Challenges Faced by Healthcare Professionals During the COVID-19 Pandemic: A Qualitative Inquiry From Bangladesh

Community health volunteers' experiences during the COVID-19 pandemic in Kiambu county, Kenya: A qualitative study

BACKGROUND

For already overburdened health systems in low- and middle-income countries (LMICs), the COVID-19 pandemic presented an almost impossible challenge. In Kenya, efforts to mitigate the impact of the pandemic included the mobilization of community health volunteers (CHVs), a cadre that has been historically understaffed and under-resourced. These volunteers were required to sustain the delivery of routine community-based health services while also taking on additional responsibilities related to COVID-19 mitigation. This study explored the challenges faced by CHVs during the COVID-19 response in Kiambu County; focusing on their experiences with control measures, impacts on community-level healthcare delivery, and perspectives on the government's pandemic response within the community health framework.

METHODS

This study employed a phenomenological exploratory qualitative design. Due to logistical constraints, only two focus group discussions could be conducted with 24 CHVs, representing 48% of eligible participants who met the inclusion criteria: a minimum of five years of experience, active involvement in the pandemic response, and availability for the interview. Data were digitally recorded, transcribed, translated, and coded for thematic analysis.

RESULTS

Specific themes from the experiences of the CHVs during the COVID-19 lockdown were: (1) dedication and commitment to serving the community; (2) overcoming demoralization; and (3) community barriers to health care delivery and access. In regards to the community perspectives of COVID-19, the CHVs relayed widespread misinformation among community members, with experiences of stigma due to COVID-19 misconceptions. They also gave second-person accounts of the economic strife the community went through as a result of mitigation measures. The CHVs were skeptical in the county's preparedness in dealing with both the COVID-19 and future pandemics.

CONCLUSION

Despite facing stigma, misinformation, limited resources, and economic hardships, CHVs demonstrated commitment to their roles. Their efforts not only underscored their resilience but also revealed critical gaps in preparedness and resource allocation within the healthcare system. However, the small number of FGDs and insufficent data saturation should be considered when interpreting the findings. Nonetheless, our study provides a starting point for further research and comparative analysis across other counties in Kenya.

Parental acceptance of novel children's medical syringes and their influencing factors

Background

With the rising global demand for medical syringes among children, the unsuitability of traditional syringes may negatively affect their physical and mental health.

Methods

This study integrates the extended Technology Acceptance Model (TAM) to survey 455 child guardians on 10 variables influencing their attitudes toward pediatric medical syringes.

Results

Results indicate that aesthetic preferences of users significantly influence the price value sensitivity and purchasing decisions of children's guardians. Furthermore, the product's function and price value significantly shape users' behavioral intentions. Technology anxiety and time and error reduction emerge as key factors influencing perceived risks.

Conclusions

This study offers product designers crucial insights into purchasing factors for children's medical products, aims to enhance product development and iteration efficiency, and promotes more accurate innovation, decision-making, and communication. Additionally, it proposes new recommendations for ethical and marketing strategies.

Health care providers have faced the pandemic altruistically, but financial support is important for their well-being and motivation to work

OBJECTIVES

The COVID-19 pandemic has significantly stressed healthcare systems globally, placing unprecedented demands on healthcare workers (HCWs). This study investigated the effects of financial support (hazard pay) on the well-being, job satisfaction, and motivation of frontline HCWs during the Pandemic.

STUDY DESIGN

Cross-sectional study.

METHODS

A cross-sectional study was conducted using an online questionnaire from July to November 2022, involving 637 frontline HCWs from Kazakhstan. Measures included the Copenhagen Burnout Inventory, the DASS-21 scale, the WHO-5 Well-being Index, and scales for job satisfaction and work motivation. Statistical analysis employed descriptive statistics, Mann-Whitney U-tests, Bayesian statistics, χ2-test, correlation, and linear regression analyses, alongside generalized mediation models.

RESULTS

Most HCWs (80.1 %) reported receiving financial support, with varied satisfaction levels. Those without financial support exhibited significantly higher burnout levels and more severe symptoms of depression and anxiety compared to their supported colleagues. Satisfaction with financial support was positively associated with job satisfaction and negatively with burnout and DAS symptoms. Mediation analysis highlighted that job satisfaction and burnout significantly mediated the relationship between satisfaction with financial support and work motivation. Therefore, financial support was crucial in mitigating the adverse effects of the pandemic on HCWs' mental health and motivation.

CONCLUSION

The study emphasizes the role of financial support in enhancing HCWs' well-being and motivation to work, suggesting that well-structured financial incentive programs are essential for sustaining healthcare services during and beyond global health emergencies. The direct and mediated relationships underscore the importance of adequate financial incentives in maintaining healthcare workforce stability during crises.

The Role of Short-Form Video Apps in Mitigating Occupational Burnout and Enhancing Life Satisfaction Among Healthcare Workers: A Serial Multiple Mediation Model

Background: The intersection of occupational burnout and digital leisure activities has garnered increasing scholarly attention in recent years. However, limited research has examined how Chinese healthcare workers engage with short-form video apps as a stress management tool. Objectives: This study employs a serial multiple mediation model to explore the impact of occupational burnout on the use of short-form video apps and its subsequent effects on a sense of community, intrinsic rewards, and life satisfaction among Chinese healthcare workers aged 18-34. Methods: Data were collected through an online survey, with 362 valid responses, and analyzed using descriptive statistics, hierarchical regression, and mediation analyses, including serial mediation via SPSS 25.0. Results: The results demonstrate a positive direct association between occupational burnout and the use of short-form video apps. Furthermore, the relationship between the use of short-form video apps and life satisfaction was mediated through two distinct pathways, namely, a sense of community and intrinsic rewards. Conclusions: These findings contribute to the expanding body of literature on the role of digital media in stress management and well-being among healthcare workers, as well as highlighting evidence-based digital interventions to support healthcare workers' well-being in high-stress settings.

Users' Perceived Service Quality of National Telemedicine Services During the COVID-19 Pandemic in Bangladesh: Cross-Sectional Study

Background

COVID-19 created an opportunity for using teleconsultation as an alternative way of accessing expert medical advice. Bangladesh has seen a 20-fold increase in the use of teleconsultation during the pandemic.

Objective

The aim of our study was to assess the influence of service quality and user satisfaction on the intention to use teleconsultation in the future among users of national teleconsultation services during the pandemic.

Methods

A cross-sectional survey was conducted in 2020 among users of the national teleconsultation service-Shastho Batayon for acute respiratory infection. A validated mobile health service quality model based on structural equation modeling and confirmatory factor analysis was used to analyze the data with SmartPLS (version 3.0).

Results

Among the 2097 study participants, 1646 (78.5%) were male, 1416 (67.5%) were aged 18-39 years, 1588 (75.7%) were urban residents, 1348 (64.2%) had more than 10 years of schooling, and 1657 (79%) were from middle-income households. From a consumer perspective, the quality of the service platform (β=.946), service interaction (β=.974), and outcome (β=.955) contributed to service quality. Service quality was positively associated with user satisfaction (β=.327; P<.001) and intention to use teleconsultation services (β=.102; P<.001). User satisfaction was positively associated with the intention to use teleconsultation services (β=.311; P<.001).

Conclusions

The increase in the use of teleconsultation during the pandemic indicated that such services were potentially used for emergencies. However, the future use of teleconsultation will be dependent on the quality of service and user satisfaction. Our findings are relevant for low-income contexts where teleconsultation services are used to address gaps in service delivery.

The Moderating Role of Emotional Intelligence on the Relationship Between Nurses' Preparedness to Care for COVID-19 Patients and Their Quality of Work Life

Emotional intelligence (EI) is increasingly recognized as a key factor in healthcare, where managing emotions is vital for job satisfaction, productivity, and interpersonal relationships. For nurses, particularly during the COVID-19 pandemic, EI plays a pivotal role in navigating emotional challenges and improving their quality of work life (QoWL). This study examined how EI moderates the relationship between nurses' preparedness to care for COVID-19 patients and their QoWL. A cross-sectional, correlational design was used, involving 267 nurses from various healthcare settings. Data were collected through the Emotional Intelligence Scale, the Quality of Nursing Work Life survey, and demographic questionnaires. The sample was predominantly female (94.4%), with a mean age of 37.47 years (SD = 8.09) and an average of 8.43 years of experience (SD = 6.33). Most nurses (87.3%) attended COVID-19-related workshops, with 76.4% feeling prepared to care for COVID-19 patients. Emotional intelligence levels were high, with 93.6% of nurses reporting good personal competence and 85.4% reporting good social competence. Descriptive results showed that 71% of nurses perceived their QoWL as good, while 29% rated it as fair. Pearson correlation analysis revealed significant positive correlations between both personal competence (r = 0.33, p < 0.001) and social competence (r = 0.34, p < 0.001) with QoWL, but preparedness to care for COVID-19 patients did not correlate significantly with either EI or QoWL. Hierarchical regression analysis demonstrated that, although nurses' preparedness alone did not predict QoWL (β = 0.034, p = 0.57), including emotional intelligence as a moderator explains 41% of the variance in QoWL. Both personal (β = 0.578, p < 0.001) and social competence (β = 0.665, p < 0.001) components of EI had significant buffering effects on the relationship between preparedness and QoWL. These findings suggest that fostering EI in nurses can enhance their resilience and improve their work life quality, particularly in high-stress healthcare environments like those experienced during the pandemic.

