Binge drinking alcohol and circadian misalignment in night shift nurses is associated with decreased resiliency to COVID-19 infection

Background: Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in exposed individuals. Alcohol misuse and shift work with subsequent misaligned circadian rhythms are known to promote a pro-inflammatory state and thus could increase susceptibility to COVID-19. To test this hypothesis, we conducted a prospective, cross-sectional observational survey-based study in nurses using the American Nursing Association network. Method(s): We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift). Result(s): By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79). Conclusion(s): Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.Copyright © 2023 The Authors. Alcohol: Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.

[Sleep disorders in nurses working during the COVID-19 pandemic]. / Rasstroistva sna u meditsinskikh sester, rabotayushchikh v period pandemii COVID-19.

The reorganization of treatment facilities during the COVID-19 pandemic has altered the working conditions of large numbers of the health workers (HW) worldwide. The implementation of professional activities in such realities has led to an increased risk of developing a number of psychological disorders, including insomnia. The percentage of insomnia in HW has increased significantly. The nurses were the most vulnerable, because they are women and they work in an understaffed environment. The influence of shift work and stress conditions on the risk of insomnia, methods of prevention and treatment of this disorder are thoroughly examined in the article.

Post-COVID Challenges in Occupational Medicine as a Branch of Clinical and Educational Medicine

BACKGROUND: The COVID-19 pandemic has exhausted the employees of hospital center and had a negative impact on medical students. AIM: The aims are to show the efforts of Occupational Medicine to provide support for healthcare workers and to increase student's interest in O.M. MATERIALS AND METHODS: Out of the total number of employees of the Clinical Hospital Center Rijeka, which is 3500, 275 of them claim for recognition of COVID-19 occupational diseases in 2022. The 6th-year medical students of the Rijeka Faculty of Medicine, 130 in total and 22 sanitary engineers were surveyed by the quality service regarding their satisfaction with the Occupational Medicine classes. Statsoft Statistica 10 was used to calculate the results. RESULT(S): All HCW are recognized as having COVID-19 as a professional disease. Older age correlated with greater absenteeism. Hospital employees are dissatisfied, tired, they demand work benefits, contraindications for shift work, night work, work in COVID centers, and requesting maternity leave. Many also quit their jobs the hospital management is looking for and hiring new employees, who quickly leave due to difficult working conditions and low incomes. Occupational medicine also has a problem with students. During the pandemic, classes were held online. Interest in classes declined, a small number of students joined the lectures, but all responded to the survey. The answers showed a lack of interest in the Occupational Medicine course. With subsiding of the pandemic, it would be obligatory to continue "live" classes, take students on a tour of industrial facilities, and cancel the failed evaluation of teachers. CONCLUSION(S): Easing of working conditions for HCW and changes in teaching is necessary.Copyright © 2023, Scientific Foundation SPIROSKI. All rights reserved.

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.

The effects of shift-work schedules on the sleep, health, safety, and quality of life of police employees during the COVID-19 pandemic.

Introduction: The negative health and safety consequences of police fatigue are increasingly recognized as a critical problem. This study's objective was to measure the effects of different shift schedules on police employee health, safety, and quality of life. Methods: A cross sectional research design surveyed employees (N = 319) from a large, U.S. west coast municipal police service during the fall of 2020. The survey was made up of a battery of validated instruments designed to assess dimensions of health and wellness (e.g., sleep, health, safety, and quality of life). Results: We found 77.4% of police employees had poor sleep quality, 25.7% had excessive daytime sleepiness, 50.2% had PTSD symptoms, 51.9% had depressive symptoms, and 40.8% had anxiety symptoms. Working night shifts significantly decreased sleep quality and increased excessive sleepiness. Furthermore, employees working night shifts were significantly more likely to report falling asleep at the wheel while driving home than employees working other shifts. Discussion: Our findings have implications for interventions designed to promote police employee sleep health, quality of life, and worker safety. We urge researchers and practitioners alike to target night shift workers, to help mitigate these risks.

Shift workers are at increased risk of severe COVID-19 compared with day workers: Results from the international COVID sleep study (ICOSS) of 7141 workers.

The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23-5.95) and need for hospital care (aOR = 5.66, 1.89-16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12-2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.

