Frontline Healthcare Workers Research Articles

Family experiences reported by healthcare worker parents during the COVID-19 pandemic

PurposeParents, who were working as essential frontline healthcare workers experienced unique stressors during the COVID-19 pandemic including disruption of regular routines, long lapses away from family, extreme work stress and subsequent difficulty in compartmentalizing work-related concerns when at home. The purpose of this study was to assess COVID-19 exposure and impact of frontline healthcare workers who are parents. Design & methodsThis study quantitatively assessed the COVID-19 exposure and impact and qualitatively explored perceptions of parents of children 9 to 17 years of age, who were also frontline healthcare workers. ResultsParticipants (N = 79) using the COVID-19 Exposure and Family Impact Survey (CEFIS) reported exposure mean scores of 10.03 (SD = 2.63); and impact scores mean scores of 3.18 (SD = 0.46). Thematic analysis identified four themes, each with 2 subthemes: 1) family stressors increased (e.g., concerns about health and safety, losses of lifestyle patterns); 2) changes in children's health and well-being (e.g., isolation from family and friends, mental health problems); 3) virtual school difficulties (e.g., parent and student challenges, home school option); 4) skill building opportunities (e.g., enhanced emotional connections, increased family activities). ConclusionThe CHAMPS Family Health Study suggests that families of essential workers are especially vulnerable to the effect of COVID-19, as are those families of essential workers who include child/ren with special health care needs. Practice implicationsPreparation for future emergencies requires strategies to mitigate consequences and promote well-being. These results highlight the need for supportive approaches to decrease the negative consequences of stress and to augment skills for family connection and cooperation.

Healthcare workers' knowledge and risk perception regarding the first wave of COVID-19 in Khyber Pakhtunkhwa, Pakistan: an online cross-sectional survey.

Increased COVID-19 transmission among the populace may be caused by healthcare workers (HCWs) who lack knowledge, awareness, and good preventive practices. Additionally, it may cause elevated stress levels, anxiety, poor medical judgement, and situational overestimation. The present survey aimed to assess knowledge and risk perception regarding COVID-19 among HCWs in Khyber Pakhtunkhwa (KP), Pakistan. A web-based online, pre-tested questionnaire comprising 26 items was circulated via social media in April 2020 amongst HCWs in major tertiary care facilities in KP. The study's results, revealing both the commendable knowledge levels among HCWs about COVID-19 and their heightened risk perception, highlight the critical need for targeted interventions to address the potential impact on self-protective behaviour and mental health within this vital workforce. This insight is important for designing strategies that not only enhance HCWs' well-being but also ensure the continued effectiveness of healthcare delivery during pandemics. The percentage mean score (PMS) of COVID-19 knowledge was 85.14±10.82. Male HCWs and those with an age older than or equal to 32 years demonstrated a higher knowledge score (85.62±11.08; P=0.032 and 87.59±7.33, P=0.021, respectively). About 76% of HCWs feared contracting COVID-19. Nearly 82% of respondents were mentally preoccupied with the pandemic and also terrified of it. 'Of these, 81% were nurses, 87% had a job experience of 6-8 years and 54.45% were frontline workers. Feelings of panic and concern about the pandemic were found to be more in HCWs who were physicians above the age of 32, and who had 3-5 years of work experience. HCWs' overall risk perception was found to be significantly different between males (7.04±2.26) and females (8.01±1.97), job experience of 6-10 years (8.04±177) with 3-5 years and younger than or equal to 2 years job experience (7.18±2.43,6.93±2.22), respectively, and between frontline HCWs (7.50±2.10) and non-frontline HCWs (6.84±2.40). HCWs demonstrated good knowledge about COVID-19. As the risk perception of COVID-19 among HCWs is high, it can raise concerns about their self-protective behaviour, and mental health. These issues need to be addressed.

