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Akram F, Pidcock M, Oake D, Sholler GF, Farrar MA, Kasparian NA. "The usual challenges of work are all magnified": Australian paediatric health professionals' experiences during the COVID-19 pandemic. Int J Cardiol Congenit Heart Dis 2023; 11:100434. [PMID: 36571073 PMCID: PMC9769021 DOI: 10.1016/j.ijcchd.2022.100434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background The COVID-19 pandemic has significantly increased stress and strain on health professionals. With a focus on paediatric cardiac care, this study explored health professionals' concerns about COVID-19, perceptions of the impact of pandemic on healthcare, and experiences of psychological stress. Methods Paediatric health professionals working at a large quaternary hospital in Australia were invited to complete a survey between June 2020 and February 2021. Demographic factors, clinical role characteristics, and anxiety and depressive symptoms were assessed. Qualitative data on experiences and perceived effects of the pandemic on paediatric cardiac care were also collected. Results 228 health professionals (152 nurses, 37 medical doctors, 22 allied and mental health professionals, 17 medical research and administrative staff) participated in the survey (54.4% response rate, 85% women). Half the sample (52.2%) endorsed 'moderate' to 'extreme' worry about COVID-19 and 38% of participants perceived healthcare services as adversely impacted by the pandemic to a 'great' or 'very great' extent. Almost one in five health professionals reported anxiety (18%) and 11% reported depressive symptoms indicative of a need for clinical intervention. Six themes were identified in the qualitative data: (1) Concern about the consequences of visitor restrictions and disrupted patient services, (2) Intensified strain on healthcare workers, (3) Feelings of fear and loss, (4) Social isolation and disconnection, (5) Adapting to change, and (6) Gratitude. Conclusion Timely, tailored policies, supports, and interventions are needed to address health professionals' mental health needs during and beyond the pandemic, to minimize the far-reaching impact of situational stressors.
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Affiliation(s)
- Farah Akram
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Madeleine Pidcock
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Diane Oake
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Gary F Sholler
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Paediatrics and Child Health, University of Sydney, Sydney, Australia
| | - Michelle A Farrar
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
- Department of Neurology, Randwick, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Nadine A Kasparian
- Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Mujtaba M, Kotwani S, Qayyum D, Saghir T, Bhatti KI, Khalid MR, Khanzada MF, Aman S, Shaikh KA, Buraro S, Karim M. Impact of COVID-19 on cardiovascular clinics: Are we ready for telemedicine? SAGE Open Med 2023; 11:20503121231153755. [PMID: 36778198 PMCID: PMC9912032 DOI: 10.1177/20503121231153755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/12/2023] [Indexed: 02/11/2023] Open
Abstract
Objective The need for telemedicine was felt more than ever during the COVID-19 pandemic, which impacted health care worldwide. Therefore, this study aimed to determine the difficulties faced by patients in visiting the cardiac outpatient department during COVID-19, along with assessing the awareness and acceptability of telemedicine. Methods In this cross-sectional study, selected patients presenting to outpatient department of a tertiary care cardiac hospital were interviewed regarding the difficulties faced by patients in visiting the outpatient department during COVID-19 and their awareness and acceptability of telemedicine using a self-designed structured questionnaire. Results Of the 403 patients, 58.3% were male, the mean age was 53.04 ± 11.73 years, and most (77.7%) were urban residents. Ischemic heart disease was present in 69.5%, followed by hypertension (38.7%) and heart failure (29.3%). A total of 26.6% required emergency room visits. Limited appointments (55.6%) was the most common problem faced by patients during COVID-19, followed by financial issues (17.1%), fear of acquiring infection (13.4%), and limited mobility due to lockdown (22.6%). Only 12.2% were aware of telemedicine, 4.5% had previously used it, and 41.2% were willing to opt for telemedicine in the future. No internet access (39.2%) was the key barrier to the usage of telemedicine, followed by a lack of free medicine (39%) and a lack of a smart device (31.5%). Conclusion Limited appointments due to COVID-19 restrictions has made it difficult for patients to visit the clinics, which has led to increased emergency room visits. Telemedicine awareness was found to be limited; however, many patients were willing to adopt it provided their limitations could be overcome.
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Affiliation(s)
- Mustajab Mujtaba
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan,Mustajab Mujtaba, National Institute of
Cardiovascular Diseases, A203, Mehran Square, Clifton block 8, Karachi 75530,
Pakistan.
| | - Sapna Kotwani
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
| | - Danish Qayyum
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
| | - Tahir Saghir
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
| | | | | | | | - Saba Aman
- Dr. Ruth K.M. Pfau Civil Hospital
Karachi, Karachi, Pakistan
| | | | | | - Musa Karim
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
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Seruwagi G, Nakidde C, Lugada E, Ssematiko M, Ddamulira DP, Masaba A, Luswata B, Ochen EA, Okot B, Muhangi D, Lawoko S. Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations. Confl Health 2022; 16:25. [PMID: 35551630 PMCID: PMC9096741 DOI: 10.1186/s13031-022-00451-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We studied the association between psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda during the COVID-19 pandemic.
