A reverse pattern in work motivation among Vietnamese health care workers during the prolonged COVID-19 outbreak of 2021: Determinants and implications.

Background: The workload burden of the COVID-19 pandemic on health systems requires not only financial support but also long-term and contextualized policies. We assessed the work motivation and its determinants among health workers at Vietnamese hospitals and facilities during the prolonged COVID-19 outbreaks in 2021. Methods: A cross-sectional study was conducted among 2814 health care professionals across all three regions of Vietnam from October to November 2021. An online questionnaire, including the Work Motivation Scale, distributed by the snowball method to a subgroup of 939 respondents, investigated changes in working characteristics due to COVID-19, work motivation, and occupational intention. Results: Only 37.2% of respondents committed to their current job and about 40% reported a decrease in their job satisfaction. The Work Motivation Scale scored the lowest in "financial motivation" and the highest in "perception of work value". Participants who were in the north region, of younger age, unmarried, and who had a low level of adaptability to external work pressure, shorter experience, and less job satisfaction tended to be less motivated and committed to their current job. Conclusions: Intrinsic motivation has increased in importance during the pandemic. Therefore, policymakers should develop interventions that raise intrinsic, psychological motivation instead of only focusing on salary raises. Issues about intrinsic motivations of health care workers such as low adaptability to stress and professionalism in routine work should be prioritized during the pandemic preparedness and control.

Impacts of COVID-19 on career choices in health professionals and medical students.

BACKGROUNDS: The COVID-19 pandemic has resulted in not only significant mortalities in Vietnam but has had an impact on its economy. Previous studies have highlighted how the pandemic has had a marginal impact on Vietnamese healthcare workers working at the frontlines. To date, there have been several other studies examining the impact of COVID-19 on intentions to transition between jobs among healthcare professionals, but this has yet to be explored amongst Vietnamese healthcare workers. METHODS: To achieve the study's objectives an online cross-sectional study was conducted between September to November 2021. Snowball sampling methodology was adopted for the recruitment of participants. The questionnaire that was used for this study comprised of the following sections: (a) socio-demographic information; (b) impact of COVID-19 on work; (c) risk of exposure to COVID-19; (d) career choices/intentions to change job, and (e) motivation at work. RESULTS: There were 5727 completed the entire survey. 17.2% of the respondents have had increased job satisfaction, 26.4% reported increased motivation to work, and 40.9% reported decreased motivation to work. Whilst there were changes in the daily work intensity and the level of work-related stress, more than 60% of respondents we sampled did not intend to switch careers. Demographic variables like gender, whether one was a student or an existing healthcare worker, and income related to work motivation. The community's stigma was a negative factor that declined intrinsic motivation as well as decreased work retention. CONCLUSIONS: Our study is instrumental in identifying the impact of COVID-19 on career choices amongst Vietnamese healthcare workers. The factors identified have clear implications for policymaking.

Impact of COVID-19 on the change in work conditions and career choices in general Vietnamese population

Objectives The onset of COVID-19 has resulted in both morbidity and mortality. It also has a consequential impact on the Vietnamese economy. Prior studies have examined the impact of COVID-19 on healthcare professionals' career decisions. However, no study remains to have examined the work conditions and career choices in a general Vietnamese population. Our study aims to identify factors associated with the change in work conditions and career choices in general Vietnamese population. Methods An online cross-sectional study between September 2021 through to November 2021 (during the Omicron COVID-19 pandemic). Snowball sampling method was utilized in recruiting the participants. The questionnaire used in this study included the following questions: (a) Socio-demographic information;(b) impact of COVID-19 on personal habits/daily expenses;(c) Current nature of work and impact of COVID-19 on work;(d) Impact of COVID-19 on career decisions. Data analysis was performed using STATA version 16. Descriptive analysis followed by Ordered logit regression was performed, to identify potential covariates. Results Six hundred and fifty participants were recruited, of which only 645 completed the survey. The completion rate was 99.2%. This study demonstrated the impact that COVID-19 has on finances, as only 32% of those sampled reported that they were able to pay in full. 46.6% of the respondents have had a decrease in their overall household income. With regards to their employment and work characteristics, 41.0% reported a decrease in their work satisfaction and 39.0% reported having reduced motivation for work. Females were less likely to consider transiting from their current job to another field than male participants. Respondents who were married, had a higher level of commitment to their current job, and lower inclination to transition to another field. Respondents experiencing financial difficulties were more likely to consider a transition to another field/work. Conclusion This is perhaps one of the first studies to have examined the impact of COVID-19 on work intentions regarding career choices and transitions in the general Vietnamese population. Future financial policies must take into consideration these factors.

