This study aimed to develop and validate a new scale to measure health problem prevention and control strategies employed by medical rescuers fighting epidemics. In Study I, a qualitative study, focus group discussion, and expert panel review were conducted to generate items that capture components of prevention and control strategies. In Study II, exploratory factor analysis was used to examine the scale's structure. In Study III, the scale's validity and reliability were assessed via confirmatory factor analysis, average variance extracted, composite reliability, and Cronbach's α. Data analysis was performed using Nvivo 12.0, SPSS 25.0, and Amos 23.0. The final scale was divided into three subscales (comprising 5 factors and 18 items on the Before Medical Rescue subscale, 6 factors and 28 items on the During Medical Rescue subscale, and 4 factors and 14 items on the After Medical Rescue subscale). The scale has excellent validity and reliability and can be used to measure the health problem prevention and control strategies of medical rescuers fighting epidemics.

To assess the demands for support measures of healthcare workers (HCWs) in China's high-workload provinces during the COVID-19 pandemic and identify specific needs to make evidence-based recommendations.

Prospective cross-sectional study.

Conducted in three Chinese provinces characterised by their significant healthcare demands during the pandemic.

The study comprised 683 HCWs, including doctors, nurses, resident physicians and hospital administrators. The sample was predominantly female (68.1%), with the majority aged between 25 and 34 years. Participants were recruited through convenience and snowball sampling methods, with a focus on individuals working in high-intensity clinical environments.

Hierarchical analysis was performed to assess the layered impact of support measures across different roles and genders. Substantial gender disparity was observed, with female staff reporting significantly reduced access to material support (p<0.001), family counselling (p<0.001) and health management (p<0.05), alongside a generally higher demand for various support types. In contrast, HCWs assigned to COVID-19 units did not exhibit heightened needs for COVID-specific training (p<0.001), material support (p<0.001), stress management (p<0.001), family counselling (p<0.001) or rational shift patterns (p<0.001) compared with those in non-COVID-19-focused roles.

The study identifies significant support deficiencies, particularly among female HCWs, and emphasises the necessity for targeted interventions to strengthen healthcare system resilience. Recommendations include prioritising adequate rest, equitable resource allocation and the implementation of gender-oriented policies to ensure workforce sustainability and maintain care quality. Further research should focus on longitudinal support dynamics.

Social support is a critical factor in maintaining the mental health of healthcare workers in high-pressure occupational settings. However, few studies have systematically explored the different types of social support and their influencing factors. This study aims to investigate the current status of social support for healthcare workers under high pressure, along with the related protective and risk factors.

This cross-sectional study collected data through an online questionnaire involving 625 doctors and nurses from the First Affiliated Hospital of Chongqing Medical University. The Social Support Rating Scale (SSRS) was used to assess levels of social support, including objective support, subjective support, and support utilization. Data analysis was conducted using SPSS 26.0, employing univariate and linear regression analyses to examine gender differences and the impact of various factors on social support.

The study found that the total social support score was increased by factors such as family cohesion, living with others, older age, and professional identity (with doctors achieving higher scores than nurses), while insecure attachment and being an only child reduced the total social support score.

This study reveals the multidimensional impact of various factors on social support for healthcare workers in high-pressure occupational settings. These findings provide a basis for promoting individual mental health and also highlights the need to pay more attention to the mental health of those healthcare workers with poor interpersonal relationships, younger individuals, and nurses in high-pressure environments.

During the COVID-19 lockdown, it was difficult for residency training programs to conduct on-site, hands-on training. Distance learning, as an alternative to in-person training, could serve as a viable option during this challenging period, but few studies have assessed its role.

This study aims to investigate the impact of distance learning during the lockdown on residents' self-assessed competency development and to explore the moderating effect of poor mental health on the associations. It is hypothesized that radiology residents who were trained through distance learning during the lockdown were more likely to report higher self-assessed competency compared to those who did not receive organized, formal training.

A cross-sectional survey was conducted in 2021 among all of the radiology residents in 407 radiology residency programs across 31 provinces of China. To estimate the long-term outcomes of radiology residents' training after the initial COVID-19 outbreak, this study measured 6 core competencies developed by the US Accreditation Council for Graduate Medical Education reported by radiology residents. Multiple linear regression and moderating effect analysis were conducted to examine the associations between distance learning, mental health status, and self-assessed competencies. Mental health status moderated the association between distance learning and self-assessed competency of radiology residents.

A total of 2381 radiology residents (29.7% of the 8,008 nationwide) met the inclusion criteria and were included in the analysis. Among them, 71.4% (n=1699) received distance learning during the COVID-19 lockdown, and 73.2% (n=1742) reported mental health struggles ranging in severity from slight to extremely severe. Radiology residents who were trained through distance learning (β=0.35, 90% CI 0.24-0.45) were more likely to report higher self-assessed competencies. This was particularly true for the competency of "interpersonal and communication skills" (β=0.55, 90% CI 0.39-0.70). Whereas, the competency of "patient care and technical skills" (β=0.14, 90% CI 0.01-0.26) benefited the least from distance learning. Poor mental health significantly moderated the relationship between distance learning and competency (β=-0.15, 90% CI -0.27 to -0.02).

Distance learning, a means of promoting enabling environments during the COVID-19 lockdown, serves its purpose and helps generally improve residents' self-assessed competencies, though different competency domains benefit unequally. The impact of mental health status calls for special attention so that distance learning can fulfill its potential.

The COVID-19 pandemic posed unprecedented challenges to healthcare providers globally. The firsthand lived experiences of healthcare professionals who worked on the frontlines are invaluable. This study explores the experiences of frontline physicians during the early waves of the COVID-19 pandemic. This is a descriptive qualitative study conducted in Isfahan, Iran, during September and October 2020, in anticipation of the third wave of COVID-19 pandemic. Thirteen physicians from COVID-19-designated hospitals affiliated to the Isfahan University of Medical Sciences were purposively selected for semi-structured interviews. Data were analyzed using content analysis method. Our study identified seven main categories with 17 subcategories, encapsulating healthcare professionals' experiences during the pandemic. These categories include (1) clinical decision-making in fog, (2) an unprepared health system, (3) defects in the education and research system, (4) homecare as a missing component in the healthcare system, (5) culture as a barrier, (6) poor interdisciplinary collaboration, and (7) concerns and mental rumination due to COVID-19. The findings of this study provide valuable insight into the experiences and decision-making processes of healthcare professionals throughout the COVID-19 pandemic, emphasizing the need for comprehensive support and better preparedness for probable future health crises.

In hospitals, decisions are often made under time pressure. There is, however, little evidence on how time pressure affects the quality of treatment and the documentation behaviour of physicians.

We implemented a controlled laboratory experiment with a healthcare framing in which international medical students in the Czech Republic treated patients in the role of hospital physicians. We varied the presence of time pressure and a documentation task.

