Frontline Health Professionals Research Articles

Utilization of technology to provide on-the-job trainings on Emergency Obstetric and Neonatal Care: Perspectives of nurses and midwives working in Rwanda's remote health facilities.

One of the targets for the third sustainable development goals is to reduce worldwide maternal mortality ratio (MMR) to less than 70 deaths per 100,000 live births by 2030. To address issues affecting women and the newborns during childbirth and postnatal period, concerted efforts from governments and their stakeholders are crucial to maximize the use of technology to enhance frontline health professionals' skills to provide the emergency obstetric and newborn care (EmONC). However, no study has garnered nurses' and midwives' perspectives regarding the application of technology-enhanced learning approach to provide on-the-job Continuous Professional Development (CPD) and factors that may influence the application of this training approach in the Rwandan context. The study collected data from nurses and midwives from forty (40) public health facilities in remote areas nationwide. The study applied a qualitative descriptive design to explore and describe nurses' and midwives' perspectives on the feasibility and acceptability of technology enhanced learning approaches such as e-learning, phone-based remote training, and other online methods to provide trainings in EmONC. Two focus group discussions with EmONC mentors, two with nurses and midwives were conducted. Twelve key informant interviews were conducted. Participants were selected purposively. In total, 54 individuals were included in this study. A thematic approach was used to analyse data. Nurses and midwives highlighted the need to provide refresher trainings about the management of pre-eclampsia. Most of the EmONC trainings are still provided face-to-face and the use of technology enhanced learning approaches have not yet been embraced in delivering EmONC CPDs for nurses and midwives in remote areas. Nurses and midwives found the first developed prototype of smartphone app training of the EmONC acceptable as it met the midwives' expectations in terms of the knowledge and skills' gap in EmONC. Although the newly developed application was found acceptable, further research involving practical sessions by nurses and midwives using the developed application is needed to garner views about the ease of use of the application, relevance of the EmONC uploaded content on the app, and needed improvements on the app to address their needs in EmONC.

Driving innovation in health care: exploring the impact of ambidextrous leadership on creative performance among frontline health professionals in Norway

BackgroundIn recent years, there has been an increasing focus on enhancing frontline health professionals’ ability to think and act innovatively, also known as their creative performance. However, previous research has had two limitations. First, only a few leadership styles and their associations with this capability have been examined. Second, there has been a lack of research on identifying potential process mediators and examining their role in the relationship between leadership styles and the professionals’ capability. To address this knowledge gap, our study investigates the impact of ambidextrous leadership, a relatively new leadership style, on frontline health professionals’ creative performance. Additionally, we explore whether frontline health professionals’ learning orientation (an individual factor) and relationship learning (an organizational factor) act as process mediators in this association. No previous research has focused on these relationships. Thus, the study offers a unique contribution to health services research.MethodsThis is a cross-sectional study with a convenience sample of N = 258 health professionals in nine Norwegian municipalities. The results of this study were analyzed using PLS-SEM with SmartPLS 3 software. The study examined both direct and indirect relationships through bootstrapping.ResultsThe results reveal a positive link between health professionals’ creative performance and ambidextrous leadership \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ (\\beta $$\\end{document} = 0.224). Both relationship learning and learning orientation were found to operate as complementary process-mediating factors between health professionals’ creative performance and ambidextrous leadership. The strength of the two individual relationships that constitute the process-mediating factors indicates that ambidextrous leadership has a stronger impact on relationship learning than on learning orientation \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ (\\beta $$\\end{document} = 0.504 versus \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\beta $$\\end{document} = 0.276). However, when we examined the individual associations between the two factors and creative performance, the strength of the relationships was quite different. The findings reveal that learning orientation is significantly more positively associated with creative performance than relationship learning \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ (\\beta $$\\end{document} = 0.302 versus \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\beta $$\\end{document} = 0.163). Ambidextrous leadership, learning orientation, and relationship learning explain 26% (R2 = 0.262) of the variance in professionals’ creative performance.ConclusionsThis study suggests that ambidextrous leadership can facilitate health professionals’ creative performance directly and indirectly through the two process-mediating factors: relationship learning and learning orientation. Thus, a practical implication is the importance for health service organizations of clear awareness of the numerous advantages of having leaders who actively practice an ambidextrous leadership style.