Patient flow management in biological events: a scoping review

INTRODUCTION

Biological Events affect large populations depending on transmission potential and propagation. A recent example of a biological event spreading globally is the COVID-19 pandemic, which has had severe effects on the economy, society, and even politics,in addition to its broad occurrence and fatalities. The aim of this scoping review was to look into patient flow management techniques and approaches used globally in biological incidents.

METHODS

The current investigation was conducted based on PRISMA-ScR: Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. All articles released until March 31, 2023, about research question were examined, regardless of the year of publication. The authors searched in databases including Scopus, Web of Science, PubMed, Google scholar search engine, Grey Literature and did hand searching. Papers with lack of the required information and all non-English language publications including those with only English abstracts were excluded. Data extraction checklist has been developed Based on the consensus of authors.the content of the papers based on data extraction, analyzed using content analysis.

RESULTS

A total of 19,231 articles were retrieved in this study and after screening, 36 articles were eventually entered for final analysis. Eighty-four subcategories were identified,To facilitate more precise analysis and understanding, factors were categorised into seven categories: patient flow simulation models, risk communication management, integrated ICT system establishment, collaborative interdisciplinary and intersectoral approach, systematic patient management, promotion of health information technology models, modification of triage strategies, and optimal resource and capacity management.

CONCLUSION

Patient flow management during biological Events plays a crucial role in maintaining the performance of the healthcare system. When public health-threatening biological incidents occur, due to the high number of patients, it is essential to implement a holistic,and integrated approach from rapid identification to treatment and discharge of patients.

Diabetes specialist nurses' knowledge, skills, and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional survey

BACKGROUND

The number of diabetes specialist nurse as well as their knowledge and skills have increased in Gansu Province since 2017. However, China has not fully addressed how to improve their professional skills to deliver effective health education.

AIMS

To investigate the knowledge, skills, and personal attributes of competent health education practices among diabetes specialist nurses in Gansu Province, western China, and the potential influencing factors.

DESIGN

Cross-sectional study.

METHODS

In total, 178 diabetes specialist nurses from 45 hospitals participated in this study. Data were collected between December 2022 and April 2023 using the Nurse Health Education Competence Instrument (I-CepSE) and a self-report questionnaire. Descriptive and inferential statistics, including univariate and multiple linear regression analyses, were used to analyze data.

RESULTS

The mean scores of overall I-CepSE, knowledge, skills, and personal attributes were 218.77 ± 31.65, 77.80 ± 18.27, 103.95 ± 13.75 and 37.02 ± 4.73, respectively. A shortage of nursing staff and heavy workload (81.4 %), lack of cooperation from patients (56.5 %), lack of access to educational resources during work placement (54.2 %), and nurses' lack of knowledge/skills in health education (53.1 %) were common barriers to health education implementation. The regression models for the overall health education competence domain were significant (P < 0.001) with R2 values ranging from 31.9 % to 50.5 %. Education level and years of experience in diabetes-related care were found to be significant on all knowledge, skills, and personal attitude scales (P < 0.05), and age was associated with diabetes specialist nurses' skills and personal attitude scores (P < 0.05).

CONCLUSION

Diabetes specialist nurses demonstrated moderate to high levels of health education knowledge, skills, and attitudes. However, they lacked knowledge of pedagogical techniques and resources, with inadequate educational skills. This study suggests that reasonable nursing human resource allocation and continuous education and training are crucial for improving health education competence.

Challenges Experienced by Health Care Workers During Service Delivery in the Geographically Challenging Terrains of North-East India: Study Involving a Thematic Analysis

BACKGROUND

The public health landscape in North-East India is marked by the foundational principle of equitable health care provision, a critical endeavor considering the region's intricate geography and proximity to international borders. Health care workers grapple with challenges, such as treacherous routes, limited infrastructure, and diverse cultural nuances, when delivering essential medical services. Despite improvements since the National Rural Health Mission in 2005, challenges persist, prompting a study to identify health care workers' challenges and alternative strategies in Manipur and Nagaland.

OBJECTIVE

This study aims to document the challenges experienced by health care workers during service delivery in the geographically challenging terrains of North-East India.

METHODS

This study is part of the i-DRONE (Indian Council of Medical Research's Drone Response and Outreach for North East) project, which aims to assess the feasibility of drone-mediated vaccine and medical delivery. This study addresses the secondary objective of the i-DRONE project. In-depth interviews of 29 health care workers were conducted using semistructured questionnaires in 5 districts (Mokokchung and Tuensang in Nagaland, and Imphal West, Bishnupur, and Churachandpur in Manipur). Nineteen health facilities, including primary health care centers, community health centers, and district hospitals, were selected. The study considered all levels of health care professionals who were in active employment for the past 6 months without a significant vacation and those who were engaged in ground-level implementation, policy, and maintenance activities. Data were recorded, transcribed, and translated, and subsequently, codes, themes, and subthemes were developed using NVivo 14 (QSR International) for thematic analysis.

RESULTS

Five themes were generated from the data: (1) general challenges (challenges due to being an international borderline district, human resource constraints, logistical challenges for medical supply, infrastructural issues, and transportation challenges); (2) challenges during the COVID-19 pandemic (increased workload, lack of diagnostic centers, mental health challenges and family issues, routine health care facilities affected, stigma and fear of infection, and vaccine hesitancy and misinformation); (3) perception and awareness regarding COVID-19 vaccination; (4) alternative actions or strategies adopted by health care workers to address the challenges; and (5) suggestions provided by health care workers. Health care workers demonstrated adaptability by overcoming these challenges and provided suggestions for addressing these challenges in the future.

CONCLUSIONS

Health care workers in Manipur and Nagaland have shown remarkable resilience in the face of numerous challenges exacerbated by the pandemic. Despite infrastructural limitations, communication barriers, and inadequate medical supply distribution in remote areas, they have demonstrated adaptability through innovative solutions like efficient data management, vaccination awareness campaigns, and leveraging technology for improved care delivery. The findings are pertinent for not only health care practitioners and policymakers but also the broader scientific and public health communities. However, the findings may have limited generalizability beyond Manipur and Nagaland.

Exploring the challenges of emergency medical service providers in the initial phase of the COVID-19 pandemic: a qualitative content analysis

BACKGROUND

As the COVID-19 pandemic continues to unfold, there has been a substantial increase in the demand for prehospital services. Emergency medical service (EMS) providers have encountered a myriad of challenges that have had a discernible impact on their professional performance. This study was designed to explore the challenges faced by EMS providers during the initial phase of the COVID-19 pandemic.

METHODS

This qualitative research was conducted using a content analysis approach at emergency medical centers affiliated with Hamadan University of Medical Sciences in Iran between April and August 2021. This study included the participation of 21 EMS personnel, which was conducted using purposive sampling and semistructured interviews, and continued until data saturation was reached. The conventional content analysis method, as outlined by Graneheim and Lundman, was applied for data analysis.

RESULTS

The analysis of the interview data resulted in the identification of 219 primary codes, which were then organized into ten distinct categories. These categories were further consolidated into three overarching themes: personal safety challenges, professional-organizational challenges, and threatened mental health.

CONCLUSIONS

EMS personnel play a critical role in healthcare during disasters and pandemics, facing challenges that can have negative effects. Managing these challenges can impact mental health and professional well-being, but awareness, support, resources, and services can help mitigate adverse consequences.

Pandemic lessons on essential healthcare services for the urban poor: a qualitative perspective of users and providers in Bangladesh

OBJECTIVE

The COVID-19 pandemic imposed unprecedented challenges to health systems globally. This study explored slum dwellers' experience of receiving essential health services during the pandemic and the challenges faced by healthcare providers in urban areas of Bangladesh.

DESIGN

The study followed a cross-sectional study design using qualitative methods.

SETTING

The study was conducted in Dhaka and Gazipur City Corporations during November 2020-February 2021.

PARTICIPANTS

17 key informant interviews were carried out with healthcare providers and policy-makers and 22 in-depth interviews were carried out with slum dwellers. Thematic analysis was performed.

