Health Moral Impasse and Emotional Resilience Enhancement Measures During Covid 19 Pandemic

Aim: This systematic review aims at presenting the moral impasse factors on health professionals in times of crisis such as pandemic covid-19 but also in the wider framework of the last decade and seeking enhancement methods of mental resilience. Methodology: The sources searched were based primarily on literature Pubmed database. Keywords such as "moral impasse", "mental resilience", "moral distress" and "covid-19" were used. The articles found, without timing, were 102 and here 13 were used. Inclusion criteria were the statistical representation, conclusions were presented additionally coupled with Covid-19 era and moral impasse and the creation of emotional resilience in healthcare sector according to the most recent studies. Results: Factors that contribute to healthcare workers' moral burnout are categorized into three classes: internal factors, external and clinical conditions. The emergence of SARS-CoV-2 revealed new factors for instance the availability and management of limited resources, the lack of protection for themselves and their loved ones, the time and critical cases management, the end of life care, the communication skills between colleagues, the infections' prevention and the imposition of new health protocols, which, added to already existing areas though. Analysis of factors and address them leads to the need for mental resilience enhancement of healthcare providers, which can be carried out at individual, interpersonal, but mainly in administrative-organizational level. Conclusion: The essential and foremost interventions pertain to the perception of ethical problems by the health administration at the time, the provision of understanding and solidarity to the clinical caregivers and their inclusion in the decision-making process but also the common response of the ethical issues that arise in the health sector both in times of crisis and in more general terms.

THE INVESTIGATION OF THE PSYCHOLOGICAL BURDEN OF PATIENTS AFTER HOSPITALIZATION FOR COVID 19.

OBJECTIVE: The aim: The current Cross-Sectional study investigated the psychosocial effects on recovered Covid 19 patients in a General Hospital in Greece. It was investigated the impact of Covid 19 on levels of social support, loneliness, resilience & PTSD. Furthermore, the correlation between all the above factors was studied. PATIENTS AND METHODS: Materials and methods: 107 adult patients participated. The questionnaire was fulfilled after signature of consensus form. This happened after their discharge from the hospital, without exclusion of infected on previous time. The questionnaire included 5 particular sections: a) Socio-demographic characteristics, b) social support scale, c) IES Covid 19 scale, d) UCLA scale e) CD-Risc scale. In terms of statistical analysis, the comparison between two groups of quantitative variables was conducted through Student's t-test. Related to examination of relationship between two quantitative variables was used Pearson's correlation coefficient (r). The Statistical analysis package used was SPSS 22. RESULTS: Results: The 55,1% of sample were women, married (57,9 %) and (39,3%) university graduates. Moreover, the rate of overweight was significant (39,3%). Related to psychosocial factors, observed high level of resilience (70,6), moderate level of loneliness (39,1) and 57,9% of participants showed moderate social support. At last, PTSD level as a result of Covid 19 was moderate (33,5). A strong correlation was observed between higher mental resilience and lower feelings of loneliness. CONCLUSION: Conclusions: The levels of determining factors of negative psychological effects, reveal the need for a preparation of political improvement policies in relation to mental health of rehabilitated persons, as well as the promotion of actions that would contribute to the development of a more effective supportive framework.

Investigating Nurses Stress Response Strategies During the COVID-19 Pandemic.

BACKGROUND: Stress response strategies are a conscious effort to solve personal and interpersonal problems, aiming to minimize stress. OBJECTIVE: The aim of this study is to investigate the stress response strategies of nurses during the COVID-19 pandemic. METHODS: The sample consisted of 550 Greek nurses working in Greece and other European countries (460 women and 90 men). Ways of Coping was used as the data collection tool. Participants were invited to complete the questionnaire via online GOOGLE FORMS. The statistical processing was carried out using a descriptive and inferential analysis via the statistical package for Social Science (SPSS v.21). RESULTS: Analysis of the results shows a statistically significant difference between the two genders in the questionnaire's subscales "Search for social support" (Women=1.88, Men=1.57, p<0.001) and "Wishful Thinking" (Women=1.76, Men=1.51, p <0. Also, there was a statistically significant difference in terms of country of work regarding the following subscales: 'Search for social support' (Greece=1.85, Outside Greece=1.67, p=0.019), 'Wishful Thinking' (Greece=1.74, Outside Greece=1.51, p=0.005) and 'Problem Solving Assertion' (Greece=1.39, Outside Greece=1.13, p=0.001). CONCLUSION: Stress response strategies for nurses are fundamental in addressing the difficult situations and conditions they face due to the COVID-19 pandemic.

