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Background: The global pandemic raised ethical issues for nurses about caring for all patients, not just those with COVID-19. Italy was the first European country to be seriously affected by the first wave, while Estonia's infection and death rates were among the lowest in Europe. Did this raise different ethical issues for nurses in these two countries as well? Aim: The aim was to describe and compare ethical issues between nurses working during the first wave of the COVID-19 pandemic in Estonia and Italy. Research design: A cross-sectional survey study with a self-administered questionnaire. The impact of COVID- 19 emergency on nursing care questionnaire was used. Participants and research context: Convenience sampling was used to recruit 1098 nurses working during the first wave of the pandemic in 2020: 162 from Estonia and 936 from Italy. Ethical considerations: Research ethics approvals were obtained, and the nurses provided informed consent. Results: The most frequent ethical issues for Estonian nurses were professional communication and ensuring access to care for patients without COVID-19, and for Italian nurses, the end-of-life care and the risk of them getting the virus and transmitting it to their loved ones. There were no statistically significant differences in the frequency of ethical issues between Estonian nurses working with patients with and without COVID-19. Italian nurses caring for COVID-19 patients faced statistically significantly more (both p <.001) issues around prioritising patients and end-of-life. Nurses working with patients without COVID-19 in Italy faced more issues about access to care (p <.001). Conclusions: Estonian and Italian nurses, working in different clinical contexts during the first wave of the pandemic, faced different ethical issues. Local contextual aspects need to be considered to support nurses' ethical decision-making in providing care during future crises and to ensure ethical care for patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe and evaluate how nurses caring for COVID and non‐COVID patients assess changes in their work and in nursing activities during the two waves of the COVID‐19 pandemic. Methods: Two cross‐sectional surveys were conducted for Estonian nurses working during the first and second waves of the COVID‐19 pandemic, using The impact of COVID‐19 emergency on nursing care questionnaire. Based on convenience sampling, the data were collected among the members of professional organizations, unions and associations. Responses from the first (n = 162) and second wave (n = 284) were analysed using descriptive statistics, Fisher's exact test and McNemar's test. Results: The COVID‐19 pandemic changed the working context during both waves for nurses caring for COVID and non‐COVID patients. Changes were considered to a greater extent during the second wave, when Estonia was severely affected, and by nurses caring for COVID patients. During the second wave, the number and complexity of patients increased, and nurses caring for COVID patients performed fundamental care, nursing techniques and symptom control significantly more frequently compared to nurses caring for non‐COVID patients. Conclusion: Taking care of COVID patients is demanding, requiring nurses to perform more direct patient care. However, the pandemic also increased the frequency of activities not related with direct patient care. Summary statement: What is already known about this topic? The COVID‐19 pandemic has influenced the context of care and all dimensions of nurses' work.Despite increasing research on the impact of the COVID‐19 pandemic on nursing care, little attention has been given to differences between caring for COVID and non‐COVID patients during the different waves of the COVID‐19 pandemic. What this paper adds? Nursing care for COVID patients requires from nurses more direct patient care through fundamental care activities, nursing techniques and symptom control compared to non‐COVID patients.The impact of the COVID‐19 pandemic on nurses' work reflects the severity and progress of different waves of the pandemic, which needs to be considered in preparing for future pandemics.Nursing care during a pandemic may also lead to an extensive workload due to tasks not related to direct patient care as nurses contribute to the management of the pandemic on all levels of health care. The implications of this paper: The COVID‐19 pandemic has had a significant impact on nursing, where the mitigation of long‐term effects of the pandemic is still ongoing, and thus, knowledge about the details of the resulting changes is required.Study findings enable us to mitigate the impact of the pandemic on nurses and to highlight aspects that need to be taken into account when preparing for future pandemics. [ABSTRACT FROM AUTHOR]

The objectives of this study were to find out how motivated depressed patients are to exercise regularly, to measure the physical activity of depressed patients and to find out how regular Nordic Walking affects the mood and physical fitness of depressed patients. A cross-sectional study was carried out. Three years after the Prediction of Primary Episodes of Depression in Primary Medical Care study, telephone calls were made to 178 patients who had had depression during that study. We enquired whether and why they would be interested in starting regular Nordic Walking three times a week, at least 30 min at a time, for 24 weeks. Furthermore, there were questions about the patients' earlier physical activity. The Composite International Diagnostic Interview was used to assess depression. To measure physical fitness, we used an outdoor 2 km walking test. Altogether, 106 patients were interviewed, 48 (45%) of them were depressed and 58 (55%) were nondepressed. Of the depressed patients, 16, and of the nondepressed patients, five, started the training programme. During the past 2 years, 12 of the patients had not had any regular physical activity. One-fourth of the depressed patients completed the study. Mean fitness index was 21.99 plus or minus 20.38 at week 0 and 38.72 plus or minus 26.12 at week 24. The feedback of the patients and their families to the programme was positive. Depressed patients in family practice were physically inactive. About one-third of the depressed patients were motivated to start regular physical activity. Nordic Walking increased the patients' physical activity and improved their mood.

Background: The shortage of GPs is a worldwide phenomenon, which encourages the migration of GPs and consequently exacerbates the GP shortage. This shortage imposes a threat for the entire healthcare system. Aim: To explore the driving forces of GPs' migration in Europe and their reasons to stay in the new country, to migrate further, or to return to their home country. Design & setting: An exploratory, qualitative study of European GPs who have migrated within Europe. Method: Individual interviews were conducted until data saturation and audio-recordings were transcribed. Thematic analysis was performed using NVivo. Results: Fifteen interviews with GPs from eight different European countries were conducted. The reasons why European GPs migrate and decide to stay or to leave were grouped under the following three themes: professional development; personal reasons; and the situation in the home country or the organisation of health care. New professional challenges, better working environment, and higher quality training programmes were mentioned as the main reasons for migration. Personal reasons, such as family's satisfaction with the living environment, closeness to other family members, and financial considerations, seemed to influence the decision to stay or leave the most. Conclusion: Migration caused by dissatisfaction with the working and living environment is something countries could potentially work on in order to retain their GPs. As some countries in Europe rely more and more on international recruitment to combat the GP shortage, which in turn worsens the situation in other countries, a more unified Europe-wide approach to GP shortage and migration is needed. [ABSTRACT FROM AUTHOR]