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Background: We aimed to evaluate the impact of health care vaccine mandates on vaccine uptake and infection risk in a cohort of Canadian health care workers (HCWs)., Methods: We conduct interrupted time series analysis through a regression discontinuity in time approach to estimate the immediate and delayed impact of the mandate. Multilevel mixed effect modeling fitted with restricted maximum likelihood was used to estimate impact on infection risk., Results: The immediate and sustained effects of the mandate was a 0.19% (P < .05) and a 0.012% (P < .05) increase in the daily proportion of unvaccinated HCWs getting their first dose, respectively. An additional 623 (95% confidence interval: 613-667) HCWs received first doses compared to the predicted uptake absent the mandate. Adjusted test positivity declined by 0.053% (95% confidence interval: 0.035%, 0.069) for every additional day the mandate was in effect., Discussion: Our results indicate that the mandate was associated with significant increases in vaccine uptake and infection risk reduction in the cohort., Conclusions: Given the benefit that vaccination could bring to HCWs, understanding strategies to enhance uptake is crucial for bolstering health system resilience, but steps must be taken to avert approaches that sacrifice trust, foster animosity, or exacerbate staffing constraints for short-term results., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Health care professionals (HCPs) historically exhibit high rates of stress, burnout, and low rates of service utilization from Employee Assistance Programs (EAPs) and Professional Health Programs (PHPs). New and magnified stressors that accompanied COVID-19 exacerbated HCPs' risk of burnout., Purpose: During the pandemic, this study examined Ohio HCP's utilization of EAPs and PHPs, knowledge of available services, barriers to accessing services, and likelihood of future service utilization. Conditions needing to change to increase likelihood of future utilization were also explored., Methods: A one-time survey was administered in July and August of 2021 to HCPs from 13 licensing boards in Ohio. This study used a subset of data to examine the extent of convergence between quantitative results-analyzed using frequency calculations-and results from thematic analysis of corresponding open-ended survey items. Qualitative results supported and elaborated the quantitative findings., Results: Fewer than 25% of respondents ( N = 12,807) utilized EAPs or PHPs to address mental health concerns. Obstacles impeding service utilization included issues around awareness, time commitment, and confidentiality-a concern encompassing issues of stigma and fear of employment repercussions. Noting multiple obstacles to accessing EAPs and PHPs, HCPs in Ohio reported low rates of support service utilization and low likeliness to use services in the future despite their experiences of extreme stress and burnout., Conclusions: Addressing the time commitment and confidentiality concerns could increase the likelihood of accessing services. Employers of HCPs should explore additional support mechanisms such as comprehensive wellness programs and innovative, brief intervention strategies to combat burnout, especially during viral outbreaks and other high-stress events., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: During the COVID-19 pandemic, with many nurses being infected, understanding compliance with standard precautions (SP) among nurses in Kazakhstan is crucial for improving infection prevention and control and preparedness for future emergencies. The study aimed to assess Kazakh nurses' SP compliance amid the COVID-19 pandemic and examine the factors associated with their compliance., Methods: Quantitative, cross-sectional design. This research surveyed 241 clinical nurses in Astana, Kazakhstan using a standardized tool from December 2021 to April 2022., Results: This study found 76.0% SP compliance among the nurses. The highest compliance was observed in the dimension "Decontamination of spills and used articles" (86.0% compliance rate), followed by "Use of protective devices" (83.5% compliance rate), "Prevention of cross-infection from person to person" (72.7% compliance rate), "Disposal of sharps" (65.4% compliance rate), and "Disposal of waste" (56.0% compliance rate). Nurses' age and educational qualification influences the nurses' SP compliance., Discussion: While the nurses' compliance rate in this study was moderate, specific areas warrant more attention, such as their compliance with proper waste and sharps disposal., Conclusions: This study highlighted the experiences of nurses in Kazakhstan on their compliance with SP during the pandemic., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The COVID-19 pandemic continues to spread throughout the world causing serious morbidity and mortality. Health care professionals (HCP) are on the front line in the face of this pandemic and are identified as priorities for COVID-19 vaccination. This study aimed to estimate the acceptability rate of the COVID-19 vaccination among HCP and to identify their predisposing factors. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire including a randomized sample of HCP in Southern Tunisia, on March-April 2021. Results: Among 300 participants, the COVID-19 vaccine acceptability rate was 65.3%. Factors independently associated with vaccine acceptability were age groups <30 years [Adjusted Odds Ratio (AOR)=4.36; p  = 0.002)], urbanity of residence (AOR = 3.44; p  = 0.027), medical professional category (AOR = 2.69; p  = 0.023) and caring for coronavirus infected patients (AOR = 2.32; p  = 0.047). Belief that COVID-19 vaccination is important to work safely as a health care provider (AOR = 3.26; p  = 0.013), should be available for all HCP (AOR = 17.98; p  = 0.004) and has been quickly developed before it has been thoroughly vetted and tested for efficacy and safety (AOR = 5.88; p  < 0.01) were independently associated with willingness to accept vaccine. Planning to get a COVID-19 vaccine for the next years and recommending it to the family were independent predictive factors of accepting COVID-19 vaccine ((AOR = 6.88; p  < 0.001) and (AOR = 25.03; p  < 0.001), respectively). Conclusion: The acceptance rate of vaccination against COVID-19 among Tunisian HCP is still low in South Tunisian hospitals. Socio-demographic, cultural and professional factors predisposing to the vaccination willingness were highlighted. Combating the vaccine hesitancy of HCP through enhancing sensibilization campaigns is essential to promote vaccination in general population.

Background: Mindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health., Methods: The electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool., Results: Twenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs., Conclusions: The MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable., Systematic Review Registration: PROSPERO CRD42021267621., (© 2024. The Author(s).)

Purpose: The objective of this report is to provide longitudinal insights on the impact of a health professions exposure program for high school students of underrepresented backgrounds in medicine., Context: Medical students at the University of Chicago reviewed data from their chapter of the Health Profession Recruitment and Exposure Program (HPREP) from 2016-2021 to discover trends in enrollment. This data is documented in the context of the program's mission to increase awareness of health disparities, the success of prominent alumni, and recent community efforts post-COVID-19 pandemic., Findings: Two hundred and ninety-nine high school students participated in the University of Chicago HPREP program between 2016 and 2021. Participants ranged in age from 12 to 18 years (mean = 16, SD = 1) and 74% ( n = 222) were female students. Of 252 respondents, 58% ( n = 147) identified as Black or African American, 31% ( n = 77) identified as Latinx or of Hispanic origin, and 10% ( n = 24) identified as another race or as bi-racial. Ten or fewer black male students participated in the program every year, including the 2020-2021 year in which 61 students participated., Conclusions: HPREP has played an important role in shaping the face of health care, especially in Chicago. The data suggests significant increases in the number of underrepresented minority women becoming physicians and serving Chicago communities in the next decade. Pathway programs for underrepresented students in medicine should be strategic in recruiting and educating future health professionals based on future workforce needs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Affini, Diaz, Dolan, Fletcher, Hasnain, Selkridge, Washington and Pratt.)

