Working conditions of medical workers during the COVID-19 pandemic in 2020–2021 in Novosibirsk

Introduction. The high risk of infection of healthcare workers dictates the need to study their working conditions during the COVID-19 pandemic. The study aims to research the working conditions of medical workers during the COVID–19 pandemic in multidisciplinary medical and preventive organizations. Materials and methods. Analysis of working conditions of medical workers of medical and preventive organizations. The study design is a closed population (four medical institutions were randomly selected), a target group (doctors and nurses). The authors analyzed the staffing table and 16 reports on a special assessment of working conditions at 1,251 workplaces (1,845 medical workers, of which 787 doctors, 1,058 nurses). Statistical analysis included: standard methods of descriptive statistics, determination of relationships by logistic regression (odds ratios (OR) and 95% confidence intervals (OR CI)). p<0.05 was taken as the critical level of significance. Results. The largest number of ill medical workers provided assistance to patients without signs of COVID-19 both in hospitals (86.06% of doctors, 85.85% of nurses) and in outpatient polyclinic treatment and prevention organizations (90.31% of doctors, 92.05% of nurses). The probability of getting sick COVID-19 was maximum in an infectious diseases hospital (compared with emergency departments OR 2.049;95% OR CI 1.194–4.608 and diagnostic and treatment units of medical institutions OR 3,057;95% OR CI 1,876–4,98). The workplaces of medical workers who have undergone COVID-19 in infectious diseases hospitals and specialized teams are classified as harmful class 1–3 degrees, and workers are classified as high occupational risk groups according to SARS-CoV-2. The probability of getting sick with COVID-19 is significantly higher when in contact with pathogens of infectious diseases (class of working conditions 3.3 compared to 3.1 or 3.2). Conclusion. The workplaces of medical workers who have undergone COVID-19 in infectious diseases hospitals and specialized brigades are classified as harmful class of the first to third degree, and workers are classified as high occupational risk groups for COVID–19. Ethics. Scientists have conducted the study in compliance with the Ethical principles set out in the Helsinki Declaration of 1975 with amendments of 1983 and obtaining the informed consent of patients. © 2023, Izmerov Research Institute of Occupational Medicine. All rights reserved.

About the Results of Vaccination against COVID-19 for Employees of a Cheboksary Medical Organization

Relevance. In the 21st century, humanity is faced with a pandemic unprecedented in recent history, which brought with it huge losses. All the efforts of world science are aimed at ensuring that the new coronavirus infection becomes vaccine-controlled. The Ministry of Health of Russia included vaccination against COVID-19 in the national calendar of preventive vaccinations. The most vulnerable and significant in the epidemiological chain are representatives of socially active, intensively communicating professions, including medical workers. Aims. The aim of the study was to assess the degree of severity of the post-vaccination immune response in employees of a medical organization vaccinated with the Gam-COVID-Vac preparation, who had not been ill and did not have antibodies before vaccination. Materials & Methods. The post-vaccination immunity of 80 vaccinated employees was assessed 42–62 days after the start of vaccination and 6 months later;assessment of the safety of vaccination with the Gam-Kovid-Vak vector vaccine;selection of optimal screening tests for laboratory examination of persons before the planned vaccination. The results of the PCR test for the detection of SARS-CoV-2 RNA (at the post-vaccination stage four times with an interval of 7 days) and the determination of M and G immunoglobulins to SARS-CoV-2 by the ELISA method were analyzed, post-vaccination complications and reactions were assessed at different stages, monitoring the state of health and assessing the dynamics of the post-vaccination immune response. Results. A study conducted after 6 weeks showed the high immunological efficacy of the Gam-Covid-Vac vaccine;100% of those vaccinated with one or two components of the vaccine had class G antibodies to SARS-CoV-2. Vaccination did not cause severe reactions during the observation period;among the side effects, general complaints and local pains at the injection site prevailed, which were of a short-term nature and did not have a significant impact on the health status and habitual rhythm of life of the participants. The resistance of those vaccinated to a new coronavirus infection decreased over time and amounted to 97.1% three months after vaccination and 95.6% after 6 months. COVID-19 disease in vaccinated employees (7.4% of cases of the number of vaccinated) was of moderate severity, did not lead to the development of pneumonia and respiratory failure, and did not require hospitalization. Conclusions. The results obtained allow us to conclude that the effectiveness of vaccination against COVID-19 is quite high. Revaccination is well tolerated clinically and «amplifies» the immune response when exposed to SARS-CoV-2. Immunization of employees of medical organizations is necessary, because. this focus group is the most epidemiologically potentially dangerous in terms of the spread of infection. © 2023, Numikom. All rights reserved.