Capacity of local authority and community on epidemic response in Vietnam: Implication for COVID-19 preparedness.

Local authority's response and community adaptive capacity are critically important for the prevention and control of infectious diseases, especially for the disease with an astonishing speed of spreading like COVID-19. This study aims to examine the perception on the capability of local authority's response and community adaptation among core workforces in responding to acute events in Vietnam. Health professionals, medical students, and community workers in all regions of Vietnam were invited to participate in a web-based survey from December 2019 to February 2020. The snowball sampling technique was utilized to recruit respondents. The Tobit multivariable regression model was used to identify associated factors. The results showed that based on a 0-10 numeric rating scale, the mean scores of the capacity of local agencies and community adaptation were 6.2 ± 2 and 6.0 ± 1.8, respectively. Regarding local authority competencies, the lowest score went to "Adequate equipment, infrastructures and funding for disease prevention". For community adaptation, the respondents evaluated the capacity on "Periodic training, equipment and drills to prepare for epidemic and disaster response" competency" with the lowest mark (5.2 ± 2.5). Overall, there were significant differences in the assessment of community adaptive capacity between urban and rural areas (p < 0.01). This study indicated the moderate capacity of the local authority and community adaptation on epidemics and disasters in Vietnam. It is critically necessary to develop the action plan, response scenario and strategies to optimize the utilization of equipment and human resources in combating epidemics for each setting.

Impact of SARS-CoV-2 Infection on Cognitive Function: A Systematic Review.

The prevalence and etiology of COVID-19's impact on brain health and cognitive function is poorly characterized. With mounting reports of delirium, systemic inflammation, and evidence of neurotropism, a statement on cognitive impairment among COVID-19 cases is needed. A substantial literature has demonstrated that inflammation can severely disrupt brain function, suggesting an immune response, a cytokine storm, as a possible cause of neurocognitive impairments. In this light, the aim of the present study was to summarize the available knowledge of the impact of COVID-19 on cognition (i.e., herein, we broadly define cognition reflecting the reporting on this topic in the literature) during the acute and recovery phases of the disease, in hospitalized patients and outpatients with confirmed COVID-19 status. A systematic review of the literature identified six studies which document the prevalence of cognitive impairment, and one which quantifies deficits after recovery. Pooling the samples of the included studies (total sample n = 644) at three standards of quality produced conservative estimates of cognitive impairment ranging from 43.0 to 66.8% prevalence in hospitalized COVID-19 patients only, as no studies which report on outpatients met criteria for inclusion in the main synthesis. The most common impairment reported was delirium and frequent reports of elevated inflammatory markers suggest etiology. Other studies have demonstrated that the disease involves marked increases in IL-6, TNFα, and IL-1ß; cytokines known to have a profound impact on working memory and attention. Impairment of these cognitive functions is a characteristic aspect of delirium, which suggests these cytokines as key mediators in the etiology of COVID-19 induced cognitive impairments. Researchers are encouraged to assay inflammatory markers to determine the potential role of inflammation in mediating the disturbance of cognitive function in individuals affected by COVID-19.

Severity and geographical disparities of post-COVID-19 symptoms among the Vietnamese general population: a national evaluation.

