The purpose of this study was to investigate how the COVID-19 pandemic's inaugural wave impacted the professional autonomy of family physicians in Canada. This study highlights how family physicians' resilience enabled them to overcome the many challenges they faced to provide health services to patients and has enabled them to rebuild their sense of purpose and duty of care. Four themes were found to summarize physician experiences: (1) loss of clinical autonomy and control; (2) abandonment and neglect by the health system; (3) a fear of patients "falling through the cracks" and moral injury; and (4) building resilience to support duty of care in family practice. These results highlight the emergence of resilience among family physicians to restore professional autonomy in family practice, overcoming moral injury in order to fulfil their "duty of care" to their patients. Physicians believe the health system's crisis preparedness efforts need to be dedicated to protecting the autonomy of practicing physicians to maintain the continuity of quality patient care in future health crises.

Physicians face increased emotional weariness as a result of the inherent stress and responsibility of their roles. In addition, they are vulnerable to abuse, coercion, and aggressiveness in their workplace settings. The link between burnout syndrome and psychological workplace violence (WPV) is complex and must be viewed as bidirectional. We assessed the association between the levels of burnout and psychological WPV among their colleagues among Peruvian physicians.

We performed a cross-sectional study that surveyed licensed Peruvian physicians actively practicing clinical medicine from April to December 2023. A non-probability convenience sampling via hospital interviews and diffusion through online platforms was carried out. The SPV-Health scale, validated for the Peruvian context, assessed psychological violence, while the MBI-HSS evaluated burnout dimensions. Descriptive statistics and Poisson regression models, adjusting for covariates, were employed for analysis.

We included 384 medical doctors; most participants worked in urban areas, with nearly half being specialists or subspecialists, predominantly in medicine services. Physicians experiencing burnout were 4.04 times more likely to encounter psychological violence compared to those without burnout (95% CI: 2.45-6.57), even after adjusting for age, sex, medical positions and years of medical practice (PR: 3.93; 95% CI: 2.35-6.57). Among the risk factors for psychological violence, being a resident practitioner was the only significant one (PR: 1.79; 95% CI: 1.18-2.73).

Our study underscores a significant association between Burnout Syndrome among Peruvian doctors and their experience of psychological WPV from colleagues. Tailored interventions addressing these challenges are imperative, with organizational strategies offering potential while interventions for WPV require further investigation.

This article explores the psychological burden experienced by medical assistants (MAs) in General Practices during the Covid-19 pandemic (Corona virus disease 2019 (SARS-CoV-2)) in Germany. The study aims on demanding patient behavior, increased workload, and the perceived lack of appreciation and discuss their potential impact on the MAs´ well-being and career decisions.

A qualitative approach was utilized. MAs were included via a regional practice network as well as professional associations and newsletters. In total, 21 interviews with MAs from various federal states in Germany were conducted between April and September 2021. The semi-structured interview guideline focused on daily work challenges during the pandemic and its consequences. Interviews were recorded, transcribed, and analyzed using qualitative content analysis according to Kuckartz.

The findings highlight core challenges, including demanding communication with patients, lack of appreciation in the media, a high workload, resilience versus career migration, and the needs and wishes of MAs in their everyday work. Abusive language, insults, and theft of materials by patients added significant stress. The interviews reveal how important teamwork and a supportive working environment are for overcoming these challenges.

The study underlines the urgent need for societal and political awareness regarding the challenges faced by MAs, especially during public health crises. The perceived social egoism in patient behavior, coupled with a lack of recognition and appreciation, contributed to a challenging work atmosphere and potential burnout risk. Recommendations include enhancing support for MAs, recognizing their contributions in the media, and fostering collaborative efforts between practitioners and policymakers to address the unique challenges in general practices.

German Register of Clinical Studies (DRKS) DRKS00032402; https://drks.de/search/de/trial/DRKS00032402 (Registration Date: 14.08.2023).

The detrimental impacts of COVID-19 on the mental well-being of frontline healthcare workers (HCWs) have been well studied. However, the long-term trajectory of their mental well-being remains relatively unexplored. We examined the magnitude and predictors of the psychological impact of COVID-19 on frontline HCWs during the transition into the "new normal" phase.

A cross-sectional survey was performed on frontline HCWs at two largest designated COVID-19 hospitals in Ho Chi Minh City between May and November 2022. A self-administered questionnaire captured participants' demographic characteristics and psychological distress including depression, anxiety, and insomnia. Multivariable logistic regression models were used to examine factors associated with psychological distress.

Among 462 HCWs, 85.3% self-reported having good, very good, or excellent mental health before their COVID-19 deployment, compared to 40.7% during the deployment and 55.6% at the time of the study. The prevalence of moderate-to-severe depression was 26.8%, anxiety (20.8%), insomnia (23.4%), and overall psychological distress (73.2%). Predictors for depression included pre-existing physical (adjusted odds ratio [aOR] = 2.09, 95%CI 1.03-4.22, P = 0.04) and mental health (aOR = 3.59, 95%CI 1.31-9.84, P = 0.01) conditions and being deployed during the 3rd (aOR = 6.28, 95%CI 1.12-35.08, P = 0.04) and 4th (aOR = 5.01, 95%CI 1.08-23.16, P = 0.04) COVID-19 wave. Those with mental health conditions before the deployment (aOR = 3.95, 95%CI 1.42-11.0, P = 0.008) were more likely to report anxiety symptoms. Predictors for insomnia included physical health conditions before the deployment (aOR = 2.73, 95%CI 1.37-5.44, P = 0.004), working at field hospitals (aOR = 2.44, 95%CI 1.43-4.16, P = 0.001), and currently being deployed to respond to COVID-19 (aOR = 0.35, 95%CI 0.19-0.67, P = 0.001).

Given the substantial impact of COVID-19 deployment on HCWs' long-term mental well-being, comprehensive mental health support strategies are urgently needed. As HCWs may overlook their mental health issues, a screening program with psychological support services should accompany them early in future pandemics. Further nationwide studies with longer follow-ups are necessary to understand the full extent of psychological distress among frontline HCWs in Vietnam.

The COVID-19 pandemic has significantly impacted mental health, with healthcare professionals being particularly vulnerable. This study explores the emotional distress experienced in Serbia, focusing on factors that contribute to symptoms of depression, anxiety, and stress. A total of 3328 participants from the general and healthcare populations were surveyed using the Depression Anxiety Stress Scales-Short Form (DASS-21). The analysis revealed that certain groups, such as women, non-psychiatrist doctors, individuals with a history of mental disorders, and those dissatisfied with their financial, familial, and living circumstances, were more likely to experience heightened levels of emotional stress. Moreover, healthcare professionals, especially those working in challenging conditions, may be at increased risk for mental health issues. These findings underscore the need for targeted interventions and ongoing support for those most affected, particularly within the healthcare sector, to mitigate the long-term mental health impacts of the pandemic.