Substantiation of the methodology of physiological assessment of the functional state of medical personnel during COVID-19 pandemic

Introduction. The work of medical personnel in the extreme conditions of the COVID-19 pandemic is related to the impact of nervous and emotional labor tension, high visual loads, which contributes to the formation of fatigue and overwork and requires the attention of labor physiologists. The study aims to substantiate the methodology of physiological assessment of functional fatigue of medical workers during work in a covid hospital to determine the duration of periods of work in a pandemic. Materials and methods. Comprehensive physiological and hygienic studies of the medical staff of the covid hospital during 6 months of work were aimed at a physiological study of the state of the cardiovascular system with the study of the characteristics of the response to stress loads (ECG registration on a 12-channel electrocardiograph and continuously using Holter monitoring, determination of the vegetative Kerdo index and Kvass endurance coefficient), the study of psychological conditions, hygienic assessment of the intensity of the labor process. The researchers have studied the physiological state of the central nervous system and the visual analyzer according to generally accepted methods. The authors have studied the features of neurohumoral regulation (the main mediator of the stress-implementing system — cortisol) in medical workers. We have carried out a total of 1728 measurements of psychophysiological indicators. The scientists carried out statistical data processing of the received data using statistical programs Statistika 10, Microsoft Excel 2010. Results. The researchers found that indicators of the functional state of the cardiovascular system, reflecting the degree of adaptation of the body of medical workers to industrial activity, can be used to determine physiologically justified work periods in a pandemic, further accumulation of scientific data and risk assessment of medical workers. After four months of work in medical organizations with COVID-19, the formation of an unfavorable functional state in medical personnel is reflected in changes in ECG and systemic blood pressure, increased detrenability of the cardiovascular system, the predominance of sympathetic influences. Limitations. There are quantitative restrictions due to the number of medical staff of the hospital with COVID-19. Conclusion. Pronounced loads on the visual analyzer when watching video terminal screens against the background of nervous and emotional labor tension are the leading professional factors and determine the formation of the functional state of overwork (third degree) in the medical staff of the hospital with COVID-19. Ethics. The study was approved by the Local Ethics Committee of the Izmerov Research Institute of Occupational Health (Protocol No. 4 of 04/14/2021). © 2023, Izmerov Research Institute of Occupational Medicine. All rights reserved.

Results of screening examination of employees of a medical hospital for antibodies to SARS-CoV-2

While providing medical care to patients with a new coronavirus infection, medical workers are at risk of developing COVID-19 significantly more often than the general population. In addition to morbidity risks, an important question is the duration of the immune response to COVID-19. The aim of our study is to assess the incidence of COVID-19 and the duration of the persistence of anti-SARS-CoV-2 antibodies among hospital medical staff. Material and methods. We conducted a retrospective non-randomized single-center study, based on the analysis of the laboratory database of the Municipal Clinical Hospital No. 52 (Moscow). The results of the 2160 employees were included into analysis. The inclusion criteria were as follows: at least one result of antibody determination to SARS-CoV-2 in period from June 2020 to January 2021;the date of the last antibody determination to SARS-CoV-2 no earlier than November 1, 2020. Additionally, a group of 100 employees were selected for further investigation of the persistence of immunoglobulin G (IgG) antibodies to SARS-CoV-2. Additionally, a group of 100 employees was selected, who had a confirmed fact of seroconversion for IgG and the presence of at least three results of IgG to SARS-CoV-2 determination with an interval of at least 4 weeks. Results. According to IgG determination results, by January 2021, 66.6% of all hospital employees have already been ill with COVID-19. The medical staff who worked with patients with COVID-19 been ill with COVID-19 in 78.2% of cases. The share of sick medical personnel who did not work with this group of patients was 55.3%. The first termination of antibodies persistence to SARS-CoV-2 from employees was marked from 3-4 months of observation. After 7-9 months, 23% of the observed group became seronegative. Odds ratio for the risk of COVID-19 for medical staff, who worked with COVID-19 patients was 2.89 (95% CI 2.34-3.56) to other medical staff and 3.6 (95% CI 2.82-4.59) to non-medical staff. Conclusion. The incidence of COVID-19 and the risk of infection among medical workers is significantly higher than among the general population, which dictates the need of further improvement of COVID-19 prevention measures among medical workers.Copyright © 2022 by the authors.

