Psychological distress among South African healthcare workers during the COVID-19 pandemic

Background: The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). Objectives: This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. Method: The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. Results: A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. Conclusion: Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs. Contribution: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.

Workplace health promotion programs among health workers: a systematic literature review

Objective: To identify the effect of workplace health promotion activities (WHPA) on the health status of health personnel. Methodology: A systematic literature review was performed. Six computerized databases were used to search for studies on the effect of at least one health promotion activity on the health status of health personnel. Studies were included if they were published in peer-reviewed and indexed journals and were written either in English, Spanish, or Portuguese. Information such as study population, sample size, type of study, outcome, and health promotion activities performed were extracted from each publication. All the included articles were measured in terms of their methodological quality, including the risk of bias. Results: Lower scores on perceived stress, emotional exhaustion, and mood symptoms were reported. An improvement in sleep hours and quality and a reduction in dietary sodium intake were informed. Improvements in participants' dietary habits, weight loss, and body fat percentage, along with increased physical activity and a reduction in pain levels were reported. A reduction in the prevalence of cigarette smoking was found. Conclusions: WHPAs can enhance physical and mental health, and overall well-being, and encouraging healthier behaviors among health personnel. Most of the studies targeting mental health focused their efforts primarily on reducing healthcare workers' perceived stress. WHPAs that addressed both diet and physical activity behaviors were more effective at improving weight outcomes than those that used only one approximation. Overall, this study offers valuable information on the impact of worksite-based health promotion interventions, including the effect of different strategies applied.

Objetivo: Identificar el efecto de las actividades de promoción de la salud en el lugar de trabajo (APST) sobre el estado de salud del personal sanitario. Metodología: Se realizó una revisión sistemática de la literatura. Se utilizaron seis bases de datos computarizadas para buscar estudios sobre el efecto de al menos una actividad de promoción de la salud en el estado de salud del personal sanitario. Se incluyeron los estudios publicados en revistas revisadas por pares e indexadas y escritos en inglés, español o portugués. De cada publicación se extrajo información como la población del estudio, el tamaño de la muestra, el tipo de estudio, el resultado y las actividades de promoción de la salud realizadas. Se analizaron todos los artículos incluidos en términos de su calidad metodológica, teniendo en cuenta el riesgo de sesgo. Resultados: Se registraron puntuaciones menos elevadas en el estrés percibido, agotamiento emocional y alteración del estado de ánimo. Se informó de una mejoría en las horas y la calidad del sueño, y de una reducción de la ingesta de sodio en la dieta. Se registraron mejorías en los hábitos alimentarios de los participantes, pérdida de peso y porcentaje de grasa corporal, así como un aumento de la actividad física y una reducción de los niveles de dolor. Se observó una reducción de la prevalencia del tabaquismo. Conclusiones: Las AMPS pueden mejorar la salud física y mental, así como el bienestar general, y fomentar comportamientos más saludables entre el personal sanitario. La mayoría de los estudios dirigidos a la salud mental centraron sus esfuerzos principalmente en reducir el estrés percibido por el personal sanitario. Las AMPS que abordaron tanto los comportamientos relacionados con la alimentación como con la actividad física fueron más eficaces a la hora de mejorar los resultados en cuanto al peso que las que sólo utilizaron una aproximación. En general, este estudio ofrece información valiosa sobre el impacto de las intervenciones de promoción de la salud en el lugar de trabajo, así como el efecto de las distintas estrategias aplicadas

Objetivo: Identificar o efeito das atividades de promoção da saúde no local de trabalho (APST) sobre o estado de saúde do pessoal sanitário. Metodologia: Realizou-se uma revisão sistemática da literatura. Utilizaram-se seis bases de dados computadorizadas para procurar estudos sobre o efeito de pelo menos uma atividade de promoção da saúde no estado da saúde do pessoal sanitário. Incluíram-se os estudos publicados em revistas revisadas por pares e indexadas e escritos em inglês, espanhol ou português. De cada publicação coletou-se informação como a população do estudo, o tamanho da amostra, o tipo de estudo, o resultado e as atividades de promoção da saúde realizadas. Analisaram-se todos os artigos incluídos em termos de sua qualidade metodológica, levando em consideração o risco de viés. Resultados: Registraram-se números menos elevados no estresse percebido, esgotamento emocional e alteração do estado de ânimo. Foi informada uma melhora nas horas e na qualidade do sono, e uma redução da ingesta de sódio na dieta. Registraram-se melhoras nos mejorías en los hábitos alimentarios de los participantes, pérdida de peso y porcentaje de grasa corporal, así como un aumento de la actividad física y una reducción de los niveles de dolor. Se observó una reducción de la prevalencia del tabaquismo. Conclusiones: Las APST pueden mejorar la salud física y mental, así como el bienestar general, y fomentar comportamientos más saludables entre el personal sanitario. La mayoría de los estudios dirigidos a la salud mental centraron sus esfuerzos principalmente en reducir el estrés percibido por el personal sanitario. Las APST que abordaron tanto los comportamientos relacionados con la alimentación como con la actividad física fueron más eficaces a la hora de mejorar los resultados en cuanto al peso que las que sólo utilizaron una aproximación. En general, este estudio ofrece información valiosa sobre el impacto de las intervenciones de promoción de la salud en el lugar de trabajo, así como el efecto de las distintas estrategias aplicadas.