Infectious agents such as SARS-CoV-2 require strategies to contain outbreaks, particularly in hospitals where the spread of infection is most likely. Biometric monitoring of heart rate, temperature, oxygen saturations and sleep might provide important early warning signs for SARS-CoV-2. This study aimed to determine whether a smart medical device (E4 wristband) and a pulse oximeter used to continuously measure heart rate, skin temperature and oxygen saturation would predict the onset of SARS-CoV-2 infection.

A single-centre, prospective observational cohort of 30 healthcare workers (HCWs) working in areas at high risk for exposure to SARS-CoV-2 were enrolled. HCWs were tested for SARS-CoV-2 using RT-qPCR of daily self-administered swabs for 30 days. Each participant was asked to wear an E4 wristband to measure changes in their heart rate, skin temperature and sleep throughout the study.

Nine (30%) HCWs (median (range) age of 39 (27-57) years) tested positive for COVID-19. No significant differences were found in the pre-infection and post-infection variations in the heart rate (p=0.31) or skin temperature (p=0.44). Seven of the nine positive subjects reported symptoms at some point during the study period: unusual fatigue (40%), headache (33%) and runny nose (22%) were the most frequent. Analysis of daily trends in observations demonstrated significant fluctuations in biometric parameters.

These results suggest that wearable technology might be useful in documenting signs of SARS-CoV-2 infection in exposed HCWs.

NCT04363489.

Dietetics preceptors are at risk of abandoning their role because of potential burnout. Identifying factors associated with greater and lesser burnout can help key stakeholders identify and implement strategies to prevent or mitigate burnout in dietetics preceptors.

The purpose of this study was to identify factors associated with the burnout preceptors attribute specifically to the work of precepting.

This study used a cross-sectional study design. A survey instrument including burnout measures, precepting measures, and items querying personal and work characteristics was distributed via e-mail to a random sample of 10 000 credentialed nutrition and dietetics practitioners.

Respondents who lived in the United States, were currently practicing, and had precepted during the past year were included in the sample (n = 310). The survey was conducted in October and November of 2022.

Precepting-related burnout was measured using scores on the Copenhagen Burnout Inventory; scores ranged from 0 to 100 and higher numbers indicated greater burnout.

Factors associated with precepting-related burnout were identified using an analysis of covariance. Pairwise comparisons with Tukey adjustments were done to determine differences across categories for the categorical variable in the model (ie, percent of interns requiring additional coaching). A stepwise variable selection process was performed to determine the best analytic models.

Factors associated with lower precepting-related burnout in dietetics preceptors included higher Commitment to the Preceptor Role scores, lower percentages of interns requiring additional coaching, feeling appreciated by the dietetic interns, and higher Preceptors' Perceptions of Support scores. A factor associated with higher precepting-related burnout was precepting a greater number of dietetic interns in the past year. For every 1-point change in each variable, the degree of change in precepting-related burnout was -7.9 for Commitment to the Preceptor Role, -3.2 for feeling appreciated by dietetic interns, -4.5 for Preceptors' Perceptions of Support, and +1.2 for number of dietetic interns per year. The mean ± SE difference in precepting-related burnout scores between preceptors who reported < 10% of dietetic interns requiring additional coaching and those who reported > 50% of dietetic interns requiring additional coaching was -13.7 ± 3.7.

The factors found to be associated with precepting-related burnout scores in dietetics preceptors are potentially modifiable, suggesting this burnout might be prevented or mitigated to some degree.

Nurses comprise the majority of the health workforce in the Philippines. Previous studies revealed that nurses manifest negative mental health outcomes exacerbated by COVID-19 pandemic. This study aims to determine the Professional Quality of Life (ProQOL) of nurses in the Philippines and their workplace psychosocial support interventions during the pandemic. The ProQOL measures compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS).

A self-administered online questionnaire was disseminated by the Philippine Nurses Association, Inc. to affiliated nurses via email and Facebook posts. Out of 713 responses, 239 were eligible with their data analyzed using t-test, one-way ANOVA, and post hoc pairwise multiple comparisons.

Respondents were found to have high CS (41.95 [SD 5.97]), moderate BO (23.56 [SD 6.07]), and moderate STS (26.62 [SD 8.18]). The most reported intervention was policies on confidentiality of workers' mental health (84.94%) while the least reported was community engagements under the hospital's mental health program (61.51%). ProQOL scores significantly differed in CS by age (p=0.011), position (p=0.044) and monthly income (p=0.016), BO by age (p=0.001) and years with current employer (p=0.009), and STS by region (p=0.017) and area of assignment (p=0.015). The existence of interventions yielded significant increase in CS and decrease in BO scores.

Nurses in the Philippines exhibit high and favorable ProQOL during the pandemic. The majority of respondents reported the presence of workplace interventions which yield significant differences in CS and BO. The findings highlight the importance of workplace psychosocial support interventions and the need to strengthen implementation.

The COVID-19 pandemic negatively impacted the working conditions and mental health of healthcare workers (HCWs) across the globe. Little is understood of the factors influencing the mental health of HCWs in low-and middle-income countries like Ghana, which faced significant challenges from the COVID-19 pandemic due to their overburdened healthcare systems. Our study qualitatively examined the multilevel factors influencing HCWs' mental health in response to the pandemic in Ghana, as well as coping strategies.

Utilizing an exploratory, descriptive qualitative research design, we purposively sampled and interviewed HCWs (n = 26) and administrators (n = 3) across 13 regions in Ghana from our parent study (N = 646) between November 2020 and February 2021. Semi-structured interviews explored pandemic preparedness, experiences responding to the pandemic, the impact of the pandemic on life, work, quality of care, and mental health; challenges and facilitators of the COVID-19 response; and coping strategies. Transcripts were coded through a group-based collaborative approach in the Dedoose software and analyzed thematically guided by the socio-ecological framework.

HCWs reported experiencing fear, anxiety, stress, and depression due to the COVID-19 pandemic and cited several individual, interpersonal, institutional, and societal factors that adversely impacted their mental health. Individual-level factors included low knowledge of COVID-19 risk and sequelae and contraction of COVID-19. Interpersonal factors included being a parent/caregiver, risk posed to family/household as frontline workers, and social isolation. Institutional factors included inadequate health system capacity (i.e., low staffing capacity) and pandemic preparedness (i.e., inadequate COVID-19 training), and frontline working conditions (i.e., long work hours; higher COVID-19 infection risk). Societal factors were COVID-19-related stigma against HCWs, COVID-19 social conspiracies, and sociocultural beliefs about mental health in Ghana. Despite the negative impact of the pandemic on HCWs' lives, most reported not receiving adequate support from their workplace or the government to mitigate mental health distress. However, HCWs identified several protective factors and coping strategies, including prayer/spirituality, spiritual and emotional support from family and colleagues, and, although limited, work-based or government incentives and appreciation.

