Psychological and Social Aspects of Vaccination Hesitancy-Implications for Travel Medicine in the Aftermath of the COVID-19 Crisis: A Narrative Review

Traveling Before, During, and After the Pandemic: Impact of the COVID-19 Pandemic on the Travel Behavior and Travel Medicine Practice

OBJECTIVE

The emergence of the coronavirus disease 2019 (COVID-19) pandemic severely compromised international travel and the practice of travel medicine. This study aimed to investigate the evolution of traveler behaviors and prophylactic prescriptions across the pandemic and post-pandemic periods.

POPULATION AND METHODS

A retrospective study was conducted on travelers attending the International Vaccination Center in Vila Nova de Gaia, Portugal, from August 2019 to May 2023, where data were collected on travelers' demographics, destination, duration, reasons for traveling, and data regarding travel-related vaccines and malaria prophylaxis. Travelers' characteristics were compared between Period A (pre-pandemic), Period B (pandemic), and Period C (post-pandemic).

RESULTS

The study included 1,711 travelers in the analysis. During the pandemic period, there were fewer travelers for tourism (5% decrease) and an increase in travelers for emigration and work (4.8% increase). There was also an increase in trips lasting less than two weeks among tourists, as well as trips lasting more than one month, primarily among travelers for work or emigration. During the pandemic, there was a significant decrease in Asia as a destination, with a shift toward African countries, which partially reverted in the post-pandemic period. Significant decreases in the prescriptions of vaccines were found during the pandemic and continued in the post-pandemic period.

CONCLUSION

There was a change in travelers' characteristics due to the pandemic, with a shift to shorter trips for tourism, an avoidance of Asia, and a preference for sub-Saharan African countries as a main hub of destination. Some vaccine prescription practices remained low and even decreased during or after the pandemic.

Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era

Introduction

The pandemic has led to notable psychological challenges among healthcare professionals, including nurses.

Objective

Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience.

Methods

Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected.

Results

The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship.

Conclusions

Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.