Effect of COVID-19 pandemic on sleep quality of frontline healthcare workers

Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Material(s) and Method(s): Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Result(s): A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion(s): The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.Copyright © 2023, Mr Bhawani Singh. All rights reserved.

An exploration of female healthcare workers' experiences during the COVID-19 pandemic in Bindura, Zimbabwe

This study explores the experiences and coping strategies of female frontline healthcare workers (HCWs) fighting the COVID-19 pandemic in resource-constrained settings. Female frontline HCWs face an elevated risk of contracting the COVID-19 infection and infecting their loved ones because when they return from work. The study adopted a qualitative approach to explore the experiences of female frontline HCWs working in high-volume departments at Bindura provincial hospital in Zimbabwe. Using purposive sampling, 15 participants were recruited. HCWs were asked to share their views and perspectives on COVID-19 and their work environment. The study focused on HCWs' experiences of stigma and discrimination once infected;access to treatment;understanding of transmission;and life experiences of living with COVID-19. The findings suggest that female HCWs working in high-volume departments experience a higher risk of exposure to infection, barriers to assessing personal protective equipment (PPE) and stigma, which impact their mental health. However, despite the complex interrelated challenges female frontline HCWs face in Zimbabwe, there are limited interventions to ameliorate this burden, a knowledge gap this research aims to illuminate.

Post-COVID Quality of Life and Sleep Among Younger Healthcare Workers of Designated COVID Care Centers: A Cross-Sectional Study.

Introduction Frontline healthcare workers (FLHCWs) have been persuaded to work this coronavirus disease (COVID) pandemic way in and out but the pandemic has not subsided. The persistence of symptoms after COVID infection, especially chest symptoms like early fatigue with breathlessness, has been documented very well. However, FLHCWs have repeatedly caught the COVID infection and have been working in traumatic and helpless situations since the pandemic started. Post-COVID infection, quality of life (QOL) and sleep are greatly affected, regardless of the time elapsed since discharge or recovery. The continuous assessment of COVID-infected persons for post-COVID sequelae is an important and effective step to reduce complications. Materials and methods This was a cross-sectional study conducted for a period of one year at R.L. Jalappa Hospital and Research Center, Kolar, and SNR District Hospital, Kolar, which were designated COVID care centers. FLHCWs working in these centers who had contracted COVID infection at least once, who were more than 18 years and less than 30 years, and who had experience of less than five years irrespective of their vaccination status were included in the study. FLHCWs with COVID-related health illnesses, which needed ICU admission and prolonged hospital admission, were excluded. To assess QOL, the WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaire was used. To assess sleepiness, the Epworth daytime sleepiness scale was used. The study was started after the institutional ethical committee's clearance was obtained. Results A total of 201 healthcare workers (HCWs) completed the survey. Of the participants, 119 (59.2%) were male, 107 (53.2%) were junior residents, 134 (66.7%) were unmarried, and 171 (85.1%) said they followed regular shifts. Male HCWs had higher scores in the psychological, social relationship, and environmental domains of QoL. Consultants had higher scores in all domains of QoL. Married HCWs had higher scores in the physical, psychological, and social relationship domains of QoL. Out of 201 FLHCWs, 67 (33.3%) had moderate excessive daytime sleep, and 25 (12.4%) had severe excessive daytime sleep. Few factors like gender, occupation, duration of work in the hospital, and regular shifts were statistically significant factors associated with daytime sleepiness. Conclusion The present study has shown that even after the COVID vaccination doses received by the HCWs, sleep and Qol have still been impaired among infected younger healthcare staff. Acceptable and righteous efforts must be made by the institutions for proper policymaking to manage such infectious outbreaks in the future.