The COVID-19 pandemic has adversely impacted the mental health of HCWs in Ghana, who have inadequate resources to address these distresses. Investing in healthcare infrastructure, including expanding workforce and facility capacity and providing workplace mental health wellness services, can help mitigate the mental health impact of health crises like the COVID-19 pandemic on the healthcare workforce and subsequently maximize the capacity of the health system to respond to future pandemics.

This study focuses on the influence of the pandemic on professional workers from an explicitly comparative perspective. High levels of stress and burnout have been reported among professional workers pre-pandemic, but the pandemic has had unique consequences for certain professional workers. Gender has emerged as a particularly important factor. While the existing research yields important insights of mental health concerns among professional workers, there is a need for more research that examines these impacts empirically, explicitly from a comparative perspective across professions taking gender more fully into consideration.

This paper undertakes a secondary data analysis of two different pan Canadian sources to address the pandemic impact on professional workers: The Canadian Community Health Survey (2020, 2021) administered by Statistics Canada and the Healthy Professional Worker survey (2021). Across the two datasets, we focused on the following professional workers - academics, accountants, dentists, nurses, physicians and teachers - representing a range of work settings and gender composition. Inferential statistics analyses were conducted to provide prevalence rates of self-perceived worsened mental health since the pandemic and to examine the inter-group differences.

Statistical analysis of these two data sources revealed a significant effect of the pandemic on the mental health of professional workers, that there were differences across professional workers and that gender had a notable effect both at the individual and professional level. This included significant differences in self-reported mental health, distress, burnout and presenteeism prior to and during the pandemic, as well as the overall impact of the pandemic on mental health. The high levels of distress and burnout during the pandemic were particularly evident in nursing, teaching, and midwifery - professions where women predominate.

Interventions to address the mental health consequences of the pandemic, including their unique gendered and professional dimensions, should consider the intersecting influences and differences revealed through our analysis. In addition to being gender sensitive, interventions need to take into account the unique circumstances of each profession to better respond to the mental health needs of all genders within each professional group.

There are scanty empirical and theoretical studies focusing specifically on the implementation models for the care of psychiatric nurses caring for children. Staff contribution in the process of putting clinically relevant actions into practice contributes to effective implementation, increased acceptance, and commitment. These practises can be used to improve mental health care services of children at different levels. The aim is to deepen an understanding of the perspective of care for children with mental health challenges. A qualitative, exploratory, and descriptive design was used to allow for innovative thoughts to restructure the practice of child psychiatric nursing and is based on the Practice-Orientated Theory of Dickoff. A positive focus on aspects that facilitate care for children with mental health problems is informed by the data collected. A suite of services that include practice environment, trainings, and practical assistance is feasible to support psychiatric nurses. This framework implies that psychiatric nurses need professional competence to understand the context of the environment. Psychiatric nurses need to move beyond engagement to demonstrate how they help children with psychiatric challenges and to enable the development of psychiatric nursing practice through international collaboration.

Health care professionals (HCPs) in neonatal intensive care units (NICUs) are prone to significant stress, leading to deleterious mental health effects. Recently, some studies have explored virtual reality (VR) immersion experience to mitigate these risks. However, these studies vary in clinical settings, design and mental health parameters.

To report on the safety and feasibility of VR immersion experience in busy tertiary NICU HCPs.

Ten eligible NICU HCPs without photosensitive epilepsy or cardiopulmonary disease participated. Participants underwent VR immersion (intervention arm; maximum of 15 min/session and 1 session/shift) during breaktimes in three consecutive shifts. They underwent a washout period, after which they completed 3 sessions as routine breaks (control arm) without VR experience. They completed pre-post break stress and survey questionnaires in both arms.

Analyses comprised data from 28 VR immersion and 27 control arm sessions (nine participants completed three sessions in both arms and one participant completed one session in intervention arm only). All VR immersion sessions were 'really liked' (60.7%) or 'liked' (39.3%). As far as the usage of VR devices were concerned, majority were deemed to be 'really easy' (25%) or 'easy' (57.14%). Quality of VR environments were reported to be 'Excellent' (28.6%) or 'good' (60.71%) in majority of sessions. Experience of chosen VR environments were 'really liked' (46.42%) or 'liked' (50%). Most importantly, the impact of VR experience on enhancing the break was deemed to be 'Yes, a lot' (46.42%) or 'Yes, a bit' (39.28%) in most sessions. Participants reported 'very minor' side effects in three VR sessions, none requiring any therapeutic interventions. Rest of the sessions reported 'no' side effects.

VR immersion experience is safe and feasible in busy HCPs in a tertiary NICU. Future recommendations would be to compare VR immersion experience with other well-being measures of staff.

Virtual reality immersion experience could be utilized for stress reduction in NICU HCPs.

The COVID-19 pandemic has significantly stressed healthcare systems globally, placing unprecedented demands on healthcare workers (HCWs). This study investigated the effects of financial support (hazard pay) on the well-being, job satisfaction, and motivation of frontline HCWs during the Pandemic.

Cross-sectional study.

A cross-sectional study was conducted using an online questionnaire from July to November 2022, involving 637 frontline HCWs from Kazakhstan. Measures included the Copenhagen Burnout Inventory, the DASS-21 scale, the WHO-5 Well-being Index, and scales for job satisfaction and work motivation. Statistical analysis employed descriptive statistics, Mann-Whitney U-tests, Bayesian statistics, χ2-test, correlation, and linear regression analyses, alongside generalized mediation models.

Most HCWs (80.1 %) reported receiving financial support, with varied satisfaction levels. Those without financial support exhibited significantly higher burnout levels and more severe symptoms of depression and anxiety compared to their supported colleagues. Satisfaction with financial support was positively associated with job satisfaction and negatively with burnout and DAS symptoms. Mediation analysis highlighted that job satisfaction and burnout significantly mediated the relationship between satisfaction with financial support and work motivation. Therefore, financial support was crucial in mitigating the adverse effects of the pandemic on HCWs' mental health and motivation.

The study emphasizes the role of financial support in enhancing HCWs' well-being and motivation to work, suggesting that well-structured financial incentive programs are essential for sustaining healthcare services during and beyond global health emergencies. The direct and mediated relationships underscore the importance of adequate financial incentives in maintaining healthcare workforce stability during crises.

