Quality of life and occupational performance of children with cancer in the era of the COVID-19 pandemic in terms of rehabilitation.

PURPOSE: This study was designed to determine the changes in the quality of life (QOL) and occupational performance of children with cancer and to examine their rehabilitation needs during the pandemic period in Turkey. METHODS: 60 children with cancer and their families participated in the study. The first and second assessments were carried out in April and September 2020, respectively. The pediatric quality of life inventory parent proxy-report was used to evaluate the QOL, and the Canadian occupational performance measurement was used to evaluate children's occupational performance and satisfaction. A qualitative interview was planned to determine the impact of the pandemic on children with cancer alongside their families and therefore determining the rehabilitation needs of the children. RESULTS: While there is no statistically significant change in the pain-related conditions of the children in the first six months of the pandemic (p > 0.05), procedural and treatment anxieties of the children increased during the treatment. Their QOL including cognitive state, perceived physical appearance and communication skills also showed a statistically significant decrease (p < 0.05). Both the occupational performance and satisfaction scores decreased significantly, covering the pre-pandemic and pandemic era (p < 0.01). In the qualitative interview parents expressed their children's need for physical, psychological and social participation support. Also, they emphasized the need for time management. CONCLUSIONS: During the COVID-19 pandemic, the QOL and occupational performance level of children with cancer decreased significantly. Holistic rehabilitation approaches complying with pandemic conditions are likely to benefit these children.

Symptoms related to mental disorder in healthcare workers during the COVID-19 pandemic in Brazil.

BACKGROUND: Studies of previous pandemics indicate that healthcare workers have a high risk of developing symptoms related to mental health, especially depression, anxiety, and stress. OBJECTIVE: To identify mental disorder symptoms among Brazilian healthcare workers during the Sars-Cov-2 pandemic and compare findings in different work categories. METHODS: This was an online cross-sectional study. Information related to the pandemic and mental disorder symptoms was collected. The Depression, Anxiety, and Stress Scale and the Impact of Event Scale-revised were used. Associations were estimated by the chi-square test. The mean scores were compared among work categories with ANOVA (α = 5%) and the prevalence of symptoms was estimated. RESULTS: 1,609 healthcare workers participated in the survey [mean age: 36.9 (SD = 11.6) years, women = 83.6%]. There was no association between work category and changes in mental health during the pandemic (p = 0.288) or prevalence of unsafe feeling (p = 0.218). A significant relationship was observed between maintaining work activities during the pandemic and work category (p < 0.001). Physicians had the lowest out-of-work prevalence (9.5%) while dentists had the highest (32.3%). Physicians and nurses showed the highest prevalence of in-person work routine. Psychologists presented the highest prevalence of remote work (64.0%) while dentists had the lowest (20.2%). A high prevalence of depression (D), anxiety (A), and stress (S) symptoms was observed in all professional categories (D: 57.2, 95% CI 48.3-66.1%; A: 46.20%, 95% CI = 37.2-55.2%; S: 55.80%, 95% CI = 46.8-64.8%), with physicians (D = 38.4%, A = 25.80%, S = 37.90%), psychologists (D = 50.2%, A = 39.0%, S = 43.1%), and nurses (D = 50.0%, A = 40.9%, S = 49.0%) having significantly lower scores. Psychologists had the lowest pandemic-related psychological impact (42.70%, 95% CI 36.8-48.6%). CONCLUSION: Extreme changes in the work routine of dentists and psychologists and an overall high prevalence of mental symptoms due to the pandemic were found. Researchers should focus on gathering information that can identify workers at increased risk of mental illness to guide discussions and develop actions to minimize the harm of the pandemic. In addition, we suggest that healthcare and support systems urgently adopt mental health care measures with specialized professionals to protect the psychological well-being of the healthcare community.

A behavioral economic risk aversion experiment in the context of the COVID-19 pandemic.

We investigated what degree of risk of infection with COVID-19 is necessary so that people intend to stay home, even when doing so means losing their salary. We conducted an online survey across Brazil during the initial outbreak, in which 8,345 participants answered a questionnaire designed to identify the maximum tolerated risk (k') necessary for them to disregard social distancing recommendations and guarantee their salaries. Generalized linear mixed models, path analysis structural equation, and conditional interference classification tree were performed to further understand how sociodemographic factors impact k' and to establish a predictive model for the risk behavior of leaving home during the pandemic. We found that, on average, people tolerate 38% risk of infection to leave home and earn a full salary, but this number decreased to 13% when the individual risk perception of becoming ill from severe acute respiratory syndrome coronavirus-2 is considered. Furthermore, participants who have a medium-to-high household income and who are older than 35 years are more likely to be part of the risk-taking group who leave home regardless of the potential COVID-19 infection level; while participants over 45 years old and with good financial health are more likely to be part of the risk-averse group, who stay home at the expense of any salary offered. Our findings add to the political and public debate concerning lockdown strategies by showing that, contrary to supposition, people with low socioeconomic status are not more likely to ignore social distancing recommendations due to personal economic matters.

Anticipated health effects and proposed countermeasures following the immediate introduction of telework in response to the spread of COVID-19: The findings of a rapid health impact assessment in Japan.

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.

Supporting interdependent telework employees: A moderated-mediation model linking daily COVID-19 task setbacks to next-day work withdrawal.