Neutralizing immunity against coronaviruses in Tanzanian health care workers

The ongoing vaccination efforts and exposure to endemic and emerging coronaviruses can shape the population's immunity against this group of viruses. In this study, we investigated neutralizing immunity against endemic and emerging coronaviruses in 200 Tanzanian frontline healthcare workers (HCWs). Despite low vaccination rates (19.5%), we found a high SARS-CoV-2 seroprevalence (94.0%), indicating high exposure in these HCWs. Next, we determined the neutralization capacity of antisera against human coronavirus NL63, and 229E, SARS-CoV-1, MERS-CoV and SARS-CoV-2 (including Omicron subvariants: BA.1, BQ.1.1 and XBB.1.5) using pseudovirus neutralization assay. We observed a broad range of neutralizing activity in HCWs, but no neutralization activity detected against MERS-CoV. We also observed a strong correlation between neutralizing antibody titers for SARS-CoV-2 and SARS-CoV-1, but not between other coronaviruses. Cross-neutralization titers against the newer Omicron subvariants, BQ.1.1 and XBB.1.5, was significantly reduced compared to BA.1 and BA.2 subvariants. On the other hand, the exposed vaccinated HCWs showed relatively higher median cross-neutralization titers against both the newer Omicron subvariants and SARS-CoV-1, but did not reach statistical significance. In summary, our findings suggest a broad range of neutralizing potency against coronaviruses in Tanzanian HCWs with detectable neutralizing immunity against SARS-CoV-1 resulting from SARS-CoV-2 exposure.

Closing the Educational Gap on Human Trafficking: There’s No Better Time Than Now!

IntroductionHuman trafficking is a heinous crime and violation of human rights affecting between 25 and 27 million adults and children globally each year. Current immigration and refugee policy could exacerbate the human trafficking public health crisis. Health care providers working in emergency department and urgent care settings interact with human trafficking victims and provide life-changing care. Research identifies a significant need for coordinated, consistent, and standardized education on human trafficking. The purpose of this study was to determine the effectiveness of online educational training in human trafficking on the knowledge and self-confidence of registered nurses and nurse practitioners working in the emergency department and urgent care settings in New York. MethodsAn asynchronous, online education module was designed for emergency department and urgent care registered nurses and nurse practitioners to address key components of human trafficking identification, assessment, and treatment. Using a 1-group pretest/posttest design, participants completed an existing published survey tool before and 6 weeks after education. ResultsFindings revealed statistically significant improvement (P < .05) in knowledge and confidence regarding components of identifying, assessing, and treating victims of human trafficking. Data demonstrated 63.8% of participants had never received human trafficking training, and 80% reported no history of contact with patients known or suspected of being trafficked. DiscussionResults in this study demonstrate the need for increased standardized education regarding HT for frontline health care workers.

The Unspoken Wounds: Understanding the Psychological Impact on Healthcare Professionals Fighting COVID-19 in Pakistan

During the COVID-19 pandemic, hospital staff faced numerous mental health challenges. However, limited research focused on anxiety and stress specifically among hospital workers during this time. Therefore, this study aimed to investigate the anxiety levels of healthcare workers during the COVID-19 pandemic. A multidimensional, cross-sectional survey was distributed to healthcare workers and staff at hospitals, COVID-19 laboratories, and healthcare settings. The survey included a total of 625 frontline healthcare workers, with 445 (71.2%) being male and 180 (28.8%) female. There were 405 (64.8%) lab professionals, 90 (14.0%) doctors, and 130 (20.8%) others, including nursing staff, administrative personnel, and supporting staff crucial to the functioning of healthcare settings. Among the lab professionals, 37.0% reported moderate depression levels and 16.0% reported severe depression levels during the pandemic. For doctors, 22.2% experienced mild depression and 33.33% experienced severe depression. Several factors were significantly associated with depression and anxiety among frontline healthcare workers, including physiological and social factors, fear of infection, risk of infecting family members and colleagues, lack of personal protective equipment (PPE), long working hours, untrained staff, social issues, and cooperation problems. These factors collectively contributed to reduced work efficacy during the pandemic. Frontline health workers played a critical role in the fight against COVID-19. The findings from this study have important implications for developing strategies to improve the mental health of healthcare workers during the pandemic and implementing policies that enhance work efficacy, ultimately leading to the improved outcomes.

Foreign-born nurses as COVID-19 survivors in the Nordic region: A descriptive phenomenological study.