Background: The overall pandemic created enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. Despite this, most of the available evidence on professional well-being during COVID-19 has exclusively focused on frontline health care workers., Objective: This study aimed to identify the long-term psychological needs of LTCWs derived from the COVID-19 pandemic and to explore barriers and facilitators related to digital mental health tools. This is part of a project that seeks to develop a digital mental health intervention to reduce psychological distress in this population group., Methods: We performed a qualitative study with a rapid research approach. Participants were LTCWs of the autonomous community of Catalonia. We conducted 30 semistructured interviews between April and September 2022. We used a qualitative content analysis method with an inductive-deductive approach., Results: The period of the pandemic with the highest mental health burden was the COVID-19 outbreak, with almost all workers having experienced some form of emotional distress. Emotional distress persisted over time in more than half of the participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, the feeling that pandemic times are not over, and poor working conditions that have remained since then have been the most frequently expressed determinants of such emotions. Potential barriers and facilitators to engagement with digital tools were also identified in terms of previous experience and beliefs of the target population, possibilities for the integration of a digital tool into daily life, preferences regarding the level of guidance, the possibility of social connectedness through the tool, and privacy and confidentiality. The identified factors may become especially relevant in the context of the pandemic remission phase., Conclusions: More than 2 years after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees' well-being. Considering factors that act as barriers and facilitators for the use of digital mental health tools, it is important to develop tailored tools that could offer valuable support to this population during and after a pandemic., (©Leticia González-Spinoglio, Anna Monistrol-Mula, Cecilia Vindrola-Padros, Salvatore Aguilar-Ortiz, Bernat Carreras, Josep Maria Haro, Mireia Felez-Nobrega. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 29.05.2024.)

Purpose: People with a total laryngectomy (PTL) confront safety threats related to altered airway anatomy and risk of adverse events is amplified during healthcare crises, as exemplified by COVID-19 pandemic. Understanding these challenges, how they are navigated by PTL, and what resources can be deployed to alleviate risk can improve interprofessional care by speech-language pathologists (SLPs), otolaryngologists, and other professionals., Materials and Methods: An online survey was disseminated to PTL in the United States during the COVID-19 pandemic, querying participants about safety concerns and sources of information accessed to address care. Descriptive statistics and Chi-square were used to analyze information sources consumed by tracheoesophageal, esophageal, and electrolaryngeal speakers. Content analysis was completed to identify themes and quantify responses by subtheme., Results: Among 173 respondent PTL, tracheoesophageal speakers preferentially sought otolaryngologist input, whereas esophageal and electrolaryngeal speakers more often chose SLPs (p < .01). Overall, tracheoesophageal speakers had more SLP or otolaryngologist contact. Many PTL reported stringent handwashing, neck cleaning, and hygienic risk mitigation strategies. Six themes emerged in content analysis involving risk of infection/transmission, heightened vigilance, changes to alaryngeal communication, modified tracheostoma coverage, diagnostic testing, and risk from comorbid conditions. Limited provider contact suggested pandemic barriers to healthcare access., Conclusions: PTL have a range of laryngectomy-specific needs and concerns, and type of alaryngeal communication was associated with source of information sought. Collaborations among healthcare professionals need to be optimized to improve patient navigation and overall access to specialized care., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs., Objective: This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program., Methods: A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework., Results: A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness., Conclusions: Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention., Trial Registration: ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879., (©Wei How Darryl Ang, Zhi Qi Grace Lim, Siew Tiang Lau, Jie Dong, Ying Lau. Originally published in JMIR Medical Education (https://mededu.jmir.org), 31.01.2024.)

Objective: During the Covid-19 pandemic, there has been a substantial uptake of telemental health interventions. Consequently, the objective of this study was to assess psycho-oncologists' attitudes toward and experiences with video consultations (VC) since the beginning of the Covid-19 pandemic. Additionally, we sought to investigate psycho-oncologists' perspectives on the benefits and drawbacks of VC and its' potential implementation beyond the pandemic., Methods: We used a multi-methods study design. First, semi-structured interviews with psycho-oncologists (N = 6) were conducted to inform the development of a cross-sectional online survey, which represented the quantitative part of our study. We invited psycho-oncologists, working in different settings, from all over Germany to participate., Results: Data of N = 217 participants (88% female, 49% over 10 years work experience) of the online survey was analyzed. Psycho-oncologists' acceptance toward VC was average to high. In their daily practice, they preferred in-person consultations. Improved access to care and enhanced flexibility were seen as main advantages. The most significant disadvantages included technical issues, privacy concerns at home, loss of non-verbal cues and absence of physical presence for emotional support. Nevertheless, on average, psycho-oncologists wanted to continue seeing approximately 25% of their patients via VC in the future., Conclusions: Given the average to high acceptance of VC among psycho-oncologists and their desire to continue using VC flexibly even after the pandemic, it may be beneficial to implement VC into future psycho-oncology services. Still, future research should focus on the patients' perspective and the effectiveness of VC in psycho-oncology services., (© 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

Background: The unexpected outbreak of the COVID-19 pandemic has led huge impact on health and safety of employees. Although now the epidemiological situation has improved, but it remains a challenge, especially in light of the emergence of new threats. The aim of the work is to present an epidemiological analysis of data on COVID-19 as an occupational disease in Poland., Material and Methods: The analysis covered all cases of occupational diseases sent by state sanitary inspectors to the Central Register of Occupational Diseases. The years 2020-2022 and such available data as: age, gender, activities and territorial differentiation were analyzed. The data were presented as absolute numbers and incidence rates per 100 000 employed persons and for healthcare workers also per 100 000 persons authorized to practice., Results: In the period 2020-2022 in Poland 7030 diseases recognized as occupational diseases were recorded, of which almost half were infectious diseases (47%). Among infectious diseases, dominated COVID-19 in number of 2059 cases. In this period 98.6% of all cases of COVID-19 were concentrated in the health care and social activities. According to workplaces, most diseases were caused by working in hospitals - 1825 cases (88.6% of all COVID-19 cases in the healthcare workers). Most cases concerned nurses - 1355 cases (65,8%) and doctors - 212 cases (10,3%). The incidence of COVID-19 in the group of physicians per 10 000 persons entitled to practice ranged from 2.6 in 2020 to 68.3 in 2022, while among nurses and midwives the rates were 7.9 and 194.9, respectively., Conclusions: The COVID-19 pandemic changed the picture of occupational diseases in Poland. Therefore, it is very important to understand the key contributions of people working in environments where workers are at increased risk of contracting COVID-19 due to the nature of their work, and to promote the recognition of COVID-19 as an occupational disease. Med Pr Work Health Saf. 2023;74(6):479-86., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: In the spring of 2020, the Covid-19 outbreak sent a shock wave through the Swedish society and placed an extraordinary pressure on the health and social care system for older people. In the initial phase there were few guidelines for care providers to follow and staff in home care organisations often had to tackle challenges posed by the pandemic as they appeared. The aim of this study was to understand how the spread of Covid-19 was managed in organisations providing home care to older adults in different municipalities in Region Stockholm, and what actions were taken to minimise the spread of the disease among clients and staff., Method: A descriptive qualitative study was performed based on eight interviews with managers of home care providers for older adults in three different municipalities in Region Stockholm.Three of the eight providers operate within an integrated care system. Data were analysed using conventional content analysis., Results: Three themes were identified covering actions taken to handle the spread of the virus, feelings of insecurity and anxiety, and internal and external factors influencing how the pandemic was tackled. There was no single strategy followed by all municipalities or organisations, however, there were similarities between the organisations. One such example was the introduction of cohort care and the experience of lacking personal protective equipment. Providers in the integrated care system emphasized some advantages with their system that was seen as facilitators for minimising the risk of spreading the virus, like the joint meetings with managers from both health and social care and the close contact with healthcare professionals in relation to dissemination of hygiene instructions., Conclusion: Social care workers providing home care to older persons are an important group in preventing dissemination of infectious diseases like Covid-19. For better readiness and preparedness for future pandemics, municipal home care services would need larger stocks of personal protective equipment, clear guidelines and more training on how to reduce dissemination of disease. Ways to achieve closer communication between health and social care providers should also be investigated., (© 2023. The Author(s).)

