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Houben F, Heijer CDD, Dukers-Muijrers NH, Smeets-Peels C, Hoebe CJ. Psychosocial determinants associated with healthcare workers' self-reported compliance with infection prevention and control during the COVID-19 pandemic: a cross-sectional study in Dutch residential care facilities for people with intellectual and developmental disabilities. BMC Public Health 2023; 23:2052. [PMID: 37858182 PMCID: PMC10588203 DOI: 10.1186/s12889-023-16912-0] [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: 05/01/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Healthcare workers' (HCWs) compliance with infection prevention and control (IPC) is crucial to reduce the infection transmission risk. However, HCWs' compliance with IPC in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is known to be suboptimal. Therefore, this study examined sociodemographic and psychosocial determinants associated with IPC non-compliance in this setting, to inform IPC policy and promotion programmes for adequate IPC behaviour. METHODS An online questionnaire was administered to 285 HCWs from 16 RCFs between March 2021 and March 2022. Determinants associated with IPC non-compliance were assessed using logistic regression analyses. RESULTS Being a woman (OR: 3.57; 1.73-7.37), and being a non-medical professional were associated with increased odds of non-compliance (social workers, OR: 2.83; 1.65-4.85; behavioural specialists, OR: 6.09; 1.98-18.72). Perceived inadequate education/training (aOR: 1.62; 1.15-2.27) and perceived time constraints/competing priorities (aOR: 1.43; 1.03-1.98) were also associated with increased odds of non-compliance, independent of sociodemographic variables. In contrast, the belief that the supervisor complies with IPC (descriptive norm supervisor) was associated with decreased odds of non-compliance (aOR: 0.60; 0.41-0.88). CONCLUSIONS To improve IPC in disability care settings, the implementation of tailored and structural IPC education and training programmes (e.g., on-the-job training) is recommended to increase HCWs' capabilities and bridge the IPC compliance gap between medical and non-medical professionals. In addition, role models, particularly supervisors, are crucial for promoting IPC behaviour. Facilities should create a culture of IPC compliance by norm setting, acting on, and modelling IPC behaviours at all levels of the organisation (management, medical, and non-medical staff).
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Affiliation(s)
- Famke Houben
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands.
| | - Casper Dj den Heijer
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
| | - Nicole Htm Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | | | - Christian Jpa Hoebe
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
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Marair SA, Slater N. Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review. BMC Nurs 2023; 22:230. [PMID: 37400825 DOI: 10.1186/s12912-023-01343-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/17/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention. OBJECTIVE To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East. METHODS A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out. DATA EXTRACTION AND SYNTHESIS Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach. RESULTS The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19. CONCLUSION In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation. TRIAL REGISTRATION PROSPERO (CRD42022344005).
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Affiliation(s)
- Sara Ahmed Marair
- King Saud Medical City, Riyadh, Saudi Arabia.
- University of Nottingham, Nottingham, NG1 5NT, UK.
| | - Nigel Slater
- University of Nottingham, Nottingham, NG1 5NT, UK
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Mohamed Afif A, Abdul Razak H, Choong AWD. COVID-19 pandemic experience of diagnostic radiographers: A Singapore survey. J Med Imaging Radiat Sci 2023; 54:S62-S69. [PMID: 36842892 PMCID: PMC9910016 DOI: 10.1016/j.jmir.2023.01.010] [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: 11/01/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Diagnostic Radiographers (DR) are the frontline responders during the COVID-19 outbreak, providing essential diagnostic imaging services for screening and monitoring of suspected and confirmed patients. Understanding the experience and perceptions of DR towards the COVID-19 outbreak enables radiography leaders to guide changes in the approach to managing response to future health outbreaks. This study aims to document the experiences of DR in Singapore during the COVID-19 pandemic. METHODS All DR practising in Singapore institutions were invited to participate in an online survey, disseminated by the Singapore Society of Radiographers (SSR). The survey assessed the attitudes and perceptions of the respondents on the COVID-19 pandemic. The Holmes and Rahe Stress Scale was used to identify the respondents' life events closely related to the pandemic. Data collection took place from 5 July 2020 to 5 September 2020. RESULTS A total of 123 DR responded to the survey, where 89.4% of the respondents had been involved in the imaging of suspected or confirmed COVID-19 patients. Those performing General Radiography had the highest number of cases - 300 cases a month. The fear of transmitting COVID-19 to their family presented as the primary stressor (77.2%), followed by the lack of manpower (73.2%). The global themes that emerged from the study were (1) adapting to change and (2) quality of support. CONCLUSION Radiology departments in Singapore were able to cope with the high demands of the pandemic in terms of the provision of information, supplies, and physical equipment. However, they were less prepared to handle human factors such as mental health and staff morale. The safety and well-being of staff should not be compromised to reduce staff anxiety while performing their duties. Strategies to improve their ability to adapt to changes and provision of quality support are necessary measures in future pandemic situations.
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Affiliation(s)
- A Mohamed Afif
- Radiography Department, Singapore General Hospital, Singapore.
| | - H Abdul Razak
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - AWD Choong
- Department of Diagnostic Imaging, National University Hospital, Singapore
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Tu CC, Yang D, Tu CF. Role of COVID-19 Risk Perception and Organizational Safety Climate in Preventing COVID-19 Among Taiwanese University Students. Asia Pac J Public Health 2022; 34:840-842. [PMID: 36196902 PMCID: PMC9535450 DOI: 10.1177/10105395221129109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Chia Ching Tu
- International College, Krirk
University, Bangkok, Thailand
| | - Dong Yang
- International College, Krirk
University, Bangkok, Thailand,Dong Yang, International College, Krirk
University, 43/1111 Ram-Indra Road, KM.1, Bang Khen, Bangkok 10220, Thailand.
| | - Chia Feng Tu
- Wei Gong Memorial Hospital, Toufen
City, Miaoli, Taiwan
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Salwa M, Haque MA, Islam SS, Islam MT, Sultana S, Khan MMH, Moniruzzaman S. Compliance of healthcare workers with the infection prevention and control guidance in tertiary care hospitals: quantitative findings from an explanatory sequential mixed-methods study in Bangladesh. BMJ Open 2022; 12:e054837. [PMID: 35697439 PMCID: PMC9195156 DOI: 10.1136/bmjopen-2021-054837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess healthcare workers' (HCWs) compliance with the infection prevention and control (IPC) practices and identify the factors influencing this compliance using the Health Belief Model as the theoretical framework. DESIGN Quantitative data from an explanatory sequential mixed-methods study were employed in this research. PARTICIPANTS AND SETTINGS From 17 May to 30 August 2020, 604 physicians and nurses working at six randomly selected tertiary care facilities in Dhaka City in Bangladesh took part in this study. PRIMARY AND SECONDARY OUTCOME MEASURES Compliance with the WHO's guidance on IPC measures, as well as the associated factors, was the primary outcome. RESULTS A mean compliance score of 0.49 (±0.25) was observed on a 0-1 scale. HCWs were most compliant with the medical mask wearing guidelines (81%) and were least compliant with the high-touch surface decontamination regulations (23%). Compliance with the IPC guidance was significantly associated with increasing age, female sex, working as a nurse, having non-communicable diseases and history of exposure to patients with COVID-19. Perceived benefits (B=0.039, 95% CI 0.001 to 0.076), self-efficacy (B=0.101, 95% CI 0.060 to 0.142) and cues to action (B=0.045, 95% CI 0.002 to 0.088) were positively associated with compliance. Compliance with IPC guidance was 0.061 times greater among participants who reported low perceived barriers compared with those with high perceived barriers. CONCLUSION Overall, compliance with IPC guidance among HCWs was unsatisfactory. As self-efficacy exerted the greatest contribution to compliance, it should be emphasised in any endeavour to improve HCWs' IPC adherence. Such interventions should also focus on perceived barriers, including unreliability of the information sources, unsafe working places and unavailability of protective equipment and cues to action, including trust in the administration and availability of adequate IPC guidance.
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Affiliation(s)
- Marium Salwa
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Syed Shariful Islam
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohammad Tanvir Islam
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sarmin Sultana
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Md Maruf Haque Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Syed Moniruzzaman
- Risk and Environmental Studies, Department of Social and Cultural Sciences, Karlstad University, Karlstad, Sweden
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Obeidat NA, Dodin YI, Hawari FI, Albtoosh AS, Manasrah RM, Mansour AH. Mitigating psychological distress in healthcare workers as COVID-19 waves ensue: a repeated cross-sectional study from Jordan. HUMAN RESOURCES FOR HEALTH 2022; 20:32. [PMID: 35410266 PMCID: PMC8995692 DOI: 10.1186/s12960-022-00728-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/25/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND Jordan has experienced several COVID-19 waves in the past 2 years. Cross-sectional studies have been conducted to evaluate distress in healthcare practitioners (HCPs), but there is limited evidence with regards to the impact of continuing pandemic waves on levels of distress in HCPs. We previously studied psychological distress in HCPs during the start of the pandemic (period 1, when cases were infrequent and the country was in lockdown), and demonstrated that HCPs were experiencing considerable stress, despite the country reporting low caseloads at the time. In this study, we sought to utilize the same methodology to reexamine levels of distress as COVID-19 peaked in the country and HCPs began managing large numbers of COVID-19 cases (period 2). METHODS A cross-sectional online survey utilizing a tool previously used during period 1 was completed by HCPs working in various settings. Demographic, professional and psychological factors such as distress, anxiety, depression, burnout, sleep issues, exhaustion, and fear were assessed; and coping strategies also were measured. Items in the tool were assessed for reliability and validity. A multivariable regression was used to identify factors that continued to impact distress during period 2. RESULTS Samples in both periods (n = 937, n = 876, respectively) were relatively comparable in demographic characteristics, but in period 2, a greater proportion of nurses and healthcare practitioners reported working in general hospitals. During the pandemic peak (period 2), 49.0% of HCPs reported high levels of distress (compared to 32% in period 1); anxiety and depression scores were approximately 21% higher in period 2; and 50.6% reported fatigue (compared to 34.3% in period 1). Variables significantly associated with greater distress in period 2 included experiencing burnout, experiencing sleep disturbances, being fatigued, having fatalistic fears, and having fears related to workload. Conversely, being male, reporting satisfaction at work, and using positive coping practices were associated with a significantly lower odds of being in distress. CONCLUSIONS Between the two periods (early pandemic and first wave), COVID-19-related mental health continued to deteriorate among HCPs, highlighting the need to do more to support HCP front-liners facing COVID-19 surges.
