What do Portuguese cardiologists think and feel about their work?

INTRODUCTION AND OBJECTIVES: This study reports the results of an online survey carried out by the Portuguese Society of Cardiology about its medical members' work characteristics before and during the COVID-19 pandemic, their job satisfaction, work motivation, and burnout. METHODS: A sample of 157 participants answered a questionnaire with demographic, professional, and health-related information, followed by questionnaires on job satisfaction and motivation designed and validated for this study and a Portuguese version of the Maslach Burnout Inventory. Data were analyzed through descriptive statistics, ANOVA, and MANOVA, considering gender, professional level, and sector of activity, respectively. Multiple regression was used to assess the impact of job satisfaction and motivation on burnout. RESULTS: The only variable that distinguished participants was sector of activity. Cardiologists working in the private sector worked fewer weekly hours during COVID-19, while those in the public sector worked more. The latter expressed more desire to reduce their working hours than those who worked in private medicine and in both sectors. There were no differences between sectors in work motivation, while job satisfaction was higher in the private sector. Moreover, job satisfaction negatively predicted burnout. CONCLUSIONS: Our findings point to a deterioration in working conditions during the COVID-19 pandemic, with its consequences being felt especially in the public sector, which may have contributed to the lower levels of satisfaction among cardiologists who worked exclusively in this sector, but also for those working in both public and private sectors.

Impact of Influenza in South-East Asia

Influenza infection is asymptomatic in up to 75% of cases, but outbreaks result in significant morbidity. Reports found that severe influenza complications tend to occur among the very young (<5 years) and very old (>65 years), especially those with underlying co-morbidities like diabetes mellitus and heart disease. Even with no co-morbidity, some older persons with severe influenza may require hospitalisation or intensive care, with increased risk of myocardial infarction and stroke. In South-East Asia, influenza was often seen as a mild problem and was not deemed notifiable until the appearance of the Influenza A(H1N1) pandemic in 2009. For decades the data made available were based on extrapolated estimates collected mainly from paediatric populations, resulting in inconsistent findings. Following expanded surveillance across the region using national surveillance systems for influenza-like illness (ILI) and severe acute respiratory illness (SARI), and better diagnostic methods, improved estimates of disease burden was achieved in South-East Asia. However, two studies conducted in 2008-2010 reported findings ranging from 2-3% to 11%. With regards to increased risk of complications, the estimated global annual attack rates for influenza were 5-10% in adults and 20-30% in children, resulting in 3-5 million cases of severe illness and 290,000-650,000 deaths. A study In Singapore reported that influenza is associated with annual excess mortality rates (EMR) of 11-14.8 per 100 000 person-years, especially affecting the elderly;these rates are comparable to that of the USA. As for hospitalisation rates of children under 5 years with seasonal influenza, the USA estimated a rate of 1.4 per 100,000. Comparable rates were reported in Singapore (0.7-0.9), Thailand (2.4), Viet Nam (3.9-4.7), and the Philippines (4.7). In 2018, an updated study reported a mean annual influenza-associated respiratory EMR of 4.0-8.8 per 100 000 individuals, with South-East Asia showing a high mortality rate of 3.5-9.2 per 100,000 individuals. It was already estimated in Thailand in 2004 that influenza resulted in USD23-63 million in economic costs, with the main contribution from lost productivity due to missed workdays. Thus, comparable to countries in temperate climate, the clinical and socioeconomic impact of influenza in South-East Asia appear to be just as substantial. With the emergence of the COVID-19 pandemic in 2020, global influenza incidence dropped dramatically. In South-East Asia, the trend in influenza detections was similar to the rest of the world, with numbers slightly higher than average in early 2020, followed by a quick drop-off by the end of April 2020. After April 2020, the detection rate remained low until late July 2020, when Influenza A(H3N2) predominated in Cambodia, Malaysia, the Philippines, Singapore, Thailand and Timor-Leste;influenza B in Lao People's Democratic Republic but with an upsurge in A(H3N2) activity. Following a two-year hiatus, influenza outbreaks began to re-emerge significantly since early 2022. From February through August 2022, influenza activity in the southern hemisphere remained lower than in pre-COVID-19 pandemic years, but was at the highest level compared to similar periods since the start of the COVID-19 pandemic. Reasons for the reduction during the COVID-19 pandemic include non-pharmaceutical interventions (NPIs), reduced population mixing and reduced travel, and possibly viral interference between SARS-CoV-2 and influenza virus in the same host. In general, the reduction in influenza detections however does not appear to be associated with lack of testing. The World Health Organisation (WHO) continues to recommend that vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses. Although influenza vaccine is not commonly used in most countries in South-East Asia, its burden is similar in other parts of the world where influenza vaccine is now routinely used. Currently, the countries in South-East Asia that are providing free influenza vacc na ion for those at high risk include Thailand, Singapore, the Philippines and Lao People's Democratic Republic.Copyright © 2023

