Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

IntroductionThe coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers.ObjectiveThe purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic.MethodsThe present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded.ResultsThe sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectively). Women showed higher values in both scales (p < 0.01). Subjects working in COVID-19 wards scored significantly higher on both the FAS and CBI scales; they were also younger and with less work experience (p < 0.01). Staff treated for COVID-19 scored higher on the burnout scale (p < 0.01) than the uninfected staff. Fatigue showed a strong positive correlation with burnout (p < 0.01, r = 0.70). Stepwise multiple regression showed that the variation of fatigue was explained by 47.0% and 6.1% by the scores on the subscales of personal and work-related burnout, respectively.ConclusionIn conclusion, high rates of fatigue and burnout were found in the studied population. Nurses working with COVID-19 patients had higher rates of fatigue and burnout compared to those working elsewhere. There was a strong positive correlation (r = 0.70) between burnout and fatigue. Particular attention should be paid to staff who became ill and need to be treated.     

Satisfied as professionals,but also exhausted and worried!!: The role of job demands,resources and emotional experiences of Spanish nursing home workers during the COVID-19 pandemic

Nursing home workers have been exposed to great physical and mental burdens during the COVID-19 pandemic. Although this has generated high levels of exhaustion, it may also have contributed to feelings of professional satisfaction. The objective of this study was to explore the levels of satisfaction among nursing home workers during the COVID-19 pandemic, as well as the role of job demands, resources and emotional experiences in explaining their levels of satisfaction. This cross-sectional study was conducted in Spain between March and May 2020. Three hundred and thirty-five nursing home workers participated. A quantitative analysis was conducted, as was a content analysis of the responses to an open-ended question about the respondents' perceptions of job demands and resources during the crisis. The results showed that workers had very high levels of satisfaction. Social pressure from work, contact with death and suffering, and emotional exhaustion were negatively associated with satisfaction. Moreover, under conditions of extensive contact with suffering people and great fear of contagion, social support at work was shown to promote professional satisfaction. In conclusion, nursing home workers in Spain experienced high rates of satisfaction during the COVID-19 crisis despite the high job demands, lack of job resources, fear of contagion and exhaustion. The main practical implication of this study is the importance of ensuring optimal working conditions in the nursing home sector in order to guarantee professional satisfaction, prevent burnout, reduce turnover and promote post-crisis resilience.     

Thermal discomfort in healthcare workers during the COVID-19 pandemic

Introduction:Due to the COVID-19 pandemic, healthcare workers are now required to use additional personal protective equipment (PPEs) to protect themselves against the virus. That led to an increased clothing insulation which is negatively affecting the perceived healthcare workers’ thermal sensation.Objectives:While demonstrating through software simulations the potential level of thermal discomfort healthcare workers involved in the COVID-19 emergency can be subjected to, this work aims at identifying measures to improve thermal sensation perception and acceptable thermal conditions for medical personnel.Methods:After having obtained the insulation values of individual clothing used by staff during COVID-19 emergency through the use of a thermal well-being evaluation software, the Fanger indexes (PMV - Predicted Mean Vote and PPD - Predicted Percentage of Dissatisfied) were calculated in order to estimate staff satisfaction to microclimatic conditions.Results:The use of COVID-19 additional PPEs with an air temperature equal to 22 °C (normally considered optimal) brings the PMV index equal to 0.6, which corresponds to 11.8 % being unsatisfied (PPD) due to perceived heat.Discussion:The use of additional protective devices significantly increases the clothing insulation level, facilitating the onset of conditions of thermal discomfort in the health workers. Workers engaged in the execution of nasopharyngeal swabs were most affected by the summer weather conditions and certainly represent the most critical category, for which it would be recommended to implement a higher turnover of service to reduce individual exposure time and consequent discomfort.     

