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1.
International Journal of Nursing Studies ; JOUR: 104385,
Article in English | ScienceDirect | ID: covidwho-2105098

ABSTRACT

Background Intensive care unit (ICU) nurses are at an increased risk of burnout and may have an intention-to-leave their jobs. The COVID-19 pandemic may increase this risk. Objective The objective of this study was to describe the prevalence of burnout risk and intention-to-leave the job and nursing profession among ICU nurses and to analyse the relationships between these variables and the work environment after two years of the COVID-19 pandemic. Design A national cross-sectional survey of all nurses working in Belgian ICUs was conducted between December 2021 and January 2022 during the 4th and 5th waves of the COVID-19 pandemic in Belgium. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to measure the work environment, intention-to-leave the hospital and/or the profession was assessed. The risk of burnout was assessed using the Maslach Burnout Inventory scale including emotional exhaustion, depersonalisation, and reduced personal accomplishment. Setting Nurses in 78 out of 123 Belgian hospital sites with an ICU participated in the survey. Participants 2321 out of 4851 nurses (47.8%) completed the entire online survey. Results The median overall risk of burnout per hospital site (high risk in all three subdimensions) was 17.6% [P25: 10.0 - P75: 28.8] and the median proportion of nurses with a high risk in at least one subdimension of burnout in Belgian ICUs was 71.6% [56.7–82.7]. A median of 42.9% [32.1–57.1] of ICU nurses stated that they intended-to-leave the job and 23.8% [15.4–36.8] stated an intent-to-leave the profession. The median overall score of agreement with the presence of positive aspects in the work environment was 49.0% [44.8–55.8]. Overall, nurses working in the top 25% of best-performing hospital sites with regard to work environment had a statistically significant lower risk of burnout and intention-to-leave the job and profession compared to those in the lowest performing 25% of hospital sites. Patient-to-nurse ratio in the worst performing quartile was associated with a higher risk for emotional exhaustion (OR = 1.53, 95% CI:1.04–2.26) and depersonalisation (OR = 1.48, 95% CI:1.03–2.13) and intention-to-leave the job (OR = 1.46, 95% CI:1.03–2.05). Conclusions In this study, a high prevalence of burnout risk and intention-to-leave the job and nursing profession was observed after two years of the COVID-19 pandemic. Nevertheless, there was substantial variation across hospital sites which was associated with the quality of the work environment. Tweetable “Burnout & intention to leave was high for Belgian ICU nurses after 2 years of COVID, but wellbeing was better with high quality work environments and more favourable patient to nurse ratios”.

2.
Ann Work Expo Health ; 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2107360

ABSTRACT

OBJECTIVES: Nearly all workers and industry sectors have been affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic in some form since March 2020. However, the pandemic-related stressors experienced in the workplace may vary from industry to industry and may have disproportionally affected some workers. This study investigates increased stress levels, stressor events, and other perceptions of stress from at-risk workers during COVID-19. METHODS: An in-depth work-related stress survey that incorporated many aspects of work, life, work-life balance, and the health of employer-employee relationships was developed with a focus on COVID-19-related stressors. The cross-sectional survey was distributed online through professional networks from October to November 2021. The survey results were statically analyzed using Kruskal-Wallis one-way analysis of variance (ANOVA) after grouping the industry sectors into the four groups to determine trends within these groupings. RESULTS: The survey was completed by 670 workers in sectors such as manual labor, business/office service, healthcare, and education. A variety of trends were determined between the occurrence of COVID-19 and work stress which had, in some cases, affected some industry sectors to a larger degree than others. More than 50% of the participants reported experiencing an increased workload since the onset of the pandemic with some sectors, like healthcare, reporting an increased workload more frequently at 80%. Around 55% of respondents believed they could be exposed to COVID-19 in their workplace, ranging from 52% of business/office service workers to 77% of healthcare workers. CONCLUSIONS: As workplaces navigate past the pandemic, occupational stress should be addressed head-on through workplaces providing expanded resources so as to assure work stress associated with future pandemics are mitigated appropriately. Whether the stressor is associated with irregular shift work or psychosocial aspects (i.e. relying on coworkers), many of these stressors have the possibility to become exacerbated by external factors such as pandemics.

