Expectations, Fears and Perceptions of doctors during Covid-19 Pandemic

Exploring the Impact of COVID-19 on Home Care Workers: A Qualitative Study

This qualitative study aimed to gain insight into the impact of COVID-19 on Home Care Workers (HCWs). During COVID-19 HCWs provided a lifeline for home care clients to support older people remaining living in their own homes. With a high-risk client base, HCWs were one of the few (Health and Social Care Professional) HSCPs to continue providing home-based care throughout COVID-19. Despite these contributions HCWs provided for aging in place during COVID-19, a paucity of research exists in relation to the challenges and impact of the pandemic on HCWs. Three in-person focus groups were conducted (n = 23). Two main themes were produced guided by a Reflexive Thematic Analysis approach to enable the researchers to best represent the participants experiences: Challenges and concerns to the personal and private lives of HCWs and Navigating home-based complexities of HCWs workplace during COVID-19. health care challenges to minimize impact to HCWs issues to create a safe workplace for HCWs.

Effect of vagus nerve stimulation (taVNS) on anxiety and sleep disturbances among elderly health care workers in the post COVID-19 pandemic

BACKGROUND

Healthcare workers (HCWs) have been significantly impacted by the pandemic. Elderly health care workers carry out a variety of duties at work and have years of clinical expertise. Anxiety and insomnia are among the more commonly encountered problems in senior physicians and other geriatric medical professional populations.

OBJECTIVE

The study aims to determine the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric medical professionals.

METHOD

42 Participants were enrolled in this study based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope approach, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The Experimental group A received non-invasive transcutaneous auricular vagal nerve stimulation(taVNS) and Control group A received Jacobson's progressive muscle relaxation technique.

RESULTS

With a p value of 0.001, transcutaneous auricular vagal nerve (taVNS) stimulation significantly improved sleep quality and reduced anxiety after 4 weeks.The post-intervention assessment revealed a highly significant improvement in Group A, with a T value of 251 (p < 0.001).

CONCLUSION

The findings suggest that taVNS may be an effective intervention for addressing anxiety and sleep issues in geriatric medical professionals. These results contribute to the exploration of non-invasive strategies to enhance the well-being of healthcare professionals working in demanding environments.

Assessing airborne transmission risks in COVID-19 hospitals by systematically monitoring SARS-CoV-2 in the air

IMPORTANCE

Risk management and control of airborne transmission in hospitals is crucial in response to a respiratory virus pandemic. However, the formulation of these infection control measures is often based on epidemiological investigations, which are an indirect way of analyzing the transmission route of viruses. This can lead to careless omissions in infection prevention and control or excessively restrictive measures that increase the burden on healthcare workers. The study provides a starting point for standardizing transmission risk management in designated hospitals by systemically monitoring viruses in the air of typical spaces in COVID-19 hospitals. The negative results of 359 air samples in the clean and emergency zones demonstrated the existing measures to interrupt airborne transmission in a designated COVID-19 hospital. Some positive cases in the corridor of the contaminant zone during rounds and meal delivery highlighted the importance of monitoring airborne viruses for interrupting nosocomial infection.

Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study

BACKGROUND

The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context.

PURPOSE

To explore the perceptions and lived experiences of family members  living with people diagnosed with COVID-19 in South Africa.

METHODS

A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee-reference number: BREC00003228/2021.

RESULTS

Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members  living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic  perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19.

DISCUSSION AND CONCLUSION

Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to  the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.

Frontline Health Care Workers' Mental Health and Well-Being During the First Year of the COVID-19 Pandemic: Analysis of Interviews and Social Media Data

BACKGROUND

The COVID-19 pandemic has shed light on fractures in health care systems worldwide and continues to have a significant impact, particularly in relation to the health care workforce. Frontline staff have been exposed to unprecedented strain, and delivering care during the pandemic has affected their safety, mental health, and well-being.

OBJECTIVE

This study aimed to explore the experiences of health care workers (HCWs) delivering care in the United Kingdom during the COVID-19 pandemic to understand their well-being needs, experiences, and strategies used to maintain well-being (at individual and organizational levels).

METHODS

We analyzed 94 telephone interviews with HCWs and 2000 tweets about HCWs' mental health during the first year of the COVID-19 pandemic.

RESULTS

The results were grouped under 6 themes: redeployment, clinical work, and sense of duty; well-being support and HCW's coping strategies; negative mental health effects; organizational support; social network and support; and public and government support.

CONCLUSIONS

These findings demonstrate the need for open conversations, where staff's well-being needs and the strategies they adopted can be shared and encouraged, rather than implementing top-down psychological interventions alone. At the macro level, the findings also highlighted the impact on HCW's well-being of public and government support as well as the need to ensure protection through personal protective equipment, testing, and vaccines for frontline workers.

Impact of COVID-19 pandemic on health care workers (HCWs) in Sindh Province of Pakistan

BACKGROUND

In Pakistan, the COVID-19 outbreak posed a significant challenge for healthcare workers in the country's public hospitals. The HCWs faced several problems in terms of the COVID-19 pandemic. Therefore this study investigated how the COVID-19 pandemic has affected the medical staff at the public hospital in Sindh Province, Pakistan.

METHODS

In this study, a qualitative exploratory design was used. Semi-Structure interviews (SSI) were conducted by using an open-indeed questionnaire (OIQ) for data collection. An inductive approach was used for theoretical data analysis. A total of 320 HCWs participated to complete the criteria of the study from 10 different public hospitals.

RESULTS

The study result showed the Sindh public hospital's insufficient infrastructure, lack of health protective equipment, shortages of isolation rooms and beds, and emergencies during the COVID-19 pandemic caused HCWs to experience physical and psychological weariness, sleep disturbance, mental stress, and fear of infection.

CONCLUSION

The study concluded that public hospitals' insufficient infrastructure, furniture, emergency wards, and safety equipment during the COVID-19 pandemic significantly damaged HCWs' physical and psychological health, generating fear of infection and sleep disturbance. Additionally, Sindh healthcare workers' fear of illness and isolation may impair family connections.

Administrators' preparedness to address physician burnout before and during COVID-19

Occupational burnout has become widespread. The syndrome can be especially harmful in health care settings, affecting clinicians, organizational effectiveness, and patient safety. Certain approaches have proven helpful in some cases in combatting the syndrome. The coronavirus pandemic presented physicians with unique challenges, which appeared to have magnified work stress This national survey specifically explored interventions used by health care leaders to reduce burnout and whether these interventions proved effective during a pandemic. We also discuss effective and appropriate organizational measures to reduce physician burnout and its associated risks during crises.

Stigmatization, panic disorder, and death anxiety among patients of Covid-19: Fourth wave of pandemic in Pakistan

BACKGROUND

In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus.

METHODS

The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory.

RESULTS

Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates.

CONCLUSION

This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time.

Guidelines for Infection Control and Burnout Prevention in Healthcare Workers Responding to COVID-19

During the coronavirus disease 2019 (COVID-19) pandemic, frontline healthcare workers (HCWs) suffered more distress from the possibility of contracting the virus, quarantine, social stigma, and prejudice against their families. Many studies have investigated the impact of the pandemic on HCWs; however, studies or guidelines presenting strategies to overcome these challenges are lacking. As part of a 2020 research project supported by the Ministry of Health and Welfare, titled "Health impact assessment of healthcare workers undertaking coronavirus disease 2019 treatment and management in Korea: Identifying problems and researching effective solutions" (HC20C0003), we created guidelines to respond to serious problems posed by infection control. and burnout among HCWs during COVID-19 response measures throughout the extended pandemic period. We formulated the guidelines by means of a systematic review and collated them with the latest literature. The guidelines will highlight the gravity and impact of infection control and burnout among HCWs responding to COVID-19 and include potential prevention strategies, and they can be used as a reference in the event of another emerging infectious disease outbreak in the future.

