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Introduction: Rural doctors typically work in low resource settings and with limited professional support. They are sometimes pushed to the limits of their usual scope of practice to provide the medical care needed by their community. In a previous phenomenological study, we described the concept of clinical courage as underpinning rural doctors' work in this context. In this paper, we draw on rural doctors' experiences during the unfolding COVID pandemic to re examine our understanding of the attributes of clinical courage. Methods: Semi structured interviews were conducted with rural doctors from 11 countries who had experience preparing for or managing patients with COVID 19. Interviews were transcribed verbatim and coded using NVivo. A deductive thematic analysis was undertaken to identify common ideas and responses related to the features of clinical courage. Results: Thirteen interviews from rural doctors during the unfolding COVID 19 pandemic affirmed and enriched our understanding of the attributes of clinical courage, particularly the leadership role rural doctors can have within their communities. Conclusion: This study extended our understanding that rural doctors' experience of clinical courage is consistent amongst participants in many parts of the world, including developing countries. [ABSTRACT FROM AUTHOR]

Background: Repeated contact with patients with COVID-19 and working in quarantine conditions has made health workers vulnerable to psychological distress during the COVID-19 pandemic. The goal of the present systematic review and meta-analysis was to examine the prevalence of the various psychological distresses among health workers during the COVID-19 pandemic. Methods: PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases were searched for access to papers examining psychological distress among healthcare workers during the COVID-19 pandemic. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Heterogeneity among the studies was examined using the Cochran's Q test; because heterogeneity was significant, the random effects model was used to examine the prevalence of psychological distress. Results: Overall, 12 studies with a total sample size of 5265 were eligible and included in the analysis. Prevalence rates of depression, anxiety, and PTSD were 20% (95% CI: 14-27), 23% (95% CI: 18-27), and 8% (95% CI: 6-9), respectively. The highest prevalence rates of depression and anxiety were related to the SDS and the GAD-7, respectively, and the lowest prevalence rates of the two aforementioned variables were related to the DASS-21. Conclusions: The high prevalence of psychological distress among healthcare workers during the COVID-19 epidemic can have negative effects on their health and the quality of services provided. Therefore, training coping strategies for psychological distress in this pandemic seems necessary. [ABSTRACT FROM AUTHOR]