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Hellström S, Jonsdotter A, Jonsson M, Pettersson K, Saltvedt S, Herbst A, Ågren J, Ådén U, Domellöf M, Hagberg H, Carlsson Y. A follow up on the feasibility after national implementation of magnesium sulfate for neuroprotection prior to preterm birth. Acta Obstet Gynecol Scand 2023; 102:1741-1748. [PMID: 37680134 PMCID: PMC10619608 DOI: 10.1111/aogs.14673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION The risk for brain injury manifested as cerebral palsy is higher in very preterm born children than in term. Prenatal administration of magnesium sulfate (MgSO4 ) has been shown to be neuroprotective and reduces the proportion of very preterm born children later diagnosed with cerebral palsy. A Swedish national clinical practice guideline was implemented in March 2020, stipulating the administration of a single intravenous dose of 6 g MgSO4 1-24 h prior to delivery before gestational age 32+0, aiming for 90% treatment coverage. The aim of this study was to evaluate the feasibility of this new clinical practice guideline in the first year of its implementation. MATERIAL AND METHODS Data on MgSO4 treatment were collected by reviewing the medical charts of women who gave birth to live born children in gestational age 22+0-31+6 during the period of March 1, 2020 to February 28, 2021, at five Swedish university hospitals. Women with pre-eclampsia, eclampsia, or high elevated liver enzymes low platelets (HELLP) were excluded. RESULTS A total of 388 women were eligible and 79% received treatment with MgSO4 . Of the 21% not receiving treatment, 9% did not receive treatment due to lack of knowledge about the clinical practice guideline, 9% were not possible to treat and 3% had missing data. The proportion treated increased from 72% to 87% from the first to the last 3 months. Of those treated, 81% received the drug within the stipulated timeframe (mean 8.7 h, median 3.4 h). CONCLUSIONS There was a positive trend over time in the proportion of women receiving MgSO4 treatment, but the a priori target of 90% was not reached during the first year of implementation. Our findings indicate that this target could be reached with additional information to clinicians.
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Affiliation(s)
- Sara Hellström
- Department of Obstetrics and Gynecology, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
- Division of Neonatology, Department of Pediatrics, The Queen Silvia Children's HospitalSahlgrenska University HospitalGothenburgSweden
| | - Andrea Jonsdotter
- Department of Obstetrics and Gynecology, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
- Center of Perinatal Medicine and HealthInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Maria Jonsson
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Karin Pettersson
- Clinical Intervention Science and Technology, CLINTECKarolinska InstituteStockholmSweden
| | - Sissel Saltvedt
- Department of Women's and Children's HealthKarolinska Institutet, Karolinska University HospitalStockholmSweden
| | - Andreas Herbst
- Department of Obstetrics and Gynecology, Skåne University HospitalInstitution for Clinical Sciences Lund, Lund UniversityLundSweden
| | - Johan Ågren
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Ulrika Ådén
- Department of Women's and Children's HealthKarolinska Institutet, Karolinska University HospitalStockholmSweden
- Department of Biomedical and Clinical SCIENCESLinköping UniversityLinköpingSweden
| | - Magnus Domellöf
- Department of Clinical Sciences, PediatricsUmeå UniversityUmeåSweden
| | - Henrik Hagberg
- Department of Obstetrics and Gynecology, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
- Center of Perinatal Medicine and HealthInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Ylva Carlsson
- Department of Obstetrics and Gynecology, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
- Center of Perinatal Medicine and HealthInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
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Damghanian H, Hedayati S, Farhadinejad M, Rastgar AA. Lessons learned from behaviors of the employees in Iranian banks during the Covid-19 pandemic crisis: A phenomenological study. Heliyon 2023; 9:e21445. [PMID: 38045175 PMCID: PMC10692766 DOI: 10.1016/j.heliyon.2023.e21445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 09/26/2023] [Accepted: 10/20/2023] [Indexed: 12/05/2023] Open
Abstract
The aim of this research is to analyze the experiences of employees during the Covid-19 pandemic cri-sis and conceptualize the lessons learned to deal with similar crises in the future. To achieve this, a qualitative approach with a phenomenological strategy was conducted through semi-structured, in-depth interviews with 16 front-line employees of Bank Melli, the largest state bank in Iran. The study found that employee behavior plays a critical role in crisis management, with functional behaviors such as preventive measures, stress management, and sharing valid information being essential. Dysfunctional behaviors such as resistance to change and inconsistent behaviors were also identified. The prevention of infection and stress management were identified as key behaviors to cope with the crisis, while media literacy and acceptance of change were crucial for correct information analysis and crisis management. Overall, the study highlights the challenges faced by employees during the Covid-19 crisis and provides valuable lessons from a behavioral perspective for managers in the banking industry to manage disruptions caused by current and future pandemics. The study emphasizes the importance of learning from the lessons of the Covid-19 crisis to reduce negative effects on physical and mental health.
