Frontline Healthcare Workers Research Articles

ORGANIZATIONAL READINESS FOR A VIRTUAL REALITY TRAINING PROGRAM CALLED BE EPIC-VR

Abstract An essential first step to implementing virtual reality programming in home care and long-term care settings is to assess organizational readiness by determining factors that enhance the likelihood of its successful implementation. Be EPIC-VR is one such virtual reality program that supports dementia-specific, person-centered communication training for frontline healthcare workers. Guided by the Consolidated Framework for Implementation Research (CFIR), the current study aimed to identify factors influencing Be EPIC-VR’s implementation in home care and long-term care settings. Semi-structured interviews were conducted with nine managers from home care and long-term care settings in Canada. Transcripts from these interviews were analyzed using the Framework Analysis’ five-step ongoing, iterative process: familiarization, identifying a thematic framework, indexing, charting, and mapping/interpretation. Textual data were open-coded and organized deductively (using CFIR’s pre-set codes) and inductively (for emergent codes) into themes and subthemes. Four themes emerged as factors contributing to organizational readiness including 1) openness to virtual reality as a training tool, 2) staffing and training logistics, 3) organizational culture supporting staff development, and 4) external pressures for organizational sustainability. These findings will guide how the Be EPIC-VR implementation team collaborates with organizational decision makers to ensure that Be EPIC-VR is a good fit for those organizations, to prepare for its implementation, and to optimize the likelihood of success. The study findings offer valuable insights for researchers and practitioners working to implement new virtual reality interventions in home care and long-term care settings.

Dissecting the heterogeneity of “in the wild” stress from multimodal sensor data

Stress is associated with numerous chronic health conditions, both mental and physical. However, the heterogeneity of these associations at the individual level is poorly understood. While data generated from individuals in their day-to-day lives “in the wild” may best represent the heterogeneity of stress, gathering these data and separating signals from noise is challenging. In this work, we report findings from a major data collection effort using Digital Health Technologies (DHTs) and frontline healthcare workers. We provide insights into stress “in the wild”, by using robust methods for its identification from multimodal data and quantifying its heterogeneity. Here we analyze data from the Stress and Recovery in Frontline COVID-19 Workers study following 365 frontline healthcare workers for 4–6 months using wearable devices and smartphone app-based measures. Causal discovery is used to learn how the causal structure governing an individual’s self-reported symptoms and physiological features from DHTs differs between non-stress and potential stress states. Our methods uncover robust representations of potential stress states across a population of frontline healthcare workers. These representations reveal high levels of inter- and intra-individual heterogeneity in stress. We leverage multiple stress definitions that span different modalities (from subjective to physiological) to obtain a comprehensive view of stress, as these differing definitions rarely align in time. We show that these different stress definitions can be robustly represented as changes in the underlying causal structure on and off stress for individuals. This study is an important step toward better understanding potential underlying processes generating stress in individuals.

Evidence for a Negative Loss Spiral between Co-Worker Social Support and Burnout: Can Psychosocial Safety Climate Break the Cycle?

Previous research suggests that co-worker social support predicts burnout, but this relationship may be far more complex, with the potential for a reciprocal cycle of loss. Leading research on loss spirals has explicitly called for more research on interindividual factors such as social support and, by extension, how interventions that operate on these interpersonal resources could play a role in primary and secondary prevention (i.e., intervening in cycles of loss). In this study, we explore the reciprocal relationship between burnout and co-worker social support, with psychosocial safety climate (PSC) as an upstream predictor and moderator of this relationship. Using hierarchical linear modelling (N = 380 frontline healthcare workers, nested within N = 63 teams) on longitudinal data, we found a reciprocal relationship between burnout and co-worker support, which was both triggered and moderated by PSC. These findings provide initial evidence for a social support-burnout loss spiral, wherein individuals with poor co-worker support are more likely to become burnt-out, and in this depleted state they are subsequently less likely to reach out for those social supports when available, which would, in turn, lead to further burnout. This social support-burnout loss spiral is exacerbated when working in a low-PSC context, as the environment does not send positive safety signals about resource scarcity and replenishment. Therefore, PSC may be a potential target for intervention both in primary prevention (i.e., stopping the loss spiral in the first instance) and in secondary intervention, as high PSC signals to workers already in the burnout-support loss cycle when it is safe to reinvest resources or engage in recovery behavior.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam.