The psychological impact, risk factors and coping strategies to COVID-19 pandemic on healthcare workers in the sub-Saharan Africa: a narrative review of existing literature

BACKGROUND

The ongoing COVID-19 pandemic has significantly impacted the physical and mental health of the general population worldwide, with healthcare workers at particular risk. The pandemic's effect on healthcare workers' mental well-being has been characterized by depression, anxiety, work-related stress, sleep disturbances, and post-traumatic stress disorder. Hence, protecting the mental well-being of healthcare workers (HCWs) is a considerable priority. This review aimed to determine risk factors for adverse mental health outcomes and protective or coping measures to mitigate the harmful effects of the COVID-19 crisis among HCWs in sub-Saharan Africa.

METHODS

We performed a literature search using PubMed, Google Scholar, Cochrane Library, and Embase for relevant materials. We obtained all articles published between March 2020 and April 2022 relevant to the subject of review and met pre-defined eligibility criteria. We selected 23 articles for initial screening and included 12 in the final review.

RESULT

A total of 5,323 participants in twelve studies, predominantly from Ethiopia (eight studies), one from Uganda, Cameroon, Mali, and Togo, fulfilled the eligibility criteria. Investigators found 16.3-71.9% of HCWs with depressive symptoms, 21.9-73.5% with anxiety symptoms, 15.5-63.7% experienced work-related stress symptoms, 12.4-77% experienced sleep disturbances, and 51.6-56.8% reported PTSD symptoms. Healthcare workers, working in emergency, intensive care units, pharmacies, and laboratories were at higher risk of adverse mental health impacts. HCWs had deep fear, anxious and stressed with the high transmission rate of the virus, high death rates, and lived in fear of infecting themselves and families. Other sources of fear and work-related stress were the lack of PPEs, availability of treatment and vaccines to protect themselves against the virus. HCWs faced stigma, abuse, financial problems, and lack of support from employers and communities.

CONCLUSION

The prevalence of depression, anxiety, insomnia, and PTSD in HCWs in sub-Saharan Africa during the COVID-19 pandemic has been high. Several organizational, community, and work-related challenges and interventions were identified, including improvement of workplace infrastructures, adoption of correct and shared infection control measures, provision of PPEs, social support, and implementation of resilience training programs. Setting up permanent multidisciplinary mental health teams at regional and national levels to deal with mental health and providing psychological support to HCWs, supported with long-term surveillance, are recommended.

Risk Communication in Early Containment of COVID-19 Pandemic in Iran: Implementation of the World Health Organization Strategic Preparedness and Response Plan (WHO-SPRP)

Background: Health systems must have functional and efficient preparedness and response plans to manage pandemics. Moreover, it is essential to adjust to changing circumstances and the dynamic character of pandemics. The World Health Organization (WHO) introduced the Strategic Preparedness and Response Plan (SPRP), emphasizing 144 measures across 10 pillars, helping governments prepare and respond to the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine how the Iranian health system, based on the WHO-SPRP, addresses strategic preparedness and response plan in the COVID-19 pandemic at the national level. Methods: The WHO-SPRP was adopted and translated into Persian by 2 bilingual natives. The chief of the health office requested that authorized officers complete the SPRP. Then, a meeting was held by officers of related units involved in COVID-19 management to address the SPRP at regional and national levels. Results: Our findings suggest that up to August 2020, effective risk communication and community engagement were not fully established. Our response plan lacked evidence-based information and educational messaging to consistently shape public opinion and impression of a respiratory pandemic. Conclusion: The Iranian health care system and services were almost able to address the SPRP and perform the major indicators that the WHO had proposed. However, special attention should be paid to risk communication and community engagement to empower informed decision-making by individuals and communities.

Socio-Occupational and Health Conditions in Intensive Care Unit (ICU) Professionals during the COVID-19 Pandemic in Spain

Objective: The aim of this research is to analyze the socio-occupational and health conditions of Intensive Care Units (ICU) health professionals during the COVID-19 pandemic in Spain. In addition, with regard to the working conditions (availability of personal protective equipment—PPE, workload and patient/professional ratio), this research aims to analyze the possible differences depending on the Spanish region that was sampled and their professional category, as well as their relationship with the characteristic symptoms of COVID-19 (myalgias and respiratory distress). Method: A cross-sectional study performed with an online questionnaire, which was spread throughout all of the Spanish autonomous communities/regions. Results: The sample consisted of 461 ICU professionals in Spain, of whom, 94% reported an increase in their workload, and 43% reported a patient/professional ratio that was higher than it usually is. The median professional experience in the ICU was 9.73 years, with 47% of them having less than 5 years of experience in it. About 80% had undergone some diagnostic tests. There is a significant difference in ‘Serology (+)’ in terms of sex, with males having a serology (+) in 26% of the cases and females having it in 13% of the cases (p = 0.011). Most of the professionals (80%) were concerned about a possible infection, and up to 96% were worried about infecting their family members. The most common COVID-19 symptom was a headache, with there being a higher incidence of this in women. Significant differences were observed with respect to the availability of appropriate PPE depending on the Spanish region (i.e., Cataluña had best rate of PPE availability) (p = 0.005). The higher incidence of myalgias and respiratory distress were associated with a lower availability of PPE and a higher patient/professional ratio. Conclusions: The ICU staff reported an increase in their workload, with an increase in the amount of staff who had less experience. A high percentage of them have suffered symptoms, although the proportion of positive tests was low. The most characteristic symptoms of COVID-19 seem to be related to the working conditions. The results show the socio-occupational and health conditions of Spanish ICU professionals during the pandemic and point to the need to establish occupational risk-prevention measures.

COVID-19 stress and wellbeing: A phenomenological qualitative study of Pakistani Medical Doctors

The COVID-19 stress and increased job pressure have largely affected healthcare professionals’ various life domains. This study particularly explores the effect of stress caused by treating COVID-19 patients on medical doctors’ wellbeing. To explore this phenomenon, we interviewed 12 doctors treating COVID-19 patients in hospitals of metropolitan cities in Pakistan. The thematic analysis using NVivo V.12 Plus software of interviews resulted in four major themes, COVID-19 Stressors, Effects of Stress, Nature and Personality, Stress Relievers, and Stress Coping Strategies. Physicians were physically and emotionally stressed as a result of the intense work. Although they were carrying a lot of pain and hurt on their insides, participants demonstrated a sense of professional determination to overcome obstacles. Physicians are currently dealing with their emotional issues, and they should have access to complete professional help to ensure their wellbeing. The COVID-19 pandemic’s mental health effects are anticipated to last far longer than the physical health effects. This study is well-positioned to investigate frontline physicians’ opinions and attitudes concerning the COVID-19 and its impact on their daily lives and mental health. This research will help implement context-specific innovative mental health solutions to help the frontline workers.

Fear of being infected with COVID-19 virus among the medical social workers and its relationship to their future orientation

COVID-19 has been studied extensively for its direct effects on healthcare workers. Despite this, very little is known about the effect of COVID-19 fear on future orientation. Studying medical social workers' fear of being infected with COVID-19 and their future orientation was the primary method used to examine this relationship. 204 Turkish medical social workers on the pandemic's front lines were included in the total sample. Social workers were found to be extremely concerned about contracting COVID-19. Although only gender is a significant predictor of the fear of contracting COVID-19 infection, the study also found that female social workers have a higher fear of infection than males. Also, no correlation exists between social workers' vaccination status and their fear of contracting COVID-19. There was a weak negative correlation between social workers' fear of contracting COVID-19 and their future orientation, but in general, social workers had a positive future orientation. Medical social workers and front-line health care providers can use these findings to develop effective and culturally appropriate intervention programs to reduce COVID-19 concerns and foster a forward-looking outlook.