Cost-Effectiveness of Workplace Covid-19 Self-Testing: A Mathematical Modeling Study

Background: As COVID-19 cases persist, one potential intervention to reduce absenteeism in the workplace due to COVID-19 is to use rapid antigen diagnostics to mitigate the spread of SARS-CoV-2. Furthermore, routine testing in the workplace offers an avenue to reaching a large proportion of the population which could lead to a greater community impact beyond solely mitigating transmission events that occur in the workplace. We sought to identify the most cost-effective workplace testing strategies at the community level and within individual workplaces. Method(s): We used two models to understand how SARS-CoV-2 AgRDTs could best be implemented within the workplace to mitigate the spread of COVID-19. In our community-level dynamic transmission model, PATAT, we evaluated the impact of symptomatic testing and asymptomatic testing of a fixed proportion of the formally employed workforce on broader community transmission. We stratified runs by asymptomatic testing frequency, vaccine coverage, vaccine effectiveness, and Rt. Simulations were informed using demographic data from Georgia, Brazil, and the Netherlands. We conducted a cost-effectiveness analysis using the results from each country and assumed a $2.50 total cost per test. Result(s): We observed a substantial decrease in the number of infections occurring in both the workplace and community when a SARS-CoV-2 AgRDTs strategy was implemented. Under all conditions, mandatory symptomatic testing and related quarantine from the workplace averted up to 72%, 79%, and 74% of community infections in Brazil, Georgia, and the Netherlands respectively. Limiting tests to symptomatic workers was always on the cost-effectiveness frontier, regardless of the vaccine coverage, efficacy, or Rt of the virus (Figure 1), at $2-$4 per workplace infection prevented. While asymptomatic testing was on the cost-effectiveness frontier, it would cost an additional $500-$6700 to prevent one additional workplace infection. The added benefit of routine asymptomatic testing was minimal until 100% of the workforce was reached. Conclusion(s): We found self-testing with AgRDTs for the formally employed workforce is both efficient at reducing workplace and community infections as well as cost-effective when targeting symptomatic individuals. Willingness to pay to avoid workplace absenteeism may differ by country, individual workplaces, and the perceived economic value of several workdays missed. If there is a higher willingness to pay, routine asymptomatic screening may be considered.

Occupational stress and its influencing factors of primary health care workers during COVID-19.