Inequities in the mental health impacts on frontline responders and essential workers

Much of the research on the mental health impacts of the COVID-19 response have been focused on frontline healthcare workers (FHCW). However, other essential workers (OEW) have also faced many mental health challenges due to exposures associated with their employment status, which may be compounded by higher levels of social vulnerability. This chapter describes disparities among FHCW, OEW, and the general public regarding mental health outcomes associated with the pandemic. In addition, it considers the role that structural racism (e.g., historical redlining of neighborhoods and biased lending practices) plays in the higher vulnerability of OEW to the mental health impacts of the COVID-19 pandemic response. Mental health inequities overall, and among essential workers, must be addressed as part of the recovery from COVID-19 to build resilience to future public health emergencies. The model used by New York City to more equitably distribute mental health resources and support services is shared. © 2023 The authors.

Burnout, depression and associated risk factors among frontline healthcare workers in Bahrain during COVID-19

Background: Caring for patients during the COVID-19 pandemic has put frontline healthcare workers in Bahrain at risk of burnout and depression. Aims: To determine the prevalence of burnout, depression, and associated risk factors among frontline healthcare workers in Bahrain during the pandemic. Methods: A cross-sectional study was conducted from August 2020 to April 2021. The Maslach Burnout Inventory (MBI-HSS) and the Patient Health Questionnaire (PHQ-9) were administered online to 431 healthcare workers in COVID-19 treatment and quarantine facilities. Results: Almost all participants reported some degree of burnout across all three subscales: emotional exhaustion (98.8%), depersonalization (94%) and lack of personal achievement (47.9%). Moderate to severe levels of burnout were observed across the domains of emotional exhaustion (47.2%) and depersonalization (39.5%). Over half of the participants reported depressive symptoms (56.8%) and a quarter recorded moderate to severe levels of depression (20.6%). Statistically significant correlations were observed between burnout and depression. Conclusion: Frontline healthcare workers in Bahrain reported moderate to severe levels of burnout and depression during the COVID-19 pandemic. Single female doctors aged 25 to 34 years, who worked with COVID-19 patients, were more likely to report burnout. Age, nationality, profession, and work experience were the most significant determinants of burnout. Those who reported burnout also reported feeling depressed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Impacts of the COVID-19 response on frontline healthcare workers

The COVID-19 pandemic, and the responses to it that were required from frontline healthcare providers and others working in healthcare settings including environmental, clerical, and security staff, has challenged our healthcare systems in unprecedented ways. The threats to the financial, physical, and psychological well-being of healthcare professionals-many of whom entered the field due at least in part to a deep commitment to caring for and helping others-will have profound and long-lasting personal and professional impacts. Early in the pandemic response, healthcare professionals knew little about the risks they, their patients, and their loved ones faced from COVID-19 as they operated under crisis standards of care and without adequate supplies of personal protective equipment. As the pandemic response progressed, the lack of clear, science-based guidance, and the politicization of the pandemic presented new medical, ethical, and moral dilemmas. New psychological support mechanisms, including crisis counseling and evidence-based interventions, are needed for all workers in healthcare settings, regardless of their job role. © 2023 The authors.

"Why Am I Even Here If I Can't Save the Patients?": The Frontline Healthcare Workers' Experience of Burnout during COVID-19 Pandemic in Mthatha, South Africa.

INTRODUCTION: Globally, the high prevalence of burnout in healthcare workers (HCWs) is of the utmost concern. Burnout is a state of emotional exhaustion, depersonalization and a decreased sense of personal accomplishment. While the 2019 Coronavirus (COVID-19) exacerbated the burnout prevalence among HCWs, limited studies have explored this phenomenon using qualitative methodologies in the Eastern Cape Province and South Africa generally. This study explored how frontline healthcare workers experienced burnout during the COVID-19 pandemic in Mthatha Regional Hospital. METHODS: Ten face-to-face in-depth interviews were conducted with non-specialized medical doctors and nurses who directly cared for COVID-19-infected patients during the pandemic in Mthatha Regional Hospital (MRH). In-depth interviews were digitally recorded and transcribed verbatim. Data were managed through NVIVO 12 software before being thematically analyzed using Colaizzi's analysis method. RESULTS: Four main themes emerged from the analysis. These themes were burnout manifestation (emotional strain, detachment and irritability, uncertainty-induced fear, and anxiety, physical exhaustion, yet, low job accomplishment, dread and professional responsibility), precursors of burnout (occupational exposure to high mortality, staff shortages, elongated high patient volume and workload, disease uncertainties and consistent feeling of grief), alleviating factors of burnout (time off work, psychologist intervention, periods of low infection rate and additional staff), and the last theme was every cloud has a silver lining (improved infection prevention and control (IPC) measures, learning to be more empathetic, the passion remains and confidence grows). CONCLUSION: The COVID-19 pandemic brought about a rapid change in the work environment of healthcare workers who are the backbone of efficient healthcare services, thereby rendering them vulnerable to increased burnout risks. This study provides strategic information for policymakers and managers on developing and strengthening welfare policies to promote and protect frontline health workers' well-being and work functioning.