Background: The COVID-19 pandemic severely affected everyday life and working conditions for most Europeans, particularly health care professionals (HCPs). Over the past 3 years, various policies have been implemented in various European countries. Studies have reported on the worsening of mental health, work-related stress, and helpful coping strategies. However, having a closer look is still necessary to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff., Objective: This study aimed to obtain quantitative information on job-related stressors of physicians and nurses and the coping strategies of HCPs and nonmedical staff at 2 periods of the COVID-19 pandemic. By further analyzing qualitative comments, we wanted to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff on different levels of experience., Methods: A cross-sectional survey was conducted at 2 time points during the COVID-19 pandemic in several European countries. The first study period (T1) lasted between April 1 and June 20, 2020, and the second study period (T2) lasted between November 25, 2021, and February 28, 2022. On a quantitative level, we used a questionnaire on stressors for physicians and nurses and a questionnaire on coping strategies for HCPs and nonmedical staff. Quantitative data were descriptively analyzed for mean values and differences in stressors and coping strategies. Qualitative data of free-text boxes of HCPs and nonmedical staff were analyzed via thematic analysis to explore the experiences of the individuals., Results: T1 comprised 609 participants, and T2 comprised 1398 participants. Overall, 296 participants made 438 qualitative comments. The uncertainty about when the pandemic would be controlled (T1: mean 2.28, SD 0.85; T2: mean 2.08, SD 0.90) and the fear of infecting the family (T1: mean 2.26, SD 0.98; T2: mean 2.02, SD 1.02) were the most severe stressors identified by physicians and nurses in both periods. Overall, the use of protective measures (T1: mean 2.66, SD 0.60; T2: mean 2.66, SD 0.60) and acquiring information about COVID-19 (T1: mean 2.29, SD 0.82; T2: mean 1.99, SD 0.89) were identified as the most common coping strategies for the entire study population. Using thematic analysis, we identified 8 themes of personal experiences on the micro, meso, and macro levels. Measures, working conditions, feelings and emotions, and social climate were frequently mentioned topics of the participants. In T1, feelings of isolation and uncertainty were prominent. In T2, feelings of exhaustion were expressed and vaccination was frequently discussed. Moreover, unmet psychosocial needs were identified., Conclusions: There is a need for improvement in pandemic preparedness. Targeted vocational education measures and setting up of web-based mental health support could be useful to bridge gaps in psychosocial support needs in future crises., (©Svenja Hummel, Ina Michelsen, Ali Zafar, Steffen Moritz, Charles Benoy, Cédric Lemogne, Rosa Almeida, Raquel Losada, Oscar Ribeiro, Vincenza Frisardi, Ilaria Tarricone, Silvia Ferrari, Frieder Dechent, Christian G Huber, Steffi Weidt, Gwendolyn Mayer, Jobst-Hendrik Schultz. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 06.09.2023.)

Background: Postpartum depression is a risk factor for suicide and maltreatment of children, and its early detection and appropriate intervention are issues to be resolved. In Japan, local governments are working to detect postpartum depression early by conducting home visits to families with infants within 4 months postpartum, but home-visit professionals have faced new difficulties due to the coronavirus disease 2019 (COVID-19) pandemic that started in 2020. The purpose of this study was to clarify the difficulties experienced by health care professionals who perform home visits to screen for postpartum depression., Methods: Focus-group interviews were conducted during the COVID-19 pandemic with health care professionals (n = 13) who make postpartum home visits to families with infants within 4 months. Data were analyzed using thematic analysis., Results: Four main categories were identified that describe the difficulties experienced by health care professionals: "Lack of support for partners," "Difficulty in talking face-to-face," "Inability to offer family assistance," and "Anxiety about being a source of infection.", Conclusions: This study shed light on the difficulties faced by professionals in supporting mothers and children in the community during the COVID-19 pandemic. Although these difficulties were considered to have become apparent during the pandemic, the results may offer an important perspective for postpartum mental health support even after the pandemic ends. Accordingly, it may be necessary for these professionals to receive supported through multidisciplinary collaboration in order to improve postpartum care in the community., (© 2023. The Author(s).)

Background: The global coronavirus disease 2019 pandemic put extreme pressure on healthcare systems worldwide, forcing a heavy workload on healthcare professionals. Frontline treatment and care for patients with coronavirus disease 2019 compelled healthcare professionals to rapidly adapt to new working conditions. This study explores the experiences of frontline healthcare professionals to learn more about how frontline work affects their learning and skills development but also interprofessional collaboration during a pandemic., Methods: In-depth, one-to-one semi-structured interviews were conducted with 22 healthcare professionals. A broad interdisciplinary group, the participants were employed in public hospitals in four of Denmark's five regions. Using a reflexive methodology for the data analysis allowed reflexive interpretation when interpreting subjects and interpreting the interpretation., Results: The study identified two empirical themes: into the unknown and in the same boat, which we critically interpreted using learning theory and theory on interprofessionalism. The study found that the healthcare professionals moved from being experts in their own fields to being novices in the frontline of the pandemic, and then back to being experts based on interprofessional collaboration that included shared reflection. Working in the frontline was imbued with a unique atmosphere in which workers were equals and functioned interdependently, the barriers normally obstructing interprofessional collaboration set aside to focus on combating the pandemic., Conclusions: This study reveals new insights regarding knowledge on frontline healthcare professionals in terms of learning and developing new skills, as well as the importance of interprofessional collaboration. The insights contributed to the understanding of the importance of shared reflection and how the development of expertise was a socially embedded process where discussions were possible without fear of being ridiculed and healthcare professionals were willing to share their knowledge., (© 2023. The Author(s).)

The outbreak of the COVID-19 pandemic exerted significant mental burden on healthcare workers (HCWs) operating in the frontline of the COVID-19 care as they experienced high levels of stress and burnout. The aim of this scoping review was to identify prevalence and factors associated with burnout among HCWs during the first year of the COVID-19 pandemic. A literature search was performed in PubMed, Web of Science, and CINAHL. Studies were selected based on the following inclusion criteria: cross-sectional, longitudinal, case-control, or qualitative analyses, published in peer-reviewed journals, between January 1, 2020 and February 28, 2021. Studies carried out on other occupations than healthcare workers or related to other pandemics than COVID-19 were excluded. Following the abstract screen, from 141 original papers identified, 69 articles were eventually selected. A large variation in the reported burnout prevalence among HCWs (4.3-90.4%) was observed. The main factors associated with increase/ decrease of burnout included: demographic characteristics (age, gender, education level, financial situation, family status, occupation), psychological condition (psychiatric diseases, stress, anxiety, depression, coping style), social factors (stigmatisation, family life), work organization (workload, working conditions, availability of staff and materials, support at work), and factors related with COVID-19 (fear of COVID-19, traumatic events, contact with patients with COVID-19, having been infected with COVID-19, infection of a colleague or a relative with COVID-19, higher number of deaths observed by nurses during the COVID-19 pandemic). The findings should be useful for policy makers and healthcare managers in developing programs preventing burnout during the current and future pandemics. Int J Occup Med Environ Health. Int J Occup Med Environ Health. 2023;36(1):21-58., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Since the COVID-19 pandemic started, health care workers have faced various challenges to their mental health due to extreme working conditions. Yet these workers have continued to deliver care in the face of stressors and death among their patients, family, and social networks. The pandemic highlighted weaknesses within our health care work environment, especially pertaining to a need to provide increased psychological resilience to clinicians. There has been little research to determine the best practices for psychological health in workplaces and interventions to improve psychological resilience. Although some studies have attempted to provide solutions, there are noteworthy gaps in the literature on effective interventions to use in the time of crisis. The most common include an absence of preintervention data concerning the overall mental well-being of health care workers, inconsistent application of interventions, and a lack of standard assessment tools across studies. There is an urgent need for system-level strategies that not only transform the way workplaces are organized, but also destigmatize, recognize, support, and treat mental health conditions among health care workers. There is also need for more evidence-based resources to improve resilience on the job, and thereby increase clinicians' capacity to address new medical crises. Doing so may mitigate rates of burnout and other psychological conditions in times of crisis among health care workers., Competing Interests: Conflicts of interest: authors report none., (© 2023 Annals of Family Medicine, Inc.)