Competence and Attitude of Family Physicians towards Sexuality Regarding Their Sexual Orientation, Age, or Having a Partner-Survey Study and Validation

BACKGROUND

The main objective of this study was to assess different aspects of family physicians (sex, age, sexual orientation, or having a partner) regarding their competencies, attitudes, and procedures towards their patients' sexuality. We also sought to develop a valid questionnaire to perform this task.

METHODS

A cross-sectional study was performed among family and community medicine physicians in southeast Spain.

RESULTS

A total of 259 family physicians participated. Overall, 69.9% were women, 80.7% were heterosexual, 80.7% had a partner, and 50.6% had not received specific sexology training. Homosexual physicians showed a slightly more positive attitude toward sexuality. Training in sexuality established differences in competencies and procedures, but no differences were found in the attitude regarding whether the physicians had a partner or their training. While younger ages were correlated with a more positive attitude, the global score was positively correlated with the age of the professionals.

CONCLUSIONS

Competences, attitudes, and knowledge of procedures do not depend on whether the professional has a partner, but there may be slight differences regarding attitude when considering the sexual orientation of the physicians. The attitude toward sexuality may not depend on previous training. Albeit younger family physicians have a more positive attitude, all providers become more involved with sexuality as they gain professional experience.

The Impacts of COVID-19 Pandemic on the Food Sector and on Supermarket Employees in France during the First Lockdown Period

During the first lockdown period due to the COVID-19 pandemic, from the 17 March 2020 to the 11 May 2020 in France, essential professionals (nursing staff, police officers, supermarket staff, etc.) continued to be physically present at their workplaces. The present study focuses on exploring impacts of the pandemic on supermarket staff and on the food sector in France: COVID transmission among supermarket workers, working conditions, food supply, etc. For that, two anonymous surveys were addressed to supermarket employees and to supermarket supervisors. In total, 1746 responses from employees and 171 responses from supervisors were recorded all over France. Over 70% of employees and almost 50% of supervisors were women and over 50% of employees were between 25 and 40 years old. The following main trends in terms of physical and psychological impacts are revealed: 7% of employees working during the lockdown reported having COVID, although a still poorly developed screening and lack of diagnostic tests during the first lockdown should be kept in mind. The working conditions changed; higher work load, a more stressful environment, inappropriate client attitude, a lack of recognition, fatigue, and shortages were reported. A lack of government recognition, namely no prime allocations to supermarket staff during the lockdown period, is also often mentioned. Finally, no priority was given for store employees in terms of childcare.

State and trait anxiety among medical staff during the first month of COVID-19 pandemic: A sample from Turkey

OBJECTIVES

During the COVID-19 pandemic, excessive workload, a rapidly changing workplace environment, the danger of carrying the virus and transmitting the disease to their families, relatives and those they live with creates stress for the medical workers. In our study, we aimed to evaluate the state and trait anxiety levels of healthcare professionals who encounter patients with suspected COVID-19 infection and related factors.

METHOD

Data were collected from healthcare professionals working with patients diagnosed or suspected with COVID-19 via online self-report questionnaire between 9-19 April 2020. The state (STAI-S) and trait anxiety (STAI-T) scale was used to measure anxiety.

RESULTS

A total of 291 healthcare professionals, 216 women and 75 men, participated in the study. Women's state and trait anxiety were significantly higher than men's. 11 participants without any lifetime psychiatric illness experienced psychiatric symptoms and consulted to a psychiatrist. The state anxiety of those who have children, nurses and those working in branches directly related to the pandemic (Infectious Diseases, Respiratory Diseases, Emergency Medicine, Internal Medicine, Radiology, Anesthesiology and Reanimation) was higher than others. The state anxiety of those who thought they were not protected with personal protective equipment and those who did not stay in their own home was higher than others.

CONCLUSIONS

At the forefront of the fight against COVID-19, there are medical personnel who pay a serious psychological cost. Especially in terms of anxiety, we should pay attention to women, workers with children, nurses and people working in branches that are directly related to pandemics.

Resilience among health care workers while working during a pandemic: A systematic review and meta synthesis of qualitative studies

Background

Aim

Method

Results

Conclusion

Medical Students and Professionals Facing the COVID-19 Pandemic: A Cross-Sectional Survey Study about Similarities and Differences

This study aimed at exploring the emotional reaction that medical students (MS) and professionals have faced during the COVID-19 pandemic and investigating the differences between the two groups. A total of 362 MS and 330 professionals filled in an online survey during the second outbreak of the COVID-19 pandemic in Italy. The outcome measures were psychological distress with the General Health Questionnaire, stress, fear for themselves, fear for family members and cohabitants, perceived control, anger, loneliness, and feeling abandoned by institutions with Visual Analog Scales (VAS) and two open-ended questions about their perceived difficulties and the perceived consequences of the pandemic. The results showed that the level of distress among the two groups was above the threshold (MS mean: 21.85; professionals mean: 21.25). The means of the VAS of MS and professionals showed different results for the two groups, and we analyzed them with independent samples t-tests and linear regressions. MS reported higher levels of perceived loneliness (t(673.177) = −1.970, p < 0.05), while physicians reported more fear for themselves (t(655.183) = 4.799, p < 0.001), anger (t(690) = 2.096, p < 0.05), and feeling abandoned by the institutions (t(690) = 7.296, p < 0.001). The open questions were analyzed considering the most frequent words used to describe their perceived difficulties and consequences; the specificity analysis emphasizes the differences in the words used by the two groups. In conclusion, MS and physicians reported similar levels of psychological symptoms. Physicians were mostly worried about themselves, they were afraid of getting infected, while MS suffered from loneliness and the missed possibilities concerning their education.

Pandemics and the Impact on Physician Mental Health: A Systematic Review

Physician mental health is a major area of concern with physician burnout on the rise, while at the same time pandemics are becoming more frequent and serious in nature. This combination of physician burnout and pandemics has the potential for serious negative implications for physicians, patients, and health care organizations. Thus, we conduct a systematic review that examines the effect of pandemics on physician mental health using the burnout cascade as a framework. We identified 30 quantitative studies for inclusion. We find that Stages 4 and 5 of the burnout cascade are particularly troublesome with physicians experiencing high levels of anxiety and depression. Furthermore, we find in the degradation phase that physicians experience stigma which may intensify other negative effects. Physicians who are women, younger, and have less training are more susceptible to the negative effects of pandemics. We discuss overall implications and recommendations for future research.

