IPC guidelines and the WHO-5 Well-Being Index, a validated scale of 0–100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.

Results

2289 HCWs from 40 countries in Europe participated. Mean age was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n = 1699) of HCWs were directly treating patients with COVID-19, of which 32% (n = 527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This feeling was more common among junior than senior HCWs (46% versus 38%, P value < .01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2–1.8).

Conclusions

In Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.

Wellbeing in Workers during COVID-19 Pandemic: The Mediating Role of Self-Compassion in the Relationship between Personal Resources and Exhaustion

Italy was the second country to be affected by COVID-19 in early 2020, after China. The confrontation with the pandemic led to great changes in the world of work and, consequently, to the personal world of workers. In such a challenging situation, it is essential to be able to rely on resources that facilitate individual coping. The aim of this study was to understand the association between personal resources (optimism and humor) and exhaustion, and the role of self-compassion in this relationship. A structural equation model (SEM) was used to test the hypotheses on a heterogeneous sample of 422 Italian workers during the first lockdown in April–May 2020. The results revealed that optimism and humor were positively associated with self-compassion; optimism and humor also had a negative association with exhaustion; and self-compassion had a mediating role between the two personal resources and exhaustion. These results confirmed the importance of personal resources in maintaining workers’ wellbeing during a challenging period such as the pandemic. The present study also contributes to the body of knowledge on self-compassion, a relatively new construct that has been little studied in the organizational field.

The Perceived Risk of Being Infected with COVID-19 at Work, Communication, and Employee Health: A Longitudinal Application of the Job Demands–Resources Model

The perceived risk of being infected at work (PRIW) with COVID-19 represents a potential risk factor for workers during the current COVID-19 pandemic. In line with the job demands–resources (JD-R) model in the context of safety at work, in this longitudinal study we propose that PRIW can be conceptualized as a job demand (JD), whereas communication (i.e., the exchange of good-quality information across team members) can be conceived of as a job resource (JR). Accordingly, we hypothesize that PRIW at Time 1 (T1) would positively predict psychophysical strain at Time 2 (i.e., four months later), and that communication at T1 would negatively predict psychophysical strain at T2. Overall, 297 workers participated in the study. The hypothesized relationships were tested using multiple regression analysis. The results support our predictions: PRIW positively predicted psychophysical strain over time, whereas communication negatively predicted psychophysical strain over time. The results did not change after controlling for age, gender, and type of contract. Overall, this study suggests that PRIW and communication might be conceived of as a risk and a protective factor for work-related stress, respectively. Hence, to promote more sustainable working conditions, interventions should help organizations to promote an adequate balance between JDs and JRs related to COVID-19.

COVID-19 and mental disorders in healthcare Personnel: A novel framework to develop Personas from an online survey

BACKGROUND

In this paper we propose a novel framework for the definition of Personas for healthcare workers based on an online survey, with the aim of highlighting different levels of risk of developing mental disorders induced by COVID-19 and tailor psychological support interventions.

METHODS

Data were gathered from Italian healthcare workers between April and May 2020. Information about socio-demographic characteristics, current lifestyle, occupational, COVID-19 infection, and psychological indexes (Maslach Burnout Inventory, Impact of Event Scale and Patient Health Questionnaire) was collected. Respondents were divided in four subgroups based on their health profession: physicians (P), nurses (N), other medical professionals (OMP) and technical-administrative (TA). For each sub-group, collected variables (46) were reduced using Principal Component Analysis and clustered by means of k-medoids clustering. Statistical analysis was then applied to define which variables were able to differentiate among the k clusters, leading to the generation of a Persona card (i.e., a template with textual and graphical information) for each of the obtained clusters.

RESULTS

From the 538 respondents (153 P, 175 N, 176 OMP, 344 TA), the highest stress level, workload impact and risk of mental disorders were found in the N subgroup. Two clusters were identified for P, three clusters for N, two for OMP and one for TA.