Background: Health care professionals (HCP) were obliged to wear personal protective equipment (PPE) during pandemic in order to minimize the risk of transmission of the emerging virus. The objective of the study was to estimate the prevalence of adverse effects related to the wear of PPE among HCP and to determinate their predictive factors., Methods: This was a cross-sectional study including a representative sample of 300 randomized HCP at Hedi Chaker University Hospital Sfax, Tunisia, during the period August-September 2021. Data collection was carried out by an anonymous self-administered questionnaire., Results: PPE related adverse effects were noted among 87 HCP with a prevalence of 57.2%. Multivariate analysis showed that factors independently associated with PPE adverse effects were female gender (Adjusted Odds Ratio (AOR) = 1.8; p = 0.048), chronic diseases (AOR = 0.29; p = 0.001) and previous infection with COVID-19 (AOR = 0.46; p = 0.004). Frequent use of bleach or other disinfection product without protection and use of hot water at work were independently associated with a high risk of adverse effects ((AOR = 2.22; p = 0.003) and (AOR = 2.83; p = 0.005), respectively). Similarly, a duration of use of PPE>4 h per day (AOR = 1.98; p = 0.039), as well as use of visors and/or glasses (AOR = 1.84; p = 0.045) were independently associated with PPE related adverse effects., Conclusion: The prevalence of adverse effects related to the wear of PPE was alarmingly high among HCP. Multiple risk factors were highlighted, notably professional aspects. Adequate and repetitive training for caregivers on the correct use of PPE remain essential to manage this problem., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.)

Objectives: This study aimed to investigate the risk factors surrounding an increase in both burnout levels and depression among health care professionals in Taiwan through use of a longitudinal study design., Design: This is a 2-year observational study that took place from January 2019 to December 2020., Setting and Participants: Data among health care professionals were extracted from the Overload Health Control System of a tertiary medical center in central Taiwan., Methods: Burnout was measured through use of the Chinese version of the Copenhagen Burnout Inventory (C-CBI), whereas depression was ascertained by the Taiwanese Depression Questionnaire. Each participant provided both burnout and depression measurements during a nonpandemic period (2019) as well as during the COVID pandemic era (2020). Risk factors surrounding an increase in burnout levels and depression were analyzed through a multivariate logistic regression model with adjusting confounding factors., Results: Two thousand nineteen participants completed the questionnaire over 2 consecutive years, including 132 visiting doctors, 105 resident doctors, 1371 nurses, and 411 medical technicians. After adjustments, sleeplessness, daily working hours >8, and stress due to one's workload were all found to be risk factors for an increase in depression levels, whereas sleeplessness, lack of exercise, and stress due to one's workload were all found to be risk factors for an increase in personal burnout level. Being a member of the nursing staff, a younger age, sleeplessness, and lack of exercise were all risk factors for an increase in work-related burnout levels., Conclusions and Implications: Poor sleep, lack of exercise, long working hours, and being a member of the nursing staff were risk factors regarding an increase in personal burnout, work-related burnout levels and depression among health care professionals. Leaders within the hospital should investigate the working conditions and personal habits of all medical staff regularly and systematically during the COVID-19 pandemic and take any necessary preventive measures, such as improving resilience for nursing staff, in order to best care for their employees., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Healthcare professionals are at higher risk of developing and experiencing burnout. Parents may also suffer from prolonged stressful conditions that lead to physical and emotional exhaustion. Residential youth care workers assume a caregiving role that can lead to persistent stressful conditions that affect their relationship with the youth. In addition, the COVID-19 lockdown has had a negative impact on both the organization and the work, as well as on the lifestyle of workers and minors. In fact, during the pandemic, contact with families was not possible due to restrictions and this increased the need for caregivers to assume a parental role. This research aims to examine the risk of burnout in a sample of 75 healthcare professionals working with youths and the association with psychological traits. Then, we aim to evaluate these aspects during the COVID-19 lockdown The measurements, conducted in both February 2019 and April 2021, included six questionnaires: MBI to assess burnout, TAS&#95;20 to explore alexithymic traits, COPE&#95;NVI to assess coping strategies, FDS&#95;R to quantify frustration intolerance at work, IRI for empathy, and FFMQ to investigate awareness and emotional regulation. Our sample shows a medium-high risk of developing burnout, which worsened during the pandemic. A worsening of emotional skills, paralleled by a greater empathic investment required by the emergency situation, and an assumed parental role is observable. Coping strategies correlate with burnout risk, as avoidance strategies were strongly associated with emotional exhaustion. These findings suggest an urgent need to develop targeted and timely interventions for healthcare professionals in order to prevent long-term consequences.

Seasonal flu continues to be a major public health concern, and the influenza vaccine remains the most effective preventive measure. In Spain, vaccination coverage data from previous seasons show vaccination rates well below official targets; however, these figures improved significantly after the COVID-19 pandemic. Given the importance of achieving and maintaining high vaccination rates in order to avoid the clinical and economic impact of influenza, our multidisciplinary group of experts on vaccines analyzed the impact of low vaccination rates in Spain and drafted a series of measures to boost influenza vaccination coverage, particularly among priority groups., (©The Author 2022. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

The present study examined organizational, situational (i.e., COVID-19-related), and psychological factors associated with burnout during the COVID-19 pandemic among 268 health care professionals in Norway. A total burnout score based on the Burnout Assessment Tool (BAT), the four core BAT subscales (i.e., Exhaustion, Mental Distance, Cognitive Impairment, and Emotional Impairment), and the COVID-19 Burnout Scale served as the dependent variable. Among the results, organizational factors such as work-home conflict, workload, and role conflict were positively related to burnout. Although autonomy and colleague support were negatively related to burnout, support from leaders was positively related to it, which might suggest a suppressive effect. Organizational factors explained most of the variance in general burnout (i.e., BAT Total), whereas situational (i.e., COVID-19-related) factors (e.g., involvement with COVID-19, fear of COVID-19, and COVID-19-induced stress) seemed to better explain COVID-19 burnout. COVID-19-oriented actions were related only to Mental Distance. Psychological factors such as meaning were negatively related to BAT Total, Exhaustion, and Mental Distance, whereas a breach of the psychological contract was related to all subscales. Such results suggest that organizational and situational factors contribute differently to general and COVID-19 burnout and that administering pandemic-specific assessment tools can clarify how the pandemic has affected mental health.