Wellbeing and Stress Coping among Healthcare and Pharmacy Workers: Experiences during the First COVID-19 Lockdown in Lithuania

(1) Background. During the COVID-19 pandemic, healthcare professionals faced psychological and social challenges in addition to a sharp increase in workload. The aim of this work was to reveal how healthcare and pharmacy workers assessed their wellbeing and the methods of coping they employed to overcome stress during quarantine. (2) Methods. The mixed-method study was conducted between August and October 2020, integrating quantitative (n = 967) and qualitative (n = 27) strategies. Doctors, nurses, healthcare administrative staff, pharmacy specialists, and other employees of the healthcare system were interviewed retrospectively about their experiences during and following lockdown (March–June 2020). (3) Results. Overall, 38.7% of the respondents reported a decrease in psychological wellbeing, while 23.4% of the respondents reported a decrease in physical wellbeing during quarantine. The healthcare professionals’ narratives identified a shift from nonspecific fears at the beginning of the pandemic to the more concrete fear of contracting COVID-19, of infecting others, and about their loved ones, as well as undifferentiated fear. Multivariate analysis revealed that a subjective decrease in wellbeing was typical in professionals who had had direct contact with patients infected with COVID-19, as well as those with stronger fears, and those who were more likely to employ compulsive distancing and substance use as ways to cope with stress. (3) Conclusions. The results suggest that lockdown had a negative impact on healthcare workers’ wellbeing during the first pandemic wave in 2020.

The Impact of the COVID-19 Pandemic on the Psychological Well-being of Healthcare Workers in Obstetrics and Gynaecology: An Observational Study at an Apex Institute

Background and objective

The coronavirus disease 2019 (COVID-19) pandemic has affected the health, social, and economic sectors all over the world. With a view to assessing the impact of COVID-19 on the mental health of healthcare workers (HCWs), we conducted a study to find out the incidence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among HCWs.

Material and methods

This was an observational cross-sectional study conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of Psychiatry at AIIMS, New Delhi from March 2021 to June 2021. One hundred HCWs working in the Department of Obstetrics and Gynaecology were surveyed using a set of semi-structured interview schedules and structured questionnaires distributed via email or manually. The structured questionnaire included the demographic profile; other baseline information; the 42-item Depression, Anxiety, and Stress Scale (DASS-42); and the Impact of Event Scale-Revised (IES-R) instrument. Data analysis was carried out using the statistical package STATA version 14.0 (StataCorp LLC, College Station, TX).

Results

A total of 100 HCWs participated in the study, out of which 39 (39%), 45 (45%), and 16 (16%) were doctors, nursing staff, and supporting staff, respectively. Overall, 92 (92%) of the participants were women, and the mean age of the participants was 29.87 ±4.85 years. Out of the 100 participants, 17 (17%), 25 (25%), 13 (13%), and two (2%) participants had depression, anxiety, stress, and PTSD, respectively. Occupation-wise, among the nursing staff, doctors, and supporting staff, the incidence of depression was 24.4%, 15.4%, 0.0%, respectively; the anxiety rate was 33.3%, 25.6%, and 0.0%, respectively; and the rate of stress was 17.8%, 12.8%, and 0.0%, respectively. The IES-R score was significantly higher among unmarried as compared to married participants (2.70 ±7.935 vs. 1.60 ±3.583, p=0.000). Participants living in joint families had a higher DASS-42 score (DASS-D: 4.00 ±5.299 vs. 3.77 ±7.727, p=0.889; DASS-A: 4.31 ±4.398 vs. 4.12 ±7.496, p=0.905; DASS-S: 4.08 ±4.816 vs. 3.88 ±7.567, p=0.016) and lower IES-R score (1.31 ±4.922 vs. 2.66 ±9.947, p=0.752) as compared to those living in nuclear families. Depression (4.86 ±8.165 vs. 2.00 ±4.388, p=0.054), anxiety (5.31 ±7.538 vs. 2.14 ±4.704, p=0.024), stress (5.20 ±7.651 vs. 1.67 ±4.733, p=0.014) and PTSD (3.61 ±10.900 vs. 1.44 ±2.634, p=0.245) were all higher among HCWs having exposure to COVID-19 more than 10 hours per week compared to participants with an exposure of less than 10 hours per week. The participants having psychiatric illness in the family showed significantly higher mean values for DASS-42 (DASS-D: 20.00 ±26.870 vs. 3.50 ±6.264, p=0.001; DASS-A: 18.50 ±20.506 vs. 3.88 ±6.215, p=0.002; DASS-S: 18.00 ±21.213 vs. 3.64 ±6.346, p=0.003) as compared to those without any psychiatric illness in the family.

Conclusion

Based on our findings, occupational and environmental factors at the workplace play a key role in mental health outcomes, and COVID-19 has had a significant impact on the mental health of HCWs. Furthermore, we have also observed that effective planning can significantly reduce mental stress.

Investigating Predictors of Psychological Distress for Healthcare Workers in a Major Saudi COVID-19 Center

This study investigated the relationship between fear of COVID-19, previous exposure to COVID-19, perceived vulnerability to disease, sleep quality, and psychological distress among healthcare workers (HCWs) in Taif city in Saudi Arabia, which has a population of 702,000 people. A cross-sectional study design was adopted. HCWs (n = 202) completed a survey containing the Fear of COVID-19 Scale (FCV-19S), Perceived Vulnerability to Disease (PVD), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale (DASS-21). FCV-19S and sleep quality were significant predictors for psychological distress. Female gender was a significant predictor for depression and stress. Single, divorced, and widowed marital status were predictive for anxiety. FCV-19S was weakly correlated with PVD but moderately with depression, anxiety, and stress. Of the two PVD subscales, perceived infectability was weakly correlated with psychological distress. PVD and previous experience with COVID-19 were not significant predictors. Sleep quality and FCV-19S were major predictors of psychological distress. Findings indicated that poor sleep quality was strongly associated with psychological distress, while fear of COVID-19 had a moderate association. Such results support the need to design and implement psychological programs to assist HCWs in dealing with the psychological impact of this ongoing pandemic.

Pandemic experiences of family physicians infected with the COVID-19: a qualitative study

OBJECTIVES

Family physicians are usually patients' first point of contact with primary healthcare. This study aims to understand the experiences of family physicians who were infected with the COVID-19 and started working again.

STUDY DESIGN AND SETTING

This qualitative study was conducted on 18 different family health centres in Adana. Data collection was performed through 18 interviews, each lasting an average of 46.6 min. The data were analysed using the qualitative content analysis method.

PARTICIPANTS

The study included 18 family physicians (9 women and 9 men), and there were no significant differences between them by gender or seniority.

RESULTS

The results of the study have shown that family physicians who were infected with the COVID-19 and started working again have experienced high levels of anxiety at work. In addition, due to the fear of being reinfected, family physicians' social relations with their colleagues have decreased. The results are discussed under two themes: anxieties and social relationships.

CONCLUSION

In primary healthcare services, family physicians play a vital role during the pandemic. Many family physicians either lost their lives or got infected with the virus, recovered and worked in difficult conditions for a long time. Understanding the experiences of family physicians during the pandemic when they underwent COVID-19 and after they recovered could help to protect their psychological health and improve their work conditions.

Health care workers' experiences during the COVID-19 pandemic: a scoping review

BACKGROUND

COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included.

RESULTS

161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries.

DISCUSSION

This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances.

CONCLUSIONS

Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.

The Workplace and Psychosocial Experiences of Australian Senior Doctors during the COVID-19 Pandemic: A Qualitative Study

The coronavirus disease 2019 (COVID-19) pandemic has had significant mental health impacts among healthcare workers (HCWs), related to resource scarcity, risky work environments, and poor supports. Understanding the unique challenges experienced by senior doctors and identifying strategies for support will assist doctors facing such crises into the future. A cross-sectional, national, online survey was conducted during the second wave of the Australian COVID-19 pandemic. Inductive content analysis was used to examine data reporting workplace and psychosocial impacts of the pandemic. Of 9518 responses, 1083 senior doctors responded to one or more free-text questions. Of the senior doctors, 752 were women and 973 resided in Victoria. Four themes were identified: (1) work-life challenges; (2) poor workplace safety, support, and culture; (3) poor political leadership, planning and support; and (4) media and community responses. Key issues impacting mental health included supporting staff wellbeing, moral injury related to poorer quality patient care, feeling unheard and undervalued within the workplace, and pandemic ill-preparedness. Senior doctors desired better crisis preparedness, HCW representation, greater leadership, and accessible, authentic psychological wellbeing support services from workplace organisations and government. The pandemic has had significant impacts on senior doctors. The sustainability of the healthcare system requires interventions designed to protect workforce wellbeing.

