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Background: This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium. Method(s): Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021. Result(s): Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores. Conclusion(s): The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.Copyright © 2022, The Author(s).
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The aim of this study was to measure the effect of equine assisted services (EAS) on mood and anxiety in health-care workers. While the emotional toll of the COVID-19 pandemic has been felt in every aspect of our society, health-care workers have been hit especially hard. A survey conducted by Mental Health America during June - September in 2020, found 93% of health-care workers were experiencing stress and 86% reported experiencing anxiety. There is research to support a wide range of interventions to address stress, low mood, and anxiety, including pharmaceuticals, physical exercise, and animal interaction. While several studies have shown an improvement in anxiety and mood after interaction with horses, few studies have included a physically active control group to consider the effect of exercise on results. In this study conducted in October 2021, participants were recruited from area hospitals and randomly assigned to a control group (30-min guided walk with no horse interaction, n = 17), a low level EAS group (30-min self-guided farm tour, n = 20), or a mid-level EAS group (30 min of grooming a horse, n = 19). Before the intervention, participants completed a demographic survey. Pre and post activity, participants completed the Brief Mood Introspection Scale (BMIS) and State Anxiety Inventory for AdultsTM that measured currentfeelings of mood and anxiety, respectively. Data were analyzed using the repeated measures one-way ANOVA procedure in SPSS. This study was approved by the MSU Human Research and Protection Program and the Institutional Animal Care and Use Committee. Fifty-six health-care workers participated in the study, with 32% having worked in health care for less than 5 years and 33.9% having worked in health care for over 20 years. All participants had a significant improvement in State-Anxiety scores after completing their group activity (P < 0.001), with no differences among groups. Similarly, all groups had an improved BMIS score (P < 0.001). However, there was significantly greater improvement in BMIS scores in the mid-level EAS (P < 0.01) when compared with the control group. While all participants in this study improved both their current feelings of anxiety and mood after completing an activity on the farm, there was a greater improvement in mood in those individuals who spent 30 min grooming a horse when compared with the walk group without horse interaction. The results from this study provide further support for the impact of equine assisted services as a means of improving mood.Copyright © 2023
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Research indicates the COVID-19 epidemic changes people's health and diet, However, this has not yet been well discussed in Taiwan, especially in college students. Therefore, the purpose of this study is to investigate the impact of distance learning on college students' dietary patterns, sleep quality and perception of stress during the COVID-19 epidemic in Taiwan. 265 college students from a university in Taichung were recruited in this study. The self-administered online questionnaire was used to investigate the changes in eating behavior, sleep quality, and perception of stress before and one month after distance learning, and further analyzed the relationship among them. The questionnaire contains demographic information, dietary questionnaires (including six categories of food intake behaviors, convenience food intake frequency), the Pittsburgh Sleep Quality Index (PSQI) and Perceived Stress Scale (Chinese 14-item PSS). The results showed that the proportion of college students to meet the recommended Taiwan Dietary Guidelines amount in vegetables (21.9%), fruits (27.5%), meats and dairy products (15.8%), and nuts and seeds (11.3%) were lower during distance learning. The frequency of convenient food intake was lower during distance learning (13.31 +/- 6.10 points;never to occasionally). During the distance learning period, there was a significant negative correlation between dietary patterns and sleep quality (r = -0.160, p = 0.009), It shows that college students with higher dietary pattern scores have better sleep quality. During the distance learning period, there was a significant positive correlation between sleep quality and perceived stress (r = 0.320, p < 0.001), It shows that college students with higher levels of stress had poorer sleep quality. This study found that the lower the perceived stress of college students, the better their diet and sleep quality;conversely, the higher the perceived stress, the worse their diet and sleep quality. Studies have shown that a healthy, balanced diet can reduce the risk of getting various diseases. Therefore, in the post-epidemic era, it is recommended that schools increase the accessibility and availability of vegetables, fruits, dairy products, nuts and seeds on campus to make it easier for teachers and students to obtain such healthy food in order to achieve the goal of promoting balanced diet.Copyright © 2022 Nutrition Society in Taipei. All rights reserved.