Background: During COVID-19 pandemic, a shortage of surgical masks (Mask) and respirators (Resp) was experienced worldwide. We aimed to assess its pattern of use, adverse effects and user errors by Portuguese health care professionals (HCP)., Methods: A cross-sectional study was conducted through snowball convenience sample, collected by email/ social media to health care organizations. Participants answered an online anonymous survey in March 2021., Results: Mean age of 3052 respondents was 42.1 years old, 83.6% were female and 77.8% provided direct health care to COVID-19 patients. Mean time of use per shift was 6-8 hours in 40.8% of the participants. 28.0% reported never changing it during their shift. Resp use (vs Mask) was more associated with discomfort (58.2% vs 26.8%), affecting task performance (41.5 vs 18.9%) and communication (55.0 vs 40.9%), dyspnea (36.0 vs 14.4%), skin rash (37.5 vs 19.4%) and headache (37.5 vs 19.4%). Frequent user errors included touching the front while in use (70.1% Mask vs 66.3% Resp) and omitting hand hygiene before (61.8% Mask vs 55.0% Resp) or after use (61.3% Mask vs 57.0% Resp). Average number of errors was higher for Mask (4.3), than for Resp (3.2) (all: P < .001)., Conclusions: Most HCP admitted an extended use of Mask/ Resp. Resp were more prone to adverse effects and Mask more prone to errors. Strategies to reinforce good practices should be considered., (Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Objectives: The lack of validated instruments assessing vaccine hesitancy/confidence among health care professionals (HCPs) for themselves, and their patients led us to develop and validate the Pro-VC-Be instrument to measure vaccine confidence and other psychosocial determinants of HCPs' vaccination behavior among diverse HCPs in different countries., Methods: Cross-sectional survey in October-November 2020 among 1,249 GPs in France, 432 GPs in French-speaking parts of Belgium, and 1,055 nurses in Quebec (Canada), all participating in general population immunization. Exploratory and confirmatory factor analyses evaluated the instrument's construct validity. We used HCPs' self-reported vaccine recommendations to patients, general immunization activity, self-vaccination, and future COVID-19 vaccine acceptance to test criterion validity., Results: The final results indicated a 6-factor structure with good fit: vaccine confidence (combining complacency, perceived vaccine risks, perceived benefit-risk balance, perceived collective responsibility), trust in authorities, perceived constraints, proactive efficacy (combining commitment to vaccination and self-efficacy), reluctant trust, and openness to patients. The instrument showed good convergent and criterion validity and adequate discriminant validity., Conclusions: This study found that the Pro-VC-Be is a valid instrument for measuring psychosocial determinants of HCPs' vaccination behaviors in different settings. Its validation is currently underway in Europe among various HCPs in different languages.

Objective: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health., Method: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires., Results: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time., Conclusions: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time., (Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)

COVID-19 has dramatically changed the work environment in healthcare, which is creating an additional burden for healthcare professionals. In this study, we investigate the factors that trigger professionals to have negative perceptions of their jobs during the pandemic. A cross-sectional survey is used for this study. The respondents are selected based on convenience random sampling. We use 345 questionaries for the analysis. Respondents are health care professionals (nurses, doctors, midwives, technicians, etc.) working in a pandemic hospital in Turkey. We run a multivariable logistic regression model to analyze the predictors of work difficulty perception. The model is adjusted for the respondents’ demographical characteristics and emotional wellbeing. We found that depression and burnout are significantly correlated with the perception of job difficulty (OR Severe PHQ-9 = 10.8, p = 0.004; OR Severe Burnout = 7.83, p < 0.001). The professionals who are changed from one department to another are also more likely to perceive the job as difficult (OR Department Change = 1.60, p = 0.045). However, the professionals that received sufficient applause from society are more likely to think that they did not face any difficulties doing their job during the pandemic (OR Applause = 0.56, p < 0.016). Anxiety, monetary motivation, religious beliefs, and information availability did not contribute to the perceived difficulty in their jobs. Thus, efforts need to be made to give them more social support and smooth their changes in departments and functions to facilitate their jobs.

Background: This study aimed to investigate the early and longitudinal humoral response in Healthcare Workers (HCWs) after two doses of the BNT162b2 vaccine and to assess the association between metabolic and anthropometric parameters and the humoral response after vaccination., Methods: The study included 243 fully vaccinated HCWs: 25.50% previously infected with SARS-CoV-2 (with prior history of COVID-19-PH) and 74.40%-uninfected, seronegative before the first vaccination (with no prior history of COVID-19-NPH). IgG antibodies were measured, and sera were collected: prior to the vaccination, 21 days after the first dose, and 14 days and 8 months after the second dose., Results: 21 days after the first dose, 90.95% of individuals were seropositive; 14 days after the second dose, persistent immunity was observed in 99.18% HCWs, 8 months after complete vaccination-in 61.73%. Statistical analysis revealed that HCWs with PH had a greater chance of maintaining a humoral response beyond eight months after vaccination. Increased muscle mass, decreased fat mass, and younger age may positively affect long-term immunity. Smokers have a reduced chance of developing immunity compared to non-smokers., Conclusions: Fully vaccinated HCWs with PH are more likely to be seropositive than fully inoculated volunteers with NPH.

Background The exposure of health care professionals (HCP) to patients with coronavirus disease-2019 (COVID-19) in the course of performing their professional duties may expose them to contracting the virus. This may likely increase their tendency to self-medicate for prevention or treatment of perceived infection. Aim This study determined the prevalence of COVID-19 related self-medication and its determinants among HCPs in three tertiary hospitals in Southern Nigeria. Method This was a cross-sectional study that enrolled 669 adult HCPs from three tertiary hospitals in three Southern Nigerian States using a non-probability convenience sampling method. A structured self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM SPSS version 22. Results The mean age of the respondents was 35.6 ± 8.7 years. Two hundred and forty-three respondents (36.3%) reported having practiced COVID-19 related self-medication. The commonly used medications were ivermectin, azithromycin, vitamin C, chloroquine and zinc. Factors associated with self-medication were older age (p =  < 0.0001), being pharmacist (p = 0.03), higher income (p =  < 0.0001), previous COVID-19 testing (p < 0.001). Predictors of self medication were > 44 years (Adjusted Odd Ratio[AOR]:2.77,95% Confidence Interval [CI]: 1.62-4.75, p =  < 0.0001), previous COVID-19 testing (AOR = 2.68, 95% CI: 1.82-3.94, p =  < 0.0001). Conclusion About one-third of HCPs practiced COVID-19 related self-medication. HCPs that are often assumed to be health literate may not necessarily practice safe health behavior. Regular health education of the HCPs on implications of self-medications is highly recommended. There should also be formulation and effective implementation of policies that regulate purchase of medications., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Study Objectives: To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on insomnia and other sleep disturbances in health care professionals., Methods: A survey was distributed using social media and organizational emails to Brazilian active health care professionals during the COVID-19 outbreak. We explored potential associated factors including age, sex, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths, anxiety, and burnout. We evaluated new-onset/previous insomnia worsening episodes (primary outcome), new pharmacological treatments, sleep quality, duration, nightmares, and snoring (secondary outcomes)., Results: A total of 4,384 health professionals from all regions of the country were included in the analysis (44 ± 12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. The primary outcome occurred in 32.9% of respondents in parallel to 13% new pharmacological treatments for insomnia. The sleep quality worsened for 61.4%, while 43.5% and 22.8% reported ≥ 1-hour sleep duration reduction and worsening or new-onset nightmares, respectively. Multivariate analyses showed that age (odds ratio [OR]: 1.008; 95% confidence interval [CI] 1.001-1.015), females (OR: 1.590; 95% CI 1.335-1.900), weight change (decrease: OR: 1.772; 95% CI 1.453-2.161; increase: OR: 1.468; 95% CI 1.249-1.728), prevalent anxiety (OR: 3.414; 95% CI 2.954-3.948), new-onset burnout (OR: 1.761; 95% CI 1.489-2.083), family income reduction > 30% (OR: 1.288; 95% CI 1.069-1.553), and assisting patients with COVID-19 (OR: 1.275; 95% CI 1.081-1.506) were independently associated with new-onset or worsening of previous insomnia episodes., Conclusions: We observed a huge burden of insomnia episodes and other sleep disturbances in health care professionals during the COVID-19 pandemic., Citation: Drager LF, Pachito DV, Moreno CRC, et al. Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals. J Clin Sleep Med . 2022;18(2):373-382., (© 2022 American Academy of Sleep Medicine.)