Post-COVID-19 symptoms have become a significant global health concern. This study focused on assessing the prevalence, severity, and care preference of post-COVID-19 symptoms, as well as identifying determinants to inform evidence-based policy on post-COVID-19 in Vietnam. A national cross-sectional study was conducted in May 2022 among 12,361 recovered COVID-19 patients, providing the largest dataset on health status after COVID-19 in Vietnam. The study utilized ordered logistic, Poisson regression, Multilevel linear random-effects models, and Multilevel random effects ordered logistic model to identify factors associated with various aspects of post-COVID-19 conditions. Results showed that the average number of post-COVID-19 symptoms was approximately 3, with fatigue and headache being the most common symptoms. The number of post-COVID-19 symptoms varied by province, decreased with age, and was significantly correlated with the duration of infection. Age, infection period, underlying conditions, telehealth utilization, and geographical location were identified as significant determinants of post-COVID-19 symptoms. The study concluded that improving resource allocation and health-seeking behavior in underserved areas could help address differences in health outcomes and improve post-COVID-19 control in Vietnam.

Factors Associated with Community Awareness on COVID-19 in a Developing Country: Implications for Optimal Risk Communication.

Purpose: New COVID-19 variants pose great challenges in protecting the success of vaccination programs. Awareness of community becomes an important component to prevent the spread of COVID-19. This study aims to analyze people's awareness of COVID-19 and identify the implications for optimal risk communication in Vietnam. Study Methods and Materials: A total of 341 individuals participated in an online cross-sectional study. Community awareness on COVID-19 was examined by using a structured questionnaire. Multivariable Tobit regression was used to examine associated factors with community awareness. Results: Our results indicated high levels of awareness of local COVID-19 situation, transmission risks, and preventive behavioral practices during the first week of social isolation. Higher awareness of local pandemic situation was associated with female respondents (Coef.: 6.19; 95% CI: 0.51; 11.87) and larger family sizes of above 5 people (Coef.: 9.00; -1.00; 19.00). Respondents between 35-44 years old were shown to be less aware of preventive behavioral practices than other age groups, including the group of participants above 44 years old (Coef.: -0.34; 95% CI: -0.67; -0.02). Lastly, participants who were "fairly satisfied" with information resources had awareness levels of preventive behavioral practices lower than that of "unsatisfied" respondents (Coef.: -0.45; 95% CI: 0.74; -0.16). Conclusion: This study offers crucial insights into the pandemic awareness of citizens and risk communication effectiveness during COVID-19 in Vietnam. The study findings shall serve the development of policies and interventions aimed at empowering individuals in the local and global fight against coronavirus.

COVID-19 vaccination for the prevention and treatment of long COVID: A systematic review and meta-analysis.

Empirical evidence addressing the association between SARS-CoV-2 vaccination and long COVID would guide public health priorities and inform personal health decisions. Herein, the co-primary objectives are to determine the differential risk of long COVID in vaccinated versus unvaccinated patients, and the trajectory of long COVID following vaccination. Of 2775 articles identified via systematic search, 17 were included, and 6 were meta-analyzed. Meta-analytic results determined that at least one vaccine dose was associated with a protective effect against long COVID (OR 0.539, 95% CI 0.295-0.987, p = 0.045, N = 257 817). Qualitative analysis revealed that trajectories of pre-existing long COVID following vaccination were mixed, with most patients reporting no changes. The evidence herein supports SARS-CoV-2 vaccination for the prevention of long COVID, and recommends long COVID patients adhere to standard SARS-CoV-2 vaccination schedules.

Psychological Health of Surgeons in a Time of COVID-19: A Global Survey.