Harnessing distress to boost growth in frontline healthcare workers during COVID-19 pandemic: The protective role of resilience, emotion regulation and social support

This study examines the relationship between posttraumatic stress and posttraumatic growth, while assessing the moderating role of resilience, emotion regulation and social support. The authors expected that high-level distress would be associated with posttraumatic growth in healthcare workers with high resilience, high emotion regulation skills and high social support. To test this hypothesis, between 15 and 30 May, 2020, they collected data from healthcare workers (HCWs) working in worst-hit regions of central-northern Italy using an online questionnaire spread through a snowball sampling procedure. To investigate the relationship between PTSD and PTG under the influence of resilience, emotion regulation and social support, the authors performed a series of moderation analysis with 10 000 accelerated bootstrap sampling and bias-corrected confidence intervals, controlling for gender. The moderating role of resilience was significant as indicated by the model and the PTSD by resilience interaction. The same analysis performed with emotion regulation yielded a significant model for cognitive reappraisal as confirmed by the PTSD by cognitive reappraisal interaction. Finally, the moderating role of social support was significant as indicated by the interaction with PTSD. The current findings bridge the currently dichotomous narrative on HCW psychological wellbeing by showing that pandemic-related distress and growth are connected in a complex relationship that depends on intra and inter-personal factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The impact of the COVID-19 pandemic on the well-being of frontline healthcare personnel: A descriptive phenomenological study

The ongoing global catastrophe has acutely exacerbated global health impacts, posing a significant challenge to the psyche, mental health, and well-being, particularly among healthcare personnel. The problem addressed in this study examined how the COVID-19 pandemic has negatively influenced healthcare personnel's well-being during and after this pandemic crisis. A phenomenological approach performed by the researcher focused on capturing lived experiences of 16 volunteer healthcare personnel in their workplace during the COVID-19 pandemic. A qualitative methodology was applied in this research study. The leader and follower relationship were examined through the sensemaking theory emphasizing individual lived experiences through the sensemaking process of interpretation and assignment of meaning to events. The findings revealed that the COVID-19 pandemic elicited profound impacts on the mental health and well-being of frontline healthcare workers in their workplace at the Guam Memorial Hospital Authority. Individual, leader-oriented, and organizational system-wide factors continue to impact the mental health and well-being of our frontline healthcare workers during and post-pandemic periods. The physical and psychological impacts on employee well-being facilitated by the COVID-19 pandemic suggest trauma heightening stress-related disorders that may be experienced by healthcare personnel long after the pandemic subsides. Recommendations encompass strategies and initiatives that healthcare administrators and leaders may implement in the shared responsibility of designing support programs based on meeting the unique needs of healthcare professionals during and after the COVID-19 pandemic. Supportive leadership frameworks may be integrated into the organizational setting as an effective mechanism to prevent employee burnout and decreased levels of well-being during and after the COVID-19 pandemic. Educational awareness of mental health and well-being-focused strategies, programs, and initiatives are integral to preserving the welfare of our frontline healthcare personnel. Future researchers may consider extending the sample of the participants beyond healthcare industries and among various industries that provide services utilizing frontline employees. Additional research study elements may include how COVID-19 has impacted workplace culture, employee morale, and employees who have tested positive for COVID-19 while working as frontline support staff. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Listening and learning from the COVID-19 frontline in one US healthcare system