RESULTS

The study identified challenges to the provision of essential healthcare in selected areas of Dhaka and Gazipur City Corporations during the COVID-19 pandemic. The lack of information on the availability of functional healthcare facilities, fear of contracting COVID-19 and restrictions on movement and transportation, resulted in delays in seeking essential healthcare during a pandemic. Access to healthcare facilities was further hindered by various hospitals' decision to refuse care to general patients without valid, negative COVID-19 test results. Healthcare providers identified patients' tendency to hide COVID-19 symptoms as a barrier to providing healthcare services to general patients. Conversely, patients concealed their symptoms to avoid COVID-19 tests and gain access to required treatment. In addition, the reallocation of human resources for COVID-19 treatment disrupted the delivery of essential health services.

CONCLUSION

The pandemic affected the accessibility of the slum population to essential healthcare and disrupted health service delivery. The findings of the study have highlighted gaps in the health system during an emergency response period like COVID-19. The study will assist the government and other stakeholders in designing tailored interventions and allocating resources in a more efficient manner to ensure universal health coverage in the face of health emergencies.

Exploring the association between social support and anxiety during major public emergencies: a meta-analysis of the COVID-19 pandemic

Objective

The COVID-19 pandemic has prompted a surge in research focusing on mental health issues faced by society, with particular emphasis on the interplay between social support and anxiety. However, the results of these studies have often been controversial.

Methods

To address this, we conducted a meta-analysis of 104 studies (N = 107,660) to investigate the relationship between anxiety and social support and the potential moderate variables.

Results

Our meta-analysis revealed a negative correlation between social support and anxiety (r = -0.233). The study also demonstrated the variation in the relationship between social support and anxiety was moderated by cultural area (Q = 14.120, p < 0.05) and phrase of the pandemic (Q = 13.678, p < 0.05).

Conclusion

The relationship between social support and anxiety can differ across different cultural areas and throughout the phrase of the pandemic. Consequently, we advocate for a nuanced assessment of the role of social support in mitigating public anxiety, taking into account the mediating effects of these factors in the context of major public emergencies.

Impact of COVID-19 on essential service provision for reproductive, maternal, neonatal, and child health in the Southeast Asia region: a systematic review

Background

There is increasing evidence that the COVID-19 pandemic has impacted adversely on the provision of essential health services globally. The Southeast Asia region (SEAR) has experienced extremely high rates of COVID-19 infection, with potential adverse impacts on provision of reproductive, maternal, neonatal, and child health (RMNCH) services.

Methods

We conducted a systematic literature review of quantitative evidence to characterise the impact of COVID-19 on the provision of essential RMNCH services across the SEAR. Studies published between December 2019 and May 2022 were included in the study. The quality of studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist.

Findings

We reviewed 1924 studies and analysed data from 20 peer-reviewed studies and three reports documenting quantitative pre-post estimates of RMNCH service disruption because of the COVID-19 pandemic. Eleven studies were of low methodological quality, in addition to seven and five studies of moderate and high methodological qualities respectively. Six countries in the region were represented in the included studies: India (11 studies), Bangladesh (4), Nepal (3), Sri Lanka (1), Bhutan (1) and Myanmar (1). These countries demonstrated a wide reduction in antenatal care services (-1.6% to -69.6%), facility-based deliveries (-2.3% to -52.4%), child immunisation provision (-13.5% to -87.7%), emergency obstetric care (+4.0% to -76.6%), and family planning services (-4.2% to -100%).

Interpretation

There have been large COVID-19 pandemic related disruptions for a wide range of RMNCH essential health service indicators in several SEAR countries. Notably, we found a higher level of service disruption than the WHO PULSE survey estimates. If left unaddressed, such disruptions may set back hard-fought gains in RMNCH outcomes across the region. The absence of studies in five SEAR countries is a priority evidence gap that needs addressing to better inform policies for service protection.

Funding

WHO Sri Lanka Country Office.

Knowledge as a Predictor for Preparedness in Managing COVID-19 Among General Practitioners in Malaysia

Introduction The COVID-19 pandemic has changed the working environment for general practitioners (GPs). GPs had to adapt quickly when care mitigation for mild COVID-19 in the community began. We assessed Malaysian GPs' knowledge and preparedness to manage COVID-19. Method A cross-sectional online survey was conducted between May and October 2022 among the GPs. Emails were sent to GPs affiliated with the main GP organizations in Malaysia, such as the Academy of Family Physicians of Malaysia (AFPM). Additionally, participation was sought through social media groups, including the Association of Malaysian Islamic Doctors, the Federation of Private Medical Practitioners' Associations Malaysia, and the Primary Care Network. Data was collected using a self-administered questionnaire on items related to knowledge and preparedness to manage COVID-19. The content was validated by six experts. Multiple logistic regression was used to determine the predictors for preparedness. Results A total of 178 GPs participated in this study. The mean age of the GPs was 41.8 (SD 12.37) years, 54.5% were males, 47.8% had a postgraduate qualification, and 68% had up to 10 years of general practice experience. Their practices are commonly solo (55.1%), located within an urban area (56.2%) and 47.2% operate 7 days a week. A majority of GPs (n = 124, 69.7%) had a good level of knowledge of COVID-19. In contrast, about a third (n = 60, 33.7%) had a good level of preparedness to manage COVID-19. GPs with a good level of knowledge of COVID-19 had 1.96 times the odds of having a good level of preparedness as compared to GPs with lower knowledge (OR = 2.11 (95% CI: 1.06, 4.18, p = 0.03)). Conclusion A good level of knowledge is a predictor for preparedness to manage COVID-19. Relevant and targeted measures to enhance knowledge for better preparedness among the GPs to respond to future pandemics are needed.

Impact of legal recognition on the lives of the third gender: A study in Khulna district of Bangladesh

The third gender, popularly known as 'hijra', is a gender non-conforming person residing in Bangladesh. The government of Bangladesh granted legal recognition (LR) in 2013 to acknowledge them as a third gender. Thus, using an exploratory qualitative inquiry, the study sought to understand how LR affected the lives of the third gender community in the Khulna district of Bangladesh. Thirteen participants were selected following snowball sampling, and data were collected using in-depth interviews and key informant interviews. In the domain of socio-cultural dynamics, we found that the LR had enhanced the social participation of the third gender community and given them a sense of identity. On the contrary, within the domain of economic lives, the LR has not been able to change their economic situation. Moreover, in the third domain, we observed an improved situation for the third gender population in their right to vote and political participation, but in accessing healthcare facilities, inheritance, and legal services, LR remained unsatisfactory. The study recommends promoting acceptance and reducing social stigma towards the third gender community through awareness campaigns, providing professional training programs to enable their financial independence, and enacting laws to protect their rights in Bangladesh.

Health workforce incentives and dis-incentives during the COVID-19 pandemic: experiences from Democratic Republic of Congo, Nigeria, Senegal, and Uganda

BACKGROUND

The COVID-19 pandemic presented a myriad of challenges for the health workforce around the world due to its escalating demand on service delivery. A motivated health workforce is critical to effectual emergency response and in some settings, incentivizing health workers motivates them and ensures continuity in the provision of health services. We describe health workforce experiences with incentives and dis-incentives during the COVID-19 response in the Democratic Republic of Congo (DRC), Senegal, Nigeria, and Uganda.

METHODS

This is a multi-country qualitative research study involving four African countries namely: DRC, Nigeria, Senegal, and Uganda which assessed the workplace incentives instituted in response to the COVID-19 pandemic. Key informant interviews (n = 60) were conducted with staff at ministries of health, policy makers and health workers. Interviews were virtual using the telephone or Zoom. They were audio recorded, transcribed verbatim, and analyzed thematically. Themes were identified and quotes were used to support findings.

RESULTS

Health worker incentives included (i) financial rewards in the form of allowances and salary increments. These motivated health workers, sustaining the health system and the health workers' efforts during the COVID-19 response across the four countries. (ii) Non-financial incentives related to COVID-19 management such as provision of medicines/supplies, on the job trainings, medical care for health workers, social welfare including meals, transportation and housing, recognition, health insurance, psychosocial support, and supervision. Improvised determination and distribution of both financial and non-financial incentives were common across the countries. Dis-incentives included the lack of personal protective equipment, lack of transportation to health facilities during lockdown, long working hours, harassment by security forces and perceived unfairness in access to and inadequacy of financial incentives.