CONCLUSIONS

The proposed framework was able to stratify different risk levels of possible development of mental health issues in healthcare workers due to COVID-19. This approach could represent the first step towards the development of mobile health tools to tailor psychological interventions in pandemic situations.

Questionnaire Survey on Vaccination Willingness and the Status of COVID-19 Vaccination Among Patients with Rheumatic Disease: A Single-Center Survey in China

INTRODUCTION

The COVID-19 pandemic is an ongoing global pandemic. Patients with rheumatic disease are more likely to be infected with COVID-19 than the general population, and they should be vaccinated against COVID-19 for protection. This study aimed to understand the willingness to receive the COVID-19 vaccine among these patients.

METHODOLOGY

Patients who came to the Rheumatology and Immunology Department of our hospital from July 3-20, 2021, were randomly selected for a self-designed survey via an online questionnaire platform. Four hundred seventeen questionnaires were validated.

RESULTS

Males were more likely to underestimate the risk of COVID-19 infection than females, and medical workers had a higher perception of COVID-19 infection risk than nonmedical workers (both P <0.05). Among the included patients, 149 (35.73%) patients were hesitant to be vaccinated, while 268 (64.27%) patients are willing to accept vaccination. Logistic regression analysis showed that men were more willing to be vaccinated than women, and nonmedical workers were more willing to be vaccinated than medical workers (both P <0.05). A total of 55.40% of the patients did not receive the COVID-19 vaccine. The incidence of adverse reactions for the 167 patients who received the COVID-19 vaccine was 8.98%.

CONCLUSION

The vaccination rate of the patients with rheumatic disease was relatively low, as was their vaccination willingness. Patient sex, whether the patient was a medical worker, and the patient's level of knowledge about the risk of COVID-19 infection and the impact of vaccination on the disease were key factors.

Narratives of the worst experiences associated with peritraumatic distress during the COVID-19 pandemic: a mixed method study in the USA and Italy

Background: Although symptoms of posttraumatic stress disorder (PTSD) have been associated with the COVID-19 pandemic experiences, no study has explored yet the association of specific COVID-19 narratives with peritraumatic distress, the precursor of PTSD. Objective: To explore the worst experiences associated with peritraumatic distress during the first wave of the COVID-19 pandemic. Method: Adult residents (N = 1098), from the US (n = 741) and Italy (n = 357), completed an online survey including socio-demographic data, COVID-19-related experiences, the Peritraumatic Distress Inventory and an open question on their worst experiences during the first period of the COVID-19 pandemic (April-May 2020). A thematic content analysis (TCA) was conducted on the answers to the open question and a classification and regression tree (CART) analysis was used to identify the themes that best predicted the clinical levels of peritraumatic distress. Results: The main TCA themes related to participants' worst COVID-19 experiences were anxiety, threat, loss, anger, stress and constriction. Threat was the most prevalent theme and correlated with experiences such as being quarantined, being infected and a loved one receiving the diagnosis. US participants' descriptions of their worst experiences related more to life-threat and loss, while Italians reported more threat to the world, stress, social isolation, and feeling trapped. In the CART analysis, the main predictor (79.9%) was perceiving negative effects from the COVID-19 crisis. Among them, a COVID-related threat to self-experience was the most robust predictor. In its absence, being deprived of resources or experiencing high levels of anxiety were other robust predictors. Conclusions: The study provided evidence of the utility of a mixed-method approach in conceptualizing experiences associated with the COVID-19 pandemic and the risk of traumatic symptoms. Its findings may inform healthcare interventions and policies for tackling the new challenges posed by the COVID-19 pandemic. HIGHLIGHTS Clinically significant levels of peritraumatic distress symptoms were prevalent during the COVID-19 pandemic.Clinically significant levels of peritraumatic distress during the COVID-19 pandemic were related to experiences of life-threat, resource deprivation, and anxiety, cross-cutting the themes articulated by the thematic content analysis of anxiety, threat, loss, anger, stress and constriction.The US and Italian participants' descriptions of their worst experiences differed in subtle but important ways, with Americans reporting more life-threat and losses compared to Italians reporting more threat to the world, stress, social isolation, and feelings of being trapped.

