The Impact of Sociodemographic Characteristics on Coping Strategies Used by Nurses Working at COVID and Non-COVID Hospital Departments during COVID-19 Pandemic: A Cross-Sectional Study.

BACKGROUND: The aim of our study was to compare coping strategies applied by nurses working during the COVID-19 pandemic at COVID-19 (CoV) and non-COVID-19 (non-CoV) hospital departments with regards to their sociodemographic characteristics in order that the system can provide them better support in future similar situations. METHODS: A total of 380 out of 1305 nurses participated in the survey during December 2020. Coping Inventory for Stressful Situations (CISS) was used. Stepwise regression analysis was used to determine the interaction between sociodemographic characteristics and coping strategies. RESULTS: The CoV married nurses (62.2%) used problem- (p = 0.010) and emotion- (p = 0.003) focused coping more and avoidance coping less (p = 0.007). CoV nurses with master's degrees (11.1%) used both problem- and emotion-focused coping less (p < 0.01), and older nurses used emotional coping more than the younger nurses (p = 0.027), whereas younger nurses used more avoidance coping (p < 0.01). CoV nurses without children (41%) used avoidance strategies more than nurses who had 2-3 children (p < 0.001). Among non-CoV nurses, less use of emotional coping was recorded in nurses with master's degrees (4%) than in those with a high school diploma (44.2%) (p = 0.002). Avoidance coping was also used more by married non-CoV nurses (79.1%) (p < 0.001) and those without children (p < 0.001). CONCLUSIONS: Sociodemographic factors such as working experience, age, level of education and marital status influenced chosen coping strategies during the health crisis.

The Impact of Sociodemographic Characteristics on Coping Strategies Used by Nurses Working at COVID and Non-COVID Hospital Departments during COVID-19 Pandemic: A Cross-Sectional Study

Background: The aim of our study was to compare coping strategies applied by nurses working during the COVID-19 pandemic at COVID-19 (CoV) and non-COVID-19 (non-CoV) hospital departments with regards to their sociodemographic characteristics in order that the system can provide them better support in future similar situations. Methods: A total of 380 out of 1305 nurses participated in the survey during December 2020. Coping Inventory for Stressful Situations (CISS) was used. Stepwise regression analysis was used to determine the interaction between sociodemographic characteristics and coping strategies. Results: The CoV married nurses (62.2%) used problem- (p = 0.010) and emotion- (p = 0.003) focused coping more and avoidance coping less (p = 0.007). CoV nurses with master's degrees (11.1%) used both problem- and emotion-focused coping less (p < 0.01), and older nurses used emotional coping more than the younger nurses (p = 0.027), whereas younger nurses used more avoidance coping (p < 0.01). CoV nurses without children (41%) used avoidance strategies more than nurses who had 2–3 children (p < 0.001). Among non-CoV nurses, less use of emotional coping was recorded in nurses with master's degrees (4%) than in those with a high school diploma (44.2%) (p = 0.002). Avoidance coping was also used more by married non-CoV nurses (79.1%) (p < 0.001) and those without children (p < 0.001). Conclusions: Sociodemographic factors such as working experience, age, level of education and marital status influenced chosen coping strategies during the health crisis.

Can Lung Imaging Scores and Clinical Variables Predict Severe Course and Fatal Outcome in COVID-19 Pneumonia Patients? A Single-Center Observational Study.

COVID-19 prediction models mostly consist of combined clinical features, laboratory parameters, and, less often, chest X-ray (CXR) findings. Our main goal was to propose a prediction model involving imaging methods, specifically ultrasound. This was a single-center, retrospective cohort observational study of patients admitted to the University Hospital Split from November 2020 to May 2021. Imaging protocols were based on the assessment of 14 lung zones for both lung ultrasound (LUS) and computed tomography (CT), correlated to a CXR score assessing 6 lung zones. Prediction models for the necessity of mechanical ventilation (MV) or a lethal outcome were developed by combining imaging, biometric, and biochemical parameters. A total of 255 patients with COVID-19 pneumonia were included in the study. Four independent predictors were added to the regression model for the necessity of MV: LUS score, day of the illness, leukocyte count, and cardiovascular disease (χ2 = 29.16, p < 0.001). The model accurately classified 89.9% of cases. For the lethal outcome, only two independent predictors contributed to the regression model: LUS score and patient's age (χ2 = 48.56, p < 0.001, 93.2% correctly classified). The predictive model identified four key parameters at patient admission which could predict an adverse outcome.

Difference in Pandemic-Related Experiences and Factors Associated with Sickness Absence among Nurses Working in COVID-19 and Non-COVID-19 Departments.