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Affiliation(s)
- Nour A. Obeidat
- Cancer Control Office, King Hussein Cancer Center, Amman, 11941 Jordan
| | - Yasmeen I. Dodin
- Cancer Control Office, King Hussein Cancer Center, Amman, 11941 Jordan
| | | | - Asma S. Albtoosh
- Respiratory Division, Internal Medicine Department, University of Jordan, Amman, Jordan
| | - Rasha M. Manasrah
- Cancer Control Office, King Hussein Cancer Center, Amman, 11941 Jordan
| | - Asem H. Mansour
- Director General Office, King Hussein Cancer Center, Amman, Jordan
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Salwa M, Atiqul Haque M, Ibrahim Ibne Towhid M, Sultana S, Tanvir Islam M, Maruf Haque Khan M, Miah MT, Islam SS, Moniruzzaman S. Assessment of risk perception and risk communication regarding COVID-19 among healthcare providers: An explanatory sequential mixed-method study in Bangladesh. F1000Res 2022; 9:1335. [PMID: 35169463 PMCID: PMC8817067 DOI: 10.12688/f1000research.27129.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Any public health emergency demands adequate risk communication with the vulnerable population along with their optimized perception about the impending risk to ensure proper risk management and crisis control. Hence, we conducted this study to explore healthcare providers’ perceptions regarding risks of coronavirus disease 2019 (COVID-19), as well as how they are being communicated to about the risk, and how they practice risk reduction measures. Methods: We conducted a two-phased explanatory sequential mixed-method study among physicians and nurses from randomly selected tertiary healthcare facilities in Dhaka, the capital of Bangladesh. In the first phase, we assessed the general pattern and quantifiable measures of risk perception, risk communication, and infection prevention practices quantitatively. We performed multiple linear regression analyses to explore how much variability of risk perception was predicted by risk communication methods and contents. In the second phase, we collected qualitative data for in-depth understanding and exploration of participants’ experiences and insights regarding COVID-19 risk through interviews and document reviews. We manually performed thematic content analysis of the qualitative data. Finally, we triangulated findings from both phases to illustrate the research objectives. Discussion: Based on the psychometric dimensions of risk perception and psycho-social theory of the health belief model, perceptions of COVID-19 risk among healthcare providers were evaluated in this study. The relationship between risk perception and infection prevention and control practices among healthcare providers were also investigated. The explanatory sequential design of this study is expected to generate hypotheses on how risk perception is being shaped in a time of uncertainty and, thus, will help to build a proper risk communication strategy for the healthcare providers
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Affiliation(s)
- Marium Salwa
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh
| | - M Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh
| | | | - Sarmin Sultana
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh
| | - Mohammad Tanvir Islam
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh
| | - Md Maruf Haque Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh
| | - Md Titu Miah
- Department of Medicine, Mugda Medical College, Dhaka, 1214, Bangladesh
| | - Syed Shariful Islam
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh
| | - Syed Moniruzzaman
- Risk and Environmental Studies, Department of Social and Cultural Sciences, Centre for Societal Risk Research, Karlstad University, Karlstad, 65188, Sweden
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Ito Y, Kako J, Kajiwara K, Kimura Y, Kakeda T, Hamanishi S, Sasaki S, Yamanaka M, Kiyohara H, Wakiguchi Y, Endo Y, Harada K, Koga Y, Ishida M, Nishida Y, Kobayashi M, Tsubaki M. Impact of the COVID-19 pandemic on the mental health of nursing students in Japan: a cross-sectional study. Environ Health Prev Med 2022; 27:40. [PMID: 36244760 PMCID: PMC9640737 DOI: 10.1265/ehpm.22-00128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/11/2022] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND The effect of the prolonged coronavirus disease (COVID-19) pandemic on the mental health of nursing students is unclear. This study assesses the prevalence of anxiety, depression, and insomnia among nursing students in Japan during the pandemic and determines the risk factors associated with such symptoms. METHODS An online survey-based cross-sectional study was conducted from August 16 to October 16, 2021. Participants were first- to fourth-year nursing students enrolled in undergraduate programs at the eight universities in Japan. Anxiety, depression, and insomnia were assessed using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index-7, respectively. We calculated descriptive statistics for each measurement item and performed univariate and logistic regression analyses to evaluate the potential risk factors. RESULTS We received responses from 1,222 of 3,056 nursing students (response rate: 40.0%). After 25 participants were excluded due to missing outcome values, 1,197 students (valid response rate: 98.0%) were included in the analysis. The prevalence of anxiety, depression, and insomnia was 4.8%, 12.4%, and 18.0%, respectively. The risk of anxiety was lower among participants who did not have any relatives or friends who had been infected with SARS-CoV-2 than among those who did (aOR 0.36, 95% CI 0.14-0.94). The risk of depression was higher among participants whose financial status had worsened during the pandemic than among those whose financial status had not changed (aOR 3.44; 95% CI 1.98-5.96). Common factors that increased the risk of anxiety, depression, and insomnia were life satisfaction and fear of COVID-19. CONCLUSION Mental health-related symptoms among nursing students in Japan have not necessarily worsened with the spread of COVID-19 but were exacerbated by the intensity of changes in daily living and fear, which are psychosocial effects associated with the pandemic.
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Affiliation(s)
- Yoshiyasu Ito
- College of Nursing Art and Science, University of Hyogo, Akashi 673-8588, Japan
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Jun Kako
- College of Nursing Art and Science, University of Hyogo, Akashi 673-8588, Japan
| | - Kohei Kajiwara
- Faculty of Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata 811-4157, Japan
| | - Yasutaka Kimura
- Department of Nursing, Meio University, Nago 905-8585, Japan
| | | | - Seiji Hamanishi
- Faculty of Nursing, Kansai University of Social Welfare, Ako 678-0255, Japan
| | - Shinsuke Sasaki
- Department of Nursing Science, Okayama Prefectural University, Soja 719-1197, Japan
| | - Makoto Yamanaka
- School of Nursing, Aichi Medical University, Nagakute 480-1195, Japan
| | - Hana Kiyohara
- College of Nursing Art and Science, University of Hyogo, Akashi 673-8588, Japan
| | - Yuki Wakiguchi
- College of Nursing Art and Science, University of Hyogo, Akashi 673-8588, Japan
| | - Yoji Endo
- Faculty of Nursing, Kansai University of Social Welfare, Ako 678-0255, Japan
| | - Kimie Harada
- Faculty of Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata 811-4157, Japan
| | - Yuji Koga
- Faculty of Nursing, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan
| | - Michiko Ishida
- Faculty of Nursing, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan
| | - Yoko Nishida
- Faculty of Nursing, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan
| | - Masamitsu Kobayashi
- Graduate of Nursing Science, St. Luke’s International University, Tokyo 104-0044, Japan
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Mattila E, Peltokoski J, Neva MH, Kaunonen M, Helminen M, Parkkila AK. COVID-19: anxiety among hospital staff and associated factors. Ann Med 2021; 53:237-246. [PMID: 33350869 PMCID: PMC7877952 DOI: 10.1080/07853890.2020.1862905] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 12/07/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, hospital staff have experienced a variety of mental health challenges. European research on anxiety and stress among hospital workers during the pandemic is limited. This study aimed to describe the anxiety levels of Finnish hospital workers during the COVID-19 pandemic. METHODS The multidimensional, cross-sectional survey was distributed to all hospital staff working at two Finnish specialized medical care centres in the spring of 2020 (n = 1,995). The Generalized Anxiety Disorder 7-item (GAD-7) scale was used to measure the workers' anxiety. RESULTS The total mean GAD-7 score was 4.88, indicating normal anxiety levels. However, 30% (n = 1,079) of the respondents had mild, 10% (n = 194) moderate and 5% (n = 88) severe anxiety. Key risk factors were young age, working in a university hospital, problems in cooperation between co-workers, difficulty concentrating at work, a health-threatening physical and psychological workload, and a fear of being infected at work. CONCLUSION Hospital staff experienced a variety of work-related stress and anxiety issues that should be visible to hospital administrators and policymakers alike. The anxiety is independent of whether the worker is directly involved in caring for or in any way coming into contact with COVID-19 patients. Key message Fifty-five percent of hospital staff have normal anxiety levels. The remaining workers may need targeted support interventions, and a smaller proportion (15%) are in danger of developing longer-term problems affecting their well-being. The anxiety experienced by hospital workers during the COVID-19 pandemic is more severe than that of the population on average. If the pandemic continues, the well-being of hospital staff may be widely threatened. Despite the different geographical locations and COVID-19 situations, hospital workers in Finland and China had similar anxiety levels. The anxiety is independent of whether staff are working in the front line of managing the COVID-19 pandemic or of the number of covid-19 patients admitted to the hospital. The hospital workers felt anxiety because they were facing a new situation which causes changes in their work and daily routine. Health care employers should engage in long-term follow-up as regards the personnel's recovery from the burden caused by the pandemic and from work in general. It is necessary to make easily attainable, flexibly delivered and cost-effective treatment interventions for anxiety available to hospital staff.
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Affiliation(s)
- Elina Mattila
- Administration Centre, Tampere University Hospital, Tampere, Finland
| | | | - Marko H. Neva
- Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland
| | - Marja Kaunonen
- Administration Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Mika Helminen
- Tays Research Services, Tampere University Hospital, Tampere, Finland
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
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Nxumalo CT, Mchunu GG. A qualitative study to explore primary health care practitioners' perceptions and understanding regarding the COVID-19 pandemic in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e11. [PMID: 34879694 PMCID: PMC8661111 DOI: 10.4102/phcfm.v13i1.3084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is a novel virus that has rapidly spread across countries globally, and has been declared a pandemic by the World Health Organization (WHO). In South Africa, more that 1 million cases have been confirmed since case zero was detected in March 2020. South Africa is currently leading in the sub-Saharan African region in terms of COVID-19-related mortality and morbidity rates. AIM The aim of this study was to explore primary health care practitioners' perceptions and understanding regarding the COVID-19 pandemic in KwaZulu-Natal, South Africa. SETTING The study was conducted at two selected primary health care facilities (a community health centre and satellite clinic) within a low-income rural context in KwaZulu-Natal, South Africa. METHODS A qualitative study was conducted to explore and describe perceptions and understanding of primary health care practitioners regarding the COVID-19 pandemic in KwaZulu-Natal (KZN), South Africa. Data were collected from a purposive sample of 15 participants at two different clinics situated in rural KZN, South Africa. Participants comprised of nurses, physiotherapists, pharmacists, community care givers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. An audiotape was used to collect data, which were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis. RESULTS Participants reported pre-pandemic and pandemic perceptions of fear, denial, expectancy and a perceived poor preparation for the COVID-19 outbreak. The findings also revealed participants' misperceptions regarding the nature of the COVID-19 pandemic and unrealistic expectations of occupational compensations for working during the outbreak. CONCLUSION The findings of this study suggest that primary health care practitioners generally have negative perceptions and understanding regarding the pandemic because of misinformation obtained from social media. Interventions to support health care practitioners are necessary to mitigate the potentially negative implications of health practitioners' misconceptions on service delivery and their mental health.