OBJECTIVE: To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic. SUMMARY BACKGROUND DATA: The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19. METHODS: We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the Depression Anxiety Stress Scale-21 (DASS-21) and Impact of Event Scale-Revised (IES-R) scores. RESULTS: 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9% and 24.0% screened positive for depression, anxiety, stress and Post-Traumatic Stress Disorder (PTSD) respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress and PTSD (OR 1.3, 1,6, 1.4, 1.7 respectively, all p < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress and PTSD (OR 1.2, 1.2 and 1.3 respectively, all p < 0.05). Surgical specialities that operated in the Head and Neck region had higher psychological distress among its surgeons. Deployment for COVID-19-related work was not associated with increased psychological distress. CONCLUSIONS: The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.

Preference and Willingness to Pay for the Regular COVID-19 Booster Shot in the Vietnamese Population: Theory-Driven Discrete Choice Experiment.

BACKGROUND: The COVID-19 booster vaccination rate has declined despite the wide availability of vaccines. As COVID-19 is becoming endemic and charges for regular booster vaccination are being introduced, measuring public acceptance and the willingness to pay for regular COVID-19 boosters is ever more crucial. OBJECTIVE: This study aims to (1) investigate public acceptance for regular COVID-19 boosters, (2) assess the willingness to pay for a COVID-19 booster shot, and (3) identify factors associated with vaccine hesitancy. Our results will provide crucial insights into and implications for policy response as well as the development of a feasible and effective vaccination campaign during Vietnam's waning vaccine immunity period. METHODS: A cross-sectional study was conducted among 871 Vietnamese online participants from April to August 2022. An online questionnaire based on the discrete choice experiment (DCE) design was developed, distributed using the snowball sampling method, and subsequently conjointly analyzed on the Qualtrics platform. A history of COVID-19 infection and vaccination, health status, willingness to vaccinate, willingness to pay, and other factors were examined. RESULTS: Among the participants, 761 (87.4%) had received or were waiting for a COVID-19 booster shot. However, the willingness to pay was low at US $8.02, and most participants indicated an unwillingness to pay (n=225, 25.8%) or a willingness to pay for only half of the vaccine costs (n=222, 25.4%). Although information insufficiency and a wariness toward vaccines were factors most associated with the unwillingness to pay, long-term side effects, immunity duration, and mortality rate were the attributes the participants were most concerned with during the vaccine decision-making period. Participants who had children less than 18 years old in their homes infected with COVID-19 had a lower willingness to pay (odds ratio [OR] 0.54, 95% CI 0.39-0.74). Respondents who had children under 12 years old in their family who received at least 1 vaccine dose had a higher willingness to pay (OR 2.03, 95% CI 1.12-3.66). The burden of medical expenses (OR 0.33, 95% CI 0.25-0.45) and fear of the vaccine (OR 0.93, 95% CI 0.86-1.00) were negative factors associated with the level of willingness to pay. CONCLUSIONS: A significant inconsistency between high acceptance and a low willingness to pay underscores the role of vaccine information and public trust. In addition to raising awareness about the most concerning characteristics of the COVID-19 booster, social media and social listening should be used in collaboration with health professionals to establish a 2-way information exchange. Work incentives and suitable mandates should continue to encourage workforce participation. Most importantly, all interventions should be conducted with informational transparency to strengthen trust between the public and authorities.

Measurement of burnout during the prolonged pandemic in the Chinese zero-COVID context: COVID-19 burnout views scale