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Background: East during COVID-19 is a potentially serious and fatal new infection that first broke out in Italys North Eastduring Spring 2020. Among subjects considered more clinically vulnerable, patients with adrenal insufficiency (AI) have a known increased risk of infections, that could lead to poor prognosis and death due to adrenal crisis. Even the psychological and sociooccupational impact of COVID-19 could affect the health of AI patients, requiring a dynamic and continuous adaptation of the daily glucocorticoid (GC) therapy. Aim(s): To investigate if AI patients have a higher risk for COVID-19 infection than the general population, all residents in the red zone Veneto, in North-East Italy. Moreover, based on a purpose-built ADDI-COVID questionnaire, the study aimed to evaluate the subjective perception of an increased risk for COVID-19 infection and pandemic-related psycho-social impact, working life and self-adjustments of GC therapy. Method(s): Open-label, cross-sectional monocentric study on 84 (65 primary and 19 secondary) AI patients, all resident in Veneto, followed-up at the Endocrinology Unit, University-Hospital of Padua, for at least 3 years, in good and stable clinical conditions. At the end of the first COVID-19 wave (by August 2020), all patients underwent serological investigation of anti-SARS-CoV2 IgG and ADDI-COVID questionnaire. All AI patients enrolled were contacted during March-April 2021 to evaluate eventual COVID-19 infection occurrence after the second and third waves, completing a follow-up period of about 12 months. Result(s): All AI patients resulted negative to the serological test for anti-SARS-CoV2 IgG at the end of the first wave of COVID-19. After the second and third pandemic waves, COVID-19 infection occurred in 8 (10%) patients, and none needed intensive care or hospitalization. Half patients felt an increased risk of COVID-19 infection, significantly associated with an increased stress (p = 0,009) and the consequent increase of GC stress-dose (p = 0,002). Only one patient reported adrenal crisis stress correlated. The great majority of the 61 (73%) worker patients changed their working habits during the lockdown, which was inversely related with COVID-19-related stress (p = 0,0015). A significant association was found between workers and endocri- nologist contact (p= 0,046) since 18 among 20 AI patients who contacted the endocrinologist were workers. Discussion and Conclusion(s): Patients with AI residence in Veneto did not show a higher incidence of COVID19-infection compared with general population residents in Veneto after the first pandemic waves. However, the perception of increased COVID- 19 infection risk significantly impacted the psychological well-being, working habits and GC daily doses of AI patients. Especially during this pandemic period, therapeutic patient education was crucial to prevent and treat situations or conditions that could lead to an adrenal crisis. The endocrinologic consultation could help to strengthen the awareness of AI patients, especially if they were workers.