Prognostic criteria for the development of severe clinical forms of COVID-19 in medical organization workers

Employees of medical organizations are one of the risk groups for infection with a new coronavirus infection (COVID-19), including with the development of severe clinical forms. The aim of the study was to analyze the clinical manifestations of a new coronavirus infection in medical workers with the determination of laboratory markers for the development of severe COVID-19. Material and methods. The study included 186 medical workers who had COVID-19 in 2020. In 67 people (observation group), the disease occurred in the form of pneumonia, in 119 people (comparison group) - acute respiratory infection caused by SARS-CoV-2. In the acute period of the disease, a laboratory examination was carried out: a general clinical blood test, CD-typing of lymphocyte subpopulations, assessment of biochemical parameters, determination of parameters of the hemostasis system and cytokine levels. Using the binary logistic regression method, we have built multifactor models. To determine the threshold values of the indicators, we used ROC analysis. Statistical processing of materials was carried out using Microsoft Office 2016 and IBM SPSS Statistics (version 26). The differences were considered statistically significant at p<0.05. Results and discussion. The most frequent clinical manifestations of COVID-19 were: weakness, fever, myalgia, arthralgia, difficulty in nasal breathing, serous-mucous discharge from the nose, sore throat, cough, feeling of "tightness" in the chest, shortness of breath, headache, pain in the eyeballs, dizziness, anosmia, ageusia and dyspeptic manifestations in the form of diarrhea, nausea or vomiting. Markers associated with the development of severe pneumonia associated with COVID-19 have been identified. Threshold values of laboratory parameters for predicting the severe course of COVID-19 were determined: the number of platelets (less than 239x109/l), lymphocytes (less than 1.955x109/l), cytotoxic T-lymphocytes (less than 0.455x109/l), T-helper cells (less than 0.855x109/l), NK-cells (less than 0.205x109/l), ESR (more than 11.5 mm/h), LDH (more than 196 units/l), total protein (less than 71.55 g/l), D-dimer (more than 0.325 mcg/ml), CRP (more than 4.17 mg/l), IL-6 (more than 3.63 pg/l). Conclusion. The data obtained make it possible to predict the possibility of developing a severe variant of the COVID-19 course.Copyright © 2022 Infectious Diseases: News, Opinions, Training. All rights reserved.

Relationship between leadership-member exchange (LMX) and flow at work among medical workers during the COVID-19: the mediating role of job crafting.

Based on relational leadership theory and self-determination theory, this study aims to investigate the relationship between leader-member exchange (LMX), job crafting, and flow at work among medical workers in the context of the COVID-19 pandemic. Participants in the study consisted of 424 hospital employees. The results showed that: (1) the LMX positively predicted flow at work; (2) two types of job crafting (increasing structural job resources and challenging job demands) played a mediating role between the LMX and flow at work; and (3) gender did not moderate these mediating effects as suggested by previous studies. These results indicate that the LMX can not only directly predict flow at work, but also indirectly predict work-related flow through job crafting by increasing structural job resources and challenging job demands, thus providing new insights for enhancing flow experiences of medical workers.