CONCLUSION

Although important for worker motivation, financial and non-financial incentives generated some dis-incentives because of the perceived unfairness in their provision. Financial and non-financial incentives deployed during health emergencies should preferably be pre-determined, equitably and transparently provided because when arbitrarily applied, these same financial and non-financial incentives can potentially become dis-incentives. Moreover, financial incentives are useful only as far as they are administered together with non-financial incentives such as supportive and well-resourced work environments. The potential negative impacts of interventions such as service delivery re-organization and lockdown within already weakened systems need to be anticipated and due precautions exercised to reduce dis-incentives during emergencies.

Design and validation of a preliminary instrument to contextualize interactions through information technologies of health professionals

The communication of e-Health has been transformed with the advancement of information technologies, therefore it is feasible to carry out studies in the context of health professionals' interactions. Objective: This study aimed to design and validate a preliminary questionnaire to investigate the context of the communications of health professionals through information technologies considering three significant dimensions. Method: The stages provided by Hernández Sampieri guided the building, validation through Cronbach's alpha and factorial analysis. The questionnaire was applied to 43 participants who simulated health professionals. Results: We obtained an instrument that includes a demographic data section and 20 items distributed into three factors. Internal consistency reliability with Cronbach's alpha values generally of 0.848 and higher than 0.811 was obtained in each dimension. Kaiser-Meyer-Olkin's measure of sampling adequacy was regular, with 0.781, and Bartlett's test of sphericity was significant (p < 0.001). Conclusion: It is necessary to apply in real-world environments to reaffirm the results obtained.

Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis

BACKGROUND

The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs.

OBJECTIVE

This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program.

METHODS

A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework.

RESULTS

A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness.

CONCLUSIONS

Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879.

Effects of first year COVID-19 pandemic on urology practice in three major Arab Countries: Sub-Analysis of a survey by Arab association of urology research group

BACKGROUND AND OBJECTIVES

The World Health Organization (WHO) declared the coronavirus disease-19 (COVID-19) pandemic on March 11, 2020. The health care system faced tremendous challenges in providing ethical and high-quality care. The impact of COVID-19 on urological practices varied widely worldwide, including in Arab countries. This study aimed to compare the influence of the COVID-19 pandemic on urology practice in Egypt, the KSA, and the UAE during the first year of the pandemic.

METHODS

This sub-analysis assessed the demographics and COVID-19's effects on urological practice in terms of adjustments to hospital policy, including outpatient consultations, the management of elective and urgent surgical cases, and the continuation of education across the three countries. The availability of personal protective equipment (PPE) and urologists' emotional, physical, and verbal intimidation during COVID-19 were also compared.

RESULTS

Regarding the impact on hospital policy, consultations replaced by telemedicine were significantly higher in the KSA (36.15%), followed by the UAE (33.3%), then Egypt (10.4%) (P = 0.008). Elective cases requiring ICU admission were 65.1% in Egypt, 45.2% in the KSA, and 58.2% in the UAE and were performed only in high-risk patients. PPE was freely available in 20.8% of the Egyptian hospitals compared to 83.3% in the KSA and 81.8% in the UAE. Online courses were significantly higher in Egypt (70.8%), followed by the UAE (53%) and the KSA (41.7%) (P = 0.02). Emotional intimidation was higher than verbal intimidation, representing 80%, 75.9%, and 76% in the UAE, KSA, and Egypt, respectively.

CONCLUSION

This sub-analysis outlined significant hospital policy changes across the three Arab countries. Exposure to emotional, verbal, and physical intimidation was observed. The development of teleconsultations and online platforms for educational purposes was observed.

The Impact of COVID-19 on Trauma Emergency Patients in Southeastern Iran

Objective

With the COVID-19 outbreak in countries around the world, the countries' healthcare systems underwent an unprecedented shock. This study aimed to examine the resilience of the medical service delivery system in providing emergency services during the Covid-19 pandemic.

Methods

This study was conducted in a reference hospital in Kerman that provided emergency services to trauma patients. It compared service delivery before and after COVID-19, as well as during the COVID-19 peak and non-peak periods. The compared variables were the number of trauma patients admitted to the hospital and the ICU, the number of patients who died in the hospital due to trauma, and the length of stay in the hospital and the ICU.

Results

The pre- and post-COVID-19 comparisons showed no significant difference in the number of daily hospital admissions, ICU admissions, and patient deaths. The median length of stay in the ICU was significantly reduced by almost 2 days during the COVID-19 outbreak. However, the length of stay at the hospital was almost the same. Furthermore, a comparison of the COVID-19 peaks and non-peak periods indicated no statistically significant difference in the number of admissions in the ICU, hospital and ICU length of stay, and trauma-induced mortality.

Conclusion

Despite the substantial workload imposed by COVID-19 on hospitals, especially during the peak periods of the disease, the provision of medical services to emergency trauma patients did not drop significantly, and the quality of services provided to patients was within the acceptable range.

Lessons learned from the COVID-19 response in Sri Lankan hospitals: an interview of frontline healthcare professionals

Introduction

The COVID-19 pandemic revealed the lack of preparedness in health systems, even in developed countries. Studies published on COVID-19 management experiences in developing countries, including Sri Lanka, are significantly low. Therefore, lessons learned from pandemic management would be immensely helpful in improving health systems for future disaster situations. This study aimed to identify enablers and barriers to COVID-19 management in Sri Lankan hospitals through healthcare workers' perceptions.

Methods

Frontline doctors and nurses from different levels of public hospitals were interviewed online. Both inductive and deductive coding and thematic analysis were performed on the transcribed data.

Result and discussion

This study identified four themes under enablers: preparing for surge, teamwork, helping hands and less hospital-acquired infections. Seven themes were identified as barriers: lack of information sharing, lack of testing facilities, issues with emergency equipment, substandard donations, overwhelmed morgues, funding issues and psychological impact. These preparedness gaps were more prominent in smaller hospitals compared with larger hospitals. Recommendations were provided based on the identified gaps.

Conclusion

The insights from this study will allow health administrators and policymakers to build upon their hospital's resources and capabilities. These findings may be used to provide sustainable solutions, strengthening the resilience of the local Sri Lankan health system as well as the health systems of other countries.

The Development and Implementation of a Model to Facilitate Self-Awareness of Professionalism for Enrolled Nurses

Within the South African context, the nursing profession comprises different nursing cadres. The enrolled nurse is considered a sub-category of nursing and therefore does not carry the title of 'professional' as in a professional nurse. The purpose of the study was to develop, describe, implement, and evaluate a model for the facilitation of self-awareness for the professionalism of enrolled nurses at a specific nursing agency in Gauteng. A theory generating, qualitative, exploratory, descriptive and contextual design was used and was conducted following Chinn and Kramer's four stages of model development. The model can benefit nursing education because it relates to an essential aspect of growth and maturity in one's career. Ultimately, the facilitation of self-awareness for professionalism can advance one's career, or the lack of self-awareness may impede one's career. Developing, describing, implementing and evaluating this model to facilitate self-awareness for the professionalism of enrolled nurses at a specific nursing agency in Gauteng provides an original contribution to the theory in nursing professionalism and ethos. This model can be utilised as a tool to facilitate self-awareness for the professionalism of enrolled nurses at a nursing agency.

Health sector corruption in the times of COVID-19 pandemic in Bangladesh: Newspapers as mirrors of society

Objective

This paper aimed to identify and explore the major areas of health-sector corruption during COVID-19 pandemic as revealed in the print media. Findings are expected to mitigate health sector corruption in the country and contribute to strengthening the health systems.

Method

2588 news articles on health topics were identified through scanning six leading newspapers in Bangladesh during Mar. 2020 to Mar. 2021. Of these, 97 news articles focusing on corruption in health system were selected for analysis.

Findings

Findings reveal an all-embracing corruption at every stage, starting from procurement of medical supplies, to testing for COVID-19 to treatment and management of COVID-19 cases. The news papers reported about the low quality and general-purpose masks given to the frontline health workers, putting their personal protection from the virus at risk. Due to lack of stewardship and an effective monitoring system, quite a few private facilities were providing fake COVID-19 certificates, medicines and medical equipment at very high prices. For example, one particular hospital provided almost two thousand COVID-19 test certificates without testing. Although PPEs were originally sold at BDT 2000 per piece, double the amount was proposed for buying PPEs. Meropenem injection of the same quality was purchased by different government hospitals at unusually high prices. Among the measures taken to contain corruption during COVID-19 included filing cases, issuing arrest warrants and asking for submission of wealth statement and source of income of the accused persons. However, some of the accused eventually got released on bail.

Conclusion

The media, as a mirror of the society, successfully made visible the underhand corruption that was happening even during the pandemic, fulfilling its obligations to the society. They faced quite some challenges in revealing related news, especially from the government whose initial reaction was of denial and indifference.Due to lack of transparency and accountability in the sector, the patients as well as the healthcare providers had to suffer a lot.

