Remuneration, Job Satisfaction, and Performance of Health Workers During the COVID-19 Pandemic Period at the Dr. Soetomo Hospital Surabaya, Indonesia.

Purpose: One of the hospital management issues that has not been studied much during the COVID-19 Pandemic is the relationship between health workers' performance, job satisfaction and remuneration. This study aims to examine the relationship between remuneration, job satisfaction and the employee performance during 2019-2021. Materials and Methods: This study applied an employee satisfaction survey at a General Academic Hospital between 2019-2021. The population and samples were 716 employees. The data collection were based on the personnel database, remuneration database, and the annual Employee Satisfaction Survey Database for the period 2019-2021 at General Academic Hospital of Dr. Soetomo, Surabaya, Indonesia. Results: The results of the correlation test between Employee Satisfaction, Remuneration, and Performance based on employee performance objectives showed an insignificant positive correlation between the remuneration variable and satisfaction based on The Job Itself; very weak significant positive correlation between remuneration variable and Satisfaction based on Pay; a very weak significant positive correlation between the remuneration variable and Satisfaction based on Promotion; very weak significant positive correlation between remuneration variable and satisfaction based on supervision; significant positive correlation between remuneration variable and satisfaction based on coworkers; There is a significant positive correlation between remuneration and performance variables. Conclusion: The correlation between remuneration and employee satisfaction based on the Job Description Index shows that the components of the job itself, and coworkers have a positive but not significant relationship, while the components of pay, promotion, and supervision have a positive and significant relationship. Employees satisfaction with performance achievement have a positive and significant relationship, especially job satisfaction based on pay and supervision, but there is also a positive and insignificant relationship related to job satisfaction based on the job itself, promotion, and co-workers.

Predictors of Mortality Among Children with Confirmed and Suspected Cases of COVID-19 in East Java, Indonesia.

Introduction: Coronavirus disease 2019 (COVID-19) increases rapidly and causes mortality in all groups, including children. However, the predictive risk factors of mortality among children remain inconclusive. This study aimed to analyse the predictors related to mortality among children with COVID-19. Methods: Secondary data analysis was conducted using provincial COVID-19 data from April 2020 to May 2021. We selected 6441 children under age 18 to be included in this study. Chi-square and binary logistic regression were used to evaluate the predictors of mortality in children with COVID-19. Results: This study showed that the prevalence of children who died COVID-19 was 2.7%. Age, case definition, treatment status, severity of illness, and travel history had a significant relationship with survival status in children with COVID-19. As the increasing age, the risk of death with COVID-19 will decrease [AOR=0.94; CI 95%=0.91-0.97]. Otherwise, suspected status [AOR=2.12; 95% CI=1.48-3.04], hospitalization with ventilators [AOR=22.25; 95% CI=5.73-86.42], severe illness [AOR=46.76; 95% CI=21.69-100.80], and travel history [AOR=1.78; 95% CI=1.22-2.60] were significantly related with an increased risk of death in children with COVID-19. Discussion: Severe illness in children was the strongest predictor of mortality. Disease prevention and health promotion programs are the key to preventing hospitalizations in children and decreasing the mortality rate.

Incidence of SARS-CoV-2 infection in hospital workers before and after vaccination programme in East Java, Indonesia-A retrospective cohort study.