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Affiliation(s)
- Celenkosini T Nxumalo
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban.
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11
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Tagini S, Brugnera A, Ferrucci R, Mazzocco K, Compare A, Silani V, Pravettoni G, Poletti B. It won't happen to me! Psychosocial factors influencing risk perception for respiratory infectious diseases: A scoping review. Appl Psychol Health Well Being 2021; 13:835-852. [PMID: 33855817 PMCID: PMC8250503 DOI: 10.1111/aphw.12274] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/02/2021] [Accepted: 03/19/2021] [Indexed: 12/24/2022]
Abstract
Understanding the determinants of risk perception for COVID-19 might help to promote self-preventive behaviours. This scoping review aimed to map the extent, variety and characteristics of the evidence on the possible determinants of risk perception for COVID-like diseases. PubMed, Scopus and Web of Science were searched for original, peer-reviewed English-written articles published up to March 2020 and investigating risk perception determinants for respiratory infectious diseases in adults. Titles and abstracts were screened, and full texts were analysed by the first author; when unsure, eligibility was discussed with the last author. Data were collected according to an extraction sheet developed by the first and last authors. The cross-sectional evidence covers a variety of diseases, countries and timings of testing. Mostly, questionnaires recorded socio-demographics, media exposure, trust in institutions, disease proximity and knowledge; psychological variables, including personality traits, distress and self-efficacy, were less investigated. A miscellaneous operationalization of risk perception emerged, including the likelihood of getting sick, perceived dangerousness, concerns or a combination of them. A comprehensive understanding of the substantial amount of evidence may be challenging due to methodological heterogeneity. Referring to uniform theoretical frameworks is recommended; also, longitudinal research may be implemented to probe causal relationships.
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Affiliation(s)
- Sofia Tagini
- Department of Neurology and Laboratory of NeuroscienceIstituto Auxologico ItalianoIRCCSMilanItaly
| | - Agostino Brugnera
- Department of Human and Social SciencesUniversity of BergamoBergamoItaly
| | - Roberta Ferrucci
- Department of Health SciencesAldo Ravelli Center for Neurotechnology and Experimental Brain TherapeuticsInternational Medical SchoolUniversity of MilanMilanItaly
- ASST Santi Paolo e CarloNeurology Clinic IIIMilanItaly
- IRCCS Ca' Granda Foundation Maggiore Policlinico HospitalMilanItaly
| | - Ketti Mazzocco
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
- Applied Research Division on Cognitive and Psychological SciencesEuropean Institute of OncologyMilanItaly
| | - Angelo Compare
- Department of Human and Social SciencesUniversity of BergamoBergamoItaly
| | - Vincenzo Silani
- Department of Neurology and Laboratory of NeuroscienceIstituto Auxologico ItalianoIRCCSMilanItaly
- Department of Pathophysiology and Transplantation‘Dino Ferrari’ CenterUniversity of MilanoMilanItaly
| | - Gabriella Pravettoni
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
- Applied Research Division on Cognitive and Psychological SciencesEuropean Institute of OncologyMilanItaly
| | - Barbara Poletti
- Department of Neurology and Laboratory of NeuroscienceIstituto Auxologico ItalianoIRCCSMilanItaly
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James K, Thompson C, Chin-Bailey C, Davis KD, Nevins DH, Walters D. COVID-19 related risk perception among taxi operators in Kingston and St. Andrew, Jamaica. JOURNAL OF TRANSPORT & HEALTH 2021; 22:101229. [PMID: 34377665 PMCID: PMC8337287 DOI: 10.1016/j.jth.2021.101229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND In the Caribbean, all countries have confirmed COVID-19 cases. Considering the high infectivity of the virus, no preexisting immunity to the virus and an associated modest reproductive rate (R0), the high density of persons utilizing public transport is of immense public health concern. Public transport systems may facilitate and accelerate the transmission of the disease. AIM The aim of this study was to assess the COVID-19 related risk perceptions among taxi drivers by virtue of their occupation and the implications for health promotion interventions. METHODS A cross-sectional study was conducted in May 2020 among 282 taxi drivers in the Kingston and St. Andrew (KSA) metropolitan region in Jamaica. A 28-item anonymized self-administered questionnaire was used to collect data which was subsequently analyzed using SPSS version 20. A risk score was generated and the Mann-Whitney U and Kruskal Wallis tests were used to determine differences in the mean ranks for risk perception score as applicable. A 5% alpha level was utilized in determining statistical significance. RESULTS Risk perception scores ranged from 10 to 21 with a median of 17 (IQR 3.25) and there was no statistically significant difference in the median risk perception score by socio-demographic variables. There was however, a statistically significant positive correlation (Spearman's rho = 0.238, p=<0.001) between risk perception and knowledge. Approximately, 86% of respondents reported that they obtained COVID-19-related information from news reports (traditional media). CONCLUSION Taxi drivers perceive themselves to be at occupationally related risk of COVID-19. Therefore, greater understanding of this issue is paramount as it can aid in the crafting of initiatives that may enhance personal safety of both taxi drivers and commuters.
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Affiliation(s)
- Kenneth James
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | - Camelia Thompson
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | - Cameal Chin-Bailey
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | | | - Desmalee Holder Nevins
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | - Dawn Walters
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
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Herdea V, Duduciuc A, Ghionaru R, Comnea L, Păduraru L, Diaconescu S. Assessment of the risk of infection among Romanian physicians at the outbreak of the SARS CoV-2 pandemic. Eur J Gen Pract 2021; 27:235-240. [PMID: 34431427 PMCID: PMC8405117 DOI: 10.1080/13814788.2021.1963434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In March 2020, the WHO declared the SARS CoV-2 pandemic. This had an immediate and dramatic impact on Romanian physicians. OBJECTIVES To analyse SARS-CoV-2 risk perception among Romanian physicians following the official WHO pandemic announcement. METHODS A questionnaire was sent to Romanian physicians (n = 319) between 13 and 27 of March 2020 to determine the perceived threat of exposure to SARS CoV-2 infection, the assessment COVID-19 sources of documentation, physicians' access to personal protective equipment and the attitude towards a prospective vaccine against SARS CoV-2. RESULTS Confronted with a new and unknown disease, the lack of appropriate information regarding disease management, media pressure and the lack of protective equipment, physicians experiencing a highly stressful a period. We found a significant relationship between the perceived level of fear and the risk of infection with SARS CoV-2 among respondents. A relationship was also found between the perceived level of fear related to COVID-19 and the acceptance of future vaccines against SARS CoV-2. Our data show that doctors working in urban areas considered the medical research on COVID-19 as clearer than those working in rural locations did. CONCLUSION Pandemic preparedness should focus on measures that make medical practice safe (supplies, working protocols, experience sharing with experts/colleagues from other countries).
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Affiliation(s)
- Valeria Herdea
- Department of Family Medicine, Pharmacy, Science and Technology 'George Emil Palade', University of Medicine, Târgu Mureș, Romania
| | - Alina Duduciuc
- Faculty of Communication & Public Relations, National University of Political Studies and Public Administration, Bucharest, Romania
| | - Raluca Ghionaru
- Department of Family Medicine, Romanian Association for Pediatric Education in Family Medicine [AREPMF], Bucharest, Romania
| | - Laura Comnea
- Department of Family Medicine, Romanian Association for Pediatric Education in Family Medicine [AREPMF], Bucharest, Romania
| | - Luminita Păduraru
- Department of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', Iasi, Romania
| | - Smaranda Diaconescu
- Department of Medicine, University of Medicine and Pharmacy 'Grigore T. Popa', Iasi, Romania
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Superio DL, Anderson KL, Oducado RMF, Luceño MT, Palcullo VEV, Bendalian MVT. The information-seeking behavior and levels of knowledge, precaution, and fear of college students in Iloilo, Philippines amidst the COVID-19 pandemic. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2021; 62:102414. [PMID: 34189029 PMCID: PMC8225315 DOI: 10.1016/j.ijdrr.2021.102414] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 05/16/2023]
Abstract
COVID-19 pandemic is devastating the health, social, and economic well-being of citizens worldwide. The high rates of morbidity and mortality and the absence of vaccines cause fear among the people regardless of age, gender, or social status. People's fear is heightened by misinformation spread across all media types, especially on social media. Filipino college students are one of the top Internet users worldwide and are very active in social media. Hence they are very prone to misinformation. This paper aims to ascertain the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines, and determine the effects of their information-seeking behavior on the variables above. This paper is a cross-sectional survey that used a qualitative-quantitative method and snowball sampling technique. Data were gathered among 228 college students using an online survey instrument a few months after the pandemic began. College students were knowledgeable of the basic facts about the highly infectious COVID-19. However, the majority were inclined to believe the myths and misinformation regarding the pandemic. Television was the primary, most believable, and preferred source when seeking information. The Internet as a preferred source of information was significantly associated with a high level of knowledge. In contrast, the information sourced from interpersonal channels were found to make college students very cautious. The local presence of COVID-19 cases had caused college students to fear, likely exacerbated by the plethora of information about the pandemic, mostly from Facebook. This is the first study conducted on the effects of the information-seeking behavior on the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines.
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Affiliation(s)
- Daryl L Superio
- Aquaculture Dept., Southeast Asian Fisheries Development Center, 5021, Tigbauan, Iloilo, Philippines
| | | | | | - Myrna T Luceño
- Central Philippines University, Jaro, 5000, Iloilo City, Philippines
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15
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Okoh M, Onyia N, Okoh DS, Abah AA, Otakhoigbogie U, Adedapo HA, Oyetola EO, Agho ET, Owotade FJ. Awareness of COVID-19 and the Dental Implications of its Oral Manifestations among Dental Health Practitioners in Nigeria. Niger Med J 2021; 62:194-201. [PMID: 38694212 PMCID: PMC11058442 DOI: 10.60787/nmj-62-4-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024] Open
Abstract
Background There are many aspects of COVID-19 that are related to dental practice. Hence, this study aimed to assess the level of awareness of COVID-19 concerning its symptoms, transmission and prevention and the dental implications of its oral manifestations among dentists in Nigeria. Methodology This is a cross-sectional study that sampled dentists who work in Nigeria regardless of their place of work with an online questionnaire using Google forms to collect the data. The questionnaire was anonymous to maintain the privacy and confidentiality of all information collected in the study. The survey was a structured questionnaire divided into three sections: Dentists' demographics, knowledge of the disease and dental implications of COVID-19. Results This study included 206 dentists practising in Nigeria, with 126 (61.2%) males and 80 (38.8%) females. A total of 191 (92.7%) dentists perceived COVID-19 as highly contagious and deadly. Almost all the participants (n=205, 99.5%) were knowledgeable about the mode of transmission of the disease through respiratory droplets. A total of 204 (99.0%) affirmed that dental practitioners were at risk of becoming infected with COVID-19. About 84.5% reported that salivary glands can serve as a potential reservoir for COVID-19. Conclusion The awareness of COVID-19 concerning the mode of transmission, symptoms and prevention among the dental professionals was encouraging. This would lead to enhanced infection control in dental settings. The majority of the participants reported that saliva can be used as a promising non-invasive specimen for diagnosis, monitoring and infection control in patients with COVID-19.