3.
Eur J Oncol Nurs ; 61: 102207, 2022 Oct 02.
Article in English | MEDLINE | ID: covidwho-2104849

ABSTRACT

PURPOSE: The covid-19 global pandemic has impacted on nurses who have rapidly adapted to new ways of working, and experienced negative impacts due to over-stretched services. Two surveys captured the experiences of lung cancer and mesothelioma specialist nurses in the United Kingdom (UK) in 2020, but the impact of later stages of the pandemic was unknown. This study aimed to explore the impact of covid-19 on lung Cancer and mesothelioma nurses since January 2021, the second wave of the pandemic. METHODS: An online cross-sectional survey with both open and closed questions explored the impact of covid-19 on ways of working and workload, quality of care, and health and wellbeing. The survey was open to UK based lung cancer and mesothelioma advanced or specialist nurses. RESULTS: 85 nurses responded to the survey. The majority were Clinical Nurse Specialists, based in England. Respondents reported changes in ways of working due to redeployment, staff shortages, and home working. Widespread adoption of virtual working practices led to concerns of negative impacts. Perceived excessive workload impacted on care with two-thirds of the sample (57, 67%) reporting they had been unable to provide the same quality of care to patients. Impacts on nurses' health and wellbeing were reported with two-thirds of the sample (56, 66%) reporting a deterioration in emotional wellbeing and mental health. Coping mechanisms employed included online team support to share experiences and increased uptake of exercise; however, impacts on lifestyle and access to coping mechanisms varied. CONCLUSION: Nurses have stepped up to the challenges of the pandemic with teamwork and innovation, but pressure arising from the pandemic and high workloads led to negative impacts on wellbeing. The authors have provided recommendations to improve patient care and support the wellbeing of nurses, which will be key to a resilient workforce living with covid-19. Whilst this study focussed on lung cancer and mesothelioma specialists, the findings have wider implications for other cancer specialties.

4.
Br J Gen Pract ; 2022 Aug 30.
Article in English | MEDLINE | ID: covidwho-2081799

ABSTRACT

BACKGROUND: Following a large-scale, pandemic-driven shift to remote consulting in UK general practice in 2020, 2021 saw a partial return to in-person consultations. This occurred in the context of extreme workload pressures because of backlogs, staff shortages, and task shifting. AIM: To study media depictions of remote consultations in UK general practice at a time of system stress. DESIGN AND SETTING: Thematic analysis of national newspaper articles about remote GP consultations from two time periods: 13-26 May 2021, following an NHS England letter, and 14-27 October 2021, following a government-backed directive, both stipulating a return to in-person consulting. METHOD: Articles were identified through, and retrieved from, LexisNexis. A coding system of themes and narrative devices was developed iteratively to inform data analysis. RESULTS: In total, 25 articles reported on the letter and 75 on the directive. Newspaper coverage of remote consulting was strikingly negative. The right-leaning press in particular praised the return to in-person consultations, depicting remote care as creating access barriers and compromising safety. Two newspapers led national campaigns pressuring the government to require GPs to offer in-person consultations. GPs were quoted as reluctant to return to an 'in-person by default' service (as it would further pressurise a system already close to breaking point). CONCLUSION: Remote consultations have become associated in the media with poor practice. Some newspapers were actively leading the 'war' on general practice rather than merely reporting on it. Proactive dialogue between practitioners and the media might help minimise polarisation and improve perceptions around general practice.

5.
Journal of Primary Health Care ; JOUR
Article in English | Web of Science | ID: covidwho-2082472

ABSTRACT

Introduction. New Zealand general practice and primary care is currently facing significant challenges and opportunities following the impact of the coronavirus disease 2019 (COVID-19) pandemic and the introduction of health sector reform. For future sustainability, it is important to understand the workload associated with differing levels of patient case mix seen in general practice. Aim. To assess levels of morbidity and concomitant levels of socio-economic deprivation among primary care practices within a large primary health organisation (PHO) and associated Maori provider network. Methods. Routinely collected practice data from a PHO of 57 practices and a Maori provider (PHO) of five medical practices in the same geographical area were used to compare a number of population health indicators between practices that had a high proportion of high needs patients (HPHN) and practices with a low proportion of high needs patients (Non-HPHN). Results. When practices in these PHOs are grouped in terms of ethnicity distribution and deprivation scores between the HPHN and Non-HPHN groups, there is significantly increased clustering of both long-term conditions and health outcome risk factors in the HPHN practices. Discussion. In this study, population adverse health determinants and established co-morbidities are concentrated into the defined health provider grouping of HPHN practices. This 'concentration of complexity' raises questions about models of care and adequate resourcing for quality primary care in these settings. The findings also highlight the need to develop equitable and appropriate resourcing for all patients in primary care.