We observed worse treatment quality when individuals were faced with a combination of a documentation task and time pressure. In line with the concept of the speed-accuracy trade-off, we showed that quality changes are likely driven by less accuracy. Finally, we showed that while documentation quality was relatively high overall, time pressure significantly lowered the latter leading to a higher hypothetical profit loss for the hospital.

Our results suggest that policy reforms aimed at increasing staffing and promoting novel technologies that facilitate physicians' treatment decisions and support their documentation work in the hospital sector might be promising means of improving the treatment quality and reducing inefficiencies potentially caused by documentation errors.

Dysfunctional grief was not addressed adequately during the COVID-19 pandemic. This study aimed to develop a dysfunctional pandemic grief model specific to healthcare workers who experienced patient deaths during the COVID-19 pandemic. We conducted an anonymous online survey among 568 nursing professionals who had experienced a patient's death while working at three tertiary-level hospitals. We further assessed psychological status using the Pandemic Grief Scale (PGS) for Healthcare Workers, Pandemic Grief Risk Factors (PGEF), Utrecht Grief Rumination Scale (UGRS), Grief Support HealthCare Scale (GSHCS), Patient Health Questionnaire-9 (PHQ-9), and Stress and Anxiety in Viral Epidemic-9 (SAVE-9). PGS correlated with PGRF, UGRS, GSHCS, PHQ-9, and SAVE-9 (all p < 0.01). Linear regression analysis revealed that PGRF (𝛽=0.44, p < 0.001), UGRS (𝛽=0.24, p < 0.001), GSHCS (𝛽=-0.09, p = 0.004), and PHQ-9 (𝛽=0.23, p < 0.001) expected pandemic dysfunctional grief. Mediation analysis showed that PGRF directly influenced PGS; UGRS and GSHCS positively and negatively mediated the relationship between PGRF and PGS, respectively. The dysfunctional pandemic grief model shows that it is important to address grief risk factors, manage rumination, and provide effective psychological support to healthcare workers.

With the rapid population aging in China, smart senior care is urgently demanded. Therefore, it is necessary to comprehensively consider people's demand for smart senior care for its better development. This study aimed to explore the needs and expectations of relevant stakeholders of smart senior care in China in the context of active aging.

This is a qualitative descriptive study, in which 21 semi-structured interviews were conducted between October 2021 and March 2022. A total of seven community-dwelling older adults, seven smart senior care managers, and seven providers were selected using purposeful sampling. Interviews were transcribed, translated into English, and analyzed by the thematic analysis method.

Four major themes and 12 subcategories were identified in the data: "challenges of smart senior care" (low acceptance of users; high cost vs. low purchasing power; low coverage of smart devices and applications), "meet the demands of users" (strong medical care needs; meticulous life care needs; extensive social interaction needs), "multi-body participation" (online and offline integration; government's broader role; cooperative gaming), and "all-around guarantee" (legal guarantee, technological empowerment, network security guarantee).

To develop smart senior care in China in the context of active aging, it is essential to clarify the current issues and challenges faced by relevant stakeholders of smart senior care. To better develop smart senior care, we need to meet the health, life, and social care need of users, through multi-body participation and all-around guarantee.

The infection caused by the COVID-19 virus, with its high capacity for spread and transmission, reached the level of an international pandemic, affecting many people and resulting in a large number of deaths.

To analyse the experiences of nursing professionals caring for patients with COVID-19 during the early stages of the pandemic and the skills or coping strategies that they employed.

A qualitative study was carried out with an interpretative phenological design. Semistructured interviews were conducted with 20 nursing professionals working in emergency and critical care units, which were adapted to care for patients with symptoms of the disease, in public hospitals in Madrid, Spain. The data were analysed following, the Interpretive Phenomenological Analysis (IPA) of Smith et al. FINDINGS: Five themes were identified: "emotional brain training (EBT) to cope with great emotional stress", "material and sequential difficulties"; "an experience similar to a war that can cause burnout"; "Second Victim Syndrome (SVS), the emotional impact of witnessing trauma"; and "Surviving COVID-19 with overloads of energy and positivity".

Nursing professionals who cared for patients with Covid-19 during the first wave of the pandemic lived an experience in which they experienced a brain training of feelings, including sadness, impotence, fear, anger, pain and much worry. They also experienced a great feeling of suffering and guilt as in Second Victim Syndrome, in a situation similar to a war, due to the number of deaths caused by the virus, with all this resulting in a great overload of work. It is essential that these situations do not affect the mental health of these professionals in the dimensions that they did, and it is necessary to regain enthusiasm and motivation to provide comprehensive care for patients with COVID-19. Nursing professionals are not alone and need to be taken care of to respond to the chaos that can cause a pandemic, without ignoring the risks that it entails. They require specific training, which is necessary to provide them with proper security, and it is necessary to develop health and welfare policies, which will not be possible without first understanding their experiences.

The sub-Saharan African Regional Partnership for mental health and capacity building (SHARP) study was a clinic-randomized trial of two implementation strategies for integrating depression screening and treatment into non-communicable diseases' (NCD) clinics in Malawi between 2019 and 2022. We report on the barriers to implementing depression care integration at SHARP study sites and potential solutions.

N = 39 in-depth interviews with participants from all ten sites were conducted, recorded, transcribed, coded in NVivo 12 and analyzed by qualitative experts. We used thematic analysis to identify implementation challenges and potential solutions. The Consolidated Framework for Implementation Research helped to develop guides and organize the results.

Outer setting barriers included high workload (due to high patient volume, increased paperwork, shortage of staff), the effects of coronavirus disease 2019 (COVID-19) pandemic, staff turnover and negative provider attitudes. Limited clinic space arose as an inner setting barrier. Workload can be overcome by increasing the number of NCD personnel, decentralizing the depression/NCD services and integrating mental health and NCD documents (implementation process). The COVID-19 pandemic presented unique challenges including fear of interpersonal contact and changes in scheduling staff that were difficult to overcome in the short term. To deal with the effects of staff turnover, participants identified the need for continuous depression training to new providers. Lobbying for more rooms from leadership can address concerns of limited space. To reduce negative provider attitudes, participants urged facility leadership to make themselves available for consultations and mentorship and to provide continuous learning opportunities such as refresher trainings.

The experience in the SHARP study highlights the need for a culture of continuous learning and adaptation in healthcare settings, enabling the development of strategies to overcome evolving challenges. Planning for the integration of mental health and NCD care should extend beyond immediate challenges and consider long-term goals and sustainability.

This study reports part of the findings from the endpoint evaluation of the SHARP clinical trial that is registered at ClinicalTrials.gov, NCT03711786 first posted 20,181,018.

