Occupational stress of physicians and nurses in emergency departments after contracting COVID-19 and its influencing factors: a cross-sectional study

Levels and related factors of occupational stress among nurses: hospital-based evidence from China, 2023

Background

China's birth rate continues to decline, reaching only 6.39% in 2023. In light of this trend, hospitals may need to reassess their allocation of resources, including funding, staffing, and facilities. Nurses may face job insecurity and uncertainty regarding their roles, which could prompt some to consider transitioning to different specialties. This study aimed to investigate the levels of occupational stress among nurses in the context of low fertility in China in 2023 and to identify the factors contributing to this stress. In addition, the study sought to explore the relationship between family dysfunction, low fertility rates, and occupational stress levels.

Methods

This descriptive cross-sectional study involved 270 nurses working in hospitals, who were recruited between December 2023 and January 2024 through a Chinese free web-based platform (Sojump) to complete online questionnaires. In addition to demographic information, the Nursing Job Stressors Scale (NJSS) and the Family APGAR Index were utilized for data collection. The data were analyzed using descriptive and inferential statistics, including correlation and multiple linear regression analysis. For continuous variables, the mean, standard deviation (SD), median, and interquartile range were reported, while counts and percentages were used for categorical variables. The independent t-test and one-way analysis of variance were employed for univariate analysis. Multiple linear regression was utilized for multivariate analysis. A p-value of less than 0.05 was considered statistically significant.

Results

The participants' average scores for the NJSS and Family APGAR Index were 1.76 ± 0.58 and 6.35 ± 3.30 points, respectively. In addition, workload and time pressure were rated highest among the sub-scales of the NJSS. The top five job stressors for nurses were Q3 (Wages and other benefits are low), Q1 (The social status of nursing is too low), Q5 (Frequent shift work), Q12 (Too much useless paperwork), and Q16 (Fear of mistakes and accidents at work). The score of the Family APGAR Index demonstrated a negative correlation with occupational stress (r = -0.19, p < 0.001). The results of the multiple linear regression analysis showed that a high level of worry about losing one's job (SE = 0.044, β = 0.152, t = 2.567, p = 0.011) and poorer family APGAR scores (SE = 0.035, β = -0.202, t = -3.406, p < 0.001) were associated with higher NJSS scores.

Conclusion

The nurses reported experiencing a moderate level of occupational stress in the context of low fertility in China. The key predictors of occupational stress among the nurses included concerns about job security and the Family APGAR classification. Implementing fair compensation and providing more effective family-oriented support programs are essential for reducing occupational stress among nurses.

Workplace Factors Contributing to Professional Stress in Family Medicine

OBJECTIVES

The main objective was to assess the relationship between sociodemographic and occupational factors and stress levels among healthcare workers in family medicine in Bosnia and Herzegovina, using the PSS-10-BH scale.

MATERIAL AND METHODS

A cross-sectional study was conducted using the PSS-10-BH questionnaire distributed via Google Forms to primary care nurses and physicians between July and August 2022.

RESULTS

The study included 272 participants, with a mean age of 44.7 (±10.55), predominantly women (86.8%) and physicians (58.8%). The mean PSS-10-BH total score for the sample was 21.26 (±6.77) ranging from 3 to 36. The linear regression model indicated male gender and older age showed an association with slightly lower stress levels. Marital status and the number of children showed a slight positive association with stress levels. Occupation (B=-3.068, 95%CI: -5.442 to -0.694, P=0.012) was associated with stress, with physicians tending to report lower stress levels compared to nurses. Years of work experience (B=0.060, 95%CI: -0.190 to 0.309, P=0.636), and patient load (B=0.082, 95%CI: 0.027 to 0.137, P=0.004) were associated with higher stress levels. The results suggest that work-related variables are significant predictors of stress levels as measured by the PSS-10-BH scale in this sample of healthcare workers. The included predictors explain 10% of the variability in the outcome, indicating additional unidentified contributing factors.

CONCLUSION

Occupational factors, particularly profession, work experience, and daily patient load, significantly influence stress levels in healthcare workers. Further research is needed to explore other potential influences and refine interventions aimed at managing stress in this population.

Pandemic scars: long-term impact of COVID-19 on work stress among healthcare workers in China

PURPOSE

This study mainly focused on the long-term effect of different risk exposure levels and prior anti-epidemic experience of healthcare workers in mitigating COVID-19 on their work stress in the post-COVID era.

DESIGN/METHODOLOGY/APPROACH

The study sample included 359 physicians, 619 nurses, 229 technicians and 212 administrators, for a total of 1,419 healthcare workers working in the Lanzhou area during the investigation. Data were analyzed by multivariate regression models.

FINDINGS

Our findings indicated that the interaction between pandemic effect mitigation experience and high-risk exposure significantly affected healthcare workers in the post-COVID era by increasing their work stress (p < 0.001) and reducing their rest time (p < 0.001). Healthcare workers may have experienced worse outcomes in the long term if they had higher levels of risk exposure and more experience in fighting epidemics. Furthermore, poor mental health (p < 0.001) and prior experience with SARS (p < 0.001) further amplified these adverse effects. However, surprisingly, we did not observe any effect of prior anti-epidemic experience or high-risk exposure on the mental health of healthcare workers in the post-COVID era (p > 0.1).

RESEARCH LIMITATIONS/IMPLICATIONS

The adverse impact of COVID-19 may have left long-lasting effects on Health professionals (HPs), particularly those with high Risk exposure (RE) and more mitigation experience. Poor Mental health (MH) and previous experience in mitigating previous similar outbreaks (such as SARS) are risk factors that should be considered. Support programs must be designed and promoted to help HPs respond and improve their performance.