[Background] Since the outbreak of COVID-19, primary health care workers have been facing un-precedented work pressure, and their occupational stress should be taken seriously. [Objective] To analyze the occupational stress situation and its influencing factors of primary health care workers in Guangdong Province, and to propose targeted interventions. [Methods] Using a multi-stage stratified random sampling method, each prefecture-level city in Guangdong Province was classified into "good", "medium", or "poor" category based on its gross domestic product (GDP) in 2019 released by the Guangdong Provincial Bureau of Statistics. In September 2021, four primary health care institutions were randomly selected from each stra-tum, and a total of 1 327 staff members were selected for the study. The Core Occupational Stress Scale (COSS) and a basic information questionnaire designed by the authors were used. Mann-Whitney U test was used to compare the means between two groups, and Kruskal-Walis H test was used to compare the means among multiple groups. The comparison of categorical data was performed by trend chi2 test or Pearson chi2 test;the analysis of factors influencing occupational stress was performed by dichotomous multiple logistic regression analysis. [Results] There were 365 health care workers reporting occupational stress in this survey, and the positive rate of occupational stress was 27.5%. The total occupational stress score in M (P25, P75) and the scores of social support, organization and reward, demand and effort, and control were 45.0 (40.0, 50.0), 20.0 (17.0, 21.0), 14.0 (12.0, 17.0), 12.0 (10.0, 15.0), and 5.0 (4.0, 6.0), re-spectively. The results of dichotomous multiple logistic regression analysis showed that high education, low income, doctor positions, long working hours in a day, and shift work were associated with the occurrence of reporting occupational stress (P < 0.05). [Conclusion] Education, average monthly income, job category, daily working hours, and shifts are factors influencing the occurrence of reporting occupational stress in primary health care workers;targeted interventions should be implemented to reduce their occupational stress levels.Copyright © 2023, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

Basic needs of the first batch of medical staff in the fever clinic of Peking union medical college hospital during Coronavirus disease 2019 outbreak: A qualitative study.

Objective The objective of this study was to investigate the basic needs of medical staff during the coronavirus disease 2019 pandemic in a fever clinic, so as to provide a reference for the global epidemic medical teams. Methods A semi-structured qualitative interview outline was designed, including: (1) work level: Working hours, working intensity, and safety guarantee in a fever clinic;(2)life level: Diet, sleep, and physical comfort;(3)psychological level: Emotion, pressure, coping style, and interpersonal resources. The basic needs of the first batch of the fever clinic in Peking Union Medical College Hospital was studied by open telephone interviews. Results A total of 37 medical staff were interviewed, including 8 males (21.6%) and 29 females (78.4%). Among them, there were 16 doctors (43.2%), 19 nurses (51.4%), and 2 medical technicians (5.4%). In terms of work settings, the ideal continuous working time was 4-6 hours per shift. There should be pro re nata positions during extremely high workload, and sufficient personal protective equipment was the key to safety. In terms of living conditions, providing meals according to different shifts was important for dietary needs, and sleeping pills were temporarily needed for sleep. In terms of psychological reactions, nervousness and worrying were relatively common. Family and colleagues were important resources of support. Sport could help relieve physical and psychological stress, and psychological support from psychologists was helpful in reducing their negative emotions. Conclusions The basic needs of medical staff should be respected so as to keep the efficacy of their work. We suggest that medical staff can rest after each 4-6 h working shift. Personal protective equipment should be sufficient. Psychological support should be noted in all of them and provided when necessary.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

La porosité des frontières du travail notarial à l'heure du « distanciel »

Depuis la pandémie de Covid-19, le télétravail s'est généralisé dans des entreprises notariales de proximité jusqu'alors peu concernées. Leurs employés l'ont expérimenté lors du premier confinement, pendant lequel les notaires ont en partie maintenu à distance leur activité. Le dynamisme de ce secteur, sa libéralisation, la dématérialisation des activités et le profil des travailleurs, féminisé et qualifié, ont facilité la généralisation du télétravail sous divers statuts (salarié, intérimaire, indépendant…). Cette pratique s'est répandue au prix d'une porosité croissante des frontières du travail notarial et de stratégies diversifiées de circonscription du temps et de l'espace. Celles-ci varient selon les métiers, offices, statuts, profils socio-démographiques, trajectoires, ressources et conditions de vie des travailleurs concernés, dans un milieu marqué par d'importantes hiérarchisations genrées. La volonté de travailler autrement motive en partie ce choix du travail à distance, mais aussi de formes alternatives d'emploi, voire de sortie de ce secteur.Alternate :Since the Covid-19 pandemic, teleworking has become widespread in notary offices which, as small local businesses, were hardly concerned before. Their employees have experimented it during the first containment, during which notaries have partly maintained their activity at a distance. The dynamism of this sector, its liberalization, the dematerialization of activities and the feminized and qualified profile of workers have facilitated the generalization of telework under various statuses (salaried, temporary, self-employed, etc.). This practice has spread at the cost of an increasing porosity of the boundaries of notarial work and of diversified strategies for circumscribing time and space. These strategies vary according to the professions, offices, status, socio-demographic profiles, trajectories, resources and living conditions of the workers concerned, in an environment marked by significant gender hierarchies. The desire to work differently partly motivates this choice of remote work, but also of alternative forms of employment, or even of leaving this sector.