Condições de trabalho e biossegurança dos profissionais de saúde e trabalhadores invisíveis da saúde no contexto da COVID-19 no Brasil / Work conditions and biosafety of health professionals and invisible health workers in the context of COVID-19 in Brazil

Resumo O artigo versa sobre as condições de trabalho na saúde no contexto da pandemia no Brasil. Trata-se de estudo transversal que utilizou dados de recorte das pesquisas "Condições de trabalho dos profissionais de saúde no contexto da Covid-19 no Brasil" e "Os Trabalhadores invisíveis da saúde: condições de trabalho e saúde mental no contexto da Covid-19 no Brasil", objetivando conhecer as condições de trabalho e a biossegurança desses dois contingentes profissionais distintos e desiguais, socialmente. A análise dos dados comprova que as condições de trabalho foram extremamente afetas em função da infraestrutura inadequada, trabalho extenuante, biossegurança em risco, exaustão, medo da contaminação e da morte, fortes sinais de esgotamento físico e mental entre os trabalhadores. Aponta também para discriminação e desigualdades de direitos sociais e de valorização profissional que demarcam os mundos do trabalho apontados nas pesquisas, enfatizando as profundas desigualdades existentes no Brasil e em suas regiões. Conclui-se mostrando a importância de formulação de políticas públicas no âmbito da gestão do trabalho no SUS que assegurem a proteção, valorização e redução das desigualdades apontadas no artigo.

Abstract The present article addresses the work conditions in health in the context of the COVID-19 pandemic in Brazil. This is a cross-sectional study that used data from the surveys "Working conditions of healthcare professionals in the context of Covid-19 in Brazil" and "Invisible healthcare workers: work conditions and mental health in the context of Covid-19 in Brazil", seeking to better understand the working conditions and biosafety of these two distinct and socially unequal professional contingents. Data analysis proves that work conditions were extremely affected due to inadequate infrastructures, strenuous work, biosecurity at risk, exhaustion, fear of contamination and death, strong signs of physical and mental exhaustion, among workers. It also points out the discrimination and inequalities of social rights and professional development that mark the worlds of work highlighted in the surveys, emphasizing the profound inequalities that exist in Brazil and in its regions. It concludes by showing the importance of formulating public policies within the scope of work management in SUS, which ensures the protection, appreciation and reduction of inequalities pointed out in this article.

Burnout levels and associated factors among Intensive Care Unit workers during the first wave of the COVID-19 pandemic in Chile: A cross-sectional study / Niveles de Burnout y factores asociados en trabajadores de la unidad de cuidados intensivos en la primera ola de la pandemia COVID-19 en Chile: estudio transversal

Introduction The COVID-19 pandemic resulted in an unpredictable healthcare crisis with a high psychological burden on healthcare workers. Objective To evaluate burnout levels and their associated demographics and occupational factors among intensive care unit healthcare workers during the COVID-19 pandemic in a single hospital in the city of Temuco, Chile. Methods A cross-sectional design in which a sociodemographic questionnaire and the Maslach Burnout Inventory for Human Services were sent to health care workers in a single Chilean Intensive Care Unit during the pandemic COVID-19. Burnout levels, demographic, and occupational factors are reported using descriptive statistics; correlations between burnout levels and demographic-occupational factors were analyzed using Spearman's and rank-biserial correlation coefficients; and multiple linear stepwise regression was used to assess the contribution of demographic and occupational factors to participants' burnout levels. Results A total of 84 participants (46 women and 38 men) were included in the analysis. Depersonalization and low personal accomplishment were evidenced in 95.2% and 98.8% of the intensive care unit healthcare workers, respectively. Emotional exhaustion was positively correlated with having children ( = 0.72; < 0.01). Age ( = 0.79; < 0.05), sex ( = 0.30; < 0.05), and prior experience in intensive care unit facilities ( = 0.71; < 0.05) were correlated with depersonalization. Feeling of personal accomplishment was positively correlated with with sex ( = 0.70; < 0.05) and type of work shift ( = 0.29; < 0.01). Conclusions The intensive care unit healthcare workers in this study reported high levels of depersonalization and low feelings of personal accomplishment during an advanced stage of the COVID-19 pandemic. Older age, being female, having children, having intensive care unit experience, and working at 4th shift were factors related to burnout dimensions.