In 2020, amid limited COVID-19 vaccination access, many nurses from Black, Asian and Minority Ethnic (BAME) groups in the United States of America and United Kingdom succumbed to the virus. No fatalities among Filipino foreign-born nurses (FBNs) in the BAME groups were recorded in the Nordic region. This study explored the experiences of Filipino FBNs in the Nordic region who, during the initial 2020 pandemic wave, cared for COVID-19 patients, contracted the virus and subsequently recovered. The research employed a descriptive phenomenological methodology to explore the experiences of six Filipino FBNs who had recovered from COVID-19 in various regions of the Nordic countries, including Finland (n = 1), Sweden (n = 1), Denmark (n = 2), Norway (n = 1) and Iceland (n = 1). Data collection occurred through online videoconferencing between September 2020 and February 2021, utilising a semi-structured approach. The data analysis was conducted following Sundler and colleagues' qualitative thematic analysis, which is grounded in descriptive phenomenology. The data analysis yielded three primary themes and twelve sub-themes, which explored the experiences of Filipino FBNs with COVID-19 infection. The study demonstrated that unclear national guidelines impacted nurses' preparedness in caring for COVID-19 patients, contributing to their susceptibility to contracting the virus. The lack of occupational healthcare services for nurses during and after the pandemic affected their work morale in an unfamiliar setting. The study provided valuable insights into the experiences of Filipino FBNs during the COVID-19 pandemic, emphasising the need for clearer guidelines, enhanced training and improved support for healthcare workers. It highlighted the psychological impact of COVID-19, emphasising the importance of mental health support and stigma reduction efforts. The study also emphasised the significance of improving occupational health services to support the well-being and recovery of healthcare workers during and after the pandemic, with implications for developing comprehensive strategies to protect frontline healthcare workers in health crises.

Evaluation of anxiety and hopelessness levels in emergency service workers during the COVID-19 pandemic in Turkey

Background/Aim: The COVID-19 pandemic led to a significant threat to the lives of individuals, particularly frontline healthcare workers. This brought about negative emotions, such as anxiety and hopelessness. Despite the existence of research evaluating psychiatric symptoms among healthcare personnel during the COVID-19 pandemic, this study is also significant in terms of evaluating and emphasizing the common negative emotions experienced by frontline healthcare workers during the pandemic. This study aimed to evaluate anxiety and hopelessness levels in emergency service workers during the COVID-19 pandemic and to examine these levels in terms of specific variables. Methods: This cross-sectional study was conducted among emergency service healthcare workers, including doctors, nurses, and healthcare officers working in a training and research hospital from July 10 to August 10, 2020 during the pandemic. Participants completed a survey that included a sociodemographic information form, the State and Trait Anxiety Inventory (STAI), and the Beck Hopelessness Scale (BHS). A total of 135 personnel without a history of psychiatric illness or use of psychiatric medication were included in the study. Results: Of the 135 participants in the study, 67 were female, and 68 were male. The mean state anxiety score for all participants was 44.5 (12.6), trait anxiety score was 44.2 (7.3) and hopelessness score was 7.1 (5.2). It was found that the anxiety of emergency service workers during the pandemic was at a moderate level and their hopelessness was at a mild level. In the study, higher scores were found in hopelessness and state-trait anxiety measurements in married individuals compared to single participants (P=0.040, P=0.003, P=0.001, respectively). Trait anxiety scores were significantly higher among those with chronic diseases compared to those without chronic diseases, and in those living with families compared to those living alone (P=0.039 and P=0.017, respectively). A positive and moderate relationship was observed between hopelessness levels and state-trait anxiety levels (P&lt;0.001 for all, r=0.457, r=0.425, respectively). Conclusion: During the COVID-19 pandemic, increased levels of anxiety and hopelessness were detected among healthcare workers in emergency services. It was observed that as the working time in the emergency department increased, hopelessness and state anxiety levels of the employees also increased.

Training and Active Case Detection to Prevent Leprosy: Effect on Knowledge, Attitude and Skills of Health Workers on Early Diagnosis of Leprosy in a Leprosy Hotspot District in Ethiopia.

Despite all of the efforts, leprosy continues to affect hundreds of thousands of people every year, including children, showing the ongoing transmission of the disease within the population. The transmission of leprosy can be interrupted through an integrated approach that includes active case-finding, contact tracing and capacity building of health workers. A cross-sectional study design was used to assess the knowledge, attitudes and skills of health workers in the screening and diagnosis of leprosy. One hundred and eighty-one and eighty-eight health care workers participated in the pre-and post-assessment surveys, respectively. Data were collected through interviews and an observational checklist. Frequency tables and graphs were used to describe the study variables, and statistical significance between pre- and post-assessment surveys was declared at p-value < 0.5. The percentages of healthcare workers with good knowledge, positive attitudes and skills were 61.2%, 55.6% and 51.7% in the pre-assessment survey and 77.3%, 56.3% and 75.0%, respectively, in the post-assessment survey. There was a significant improvement in the knowledge and skill scores of participants in the post-assessment survey (p < 0.01). During the campaign, 3780 index contacts were screened; 570 (15.1%) were diagnosed with skin diseases, and 17 new leprosy cases were diagnosed (case detection rate of 45 per 10,000 contacts). Training improved the knowledge and skills of healthcare workers, and a large number of skin diseases were detected through mass screening and active case findings. Providing training for frontline healthcare workers contributed to the detection of more cases and facilitated early detection of leprosy cases.