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Background: The coronavirus disease (COVID-19) pandemic has affected the medical education throughout the world. A study was done to assess the effect of education and psychological behavior on medical students. Aims and Objectives: The objective of the study is to evaluate the effect of COVID-19 on medical graduates in various aspects such as education, effect on clinical rotations, impact on the technology used for online classes, effect on quality of life, loneliness, sleep, and depressive symptoms. Material(s) and Method(s): A set of questions were distributed to Government Medical college, Suryapet students during November 2021-January 2022. Questionnaire aimed to study students' viewpoint of COVID-19's impact on their education, mental health, and willingness to participate clinically. Result(s): One hundred medical students from Government Medical College, Suryapet participated in this study. Most students (88%) agreed that pandemic had disrupted their medical education. About 64% agreed to attend clinical rotations and 68% of students accepting the risk of contracting COVID-19 in clinical rotations. COVID-19 had an impact on technology tools used for medical education. Students reported that COVID-19 had moderate impact on quality of life, sleep quality, anxiety, and depressive symptoms. Conclusion(s): The COVID-19 had an overall significant negative impact on undergraduate medical education. It is recommended that measures need to be taken to relieve students' stress.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Previous studies have demonstrated that low-intensity intervention is effective in improving mental health in young people. Whilst interventions have majorly been offered online during COVID-19 pandemic, it is not known whether low-intensity interventions delivered online can also help reduce the level of distress experienced by young people. The study aimed to determine whether a low-intensity online intervention (LiON) can reduce levels of distress in young people greater than those in similar initial distress levels but received no intervention. Young people aged 15 to 24 were recruited for the 4-weekly LiON intervention consisting of three modules namely sleep and relaxation, stress-coping and problem-solving. The reductions in distress level after intervention were compared to those that occurred over a period of 3 months among community young people with similar baseline K6 distress levels. Seventy-four young people (mean age 20.24 [SD 2.26] years, 71.6% female) received the LiON intervention from December 2021 to July 2022. We observed a greater improvement in their distress levels after receiving the intervention than those with no intervention in the community (beta -4.13, 95%CI -5.12, -3.07, p < .001, Cohen's f2 0.027). The findings offered evidence that the LiON intervention significantly reduced young people's distress level in addition to the improvement that may occur naturally. The use of LiON is adaptable to a wider variety of frontline community organizations. Future evaluation of its cost-effectiveness is warranted.
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Introduction: Macrophage activation syndrome (MAS) is a severe hyper inflammatory condition caused by the over-activation and proliferation of T cells, NK cells and macrophages. It is often associated with complications of rheumatic/immune diseases. We present a case of a 15-year-old female who experiences recurrent episodes of MAS without any known definitive underlying etiology. Case Presentation: A 15-year-old previously healthy female developed fatigue, fevers, myalgia, chest pain, splenomegaly and lymphadenopathy 10 days after receiving her first Pfizer COVID-19 vaccine. Her symptoms recurred 10 days after receiving the second dose. Her myocarditis, MIS-C, and infectious work up was negative except for positive EBV IgG. Laboratory studies revealed anemia, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia. She initially responded to decadron;however, her symptoms recurred with steroid taper. Bone marrow biopsy revealed hemophagocytosis. Whole exome sequencing (WES) revealed a heterozygous variant of uncertain significance in UNC13D c.962C>A (p.Thr321Asn). She had multiple re-admissions with significantly elevated inflammatory markers, including extremely high IL2-R, IL-18 and CXCL9. Each episode was complicated by an acute viral infection. She responds to high dose steroids, anti-IL-1, and JAK inhibitors. Nonetheless, it has been difficult to wean decadron without triggering a flare. She continues to require increasing doses of baricitinib. Discussion(s): MAS may be seen as a complication of rheumatic diseases, as well as inborn errors of immunity. However, none of these conditions have been diagnosed in this patient despite extensive testing, including WES. The degree of her immune dysregulation has been very severe making her disease process unpredictable and extremely difficult to control. She has frequent flares precipitated by viral infections or attempts at adjusting her immunomodulators. Weaning her medications has been challenging as she continues to require increasing doses of baricitinib and corticosteroids. The UNC13D gene is associated with autosomal recessive familial hemophagocytic lymphohistiocytosis type 3 (FHL3). Our patient is heterozygous for an UNC13D variant of uncertain significance. Additional genetic inquiries with whole genome sequencing to help elucidate the underlying etiology of her severe condition is being conducted. We hypothesize she developed MAS due to a combination of genetic predisposition, prior EBV infection, and immune stress associated with the COVID-19 vaccine. [Formula presented] [Formula presented] [Formula presented]Copyright © 2023 Elsevier Inc.