Living with unsettled baby behaviours: Qualitative interview study exploring parental perceptions and experiences of help-seeking.

To explore parents' perceptions/experiences of help-seeking for unsettled baby behaviours, including views and experiences of obtaining advice from primary healthcare professionals. Semi-structured qualitative interviews. Recruitment occurred via social media, general practice and health visiting teams. Remote semi-structured interviews were conducted with parents of babies. Babies were under 12 months old at time of interview, and parents had perceived unsettled baby behaviours in their first 4 months of life. Interviews were transcribed and data analysed using reflexive thematic analysis. Based on interviews with 25 mothers, four main themes were developed. 'The need for answers' highlighted parental uncertainty about what constitutes normal baby behaviour, leading to help-seeking from multiple sources. 'The importance of health professionals' and 'Experiencing health professional support' identified perceptions about limited access, communication, mixed advice and how these influenced parental perception/management of behaviours. 'Foundations to help-seeking' highlighted important roles of social support and online help for valued shared experiences, emotional and practical support. Health professional access and advice are important to parents, despite the increasing role of online help and importance of social support. More support and improved access to reliable sources of information is needed for parents. Findings will inform future research and clinical practice to address parental uncertainties. Qualitative research with front-line health professionals is necessary. Findings can inform the development of resources to support professionals/families managing unsettled babies. Standards for Reporting Qualitative Research. A public contributor was involved throughout all stages of the research. Emerging findings were discussed at a parent group. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Addressing parental uncertainties is important; about what is normal, non-pharmacological approaches and when pharmacological intervention is required. A digital information/self-management intervention may be useful for parents/clinicians.

Determinants of diabetic nephropathy among adult diabetic patients on follow-up at public hospitals in Addis Ababa, Ethiopia: A case-control study.

Diabetic nephropathy is defined as patients with diabetes mellitus who have persistent proteinuria for at least three consecutive measurements per year, a high blood creatinine level (>130 mol/l), or a decrease in glomerular filtration rate (<60 ml/min). Limited studies were done in Ethiopia on determinants of diabetic nephropathy among diabetic patients. Therefore, this study aimed to identify determinants of nephropathy among adult diabetic patients on follow-up at public hospitals in Addis Ababa, Ethiopia, 2022. A hospital-based unmatched case-control study design was conducted from 6 September to 9 November 2022, among diabetic patients on follow-up at public health hospitals in Addis Ababa. Using consecutive sampling techniques, a total of 442 (353 controls and 89 cases) were recruited, with a control-to-case ratio of 4:1. The data were collected using a structured and interview-administered questionnaire and variables like high-density lipoprotein, low-density lipoprotein, Glycated hemoglobin, and type of diabetes were extracted from the medical records of the patients using a checklist. The collected data were entered into Epidata 3.1 and analyzed by STATA version 15.0. Variables with a p-value < 0.25 in the bivariable logistic regression were selected for the final model. In multivariable logistic regression model fitting, variables with a p-value < 0.05 with 95% CI adjusted odds ratio have declared statistically significant risk factors of diabetic nephropathy. In this study, out of 442 study participants, 334 controls and 89 cases were included in the analysis, with a response rate of 94.6% and 100%, respectively. The majority of the study participants were 92.13% of cases and 84.13% of controls; 7.87% of cases, and 15.87% of controls were type 2 diabetes mellitus. Age 65 and above years old (AOR: 2.42; 95% CI: 1.28, 4.57); Smoking cigarette (AOR: 2.22; 95% CI: 1.18, 4.16); Non-adherent to diet (AOR: 2.11; 95% CI: 1.15, 3.84); Drinking alcohols (AOR: 1.95; 95% CI: 1.07, 3.52); Duration with diabetes more than 10 years (AOR: 3.39; 95% CI: 1.76, 6.54); Poor glycemic control (AOR: 2.19; 95% CI: 1.23, 4.28); and Low-density lipoprotein (AOR: 2.97; 95% CI: 1.69, 5.28) were found to be statistically significant risk factors of nephropathy among diabetic patients. This study found that old age, smoking cigarettes, non-adherence to diet, duration of diabetes, alcohol drinking, Glycated hemoglobin A1C, and high low-density lipoprotein were risk factors for nephropathy. Hence, continuous health education on lifestyle modifications and diabetic-related complications in each follow-up visit via front-line health professionals are very essential to avert the problem.