Exploring rural doctors’ early experiences of coping with the emerging COVID‐19 pandemic

Purpose

To understand how rural doctors (physicians) responded to the emerging COVID‐19 pandemic and their strategies for coping.

Methods

Early in the pandemic doctors (physicians) who practise rural and remote medicine were invited to participate through existing rural doctors’ networks. Thirteen semi‐structured interviews were conducted with rural doctors from 11 countries. Interviews were transcribed verbatim and coded using NVivo. A thematic analysis was used to identify common ideas and narratives.

Findings

Participants’ accounts described highly adaptable and resourceful responses to address the crisis. Rapid changes to organizational and clinical practices were implemented, at a time of uncertainty, anxiety, and fear, and with limited information and resources. Strong relationships and commitment to their colleagues and communities were integral to shaping and sustaining these doctors’ responses. We identified five common themes underpinning rural doctors’ shared experiences: (1) caring for patients in a context of uncertainty, fear, and anxiety; (2) practical solutions through improvising and being resourceful; (3) gaining community trust and cooperation; (4) adapting to unrelenting pressures; and (5) reaffirming commitments. These themes are discussed in relation to the Lazarus and Folkman stress and coping model.

Conclusions

With limited resources and support, these rural doctors’ practical responses to the COVID‐19 crisis underscore strong problem‐focused coping strategies and shared commitments to their communities, patients, and colleagues. They drew support from sharing experiences with peers (emotion‐focused coping) and finding positive meanings in their experiences (meaning‐based coping). The psychosocial impact on rural doctors working at the limits of their adaptive resources is an ongoing concern.

Online Learning Methods during COVID-19 Pandemic: On an Indonesian Nursing Student Experience

BACKGROUND: The policy of limiting community activities during the COVID-19 pandemic affects the learning process. The expectation of the online learning methods is a stressor for the students. For this reason, it is necessary to explore the experiences of the students during online learning. AIM: The purpose of this study was to explore the experiences, especially hopes and needs of the students, while undergoing online learning during the COVID-19 pandemic. METHODS: This study applied a qualitative approach with a phenomenological design. The participants involved were six health students from the Faculty of Health Sciences in Yogyakarta, Indonesia. They were recruited using a purposive sampling technique. Data were collected through online interview. The data were then analyzed using the Colaizzi technique. RESULTS: The results illustrated that there are two themes of the students’ expectations during the learning, including the expectations of the learning process and the expectations of the lecturers. There are two themes for the students’ needs during the online learning, namely, family support and internet network support. The students expect that the learning process is carried out with a combination of learning methods and the lecturers to understand the problems faced by students. CONCLUSION: The students need the support of a good internet network and family support so that they can participate in the online learning well.

Work-based concerns of Australian frontline healthcare workers during the first wave of the COVID-19 pandemic

OBJECTIVE

This research sought to gauge the extent to which doctors, nurses and paramedics in Australia were concerned about contracting SARS-CoV-2 during the country's first wave of the virus in April 2020.

METHODS

Australian registered doctors, nurses and paramedics (n=580) completed an online questionnaire during April 16-30, 2020 (period immediately following the highest four-week period (first wave) of SARS-CoV-2 confirmed cases in Australia).

RESULTS

During April 2020, two-thirds of participants felt it was likely they would contract SARS-CoV-2 at work. Half the participants suggested Personal Protective Equipment (PPE) supplies were inadequate for them to safely perform their job, with two-thirds suggesting management advised them to alter normal PPE use. One-third of participants suggested they were dissatisfied with their employer's communication of COVID-19 related information. Conclusions and implications for public health: After reports of PPE shortages during Australia's first SARS-CoV-2 wave, and suggestions access to PPE was still limited during Australia's second wave five months later, we must forecast for this and future pandemics ensuring adequate access to PPE for frontline healthcare workers. Further, ensuring consistent and standardised pathways for communication to staff (acknowledging the reality that information may rapidly change) will help alleviate frustration and anxiety.

How South African Families Protected Themselves during the COVID-19 Pandemic: A Qualitative Study

The World Health Organization (WHO) reported a cluster of cases of ‘viral pneumonia’—‘Coronavirus Disease 2019’ (COVID-19)—in Wuhan City, the People’s Republic of China on 31 December 2019. To curb the spread of the virus, various containment measures were introduced. However, no study has explored how families protected themselves during the pandemic. Therefore, this study explored how families protected themselves during the COVID-19 pandemic using a qualitative exploratory design. Thirty-one adult participants, representing families in the Western Cape province of South Africa, were virtually interviewed. The sampling approach was both convenient and snowball. The data were analysed using thematic analysis. The results show that families followed and adapted to the mainstream protection measures as implemented by the South African government but in addition believed that adherence to non-pharmaceutical interventions would protect them from contracting the virus. Therefore, the government and other stakeholders should support families in making it easier to protect themselves during the current and future pandemic(s).

COVID-19 infection and its consequences among surgical oncology patients: A systematic analysis, meta-analysis and meta-regression

We conducted this meta‐analysis to address the outcomes in cancer patients after oncologic surgery during COVID‐19 pandemic. The primary endpoint was the COVID‐19–related mortality rate. Higher body mass index was significantly and negatively associated with higher all‐cause mortality and in‐hospital COVID‐19 infection rates. Male sex, preoperative respiratory disease, and smoking history were positively and significantly associated with increased all‐cause mortality rates. Furthermore, male sex was positively and significantly associated with the COVID‐19 infection rate.

Fear of COVID-19, poor quality of sleep, irritability, and intention to quit school among nursing students: A cross-sectional study

PURPOSE

This study aims to assess the fear of coronavirus disease 2019 (COVID-19) and its influence on the students' fear of COVID-19 and intention to leave nursing school.

DESIGN AND METHODS

This study employed a cross-sectional design using self-report questionnaires distributed to 261 nursing students from the Philippines.

FINDINGS

The first-year nursing students are found to be the most fearful among the group. The students' fear of COVID-19 is associated with their high irritability, poor sleep quality, and desire to quit nursing school.

PRACTICE IMPLICATIONS

Students are perturbed by the pandemic and teachers should implement supportive, teaching-learning strategies to address the student's needs.

Wounded Healers of the Pandemic: A Qualitative Study on Mental Health and Protective Factors of Physicians Who Recovered from COVID-19

Backgroud

Physicians are at a high risk of being infected by coronavirus disease (COVID-19).

Methodology

Our aim was to understand lived experiences of physicians who recovered from COVID-19 by focusing on mental health and psycho-social protective factors through a qualitative study using a narrative approach. A semi-structured questionnaire was outlined referring to literature and seeking experts' opinions. Telephonic interviews were conducted after fulfilling the inclusion criteria. Interviews were transcribed verbatim, and narratives were written and interpreted.

Results

Mental health concerns identified from the narratives of five physicians are fear of infecting others, feeling guilty of transmitting infection, stigma, loneliness, and worry about complications after recovery. Social support, faith in a higher power, sense of purpose, and resilience were their sources of strength.

Conclusion

Given the vulnerability and professional commitment to serve people, there is an urgent need to address their mental health needs. Support groups and having interactions with mental health professionals during periods of isolation are some recommendations.