Influence of COVID-19 Mobility-Restricting Policies on Individual Travel Behavior in Malaysia

The COVID-19 pandemic has resulted in new postpandemic travel patterns as a result of the stay-at-home policies and restricted movement orders imposed by the Malaysian government. The purpose of this study was to investigate the changes in individual travel behavior after the government imposed a series of lockdowns, also known as movement control orders (MCO). From March to April 2021, a questionnaire survey was distributed throughout Malaysia, and 435 complete responses were collected. Results indicated that the respondents predominantly chose private cars for various traveling purposes during the pandemic. When choosing a travel mode during the pandemic, married respondents and essential workers placed a significantly higher priority on pandemic-related - items such as cleanliness, infection concern, social distance, and wearing face masks, compared to single respondents and nonessential workers. Binary logistic regression models were developed to estimate individuals’ propensity to make trips for different purposes, i.e., work/study, social activities, recreational activities, and religious activities. Results indicated that essential workers were nearly three times more likely than the general population to make a work trip during the pandemic. Regarding social and recreational trips, males were more likely to make such types of trips as compared to females. Furthermore, those who perceived a higher risk of infection were less likely to make social and recreational trips. Regarding religious trips, males were significantly more likely to make such trips during the pandemic as compared to females. In addition, Muslims had significantly higher odds of making a trip for religious purposes during the pandemic. The findings of this study could be useful in transportation planning when considering travel restrictions during pandemics based on peoples’ travel purposes and mode choices.

A cross-sectional study of COVID-19 pandemic-related organizational aspects in health care

Aim

This study explores how healthcare professionals included in the COVID‐19 contingency plan experienced organizational changes, and explores factors associated with the experiences. Additionally, the study aimed to identify learning points for future similar scenarios.

Design

A cross‐sectional study.

Methods

A questionnaire survey of healthcare professionals at three Danish hospitals, June 2020.

Results

A total of 1,448 healthcare professionals completed the questionnaire. Hereof, 813 (57%) were relocated to new settings/new jobs. The majority experienced that their relocation was totally (49%) or partially (31%) imposed, and 51% reported that the overall experience of the new job function was satisfactory. Type of profession and whether relocation to the new job function was imposed were the main variables associated with the overall experience of being part of the contingency plan. Suggestions for future scenarios included training adjusted to individual competencies, more targeted information, voluntariness with consideration of individual needs and clarification of expectations.

COVID ‐19 exposure, pandemic‐related appraisals, coping strategies, and psychological symptoms among the frontline medical staff and gender differences in coping processes

This study sought to explore the effects of COVID‐19 exposure, pandemic‐related appraisals and coping strategies on psychological symptoms among the front‐line healthcare workers based on the transactional theory of stress and coping. A cross‐sectional study was conducted in a Wuhan hospital designated for inpatients with COVID‐19, assessing COVID‐19 exposure (whether or not exposed to confirmed patients at workplace), psychological symptoms, appraisals, and coping strategies in 311 participants. Results revealed that the pandemic markedly affected healthcare workers' mental well‐being through appraisal and coping, with 38.9% reporting high levels of psychological symptoms. Primary appraisal related closely with COVID‐19 exposure, especially in female, while secondary appraisal was associated with problem‐focused coping. Both problem‐focused and emotion‐focused coping had a protective effect against psychological symptoms, but also showed gender differences in its relations with other variables. These findings could potentially benefit to enrich relevant theories, and to develop psychological programs for future epidemics.

Impact of COVID-19 pandemic on mental health, risk perception and coping strategies among health care workers in Albania - evidence that needs attention

Background

The COVID-19 pandemic impacted health care workers in many ways including mental health. This impact is usually underestimated in particular in developing countries.

Objectives

The study aims to assess the level of anxiety, depression, risk perception, and coping strategies of Albanian healthcare workers during the COVID-19 pandemic and to identify associated factors.