FRAILTY ASSESSMENT FROM PAPER TO ONLINE: THE E-FI-CGA WEB APP

Abstract Background Early frailty assessment is crucial for improving care for older adults through enhancing frailty-informed care planning and execution. To increase the access and use of the established electronic Frailty Index based on the Comprehensive Geriatric Assessment tool, we developed an online software application: the web-based eFI-CGA. Methods End-user requirements primarily adapted the standalone version of the eFI-CGA and covered assessment competency, interface familiarity, accessibility and convenient use by front-line health professionals. Web app-bounded features included user-account authentication and authorization, user-space management, record-search and retrieval, and functions for data management, analysis and display. The web app development used the Microsoft Azure web server with the ASP.NET framework, combined Webforms and Model-View-Controller architecture, and C# programming language with standard client-side libraries incorporating scripting and mark-up languages. Results The web-based eFI-CGA was technically released and accessible online (efi-cga). Tests on the web pages for all the web pages (e.g., Home, Signup Login, Assessment, Search, and Analysis) using large sizes of systematically designed test data and mocked patient cohorts showed that the web software functions meet the requirements with 100% accuracy. Conclusion The web-based eFI-CGA provides a valuable remote frailty assessment and information retrieval method for healthcare professionals, promoting effective multidisciplinary integrated care of older adults. Further work is needed to allow the safe use of the web app. We are also planning a patient-oriented frailty assessment tool for community-dwelling older adults.

Fatores de risco à saúde mental dos profissionais da saúde durante a pandemia de COVID-19: revisão sistemática

Abstract The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers’ mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.

O.4.4-3 Developing a bespoke undergraduate physical activity course for a Portuguese Medical School - the VANGUARD European Union Erasmus+ project

Abstract Purpose Embedding physical activity in the undergraduate curricula of frontline health professionals is one of the policies recommended by the World Health Organization and the European Commission to promote health-enhancing physical activity (HEPA). The VANGUARD project is supported by the European Union Erasmus+ Programme, and aims to embed physical activity in the undergraduate curricula of healthcare professionals in European countries. Within this project, this work aimed to describe the bespoke development of a physical activity and health course integrated into the undergraduate medical curriculum of a Portuguese Medical School. Project or policy description The School of Medicine and Biomedical Sciences of the University of Porto (ICBAS) was the invited Medical School to implement the VANGUARD project in Portugal - led by the Institute of Public Health of the University of Porto (ISPUP). An auscultation process with the undergraduate medical students was held to evaluate the importance of HEPA in their curriculum and assess the preferred operational characteristics of including a physical activity and health course in the Integrated Master’s degree in Medicine. A course proposal structure was then developed by the VANGUARD project Portuguese team from ISPUP, the Director of the Integrated Master’s degree in Medicine, and the Coordinator of the Medical Education Office of ICBAS, based on the students’ acceptability, the Medical School constraints, and VANGUARD project goals and resources. The course integrates 26 lessons, from physical activity technical terminology, epidemiology and guidelines, going through its relation with noncommunicable diseases (using #MovementForMovement resources), to Portuguese National Health Service brief intervention tools and community-based exercise programs - in a total of 20 hours of contact, including continuous evaluation and final case studies analysis. The course will be offered on an optional basis to 2nd-year medical students, on an online training platform, using a self-paced learning method. After embedding this course in ICBAS, it will be presented to the Council of Portuguese Medical Schools to be scaled up nationally. Conclusions Medical doctors and Medical Schools are key stakeholders in HEPA promotion, especially in the health sector. Successful implementation of HEPA policies requires tailored solutions to organizations and direct involvement of target groups in policy development.