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Aims: to investigate if mental disorders and cognitive performance are associated with interpersonal behaviours and negative emotions among youth during the COVID-19 pandemic. Method(s): This work is part of the Brazilian High-Risk Cohort for Mental Conditions (BHRC), which included 6-12 years-old children at baseline (Year 2010) who participated in an online COVID-19 wave (N = 1.144). Outcomes were factor socres from specifc sections of the international Coronavirus Health and Impact Survey (relationship changes, stress, and concerns related to COVID-19). A structured interview (DAWBA, DSM-IV) assessed externalizing and internalizing disorders. Cognitive predictors were IQ and executive function assessed at baseline. We used Generalized Linear Models adjusting for sex and socioeconomic variables. First, higher IQ (B = 0.0032;t = 2.714;p = .006) and any internalizing disorder prior to the pandemic (B = 0.0902;t = 2.228;p = .026) were associated with higher perceived stress during the pandemic. Second, any externalizing disorder (B = -0.1449;t = -2.066;p = .039) was linked with lower levels of COVID-19-related worries, whilst higher performance in executive function tasks was associated with higher levels (B = 0.1803;t = 4.796;p = .001). Third, higher IQ was linked with negative changes in interpersonal relationships (B = -0.0007;t = -3.371;p = .0007). Conclusion(s): This study showed that lifetime externalizing and internalizing disorders, in addition to cognitive variables at lifetime externalizing and internalizing disorders, in addition to cognitive variables at an early age, were associated with distinct mental health outcomes during the COVID-19 pandemic.
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Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Objectives: Goal Attainment Scaling (GAS) quantifies the effect of interventions on individuals' personal goals. Goals that are meaningful to individual patients are set by GAS interviewers (physicians/academics, experienced in clinical research/trials) in collaboration with patients and/or their caregivers. The SARS-CoV-2 pandemic presented a major challenge to health care worldwide. We investigated how the SARS-CoV-2 pandemic affected the use and implementation of GAS in clinical/research settings. Method(s): Eleven GAS interviewers in Canada, the US, UK and Australia with current/past experience working with patient-caregivers to identify goals and build scales to measure goal attainment as an outcome were interviewed using a semi-structured approach. They described how the pandemic affected GAS use in clinical/research settings. Interviews were recorded and transcribed, then themes were identified and coded in Nvivo 12. Result(s): Most GAS interviews were moved to the virtual environment during the pandemic (9/11). GAS interviewers identified few negative impacts. Some goals required modification (e.g. going to the gym or shops). Pandemic stress impacted both interviewers and interviewees. Even so, most GAS interviewers (8/11) emphasized positive impacts of the pandemic. These were: 1) the virtual environment meant patients were more readily available as they did not need to travel;2) because interviewers did not have to travel, patient recruitment could be expanded into more remote geographical areas;3) researchers could recruit and retain more participants and collect data more quickly;and 4) interviewers commented they became more open to technology because of the pandemic (9/11). Conclusion(s): Despite the challenges of the SARS-CoV-2 pandemic for health care, most GAS interviewers found that the impacts were largely positive for using GAS in clinical/research settings. The ability to deploy GAS through a virtual platform could facilitate the uptake of GAS as a patient-centric outcome measure.Copyright © 2023
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Throughout the COVID-19 pandemic, OnTrackNY teams provided coordinated specialty care (CSC) in a radically shifted environment. This presentation describes adaptations to OnTrackNY's model implemented during the pandemic. Method(s): OnTrackNY providers were recruited to participate in indepth, qualitative interviews conducted using phone and video platforms. The project team co-developed the qualitative interview guides with OnTrack Central trainers for each of the six team member roles. A coding team used the FRAME to identify the top three role-based adaptations to the OnTrackNY model from transcripts of qualitative interviews. Result(s): Twenty-three providers (n = 3-4 providers per role) discussed challenges and adaptations of providing CSC services during the pandemic. Use of telehealth was a major adaptation applied across all roles. Adaptations to outreach included narrowing community outreach to inpatient and emergency settings, increasing communication with referral sources, increasing contact with newly referred participants and families. Peer specialist adaptations include conducting physically-distanced groups, discussing current events and expanding online resources for engagement. SEES adaptations included monitoring evolving employment opportunities, conducting mock job interviews remotely, and supporting online learning. Adaptations to PCP/RN roles included sending equipment home for monitoring heath, changing methods and frequency of administering medication, and providing education regarding COVID-19 and vaccination. Adaptations to the Primary Clinician role included increasing informal 'check-ins', using screen sharing to complete assessments and safety plans, and addressing increased stress due to the pandemic. Conclusion(s): Adaptations to CSC were common with providers most frequently making changes to format and setting of care delivery and content modifications. Future work will examine implications of adaptations and OnTrackNY fidelity indicators.