COVID-19疫情背景下医务工作人员职业倦怠情况及其影响因素的分析

目的  了解COVID-19疫情背景下定州市和青岛市两地医务工作人员发生职业倦怠情况及其影响因素。方法  2021年7月―2021年8月对定州市和青岛市的医务工作者进行横断面调查。利用职业倦怠调查普适量表(maslach burnout inventory general survey, MBI-GS)评价职业倦怠水平,采用Kruskal-Wallis H秩和检验和二分类logistic回归分析模型分析医务工作者职业倦怠水平的影响因素。结果  982名被调查者中,发生职业倦怠的比例为91.1%,其中达到轻中度、重度的比例分别为71.5%和19.6%。多因素分析显示工作满意度感觉一般或者比较不满意(OR=3.108, 95% CI: 1.653~5.843)、应对方式为消极应对(OR=1.129, 95% CI: 1.071~1.191)人群发生重度职业倦怠者风险更高;同时睡眠时间缩短(OR=0.331, 95% CI: 0.166~0.662)的人群发生重度职业倦怠者风险更低。Spearman相关分析中,医务工作者的积极应对方式、消极应对方式与职业倦怠呈正相关(P < 0.001),社会支持情况、生活满意度情况与职业倦怠呈负相关(P < 0.001)。结论  定州市和青岛市大部分的医务工作人员职业倦怠水平较高,需提高工作和生活满意度等关怀和社会支持力度,同时也要考虑适当增加防疫工作中的认同感和积极性以促进职业健康水平。     

四川省艾滋病护理人员心理一致感与职业倦怠及其相关性研究

目的 调查四川省艾滋病护理人员心理一致感与职业倦怠水平,了解艾滋病临床护理人员心理一致感与职业倦怠的相关性。方法 采用心理一致感量表(SOC-13)、职业倦怠量表(MBI)对四川省艾滋病治疗定点医疗机构的158名护士进行问卷调查,并用偏相关分析进行相关分析。结果 护士的心理一致感总分(58.72±9.75分),职业倦怠的3个维度即情感耗竭、去人格化和个人成就感得分(28.63±7.74分)、(11.35±3.83分)和(34.79±6.50分);偏相关分析显示,护士的心理一致感3个维度与职业倦怠3个维度的相关性均有统计学意义(P＜0.001)。结论 艾滋病护理人员的职业倦怠情况严重,心理一致感与职业倦怠具有显著相关性,护士心理一致感水平越高,职业倦怠水平越低,提高艾滋病临床护理的人员心理一致感,可以有效缓解职业倦怠。     

Stress and burnout in health care workers during COVID-19 pandemic: validation of a questionnaire

Journal of Public Health - To validate a questionnaire to assess stress and burnout in healthcare workers during COVID-19 pandemic. In this study, content validity, Cronbach’s alpha, and...     

Occupational hand dermatitis web survey in a university hospital during COVID-19 pandemic: the SHIELD study

Background: Occupational hand dermatitis (OHD) is a skin disease occurring on employees’ hands in certain jobs. Little is known about prevalence, incidence and characteristics of this adverse skin reaction and its associated risk factors during COVID-19 pandemic. To evaluate both prevalence and incidence of OHD and associated risk factors in Italian clinicians. Methods: A cross-sectional study was performed using a self-report questionnaire. Results: Two hundred and thirty clinicians responded to the survey and 82% of responders did not report previous OHD history before the COVID-19 pandemic. Daily use of gloves was reported by 80% of responders. OHD prevalence was 18%, while incidence was 80%. We found a protective effect on symptom occurrence for vinyl/nitrile gloves if the time with gloves was ≥ 6 hours per day. Conclusions: This survey reveals a high OHD incidence in an Italian population of clinicians. Furthermore, wearing vinyl/nitrile gloves for at least 6 hours a day had a protective effect on symptom onset.     

Sense of coherence in Crete and Sweden: Key findings and messages from a comparative study

Background/objective: The concept of ‘‘sense of coherence’’ (SOC) was introduced in 1987 by Aaron Antonovsky to describe a dispositional orientation, ‘‘a way of seeing the world’’, which is presumed to enhance health. This study reports on the results of the first implementation of SOC in rural Crete and discusses the findings, with a view to the potential impact on primary care delivery in rural Crete. Methods: This study forms part of a follow-up project initially established in 1988 in the rural area of Spili, Crete. All participants of the initial study still living in the area (n = 248) were eligible. Data were obtained from 200 subjects (91 males and 109 females) aged 28-92 years, resulting in a second-phase participation rate of 80.7%. The SOC scales (both the SOC-29 and SOC-13 forms) were recorded for 175 (87.1%) of the participants. Results: Comparing the SOC scores among Cretan males and females, there is a statistically significant difference (p < 0.0001), with men reporting a higher sense of coherence than women, regardless of the form of the questionnaire used. Cretan women seem to score significantly lower than their Swedish counterparts (p < 0.0001), while Cretan men tend to report a higher SOC compared to their matched Swedish reference population (p = 0.07). Discussion: The study introduces other issues worthy of additional research, particularly with regard to the significantly lower SOC scores obtained by Cretan women, compared to Cretan men. These low SOC scores raise the issue of a potential increase of psychiatric morbidity in the area, leading to a high impact on primary care services. Future investigation into the health impact of SOC factors could be of value to primary care physicians located in rural Crete.     