Performance in prognostic capacity and efficiency of the Thoracic Care Suite GE AI tool applied to chest radiography of patients with COVID-19 pneumonia

OBJECTIVE

Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit INSIGHT CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays.

METHODS

Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorableclinical course, were collected. The number of affected lung fields for the two CXRs was assessed using the AI tool.

RESULTS

One hundred fourteen patients (57.4±14.2 years, 65-57%-men) were retrospectively collected. Fifteen (13.2%) required ventilatory support. Progression of pneumonic extension ≥0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26s of radiological time.

CONCLUSIONS

Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.

"Beating Your Head Against the Wall": Burnout on the Rise Among Local Health Department Communication Officials

The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals globally. Despite the varied challenges encountered by frontline healthcare professionals, the difficulties faced by public health communication officials in particular has remained an underexplored area of research. This study examined the specific challenges experienced by communication officials during the COVID-19 pandemic in the United States. A qualitative research design was used to conduct in-depth interviews with communication officials working in local health departments (LHDs) in 2022. A total of 14 participants were recruited through purposive sampling, coupled with a data saturation strategy, from LHDs situated in Kansas, Missouri, and Oklahoma. Thematic analysis revealed 3 key themes: (1) main challenges faced by LHDs during the COVID-19 pandemic, (2) challenges related to information dissemination on social media, and (3) burnout experienced by communication officials. This study's findings suggest that communication officials should be provided with the necessary resources and training to effectively handle misinformation, toxic behaviors, and bullying on social media while prioritizing their mental health. In addition, federal, state, and local health agencies should provide timely, clear, and accurate information to address the challenges faced by communication officials in their bid to disseminate information effectively.

Knowledge, beliefs, and practices related to coronavirus disease 2019 (COVID-19) infection and vaccination in healthcare personnel working at nonacute care facilities

OBJECTIVE

To characterize experiences, beliefs, and perceptions of risk related to coronavirus disease 2019 (COVID-19), infection prevention practices, and COVID-19 vaccination among healthcare personnel (HCP) at nonacute care facilities.

DESIGN

Anonymous survey.

SETTING

Three non-acute-care facilities in St. Louis, Missouri.

PARTICIPANTS

In total, 156 HCP responded to the survey, for a 25.6% participation rate). Among them, 32% had direct patient-care roles.

METHODS

Anonymous surveys were distributed between April-May 2021. Data were collected on demographics, work experience, COVID-19 exposure, knowledge, and beliefs about infection prevention, personal protective equipment (PPE) use, COVID-19 vaccination, and the impact of COVID-19.

RESULTS

Nearly all respondents reported adequate knowledge of how to protect oneself from COVID-19 at work (97%) and had access to adequate PPE supplies (95%). Many HCP reported that wearing a mask or face shield made communication difficult (59%), that they had taken on additional responsibilities due to staff shortages (56%), and that their job became more stressful because of COVID-19 (53%). Moreover, 28% had considered quitting their job. Most respondents (78%) had received at least 1 dose of COVID-19 vaccine. Common reasons for vaccination were a desire to protect family and friends (84%) and a desire to stop the spread of COVID-19 (82%). Potential side effects and/or inadequate vaccine testing were cited as the most common concerns by unvaccinated HCP.

CONCLUSIONS

A significant proportion of HCP reported increased stress and responsibilities at work due to COVID-19. The majority were vaccinated. Improving workplace policies related to mental health resources and sick leave, maintaining access to PPE, and ensuring clear communication of PPE requirements may improve workplace stress and burnout.

Compassionate Nursing Care for COVID-19 Patients in the ICU in the Western Region of Saudi Arabia: A Lived Experience Study

INTRODUCTION

The rapid spread and the severity of symptoms of COVID-19 led to an increasing number of critical cases that need to be admitted to intensive care units (ICUs) worldwide. Compassion is a principle of nursing practice and indicates the meaning of providing high-quality care in all units, especially in the ICU. It means that nurses know what is important to patients and when they should be there for them when it is needed. There is a paucity of literature from Saudi Arabia that explores how critical care nurses perceive compassionate care during COVID-19.

OBJECTIVES

The aim of this study was to investigate the lived experiences of critical care nurses providing compassionate care to COVID-19 patients at King Abdulaziz Medical City, Jeddah, Saudi Arabia.

METHODS

A prospective, cross-sectional, descriptive phenomenological approach was utilized in this study. Data were collected from 13 ICU nurses through interviews. Collected data were transcribed and analyzed using Colaizzi's data analysis method.

RESULTS

 Eleven out of the 13 ICU nurses hold a Bachelor of Science in Nursing (BSN) and have more than five years of experience. Despite all the challenges surrounding the care for critically ill COVID-19 patients, nurses provide compassion in different ways to show personal interest to the patients. Data analysis revealed five themes: (1) contemporary meaning and competencies for compassionate nursing care, including communication and the inability to freely use touch; (2) physical symptoms, including discomfort, body aches and headaches, and sleep disturbances; (3) emotional turmoil, where three sub-themes emerged, including fear and anxiety, uncertainty, and isolation and loneliness; (4) role changing, including frequent guidelines change, additional roles and responsibilities, and altruism; (5) professionalism, including cultural facets of care, teamwork, and support.

DISCUSSION

The COVID-19 pandemic has caused major changes in nurses' working environment and so their experience. The results of this study indicated that nurses working in the ICU experienced remarkable and massive physical, psychological, and emotional symptoms during the COVID-19 pandemic. The nurses extended the relationships to the patients' families as they are at high risk of stress, anxiety, and depression. In addition, they were able to support them in dealing with the fear associated with the uncertainty of COVID-19. Also, results revealed that remote therapeutic relationships and psychotherapy can be credible and trustworthy alternatives to in-person care.

CONCLUSIONS

The results of this study indicated that ICU nurses provide compassionate care despite experiencing unprecedented and immense physical, psychological, and emotional symptoms during the COVID-19 pandemic.

RECOMMENDATIONS

Further study is recommended using other research methodologies. It is also recommended to conduct the same study in different cities for better generalization.

Addressing the challenges of AI-based telemedicine: Best practices and lessons learned

Telemedicine is the use of technology to provide healthcare services and information remotely, without requiring physical proximity between patients and healthcare providers. The coronavirus disease 2019 (COVID-19) pandemic has accelerated the rapid growth of telemedicine worldwide. Integrating artificial intelligence (AI) into telemedicine has the potential to enhance and expand its capabilities in addressing various healthcare needs, such as patient monitoring, healthcare information technology (IT), intelligent diagnosis, and assistance. Despite the potential benefits, implementing AI in telemedicine presents challenges that can be overcome with physician-guided implementation. AI can assist physicians in decision-making, improve healthcare delivery, and automate administrative tasks. To ensure optimal effectiveness, AI-powered telemedicine should comply with existing clinical practices and adhere to a framework adaptable to various technologies. It should also consider technical and scientific factors, including trustworthiness, reproducibility, usability, availability, and cost. Education and training are crucial for the appropriate use of new healthcare technologies such as AI-enabled telemedicine. This article examines the benefits and limitations of AI-based telemedicine in various medical domains and underscores the importance of physician-guided implementation, compliance with existing clinical practices, and appropriate education and training for healthcare providers.

Hospital Readiness and Perceived Health Professional Challenges to Prevent Pandemics in Gedeo Zone, Ethiopia: A Mixed-Method Study

Background

Pandemics pose serious threats to health, society, and economy worldwide. Ethiopia has been affected by the COVID-19 pandemic, which has caused millions of deaths and disrupted essential health services. The readiness of health systems and the challenges that health professionals face in delivering pandemic-related services are crucial for preventing and controlling pandemics. However, these aspects have not been adequately assessed in low-income countries like Ethiopia, where poor prevention techniques and challenging work conditions can increase the transmission of diseases and overwhelm the weak healthcare system. This study aimed to assess hospital readiness and health professional challenges to prevent pandemics in Ethiopia.

Methods

A mixed-methods study design was used to collect data from 24 health professionals and four public hospitals using interviews and a checklist which explored the challenges and barriers of health professionals in preventing pandemics and assessed the hospital readiness. Data were analyzed thematically with open code software and descriptively with SPSS software.

Results

The study revealed the alarming gaps in the hospitals' readiness and the health professionals' capacity to prevent and control pandemics. Most of the hospitals had insufficient preparedness in terms of administrative activities, infection prevention and control (IPC) activities, emergency room preparedness, outpatient services, and logistics and supplies. The health professionals faced multiple challenges, such as lack of resources, training, personal protection, psychological support, and workload. The most critical challenges were the lack of personal protective equipment (PPE) and training, which compromised their safety and effectiveness.

