Fear of COVID-19 Impact on Professional Quality of Life among Mental Health Workers

The Serial Mediation Effect of COVID-19 Anxiety and COVID-19 Burnout on the Relationship Between the Fear of COVID-19 and COVID-19 Quality of Life in Nurses

There is growing interest in the association between COVID-19-related stressors and quality of life. This study aimed to extend current knowledge by investigating the potential mediating roles of COVID-19 anxiety and COVID-19 burnout in the association between fear of COVID-19 and COVID-19 quality of life in nurses. A total of 300 nurses were selected by convenience sampling approach from a training and research hospital serving as a pandemic hospital in Turkey. COVID-19 anxiety, COVID-19 burnout, and COVID-19 quality of life data were collected using the self-reported questionnaires using both online and paper-and-pencil versions of the questionnaires. Structural equation modeling was used to conduct serial multiple mediation analysis. We found statistically significant associations among fear of COVID-19, COVID-19 anxiety, COVID-19 burnout, and COVID-19 quality of life. Serial multiple mediation analysis revealed that the association of fear of COVID-19 with COVID-19 quality of life was partially mediated by COVID-19 anxiety and COVID-19 burnout. These results indicate that the association of fear of COVID-19 with COVID-19 quality of life in nurses may be changed through COVID-19 anxiety and COVID-19 burnout, which appear to play serial multiple mediating roles in this association. These findings enrich our understanding of the associations among these psychological factors and suggest that focusing solely on fear of COVID-19 without considering the mediating effects of COVID-19 anxiety and COVID-19 burnout might not be adequate for reducing the COVID-19-impact on the quality of life among nurses.

Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-Revised

Background: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69-0.88), high convergent validity (item total correlations r range = 0.39-0.81, and correlations with the IES-R's total score r range = 0.62-0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42-0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12-0.39) and the diagnosis of hypertension (r range = 0.12-0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction).

Predictors of quality of professional life and well-being of medical residents and interns: Role of gender and workplace spirituality

Background and Aims

The well-being of physicians in their professional lives has a major influence on the quality of medical care and patient outcomes. This study explored how Professional Quality of Life (ProQOL) and psychological well-being are connected to workplace spirituality (WPS) and demographic factors like age and gender. It also compared the average levels of ProQOL, psychological well-being, and WPS between medical residents and interns.

Methods

In a cross-sectional study, 230 medical residents and interns completed three questionnaires, including ProQOL, Ryff Scale Psychological Wellbeing-Short Form, and WPS. The data was analysed using Pearson correlation, independent t-test, ANOVA, and multiple linear regression modeling.

Results

Residents and interns had moderate ProQOL levels and higher work spirituality. However, medical residents scored lower in occupational spirituality and compassionate care fulfillment compared to interns while experiencing higher levels of emotional exhaustion and secondary mental strain. Gender disparities were significant, with women scoring higher in compassionate care fulfillment but lower in secondary mental strain. Regression analysis showed that occupational spirituality positively predicted professional, compassionate care fulfillment (B = 0.910, p < 0.001) but negatively predicted emotional exhaustion in both groups.

Conclusions

These findings underscore the importance of understanding factors like gender and work spirituality to enhance the well-being and quality of care provided by medical residents and interns.

Risk perception and quality of working life of nurses in infectious disease department in China: The chain-mediating effects of psychological resilience and social support

AIM

To determine whether social support and psychological resiliency are significant mediators of the associations between risk perception and quality of working life in Chinese nurses working with infectious diseases.

DESIGN

A cross-sectional study.

METHODS

A cross-sectional survey of 879 nurses in infectious diseases department of specialty or general hospitals in China completed online questionnaires on the nurses' risk perception questionnaire, quality of working life, psychological resilience and the social support rating scale.

RESULTS

Our study observed that risk perception directly negatively influences the quality of working life of infectious disease nurses, while psychological resilience and social support positively chain mediate this relationship.

CONCLUSION

Critical elements impacting the quality of working life of infectious disease nurses are risk perception, psychological resilience and social support. Managers may think about decreasing the level of risk perception and enhancing the quality of working life of infectious disease nurses by enhancing their psychological resilience and providing support.

PUBLIC CONTRIBUTION

The quality of working life of infectious disease nurses should be a priority for nursing management; it is critical to maintain their health and well-being, raise the quality of care and lower turnover. Managers should create resilience-building programmes and support tools to assist nurses properly perceive risks and adopt protective strategies to deal with them to improve the quality of working life for nurses.

Development, validation, and accuracy of ORCHESTRA emotional exhaustion screening questionnaire among healthcare workers during COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic has posed unprecedented challenges, particularly for healthcare workers (HCWs). The prolonged struggles exposed the HCWs to a variety of stressors, potentially leading to burnout. Emotional exhaustion is widely recognized as the core component of burnout. This research aims to conceptualize and develop an emotional exhaustion screening questionnaire through literature review, validation, and accuracy testing.