Background: The COVID-19 pandemic called for rapidly considerable changes in the healthcare system. Healthcare professionals from different departments within the hospital settings were enrolled in the emergency preparedness. This study, therefore, aimed to explore the healthcare professionals' experiences attending the ICU-preparedness and caring for patients with COVID-19 during the initial stage of the pandemic., Methods: A descriptive explorative qualitative study was conducted by interviewing healthcare professionals during spring 2020, exploring their experiences as part of the ICU-preparedness team and caring for patients with COVID-19 in the ICU. Healthcare professionals from different departments were recruited by purposive sampling. The interviews were transcribed verbatim and analysed using content analysis., Findings: Sixteen nurses and four physicians from a university hospital in Denmark participated. The analysis revealed three main themes and eight sub-themes. The main themes were (1) Professionalism in work-life (adaption, the patient's welfare, insecurity, and security), (2) Community Spirit (responsibility and contribution), and (3) Institutional organisation (the role of management, loss of freedom, and information)., Interpretation: Despite work specialities and professions, the participants reported a uniformity of similar experiences of uncertainties, but also a sense of community arose during the first phase of COVID-19., Recommendations: To ensure resilience and mental health, and well-being for the healthcare professionals, comprehensive support should be provided. Guidelines for interventions and training are necessary to promote preparedness and reduce psychological stress., (Copyright © 2021. Published by Elsevier Ltd.)

Background: The outbreak of the COVID-19 pandemic greatly affected dentistry. Dental procedures are considered one of the modes of transfer of COVID-19 infection due to generation of aerosols. To prevent transmission of this virus through dental procedures, guidelines were issued by the World Health Organisation (WHO), Centers for Disease Control and Prevention (CDC) and Ministry of Health of each country., Objective: The aim of this study is to establish a safe protocol for performing dental procedures in a crisis capacity situation of personal protective equipment (PPE)., Methods: A strategy for performing the dental procedures was formulated in accordance with the guidelines provided by the Ministry of Health, Pakistan before vaccination of HCPs against COVID-19. These guidelines also accorded the strategies provided by the WHO and CDC. 40 health care professionals (HCPs) participated in the study and were divided in two groups. Group A performed non-aerosol generating procedures (non- AGPs) and group B performed aerosol generating procedures (AGPs). A total of 6372 aerosol generating procedures were performed from 1 August 2020 to 31 March 2021. The safety of this protocol was established by the number of HCPs contracting COVID-19 infection., Results: Only 1 HCP contracted COVID-19 infection preceding the AGPs from group B following the formulated strategy., Conclusion: Reported strategy based on the dental system in Pakistan is considered safe to be implemented worldwide during the COVID-19 pandemic.

Aims: This study aimed to investigate how the psychological health of health care professionals (HCP) on COVID duty was different from those who were not directly in contact. Methodology: Of 473 (76%) randomly selected respondents (doctors and nurses) to a WhatsApp request message, 450 subjects' data were finally analyzed. Result: The prevalence of stress, anxiety and depression among HCP was 33.8, 38.9 and 43.6%, respectively. Compared with nonexposed professionals, COVID-19-exposed professionals had roughly double the score of these morbidities (t = 6.3, p < 0.001; t = 6.9, p < 0.001; t = 6.0, p < 0.001). Most worry (71.11%) was about the health of their family, followed by themselves (35.55%). Conclusion: The level of exposure, feelings of uncertainty and fear of infection emerged in our study as possible risk factors for psychological morbidities among HCP.

Background: The situation of the COVID-19 global pandemic has generated an unprecedented state of emergency worldwide that has had a psychological impact on health care workers working in the ICU and this has created the need to implement different psychological strategies., Aim: This study explores (a) the prevalence of symptoms associated with generalized anxiety disorder (GAD), (b) the relationship between GAD symptoms and resilience skills, and (c) which of the resilience skills were associated with a probable GAD among the ICU professionals during the COVID-19 pandemic., Study Design: Cross-sectional survey design., Methods: We explored anxiety and resilience in 448 ICU health care workers using an online survey., Results: The participants showed high resilience levels and more than half of them presented symptoms consistent with a possible diagnosis of GAD. The GAD symptoms were more prevalent among women, nursing assistants, interns, staff who worked on rotation and health care workers who had to attend to more than 20 COVID patients. Significant negative correlations between resilience skills and GAD symptoms were found. The multiple regression analysis showed that resilience skills contribute to 14.4% of the variance for GAD symptoms. The binary logistic regression showed that the only skill that had a significant and negative predictive effect was "I usually take things in my stride" (OR = 0.774, 95% CI 0.67, 0.88; P = .000). This ability was the differentiating skill between professionals who equal or exceed the cut-off point established for the diagnosis of a probable GAD regarding those who do not., Conclusion: ICU professionals developed symptoms consistent with a possible diagnosis of GAD due to their exposure to extremely stressful circumstances. However, resilience skills acted as a protective factor., Relevance to Clinical Practice: The importance of incorporating programmes that mitigate these psychological effects and to promote adaptive coping styles during pandemics has become a need after what ICU professionals have gone through., (© 2021 The Authors. Nursing in Critical Care published by John Wiley & Sons, Ltd on behalf of British Association of Critical Care Nurses.)

Background: The COVID-19 pandemic has affected populations worldwide, with extreme health, economic, social, and political implications. Health care professionals (HCPs) are at the core of pandemic response and are among the most crucial factors in maintaining coping capacities. Yet, they are also vulnerable to mental health effects caused by managing a long-lasting emergency with a lack of resources and under complicated personal concerns. However, there are a lack of longitudinal studies that investigate the HCP population., Objective: The aim of this study was to analyze the state of mind of HCPs as expressed in online discussions published on Twitter in light of the COVID-19 pandemic, from the onset of the pandemic until the end of 2020., Methods: The population for this study was selected from followers of a few hundred Twitter accounts of health care organizations and common HCP points of interest. We used active learning, a process that iteratively uses machine learning and manual data labeling, to select the large-scale population of Twitter accounts maintained by English-speaking HCPs, focusing on individuals rather than official organizations. We analyzed the topics and emotions in their discourses during 2020. The topic distributions were obtained using the latent Dirichlet allocation algorithm. We defined a measure of topic cohesion and described the most cohesive topics. The emotions expressed in tweets during 2020 were compared to those in 2019. Finally, the emotion intensities were cross-correlated with the pandemic waves to explore possible associations between the pandemic development and emotional response., Results: We analyzed the timelines of 53,063 Twitter profiles, 90% of which were maintained by individual HCPs. Professional topics accounted for 44.5% of tweets by HCPs from January 1, 2019, to December 6, 2020. Events such as the pandemic waves, US elections, or the George Floyd case affected the HCPs' discourse. The levels of joy and sadness exceeded their minimal and maximal values from 2019, respectively, 80% of the time (P=.001). Most interestingly, fear preceded the pandemic waves, in terms of the differences in confirmed cases, by 2 weeks with a Spearman correlation coefficient of ρ(47 pairs)=0.340 (P=.03)., Conclusions: Analyses of longitudinal data over the year 2020 revealed that a large fraction of HCP discourse is directly related to professional content, including the increase in the volume of discussions following the pandemic waves. The changes in emotional patterns (ie, decrease in joy and increase in sadness, fear, and disgust) during the year 2020 may indicate the utmost importance in providing emotional support for HCPs to prevent fatigue, burnout, and mental health disorders during the postpandemic period. The increase in fear 2 weeks in advance of pandemic waves indicates that HCPs are in a position, and with adequate qualifications, to anticipate pandemic development, and could serve as a bottom-up pathway for expressing morbidity and clinical situations to health agencies., (©Aviad Elyashar, Ilia Plochotnikov, Idan-Chaim Cohen, Rami Puzis, Odeya Cohen. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.10.2021.)