Conclusion

The study underscored the need to enhance the hospitals' readiness and the health professionals' capacity to prevent and control pandemics and health professionals faced various challenges in preventing and controlling pandemics. These challenges include lack of resources, training, psychological support, and lifestyle changes which may compromise their quality of care, safety, and well-being.

Depression, anxiety and stress among healthcare workers in the context of the COVID-19 pandemic: a cross-sectional study in a tertiary hospital in Northern Vietnam

Introduction

The outbreak of coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) had significant effects on the mental well-being in general, particularly for healthcare professionals. This study examined the prevalence of depression, anxiety, and stress, and identified the associated risk factors amongst healthcare workers during the COVID-19 outbreak in a tertiary hospital located in Vietnam.

Methods

We conducted a cross-sectional study at a tertiary-level hospital, where the Depression Anxiety and Stress Scale 21 (DASS-21) web-based questionnaire was employed. We analyzed the determinant factors by employing multivariate logistic models.

Results

The prevalence of depression, anxiety, and stress symptoms were 19.2%, 24.7%, and 13.9%, respectively. Factors such as engaging in shift work during the pandemic, taking care of patients with COVID-19, and staff's health status were associated with mental health issues among health professionals. In addition, having alternate rest periods was likely to reduce the risk of stress.

Conclusion

The prevalence of mental health problems in healthcare workers during the COVID-19 pandemic was relatively high. Having resting periods could potentially mitigate the development of stress among health professionals. Our findings could be taken into account for improving mental health of the health professional population.

The COVID-19 pandemic has impeded cytopathology practices and hindered cancer screening and management

The COVID-19 pandemic has had a global impact on the environment and economy and has affected hospital administration and patient behaviour. Since human-to-human coronavirus transmission occurs via droplets and physical contact, health care professionals are particularly vulnerable to contracting COVID-19. Many cytopathology laboratories updated their workflow, established new standard biosafety protocols, and built digital pathology or telescope platforms to mitigate these risks and deal with the shortage of health care personnel. The COVID-19 pandemic also disrupted medical education-all indoor training events, including conferences, multidisciplinary tumour boards, seminars, and microscope inspections were postponed. As a result, many laboratories now use new web-based applications and platforms to maintain educational programs and multidisciplinary tumour boards. To comply with government directives, health care facilities postponed non-emergency surgeries, reduced the number of routine medical examinations, restricted visitor numbers, and scaled back cancer screening activities, resulting in a sharp decline in cytopathology diagnoses, cancer screening specimens, and molecular testing for cancer. Subsequent misses or delays in the diagnosis and treatment of cancer were not uncommon. This review aims to provide comprehensive summaries of the consequences of the COVID-19 pandemic for cytopathology, particularly in terms of cancer diagnosis, workload, human resources, and molecular testing.

Nano-based techniques: A revolutionary approach to prevent covid-19 and enhancing human awareness

In every century of history, there are many new diseases emerged, which are not even cured by many developed countries. Today, despite of scientific development, new deadly pandemic diseases are caused by microorganisms. Hygiene is considered to be one of the best methods of avoiding such communicable diseases, especially viral diseases. Illness caused by SARS-CoV-2 was termed COVID-19 by the WHO, the acronym derived from "coronavirus disease 2019. The globe is living in the worst epidemic era, with the highest infection and mortality rate owing to COVID-19 reaching 6.89% (data up to March 2023). In recent years, nano biotechnology has become a promising and visible field of nanotechnology. Interestingly, nanotechnology is being used to cure many ailments and it has revolutionized many aspects of our lives. Several COVID-19 diagnostic approaches based on nanomaterial have been developed. The various metal NPs, it is highly anticipated that could be viable and economical alternatives for treating drug resistant in many deadly pandemic diseases in near future. This review focuses on an overview of nanotechnology's increasing involvement in the diagnosis, prevention, and therapy of COVID-19, also this review provides readers with an awareness and knowledge of importance of hygiene.

Healthcare Professionals' Experiences During the COVID-19 Pandemic in Sudan: A Cross-Sectional Survey Assessing Quality of Life, Mental Health, and Work-Life-Balance

Objectives: The main objective of this research was to investigate the Work-life balance (WLB), mental health, and quality of life and their associated factors among Healthcare Professionals (HCPs) in Sudan during the peak of the COVID-19 pandemic during 2021. Methods: An observational cross-sectional web-based survey was conducted during August-December 2021 among a sample of 430 HCPs working in the hospitals of four Sudanese states. The study used the WHOQoLBREF scale, Work-Life Balance Scale, and General Anxiety Disorder (GAD-7). Results: HCPs reporting a poor quality of life made up 33.5% (95% CI 29.1-38.0), while those reporting worse WLB made up 52.6% (95% CI 47.8-57.2). HCPs reporting moderate to severe anxiety symptoms accounted for 35.8% (95% CI 31.4-40.5). The Multiple Regression model indicated that an increase in the anxiety scores is associated with a decrease in Health-related Quality of Life (HRQoL) (β= 0.831, p < 0.05). Female HCPs exhibited 4.53-fold lower HRQoL scores than their male colleagues (p < 0.05). Conclusion: Approximately one-third of the HCPs in Sudan reported low HRQoL and suffered from moderate to severe anxiety, while a large portion of them had an unequal work-life balance during COVID-19. Health policies addressing these factors are needed to improve the quality of health of HCPs.

COVID-19 retreats and world recovers: A silver lining in the dark cloud

The coronavirus disease (COVID-19), which the World Health Organization classified as the Sixth Public Health Emergency Of International Concern (PHEIC) on January 30, 2020, is no longer a PHEIC. Millions were affected due to unawareness. The increase in fatalities and shortage of medicine was the first outrage of COVID-19. As per the Johns Hopkins COVID-19 resource center database, it was observed that the disease has spread dynamically across 200+ nations worldwide affecting more than 600 million people from 2019 to 2023, and over thousands of people were victimized regularly at a 2% mortality rate (approx.). In the midway, the mutant variants of concern like omicron, and delta have also created havoc and caused significant impact on public health, global economy, and lifestyle. Since 2019, 3 years now passed and the dynamic disease statistics seem decelerated; moreover, the prevalence of COVID-19 is also fading. The Johns Hopkins resource center has also stopped recording the data of the global pandemic recently from March 10, 2023. Hence, based on the facts, we are presenting a concise report on the pandemic from 2019 to 2023, which includes a brief discussion of the global pandemic. We have highlighted global epidemiology, emphasizing the Indian COVID scenario, vaccination across the globe, and the psychosocial and geopolitical consequences of COVID-19 with a brief background to pathology, clinical management, and the worldwide response against triage. A lot has changed and still needs to change after three tough years of COVID-19. Even though science has progressed and advanced research in medicine is pointing toward future generations, there is no standard care supplied for COVID-19-like calamities. COVID-19 cases might have declined but its influence on the society is still stagnant. This COVID experience has taught us that, despite our bleak beginnings, there is always hope for the future and that we must act with foresight to improve things for future generations.

A literature review on the impact of disasters on healthcare systems, the role of nursing in disaster management, and strategies for cancer care delivery in disaster-affected populations

This review article highlights the critical role of nurses in disaster management, with a specific focus on addressing blood tumors in disaster-affected populations. Disasters have a significant impact on healthcare systems and populations, and nurses play a crucial role in disaster preparedness, response, and recovery. The article provides case studies and successful examples of nursing interventions in disaster settings and tumor management, emphasizing the challenges and opportunities in providing cancer care in disaster settings. Recommendations for future research and practice in disaster nursing and blood tumor care are also presented. This information is essential for healthcare professionals and policymakers involved in disaster management, as well as researchers and clinicians working in the field of cancer care.

Experience of Pediatric Nurses in Parent-Child Isolation Units of COVID-19 Designated Hospitals: A Qualitative Study

Background

The omicron pandemic in Shanghai has created unprecedented challenges for pediatric medical institutions, and the work of pediatric nurses has changed rapidly due to the introduction of parent-child treatment. This study aimed to explore the experiences of pediatric nurses in the parent-child isolation unit of COVID-19-designated hospitals and provide a basis for developing feasible interventions as the next step.

Methods

Using phenomenological research methods, 12 nurses working in the parent-child isolation unit of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine from April 1, 2022, to June 15, 2022, were selected by purposive sampling. Semi-structured interviews and data analysis were conducted using Colaizzi's 7-step analysis.

Results

Data analysis revealed three major themes and 11 subthemes. The main themes were "risk factors", "protection factors", and "resilience strategies". The sub-themes were "challenge of caring for both adults and children simultaneously", "lack of adult expertise leads to inadequate coping skills", "change in the care population increased communication difficulties", "physical and psychological distress", "social support", "social recognition", "awareness of responsibilities and roles", "team coming together", "hunger for knowledge", "health promotion", and "psychological adjustment strategies".