METHOD

A literature review of questionnaires and extraction of items on emotional exhaustion were performed in June 2022. We proceed with the face validity of the items by experts. The items with good content validity ratio and index were selected and reworded to suit the context of HCWs working during the COVID-19 pandemic. A pilot test of the questionnaire was done in the Central University Hospital of Asturias (HUCA) from October to December 2022 with a sample of 148 HCWs from the ORCHESTRA cohort to determine its reliability, convergent validity, and accuracy.

RESULTS

Our literature review identified 15 validated questionnaires. After exclusion, 32 items were sent for content validation by experts, yielding five final items that proceeded with the pilot test. Resulting in a Cronbach's alpha-coefficient of .83 for the scale and .78 for dichotomous responses, demonstrating good internal consistency and convergent validity. The result of our accuracy test yielded sensitivity (90.6%) and specificity (91.6%) for the OEEQ scale; and sensitivity (88.7%) and specificity (89.5%) for OEEQ dichotomous responses.

CONCLUSION

This study developed and validated the ORCHESTRA Emotional Exhaustion Questionnaire, demonstrating the questionnaire's clarity, relevance, and comprehensibility in screening emotional exhaustion among HCWs.

Influences of healthcare workers' behaviours towards infection prevention and control practices in the clinical setting: A systematic review

AIM

To systematically evaluate empirical studies investigating the influences of healthcare workers' behaviours towards infection prevention and control practices in the Coronavirus clinical space, and to appraise and synthesise these findings.

DESIGN

A systematic review of the literature.

METHODS

The review used a five-step framework described by Khan et al. (Journal of the Royal Society of Medicine, 2003, 96 and 118) of Framing questions for a review; Identifying relevant work; Assessing the quality of studies; Summarising the evidence; and Interpreting the findings. Searches were conducted in CINHAL, MEDLINE, PsychINFO, Scopus, and Google Scholar databases to retrieve relevant peer-reviewed literature published in English between 2019 and 2023. Covidence and Joanna Briggs Quality appraisal tools were used for critical assessment. To improve transparent reporting, this review used a Synthesis Without Meta-analysis (SWiM) in systematic review guidelines, as informed by Campbell et al. (BMJ, 2020, 368).

RESULTS

Twenty studies were included in this review, identifying nine themes describing factors influencing HCWs' behaviours towards IPC practices in the coronavirus environment. The overarching influences emerged as knowledge-oriented, person-oriented, and environment-oriented.

CONCLUSION

Healthcare workers' responsibilities at point-of-care involve providing direct care to patients with highly transmissible infections and working in clinical settings that may be ill-designed for IPC practices, increasing the risk of transmission. Given the lack of a definitive solution to eradicate new mutant viruses and that IPC practices are the mainstay of prevention and control of transmissible, measures to improve are imperative. The identified HCWs' domains on behaviours towards IPC are critical in strategies to mitigate risks and further set an opportunity for developing an IPC model congruent with the rapid response required for HCWs during emerging or re-merging mutant virus outbreaks. This is significant, given that HCWs' preparedness with IPC practices at point-of-care is central to patient care, the workforce and community safety.

Professional quality of life, psychological well-being, and work engagement of healthcare professionals in two Greek hospitals during COVID-19: A cross-sectional study

BACKGROUND

During the COVID-19 pandemic, the mental health of healthcare professionals has emerged as an issue of great concern.

OBJECTIVE

To investigate the levels of professional quality of life, psychological well-being, and work engagement among healthcare professionals in two Greek hospitals during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted in December 2021 in two public hospitals in Greece. To assess the levels of professional quality of life, psychological well-being, and work engagement, respondents completed the Professional Quality of Life Scale Version 5 (ProQOL-V), the Psychological Well-being (PWB) scale, and the Utrecht Work Engagement Scale (UWES-17).

RESULTS

A total of 150 questionnaires were distributed, and 102 were returned (response rate: 68%). It was found that as burnout levels increased, the levels of work engagement decreased (rho = -0.36, p-value < 0.01). Higher levels of compassion satisfaction were associated with higher work engagement (rho = 0.48, p-value < 0.01). Multivariable analysis revealed that healthcare personnel's contact with patients or service users exposed to or who have experienced traumatic events was associated with less positive relationships with others (and, consequently, lower levels of psychological well-being) (p-value = 0.035).

CONCLUSIONS

Healthcare professionals in the two public hospitals in Greece, experienced moderate levels of compassion satisfaction, burnout, and secondary traumatic stress during the COVID-19 pandemic. Their psychological well-being was also found to be moderate, and their levels of work engagement were moderate to high. Supporting the physical and psychological well-being of healthcare professionals is essential for their ability to provide high-quality care in times of crisis, such as during the COVID-19 pandemic.