The “we” factor in improvisational statecraft: frontline repair of the state in Indonesia’s crisis response amidst resource constraints

Street-level bureaucrats, confined by meager discretion, often find themselves reconciling the challenging terrain of inflexible policies with messy frontline realities. With a phenomenological lens, we examine how Indonesia’s frontline healthcare workers exercise discretion and improvise informal practices to adapt policies and deliver care despite scarce resources during the COVID-19 crisis. As formal emergency protocols lie encumbered under conditions of austerity, a grassroots motivation for communal action occurs from exchanges between peers mired in resource quandaries, encapsulating an improvisational “we” cohering frontline allies. Manifesting through focused responses drawing on unwritten collegial knowledge, these collaborative efforts embody the relational essence and defining contours of frontline policy repair, as opposed to isolated discretion. Probing further into these repair processes surfaces how shared struggles have the power to ignite collective capacity, empowering bureaucrats to govern complexity in concert, construct agency despite constraints, and promote equity in times of scarcity. Our findings champion tending to institutional receptivity and solidarity-anchored creative frontline initiatives, endorsing agile, adaptive processes finely tuned to situational realities that contests paradigms fixated solely on compliance.

Immune Response to COVID-19 Vaccination in Frontline Healthcare Workers.

This study evaluated the immune response to vaccination against COVID-19 in 534 healthcare frontline workers in Vilnius, Lithuania. The incidence of COVID-19 was reduced significantly after vaccination started in the healthcare sector. SARS-CoV-2 antibodies were detected in groups V-VII and this level of antibodies was found to be effective in preventing COVID-19. Sustained immune response was achieved after two vaccination doses, which remained stable for up to 6 months. After the booster dose, antibody levels remained high for an additional 12 months. Although SARS-CoV-2 antibody levels decreased after 6 months, even lower levels of antibodies provided protection against the Delta strain. The booster dose distributed the antibody titer in the high-level antibody groups, offering maximum protection at 12 months. However, even individuals with high antibody titers were observed to contract COVID-19 after vaccination with a booster dose and 6 months in the presence of the Omicron strain. Unfortunately, high levels of antibodies did not provide protection against the new strain of COVID-19 (the Omicron variant), posing a risk of infection. When comparing the antibody titer of vaccinated participants without COVID-19 and those with COVID-19, the change in antibodies after vaccination was significantly lower in infected participants. Individuals with comorbidities and specific conditions had lower antibody levels.

Burnout and Coping Styles among Frontline Healthcare Workers: A Cross-Sectional Study

Introduction: Healthcare professionals lead the healthcare services with their all resources of psychological as well physical to help the patients. However, the psychological well-being of these professionals is being affected by factors such as the lack of fixed working hours, prolonged standing, shift work and additional administrative tasks which they perform. Prolonged exposure adds to burnout in their work life. Objective: The objective of the present study was to examine burnout and coping styles among healthcare workers in India. Methods: It was a cross-sectional study, and participants who were working in the healthcare setup were contacted (N = 100). They were assessed on the professional quality of life scale and the COPE scale. Result and Conclusion: Overall, a moderate level of burnout was reported (M = 21.98, SD = 3.13) among healthcare professionals. Also, problem-focused coping styles were observed among the participants, i.e., ‘planning coping’ (M = 13.22, SD = 1.63), ‘active coping’ (M = 12.90, SD = 1.53), and ‘suppression of competing activities’ (M = 11.02, SD = 1.89). a significant relationship was observed between burnout and coping styles (r = -.24, p&lt;0.05). The findings suggest that burnout exists among healthcare professionals which needs to be taken care of with interventional strategies.

Overcoming walls and voids: Responsive practices that enable frontline workers to feel heard.