Night shift work and sleep deprivation in relation to vaccine induced SARS-CoV-2 antibody responses in a general population cohort (COVICAT study)

IntroductionNight shift work and sleep deprivation have been associated with lower antibody responses induced by vaccination against seasonal influenza, meningitis-C and hepatitis A. We examined the association of exposure to night shift work and sleep deprivation with antibody levels induced by COVID-19 vaccines.Materials and MethodsThis study was nested in an ongoing population-based cohort in Catalonia, Spain. Blood samples were collected in 2021 from a random subsample of 1,090 participants. We measured 3 immunoglobulins (Ig)M, IgG, and IgA antibodies against 5 SARS-CoV-2 antigens, including RBD (receptor-binding domain), S (spike-protein), and S2 (subunit 2 from spike-protein). We collected data on night shift work (current night work, frequency, duration) and sleep metrics (sleep duration, sleep problems, changes in sleep duration since the beginning of the pandemic). We adjusted linear regression estimates (% change) for individual- and area-level covariates, time since vaccination, vaccine doses and type. Analyses were restricted to participants without previous COVID-19 infection (N=639). Infection status was defined using questionnaires, SARS-CoV-2 test registry and serology information (seropositivity to N-antigen).ResultsParticipants' mean age was 57.6 years, 57% were female, 73% received 2 vaccine doses (42% Pfizer, 44% AstraZeneca),5.8% were current night workers and 36.5% of the sample reported sleep problems. No overall association pattern was observed between current? night work and vaccine-induced antibody responses. IgG levels tended to be lower (differences in the range of 3.6–53.7%) among night workers, compared to day workers but differences were not statistically significant. Participants with short sleep (<=6 hours) had significantly lower IgM antibody levels compared to those that reported 7 hours of sleep. No clear pattern was observed with sleep quality.ConclusionsFurther research in larger studies is needed to evaluate the influence of night shift work and impaired sleep on vaccine induced immune responses and risk of breakthrough infections.

Healthy sleep and nursing

The COVID-ig pandemic has increased and highlighted the day-to-day demands of nursing and effects on sleep.1 During the pandemic, the prevalence of sleep disturbances among healthcare workers and nursing students was 31% and 27% (respectively), compared to 18% of the general population.2,3 Given that sleep is important for cognitive, emotional and physical wellbeing,4,5 sleep may be especially important for nurses - a demanding profession that often requires shift work - a known risk factor for poor sleep.1,6 Studies support the importance of sleep for nurses.7"9 Poor sleep has been associated with reduced quality of life, weight gain, hypertension, and diabetes among nurses.7,8,10"12 In addition to personal health concerns, poor sleep has also been associated with medical errors,13 reduced job productivity9 and burnout.14"16 Perhaps most concerning, studies suggest that although objective performance continues to decline with chronic partial sleep deprivation, subjective ratings of alertness level-off.17 This means that an individual who is sleep deprived becomes less aware of how their performance has been impaired, in much the same way that a person who is intoxicated does not realise many of their cognitive and physical abilities are compromised.18 Fortunately, wellness programs that recognise the importance of sleep are being developed to support nurses. There are thoughts that strategies to promote wellbeing and resilience should be developed early in a nurse's career.1 However, many of these initiatives fail to identify the importance of sleep despite growing concerns of poor sleep during the graduate nurse year.1 In a recent study of 88 newly graduated nurses working in a tertiary hospital in South Korea, Kim and Lee found a significant decline in subjective sleep quality over the first four months of undertaking shift work as a nurse, which was associated with a decline in quality of life.23 Similarly Donovan and colleagues reported emotional, physical and mental exhaustion was often attributed to sleep deprivation during the graduate year of nursing and midwifery24 Epstein and colleagues also explored sleep during the graduate year and found graduate nurses had limited and potentially counterproductive strategies to cope with fatigue.25 Whether poor sleep continues, worsens, or improves during the nursing career remains unclear. Prevalence of mental health problems and sleep disturbances in nursing students during the COVID-19 pandemic: a systematic review and meta-analysis. Sampson M, Melnyk B, Hoying J. The MINDBODYSTRONG intervention for new nurse residents: 6-Month effects on mental health outcomes, healthy lifestyle behaviors, and job satisfaction.

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 unprecedented 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 stratum, and a total of 1327 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 χ2 test or Pearson χ2 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), respectively. 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.

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.

Sleepiness and safety at work among night shift NHS nurses.