Positive effects of art therapy on depression and self-esteem of older adults in nursing homes

Depression and self‐esteem affects the health and quality of life of older adults who live in nursing homes. This study tested the effectiveness of art therapy activities on reducing the depression and improving the self-esteem of elderly living in long‐term care institutes. This was a quasi‐experimental study. A purposive sampling strategy was used to select 55 subjects who were aged 65 and above with intact mental functions and depression tendencies and currently residing in nursing homes in Kaohsiung, Taiwan. 29 subjects who participated in a selection of 12 artistic activities were assigned to the experimental group and 26 subjects who adhered to their ordinary activities were allocated to the control group. Structured questionnaires of the artistic group were used for data collection. The art therapy programs showed promising effects in improving the depression and self‐esteem of older adults living in nursing homes. Art therapy activities benefit the mental health of older adults. Incorporating artistic activities into social work care may help develop long‐term care into a more diverse, unique, and innovative direction.     

疫情防控常态化背景下疫苗集中接种点医务人员职业倦怠现况调查

目的 本研究调查新冠疫苗全面接种时期相关医务人员的职业倦怠状况,探讨个体因素以及社会支持对倦怠水平的影响。方法 在南京市12个行政区中随机抽取4个辖区的新冠疫苗集中接种点,将全部医务人员共428名作为研究对象进行问卷调查,问卷包括人口学特征、中文版职业倦怠量表和社会支持量表。结果 医务人员情感耗竭、人格解体、个人成就感降低维度得分分别为(17.99±7.89)、(7.20±3.52)和(12.07±5.30)分。多元线性回归分析结果显示,上司支持(β=-0.180, P< 0.05)、同事支持(β=-0.180, P< 0.05)为情感耗竭的保护因素,已婚、问诊岗位为情感耗竭的危险因素(β=0.161、β=0.095,P值均< 0.05),女性是人格解体的保护因素(β=-0.096,P< 0.05),亲友支持(β=-0.235, P< 0.05)是人格解体的保护因素,已婚是人格解体的危险因素(β=0.142,P< 0.05),同事支持(β=-0.168, P< 0.05)、亲友支持(β=-0.210, P< 0.05)、工龄(β=-0.154, P< 0.05)为个人成就感降低的保护因素,硕士学历是个人成就感降低的危险因素(β=0.126,P < 0.05)。结论 重视提高全方面社会支持,重点关注已婚、男性、硕士学历以及较短工龄医务人员的心理健康。     

Management of pain in older people within the nursing home: a preliminary study

The provision of continuing care for older people has largely shifted from the hospital setting to the community, and nursing homes increasingly provide support for older people, many of whom exhibit multiple pathology and complex health and social care needs. However, the quality of pain management within this setting has been identified as an issue of concern. It has been estimated that approximately two-thirds of people aged 65 years and over experience chronic pain, and that the prevalence of chronic pain in nursing home residents is between 45% and 80%. However, there exist a number of barriers to the identification and management of chronic pain among older people resident in nursing homes, including sensory impairments in older people themselves and educational deficits among professionals. Such barriers need to be overcome if pain management is to be improved. The present study involved administering a pre-piloted postal questionnaire to the managers of 121 nursing homes within a geographically defined area. Sixty-eight (56%) were completed and returned. The questionnaire broadly covered the following: prevalence of chronic pain and use of interventions; assessment and management strategies; education and training; and communication barriers. Overall, 37% of nursing home residents were identified as experiencing chronic non-malignant pain (pain lasting longer than 3 months not caused by cancer) and 2% were reported as experiencing chronic malignant pain (pain lasting for more than 3 months caused by cancer). Paracetamol was identified as the most 'often' used analgesia for both pain modalities. Sixty-nine per cent of nursing homes did not have a written policy regarding pain management and 75% did not use a standardised pain assessment tool. Forty-four per cent of nursing homes provided education or training sessions for qualified staff and 34% provided this for care assistants. Forty per cent of qualified staff and 85% of care assistants had no specialist knowledge regarding the management of pain in older people. The present study confirms the need for the development of effective pain management strategies underpinned by appropriate training and education in order to meet the particular needs of older people.     