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Aim: To determine the attitude of medical practitioners towards collaborating with dental professionals during a pandemic. Material(s) and Method(s): The present study is a cross sectional survey conducted among the medical practitioners of India. 2100 medical practitioners were randomly selected as study subjects. The data pertaining to their attitude toward collaboration with dental professionals were gathered using a self-administered questionnaire. Data was analyzed using descriptive studies. Result(s): Among the study subjects, 93% of the medical doctors said in the future if the pandemic occurs then they would feel contended if they were to be given the provision to be aided by a well-trained dental support team, 80% of them said they experienced high stress during the pandemic. When asked to specify the reason in case they have not approached the dentist during the pandemic, 89% said they did not ponder over the thought of taking help from the dentist. Conclusion(s): If a pandemic occurs in the future, the contribution of the dentist can be beyond dentistry provided we adopt and execute proper measures and plan them beforehand.Copyright © 2021 Muslim OT et al.
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Background: COVID-19-Pandemic Lockdowns initiated online teaching-learning in India. We aimed to assess mental health (MH) of adolescents studying online for academic milestone of matriculation during these circumstances. Material(s) and Method(s): It was a cross sectional study carried out in Western Maharashtra, during 2021. MH of study subjects was assessed by presence and severity of symptoms of depression, anxiety, stress (DAS) and emotional intelligence (EI). They were measured by DAS Scale-42 (DASS-42) and Schutte's self-report EI test (SET) respectively with collection of socio-demographic information maintaining confidentiality. Data were analysed by SPSS-20 software. MH parameters were compared with pre-pandemic pilot and other studies to study effect of online education and overall COVID-19 Pandemic scenario on MH of study subjects. Result(s): Total 1162 adolescents participated, out of which 59 were omitted from the analysis due to incomplete data. Out of remaining 1103 participants, 43% boys & 57 % girls with the mean age of 14.69 (+0.78) years. Majority of them belonged to middle socio-economic-status. Mean DAS and EI scores denoted mild anxiety with no evidence of depression and stress. Mean EI score was in normal range. Mean DAS scores were significantly lower and mean EI score was significantly higher than reported in -pandemic pilot and other studies. Conclusion(s): MH derangement of matriculating adolescents during COVID-19- Pandemic with online education seemed to be less severe than that was in pre-pandemic times with in-class education. Recommendations: MH support at schools needs to be strengthened. During the post-COVID-19 period, online school education may be continued in LMIC like India on the basis of willingness of students and parents but with caution and understanding of socio-cultural background and support.Copyright © 2022 Pravara Institute of Medical Sciences. All rights reserved.
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Aims: The impacts of the coronavirus disease of 2019 (COVID-19) pandemic on mental health have been relatively severe. This study examined the influence of the COVID-19 especially on depression and suicidal ideation in community-dwelling elderly in Korea. Method(s): Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea). A total of 2423 elderlies were recruited from 22 counties in Jeollanam-do between April and October 2021. We used self-reported questionnaires, including sociodemographic factors, COVID-19 related stress, suicidal ideation, Geriatric Depression Scale-Short Form Korean Version (GDS-SF). Logistic regression was performed to examine the factors on depression and suicidal ideation. Result(s): Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, the worry of COVID-19 infection and restriction of daily activity due to COVID-19 pandemic were significantly associated with depression. Male sex, poor perceived health status, disability in house chores and depressive symptom are risk factors for suicidal ideation. Conclusion(s): These findings showed that increased risk factor for depression and suicidal ideation in community dwelling elderly during COVID-19 pandemic. We confirmed that feelings of isolation and negative perception of health were risk factors on depression in community dwelling elderly in the context of the COVID -19 pandemic. Also male, poor self-perceived health status, difficulty of independent living and worry and depression are increased the risk of suicidal ideation among the elderly.
