Stress and resilience in the workers of three health authorities of Emilia-Romagna during the COVID-19 pandemic

Aims: The aim of the present study was to study the prevalence of depression, anxiety, stress, and post-traumatic symptoms in Health-Care Workers (HCWs) of three Health Authorities of Emilia-Romagna, Italy during the COVID pandemic. Material(s) and Method(s): An online questionnaire was spread to the staff of the University Hospital of Modena and the Local Health Agencies of Modena and Romagna, including the Depression Anxiety Stress Scale (DASS-21), the Impact of Event Scale - Revised (IES-R), and the Utrecht Work Engagement Scale - Short Version (UWES-9). The scores at DASS-21 and IES-R were used as dependent variables in multivariate logistic regression models. Result(s): A total of 5868 HCWs were reached (response rate of 22.4%), 76.1% of which were women, mostly aged between 45 and 54 years. Rates of positive scores were: 27.9% DASS-21 Depression;28.4% DASS-21 Anxiety;34.7% DASS-21 Stress;21.9% IES-R. At the multivariate logistic regression, the following were statistically significant risk factors for positive scores: female sex, young age, and working at the front line. An increase in alcohol and tobacco consumption and worsening of eating habits were also strongly associated with symptoms. At UWES-9, the three samples reported lower vigor than dedication and absorption, which are at a medium-high level. Conclusion(s): HCWs have experienced high levels of emotional distress related to the COVID-19 pandemic. Significant improvements are needed not only in terms of organization and distribution of resources, but also in provision of dedicated psycho-social interventions.Copyright © 2023

Psychological impact of the covid-19 pandemic on health care professionals: A cross sectional analysis of three sets of data

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

Protected Discharge Model for Mild to Moderate Covid Patients in a North-East Italian Hospital

The Covid-19 emergency has determined an unpredictable increase in the number of patients with Covid-like symptoms in the Emergency Department (ED) of Italian hospitals. A continuity of care pathway between hospital and territorial services that defines the possibility of activating a protected discharge model has been implemented in the ULSS 6 Euganea – Health Trust (District of Padua) for patients with a mild-moderate degree of respiratory insufficiency (phenotyped according to clinical-functional and radiological criteria). The protected discharge model integrates territorialservices (active surveillance of General Practitioners and Covid Special Units) and hospital services (provided by Pulmonology and Emergency Department) and aims to guarantee a coordinated healthcare pathway for Covid patients (daily interaction, early identification of risk factors and constant monitoring of the respiratory function), in order to efficiently use the human and technological resources available and reduce inappropriate hospitalizations. The prescription and monitoring of oxygen home therapy (with an oxygen concentrator) is part of the therapeutic process for the home management of this patients. Between November 2020 and April 2021 at the Hospital of Cittadella (ULSS 6 Euganea) the above mentioned discharge model was activated for 205 patients with a mild-moderate degree of respiratory insufficiency (average age 66.5). The average duration of hospital telemonitoring was 8.2 days. Up to April 30, in 86/205 patients (42.0%) no access to the ED nor hospitalization were reported;for 69/205 patients (33.7%) one or more accesses to the ED and no hospitalization were reported;38/205 patients were later hospitalized (18.5%), 3/205 patients (1.5%) died. Preliminary analysis of our data suggests that the protected discharge model implemented is proving to be efficient in the management of mild-moderate Covid patients. © 2021, Springer Nature Switzerland AG.