Features of the profile of the professional crisis of medical workers with professional deformities in the context of the COVID-19 pandemic

Introduction. The specifics of the professional activity of medical workers in the context of the COVID-19 pandemic, in the presence of stressful factors of production situations, negatively affects the professional profile of specialists and leads to the opportunity of a professional crisis. Purpose. To identify the features of the profile of the professional crisis of medical workers with professional deformities in the context of the COVID-19 pandemic. Materials and methods. The study conducted on 816 medical workers with occupational deformities included questionnaires on the personality profile of the crisis by A.E. Taras and on burnout by C. Maslach & S. Jackson, K. Pearson's correlation criterion, descriptive statistics and Chaddock's table to reveal the tightness of correlation processes. Results. The main features of the profile of the professional crisis of medical workers with deformities in the professional field include a high level of functional disorders of cardiac activity and the activity of the gastrointestinal tract;functional disorders of breathing, autonomic system, thinking, sleep;symptoms of anxiety and increased emotionality;attempts to escape from problems, and depressive mood coloring. Limitations. When studying the characteristics of the profile of the professional crisis, a psychodiagnostic study was conducted using the author's methods on a sample of 816 voluntarily participating medical workers with professional deformities in the context of the COVID-19 pandemic, which is a sufficient reference sample. Conclusion. In the context of the COVID-19 pandemic, the grading of deformations in the professional field of medical workers will contribute to: normalization of the activity of the autonomic, respiratory and cardiovascular systems, and the gastrointestinal tract;harmonization of the sleep-wake cycle;reduction of depression, attempts to escape from problems, tension, complications of thinking, anxiety. © POLYAKOVA O.B., BONKALO T.I., 2022.

Comparison of peripheral blood T, B, and NK lymphocytes between frontline medical workers for treating patients of COVID-19 and normal outpatient and emergency medical workers in China.

The outbreak of the novel coronavirus disease 2019 (COVID-19) has led to significant mental stress for frontline medical workers treating patients with confirmed COVID-19 in China. Psychological stress has an impact on the immune system. The number and percentage of lymphocyte subsets are standard indicators of cellular immune detection. Here, we reported the differences in CD3, CD4, CD8, CD19, and CD56 lymphocytes between 158 frontline medical workers and 24 controls from medical staffs of the outpatient and emergency departments. We found that frontline medical workers had significantly lower absolute values and percentages of CD19+ B cells, especially in the female and the aged ≥40 years subgroup. Stratification analysis showed that the absolute values of CD4+ T cells were significantly lower in the aged <40 years subgroup, while percentages of CD8+ T cells were lower and percentages of CD56+ NK cells were higher in the aged ≥40 years subgroup. In summary, this study suggests paying more attention to frontline medical workers' mental health and immune function, and properly providing them with psychological interventions and measures of care.

Mental health predictors of medical staff in the early stage of COVID-19 pandemic in Poland

Aim of the study: To identify the sociodemographic predictors of general functioning, stress, anxiety and depression in Polish medical workers' group in the early stage of COVID-19 pandemic. Material(s) and Method(s): A cross-sectional observational study using an online questionnaire was conducted via both professional organizations and social media groups. A total of 303 completed responses were received. More than half of participants (54.8%) work in public hospitals, the majority was females (77.6%), nurses (38.3%), the age was ranged from 22 to 68 years (M = 41.37;SD = 11.38). The semi-structured online questionnaire covered following areas: (1) general sociodemografic data, including health state and COVID-19 related questions;(2) psychological impact and mental health, measured by GHQ-30 and DASS-21. Result(s): Overall, our results showed that sex, years of experience and profession have predictive power to explain mental health being of medical workers during COVID-19. In our study, females reported worse general functioning (GHQ-30) and higher stress (DASS-21) than males. Longer working experience is predictor of better interpersonal relationships (GHQ-30). Discussion(s): Years of experience and gender accounted for 27% of the variance of the level of stress in medical staff group. With the years of experience of healthcare professionals, the stress decreases. Nurses reported less severity of anxiety than other medical workers. We assume those results are connected with education process as well as experience level. Conclusion(s): It may be important to develop a personalized intervention, considering the main predictors of mental well-being. Authorities should consider creating the tailored-made programs for medical professions.Copyright © 2023 Polish Psychiatric Association. All rights reserved.

Relationship between covid-pandemic anxiety and sleep disorder with menstrual disorders among female medical workers.