The COVID-19 pandemic has led to significant psychological distress among frontline healthcare workers (HCWs), with a particular increase in trauma-related symptoms. This study investigated the longitudinal course of trauma-associated symptoms and behaviors in HCWs and the effectiveness of a brief dialectical behavior therapy (DBT)-informed intervention in mitigating these symptoms over 12 months. The trial included 225 HCWs randomly assigned to one of three groups: no intervention (control), in-person DBT-informed intervention, or online DBT-informed intervention. Over time, a natural decrease in PTSD symptoms was observed in all groups. Contrary to expectations, no difference was found between the control and intervention groups. However, for participants with severe PTSD symptoms, the intervention significantly mitigated their distress. No differences emerged between in-person and online interventions, suggesting equal effectiveness. Females reported higher trauma-related symptoms, while no differences emerged among different professional roles. These findings underscore the importance of targeted interventions for HCWs experiencing severe symptoms and highlight the potential of online modalities. Further research is needed to optimize the deployment of mental health resources within the healthcare setting, particularly during crises.

Ensuring the total well-being of healthcare workers (HCWs), including their mental health and psychological well-being, is an essential aspect in the delivery of patient care and the preservation of the health workforce. This study aimed to determine the level of mental well-being and emotional state of HCWs in terms of depression, anxiety, and stress using the DASS-21 scale in a tertiary government hospital during the COVID-19 pandemic in the Philippines and to identify the job-related factors that may be associated with these outcomes.

This is an analytical, cross-sectional study among HCWs involved in direct patient care in a tertiary government hospital in the Philippines during the COVID-19 pandemic. Data collection was conducted from February to March 2022 through an online self-administered questionnaire, which included the Demand-Control-Support Questionnaire (DCSQ), and the 21-item Depression Anxiety Stress Scale (DASS-21). This was sent to doctors, nurses, and allied medical workers actively working in the clinical areas. All responses were collected and analyzed.

Three hundred sixty-four healthcare workers were included in the study. Majority were single (62.62%), living with immediate family (50.82%), and working in a COVID-designated area (62.09%). High prevalence of depression (49.18%), anxiety (61.54%), and stress (30.22%) was found among the HCWs. Work in high infection/COVID-designated areas was significantly associated with anxiety and stress, and high-job demand was significantly associated with all three mental health states compared to low job-demand.

Focus should be placed on modifying the condition of high job demand among healthcare workers working in hospitals. This includes ensuring optimum staffing levels and patient to HCW ratio which avoids HCWs from being subjected to high workloads and time pressures that subsequently increase risk for stress, anxiety, and depression.

The COVID-19 pandemic has caused psychological distress to the population and healthcare workers. Physicians' well-being is essential and contributes significantly to overall health. This study aimed to assess the strain on Polish general practitioners from the effects of the COVID-19 pandemic and to ascertain the potential predictors of their distress.

Data was collected using a self-reported online questionnaire from 162 GPs in Poland between December 2020 and August 2021 as part of the international PRICOV-19 study. General practitioners' well-being was evaluated using the validated Mayo Clinic's expanded 9-item well-being index (eWBI). Spearman's correlation was used to measure the strength and direction of association between general practitioners' distress level and continuous variables, and for ordinal variables, Gamma correlation was recommended for many tide ranks. We also checked the association of the level of distress with continuous variables by categorizing them and applying the Kruskal-Wallis test likewise for a comparison of the distress in different practice locations.

A vast majority (80%) of respondents were considered at risk of distress during the COVID-19 outbreak, with an eWBI score of 2 or more. Higher distress scores were exhibited among general practitioners who reported increased responsibilities during the COVID-19 pandemic and perceived need for additional training. The experience of collaboration with neighbouring practices and the provision of adequate governmental support emerged as significant protective factors against distress. No correlation was observed between Polish general practitioners' distress level and years of professional experience, number of patients in the practice, number of doctors working there, the practice's location, or working with more vulnerable patient populations.

Our findings proved that COVID-19 placed an extraordinary emotional burden on Polish general practitioners and highlighted the importance of targeted support services and resource allocation to primary healthcare in Poland in case of any potential future crisis similar to the COVID-19 pandemic.

This paper investigates the effects of work demands on burnout indices of emotional exhaustion, depersonalization and personal accomplishment, and mental health indices of anxiety, depression and stress, among Australian nurses and midwives. We used de-identified self-reported survey data from approximately 11,000 Australian nurses and midwives during the pandemic. Linear and quantile regression analyses explored how working conditions affect different aspects of nurses and midwives' burnout and mental health. Results show how working conditions affect burnout and mental health heterogeneously depending on the severity of the mental health symptoms. Increased quantitative and emotional work demands significantly impact occupational burnout indices of emotional exhaustion and depersonalization, and mental health indices of anxiety, depression, and stress among Australian nurses and midwives. Quantitative and emotional demands have more significant effects on people with higher levels of anxiety, depression, stress, and depersonalization than on those with milder or lesser symptoms. Given recent national and international policy focus on psychosocial hazards at work, this paper suggests that governments and health care providers need to monitor such hazards among nurses and midwives and introduce policies that reduce excessive quantitative or emotional burden to minimise risk of burnout and poor mental health and support good mental health among nurses and midwives.

The COVID-19 pandemic in Singapore led to limited access to mental health services, resulting in increased distress among the population. This study explores the potential benefits of offering a digital mental health intervention (DMHI), Wysa, as a brief and longitudinal intervention as part of the mindline.sg initiative launched by the MOH Office for Healthcare Transformation in Singapore. The paper aims to (i) Evaluate the engagement and retention of Singaporean users across the brief intervention on the mindline.sg website and the longitudinal app version of Wysa; (ii) Examine the types of negative thoughts and challenges managed during the pandemic; and (iii) Assess the impact of the conversational agent (CA) in supporting cognitive restructuring across attributional styles and cognitive patterns. A retrospective observational design with a mixed-methods approach was utilized. Website users (N = 69,055) and app users (N = 4,103) from September 1, 2020, to July 25, 2022, were included in the study. Engagement and retention were evaluated through usage data, and T-tests were used to compare engagement and retention between the app and website. A thematic analysis assessed the types of negative thoughts and the success of cognitive restructuring. Logistic regression was used to estimate the likelihood of restructuring based on negative thought type and attributional style. Users who used the longitudinal intervention after first using a brief intervention demonstrated significantly higher engagement and retention (P < 0.001). In user ratings received for mindline.sg (n = 8,959), 83.03% rated the app 3 or higher (out of 5) on helpfulness. 91.6% of the users (n = 862) who attempted cognitive restructuring (n = 790) on the app successfully reframed a thought. A single conversation with Wysa was also significantly associated with the ability to restructure future-oriented negative thoughts (P < 0.001) and internal, stable and global (P < 0.001) negative thoughts, while other attributional styles required more intervention. Psychosocial challenges managed by users during COVID-19 were also documented through negative thoughts mentioned within the CA. The findings demonstrate that brief interventions can facilitate enhanced engagement with DMHIs and that digital interventions can successfully facilitate cognitive restructuring and improve mental health outcomes. The study provides useful inputs to guide the development of DMHIs and improve their effectiveness.

