COVID-19 vaccination intention and hesitancy: Mistrust on COVID-19 vaccine benefit a major driver for vaccine hesitancy among healthcare workers; a cross-sectional study in North India.

Background: The advent of an effective novel COVID-19 vaccine could extinguish the current devastating pandemic but the vaccine hesitancy is a hurdle for the public health system, so this study estimated the COVID-19 vaccination intention and hesitancy among the healthcare workers, the priority target group for the COVID-19 vaccination in India. Methods: A web-based cross-sectional survey was conducted among the healthcare workers in Chandigarh, a union territory in North India, using a Snowball sampling technique. A total of 403 healthcare workers participated in the study between 2nd and 25th January 2021. The primary data collected were the intention to get vaccinated against the available COVID-19 vaccine and the concerns regarding the new vaccines. The attitude towards novel COVID-19 vaccine was assessed using developed Vaccine attitude examination scale. These questionnaire, which were delivered via WhatsApp, was filled by the participants over Google forms. Results: Among the 403 respondents surveyed, the majority (54.6%) reported they were definitely intended to get vaccinated against COVID-19, however, 7% expressed a resistance for inoculation with COVID-19 vaccination. The perceived susceptibility (aOR = 0.511, CI 0.265-0.987) and severity of COVID-19 infection (aOR = 0.551 CI 0.196-0.704) and not being concerned about the efficacy of new COVID-19 vaccines (aOR = 0.702 CI 1.109-26.55) were found to have the highest significant odds of intention to take the COVID-19 vaccine. The majority (62%) were concerned about the safety of the vaccine, in terms of side-effects, quality control, and doubted efficacy of the vaccine. The mistrust of the benefits of the vaccine is a significant predictor for vaccine hesitancy among the healthcare workers (aOR = 5.205 CI 3.106-8.723). Conclusion: Therefore, strategic communication and vaccine-acceptance programs should be formulated in order to combat the prevailing mistrust on the vaccine safety and efficacy and attain effective coverage to gain herd immunity.

Mental Health Outcomes of Perceived Stress, Anxiety, Fear and Insomnia, and the Resilience among Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units.

Background: The coronavirus disease-2019 (COVID-19) pandemic has led to a significant disruption in healthcare delivery and poses a unique long-term stressor among frontline nurses. Hence, the investigators planned to explore the adverse mental health outcomes and the resilience of frontline nurses caring for COVID-19 patients admitted in intensive care units (ICUs). Materials and methods: A cross-sectional online survey using Google form consisted of questionnaires on perceived stress scale (PSS-10), generalized anxiety disorder scale (GAD-7), Fear Scale for Healthcare Professionals regarding the COVID-19 pandemic, insomnia severity index, and the Connor-Davidson Resilience Scale-10 (CD-RISC) were administered among the nurses working in COVID ICUs of a tertiary care center in North India. Results: A considerable number of subjects in the study reported symptoms of distress (68.5%), anxiety (54.7%), fear (44%), and insomnia (31%). Resilience among the frontline nurses demonstrated a moderate to a high level with a mean percentage score of 77.5 (31.23 ± 4.68). A negative correlation was found between resilience and adverse mental outcomes; hence, resilience is a reliable tool to mitigate the adverse psychological consequences of the COVID-19 pandemic. Conclusion: Emphasizing the well-being of the nurses caring for critical COVID-19 patients during the pandemic is necessary to enable them to provide high-quality nursing care. How to cite this article: Jose S, Cyriac MC, Dhandapani M, Mehra A, Sharma N. Mental Health Outcomes of Perceived Stress, Anxiety, Fear and Insomnia, and the Resilience among Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Indian J Crit Care Med 2022;26(2):174-178.

Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units.

BACKGROUND: In the event of coronavirus disease-2019 (COVID-19) spread worldwide, frontline healthcare workers play a key role in the containment of this devastating pandemic, and to prevent the cross-transmission and gain confidence in battle with the pandemic, they are wearing personal protective equipment (PPE). AIM AND OBJECTIVE: To explore the adverse health problems and skin reactions caused by the use of PPEs among the frontline nurses in the ICUs of COVID hospital. MATERIALS AND METHODS: A cross-sectional study was conducted using an online-based questionnaire assessing the physical problems, and adverse skin reactions of PPEs were sent among the 150 frontline nurses in ICUs of COVID hospital. The collected data were analyzed using descriptive statistics. RESULTS: We got 137 valid responses from frontline nurses, and the most common adverse health effects expressed by them were headache (73.4%), extreme sweating (59.6%), and difficulty in breathing (36.7%); 91.7% complained about the fogging of the goggle. Majority of frontline nurses expressed nasal bridge scarring (76.64%) and indentation and pain on the back of the ears (66.42%) as the adverse skin reactions after wearing N95 masks. The common skin problems identified due to double gloving of latex gloves were excessive skin soakage with sweat (70.07%) and skin chapping (19%). The protective clothing caused minimal adverse reactions, and excessive sweating (71.53%) was the most reported. CONCLUSION: The healthcare workers wearing PPE for a prolonged period show significant adverse effects, so appropriate strategies should be taken to prevent the adverse effects by designing effective PPEs and education of preventive measures among healthcare workers. HOW TO CITE THIS ARTICLE: Jose S, Cyriac MC, Dhandapani M. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Indian J Crit Care Med 2021;25(2):134-139.

Burnout and Resilience among Frontline Nurses during COVID-19 Pandemic: A Cross-sectional Study in the Emergency Department of a Tertiary Care Center, North India.

BACKGROUND: The COVID-19 pandemic had a massive impact on healthcare systems, increasing the risks of psychological distress in health professionals. Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined by the three dimensions of emotional exhaustion, cynicism, and personal inefficacy. METHODOLOGY: A cross-sectional descriptive design was used to assess the burnout and resilience among frontline nurses in the emergency department of a tertiary care center in North India during COVID-19 pandemic. The sample consisted of 120 frontline nurses working in the emergency department, selected by a simple random sampling method. Data were collected using the Maslach burnout inventory-general survey and the Connor-Davidson Resilience Scale. RESULTS: The nurses in the emergency during pandemic experienced a moderate-to-severe level of burnout in emotional exhaustion (29.13 ± 10.30) and depersonalization (12.90 ± 4.67) but mild-to-moderate level of burnout in reduced personal accomplishment (37.68 ± 5.17) and showed a moderate to a high level of resilience (77.77 ± 12.41). The two metrics of burnout viz., emotional exhaustion and personal inefficacy had a significantly negative correlation with resilience among the frontline nurses in the emergency (r = 0.25, p < 0.05 and r = 0.31, p < 0.01, respectively). A significant negative correlation has been identified between burnout and resilience that informs the role of resilience in alleviating burnout during this pandemic. CONCLUSION: Effective interventions for improving resilience are needed to relieve nurses' burnout and workplace stressors. Also, the administration should ensure a healthy workplace and adopt a positive attitude and harmonious relationship with the frontline workers in the mitigation of the pandemic. HOW TO CITE THIS ARTICLE: Jose S, Dhandapani M, Cyriac MC. Burnout and Resilience among Frontline Nurses during COVID-19 Pandemic: A Cross-sectional Study in the Emergency Department of a Tertiary Care Center, North India. Indian J Crit Care Med 2020;24(11):1081-1088.