The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors. A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale. In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05). Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

Contribution of rumination and psychological resilience to post-traumatic growth of front-line healthcare workers in mobile cabin hospitals under Normalized epidemic Prevention and Control Requirements

To understand the level of post-traumatic growth (PTG) and influencing factors among front-line healthcare workers (HCWs) working in mobile cabin hospitals treating patients with Coronavirus Disease 2019 (COVID-19) under the Normalized Epidemic Prevention and Control Requirements adopted in China. A random sampling method was used to select 540 HCWs of the Chongqing-aid-Shanghai medical team from April to May 2022 as the study participants. Participants completed a general information questionnaire, the Post-traumatic Growth Inventory-Chinese version (PTGI-C), the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) and the Chinese Event Related Rumination Inventory (C-ERRI). Among the 540 included HCWs, 83.15 % were nurses and 78.89 % were women. The average scores for PTG (62.25 ± 16.73) and psychological resilience (64.22 ± 15.38) were at moderate levels, and the average score for rumination was low (21.62 ± 10.77). Pearson correlation analysis showed that CD-RISC and C-ERRI scores were positive with the PTGI-C score (r = 0.528, 0.316, P < 0.001). Multiple linear regression analysis identified psychological training or intervention during the COVID-19 epidemic (β = 2.353, P = 0.044), psychological resilience (β = 0.525, P < 0.001) and deliberate rumination (β = 0.732, P < 0.001) as factors significantly associated with the PTG of front-line HCWs, which together explained 36.8 % of the total variance in PTG (F[5,539] = 63.866, P < 0.001). In general, psychological resilience and deliberate rumination can promote PTG among HCWs and can be improved by strengthening psychological training and interventions for HCWs working under the Normalized Epidemic Prevention and Control Requirements.

Engaging staff to improve COVID-19 vaccination response at long-term care facilities (ENSPIRE): A cluster randomized trial of co-designed, tailored vaccine promotion materials

BackgroundCOVID-19 vaccination rates among long-term care center (LTCC) workers are among the lowest of all frontline health care workers. Current efforts to increase COVID-19 vaccine uptake generally focus on strategies that have proven effective for increasing influenza vaccine uptake among health care workers including educational and communication strategies. Experimental evidence is lacking on the comparative advantage of educational strategies to improve vaccine acceptance and uptake, especially in the context of COVID-19. Despite the lack of evidence, education and communication strategies are recommended to improve COVID-19 vaccination rates and decrease vaccine hesitancy (VH), especially strategies using tailored messaging for disproportionately affected populations. MethodsWe describe a cluster-randomized comparative effectiveness trial with 40 LTCCs and approximately 4000 LTCC workers in 2 geographically, culturally, and ethnically distinct states. We compare the effectiveness of two strategies for increasing COVID-19 booster vaccination rates and willingness to promote COVID-19 booster vaccination: co-design processes for tailoring educational messages vs. an enhanced usual care comparator. Our study focuses on the language and/or cultural groups that are most disproportionately affected by VH and low COVID-19 vaccine uptake in these LTCCs. ConclusionFinding effective methods to increase COVID-19 vaccine uptake and decrease VH among LTCC staff is critical. Beyond COVID-19, better approaches are needed to improve vaccine uptake and decrease VH for a variety of existing vaccines as well as vaccines created to address novel viruses as they emerge.

Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia

ObjectiveNon-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19...

Association between Posttraumatic Stress Symptoms and Resilience in Frontline Healthcare Workers during the COVID-19 Pandemic in Vietnam

The COVID-19 pandemic has placed a considerable burden on frontline healthcare workers (HCWs), thus increasing their vulnerability to developing posttraumatic stress disorder (PTSD). Our study aimed to examine the relationship between possible PTSD symptoms and resilience and identify associated factors with possible PTSD symptoms among Vietnamese frontline HCWs during the COVID-19 pandemic in 2021. We conducted a cross-sectional study across medical facilities at three administrative levels: provincial, district, and commune levels of Vietnam's healthcare service and management systems. The Item of Event Scale-Revised (IES-R) and Brief Resilience Scale (BRS) were used to measure possible PTSD symptoms and psychological resilience accordingly. In the sample of 763 HCWs, two-thirds were women, their median age was 34, and nearly half were nurses. 15.9% of HCWs reported having possible PTSD symptoms. Several variables, including COVID-19 concerns: worried about being infected with COVID-19, lacking personal protective equipment (PPE), about an uncontrollable pandemic, feeling lonely about being isolated from family, and resilience capacity were statistically significant with having possible PTSD symptoms. Multiple logistic regression showed that reused PPE, concerns about lacking PPE, and low levels of resilience were significantly associated with an increased likelihood of possible PTSD symptoms. It is suggested that greater priority should be given to improving healthcare plans to mitigate HCWs' PTSD symptoms and improve their resilience trait.