6.
Int J Occup Med Environ Health ; 2022 Oct 13.
Article in English | MEDLINE | ID: covidwho-2067272

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has caused unseen pressure on healthcare systems in many countries, jeopardizing the mental well-being of healthcare workers. The authors aimed to assess the mental well-being of Finnish healthcare workers from 2 hospital districts (Helsinki University Hospital [HUS] and Social and Health Services in Kymenlaakso [Kymsote]) with differing COVID-19 incidence rates during the first wave of the COVID-19 pandemic in spring 2020. MATERIAL AND METHODS: A total number of 996 healthcare workers (HUS N = 862, Kymsote N = 134) participated in this prospectively conducted survey study during summer 2020. Symptom criteria of self-reported mental health symptoms followed ICD-10 classification, excluding duration criteria. Participants were divided into symptom categories "often/sometimes", and "rarely/never". These groups were compared to sociodemographic factors and factors related to work, workload, and well-being. RESULTS: The degree of mental health symptoms did not differ between the 2 healthcare districts despite differing COVID-19 incidences (p = 1). The authors observed a significant relationship between self-reported diagnostic mental health symptoms and experiences of insufficient instructions for protection against COVID-19 (in HUS cohort p < 0.001), insufficient recovery from work (p < 0.001), and subjective increased workload (p < 0.001). CONCLUSIONS: The authors' results show the importance of well-planned and sufficient instructions for protection from SARS-CoV-2 for healthcare workers, indicating their need to feel safe and protected at work. The workload of healthcare workers should be carefully monitored to keep it moderate and ensure sufficient recovery. Sufficient control of the epidemic to keep the burden of the healthcare system low is vital for healthcare workers' well-being.

7.
CMAJ. Canadian Medical Association Journal ; 64(5 Supplement 1):S39, 2021.
Article in English | EMBASE | ID: covidwho-2065169

ABSTRACT

Background: Trauma calls with substantial injuries are low volume;exposure per fellow is low. A pilot questionnaire demonstrated that fellows were unaware of colleagues' trauma workload. There was no standardized process for departmental case review. With COVID-19 precautions limiting face-to-face time with colleagues, we were concerned that learning may be affected. We aimed to improve education by identifying cases with high potential for shared learning or system improvement and instigating a triannual Coffee and Cases meeting. Method(s): We devised a feedback form for trainees to fill in following each trauma team activation. These data were combined with trauma registry data to provide an overall perspective on the anesthesia workload for trauma and presented via Teams to the entire department. Infographics were used to illustrate cases and highlight important learning points. These were combined with up-to-date literature regarding pediatric trauma management. Trainees were reaudited following the talk. Result(s): During the pilot questionnaire, just 14.3% of fellows agreed with the statement: I am aware of the number of trauma calls, mechanisms of trauma and injuries sustained, presenting to Sick Kids in the previous month. In total, 71.4% disagreed and 14.3% strongly disagreed. Reaudit in November 2020 following the Coffee and Cases meeting online via Teams showed 100% agreement, with 71.4% strongly agreeing. Because of clinical commitments, it is often not possible for all relevant and interested staff members to attend such meetings, so a supplementary update PDF was provided via hospital email. Issues were identified regarding communication (team briefing), billing and prompt drug availability. These issues were addressed and reaudited. Conclusion(s): The questionnaire allowed us to collect real-time feedback on our trauma service and collate learning points from cases. This was integrated with up-to-date literature. Trauma patients may present critically unwell, yet the environment may be unfamiliar to rotating staff. Education is vital. Infographics helped us to illustrate cases, highlighting important learning points. These are 30 times more likely to be read than text so can successfully improve readership and learning of information..