Methods Cross-sectional survey data on psychological distress, social support, demographics, socio-economic and behavioral variables was gathered from 1014 adult refugees randomly sampled from urban, semi-rural and rural refugee settlements in Uganda, using two-staged cluster sampling. Data was analyzed in SPSS-version 22, and statistical significance was assumed at p < 0.05. Results Refugees resident in rural/semi-rural settlements exhibited higher levels of psychological distress [F(2, 1011) = 47.91; p < 0.001], higher availability of social interaction [F(2, 1011) = 82.24; p < 0.001], lower adequacy of social interaction [F(2, 1011) = 54.11; p < 0.001], higher availability of social attachment [F(2, 1011) = 47.95; p < 0.001], and lower adequacy of social attachment [F(2, 1011) = 50.54; p < 0.001] than peers in urban settlements. Adequacy of social interaction significantly explained variations in psychological distress levels overall and consistently across settlements, after controlling for plausible confounders. Additionally, adequacy of social attachment significantly explained variations in psychological distress levels among refugees in rural settlements, after controlling for plausible confounders. Conclusion There is a settlement-inequality (i.e. rural vs. urban) in psychological distress and social support among conflict refugees in Uganda. To address psychological distress, Mental Health and Psychosocial Support Services (MHPSS) should focus on strategies which strengthen the existing social networks among refugees. Variations in social support are a key predictor of distress which should guide tailored need-adapted interventions instead of duplicating similar and generic interventions across diverse refugee settlements.
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Affiliation(s)
- Gloria Seruwagi
- Makerere University School of Public Health, Kampala, Uganda. .,Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda.
| | - Catherine Nakidde
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Eric Lugada
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Maria Ssematiko
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | | | | | - Brian Luswata
- Directorate of Governance and Regulation, Ministry of Health, Kampala, Uganda
| | - Eric A Ochen
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Betty Okot
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Denis Muhangi
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Stephen Lawoko
- Department of Public Health Faculty of Medicine, Gulu University, Gulu, Uganda
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Abstract
OBJECTIVES This study aimed to investigate the presence of perceived stressors, psychological safety and teamwork in healthcare professionals. As the timeframe for this study spanned the first wave of the COVID-19 pandemic, data were captured demonstrating the impact of the pandemic on these factors. DESIGN Qualitative interview study. SETTING All staff working within the emergency and critical care departments of one National Health Service Trust in London, UK. PARTICIPANTS Forty-nine participants were recruited using a purposive sampling technique and interviewed when the first wave of the COVID-19 pandemic had subsided. MAIN OUTCOME MEASURES Evaluation of changes in perceived stressors, psychological safety and teamwork in individuals working during the COVID-19 pandemic. RESULTS The thematic analysis relating to a participant's lived experiences while working during COVID-19 led to the construction of five key themes, including 'psychological effects' and 'changes in team dynamics'. Several psychological effects were described, including the presence of psychological distress and insights into the aetiology of moral injury. There was marked heterogeneity in participants' response to COVID-19, particularly with respect to changes in team dynamics and the perception of a psychologically safe environment. Descriptions of improved team cohesiveness and camaraderie contrasted with stories of new barriers, notably due to the high workload and the impact of personal protective equipment. Building on these themes, a map of key changes arising due to the pandemic was developed, highlighting potential opportunities to provide targeted support. CONCLUSIONS Working on the front line of a pandemic can have significant implications for healthcare workers, putting them at risk of psychological distress and moral injury, as well as affecting team dynamics. There is striking heterogeneity in the manifestation of these challenges. Team leaders can use the themes and qualitative data from this study to help identify areas for management focus and individual and team support.
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Affiliation(s)
- Kate Grailey
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Adam Lound
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Stephen Brett
- Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK
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Abraham SA, Berchie GO, Doe PF, Agyare E, Addo SA, Obiri-Yeboah D. Effects of COVID-19 pandemic on ART Service delivery: perspectives of healthcare workers in a Teaching Hospital in Ghana. BMC Health Serv Res 2021; 21:1295. [PMID: 34856995 PMCID: PMC8637519 DOI: 10.1186/s12913-021-07330-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/17/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Ghana has a generalized HIV epidemic and efforts have been made to curb the spread and reverse its effects on the general population. In the wake of COVID-19 pandemic, the health system was unsettled and antiretroviral therapy (ART) care has been impacted in diverse ways. The study sought to explore the effects of COVID-19 on ART service provision in Ghana from the perspectives of the healthcare workers. METHODS An exploratory-descriptive qualitative approach was employed in this study. Using maximum variation sampling method, fifteen healthcare workers; nurses, data managers and pharmacists were recruited from an ART clinic in a Teaching Hospital in Ghana. In-depth interviews were conducted and analysed using Braun and Clarke thematic approach. RESULTS Three themes emerged from the data; "… And the pandemic struck", "Impact of the pandemic on ART service delivery"; "Effecting the needed change". The healthcare workers' initial reactions to the pandemic and their show of commitment in ensuring continued ART service was evident. COVID-19 impacted service delivery in three main ways; (1) clients' clinic attendance was erratic at various stages of the pandemic, (2) irregular resource availability as shortage was reported due to affected last mile delivery as a result of the lockdown in Accra, and (3) the health worker-patient interaction became less engaging because of established COVID-19 protocols. The healthcare workers however instituted strategies such as adjusting the patient appointment schedule, health professionals' work schedule, establishing several work stations, task-shifting, and ensuring the implementation of all the COVID-19 protocols within the ART unit to ensure consistent service delivery as well as patient and staff safety. The study also found a decline in the implementation of several strategies established in the ART clinic during the initial phases of the pandemic such as a decline in the supply of Personal Protective Equipment (PPEs) by hospital management. CONCLUSIONS Although several strategies were implemented to manage the effects of the pandemic on ART care, there is a need to establish pathways of support for healthcare workers within the ART clinic and to consolidate as well as institutionalise the changes that ensured continuous but safe service delivery.