Methods

A cross-sectional online study was conducted from April to May 2020 by recruiting health care personnel through the snowballing method. Data collection was carried out through social media using the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9) by Google forms. Participants were recruited from all health care sectors including doctors, nurses, etc. working in both the public and private sectors.

Results

410 questionnaires were included in the analysis. Most participants were nurses (59.3%), female (78.5%), and belonged to the age group 26–40 years (46.3%). Mild levels of anxiety were expressed in 26.9% of participants while 7.2% of them expressed moderate levels. 23.1% and 12.1% of participants expressed respectively mild and moderate depression levels. High levels of risk perception were found. A statistical association was found between occupation (p = 0.011), gender (p = 0.031), providing care for COVID-19 patients (p = 0.011), and the availably of mental health support in the workplace. Poor coping strategies were reported among participants.

Conclusions

Mental health support should be a priority of the healthcare system in particular for young health care workers caring for COVID-19 patients. It can improve the mental health status of health care workers and their family members, impacting the quality of care provided.

Pediatric hematology/oncology healthcare professional emotional health during COVID-19

Objectives

Little is known about the impact of coronavirus disease 2019 (COVID‐19) on healthcare professional emotional health in pediatric hematology/oncology. Primary objective was to describe anxiety, depression, positive affect, and perceived stress among pediatric hematology/oncology healthcare professionals following a COVID‐19 outbreak. Secondary objectives were to compare these outcomes based on contact with a positive person, and to identify risk factors for worse outcomes.

Materials and methods

We included 272 healthcare professionals working with pediatric hematology/oncology patients. We determined whether respondents had direct or indirect contact with a COVID‐19‐positive individual and then measured outcomes using the Patient‐Reported Outcomes Measurement Information System (PROMIS) depression, anxiety, and positive affect measures, and the Perceived Stress Scale.

Results

Among eligible respondents, 205 agreed to participate (response rate 75%). Sixty‐nine (33.7%) had contact with a COVID‐19‐positive person. PROMIS anxiety, depression, and positive affect scores were similar to the general United States population. Those who had contact with a COVID‐19‐positive individual did not have significantly different outcomes. In multiple regression, non‐physicians had significantly increased anxiety (nurses: p = 0.013), depression (nurses: p = 0.002, pharmacists: p = 0.038, and other profession: p = 0.021), and perceived stress (nurses: p = 0.002 and other profession: p = 0.011) when compared to physicians.

Conclusions

Pediatric hematology/oncology healthcare professionals had similar levels of anxiety, depression, and positive affect as the general population. Contact with a COVID‐19‐positive individual was not significantly associated with outcomes. Non‐physician healthcare professionals had more anxiety, depression, and perceived stress when compared to physicians. These findings may help to develop programs to support healthcare professional resilience.

The role of fortitude, loneliness, and depression in the association between risk perception of contracting COVID-19 and life satisfaction: serial mediation analysis

Recently, the COVID-19 pandemic has been found to have a negative impact on both physical wellbeing and mental health. Increased risk perception of contracting the virus has been associated with adverse psychological outcomes and reduced life satisfaction. However, susceptibility to psychological distress is influenced by personality-related characteristics. This study focuses on fortitude as a potential protective factor. The aim of this study is to investigate the parallel and serial mediating roles of fortitude, loneliness, and depression in the relationship between risk perception and life satisfaction. The participants were young adults ( N = 337) who have completed five self-report questionnaires: University of California Los Angeles Loneliness Scale, Centre for Epidemiological Studies Depression Scale, Fortitude Questionnaire, Satisfaction with Life Scale, and COVID-19 Risk Perception Scale. Descriptive statistics were generated, and structural equation modelling was used to examine the parallel and serial mediating roles of loneliness, depression, and fortitude. Positive associations were found between risk perception and loneliness and depression, and fortitude was found to mediate the relationship between risk perception and life satisfaction, between loneliness and life satisfaction, and between depression and life satisfaction. The overall serial mediation was also found to be significant, thereby supporting the hypothesis that those who perceive themselves to be at a risk of contracting COVID-19 have higher loneliness scores, which in turn is associated with higher depression scores. These findings confirm that fortitude is a salient protective factor and suggest that improving the perception of the ability to manage the risk of infection can enhance psychological wellbeing.