Anxiety among Cameroonian dentists during the COVID-19 pandemic: A cross-sectional web-based survey

Objective: To assess anxiety among dentists practicing in Cameroon during the coronavirus disease 2019 (COVID-19) pandemic. We conducted a cross-sectional web-based survey, and used the Hamilton Anxiety Rating Scale (HAM-A) to appraise anxiety symptoms and severity. Result(s): Overall, 82 questionnaires were fully completed and retained for analysis. The mean age (standard deviation) of participants was 30.2 (2.6) with 52 (62.2%) being male. The mean (standard deviation) HAM-A score was 10.5 (4.6), with minimum and maximum values of 4 and 26/56. We found that 13 (15.8%) had moderate to severe anxiety (with 11 having moderate symptoms and 2 having severe), and 69 (84.2%) had no, minimal or mild anxiety. Participants working in health facilities with more than one dentist, where less likely to have moderate/severe anxiety (OR: 0.22, 95% CI: 0.05;0.78).Copyright © 2021 The Author(s)

Examining the structural effect of working time on well-being: Evidence from Abu Dhabi

Does working time affect workers' wellbeing? We studied this question in the context of the Emirate of Abu Dhabi, drawing on the results its Quality-of-Life Survey conducted in 2019/2020. The empirical analysis examined the effect of working hours on various elements of wellbeing. Preliminary analysis and path analysis justified the significance of eight variables: work-life balance, frequency of meeting with friends, happiness, stress, time spent with family, self-assessment of health, satisfaction with income, and difficulty in fulfilling family responsibilities. The model became significantly less efficient when including variables such as job satisfaction, job security, time spent in sport, sleeping and leisure. The implications were discussed in the light of international research literature and post-COVID workplace arrangements and flexibilities. © 2022 Department of Community Development

Impact of COVID19 on work return after 6 months of hospitalization

Post-COVID syndrome has directly affected quality of life, reduced individual health status and it also could bring slow return to work and to routine activities of daily life. Objective(s): The aim of this study was to assess the impact of moderate to severe COVID-19 infection on work return, physical activity, and persistent symptoms 6 months after hospitalization. Method(s): We included 94 patients referred to the post-COVID outpatient clinic, who were hospitalized by COVID-19 with pulmonary involvement and requirement of O2 supplementation. A survey was applied by telephone after 6 months of hospitalization. Result(s): The mean age was 52+/-13yrs and 63% was male. 48% were admitted in the ICU. Among the patients who answered the survey (n=70), 54 patients (77%) reported post-discharge physical activity and 54.2% maintained a training frequency of 2 to 3 times or more per week. Except one, all patients that became asymptomatic performed exercises after discharge (n = 18/19). Regarding job, 62 patients worked before COVID-19 infection and all of them returned to their activities. Although back to work, 64.2% reported low energy or fatigue throughout the workday after 6 months. It was also reported a persistence of other symptoms by 73% of patients, mainly: memory loss (41%), myalgia (40%), fatigue (37%) and dyspnea (24%). Conclusion(s): After COVID19 hospitalization, patients managed to get back to work but two-thirds of them with impairments related particularly to low energy or fatigue during the day. Perform regular exercises could improve symptoms and help to decrease the impact of COVID19 in work activities.