BACKGROUND: It has been more than 2 years since the 2019 novel coronavirus disease (COVID-19) pandemic destabilized the world, adversely affecting not only physical health, but also mental health. During this time, frontline medical workers were at a greater health risk, especially female medical workers. Changes or abnormalities in the menstrual cycle-an important indicator of women's health-may jeopardize female reproductive functioning. Considering that emotional health and sleep status may be related to the menstrual cycle, this study aimed to investigate the association between menstrual cycle changes, anxiety, sleep dysfunction, and other factors among female medical workers during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted by distributing online questionnaires to female medical workers in China from February to May 2022. The study included 160 women aged 18-45 years old. The questionnaires covered data related to the participants' sociodemographic characteristics, medical and reproductive history, and lifestyle. The Rating Scale for Clinical Manifestations of Menopathy (SCMM), Self-Rating Anxiety Scale (SAS), and Sleep Dysfunction Rating Scale (SDRS) were utilized. Data were analyzed using chi-square tests, t-tests, and linear regression analysis. RESULTS: A total of 160 female medical staff were randomly selected in this research, of whom seven scored less than 3 points, 85 scored 3-11 points, and 68 scored more than 11 points on the total score of the SCMM. Compared to pre-pandemic scores, scores of dizziness and tinnitus were significantly higher during the COVID-19 pandemic. Scores corresponding to the following clinical symptoms were also higher during the pandemic: Menopathy, including hypaphrodisia, dim complexion, abnormal urination, languidness, dim menstruation, thin menstruation, dysmenorrhea, and empty or saggy lower abdomen (p < 0.05). However, pre-pandemic scores of vaginal bleeding quantity were significantly higher than those found during the COVID-19 pandemic (p < 0.05). Scores of vaginal bleeding quantity were significantly lower in cabin hospitals than other types of hospitals, and a similar finding was observed for vaginal bleeding duration (all p < 0.05). Moreover, the findings of the univariable and multivariable linear regression analysis revealed a link between consistent exercise, the underlying illness, the SDRS score, the SAS score, and the total score of SCMM (p < 0.05). CONCLUSIONS: In this study, we found that menstruation in female medical workers was affected by the COVID-19 pandemic. Furthermore, regular exercise and good physical condition were protective factors, while anxiety and insomnia were risk factors for menstrual abnormalities.

The psychological stress response of COVID-19 to medical staff and prevention: A large sample study from China.

Objectives: In the face of the COVID-19 pandemic, medical staff in China were more likely to suffer from psychological problems. By investigating the actual state of psychological stress response of medical staff during the COVID-19 outbreak, the study discussed and analyzed the influencing factors of different psychological states in order to prevent the occurrence of serious adverse emotional events in medical staff. Methods: In the Xiangyang Central Hospital, 1,466 medical staff members have adopted the Psychological Questionnaire for Emergencies Events of Public Health (PQEEPH), which includes questions about depression, neurasthenia, fear, obsessive anxiety, and hypochondriac disorders. The questionnaire also asks about gender, age, education level, health, department, position, and whether personnel exposure history correlation analysis has been confirmed. Results: The survey revealed that 55% had depression, 26.7% had neurasthenia, 95% had fear, 47.9% had obsessive anxiety, and 69.3% had hypochondria. The effects of depression and hypochondriac emotional stress were significantly greater in female workers than in male workers (p < 0.05). Those with higher educational levels had a stronger emotional stress response. Medical professionals with or without contact histories, those who were suspected or confirmed, as well as those in various positions and departments, all demonstrated significant differences in their stress emotions (p < 0.05). Conclusion: Emotional stress affected medical professionals, especially doctors and nurses, who were on the front lines of clinical work in the face of significant public health emergencies. Therefore, to reduce the stress burden and enhance mental health on medical staff, hospitals were suggested to improve their emergency management practices. In addition, the sensitization knowledge training and psychological counseling for front-line clinical staff should be strengthened.

