Socio-Occupational and Health Conditions in Intensive Care Unit (ICU) Professionals during the COVID-19 Pandemic in Spain

Objective: The aim of this research is to analyze the socio-occupational and health conditions of Intensive Care Units (ICU) health professionals during the COVID-19 pandemic in Spain. In addition, with regard to the working conditions (availability of personal protective equipment-PPE, workload and patient/professional ratio), this research aims to analyze the possible differences depending on the Spanish region that was sampled and their professional category, as well as their relationship with the characteristic symptoms of COVID-19 (myalgias and respiratory distress). Method: A cross-sectional study performed with an online questionnaire, which was spread throughout all of the Spanish autonomous communities/regions. Results: The sample consisted of 461 ICU professionals in Spain, of whom, 94% reported an increase in their workload, and 43% reported a patient/professional ratio that was higher than it usually is. The median professional experience in the ICU was 9.73 years, with 47% of them having less than 5 years of experience in it. About 80% had undergone some diagnostic tests. There is a significant difference in 'Serology (+)' in terms of sex, with males having a serology (+) in 26% of the cases and females having it in 13% of the cases (p = 0.011). Most of the professionals (80%) were concerned about a possible infection, and up to 96% were worried about infecting their family members. The most common COVID-19 symptom was a headache, with there being a higher incidence of this in women. Significant differences were observed with respect to the availability of appropriate PPE depending on the Spanish region (i.e., Cataluña had best rate of PPE availability) (p = 0.005). The higher incidence of myalgias and respiratory distress were associated with a lower availability of PPE and a higher patient/professional ratio. Conclusions: The ICU staff reported an increase in their workload, with an increase in the amount of staff who had less experience. A high percentage of them have suffered symptoms, although the proportion of positive tests was low. The most characteristic symptoms of COVID-19 seem to be related to the working conditions. The results show the socio-occupational and health conditions of Spanish ICU professionals during the pandemic and point to the need to establish occupational risk-prevention measures.

Predisposición del personal sanitario a la vacunación frente a la COVID-19

Objective: to understand the disposition among healthcare staff to be vaccinated against SARS-Co V-2 and their reasons for it. Method: a cross-sectional study through online survey conducted between December 2020 and February 2021. The study included professionals from the Spanish Health System belonging to any category who had managed COVID-19 patients from March 2020, both in the hospital and the community settings, including Primary Care. Non-probabilistic sampling, and ad hoc questionnaire: sample characteristics, concern about contagion, and willingness to be vaccinated against COVID-19. Descriptive analysis. Results: the study included 834 healthcare professionals. There was a high disposition to be vaccinated against SARS- Co V-2 (92% of the participan ts would receive the vaccine). The main reasons were concern about getting infected and infecting their relatives, followed by the need to end up the current pandemics as soon as possible. The decision of receiving the vaccine or not was only statistically influenced by professional category and gender, with nurses and doctors as well as men presenting the highest rates claiming that they would receive the vaccine. Conclusions: this study showed the positive disposition of the healthcare staff towards current vaccines against SARS- CoV-2. Moreover, almost all healthcare professionals involved showed high concern for the possibility to infect a relative with the disease, or the possibility of becoming infected. The fact that said professionals were working with patients positive for COVID-19 at that time had no impact on their decision to receive the vaccine. Objetivo: conocer la predisposición del personal sanitario a la vacunación contra el SARS-CoV-2 y sus razones para ello. Método: estudio transversal mediante encuesta online realizada entre diciembre de 2020 y febrero de 2021. Profesionales del sistema sanitario español pertenecientes a cualquier categoría que hubieran trabajado atendiendo a pacientes con C0- VID-19 desde marzo de 2020, tanto en el ámbito hospitalario como extrahospltalario, incluyendo Atención Primaria. Muestreo no probabilístlco, Cuestionarlo ad hoc. características de la muestra, preocupación por el contagio y predisposición a la vacunación frente al COVID-19. Análisis descriptivo. Resultados: participaron 834 profesionales sanitarios. La pre-disposición para la vacunación frente al SARS-CoV-2 fue elevada (92% de los encuestados se administrarían la vacuna), Las principales razones fueron la preocupación por el contagio de familiares y por el contagio propio, seguido por la necesidad de finalizar con la pandemia actual lo antes posible. La decisión de administrarse o no la vacuna solo se ve estadísticamente influenciada por la categoría profesional y el sexo, siendo enfer-meras y médicos los porcentajes más altos que han afirmado que sí se administrarían la vacuna, así como los hombres. Conclusiones: a través de este estudio se evidencia la predisposición positiva del personal sanitario hacia las vacunas actuales frente al SARS-CoV-2. Además, casi la totalidad de los profesionales sanitarios encuestados tienen una elevada preocupación por la posibilidad de contagiar la enfermedad a un familiar, o ante la probabilidad del contagio propio. No influye en la decisión de administrarse la vacuna si en el momento actual dichos profesionales estaban trabajando con pacientes C0- VID-19 positivos.

Stress and quality of life of intensive care nurses during the COVID-19 pandemic: Self-efficacy and resilience as resources.

BACKGROUND: Health care workers employed in the COVID-19 emergency are at a high risk of stress. AIMS AND OBJECTIVES: To explore the mediating roles of self-efficacy and resilience between stress and both physical and mental quality-of-life components in intensive care nurses during the COVID-19 pandemic. DESIGN: Cross-sectional survey design. METHODS: The stress subscale (depression, anxiety, and stress scale in Spanish Scale, DASS-21), the summary components (physical and mental) of health-related quality of life (SF-36), the general self-efficacy scale (GSES), and the resilience scale (RS-14) were administered in 308 intensive care nurses. Serial multiple mediator models were used. RESULTS: There was a significant indirect effect of levels of perceived stress on both physical and mental health components through self-efficacy and resilience. Specifically, greater perception of self-efficacy was associated with a lower perception of stress and greater resilience, while higher resilience was associated with greater physical and mental health (B = -0.03; SE = 0.02; 95% confidence interval [CI] = [-0.07, -0.01]; B = -0.03, SE = 0.01, 95% CI = [-0.07, -0.01], respectively). It was observed that self-efficacy alone also mediates the relationship of the perception of stress on the components of physical and mental health (B = -0.07; SE = 0.05; 95% CI = [-0.18, -0.03]; B = -0.09; SE = 0.04; 95% CI = [-0.17, -0.24], respectively). However, resilience alone was not a significant mediator of these associations. CONCLUSIONS: It can be concluded that stress is linked to the physical and mental health components related to quality of life through self-efficacy and resilience. RELEVANCE TO CLINICAL PRACTICE: These psychological resources would allow the nursing staff to maintain a good quality of life despite high levels of stress. These findings have implications for future research in terms of both model testing and clinical application.

Resilience and anxiety among intensive care unit professionals during the COVID-19 pandemic.

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.