Mental health status of healthcare workers at a third line tunisian hospital during COVID-19 pandemic

Introduction: During the COVID-19(coronavirus-19 disease) pandemic, health care workers (HCWs) faced the risk of infection and distressing work to meet health requirements. The aim of the present stud ywas to evaluate perceptions of HCWs of their security at work in COVID-19 units and their coping strategies, at the military hospital of Tunis, during the second wave of COVID-19. Methods:A cross-sectional study was conducted via an auto-questionnaire on February 2021.HCWs of the military hospital of Tunis were included. Participants were asked about their perceived security at work in COVID-19 units and their coping behaviors. Mental disorders were assessed, via qualitative questionnaires. Results:A total of 110 HCWs’ responses were collected. Fifty-eight participants (52.7%) were females. The mean age was 33.7 years (SD 9.3). They were doctors at 45.5% and nurses at 39.1%. HCWs declared having worked in COVID-19 units in 81.8% of cases. The participants reported their fears about being infected in 58.2% and infecting family members in 85.5% of cases. Protective factors included information about the disease (80%), availability of personal protective equipment (PPE) (80.9%), support from colleagues(72.7%)or superiors at work (50.9%), and ability to communicate with others (63.6%). Depression, anxiety, and insomnia were found in respectively 25.5%, 30%, and 41.8% of HCWs. In multivariate analysis, suffering from a traumatic distress was significantly associated with anxiety and depression (p<0.01 and, p<0.05 respectively). In addition, insomnia severity was linked to age (p=0.05) and having colleagues infected with COVID-19 (p<0.05). Conclusion:In the present study, HCWs of the military hospital of Tunis stated having high levels of insomnia, anxiety, and depression since the early outbreak of the COVID-19 pandemic. These mental disorders may have a negative impact on the quality of life of HCWs and should be enhanced by psychological support and preventive measures.     

The impact of personal coaching on influenza vaccination among healthcare workers before and during COVID-19 pandemic

BackgroundWithout the implementation of mandatory vaccination, it was difficult to increase the influenza vaccination rate among healthcare workers. We described the strategy of personal coaching and assess its impact in increasing the influenza vaccination rate among healthcare workers in Hong Kong.MethodsPersonal coaching of individual staff led by the infection control officer (ICO) and senior nursing officer (SNO) from infection control team could overcome barriers and promote on-site vaccination. The influenza vaccination rates among different categories of staff in 2016/2017 (year 1, baseline), 2017/2018 (year 2, promotion using social media), and 2018/2019 to 2020/2021 (year 3–5, promotion using personal coaching) were analysed in a healthcare region with 8490 ± 206 staff during the study period.ResultsWith the implementation of personal coaching, the influenza vaccination rates increased significantly among medical (65.0% vs 57.0%, p = 0.048), nursing (30.6% vs 21.1%, p < 0.001), allied health (37.0% vs 27.4%, p < 0.001), care-related supporting staff (37.7% vs 27.3%, p < 0.001), and non-professional staff (27.3% vs 22.3%, p < 0.001) in year 3 compared with year 2, and also significantly increased among all staff in year 4 (38.0% vs 34.7%, p < 0.001) and year 5 (45.2% vs 38.0%, p < 0.001) when compared with the preceding year. The increase in vaccination rate was not apparent with social media promotion alone (26.4%, year 2 vs 25.6%, year 1, p = 0.305).ConclusionPersonal coaching led by ICO and SNO significantly increased the vaccination rates among healthcare workers in 3 consecutive years. This model could be promulgated to unit heads to establish a hospital culture conducive to vaccination.     

Perspectives of certified nursing assistants and administrators on staffing the nursing home frontline during the COVID‐19 pandemic