Background: The incidence of the Coronavirus Disease 2019 (COVID-19) among healthcare workers (HCWs) is widespread. It is important to understand COVID-19 characteristics among HCWs before and after vaccination. We evaluated the incidence of COVID-19 among HCWs in East Java, Indonesia comparing the characteristics of the disease between the pre- vs post-vaccination periods. Methods: A retrospective observational study was conducted among HCWs in two major hospitals in East Java, Indonesia, between April 01, 2020, and Oct 31, 2021. All HCWs were offered vaccination with inactivated viral vaccine (CoronaVac) from Jan 15, 2021. Therefore, we divided the time of the study into the pre-vaccination period (between April 01, 2020, and Jan 14, 2021) and post-vaccination period (between Jan 15 and Oct 31, 2021). We then compared the pattern of COVID-19 infections, and hospitalisations between these periods. Findings: A total of 434 (15.1%) and 649 (22.6%) SARS-CoV-2 infections were reported among study participants (n = 2878) during the pre-vaccination and post-vaccination periods, respectively. The vaccine effectiveness was 73.3% during the first 3-4 months after vaccination but this decreased to 17.6% at 6-7 months after vaccination, which coincided with the emergence of the delta variant. The overall hospitalisation rate was reduced from 23.5% in the pre-vaccination period to 14.3% in the post-vaccination period. Hypertension appeared to be the strongest risk factor affecting hospitalisation in the pre-vaccination period. However, the risk due to hypertension was reduced in the post-vaccination period. Interpretation: The risk to contract COVID-19 remains high among HCWs in East Java, Indonesia. Vaccination is important to reduce infection and hospitalisation. It is essentially important to evaluate the characteristics of COVID-19 infection, hospitalisation, the impact of co-morbidities and vaccine effectiveness in order to improve the measures applied in protecting HCWs during the pandemic. Funding: Mandate Research Grant No:1043/UN3.15/PT/2021, Universitas Airlangga, Indonesia.

Hypertension is associated with antibody response and breakthrough infection in health care workers following vaccination with inactivated SARS-CoV-2.

Several types of vaccines have been developed to prevent the coronavirus disease 2019 (COVID-19). It is important to understand whether demographic and clinical variables affect the effectiveness of various types of vaccines. This study analysed the association between demographic/clinical factors, antibody response and vaccine effectiveness in healthcare workers vaccinated with inactivated virus. We enrolled 101 healthcare workers who received two doses of inactivated viral vaccine (CoronaVac). Blood samples were analysed at 1, 3, and 5 months after the second dose of vaccination. Data regarding demographic characteristics, medical histories, and clinical parameters were collected by interview and medical examination. In a separate retrospective study, we analysed the incidence of vaccine breakthrough infection on 2714 healthcare workers who received two doses of inactivated viral vaccine. Medical histories and demographic data were collected using a structured self-reported questionnaire. We found that antibody titres markedly increased at 1 month after vaccination but gradually decreased at 3-5 months post-vaccination. We observed a significant association between age (≥40 years) and antibody level, whereas sex and body mass index (BMI) exhibited no effect on antibody titres. Amongst clinical variables analysed, high blood pressure and history of hypertension were significantly correlated with lower antibody titres. Consistently, we found a significant association in the retrospective study between hypertension and the incidence of breakthrough infection. In conclusion, our results showed that hypertension is associated with lower antibody titres and breakthrough infection following COVID-19 vaccination. Thus, blood pressure control might be important to improve the efficacy of inactivated virus vaccine.

Association of stigma with mental health and quality of life among Indonesian COVID-19 survivors.

BACKGROUND AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) survivors face societal stigma. The study aims to analyze the association of this stigma with the mental health and quality of life of COVID-19 survivors. METHODS: In this cross-sectional study, we observed 547 adults who were previously documented as severe acute respiratory syndrome coronavirus (SARS-CoV-2) positive by a polymerase chain reaction (PCR) test, treated in a hospital or an emergency hospital and proven to be SARS-CoV-2 negative by their latest PCR test. We adopted the Berger HIV Stigma Scale to measure stigma; the World Health Organization Quality of Life Brief Form to measure quality of life; and the Mental Health Inventory-38 to measure mental health. The chi-square and binary logistic regression tests were used to find the correlation between the variables. RESULTS: The multivariate analysis revealed that medium stigma was more likely related to quality of life and mental health than low stigma. Females were less likely to experience stigma related to mental health than men, and respondents who worked as laborers and entrepreneurs were less likely to experience stigma related to mental health than those who worked as civil workers/army personnel/teachers/lecturers. COVID-19 survivors experienced medium stigma in society and lower quality of life and mental health status. We found that quality of life and mental health were affected by stigma, sex, and occupation. CONCLUSION: COVID-19 survivors are a vulnerable group that is most at risk when they return to their communities. Creating a safe environment and providing respectful care, including addressing complex stigma factors, is vital for developing appropriate interventions.