Prevalencia de anticuerpos contra SARS-CoV-2 en pacientes con cáncer y trabajadores de la salud vacunados con dos dosis de BNT162b2 o AZD122. Análisis de propensión / Prevalence of SARS-CoV-2 antibodies in cancer patients and healthcare workers vaccinated with two doses of BNT162b2 or AZD122. A propensity analysis

Resumen Antecedentes: La vacunación es la intervención más efectiva para reducir la carga de enfermedad por SARS-CoV-2; sin embargo, persisten brechas en el conocimiento en relación con la respuesta inmunológica de los pacientes con cáncer (PC). Objetivos: Evaluar la respuesta humoral (anticuerpos anti-S) en PC y trabajadores de salud (TS) vacunados con dos dosis de la vacuna BNT162b2 o AZD122. Material y métodos: Se cuantificaron anticuerpos poliespecíficos contra la proteína de espiga de SARS-CoV-2 (anti-S) y se efectuó una puntuación de propensión 1:1 para equilibrar las características basales. Se realizaron regresiones logísticas múltiples para evaluar el efecto de las variables relacionadas con la respuesta humoral. Resultados: Se incluyeron 127 PC (22 %) y 439 TS (78 %). Ambas poblaciones desarrollaron anticuerpos anti-S en respuesta a la vacunación. La vacuna de ARNm (BNT162b2) se asoció a mayor probabilidad de mostrar concentraciones de anticuerpos anti-S ≥ 1000 UI/mL, mientras que el cáncer activo se relacionó con menor probabilidad de presentar títulos altos de anticuerpos. Conclusiones: La vacuna BNT162b2 se asoció a respuesta humoral mayor. Es necesario contar con más información y estrategias de vacunación en pacientes inmunosuprimidos. Es relevante la selección de los mejores biológicos para esta población y considerar las características individuales.

Abstract Background: Vaccination is the most effective intervention for reducing the burden of SARS-CoV-2-related disease; however, gaps in knowledge regarding cancer patients (CPs) immune response persist. Objectives: To evaluate the humoral response (anti-S antibodies) in CPs and healthcare workers (HCWs) vaccinated with two doses of BNT162b2 or AZD122 vaccines. Material and methods: Polyspecific anti-SARS-CoV-2 spike protein (anti-S) antibodies were quantified, and a 1:1 propensity score was used to balance baseline characteristics. Multiple logistic regressions were carried out to evaluate the effect of humoral response-related variables. Results: One-hundred and twenty-seven CPs (22 %) and 439 HCWs (78 %) were included. Both populations developed anti-S antibodies in response to vaccination. The mRNA-based vaccine (BNT162b2) was associated with higher odds of having anti-S antibody titers ≥ 1,000 U/mL, while active cancer was related to a lower probability of developing high antibody titers. Conclusions: The BNT162b2 vaccine was associated with a higher humoral response. It is necessary for more information and vaccination strategies to be available for immunosuppressed patients in order to select the best biologics for this population based on individual characteristics.

Effect of COVID-19 pandemic on sleep quality of frontline healthcare workers

Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Materials and Methods: Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Results: A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion: The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.

Safety culture among operating room healthcare workers: still a long way to go. An analytical cross-sectional study from Turkey

Introduction: safety culture attitudes of health workers are still not at the desired level. Although the creation of patient safety culture is important for all health care environments, it is more vital for critical units. Objective: to determine the patient safety culture levels of those working in the operating room environment and compare them with the 2008 results of the same hospitals. Materials and Methods: an analytical cross-sectional study was conducted in 2017-2018. The Turkish version of the Hospital Survey on Patient Safety Culture was administered to nurses, anesthesia technicians, assistant physicians, and specialist physicians working in the Operating Rooms (n=258) of two university hospitals in Konya, a large city in Anatolian region of Turkey. Results: average percent positive response to the 42 items was low (41%, n=258). While there was no change in one dimension of the questionnaire compared to 2008; there was a positive change in 8 dimensions and a negative change in 3 dimensions. All 12 dimensions were lower than the Agency for Healthcare Research and Quality score. Discussion: Despite many studies, policy developments and interventions on patient safety, the improvement of a patient safety culture is very slowly in Turkey as in other countries. Conclusion: non-reporting of errors and a punitive approach in case of errors are still considered the most important problems.

Introducción: las actitudes del personal de salud frente a la cultura de la seguridad siguen sin alcanzar su nivel deseado. Aunque la creación de una cultura de seguridad del paciente es importante en todos los entornos de cuidado, es vital en las unidades de cuidado crítico. Objetivo: determinar los niveles de cultura de seguridad del paciente de quienes trabajan en quirófanos y compararlos con los 2008 resultados de los mismos hospitales. Materiales y métodos: se realizó un estudio transversal analítico entre 2017 y 2018. La versión en turco de la Encuesta Hospitalaria sobre Cultura de Seguridad del Paciente se administró a profesionales de enfermería, anestesistas, médicos auxiliares y médicos especialistas que trabajaban en los quirófanos (n=258) de dos hospitales universitarios de Konya, una ciudad de la región de Anatolia en Turquía. Resultados: El porcentaje medio de respuestas positivas a los 42 ítems fue bajo (41%, n=258). Si bien no hubo cambios en una dimensión del cuestionario en comparación con los 2008 resultados, hubo un cambio positivo en 8 dimensiones y un cambio negativo en 3 dimensiones. Las 12 dimensiones presentaron una puntuación inferior a la de la Agencia para la Investigación y la Calidad del Cuidado de la Salud. Discusión: A pesar de los numerosos estudios, desarrollos en política e intervenciones en materia de seguridad del paciente, la mejora de la cultura de seguridad del paciente es muy lenta en Turquía, al igual que en otros países. Conclusión: No notificar errores y un enfoque punitivo en caso de error siguen considerándose los problemas más importantes.

