Factors affecting the intention of healthcare workers and students to receive COVID-19 booster dose vaccination: a systematic review (preprint)

Background The COVID-19 pandemic has caused an unprecedented health, social and economic crisis worldwide, as the SARS-CoV-2 virus has managed to cause a major threat with significant morbidity and mortality in certain population groups. The risk of the virus is exacerbated by its easy transmission and continued spread, despite multilevel interventions, extensive containment measures and vaccination. Vaccine hesitancy refers to a person’s reluctance, delay in accepting or even refusing to be vaccinated despite available vaccination services.Objective To investigate the factors that influence health professionals and students of health sciences to accept, or not, a booster dose of a COVID-19 vaccine. Sub-objectives were to assess vaccine hesitancy, and specifically those of booster doses, and the presentation of views and attitudes in the above population groups.Methods The relevant bibliography was searched electronically in scientific databases such as PubMed, Embase, Cochrane Library and Scopus until August 2023. The main selection criteria were mainly descriptive studies, published in English and Greek. The subjects were human over 18 years old. The time frame of this search was the last four years.Results From the results of the systematic review, it was shown that many different factors influence the intention of both healthcare workers and students, as well as those in the general population, to accept a COVID-19 booster dose vaccine. At the same time, the health professionals and students of different countries and continents -that were studied- present diverse socio-demographic characteristics that influence their willingness, or not, to be vaccinated.Conclusions COVID-19 booster doses offer further immunity and reduce severe impacts of the disease, such as hospitalization and death. Since health professionals play a critical role in shaping local communities’ attitudes towards vaccines, their beliefs and attitudes play a crucial role. For this reason, it is recommended both training students and healthcare workers via competent institutions, as well as to mobilize and sensitize them, in order to base their attitudes on evidence-based practice. As new technologies and policies are built around COVID-19 vaccines, ongoing testing of their effectiveness, and updated guidelines according to the population group are proven vital to the impact of the disease. Further future studies are necessary.

Social Support and Resilience Are Protective Factors against COVID-19 Pandemic Burnout and Job Burnout among Nurses in the Post-COVID-19 Era (preprint)

Nurses have experienced several psychological and work-related issues during the COVID-19 pandemic including pandemic burnout and job burnout. The aim of the study was to examine the impact of social support and resilience on COVID-19 pandemic burnout and job burnout among nurses. We conducted a cross-sectional study in Greece. Study population included 963 nurses. We measured social support, resilience, COVID-19 pandemic burnout, and job burnout with the Multidimensional Scale of Perceived Social Support, Brief Resilience Scale, COVID-19 burnout scale, and single item burnout measure respectively. Nurses received high levels of social support, while their resilience was moderate. Additionally, nurses experienced moderate levels of COVID-19 burnout and job burnout. Increased social support (adjusted beta = -0.075, 95% CI = -0.125 to -0.024) and increased resilience (adjusted beta = -0.399, 95% CI = -0.491 to -0.308) were associated with reduced COVID-19 pandemic burnout. We found a negative relationship between social support and job burnout (adjusted beta = -0.263, 95% CI = -0.405 to -0.121). A similar negative relationship was found between resilience and job burnout (adjusted beta = -0.529, 95% CI = -0.785 to -0.272). Social support and resilience can act as protective factors against COVID-19 pandemic burnout and job burnout among nurses. Policy makers should develop and implement appropriate strategies to improve nurses’ social support and resilience since they are the backbone of healthcare systems worldwide.

The influence of job burnout on quiet quitting among nurses: the mediating effect of job satisfaction (preprint)

