Optimizing the Practice Environment for Medical Staff in the Post-pandemic Era: A Discrete Choice Experiment.

Objective: This study aimed to elicit the stated job preferences of Chinese medical staff in the post-pandemic era and identify the relative importance of different factors in the practice environment. Methods: We used an online discrete choice experiment (DCE) survey instrument to elicit the job preferences of medical staff (doctors and nurses) in tertiary hospitals in Anhui, China. Attributes and levels were generated using qualitative methods, and four attributes were considered: career development, workload, respect from society, and monthly income. A set of profiles was created using a D-efficient design. The data were analyzed considering potential preference heterogeneity, using the conditional logit model and the latent class logit (LCL) model. Results: A total of 789 valid questionnaires were included in the analysis, with an effective response rate of 73.33%. Career development, workload, respect from society, and monthly income were significant factors that influenced job preferences. Three classes were identified based on the LCL model, and preference heterogeneity among different medical staff was demonstrated. Class 1 (16.17%) and Class 2 (43.51%) valued respect from society most, whereas Class 3 (40.32%) prioritized monthly income. We found that when respect from society was raised to a satisfactory level (50-75% positive reviews), the probability of medical staff choosing a certain job increased by 69.9%. Conclusion: Respect from society was the most preferred attribute, while workload, monthly income, and career development were all key factors in the medical staff's job choices. The heterogeneity of the medical professionals' preferences shows that effective policy interventions should be customized to accommodate these drive preferences.

The psychological impact of COVID-19 on Chinese healthcare workers: a systematic review and meta-analysis.

PURPOSE: This study aimed at investigating five dimensions of the psychological impact (post-traumatic stress symptoms (PTSS), anxiety, depression, sleep disturbance or profession-related burnout) of COVID-19 on healthcare workers (HCW) in China. METHODS: Studies that evaluated at least one of the five target dimensions of the psychological impact of COVID-19 on HCW in China were included. Studies with no data of our interest were excluded. Relevant Databases were searched from inception up to June 10, 2020. Preprint articles were also included. The methodological quality was assessed using the checklist recommended by AHRQ. Both the rate of prevalence and the severity of symptoms were pooled. The protocol was registered in PROSPERO (CRD42020197126) on July 09, 2020. RESULTS: We included 44 studies with a total of 65,706 HCW participants. Pooled prevalence rates of moderate to severe PTSS, anxiety, depression, and sleep disturbances were 27% (95% CI 16%-38%), 17% (13-21%), 15% (13-16%), and 15% (7-23%), respectively; while the prevalence of mild to severe level of PTSS, anxiety, and depression was estimated as 31% (25-37%), 37% (32-42%) and 39% (25-52%). Due to the lack of data, no analysis of profession-related burnout was pooled. Subgroup analyses indicated higher prevalence of moderate to severe psychological impact in frontline HCW, female HCW, nurses, and HCW in Wuhan. CONCLUSION: About a third of HCW in China showed at least one dimension of psychological symptoms during the COVID-19 pandemic, whereas the prevalence of moderate and severe syndromes was relatively low. Studies on profession-related burnout, long-term impact, and the post-stress growth are still needed.

Latent profile analysis of mental health among Chinese healthcare staff during the COVID-19 pandemic.

The mental health of individuals has become increasingly important during the novel coronavirus-2019 (COVID-19) pandemic. Given the number of healthcare staff that are helping to treat the victims of COVID-19 all over the world, there is a lack of research concerning the mental health of healthcare staff, and of the prior studies carried out, the research has been relatively descriptive and has not used more sophisticated types of analyses (e.g. latent profile analysis [LPA]). The aim of the present study was to investigate profiles of mental health among Chinese healthcare staff during the COVID-19 pandemic. The sample comprised of 456 healthcare staff, and participants completed an online survey including individual information and their working status during the COVID-19 pandemic. The survey included the Chinese Mental Health Scale (MHS-C), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). Utilizing the LPA, two profiles of mental health (good mental health and poor mental health) were identified for Chinese healthcare staff during the COVID-19 pandemic. Compared to those with a good mental health profile, those with poor mental health profile had significantly higher scores on SAS and SDS. Female healthcare staff had higher mental health disturbances than males. Taking care and protecting the mental health of healthcare staff is very important in the fight against COVID-19. The need for employers to implement positive and effective measures among mental healthcare staff is likely to help them to cope better with mental health issues and improve mental health, as well as enhance resilience. Healthcare staff with good mental health can dedicate themselves to better nursing practice and nursing education during the COVID-19 epidemic.

Associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID-19 prevention measures among Chinese healthcare students.

AIM: To investigate the associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID-19 prevention measures in Chinese Healthcare students. DESIGN: A cross-sectional survey collecting data in Hong Kong and Fujian Province of China in April 2020. METHODS: A convenience and snowball sample of 2706 students aged 18 years or older and studying a healthcare programme were recruited in tertiary education institutions/universities in Hong Kong and Putian. The participants completed the questionnaire with six scales: Social Distancing Scale; Personal Hygiene Scale; Empathic Responding Scale; Wishful Thinking Scale; Perceived Stress Scale and Perceived Threat Scale. Path analysis was performed to identify factors associated with the preventive measures outcomes. p value < .05 was considered as statistical significance. RESULTS: The participants reported high compliances to both social distancing (SoD) and personal hygiene measures (PHM). Confidence to manage the current situation, wishful thinking and empathetic responding directly predicted compliance with SoD and PHM. The final model constructed demonstrated a very good fit to the data. CONCLUSION: The findings suggest that students who are male, habituate in Hong Kong, have more clinical experience and weak confidence to manage the threat tend to have lower compliance with the COVID-19 preventive measures. IMPACT: The predictive model constructed is the first one to explore factors associating with the compliance with infection control measures in healthcare students amid the COVID-19 outbreak. As the infection control behaviours of healthcare students, whom are still under training and are the high-risk group of being infected and infecting others in the community, are rarely reported in literature, this study has provided empirical evidence to nurses and other healthcare professionals to identify students susceptible to poor compliance and provide early monitoring and education to suppress the COVID-19 transmission.