The World Health Organization declared that coronavirus disease 2019 (COVID-19) constitutes an international public health emergency, which has strained health resources. In this study, we aimed to understand medical students' willingness to join the workforce fighting against the COVID-19 pandemic and identify factors associated with their decisions.

We conducted a nationwide cross-sectional study using the Wen-Juan-Xing platform and a pre-designed questionnaire from 23 March to 19 April 2021. We conducted logistic regression analyses to identify the determinants associated with the willingness.

Among the 5022 medical students, the majority (n = 4289, 85.40%) expressed willingness to work on the COVID-19 frontline. Logistic regression indicated that medical students' willingness to work on the COVID-19 frontline in China was associated with gender, region, reason for choosing medicine, having medical workers in the family, students whose family members, relatives or friends experienced COVID-19, and professional attitude. Females (odds ratio (OR) = 1.305; 95% confidence interval (CI) = 1.100-1.549; P = 0.0023), medical students from urban areas (OR = 1.295; 95% CI = 1.089-1.539; P = 0.0034), medical students whose choice of a medical career was their desire (OR = 1.579; 95% CI = 1.290-1.933; P < 0.0001), medical students whose parents or relatives are medical workers (OR = 1.266; 95% CI = 1.066-1.505; P = 0.0073), medical students whose family members, relatives, or friends have never been infected with COVID-19 (OR = 4.567; 95% CI = 3.002-6.947; P < 0.0001), and medical students with undisturbed of professional attitudes (OR = 4.280; 95% CI = 3.241-5.654; P < 0.0001) showed increased willingness to work on the COVID-19 frontline compared with their counterparts.

Medical students demonstrated a strong willingness to contribute to COVID-19 work during the pandemic in China. The findings may provide valuable information for emergency management so that policymakers can maintain sufficient health resources and provide quality health care in similar health emergencies in the future.

The healthcare sector is facing increasing work pressure, making a healthy workforce essential. Appreciation is a factor influencing well-being, and the COVID-19 pandemic offers valuable insights into this. This study aims to: 1) describe to what extent end-of-life care providers felt appreciated and understood during the first 18 months of the pandemic, 2) examine the impact of appreciation on their well-being, and 3) explore their perceptions of what appreciation should look like.

A longitudinal mixed methods study among healthcare providers in the Netherlands delivering end-of-life care during the COVID-19 pandemic. Surveys were conducted at four timepoints (n = 302), and interviews were conducted at three timepoints (n = 17) during the first 18 months of the pandemic. Generalized Estimating Equations analysis was performed on the quantitative data and thematic analysis was conducted on the interview data.

This study shows that feeling of appreciation among healthcare providers peaked in the first wave of the pandemic, but significantly dropped in the second wave, with only about half of the healthcare providers feeling appreciated. This slightly improved afterwards. Furthermore, nearly half of healthcare providers felt misunderstood during the first 18 months of the pandemic. Additionally, this study shows that between September 2020 and September 2021 about 1 in 3 healthcare providers had a score on the Well-Being Index indicating higher risk for burnout. Feeling appreciated and not feeling understood were both significantly associated with worse well-being. Interviews revealed that nurses did not always feel understood and appreciated by society, employers, patients and their families, as well as their own friends and family, leading to feelings of sadness, anger, and frustration. Three major themes emerged: 'recognizing real needs, 'we are not in this together' and 'short-lived appreciation that failed to lead to structural changes'.

This study shows that during the COVID-19 pandemic, healthcare providers often felt neither appreciated nor understood, which is associated with lower scores of well-being. The expressed appreciation often did meet their needs or expectations, from both employers and society. With healthcare provider well-being still under strain, sustained attention to appreciation and understanding is important for retaining the workforce.

Burnout is a global concern, and critical healthcare professionals have been identified as a high-risk population of burnout. Early identification is crucial, but the prevalence of burnout and its risk factors demonstrate significant geographical variations. This study aims to investigate the prevalence of burnout among critical healthcare professionals and explore potential risk factors during the post-pandemic era in Taiwan.

A web-based questionnaire survey was conducted from December 1, 2023, to January 31, 2024, targeting critical healthcare professionals employed in selected medical institutions affiliated with the Chang Gung Memorial Hospital Foundation, one of Taiwan's largest healthcare organizations. Demographic information, the Subjective Happiness Scale (SHS), current work stressors and self-reported general health data were collected. The study utilized the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-MP). Univariate and multivariate logistic regression were employed to investigate the association between risk factors and each burnout subscales. A systematic review of Asian literature concerning burnout among critical care practitioners was also conducted.

In our study, 254 participants were enrolled, with an overall burnout rate of 35.4%. The prevalence of high emotional exhaustion (EE) was 70.9%, high depersonalization (DP) was 56.3%, and low personal accomplishment (PA) was 60.6%. Young, unmarried populations, individuals with limited work experience, longer working hours, and night shifts are potential vulnerable groups susceptible to burnout. The top three stressors identified were excessive workload, the burden of administrative tasks, and a shortage of vacation time. Our systematic review included 20 Asian studies on the same issue, with variable burnout prevalence ranging from 16.3 to 82.1%.

The prevalence of burnout was high among critical healthcare professionals in post-pandemic Taiwan, particularly affecting younger, unmarried populations and individuals with limited work experience, longer hours, and more night shifts. The influence of pandemic-related factors has decreased. Regional variations in burnout have been observed across Asia, highlighting the need for further research to identify local risk factors and protect the well-being of professionals and healthcare quality.

The knowledge gaps on the experiences of early career health professionals during the COVID-19 pandemic informed this study, which examined their vaccination status, personal and workplace experiences in South Africa.

Wits longitudinal Study to Determine the Operation of the labour Market among its health professional graduates (WiSDOM), a prospective longitudinal cohort study established in 2017, consists of eight health professional groups of clinical associates, dentists, doctors, nurses, occupational therapists, oral hygienists, pharmacists and physiotherapists. As a part of annual follow-up surveys, we examined the personal and workplace experiences and the vaccination status of cohort members during the COVID-19 pandemic years: 2020 until 2022. We measured workplace experiences using a Likert scale that ranged from 1 (strongly disagree) to 7 (strongly agree). We constructed a composite index of positive workplace COVID-19 support using a principal component analysis.We compared differences among the professional groups using proportions for categorical variables and means for numerical variables. We used multiple linear regression to investigate factors associated with the workplace COVID-19 support score and Firth's penalised logistic regression for COVID-19 infection and vaccination.