Introdução: as atitudes de cultura de segurança dos profissionais de saúde ainda não estão no nível desejado. Embora a criação da cultura de segurança do paciente seja importante para todos os ambientes de assistência médica, ela é mais vital para as unidades críticas. Objetivo: determinar os níveis de cultura de segurança do paciente daqueles que trabalham no ambiente da sala de cirurgia e compará-los com os resultados de 2008 dos mesmos hospitais. Materiais e Métodos: um estudo analítico de corte transversal foi realizado em 2017-2018. A versão turca da Pesquisa Hospitalar sobre Cultura de Segurança do Paciente foi aplicada a enfermeiros, técnicos de anestesia, médicos assistentes e médicos especialistas que trabalham nas salas de cirurgia (n=258) de dois hospitais universitários em Konya, uma grande cidade na região da Anatólia, Turquia. Resultados: a porcentagem média de respostas positivas aos 42 itens foi baixa (41%, n=258). Embora não tenha havido alteração em uma dimensão do questionário em comparação com 2008, houve uma alteração positiva em 8 dimensões e uma alteração negativa em 3 dimensões. Todas as 12 dimensões foram inferiores à pontuação da Agency for Healthcare Research and Quality. Discussão: Apesar de muitos estudos, desenvolvimentos de políticas e intervenções sobre a segurança do paciente, o aprimoramento de uma cultura de segurança do paciente é muito lento na Turquia, assim como em outros países. Conclusão: a não notificação de erros e uma abordagem punitiva em caso de erros ainda são considerados os problemas mais importantes.

"Congelei com medo de me contaminar": tratando um caso de TEPT crônico com imobilidade tônica em uma fisioterapeuta da linha de frente na pandemia de COVID-19 / "I froze for fear of contaminating myself": treating a case of chronic PTSD with tonic immobility in a physiotherapist frontline during COVID-19 pandemic

RESUMO Objetivo: Neste estudo relatamos o caso de uma profissional de saúde com vivência de imobilidade tônica (IT) e posterior desenvolvimento de transtorno de estresse pós-traumático (TEPT) crônico em decorrência de trauma laboral por conta da COVID-19 que recebeu tratamento remoto com terapia cognitivo-comportamental focada no trauma (TCC-FT). Métodos: Relato de caso de uma paciente acompanhada por seis meses após o recebimento de TCC-FT remota. Resultados: Paciente do sexo feminino, de 36 anos, fisioterapeuta, que desenvolveu TEPT crônico e experienciou IT por medo da contaminação por coronavírus. As escalas psicométricas demonstraram que a TCC-FT reduziu consideravelmente os sintomas de TEPT e depressão e aumentou o apoio social e a resiliência. De acordo com o relato, o tratamento melhorou a concentração e a motivação, e reduziu o sentimento de culpa, a irritabilidade, a insegurança e o desconforto em lidar com outras pessoas. Conclusão: Este artigo demonstra que traumas decorrentes da COVID-19 podem ser capazes de desencadear IT e exemplifica um favorável desempenho da TCC-FT na melhoria global da saúde mental dos pacientes com TEPT crônico com vivência de IT.

ABSTRACT Objective: In this study, we report the case of a health professional with experience of tonic immobility (TI) and subsequent development of post-traumatic stress disorder (PTSD) as a result of occupational trauma due to COVID-19 who received remote treatment with Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods: A case report of a patient followed for six months after receiving remote TF-CBT. Results: A 36-year-old female patient, the physiotherapist who developed chronic PTSD and experienced TI for fear of coronavirus contamination. Psychometric scales demonstrated that TF-CBT considerably reduced PTSD and depression symptoms and increased social support and resilience. According to the report, the treatment improved concentration and motivation, and reduced feelings of guilt, irritability, insecurity, and discomfort in dealing with other people. Conclusion: This article demonstrates that trauma resulting from COVID-19 can trigger TI and exemplifies a favorable performance of TF-CBT in the global improvement of the mental health of patients with chronic PTSD who experience TI.