Purpose: The on-going COVID-19 pandemic has drastically impacted healthcare systems worldwide. Understanding the perspectives and insights of frontline healthcare workers caring for and interacting with patients with COVID-19 represents a timely, topical, and important area of research. The purpose of this qualitative action research study was to assist one US healthcare system that has an expansive footprint with the implementation of a needs assessment among its frontline healthcare workers. The leadership within this healthcare system wanted to obtain a deeper understanding of how the COVID-19 pandemic was impacting the personal and professional lives of its workers. Further, the organisation wanted to solicit employees' feedback about what they needed, understand the issues they were facing, and solicit their ideas to help the organisation know where to take action. Design/methodology/approach: This qualitative research employed 45 focus groups, referred to as virtual listening calls (LCs) in this organisation, which were held over a four-week period. A total of 241 nursing staff, representing healthcare facilities across the country, attended 26 of the LCs. A total of 19 LCs were held with 116 healthcare workers who are employed in other clinical roles (e.g. therapists) or administrative functions. Findings: Extending beyond the available research at the time, this study was initiated from within a US healthcare system and informed by the frontline healthcare employees who participated in the LCs, the findings of this study include the perspectives of both nursing and other healthcare workers, the latter of which have not received considerable attention. The findings underscore that the COVID-19 pandemic has wreaked havoc on the personal and professional lives of all of these healthcare workers and has exacted an emotional toll as noted in other studies. However, this study also highlights the importance of listening to employees' concerns, but more importantly, their recommendations for improving their experiences. Notably, the organisation is in the midst of making changes to address these frontline workers' needs. Originality/value: The study, inclusive of nursing and other healthcare staff, demonstrates how an organisation can adapt to a crisis by listening and learning from its frontline employees. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

A study on the relationship between sociodemographic characteristics and job stress and satisfaction among healthcare workers in Turkey during the COVID-19 pandemic.

The aim of this study was to determine the sociodemographic characteristics that affect job stress and job satisfaction in 454 healthcare workers (physicians, nurses, midwives, technicians, and other healthcare personnel) working with COVID-19 patients in primary healthcare institutions in Turkey with a cross-sectional, web-based survey between 9 and 30 August 2021. The survey included a personal information form, a standard job stress scale, and the Minnesota Satisfaction Questionnaire. The levels of job stress and job satisfaction did not differ between male and female respondents. Singles reported lower job stress and higher job satisfaction than the married respondents. Job stress did not differ between departments, but respondents on the front line who worked in a COVID-19 intensive care unit (ICU) (at any point and/or at the time of the study) or the emergency department reported lower job satisfaction than those working in other departments. Similarly, while stress did not differ by educational status, satisfaction of respondents with bachelor's or master's degree was lower than that of the rest. Our findings also suggest that working in a COVID-19 ICU and age are significant predictors of higher stress, whereas lower education, working in a COVID-19 ICU, and being married are good predictors of lower satisfaction. Further research should include other sociodemographic variables that may affect stress and satisfaction at work, and similar studies should follow up to see what was left in the wake of the pandemic.

Urip iku urup (life is lit) by service to others: a qualitative study of frontline healthcare workers' lived experiences providing patient care in Indonesia's COVID-19-designated hospital.