During the COVID-19 pandemic in Shanghai, medical workers were more vulnerable to psychological problems. This two-phase cross-sectional survey was conducted by online questionnaires to investigate the symptoms of depression, anxiety, stress, post-traumatic stress disorder (PTSD), and fatigue in healthcare workers during the outbreak of COVID-19 and after the resumption of work and production in Shanghai. The questionnaire included the Depression Anxiety Stress Scale-21 (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Fatigue Assessment Instrument (FAI). In Phase I (n=2192), the prevalence of depression, anxiety, stress, and PTSD symptoms among medical staff was 45.48, 41.93, 20.35, and 75.55%. In Phase II (n=1031), after work resumed in Shanghai, the prevalence was 19.79, 21.44, 28.23, and 12.22%, respectively. Fatigue had a mean score of 121.23±45.776 in Phase I and 144.73±44.141 in Phase II. Binary logistic regression identified risk factors associated with this psychological status: personal and familial chronic disease history; occupation, including doctor, nurse, or administrative staff; working in the fever clinic, infectious disease department, emergency or intensive care unit, hemodialysis room, or clinical laboratory; work experience of 3-6 years or 7-10 years; and involvement in nucleic acid sampling team. Medical staff self-reported comparatively high rates of depression, anxiety, stress, and, especially, PTSD symptoms during the COVID-19 pandemic in Shanghai. Our study indicated that after work resumption in Shanghai, it appeared that the overall mental health of medical staff improved somewhat. Nevertheless, the high level of fatigue exhibited still cannot be ignored.

Practice context is known to influence the deployment of competencies. The COVID-19 pandemic created a major disruption in many practice contexts. The objective was to understand the lived experience of rehabilitation clinicians during a major disruption of their practice context, namely, the COVID-19 pandemic.

We used a longitudinal phenomenological design. Eligible clinicians were occupational therapists (OT), physical therapists (PT), physiotherapy technologists (Phys T.), speech-language pathologists (S-LP) and audiologists (AUD), working in the same rehabilitation workplace for at least 2 years before March 2020 (the pandemic). Clinicians who were reassigned to roles outside the field of rehabilitation were excluded. We conducted individual online interviews using a guide developed by the team with expertise and knowledge of the phenomenon. An interpretative phenomenological analysis was carried out. Results were discussed until the research team reached a consensus.

A total of 32 clinicians participated in the study (12 OT, 5 PT, 5 Phys T., 7 S-LP, 3 AUD), working with a variety of clienteles and work settings, for an average of 11.7 ± 7.6 years in the same practice setting. A wide range of emotions (e.g. anger, sadness, guilt, fear, pride) reflected clinicians' experience during disruption. Professional expertise was perceived as being enhanced by disruption as clinicians stepped out of their comfort zone; this encouraged reflective practice and a recognition of the need to be more explicit about their decision-making process. Collaboration with colleagues was perceived as key for effective coping and deployment of adaptative expertise.

A disruption in the practice context may have positive effects on professional expertise through the mobilization of reflective practice.

The COVID-19 spread rapidly all over the world and pandemic process has negatively affected nurses. Sleep disorders and depression are among these negative effects. Managers' awareness of problems experienced by nurses and taking precautions will increase employee and patient satisfaction and provide quality patient care. The study was conducted in descriptive, cross-sectional and correlational design to explain nurses' sleep quality and depression levels and relationship between them during the COVID-19 pandemic with 142 nurses who completed Personel Information Form, Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Index (BDI). Sleep quality of nurses (64.8%) was poor, 33.1% had depression, and high school education, having a chronic illness and PSQI score increased the risk of depression level of nurses. Results highlight COVID-19 pandemic affected nurses' sleep quality and depression levels. All managers should be pioneers in providing psychological support to nurses and preparing and implementing a program for prevention of insomnia and depression.

Primary care clinicians are especially prone to burn-out. The primary objective of this study was to investigate factors contributing to burn-out and moral distress and their relationship among practising family physicians (FPs) in California early in the COVID-19 pandemic.

Cross-sectional study, online survey evaluating burn-out, moral distress and associated factors.

California FPs between July and August 2020 practising in community health centres, hospital systems, private clinics and university systems were surveyed with a 22-item online questionnaire.

FPs practising in California were eligible. The final sample included 218 physicians.

The primary independent variable was frequency of moral distress and the primary outcome variable was worsening burn-out. Moderator variables included gender and employer support.

FPs experiencing higher burn-out and moral distress were more likely to report concerns regarding personal COVID-19 risk and lack of personal protective equipment. Practising self-care and personal wellness were associated with decreased moral distress. Female physicians were 3.86-fold more likely to report worsening burn-out compared with male physicians. Employer support was associated with a 59% reduced burn-out risk and 54% reduction in frequent moral distress. Frequent moral distress was associated with a 3.12- fold higher burn-out risk. Gender moderated the relationship between moral distress and burn-out. Moral distress was associated with a 3.55-fold increase in burn-out risk among females.

Female FPs experienced greater levels of moral distress and burn-out than male physicians. Moral distress was differentially associated with increased burn-out among female physicians. Employer support was a protective factor against moral distress and burn-out.

Working as a pregnant clinical nurse might experience a range of challenges, such as significant anatomical and physiological changes as well as emotional and cognitive changes. That might be particularly obvious under the historical background of coronavirus disease-2019 (COVID-19) pandemic. However, a dearth of studies has explored the experiences of working as a pregnant nurse during this special period. This study aimed to explore the experiences of working as a clinical nurse while pregnant during the COVID-19 pandemic.

A descriptive qualitative design was selected. Purposive sampling, combined with maximum variation strategy and snowball sampling, were utilized to identify and select participants from tertiary-teaching hospitals, specialized hospitals, and community hospitals in Zhejiang Province, southeastern China. Online semi-structured individual interviews were used to collect data, and conventional content analysis was used to analyze the data.

Eleven Chinese nurses with a mean age of 31.8 years, ranging from 26 to 40 years, participated in this study. Four themes and twelve subthemes emerged: (1) still adhering to work as a clinical nurse despite being pregnant during the pandemic; (2) working during pregnancy under pandemic is still an ordinary nurse; (3) still staying in the special life phase as a pregnant mother; and (4) growth and gains as pregnant mother.

The pregnant clinical nurses suffered from various changes and difficulties during the pandemic. Managers, occupational health and other health system leaders, and policymakers should be aware of the importance of establishing a work environment that guarantees safe continued pregnancy. Future studies should focus on the establishment of specific guidelines and manuals regarding how pregnant nurses worked, as well as the development of self-protection interventions during pregnancy. Moreover, research on moral stigma and bullying in nursing during pregnancy deserves further exploration.

Not applicable.

Cardiovascular disease (CVD) is the leading cause of death globally and is predominantly associated with a cluster of lifestyle risk factors. Mobile health (mHealth) apps offer the potential to overcome traditional barriers by supporting healthy lifestyle behaviours. However, knowledge about perceptions of mHealth lifestyle apps among healthcare professionals and people with CVD is sparse. This study examined barriers and facilitators of using the mHealth apps for healthy lifestyle support among healthcare professionals and CVD patients.