8.
Pharmaceutical Journal ; 309(7965), 2022.
Article in English | EMBASE | ID: covidwho-2065053
9.
Pharmaceutical Journal ; 307(7956), 2022.
Article in English | EMBASE | ID: covidwho-2065011
10.
Pharmaceutical Journal ; 307(7956), 2022.
Article in English | EMBASE | ID: covidwho-2065010
11.
Int J Environ Res Public Health ; 19(19)2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2065944

ABSTRACT

Chronic stress has been associated with a range of health disparities, but examination of occupational stress, especially in the wake of COVID-19, has been minimal for many careers. A novel methodology involving work stress diaries and collection of salivary cortisol was employed to determine correlations between occupations, occupational stressors, and how well these are related to the physiological response to stress exposure, the release of cortisol. While cortisol levels tended to follow typical circadian rhythm based on sampling times, cortisol levels also followed the subjective stress levels listed in the work stress diaries following linear regression analysis using the pooled study population data (p = 0.042). When comparing the stressors between the studied careers, participants who worked in the healthcare industry accounted for one-third of the total participants, but reported nearly half (42%) of the more severe occupational stressors listed in the diaries. Finally, the most commonly listed emotional reactions to exposures listed included feelings of stress, frustration, anger, anxiety, or overwhelm. As the workplace progresses from the pandemic, the opportunity to reduce occupational stress exposures in the workplace is at hand. Companies that work towards minimizing the stress faced by their workforce would have a healthier and more relaxed workforce.


Subject(s)
COVID-19 , Occupational Stress , COVID-19/epidemiology , Circadian Rhythm , Humans , Hydrocortisone/analysis , Occupational Stress/epidemiology , Occupational Stress/psychology , Saliva/chemistry , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Workplace/psychology
12.
Pharmaceutical Journal ; 306(7947), 2022.
Article in English | EMBASE | ID: covidwho-2064932
13.
Pharmaceutical Journal ; 306(7947), 2022.
Article in English | EMBASE | ID: covidwho-2064927
14.
Archives of Disease in Childhood ; 107(Supplement 2):A478-A479, 2022.
Article in English | EMBASE | ID: covidwho-2064062

ABSTRACT

Aims To understand barriers of implementing a near-miss reporting and sharing of lessons as part of patient safety II culture. Staff must be encouraged to report less serious incidents and near misses as well as more serious errors if lessons are to be learned and patient safety enhanced.1 A key task in the enhancement of patient safety involves the ability to learn from error.2 The intention is that any staff member, irrespective of role, grade, seniority, or experience, can call 'Stop the Line' if they see that required safety procedures and checks are not being followed. All members of staff are encouraged to 'Stop the Line' if they notice a series of steps/process that could potentially cause harm to a patient. The event/incident that is stopped is referred to as a 'near miss'. Methods Stop the line piloted in specific clinical area in our trust (Paediatrics unit, surgical ward, neurosurgical theatres). This project was commenced on 1st November 2020. But due to Covid 19 clinical workload pressure it was paused from April 2021, I took over the project last September 2021. -Despite the project being piloted since last year, still considerable number of staff not fully understanding the project and what are near misses and small numbers of near misses reported throughout following months. -A survey formulated and distributed to health staff across the trust to explore their knowledge of near misses and the barriers for lack of reporting. Results The survey designed and published to the staff through global email. Survey structured of four segments including the Department and Job position, Knowledge about the project, definition of a near miss event and how to report a near miss, questions to check situations classifications as near misses or not and questions regarding their perception of barriers for reporting near misses. -Total 60 Respondents from different departments and roles: -Respondents included variant range of roles in the health care system including Consultants, Support workers, Junior doctors, Staff Nurses, Head of Outpatient Services, Healthcare assistants, ward clerks, Pharmacist, Digital Communications Managers, Project officers, members from Patient Safety & Improvement, Resuscitation officers. 90% of respondents reported knowledge of near miss definition, and similar proportion acknowledges that near misses should be reported (87%) (figure 1). -Approximately two thirds of staff respondents were knowledgeable how to report near misses (63%) compared to 37% who did not (figure 1). -Among variable scenarios 73-88% of respondents could identify the near miss events. -Main suggested barriers to reporting near miss events were time constraints, lack of awareness of importance of near misses reporting and fear of reporting on colleagues involved in the event. Conclusion There is a gap between staff intent to record a near miss occurrence and actual event reporting which could be either due to low incidence of near misses in the health organization or simply because of under reporting. (Figure Presented).