Formative Evaluation and Adaptation of a Hypertension Extension for Community Health Outcomes Program for Healthcare Workers within the Federal Capital Territory, Nigeria.

The Extension for Community Health Outcomes (ECHO) model has been used extensively to link care providers in rural communities with experts with the aim of improving local patient care. The aim of this qualitative research study was to assess the feasibility, acceptability, perceived needs, and contextual factors to guide implementation of a hypertension focused ECHO program for Community Health Extension Workers (CHEWs) in the Federal Capital Territory, Nigeria. From September 2020 to December 2020, key informant interviews were performed with seven global organizations (hubs) providing ECHO training focused on cardiovascular disease or nephrology to identify contextual factors and implementation strategies used by each hub. In February 2022, seven focus group discussions were performed with 42 frontline healthcare workers in the Federal Capital Territory to inform local adaptation of a hypertension ECHO program. Directed content analysis identified major themes which were mapped to the Consolidated Framework for Implementation Research. Qualitative analyses were performed using Dedoose, and results were synthesized using the Implementation Research Logic Model. We found both barriers and facilitators across the Consolidated Framework for Implementation Research domains that mapped to a number of constructs in each one. The results of these analyses confirmed that the core components of the ECHO model are a feasible and appropriate intervention for hypertension education of healthcare workers. However, implementing the ECHO program within the Federal Capital Territory may require strategies such as utilizing communications resources effectively, developing incentives to motivate initial participation, and providing rewards or recognition for ongoing engagement. These results provide valuable formative insights to guide implementation of our proposed hypertension ECHO program for CHEWs in the Federal Capital Territory, Nigeria. This information was used for key decisions around: 1) scope and content of training, 2) format and frequency, 3) selection of implementation strategies, and 4) building a community of practice.

Knowledge, Attitudes, and Willingness of Healthcare Workers in Iraq's Kurdistan Region to Vaccinate against Human Monkeypox: A Nationwide Cross-Sectional Study.

Although human monkeypox infections had not been recorded in the Kurdistan region of Iraq as of August 2023, the rapid growth of cases worldwide and the detection of monkeypox in neighboring Middle Eastern nations call for careful planning and timely response measures. Educating and empowering frontline healthcare workers (HCWs) so that they can act to curb the spread of monkeypox infections are core elements of primary prevention and protecting public health. Therefore, this study aimed to assess HCWs' knowledge and attitudes about monkeypox and their willingness to vaccinate against monkeypox. By employing a convenience sampling method, an online survey was disseminated via Google Forms between 1 November 2022 and 15 January 2023. The researchers utilized regression analyses to ascertain the factors associated with the three parameters: knowledge, attitude, and the willingness to vaccinate. A total of 637 HCWs were included in the analysis (ages ranged between 21 and 51 years). The mean overall scores were 8.18 of a max score of 16 (SD 3.37), 3.4 of 5 (SD 1.37), and 2.41 of 5 (SD 1.25) for knowledge, attitude, and willingness to vaccinate, respectively. A multivariate logistic regression analysis demonstrated that HCWs who had heard about monkeypox before 2022 rather than later had a higher level of knowledge (AOR: 4.85; 95% CI: 2.81-8.36; p < 0.001). In addition, those who had newly joined the workforce or had less than 1 year experience in practice had more positive attitudes about curbing monkeypox (AOR: 0.35; 95% CI: 0.20-0.59; p < 0.01) than those who practiced for longer. No significant predictors of willingness to vaccinate against monkeypox were identified. The research revealed that HCWs exhibited a relatively low level of monkeypox knowledge. They also had poor attitudes towards monkeypox vaccination and were therefore reluctant to receive the vaccines. Imparting knowledge about the infectious disease can cultivate better awareness and attitudes among HCWs as to their roles in mitigating the spread of an epidemic in the foreseeable future.

Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan

BackgroundThe COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives.MethodsA cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.ResultsA total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn’t receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn’t receive training, labeled as “high risk” compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10–0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25–0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23–12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don’t have skills to wear them.ConclusionOur findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.

Pattern of Violence Among Healthcare Workers in a Tertiary Care Government Hospital and a Multi-Specialty Private Hospital in Sagar, India: A Cross-Sectional Study.