ORIGINALITY/VALUE

Our study presents compelling evidence that the COVID-19 pandemic will have long-term detrimental effects on the work stress of healthcare workers.

Factors Associated with Stress among Healthcare Personnel after COVID-19 in Northeast Thailand: A Cross-sectional Study

Background

The coronavirus disease (COVID-19) has affected people psychologically worldwide, particularly healthcare personnel. Even though the COVID-19 pandemic situation has eased, healthcare personnel must still perform their duties, which has resulted in psychological impacts, particularly stress.

Objectives

This study aimed to examine the risk factors associated with stress among healthcare personnel post-COVID-19 pandemic in northeast Thailand.

Methods

A cross-sectional analytic design was conducted from January to April 2023. One thousand and three hundred healthcare workers were selected from primary, secondary, and tertiary hospitals across 16 districts within Chaiyaphum province. The questionnaires were used to collect data, and the stress test 5 (ST-5) questionnaire was used to investigate stress among healthcare personnel.

Results

The overall stress rate for healthcare workers was 15.47%, including very severe (8.85%) and severe (6.62%). The factors associated with stress consisted of work position, environment of work, personal life such as education level and income, and responsibility for taking care of family members, in addition to experiencing quarantine from COVID-19 were more likely to have a high risk of stress problems among healthcare workers.

Conclusion

This result highlighted that the mental health of personnel should be in critical situations, and those found severely afflicted should undergo professional care. To prevent psychological issues, particularly stress, health organizations should be concerned with strong organizational management, which includes supporting bonuses and providing high-quality personal protective equipment (PPE) to healthcare staff.

Risk Factors of Developing Postinfectious Irritable Bowel Syndrome in Shigellosis Patients, 5 Years After Hospitalization During the Outbreak

Background

Irritable bowel syndrome (IBS) can be triggered by bacterial dysentery. This study aimed to investigate postinfectious IBS and its risk factors after the shigellosis outbreak in hospitalized patients.

Methods

This retrospective study was conducted in 2020-2021 in referral hospitals for Shigella gastroenteritis during the 2014 shigellosis outbreak in Isfahan. The Shigella-infected group included hospitalized shigellosis patients with clinical symptoms and positive stool culture. The control group included patients matched pairwise on age and sex to the Shigella-infected group, admitted to the same hospitals in the same period with diagnoses other than shigellosis. Both groups had no history of diagnosed IBS before the outbreak. The incidence of IBS (according to Rome-III criteria) and its related factors was compared between the 2 groups 5 years after infection.

Results

Of 619 participants, 220 (35.5%) were in the Shigella-infected group. The 5-year incidence of IBS was 31.8% and 5.7% in the Shigella-infected and control groups, respectively. Multivariate analysis showed that shigellosis was significantly associated with increased risk of IBS (odds ratio [OR], 17.18 [95% confidence interval {CI}, 9.37-31.48]). Multivariate analysis indicated education level (OR, 4.15 [95% CI, 1.47-11.73]), diarrhea lasting >4 days (OR, 1.69 [95% CI, 1.17-2.44]), and abdominal cramps during the infection (OR, 0.27 [95% CI, .77-.95]) associated with postinfectious IBS (P < .05).

Conclusions

Hospitalized patients with Shigella gastroenteritis are at increased risk of IBS within 5 years after infection. Factors such as higher education level and the absence of abdominal cramps and diarrhea persisting for >5 days during hospitalization can further increase this risk.

The workload change and depression among emergency medical staff after the open policy during COVID-19: a cross-sectional survey in Shandong, China

Introduction

In the middle of December 2022, the Chinese government adjusted the lockdown policy on coronavirus disease 2019 (COVID-19), a large number of infected patients flooded into the emergency department. The emergency medical staff encountered significant working and mental stress while fighting the COVID-19 pandemic. We aimed to investigate the workload change, and the prevalence and associated factors for depression symptoms among emergency medical staff after the policy adjustment.

Methods

We conducted a cross-sectional online survey of emergency medical staff who fought against COVID-19 in Shandong Province during January 16 to 31, 2023. The respondents' sociodemographic and work information were collected, and they were asked to complete the 9-item Patient Health Questionnaire (PHQ-9) then. Univariate and multivariate logistic regression analyses were applied to identify the potential associated factors for major depression.

Results

Nine hundred and sixteen emergency medical personnel from 108 hospitals responded to this survey. The respondents' weekly working hours (53.65 ± 17.36 vs 49.68 ± 14.84) and monthly night shifts (7.25 ± 3.85 vs 6.80 ± 3.77) increased after the open policy. About 54.3% of the respondents scored more than 10 points on the PHQ-9 standardized test, which is associated with depressive symptoms. In univariate analysis, being doctors, living with family members aged ≤16 or ≥ 65 years old, COVID-19 infection and increased weekly working hours after the open policy were significantly associated with a PHQ-9 score ≥ 10 points. In the multivariate analysis, only increased weekly working hours showed significant association with scoring ≥10 points.

Conclusion

Emergency medical staff' workload had increased after the open policy announcement, which was strongly associated with a higher PHQ-9 scores, indicating a very high risk for major depression. Emergency medical staff working as doctors or with an intermediate title from grade-A tertiary hospitals had higher PHQ-9 scores, while COVID-19 infection and weekly working hours of 60 or more after the open policy were associated with higher PHQ-9 scores for those from grade-B tertiary hospitals. Hospital administrators should reinforce the importance of targeted emergency medical staff support during future outbreaks.