15.
Archives of Disease in Childhood ; 107(Supplement 2):A376-A377, 2022.
Article in English | EMBASE | ID: covidwho-2064050

ABSTRACT

Aims The Covid-19 pandemic has significantly impacted the education of doctors in training, with disruption to training events and teaching, as well as staff redeployment. During the initial wave of the pandemic, patient numbers in paediatrics were low and there was time for reflection, leadership and management opportunities. However, post lockdown there were significantly more paediatric attendances to A&E, resulting in surges of admissions never previously seen at that time of year, putting a substantial strain on the medical team. In our paediatric department, we found that our established hour-long weekly lunchtime teaching and education programme was no longer sustainable. We therefore developed a new format - a microteaching programme to ensure evidencebased, relevant teaching was maintained at a time of highly stretched resources. Methods In December 2020 the microteaching programme was launched;the concept was five-minute teaching sessions rostered between junior doctors following Thursday morning handover so more of the multidisciplinary team, including nurses and medical students, could attend. The teaching could take any format such as quizzes, powerpoints or games and focussed on common paediatric topics. Feedback was collected after each session. The programme was reinforced with the new intake of junior doctors in August 2021. To obtain feedback on the effectiveness of the new format, an online survey was sent to all grades from foundation doctors and trainee Advanced Nurse Practitioners to consultants, to capture quantitative alongside qualitative data in November 2021. Results There were eleven responses to the survey, with 81.8% having attended the microteaching programme. Those who had not attended were excluded from subsequent quantitative analysis. Reasons for non-attendance were thematically analysed and found to be based on working patterns, such as working less than full time. 88.8% of respondents felt microteaching content was relevant to their training and 100% agreed it was at an appropriate level. 100% felt they had learnt something from microteaching with two-thirds of respondents strongly agreeing with this statement. Barriers to regular teaching included unanticipated staff movement due to urgent clinical need, senior staff being unaware of the scheduled teaching programme or concern about ward pressures and workload. Respondents felt microteaching was a useful concept that ensures teaching takes place, helps keep knowledge up-to-date and prompts further reading. Conclusion Despite the Covid-19 pandemic significantly impacting trainees' teaching, the implementation of the microteaching programme locally, and subsequent survey, have demonstrated a positive way for learning opportunities to continue despite clinical pressures. The survey highlights the need for senior support to ensure the value of teaching is recognised and designated teaching time is kept. It emphasises the need for re-evaluation of the teaching rota to minimise disruption secondary to staff movement. Following feedback, to maximise the impact of each session at the start of the new teaching rota, we will summarise key points via email so trainees unable to attend can still benefit. Overall, the microteaching programme enables key concepts to be presented during morning handover and allows educational opportunities to continue without adversely impacting on clinical duties in the paediatric department.

16.
Journal of Veterinary Emergency and Critical Care ; 32(Supplement 2):S7, 2022.
Article in English | EMBASE | ID: covidwho-2063953

ABSTRACT

Introduction: Historically, visitation of critically ill animals had been common in veterinary ICUs, with visits chaperoned by both veterinarians and the nursing team. Visits may represent a source of comfort and information for owners, but may also be time-consuming to veterinary staff. During the COVID-19 pandemic, almost all specialty/emergency veterinary hospitals pivoted to curb-side service, and typically highly limited client entry into the building for staff safety. Similar restrictions on visitation were instituted in human ICUs, leading to stress among clinicians, nurses, and patient families. The proposed study aimed to assess the visitation policies reported by critical care veterinarians and technicians and the spectrum of effects on veterinary team members. Method(s): An electronic survey was distributed to the emergency and critical care community using email and social media. The study was exempted by the institutional review board. Survey questions included demographics, COVID-19 hospital policies, and questions about the impact of restricting visitation. Descriptive statistics were used. Result(s): There were 326 respondents to the survey, with veterinarians (53%) and veterinary technicians/assistants (40%) being the most common. Visitation restrictions were reported by 286 (88%) participants. Of those, 264 (81%) reported permitting visits only for euthanasia/endof life discussion and/or on a case-by case arrangement and 20 (6%) allowed no visitation at all. By comparison, prior to COVID-19, 309 (95%) respondents reported no visitation restrictions. For the veterinary team, 244 (75%) felt sad if they had to decline a visit, while 211 (65%) reported feeling anxious and/or guilty. Most respondents (218;67%) felt the owners were understanding. Restricting visits was perceived to improve time for patient care for 195 (60%) respondents, decrease overall workload for 192 (59%) respondents, and decrease stress for 137 (42%) respondents. Conclusion(s): Visitation restriction impacts veterinary staff both positively and negatively;careful evaluation of visitation policies is warranted. The impact on owners should also be evaluated.