We conducted an in-depth qualitative study employing individual semi-structured interviews with 8 CVD healthcare professionals and 4 patients with CVD in Australia. Participants were asked open-ended questions about their perceptions and experiences with mHealth lifestyle apps. A thematic analysis approach was used to establish perceived barriers and facilitators for mHealth lifestyle apps.

Most participants perceived mHealth lifestyle apps as useful. The key perceptions of facilitators included features for tailoring to personal needs, low costs and wide availability of the apps and addressing barriers to use like reminders. Both healthcare professionals and patients identified the strengths and weaknesses regarding the usefulness of mHealth lifestyle apps. Healthcare professionals and patients perceived several barriers to mHealth app use including trustworthiness, scientific validity, language barriers, the capability of using an app or digital literacy, costs for some commercial apps, and accessibility of an app for low-income groups.

Lifestyle apps provide an opportunity for better patient and healthcare professional communications, however, several barriers including improving digital health literacy and scientific validations of the apps are required before being recommended in clinical practice. Findings from this study can inform potential mHealth lifestyle app design to meet the demands of users. Addressing these barriers effectively can enhance the adoption and efficacy of mHealth apps, ultimately contributing to improved CVD management and healthier lifestyle behaviours.

By the beginning of the coronavirus disease 2019 (COVID-19) pandemic, emergency medical services (EMSs) played a key first-line role in patients affected by this disease care. In Iran, EMSs is a main part of health system that has a substantial role in managing emerging crisis and disasters. This study aimed to investigate the experience of the EMSs staff encountering with COVID-19 patients.

This was a descriptive qualitative study conducted on 14 EMSs staff selected by purposive sampling from August 2021 to September 2022. This study was conducted in the southern part of Iran. Data were collected using a semi-structured interview, and Graneheim, U.H. and Lundman, B. (2004) conventional content analysis method applied for their analysis MAXQDATA 2020 was used to store the interview data and codes. Till reaching data saturation, sampling was continued.

Data analysis contributed to the extraction of 783 primary codes, 15 subclasses, 4 classes, and 2 main themes, including "committed care" (with two classes of "respect to the personal identity of the patient" and "facilitators to adhere to care") and "the bottleneck of care in the shadow of fear" (with two classes of "the fine line between fear and responsibility" and "the sacrifice in care").

Although there was a fear of encountering COVID-19 patients among the EMSs staff, they provided devotional and committed care to patients considering moral values and human principles. Health policymakers should minimize the challenges of EMSs staff encountering with emerging infectious diseases with effective planning.

Coronavirus disease 2019 (COVID-19) infection caused unparalleled hastening of the transmission of infection worldwide, commonly affecting healthcare workers' well-being. Nursing staff spend most hours caring for patients and are the first contact that patients utilise when reporting symptoms or receiving treatment.

This study aims to evaluate the knowledge of COVID-19 among psychiatric nurses at a tertiary psychiatric hospital.

Weskoppies Hospital, Gauteng, South Africa.

We conducted a qualitative study comprising 14 semi-structured interviews with nurses working at Weskoppies Hospital in South Africa. We used open-ended questions to facilitate the discussion and provide some structure for the interview while still allowing the participants to elaborate freely. The recordings were later transcribed into text.

Twenty nurses working full time at the hospital, were recruited for the study. The nurses' knowledge about COVID-19 was summarised into five major themes, each with subthemes: signs and symptoms of COVID-19, risk of contracting the virus, the spread of COVID-19, prevention, and complications. In this study, the majority of participants had relatively good knowledge regarding COVID-19.

The majority of nurses at the hospital had adequate knowledge about COVID-19 but limited knowledge about the mode of transmission of the infection. Consistently improving healthcare workers' knowledge about infection control measures through training, supplying information and identifying areas for improvement can ultimately enhance patient care and outcomes.

This study sheds light on the value of nurses' understanding of COVID-19, particularly in a psychiatric setting.

During infectious disease outbreaks such as the COVID-19 pandemic, nurses are crucial in patient care and public health safety; however, they face challenges such as inadequate training and high stress in isolation wards. Virtual reality (VR) technology offers innovative training solutions to enhance nurses' clinical skills and preparedness. However, extensive studies on its effectiveness in isolation ward environments are still limited.

This study aims to develop a nonimmersive VR (NIVR) simulation training program for isolation wards and further validate its feasibility and training effectiveness in aiding nurses in adapting to isolation ward settings.

This study was a prospective, parallel, open-label, randomized controlled trial. A total of 90 nurses from 3 hospitals in China were randomly assigned to either the control or intervention group, with 45 (50%) individuals in each group. Both groups received training on isolation ward layout and nursing procedures. The control group underwent a 4-hour conventional training session consisting of 2 hours of face-to-face lectures and 2 hours of ward visits. The intervention group received a 4-hour NIVR simulation training session. Subsequently, both groups completed approximately 4 hours of emergency drills and assessments.

After the intervention, there were no significant differences in theoretical test or performance assessment scores between the 2 groups (t88=-0.30, P=.75; Cohen d=-0.06; z score=0.00, P>.99), using a 2-tailed t test. However, the intervention group completed 6 tasks faster than the control group (t88=5.10, P<.001; Cohen d=1.08), with an average reduction of about 3 minutes (control group: mean 43.91, SD 2.99 min; intervention group: mean 40.77, SD 2.85 min). Notably, they completed task 3 (patient reception inward) and task 6 (exiting the isolation area) significantly quicker (t88=3.22, P=.002; Cohen d=0.68; t88=3.03, P=.003; Cohen d=0.64, respectively), with no significant differences for the other tasks.

This study highlights the potential of NIVR simulation training for nurses working in isolation wards. Although NIVR simulation training does not significantly surpass traditional methods in imparting theoretical knowledge, it does reduce task completion time for specific activities. Its capacity for safe, repetitive practice and realistic scenario simulation makes NIVR a valuable tool in medical education. Further research and optimization of VR simulation training programs are recommended to enhance nurses' practical skills and pandemic preparedness.

Chinese Clinical Trial Registry ChiCTR240083155; https://www.chictr.org.cn/hvshowproject.html?id=250356&v=1.0.

The COVID-19 pandemic is a global crisis, and health systems worldwide have faced numerous challenges in containing it. This study aimed to identify the challenges faced by the Iranian health system in controlling the COVID-19 pandemic.

A conventional content analysis approach was employed in this qualitative study. The research sample included experts responsible for managing, making decisions about preventing COVID-19, and caring for and treating patients. The purposive sampling technique was used to select the participants. Data saturation was achieved after 29 interviews. Additionally, conventional content analysis was applied for data analysis.