Aims: To analyse the relationship between work engagement, sense of coherence and psychological distress levels in Spanish health professionals who were active during the COVID-19 pandemic lockdown., Background: Work engagement and sense of coherence can help professionals to cope with work-related psychological distress due to the harsh conditions of the COVID-19 working environment., Methods: Cross-sectional observational study of 1,459 health care professionals. The Utrecht Work Engagement Scale, the Sense of Coherence Scale and Goldberg's General Health Questionnaire were distributed and analysed with descriptive and multiple linear regression methods., Results: High levels of work engagement, especially in the dedication dimension, of sense of coherence, in particular in the meaningfulness dimension, and psychological distress were obtained. Significant correlations (p < .001) were identified between all the variables., Conclusions: Work engagement and sense of coherence correlated positively with each other and both negatively with psychological distress. So, health care professionals, despite presenting psychological distress, perceive their work satisfactorily and positively despite the severity of the situation and the harsh conditions., Implications for Nursing Management: Sense of coherence and work engagement are protective factors against psychological distress. Preventive measures for professionals should go through the dimensionalization of the problem and the adaptation of practical measures for daily management., (© 2021 John Wiley & Sons Ltd.)

Online surveys of health professionals have become increasingly popular during the COVID-19 crisis because of their ease, speed of implementation, and low cost. This article leverages an online survey of general practitioners' (GPs') attitudes toward the soon-to-be-available COVID-19 vaccines, implemented in October-November 2020 (before the COVID-19 vaccines were authorized in France), to study the evolution of the distribution of their demographic and professional characteristics and opinions about these vaccines, as the survey fieldwork progressed, as reminders were sent out to encourage them to participate. Focusing on the analysis of the potential determinants of COVID-19 vaccine acceptance, we also tested if factors related to survey participation biased the association estimates. Our results show that online surveys of health professionals may be subject to significant selection bias that can have a significant impact on estimates of the prevalence of some of these professionals' behavioral, opinion, or attitude variables. Our results also highlight the effectiveness of reminder strategies in reaching hard-to-reach professionals and reducing these biases. Finally, they indicate that weighting for nonparticipation remains indispensable and that methods exist for testing (and correcting) selection biases.

Trauma is a major global health problem. Currently a trauma curriculum, from a psychological perspective, has not been uniformly incorporated in medical education. Nonetheless, professionals from various medical disciplines have an integral role in providing trauma care to survivors. The current COVID-19 pandemic only underscores the relevance and urgent need of this training, as studies show an uptick in mental health disorders due to this trauma. This article will present a discussion on the need for trauma curriculum for health care professionals, using information gained through trauma informed care workshops for healthcare personnel at Aga Khan University Hospital Pakistan., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: COVID-19 has spread widely among health care workers. Oral health care workers have an increased risk of being infected owing to dental practice characteristics. New, effective vaccines against COVID-19 have been approved for use. The authors aim was to evaluate intentions to be vaccinated against COVID-19 in a population of dentists and identify factors associated with their intentions., Methods: The authors conducted an anonymous online survey among 761 dentists enrolled at the Board of Physicians and Dentists of the District of Monza Brianza, Monza, Italy. The authors collected data on demographic characteristics, influenza vaccine uptake, COVID-19 history, vaccine attitudes, and specific reasons for their intentions to be vaccinated against COVID-19 or not., Results: Overall, 421 dentists completed the survey. More than 82% of the participants declared their intention to be vaccinated against COVID-19. The multivariate logistic regression model reported a positive association with receiving the influenza vaccine in the 2020-2021 influenza season (odds ratio, 5.15; 95% CI, 2.14 to 12.39) and a negative association with receiving a diagnosis of COVID-19 previously (odds ratio, 0.32; 95% CI, 0.15 to 0.66). The participants' main reason for supporting vaccination was to protect their family and friends (87%) and their main reason for opposing vaccination was the lack of information (39%)., Conclusions: It is fundamental to consider vaccine hesitancy in health care workers and address it properly because they must provide recommendations to patients and promote adherence to vaccination programs., Practical Implications: The vaccination of dental practitioners should be prioritized owing to the high risk related to dental practice., (Copyright © 2021 American Dental Association. Published by Elsevier Inc. All rights reserved.)

We examined the manifestation of major depressive disorder, generalized anxiety disorder, substance use disorder, post-traumatic stress disorder, and panic attacks among health care professionals during the first COVID-19 wave (n = 6409) by means of mental disorder screening instruments. Logistic regressions were used to gauge individual risk factors; population attributable risk proportions (PARP) were inferred to identify the most important risk factors at the societal level. Data were weighted to represent general profiles of Belgian health care professionals. Lifetime, pre-pandemic emotional problems and work-related factors during the first wave of COVID-19 were strongly associated (mean adjusted odds ratios of 3.79 and 1.47, respectively) with positive screens for current mental disorders (occurrence of 29.3%). Most prominently, the data suggest that disruptions of work-life balance account for more than a quarter of the observed mental health problems due to the combination of widespread occurrence and strong association., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Aims: To describe the level of work engagement of active health care professionals during the COVID-19 pandemic, and its relationship with psychological distress according to the professional category., Background: Health care professionals working on the front line of the COVID-19 pandemic are at risk of psychological distress, and work engagement could be a positive attitude that could serve as a protective factor., Methods: Cross-sectional observational study of 1,459 health care professionals. Psychological distress was measured with the General Health Questionnaire and work engagement with the Utrecht Work Engagement Scale. Data were analysed with bivariate analyses and correlations., Results: Psychological distress was reported by 80.6% of health care professionals. Work engagement as high with a total mean score of 5.04 (SD = 1.14). The results showed that distressed professionals showed significantly lower levels of work engagement., Conclusions: The present study identified psychological distress and work engagement experienced by health care professionals during the COVID-19 pandemic. Most of the variables included in the study revealed a significant relationship with psychological distress and work engagement., Implications for Nursing Management: The relationship between the working conditions with psychological distress and work engagement suggests that improvements in the workplace are needed to promote protective measure for the mental health of health care professionals., (© 2021 John Wiley & Sons Ltd.)

Background: The COVID-19 outbreak has imposed physical and psychological pressure on health care professionals, including frontline physicians. Hence, evaluating the mental health status of physicians during the current pandemic is important to define future preventive guidelines among health care stakeholders., Objective: In this study, we intended to study alterations in the mental health status of Portuguese physicians working at the frontline during the COVID-19 pandemic and potential sociodemographic factors influencing their mental health status., Methods: A nationwide survey was conducted during May 4-25, 2020, to infer differences in mental health status (depression, anxiety, stress, and obsessive compulsive symptoms) between Portuguese physicians working at the frontline during the COVID-19 pandemic and other nonfrontline physicians. A representative sample of 420 participants stratified by age, sex, and the geographic region was analyzed (200 frontline and 220 nonfrontline participants). Moreover, we explored the influence of several sociodemographic factors on mental health variables including age, sex, living conditions, and household composition., Results: Our results show that being female (β=1.1; t=2.5; P=.01) and working at the frontline (β=1.4; t=2.9; P=.004) are potential risk factors for stress. In contrast, having a house with green space was a potentially beneficial factor for stress (β=-1.5; t=-2.5; P=.01) and anxiety (β=-1.1; t=-2.4; P=.02)., Conclusions: It is important to apply protective mental health measures for physicians to avoid the long-term effects of stress, such as burnout., (©Sónia Ferreira, Mafalda Machado Sousa, Pedro Silva Moreira, Nuno Sousa, Maria Picó-Pérez, Pedro Morgado. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 09.06.2021.)