17.
American Journal of Transplantation ; 22(Supplement 3):399-400, 2022.
Article in English | EMBASE | ID: covidwho-2063391

ABSTRACT

Purpose: In organ transplant, med errors, adverse drug events, and nonadherence lead to increased healthcare utilization and graft loss. Veterans with transplants are a high-risk population. Method(s): A med safety dashboard was created to identify potential issues that included missing pertinent labs, concerning trends in labs, drug-drug interactions, immunosuppressant non-adherence (refill gaps, expired meds), and transitions in care. This system was tested through a 24-month, prospective, cluster-randomized controlled multicenter study. Pharmacists at 5 intervention sites used the dashboard to identify and address potential med safety issues, which was compared with usual care provided at 5 control sites. Interim findings regarding dashboard functionality and interventions are reported here. Result(s): The study opened Mar 2019 and closed Jun 2021, with a COVID-19 induced hiatus (Apr to Jun 2020). As of the last interim analysis (18m follow-up), there were 1,928 patients enrolled across the 10 sites (1,181 intervention vs 815 control). Mean age was 65 years, 95% male, and 27% Black. Mortality was 9.3%, with no difference between arms (intervention 9.5% vs control 9.0%). ED visits (intervention 38.4% vs control 45.6%) and hospitalizations (intervention 25.6% vs control 37.6%) were higher in the control arm. The dashboard produced a total of 18,132 alerts from the 5 intervention sites;a rate of 1-2 per pt-month. Lab-based issues were most common (Figure 1), followed by non-adherence and transitions in care;70% of alerts were addressed (Figure 2 blue bars) in about 40 days (Figure 2 orange line). Actions taken by pharmacists are displayed in Figure 3, which were often already addressed or not clinically relevant. Adjustments made to med regimens based on dashboard alerts were uncommon. Multivariable modeling demonstrated location site, type of alert, and transplant type were predictors of alerts being addressed (Table 1). Conclusion(s): This multicenter cluster-randomized controlled trial demonstrates that a med safety dashboard is feasibly deployable across the VA healthcare system, creating valid alerts;although most alerts were already addressed by other providers or deemed not to be clinically actionable. Future dashboard refinements should focus on reducing non-actionable alerts and addressing workload barriers to timely review. (Figure Presented).

18.
Gesundheitswesen, Supplement ; 84(8-9):773-774, 2022.
Article in English | EMBASE | ID: covidwho-2062338

ABSTRACT

Einleitung The pandemic poses a variety of health-related challenges for workers in different occupations. Employees in essential jobs experienced higher demands and workloads while many office workers transitioned into home office and had to cope with several new demands (e.g. developing new daily routines, managing childcare, mastering digital technologies). In addition, shifts into short-time work or unemployment elevated job insecurity and financial strains in the working population. Thus, the pandemic exposes workers to a number of stressors possibly influencing their health. Our research takes a closer look at occupational differences in health-related changes. With the goal to analyse intra-individual changes in mental health by occupation, the current analysis investigates differences between occupational groups in self-reported changes in general health during the first COVID-19 pandemic wave in Germany. Methoden We use prospective cohort data of the German National Cohort (NAKO), which combines pre-pandemic baseline measures of health indicators of more than 100,000 workers with data collected during the first wave of the pandemic (February to August 2020). The classification of workers into different occupational groups is based on the German Classification of Occupations 2010 (Klassifikation der Berufe, KldB 2010). We distinguish between horizontal (occupational sectors and segments) and vertical occupational differences (skill level and personnel responsibility). Health is measured by self-rated health ('Compared to the time before the Corona pandemic, how would you describe your current state of health?') and mental health (depressive symptoms, anxiety disorder symptoms). Multivariable analysis linking deterioration in general health (yes/no) to occupational characteristics were carried out. Ergebnisse On average, 10.1 % of employees reported a deterioration in self-rated health during the first pandemic wave. The decline was the most pronounced in elderly care (adj. prevalence of 12.3%), education and social work (11.8%), administration (11.7%), and in pharmacy (11.3%). Employees in office jobs (11.1%), and in the segments of hospitality and cultural services (10.8%) also experienced a larger deterioration in general health than the average. Schlussfolgerung Our study fills an important gap in research by focusing on health-related changes due to pandemic in different occupational groups. Our analysis can highlight important adversities by occupation which might not be directly related to infection risk. Addressing them and improving working conditions in those occupations could be an important policy task. Our further research plan includes the analyses of intra-individual changes in mental health by occupation. We plan to have a specific focus on how pandemic-related work changes (such as home office, job insecurity or increased workload) contributed to changes in mental health.