Safety profile of CoviShield (ChAdOx1nCoV-19) vaccine among healthcare workers in a tertiary care hospital

Background: Coronavirus 2019 was declared as a pandemic by the World Health Organization in March 2020. Bereft of specific treatment for the disease, vaccinations and COVID appropriate behavior have come to be the main approaches to combat the pandemic. A number of vaccines have been approved after clearing clinical trials. Hence, it is essential to evaluate the safety profile of each vaccine for ensuring optimum health of the general population. This study was conducted to evaluate the adverse events following CoviShield vaccination in a tertiary care center. Aims and Objectives: The aim of the study was to describe the pattern of adverse effects, treatment given, and comorbidities seen in healthcare workers (HCW) who reported to the adverse drug reaction (ADR) monitoring center in the department of pharmacology Government T.D. Medical College, Alappuzha, following CoviShield vaccination from January 2021 to October 2021. Materials and Methods: A retrospective and descriptive study was carried out at Department of Pharmacology, GTDMCA involving all HCW who reported side effects following CoviShield vaccination in the ADR monitoring centre (AMC) in the Department of Pharmacology, GTDMCA from January 2021 to Oct 2021. Results: Out of 620 HCWs who reported adverse event following vaccination, majority (45%) were from the age group 21–30 years. About 83% of HCWs who reported adverse effect were women. Majority of the respondents (96%) experienced the adverse effects within 24 h. About 88% of respondents experienced these adverse effects after the initial dose alone. Commonly encountered adverse effects were fever (57%), headache (43%), myalgia (38%) etc. Hypertension (7%) was the most common comorbidity seen. Majority of the beneficiaries (70%) took paracetamol for the treatment of the adverse effect. Conclusion: Majority of the vaccinated HCWs experienced minor and self-limiting adverse event following immunization (AEFI) with Chimpanzee Adenovirus Oxford novel CoronaVirus-19. No serious AEFI were reported to the AMC. Despite the record speed at which the vaccine has been developed, it has shown to have a good safety profile considering the millions of doses that have been administered.

Prevalence of depression in healthcare workers of a COVID-19 First Line Treatment Centre in North Kerala

Background: The COVID-19 pandemic had a widespread impact over the health-care system all over the world. This had resulted in varying degrees of psychological issues on healthcare workers. Aim and Objectives: The aim of the study was to assess the prevalence of depression among healthcare workers of a COVID-19 first line treatment center (CFLTC). Materials and methods: In this cross-sectional study, 240 healthcare workers who volunteered for the study at COVID first line treatment centre-3 NIT mega boys’ hostel, Kozhikode, Kerala were recruited. They were interviewed, basic demographic data and patient health questionnaire-9 was administered. The data were analyzed with Microsoft Excel. The prevalence among various categories of healthcare workers were compared. Results: The prevalence of depression among healthcare workers was 52%. The prevalence of depression is each category of staff-doctors, staff nurses, cleaning staffs, and patient caretakers-separately. It was found that depression is inversely proportional to the knowledge, experience, medical qualification, and training. Conclusion: The prevalence of undetected depression is high among healthcare workers working in unconventional environment as in warfront situations such as COVID pandemic. The present study emphasizes the importance of proper screening of depression among healthcare workers in such circumstances in years to come.

Perfil de profissionais de saúde na pandemia covid-19 no Rio de Janeiro: um estudo web surveys / Profile of healthcare workers during the covid-19 pandemic in Rio de Janeiro: a web survey study

OBJETIVO: Identificar o perfil dos profissionais de 3º grau da área da saúde que atuaram no início da pandemia causada pelo vírus SARS-CoV-2. MÉTODO: Trata-se um estudo quantitativo com 155 profissionais de nível superior que participaram de uma web survey, cuja análise ocorreu por meio de estatística descritiva. RESULTADOS: O grupo foi composto predominantemente por enfermeiras, assistentes sociais, médicos, psicólogos e nutricionistas. Todos tinham orientação heterossexual, identidade cisgênero, idade entre 25 e 49 anos, eram autodeclarados como brancos, adeptos da religião católica, casados ou em união estável, possuindo pós-graduação, com vínculo profissional estatutário, mais de um filho em idade escolar e vivendo com três a quatro pessoas no mesmo domicílio. CONCLUSÃO: O perfil caracterizado pode ser útil para dialogar com estudos sobre saúde do trabalhador, risco ocupacional, trabalho remunerado e atividades privadas de profissionais da área de saúde.

OBJECTIVE: To identify the profile of tertiary healthcare workers working at the beginning of the SARS-CoV-2 pandemic. METHOD: This is a quantitative study involving 155 tertiary healthcare professionals who participated in a web survey, and the analysis was performed using descriptive statistics. RESULTS: The group consisted mainly of nurses, social workers, doctors, psychologists, and nutritionists. All identified as heterosexual, cisgender, between the ages of 25 and 49, self-identified as white, Catholic, married or in a stable relationship, with a postgraduate education, a legal professional affiliation, more than one school-age child, and living with three to four people in the same household. CONCLUSION: The characterized profile may be useful for engaging in studies on workers' health, occupational risk, paid work, and private activities of health professionals.