Mental health condition of physicians working frontline with COVID-19 patients in Bangladesh

BACKGROUND

The impact of the unpredictable COVID-19 pandemic had triggered new challenges for mental health. This quick survey aimed to identify the mental health status of physicians who served the people during COVID-19 in Bangladesh.

METHODOLOGY

The cross sectional survey was conducted adopting a quantitative approach and using an online questionnaire through Facebook Platform Group. Data was collected from August-October, 2020, on socio-demographic status, information on COVID-19 and questionnaires about Depression Anxiety Stress Scale (DASS-21). A total of 395 participants were enrolled from all eight administrative divisions of Bangladesh.

RESULT

Our study reported a higher prevalence of depression (55.3%), anxiety (35.2%), and stress (48.4%) among 347 participants. Female physicians were found to have more stress (OR = 2.16, 95% CI: 1.09 - 4.30) compared to the male. Physicians who were previously diagnosed as mentally ill were found to be significantly more depressed (OR = 3.45, 95% CI: 1.07 - 11.10) and stressed (OR = 4.22, 95% CI: 1.48 - 12.02) compared to them who did not. Along with that, having a chronic disease, working in non-government and COVID hospitals significantly contributed to poor mental health outcomes.

CONCLUSION

The study findings denoted that, the mental health of physicians was deeply affected by the pandemic situation. The availability of appropriate mental health support will help foster resilience by giving them the ability and confidence to manage crisis moments like the COVID-19 pandemic.

The impact of COVID-19 on supply decision-makers: the case of personal protective equipment in Spanish hospitals

BACKGROUND

The COVID-19 pandemic has been recognized as a trigger for redefining supply chains at the global level, and has created an intense debate within the academic community and among policy-makers and practitioners. Among other industries, health care has been dramatically hit by the scarcity of "medical products," specifically for personal protective equipment (PPE-like), due to supply chain disruptions coupled with dramatically increased demand. We aimed to analyze how the scarcity of PPE-like during the COVID-19 pandemic has modified the behavior of decision-makers in the PPE-like supply chain at the hospital level, and to explore what changes could be implemented to cope with future PPE-like shortages.

METHODS

We used an explorative approach based on semi-structured interviews with key informants in the Spanish health care industry. More specifically, we held interviews to industry experts at three hospitals in three Spanish regions to map the consequences of the COVID-19 pandemic onto the buying decision-making process.

RESULTS

Different strategies were developed by decision-makers at hospitals before, during, and after the first wave of the COVID-19 pandemic in Spain. Our paper offers two main findings: a) decision-makers changed their purchasing behavior from a cost main driver to guaranteeing the availability of supplies; b) they supported the idea of giving more "strategic autonomy" to Spain or Europe through back and nearshoring decisions.

CONCLUSIONS

This paper could be of interest to health care management at the national, regional, and hospital levels, as well as for policy-makers, since it could help to establish and configure policies to support the sourcing of medical products (specifically PPE-like) to anticipate potential supply disruptions. Our paper contributes to the limited existing literature on how purchasing strategies at the decision-maker level and supply vary in the health care industry when a public health crisis appears, and what potential solutions might be for policy-makers and practitioners involved in the health care industry.

Depression among health workers caring for patients with COVID-19 in Egypt

Background

Health care workers caring for patients with COVID-19 pandemic are prone to extraordinary stressors and psychological problems. The aim of this study was to estimate the prevalence and risk factors of major depressive disorder among health care providers who are caring for patients with COVID-19.

Methods

Two hundred-seventy of health care workers were screened for depressive symptoms by DASS-21 Questionnaire. Only 152 of the participants accepted to be interviewed using SCID-I for diagnosis of major depressive disorder.

Results

According to DASS-21, 28.1% of HCWs had mild-to-moderate depressive symptoms, and 64.8% with severe symptoms. Of 152 who were interviewed using SCID-I, 74.3% were diagnosed with major depression disorder.

Young age, decreased sleep hours, female sex, past history of a psychiatric disease, fear of COVID-19 infection for themselves or their relatives, and fear of death with COVID-19 for themselves or their relatives were significant predictors for major depressive disorder and its severity.

Conclusion

Major depressive disorder is common among HCWs during COVID-19 pandemic. Screening for depression, particularly for young females, and early treatment are recommended.

Stigmatization spreads faster than the virus. Viruses do not discriminate, and neither should we." Combatting the stigmatization surrounding coronavirus disease (COVID-19) pandemic

Infectious diseases are one of the most important problems of the last century. Epidemics have caused the stigmatization of managers, healthcare professionals, and those likely to be infected throughout history. Although many infectious diseases caused stigmas both in the past and today, a new name is added to the list of epidemics in various regions in the world each year and the masses become alerted. The latest disease added to the list is the new coronavirus (COVID-19). Today, because of the COVID-19 pandemic, which has influenced the whole world, the risk of social stigmatization reappears. In this context, it is very important to take the necessary measures to prevent stigmatization and to plan the interventions.

The mental health of Australian medical practitioners during Covid-19

OBJECTIVES

To ascertain whether doctors were experiencing higher rates of distress during Covid-19 and whether this was impacted by demographic factors. Our hypotheses were that being a junior doctor, having a previous mental health diagnosis and treating Covid-19 positive patients would predict higher rates of distress.

METHODS

Cross-sectional survey conducted via Survey Monkey. Voluntary participants were recruited from the mailing list of a national-based referral service for doctors to psychiatrists. Distress was measured using the Kessler Psychological Distress Scale (K10). Demographic factors were analysed for predictive value of a higher rating on the K10. Areas of concern in relation to Covid-19 and preference for support services were measured on a Likert scale and compared to levels of distress.

RESULTS

The rate of very high distress was 15%. Being a junior doctor and having a previous mental health diagnosis were predictive factors of a higher K10 score. K10 was not affected by likelihood of contact with Covid-19-positive patients. Social isolation had a larger impact on mental health in the context of a previous psychiatric diagnosis. Face-to-face assessments were preferred.

CONCLUSIONS

Rates of distress in doctors have been higher than baseline during Covid-19. Some groups have been particularly vulnerable.

Primary health care physicians' perspective on COVID-19 pandemic management in Qatar: a web-based survey

OBJECTIVES

To assess primary care physicians' satisfaction towards COVID-19 pandemic management in Qatar and to identify the associated factors with their satisfaction.

DESIGN

A cross-sectional web-based survey conducted from 1 June to 30 July 2020.

SETTING

All the 27 public primary healthcare centres in Qatar.

PARTICIPANTS

294 primary care physicians working in the publicly run primary healthcare corporation in Qatar.

PRIMARY OUTCOME MEASURES

Overall satisfaction towards COVID-19 management in Qatar and satisfaction towards each aspect of this management including COVID-19 clinical practice guidelines, psychological support, team dynamics, work safety as well as institutional and governmental regulations.

RESULTS

294 primary care physicians participated in the survey with a response rate of 65%. Overall satisfaction of physicians towards COVID-19 19 management at Primary Health Care Corporation was 77%. The highest satisfaction was towards institutional and governmental support while it was the lowest towards the corporation case definition and management of COVID-19 guidelines. Female physicians were less satisfied with psychological support in comparison to males (64.1% and 51% respectively, p=0.049). Overall satisfaction towards case definition and management of COVID-19 guidelines were strongly correlated with their clarity, updating these guidelines in due time and applicability of the guidelines (r=0.759 P<0.001; r=0.701 P<0.001; r=0.698 P<0.001) respectively, while satisfaction towards work safety was strongly correlated with availability and quality of Personal Protective Equipment provided (r=0.83 P<0.001 and r=0.811 P<0.001 respectively).