BACKGROUND: Sleepiness associated with night shift working (NSW) is known to adversely affect workers' health and well-being. It has been associated with adverse safety outcomes and is a recognized workplace hazard among healthcare workers. AIMS: This study was aimed to assess the prevalence of self-reported sleepiness in NSW nurses and midwives. This study also explored the consequences of sleepiness on safety at work and driving. METHODS: A cross-sectional study of NSW nurses and midwives was conducted at an National Health Service (NHS) hospital trust from 16 March 2020 to 1 June 2020. Data were collected by online questionnaire and included information on demographics, shift work and safety aspects. Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). RESULTS: Data collection coincided with the first coronavirus pandemic peak in England. Out of 1985 eligible NSW nurses and midwives, 229 participated in the study, with a response rate of 12%. The prevalence of sleepiness was 28%. Following a night shift, 49% of nurses reported nodding off at the wheel and 44% reported a near-miss car accident in past 12 months. An abnormal ESS score was significantly associated with near-miss car accidents (odds ratio [OR] 2.75, 95% confidence interval [CI] 1.31-5.77) and with low confidence in undertaking complex tasks at night (OR 2.64, 95% CI 1.20-5.84). CONCLUSIONS: More than a quarter of NSW nurses and midwives reported excessive daytime sleepiness although, due to the low response rate, this may not be representative. Adverse driving events were common. Elevated ESS scores correlated well with safety issues relating to work and driving.

Circadian Disruption in Night Shift Work and Its Association with Chronic Pulmonary Diseases.

Globalization and the expansion of essential services over continuous 24 h cycles have necessitated the adaptation of the human workforce to shift-based schedules. Night shift work (NSW) causes a state of desynchrony between the internal circadian machinery and external environmental cues, which can impact inflammatory and metabolic pathways. The discovery of clock genes in the lung has shed light on potential mechanisms of circadian misalignment in chronic pulmonary disease. Here, the current knowledge of circadian clock disruption caused by NSW and its impact on lung inflammation and associated pathophysiology in chronic lung diseases, such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and COVID-19, is reviewed. Furthermore, the limitations of the current understanding of circadian disruption and potential future chronotherapeutic advances are discussed.

Lifestyle behaviors among Canadian nurses working night shifts in the COVID-19 era: a pilot study.

Abstract: Working night shifts has been associated with negative mental health consequences such as depression, anxiety, and sleep problems. The objectives of this study were to determine the lifestyle behaviors (prevalence of nicotine, caffeine, cannabis, sleep-promoting medication, and alcohol use) and the association between job stress, sleep quality, anxiety, and depression among registered nurses working night shifts in the Canadian province of Saskatchewan in the COVID-19 era. Twenty-two registered nurses ranging from ages 25-65 that work permanent or rotating night shifts participated in an online survey from April 11th to July 15th, 2022. The results showed a strong positive association between sleep disturbance, and depression r (19) = 0.50, [p = 0.029, 95% CI, 0.06, 0.78]. A positive correlation was found between higher levels of reported anxiety and sleep disturbance r (19) = 0.69, [p = 0.001, 95% CI, 0.34, 0.87]. There was a positive correlation between depression and occupational exhaustion r (17) = 0.56, [p = 0.021, 95% CI, 0.10, 0.82]. Anxiety was significantly related to occupational exhaustion r (17) = 0.65, [p = 0.005, 95% CI, 0.24, 0.86] and depersonalization r (17) = 0.52, [p = 0.005, 95% CI, 0.06, 0.80], but not significantly related to personal accomplishment r (17) = -0.34, [p = 0.185, 95% CI, -0.70, 0.17]. In conclusion, a sample of Canadian nurses working night shifts in the province of Saskatchewan during the COVID-19 pandemic showed a significant positive relationship among sleep disturbance, anxiety, and depression. Furthermore, most nurses reported using at least one or more of the following substances: sleep-promoting medication, nicotine, alcohol, and cannabis.

Effect of shift work on frontline doctors' mood and sleep during the COVID-19 pandemic.