Background Workplace violence in hospitals is an occupational hazard that affects healthcare workers (HCWs) negatively in many aspects and causes deterioration of the doctor-patient relationship, resulting in providence of substandard healthcare. This study was conducted to compare the pattern of violence in a tertiary care government teaching hospital and a multi-specialty private trust hospital in Sagar district, Madhya Pradesh, India. Methodology After ethical clearance of this cross-sectional, observational study, participants (frontline healthcare workers, including doctors and nurses) were asked about the type, frequency, department, and place of violence, etc., along with its perceived causes, solutions, and arrangements made by hospitals for dealing with it using a pretested, semi-structured questionnaire. Data analysis was performed using IBM SPSS Version 26.0 (IBM Corp., Armonk, NY). Categorical variables were described using frequency and percentages, and inferential analysis was conducted using the chi-square/Fisher's exact test. A P-value of <0.05 was considered statistically significant. Results Among the 113 participants, 67 (59.3%) were female, 53 (46.9%) were doctors, and 60 (53.1%) were nurses. The mean age of participants was 30.9±7.3 years. Predominantly verbal, emotional, and physical violence were present in 96.5%, 43.4%, and 6.2% of participants, respectively. Violent incidents against healthcare workers were more frequent in government hospitals as compared to private hospitals. Most healthcare workers (87.6%) tried to resolve violent incidents peacefully, and 1.8% tried to fight back. The most perceived cause of violence in both setups was a lack of morality and literacy among patients and their relatives (i.e., 83.2%), followed by a lack of proper facilities and a lack of trust in healthcare workers. Conclusion Both setups faced a substantial amount of violence. The loopholes in both setups, considering resources, security, and other facilities, are clearly visible, and specific steps must be adopted to protect both systems from violence.

Political instability and hiv/aids response in the south west and north west regions of Cameroon: a qualitative study

BackgroundPolitically motivated violence and insecurity continue to be a major threat to progress in HIV epidemic control and a significant contributor to health inequality. Despite a decreasing HIV/AIDS disease burden, the Republic of Cameroon in West Africa is experiencing ongoing political instability in her North and South West Regions. Our study used qualitative methods to better understand key frontline health care providers’ (fHCP) perceptions of the effects of political instability on HIV/AIDS response gains in Cameroon since 2018, as well as lessons learned for overcoming them.MethodsBetween July and August 2022, semi-structured, in-depth key informant interviews involving 10 purposively selected participants were conducted in the two regions. Interviews were recorded and transcribed verbatim, coded thematically, and analyzed manually.ResultsSix overarching themes emerged from the transcribed key informant interviews. They were as follows: Challenge with access to and availability of health care services (HIV care, commodity supply chain) in the smaller communities; Impact on continuity of treatment; Increased risk of new HIV infections; The socioeconomic impact of the crisis on the quality of life; The impact of the crisis on fHCPs’ physical and mental health and the health system’; and Coping mechanisms.ConclusionsFrontline healthcare workers have acknowledged the significant impact the current political instability has had in hindering the development and advancement of a successful local response to HIV/AIDS in the two impacted regions of Cameroon. Coordinated efforts must be made to strengthen the health sector in areas such as HIV healthcare decentralization, supply chain, and protecting frontline healthcare workers from political quagmires in order to lessen the impact of the nation’s socio-political crisis on the HIV/AIDS response and, more generally, on the entire health sector.

Evaluation of Mental Health Status of the Pregnant Women Working in Hospitals During Covid-19 Era: A Cross-Sectional Study

Background: Many of women and pregnant women are front-line health care workers in the COVID-19 era and are worried about the possible impacts of COVID-19 on their fetus. Due to the pressure and high working load on the healthcare workers during the COVID-19 crisis, the healthcare workers were potentially at risk of different types of mental health disorders. Objective: We aimed to evaluate the correlation between mental health status and the level of COVID-19 related anxiety in pregnant healthcare workers in the COVID-19 era in Iran from August 2020 to December 2020. Methods: This cross-sectional study included 64 pregnant clinical residents, general physicians, nurses and other medical staff who worked in the hospitals in Iran, from August 2020 to December 2020 using an anonymous online survey available on Google Form platform. The online survey consisted of socio-demographic questions, pregnancy-related questions, and questions about medical/drug history. The Persian versions of General Health Questionnaire – 28 [GHQ-28], and Corona Disease Anxiety Scale [CDAS] were also filled by the participants. Results: The mean age and gestational age of the participants were 31.3±3.9 years, and 24.5±10.1 weeks respectively. Psychological problems were moderate [total score GHQ-28&gt; 40] in 9.4% [n: 6] of the pregnant healthcare workers. The frequency of moderate/severe problems in the four subclasses, including somatic symptoms, anxiety/insomnia, social dysfunction, and depression were 9[14.1%], 25[39.0%], 7[10.9%], and 10[15.6%], respectively. According to CDAS, 26.5% of participants had moderate to severe COVID-19 related anxiety. COVID-19 related anxiety and its subclasses, physical and psychological, were significantly correlated with GHQ-28 total score and its subclasses, including somatic symptoms, anxiety/insomnia, social dysfunction, and depression among pregnant health care workers [P&lt;0.01]. Conclusion: According to the results of the current study, over 25% of the pregnant health care workers have moderate to severe COVID-19 related anxiety; so, it is crucial for policymakers to focus on the mental health of the pregnant health care workers during the COVID-19 pandemic.