Conclusion

Hospital managers should optimize hospital management strategies, pay attention to multi-departmental and multidisciplinary team cooperation, reduce the burden on pediatric nurses, improve the work and rest environment, mobilize the hospital support system, and maintain nurse's physical and mental health, establish a warm parent-child isolation unit encourages nurses to listen to the patients' voices and adopt diversified communication methods, and strengthen the publicity of the nursing profession, improve social support and recognition, and enhance the sense of self-worth and mission.

The association between workload and quality of work life of nurses taking care of patients with COVID-19

BACKGROUND

The COVID-19 epidemic has brought significant changes and complexities to nurses' working conditions. Given the crucial role of health workers, particularly nurses, in providing healthcare services, it is essential to determine the nurses' workload, and its association with the quality of work life (QWL) during COVID-19 epidemic, and to explain the factors predicting their QWL.

METHODS

A total of 250 nurses, who provided care for patients with COVID-19 in Imam Hossein Hospital of Shahrud, and met the inclusion criteria, were considered the samples in the present cross-sectional study in 2021-2022. Data were collected using the demographic questionnaire, NASA Task Load Index (TLX), and Walton's QWL questionnaire, which were analyzed using SPSS26 and based on descriptive and inferential statistical tests. A p-value less than 0.05 was considered significant for all cases.

RESULTS

The nurses' mean scores of workload and QWL were 71.43 ± 14.15 and 88.26 ± 19.5, respectively. Pearson's correlation test indicated a significant inverse relationship between workload and QWL (r=-0.308, p < 0.001). The subscales with the highest perceived workload scores were physical demand and mental demand (14.82 ± 8.27; 14.36 ± 7.43), respectively, and the subscale with the lowest workload was overall performance (6.63 ± 6.31). The subscales with the highest scores for QWL were safety and health in working conditions and opportunity to use and develop human capabilities (15.46 ± 4.11; 14.52 ± 3.84), respectively. The subscales with the lowest scores were adequate and fair compensation, work and total living space (7.46 ± 2.38; 6.52 ± 2.47), respectively. The number of children (β = 4.61, p = 0.004), work experience (β= -0.54, p = 0.019), effort (β = 0.37, p = 0.033) and total workload (β= -0.44, p = 0.000) explained 13% of the variance of nurses' QWL.

CONCLUSIONS

The study's findings showed that a higher workload score is associated with nurses' lower perception of QWL. In order to improve the QWL of nurses, reducing the physical and mental demands of their workload and strengthening overall performance is necessary. Additionally, when promoting QWL, adequate and fair compensation and the work and living space should be considered. The researchers suggest that hospital managers should make more significant efforts to develop and promote the QWL of nurses. To achieve this goal, organizations can pay attention to other influential factors, primarily by increasing organizational support.

Hospital response challenges and strategies during COVID-19 pandemic: a qualitative study

Background

At the beginning of the COVID-19 pandemic, healthcare managers at hospitals did not have sufficient experiences to appropriately respond to the COVID-19 outbreak. Due to a lack of preparedness, many challenges arose in the healthcare system, and each country developed and implemented strategies depending on national policies. This study aimed to understand challenges during the COVID-19 pandemic and strategies used in Iranian hospitals.

Methods

A qualitative research was conducted in four hospitals in an urban area of Iran. In-depth semi-structured interviews were performed with 32 participants including healthcare managers, nurses, and medical doctors. Data underwent qualitative content analysis.

Results

Four categories were developed: 'capacity expansion', 'management affairs', 'diagnostic services," and therapeutic services'. Each category consisted of 2-3 subcategories.

Conclusion

Hospitals should be prepared to intelligently respond to future epidemics. It is necessary to develop a comprehensive epidemic plan for the management of disasters to reduce the impact of the epidemic and minimize the risk to public health and ensure that resources are allocated in an efficient and effective manner.

The COVID-19 pandemic impact on the Polish medical personnel work: a survey and in-depth interviews study

Objective

The objective of the study was to examine the impact of the COVID-19 pandemic on the work of medical personnel in terms of: task scope, preparation to perform medical tasks related to the pandemic, team collaboration, involvement in tasks performed, concerns about performing tasks related to the pandemic, stress levels.

Methods

The mixed-method approach was applied to this cross-sectional study. The online questionnaire which included 40 questions was completed via Google among medical personnel in Poland. Eight semi-structured, in-depth interviews were conducted to deepen the data obtained with the questionnaires.

Participants

The questionnaire was completed by 215 healthcare professionals, with the largest group being nurses (56.3%) followed by physicians (22.3%), midwives (11.6%) and other healthcare professionals (e.g., physiotherapists, paramedics, nutritionists - 9.8%). Among the respondents were people who worked in the hospital in the so-called "covid wards" (31.2%) and other hospital wards (60%) as well as people who were employed outside the hospital (8.8%).

Results

The pandemic affected the nature and range of tasks performed by health professionals. Initially, respondents felt unprepared to work under pandemic conditions, but over time their ratings increased in all areas studied. More than half of respondents reported no change in interpersonal relationship within the team, but nearly 35% noted a worsening and only one in 10 claimed improvement. Study participants rated their own commitment to tasks slightly higher than that of their colleagues (mean 4.9 and 4.4 respectively) but the overall rating was high. The mean self-rating of work stress increased from 3.7 before the pandemic to 5.1 during the pandemic. Most of the respondents were afraid of transmission of the infection to their relatives. Other fears included the possibility of making a medical error, not being able to help the patient, not having enough personal protective equipment (PPE) and contracting SARS-CoV-2.

Conclusion

The conducted study revealed that the organization of medical care in the initial period of the pandemic, especially the hospital care of patients infected with SARS-CoV-2, was quite chaotic. The most affected were the people who were transferred to work in the covid wards. Not all medical professionals were prepared to work with the COVID-19 patients, as they lacked experience working in such facilities, especially in intensive care units (ICU). Working under time pressure and under new conditions led mainly to an increase in perceived stress and conflicts between staff.

Association of workload and practice of respectful maternity care among the healthcare providers, before and during the early phase of COVID-19 pandemic in South Western Nepal: a cross-sectional study

INTRODUCTION

Respectful maternity care is an approach that involves respecting women's belief, choices, emotions, and dignity during the childbirth process. As the workload among maternity care workforce affects intrapartum quality care, respectful maternity care might have also been affected, particularly during the pandemic. Thus, this study was conducted to examine the association between workload among healthcare providers and their practice of respectful maternity care, before and during the early phase of pandemic.

METHODS

A cross-sectional study was conducted in South Western Nepal. A total of 267 healthcare providers from 78 birthing centers were included. Data collection was done through telephone interviews. The exposure variable was workload among the healthcare providers, and the outcome variable was respectful maternity care practice before and during the COVID-19 pandemic. Multilevel mixed-effect linear regression was used to examine the association.

RESULTS

The median client-provider ratio before and during the pandemic was 21.7 and 13.0, respectively. The mean score of respectful maternity care practice was 44.5 (SD 3.8) before the pandemic, which was decreased to 43.6 (SD 4.5) during the pandemic. Client-provider ratio was negatively associated with respectful maternity care practice for both times; before (Coef. -5.16; 95% CI -8.41 to -1.91) and during (Coef. -7.47; 95% CI -12.72 to -2.23) the pandemic.

CONCLUSIONS

While a higher client-provider was associated with a lower respectful maternity care practice score both before and during the COVID-19 pandemic, the coefficient was larger during the pandemic. Therefore, workload among the healthcare providers should be considered before the implementation of respectful maternity care, and more attention should be given during the pandemic.

Practice and knowledge of dietary supplement consumption among Indonesian adults post-delta wave of the COVID-19 pandemic

Background: Increasing dietary supplement (DS) consumption was observed during the COVID-19 pandemic, including during the post-Delta wave period. This study aimed to measure the practice of DS consumption and respondents' knowledge of DS. Methods: An internet-based survey was distributed from October-December 2021 and obtained 541 valid and completed responses. Descriptive analysis was performed to present the practice of DS consumption, including frequency, duration, aim, preferable dosage form etc. Level of knowledge on DS principles, side effects and regulation were also measured. Inferential analyses were conducted to determine the predictors of the respondents' DS practice and level of knowledge. Results: Data from 541 valid responses showed that 77.63% of respondents consumed DS in the last 3 months, with only 59.52% reporting also consuming DS before the COVID-19 pandemic. One half of the respondents had good knowledge about DS; however, some knowledge regarding side effects and possible drug-supplement interaction needed improvement. Their DS consumption practice was affected by their economic status and history of contracting COVID-19. Nevertheless, the level of knowledge was not affected by the sociodemographic factors and DS supplement experience. Conclusions: Taken together, the practice of self-consumption of DS in Indonesia is increasing; hence, knowledge of DS is necessary to avoid detrimental effects that might occur in the future. Increasing access to information on better labelling and educating consumers about DS are important actions to consider.