ObjectiveTo identify best practices to support and grow the frontline nursing home workforce based on the lived experience of certified nursing assistants (CNAs) and administrators during COVID‐19.Study settingPrimary data collection with CNAs and administrators in six New York metro area nursing homes during fall 2020.Study designSemi‐structured interviews and focus groups exploring staffing challenges during COVID‐19, strategies used to address them, and recommendations moving forward.Data collectionWe conducted interviews with 6 administrators and held 10 focus groups with day and evening shift CNAs (n = 56) at 6 nursing homes. Data were recorded and transcribed verbatim and analyzed through directed content analysis using a combined inductive and deductive approach to compare perceptions across sites and roles.Principal findingsCNAs and administrators identified chronic staffing shortages that affected resident care and staff burnout as a primary concern moving forward. CNAs who felt most supported and confident in their continued ability to manage their work and the pandemic described leadership efforts to support workers'' emotional health and work–life balance, teamwork across staff and management, and accessible and responsive leadership. However, not all CNAs felt these strategies were in place.ConclusionsBased on priorities identified by CNAs and administrators, we recommend several organizational/industry and policy‐level practices to support retention for this workforce. Practices to stabilize the workforce should include 1) teamwork and person‐centered operational practices including transparent communication; 2) increasing permanent staff to avoid shortages; and 3) evaluating and building on successful COVID‐related innovations (self‐managed teams and flexible benefits). Policy and regulatory changes to promote these efforts are necessary to developing industry‐wide structural practices that target CNA recruitment and retention.     

Predictors of shoulder and back injuries in nursing home workers: a prospective study

BACKGROUND: Nursing assistants (NAs) working in nursing homes have among the highest back and shoulder injury rates in the US. Incidence, severity, and cost of non-traumatic soft tissue musculoskeletal disorders in the nursing home industry in Washington State are quite high. METHODS: To determine whether resident characteristics data reported on the Health Care Financing Administration Minimum Data Set (MDS) could be used as a surrogate measure of cumulative exposure to physical loads, we conducted an 18-month prospective study in one nursing home. RESULTS: The combined NA injury incidence rate (IR) was 45.8 self-reported back and shoulder injuries per 100 [FTE] workers per year. In general, MDS reported resident characteristics failed to predict risk with the exception of exposure to loss of voluntary leg mobility (OR = 1.11 per person-shifts of exposure, 95% CI [0.97-1.27]), with the highest risk on the day shift (OR = 1.15, 95% CI [0.95-1.40]). CONCLUSIONS: These findings suggest social integration and work organization issues may be more important predictors of back and shoulder injuries in nursing assistants than reported resident characteristics as measured by the MDS.     

新型冠状病毒肺炎疫情早期对北京协和医院发热门诊医务人员心理支持特点分析

目的分析新型冠状病毒肺炎疫情早期对北京协和医院发热门诊医务人员的心理支持情况,探索如何为一线医务人员提供更好的心理支持。 方法收集并分析在疫情早期(2020年1月23日至4月27日)对北京协和医院发热门诊医务人员的心理热线工作中所收集的定性及定量资料：基础信息、定性访谈、综合生理-心理-社会评估问卷(UPPSAQ-70),、事件影响量表修订版(IES-R)及职业耗竭问卷(MBI)。 结果共有120名医务人员完成了上述研究(应答率为96.0%)。绝大部分医务人员认为个体防护督导和调整工作时间及强度等措施是重要的和有帮助的。其中,5.0%有显著应激反应,41.7%有职业耗竭,10.8%有显著抑郁,8.3%存在综合生理-心理-社会功能不良;心理健康状况优于其他类似研究发现。抑郁评分与高警觉(b＝0.812,P<0.001)及情感耗竭(b＝0.072,P＝0.020)有关。 结论最早开始支持性心理工作等综合干预能有效减少和缓冲心理应激,减少负面心理状况的发生。高警觉、情感耗竭与抑郁存在相关性。未来类似工作中应尽早提供支持性的整体干预,尤其是纳入降低高警觉的干预模块。     

Strength Training and Light Physical Activity Reduces the Apnea-Hypopnea Index in Institutionalized Older Adults

ObjectivesTo determine the effect of 7 weeks of resistance training and walking on the apnea-hypopnea index (AHI) in institutionalized older adults compared with a usual care control group.DesignSecondary analysis of data from a randomized controlled trial.SettingTen nursing and 3 assisted living facilities in Arkansas.ParticipantsInstitutionalized older adults.InterventionsExercise group (EG) performed supervised resistance training to arm and hip extensors on 3 days a week with additional 2 days a week of light walking. Usual care group (UC) participated in the usual activities provided within their living facility.MeasurementsTwo nights of polysomnography before and following 7-week intervention.ResultsAdjusted means in the EG group showed a decrease in AHI from 20.2 (SD ±1.3) at baseline to 16.7 (SD ±0.9) at 7 weeks. Absolute strength gains were not associated with improved AHI.ConclusionSupervised resistance training and light walking reduced the severity of obstructive sleep apnea in institutionalized older adults.