Evaluation of community pharmacist follow-up supported by the use of healthcare technology for type 2 diabetes patients

BackgroundPrevalence of type 2 diabetes is high in Belgium (estimated at over 10%, 1 patient out of 3 being unaware of their diagnosis). Management based on a change of lifestyle and the adoption of health-promoting behaviors, supplemented when needed with drug treatment, prevents complications, improves the patient's quality of life and reduces mortality. Multidisciplinary patient support is essential. In this, pharmacists have a key role, e.g. through therapeutic patient education activities, in which they are increasingly involved. Moreover, research suggests that the use of mobile technologies can be a useful tool for helping patients with their daily life and disease management. ObjectivesThis study aims at exploring the benefits of community pharmacist follow-up supported by the use of mobile technologies in the monitoring of individuals with type 2 diabetes. The presented intervention aimed to reinforce the patients' willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of medication adherence. MethodsA quantitative quasi-experimental study was conducted in community pharmacies throughout Belgium over a 6-month period with 3 data collection periods (before, during and after the intervention). Primary outcomes, related to the level of medication adherence, and secondary outcomes, considered as markers of the patient's overall health, were analyzed. In addition, qualitative data concerning participants' opinions on their experience were collected. Results66 patients participated in the study, with 50 remaining after 3 months and 46 completing the entire study. Statistical analyses did not show an improvement in the level of medication adherence. This parameter was high from the beginning, reflecting patients with controlled diabetes. However, statistically significant results were observed for systolic blood pressure and waist circumference (both improved), while other outcomes showed a positive trend or remained stable. Patient follow-up by the pharmacist was a positive experience for both parties which noted their interest and satisfaction for the project. ConclusionsAlthough clinical results are not conclusive, patients were motivated and the attrition rate was low. Participants showed their interest in participating in this kind of project, opening up opportunities for further studies in the community pharmacy setting. As front-line health professionals, community pharmacists certainly have a key-role to play in therapeutic patient education and mobile technologies could be additional tools in this process.

Create.Connect.Unwind: A creative response to the pandemic for NHS staff well-being

This article presents a reflection on the hurdles faced by arts and health organizations during England’s COVID-19 lockdown in 2020–21 through the work of the arts team at Manchester University NHS Foundation Trust (MFT), Lime Arts. As the pandemic hit, Lime risked being shut down, their premises reallocated and staff redeployed. Convinced that, more than ever, frontline health professionals might benefit from creative workshops, Lime piloted a six-month innovative programme of online creative workshops for MFT staff. Lime then partnered with the Employee Health and Wellbeing Service to take the online workshops across the Trust, creating a new project called Create.Connect.Unwind. The pilot phase ended in May 2022 with a Creativity and Wellbeing Festival at Manchester Royal Infirmary. The authors reflect on this two-year project, considering in retrospect the team response, the participant response and the artwork created as well as the creative perspective behind the project.

The impact of pandemics on healthcare providers' workloads: A scoping review.

To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting. Scoping review. A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty-five studies met the inclusion criteria. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review checklist. Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non-normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient-to-nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages. Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics. Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID-19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce. No patient or public contribution.