In 2022, the mean age of the 363 cohort members was 28.9 (± 2.1), and the majority were female (74.2%). In 2020, 22.6% of the cohort reported COVID-19 infections but this increased to 45.3% by 2021. The composite index shows that doctors and nurses reported the lowest COVID-19 workplace support, while oral hygienists and dentists reported the most support. Although 89.5% of cohort members reported full COVID-19 vaccination status, 9.4% indicated non-intention to get vaccinated. The regression analysis showed that doctors (p<0.001) and women (p<0.05) reported significantly lower workplace COVID-19 support scores. Those working in hospitals had 17.1% higher COVID-19 infections (p<0.01). The lack of a COVID-19 supportive workplace resulted in 15.7% higher infections among early career health professionals (p<0.01).

The study findings underscore the need for positive practice environments for early career health professionals in South Africa.

Corona Virus Disease of 2019 (COVID-19) is an unprecedented challenge to health care systems globally and locally. The study aimed to assess generalized anxiety disorder and associated factors among health care providers (HCP) during COVID-19 pandemic. A total of 202 health care providers participated in the study. This was a hospital-based cross-sectional study. The survey questionnaire consisted of six components: demographic factors, occupational factors, psychological factors, socioeconomic factors, and the multi-dimensional scale of perceived social support (MSPSS). The symptoms of anxiety were measured by a standardized questionnaire, a 7-item Generalized Anxiety Disorder scale (GAD-7). Chi-Square statistic was used as a selection criterion for the predictors of generalized anxiety disorder to be included in the final binary regression analysis model at α<0.05. Among 202 health care providers interviewed, the overall prevalence of anxiety symptoms was 59.9%. Some of the aspects that reduced the risk of GAD were; being a younger HCP (OR 0.11, P = 0.004), fewer years of experience (OR 0.09, P = 0.008), availability of workplace precautionary measures (OR 0.06, P = 0.004), lower income level (OR = 0.04, P = 0.014), living alone (OR = 0.02, P = 0.008) and permanent employment terms (OR = 0.0001, P< 0.0001). On the other hand, insufficient state of personal protective equipment (PPEs) (OR = 10.64, P = 0.033), having a family member as a COVID-19 contact (OR = 11.24, P = 0.023) and facing COVID-19 related stigma (OR = 8.06, P = 0.001) significantly increased the odds of GAD. The study result is a call to prioritize the health care providers' psychological well-being by putting in place measures to preserve and enhance their resilience in order to ensure they work optimally and sustain service delivery during a pandemic.

Aim: This study investigated the impact of the COVID-19 pandemic on the emotional and spiritual well-being and the resilience of advanced clinical practitioners in the United Kingdom. Background: Advanced clinical practitioners are experienced healthcare professionals educated to a master's level who demonstrate expertise, professional judgment, and autonomy across four pillars of advanced practice. Normally, in nursing and the allied health professions, advanced clinical practitioners provide clinical leadership and improve clinical continuity by providing high-quality care to patients through complex decision-making and managing risk. The role contributes to workforce transformation enabling organizations to meet changing population, patient, and service delivery needs. Advanced clinical practitioners' well-being and resilience were particularly at risk during the pandemic due to the increased workload, moral distress, redeployment into other clinical areas, and isolation. Phase 1 of this study identified that advanced clinical practitioners had worryingly low levels of well-being and resilience during the first 6 months of the pandemic. This paper reports Phase 2' findings 1 year into the pandemic. Method: Three hundred and seventy-one respondents completed an online survey comprising three validated scales assessing resilience and emotional and spiritual well-being. Results: One year into the pandemic, advanced clinical practitioners reported a continued decline in their well-being, with average scores on this measure being 12 percent lower compared to prepandemic levels Differences also emerged in the scores of advanced clinical practitioners practicing in primary and secondary care services. Conclusion: Our findings showed the ongoing deleterious impact of the pandemic on the well-being and resilience of advanced clinical practitioners. As the attention of healthcare leaders shifts to the delivery of services post-COVID-19, the longer-term impact of the pandemic on the mental health and well-being of the workforce, alongside the ongoing workforce crisis in the UK and globally, means the well-being and resilience of advanced clinical practitioners need urgent addressing if these role holders are to continue to lead patient care, workforce transformation, and service innovation. Tailored interventions to support advanced clinical practitioners appear necessary to prevent significant workforce impact including absenteeism, long-term stress, sickness absence, and loss to the healthcare workforce.

To thoroughly describe 1) the stressors experienced by nurses during the first waves of the COVID-19 pandemic, 2) the extent to which experiencing these stressors affected nurses' psychological and physical health and 3) the health resources nurses used to protect and maintain their psychological and physical health during this period.

We used a theory-driven descriptive qualitative design and conducted seven focus groups of 2-5 nurses (total = 23 nurses) distinguished by their degree of contact with COVID-19 patients hospitalized in Switzerland.

A thematic analysis identified three main themes and their respective sub-themes: 1) Lived experiences and stressors (Living in a strange world; Hard work alone behind closed doors; Contaminating or being contaminated; Living at home behind closed doors; A war of attrition after the first wave); 2) Health (Everything is fine; Multiple traumas; Stress; Long-term exhaustion); 3) Resources (Societal and institutional resources; Direct relational resources; Resources specific to individuals).

All the nurses interviewed had been ceaselessly and intensely exposed to stressors in their professional and private lives. However, the repercussions of these stressors on their mental or physical health differed. Indeed, some nurses reported having used resources to protect and maintain their health.

The COVID-19 pandemic has placed nurses at the forefront of healthcare, exposing them to various mental health challenges such as depression, anxiety, and post-traumatic stress disorder (PTSD). However the long-term effects and risk factors of the COVID-19 pandemic on nurses' mental health are unknown. The objective of our study is to investigate the enduring impact of the COVID-19 pandemic on the psychological distress and PTSD of nurses, while also identifying the factors that influence these outcomes.

To investigate this question, we conducted a self-reported questionnaire survey of 8785 registered nurses recruited using snowball sampling methodology from 22 provinces in China, at five time points (T0-T4). At all times, we took measures of general health, while at the last four times we also measured PTSD. And we used logistic regression analysis to explore their impacts.