Primary Health Care Nurses' Perceptions of Risk During COVID-19: A Qualitative Study

PURPOSE

COVID-19 has presented health care professionals with unprecedented challenges. Significant risks have emerged as nurses have continued to work in delivering frontline health care during the pandemic. Feeling "at risk" has significant deleterious effects on nurses. The study sought to explore the perceptions of risk by Australian primary health care nurses (PHC) during COVID-19.

METHODS

Twenty-five Australian PHC nurses were purposively recruited from survey respondents who indicated a willingness to be interviewed. Phone interviews were undertaken between June and August 2020. Audio-recordings were transcribed and analyzed thematically.

FINDINGS

Participants shared concerns about risks in the workplace that emerged during COVID-19 and described the strategies used to mitigate these identified risks. Three themes were identified: (a) Professional concerns, (b) Personal/family concerns, and (c) Patient needs.

CONCLUSIONS

Understanding PHC nurses' perceptions of risk during COVID-19 provides an important insight into how they can be better supported to manage the risks that they face and feel safer in their workplace. Ensuring that PHC nurses are well-supported is important to optimize job satisfaction, reduce burnout and improve patient care.

CLINICAL RELEVANCE

There is a need to ensure that nurses feel safe during crises such as pandemics to protect both individual nurses and the broader workforce. Protecting the health workforce is essential to optimizing service delivery and promoting health outcomes.

Psychological and work-related factors associated with emotional exhaustion among healthcare professionals during the COVID-19 outbreak in Italian hospitals

The coronavirus disease 2019 (COVID‐19) pandemic has induced considerable psychological distress in healthcare workers, increasing the risk of burnout. This research aimed to investigate sociodemographic, work‐related, COVID‐19‐related, and psychological factors associated with emotional exhaustion (the core component of burnout) among healthcare professionals during the first wave of the COVID‐19 pandemic in Italy. A cross‐sectional study was conducted to assess risk (e.g. perceived risk and fear of contagion, stress) and protective factors (e.g. job satisfaction, resilience) for emotional exhaustion among 616 hospital staff. Women, nurses, shift workers, those with a permanent contract, and frontline workers reported significantly higher levels of emotional exhaustion compared to others. Significant risk factors predicting emotional exhaustion were prolonged use of personal protective equipment, increased work pressure, lack of support, and prolonged working hours; psychologically protective factors were resilience and job satisfaction, while perceived stress was found to be a significant psychological risk factor. Organizational interventions should focus on these factors to prevent the onset of burnout.

International survey of audiologists during the COVID-19 pandemic: effects on mental well-being of audiologists

OBJECTIVE

The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic.

DESIGN

A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3).

STUDY SAMPLE

239 audiologists from around the world.

RESULTS

The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor.

CONCLUSIONS

Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic.

[Concern about COVID-19 infection and workload as predictors of psychological distress during the health emergency in Peruvian healthcare personnel]

INTRODUCTION

During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing.

OBJECTIVE

To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers.

METHODS

Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale.

RESULTS

It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (p <0.01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; p <0.001), where concern about COVID-19 (β = -0.436; p <0.01) and workload (β = 0.239; p <0.01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33).

CONCLUSIONS

Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Impact of the coronavirus disease 2019 pandemic on healthcare workers: systematic comparison between nurses and medical doctors

PURPOSE OF REVIEW

The COVID-19 outbreak has had major impact on individual's psychological health and overall well being worldwide. Evidence shows that these psychological challenges are especially prominent in healthcare workers (HCW); especially in nurses. Indeed, several studies report that nurses suffer more psychologically because of the consequences of the pandemic compared with medical doctors. To further look into this, we systematically review the recent literature to see whether the psychological impact of the COVID-19 pandemic differs between medical doctors and nurses across studies and which aspects of mental health are especially affected in nurses.

