Impact of Isolation measures on pregnancy outcome during the COVID-19 pandemic.

This study aims to explore the impact of isolation measures implemented during the COVID-19 pandemic on childbirth outcomes in pregnant women. The design was a retrospective cohort study. The pregnant women during the outbreak lockdown and isolation from February 1 to April 30, 2020, were defined as the exposed population, and the pregnant women in the same time frame in 2019 as the non-exposed population. All data for the study were obtained from the National Health Care Data Platform of Shandong University. Generalized linear regression models were used to analyze the differences in pregnancy outcomes between the two study groups. A total of 34,698 pregnant women from Shandong Province, China in the data platform met the criteria and were included in the study. The proportions were 11.53% and 8.93% for macrosomia in the exposed and the non-exposed groups and were 3.47% and 4.37% for low birth weight infants, respectively, which were significantly different. They were 22.55% and 25.94% attributed to average exposed effect for macrosomia and low birth weight infants. Meanwhile, the mean weight and standard deviation of full-term infants in the exposure group were 3414.80 ± 507.43 g, which were significantly higher than in the non-exposed group (3347.22 ± 502.57 g, P < 0.001). The effect of exposure was significant in the third trimester. In conclusion, the isolation during the COVID-19 pandemic increases the birth weight of infants and the probability of macrosomia, regardless of which trimester in isolation a pregnant woman was, while the third trimester is the sensitive window of exposure. Our findings provide a basis for health care and policy development during pregnancy in COVID-19, due to COVID-19 still showing a pandemic trend around the world in 2022.

Serial-Multiple Mediation of Job Burnout and Fatigue in the Relationship Between Sickness Presenteeism and Productivity Loss in Nurses: A Multicenter Cross-Sectional Study.

Background: In China, sickness presenteeism, job burnout, and fatigue are common among nurses during the COVID-19 pandemic. We propose the prevalence of sickness presenteeism can adversely affect nurses' physical and mental health, negatively impact their work productivity and quality, and pose a threat to patients' safety. Therefore, this study examines the mechanism of productivity loss caused by sickness presenteeism, fatigue, and job burnout. Objectives: To investigate the serial-multiple mediating effect of job burnout and fatigue in the relationship between sickness presenteeism and productivity loss among nurses. Methods: A multicenter cross-sectional survey was undertaken by administering an online questionnaire from December 2020 to May 2021. Stratified cluster sampling was used to include 3,491 nurses from 14 hospitals in Shandong Province, China. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Chalder Fatigue Scale, and Maslach Burnout Inventory. Data analyses were carried out using descriptive statistics, one-way analysis of variance, independent-samples t-test, Pearson correlation analysis, hierarchical regression, and bootstrapping method. Results: From the 3,491 nurses who volunteered in this online survey, only 2,968 valid questionnaires were returned. Sickness presenteeism exhibited a prevalence of 70.6% during the COVID-19 pandemic. The average score of health-related productivity loss was 15.05 ± 4.52, fatigue was 8.48 ± 3.40, and job burnout was 39.14 ± 19.64. Sickness presenteeism was positively associated with fatigue and job burnout while job burnout was positively associated with nurse fatigue. Sickness presenteeism, fatigue, and job burnout were also positively correlated with health-related productivity loss. Statistically significant paths via the single mediation of fatigue and job burnout were established. A statistically significant serial-multiple mediating effect of fatigue and job burnout on the association between sickness presenteeism and productivity loss accounted for 35.12% of the total effect size. Conclusions: There was a high incidence of sickness presenteeism and job burnout among Chinese nurses. High-frequency sickness presenteeism may result in increased productivity loss through the two mediating effects of fatigue and job burnout. Sickness presenteeism may increase fatigue, promote job burnout, and result in increased productivity loss among Chinese nurses during the COVID-19 pandemic.

Predictors of Shift Work Sleep Disorder Among Nurses During the COVID-19 Pandemic: A Multicenter Cross-Sectional Study.

Background: Nurses have a high incidence of shift work sleep disorder, which places their health and patient safety in danger. Thus, exploring the factors associated with shift work sleep disorder in nurses is of great significance in improving their sleep health, nursing personnel staffing, and scheduling during the COVID-19 pandemic. Objectives: The purpose of this study was to investigate the incidence of shift work sleep disorder during the COVID-19 pandemic and explore the factors associated with shift work sleep disorder in Chinese nurses. Methods: This was a multicenter cross-sectional study using an online survey. Stratified cluster sampling was used to include 4,275 nurses from 14 hospitals in Shandong, China from December 2020 to June 2021. Stepwise multivariate logistic regression analysis and random forest were used to identify the factors associated with shift work sleep disorder. Results: The prevalence of shift work sleep disorder in the sampled shift nurses was 48.5% during the COVID-19 pandemic. Physical fatigue, psychological stress, shift work more than 6 months per year, busyness during night shift, working more than 40 h per week, working more than four night shifts per month, sleeping more than 8 h before night shift, using sleep medication, irregular meals, and high-intensity physical activity were associated with increased odds of shift work sleep disorder. Good social support, good work-family balance, napping two or three times per week, resting more than one day after shifts, intervals of 8 days or more between shifts, and taking turns to rest during the night shift were associated with decreased odds of shift work sleep disorder. Conclusions: Shift work sleep disorder may be associated with scheduling strategies and personal behavior during the COVID-19 pandemic. To reduce the incidence of shift work sleep disorders in nurses, nursing managers should increase night shift staffing, extend rest days after shift, increase night shift spacing, and reduce overtime, and nurses need to seek more family and social support and control their sleep schedules and diet.