Addressing the Increasing Mental Health Distress and Mental Illness Among Young Adults in the United States

ABSTRACT

Recent surveys show rising numbers of young people who report anxiety and depression. Although much attention has focused on mental health of adolescent youth, less attention has been paid to young people as they transition into adulthood. Multiple factors may have contributed to this steady increase: greater exposure to social media, information, and distressing news via personal electronic devices; increased concerns regarding social determinants of health and climate change; and changing social norms due to increased mental health literacy and reduced stigma. The COVID-19 pandemic may have temporarily exacerbated symptoms and impacted treatment availability. Strategies to mitigate causal factors for depression and anxiety in young adults may include education and skills training for cognitive, behavioral, and social coping strategies, as well as healthier use of technology and social media. Policies must support the availability of health insurance and treatment, and clinicians can adapt interventions to encompass the specific concerns and needs of young adults.

Factors Affecting Fear of COVID-19 Infection in Healthcare Workers in COVID-19 Dedicated Teams: Focus on Professional Quality of Life

This study examined factors related to high fear of coronavirus disease 2019 (COVID-19) infection in healthcare workers (HCWs) in COVID-19 dedicated teams. We assigned 371 HCWs to low, medium, and high COVID-19 infection fear groups, and investigated factors associated with COVID-19 infection fear. High COVID-19 infection fear was significantly associated with being a woman and poor professional quality of life. High COVID-19 infection fear group had higher burnout levels and secondary traumatic stress scores than the low and medium fear groups. These findings deepen our understanding of risk factors for and psychological outcomes of COVID-19 infection fear in HCWs.

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Background

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

Methods

A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

Results

A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

Conclusion

This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

The Impact of the COVID-19 Pandemic on Mental Health and Quality of Life in COVID-19 Department Healthcare Workers in Central Greece

BACKGROUND

The pandemic crisis created conditions of insecurity and threat and brought about changes in social contacts and everyday life. Frontline healthcare workers (HCW) were mostly affected. We aimed to evaluate the quality of life and negative emotions in COVID-19 HCW and searched for factors influencing the above.

METHODS

The present study was conducted among three different academic hospitals in central Greece (04/2020-03/2021). Demographics, attitude towards COVID-19, quality of life, depression, anxiety, stress (using the WHOQOL-BREF and DASS21 questionnaire) and the fear of COVID-19 were assessed. Factors affecting the reported quality of life were also assessed.

RESULTS

The study involved 170 HCW in COVID-19 dedicated departments. Moderate levels of quality of life (62.4%), satisfaction with social relations (42.4%), working environment (55.9%) and mental health (59.4%) were reported. Stress was present in 30.6% of HCW; 20.6% reported fear for COVID-19, depression (10.6%) and anxiety (8.2%). HCW in the tertiary hospital were more satisfied with social relations and working environment and had less anxiety. Personal Protective Equipment (PPE) availability affected the quality of life, satisfaction in the work environment and the presence of anxiety and stress. Feeling safe during work influenced social relations and fear of COVID-19 Conclusion: The HCW quality of life is affected in the pandemic. Feelings of safety during work related to the reported quality of life.

The Association between Fear of COVID-19 and Health-Related Quality of Life: A Cross-Sectional Study in the Greek General Population

The aim of this cross-sectional study was to assess the level of fear related to the SARS-CoV-2 virus and the association of fear, and of sociodemographic and clinical characteristics, with health-related quality of life (HRQoL). A large sample of the Greek general population (N = 583) completed the validated versions of the Fear of COVID-19 scale (FCV-19s) and the 12-item Short Form (SF-12), and provided data on socio-demographic status, health history and COVID-19 protective behaviors. Variables were compared with Mann-Whitney and Kruskal-Wallis tests and associations with Spearman’s correlations. Gamma regression models investigated the influence of sociodemographic and COVID-related variables on HRQoL. The mean FCV-19s score for the sample was 18.3 ± 5.6, and physical and mental component summary scores were 50.2 ± 7.9 and 46.7 ± 10.1, respectively. More fear of COVID-19 was expressed by females (p < 0.001), individuals with comorbidities (p < 0.01), those with contacts with comorbidities (p < 0.001), and individuals not having caught COVID-19 (p < 0.05). Contrastingly, less fear was expressed by unvaccinated individuals and those with less frequent intake of information about the pandemic. Item level and overall FCV-19s scores were negatively associated with SF-12 summary scores, and fear of COVID-19 was the most important predictor of both physical and mental HRQoL. The findings from this and other similar studies could help to identify specific population groups in need of interventions to improve their physical and mental health, which had deteriorated due to the pandemic.