BACKGROUND: While COVID-19 affects every walk of human life, it especially implicates healthcare workers at the forefront of the pandemic due to their vulnerable involvement in providing first-line treatment. This study presents the lived experiences of frontline healthcare workers serving in Indonesia's COVID-19-designated hospital, one of the severely afflicted healthcare settings wherein resource challenges, public health crisis, and political constraints intersect as policy conundrums. METHODS: Using a qualitative exploratory-descriptive approach, this study drew on thirteen in-depth, semi-structured interviews with frontline healthcare workers who have experiences providing first-line COVID-19 patient care in the COVID-19 hospital. The data analysis commenced with the verbatim transcription of the interview data, which was then subjected to a systematic thematic analysis employing hermeneutic phenomenological principles. RESULTS: The exploration of the participants' accounts reveals eight interconnected themes: facing resource scarcity and resignation; experiencing service-induced burnout due to occupational workload; encountering fears of being infected and infecting others; engaging in positivity through social connectedness; having dilemmas over healthcare rationing; developing negative emotions during patient interactions; coping through spirituality and religiosity; and embodying a life of service. CONCLUSION: Managing healthcare in resource-limited, crisis settings presents multifaceted challenges that exceed mere structural modifications, requiring prioritized public health investment to ensure optimal patient care. Therefore, healthcare policy development and implementation should equally emphasize the well-being of frontline healthcare workers to foster sustainable healthcare delivery and achieve improved patient outcomes.

Clinical Safety and Performance Evaluation of New Personal Protective Equipment During the COVID-19 Pandemic

As the healthcare response to the COVID-19 pandemic continues, providing enhanced protection to frontline healthcare personnel exposed to aerosolized infectious material is essential. The rapid spread of the COVID-19 virus across the globe in early 2020 generated an overwhelming surge in demand for effective personal protective equipment (PPE), in particular, passive personal respirators (PPR). Global manufacturing of PPR was limited, and research and development of improved respirators were restricted by the availability of accredited laboratories for timely testing at the peak of the pandemic. The authors have described a clinical method of safety and efficacy testing of a new PPR, the TopBioShield, using portable capnography for the measurement of end-tidal pCO2 (ETCO2) and bedside pulse oximetry to measure oxygen saturation (SpO2), respiratory rate (RR), and heart rate (HR) in healthy volunteers to overcome shortages of clinical testing capabilities during the height of the pandemic. Twenty-eight volunteers with a median age of 41 years (range 16–71) representing all 10 subgroups of head/face size were included. Only one participant asked to withdraw due to a feeling of claustrophobia after 30 min. Clinical monitoring while wearing TopBioShield revealed ETCO2, SpO2, respiratory rate, and heart rate measurements were within normal limits in all the subjects throughout the experiment. Bedside clinical monitoring is effective in demonstrating the physiological safety of PPR and is an important alternative to conventional mannequin testing. In this study all measured values over a 90-min experiment period were within normal limits, demonstrating the effectiveness of TopBioShield in preventing CO2 retention. Clinical testing methods must adhere to the highest standards and are essential during times of shortage. © 2023, The Institution of Engineers (India).

Effects of COVID-19 pandemic on mental health among frontline healthcare workers: A systematic review and meta-analysis.

Background: As some countries announced to remove Coronavirus Disease 2019 (COVID-19) border, it indicates that the COVID-19 may have entered its terminal stage. In this COVID-19 pandemic, the mental health of frontline healthcare workers (HCWs) experienced unprecedented challenges. However, the impact of the COVID-19 pandemic on mental health among frontline HCWs lacks a high-quality and long-term systematic review and meta-analysis. Methods: We conducted a systematic review and meta-analysis according to PRISMA guidelines. The system searches EMBASE, MEDLINE, PsycINFO, Cochrane Library, ScienceNet, and ERIC. Analyze the mental health problems of frontline HCWs in different regions and periods, including insomnia, stress, anxiety and depression. This study was registered in PROSPERO under the number CRD42021253821. Results: A total of 19 studies on the effects of COVID-19 pandemic on mental health among frontline HCWs were included in this study. The overall prevalence of insomnia was 42.9% (95% CI, 33.9-51.9%, I 2 = 99.0%) extracted from data from 14 cross-sectional studies (n = 10 127), 1 cohort study (n = 4,804), and 1 randomized controlled trial (RCT; n = 482) in 10 countries. The overall prevalence of stress was 53.0% (95% CI, 41.1-64.9%, I 2 = 78.3%) extracted from data from nine cross-sectional studies (n = 5,494) and 1 RCT study (n = 482) from eight countries. The overall prevalence of anxiety and depression was 43.0% (95% CI, 33.8-52.3%, I 2 = 99.0%) and 44.6% (95% CI, 36.1-53.1%, I 2 = 99.0%) extracted from data from 17 cross-sectional studies (n = 11,727), one cohort study (n = 4,804), and one RCT study (n = 482) from 12 countries. The prevalence of stress and depression was higher in 2020, while the prevalence of insomnia and anxiety was higher in 2021. The prevalence of mental health problems among physicians was higher than that of other frontline HCWs. The prevalence of mental health problems among frontline HCWs is higher in South America and lower in North America. Conclusions: This systematic review and meta-analysis showed that the COVID-19 pandemic have significant effects on mental health among frontline HCWs. The overall prevalence of insomnia, stress, anxiety and depression among frontline HCWs is high. Therefore, the health policy-makers should pay attention to and respond to the mental health problems of frontline HCWs in the context of public health emergencies. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/.