The participants in this study identified the most significant challenges faced by Iran's health system in controlling the COVID-19 pandemic, including issues related to human resources, physical and organizational structures, financial resources, inter-sectoral collaboration, personal protective equipment (PPE), social responsibility, and information services.

Identifying these challenges can help health system managers prioritize the most critical issues. Addressing these challenges requires more than just the efforts of health systems; cooperation at the macro governance level is essential. Governments should start planning to formulate appropriate strategies.

This study aimed to explore the perceptions of donation coordinators in Canada and understand how the COVID-19 pandemic impacted their work activities.

A sequential mixed-method design incorporating a cross-sectional survey investigating demographic data, substance use and abuse and perceived stress related to the pandemic and semistructured qualitative interviews to further investigate those.

Organ donation organisations across Canada.

Canadian organ and tissue donation coordinators working within deceased donation programmes. Participants were recruited using a purposive sampling technique for the survey and qualitative interviews. Recruitment and data collection took place between January 2022 and March 2023.

The data were analysed using descriptive statistics for the quantitative findings and content analysis for the qualitative data.

Of the 175 available coordinators, 120 participated in the survey, and 39 participated in the qualitative interviews. The great majority were female (n=98; 81.7%), registered nurses (n=117; 97.5%) and on average 42 years old (SD=9.64). The survey result for perceived stress showed that, on average, coordinators did not experience high stress levels during the pandemic. We also identified an increase in the consumption of substances to manage workplace stress near the pandemic's beginning. The qualitative interviews yielded two main themes (Personal Life Changes and Workplace Adjustments) in which coordinators reported their views on challenges with uncertainties, effects on their personal lives, redeployment, stressors and among others.

Our study's results provide a comprehensive understanding of the perceptions and experiences of coordinators in Canada during the COVID-19 pandemic. Using a combination of methods, we identified various ways coordinators were affected by the pandemic in their personal and professional lives. These findings highlight the need to support the development of adaptive strategies and promote resilience during crises.

The practical application of infectious disease emergency plans in mental health institutions during the ongoing pandemic has revealed significant shortcomings. These manifest as chaotic management of mental health care, a lack of hospital infection prevention and control (IPC) knowledge among medical staff, and unskilled practical operation. These factors result in suboptimal decision-making and emergency response execution. Consequently, we have developed a digital-based emergency prevention and control system to reinforce IPC management in psychiatric hospitals and enhance the hospital IPC capabilities of medical staff.

The system incorporates modern technologies such as cloud computing, big data, streaming media, and knowledge graphs. A cloud service platform was established at the PaaS layer using Docker container technology to manage infectious disease emergency-related services. The system provides application services to various users through a Browser/Server Architecture. The system was implemented in a class A tertiary mental health center from March 1st, 2022, to February 28th, 2023. Twelve months of emergency IPC training and education were conducted based on the system. The system's functions and the users' IPC capabilities were evaluated.

A total of 116 employees participated in using the system. The system performance evaluation indicated that functionality (3.78 ± 0.68), practicality (4.02 ± 0.74), reliability (3.45 ± 0.50), efficiency (4.14 ± 0.69), accuracy (3.36 ± 0.58), and assessability (3.05 ± 0.47) met basic levels (> 3), with efficiency improvement and practicality achieving a good level (> 4). After 12 months of training and study based on the system, the participants demonstrated improved emergency knowledge (χ2 = 37.69, p < 0.001) and skills (p < 0.001).

The findings of this study indicate that the digital-based emergency IPC system has the potential to enhance the emergency IPC knowledge base and operational skills of medical personnel in psychiatric hospitals. Furthermore, the medical personnel appear to be better adapted to the system. Consequently, the system has the capacity to facilitate the emergency IPC response of psychiatric institutions to infectious diseases, while simultaneously optimising the training and educational methodologies employed in emergency prevention and control. The promotion and application of this system in psychiatric institutions has the potential to accelerate the digitalisation and intelligence construction of psychiatric hospitals.

The disruption of health service delivery during public health emergencies, like Ebola and COVID-19, due to hesitancy among healthcare workers (HCWs) is well-documented. While previous studies have identified motivating factors for HCWs, accommodating all is often unfeasible due to resource limitations. Thus, identifying precise preferences is crucial from a policy standpoint. This study aims to discern HCWs' preferences regarding working conditions and fringe benefits to ensure continued service during emergencies. Additionally, we investigate potential variations in preferences among HCWs who served in dedicated COVID-19 units versus those who did not, considering differences in perceived and realized risks. Conducting a discrete choice experiment (CE) and in-person interviews with 370 HCWs from four tertiary-level hospitals in Bangladesh, our findings reveal HCWs prioritize improving working conditions over fringe benefits. Notably, those in dedicated COVID-19 units exhibit a divergent preference pattern, indicating significant influence of perceived and realized risks. These insights offer valuable guidance for policymakers to address HCWs hesitancy and ensure optimal service delivery during national health crises.

Nurses working in Intensive Care Unit (ICU) for COVID-19 are more at risk as they interact more with infected patients. Therefore, this study aimed to explore the experience of Indonesian nurses who work in ICU for COVID-19 patients.

A qualitative hermeneutic phenomenological approach was used. A total of 20 nurses working in the respective ICUs of eight COVID-19 referral tertiary hospitals in Indonesia were recruited using purposive sampling. Semistructured individual video call interviews were conducted in June-September 2021; then, Diekelmann's hermeneutic phenomenological approach was used to analyze and interpret the data.

Thirteen subthemes describing the following four themes, namely, the pleasing and bad feelings, new challenges of working, nursing professional growth, and nurse resource management for COVID-19.

This study describes nurses' experiences working in ICUs during the COVID-19 crisis, such as their feelings, perceived challenges, and received support. Nurse leaders play a significant role in providing adequate Personal Protective Equipment (PPE), flexible work shifts, and a caring and healing work environment. However, being aware of the limit of pressure that an individual can manage and providing adequate allowance as rewards for work in risky areas are essential to avoid burnout.

Previous studies have shown that, during the coronavirus disease 2019 (COVID-19) pandemic, nurses were being reassigned to non-COVID-19 wards, opting to take leave, or resigning because of concerns of infecting their families. Even so, many nurses decided to continue working. However, a literature review revealed a lack of research clarifying how nurses coped with their anxiety and came to the decision to work in a COVID-19 intensive care unit.

To determine the process by which nurses living with their families decided to work in an intensive care unit during the COVID-19 pandemic and the factors that influenced their decision.

Fifteen registered nurses who lived with their families and decided to work in a COVID-19 intensive care unit during the pandemic were recruited for an individual, semi-structured interview. Charmaz's constructivist grounded theory was used to analyze the transcripts.