Global prevalence of low resilience among the general population and health professionals during the COVID-19 pandemic: A meta-analysis

ObjectiveTo estimate the global prevalence of low resilience among the general population and health professionals during the COVID-19 pandemic. MethodsEmbase, Ovid-MEDLINE, PubMed, Scopus, Web of Science, CINAHL, WHO COVID-19 databases, and grey literature were searched for studies from January 1, 2020, to August 22, 2022. Hoy's assessment tool was used to assess for risk of bias. Meta-analysis and moderator analysis was performed using the Generalized Linear Mixed Model with a corresponding 95 % confidence interval (95 % CI) adopting the random-effect model in R software. Between-study heterogeneity was measured using I2 and τ2 statistics. ResultsOverall, 44 studies involving 51,119 participants were identified. The pooled prevalence of low resilience was 27.0 % (95 % CI: 21.0 %–33.0 %) with prevalence among the general population being 35.0 % (95 % CI: 28.0 %–42.0 %) followed by 23.0 % (95 % CI: 16.0 %–30.9 %) for health professionals. The 3-month trend analysis of the prevalence of low resilience beginning January 2020 to June 2021 revealed upward then downward patterns among overall populations. The prevalence of low resilience was higher in females, studied during the delta variant dominant period, frontline health professionals, and undergraduate degree education. LimitationsStudy outcomes showed high heterogeneity; however, sub-group and meta-regression analyses were conducted to identify potential moderating factors. ConclusionsGlobally, 1 out of 4 people among the general population and health professionals experienced low resilience due to COVID-19 adversity. The prevalence of low resilience was twice as much among the general population compared to health professionals. These findings provide information for policymakers and clinicians in the development and implementation of resilience-enhancing programs.

A quality improvement approach in co-developing a primary healthcare package for raising awareness and managing female genital schistosomiasis in Nigeria and Liberia.

Girls and women living in endemic areas for urogenital schistosomiasis may have lifelong vulnerability to female genital schistosomiasis (FGS). For >2decades, the importance of FGS has been increasing in sub-Saharan Africa, but without established policies for case detection and treatment. This research aimed to understand the level of FGS knowledge of frontline health workers and health professionals working in endemic areas and to identify health system needs for the effective management of FGS cases and prevention of further complications due to ongoing infections. Workshops were conducted with health workers and stakeholders using participatory methods. These workshops were part of a quality improvement approach to develop the intervention. Health workers' and system stakeholders' knowledge regarding FGS was low. Participants identified key steps to be taken to improve the diagnosis and treatment of FGS in schistosomiasis-endemic settings, which focused mainly on awareness creation, supply of praziquantel, development of FGS syndromic management and mass administration of praziquantel to all eligible ages. The FGS intervention component varies across countries and depends on the health system structure, existing facilities, services provided and the cadre of personnel available. Our study found that co-developing a new service for FGS that responds to contextual variations is feasible, promotes ownership and embeds learning across health sectors, including healthcare providers, NTD policymakers and implementers, health professionals and community health workers.

The beneficial role of personality in preserving well-being during the pandemic: A longitudinal population study

BackgroundThe COVID-19 pandemic resulted in increased rates of mental health problems. We examined the possible role of the personality characteristic, Locus of Control (LOC), in moderating pandemic-induced stress. MethodsThe UK-based Avon Longitudinal Study of Parents & Children (ALSPAC), 7021 adults (mean ages: women 57.6 (SD = 4.48); partners 60.5 (SD = 5.36)) responded to a 2020 questionnaire which included a generalised measure of LOC. Between March 2020–January 2021, questionnaires focussed on the pandemic were administered, which included measures of mental health. Over 60 % of respondents completed questionnaires at three timepoints of interest. ResultsIn those with an internal LOC higher rates of positive well-being and reduced likelihood of anxiety and depression were shown compared to those who were external, e.g. after adjustment for socioeconomic/demographic factors mean differences in well-being score for internal compared with external women was +2.01 (95%CI +1.02,+2.10) p = 0.0001; for their partners +2.52 (95%CI +1.22,+3.82) p = 0.0002. External women were more likely than internals to have depression (adjusted OR 3.41 [95%CI 1.77,6.57] p < 0.0005. LimitationsAttrition is a problem in this 30-year-old longitudinal cohort. Those still participating are more likely to have higher education and SES levels, be female and have an internal LOC. This population suffers from a lack of ethnic diversity. ConclusionsHaving an internal LOC positively moderated the effects of pandemic-induced stress on the frequency of anxiety and depression in middle-age. Programmes geared to raise internality and coping strategies may have long-term benefits on well-being in stressful situations, especially for women and frontline health professionals.