Psychological Trauma among Health Care Professional during Covid-19 Pandemic

Introduction: Covid-19 is a complex respiratory infectious disease that is impacting all sectors and industries. This pandemic is known to create a chaos among the healthcare sector and affecting psychological burden of healthcare professional. Less is known about the negative psychological influence of Covid-19 on the healthcare professionals, working in Pakistani hospitals. This study reported the prevalence of psychological trauma among healthcare professionals during Covid-19 pandemic. Material(s) and Method(s): The study adopted a cross-sectional study design and collected a quantitative sample of 195 healthcare professionals, who are working on front and second line. These professionals include;doctors, nurses, and other hospital staff. The data is collected from Liaquat National Hospital of Karachi, Pakistan during the period from April 2021 to March 2022. The study adopted a COPAQ questionnaire to assess psychological trauma among healthcare professionals. Results & Discussion:Majority of sample were aged less than or equal to 30-years, with more female healthcare professionals than male. Pearson Chi Square showed a significant association of psychological trauma with residence, socioeconomic status, working position and health care professionals with p<0.05. The odds ratio at confidence interval of 95%, for psychological trauma, in Univariate analysis urban resident were found 3.9 times, frontline workers gives 7.8 times, doctors gives 17.8 times and nurses gives 6.9 times more likely for psychological trauma and samples with income less than Rs. 25000 were found 0.13 times less likely for psychological trauma with p<0.05. In multivariate analysis none of the factors give significant association. Conclusion(s): The study recommended that a multi-sectoral and milti-pronged should be developed, to offer technical support for advancing of the healthcare system across the country. Future scholars are recommended to investigate the factors associated to psychological distress across different cities of Pakistan and make a comparison for better understanding. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Psychological stress and coping strategies among frontline healthcare workers supporting patients with coronavirus disease 2019: a retrospective study and literature review.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak might have a psychological impact on frontline healthcare workers. However, the effectiveness of coping strategies was less reported. OBJECTIVES: We aimed to investigate the sources of stress and coping strategies among frontline healthcare workers fighting against COVID-19. We also performed a literature review regarding the effects of coping methods on psychological health in this population. METHODS: We included frontline healthcare workers who completed an online survey using self-made psychological stress questionnaires in a cross-sectional study. We evaluated the association between potential factors and high-stressed status using a logistic regression model. We performed the principal component analysis with varimax rotation for factor analysis. We also performed a systematic review of published randomized controlled studies that reported the effects of coping methods on psychological health in COVID-19 healthcare workers. RESULTS: We included 107 [32 (29-36) years] respondents in the final analysis, with a response rate of 80.5%. A total of 41 (38.3%) respondents were high-stressed. Compared with the low-stressed respondents, those with high-stress were less likely to be male (46.3% versus 72.7%, p = 0.006), nurses (36.6% versus 80.3%, p < 0.001), and more likely to have higher professional titles (p = 0.008). The sources of high-stress in frontline healthcare workers were categorized into 'work factor', 'personal factor', and 'role factor'. A narrative synthesis of the randomized controlled studies revealed that most of the coping methods could improve the psychological stress in healthcare workers during the COVID-19 pandemic. CONCLUSION: Our findings suggest that some frontline healthcare workers experienced psychological stress during the early pandemic. Effective coping strategies are required to help relieve the stress in this population.