Four core categories were identified. When the nurses perceived their facility would accept a patient with COVID-19, they: (1) assessed the risk of infection to their family, (2) weighed their anxiety against their sense of mission, (3) reduced the risk of infection, and (4) discussed the decision with their family members.

The decision involved fear of infecting families, trust in the hospital, and sense of mission. Hospitals' consideration of the situation was important in motivating employees and reducing anxiety. There was a gender bias in this study. The large number of male participants resulted from the characteristics of the participating COVID-19 intensive care units, reflecting gender roles in Japan, where men often work and women are responsible for housework and childcare. Facilities and managers should foster a workplace culture that values employees, even in ordinary times. Our findings may help healthcare organizations support nurses in an emerging infectious disease pandemic and ensure nurses are available in healthcare systems with limited resources.

This cross-sectional study was carried out to determine the relationship between the COVID-19 burnout levels of nurses and their holistic nursing competence. The data were collected from 468 nurses working in a hospital between 1 August 2021-9 September 2021 by using a Sociodemographic Information Form, the COVID-19 Burnout Scale(BCV-19S), the Holistic Nursing Competence Scale(HNCS). The mean scores on the total BCV-19S and HNCS were 36.36(9.51) and 194.27(35.71),respectively. It was found that the mean score on the total BCV-19S was significantly higher in nurses worked ≥ 51 hours a week on average, worked in the COVID-19 pandemic unit (p < 0.05). The mean score of nurses who worked ≤ 40 hours a week on average on the total HNCS was significantly higher (p < 0.05). In this study, it was determined that nurses' COVID-19 burnout levels and holistic nursing competence were high. Nurses' COVID-19 burnout levels positively affected their holistic nursing competence.

Health care professionals often generate novel solutions to solve problems during day-to-day patient care. However, less is known about generating novel and useful (i.e., creative) ideas in the face of health care system failure. System failures are high-impact and increasingly frequent events in health care organizations, and front-line professionals may have uniquely valuable expertise to address such occurrences.

Our interdisciplinary team, blending expertise in health care management, economics, psychology, and clinical practice, reviewed the literature on creativity and system failures in health care to generate a conceptual model that describes this process. Drawing on appraisal theory, we iteratively refined the model by integrating various theories with key concepts of system failures, creativity, and health care worker's well-being.

The SFC model provides a conceptualization of creativity from front-line care professionals as it emerges in situations of failure or crisis. It describes the pathways by which professionals respond proactively to a systems failure with creative ideas to effectively address the situation and affect these workers' well-being.

Our conceptual model guides health care managers and leaders to use managerial practices to shape their systems and support creativity, especially when facing system failures. It introduces a framework for examining system-failing creativity (SFC) and general creativity, aiming to improve health care quality, health care workers' well-being, and organizational outcomes.

Since the outbreak of the COVID-19 pandemic, healthcare workers (HCWs) have faced multiple difficulties in their work and personal lives. However, most of the quantitative reviews have focused on the extent of the pandemic's impact on the HCWs and have thus failed to fully capture the HCWs' experiences and the complexity of the problems they encountered. Therefore, this qualitative systematic review elucidates the HCWs' challenges brought about by the pandemic, their perceptions of the existing support and the support that require further attention.

The literature search spanned five databases: Scopus, PubMed, Web of Science, CINAHL and PsycInfo, targeting qualitative studies of HCWs' pandemic experiences from December 2019 to December 2023. These studies underwent strict quality and relevance assessment, emphasising critical appraisal and selection. Findings were unified through meta-synthesis, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered in PROSPERO.

This study analysed 29 qualitative studies on HCWs' experiences during the pandemic and their perceptions of support, identifying four themes of HCWs' physical and mental well-being, the impact of the pandemic on their professional and personal lives, their work environments and the support they received. These themes encompassed 8 main categories and 25 codes. The research revealed that the pandemic and work conditions negatively influenced their health, affecting their professional and personal lives. Current support has lessened the pandemic's effects on HCWs but should also address future requirements like long-term psychological support.

The studies identified the challenges faced by HCWs during the pandemic, and the existing support. However, due to the complex interactions between the work and environmental factors, the effectiveness of the existing support remains challenging. To improve their effectiveness, the future support should target the interactions between the HCWs and the work system.

CRD42023426238.

The Smart Choice logo (SCL), as an encouraging form of front-of-package nutrition labeling (FOPNL), helps consumers to choose low-oil, -salt, and -sugar mooncakes during the Mid-Autumn Festival. It is widely acknowledged that nutrition knowledge contributes to nutrition label use, but there has been little research on whether it helps enhance consumers' willingness to pay (WTP). Our study aims to fill this gap by investigating 630 randomly selected Chinese adults from Jilin, Inner Mongolia, Shaanxi, Shandong, Henan, Sichuan, and Guangdong. The semi-double-bounded dichotomous choice contingent value method was selected to measure their WTP for pre-packed mooncakes with the SCL at 20 different premium levels, ranging from 0% to 95% of the price per unit. It was found that the respondents' WTP decreased by 0.7% as the premium level increased by 1%, and the WTP of people from South China, those who were obese, and those with a high income was not sensitive to changes in premium. Nutrition knowledge played a negative moderating role, and the probability of the premium levels affecting WTP decreased by 1.0% for each 1 point increase in the nutrition knowledge level. These findings highlight the potential implications associated with SCL promotion and differentiated mooncake pricing, as well as the supply of healthier Chinese holiday foods.

During the coronavirus disease (COVID-19) pandemic, caesarean section (CS) has been the preferred deliver method for pregnant women with COVID-19 in order to limit the use of hospital beds and prevent morbidity among healthcare workers.

To evaluate delivery methods used during the COVID-19 pandemic as well as the rates of adverse events and healthcare worker morbidity associated with caesarean deliveries.

We investigated maternal and neonatal backgrounds, delivery methods, indications and complication rates among pregnant women with COVID-19 from December 2020 to August 2022 in Mie Prefecture, Japan. The predominant mutation period was classified as the pre-Delta, Delta and Omicron epoch.

Of the 1291 pregnant women with COVID-19, 59 delivered; 23 had a vaginal delivery and 36 underwent CS. Thirteen underwent CS with no medical indications other than mild COVID-19, all during the Omicron epoch. Neonatal complications occurred significantly more often in CS than in vaginal delivery. COVID-19 in healthcare workers was not attributable to the delivery process.

The number of CS with no medical indications and neonatal complications related to CS increased during the COVID-19 pandemic. Although this study included centres that performed vaginal deliveries during COVID-19, there were no cases of COVID-19 in healthcare workers. It is possible that the number of CS and neonatal complications could have been reduced by establishing a system for vaginal delivery in pregnant women with recent-onset COVID-19, given that there were no cases of COVID-19 among the healthcare workers included in the study.