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Aim: Adolescents have experienced disruption in their daily routines, including changes in health behaviors such as an increased sedentary behavior and increased smartphone usage. The aim of this study was to assess the association of health behaviors with mental health problems. Method(s): Five cross-sectional surveys (February 2021 to May 2022) were performed during the pandemic assessing physical activity, smartphone usage, depressive symptoms (Patient Health Questionaire-9 (PHQ-9)), anxiety symptoms (Generalized Anxiety Disorder Scale 7 (GAD-7)), sleep quality (Insomnia Severity Index 7 (ISI-7)), and stress (Perceived Stress Scale 10 (PSS-10)). In total, N = 7201 adolescents (age: 14-20 years ((MW +/- SD): 16.63 +/- 1.49 years);70.2% female, 18.8% migration background) participated. Result(s): A strong increase in mobile phone usage as well as a decrease in physical activity as compared to pre-pandemic data were observed (p < 0.001). Compared to the lowest smartphone user group (<1 h/d), the adjusted odds ratios (aOR) for depressive symptoms increased with increasing smartphone usage to 1.98 (3-4 h/d), 3.30 (5-6 h/d), 4.96 (7-8 h/d), and 6.79 (>8 h/d). High utilizers (>8 h/d) were also more likely to experience clinically relevant anxiety, insomnia, or stress symptoms (aORs 3.23-5.75) compared to those using the smartphone less than 1 h/d. Conclusion(s): Results highlight the need for measures to promote responsible smartphone usage as well as to increase physical activity, so as to promote mental health in adolescence.Copyright © 2023
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Aims: Health Care Workers (HCW) have had to deal with mental health-related stressors during the COVID-19 pandemic and exhibited higher rates of anxiety, depression, insomnia, and post-traumatic stress symptoms. The impact of the COVID-19 pandemic on mental health of a sample of hospital HCWs was assessed over time, relating to quality of life, post-traumatic growth, burnout, sleep changes, and resilience. Method(s): An online, three-phase, survey was sent to the whole working population of the University Hospital of Modena, covering 12 months (baseline questionnaire sent in June 2020). Sociodemographic and behavioral information related to COVID-19 were collected, together with screening for anxiety, depression, stress, and post-traumatic symptoms. A multivariate analysis was conducted to analyze changes across time. Result(s): 457 HCWs completed all three stages of the survey, M/F ratio: 28.0/71.9%. Anxiety and stress were significantly associated to having been in direct charge of COVID+ patients (anxiety OR = 2.22, 95% C.I. = 1.06-4.78, p-value = 0.04;stress OR = 2.03, 95% C.I. = 1.05-3.95, p-value = 0.04). Stress was associated to perception of increased workload both at baseline (OR = 1.79, 95% C.I. = 1.02-3.18, p-value = 0.05) and at first follow-up (OR = 1.97, 95% C.I. = 1.08-3.73, p-value = 0.03). Significant changes over time were registered as to increased alcohol consumption and a more imbalanced diet. Conclusion(s): Results are helpful to guide support interventions and organizational actions to improve the well-being and functioning of HCWs.Copyright © 2023
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Background: Work stress among healthcare staff has been identified as an extensive problem already before the pandemic. To be able to treat the surge of COVID-19 patients in need of intensive care COVID-19 ICUs were swiftly set up and staffed. The aim of this study was to investigate what staff perceived as most stressful. Material(s) and Method(s): During spring 2020 up to 270 COVID-19 patients were simultaneously treated in ICU's in the greater Stockholm and Sormland regions, upholding 100 ICU beds pre-pandemic.1 Staff reactions to work in a COVID-19 ICU was collected in a survey. Nine causes for stress were scored on a five graded likert like scale from does not agree to fully agrees. 612 nurses and physicians, both regular ICU staff and newcomers, working in ICU's in 2 larger and 3 smaller hospitals responded, (response rate approx. 35%). Data was analyzed using structural equation modeling to calculate loading of each factor. Result(s): The highest scoring cause of stress was "making a mistake". "Getting infected" got the lowest score among the 9 predefined causes. Conclusion(s): Clinicians working in COVID-19 ICUs were generally confident not to get infected at work. Commitment to maintain patient safety and frustration not to live up to standards of care in this strained situation was reflected in "making a mistake" and "relatives cannot visit" scoring as the number one and three out of the nine causes of stress. Increased knowledge about work-related stressors is crucial, in order to prevent detrimental impacts of such stressors.