Applications of Digital Mobile Technologies in Response to the COVID-19 Pandemic: Some Evidence from Frontline Healthcare Workers in Three Tertiary Hospitals in Ghana

The World Health Organization (WHO) declared the COVID-19 pandemic a public health disaster of global concern on the 30th January 2020. With the highly infectious COVID-19 virus inevitably spreading across nations and causing significant health and economic impacts, leveraging Digital Mobile Technologies (DMTs) by frontline healthcare practitioners has been touted as a lifeline. Since January 2020, various frontline health workers, health experts, and health institutions across the globe have progressively embraced the use of numerous DMTs as an essential means of restraining the highly infectious disease spread. DMTs such as smart mobile phones and other digital mobile technologies are the reliable means of sharing pertinent health information, awareness, and surveillance as well as facilitating access to crucial healthcare services, especially in designated COVID-19 health facilities. Therefore, this study employed, an online survey using an exploratory-based research design to investigate how the COVID-19 pandemic has revolutionized the usage of DMTs among (n=1,126) frontline healthcare practitioners in three leading tertiary hospitals in Ghana. We adopted technology acceptance model (TAM) to study the adoption and utilization of DMTs and their limitations by frontline healthcare workers in COVID-19 management. We found that 75.1% (n=846 out of 1,126) of frontline healthcare workers, comprising nurses, medical doctors, physician assistants, and COVID-19 contact tracers were aware of DMTs, adopted and used DMTs in response to the COVID-19 pandemic and its management. However, 93.0% (n=784 out of 846) of those who were aware of the DMTs employed them in their daily operations beyond the fight against the COVID-19 pandemic. Our analyses also indicate that increased usage of these DMTs has significantly enhanced public healthcare campaigns and education on the COVID-19 pandemic in Ghana. These mobile applications have also improved and boosted healthcare communications among practitioners on measures against the COVID-19 pandemic. In terms of originality, this study expands our understanding of digital technology in response to the COVID-19 Pandemic in less studied regions such as Africa, West Africa, and Ghana to be specific. Secondly, the study contributes to filling a gap in our understanding of how theories such as TAM function in crisis communication management. Finally, the study recommends health authorities and governments in developing countries incorporate DMTs in their current health care systems, especially in public health emergencies like COVID-19 preparedness. © 2022 by authors.

Relationship between social support, anxiety, and depression among frontline healthcare workers in China during COVID-19 pandemic.

Background: Social support is an important factor affecting individual mental health. However, the relationship between social support and mental health in frontline healthcare workers (FHW) during the coronavirus disease 2019 (COVID-19) pandemic has garnered less attention. In this study, we aimed to investigate the level of social support and the prevalence of depression and anxiety in FHW during the COVID-19 pandemic and determine the factors affecting the relationship between social support, depression, and anxiety. Methods: A cross-sectional study using an online survey was conducted to collect data from FHW between 15 February and 31 March 2020 in China. The data included demographic factors, Self-rated Depression Scale (SDS), Self-rated Anxiety Scale (SAS), and Social Support Rate Scale (SSRS). Spearman correlation test was performed to determine the correlation among SAS, SDS, and SSRS scores. Multiple linear regression analysis was performed to determine the relationship among demographic factors, social support, depression, and anxiety in FHW. Results: Of all 201 participants, 44 (21.9%) had depressive symptoms and 32 (15.9%) had anxiety symptoms. The average total SSRS scores among FHW were lower than that of the norms of the Chinese general population (37.17 ± 7.54 versus 44.38 ± 8.38, P < 0.001). Marital status positively affected the SSRS score (ß = 7.395, P < 0.01). Age over 40 years old negatively affected the SSRS score (ß = -5.349, P = 0.017). The total SSRS score, subjective social support score, objective social support score, and support utilization score among FHW negatively correlated with the SAS score and SDS score (P < 0.05). A lower support utilization score was significantly associated with high anxiety and depressive symptoms (ß = -0.869, P = 0.024; ß = -1.088, P = 0.035, respectively). Conclusion: During the COVID-19 pandemic, FHW experienced depression, anxiety, and inadequate social support. The marital status and age had a major impact on social support. Social support was inversely associated with depression and anxiety. Improving the mental health of FHW by strengthening social support is crucial. Future studies are needed to investigate how to improve the level of social support and mental health condition of FHW facing public health emergencies in the future.