BACKGROUND: The aim of this study is to determine the main variables associated with nurses' sickness absence (SA) and to improve the prediction of SA based on pandemic-related experiences. The second aim is to examine the differences between COVID-19 (CoV) and non-COVID-19 (non-CoV) nurses in levels of post-traumatic stress disorder (PTSD) symptoms, personality traits, coping strategies and professional stressors experienced. METHODS: This historical prospective study enrolled 1305 nurses from the University Hospital of Split, Croatia. A total of 380 subjects participated in the study, 163 non-CoV and 217 CoV subjects. Nurses' pandemic-related experience questionnaires, Big Five Inventory (BFI), Post-traumatic Stress Disorder Checklist (PCL-5), Coping Inventory for Stressful Situations (CISS) and Occupational Stress Questionnaire, were used for evaluation. RESULTS: Non-CoV nurses felt more fear of infection, were more socially distanced, had more PTSD symptoms and neuroticism and felt more stress due to public criticism and job requirements compared to CoV nurses; p < 0.001. The groups of SA users and non-SA users could be distinguished based on predictor variables in CoV and non-CoV nurses, with a correct classification of 84.8% vs. 79.1%. CONCLUSIONS: It was possible to predict the probability of using SA among nurses due to pandemic professional experience, personality traits and coping strategies.

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia.

BACKGROUND: Lung ultrasound (LUS) is a useful imaging method for identifying COVID-19 pneumonia. The aim of this study was to explore the role of LUS in predicting the severity of the disease and fatality in patients with COVID-19. METHODS: This was a single-center, follow-up study, conducted from 1 November 2020, to 22 March 2021. The LUS protocol was based on the assessment of 14 lung zones with a total score up to 42, which was compared to the disease severity and fatality. RESULTS: A total of 133 patients with COVID-19 pneumonia confirmed by RT-PCR were enrolled, with a median time from hospital admission to lung ultrasound of one day. The LUS score was correlated with clinical severity at hospital admission (Spearman's rho 0.40, 95% CI 0.24 to 0.53, p < 0.001). Patients with higher LUS scores were experiencing greater disease severity; a high flow nasal cannula had an odds ratio of 1.43 (5% CI 1.17-1.74) in patients with LUS score > 29; the same score also predicted the need for mechanical ventilation (1.25, [1.07-1.48]). An LUS score > 30 (1.41 [1.18-1.68]) and age over 68 (1.26 [1.11-1.43]) were significant predictors of fatality. CONCLUSIONS: LUS at hospital admission is shown to have a high predictive power of the severity and fatality of COVID-19 pneumonia.

Questionnaire for Assessing Social Contacts of Nurses Who Worked with Coronavirus Patients during the First Wave of the COVID-19 Pandemic.

(1) Background: The aim of the present study was to develop and validate the psychometric characteristics of a scale measuring nurses' experiences working with COVID-19 patients. (2) Methods: The participants were 180 Croatian nurses who worked in departments with COVID-19 patients, with a mean age of 36.8 years (ranging from 20 to 48). Research was conducted from March to June 2020. For the purpose of constructing the scale, 10 statements were developed. Factor analysis was used to determine the factor structure and construct validity of the scale. (3) Results: The scale consisted of nine statements divided into a three-factor structure: factor I-stigmatization and mistrusting (four items), factor II-social distancing (four items), and factor III-fear of infection (two items). Cronbach α was calculated to confirm the reliability of the scale: factor I-α = 0.80, factor II-α = 0.76, and factor III-α = 0.70. (4) Conclusion: The nurses' pandemic-related experiences scale showed good psychometric properties and can be applied in future research as a standardized tool for measuring health care workers' experience during COVID-19 or other infectious crises.

Pulmonary Embolism Associated with COVID-19 Occurs in Predominantly Elderly Patients with Comorbidities: A Single Center Retrospective Study.

Introduction: Complications of COVID-19 infection have been greatly investigated. The most recent studies found strong association of COVID-19 pneumonia with thromboembolism. The aim of research was to describe clinical and computed tomography pulmonary angiograms (CTPA) characteristics of COVID-19 related pulmonary artery thromboembolism (PE). Methods: All consecutive CTPA with positive PE in COVID-19 patients from University Hospital Split, from March 23, 2020 to January 31, 2021 were analyzed. Baseline data were collected from patient's electronic records. CTPA scan analysis identified PE anatomical location (i.e., main, lobar, segmental, or subsegmental). Results: A total number of 78 positive CTPA in COVID-19 patients was mainly in elderly with several co-morbidities, high D-dimer levels, at median of 14 days. CTPAs showed involvement of the entire pulmonary artery tree, mainly of the small-to medium diameter pulmonary artery branches, unilaterally (n = 31, 39,74%), and bilaterally (n = 33, 42.31%). The large-diameter branches were the most rarely affected as a single location (n = 14, 17.95%). Conclusion: PE occurred in predominantly elderly people, having several comorbidities, and high D-dimer levels. Embolic involvement of pulmonary branches of all sizes were found, the most frequent of small to medium diameter branches. Further investigation is needed to better understand mechanisms and course of the COVID-19 related PE.