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

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

Pharmacists' Mental Health during the First Two Years of the Pandemic: A Socio-Ecological Scoping Review

Healthcare workers have been under a great deal of stress and have been experiencing burnout throughout the COVID-19 pandemic. Among these, healthcare workers are pharmacists who have been instrumental in the fight against the pandemic. This scoping review examined the impact of the pandemic on pharmacists' mental health and their antecedents using three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies included primary research articles that examined the mental health antecedents and outcomes among pharmacists during the first two years of the pandemic. We used the Social Ecological Model to categorize antecedents per outcome. The initial search yielded 4165 articles, and 23 met the criteria. The scoping review identified pharmacists experiencing poor mental health during the pandemic, including anxiety, burnout, depression, and job stress. In addition, several individual, interpersonal, organizational, community, and policy-level antecedents were identified. As this review revealed a general decline in pharmacists' mental health during the pandemic, further research is required to understand the long-term impacts of the pandemic on pharmacists. Furthermore, we recommend practical mitigation strategies to improve pharmacists' mental health, such as implementing crisis/pandemic preparedness protocols and leadership training to foster a better workplace culture.

Structural Equation Modelling of Professional Values and Competency of Nurses During the COVID-19 Pandemic

Background

The COVID-19 pandemic is a global health crisis that affected nurses’ professional values and competence.

Aim

Our study examined the relationship between nurses’ professional values and competence in Saudi Arabia during the COVID-19 pandemic.

Methods

This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data.

Findings

The emerging model showed acceptable model fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong, direct effect on activism. Justice had a moderate, direct impact on trust, while activism had a weak, direct impact on trust. Professionalism and caring had strong, indirect effects on professional competence by mediating the dimension of activism.

Discussion

The study’s findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence.

Conclusion

This study provides a structural model of the interaction between nurses’ professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses’ professional values and competence.

Applying the COM-B Model to Understand the Drivers of Mistreatment During Childbirth: A Qualitative Enquiry Among Maternity Care Staff

INTRODUCTION

Respectful maternity care (RMC) during childbirth is an integral component of quality of care. However, women's experiences of mistreatment are prevalent in many low- and middle-income countries. This is a complex phenomenon that has not been well explored from a behavioral science perspective. We aimed to understand the behavioral drivers of mistreatment during childbirth among maternity care staff at public health facilities in the Sindh province of Pakistan.

METHODS

Applying the COM-B (capability-opportunity-motivation that leads to behavior change) model, we conducted semistructured in-depth interviews among clinical and nonclinical staff in public health facilities in Thatta and Sujawal, Sindh, Pakistan. Data were analyzed using thematic deductive analysis, and findings were synthesized using the COM-B model.

RESULTS

We identified several behavioral drivers of mistreatment during childbirth: (1) institutional guidelines on RMC and training opportunities were absent, resulting in a lack of providers' knowledge and skills; (2) facilities lacked the infrastructure to maintain patient privacy and confidentiality and did not permit males as birth companions; (3) lack of provider performance monitoring system and patient feedback mechanism contributed to providers not feeling appreciated or recognized. Staff bias against patients from lower castes contributed to patient abuse and mistreatment. The perspectives of clinical and nonclinical staff overlapped regarding potential drivers of mistreatment during childbirth.

CONCLUSIONS

Addressing mistreatment during childbirth requires improving the knowledge and capacity of maternity staff on RMC and psychosocial support to enhance their understanding of RMC. At the health facility level, governance and accountability mechanisms in routine supervision and monitoring of staff need to be improved. Patients' feedback should be incorporated for continuous improvement in providing maternity care services that meet patients' preferences and needs.

Indian Healthcare Workers' Issues, Challenges, and Coping Strategies during the COVID-19 Pandemic: A Cross-Sectional Study

India faced the maximum number of mortalities and morbidities during the second wave of COVID-19. Healthcare workers (HCWs) worked in high-pressure and stressful environments. Therefore, this study aimed to assess the common issues, challenges, and coping strategies of HCWs, as well as the statistical association between demographical characteristics and coping strategies. A cross-sectional study was conducted with 759 HCWs, involving simple, random sampling in Rajasthan, India, between August 2022 and October 2022. Participants responded to a self-administered questionnaire that included a Brief-COPE inventory. The statistical association between commonly adopted coping strategies and demographic characteristics was tested using the chi-square test and Fisher's exact test. A total of 669 (88%) respondents agreed that they faced issues during the COVID-19 pandemic: 721 (95%) participants experienced challenges at the personal level, 716 (94%) at the organizational level, and 557 (74%) at the societal level. Problem-focused coping strategies were frequently adopted by the participants. Gender, marital status, education, hours of work per day, and residential area were significantly associated with a problem-focused coping strategy (p < 0.05). The findings of this study reported a limited use of coping strategies by the participants during the public health crisis, despite facing issues and challenges at work. These findings highlight the need to assist HCWs in developing coping mechanisms to maintain good mental health at work.

The mental health of laboratory and rehabilitation specialists during COVID-19: A rapid review

Backgrounds

Healthcare workers have experienced considerable stress and burnout during the COVID-19 pandemic. Among these healthcare workers are medical laboratory professionals and rehabilitation specialists, specifically, occupational therapists, and physical therapists, who all perform critical services for the functioning of a healthcare system.

Purpose

This rapid review examined the impact of the pandemic on the mental health of medical laboratory professionals (MLPs), occupational therapists (OTs) and physical therapists (PTs) and identified gaps in the research necessary to understand the impact of the pandemic on these healthcare workers.

Methods

We systematically searched "mental health" among MLPs, OTs and PTs using three databases (PsycINFO, MEDLINE, and CINAHL).

Results

Our search yielded 8887 articles, 16 of which met our criteria. Our results revealed poor mental health among all occupational groups, including burnout, depression, and anxiety. Notably, MLPs reported feeling forgotten and unappreciated compared to other healthcare groups. In general, there is a dearth of literature on the mental health of these occupational groups before and during the pandemic; therefore, unique stressors are not yet uncovered.

Conclusions

Our results highlight poor mental health outcomes for these occupational groups despite the dearth of research. In addition to more research among these groups, we recommend that policymakers focus on improving workplace cultures and embed more intrinsic incentives to improve job retention and reduce staff shortage. In future emergencies, providing timely and accurate health information to healthcare workers is imperative, which could also help reduce poor mental health outcomes.

Adherence to Infection Prevention and Control Measures Among Health-Care Workers Serving in COVID-19 Treatment Centers in Punjab, Pakistan

OBJECTIVE

Infection prevention and control (IPC) measures are easily adoptable activities to prevent the spread of infection to patients as well as among health-care workers (HCWs).

METHODS

This cross-sectional study evaluated the adherence to IPC measures among HCWs working at coronavirus disease 2019 (COVID-19) treatment centers in Punjab, Pakistan. HCWs were recruited by means of convenient sampling through Google Form^® using the World Health Organization risk assessment tool. All data were analyzed using SPSS 20.

RESULTS

A total of 414 HCWs completed the survey (response rate = 67.8%), and majority of them were males (56.3%). Most of the HCWs were nurses (39.6%) followed by medical doctors (27.3%). Approximately 53% reported insufficiency of personal protective equipment (PPE), 58.2% did not receive IPC training and 40.8% did not have functional IPC team at their health facilities. The majority of HCWs (90%) used disposable gloves and N95 facemasks while interacting with COVID-19 patients. Nearly 45% used protective face shields and gowns before providing care to their patients. Hand hygiene practices while touching, and performing any aseptic procedure was adopted by 70.5% and 74.1% of HCWs, respectively.

CONCLUSIONS

In conclusion, the adherence to IPC measures among Pakistani HCWs working in COVID-19 treatment centers is good despite the limited availability of PPEs. Their practices can be optimized by establishing institutional IPC teams, periodic provision of IPC training, and necessary PPE.

[Performance in prognostic capacity and efficiency of the Thoracic Care Suite GE AI tool applied to chest radiography of patients with COVID-19 pneumonia]

OBJECTIVE

Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit INSIGHT CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays.

METHODS

Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorable clinical course, were collected. The number of affected lung fields for the two CXRs was assessed using the AI tool.

RESULTS

One hundred fourteen patients (57.4 ± 14.2 years, 65 -57%- men) were retrospectively collected. Fifteen (13.2%) required ventilatory support. Progression of pneumonic extension ≥ 0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26 seconds of radiological time.

CONCLUSIONS

Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.