Monitoring of antibody levels in healthcare workers after inactivated coronavirus disease 19 vaccination

SUMMARY OBJECTIVE: Because of the coronavirus disease 19 pandemic, studies on vaccination are being conducted in our country as well as across the world. In this study, the antibody levels in healthcare workers vaccinated with two doses of inactivated vaccine and the factors affecting these levels were investigated. METHODS: Randomly selected volunteers from healthcare workers, who had been vaccinated with two doses of inactivated vaccine in January to February 2021, were included in the study. Blood samples were drawn twice, 1 month and 6 months after the second dose vaccine (CoronaVac:Sinovac Life Science Co, Ltd, Beijing, China). The antibody levels were determined by the chemiluminescence microparticle immunoassay method using kits for quantitative detection of immunoglobulin class G antibodies to severe acute respiratory syndrome coronavirus 2. RESULTS: The mean antibody levels of 129 volunteers were 1232.5 (min: 103 to max: 7151) AU/mL in the first month and 403.5 (min: 23 to max: 4963) AU/mL in the sixth month. According to the survey results, 91 (71%) volunteers had not been diagnosed with coronavirus disease 19 before vaccination. The antibody levels 1 month and 6 months after the second dose of vaccination were significantly higher in those who had been diagnosed with coronavirus disease 19 before vaccination than in those who had not. It was found that age, gender, fast food, or healthy nutrition had no effect on antibody levels. CONCLUSION: Vaccines are very important both to protect against coronavirus disease 19 and to experience only a mild form of the disease. Immunoglobulin class G levels formed after vaccination may be affected by many factors and may decrease over time.

Symptoms of post-traumatic stress disorder and affects in healthcare workers during the COVID-19 pandemic / Sintomas de transtorno de estresse pós-traumático e afetos em profissionais da saúde durante a pandemia da COVID-19

Objective: This study aimed to evaluate symptoms of post-traumatic stress disorder and affects in health professionals during the COVID-19 pandemic. Method: Three hundred and seventy-four health professionals, among which 235 were front-line and 139 non-front-line workers, answered an online questionnaire consisting of socio-demographic data, identification of past mental disorders, personal experience facing the pandemic, the Impact of Event Scale, and the Positive and Negative Affect Schedule. The sample consisted mainly of physicians and nursing staff aged between 30 and 49 years. Results: The results demonstrate high scores of symptoms related to post-traumatic stress disorder, with greater expressiveness among front-line professionals, especially in the nursing staff, and a strong correlation of these results with negative affects. Conclusion: Psychological assistance and interventions directed to health professionals are urgent to mitigate the impacts caused by the COVID-19 pandemic.

Objetivo: Este estudo objetivou avaliar sintomas de transtorno de estresse pós-traumático e afetos em profissionais de saúde durante a pandemia da COVID-19. Método: Trezentos e setenta e quatro profissionais da área da saúde, dentre os quais 235 profissionais que estavam atuando na linha de frente e 139 que não estavam na linha de frente, responderam a um questionário online composto por dados sociodemográficos, identificação de transtornos mentais pregressos, experiência pessoal frente à pandemia e Escala do Impacto do Evento e Escala de Afetos Positivos e Afetos Negativos. A amostra foi composta majoritariamente de médicos e funcionários da equipe de enfermagem com idades entre 30 e 49 anos. Resultados: Os resultados demonstram altas pontuações de sintomas relativos ao transtorno de estresse pós-traumático, com maior expressividade nos profissionais da linha de frente, principalmente na equipe de enfermagem, e forte correlação desses resultados com afetos negativos. Conclusão: O atendimento e intervenções psicológicas direcionadas aos profissionais de saúde são urgentes para mitigar os impactos causados pela pandemia da COVID-19.

An assessment on the implementation of same day antiretroviral therapy initiation in eThekwini clinics, KwaZulu­Natal, South Africa

The World Health Organization (WHO) recom mends same day initiation (SDI) of antiretroviral therapy (ART) for all individuals diagnosed with HIV irrespective of CD4+ count or clinical stage. Implementation of program is still far from reaching its goals. This study assessed the level of implementation of same day ART initiation. A longitudinal study was conducted at four primary healthcare clinics in eThekwini municipality KwaZulu Natal. Data was collected between June 2020 to October 2020 using a data extraction form. Data on individuals tested HIV positive, number of SDI of ART; and clinicians working on UTT program were compiled from clinic registers, and Three Interlinked Electronic Registers.Net (TIER.Net). Non governmental organisations (NGO) supporting the facility and services information was collected. Among the 403 individuals who tested HIV positive, 279 (69.2%) were initiated on ART on the same day of HIV diagnosis from the four facilities. There was a significant association between health facility and number of HIV positive individuals initiated on SDI (chi square=10.59; P value=0.008). There was a significant association between facilities with support from all NGOs and ART SDI (chi square=10.18; P value=0.015. There was a significant association between staff provision in a facility and SDI (chi square=7.51; P value=0.006). Urban areas clinics were more likely to have high uptake of SDI compared to rural clinics (chi square=11,29; P value=0.003). Implementation of the Universal Test and Treat program varies by facility indi cating the need for the government to monitor and standardize implementation of the policy if the program is to yield success.