The incidence of whole levels psychological distress among nurses was 27.7% at T0, peaking at 57.6% at T4. For severe psychological distress, it began at 5.5% at T0 and rose to 9.5% at T4. PTSD rates among nurses were recorded at 7.8% in T1, reaching a maximum of 14.7% in T4. They all got progressively worse in the volatility. In all times, coping strategies are independent factors for various levels of psychological distress and PTSD, while social support is a key factor for severe psychological distress and PTSD.

Our findings indicated a gradual deterioration in the mental health of nurses following the COVID-19 outbreak. In all instances, coping strategies exhibit an independent correlation with all grades of psychological distress and post-traumatic stress disorder (PTSD), whereas social support emerges as an independent protective factor mitigating the risk of severe psychological distress and PTSD.

This study aimed to provide a detailed analysis of the pandemic's impact on the veterinary profession and education in Austria.

Two online surveys were conducted from November 2022 to January 2023, inviting all veterinarians and veterinary students in Austria to share their experiences on the impact of the pandemic on their veterinarian work and education in a free text question.

A total of n = 289 veterinarians and n = 272 veterinary students provided an answer. In summary, 39.8% of veterinarians reported no impact by the pandemic, while others experienced changes in workload (19.7%), changes in client behavior (14.9%), implementation of safety measures (13.1%), and organizational changes (13.1%). Additional impacts included effects on mental health, private life, finances, as well as physical health. Changes were more frequently mentioned in veterinarians working with pets compared to those working with livestock. In the student panel, only a minority reported no significant impact (8.1%) but 44.9% reporting changes due to online and hybrid learning. Key issues included impaired learning conditions (34.9%), and social distancing (34.6%) leading to social isolation. Some students appreciated increased flexibility and reduced commuting (10.7%), while others experienced mental health challenges (10.7%). Further impacts were related to the implementation of safety measures (5.5%), organizational changes (4.8%) and impaired physical health due to infection (1.1%). Negative changes related to distance learning were mainly reported by students in the final study phase, whereas those in the first study phase reported more positive aspects related to online/hybrid learning.

Overall, this study highlights the significant impact of the COVID-19 pandemic on veterinary education and professional practice in Austria, revealing diverse challenges for students and relatively lower but still notable effects on practicing veterinarians. Future research should monitor these impacts longitudinally and explore the integration of beneficial practices into standard veterinary education and care, such as effective digital learning platforms and appointment-based systems.

Over the years, humanity has faced various global crises of different kinds that have caused great suffering in the community, such as wars, slavery, torture or the Holocaust, but also climate change, economic crises, or sanitary disasters. The recent pandemic posed a barrier to palliative and End-of-Life (EoL) care, as the need for physical distance made it difficult to retain essential human interactions while minimizing the risk of viral transmission. During the COVID-19 pandemic, the robustness of supportive networks (i.e., family, friends, neighbors, and community members) determined whether someone experienced a calm death at home or an unnecessary hospital admission, labeled as an 'emergency'. In this vein, active establishment and strengthening of such networks are the foundation of compassionate community efforts. Firstly, providing both physical and emotional support to the entire network of caregivers enhances their ability to care for others and improves the overall experience of death, including the process of dying and the ensuing bereavement period. Furthermore, individuals can enhance their own physical and mental health by practicing compassion. The ability of networks to withstand and recover from physical and emotional challenges, while maintaining strong and supportive relationships among its members, depends on the health and overall well-being of those members. Therefore, we argue that active community participation and death education can strengthen a community's capacity to assist people facing death, dying, and bereavement.

Given the longevity of the COVID-19 pandemic, it is important to address the perceptions and experiences associated with the progression of the pandemic. This narrative can inform future strategies aimed at mitigating moral distress, injury, and chronic stress that restores resilience and well-being of HCWs. In this context, a longitudinal survey design was undertaken to explore how health care workers are experiencing the COVID-19 pandemic over time. A qualitative design was employed to analyze the open ended survey responses using a thematic analysis approach. All physicians and staff at an academic health science centre in Toronto, Ontario, Canada were invited to participate in the survey. The majority of survey respondents were nurses and physicians, followed by researchers/scientists, administrative assistants, laboratory technicians, managers, social workers, occupational therapists, administrators, clerks and medical imaging technologists. The inductive analysis revealed three themes that contributed to moral tensions and injury: 1) experiencing stress and distress with staffing shortages, increased patient care needs, and visitor restrictions; 2) feeling devalued and invisible due to lack of support and inequities; and 3) polarizing anti- and pro-public health measures and incivility. Study findings highlight the spectrum, magnitude, and severity of the emotional, psychological, and physical stress leading to moral injury experienced by the healthcare workforce. Our findings also point to continued, renewed, and new efforts in enhancing both individual and collective moral resilience to mitigate current and prevent future moral tensions and injury.

Healthcare workers are continuously exposed to challenging environments, making them liable for poor mental health. The COVID-19 pandemic exacerbated this problem, however available data in Lebanon is scarce. We conducted this investigation to provide comprehensive evidence on the mental health of Lebanese healthcare workers.

In this systematic review, we analyzed 3957 workers reported in 15 cross-sectional studies (10 during and five before the pandemic), identified after searching four databases. Examined mental health problems included depression, anxiety, stress, posttraumatic stress disorder (PTSD), and poor sleep quality. STATA software was used to pool the prevalence across studies. Subgroup analyses were performed based on the pandemic status, severity of mental health problems, and healthcare worker type. Gender and marital status were analyzed as potential risk factors. The methodological quality of all included studies was good as per the National Institute of Health risk of bias tool.

Anxiety, depression, stress, PTSD, insomnia, and poor sleep quality were reported in 50%, 52%, 50%, 35%, 45%, and 41% of the population, respectively. Most cases had mild anxiety (40%), mild depression (45%), but severe stress (27%). Depression and anxiety were highest among pharmacists (69% and 56%) and nurses (49% and 45%), respectively. Compared to the pre-pandemic period, depression (36% vs. 62%) and anxiety (30% vs. 56%) rates were higher during the pandemic, while stress levels were lower (62% vs. 45%). Both gender and marital status were insignificant predictors of depression, anxiety, stress, or PTSD.

Depression, anxiety, posttraumatic stress, insomnia, and poor sleep quality are experienced by approximately one in every two Lebanese healthcare workers. The rate of depression and anxiety almost doubled during the pandemic with higher rates among pharmacists and nurses than physicians and residents. Both gender and marital status were deemed insignificant predictors of reported mental health problems.