Factors of Stress Resistance in Doctors and Medical Workers during the COVID-19 Pandemic

Purpose. The purpose of this study was to analyze the severity of stress reactions and highlight stress resistance factors in medical workers under the COVID-19 pandemic. Materials and methods. The methodological complex included: social and demographic questionnaire;the Perceived Stress Scale-10 questionnaire;State-Trait Anxiety Inventory;Maslach Burnout Inventory, Russian adaptation, version for healthcare workers);Russian-language version of the 24-itemHEXACO six-factor Personality Inventory;Russian-language version of Kuhl and Fuhrmann Self-regulation Study Methodology (Selbststeuerungs-Inventar – SSI). A total of 318 medical workers (mean age 38.7±11.6 years) participated in the online survey in the period between Apr. 27, 2020, and Nov. 20, 2021. Results. The results of the study revealed that a low level of stress resistance and a high level of emotional burnout were mostly detected in medical workers with specialized secondary education under the age of 30, in female medical staff and among respondents who did not have their own children. The dynamics of changes in burnout rates directly corresponded to the dynamics of changes in morbidity rates during the pandemic periods. Psychological factors of medical staff stress resistance under the COVID-19 pandemic conditions were identified, including such personality traits as extraversion, openness to new experiences and conscientiousness, a developed capacity for self-regulation, will development, orientation to act after failures, as well as congruence of own feelings and readiness to integrate contradictions. Conclusion. The conclusion summarizes the results and presents the limitations and prospects of this study. © 2023, Professionalnye Izdaniya. All rights reserved.

INFLUENCE OF ORGANIZATIONAL FACTORS ON THE FORMATION OF MENTAL MALADAPTATION IN MEDICAL WORKERS DURING THE PANDEMIC OF A NEW CORONAVIRUS INFECTION COVID-19

The aim of the study is to analyze the modern foreign and domestic scientific literature devoted to the influence of pro-duction factors on the formation of mental maladaptation in medical workers, as well as possible methods of its prevention and curing. Materials and research methods. Scientific studies of negative psychological reactions and manifestations of mental disorders in medical workers of various profiles in the COVID-19 pandemic were analyzed. The search protocol included the use of various databases, including PubMed;Russian information and analytical portal in science, technology, medicine, and education — eLIBRARY.ru;open-access statistical reporting data;and official websites of scientific journals on the subjects under study. Study results and their analysis. The results of the study showed that most medical professionals experienced stress caused by organizational factors such as a lack of personal protective equipment (PPE), fears of not being able to receive quality medical care if they were sent to work elsewhere, fears of rapidly changing context, lack of access to current information and communication, lack of special medications, shortage of ventilators and beds in intensive care units In the conditions of regular health care work, most of the professionals noted tension in the process of performing professional duties, exceeding their physical and mental capacities, which was one of the main reasons for anxiety, nervousness or stress at work. © Burnasyan FMBC FMBA.

HARDINESS AND COPING STRATEGIES OF MEDICAL WORKERS IN COUNTERING EMOTIONAL BURNOUT (DURING THE FOURTH WAVE OF THE COVID-19 PANDEMIC IN RUSSIA)

In the context of the COVID-19 pandemic, the problem of psychological well-be-ing of medical workers is becoming particularly relevant. The appeal of physicians to intrapersonal hardiness resources, the use of optimal coping strategies for long-term work in a pandemic increases the likelihood of a more favorable passage of a stressful period and a decrease in emotional burnout. Goal. To identify the specifics of emotional burnout of medical workers during the fourth wave of the COVID-19 pandemic in the context of the characteristics of the state of hardiness and the use of coping strategies. Adaptation to the Russian language of the methodology "Burnout scale in COVID-19 (COVID-19-BS)” (M. Yıldırım, F. Solmaz). Materials and methods of research. The study was conducted in November-De-cember 2021. The study sample included 128 medical workers: 37.5% doctors, 47% middle and junior medical personnel, 15.5% medical students who volunteered to work in medical institutions during the pandemic;23% men, 77% women;aged 21 to 63 years (M=35 years). The study was conducted in the city of Ivanovo (47%), the city of Moscow and the Moscow region (57%). The following techniques were used: "The test of hardiness” (S. Muddy, in the Russian-language adaptation of E.N. Osin, E.I. Rasskazova), "Questionnaire of coping methods” (OSS) (R. Lazarus, S. Folkman, in the Russian-language adaptation of T.L. Kryukova, E.V. Kuftyak, M.S. Zamyshlyaeva), "Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) for Healthcare workers” (S. Chang with et al.;in the Russian-language adaptation by S.E. Mosolova et al.), "Burnout scale in COVID-19 (COVID-19-BS)” (M. Yildi-rim, F. Solmaz). The empirical data obtained were interpreted and processed using qualitative and quantitative methods of analysis, including: descriptive statistics, Spearman correlation analysis, linear regression analysis (step selection method), Mann-Whitney U-test. Results. The study showed that every third medical employee at work during the fourth wave of the COVID-19 pandemic in Russia, in the context of the COVID-19 epidemic, experiences stress and anxiety, shows signs of emotional burnout. Two-thirds of medical workers as a whole have demonstrated a sufficient level of hardiness development. Hardiness parameters are negatively associated with anxiety and emotional burnout of physicians during the COVID-19 pandemic. The greatest durability of this effect is provided by such parameters of resilience as "engage-ment” and "risk taking”. Which indicates that hardiness may be a protective factor for medical professionals. The most implemented coping strategies among physicians are problem solving planning, social support search, self-control, positive reassessment. The choice of non-constructive copings (confrontation, distancing, escape-avoidance) promotes the development of emotional burnout. The study con-firmed the reliability and validity of the COVID-19-BS questionnaire for measuring emotional burnout associated with COVID-19. Conclusion. The data obtained on the peculiarities of the psychological state of medical workers during the fourth wave of the COVID-19 pandemic indicate the need to continue work related to their psychological support and support for their personal and professional development, prevention of depression and post-trau-matic stress disorder. © 2022, Science and Innovation Center Publishing House. All rights reserved.

