Changes of working conditions and job-related challenges due to the SARS-CoV-2 pandemic for medical assistants in general practices in Germany: a qualitative study.

BACKGROUND: In Germany, general practices are usually contacted first by patients with health complaints, including symptoms characteristic of SARS-CoV-2. Within general practices, medical assistants (MAs) are the first contact person for patients and perform various tasks in close physical patient contact. Working conditions of MAs have been characterized as challenging, e.g., due to low salaries, a high workload, time pressure and frequent interruptions. The potential changes of working conditions and job-related challenges experienced by MAs due to the SARS-CoV-2 pandemic have not been fully explored. We aimed to address this knowledge gap among MAs working in general practices in Germany. METHODS: Semi-structured telephone interviews were conducted between March and April 2021 with 24 MAs. Medical assistants of legal age, who worked in general practices in Germany, and who were continuously employed and without change of employer in 2020 were eligible for participation. Interview recordings were transcribed verbatim and content-analyzed using MAXQDA, using deductive and inductive coding. RESULTS: The SARS-CoV-2 pandemic posed great challenges for MAs, including a dramatic increase in workload, changes in occupational tasks, increased hygiene measures, rearrangements of work organization, childcare issues, and structural and personnel challenges within their practice. Participants described both improved but also worsened collaboration with their employers and colleagues due to the pandemic. Many MAs complained about issues regarding SARS-CoV-2-related billing processes and an increase in unpleasant patient behavior, including disregard of practice rules or frequent verbal insults. Many also did not feel adequately appreciated by politics, media, or society for their efforts during the pandemic. Positive changes were perceived to be the expansion of digital communication channels and a growing social cohesiveness of practice teams. CONCLUSIONS: Our study suggests that the SARS-CoV-2 pandemic posed great challenges for MAs. The pandemic seems to have worsened MAs' working conditions, which had been described as challenging already prior to the pandemic. In order to improve job satisfaction and to prevent loss of healthcare personnel, measures must be taken to improve working conditions of MAs in general practices.

Attitudes and stressors related to the SARS-CoV-2 pandemic among emergency medical services workers in Germany: a cross-sectional study.

BACKGROUND: The aim was to investigate attitudes and stressors related to the SARS-CoV-2 outbreak among emergency medical services (EMS) workers in Germany. We further aimed to detect possible changes within a 5-week period and potential determinants of attitudes and stressors. METHODS: We conducted two cross-sectional studies using an online questionnaire in early April 2020 (i.e., the first peak of the SARS-CoV-2 outbreak in Germany) and five weeks later. The study instrument comprised sociodemographic items, self-devised items on pandemic-related attitudes, stressors and work outcomes, and established instruments assessing depressive symptoms and symptoms of anxiety. Logistic regression was performed to identify possible determinants. RESULTS: Data of 1537 participants was included in the analysis (April: n = 1124, May: n = 413, 83.1% male, median age 32). Most participants agreed that their personal risk of infection was higher compared to the general population (April: 87.0% agreement, May: 78.9%). The greatest stressor was uncertainty about the pandemic's temporal scope (82.0 and 80.9%, respectively). Most participants (69.9, 79.7%) felt sufficiently prepared for the pandemic and only few felt burdened by their financial situation (18.8, 13.3%). Agreement to all stressors decreased from April to May except related to the childcare situation. Regression analysis identified subgroups to be burdened more frequently such as older employees, those with SARS-CoV-2 cases among their colleagues, and those with lower paramedic training levels. CONCLUSIONS: We identified key SARS-CoV-2-related stressors whose levels generally decreased within a 5-week period. Our results indicate that EMS workers are less affected by existential fears and rather worry about their personal infection risk.

The Relationship of Medical Assistants' Work Engagement with Their Concerns of Having Made an Important Medical Error: A Cross-Sectional Study.

OBJECTIVES: We aimed to examine associations of work engagement with self-reported concerns of having made medical errors among medical assistants. METHODS: We used cross-sectional questionnaire data from 424 medical assistants in Germany (collected between March and May 2021). The nine-item Utrecht Work Engagement Scale assessed the subdimensions vigor, dedication, and absorption. Participants further reported whether they were concerned that they had made an important medical error in the last three months. Work engagement scores were used both as categorized variables (i.e., highest tertile vs. remaining tertiles) and continuous variables (i.e., z-scores) and their associations with concerns to have made an important medical error were examined using multivariable logistic regression to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). RESULTS: High vigor (versus low vigor) and high dedication (versus low dedication) were associated with substantially reduced odds of expressing concerns to have made an important medical error (OR = 0.19, 95%CI = 0.04-0.85 and OR = 0.25, 95%CI = 0.07-0.88, respectively), but absorption was not (OR = 1.10, 95%CI = 0.43-2.86). Analyses with z-scores confirmed this pattern of associations for vigor and absorption, but less so for dedication (OR = 0.72, 95%CI = 0.47-1.11). CONCLUSIONS: Vigor and possibly also dedication are inversely related to concerns of having made an important medical error. Our findings may suggest that promotion of these subdimensions of work engagement may improve patient safety.

Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study

ObjectivesThe COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact and involvement in various high-risk dental procedures. This study aimed to investigate attitudes, stressors and work outcomes among DAs from all over Germany at the peak of cases in spring 2020.DesignCross-sectional study. Descriptive analysis and logistic regression.SettingDental, maxillofacial surgery and orthodontic practices across Germany, April 2020.ParticipantsParticipants aged 18 years and above and currently working as DAs in Germany.Primary and secondary outcome measuresA self-devised online questionnaire was employed comprising questions on SARS-CoV-2-related attitudes, stressors and work outcomes. Validated scales assessed symptoms of depression and anxiety.ResultsAmong 1481 participating DAs (median age 35 years, 98.4% female, 91.8% working in dental practices), major stressors were uncertainty about the pandemic’s temporal scope (97.9% agreement, n=1450), uncertainty about one’s financial situation (87.8%, n=1301), uncertainty about how to act correctly (87.6%, n=1298) and thoughts about a possible infection during work (83.8%, n=1241). Forty-two per cent of DAs (n=622) felt sufficiently prepared for dealing with patients with SARS-CoV-2. Only 17.5% (n=259) agreed that material for personal protection was sufficiently available. Multivariable logistic regression analyses suggested that working in a dental practice, compared with orthodontic and maxillofacial surgery practices, was significantly associated with uncertainty about one’s financial situation (OR 2.13 (95% CI 1.33 to 3.44)) and with the reported availability of personal protective equipment (PPE) (0.55 (0.36 to 0.84)).ConclusionsTraining about correct behaviour of DAs during future infectious disease outbreaks is needed, especially for DAs working in dental practices. In the future, it will also be necessary to strengthen supply chains to ensure that PPE is sufficiently available in a timely manner.

Pandemic-related attitudes, stressors and work outcomes among medical assistants during the SARS-CoV-2 ("Coronavirus") pandemic in Germany: A cross-sectional Study.

BACKGROUND: The SARS-CoV-2 virus has spread rapidly around the globe since December 2019 creating much uncertainty among medical staff. Due to close patient contact, medical assistants are at increased risk of an infection. Several studies have investigated psychological consequences of the SARS-CoV-2 pandemic on medical staff, yet studies in the outpatient setting are scarce and studies addressing medical assistants are lacking. This study aimed to investigate pandemic-related stressors, attitudes, and work outcomes among medical assistants and to identify possible determinants. METHODS: The population under study were medical assistants across entire Germany. A self-devised online questionnaire was published between April 7th, 2020, and April 14th. including questions on pandemic-related stressors, attitudes and work outcomes. Additionally, symptoms of depression and anxiety disorder were measured by PHQ-2 and GAD-2, respectively. Logistic regression was performed to identify possible determinants. RESULTS: 2150 medical assistants provided complete data (98.0% female, mean age 37.6 years). Major stressors were uncertainty about the temporal scope of the pandemic (95.1% agreement), about how to act correctly (77.5%), feelings of not being allowed to let patients down (75.9%), uncertainty about one's financial situation (67.4%) and about contact persons for further information (67.1%). One third (29.9%) of the study population screened positively for depression and 42.6% for anxiety disorder. Feeling burdened by one's financial situation was significantly associated with working in specialist practices (1.32 [1.08-1.62]), caring for children (1.51 [1.22-1.87]), depression (1.28 [1.01-1.62]), and anxiety disorder (1.93 [1.55-2.39]). Feeling burdened by thoughts about virus contraction at work was also significantly associated with working in specialist practices (1.33 [1.07-1.64]), caring for children (1.33 [1.07-1.66]), depression (1.54 [1.18-2.00]), and anxiety (4.71 [3.71-5.98]). CONCLUSIONS: This study provides novel evidence regarding major SARS-CoV-2 pandemic-related stressors among medical assistants and suggests need for special support for medical assistants caring for children and working in specialist practices.