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Affiliation(s)
- Susanna Aba Abraham
- Department of Adult Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Gifty Osei Berchie
- Maternal and Child Health Department, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Patience Fakornam Doe
- Department of Adult Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Elizabeth Agyare
- Clinical Microbiology/Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Stephen Ayisi Addo
- Programme Manager, National HIV/AIDS Control Programme, Korle-Bu, Accra, Ghana
| | - Dorcas Obiri-Yeboah
- Clinical Microbiology/Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana
- Microbiology and Immunology Department, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Directorate of Research Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
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Ching SM, Ng KY, Lee KW, Yee A, Lim PY, Ranita H, Devaraj NK, Ooi PB, Cheong AT. Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis. PLoS One 2021; 16:e0257983. [PMID: 34648526 PMCID: PMC8516240 DOI: 10.1371/journal.pone.0257983] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/14/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic. MATERIAL AND METHODS We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI. RESULTS We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8-41.3), anxiety 39.7(95%CI: 34.3-45.1), stress 36.4% (95%CI: 23.2-49.7), fear 71.3% (95%CI: 54.6-88.0), burnout 68.3% (95%CI: 54.0-82.5), and low resilience was 16.1% (95%CI: 12.8-19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30-1.68) and nurses (OR = 1.21; 95%CI = 1.02-1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49-1.85), (Nurse: OR = 1.36; 95%CI = 1.16-1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28-1.97). CONCLUSION In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.
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Affiliation(s)
- Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
- Centre for Research, Bharath Institute of Higher Education and Research, Selaiyur, Chennai, Tamil Nadu, India
| | - Kar Yean Ng
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang Selangor, Malaysia
| | - Kai Wei Lee
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Malaysia
- Centre for Research on Communicable Diseases, Universiti Tunku Abdul Rahman, Kajang, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hisham Ranita
- Universiti Malaya Library, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Pei Boon Ooi
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang Selangor, Malaysia
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Norhayati MN, Che Yusof R, Azman MY. Prevalence of Psychological Impacts on Healthcare Providers during COVID-19 Pandemic in Asia. Int J Environ Res Public Health 2021; 18:9157. [PMID: 34501747 PMCID: PMC8431592 DOI: 10.3390/ijerph18179157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 12/11/2022]
Abstract
COVID-19 has impacted people psychologically globally, including healthcare providers. Anxiety, depression, and stress are the most common impacts that have affected these people. Thus, this study was aimed to ascertain the estimated prevalence of psychological impacts among healthcare providers in the Asian region. A systematic search was performed in the MEDLINE, CINAHL, and Scopus databases for original research articles published between 2020 and April 2021. Only studies published in English were included. The quality of data was assessed using the Joanna Briggs Institute Meta-Analysis, and the analysis was performed using generic inverse variance with a random-effects model by Review Manager software. A total of 80 studies across 18 countries in Asia region were pooled to assess the data prevalence on anxiety (34.81% (95% CI: 30.80%, 38.83%)), depression (34.61% (95% CI: 30.87%, 38.36%)), stress (31.72% (95% CI: 21.25%, 42.18%)), insomnia (37.89% (95% CI: 25.43%, 50.35%)), and post-traumatic stress disorder (15.29% (95% CI: 11.43%, 19.15%)). Subgroup analyses were conducted across regions, type of healthcare providers, sex, and occupation. This review has identified a high prevalence of anxiety, depression, stress, and insomnia but a low prevalence of post-traumatic stress disorder among healthcare providers in Asia regions. Effective intervention support programs are urgently needed to improve psychological health of healthcare providers and maintaining the health system.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Ruhana Che Yusof
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Mohd Yacob Azman
- Federal Government Administrative Centre, Medical Practice Division, Ministry of Health, Level 7, Block E1, Parcel E, Putrajaya 62590, Malaysia
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