The COVID-19 crisis has compelled many organizations to implement full-time telework for their employees in a bid to prevent a transmission of the virus. At the same time, the volatile COVID-19 situation presents unique, unforeseen daily disruptive task setbacks that divert employees' attention from routinized work tasks and require them to respond adaptively and effortfully. Yet, little is known about how telework employees react to such complex demands and regulate their work behaviors while working from home. Drawing on Hobfoll's (1989) conservation of resources (COR) theory, we develop a multilevel, two-stage moderated-mediation model arguing that daily COVID-19 task setbacks are stressors that would trigger a resource loss process and will thus be positively related to the employee's end-of-day emotional exhaustion. The emotionally exhausted employee then enters a resource preservation mode that precipitates a positive relationship between end-of-day exhaustion and next-day work withdrawal behaviors. Based on COR, we also predict that the relation between daily COVID-19 task setbacks and exhaustion would be more positive in telework employees who have higher (vs. lower) task interdependence with coworkers, but organizations could alleviate the positive relation between end-of-day exhaustion and next-day work withdrawal behavior by providing employees with higher (vs. lower) telework task support. We collected daily experience-sampling data over 10 workdays from 120 employees (Level 1, n = 1,022) who were teleworking full-time due to the pandemic lockdown. The results generally supported our hypotheses, and their implications for scholars and managers during and beyond the pandemic are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Working in a pandemic: Exploring the impact of COVID-19 health anxiety on work, family, and health outcomes.

The COVID-19 pandemic has unhinged the lives of employees across the globe, yet there is little understanding of how COVID-19 health anxiety (CovH anxiety)-that is, feelings of fear and apprehension about having or contracting COVID-19-impacts critical work, home, and health outcomes. In the current study, we integrate transactional stress theory (Lazarus & Folkman, 1984) with self-determination theory (Deci & Ryan, 2000) to advance and test a model predicting that CovH anxiety prompts individuals to suppress emotions, which has detrimental implications for their psychological need fulfillment. In turn, lack of psychological need fulfillment hinders employees' abilities to work effectively, engage with their family, and experience heightened well-being. Our model further predicts that handwashing frequency-a form of problem-focused coping-will mitigate the effects of CovH anxiety. We test our propositions using a longitudinal design that followed 503 employees across the first four weeks that stay-at-home and social distancing orders were enacted. Consistent with predictions, CovH anxiety was found to impair critical work (goal progress), home (family engagement) and health (somatic complaints) outcomes due to increased emotion suppression and lack of psychological need fulfillment. Further, individuals who frequently engage in handwashing behavior were buffered from the negative impact of CovH anxiety. Combined, our work integrates and extends existing theory and has a number of important practical implications. Our research represents a first step to understanding the work-, home-, and health-related implications of this unprecedented situation, highlighting the detrimental impact of the anxiety stemming from the COVID-19 pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The influences of the COVID-19 pandemic on medical service behaviors.

The outbreak of the novel coronavirus (COVID-19) has greatly impacted medical services worldwide. In addition to changing the processes used by hospital medical services, it has also changed the behaviors of medical staff, resulting in a completely different appearance. Fear of being infected with COVID-19 makes patients fear entering hospitals, and hospitals must repeatedly screen patients prior to entry in order to confirm that they are not infected. Patients are then separated according to their symptoms and travel, occupation, contact and cluster histories (TOCC), which seriously affects them. In addition, hospitals have invested a lot of money into the whole visiting process and into the equipment required to prevent the spread or lessen the impact of COVID-19.

Understanding the Intersection of Working from Home and Burnout to Optimize Post-COVID19 Work Arrangements in Radiation Oncology.

PURPOSE: To evaluate burnout in an academic radiation oncology program after the workforce shifted to working from home all or part of the time to better understand the impact of remote work and if it is sustainable after the COVID-19 virus abates. METHODS AND MATERIALS: In May 2020, in the midst of work-safe policies in the state and stabilizing COVID-19 case numbers, the Qualtrics-based MiniZ burnout survey was amended to include questions related to COVID-19 and working from home and was emailed to all radiation oncology employees across 3 departments: radiation oncology, radiation physics, and experimental radiation oncology. Descriptive and χ2 statistics were calculated within Qualtrics using StatIQ to evaluate factors associated with burnout and positive work from home experience. RESULTS: Five hundred seventy-five employees completed the survey. Aggregating 3 responses that indicate having some degree of burnout, the rate of burnout across the cohort was 32%. For the same survey questions administered a year earlier, burnout rate was reported to be 40%. In the current survey, radiation oncology faculty and therapists had the highest reported burnout rates, at 47% and 44%, respectively (P = .031). The majority of employees working from home at least part of the time reported the experience was positive (74%, 323/436), and feeling positive about working from home was associated with reduced burnout (P = .030). Qualitative data review suggested the main drivers of unfavorable work-from-home responses were child/family care issues and information technology issues. CONCLUSIONS: Burnout was not increased during the emerging COVID-19 period compared with pre-COVID data. The shift to working from home was positive for most of the workforce and a potential benefit in reducing burnout for many staff groups. Maintaining work-from-home options post COVID-19 may help reduce burnout long term. It is important to personalize options for those unable to work effectively from home and to resolve information technology challenges to ensure functionality.

Self-reported impact of respirator use on health care worker ability to perform patient care.

In a study of 1,152 health care workers surveyed prior to the COVID-19 pandemic, most disagreed that respiratory protective equipment use interferes with patient care but reported that it would affect respirator use compliance if it did. A patient's fear reaction variably influenced self-reported health care worker compliance with respirator use. Strategies to improve protective equipment design may remove potential barriers to respirator use and allow better health care worker-patient relationships.