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Affiliation(s)
- Mercy Okoh
- Department of Oral and Maxillofacial Pathology and Medicine, School of Dentistry, University of Benin, Nigeria
| | - Nonso Onyia
- Department Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | | | - Aderonke Adebowun Abah
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Uwaila Otakhoigbogie
- Department of Oral Pathology and Oral Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Happy Adeyinka Adedapo
- Department of Oral Pathology and Oral Medicine, University College Hospital, Ibadan, Nigeria
| | - Elijah Olufemi Oyetola
- Department of Oral Pathology and Oral Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Foluso John Owotade
- Department of Oral Pathology and Oral Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
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Barqawi HJ, Kampani DD, Haddad ES, Al-Roub NM, Abu-Gharbieh E. Readiness of physicians and medical students to cope with the COVID-19 pandemic in the UAE. PLoS One 2021; 16:e0251270. [PMID: 33956910 PMCID: PMC8101710 DOI: 10.1371/journal.pone.0251270] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/22/2021] [Indexed: 12/23/2022] Open
Abstract
Background Coronavirus disease (COVID-19), caused by Severe Acute Respiratory Syndrome–Coronavirus 2 (SARS-CoV2), is the defining global health crisis of this time. It is responsible for significant morbidity and has had severe socioeconomic consequences. This study aims to assess the knowledge, preparedness and attitudes of medical students, physicians and faculty members in the United Arab Emirates (UAE) on COVID-19 and their perspective on the roles of educational and healthcare institution towards improving pandemic preparedness and enabling optimal care. Methodology An exploratory, descriptive cross-sectional study was conducted with 444 participants, using a non-probability convenience sampling method. English-speaking participants from the medical field aged 18 and above were included in the study. The validated questionnaire was administered online and distributed across social media platforms from May-July 2020. T-test, ANOVA, Kruskal-Wallis test and Mann-Whitney-U test were used when appropriate. Responses were analysed and statistical tests applied using IBM SPSS, version 25. Results The knowledge scores were calculated amongst different ages and professional status, and the mean was 59.08% (SD = 12.848%). Almost half of the participants obtained poor knowledge scores (less than 60%). Most of the participants followed the latest updates on COVID-19 (86.7%). The majority opted to obtain information from the national health authorities (63.4%). The mean preparedness score among the participants was 68.65% (SD = 17.456%). Being in contact with patients significantly increased the preparedness score (p < 0.001). Only 27.9% of the participants believed their college education provided adequate knowledge to deal with epidemics or pandemics. Several barriers affect willingness to work in a pandemic, with 80.6% of participants worried about posing a risk to family members. Conclusion This study highlights the importance of establishing tailored COVID-19 related education programs to improve knowledge levels, especially in medical students. Efforts are still needed to promote effective control measures and address the barriers affecting willingness to work in a pandemic.
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Affiliation(s)
- Hiba J. Barqawi
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Drishti D. Kampani
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Enad S. Haddad
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Nora M. Al-Roub
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Eman Abu-Gharbieh
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- * E-mail:
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Malik S, Ullah I, Irfan M, Ahorsu DK, Lin CY, Pakpour AH, Griffiths MD, Rehman IU, Minhas R. Fear of COVID-19 and workplace phobia among Pakistani doctors: A survey study. BMC Public Health 2021; 21:833. [PMID: 33931040 PMCID: PMC8086971 DOI: 10.1186/s12889-021-10873-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/16/2021] [Indexed: 12/17/2022] Open
Abstract
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.
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Affiliation(s)
- Sadia Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, 25000 Pakistan
| | - Muhammad Irfan
- Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Daniel Kwasi Ahorsu
- Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, RM QT 512 Hong Kong China
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, ShahidBahounar BLV, Qazvin, 3419759811 Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - Ibad Ur Rehman
- Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Rafia Minhas
- Avicenna Medical and Dental College, Lahore, Pakistan
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Abu-Elenin MM. Immediate psychological outcomes associated with COVID-19 pandemic in frontline physicians: a cross-sectional study in Egypt. BMC Psychiatry 2021; 21:215. [PMID: 33910544 PMCID: PMC8080092 DOI: 10.1186/s12888-021-03225-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/12/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The mental health of frontline healthcare workers is influenced by the crisis of the COVID-19 pandemic. This adversely affects their clinical performance and productivity. Therefore, it is important to recognize levels of anxiety, depression and identify the contributing factors. METHODS A cross-sectional study recruited physicians working at frontline positions in university teaching and isolation hospitals in the Mid Delta Region of Egypt from April to May 2020. Data was collected through an electronic online survey. Anxiety and depression levels were assessed using General Anxiety Disorder-7 and Patient Health Questionnaire - 9 respectively. RESULTS The study included 237 physicians, their mean age was 38.2 ± 6.2 years and 58% of them were males. Overall, 78.9% and 43.8% of all participated physicians reported symptoms of anxiety and depression. 85% of respondents had children with a significant increase in the risk of anxiety (OR = 20.2). This study revealed that poor sleep quality, being a resident physician, disrupted social life, and stigma exposure due to COVID-19, were significant mediating factors for the observed anxiety (OR = 0.53,3.28,0.18,1.56 respectively) and depressive symptoms (OR = 0.51,1.39,0.56,1.9 respectively). However, working in isolation hospitals wasn't a significant contributing factor. CONCLUSION The frontline physicians experienced a high rate of mental symptoms during the COVID-19 pandemic. That requires prompt intervention, taking into consideration the underlying determinants.
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Affiliation(s)
- Mira Maged Abu-Elenin
- Department of Public Health and Community Medicine, Faculty of Medicine,Medical Campus, Tanta University, 1st El-Geish Avenue, Tanta, 21561, Egypt.
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Hawari FI, Obeidat NA, Dodin YI, Albtoosh AS, Manasrah RM, Alaqeel IO, Mansour AH. The inevitability of Covid-19 related distress among healthcare workers: Findings from a low caseload country under lockdown. PLoS One 2021; 16:e0248741. [PMID: 33793579 PMCID: PMC8016221 DOI: 10.1371/journal.pone.0248741] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 03/04/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives To characterize psychological distress and factors associated with distress in healthcare practitioners working during a stringent lockdown in a country (Jordan) that had exhibited one of the lowest incidence rates of Covid-19 globally at the time of the survey. Methods A cross-sectional online survey sent to healthcare practitioners working in various hospitals and community pharmacies. Demographic, professional and psychological characteristics (distress using Kessler-6 questionnaire, anxiety, depression, burnout, sleep issues, exhaustion) were measured as were sources of fear. Descriptive and multivariable statistics were performed using level of distress as the outcome. Results We surveyed 937 practitioners (56.1% females). Approximately 68%, 14%, and 18% were nurses/technicians, physicians, and pharmacists (respectively). 32% suffered from high distress while 20% suffered from severe distress. Exhaustion, anxiety, depression, and sleep disturbances were reported (in past seven days) by approximately 34%, 34%, 19%, and 29% of subjects (respectively). Being older or male, a positive perception of communications with peers, and being satisfied at work, were significantly associated with lower distress. Conversely, suffering burnout; reporting sleep-related functional problems; exhaustion; being a pharmacist (relative to a physician); working in a cancer center; harboring fear about virus spreading; fear that the virus threatened life; fear of alienation from family/friends; and fear of workload increases, were significantly associated with higher distress. Conclusion Despite low caseloads, Jordanian practitioners still experienced high levels of distress. Identified demographic, professional and psychological factors influencing distress should inform interventions to improve medical professionals’ resilience and distress likelihood, regardless of the variable Covid-19 situation.
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Affiliation(s)
- Feras I. Hawari
- Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center and University of Jordan, Amman, Jordan
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
- * E-mail:
| | - Nour A. Obeidat
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
| | - Yasmeen I. Dodin
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
| | - Asma S. Albtoosh
- Respiratory Division, Internal Medicine Department, University of Jordan, Amman, Jordan
| | | | | | - Asem H. Mansour
- Director General Office, King Hussein Cancer Center, Amman, Jordan
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Mental Health Status of Healthcare Professionals and Students of Health Sciences Faculties in Kuwait during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042203. [PMID: 33672372 PMCID: PMC7926878 DOI: 10.3390/ijerph18042203] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/15/2022]
Abstract
Objectives: This study aimed to assess the impact of the COVID-19 pandemic on the mental health status of healthcare professionals (HCPs) and undergraduate students in the health sciences center (HSCUs). In addition, it explored the factors associated with the increased levels of mental health burden among the study population. Methods: A cross-sectional study was performed using two online-administered questionnaires: the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7), which were distributed in parallel to HCPs and HSCUs in Kuwait. These instruments are validated assessment scales to assess mental health status: depression (PHQ-9) and anxiety (GAD-7). Statistical analyses were carried out using SPSS- version 25. Results: A total of 857 individuals (559 HCPs and 298 HSCUs) participated in this study. The prevalence of moderately severe depression or severe depression (PHQ-9 total score of ≥15) among respondents was 66.6%. The median (interquartile range, IQR) PHQ-9 score was significantly higher among HSCUs (20 {11.5}) compared to HCPs (17 {8}). The prevalence of severe anxiety (GAD-7 total score of ≥15) among respondents was 36.7%. There were no significant differences between the median (IQR) GAD-7 scores among the HCPs (14 {7}) and HSCUs (13 {8}). Binary logistic regression analysis revealed that three variables were significantly and independently associated with severe depression among HCPs. The prevalence of severe depression was found to be greater among females compared to males. In addition, it was significantly lower among those who were aged ≥50 years, and those who reported that they were not in direct contact with COVID-19 patients. Among HSCUs, females showed greater depression than males. In contrast, those aged >29 years and who had no history of chronic disease showed lower depression compared to their counterparts in the 18–29 years age group and who had a chronic disease history. Conclusions: The COVID-19 pandemic had a significant negative impact on the mental health of HCPs and HSCUs in Kuwait. This highlights the need for proactive efforts to support their mental health and well-being through educational campaigns and psychological support programs.