Identifying challenges in implementing child rights instruments in Nigeria: A nationwide survey of knowledge, perception, and practice of child rights among doctors and nurses

Context: After thirty years of ratifying the child rights convention and nineteen years of the Child Rights Act, implementing child rights instruments remains challenging in Nigeria. Healthcare providers are well positioned to change the current paradigm. Aim: To examine the knowledge, perception, and practice of child rights and the influence of demographics among Nigerian doctors and nurses. Materials and methods: A descriptive, cross-sectional online survey was done using nonprobability sampling. Pretested multiple-choice questionnaire was disseminated across Nigeria's six geopolitical zones. Performance was measured on the frequency and ratio scales. Mean scores were compared with 50% and 75% thresholds. Results: A total of 821 practitioners were analyzed (doctors, 49.8%; nurses, 50.2%). Female-to-male ratio was 2:1 (doctors, 1.2:1; nurses, 3.6:1). Overall, knowledge score was 45.1%; both groups of health workers had similar scores. Most knowledgeable were holders of fellowship qualification (53.2%, P = 0.000) and pediatric practitioners (50.6%, P = 0.000). Perception score was 58.4% overall, and performances were also similar in both groups; females and southerners performed better (59.2%, P = 0.014 and 59.6%, P = 0.000, respectively). Practice score was 67.0% overall; nurses performed better (68.3% vs. 65.6%, P = 0.005) and postbasic nurses had the best score (70.9%, P = 0.000). Conclusions: Overall, our respondents' knowledge of child rights was poor. Their performances in perception and practice were good but not sufficient. Even though our findings may not apply to all health workers in Nigeria, we believe teaching child rights at various levels of medical and nursing education will be beneficial. Stakeholder engagements involving medical practitioners are crucial

Development and validation of interpersonal emotion regulation questionnaire for healthcare workers / 中华行为医学与脑科学杂志

Objective:To develop the interpersonal emotion regulation questionnaire for healthcare workers and examine its reliability and validity.Methods:Based on the theory of social regulatory cycle (SRC), literatures review and semi-structured interview were used to form the item pool of the scale.Through expert consultation, project analysis and the exploratory factor analysis, the scale items were screened, and the interpersonal emotion regulation questionnaire for healthcare workers was initially formed.The convenient sampling method was adopted to select 619 healthcare workers from multiple hospitals in Anhui province to conduct the formal survey to test the reliability and validity of the questionnaire and confirmatory factor analysis (CFA) using the SPSS 24.0 and Mplus 8.0 software.Results:There were 18 items and four dimensions including emotion identification, motivation, regulation strategy and implementation strategy process in the interpersonal emotion regulation questionnaire for healthcare workers.The results of CFA showed that the questionnaire fitted the data with well construct validity.The correlation coefficients between each dimension and the scale were 0.830-0.932.The Cronbach’s α coefficient of the overall questionnaire was 0.962, the split-half reliability was 0.880 and the test-retest reliability was 0.786.The score of total questionnaire was significantly positively correlated with the score of emotional intelligence ( r=0.680, P<0.001) and empathic ability ( r=0.554, P<0.001), and was significantly negatively correlated with the doctor-patient relationship ( r=-0.353, P<0.001). Conclusion:The interpersonal emotion regulation questionnaire for healthcare workers has satisfactory reliability and validity, which can be used to measure the ability of interpersonal emotion regulation in healthcare workers.

Trauma and Coping in Battling the COVID-19 Pandemic Among Malaysian Healthcare Workers

@#Introduction: Prolonged COVID-19 pandemic with high morbidity and mortality may cause traumatic events to Healthcare Workers (HCW), resulting in Post-Traumatic Stress Disorder (PTSD) symptoms. Hence, this study aims to determine the prevalence of PTSD symptoms and its association with coping strategies among HCW in managing COVID-19 pandemic at Klang Valley Public Hospitals in Malaysia. Methods: A cross-sectional study with total of 424 eligible respondents were recruited through stratified random sampling. Data was collected from 6th May until 6th June 2021 using a self-administered online questionnaire adopted from MPCL-5 and Brief COPE instruments. IBM Statistical Package for Social Sciences Version 26 was used to analyse data. Result: 25% of the respondents demonstrated PTSD symptoms. Respondents who are single (aOR=3.319, 95% CI: 1.912, 5.762, p-value <0.001) and had history of positive COVID-19 (aOR= 2.563, 95% CI:1.058, 6.209, p-value=0.037) were more likely to experience PTSD symptoms. Frequently coping with self-blaming (aOR= 7.804, 95% CI: 3.467, 17.568, p-value < 0.001), behavioural disengagement (aOR= 7.262, 95% CI: 1.973, 26.723, p-value =0.003), humour (aOR= 5.303, 95% CI: 1.754, 16.039, p-value =0.003), venting emotion (aOR= 3.287, 95% CI: 1.521, 7.105, p-value =0.002) and less planning (aOR= 2.006, 95% CI:1.154, 3.487 p-value =0.014) are significant predictors for PTSD symptoms. Conclusion: One in four HCW managing COVID-19 in Klang Valley public hospitals experienced PTSD symptoms. Therefore, urgent interventional program targeting HCW who are single with history of positive COVID-19 is beneficial to prevent PTSD. Maladaptive coping strategies like self-blaming, venting emotion, humour and behavioural disengagement should be replaced with more adaptive coping strategies like planning, self-compassion, self-care and self-reflection.