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Affiliation(s)
- Hossein Damghanian
- Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran
| | - Sadegh Hedayati
- Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran
| | - Mohsen Farhadinejad
- Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran
| | - Abbas Ali Rastgar
- Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran
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Akerstrom M, Sengpiel V, Hadžibajramović E, Carlsson Y, Graner S, Andersson O, Jonsson M, Naurin E, Veje M, Wessberg A, Linden K. The COPE Staff study: Study description and initial report regarding job satisfaction, work-life conflicts, stress, and burnout among Swedish maternal and neonatal healthcare workers during the COVID-19 pandemic. Int J Gynaecol Obstet 2023; 162:989-997. [PMID: 36998146 DOI: 10.1002/ijgo.14772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE To describe the study design of the COPE Staff cohort study on working conditions for maternal and neonatal healthcare workers (MNHCWs), and present baseline data regarding job satisfaction, work-life conflicts, stress, and burnout. METHODS Between January and April 2021, 957 MNHCWs (administrative and medical staff) completed a baseline survey. Average levels of job satisfaction, work-life conflicts, stress, and burnout, and associations to perceived workload were assessed. RESULTS The average levels of job satisfaction, work-life conflicts, stress, and burnout were 68.6 (95% confidence interval [CI] 64.3-72.8), 42.6 (95% CI 37.3-48.0), 42.0 (95% CI 37.7-46.3), and 1.9 (95% CI 1.6-2.2), respectively. The respondents scoring above critical values indicating clinical burnout ranged between 3% and 18%, respectively, for the four burnout sub-dimensions. Women reported significantly higher levels of stress and burnout. Younger participants had lower job satisfaction and higher levels of work-life conflicts, stress, and burnout. Higher perceived workload was significantly associated with lower job satisfaction levels and higher levels of work-life conflicts, stress, and burnout. CONCLUSIONS Our results indicate associations between MNHCWs perceived workload and job satisfaction, work-life conflicts, stress, and burnout during the COVID-19 pandemic. Eighteen percent scored above critical values for exhaustion.
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Affiliation(s)
- Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emina Hadžibajramović
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ylva Carlsson
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofie Graner
- Department of Medicine, Center for Pharmacoepidemiology, Karolinska Institute, Stockholm, Sweden
- BB Stockholm, Danderyd Hospital, Stockholm, Sweden
| | - Ola Andersson
- Department of Clinical Sciences Lund, Paediatrics, Lund University, Lund, Sweden
- Department of Neonatology, Skåne University Hospital, Malmö, Sweden
| | - Maria Jonsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Elin Naurin
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Malin Veje
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Wessberg
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Björk L, Corin L, Akerstrom M, Jonsdottir IH, Innocenti AD, Wijk H, Ahlstrom L. Under pressure - The working situation of Swedish healthcare managers during the first wave of COVID-19. Front Psychol 2023; 13:1052382. [PMID: 36710753 PMCID: PMC9874142 DOI: 10.3389/fpsyg.2022.1052382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction The aim of this study is to provide insight into the psychosocial work situation of hospital managers during the first wave of the COVID-19 pandemic. Methods Mixed-effect modelling was used on survey data on job demands, job resources, job motivation, and work-life balance among over 500 managers working in 55 departments of a large Swedish university hospital in 2019 and 2020. Responses from 6011 employees were then used to stratify the analysis for COVID-19 exposure. Inductive content analysis was applied to open-ended questions on the managers' views on organisational prerequisites during the onset of the pandemic. Results The proportion of managers reporting difficulties with role clarity, quantitative demands, decision-making authority, and emotional support, time for recovery at work, motivation deficits, or problems with work-life balance clearly increased during the first wave of the pandemic. The proportion of managers reporting negative responses was higher in departments with high COVID-19 exposure. The qualitative analysis shows that overall governance in terms of clear, fair, and well-communicated routines, resource allocation, and division of responsibilities constituted an important framework for managerial during the crisis. First-line managers also require a mandate to re-organize their roles and their teams to successfully adapt to the situation. Organisational and social support was also important resources. Discussion This is the first study investigating healthcare managers' work situation during the first wave of the COVID-19 pandemic in a Swedish context. As expected, it indicates an increasingly strained work situation during the crisis, but it also provides findings on organisational prerequisites that allow healthcare managers to cope with stressful situations. In line with previous research on organisational resilience, the study provides suggestions for how higher-level managers can act in order to provide front-line managers with the organisational prerequisites they need to adapt, learn and develop successfully during times of unpredictability, insecurity, and rapid change in order to offer the best possible support to health care workers.
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Affiliation(s)
- Lisa Björk
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden,*Correspondence: Lisa Björk, ✉
| | - Linda Corin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H. Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl Innocenti
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Orthopedics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Zangeneh Soroush M, Tahvilian P, Koohestani S, Maghooli K, Jafarnia Dabanloo N, Sarhangi Kadijani M, Jahantigh S, Zangeneh Soroush M, Saliani A. Effects of COVID-19-related psychological distress and anxiety on quality of sleep and life in healthcare workers in Iran and three European countries. Front Public Health 2022; 10:997626. [PMID: 36504977 PMCID: PMC9732084 DOI: 10.3389/fpubh.2022.997626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line. Methods This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded. Results Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p-values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF. Discussion This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations.
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Affiliation(s)
- Morteza Zangeneh Soroush
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Bio-Intelligence Research Unit, Electrical Engineering Department, Sharif University of Technology, Tehran, Iran
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Tahvilian
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Sepideh Koohestani
- Department of Electrical Engineering, Islamic Azad University, Qazvin Branch, Qazvin, Iran
| | - Keivan Maghooli
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nader Jafarnia Dabanloo
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Sepehr Jahantigh
- Department Chemical Engineering, Sahand University of Technology, Tabriz, Iran
| | | | - Amitis Saliani
- Department of Genomic Medicine, Queen Mary University of London, London, United Kingdom
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