A study on level of mental health and influencing factors of medical staff in the makeshift hospital during COVID-19 in Shanghai.

Objective To analyze the mental health status of medical staff in the Fourth Branch of National Convention and Exhibition Center Makeshift Hospital during the COVID-19 epidemic in Shanghai to lay a theoretical foundation for the mental health and psychological intervention of medical staff in COVID-19 and other public health emergencies. Methods An online questionnaire survey was conducted with the generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and Athens insomnia scale (AIS) before medical staff entering the makeshift hospital and one month later. Results The detection rates of anxiety, depression and insomnia were 18.4%, 22.1% and 27.0% respectively before entering the makeshift hospital, and 28.8%, 59.3% and 64.2% respectively during the follow-up period one month later. The GAD-7, PHQ-9 and AIS scores of medical staff after working in the makeshift hospital for one month increased significantly compared with those at the baseline period (P<0.01). Female and previous history of using sedative and hypnotic drugs were risk factors for increased depression level among medical staff in the makeshift hospital. Conclusions The anxiety, depression and insomnia levels of the medical staff in Shanghai increased after working in the makeshift hospital for one month. It is of great significance for the front-line support work to identify the medical staff with serious psychological problems and carry out psychological intervention in the early stage.Copyright © 2022 Authors. All rights reserved.

The Prototype of Healthy Smart Building Based on Google Assistant

Coronaviruses are a group of viruses from the subfamily Orthocronavirinae in the Coronaviridae family and the order Nidovirales. In general, the transmission of this virus occurs through droplets or body fluids splashed on someone or objects around them within 1-2 meters' distance away through coughing and sneezing. Office buildings, cafes, and shopping areas are one of the clusters for spreading the coronavirus because the following places lack awareness of health protocols. This research will create a healthy and Smart Building system where this system consists of two devices from the following problems. The first device is a health procedures checker system where using an ultrasonic sensor as an automatic switch can provide a hand sanitizer as the first step to kill viruses. The GY609 sensor is used, which can measure the temperature of visitors without touching it. The second system is the Smart Switch;the doors and lights can control using voice using google assistant to minimize the doorknob's touch or the light switch. The healthy and Smart building test results are for the intelligent, healthy procedures system, 3-7 cm is the optimal distance from the hand to the sensor, 5cm is the distance from the hand to the temperature sensor, and the motor working time is 1 second. For the Smart switches, the recommended network system is 3G, 4G, or Wi-Fi to avoid excessive delays. © 2022 IEEE.

Temporal Dimensions of Job Quality and Gender: Exploring Differences in the Associations of Working Time and Health between Women and Men.

Research shows strong links between working time organization and workers' health outcomes. Working time is also known to be highly gendered, with men and women working to different schedules. This article merges these two strands of research and takes a gender-based approach to investigating the relationship between temporal job quality and self-reported health in Europe. First, the sixth European Working Conditions Survey (EWCS) is used to establish the relationship between temporal dimensions of job quality and health and well-being outcomes for employed women and men. This is then corroborated using larger samples and more restricted measures of job quality drawn from micro-data from the 2019-2020 EU Labor Force Survey (LFS). The analyses show that good temporal job quality is positively associated with health and subjective well-being for both women and men, but this effect is significantly stronger for women, who are also at a greater risk of exposure to low control over working time and time under-employment. The findings highlight the importance of studying the impact of working and employment conditions on health from gender perspective, and the need for further exploration of job quality due to changes in the spatio-temporal organization of work during and beyond the COVID-19 pandemic.

The Concept of "Leave Days" in Romanian Labour Law

Working time has maximum limits strictly regulated at national and European level. Periods that do not constitute working time are considered rest time. Among the periods that do not make up working time, in this paper we will explain the concept of "leave days" (days off), not legally defined and even slightly obscure in the current Romanian legislative landscape. The notion of leave days does not benefit from a rigorously outlined legal definition. So, we shall attempt some clarifications. Besides, the paper includes an analysis of recent developments in Romanian Labour Law on working time, in the period of COVID 19 crisis. The heterogeneous nature of the situations considered and their disparate regulation makes it difficult to outline a single legal regime for leave days;from justification to effects, they cover a wide range of legal realities. That is why, however, we deemed useful a synthesis of the situations where this concept is regulated in Romanian law, as well as the legal consequences of these rules on the parties to the individual employment contract.

