Sufficient personal protective equipment training can reduce COVID-19 related symptoms in healthcare workers: A prospective cohort study

The association of fear of COVID-19 on occupational stress in pediatric nurses: Examining the mediating role of psychological well-being

PURPOSE

This study investigated the associations of fear of COVID-19 with occupational stress and the mediating role of psychological well-being in pediatric nurses.

METHODS

This cross-sectional study was conducted between December 2021 and February 2022. The sample consisted of 464 pediatric nurses from public or university hospitals in Türkiye. Data were collected using a sociodemographic characteristics questionnaire, the Fear of COVID-19 Scale, the Occupational Stress Scale, and the Psychological Well-Being Scale. The data were analyzed using Pearson's correlation and regression analysis.

RESULTS

Participants' fear of COVID-19 was positively associated with their occupational stress (F = 17.263; p < 0.001) but negatively associated with their psychological well-being (F = 10.575; p = 0.001). Their psychological well-being was negatively associated with their occupational stress (F = 22.084; p < 0.001). Nurses fear of COVID-19 explained three and 2 % of their occupational stress and psychological well-being, respectively. Nurses' psychological well-being explained 4 % of their occupational stress. The results showed that participants' psychological well-being did not mediate between their fear of COVID-19 and occupational stress.

CONCLUSION

Pediatric nurses fear COVID-19 but have an above-mean level of occupational stress and psychological well-being. In conclusion, psychological well-being does not mediate between pediatric nurses' fear of COVID-19 and occupational stress.

PRACTICE IMPLICATIONS

The pandemic was a traumatic experience for pediatric nurses. Hospital administrators and nurse managers must monitor the psychosocial health of pediatric nurses and support them in times of crisis.

Health and care workers in long-term care facilities and their role in preventing emerging infectious diseases: A scoping review

BACKGROUND

The COVID-19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long-term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood.

AIM

Describe how health and care workers contribute to the prevention of emerging infectious diseases in long-term care facilities.

DESIGN

A scoping review.

METHODS

A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long-term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross-checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings.

RESULTS

A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: "The roles of health and care workers evolve with the times", "The core competencies of health and care workers are essential for preventing emerging infectious diseases in long-term care facilities" and "The key to successful prevention of emerging infectious diseases in long-term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels". Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes.

CONCLUSIONS

The roles of health and care workers are evolving, and effective infection prevention within long-term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers.

CLINICAL RELEVANCE

Infection prevention efforts within long-term care facilities must take into account the evolving roles of health and care workers, with a focus on guaranteeing access to resources, training and support that will help them gain the core competencies necessary for juggling those roles. In addition, there is an urgent need for research instruments that will help assess those competencies and identify areas of improvement.

Cohort profile: recruitment and retention in a prospective cohort of Canadian healthcare workers during the COVID-19 pandemic

PURPOSE

Healthcare workers were recruited early in 2020 to chart effects on their health as the COVID-19 pandemic evolved. The aim was to identify modifiable workplace risk factors for infection and mental ill health.

PARTICIPANTS

Participants were recruited from four Canadian provinces, physicians (medical doctors, MDs) in Alberta, British Columbia, Ontario and Quebec, registered nurses (RNs), licensed practical nurses (LPNs) and healthcare aides (HCAs) in Alberta and personal support workers (PSWs) in Ontario. Volunteers gave blood for serology testing before and after vaccination. Cases with COVID-19 were matched with up to four referents in a nested case-referent study.

FINDINGS TO DATE

Overall, 4964/5130 (97%) of those recruited joined the longitudinal cohort: 1442 MDs, 3136 RNs, 71 LPNs, 235 PSWs, 80 HCAs. Overall, 3812 (77%) were from Alberta. Prepandemic risk factors for mental ill health and respiratory illness differed markedly by occupation. Participants completed questionnaires at recruitment, fall 2020, spring 2021, spring 2022. By 2022, 4837 remained in the cohort (127 had retired, moved away or died), for a response rate of 89% (4299/4837). 4567/4964 (92%) received at least one vaccine shot: 2752/4567 (60%) gave postvaccine blood samples. Ease of accessing blood collection sites was a strong determinant of participation. Among 533 cases and 1697 referents recruited to the nested case-referent study, risk of infection at work decreased with widespread vaccination.