19.
Hpb ; 24(Supplement 1):S150-S151, 2022.
Article in English | EMBASE | ID: covidwho-2061210

ABSTRACT

Introduction: The hepato-pancreato-biliary (HPB) unit had to scale down the clinical workload and reallocate resources to combat COVID-19. We report local audit evaluating the impact of COVID-19 on the unit and its impact on cancer surgery. Method(s): We performed a comparative audit of the HPB team surgical workload for January-June 2019 (baseline) and 2020 (COVID-19). Elective and emergency cases performed under general anesthesia were audited. Elective cases included hernia surgeries, biliary surgeries (cholecystectomy and complex biliary resections), liver, and pancreatic resections. Emergency cases included cholecystectomies and laparotomies performed for general surgical indications. We excluded endoscopy and procedures done under local anaesthesia. Result(s): Elective surgical workload decreased by 42.3% during the COVID-19 pandemic (n=200 (2019) vs. 347 (2020)). Hernia surgery decreased by 63.9% (n=155 (2019) vs. 56 (2020)) and cholecystectomy by 40.3% (n=144 (2019) vs. 86 (2020)). Liver and pancreatic resection volume increased by 16.7% (n=30 (2019) vs. 35 (2020)) and 111.1% (n=9 (J 2019) vs. 19 (2020)). The emergency surgical workload reduced by 40.9% (n=193 (2019) vs. 114 (2020)). Conclusion(s): Reallocation of resources due to the COVID-19 pandemic did not adversely impact elective HPB oncology work. With prudent measures in place, essential surgical services can be maintained during a pandemic. Copyright © 2022

20.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-344100

ABSTRACT

Background: Intensive care unit (ICU) nurses are at an increased risk of burnout and may have an intention-to-leave their jobs. The COVID-19 pandemic may increase this risk. Objective: The objective of this study was to describe the prevalence of burnout risk and intention-to-leave the job and nursing profession among ICU nurses and to analyse the relationships between these variables and the work environment after two years of the COVID-19 pandemic. Design: A national cross-sectional survey of all nurses working in Belgian ICUs was conducted between December 2021 and January 2022 during the 4th and 5th waves of the COVID-19 pandemic in Belgium. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to measure the work environment, intention-to-leave the hospital and/or the profession was assessed. The risk of burnout was assessed using the Maslach Burnout Inventory scale including emotional exhaustion, depersonalisation, and reduced personal accomplishment. Setting: Nurses in 78 out of 123 Belgian hospital sites with an ICU participated in the survey. Participants: 2,321 out of 4,851 nurses (47.8%) completed the entire online survey. Results: The median overall risk of burnout per hospital site (high risk in all three subdimensions) was 17.6% [P25: 10.0 - P75: 28.8] and the median proportion of nurses with a high risk in at least one subdimension of burnout in Belgian ICUs was 71.6% [56.7 - 82.7]. A median of 42.9% [32.1 - 57.1] of ICU nurses stated that they intended-to-leave the job and 23.8% [15.4 - 36.8] stated an intent-to-leave the profession. The median overall score of agreement with the presence of positive aspects in the work environment was 49.0% [44.8 - 55.8]. Overall, nurses working in the top 25% of best-performing hospital sites with regard to work environment had a statistically significant lower risk of burnout and intention-to-leave the job and profession compared to those in the lowest performing 25% of hospital sites. Patient-to-nurse ratio in the worst performing quartile was associated with a higher risk for emotional exhaustion (OR = 1.53, 95% CI:1.04-2.26) and depersonalisation (OR = 1.48, 95% CI:1.03-2.13) and intention-to-leave the job (OR = 1.46, 95% CI:1.03-2.05). Conclusions: In this study, a high prevalence of burnout risk and intention-to-leave the job and nursing profession was observed after two years of the COVID-19 pandemic. Nevertheless, there was substantial variation across hospital sites which was associated with the quality of the work environment.

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