Introduction: Quiet quitting seems to be a new threat for healthcare workers and organizations. Individuals now tend to stay at their jobs covering only the bare requirements. High levels of burnout among nurses especially after the COVID-19 pandemic could further increase their levels of quiet quitting. Objective: To investigate the impact of nurses’ job burnout on their quiet quitting. Moreover, we assessed the mediating effect of job satisfaction on the relationship between burnout and quiet quitting. Methods: We conducted a cross-sectional study in Greece. We collected data during June 2023. A convenience sample of 946 nurses was obtained. We used the “Quiet Quitting” Scale (QQS) to measure levels of quiet quitting within nurses, the “Copenhagen Burnout Inventory” to measure job burnout, and “Job Satisfaction Survey” (JSS) to measure job satisfaction. In mediation analysis, we controlled for the effects of demographic and job characteristics. Results: Mean score on QQS was 2.36, while on JSS was 101.23. Also, mean scores on work-related burnout, personal burnout, and client-related burnout were 62.25, 64.53, and 64.45 respectively. Job burnout was a positive predictor of quiet quitting (beta = 0.009, 95% confidence interval = 0.007 to 0.012, p < 0.001), while job satisfaction was a negative predictor of quiet quitting (beta = -0.004, 95% confidence interval = -0.006 to -0.003, p < 0.001). Job satisfaction partially mediated the positive relationship between burnout and quiet quitting (indirect effect = 0.0035, 95% confidence interval = 0.0021 to 0.0051, p < 0.001). Conclusion: Job burnout affected quiet quitting within nurses through the mediating effect of job satisfaction. It is essential to reduce burnout and improve satisfaction to decrease level of quiet quitting among nurses. Effective measures should be taken to decrease nurses’ job burnout in order to improve their job satisfaction and thereby reduce their quiet quitting.

Nurses quietly quit their job more often than other healthcare workers: an alarming issue for healthcare services (preprint)

Background: Quiet-quitting phenomenon in not new but has been frequently discussed during the COVID-19 pandemic. Interestingly, the level of quiet quitting among healthcare workers (HCWs) has not been measured yet. Objective: To assess the level of quiet quitting among HCWs, and identify possible differences between nurses, physicians, and other HCWs. Moreover, we investigated the impact of socio-demographic variables, job burnout, and job satisfaction on quiet quitting levels. Methods: We conducted a cross-sectional study with a convenience sample of HCWs during June 2023. HCWs included nurses, physicians, dentists, pharmacists, midwives, psychologists, and physiotherapists that have been working in healthcare services. We measured socio-demographic characteristics of HCWs, job burnout with “Copenhagen Burnout Inventory”, job satisfaction with “Job Satisfaction Survey”, and quiet quitting with “Quiet Quitting” Scale. Results: Study population included 1760 HCWs with a mean age of 41.1 years. Among our sample, 57.9% were quiet quitters, while 42.1% were non quiet quitters. In particular, 67.4% of nurses were quiet quitters, while prevalence of quiet quitting for physicians and other HCWs were 53.8% and 40.3% respectively (p<0.001). Multivariable linear regression analysis identified that the levels of quiet quitting were higher among nurses than physicians and other HCWs. Moreover, greater job burnout contributed more to quiet quitting, while less satisfaction implied more quiet quitting. Shift HCWs, and those working in private sector experienced higher levels of quiet quitting. Additionally, we found a negative relationship between clinical experience and quiet quitting. Conclusions: More than half of our HCWs were described as quit quitters. Levels of quiet quitting were higher among nurses even when controlling for several confounders. Higher levels of job burnout and lower levels of job satisfaction were associated with higher levels of quiet quitting.

Prevalence and risk factors of adverse effects after the first COVID-19 booster dose: evidence from Greece (preprint)

Background: In general, COVID-19 vaccines are safe and effective, but minor adverse effects are common. Objective: To estimate the prevalence of adverse effects after the first COVID-19 booster dose, and to identify possible risk factors. Material and methods: We conducted a cross-sectional study with a convenience sample in Greece during November 2022. We measured several adverse effects after the booster dose, such as pain at the injection site, swelling at the injection site, fatigue, muscle pain, headaches, fever, chills, nausea, etc. We considered gender, age, chronic disease, self-assessment of health status, COVID-19 diagnosis, and self-assessment of COVID-19 course as possible predictors of adverse effects. Results: In our sample, 96% developed at least one adverse effect. Half of the participants (50.2%) developed one to five adverse effects, 35.9% developed six to ten adverse effects, and 9.5% developed 11 to 16 adverse effects. Mean number of adverse effects was 5.5. The most frequent adverse effects were pain at the injection site (84.3%), fatigue (70.8%), muscle pain (61%), swelling at the injection site (55.2%), headache (49.8%), fever (42.9%), and chills (41%). Females developed more adverse effects than males (p<0.001). Also, we found a positive relationship between severity of COVID-19 symptoms and adverse effects of COVID-19 vaccines (p=0.005). Moreover, younger age was associated with increased adverse effects (p<0.001). Conclusions: Almost all participants in our study developed minor adverse effects after the booster dose. Female gender, worse clinical course of COVID-19, and decreased age were associated with increased adverse effects.