This study aimed to understand nurses' perceptions of COVID-19-related policies and risks during the outbreak of COVID-19 in Hong Kong and to determine how their perceptions influenced their mental health status. A web-based online survey among Hong Kong nurses was conducted. The questionnaire included a self-designed 5-point Likert scale with 17 items to assess the nurses' perceptions of COVID-19-related policies and risks, as well as the Davidson Trauma Scale (DTS), the Perceived Stress Scale (PSS), the Patient Health Questionnaire-2 (PHQ-2) and the Generalised Anxiety Disorder scale (GAD) for measurement of posttraumatic stress disorder (PTSD), stress, depression and anxiety, respectively. Of 592 nurses enrolled, 30.6% had PTSD (DTS total score ≥40), and 80.4%, 19.9% and 16.4% had moderate-to-high levels of stress (PSS-10 score ≥14), depression (PHQ-2 score ≥3) and anxiety (GAD score ≥3), respectively. The top three concerned aspects were 'worried about themselves and friends to suffer this disease' (84.5%), 'insufficient number of isolation wards' (81.8%) and 'insufficient number of personal protective equipment' (74.3%). Logistic regression analyses showed that more negative perception on 'personal protective equipment in the healthcare institutions', 'the confidence in HK's control of COVID-19', 'worried about themselves and friends to suffer this disease' and 'self-perceived risk of infection' indicated higher severity of the four mental health problems (all p < 0.01). The perception on 'public gathering ban', 'the number of isolation wards' and 'expected time to control COVID-19' were significantly associated with PTSD and stress (all p < 0.05). Nurses' perception on government policies and COVID-19 risks played an important role in predicting their mental health status. Policy makers should be aware of nurses' psychological responses and provide timely and targeted emotional support to nurses amid and after the COVID-19 pandemic.

To examine the association of disaster literacy with collectivism, social support, psychological resilience and self-efficacy among nurses and analyze the influencing mechanisms among these factors.

Nurses' disaster literacy is important for future preparation. However, there is a paucity of research in this field.

From January to August 2023, we recruited 1573 nurses in 15 hospitals in Zhejiang province, China using convenient sampling. Based on Social-Ecological Model, questionnaires regarding collectivism, social support, psychological resilience, self-efficacy and disaster literacy were distributed via online platform. Data were analyzed using structural equation model to examine the relationships between the study variables.

Nurses had a medium level of disaster literacy with the lowest score in critical literacy. Nurses' collectivism not only had positive direct effect on disaster literacy, but also had indirect pathways from social support, psychological resilience and self-efficacy to influence the level of disaster literacy.

Multilevel factors including collectivism, social support, psychological resilience and self-efficacy were associated with disaster literacy. Understanding the influencing mechanism would inform effective interventions.

Our findings illustrate the importance for nurse managers, administrators and authorities to work together to develop and implement effective nursing curriculum and training programs to improve nurses' disaster literacy for future preparation.

Coronavirus disease (COVID-19) is an illness that has critical effects on public health and overall circumstances across the world. The performance of nurses represents the vital actions in providing care for COVID-19 patients. The aim of this study was to assess job performance and associated nurses, patients, and environmental-related factors among nurses providing care to COVID-19 patients in Egypt through the following: assessing the nurses' knowledge regarding care of COVID-19 patients; assessing the nurses' practice regarding care of COVID-19 patients; assessing different factors that affect different types of nurses' job performance; and assessing the factors associated with the job performance of nurses providing care to COVID-19 patients.Design A descriptive exploratory study was used to meet the aim of the study.Setting The study was conducted at Ain Shams University COVID-19 Hospital.Study subjects A convenient sample of all 52 available nurses working at Ain Shams University COVID-19 Hospital. Data collection tools: The data was collected using a self-administered questionnaire. It consisted of the following: A. Self-administered nurses' questionnaire: Part I: Demographic characteristics of nurses. Part II: Nurses knowledge assessment. Part III: Factors associated with nurses' job performance. B. Narses's practice observational checklist. Results: The mean age (mean ± SD) of the study population was 40.59 ± 6.90. As regards their years of experience working as nurses, only 32.7% of them have more than ten years of experience. In relation to the total satisfactory level of knowledge about coronavirus, the study reveals that 55.8% of the nurses have unsatisfactory knowledge regarding coronavirus, There is a highly significant relationship between level of practice and years of experience (p-value < 0.001**), while there is a significant relationship between level of practice and educational level and attending the training courses about caring for COVID-19 patients (P-value 0.033*, P-value 0.025*), respectively.Conclusion The study concluded that most of the studied nurses had unsatisfactory knowledge, and more than half had incompetent practice scores about nursing care practices for patients with COVID-19. There was a positive linear correlation between the nurses' knowledge and practice. The factors affecting their performance in caring for patients with COVID-19, lack of cooperation between nurses and patients, lack of supplies and equipment during care were the most frequently reported factors, as were an unequal nurse-patient ratio, many nursing tasks, and a lack of patients' knowledge.Recommendation The study recommends the importance of promoting the nursing care guidelines as a standard procedure in ICUs, and the nursing care guideline educational program for patients with COVID-19 should be scheduled regularly for nurses. Providing the hospitals with supplies to avoid the shortage's effect on nurses' performance.

Numerous studies have highlighted the prevalence of mental health disorders among healthcare professionals during the COVID-19 pandemic, with varying indications of emotional strain. This study compares the psychological functioning of healthcare workers at the onset of the pandemic and two years later, offering a comprehensive assessment of their emotional and mental health status in the evolving context of COVID-19.

This longitudinal analysis examined the relationship between stress, emotional processing, and their positive/negative impacts on medical personnel working in Polish hospitals and outpatient clinics in 2020 (n = 285) and 2022 (n = 252). The study employed the Toronto Alexithymia Scale-20 (TAS-20), Cohen's Perceived Stress Scale (PSS-10), Mini-COPE, Acceptance of Illness Scale (AIS), Emotional Processing Scale (EPS), STAI, and PANAS to assess psychological responses and coping mechanisms.

Findings revealed a significant increase in denial, substance use, self-blame, negative mood, and impaired psychological and somatic functioning, alongside heightened symptoms of depression and anxiety. Conversely, a marked decrease in planning, positive reinterpretation, acceptance, religious coping, and seeking social support (both emotional and instrumental) was observed over the two-year period.

The prolonged nature of the COVID-19 pandemic has profoundly affected the psychological resilience of healthcare professionals, eroding critical emotional resources necessary for maintaining interpersonal relationships and mental well-being. These results underscore the need for targeted interventions to support the mental health of medical staff in the ongoing crisis.

The COVID-19 pandemic has significantly impacted advanced practice nurses' practice and posed great challenges in patient care delivery.

