Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation.

Burnout syndrome is characterized by exhaustion, cynicism, and reduced effectiveness. Workers with high burnout scores who continue their professional activities are identified as experiencing non-clinical burnout (NCB), which includes early stages where burnout symptoms (BNS) are present but not yet severe enough to necessitate work leave. This study aimed to investigate the impact of BNS on attention performance among healthcare workers (HCWs) at a COVID-19 reference hospital during the pandemic. The Maslach Burnout Inventory (MBI) was applied to assess the three burnout dimensions. The Continuous Visual Attention Test (CVAT) evaluated four different attention subdomains. Participants were divided into two groups based on their scores on the MBI: controls and NCB. Thirteen controls were matched with 13 NCB subjects based on age, sex, and HCW category. This sample (n = 26, 65% male) consisted of 11 physicians and 15 nursing professionals with a mean age of 35.3 years (standard deviation = 5.47). NCB subjects had higher impulsivity than controls. There were not any significant group differences in the other attention subdomains. We found significant correlations between impulsivity and all burnout dimensions: higher absolute scores in BNS are associated with higher impulsivity. We concluded that NCB leads to executive attention deficits.

Spirituality as a protective factor for chronic and acute anxiety in Brazilian healthcare workers during the COVID-19 outbreak.

BACKGROUND: Anxiety symptoms (AS) are exacerbated in healthcare workers (HCWs) during the COVID-19 pandemic. Spirituality is known to protect against AS in the general population and it is a construct that differs from religion. It can be assessed using structured questionnaires. A validated questionnaire disclosed three spirituality dimensions: peace, meaning, and faith. In HCWs we investigated the predictors of chronic anxiety (pre-COVID-19 and during the pandemic) and acute anxiety (only during the pandemic), including spirituality in the model. Then, we verified which spirituality dimensions predicted chronic and acute anxiety. Lastly, we studied group differences between the mean scores of these spirituality dimensions. MATERIAL AND METHODS: The study was carried out in a Brazilian Hospital. HCWs (n = 118) were assessed for spirituality at a single time-point. They were also asked about AS that had started pre-COVID-19 and persisted during the pandemic (chronic anxiety), and AS that had started only during the pandemic (acute anxiety). The subjects without chronic anxiety were subdivided into two other groups: acute anxiety and without chronic and acute anxiety. Forward stepwise logistic regressions were used to find the significant AS predictors. First, the model considered sex, age, religious affiliation, and spirituality. Then, the analysis were performed considering only the three spirituality dimensions. Group means differences in the spirituality dimensions were compared using univariate ANCOVAS followed by T-tests. RESULTS: Spirituality was the most realible predictor of chronic (OR = 0.818; 95%CI:0.752-0.890; p<0.001) and acute anxiety (OR = 0.727; 95%CI:0.601-0.881; p = 0.001). Peace alone predicted chronic anxiety (OR = 0.619; 95%CI:0.516-0.744; p<0.001) while for acute anxiety both peace (OR:0.517; 95%CI:0.340-0.787; p = 0.002), and faith (OR:0.674; 95%CI:0.509-0.892; p = 0.006) significantly contributed to the model. Faith was significantly higher in subjects without AS. CONCLUSION: Higher spirituality protected against chronic and acute anxiety. Faith and peace spirituality dimensions conferred protection against acute anxiety during the pandemic.

Assessment of Attentional Functioning in Health Professionals of a Brazilian Tertiary Referral Hospital for COVID-19.

This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-hour daily shifts are common for hospital employees in Brazil. A MANCOVA was performed to examine between-group differences, using age, sleep quality, sex, education level, previous COVID-19 infection, and profession as covariates. Of 124 participants, 80 had substantial exposure and 44 had minimal exposure to COVID-19. The overall MANCOVA reached statistical significance (P = 0.048). Post hoc ANCOVA analysis showed that the substantial exposure group had a statistically significantly higher intraindividual variability of reaction time of all correct target responses (P = 0.017, Cohen's δ = -0.55). This result remained after removing those with a previous COVID-19 infection (P = 0.010, Cohen's δ = -0.64) and after matching groups for sample size (P = 0.004, Cohen's δ = -0.81). No other variables reached statistical significance. Concluding, hospital professionals with a substantial level of exposure to patients with COVID-19 show a significant attention decrement and, thus, may be at a higher risk of accidental SARS-CoV-2 infection.