Burnout is an important public health issue at times of the COVID-19 pandemic. Current measures which focus on work-based burnout have limitations in length and/or relevance. When stepping into the post-pandemic as a new Norm Era, the burnout scale for the general population is urgently needed to fill the gap. This study aimed to develop a COVID-19 Burnout Views Scale (COVID-19 BVS) to measure burnout views of the general public in a Chinese context and examine its psychometric properties. A multiphase approach including literature review, expert consultation, and pilot testing was adopted in developing the scale. The scale was administered to a sample of 1,078 of the general public in Hong Kong with an average age of 34.45 years (SD = 12.47). Exploratory and Confirmatory Factor Analyses suggested a 5-item unidimensional model of COVID-19 BVS. The CFA results indicated that the COVID-19 BVS had a good model fit, as χ2 (10.054)/5 = 2.01, SRMR = 0.010, CFI = 0.998, RMSEA = 0.031. Five items were maintained in EFA with high internal consistency in terms of Cronbach's α of 0.845 and McDonald's ω coefficient of 0.87, and the corrected item-to-total correlations of 0.512 to 0.789 are way above the acceptable range. The KMO values of 0.841 and Bartlett's Test of Sphericity (p < 0.01) verified the normal distribution of the EFA and the adequacy of the EFA sampling. The analyses suggest that the COVID-19 BVS is a promising tool for assessing burnout views on the impacts of the epidemic on the Chinese general populations.

Protecting mental health of young adults in COVID-19 pandemic: Roles of different structural and functional social supports.

BACKGROUND: Concerning rates of psychological disorders are increasingly recognized in young adults during the COVID-19 pandemic. This study aimed to examine the associations of different structural and functional social supports on depression, anxiety, and stress among young adults in Vietnam. METHODS: An online cross-sectional study was performed on 236 respondents aged 16 to 30 years in Vietnam from June to July 2020. The Depression, Anxiety and Stress Scale-21 Items (DASS-21); the Multidimensional Scale of Perceived Social Support (MSPSS), and the LUBBEN Social Network Scale (LSNS-6) was used to measure psychological health, functional and structural social support characteristics. Multi-level mixed-effect logistic regression was used to identify associations between social support and anxiety, depression, and stress. RESULTS: The rate of at least mild depression, anxiety, and stress were 30.1%, 34.8%, and 35.6%, respectively. Structural supports measured by LSNS-6 were not associated with the likelihood of having depression, anxiety, and stress (p>0.05). Respondents having friends with whom they could share joys and sorrows were less likely to have anxiety (aOR = 0.61, 95%CI = 0.41-0.90) and stress (aOR = 0.66, 95%CI = 0.45-0.96). Having family support in decision-making was also negatively associated with depression, anxiety, and stress. Meanwhile, those having family and friends who tried to help them were more likely to suffer stress (aOR = 1.94, 95%CI = 1.16-3.24) and depression (aOR = 2.09; 95%CI = 1.11-3.92), respectively. CONCLUSION: This study highlighted a high rate of psychological problems among young adults during the COVID-19 pandemic in Vietnam. Emotional support from friends and advice support from family were important components that should be considered in further interventions to mitigate the psychological problems in young adults.

Global mapping of epidemic risk assessment toolkits: A scoping review for COVID-19 and future epidemics preparedness implications.

Preparedness and responses to infectious disease epidemics and pandemics require the understanding of communities' and multisectoral systems' characteristics with regards to diseases transmission and population's vulnerabilities. This study aimed to summarize measurement profiles of existing risk assessment toolkits to inform COVID-19 control at global and national levels. An online search in different databases and online sources was performed to identify all epidemic risk and vulnerability assessment instruments. Medline/PubMed, Web of Science databases, and websites of public health organizations were used for the searching process. Of 14 toolkits, levels of setting were mostly at the global or nation level. Components such as Governance and Legislation, Financing, Health Service Provision, and Human Resources are key domains in almost all toolkits. Some important issues for disease detection and surveillance, such as laboratory or capacity of the community for disease control, were not adequately addressed in several toolkits. Limited studies were found that validated the toolkits. Only five toolkits were used in COVID-19 studies. This study provides a summary of risk assessment toolkits to inform epidemic responses. We call for global and national efforts in developing more contextualized and responsive epidemic risk assessment scales incorporating specific-disease and -country factors to inform operational decisions making and strengthen countries' capacities in epidemic responses.