There is increasing recognition that beyond frontline workers' ability to speak up, their feeling heard is also vital, both for improving work processes and reducing burnout. However, little is known about the conditions under which frontline workers feel heard. This inductive qualitative study identifies barriers and facilitators to feeling heard among nurses in hospitals. We conducted in-depth semistructured interviews with registered nurses, nurse managers, and nurse practitioners across four hospitals ( N = 24) in a U.S. health system between July 2021 and March 2022. We coded with the aim of developing new theory, generating initial codes by studying fragments of data (lines and segments), examining and refining codes across transcripts, and finally engaging in focused coding across all data collected. Frontline nurses who spoke up confronted two types of challenges that prevented feeling heard: (a) walls, which describe organizational barriers that lead ideas to be rejected outright (e.g., empty solicitation), and (b) voids, which describe organizational gaps that lead ideas to be lost in the system (e.g., structural mazes). We identified categories of responsive practices that promoted feeling heard over walls (boundary framing, unscripting, priority enhancing) and voids (procedural transparency, identifying a navigator). These practices appeared more effective when conducted collectively over time. Both walls and voids can prevent frontline workers from feeling heard, and these barriers may call for distinct managerial practices to address them. Future efforts to measure responsive practices and explore them in broader samples are needed. Encouraging responsive practices may help ensure that frontline health care workers feel heard.

Engage, educate, escape: The New Jersey Department of Health Project Firstline Escape Room

Objective: Participating in an escape room is not just an entertainment but can also be a form of education. Because of this, the New Jersey Department of Health (NJDOH), Project Firstline (PFL) created an escape room interactive training tool and skills-building exercise to encourage the identification and use of key infection control principles by current and future healthcare workers. Design and Setting: PFL is a US initiative that aims to provide infection prevention and control (IPC) knowledge to frontline healthcare workers. This article details health educators’ descriptions and experiences of an escape room developed as part of this initiative; guidance on how to incorporate this modality of learning into present and future teaching; and assessment data and feedback from participants to begin to understand the impact and effectiveness of this approach to learning. Methods: A total of 8 sessions, conducted in 3 locations, with 64 participants, yielded survey assessment data from 41 participants. Results: Quantitative results indicated that participants were highly satisfied with the escape room experience and reported an increased level of knowledge after participation. In addition, participants reported extremely high levels of intention to implement the training they received, and all would recommend the escape room experience to a friend or a colleague. Qualitative data supports the overall findings and provides specific examples of how participants said they would implement the knowledge they learned, along with additional positive feedback. Conclusion: Current and continuing efforts to promote PFL’s escape room are described, along with improvements and future actions.

Retraction: Mental health problems among front-line healthcare workers caring for COVID-19 patients in Vietnam: a mixed methods study.

[This retracts the article DOI: 10.3389/fpsyg.2022.858677.].

Development of an Advanced Robotic System with Line Tracking and Sanitization in Healthcare Industry

COVID-19 is highly transmittable, especially for frontline healthcare workers. Far-UVC light at 222 nm wavelength effectively inactivates the virus and is safe for human skin and eyes. To reduce the contact between healthcare workers and infected patients while sanitizing the area, this work introduces UVood, an advanced robotic system with automated line tracking and sanitizer to enhance the safety of frontline healthcare workers during the COVID-19 pandemic. Utilizing far-UVC light, the system achieves effective sanitization without harm to humans. Controlled by an Arduino Mega microcontroller and incorporating infrared (IR) and passive infrared (PIR) sensors, UVood allows precise navigation and continuous disinfection. This prototype also integrates a touchscreen as a user interface for user control. Through the functionality verification, the developed proof-of-concept prototype has successfully demonstrated its great potential in healthcare automation and infection prevention.

Culture, conditions and care support mental health of healthcare workers during crises.

The coronavirus disease 2019 (COVID-19) pandemic has presented immense challenges to health systems worldwide and significantly impacted the mental health of frontline healthcare workers. This study drew on the experiences of frontline healthcare workers to examine organizational strategies needed to support the mental health and well-being of healthcare workers during times of crisis. Semi-structured focus groups or individual interviews were conducted with healthcare workers to examine their perspectives on organizational strategies for enhancing staff mental health and well-being during crises. Data were analysed thematically. Following this, evidence for the identified strategies was reviewed to assess alignment with participant views and recommendations. Thirty-two healthcare workers from diverse disciplines (10 allied health, 11 nursing, 11 medical) participated in the study. Data analysis identified three broad themes contributing to supporting mental health and well-being. These themes can be encapsulated as the 'Three Cs'-culture (building an organizational culture that prioritizes mental health); conditions (implementing proactive organizational strategies during crises) and care (ensuring fit-for-purpose strategies to support mental health and well-being). Study findings underscore the necessity of an integrated and systemic organizational approach to address mental health and well-being in the healthcare workplace. This approach must be long term with the components of the 'Three Cs', particularly cultural change and conditions, viewed as a part of a suite of strategies to ensure crisis preparedness. It is imperative that organizations collaborate with their staff, providing support and fostering a safe and inclusive work environment that ultimately benefits patients, their care and staff well-being.

Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences.

To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden. An online fully mixed-methods design. A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021,analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis. No patient or public contribution. The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder. This study might guide how to prepare for resilience in future emergencies.

Prevalence of Covid-19 infection among healthcare workers in Central Hospitals of Covid-19 vs non-Covid-19 hospitals in Khuzestan Province, Iran.

Healthcare workers (HCWs) are at high risk of contracting Covid-19 due to their frontline roles and close interactions with infected patients. Understanding the prevalence of Covid-19 infection among HCWs and the factors contributing to it is crucial for informing mitigation strategies. However, the available data on Covid-19 infection rates among Iranian HCWs is limited. The primary objective of this study was to compare the prevalence of Covid-19 infection among HCWs working in hospitals dedicated to Covid-19 care versus HCWs in other non-Covid-19 hospitals in Khuzestan province, Iran. Additionally, the study aimed to identify potential risk factors associated with Covid-19 transmission and symptom severity in this population. This cohort study recruited 3,012 HCWs from 35 hospitals in Khuzestan province. Covid-19 diagnosis was made using RT-PCR testing, chest CT scans, and clinical examination. Overall, 96% (n=2,918) of the 3,012 HCWs were infected with Covid-19. The prevalence was significantly higher among HCWs from Covid-19 hospitals (59.83%, n=1,746) compared to those from non-Covid-19 hospitals (5.75%, n=168). The capital city of Ahvaz had the highest proportion of Covid-19 cases at 28%. HCWs, especially those working in hospitals dedicated to Covid-19 care, face a substantial risk of contracting the virus. The high infection rates observed may be attributed to factors like weakened immune systems, non-compliance with precautions, and delayed diagnosis. These findings underscore the critical need to strengthen infection control measures, improve access to personal protective equipment, and enhance surveillance of Covid-19 among frontline HCWs in Iran.

Adapting the Stress First Aid Model for Frontline Healthcare Workers during COVID-19.

The coronavirus pandemic has generated and continues to create unprecedented demands on our healthcare systems. Healthcare workers (HCWs) face physical and psychological stresses caring for critically ill patients, including experiencing anxiety, depression, and posttraumatic stress symptoms. Nurses and nursing staff disproportionately experienced COVID-19-related psychological distress due to their vital role in infection mitigation and direct patient care. Therefore, there is a critical need to understand the short- and long-term impact of COVID-19 stress exposures on nursing staff wellbeing and to assess the impact of wellbeing programs aimed at supporting HCWs. To that end, the current study aims to evaluate an evidence-informed peer support stress reduction model, Stress First Aid (SFA), implemented across units within a psychiatric hospital in the New York City area during the pandemic. To examine the effectiveness of SFA, we measured stress, burnout, coping self-efficacy, resilience, and workplace support through self-report surveys completed by nurses and nursing staff over twelve months. The implementation of SFA across units has the potential to provide the workplace-level and individual-level skills necessary to reduce stress and promote resilience, which can be utilized and applied during waves of respiratory illness acuity or any other healthcare-related stressors among this population.

A Longitudinal RCT on the Effectiveness of a Psychological Intervention for Hospital Healthcare Workers During the COVID-19 Pandemic: What We Learned to Date.

The COVID-19 pandemic has led to significant psychological distress among frontline healthcare workers (HCWs), with a particular increase in trauma-related symptoms. This study investigated the longitudinal course of trauma-associated symptoms and behaviors in HCWs and the effectiveness of a brief dialectical behavior therapy (DBT)-informed intervention in mitigating these symptoms over 12months. The trial included 225 HCWs randomly assigned to one of three groups: no intervention (control), in-person DBT-informed intervention, or online DBT-informed intervention. Over time, a natural decrease in PTSD symptoms was observed in all groups. Contrary to expectations, no difference was found between the control and intervention groups. However, for participants with severe PTSD symptoms, the intervention significantly mitigated their distress. No differences emerged between in-person and online interventions, suggesting equal effectiveness. Females reported higher trauma-related symptoms, while no differences emerged among different professional roles. These findings underscore the importance of targeted interventions for HCWs experiencing severe symptoms and highlight the potential of online modalities. Further research is needed to optimize the deployment of mental health resources within the healthcare setting, particularly during crises.