Is the handgrip strength a good nutritional assessment method for people living with HIV? / A força de preensão manual é um bom método para avaliação nutricional de pacientes vivendo com HIV?

ABSTRACT Objective The study aimed to verify the relationship between handgrip strength measurement and classic anthropometric values in HIV positive outpatients. Methods This was a cross-sectional study that enrolled HIV-positive outpatients treated at the Gaffrée and Guinle University Hospital, aged between 20 and 60 years and considered to be well-nourished or moderately malnourished, according to the Global Subjective Analysis. The patients' bilateral handgrip strength were assessed (Jamar dynamometer), and classic anthropometry variables (weight, height, body mass index, arm muscle area, arm fat area, arm muscle circumference, and triceps skin fold) were measured. The Kolmogorov-Smirnov test, t-test, bivariate correlation and regression analysis were used (SPSS 21® software), with a significance level of 5%. Results A total of 242 patients were assessed. According to the Global Subjective Analysis, 218 (90.1%) patients were classified as well nourished (Global Subjective Analysis-A) and 24 (9.9%) as moderately malnourished (Global Subjective Analysis-B). The average dominant hand handgrip strength with standard deviation was 30.5±9.5kgf and 24.1±6.1kgf for Global Subjective Analysis-A and Global Subjective Analysis-B patients, respectively. Handgrip values were not influenced by age. The handgrip strength showed in both genders a significant correlation with weight, body mass index, and with anthropometric parameters related to lean body mass (arm muscle circumference and arm muscle area), but without correlation with the non-lean mass parameter (arm fat area). The handgrip strength of the dominant hand was a predictor of the following variables associated with lean body mass, i.e., arm muscle circumference and arm muscle area (R2=0.194, t=7.7, p<0.001, and R2=0.192, t=7.6, p<0.001, respectively). However, handgrip strength was not a predictor of arm fat area. Conclusion Measurement of handgrip strength was a useful method for nutritional assessment in outpatients with HIV due to a significant relationship with anthropometric parameters associated with lean body mass.

RESUMO Objetivo Este estudo buscou verificar a relação entre a mensuração da força de preensão manual e os valores das medidas antropométricas clássicas em pessoas vivendo com HIV em acompanhamento ambulatorial. Métodos O estudo foi transversal, com inclusão de pessoas vivendo com HIV atendidas no Hospital Universitário Gaffrée e Guinle, entre 20 e 60 anos e consideradas bem nutridas ou desnutridas moderadas, de acordo com Análise Subjetiva Global. Foi mensurada a força de preensão manual bilateralmente (dinamômetro Jamar®) e realizada antropometria clássica: peso, estatura, índice de massa corporal, área muscular do braço, área gordurosa do braço, circunferência muscular do braço e dobra cutânea tricipital. Através do software SPSS 21®, foram utilizados o teste de Kolmogorov-Smirnov, teste t, correlação bivariada e análise de regressão, com nível de significância de 5%. Resultados Foram analisados 242 pacientes. Conforme análise de objetivo geral, 218 (90,1%) pacientes foram classificados como bem nutridos (Análise Subjetiva Global-A), e 24 (9,9%), como desnutridos moderados (Análise Subjetiva Global-B). O valor médio com o desvio-padrão da força de preensão manual da mão dominante foi de 30,5±9,5kgf e 24,1±6,1kgf para pacientes Análise Subjetiva Global-A e Análise Subjetiva Global-B, respectivamente. Os valores da força de preensão manual não foram influenciados pela idade. A força de preensão manual apresentou correlação significativa com o peso, com o índice de massa corporal e com parâmetros antropométricos relacionados à massa corporal magra (circunferência muscular do braço e área muscular do braço), mas sem correlação com parâmetro não relacionado à massa magra (força de preensão manual) em ambos os sexos. A força de preensão manual da mão dominante foi preditora das variáveis relativas à massa magra circunferência muscular do braço e área muscular do braço (R2=0,194, t=7,7; p<0,001; e R2=0,192, t=7,6; p<0,001, respectivamente). Contudo, a força de preensão manual não foi preditora da área gordurosa do braço. Conclusão A mensuração da força de preensão manual foi um bom método para avaliação nutricional em pacientes ambulatoriais vivendo com HIV com significativa relação com parâmetros antropométricos associados à massa corporal magra.