Frontline health professionals’ perceptions about HIV and youth

Frontline health professionals’ perceptions about HIV and youth

The prevalence of posttraumatic stress disorder and its associated factors among frontline health workers during the COVID-19 pandemic working at case management center in Ethiopia, 2020.

COVID-19, because of its rapid transmission and the uncertainty about how it is transmitted, evoked fear and anxiety among frontline health professionals. This study aimed to assess the prevalence of posttraumatic stress disorder (PTSD) and its association with impairments in functioning and comorbid mental health symptoms in Ethiopia in 2020. An English-language, online, cross-sectional survey study was administered to 207 different health professionals working at a COVID-19 center using a random sampling technique. The 17-item Symptom Scale for Posttraumatic Stress Disorder-Self-Reporting Version was used to determine the presence of PTSD. Bivariate and multivariable logistic regression analyses were conducted to determine psychosocial factors associated with PTSD. The overall prevalence of PTSD in this study was 55 (26.5%). Those at the highest risk included women, those working at a high-risk site, current substance users, and professionals with poor quality of sleep. The prevalence of PTSD among frontline health care providers was higher than in the general population. Some environmental and psychological variables were associated with increased risk. We recommend that health care providers who provide frontline care be regularly screened for PTSD and provided with mental health services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Front-line health professionals' recognition and responses to nonfatal strangulation events: An integrative review.

The aim of this study was to determine how front-line health professionals identify and manage nonfatal strangulation events. Integrative review with narrative synthesis was conducted. A comprehensive database search was conducted in six electronic databases (CINAHL, Wed of Science, DISCOVER, SCOPUS, PubMed and Scholar) resulting in 49 potentially eligible full texts, reduced to 10 articles for inclusion after exclusion criteria were applied. An integrative review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines. Data were extracted, and a narrative synthesis using Whittemore and Knafl (2005) framework was undertaken to determine how front-line health professionals identify and manage nonfatal strangulation events. The findings identified three main themes: an overall failure by health professionals to recognize nonfatal strangulation, a failure to report the event and a failure to follow up on victims after the event. Stigma and predetermined beliefs around nonfatal strangulation, along with a lack of knowledge about signs and symptoms, were the salient features in the literature. Lack of training and fear of not knowing what to do next are barriers to providing care to victims of strangulation. Failure to detect, manage and support victims will continue the cycle of harm through the long-term health effects of strangulation. Early detection and management of strangulation are essential to prevent health complications, particularly when the victims are exposed to such behaviours repeatedly. This review appears to be the first to explore how health professionals identify and manage nonfatal strangulation. It identified the significant need for education and robust and consistent screening and discharge policies to assist health providers of services where victims of nonfatal strangulation attend. This review contains no patient or public contribution since it was examining health professionals' knowledge of identifying nonfatal strangulation and the screening and assessment tools used in clinical practice.

COVID-19 Pandemic and Its Effect on Resident Physicians' Mental Well-Being: A Cross-Sectional Study in Kuwait.

Concerns about COVID-19's long-term consequences on the mental health of frontline health professionals are mounting as the entire world strives anew to contain it. The primary objective of this research is to describe the impact of working during the COVID-19 pandemic on resident physicians' mental health. A cross-sectional online survey using the Google Forms platform was conducted from May 1to May 30, 2021, on 311 residents currently enrolled in a residency program at the Kuwait Institutional of Medical Specialization (KIMS). Socio-demographic details of each resident physician were collected and the scores related to depression, anxiety, and stress were measured using the previously validated depression anxiety stress scale-21 (DASS-21). Higher stress and depression scores were seen in those who were devoid of the option to work with COVID-19 patients, who reported that working during the pandemic affected their study schedule, and who lost off-service training time. Further, the anxiety scores were significantly higher in females. The impact of the ongoing pandemic on residents' mental health is grave, necessitating psychological treatment and support. The study discovered various factors linked to depression, anxiety, and stress. As a result, these aspects must be regarded to protect the doctors' mental health.