CONCLUSION

Most primary care physicians in Qatar who responded to the survey were satisfied with the COVID-19 guidelines developed rapidly in response to this pandemic. Availability and quality of PPE were a particular concern. The clinicians who were less satisfied were younger and female.

Willingness to Work amongst Australian Frontline Healthcare Workers during Australia's First Wave of Covid-19 Community Transmission: Results of an Online Survey

OBJECTIVES

The majority of research investigating healthcare workers' (HCWs) willingness to work during public health emergencies, asks participants to forecast their perceptions based on hypothetical emergencies, rather than in response to the actual public health emergencies they have experienced. This research explored frontline HCWs willingness to work during Australia's first wave of the COVID-19 pandemic among frontline HCWs.

METHODS

Participants (n = 580) completed an online questionnaire regarding their willingness to work during the pandemic.

RESULTS

A total of 42% of participants reported being less willing to work during the pandemic compared to before. Availability of personal protective equipment (PPE), concern expressed by family members, and viral exposure were significant barriers. A third of participants disagreed that some level of occupational risk for exposure to infectious disease was acceptable while a quarter of participants had received communications from their workplace concerning obligations to work during COVID-19.

CONCLUSIONS

The COVID-19 pandemic has impacted Australian frontline HCWs' willingness to work. Scarcity of PPE and exposure to the virus were the most cited reasons impacting on willingness to work. Appropriate policies and practices should be implemented and communicated efficiently to frontline HCW's. This research provides insight into the lived experiences of Australian healthcare professionals' willingness to work during a pandemic.

Association of Working Environment and Anxiety Levels in Clinical Professionals During the COVID-19 Pandemic

Introduction Coronavirus disease 2019 (COVID-19) is a global pandemic and has become a major life-threatening challenge. The sudden and fast spread of the COVID-19 pandemic worldwide caused a sudden increase in the workload of health care workers in parallel with the possible increase in mortality rates and the spread of this disease to a large number of people. Clinicians, who are our frontline warriors, are not only at high risk of catching COVID-19, but their mental health is also at stake. The objective of this study was to determine the prevalence of anxiety and its association with the working environment in clinical professionals during the COVID-19 pandemic. Methods This cross-sectional study collected data from 400 medical doctors through an online survey, carried out for six months. The anxiety of participants was assessed by using the Zung Self Rating anxiety scale (SAS). An anxiety index of greater than or equal to 50 was marked as anxious. Descriptive chi-square analysis and correlation analysis were used. Results This study found that out of a total, 20.1% of the participants suffered from anxiety. Anxiety was found to be positively associated with sociodemographic factors like the age of the doctor (p=0.001), their gender (p=0.000), their working environment (p=0.005), working in basic healthcare units (p=0.015), patient load per week (p=0.005), personal protective equipment (PPE) availability to doctor according to WHO guidelines (p=0.007), and patient compliance with doctors' orders (p=0.009). Conclusion We conclude that professional healthcare workers suffered from anxiety due to working conditions in the COVID-19 pandemic. Specific interventions and steps such as improving staffing and resources, policies to ensure fair distribution of working hours and rest breaks, workplace protections, work-family balance, health professional's emotional stability, and long-term benefits should be taken so as to minimize the lasting effects of these factors.

Development and Validation of a Chinese Version of a School-to-Work Transition Anxiety Scale for Healthcare Students

OBJECTIVE

The aim of this paper was to develop an appropriate scale measuring healthcare students' anxiety during the transition from school to work.

METHODS

After an extensive literature review and panel discussion to prove the face validity and content validity, the initial item pool was reduced to 52 items. In a pilot study, a sample of four hundred and twenty-four healthcare students participated, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used. Psychometric properties-construct validity, convergent validity, discriminant validity, goodness of fit, and reliabilities-were also analyzed.

RESULTS

After the use of EFA, the 52 items were reduced to 31 items in four factors, with 66.70% of the total variance explained. The Cronbach's alpha values ranged between 0.91 and 0.93. The study also used CFA to validate the EFA model, and the results demonstrated that with the same thirty-one items in a 7-point Likert scale, the model was a better fit in four factors: "inexperience in professional knowledge and skills" (nine items; factor loadings: 0.642-0.867; 43.72% of the variance explained), "fear of death" (eight items; factor loadings: 0.745-0.831; 9.94% of the variance explained), "fear of being infected" (eight items; factor loadings: 0.678-0.866; 7.86% of the variance explained), and "interpersonal interactions" (six items; factor loadings: 0.704-0.913; 5.18% of the variance explained). The CFA model demonstrated a good model fit in the χ²/df ratio (1.17; p = 0.016), CFI (0.99), TFI (0.99), and RMSEA (0.02). The composite reliabilities ranged from 0.89 to 0.92, confirming the StWTA-HS scale's stability and internal consistency. The convergent validity and discriminant validity were also confirmed. The StWTA-HS scale has been proven to be a stable scale to measure healthcare students' school-to-work transition anxiety.

Perception, preparedness and response of health care personals towards COVID-19 pandemic in Azad Jammu & Kashmir, Pakistan: A cross sectional interview based study

Objective

To assess the state of knowledge, perception, preparedness and satisfaction level of health care personals (HCPs) in Azad Jammu & Kashmir (AJK) towards COVID-19.

Study design

It was cross sectional survey conducted by personal interviews.

Methodology

The study was conducted by interviewing 302 HCPs from 7 major district headquarter hospitals of AJK from May to September 2020. The questionnaire included 29 questions about demography, perception, training, preparedness, knowledge and awareness of HCPs about COVID-19. The data was encoded and analyzed statistically.

Results

Majority of the respondents (78.5%) believed that corona-virus is a serious health threat. However, 10.6% perceived it as a bio-weapon and 4.3% as not dangerous. About 10% of doctors were not considering it very dangerous compared to 1% of paramedics and 2.5% of the supporting staff (P = 0.003). About 55% of the respondents showed confidence of the steps taken by government for prevention of COVID-19 while 45% had an opposite view. More than 70% of the participants had no formal training and the ratio of trained personals was significantly higher (0.018) in paramedical staff (33%) than doctors (15%). About 53% of the respondents were not satisfied with the provision of PPEs and 64% were not satisfied with their work and wages situation. Majority of the respondents (97%) were observed to follow the protocols for personal protection.

Conclusion

Majority of HCPs perceive covid-19 as a serious health concern. However, most of the HCPs are neither well trained for the current pandemic nor fully satisfied about personal protection, work load, and wages.

Comparing the Impact of COVID-19 on Nurses' Turnover Intentions before and during the Pandemic in Qatar

Background: Although several studies examining nurses’ turnover intentions have been conducted, few studies have been conducted to explore how COVID-19 contributes to nurses’ turnover intentions. This study aims to compare nurses’ turnover (TO) intentions before and during COVID-19. Methods: The cross-sectional study was conducted using the Turnover Intention Scale (TIS-6) and a convenience sample of participants from the largest healthcare provider in Qatar between August and September 2020. Results: A total of 512 nurses were included in the final analysis. The majority were between 31 and 40 years of age (61.5%), 67.6% were females, 76.4% were married, 79.7% had a BSN, 43% had less than 5 years of experience, and 60.4% had worked in COVID-19 designated facilities. The turnover intentions were higher compared with before COVID-19 (p < 0.01). Conclusion: Nurses in Qatar have higher TO intentions during COVID-19. The participants’ characteristics and stress levels are playing a major role in nurses’ decision to leave during COVID-19. Understanding the factors that contribute to turnover intentions is crucial for workforce planning, especially during pandemics.