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Introduction: The Covid-19 pandemic has put unprecedented pressures on the National Health Service (NHS) with adult critical care being one of the key specialties that has been affected. NHS staff have been working relentlessly throughout the pandemic and adult critical care teams were at the forefront of that. Thames Valley & Wessex and Kent, Surrey & Sussex Adult Critical Care Operational Delivery Networks had heard from our unit matrons and clinical leads around their concerns for the wellbeing of their staff. We had also heard of the number of critical care nurses who have either left their roles or are planning to leave. Objective(s): As Networks our main objective was to gain a better understanding on some of the factors that locally might be influencing the wellbeing of our staff and any intentions to leave, and to see if this aligns with the published research. The Networks also planned to develop a series of recommendations based on the results from the data. Method(s): A survey was developed as a method of gathering both qualitative and quantitative self-reported data from nurses currently working on adult critical care units. All survey data collected was anonymous. This was circulated, via the unit Matrons and Nurse Leads, to nursing staff within their critical care department. Result(s): The survey produced a large amount of data, with 427 responses (approximately 15% of nurses) from 33 units across 24 questions. The data found that 51% of nurses report that Covid-19 has made them less likely to stay in their current roles. 7 in 10 reported high levels of stress because of their work with the most common cause of stress being "staff shortages" and "being asked to work on other wards". The results also showed within the next 3 years, 50% of nurses are planning on leaving their current roles in their adult critical care unit with 47% of nurses feeling they do not get adequate salary. On a positive note, 87% of nurses feel they are having a positive impact on patient care with 74% reporting that they would recommend adult critical care nursing to other nurses. Following this analysis of the data, the networks developed six recommendations that looked at repeating and sharing the report, wellbeing, salary, contributing factors for stress and dedicated time for education and development. Alongside a formal report, individual units with more than five participants were provided with an infographic, personalised to them with their results. Conclusion(s): The data showed points of significant interest for the networks and units and has generated interest from the wider critical care community, with the desire to replicate this survey Nationally. It is clear that despite 87% of nurses feeling they have a positive impact on patient care and 74% recommending critical care nursing to others, 50% of nurses are looking to leave. We need to understand this aspect in more detail along with the two key reasons for stress, moving to the wards and staff shortages.
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There is growing momentum to understand the value of the arts in mental health and wellbeing. Engagement with the arts can promote wellbeing by helping to build resilience, aid recovery and foster social connections. Aim(s): To co-develop, implement and evaluate the impact of Culture Dose for Kids (CDK), an arts engagement program, on young people's anxiety. Method(s): Mixed methods [surveys and interviews] were used to research an 8-week series of face-to-face arts engagement sessions conducted at the Art Gallery of New South Wales with anxious youth (9-12 years) and their parents/carers. Result(s): Findings indicate that the children's anxiety scores decreased over the eight-week program. Sustained high attendance rates throughout were another marker of its effectiveness and engagement, although a COVID outbreak affected several sessions. Qualitative data, from parent and children's interviews, offered greater insight and meaning into CDK's impact on the child and family. Not only did parents find CDK calming and stress-relieving for themselves ('a little gift of time'), but they said that they are using some strategies and topics from the sessions to connect more closely with their child and their child's issues. By engaging both parent and child in this inclusive, non-stigmatizing arts-based mental health intervention, a more holistic, family-centred, community approach to supporting wellbeing occurred. Conclusion(s): This study responds to the recent call to move beyond the formal mental health system to facilitate community-led initiatives and infrastructure to strengthen young people's overall mental health and well-being and their social connections and involvement with their community.