The aim of this study was to investigate the impact of the COVID-19 pandemic on the practice of advanced practice nurses in mainland China and Hong Kong Special Administrative Region (SAR). Methods A cross-sectional descriptive survey was conducted March 2021 and January 2022. Advanced practice nurses were invited to participate in an online survey. The questionnaire described the socio-demographic characteristics, the impact of the COVID-19 pandemic on advanced nursing practice, patient outcomes, education needs about COVID-19, and the challenges, support, and concerns related to the advanced practice nurse practice during the pandemic. Wilcoxon signed-rank test or McNemar test were applied to measure the practice of APNs before and during the COVID-19 pandemic.

Respondents (N = 336) were from mainland China (n = 234) and Hong Kong SAR (n = 102). Participants reported increased practice-related workload during the pandemic. The proportions of advanced practice nurses focused on disease prevention (36.9%) and psychosocial well-being (15.5%) for patient-focused outcomes during the pandemic were higher compared to before the pandemic. Key challenges and concerns during the pandemic included heavy workloads and health concerns for themselves and their families. Despite difficulties, there were reports of positive changes since the outbreak including implementation of innovative measures to facilitate the advanced practice nursing and education about COVID-19.

The study findings highlight that advanced practice nurses' work and responsibilities have changed in response to the pandemic. Providing education about COVID-19, innovative measures to facilitate advanced practice nursing, and understanding advanced practice nurses' concerns and challenges in providing patient care may inform future developments for improving their professional practice.

This study aims to explain the variability in organizational commitment by examining a range of individual and organizational factors. The predictors include personality traits from the HEXACO model, organizational orientations, subjective wellbeing, perceived employment uncertainty, duration of employment, and income satisfaction. The sample consisted of 1,127 employees, with 49.4% from the private sector and 50.6% from the public/state-owned sector. Multiple regression analysis revealed that the models were statistically significant for both sectors. Public sector employees demonstrated higher levels of continuance commitment, likely due to job security, while private sector employees exhibited higher levels of affective and normative commitment. The model accounted for 51.8% of the variance in organizational commitment for public sector employees and 39.2% for private sector employees. These findings underscore the distinct commitment patterns between sectors and emphasize the role of both dispositional and contextual factors in shaping organizational commitment.

Mpox continues to spread in China, and stakeholders' experiences may help inform prevention and control strategies.

Qualitative study.

A qualitative study across 14 Chinese cities recruited stakeholders from Centers for Disease Control and Prevention (CDCs), community-based organizations (CBOs), and hospitals involved in curbing mpox. Semi-structured interviews were conducted by telephone and analyzed using Colaizzi's phenomenological method.

15 CBOs workers, 14 CDCs staff, and 13 healthcare workers were recruited. Three theme categories were identified: "Efforts to curb mpox epidemic", including CDCs' epidemic management and health education, hospitals' diagnosis, treatment, and care, CBOs' counseling, publicity, and referrals. "Challenges to curb mpox epidemic", including negative impacts of hospital-based quarantine, lack of specific antiviral drugs, gay identity disclosure concerns, psychological problems, contact tracing difficulties, and inadequate communication and collaboration. "Recommendations for curbing mpox epidemic", including prioritizing supervised home-based quarantine, incorporating HIV-related indicators into hospital quarantine criteria, reducing the cost of hospital quarantine, accelerating the development of vaccines and drugs, enhancing patient privacy protection, psychological training for stakeholders, establishing a task force that comprises personnel who are experienced in contact tracing and strengthening communication and collaboration.

Effective control of mpox spread requires strengthening collaboration with CBOs and community healthcare centers (CHCs) and working out a flexible and contextualized mechanism. It also needs to reinforce patient privacy protection and integrate stigma reduction into strategies. Additionally, it is important to include HIV-related indicators in the quarantine evaluation and provide psychological training for stakeholders to help them manage their mental health and improve counseling skills.

A review of key learnings from the response to the COVID-19 pandemic in nursing homes in Ireland can inform planning for future pandemics. This study describes barriers and facilitators contributing to COVID-19 outbreak management from the perspective of frontline teams.

A qualitative study involving ten online focus group meetings was conducted. Data was collected between April and June 2023. The focus group discussions explored the views, perceptions and experiences of COVID-19 Response Team (CRT) members, clinical/public health experts who worked with them, and care professionals who worked in frontline managerial roles during the pandemic. All nine Community Healthcare Organisations and six Public Health Areas in Ireland were represented. Inductive reflexive thematic analysis was carried out using NVivo Pro 20.

In total, 54 staff members participated in focus group meetings. Five themes were developed from a thematic analysis that covered topics related to (1) infection prevention and control challenges and response to the pandemic, (2) social model of care and the built environment of nursing homes, (3) nursing home staffing, (4) leadership and staff practices, and (5) support and guidance received during the pandemic.

The response to the COVID-19 pandemic has resulted in a steep learning curve, internationally and in Ireland. Preparing better for future pandemics not only requires changes to infection control and outbreak response but also to the organisation and operation of nursing homes. There is a great need to strengthen the long-term care sector's regulations and support around staffing levels, nursing home facilities, governance, use of technology, infection prevention and control, contingency planning, and maintaining collaborative relationships and strategic leadership. Key findings and recommendations from the Irish example can be used to improve the quality of care and service delivery at local, national, and policy levels and improve preparedness for future pandemics, in Ireland and internationally.

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.

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.

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).

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.

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

Few studies quantified the influence of the coronavirus disease 2019 (COVID-19) pandemic on medical teaching and scientific research activities in China. This is the first national study to investigate such topics from the viewpoint of physicians practicing obstetrics and gynecology in China.

This is a national questionnaire survey with online interviews for respondents. This two-stage, stratified, cluster sampling method was applied based on city categories (categories 1 to 3 correspond to < 10,000, 10,000 to 30,000, and > 30,000 beds, respectively), hospital levels (primary, secondary, and tertiary), and hospital types (general and specialized) in China among physicians practicing obstetrics and gynecology. Physicians documented notable alterations in both overall and specialized teaching and research engagements. Comparative analyses were conducted across diverse municipal and hospital attributes.

Data were collected from a representative sample of 11,806 physicians from 779 hospitals across 157 cities and 31 provinces. Notably, except for online seminars, a minimum reduction of 20% in both overall and specialized teaching and research activities was observed among physicians. Up to 61.7% (95% confidence interval 59.3-64.0) of physicians reported either a complete termination or a > 50% decline in resident training. Compared with category 1 cities and primary hospitals, category 3 cities and tertiary hospitals experienced greater reductions in items of resident or graduate education, visiting scholar, clinical trials, and laboratory studies (adjusted p values < 0.05), coupled with notable increases in online seminar participation (adjusted p values of 0.002 and < 0.001, respectively).

Amidst the COVID-19 pandemic in China, activities requiring direct, face-to-face communication were more affected in resource-rich cities and general hospitals compared to resource-limited areas and specialized hospitals. Residency training experienced the most significant decline. Conversely, participation in online seminars increased, providing additional opportunities for continuing medical education.