Impact of personal protective equipment on psychological and physical health during menstruation: A cross-Sectional study among female frontline healthcare workers during COVID pandemic.

Introduction: During the Coronavirus disease 2019 (COVID-19) pandemic, personal protective equipment (PPE) has undoubtedly provided a shield of protection for the healthcare workers fighting the disease. However, the layers of the PPE kit restrict basic human activities and also have been associated with various other problems like dehydration, suffocation, breathlessness, headache, and dermatitis. Material and Methods: A cross-sectional study was done among 180 Female health workers who wore the PPE kit during COVID-19 duty in a tertiary health care center during the period March 2021 to May 2021. The content-validated survey tool developed by Google Forms used as a platform was sent to 180 Female health workers of COVID-19 hospitals to minimize face-to-face or physical interaction. The Work-Related Quality of Life Scale (WRQoL) was used. Results: The majority of the participants were interns (48.9%) and belonged to the age group of 21 to 25 years (67.7%). The approximate duration of wearing a PPE kit was 6 to 12 h for almost half of the study participants. Sanitary pads were used by over 90% of the participants. Only 59 out of 180 (32.7%) were provided with an extra PPE kit during menstruation. About 131 (72.7%) Female Health workers (FHWs) (FHWs) had to remove the PPE kit due to excessive sweat during menstruation; 110 FHW's out of 180 (61.1%) who participated in the study had to remove the PPE kit due to severe thirst and dehydration. Sweating (91%), dehydration (86.7%), rashes (49.9%), extreme thirst (56.5%), abdominal cramps (53.3%), and headache (59.8%) were the major complaints of the participants. The majority of the participants had low quality of life scores based on WRQoL. Conclusions: Use of PPE for long hours especially during menstruation can affect one both physically and psychologically compromising the work performance and decision-making. Minor changes in the work place environment can drastically improve the work-related quality of life.

"Pandemic Fatigue! It's Been Going On since March 2020": A Photovoice Study of the Experiences of BIPOC Older Adults and Frontline Healthcare Workers during the Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic intensified the stressful and already difficult circumstances of communities of color. Yet, there is no current photovoice research highlighting the lived experiences of these communities from two perspectives-the older adults (OAs) and the frontline healthcare workers (FLHWs). This qualitative study used photovoice to visually portray the struggles of Black, Indigenous, and persons of color (BIPOC) OAs (n = 7) and younger FLHWs (n = 5) who worked with older adults during the pandemic and how they coped and recovered from the challenges of the pandemic. The investigators conducted a three-day training of ten research assistants (RAs) who were paired with either an OA or an FLHW for the photovoice sessions conducted in four stages. Upon examination of the narratives, focus group transcriptions, and photo stories, it became clear that participants faced different challenges during the pandemic, such as the fear of COVID-19 exposure, struggles to adopt COVID-19 mitigation strategies, workplace challenges, and social isolation. Amid this crisis of suffering, isolation, and sadness, participants employed two major strategies to deal with the challenges of the pandemic: positive reappraisal and self-care practices. The findings have implications for clinical social workers, mental health counselors, faith communities, nurse managers and administrators, and policymakers.