ABSTRACT
Problem: Environmental stress during pregnancy has known impacts on both maternal and fetal health. In terms of theCOVID-19 pandemic, the majority of published work has focused on the impact of the infection itself, without considering the potential immune impact of pandemic related-stress.We, therefore, assessed the impact of pandemic stress, independently of SARS-CoV-2 infection, on the circulating and placental immune profiles of pregnant individuals. Method(s): Placentas from 239 patients were collected at the Sainte- Justine Hospital, Montreal, Canada. Of these, 199 patients delivered during the pandemic and were exposed to pandemic stress with (+: 79) or without (-: 120) SARS-CoV-2 infection, the latter exposed to pandemic stress only. Pre-pandemic historic controls (uncomplicated pregnancies, Ctrl: 40), were also included. Placental biopsies were collected to assess cytokine levels by ELISAs and histopathological lesions. A sub-study with 35 pre-pandemic pregnancies (unexposed) and 20 who delivered during the pandemic (exposed) was also conducted. The latter (exposed/unexposed) were all uncomplicated pregnancies. We collected maternal blood prior to delivery for immunophenotyping, and plasma/peripheral blood mononuclear cells (PBMCs) were isolated. Inflammatory mediators in the plasma were quantified by ELISAs. Co-culture assays with PBMCs and human umbilical vein endothelial cells (HUVECs) were performed to assess endothelial activation. Demographical/obstetrical data were obtained through chart review. Result(s): SARS-CoV-2+ patients were multiethnic (63.4%), had higher pre-pregnancyBMI (28.9 vs. 24.8 inCtrl, P<.05), and elevated preterm birth rate (16.5% vs. 5.8% in SARS-CoV-2-, P < .05 and 0.0% in Ctrl, P < .01). In the placentas, we observed an increase in the levels of IL- 1Ra (P < .05) and CRP (P < .05) in both SARS-CoV-2 groups, while IL-6 (P = .0790) and MCP-1 (P < .001) were elevated solely in SARS-CoV- 2-. These changes were predominant in placentas with inflammatory lesions on histopathological analysis. Moreover, we observed elevated CD45+ cells (P < .001) in the placentas from both SARS-CoV-2 groups versus Ctrl. Considering that the differences we observed were important in the SARS-CoV-2- group, we performed a study solely on uncomplicated pregnancies, either exposed or unexposed to pandemic stress. At the systemic level, we observed a decrease in the percentage of Th2 cells (P < .001), leading to a pro-inflammatory Th1/Th2 imbalance in exposed individuals. Decreased Treg (P < .05) and Th17 (P < .05) versus unexposed was also observed. Surprisingly, decreased levels of circulating IL-6 (P < .05), MCP-1 (P < .01), and CRP (P<.05) were seen in exposed versus unexposed individuals. Finally,we observed increased secretion of ICAM, a marker of endothelial activation, solely in endothelial cells co-cultured with PBMCs from exposed individuals. Conclusion(s): Overall, placental inflammatory profiles differed between pregnant individuals exposed to pandemic stress with or without SARS-CoV-2 infection. Moreover, we observed that the pandemic stress exposed group presented a systemic pro-inflammatory bias. This highlights the need to understand the differences between the effects of pandemic-related stress and the added burden of SARS-CoV-2 infection itself on maternal and fetal health. Our work also supports an association between an increased risk of hypertension/ preeclampsia and SARS-CoV-2 infection that might be driven in part by pandemic-related stress.