Resilience among pediatric healthcare workers during the COVID-19 pandemic in a tertiary hospital

OBJECTIVES@#Healthcare workers are at the center of the pandemic, dealing with cases while being at risk of acquiring the infection themselves, causing work-related stress. Despite this, they continue reporting for duty. This paper aims to determine the factors that affect resilience of pediatric healthcare-workers in close contact with patients suspected with COVID infection and its association to sleeping disturbance during the first two years of COVID – 19 pandemic in a tertiary hospital in the Philippines.@*METHODOLOGY@#This is a cross-sectional study. Healthcare-workers who render bedside patient care for those suspected or with COVID-19 infection, not diagnosed with any mental health illness, and fit the inclusion criteria were chosen through purposive sampling and asked to answer questionnaires with demographic survey, BRS and PSQI tool.@*RESULTS@#Among 89 participants, females were predominant (60.67% ). Majority were in the 30- 39 age group (44.94%) and are nurses (40.45%) or doctors (39.33%) who were single (76.40%). Many have normal resilience as measured from their BRS scores with an average PSQI per category equal to or exceeded 5.00. The correlation coefficient was at -0.338 (p-value 0.001) between the BRS and PSQI scores, indicating that a significant negative correlation exists between the two scores.@*CONCLUSION@#Normal resilience was reported in the majority of the healthcare workers. All study participants had poor sleep quality as determined in the overall average PSQI score. A negative correlation between resilience and sleep quality was observed, denoting that poor sleep quality can be associated with lower resilience, and vice versa. However, temporality cannot be assumed with this study.

Outcome of Program Kesihatan Optimum Sanubari (SANUBARI) Wellness-based Self-management Intervention in Coaching Healthcare Workers for Well-being in COVID-19 Pandemic

@#Introduction: This study measured the outcome of the Optimal Health Program (OHP) among frontline healthcare workers during the COVID-19 pandemic. The OHP is a wellness-based self-management intervention focused on well-being to gain optimal health. OHP is originally from Australia and has been translated, culturally adapted and branded as the Program Kesihatan Optimum Sanubari (SANUBARI). The program was conducted as a psychosocial intervention and the outcomes measured were self-efficacy, coping styles and well-being. Methods: Eligible participants were nurses who actively managed COVID-19 inpatients in Hospital Kuala Lumpur and committed to complete the intervention. Those who did not provide consent or had comorbidity, unstable medical or psychiatry illnesses were excluded. 43 nurses were recruited through convenience sampling method and completed outcome measures from General Self-Efficacy Scale, Brief COPE and WHO-5 Well-being Index, before and 1-month after the intervention. The OHP was conducted via group-based, using OHP Sanubari workbook with 5 weekly sessions by trained facilitators and lasted for 60 to 90 minutes per session. Results: Significant improvement was observed 1-month post intervention for self-efficacy (t(42)=5.64, p <0.001) and well-being(t(42)=2.14, p<0.05); different approach coping strategies(acceptance, use of informational support, positive reframing, active coping, and planning) and avoidant coping strategies(distraction, venting, denial, and substance use). Whilst, humor coping reduced significantly 1-month post-intervention (t(42)=3.66, p<0.05). Conclusion: This study reports the positive outcome of OHP on the mental health status of healthcare workers during the pandemic. This program can be considered as a tool towards optimal health throughout their career.

Presenteeism in front-line physicians involved in COVID-19-related clinical practice: a national survey of employed physician members of the Japan Medical Association

BACKGROUND@#The coronavirus disease 2019 (COVID-19) pandemic may have increased the rate of presenteeism among front-line physicians. Presenteeism is the term used to describe attendance at work despite ill health that would normally prompt rest or absence from work. This study aimed to examine the associations between COVID-19 clinical practice and presenteeism among physicians.@*METHODS@#A cross-sectional study was conducted from December 2021 to January 2022. The questionnaires were distributed to 21,737 employed physicians who were members of the Japan Medical Association. Presenteeism was measured by the Work Functioning Impairment Scale. Multiple logistic regression analysis was used to evaluate the association between COVID-19 clinical practice and presenteeism.@*RESULTS@#Overall, 3,968 participants were included in the analysis, and presenteeism was observed in 13.9% of them. The rate of presenteeism significantly increased with both the number of COVID-19 patients treated and the percentage of work time spent treating these patients (both P values for trend < 0.001). In comparison to those not currently engaged in the treatment of COVID-19 patients, presenteeism was significantly higher among front-line (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.16-2.53) and second-line physicians supporting those in the front-line (aOR = 1.45, 95% CI: 1.17-1.78). There was no association between involvement in COVID-19 vaccination services and presenteeism.@*CONCLUSIONS@#The burden on front-line and second-line physicians in COVID-19 clinical practice must be minimized. Employed physicians also need to recognize the importance of communicating with their workplaces about presenteeism.