The Impact of Extended Reality on Surgery: A Scoping Review

Aim: Extended reality (XR) is a spectrum of technologies encompassing augmented reality (AR), virtual reality (VR), augmented virtuality (AV), mixed reality (MR). This scoping review maps out current utilisation and future prospects of XR-assisted surgery. Method: A systematic search of PubMed, Scopus, Embase was performed. Primary studies describing surgical procedures on human subjects, dentistry, anaesthetic procedures for surgery were included. Non-surgical, rehabilitation, bedside, veterinary procedures, robotic surgery were excluded. Studies were classified into preoperative planning, intraoperative navigation/guidance, patient pain, patient anxiety, surgical training, surgeon confidence. Results: 213 studies were included for analysis. Thirty-six studies on pre-operative planning noted VR improved surgeon's understanding of anatomical sites, leading to reduced operating time and surgical trauma. Fifty-nine studies on intra-operative planning noted AR headsets highlight 'negative structures', reducing chance of accidental incision. Fourteen studies on patients' pain found VR-induced meditative state resulted in less analgesics for patient comfort. Twelve studies on patient anxiety found VR failed to change patients' physiological parameters such as arterial blood pressure, cortisol levels, heart rate. Sixty-eight studies explored surgical training, with VR being most cost-effective. Thirteen studies documented increased surgeon confidence. Conclusions: XR-assisted surgery's growth is fuelled by hardware and software innovations. Training and pre-operative planning are mostly achieved by VR;intraoperative guidance is mostly supplemented with AR. The other sections of XR spectrum, AV and MR, are underexplored. Working time restrictions during surgical training, COVID-19's impact on limiting physical presence and increasing complexity of surgical procedures means that XR-assisted surgery may assume a greater role in coming decades.

ONE YEAR of DIGITAL HEALTH APPLICATIONS (DIGA) in GERMANY-RHEUMATOLOGISTS' PERSPECTIVES

Background: Based on given legislation (ŞŞ 33a and 139e SGB V, Social Code Book V) the German approach to digital health applications (Digitale Gesundheitsanwendungen, DiGA) allows reimbursed prescription of approved therapeutic software products (listed in the DIGA directory https://diga.bfarm.de/de/verzeichnis) for patients since October 6th, 2020. Objectives: To evaluate the level of knowledge on DiGA among members of the German Society for Rheumatology (DGRh) after one year of DiGA under the conditions of the COVID-19 pandemic using the DiGA Toolbox of the 'health innovation hub' (hih), a think tank and sparrings partner of the German Federal Ministry of Health. Methods: Anonymous cross-sectional online survey using LimeSurvey (https://limesurvey.org). The survey was promoted by newsletters sent out to DGRh newsletter recipients and Twitter posts. Ethical approval was obtained. Results: 75 valid participants reported that they care more than 80% of their working time for patients with rheumatic diseases. Most were working in outpatient clinics (54%) and older than 40 years of age (84%). Gender distribution was balanced (50%). 70% were aware of the possibility to prescribe DiGA. Most were informed on this for the frst time via trade press (63%), and only 8% via the professional society. 46% expect information on DiGA from professional societies and the medical chambers (36%) but rarely from the manufacturer (10%) and the responsible ministry (4%). Respondents would like to be informed about DIGA via continuing education events (face-to-face 76%, online 84%), trade press (86%), and manufacturers test accounts (64%). Only 7% have already prescribed a DiGA, 46% planned to do so, and 47% did not intend DiGA prescriptions. Relevant aspects for prescription are given in Figure 1. 86% believe that using DiGA/medical apps would at least partially be feasible and understandable to their patients. 83% thought that data collected by the patients using DiGA or other digital solutions could at least partially influence health care positively. 51% appreciated to get DiGA data directly into their patient documentation system resp. clinical electronic health record (EHR) and 29% into patients' owned EHR. Conclusion: DiGA awareness was high whereas prescription rate was low. Mostly, physician-desired aspects for DiGA prescriptions were proven efficacy and efficiency for physicians and patients, risk of adverse effects and health care costs were less important. Evaluation of patients' barriers and needs are warranted. Our results will contribute to the implementation and dissemination of DIGA.