COVID-19 Burnout Subject to the Dynamic Zero-COVID Policy in Hong Kong: Development and Psychometric Evaluation of the COVID-19 Burnout Frequency Scale

We sought to develop and validate a self-assessment burnout scale of the Chinese general population during the COVID-19 pandemic in the context of a dynamic zero-COVID policy. Factors relevant to individuals' burnout during the prolonged COVID-19 pandemic were identified in the literature and through the reviews of an expert panel. A convenience sample of 1087 was randomly divided into two subsamples and the scale's psychometric properties were assessed. Findings suggested that the COVID-19 BFS has adequate reliability (α= 0.90) along with factorial, concurrent, and convergent validity. Results of confirmatory factor analysis (CFA) supported the one-factor structure of the scale. Concurrent validity results indicate a significant positive correlation between COVID-19 BFS and the Fear of COVID-19 Scale (r = 0.131, p < 0.001), suggesting that individuals with higher levels of burnout may also have higher levels of fear of COVID, or vice versa. The scale was also correlated positively with being against the dynamic zero-COVID strategy (r = 0.340, p < 0.001), indicating that a higher level of burnout may be associated with individuals who are against the dynamic zero-COVID strategy. The results suggest the five-item COVID-19 BFS is a valid and reliable scale for the measurement of burnout frequency of the Chinese general population in relation to the prolonged COVID-19 pandemic in a dynamic zero-COVID policy context.

Investigating Psychological Differences Between Nurses and Other Health Care Workers From the Asia-Pacific Region During the Early Phase of COVID-19: Machine Learning Approach.

BACKGROUND: As the COVID-19 pandemic evolves, challenges in frontline work continue to impose a significant psychological impact on nurses. However, there is a lack of data on how nurses fared compared to other health care workers in the Asia-Pacific region. OBJECTIVE: This study aims to investigate (1) the psychological outcome characteristics of nurses in different Asia-Pacific countries and (2) psychological differences between nurses, doctors, and nonmedical health care workers. METHODS: Exploratory data analysis and visualization were conducted on the data collected through surveys. A machine learning modeling approach was adopted to further discern the key psychological characteristics differentiating nurses from other health care workers. Decision tree-based machine learning models (Light Gradient Boosting Machine, GradientBoost, and RandomForest) were built to predict whether a set of psychological distress characteristics (ie, depression, anxiety, stress, intrusion, avoidance, and hyperarousal) belong to a nurse. Shapley Additive Explanation (SHAP) values were extracted to identify the prominent characteristics of each of these models. The common prominent characteristic among these models is akin to the most distinctive psychological characteristic that differentiates nurses from other health care workers. RESULTS: Nurses had relatively higher percentages of having normal or unchanged psychological distress symptoms relative to other health care workers (n=233-260 [86.0%-95.9%] vs n=187-199 [74.8%-91.7%]). Among those without psychological symptoms, nurses constituted a higher proportion than doctors and nonmedical health care workers (n=194 [40.2%], n=142 [29.5%], and n=146 [30.3%], respectively). Nurses in Vietnam showed the highest level of depression, stress, intrusion, avoidance, and hyperarousal symptoms compared to those in Singapore, Malaysia, and Indonesia. Nurses in Singapore had the highest level of anxiety. In addition, nurses had the lowest level of stress, which is the most distinctive psychological outcome characteristic derived from machine learning models, compared to other health care workers. Data for India were excluded from the analysis due to the differing psychological response pattern observed in nurses in India. A large number of female nurses emigrating from South India could not have psychologically coped well without the support from family members while living alone in other states. CONCLUSIONS: Nurses were least psychologically affected compared to doctors and other health care workers. Different contexts, cultures, and points in the pandemic curve may have contributed to differing patterns of psychological outcomes amongst nurses in various Asia-Pacific countries. It is important that all health care workers practice self-care and render peer support to bolster psychological resilience for effective coping. In addition, this study also demonstrated the potential use of decision tree-based machine learning models and SHAP value plots in identifying contributing factors of sophisticated problems in the health care industry.