FUTURE PLANS

Serology results (concentration of IgG) together with demographic data will be entered into the publicly accessible database compiled by the Canadian Immunology Task Force. Linkage with provincial administrative health databases will permit case validation, investigation of longer-term sequelae of infection and comparison with community controls. Analysis of the existing dataset will concentrate on effects on IgG of medical condition, medications and stage of pregnancy, and the role of occupational exposures and supports on mental health during the pandemic.

Fata HMR, Busrah N, Darling-Fisher C, Idris DR. "Embracing the Inner Strength and Staying Strong": Exploring Self-Care Preparedness among Nurses for Enhancing Their Psychological Well-Being against the Long-Term Effect of COVID-19 Pandemic in Brunei Darussalam

During three years of the unprecedented, massive COVID-19 pandemic that affected the world, nurse front liners faced substantial challenges and experienced long-term adverse mental health. This study explored psychological self-care practices undertaken by nurses to strengthen their mental health and develop resilience in their professional care role while addressing the challenges of the COVID-19 era. A qualitative descriptive exploratory study was conducted on 40 nurses who worked in providing COVID-19 care across Brunei using focus groups aided by semi-structured open-ended questions. Data were thematically analyzed using constructivist grounded theory. Four themes emerged: (1) 'Care of the mind, heart and soul'; (2) 'Physical care for the psychological well-being'; (3) 'Venting out and distraction'; (4) 'Have faith, think and stay positive'. The challenges of dealing with a worldwide pandemic unintentionally placed nurses' mental well-being at risk while the government strategized and prioritized containing and preventing the spread of and death from COVID-19. Health administrators, as well as nursing educators, need to promote and develop resources to strengthen nurses' psychological self-care practices. This will not only benefit individual nurses but will help promote the well-being of patients and employees, improve the health of all, and counteract any unintended stressful situations, even beyond the COVID-19 pandemic.

Transmission and Risk Factors of COVID-19 among Health Care Workers

Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were reviewed, including eligible English articles published between April 2020 and May 2022. Job category, work environment, personal protective equipment (PPE) noncompliance, lack of PPE awareness and training, unvaccinated status, and competing community and household exposures were identified as risk factors for SARS-CoV-2 transmission among HCWs. Effective measures to protect HCWs from SARS-CoV-2 need to account for the identified occupational risk factors. Identifying and understanding COVID-19 risk factors among HCWs must be considered a public health priority for policy makers to mitigate occupational and community transmission in current and future epidemics.

The prevalence and determinants of SARS-CoV-2 infections among healthcare workers, results of a cross-sectional study in the Silesian Voivodeship

OBJECTIVES

A significant proportion of healthcare workers (HCWs) had been infected with SARS-CoV-2, which complicated the organization of patient care during the COVID-19 pandemic. However, the exact scale of infection prevalence among the group of HCWs is not known, therefore this study aimed to assess the prevalence of SARS-CoV-2 infection among HCWs in the Silesian voivodeship, Poland, and to define its determinants.

MATERIAL AND METHODS

The cross-sectional study was conducted in 2 multidisciplinary hospitals in the Silesian voivodeship during the period October 2021-February 2022. The standardized WHO questionnaire Surveillance protocol for SARS-CoV-2 infection among health workers was completed by 242 HCWs. To assess the prevalence of SARS-CoV-2 infection and its determinants, such as personal, occupational, and work environment-related conditions and preventive behaviors, the collected data were subjected to statistical analysis. For this purpose, descriptive and analytical statistics (significance of differences in χ2 test) were used.

RESULTS

Almost half (42.6%) of subjects were infected with coronavirus, most frequently care assistants (57.1%) and paramedics (50%). People suffering from chronic diseases were infected significantly more often (p < 0.001). The majority of the infected HCWs declared previous contact with COVID-19 patients (56.3%). Unfortunately, 10.3% of respondents refused to be vaccinated against COVID-19, most often care assistants (38.1%) and nurses (10.6%). The determinants such as sex, age, occupation, place of work (ward), participation in occupational safety and health training, use of personal protective equipment (PPE), or preventive behaviors did not significantly affect the risk of infection (p > 0.05).

