Impact of COVID-19 pandemic on pediatric healthcare burnout in acute care: a longitudinal study

COVID-19 vaccination knowledge, attitudes, and practices within a majority Hispanic/Latino pediatric healthcare system

PURPOSE

Early COVID-19 vaccine uptake remains unexplored among Hispanic/Latino pediatric healthcare workers (HCWs). This study examined COVID-19 vaccination knowledge, attitudes, and practices (KAP) among a sample of predominantly Hispanic/Latino pediatric HCWs.

DESIGN AND METHODS

Employees in a pediatric health system completed an online KAP survey May 3-July 31, 2021 (n = 643, 59 % Hispanic/Latino). A cross-sectional descriptive survey design was used to capture perceptions and behaviors regarding COVID-19 vaccination. A Firth corrected logistic regression was conducted to identify significant predictors of COVID-19 vaccination.

RESULTS

Eighty-eight percent of the sample reported they were willing or already vaccinated for COVID-19, 12 % reported vaccine hesitancy. Within our Hispanic/Latino subsample, 86 % were vaccine willing or vaccinated. Significant predictors of COVID-19 vaccination included age, considering COVID-19 a threat to U.S. health, no previous COVID-19 infection, flu vaccination, attitude that vaccines are safe, and job role. COVID-19 information sources varied between groups. Race/ethnicity did not predict vaccination. Vaccine-hesitant participants reported concerns related to long-term health effects, vaccine distrust, and fertility.

CONCLUSIONS

Vaccine acceptance was generally supported within our sample. Race/ethnicity did not predict vaccine hesitancy within our majority Hispanic/Latino sample. A subset of participants did report vaccine hesitancy however, with concerns including long-term health effects, vaccine distrust, and fertility.

PRACTICAL IMPLICATIONS

Pediatric nurses can serve as a barometer for public opinion on vaccination and may serve as a trusted source of health information for racially and ethnically diverse communities. Understanding nurses' attitudes and opinions related to vaccination is recommended as part of public messaging for future immunization campaigns.

A 2-year longitudinal study of anxiety caused by COVID-19 and job burnout among Iranian healthcare workers

Limited longitudinal studies can be found to describe the psychological effects of COVID-19 on healthcare workers (HCW); Therefore, the present study aimed to investigating the anxiety caused by COVID-19 (COV-anxiety) and job burnout (JB) among a sample of Iranian HCW during this pandemic longitudinally. This longitudinal study performed on 310 Iranian HCW. The data collection is done twice during 2020 and 2022. The Corona Diseases Anxiety Scale (CDAS) and the Maslach Burnout Inventory (MBI) have been used through online platform (Google Form). Using frequency tables, Paired-samples T tests, Pearson correlations as well as linear regression modeling data were analyzed through SPSS 16. While reductions observed in prevalence of COV-anxiety in time 2, the prevalence of severe levels of JB dimensions increased in time 2 compared to time (1) Negative correlations existed between JB and COV-anxiety. Moreover, using multivariate linear regressions, we found that COV-anxiety and JB were the final predictors of each other both in time 1 and (2) Despite the positive association between COV-anxiety and JB, increasing in JB levels with respect to decreasing in COV-anxiety levels highlights the existence of other risk factors that should be considered in future research.

Racial and Ethnic Disparities in Attendance to Well-Child Visit Recommendations during COVID-19

OBJECTIVE

To measure the impact of the COVID-19 pandemic on racial and ethnic disparities in attendance to well-child visit recommendations.

METHODS

We used the nationally representative Medical Expenditure Panel Survey (MEPS) to compare pre-pandemic (2018-2019) and pandemic (2020 and 2021) ratios of well-child visits to age-based recommendations, presenting both unadjusted and adjusted attendance disparities over time. We also used the 1996-2021 MEPS to place the pandemic changes in an historical context.

RESULTS

Average attendance decreased from 66.6% in 2018-2019 (95% confidence interval [CI]: 64.1, 69.1) to 58.6% in 2020 (95% CI: 55.5, 61.6), rebounding to 65.1% in 2021 (95% CI: 61.5, 68.7). The unadjusted disparity in attendance between White non-Hispanic and Black non-Hispanic children widened from 9.6 percentage points in 2018-2019 (95% CI: 2.8, 16.4) to 24.8 percentage points in 2020 (95% CI: 17.5, 32.2) and 21.4 percentage points in 2021 (95% CI: 11.2, 31.5). The unadjusted disparity in attendance between White non-Hispanic and Hispanic children widened from 14.8 percentage points in 2018-2019 (95% CI: 9.7, 19.8) to 26.3 percentage points in 2020 (95% CI: 19.9, 32.7) and 24.9 percentage points in 2021 (95% CI: 17.5, 32.3). Changes in disparities were large even when we controlled for health status, demographic and socioeconomic characteristics, health insurance, and state of residence. Magnitudes of the racial and ethnic attendance disparities during the pandemic's first two years were unprecedented since 1996.

CONCLUSIONS

Widening attendance disparities during the pandemic highlight the need to build a more equitable health care system for all children.

"The forest and the trees": a narrative medicine curriculum by residents for residents

A 7-session narrative medicine (NM) curriculum was designed and facilitated by pediatrics residents for pediatrics residents in order to unpack challenging experiences during clinical training and strengthen relationships with colleagues and patients. The primary facilitator, a resident with a master's degree in NM, provided facilitator training to her co-residents with whom she co-led the workshops in the curriculum. We conducted, transcribed, and analyzed individual interviews of 15 residents, with three resultant themes: reflection on personal and professional identity; connection to others and community building; and reconceptualization of medical practice. Residents shared that they experienced greater solidarity, professional fulfillment, appreciation for multiple facets of their identities, recognition of holding space for vulnerability, and advocacy for marginalized populations. Our study highlights the feasibility and effectiveness of peer-led NM workshops to enhance clinical training through self-reflection, inclusion of persons from underrecognized backgrounds, and promotion of values consistent with humanistic care. IMPACT: A novel narrative medicine curriculum was designed and facilitated by pediatrics residents for pediatrics residents. The curriculum was feasible and acceptable to pediatrics residents and required a facilitator with content and methodology expertise in narrative medicine to train additional facilitators. Three themes emerged from resident interviews: reflection on personal and professional identity; connection to others and community building; and reconceptualization of medical practice on individual and global levels.