Effort Reward Imbalance and Insomnia Among Greek Healthcare Personnel During the Outbreak of COVID-19.

BACKGROUND: This study's objective was to examine associations between insomnia as measured by Athens Insomnia Scale (AIS) and perceived psychological work stress among nurses and physicians working in secondary and tertiary hospitals in Greece during the outbreak of COVID-19 pandemic. OBJECTIVE: Taking into account the small but significant differences in the development of ADHD in women, this literature review aims at identifying the special characteristics of ADHD symptoms in all stages of a woman's life from childhood to menopause. Being aware of these signs is important to provide the best quality of health care in ADHD women. METHODS: A cross-sectional study was conducted on a random sample of 268 healthcare workers (200 nurses and 68 physicians). The 8-item version of the AIS was used to assess insomnia. Perceived psychological work stress was investigated using the 23-item Effort-reward Imbalance (ERI) questionnaire based on the ERI model. RESULTS: HCWS who cared for more than 5 patients and worried about personal issues had a higher insomnia score. ER-ratio and over-commitment are significantly associated with insomnia. A significant correlation was found between worries about pandemic COVID-19 and over-commitment. CONCLUSION: Since high effort-reward imbalance (ER-ratio > 1) and overcommitment were positively associated to insomnia and the treatment of more than five patients with COVID-19 infection was impacting predictor of sleep difficulties, it is necessary to implement a reward system in which physicians and nurses will work in a less stressful environment aiming at reducing personnel's negative feelings, poor health and sleeping difficulties.

ICU Nurse's Moral Distress as an Occupational Hazard Threatening Professional Quality of Life in the Time of Pandemic COVID 19.

BACKGROUND: Moral distress is an unpleasant feeling that arises when one is forced to behave in such a way that it violates one's personal beliefs and values about what is right and what is wrong. Moral distress, unlike other forms of distress, contains an incompatible conflict between one's personal moral limitations and the acts that accompany it. OBJECTIVE: to investigate moral distress and its effects on the ICU nursing staff, their professional quality of life as well as, related factors. METHODS: The total sample of this cross-sectional study comprised of 258 ICU nurses working in reference hospitals for COVID 19 recruited online using google forms. The study tools are: a) "Measure of Moral Distress for Healthcare Professionals (MMD-HP)" to assess intensity and frequency of moral distress b) "Professional Quality of Life Scale (ProQOL-5)" to assess professional quality of life. Data were analyzed using IBM SPSS Statistics 25,0 (IBM Analytics, IBM Software Group Statistical Package). RESULTS: Overall MMD-HP score ranged from 3 to 262 with a mean score of 116.52 (SD= 68.56). Distress score ranged from 5 to 79 with a mean score of 43.67 (SD=17.44) while intensity score ranged from 3 to 108 with a mean score 52.04 (SD=22.69). Bivariate analysis showed there is a statistically significant positive correlation between the intensity of moral distress and overall moral distress score with years of service in ICU and age. Nurses' Assistants (m=48.1 p=0.021) scored higher than Registered nurses in distress and intensity score (m=54.1 p=0.020) while female also scored higher in overall MMD-HP (m=121.2 p=0.049). Multivariate logistic regression analysis, showed that secondary trauma scale was independently associated with a higher distress scale score and a higher MMD-HP. CONCLUSION: Educational support that provide information about dealing with moral distress during the coronavirus pandemic and how ICU nurses should deal with ethical issues that may confront in the everyday professional life is essential. Hospitals should monitor moral distress and there should be workshops that could build moral resilience and maintain high professional quality of life.