A Cross-Sectional Study on the Psychological Changes of Medical Personnel in Hospitals Who Experienced Special COVID-19 Situations.

The COVID-19 pandemic contributed to an increase in mental health issues; Psychological changes occur in health professionals who are more susceptible to infection. The purpose of this study was to investigate health professionals' levels of anxiety, rage, and depression in COVID-related special circumstances. A general hospital in Korea experienced a widespread COVID-19 outbreak. There was a total of 149 involved frontline and non-frontline health professionals surveyed. The State-Trait Anger Expression Inventory, General Anxiety Disorder-7, and Korean Screening Tool for Depressive Disorders were utilized in the evaluation of their rage, anxiety, and depression. Anxiety and depression were found to be significantly higher among health professionals by occupation than among non-health professionals. Frontline workers were more depressed than non-frontline workers, according to type of work. These psychological changes can cause PTSD, so it is necessary to check and care for the mental health of health care workers working in medical institutions in the event of mass infections. These issues have been confirmed through studies related to the occurrence of mass infections such as SARS and MERS that the occurrence of mass infections can cause PTSD. The findings proved that the COVID-19 pandemic had a psychological impact on healthcare workers. During the COVID-19 pandemic, it is critical to raise awareness of post-traumatic stress disorder among healthcare professionals.

A Study to Assess the Occupational Burnout and Level of Stress among Frontline Health Professionals during COVID-19 Pandemic in Selected Hospital of New Delhi

Introduction: During the fierce pandemic of COVID-19, the entire healthcare workforce has experienced high psycho-social stress and huge loads of work, which is likely to affect their emotional and mental well-being and guide them to a state of burnout. Objectives: This study aimed to assess the occupational burnout and level of stress among frontline health professionals during the COVID-19 pandemic and to seek the association of occupational burnout and level of stress with selected socio-demographic variables among frontline health professionals, who worked during COVID-19 pandemic respectively. Method: The descriptive survey included 200 frontline health professionals who worked during COVID-19 pandemic using non-probability purposive sampling technique. Standardised tools were used for data collection i.e. Burnout Assessment Tool for assessing occupational burnout and Perceived Stress Scale for the level of stress. Descriptive and inferential statistics were employed for the analysis of data. Results: Out of 200 health professionals, most frontline health professionals who worked during COVID-19 pandemic had an average occupational burnout. More than half of the sample had moderate, followed by 43.5% who had low and only 1% who had a high level of stress. There was a significant association of occupational burnout and level of stress with selected socio-demographic variables at a level of significance of 0.05. Conclusion: A large proportion of frontline health professionals who worked during COVID-19 had average occupational burnout and more than half suffered from moderate to high stress. Awareness must be created about factors causing stress and coping strategies, which can lead to the prevention of occupational burnout.

How did the COVID-19 pandemic affect urinary incontinence and its management in the nursing homes? A descriptive phenomenological study.

Management of urinary incontinence (UI) in nursing homes (NHs) represents a complex process that may have become more challenging during a period in which front-line health professionals (HPs) must deal with the outbreak of a new infectious disease. We aimed to investigate how UI and its management was affected in NHs during the COVID-19 pandemic based on the perception of health professionals. This qualitative study was conducted between January and March 2021 with 16 health professionals working in nineNHs in the Osona county (Barcelona, Spain) during the COVID-19 pandemic. The individual interviews were conducted via online videoconferencing and each session was audio recorded. The HPs highlighted that the COVID-19 pandemic affected the management of continence in NHs, resulting in increased UI. Two main factors were identified: workforce-related and resident-related factors. Considering the workforce, three main topics emerged: pandemic as the priority, lack of personnel and use of personal protective equipment as an obstacle to communication with residents and attending to their needs. Managing UI in NHs always has been a challenging point of care, and these challenges were worsened by the restrictions and additional difficulties that arose during the COVID-19 pandemic.