Psychological Impact of the COVID-19 Pandemic on Healthcare Professionals in Tunisia: Risk and Protective Factors

Depression and Functioning during the COVID-19 Pandemic among Adults across Tunisia

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences. We recruited a representative sample of 2014 participants (1024 males, 990 females) using random digit dialing of mobile phone numbers across all 24 governorates in Tunisia. Females reported higher depression, greater impaired functioning, and a higher likelihood of having had COVID-19. Path analysis showed a good fit to the model when paths for males and females were allowed to vary, providing evidence for gender differences. Associations between trauma exposure and depression and depression and age with functioning were stronger among females. Social support from friends was a protective factor for males only. For males, all study variables were associated with functioning indirectly through their association with depression, except for support from friends. For females, family responsibilities and health problems had both direct and indirect effects, whereas other study variables were only linked with functioning through depression. Findings provide insights into factors that can be targeted in interventions aimed at reducing depression and improving daily functioning for males and females.

Effects of Gender and Social Network Use on High School Students’ Emotional Well-Being during COVID-19

Various studies conducted during the COVID-19 pandemic have confirmed changes in online behaviour, with young people increasingly using social networks. This trend appears to correlate with a heightened risk of various psychological and emotional problems. The main aim of this study is to explore the patterns of social network use among high school students amidst the pandemic, particularly focusing on the presence of specific emotional problems and potential gender differences. In addition, this study aims to contribute to the existing body of knowledge on the influence of lockdown measures on adolescents. A probabilistic sample of N = 825 students from 20 high schools in Zagreb participated in this study. Alongside basic sociodemographic variables, this study assessed social network habits and emotional problems using the Depression Anxiety Stress Scales 21 (DASS-21). The findings indicate intensive social media engagement during the pandemic. The results of the MANOVA analysis (gender x daily time on social media) show significant effects of both the time spent on social networks and gender on mental health, while no interaction effect was observed. Female students and those who spend more time on social media have higher levels of depression, anxiety, and stress symptoms. These findings underscore the need for addressing emotional problems and habits in the virtual environment of high school students and implementing appropriate preventive and treatment interventions.

Psychological distress in healthcare workers during COVID-19 pandemic: A systematic review

OBJECTIVES

Healthcare workers serving during the COVID-19 pandemic may have been exposed to high work overload, which may have had an impact on their physical, mental, and social health. The aim of this study was to assess the risk factors associated with psychological distress among healthcare workers serving during the COVID-19 pandemic from January 2020 to December 2022.

METHODS

A systematic review was conducted based on the 2020 PRISMA statement. Articles were searched in the Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO databases.

RESULTS

A total of 59 articles were included in this systematic review. It was observed that the prevalence of psychological distress during the COVID-19 pandemic was high. Female sex, being a nurse, being young, living alone/being single, and having a chronic disease or psychiatric disorder history are the main risk factors at the personal level. Other occupational and pandemic-related factors such as having many years of work experience, the presence of COVID-19 symptoms and contact history, not enough sleep, having lower family support and limited social relationships, fear of infecting friends and family, having a reduced perception of protection by personal protective equipment, working on the frontline, and having longer service duration were found to be factors influencing the development of psychological distress during the COVID-19 pandemic.

CONCLUSIONS

There are personal, interpersonal, and organizational risk factors that can lead to the occurrence of psychological distress among healthcare staff working during the COVID-19 pandemic.

Burnout syndrome among health care workers during the COVID-19 pandemic. A cross sectional study in Monastir, Tunisia

BACKGROUND

Burnout syndrome may affect the safety of frontline healthcare care workers (HCW) and patients. We aimed to measure the prevalence of burnout among HCW in care facilities in Tunisia during the Covid-19 pandemic and to identify its associated factors.

METHODS

We conducted a cross-sectional study among HCW practicing during the covid-19 pandemic in health care facilities in the governorate of Monastir. Data collection was carried out using an anonymous self-administered questionnaire composed by three sections: epidemiological and clinical characteristics, professional conditions and the Maslach Burn out Inventory (MBI-HSS).

RESULTS

This study included 371 HCW. The prevalence of burnout was 77.9% (CI 95%: 73.6% - 82.1%). The severe level was found in 71 participants (19.1%), the moderate level in 115 (31%) and the low level in 103 (27.8%). The distribution of the levels of the burnout dimensions among the participants was as follows: high emotional exhaustion (EE) (57.4%), high depersonalization (DP) (39.4%) and low personal accomplishment (22.6%). The main determinants of burnout among healthcare professionals during COVID 19 pandemic were: working more than 6 hours per day (OR = 1.19; CI95% [1.06; 1.34]), physician function (OR = 1.17; CI 95% [1.05; 1.31]), feeling a negative impact of work on family life (OR = 1.40; 95% CI [1.13; 1.73]), and high personal estimation of COVID 19 exposure (OR = 1.15; CI95% [1.02; 1.29]).

CONCLUSION

During the COVID19 pandemic, the prevalence of burnout among health professionals was high. It was related to hard implication in COVID 19 management. Interventions like adjusting working hours, reducing workload, and providing psychological support should be taken.

Stress coping strategies used by nurses during the COVID-19 pandemic

Introduction

The risk of getting SARS-CoV-2 infection, worries about exposing loved ones, anxiety and frustration, emotional and physical exhaustion, burn out, a feeling of being overwhelmed, and struggles and challenges with parenting are a few among many factors that affect nurses' personal lives and professional functioning. The aim of the research is to assess nurses' level of stress during the COVID-19 pandemic and their sense of self-efficacy, and to learn what coping strategies they use.

Methodology/Methods

The study was carried out online and based on the diagnostic poll method, using an original survey questionnaire, the General Self-Efficacy Scale (GSES 10-40), the Mini-COPE questionnaire (0-3), and the Perceived Stress Scale PSS-10 (0-40). The respondent group was made up of nurses (n = 220) who provide health services in inpatient and outpatient health care institutions in the northeastern region of Poland. The statistical analysis was performed using the STATISTICA 13.0 package (StatSoft). The distribution of variables was checked with Shapiro-Wilk tests. The Mann-Whitney U test was used to compare two independent samples, while the Kruskal-Wallis test was used to compare more samples. The adopted statistical significance level was p < 0.05. Multivariate regression analysis was applied to determine which factors were related to the level of stress.

Results

The mean age of the participants was 43.3 years. The vast majority were women (96.4). The mean work experience of the nurses was over 20 years (58.2%). A total of 62.3% worked directly with patients in hospitals, including 11.8% respondents working at COVID-19 units and 37.7% working at primary care institutions. The analyses show that the respondents represented a high level of stress (PSS-10 - 20.9), related to their work experience as a nurse (β -0.250, p = 0.014), the number of hours worked a month (β 0.156, p = 0.015), and self-assessed health status (β -0.145, p = 0.037). They declared an average sense of self-efficacy (GSES - 29.1), which significantly depended on the nurses' places of employment (p = 0.044). Out of stress coping strategies (Mini-COPE), the younger nurses mentioned venting (p = 0.010), instrumental support (p = 0.011), sense of humour (p = 0.013) and self-blame (0.031). Practice nurses also chose the strategy of behavioral disengagement (p = 0.032), and nurse managers chose the strategy of planning (p = 0.018).

Conclusions

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect nurses' mental health and to take extensive prevention measures in critical situations. Special attention should be given to nurses who are younger and have shorter work experience. It is also important to monitor nurses' working time and health status, and those who work at outpatient health care institutions should be given more support and information.

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study's main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.