Background: Home palliative care services have played an essential role during the first wave of the SARS-CoV-2 outbreak by providing symptom control, drug procurement, and psychological support for frail patients and their families unable to leave their homes., Aim: To understand how home palliative care professionals were affected by the outbreak, describing changes and challenges in their daily work as well as their reactions to the Covid-19 pandemic in Italy., Design: Qualitative study conducted using telephone semi-structured interviews, with thematic analysis., Setting/participants: Thirty home care professionals working for an Italian non-profit organization which provides home palliative care for cancer patients and their families., Results: Three main themes were identified. The first theme showed both patient-related and practice-related challenges participants faced in their daily work, requiring the implementation of different communication methods and patient and family education on risk prevention. The second theme showed the perception of increased responsibility and being the only landmark for family played a decisive role in participants' positive attitude. The third theme highlighted the participants' perception of the critical role of a home care setting in this emergency situation., Conclusions: The first wave of the Covid-19 pandemic brought many challenges and stressors for home palliative care professionals. On the other side, they reported a satisfaction with their critical role in carrying out their work with patients at risk.

The novel coronavirus (COVID-19) has necessitated many healthcare workers operating on the frontlines. Another segment of the population whose mental well-being is being tested are the 'other essential workers' (e.g. supermarket workers). The current study aimed to compare the mental health of healthcare versus other essential workers in the early stages of the COVID-19 outbreak. The COVID-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project is a nationwide online mental health survey launched on 1 April 2020, aimed at identifying key mental health concerns. Adults currently living in Australia were invited to take part, and non-discriminative snowball sampling was employed. Participants were partitioned into healthcare workers (HCW; n=905), other essential workers (OEW; n=810), and the general population (GNP; n=3443). Across all groups, top COVID-19 related concerns were primarily associated with the health and well-being of loved ones. In terms of current levels of depression, anxiety, stress and quality of life, HCWs fared the best, and OEWs fared the worst (with the GNP falling in between). In the face of this medical crisis, Australian HCWs seem to be managing their mental health relatively well, but more supports need to be devoted to OEWs to safeguard their mental well-being., (Copyright © 2021. Published by Elsevier B.V.)

Background: Little is known about clinical staff's perspectives on preparedness for a pandemic. The purpose of this study was to obtain various clinical staff perspectives about preparedness to meet the demands for care during the early phase of the SARS-CoV-2 (COVID-19) pandemic., Methods: We conducted a qualitative study using semistructured in-person interviews from March 2020 to April 2020 at a large tertiary academic urban hospital center. Interview guides were informed by the Resilience Framework for Public Health Emergency Preparedness and analyzed using a directed content analysis approach., Results: Fifty-five clinical staff participated in the study. Three themes emerged from the data (1) Risk assessment and planning: "The powder keg," (2) Innovative evolution of roles and responsibilities, and (3) Pandemic response and capacity. In the early phases of the pandemic, participants reported varying levels of risks for dying. However, most participants adapted to practice changes and became innovative in their roles over time. Hierarchies were less relevant during care delivery, whereas team collaboration became crucial in managing workforce capacity., Discussion: As the pandemic progressed, staff preparedness evolved through a trial-and-error approach., Conclusions: The pandemic is evolving as is clinical staff preparedness to meet the demands of a pandemic. In order to get a grasp on the crisis, clinical staff relied on each other and resorted to new workarounds., (Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Emerging evidence has indicated a negative and disproportionate impact of COVID-19 on Black, Asian, and minority ethnic (BAME) communities. Previous studies have already reported that biological and social risk factors increase disease susceptibility, particularly in BAME communities. Despite frontline workers in ethnic minority communities in the United Kingdom's National Health Service attempting to quell the pandemic, disproportionate numbers of BAME physicians and other health care workers have died of COVID-19. This unprecedented situation highlights ethical and moral implications, which could further augment the impact of the pandemic on their mental health. While the government attempts to mitigate the rate of virus transmission, certain key factors inadvertently augment the negative impact of the pandemic on the mental health and general well-being of BAME communities. This study examined the available literature to explore the association between, and the wider impact of, COVID-19 on BAME communities. Furthermore, this study aims to raise awareness and provide a deeper insight into current scientific discussions., (©Peter Phiri, Gayathri Delanerolle, Ayaat Al-Sudani, Shanaya Rathod. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 01.02.2021.)

Background: COVID-19 is a terrific pandemic and a potential risk for every health care professional (HCP), especially during emergency conditions where the right timing is essential for the correct treatment. During surgery the correct setting of operative room (OR) is mandatory to reduce the risk of contamination. Personal protection equipment (PPE), specific devices, and planned OR setting are essential during surgery in pandemic COVID-19. Methods: Medline, PubMed, Scientific societies recommendations, and guidelines were consulted to identify articles reporting the setup of OR during pandemic COVID-19. Results: OR must have a high-efficiency particulate air (HEPA) filter with negative pressure and a high air exchange cycle rate. Every supply kit should be packed and placed in the OR before patient arrival. A detailed checklist of equipment and devices is necessary. Personal PPE at the highest level should be provided to every HCP (Association of the Advancement of Medical Instrumentation [AAMI]-Level-III surgical gowns; double latex-free gloves with Acceptable Quality Level <1.0; FFP3 or powered air-purifying respirator masks with face shield). Anesthesia should be performed with a rapid sequence intubation. During surgery energy devices should be settled to the lower level in combination with a smoke evacuation switch pen with disposable smoke evacuation HEPA filter to minimize surgical smoke spread. During laparoscopy low pneumoperitoneum pressures and aspiration systems must be provided. Conclusions: Emergency surgery during pandemic COVID-19 increases the risk for every HCP in the OR. A theoretical risk of transmission from the surgical field exists. It is mandatory the adoption of strong strategies to reduce the risk of contamination in the OR.

With a rise in personal protective equipment (PPE) use by all healthcare professionals (HCP) as a prime infection control strategy in the wake of the COVID-19 pandemic comes the potential increase in its misuse. Evidence suggests this failure to follow proper PPE protocol to prevent self-contamination and transmission can be attributed to both a lack of formal training and guidance and, now, atrophy of infrequently used skills, with many senior professionals demonstrating a lack of proficiency despite years of service. Previous research shows current written and illustrated instructional material depicting PPE guidelines are abundant but does not provide an answer on how best to target violations in protocol and better instruct those that are providing pre-hospital emergency healthcare.In this chapter, we aim to address the gap in paramedic-specific research into PPE protocol and provide an educational, digital tool to work alongside the current guidelines, potentially exploring the cognitive load theory as a design strategy. The use of 3D, interactive animations depicting errors in protocol and their potential contamination consequences in a device-based application could engage clinicians in a more effective way, thus increasing protection and decreasing transmission. This chapter describes the methodology behind the design and development of such an application for emergency care providers and provides the relevant materials needed to carry out user testing and evaluation once participants have been recruited., (© 2021. The Author(s), under exclusive license to Springer Nature Switzerland AG.)