RECENT FINDINGS

Across studies, there is solid evidence that nurses show poorer mental health outcomes compared with medical doctors during the COVID-19 pandemic. This is especially true for symptoms of depression, anxiety and posttraumatic stress disorder (PTSD). Here, prevalence rates in nurses are often higher than 50%. In contrast, general stress levels and burnout seem to be comparable between nurses and medical doctors.

SUMMARY

Given that nurses suffer more from depression, anxiety and PTSD symptoms during the COVID-19 pandemic, special programs addressing their needs are required.

The global prevalence of depression, anxiety, stress, and, insomnia and its changes among health professionals during COVID-19 pandemic: A rapid systematic review and meta-analysis

BACKGROUND

During the COVID-19 pandemic, the health professionals who are at the frontline of this crisis have been facing extreme psychological disorders. This research aims to provide an overall scenario of the prevalence of depression, anxiety, stress, as well as insomnia and to inspect the changes in these prevalence over time by analyzing the existing evidence during this COVID-19 pandemic.

METHODS

A systematic search was performed on March 30, 2021, in PubMed, MEDLINE, Google Scholar databases, and Web of Science. To assess the heterogeneity, Q-test,I 2 statistics, and Meta regression and to search for the publication bias, Eggers's test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity.

RESULTS

Among eighty-three eligible studies in the final synthesis, 69 studies (n = 144649) assessed the depression prevalence of 37.12% (95% CI: 31.80-42.43), 75 studies (n = 147435) reported the anxiety prevalence of 41.42% (95% CI: 36.17-46.54), 41 studies (n = 82783) assessed the stress prevalence of 44.86% (95% CI: 36.98-52.74), 21 studies (n = 33370) enunciated the insomnia prevalence of 43.76% (95% CI: 35.83-51.68). The severity of the mental health problems among health professionals increased over the time during January 2020 to September 2020.

LIMITATIONS

A significant level of heterogeneity was found among psychological measurement tools and across studies.

CONCLUSIONS

Therefore, it is an emergency to develop psychological interventions that can protect the mental health of vulnerable groups like health professionals.

The Combined Effect of Safety Specific Transformational Leadership and Safety Consciousness on Psychological Well-Being of Healthcare Workers

Occupational health researchers have begun to realize that the psychological well-being of healthcare workers who are providing treatment against COVID-19 is deteriorating. However, there is minimal research conducted on it, particularly in the context of leadership. The current study aims to fill this important gap by identifying critical factors that can enhance the psychological well-being of healthcare workers. We proposed that safety specific transformational leadership enhances psychological well-being among healthcare workers, and COVID-19 perceived risk mediates this relationship. Furthermore, the safety conscientiousness of healthcare workers was proposed to be a boundary condition that enhances the negative relationship between safety-specific transformational leadership and COVID-19 perceived risk. Data were collected from healthcare workers (N = 232) treating COVID-19 patients in the hospitals of Pakistan through well-established adopted questionnaires. The discriminant and convergent validity of the data was tested through confirmatory factor analysis by using AMOS statistical package. The mediation and moderation hypotheses were tested by using PROCESS Macro by Hayes. The results showed that safety specific transformational leadership enhances psychological well-being among healthcare workers, and COVID-19 perceived risk mediates this relationship. Moderation results also confirmed that safety conscientiousness moderates the relationship between safety specific transformational leadership and COVID-19 perceived risk. This study offers implications for both researchers and practitioners.

Investigation of the Effect of COVID-19 Perceived Risk on Death Anxiety, Satisfaction With Life, and Psychological Well-Being

This study aims to examine the effect of COVID-19 perceived risk on death anxiety, satisfaction with life, and psychological well-being. The application part of the research was conducted on staff working in a public hospital. A convenience sample of staff working in a public hospital was used and data were obtained from 573 individuals. The result of the analysis determined that the COVID-19 perceived risk explains 13.5% of the total variance on death anxiety. The regression models identified that the increase in COVID-19 risk perceptions of the participants statistically increased their death anxiety and decreased their satisfaction with life and psychological well-being.