CONCLUSIONS

Even though the PPE was used and the percentage of fully vaccinated HCWs against COVID-19 was high (89.7%), the frequency of SARS-CoV-2 infected HCWs remains high at 42.6% (95% CI: 40.7-44.5%). The main determinants of SARS-CoV-2 infection risk among HCWs were previous contact with infected individuals and the presence of chronic disease. Int J Occup Med Environ Health. 2023;36(2):201-13.

Experiences of a Nursing Team Working in a Residential Care Facility for Older Adults During the COVID-19 Pandemic

Experiences of staff working in residential long-term care facilities (LTCFs) during the coronavirus disease 2019 (COVID-19) pandemic are likely to differ from that of staff working in acute hospitals. The aim of the current study was to describe the experiences of the nursing team supporting frail older adults with high medical and care needs living in a LTCF. Using a descriptive qualitative design, data were gathered via one-to-one semi-structured interviews and thematically analyzed. Four themes emerged: Providing Care During COVID-19, Impact of COVID-19 on Staff, Organizational Management of COVID-19, and Training and Education. Visitation restrictions and staff shortages impacted all aspects of work life. Staff reported increased stress and exhaustion with COVID-19 infection resulting in long-term health issues. It is important to learn from these experiences to inform and empower staff to manage future outbreaks of infectious diseases. [Journal of Gerontological Nursing, 49(3), 40-46.].

“We must be strong in our heart, in our mind and in our soul”: An exploratory qualitative study on nurses’ psychological self-care in strengthening their mental health while providing COVID-19 care.. [DOI: 10.21203/rs.3.rs-2160729/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background It is two years since the unprecedented and massive COVID-19 pandemic affected the world. Since its emergence, nurse frontliners across the globe faced various challenges that lead them to experience adverse mental health. An important yet often overlooked or underappreciated initial coping strategy is psychological self-care. Research has shown that nurses’ psychological self-care practices strengthened their mental well-being when facing the unpredicted nature and chaos of COVID-19. This study examined the specific positive psychological self-care practices used by nurses who provided care for COVID-19 patients. Methods An exploratory qualitative study was conducted on 40 nurses who worked in providing care for confirmed and suspected COVID-19 patients across Brunei. Data was collected using focus groups aided by semi-structured open-ended questions and analysed thematically using the principles underpinning Constructivist Grounded Theory (Charmaz, 2021). Results Four themes emerged: 1) ‘Care of the mind, heart and soul’ – explained the meaning and importance of psychological self-care practices to the nurses; 2) ‘Physical care for the psychological well-being’- illuminated efforts undertaken to strengthen knowledge and practices for preparedness in caring for suspected and confirmed COVID-19 patients; 3) ‘Venting out and distraction’ – demonstrated the measures undertaken to release and relieve stress; 4) ‘Have faith, think and stay positive’ – described the importance of having faith in the higher being or supreme entity such as God for protection, and enduring the daily challenges positively Conclusions Due to the challenges of dealing with a worldwide pandemic, nurses’ mental well-being was unintentionally placed at risk while the government strategized and prioritised containing and preventing the spread of and death from COVID-19. This study describes specific psychological self-care practices undertaken by nurses to strengthen their mental health and develop resilience in their professional care role while addressing the challenges of the COVID-19 era. Health administrators, as well as nursing educators, need to promote and developing resources to strengthen nurses’ positive psychological self-care practices. This will not only benefit individual nurses but will help promote the wellbeing of patients and employees, improve the health of all, and counteract any unintended stressful situations, even beyond the COVID-19 pandemic.

Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update

Older adults in nursing homes are at greatest risk of morbidity and mortality from SARS-CoV-2 infection. Nursing home residents constituted one-third to more than half of all deaths during the early waves of the COVID-19 pandemic. Following this, widespread adaptation of infection prevention and control measures and the supply and use of personal protective equipment resulted in a significant decrease in nursing home infections and deaths. For nursing homes, the most important determinant of experiencing a SARS-CoV-2 outbreak in the first instance appears to be community-transmission levels (particularly with variants of concern), although nursing home size and quality, for-profit status, and sociodemographic characteristics are also important. Use of visitation bans, imposed to reduce the impact of COVID-19 on residents, must be delicately balanced against their impact on resident, friend or family, and staff well-being. The successful rollout of primary vaccination has resulted in a sharp decrease in morbidity and mortality from SARS-CoV-2 in nursing homes. However, emerging evidence suggests that vaccine efficacy may wane over time, and the use of a third or additional vaccine "booster" doses in nursing home residents restores protection afforded by primary vaccination. Ongoing monitoring of vaccine efficacy in terms of infection, morbidity, and mortality is crucial in this vulnerable group in informing ongoing SARS-CoV-2 vaccine boosting strategies. Here, we detail the impact of SARS-CoV-2 on nursing home residents and discuss important considerations in the management of nursing home SARS-CoV-2 outbreaks. We additionally examine the use of testing strategies, nonpharmacologic outbreak control measures and vaccination strategies in this cohort. Finally, the impact of SARS-CoV-2 on the sector is reflected on as we emphasize the need for adoption of universal standards of medical care and integration with wider public health infrastructure in nursing homes in order to provide a safe and effective long-term care sector.

Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic

The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.

COVID-19 pandemic-related mortality, infection, symptoms, complications, comorbidities, and other aspects of physical health among healthcare workers globally: An umbrella review

Background

The COVID-19 pandemic has continued to cause unprecedented concern across the globe since the beginning of the outbreak. Healthcare workers, particularly those working on the front line, remain one of the most affected groups. Various studies have investigated different aspects of the physical health of healthcare workers; however, limited evidence on the overall physical health of healthcare workers has been collectively examined.

Aim

To examine the various aspects of physical health and well-being of healthcare workers during the COVID-19 pandemic.

Design

An umbrella review.

Methods

We conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library and MEDLINE and supplemented the search with Google Scholar. Key terms related to ‘COVID-19’, ‘physical health’, ‘healthcare worker’ and ‘systematic review’ were used in the search. Systematic reviews with or without meta-analyses were included if they were published in the English language, could be obtained in full-text format, and assessed the physical health impacts of the COVID-19 pandemic on healthcare workers were included. The methodological quality of eligible studies was assessed using the Joanna Briggs Institute's checklist for systematic reviews. The data were narratively synthesised in line with the ‘Synthesis Without Meta-analysis’ guideline.

Results

Thirteen systematic reviews (represented as K = 13) that synthesized data from 1230 primary studies/reports and 1,040,336 participants met the inclusion criteria. The findings indicate a death rate of between 0.3 and 54.2 per 100 infections (K = 4). The overall case-fatality rate was estimated to be 0.87% (approximately 9 deaths per 1000 infections, K = 3). The overall infection rate among healthcare workers ranged from 3.9% to 11% (K = 5), with the highest rate associated with healthcare workers involved in screening. Considering geographic regions, the highest number of infections was reported in Europe (78.2% of 152,888 infected healthcare workers, K = 1). More nurses and female healthcare workers were infected, while deaths occurred mainly among men and medical doctors. The commonly reported symptoms included cough (56–80%, K = 3), fever (57–85%, K = 3), and headache (7–81%, K = 3), while hypertension was the most prevalent comorbidity (7%, K = 1). Additionally, a high prevalence of poor sleep quality (41–43%, K = 2), work-related stress (33–44.86%, K = 5) and personal protective equipment-associated skin injuries (48.2–97%, K = 2) affected the healthcare workers. The most reported preventive measures included laboratory testing, clinical diagnosis, adequate personal protective equipment, self-isolation, and training/orientation for infection control.

Conclusion

Healthcare workers experienced considerable COVID-19-related physical health issues, including mortalities. This requires targeted interventions and health policies to support healthcare workers worldwide to ensure timely management of the pandemic.

Tweetable abstract: This umbrella review highlights the global mortalities, infections, and other aspects of physical health of healthcare workers during the COVID-19 pandemic.