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Lasalvia A, Amaddeo F, Porru S, Carta A, Tardivo S, Bovo C, Ruggeri M, Bonetto C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open 2021; 11:e045127. [PMID: 33455940 PMCID: PMC7813385 DOI: 10.1136/bmjopen-2020-045127] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To determine burn-out levels and associated factors among healthcare personnel working in a tertiary hospital of a highly burdened area of north-east Italy during the COVID-19 pandemic. DESIGN Observational study conducted from 21 April to 6 May 2020 using a web-based questionnaire. SETTING Research conducted in the Verona University Hospital (Veneto, Italy). PARTICIPANTS Out of 2195 eligible participants, 1961 healthcare workers with the full range of professional profiles (89.3%) completed the survey. PRIMARY OUTCOME MEASURE Levels of burn-out, assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). Multivariable logistic regression analysis was performed to identify factors associated with burn-out in each MBI-GS dimension (emotional exhaustion, EX; professional efficacy, EF; cynicism, CY). RESULTS Overall, 38.3% displayed high EX, 46.5% low EF and 26.5% high CY. Burn-out was frequent among staff working in intensive care units (EX 57.0%; EF 47.8%; CY 40.1%), and among residents (EX 34.9%; EF 63.9%; CY 33.4%) and nurses (EX 49.2%; EF 46.9%; CY 29.7%). Being a resident increased the risk of burn-out (by nearly 2.5 times) in all the three MBI subscales and being a nurse increased the risk of burn-out in the EX dimension in comparison to physicians. Healthcare staff directly engaged with patients with COVID-19 showed more EX and CY than those working in non-COVID wards. Finally, the risk of burn-out was higher in staff showing pre-existing psychological problems, in those having experienced a COVID-related traumatic event and in those having experienced interpersonal avoidance in the workplace and personal life. CONCLUSIONS Burn-out represents a great concern for healthcare staff working in a large tertiary hospital during the COVID-19 pandemic and its impact is more burdensome for front-line junior physicians. This study underlines the need to carefully address psychological well-being of healthcare workers to prevent the increase of burn-out in the event of a new COVID-19 healthcare emergency.
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Affiliation(s)
- Antonio Lasalvia
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Amaddeo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- UOC Psicosomatica e Psicologia Medica, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona and Clinical Unit of Occupational Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona and Clinical Unit of Occupational Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Stefano Tardivo
- Section of Hygiene, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Chiara Bovo
- Health Director, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
| | - Mirella Ruggeri
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Rieckert A, Schuit E, Bleijenberg N, Ten Cate D, de Lange W, de Man-van Ginkel JM, Mathijssen E, Smit LC, Stalpers D, Schoonhoven L, Veldhuizen JD, Trappenburg JC. How can we build and maintain the resilience of our health care professionals during COVID-19? Recommendations based on a scoping review. BMJ Open 2021; 11:e043718. [PMID: 33408212 PMCID: PMC7789206 DOI: 10.1136/bmjopen-2020-043718] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To explore how to build and maintain the resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions. DESIGN Scoping review supplemented with expert interviews to validate the findings. SETTING Hospitals. METHODS We searched PubMed, Embase, PsycINFO, CINAHL, bioRxiv and medRxiv systematically and grey literature for articles focusing on the impact of COVID-19-like working conditions on the physical and/or mental health of healthcare professionals in a hospital setting. Articles using an empirical design about determinants or causes of physical and/or mental health and about interventions, measures and policies to preserve physical and/or mental health were included. Four experts were interviewed to reflect on the results from the scoping review. RESULTS In total, 4471 records were screened leading to an inclusion of 73 articles. Recommendations prior to the outbreak fostering resilience included optimal provision of education and training, resilience training and interventions to create a feeling of being prepared. Recommendations during the outbreak consisted of (1) enhancing resilience by proper provision of information, psychosocial support and treatment (eg, create enabling conditions such as forming a psychosocial support team), monitoring the health status of professionals and using various forms and content of psychosocial support (eg, encouraging peer support, sharing and celebrating successes), (2) tasks and responsibilities, in which attention should be paid to kind of tasks, task mix and responsibilities as well as the intensity and weight of these tasks and (3) work patterns and working conditions. Findings of the review were validated by experts. CONCLUSIONS Recommendations were developed on how to build and maintain resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions. These practical and easy to implement recommendations can be used by hospitals and other healthcare organisations to foster and preserve short-term and long-term physical and mental health and employability of their professionals.
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Affiliation(s)
- Anja Rieckert
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Research Group Chronically Ill, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Ewoud Schuit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Cochrane Netherlands, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Nienke Bleijenberg
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Research Group Chronically Ill, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Debbie Ten Cate
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Research Group Chronically Ill, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Wendela de Lange
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Janneke M de Man-van Ginkel
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Research Group Chronically Ill, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Elke Mathijssen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Linda C Smit
- Research Group Chronically Ill, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Dewi Stalpers
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Dutch Hospital Association, Utrecht, Netherlands
| | - Lisette Schoonhoven
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Jessica D Veldhuizen
- Research Group Chronically Ill, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Jaap Ca Trappenburg
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Abstract
AIMS Healthcare workers exposed to coronavirus 2019 (COVID-19) patients could be psychologically distressed. This study aims to assess the magnitude of psychological distress and associated factors among hospital staff during the COVID-19 pandemic in a large tertiary hospital located in north-east Italy. METHODS All healthcare and administrative staff working in the Verona University Hospital (Veneto, Italy) during the COVID-19 pandemic were asked to complete a web-based survey from 21 April to 6 May 2020. Symptoms of post-traumatic distress, anxiety and depression were assessed, respectively, using the Impact of Event Scale (IES-R), the Self-rating Anxiety Scale (SAS) and the Patient Health Questionnaire (PHQ-9). Personal socio-demographic information and job characteristics were also collected, including gender, age, living condition, having pre-existing psychological problems, occupation, length of working experience, hospital unit (ICUs and sub-intensive COVID-19 units vs. non-COVID-19 units). A multivariable logistic regression analysis was performed to identify factors associated with each of the three mental health outcomes. RESULTS A total of 2195 healthcare workers (36.9% of the overall hospital staff) participated in the study. Of the participants, 35.7% were nurses, 24.3% other healthcare staff, 16.4% residents, 13.9% physicians and 9.7% administrative staff. Nine per cent of healthcare staff worked in ICUs, 8% in sub-intensive COVID-19 units and 7.6% in other front-line services, while the remaining staff worked in hospital units not directly engaged with COVID-19 patients. Overall, 63.2% of participants reported COVID-related traumatic experiences at work and 53.8% (95% CI 51.0%-56.6%) showed symptoms of post-traumatic distress; moreover, 50.1% (95% CI 47.9%-52.3%) showed symptoms of clinically relevant anxiety and 26.6% (95% CI 24.7%-28.5%) symptoms of at least moderate depression. Multivariable logistic regressions showed that women, nurses, healthcare workers directly engaged with COVID-19 patients and those with pre-existing psychological problems were at increased risk of psychopathological consequences of the pandemic. CONCLUSIONS The psychological impact of the COVID-19 pandemic on healthcare staff working in a highly burdened geographical of north-east Italy is relevant and to some extent greater than that reported in China. The study provides solid grounds to elaborate and implement interventions pertaining to psychology and occupational health.
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24
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Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, Ellwood L. Implications for COVID-19: A systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic. Int J Nurs Stud 2020; 111:103637. [PMID: 32919358 PMCID: PMC7206441 DOI: 10.1016/j.ijnurstu.2020.103637] [Citation(s) in RCA: 379] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. OBJECTIVES To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. DESIGN This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. DATA SOURCES A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. REVIEW METHODS All studies describing nurses' experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. RESULTS Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. CONCLUSIONS Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses' require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Heidi Lord
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Laura Ellwood
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia.
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25
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Abolfotouh MA, Almutairi AF, BaniMustafa AA, Hussein MA. Perception and attitude of healthcare workers in Saudi Arabia with regard to Covid-19 pandemic and potential associated predictors. BMC Infect Dis 2020; 20:719. [PMID: 32993538 PMCID: PMC7523489 DOI: 10.1186/s12879-020-05443-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/23/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) face considerable mental and physical stress caring for patients with Covid-19. They are at higher risk of acquiring and transmitting this virus. This study aims to assess perception and attitude of HCWs in Saudi Arabia with regard to Covid-19, and to identify potential associated predictors. METHODS In a cross-sectional study, HCWs at three tertiary hospitals in Saudi Arabia were surveyed via email with an anonymous link, by a concern scale about Covid-19 pandemic during 15-30 April, 2020. Concerns of disease severity, governmental efforts to contain it and disease outcomes were assessed using 32 concern statements in five distinct domains. Multiple regression analysis was used to identify predictors of high concern scores. RESULTS A total of 844 HCW responded to the survey. Their average age was 40.4 ± 9.5 years, 40.3% were nurses, 58.2% had direct patient contact, and 77.3% were living with others. The majority of participants (72.1%) had overall concern scores of 55 or less out of a maximum score of 96 points, with an overall mean score of 48.5 ± 12.8 reflecting moderate level of concern. Three-fourth of respondents felt at risk of contracting Covid-19 infection at work, 69.1% felt threatened if a colleague contracted Covid-19, 69.9% felt obliged to care for patients infected with Covid-19 while 27.7% did not feel safe at work using the standard precautions available. Nearly all HCWs believed that the government should isolate patients with Covid-19 in specialized hospitals (92.9%), agreed with travel restriction to and/or from areas affected by Covid-19 (94.7%) and felt safe the government implemented curfew and movement restriction periods (93.6%). Predictors of high concern scores were; HCWs of Saudi nationality (p < 0.001), younger age (p = 0.003), undergraduate education (p = 0.044), living with others (p = 0.003) working in the western region (p = 0.003) and direct contact with patients (p = 0.018). CONCLUSIONS This study highlights the high concern among HCWs about Covid-19 and identifies the predictors of those with highest concern levels. To minimize the potential negative impact of those concerns on the performance of HCWs during pandemics, measures are necessary to enhance their protection and to minimize the psychological effect of the perceived risk of infection.