Purpose: Shift work has detrimental effects on healthcare workers, which may be further compounded by frontline work during the COVID-19 pandemic. We postulated that sleep would worsen and distress would increase during COVID-ward service. Methods: Doctors (n = 18) were recruited from a tertiary centre during the second wave of the COVID-19 pandemic in Melbourne, Australia. Participants had been rostered ON to consecutive 7 day or night shifts and a week OFF over a fortnight. 9 worked on COVID wards managing positive/suspected COVID patients, and 9 were allocated to general MEDICAL wards. Participants wore wrist actigraphy, and completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Kessler Psychological Distress Scale (K10) at baseline and the end of each week. Results: Both the COVID and MEDICAL groups spent less time in bed and had reduced total sleep time during their week ON shift compared to week OFF shift. The COVID group had worse sleep quality (PSQI Δ + 1.0, 6.8 vs 5.8, p = 0.036), daytime sleepiness (ESS Δ + 2.6, 8 vs 5.4, p = 0.014) and greater distress (K10 Δ + 1.7, 17 vs 15.3, p = 0.002) during their week ON compared to BASELINE. Conclusion: During the COVID-19 pandemic shift workers had poorer sleep during their week ON. Those working on COVID wards had greater distress during their week ON than those working on general MEDICAL wards. It is important to recognise the potential for sleep deficits and greater distress in medical workers during the pandemic.

Negative representations of night-shift work and mental health of public hospital healthcare workers in the COVID-19 era (Aladdin survey).

BACKGROUND: Many risk factors impact the health of hospital night workers, which can lead to physical and mental health disorders. During the recent period, night hospital workers have been particularly stressed. This study therefore aims to: (i) To document the prevalence of depression, anxiety, sleep disorders, and symptoms suggestive of post-traumatic stress disorder in night shift workers (NSHW) working in Parisian public hospitals after France's first COVID-19 wave ended; (ii) To estimate the effect of negative representations and perceptions of night shift work on these mental health outcomes. METHODS: An observational cross-sectional online survey of NSHW (June to September 2020) in 39 public hospitals in Paris, France. Standard scales were used to measure mental health outcomes. Weighted multinomial logistic regression models supported the identification of predictors of depression (score > 10 on the Hospital Anxiety and Depression Scale, HADS, for depression), anxiety (score > 10 on the HADS for anxiety), severe insomnia (score > 21 on the Insomnia Severity Index, ISI) and symptoms suggestive of post-traumatic stress disorder (score > 36 on the Impact of Event Scale-Revised, IES-R). RESULTS: The weighted prevalence rates [95% confidence interval] of depression, anxiety, severe insomnia, and symptoms of post-traumatic stress disorder were, respectively, 18.9% [16.5-21.2], 7.6% [6.0-9.1], 8.6% [6.9-10.2] and 11.7% [9.7-13.6]. After multiple adjustment, organizational changes in NSHW professional lives due to the COVID-19 pandemic (such as moving to another hospital department and modified schedules) and NSHW-perceived negative representations of night work were significantly associated with all studied mental health outcomes. CONCLUSION: Our findings confirm the importance of monitoring mental health and sleep quality among NSHW in Parisian public hospitals, even more during health crises. Multilevel interventions aiming at reducing negative representations and improving work organization are urgently needed to improve overall health of this frontline healthcare providers group.

Association Between Occupational Stress, Work Shift and Health Outcomes in Hospital Workers of the Recôncavo of Bahia, Brazil: The Impact of Covid-19 Pandemic.

The aim of this study was to ascertain the level of occupational stress before and during the COVID-19 pandemic, how it changed, and its association with health outcomes of hospital workers in the Recôncavo of Bahia, Brazil. A longitudinal study was conducted with 218 hospital workers over 18 years old. A semi-structured questionnaire was used for collecting sociodemographic, occupational, lifestyle, anthropometric, and health data. The main exposures were occupational stress, assessed through Job Content Questionnaire and classified according to the Demand-Control Model and reported shift work. Health outcomes considered were nutritional status assessed by Body Mass Index (BMI), Waist Circumference (WC), and Body Fat Percentage (BF%); health self-perception; and cardiovascular risk factors. We used McNemar chi-squared or Wilcoxon tests to compare levels of exposure and outcome variables before and during the pandemic, and odds ratios to evaluate associations between changes in occupational stress and shiftwork with health outcomes. During the pandemic, participants reported increased occupational stress and shift work, lower self-perceived health, and had higher BMI and cardiovascular risk factors, compared with before the pandemic. No association was observed between change in occupational stress and health outcomes. However, increased amount of shift work was related to increased BMI in the overall sample (OR 3.79, CI95% 1.40-10.30), and in health workers (OR 11.56; CI95% 2.57-52.00). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in context of the COVID-19 pandemic.

Investigating the effectiveness of employing clinical faculty members in the shift work system during the Covid-19 pandemic in Iran: A cross-sectional study.