Background: The COVID-19 pandemic has led to reduced physical activity and increased sedentary behaviors, negatively impacting mental and physical health. Engaging in physical activity at home during quarantine became essential to counteracting these adverse effects. To develop appropriate physical activity programs, assessing individuals' fitness levels and the impact of inactivity is crucial. This study aims to compare motor abilities-including flexibility, balance, reaction time, cardiovascular endurance, and lower and upper limb strength-assessed both in-person and remotely, to determine the accuracy and repeatability of self-administered tests. Methods: A total of 35 young subjects (age 24.2 ± 1.97 years, BMI 22.4 ± 2.61 kg/m2) participated in this study. Each participant underwent a battery of motor ability tests designed to assess various fitness components. The tests were administered twice for each subject: once in a laboratory setting and once remotely at home. The sequence of tests was randomly assigned to ensure unbiased results. Both the in-person and remote assessments were used to evaluate the accuracy and reliability of self-administered tests. Results: The comparison of test results between the laboratory and remote settings revealed percentage differences ranging from 5% to 10%. This variation is considered an acceptable margin of error, suggesting that the tests conducted remotely were relatively accurate when compared to those performed in a controlled laboratory environment. Conclusions: The findings indicate that remote fitness testing is a promising method for evaluating motor abilities. With an acceptable margin of error, remote assessments can be effectively used to personalize training programs based on individuals' physiological characteristics. This approach may be particularly beneficial during times of limited access to fitness facilities, such as during quarantine, or for individuals seeking more flexible fitness evaluation methods.

The COVID-19 pandemic has led to a significant adverse effect on the mental health of healthcare professionals. This study aims to assess the effects of the prolonged pandemic on burnout and mood disorders and to evaluate the influence of positive vaccination beliefs on these factors at a medical center during the extended COVID-19 pandemic.

This retrospective study analyzed the results of an online questionnaire survey including burnout status and mood disorders from 2020 to 2022. The factors related to mood moderate/severe disorders and the impact of the positive vaccine belief were also explored.

The initial analysis revealed that healthcare professionals continued to experience significant levels of personal and work-related burnout, along with mood disorders. However, the scores and the percentage of moderate to severe burnout gradually decreased. Notably, the percentage of individuals with moderate to severe mood disorders also gradually declined (2020: 13.4%, 2021: 12.3%, 2022: 11.1%). The number of participants who need professional interventions decreased from 56.2% in 2020 to 45.9% in 2021, and 46% in 2022. Multivariate analysis revealed a positive vaccine belief was associated with a lower risk of moderate/severe mood disorders, with odd ratios (OR) and 95% confidence intervals (95% CI) of 0.38 (0.28 - 0.52) and 0.41 (0.30 - 0.52) in the 2021 and 2022 cohorts, respectively. Further investigation revealed that age over 50 was linked to a positive vaccine belief in 2021 and 2022. Within the 2022 cohort, working as nurses was identified as the independent factor associated with a less positive belief, with the OR and 95% CI of 0.49 (0.27 - 0.90).

The findings of the present study suggest burnout and mood disorders are still significant during the pandemic. A positive vaccine belief may mitigate pandemic-related mental distress. Further interventions to enhance the belief combined with other supporting measures are important in a long fight against the pandemic.

Even during the third wave of the COVID-19 pandemic health professionals were facing mental health challenges. The aim of this study was to examine the mental health of doctors, nurses and other professional groups in Europe and to identify differences between the professional groups. We conducted a cross-sectional online survey in 8 European countries. We asked for demographic data, whether the participants were exposed to COVID-19 at work, for main information sources about the pandemic, the Depression Anxiety Stress Scales (DASS-21), and major stressors. A MANCOVA was carried out to find predictors of mental health among health care professionals. The sample (N = 1398) consisted of 237 physicians, 459 nurses, and 351 other healthcare professionals and 351 non-medical professionals with no direct involvement in patient care. The mean mental health of all groups was affected to a mild degree. Major predictors for depression and anxiety were the profession group with higher scores especially in the group of the nurses and working directly with COVID-patients. In the third wave of the COVID-19 pandemic, the psychological burden on health professionals has remained high, with being nurse and working directly with COVID19 patients being particular risk factors for mental distress. We found as a main result that nurses scored significantly higher on depression and anxiety than practitioners.

Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic.

This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates.

A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017).

This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics.

Clinicaltrials.gov, NCT04352634.

In context of COVID-19 as a collective trauma and the intense involvement of healthcare workers (HCWs) in the pandemic, perceived stress continues to have a tremendous impact on their psychological well-being. However, few studies have attempted to delineate the underlying mechanisms. This study examined whether COVID-19-related traumatic stress symptoms and mentalization act as mediators.

A sample of HCWs (N = 2610) from 22 hospitals in Beijing, China participated in this cross-sectional investigation. Data on their perceived stress, psychological well-being, the impact of event, and reflective function during the COVID-19 pandemic were collected using self-report questionnaires. Different mediating models were tested.

COVID-19-related stress symptoms and mentalization independently mediate the association between perceived stress and psychological well-being. These two mediators also compose a serial mediation model. In particular, higher perceived stress inhibits the psychological well-being of HCWs through increased severity of traumatic stress symptoms, which in turn is associated with hypomentalizing.

These findings shed light on the mechanisms underlying the relationship between perceived stress and psychological well-being in HCWs. We strongly recommend incorporating a mentalization framework with trauma-informed practice in prevention and intervention work with this population during this and future healthcare crisis.

A healthy nursing workforce is vital to ensuring that patients are provided quality care. Assessing nurses' well-being and related factors requires routine evaluations from health system leaders that leverage brief psychometrically sound measures. To date, measures used to assess nurses' well-being have primarily been psychometrically tested among other clinicians or nurses working in specific clinical practice settings rather than in large, representative, heterogeneous samples of nurses.

This study aimed to psychometrically test measures frequently used to evaluate factors linked to nurse well-being in a heterogeneous sample of nurses within a large academic health system.

This cross-sectional, survey-based study used a convenience sample of nurses working across acute care practice settings. A total of 177 nurses completed measures, which included the Professional Quality of Life, the short form of the Professional Quality of Life measure, the two-item Connor-Davidson Resilience Scale, the five-item World Health Organization Well-Being Index, the Secondary Traumatic Stress Scale, and the single-item Mini-Z. Internal reliability and convergent validity were assessed for each measure.

All the measures were found to be reliable. Brief measures used to assess domains of well-being demonstrated validity with longer measures, as evident by significant correlation coefficients.

This study provides support for the reliability and validity of measures commonly used to assess well-being in a diverse sample of nurses working across acute care settings. Data from routine assessments of the nursing workforce hold the potential to guide the implementation and evaluation of interventions capable of promoting workplace well-being. Assessments should include psychometrically sound, low-burden measures, such as those evaluated in this study.