Visual-Motor Reaction Parameters as Indicators of Fatigue in Emergency Medical Personnel

Introduction: Factors of the work environment affect the functional state of the central nervous system of employees, which is manifested by changes in sensorimotor reactions. Professional tasks of emergency medical personnel during the COVID-19 pandemic determine high requirements for the stability of functional systems of the body. Objective: To study the influence of professional activities on the mobility of central nervous processes in ambulance workers. Materials and methods: The study was conducted at the Ryazan City Clinical Emergency Hospital in 2021. It included 44 ambulance workers (12 doctors and 32 paramedics), 12 men and 32 women with the mean age of 35.77 ± 3.39 years, working a 24-hour shift followed by 72 hours off. We studied parameters of the complex visual-motor reaction of the subjects including the average response times and the Whipple's index using the "NS-Psychotest” computer complex equipped with the visual-motor analyzer. The data were analyzed using the Data Analysis ToolPak in Microsoft Excel 2007. Results: The established statistically significant increase in the average response time of ambulance employees by 60.75 ms (p < 0.001) by the end of the work shift indicates changes in the functional state of the central nervous system caused by fatigue. The analysis of the dynamics of indicators between the beginnings of neighboring shifts revealed positive trends expressed by an average decrease in the response time by 77.67 ms (p = 0.002) and an increase in the Whipple's index by 0.07 (p < 0.0001) in most subjects after the regulated rest period, thus indicating the effectiveness of the processes of functional restoration of the central nervous system. Conclusions: By the end of the work shift, ambulance workers demonstrated increased average visual-motor reaction times. Age under 30 and 0–5-year work experience are risk factors for poor professional adaptation proven by a high proportion of the subjects with a statistical increase in the average reaction time during the work shift. Stabilization of the dynamics of inter-shift indicators when compared at the beginning of adjacent shifts indicates proper functional restoration of the central nervous system of emergency medical personnel during the 72-hour rest period. © 2023, Federal Center for Hygiene and Epidemiology. All rights reserved.

Focus on the Mental Health of Pediatric Medical Workers in China After the COVID-19 Epidemic.

As was previously known, pediatric medical staff in China faced several hurdles including high occupational risk, multiple contradictions, heavy workload, and long working hours. After the outbreak of 2019 novel coronavirus, facing the overload of work and the potential risk of infection, pediatric medical workers may be under great psychological pressure. The purpose of this article was to call attention to the impact of the epidemic on the mental health of Chinese pediatric workers, and developing psychological intervention program that are tailored to them. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese government and authorities around the world.