Introduction: Having an accurate attitude about shift work and choosing the right people to work in the shift work system increases organizational productivity and improves the employees' life quality. Consequently, the current research investigates the effectiveness of employing clinical faculty members in the shift work system during the Covid-19 pandemic. Materials and Methods: In this descriptive study, 71 Iranian clinical faculty members with a history of shift work (night shift) during the Covid-19 pandemic participated. Circadian Type Inventory (CTI) was used to collect data. Results: Based on the results of this research (Flexible/Rigid = Mean ± SD = 2.47 ± 18.17) and (Languid/Vigorous = Mean ± SD = 2.89 ± 15.35) which revealed that although clinical faculty members in normal conditions can overcome the feeling of sleepiness due to lack of sleep, they are not flexible and cannot work in the shift work system with the ability to stay awake at unusual times of the day or night. Pearson's correlation coefficient test also showed that as the value of the Languid/Vigorous component increases, the value of the Flexible/Rigid component also increases (r = 0.410). Likewise, there was no significant relationship between the main research variables and demographic characteristics. Discussion and Conclusion: Clinical faculty members who are simultaneously responsible for the duties of teaching students, research, and treating patients, if they are employed in a shift work system, especially during the pandemic, it may lead to a decrease in the quality of teaching, lack of motivation in research and indifference toward students' affairs, reducing flexibility, inability to update what they have learned in the professional world, increasing medical errors and also reducing their ability to manage the class. Consequently, it is suggested to avoid using them in the shift work systems as much as possible.

Correlations between Insomnia and Sex, Work Experience, Shift and Body Max Index in Italian Nurses: A Scoping Profile Statement.

AIM: The present study aimed to assess any association existing between insomnia according to sex, work experience, shift and BMI values in Italian nurses. METHODS: An "ad hoc" questionnaire was created and administered online in October 2020. Data collected included: sex, years of work experience, shift work per day, BMI values, and insomnia levels. FINDINGS: A total of 341 Italian nurses were enrolled. Of these, 277 (81.23%) were females and n=64 (18.77%) males. No significant differences were assessed between ISI levels and sex, BMI scores, work experience and shift (p=.098; p=.978; p=.561; p=.222, respectively). Significant and inverse correlation was assessed between ISI values and sex (p=.019), BMI values (p=.033). While, no significant correlations were assessed between ISI levels and work experience (p=.805) and shift (p=.962), respectively. However, work experience reported significant correlations between BMI classes (p>.001) and shift (p<.001). CONCLUSION: Data suggested potential health risk factors for the nursing workforce, associated with weight gain and developing Metabolic Syndrome. Therefore, the essence of the nursing profession could affect work performance and cause problems in the family and social life, as well as stress, anxiety, depression, fatigue, and irregular sleep patterns.

Implementation of Flexible Work Arrangement among Healthcare Workers in Miri Hospital-Assessment of the Validity and Reliability of Flexible Work Arrangement Perceived Benefits and Barriers Scale, and the Exploratory Study.

Background: Flexible work arrangements (FWAs) have been widely implemented during the COVID-19 pandemic. We aimed to assess the validity and reliability of the FWA perceived benefits and barriers (FWAPB) scale and subsequently, to determine the preference and perceived feasibility, perceived benefits and barriers, and readiness to implement FWA among healthcare workers. Methods: We conducted a cross-sectional study using a self-administered questionnaire in Miri Hospital. The questionnaire was administered via a web survey design (Google Forms). The convenience sampling method was applied to recruit respondents. All healthcare workers in Miri Hospital who could read and understand English were invited to participate in the study. Response process validation, exploratory factor analysis, reliability analyses and descriptive statistics were performed. Results: A total of 339 respondents participated. All items had satisfactory response process indices. Exploratory factor analysis revealed a three-factor structure. Items of 'perceived benefits-workplace management', 'perceived benefits-family life balance' and 'perceived barriers' have high internal consistency reliability (Cronbach's alpha = 0.852-0.884) and factor loadings. Flextime is preferred and perceived to be the most feasible work arrangement. Most agreed that FWA helps in improving social distancing among colleagues (mean = 3.65, standard deviation [SD] = 0.99) and reduces their exposure to COVID-19 (mean = 3.60, SD = 1.06). A total of 44.0% of the respondents agreed Miri Hospital is ready to implement FWA. Conclusion: The FWAPB is valid and reliable. Almost half of the respondents were positive towards the implementation of FWA. These findings contribute to the understanding of FWA, and thus increase the readiness and acceptance of such an arrangement.