Germany and the United States in coronavirus distress: internal versus external labour market flexibility.

Germany and the United States pursued different economic strategies to minimise the impact of the Coronavirus Crisis on the labour market. Germany focused on safeguarding existing jobs through the use of internal flexibility measures, especially short-time work (STW). The United States relied on a mix of external flexibility and income protection. On this basis, we use macroeconomic time series to examine the German strategy of securing employment through internal flexibility by contrasting it with the chosen strategy in the United States. In Germany, temporary cyclical reductions in working hours are mainly driven via STW. US unemployment rose at an unprecedented rate, but unlike in previous recessions, it was mostly driven by temporary layoffs. However, a closer look at the blind spots of the chosen strategies in both countries showed that despite the different approaches, people in weaker labour market positions were less well protected by the chosen strategies.

COVID-19 and the labour market: What are the working conditions in critical jobs?

The COVID-19 pandemic has focused public attention on occupational groups that ensure the maintenance of critical infrastructure, provision of medical care and supply of essential goods. This paper examines the working conditions in critical jobs based on representative data from the German BAuA Working Time Survey 2019. Our analyses reveal that essential workers are more likely to perform unskilled or semiskilled activities and work in cleaning, transport and logistics, health care occupations as well as IT and natural science services. Regarding the working conditions, essential workers are paid comparatively less and are more physically proximate to others at work than nonessential workers. They more often work atypical hours, such as day and night shifts and on weekends, and have less autonomy in their working time. Additionally, critical jobs are characterised by muscular and skeletal strain due to working positions and carrying heavy loads significantly more often. Thus, our findings strongly suggest that work-related risks accumulate in critical jobs. Supplementary Information: The online version contains supplementary material available at 10.1186/s12651-022-00315-6.

The Effect of Caring Training on the Implementation of Caring Behavior and Work Culture of Nurses in Providing Services to COVID-19 Patients in an Indonesia’s National Referral Hospital

BACKGROUND: Nursing services are one of the criteria for hospital health care. Nurses are the health care workers who have the most contact with patients. Nurses had relatively limited interaction with patients during the epidemic. As a result, it is necessary to increase caring behavior in service delivery. AIM: This study aims to determine the effect of caring training on the implementation of caring behavior and work culture of nurses in providing services to COVID-19 patients in an Indonesia’s National Referral Hospital. METHODS: This study used a quasi-experimental design, with one-group pretest-posttest approach. The study was carried out in Indonesia’s National Referral Hospital. The research was conducted between August and December 2021. The caring training lasted around 4 h. Purposive sampling was used to select the sample, which included as many as 92 persons. The Caring Behaviors Inventory-42 and value culture tools were used to collect data. Questionnaires and observation sheets were utilized to retrieve direct measurement data. The collected data were analyzed using a univariate test and a Wilcoxon test for bivariate analysis. RESULTS: The average age of nurses was 34 years old, with an average working time of 9 years. There was no significant difference in knowledge between before and after care training (p >0.05). However, there was a significant difference in attitude, work culture, and caring behavior between before and after caring training (p < 0.05). CONCLUSIONS: When nurses provided care to COVID-19 patients in an Indonesian national referral hospital, the caring training had an impact on their behavior and work culture. The hospital should continue a compassionate training program, reinforce it with regulations, monitor assessments, and apply rewords and consequences.