How do we pay back? Women health workers and the COVID-19 pandemic in India

This paper looks at the experiences, vulnerabilities and contributions of women health workers during Covid 19 pandemic in India. It elaborates upon their everyday struggles and issues including incidences of violence against them, poor wages, temporariness of their jobs and other labour rights. The paper further discusses the transitioning characteristics of women health workers in the context of corporate globalization in India. The paper offers a critical reading of health worker's rights from a feminist perspective and raises the challenges and opportunities the pandemic provides in rethinking the role of women health workers in India and women welfare workers in general.

MENTAL HEALTH OF MEDICAL WORKERS UNDER COVID-19 PANDEMIC CONDITIONS

At different stages of its development, the world community has repeatedly faced various disasters, nat-ural calamities and epidemics. COVID-19 pandemic was no exception, the consequences of which, one way or another, affected everyone, but mostly medical workers. It is in the conditions of the pandemic that common stress factors emerged and aggravated, many people experienced negative mental and psychological consequences of it. However, based on the accumulated experience and the rapid development of medicine, there is an opportunity to influence the preservation of mental health of any person, as well as to identify risks and to prevent negative consequences of the pandemic. Preservation of mental health of medical workers is one of the most important tasks of public health. Factors influencing mental and psychological state of medical workers as well as possible organizational measures to support medical workers during the pandemic are considered in the article. © Burnasyan FMBC FMBA.

An investigation of the psychological stress of medical staff in Shanghai shelter hospital during COVID-19.

Objective: The purpose of this study was to assess the psychological status of medical workers from other locations who helped support the fight against COVID-19 in Shanghai and to provide a basis for psychological crisis intervention plans under designated emergencies. Methods: While supporting the Shanghai Lingang Shelter Hospital, we investigated 1,097 medical staff from other cities working in the hospital. A questionnaire comprising the general information questionnaire, health questionnaire depression scale, generalized anxiety scale, insomnia severity index scale, and mental health self-assessment questionnaire was used. Results: There were no statistically significant differences in the incidence rates of anxiety, depression, and sleep disorders among subjects of different genders, ages, and educational levels. There were statistically significant differences in the incidences of anxiety, depression, stress response, and sleep disturbance among subjects with different levels of worry about COVID-19. Conclusion: During the COVID-19 pandemic, the Lingang Shelter Hospital team experienced more psychological pressure, suggesting that medical institutions should pay attention to the mental health of frontline medical workers during COVID-19 and prepare psychological intervention measures for team members.

Influencing factors of work stress of medical workers in clinical laboratory during COVID-19 pandemic: Working hours, compensatory leave, job satisfaction.

Background: The COVID-19 pandemic continues to pose unprecedented threats and challenges to global public health. Hospital Clinical Laboratory and public health institutions have been playing an important role in case detection, epidemic research and decision-making, and epidemic prevention and control. Objective: To explore the current situation and influencing factors of work stress of medical workers in hospital clinical laboratory in fighting against COVID-19. Methods: A cluster random sampling method was used to select seven hospitals from 14 tertiary hospitals in Xiamen, and medical workers in the selected hospitals were investigated by self-administered questionnaire. A total of 150 medical workers inclinical laboratory participated in this survey, 138 valid questionnaires were collected, with a response rate of 92%. Results: The work stress scores of the medical workers in the clinical laboratory of hospital in the COVID-19 epidemic were collected (55.22 ± 11.48); The top three dimensions of work stress score were work stress (work load), external environment and doctor-patient relationship. The results of multiple stepwise regression analysis showed that the working hours per day, whether overtime and night shift can get compensatory leave and Job satisfaction with the work of the clinical laboratory were the main factors affecting the work stress level of medical workers in the clinical laboratory of hospital during COVID-19 epidemic. Conclusion: The COVID-19 has caused great harm to the physical and mental health of the public. Medical staff are in the front line of prevention and control of the epidemic, so medical workers in hospital clinical laboratory exposed to a high level of stress at work. Laboratory leaders and hospital managers should take active and effective measures to reduce the working hours of the medical staff in clinical laboratory, optimize the arrangement of night shift and overtime working, strengthen the training of group and individual pressure management, reduce the work stress of the medical staff, improve the overall happiness of the medical staff in clinical laboratory, and stabilize the clinical laboratory team, improve the physical and mental health of medical workers in clinical laboratory.