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Affiliation(s)
- Mostafa A Abolfotouh
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia. .,King Saud bin-Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia. .,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia.
| | - Adel F Almutairi
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia
| | - Ala'a A BaniMustafa
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia
| | - Mohamed A Hussein
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia.,King Saud bin-Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia
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26
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Halcomb E, McInnes S, Williams A, Ashley C, James S, Fernandez R, Stephen C, Calma K. The Experiences of Primary Healthcare Nurses During the COVID-19 Pandemic in Australia. J Nurs Scholarsh 2020; 52:553-563. [PMID: 32735758 PMCID: PMC7436753 DOI: 10.1111/jnu.12589] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE The COVID-19 pandemic has presented an international health crisis of a scope not seen in our lifetime. While much attention has been paid to health workers in critical care and acute areas, nurses working outside of hospitals are also significantly affected. This study sought to investigate the experience of nurses working in Australian primary healthcare during the COVID-19 pandemic. In particular, it sought to understand the implications on their employment status, role, and access to personal protective equipment. DESIGN AND METHODS Nurses employed in primary healthcare across Australia were invited to participate in a cross-sectional online survey through social media and professional organizations. The survey tool was composed of demographics, and of questions about the nurses' employment, work role, and access to personal protective equipment. FINDINGS Of the 637 responses received, nearly half (43.7%) reported a decrease in hours and threatened or actual loss of employment. While most respondents felt that they had sufficient knowledge about COVID-19, they expressed concern about work-related risks to themselves and their family. Most respondents described never or only sometimes having sufficient personal protective equipment in their workplace. Just over half of respondents (54.8%) felt well supported by their employer. A third of respondents (34%) perceived that care provided in their workplace was significantly or slightly worse than before the pandemic. CONCLUSIONS This is the first study of primary healthcare nurses' experiences during the COVID-19 pandemic. The study findings highlighted a concerning level of insecurity around primary healthcare nursing employment, as well as issues with the availability of personal protective equipment for these nurses. The perception that the pandemic has resulted in reduced quality of care needs further exploration to ensure that those with chronic conditions are supported to maintain and promote health. CLINICAL RELEVANCE Understanding the implications of COVID-19 on the primary healthcare nursing workforce is vital to ensure staff retention and care quality. Ensuring that the community remains healthy and supported at home is vital to both reduce the burden on the health system and reduce secondary mortality.
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Affiliation(s)
- Elizabeth Halcomb
- Xi Omicron, Professor of Primary Health Care Nursing, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Susan McInnes
- Xi Omicron, Lecturer, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Anna Williams
- Senior Lecturer/Discipline Lead Primary Health Care and Chronic Illness, School of Nursing, University of Notre Dame, Sydney, NSW, Australia
| | - Christine Ashley
- Project Officer, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Sharon James
- Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Bega, NSW, Australia
| | - Ritin Fernandez
- Professor of Nursing, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, and Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia
| | - Catherine Stephen
- Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Bega, NSW, Australia.,Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Kaara Calma
- Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Bega, NSW, Australia.,Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
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Que J, Shi L, Deng J, Liu J, Zhang L, Wu S, Gong Y, Huang W, Yuan K, Yan W, Sun Y, Ran M, Bao Y, Lu L. Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China. Gen Psychiatr 2020; 33:e100259. [PMID: 32596640 PMCID: PMC7299004 DOI: 10.1136/gpsych-2020-100259] [Citation(s) in RCA: 242] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/16/2020] [Accepted: 05/23/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Healthcare workers fighting against the coronavirus disease 2019 (COVID-19) pandemic are under tremendous pressure, which puts them at an increased risk of developing psychological problems. AIMS This study aimed to investigate the prevalence of psychological problems in different healthcare workers (ie, physicians, medical residents, nurses, technicians and public health professionals) during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis. METHODS A cross-sectional, web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic. Psychological problems were assessed using the Generalized Anxiety Disorder Scale, Patient Health Questionnaire and Insomnia Severity Index. Logistic regression analyses were used to explore the factors that were associated with psychological problems. RESULTS The prevalence of symptoms of anxiety, depression, insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%, 44.37%, 28.75% and 56.59%, respectively. The prevalence of the overall psychological problems in physicians, medical residents, nurses, technicians and public health professionals was 60.35%, 50.82%, 62.02%, 57.54% and 62.40%, respectively. Compared with healthcare workers who did not participate in front-line work, front-line healthcare workers had a higher risk of anxiety, insomnia and overall psychological problems. In addition, attention to negative or neutral information about the pandemic, receiving negative feedback from families and friends who joined front-line work, and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems. CONCLUSIONS Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic. Receiving negative information and participating in front-line work appear to be important risk factors for psychological problems. The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.
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Affiliation(s)
- Jianyu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jiajia Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Li Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Mental Health Institute of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia, China
| | - Suying Wu
- Xiamen City Xianyue Hospital, Xiamen, Fujian, China
| | - Yimiao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing, China
| | - Weizhen Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yankun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Maosheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing, China
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The psychological impact of COVID-19 pandemic on health care workers in a MERS-CoV endemic country. J Infect Public Health 2020; 13:877-882. [PMID: 32505461 PMCID: PMC7256548 DOI: 10.1016/j.jiph.2020.05.021] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 01/08/2023] Open
Abstract
Background The global pandemic of coronavirus disease of 2019 (COVID-19) has led to unprecedented psychological stress on health workers (HCWs). We aimed to assess the psychological impact of COVID-19 on HCWs in comparison to the stress brought on by the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic in Saudi Arabia. Method Between February 5th and 16th, 2020, 811 health-care workers (HCWs) of a tertiary care teaching hospital were invited to fill a questionnaire regarding concerns and worries about the novel coronavirus pandemic, along with Generalized Anxiety Disorder (GAD-7) Anxiety Severity screening tool. Results Out of 582 HCWs who completed the survey questionnaire (response rate of 71.8%), about 40% were exposed previously to MERS-CoV infected or suspected patients during a previous hospital outbreak. While there were no COVID-19 cases reported yet in Saudi Arabia at the time of data collection, still, the anxiety level from COVID-19 was significantly higher than that from MERS-CoV or seasonal influenza: 41.1% were more worried about COVID-19, 41.4% were similarly worried about both MERS-CoV and COVID-19, and 17.5% were more stressed by the previous MERS-CoV hospital outbreak. The most frequent concern was transmitting the infection to family and friends (2.71/5) than to themselves only (2.57/5). Conclusion Pandemic and epidemic infectious diseases such as COVID-19 or MERS-CoV impose a significant level of anxiety and stress on healthcare workers who are caring of infected patients, with their main concern being the risk of transmitting the infection to their families or to acquire it themselves. Therefore, optimizing the compliance of healthcare workers with the proper infection prevention and control measures is paramount during the infectious disease outbreak, to ensure their safety, to decrease the likelihood of getting infected or transmitting the infection to others, and consequently to alleviate their psychological stress and anxiety.
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Adongo PB, Tabong PTN, Asampong E, Ansong J, Robalo M, Adanu RM. Health workers perceptions and attitude about Ghana's preparedness towards preventing, containing, and managing Ebola Virus Disease. BMC Health Serv Res 2017; 17:266. [PMID: 28403852 PMCID: PMC5389014 DOI: 10.1186/s12913-017-2225-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 04/04/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Ebola virus is highly infectious and the disease can be very fatal. The World Health Organization has declared the 2014-2015 Ebola Virus Disease outbreak a Public Health Emergency of International Concern. In response to this, preparations were made in various health facilities and entry points across Ghana. This study explored health workers perceptions, and attitude about Ghana's preparedness towards preventing and containing Ebola Virus Disease. METHODS We conducted a qualitative study in five (5) of the ten (10) regions in Ghana. Five focus group discussions (N = 44) were conducted among nurses; one in each region. In addition, ten (10) health workers (2 in each region) who are members of regional Ebola Virus Disease task force were recruited and interviewed. In the Greater Accra, Volta and Western regions that have ports, six (6) port health officials: two in each of these regions were also interviewed. The interviews were recorded digitally and transcribed verbatim. Thematic content analysis was used to analyze the transcripts with the aid of NVivo 10 software. RESULTS The results of this study showed that Ghanaian health workers perceived the screening at various ports as important and ongoing but felt that the screenings at in-land ports were being undermined by the use of unapproved routes. Training of health workers was also being carried out in all the regions, however, there was a general perception among 33 out of 44 nurses that majority of health workers have not received training on Ebola Virus Disease prevention and management. Logistical challenges were also reported as some health facilities did not have adequate Personal Protective Equipment. In facilities where equipment was available, they were stored in places which are not easily accessible to health workers at all times of the day. Human resource preparation was also perceived to be a challenge as health workers (38/44 of nurses) generally expressed fear and unwillingness to work in Ebola treatment centres in the event of an outbreak in Ghana. CONCLUSIONS Our study concludes that preparatory work for Ebola Virus Disease prevention and containment in Ghana is perceived as inadequate by health workers. Ghana needs to strengthen preparation in the area of training of health workers, provision and accessibility of Personal Protective Equipment and incentives for health workers to better position her to contain and manage any Ebola Virus Disease outbreak.
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Affiliation(s)
- Philip Baba Adongo
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Box LG 13, Legon, Accra, Ghana
| | - Philip Teg-Nefaah Tabong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Box LG 13, Legon, Accra, Ghana.
| | - Emmanuel Asampong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Box LG 13, Legon, Accra, Ghana
| | - Joana Ansong
- World Health Organization Country Office for Ghana, P.O. Box M.B.142, Accra, Ghana
| | - Magda Robalo
- World Health Organization Country Office for Ghana, P.O. Box M.B.142, Accra, Ghana
| | - Richard M Adanu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Box LG 13, Legon, Accra, Ghana
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Abolfotouh MA, AlQarni AA, Al-Ghamdi SM, Salam M, Al-Assiri MH, Balkhy HH. An assessment of the level of concern among hospital-based health-care workers regarding MERS outbreaks in Saudi Arabia. BMC Infect Dis 2017; 17:4. [PMID: 28049440 PMCID: PMC5210292 DOI: 10.1186/s12879-016-2096-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 12/07/2016] [Indexed: 01/12/2023] Open
Abstract
Background Middle East Respiratory Syndrome (MERS) is caused by MERS coronavirus (MERS-CoV). More than 80% of reported cases have occurred in Saudi Arabia, with a mortality exceeding 50%. Health-care workers (HCWs) are at risk of acquiring and transmitting this virus, so the concerns of HCWs in Saudi Arabia regarding MERS were evaluated. Methods An anonymous, self-administered, previously validated questionnaire was given to 1031 HCWs at three tertiary hospitals in Saudi Arabia from October to December, 2014. Concerns regarding the disease, its severity and governmental efforts to contain it, as well as disease outcomes were assessed using 31 concern statements in five distinct domains. A total concern score was calculated for each HCW. Multiple regression analyses were used to identify predictors of high concern scores. Results The average age of participants was 37.1 ± 9.0 years, 65.8% were married and 59.1% were nurses. The majority of respondents (70.4%) felt at risk of contracting a MERS-CoV infection at work, 69.1% felt threatened if a colleague contracted MERS-CoV, 60.9% felt obliged to care for patients infected with MERS-CoV and 87.8% did not feel safe at work using standard precautions. In addition, 87.7% believed that the government should isolate patients with MERS in specialized hospitals, 73.7% agreed with travel restriction to and from areas affected by MERS and 65.3% agreed with avoiding inviting expatriates from such areas. After adjustment for covariates, high concern scores were significantly associated with being a Saudi national (p < 0.001), a non-physician (p < 0.001) and working in the central region (p < 0.001). Conclusions The majority of respondents reported concern regarding MERS-CoV infection from exposure at work. The overall level of concern may be influenced by previous experience of MERS outbreaks and related cultural issues. The concerns of HCWs may affect their overall effectiveness in an outbreak and should be addressed by incorporating management strategies in outbreak planning.