Fear of COVID-19 and workplace phobia among Pakistani doctors: A survey study

BACKGROUND

The novel coronavirus disease-2019 (COVID-19) has seriously affected the lives of millions of people across the world. It has also heavily burdened healthcare professionals and the virus poses serious risks for their personal and professional lives. Therefore, the present study examined the associations between fear of COVID-19 and workplace phobia among doctors in Pakistan during the COVID-19 pandemic.

METHODS

An online survey was conducted among 421 doctors in Pakistan between April 10 and May 25, 2020. The Workplace Phobia Scale (WPS) and the Fear of COVID-19 Scale (FCV-19S) were the main psychometric instruments used in this study.

RESULTS

There was a significant positive relationship between fear of COVID-19 and workplace panic anxiety and workplace avoidance behavior. Significantly higher fear of COVID-19 was found among (i) females compared to males, (ii) doctors with 5 years or less of work experience compared to those with more than 5 years, and (iii) postgraduate trainees compared with other ranks. Two groups (doctors who were above 30 years old and postgraduate trainees) were found to have higher levels of workplace phobia compared to their counterparts. Doctors with severe levels of fear of COVID-19 had significantly higher levels of workplace panic anxiety and workplace avoidance behavior.

CONCLUSIONS

Fear of COVID-19 was significantly associated with workplace phobia which may negatively affect doctors' performance. Therefore, important steps are needed to protect doctors' health by providing sufficient resources to allay their fears and anxieties which consequently help them in carrying out their frontline duties in response to the COVID-19 pandemic.

We're Not Gonna Fall: Depressive Complaints, Personal Resilience, Team Social Climate, and Worries about Infections among Hospital Workers during a Pandemic

Maintaining hospital workers' psychological health is essential for hospitals' capacities to sustain organizational functioning during the COVID-19 pandemic. Workers' personal resilience can be an important factor in preserving psychological health, but how this exactly works in high stakes situations, such as the COVID-19 pandemic, requires further exploration. Similarly, the role of team social climate as contributor to individual psychological health seems obvious, but how it exactly prevents workers from developing depressive complaints in prolonged crises remains under investigated. The present paper therefore applies conservation of resources theory to study the relationships between resilience, team social climate, and depressive complaints, specifically focusing on worries about infections as an important explanatory mechanism. Based on questionnaire data of 1126 workers from five hospitals in the Netherlands during the second peak of the pandemic, this paper estimates a moderated-mediation model. This model shows that personal resilience negatively relates to depressive complaints (β = -0.99, p < 0.001, 95%CI = -1.45--0.53), partially as personal resilience is negatively associated with worries about infections (β = -0.42, p < 0.001, 95%CI = -0.50--0.33) which in turn are positively related to depressive complaints (β = 0.75, p < 0.001, 95% CI = 0.31-1.19). Additionally, team social climate is associated with a lower effect of worries about being infected and infecting others on depressive complaints (β = -0.88, p = 0.03, 95% CI = -1.68--0.09). These findings suggest that resilience can be an important individual level resource in preventing depressive complaints. Moreover, the findings imply that hospitals have an important responsibility to maintain a good team social climate to shield workers from infection related worries building up to depressive complaints.

Associations between feelings/behaviors during COVID-19 pandemic lockdown and depression/anxiety after lockdown in a sample of Chinese children and adolescents

BACKGROUND

Children and adolescents may be more susceptible to mental disorders due to COVID-19 pandemic than adults. This study aimed to identify correlated factors for depression/anxiety among children and adolescents after COVID-19 pandemic lockdown.

METHODS

An online survey by cluster sampling was conducted after lockdown in 5175 Chinese children and adolescents with informed consents from their parents. The 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scales with 10-point cutoff were used to measure depression and anxiety, separately. Stepwise logistic regression was conducted. Stata 15.1 Version was used.

RESULTS

12.33% and 6.26% of all participants reported depression and anxiety after lockdown, separately. Suicidal ideation, quarreling with parents, insomnia, difficulty in concentrating during online learning, and anxious and depressed mood during lockdown were positively associated with depression and anxiety after lockdown. Missing teachers was negatively associated with both depression and anxiety. Living in urban and not living with parents were positively associated with depression.

LIMITATIONS

The past history and familial history of mental disorders have not been collected. The recall biases for collecting self-reporting information might exist, and the causal inferences cannot be drawn.

CONCLUSIONS

The prevalence of depression and anxiety in children and adolescents might decline a bit after lockdown but is still at a high level after lockdown. Gatekeepers should pay more attention to modifiable factors of psychological well-being in children and adolescents, including family and school contexts and even feelings and behaviors during COVID-19 pandemic lockdown.

Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19

Background: Studies have shown that working in frontline healthcare roles during epidemics and pandemics was associated with PTSD, depression, anxiety, and other mental health disorders. Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant PTSD, depression, and anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of distress across different groups of HCSWs working in different roles and settings. Methods: A convenience sample (n = 1194) of frontline UK HCSWs completed an online survey during the first wave of the pandemic (27 May - 23 July 2020). Participants worked in UK hospitals, nursing or care homes and other community settings. PTSD was assessed using the International Trauma Questionnaire (ITQ); Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results: Nearly 58% of respondents met the threshold for a clinically significant disorder (PTSD = 22%; anxiety = 47%; depression = 47%), and symptom levels were high across occupational groups and settings. Logistic regression analyses found that participants who were concerned about infecting others, who could not talk with their managers if there were not coping, who reported feeling stigmatized and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with higher odds for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions: This study identified predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE and further investigation of barriers to communication between managers and staff.

Experiences of healthcare providers during the coronavirus pandemic and its impact on them: protocol for a mixed-methods systematic review

INTRODUCTION

Frontline healthcare providers are redeployed to areas outside their clinical expertise and assigned high-loading workload to address the surge of patients with each coronavirus outbreak. Their importance in crisis is not in doubt. However, they experienced considerable physical distress and psychological stressors, even leading to psychological illness and infection in this environment. There is an urgent need to accurately, comprehensively and objectively understand their experiences, perceptions and current situation of burnout, post-traumatic stress disorder (PTSD), anxiety, depression, insomnia and coronavirus infection. Therefore, this protocol is to conduct a mixed-methods systematic review to summarise the evidence on the experiences of healthcare providers and impacts of the coronavirus on their psychological status and infection during the pandemics.

METHODS

Published studies on experience, perspective, impact, burnout, PTSD, anxiety, depression, insomnia, and infection of healthcare providers with SARS, Middle East respiratory syndrome and COVID-19, and written in English and Chinese will be accepted. Databases (MEDLINE, EMBASE, CENTRAL, Web of Science, PubMed, Psychology Information, WanFang and SinoMed) from inception until 30 July 2020 will be searched. Two reviewers will select, screen, extract data and assess the risk of bias independently. Risk of bias of results will be using the Mixed-Methods Appraisal Tool. Using a convergent integrated approach on qualitative/quantitative studies, we will synthesise qualitative and quantitative data separately. The incidence and number of cases about burnout, PTSD, anxiety, depression, insomnia and coronavirus infection among medical staff will be extracted. Then we will transform quantitative data to synthesise narrative findings. This protocol will be reported per the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.

ETHICS AND DISSEMINATION

Ethical assessment is not required due to the nature of the proposed systematic review. Findings of our research will be disseminated at conferences related to this field and through publication in peer-reviewed journals.

PROSPERO REGISTRATION NUMBER

CRD42020198506.