Post-COVID-19 syndrome and related dysautonomia affect patients life and work productivity (preprint)

Background: A significant percentage of COVID-19 patients experience post-COVID-19 symptoms and signs. Post-COVID-19 syndrome affects physical and mental health of patients in several ways. Aim: To investigate the impact of post-COVID-19 syndrome and related dysautonomia on patients life and work productivity. Methods: We conducted a cross-sectional study in Greece using an online questionnaire. Study population included 108 workers over 18 years old that have been diagnosed with post-COVID-19 syndrome. Patients were recruited from the Long COVID Greece patients society. We measured demographic and clinical characteristics of patients, resilience, and social support. Results: Among patients, 68.5% stated that post-COVID-19 syndrome affected their daily life to a great extent, 25% to a moderate level, and 6.5% to a small extent. Moreover, 56.5% stated that post-COVID-19 syndrome affected their work productivity to a great extent, 27.8% to a moderate level, and 15.7% to a small extent. Multivariable analysis identified that females and patients with post-COVID-19 dysautonomia had more problems in their daily life. Moreover, increased duration of COVID-19 symptoms was associated with increased daily problems. Increased resilience was related with fewer problems in daily life. Also, we found that patients with post-COVID-19 dysautonomia had less work productivity. Moreover, increased duration of COVID-19 symptoms was associated with more problems in work. Resilience was related with increased work productivity. Conclusions: Post-COVID-19 syndrome and related dysautonomia affect significantly patients daily and work life. Also, resilience is an important preventive factor improving patients life. Policy makers should develop and implement educational programs to improve patients life. Healthcare professionals should be aware of the post-COVID-19 syndrome and its consequences in order to understand post-COVID-19 patients and their problems.

Post-COVID-19 syndrome and related dysautonomia reduce quality of life, and increase anxiety and depressive symptoms: evidence from Greece (preprint)

Background: Post-COVID-19 syndrome affects a significant number of SARS-CoV-2 infected individuals even asymptomatic cases causing several neurological and neuropsychiatric symptoms and signs. Materials and Methods: An online cross-sectional study with a convenience sample was conducted in Greece from November 2022 to January 2023. We measured demographic and clinical characteristics of patients, post-COVID-19 dysautonomia, quality of life with the EQ-5D-3L, and anxiety and depressive symptoms with the Patient Health Questionnaire-4. Results: Study population included 122 patients with post-COVID-19 syndrome. One out of four patients (27.8%) manifested post-COVID-19 dysautonomia, while mean duration of COVID-19 symptoms was 11.6 months. Anxiety and depressive symptoms were worse after the post-COVID-19 syndrome (p<0.001 in both cases). A statistically significant reduction in quality of life was observed among patients after the post-COVID-19 syndrome (p<0.001 for both EQ-5D-3L index value and EQ-5D-3L VAS). Post-COVID-19 dysautonomia increased depression symptoms after the post-COVID-19 syndrome (p=0.02). We found a negative relationship between duration of COVID-19 symptoms and quality of life (p<0.001). Moreover, our results showed that depressive symptoms were more often among females after the post-COVID-19 syndrome (p=0.01). Also, quality of life was lower among females than males (p=0.004 for EQ-5D-3L index value, and p=0.007 for EQ-5D-3L VAS). Conclusions: Our results suggest that post-COVID-19 syndrome causes a tremendous impact on patients quality of life and mental health. In addition, we found that the groups most psychologically affected were patients with post-COVID-19 dysautonomia, females, and patients with longer duration of symptoms. Policy makers should attach priority to vulnerable groups in future psychiatric planning. Policy measures should focus on mental health of post-COVID-19 patients who seem to be particularly vulnerable.

Resilience and social support improve mental health and quality of life in patients with post-COVID-19 syndrome (preprint)

The effects of post-COVID-19 syndrome on patients' life are significant. As there is no prior study available, we investigated the impact of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4, and the EuroQol-5D-3L. Multivariable analysis identified that resilience and social support reduced anxiety and depression among our patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. In conclusion, our findings suggest that resilience and social support can be protective by reducing anxiety and depression, and improving quality of life among patients with post-COVID-19 syndrome. Policy makers should develop and implement healthcare management programs to provide psychological support to these patients.