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Affiliation(s)
- Mostafa A Abolfotouh
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), PO 22490, Riyadh, 11426, Kingdom of Saudi Arabia. .,King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. .,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
| | - Ali A AlQarni
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), PO 22490, Riyadh, 11426, Kingdom of Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Suliman M Al-Ghamdi
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), PO 22490, Riyadh, 11426, Kingdom of Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Mahmoud Salam
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), PO 22490, Riyadh, 11426, Kingdom of Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed H Al-Assiri
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), PO 22490, Riyadh, 11426, Kingdom of Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hanan H Balkhy
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), PO 22490, Riyadh, 11426, Kingdom of Saudi Arabia.,King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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Kim JS, Choi JS. Middle East respiratory syndrome-related knowledge, preventive behaviours and risk perception among nursing students during outbreak. J Clin Nurs 2016; 25:2542-9. [PMID: 27273475 PMCID: PMC7166634 DOI: 10.1111/jocn.13295] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/31/2022]
Abstract
Aims and objectives The aim of this study was to survey nursing students’ Middle East respiratory syndrome–related knowledge, preventive behaviours and risk perception to examine the correlations among the variables during a Middle East respiratory syndrome outbreak. Background Middle East respiratory syndrome is a new viral respiratory illness. Nursing students who engage in clinical practice at hospitals may have been exposed to Middle East respiratory syndrome infection during the Middle East respiratory syndrome outbreak. Design This study was a descriptive cross‐sectional survey. Methods Participants (n = 249) were nursing students in their third or fourth year of the programme who were engaged in clinical practice for eight hours per day at the tertiary hospitals with Middle East respiratory syndrome patients. Knowledge, preventive behaviours and risk perception related to Middle East respiratory syndrome were measured using scales developed through a preliminary survey and validity testing. Results The subjects’ knowledge level of Middle East respiratory syndrome was 84·4%; their practice of preventive behaviours was rated at 44·5%; and their risk perception rating was 2·4 out of 5. Middle East respiratory syndrome–related risk perception was significantly different according to gender and Middle East respiratory syndrome education. Middle East respiratory syndrome–related knowledge was significantly correlated with preventive behaviours and risk perception. Conclusion Considering the low scores for items regarding knowledge and preventive behaviours, it is necessary to develop effective and systematic publicity and education programmes for nursing students. Enhancing Middle East respiratory syndrome–related knowledge by considering cooperation between hospitals and universities will sharpen nursing students’ risk perception of the disease and effectively increase their preventive behaviours. Relevance to clinical practice Similar to other emerging infectious diseases, Middle East respiratory syndrome outbreaks may occur in other countries. The results of this study can be used to develop and apply efficient and feasible Middle East respiratory syndrome education programmes for nursing students during Middle East respiratory syndrome outbreaks.
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Affiliation(s)
- Ji Soo Kim
- College of Nursing, Gachon University, Incheon, Korea
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Ganguli I, Chang Y, Weissman A, Armstrong K, Metlay JP. Ebola Risk and Preparedness: A National Survey of Internists. J Gen Intern Med 2016; 31:276-81. [PMID: 26289923 PMCID: PMC4762833 DOI: 10.1007/s11606-015-3493-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/07/2015] [Accepted: 07/27/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The 2014-2015 Ebola virus disease (Ebola) epidemic centered in West Africa highlighted recurring challenges in the United States regarding risk communication and preparedness during global epidemics. OBJECTIVE To investigate perceptions, preparedness, and knowledge among U.S. internists with regard to Ebola risk. DESIGN Cross-sectional Web-based national survey distributed by e-mail between December 2014 and January 2015. PARTICIPANTS Practicing U.S. internists participating in a research panel representative of American College of Physicians (ACP) membership. MAIN MEASURES Respondents' perceptions of Ebola, reported sources of information, and reported management of possible Ebola cases. The primary predictor was the possibility of encountering Ebola (based on respondents' geographic proximity to designated airports or confirmed Ebola cases, or on their patients' travel histories). Pre-specified outcomes included reported management intensity in clinical vignettes involving patients at low risk of symptomatic Ebola as well as reported Ebola preparedness. KEY RESULTS The survey response rate was 46.1 %. Among the 202 respondents, 9.9 % (95 % CI 6.2-14.9 %) reported that they had recently evaluated a patient who had traveled to West Africa. Seventy percent (95 % CI 63.0-76.0 %) reported a practice-level protocol. The Centers for Disease Control and Prevention (CDC) was the most popular source for Ebola information (75.2 %, 95 % CI 68.7-81.0 %). Most respondents felt very (45.0 %) or somewhat prepared (52.0 %) to communicate information about or diagnose Ebola, especially those with the possibility of encountering Ebola and those who reported medical journals, professional groups, or government as information sources. One-fifth of respondents (19.8 %, 95 % CI 14.5-26.0 %) reported overly intensive management for low-risk patients. Those with the possibility of encountering Ebola were less likely to report overly intensive management (3.1 vs. 22.9 %, p = 0.011). CONCLUSIONS Internists had wide-ranging views and understanding of Ebola risk; those least likely to encounter Ebola were most likely to be overly aggressive in managing patients at low risk. Our findings underscore the need for better risk communication through various information channels to empower frontline providers in infectious disease outbreaks.
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Affiliation(s)
- Ishani Ganguli
- Massachusetts General Hospital, 55 Fruit Street Bulfinch 205, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Yuchiao Chang
- Massachusetts General Hospital, 55 Fruit Street Bulfinch 205, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Katrina Armstrong
- Massachusetts General Hospital, 55 Fruit Street Bulfinch 205, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Joshua P Metlay
- Massachusetts General Hospital, 55 Fruit Street Bulfinch 205, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
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Khan MU, Shah S, Ahmad A, Fatokun O. Knowledge and attitude of healthcare workers about Middle East Respiratory Syndrome in multispecialty hospitals of Qassim, Saudi Arabia. BMC Public Health 2014; 14:1281. [PMID: 25510239 PMCID: PMC4300996 DOI: 10.1186/1471-2458-14-1281] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 12/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the increase in prevalence of Middle East Respiratory Syndrome (MERS), healthcare workers (HCWs) are at risk of acquiring and subsequently transmitting this lethal virus. In view of this, HCWs were evaluated for their knowledge of and attitude towards MERS in Saudi Arabia. METHODS A cross sectional study was performed in two hospitals of Qassim region in Saudi Arabia. A total of 280 healthcare workers were selected to participate in this study. Knowledge and attitude were assessed by using self-administered and pretested questionnaire. Descriptive statistics were carried out to express participants' demographic information, mean knowledge score and mean attitude score of HCWs. Inferential statistics (Mann-Whitney U test and Kruskal Wallis tests, p < 0.05) were used to examine differences between study variables. Chi squares tests were used to assess the association between study variables and attitude questions. Spearman's rho correlation was used to identify the association between the knowledge, attitude scores. RESULT Participants demonstrated good knowledge and positive attitude towards MERS. The mean scores of knowledge and attitude were 9.45 ± 1.69 (based on 13 knowledge questions) and 1.82 ± 0.72 (based on 7 attitude questions). The correlation between knowledge and attitude was significant (correlation coefficient: 0.12; P <0.001). HCWs were less educated about the management (42.4%), source (66%) and consequences of MERS (67.3%), while a majority of them were well aware of the hallmark symptoms (96%), precautionary measures (96%) and hygiene issues (94%). Although the majority of respondents showed positive attitude towards the use of protective measures (1.52 ± 0.84), their attitude was negative towards their active participation in infection control program (2.03 ± 0.97). Gender and experience were significantly associated with knowledge and attitude (P < 0.05). CONCLUSIONS The findings of this study showed that healthcare workers in Qassim region of Saudi Arabia have good knowledge and positive attitude towards MERS. Yet there are areas where low knowledge and negative attitude of HCWs was observed. However, studies are required to assess the knowledge and attitude of HCWs at national level so that effective interventions could be designed as surveillance and infection control measures are critical to global public health.
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Affiliation(s)
- Muhammad Umair Khan
- Department of Clinical Pharmacy, UCSI University, No, 1 Jalan Menara Gading, Taman Connaught, Cheras 56000 Kuala Lumpur, Malaysia.
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Koh Y, Hegney D, Drury V. Nurses' perceptions of risk from emerging respiratory infectious diseases: a Singapore study. Int J Nurs Pract 2012; 18:195-204. [PMID: 22435984 PMCID: PMC7165875 DOI: 10.1111/j.1440-172x.2012.02018.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The recent emergence of virulent respiratory infectious diseases such as Severe Acute Respiratory Syndrome (SARS) and Influenza A/H1N1 viruses predisposes nurses to occupational risks. This qualitative study investigated how Chinese Singaporean nurses perceived the risks of exposure to these infectious diseases and the factors that influenced this risk perception. Data were collected through face-to-face interviews and were analyzed using Braun and Clarke's process of thematic analysis. Three themes emerged: living with risk; the experience of SARS; and acceptance of risk. The nature of nursing work was perceived to place participants at risk of infection. Another significant finding of this study is that the government's, organizations' and nurses' perceptions of new emerging respiratory infectious diseases were influenced by their previous experience with SARS. Similar to previous studies, nurses working at the 'front line' believed that infection from these diseases was an unavoidable occupational hazard.