Anxiety and Resilience of Healthcare Workers During COVID-19 Pandemic in Indonesia.

INTRODUCTION: The COVID-19 pandemic has an impact on the physical health and mental health of the community, including healthcare workers. Several studies have shown symptoms of depression, anxiety, and sleep disorders in healthcare workers during this pandemic. However, not many studies have examined the resilience of healthcare workers during this pandemic. Resilience is a person's ability to rise and adapt when times are difficult and is considered to have a protective effect on mental problems. PURPOSE: This study aims to determine the correlation between resilience and anxiety in healthcare workers during COVID-19 pandemic. MATERIALS AND METHODS: This research was a cross-sectional study with observational analytic methods. The respondents were healthcare workers at Dr. Soetomo Hospital as the COVID-19 referral hospital in Surabaya, East Java, Indonesia. Data were collected from 10 to 16 June 2020 by distributing online questionnaires through the Google form application. There were three questionnaires used: demographic data, the State-Trait Anxiety Inventory (STAI) questionnaire, and the Connor-Davidson Resilience Scale (CR-RISC) questionnaire. RESULTS: The 227 respondents had filled out the questionnaire online with 33% had high state anxiety and 26.9% had high trait anxiety. The mean score of the respondents' resilience was 69 ± 15.823. The Spearman correlation test showed a significant relationship between anxiety and resilience (p <0.05), both S-Anxiety and T-Anxiety. CONCLUSION: A significant correlation was found between the level of resilience and anxiety experienced by healthcare workers during the COVID-19 pandemic. The lower the resilience, the higher the anxiety experienced.

Neurosurgery at the epicenter of the COVID-19 pandemic in Indonesia: experience from a Surabaya academic tertiary hospital.

OBJECTIVE: Global outbreak of the novel coronavirus disease 2019 (COVID-19) has forced healthcare systems worldwide to reshape their facilities and protocols. Although not considered the frontline specialty in managing COVID-19 patients, neurosurgical service and training were also significantly affected. This article focuses on the impact of the COVID-19 outbreak at a low- and/or middle-income country (LMIC) academic tertiary referral hospital, the university and hospital policies and actions for the neurosurgical service and training program during the outbreak, and the contingency plan for future reference on preparedness for service and education. METHODS: The authors collected data from several official databases, including the Indonesian Ministry of Health database, East Java provincial government database, hospital database, and neurosurgery operative case log. Policies and regulations information was obtained from stakeholders, including the Indonesian Society of Neurological Surgeons, the hospital board of directors, and the dean's office. RESULTS: The curve of confirmed COVID-19 cases in Indonesia had not flattened by the 2nd week of June 2020. Surabaya, the second-largest city in Indonesia, became the epicenter of the COVID-19 outbreak in Indonesia. The neurosurgical service experienced a significant drop in cases (50% of cases from normal days) along all lines (outpatient clinic, emergency room, and surgical ward). Despite a strict preadmission screening, postoperative COVID-19 infection cases were detected during the treatment course of neurosurgical patients, and those with a positive COVID-19 infection had a high mortality rate. The reduction in the overall number of cases treated in the neurosurgical service had an impact on the educational and training program. The digital environment found popularity in the educational term; however, digital resources could not replace direct exposure to real patients. The education stakeholders adjusted the undergraduate students' clinical postings and residents' working schemes for safety reasons. CONCLUSIONS: The neurosurgery service at an academic tertiary referral hospital in an LMIC experienced a significant reduction in cases. The university and program directors had to adapt to an off-campus and off-hospital policy for neurosurgical residents and undergraduate students. The hospital instituted a reorganization of residents for service. The digital environment found popularity during the outbreak to support the educational process.