ABSTRACT
Background@#Studies show that healthcare workers from previous pandemics have experienced high levels of stress, anxiety with negative psychological impacts. This paper aims to identify factors affecting mental health outcomes of healthcare workers during Coronavirus Disease (COVID-19) pandemic.@*Methods@#A cross-sectional design was used to determine factors affecting mental health outcome of healthcare workers with direct contact to patients with COVID-19. Depression, anxiety and distress were measured by the nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder scale, and 22-item Impact of Event Scale–Revised, respectively. Binomial multiple logistic regression model was used to identify the factors associated with mental health outcome.@*Results@#172 healthcare workers were included. Prevalence of depression, anxiety and distress symptoms among all healthcare workers were 57%, 47.7%, 65.1%, respectively. Age and living with a family with comorbidities are significantly associated with depression and anxiety. Healthcare workers aged 31 years and above are 70% less likely to have depression symptoms (OR 0.278, CI 95%, 0.11-0.72 p=0.008 and OR 0.273, CI 95%, 0.12-0.61, p=0.002). Those living with relatives with comorbidities are 2.7 times more likely to experience depression symptoms (OR 2.731, CI 95%, 1.36-5.5, p=0.005). Healthcare workers age 31-40 years has 80% less likely to experience anxiety symptoms (OR 0.212, CI 95%, 0.09-0.5, p<0.001), and those age 41 and above have 73% less likely to have anxiety symptoms (OR 0.37, CI 95%, 0.14-0.98, p<0.045). Those living with relatives with comorbidities are 2.9 times more likely to have anxiety symptoms (OR 2.889, CI 95%, 1.46-5.73, p=0.002). Level of knowledge on COVID-19 among health care workers significantly differs across severity but has no significant association with prevalence of depression. No factors were associated with distress symptom.@*Conclusion@#Cognizant of high rates of depression, anxiety and distress among our younger healthcare workers living with relatives with comorbidities will be a challenge to establish and/or improve existing programs to promote and address mental health needs. Psychological stress can accumulate over time and have an impact later in the outbreak which should be investigated in future studies.
Subject(s)
Health Personnel , COVID-19ABSTRACT
Introduction@#It is important to wean mechanically-ventilated patients as early as possible to avoid complications such as ventilator-associated pneumonia. Supplementing the diet with additional protein may help to stimulate muscle protein synthesis which may enhance respiratory muscle function and ventilator drive. This study aims to determine the effect of whey protein supplementation on the duration of mechanical ventilation in intensive care unit patients of Ospital ng Makati.@*Methods@#We enrolled forty eligible patients in this openlabel randomized controlled trial and were assigned into two groups: Group A (N=20): patients were given enteral feeding using commercial formula with added whey protein, given as one serving every eight hours (equivalent to 18 g of additional protein per day) and Group B (N=20): patients were given enteral feeding using commercial formula alone. Weaning was started as soon as the patient fulfilled the criteria of spontaneous breathing trial and was considered successful if the patient maintained these criteria for 48 hours after extubation.@*Results@#Our study’s results showed that the mechanically intubated patients in Group A have lesser ventilatordependent days with an average of 5.4 days as compared to those in Group B with an average of 7.45 days (p=0.00). Patients in Group A were also noted to have statistically significant higher increase in serum albumin, mid-arm circumference and triceps skin fold from baseline. Twentyfive percent of patients in Group B developed ventilator acquired pneumonia and none in Group A. No mortality was noted in both groups.@*Conclusion@#Whey protein supplementation in mechanically ventilated patients can be recommended to facilitate early weaning because of its effect on early muscle protein synthesis leading to improvement of lung function and ventilator drive. It can also help in preventing malnutrition and nosocomial infections during critical illness. With all these benefits of whey protein, its use can potentially lead to shorter duration of mechanical ventilation and hospital stay which can also mean less cost of care delivery.