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Affiliation(s)
- Yiwen Koh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Naghavi SHR, Shabestari O, Roudsari AV, Harrison J. Design and validation of a questionnaire to measure the attitudes of hospital staff concerning pandemic influenza. J Infect Public Health 2012; 5:89-101. [PMID: 22341848 PMCID: PMC7102719 DOI: 10.1016/j.jiph.2011.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 11/02/2011] [Accepted: 11/03/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVE When pandemics lead to a higher workload in the healthcare sector, the attitude of healthcare staff and, more importantly, the ability to predict the rate of absence due to sickness are crucial factors in emergency preparedness and resource allocation. The aim of this study was to design and validate a questionnaire to measure the attitude of hospital staff toward work attendance during an influenza pandemic. METHOD An online questionnaire was designed and electronically distributed to the staff of a teaching medical institution in the United Kingdom. The questionnaire was designed de novo following discussions with colleagues at Imperial College and with reference to the literature on the severe acute respiratory syndrome (SARS) epidemic. The questionnaire included 15 independent fact variables and 33 dependent measure variables. A total of 367 responses were received in this survey. RESULTS The data from the measurement variables were not normally distributed. Three different methods (standardized residuals, Mahalanobis distance and Cook's distance) were used to identify the outliers. In all, 19 respondents (5.17%) were identified as outliers and were excluded. The responses to this questionnaire had a wide range of missing data, from 1 to 74 cases in the measured variables. To improve the quality of the data, missing value analysis, using Expectation Maximization Algorithm (EMA) with a non-normal distribution model, was applied to the responses. The collected data were checked for homoscedasticity and multicollinearity of the variables. These tests suggested that some of the questions should be merged. In the last step, the reliability of the questionnaire was evaluated. This process showed that three questions reduced the reliability of the questionnaire. Removing those questions helped to achieve the desired level of reliability. CONCLUSION With the changes proposed in this article, the questionnaire for measuring staff attitudes concerning pandemic influenza can be converted to a standardized and validated questionnaire to properly measure the expectations and attendance of healthcare staff in the event of pandemic flu.
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Affiliation(s)
- Seyed Hamid Reza Naghavi
- Department of Occupational Health - Barking, Havering and Redbridge University Hospitals NHS Trust, Essex, UK.
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Leppin A, Aro AR. Risk perceptions related to SARS and avian influenza: theoretical foundations of current empirical research. Int J Behav Med 2009; 16:7-29. [PMID: 19214752 PMCID: PMC7090865 DOI: 10.1007/s12529-008-9002-8] [Citation(s) in RCA: 226] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND The outbreak of severe acute respiratory syndrome in 2003 and the subsequent emergence of the H5N1 virus have highlighted the threat of a global pandemic influenza outbreak. Planning effective public health control measures for such a case will be highly dependent on sound theory-based research on how people perceive the risks involved in such an event. PURPOSE The present article aims to review theoretical models and concepts underlying current empirical research on pandemic influenza risk perception. METHOD A review was conducted based on 28 empirical studies from 30 articles which were published between 2003 and 2007. RESULTS Concepts of risk perception mostly seemed more pragmatic than theory-based and were highly heterogeneous, for instance, in terms of conceptualizing risk perception as an exclusively cognitive or as a cognitive and emotional phenomenon or whether the concept was dominated by expectancy or expectancy and value components. Similarly, the majority of studies investigating risk perceptions and protective behaviors were not model-based. CONCLUSIONS The current body of knowledge can only provide preliminary insights. Unlike the reviewed studies, which were mostly launched as a rapid response to outbreak situations, future research will have to invest more strongly into theoretical work to provide sounder evidence.
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Affiliation(s)
- Anja Leppin
- University of Southern Denmark, Institute of Public Health, Unit for Health Promotion, Niels Bohrs Vej 9, 6700 Esbjerg, Denmark.
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Di Giuseppe G, Abbate R, Albano L, Marinelli P, Angelillo IF. A survey of knowledge, attitudes and practices towards avian influenza in an adult population of Italy. BMC Infect Dis 2008; 8:36. [PMID: 18366644 PMCID: PMC2292195 DOI: 10.1186/1471-2334-8-36] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Accepted: 03/17/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several public health strategic interventions are required for effective prevention and control of avian influenza (AI) and it is necessary to create a communication plan to keep families adequately informed on how to avoid or reduce exposure. This investigation determined the knowledge, attitudes, and behaviors relating to AI among an adult population in Italy. METHODS From December 2005 to February 2006 a random sample of 1020 adults received a questionnaire about socio-demographic characteristics, knowledge of transmission and prevention about AI, attitudes towards AI, behaviors regarding use of preventive measures and food-handling practices, and sources of information about AI. RESULTS A response rate of 67% was achieved. Those in higher socioeconomic classes were more likely to identify the modes of transmission and the animals' vehicles for AI. Those older, who knew the modes of transmission and the animals' vehicles for AI, and who still need information, were more likely to know that washing hands soap before and after touching raw poultry meat and using gloves is recommended to avoid spreading of AI through food. The risk of being infected was significantly higher in those from lower socioeconomic classes, if they did not know the definition of AI, if they knew that AI could be transmitted by eating and touching raw eggs and poultry foods, and if they did not need information. Compliance with the hygienic practices during handling of raw poultry meat was more likely in those who perceived to be at higher risk, who knew the hygienic practices, who knew the modes of transmission and the animals' vehicles for AI, and who received information from health professionals and scientific journals. CONCLUSION Respondents demonstrate no detailed understanding of AI, a greater perceived risk, and a lower compliance with precautions behaviors and health educational strategies are strongly needed.
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Affiliation(s)
- Gabriella Di Giuseppe
- Department of Public, Clinical and Preventive Medicine, Second University of Naples, Naples, Italy.
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Imai T, Takahashi K, Hoshuyama T, Hasegawa N, Chia SE, Koh D. Substantial differences in preparedness for emergency infection control measures among major hospitals in Japan: lessons from SARS. J Infect Chemother 2006; 12:124-31. [PMID: 16826344 PMCID: PMC7087705 DOI: 10.1007/s10156-006-0436-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Accepted: 03/03/2006] [Indexed: 02/04/2023]
Abstract
Emergency infection control measures are essential in hospitals. Although Japan was spared from the 2003 epidemic of severe acute respiratory syndrome (SARS), hospitals were placed on high alert. The actual preparedness level of hospitals can be determined by examining individual perceptions among the hospital healthcare workers (HCWs). The objective of this study was to assess the level of preparedness of emergency infection control measures in Japan and to quantify the differences in preparedness across institutions and disciplines. From July to September 2003, a questionnaire survey concerning the perceptions of risks and countermeasures and knowledge about SARS was distributed at seven tertiary hospitals. Disciplines were categorized as emergency room (ER)/intensive care unit (ICU), surgical, medical, and “others”. Of the 9978 questionnaires administered, 6929 valid responses were received and analyzed. After adjusting for age, sex, and job category, specific institutional measures (I-scores) were found to be more indicative of the level of preparedness across institutions and disciplines than were measures of overall effectiveness (E-scores) or knowledge of preventive measures (K-scores). In particular, the difference in I-scores was much more substantial across institutions than across disciplines. Across disciplines, surgical ranked lower than ER/ICU or medical. In conclusion, substantial differences in emergency infection control measures, as perceived by HCWs, exists among hospitals in Japan, with the differences across institutions exceeding those across disciplines. To achieve a higher level of preparedness for infectious diseases, institutions should designate and implement effective emergency infection control measures.
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Affiliation(s)
- Teppei Imai
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
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Al‐Gharabli SI, Shah STA, Weik S, Schmidt MF, Mesters JR, Kuhn D, Klebe G, Hilgenfeld R, Rademann J. An efficient method for the synthesis of peptide aldehyde libraries employed in the discovery of reversible SARS coronavirus main protease (SARS-CoV Mpro) inhibitors. Chembiochem 2006; 7:1048-55. [PMID: 16688706 PMCID: PMC7417790 DOI: 10.1002/cbic.200500533] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Indexed: 11/10/2022]
Abstract
A method for the parallel solid-phase synthesis of peptide aldehydes has been developed. Protected amino acid aldehydes obtained by the racemization-free oxidation of amino alcohols with Dess-Martin periodinane were immobilized on threonyl resins as oxazolidines. Following Boc protection of the ring nitrogen to yield the N-protected oxazolidine linker, peptide synthesis was performed efficiently on this resin. A peptide aldehyde library was designed for targeting the SARS coronavirus main protease, SARS-CoV M(pro)(also known as 3CL(pro)), on the basis of three different reported binding modes and supported by virtual screening. A set of 25 peptide aldehydes was prepared by this method and investigated in inhibition assays against SARS-CoV M(pro). Several potent inhibitors were found with IC(50) values in the low micromolar range. An IC(50) of 7.5 muM was found for AcNSTSQ-H and AcESTLQ-H. Interestingly, the most potent inhibitors seem to bind to SARS-CoV M(pro) in a noncanonical binding mode.
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Affiliation(s)
- Samer I. Al‐Gharabli
- Leibniz Institut für Molekulare Pharmakologie (FMP), Department for Medicinal Chemistry, Robert‐Rössle‐Straße 10, 13125 Berlin, Germany, Fax: (+49) 30‐94793‐280
- Current address: Chemical and Pharmaceutical Engineering, German–Jordanian University, 35247 Amman 11180, Jordan
| | - Syed T. Ali Shah
- Leibniz Institut für Molekulare Pharmakologie (FMP), Department for Medicinal Chemistry, Robert‐Rössle‐Straße 10, 13125 Berlin, Germany, Fax: (+49) 30‐94793‐280
| | - Steffen Weik
- Leibniz Institut für Molekulare Pharmakologie (FMP), Department for Medicinal Chemistry, Robert‐Rössle‐Straße 10, 13125 Berlin, Germany, Fax: (+49) 30‐94793‐280
| | - Marco F. Schmidt
- Leibniz Institut für Molekulare Pharmakologie (FMP), Department for Medicinal Chemistry, Robert‐Rössle‐Straße 10, 13125 Berlin, Germany, Fax: (+49) 30‐94793‐280
- Freie Universität Berlin, Institut für Chemie und Biochemie, Takustrasse 3, 14195 Berlin, Germany
| | - Jeroen R. Mesters
- Institut für Biochemie, Center for Structural and Cell Biology in Medicine, Universität Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Daniel Kuhn
- Institut für Pharmazeutische Chemie, Philipps‐Universität Marburg, Marbacher Weg 6, 35032 Marburg, Germany
| | - Gerhard Klebe
- Institut für Pharmazeutische Chemie, Philipps‐Universität Marburg, Marbacher Weg 6, 35032 Marburg, Germany
| | - Rolf Hilgenfeld
- Institut für Biochemie, Center for Structural and Cell Biology in Medicine, Universität Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Jörg Rademann
- Leibniz Institut für Molekulare Pharmakologie (FMP), Department for Medicinal Chemistry, Robert‐Rössle‐Straße 10, 13125 Berlin, Germany, Fax: (+49) 30‐94793‐280
- Freie Universität Berlin, Institut für Chemie und Biochemie, Takustrasse 3, 14195 Berlin, Germany
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