Remote crisis intervention and suicide risk management in COVID-19 frontline healthcare workers.

Despite the propagation of virtual mental health services for vulnerable groups during COVID-19 pandemic, the implementation and evaluation of remote evidence-based practices (EBP) to manage them in low- and middle-income countries remains scarce. In the current study, we describe and evaluate the implementation process and clinical impact of brief, remote, manualized EBP for crisis intervention and suicide risk management among healthcare workers attending patients with COVID-19 (COVID-19-HCWs) in Mexico. The implementation process comprised community engagement of volunteer mental health specialists, creation of new clinical teams with different disciplines and skills, intervention systematization through manuals and education through 4-h remote training as main strategies. Mexican COVID-19-HCWs who had used a free 24-h helpline rated their pre- and post-intervention emotional distress. Therapists recorded patients' pre-intervention diagnosis, severity, and suicide risk, the techniques used in each case, and their post-treatment perception of COVID-19-HCWs' improvement at the end of the intervention. All techniques included in the intervention manual were employed at least in one case (n = 51). At the beginning of the intervention, 65.9% of the COVID-19-HCWs were considered moderately ill or worse according to Clinical Global Impression-Severity (CGI-S) scores, whereas at the end, 79.4% of them were perceived as much or very much improved according to CGI-Improvement scores (CGI-I), and their emotional distress had been significantly reduced (p < 0.001). This prospective study provides evidence that implementation of remote EBP is feasible and useful to reduce emotional distress and suicide risk among COVID-19-HCWs from a middle-income country. However, this study was limited by lack of a control group, improvement ratings provided by therapists and non-anonymous satisfaction ratings.

COVID-19 Vaccination Uptake and Its Effect on Morbidity and Mortality among Frontline Healthcare Workers in Kaduna State, Nigeria

The COVID-19 pandemic has placed tremendous burdens on healthcare workers (HCWs), accounting for over 1.4 million HCW infections and 10% of global fatalities. HCWs faced elevated infection risk, psychological distress, long working hours, fatigue, stigma, and violence. While vaccines are pivotal in reducing severe illness, HCW vaccine hesitancy, given their role as advocates, jeopardizes vaccination coverage global goals and healthcare systems. Addressing this vaccine uptake is imperative through education, transparent communication, and support to safeguard HCWs’ safety and pandemic containment. This study assessed COVID-19 vaccination uptake among frontline HCWs in Kaduna State, Nigeria, and its impact on morbidity and mortality. Utilizing a descriptive cross-sectional approach, we analyzed secondary data from the Surveillance Outbreak Response Management and Analysis System (SORMAS). The study encompassed HCWs in Kaduna State, excluding pregnant and lactating individuals, following national guidelines. Among 8095 HCWs tested for COVID-19, most were aged 31-40 years (35%), female (60.2%), and urban residents (70.3%). COVID-19 vaccination uptake was low at 17.4%, with 82.6% unvaccinated. COVID-19 infection was significantly associated with vaccination (p = 0.039). Although unvaccinated participants exhibited a higher mortality rate (60%) than vaccinated ones (40%), this difference was not statistically significant (p = 0.209). In conclusion, this study unveiled insufficient vaccination uptake among HCWs, potentially impeding pandemic response. While vaccination seemed to positively impact disease outcomes, it didn’t significantly affect the infection risk. Addressing HCW vaccine hesitancy remains critical for achieving immunization goals and ensuring healthcare system safety. Keywords: Covid-19, Vaccines, Vaccination uptake, Healthcare workers (HCW), Infection.

Surviving Covid-19 Diagnosis Among Registered Nurses: Reactions, Consequences, and Coping Mechanisms

BackgroundTo mitigate the spread of Covid-19, nurses infected with the virus were required to isolate themselves from their families and community. Isolated patients were reported to have experienced mental distress, posttraumatic stress disorder symptoms, and suicide. Though studies have reported the psychological impact of the Covid-19 pandemic, less is known about the lived experiences of nurses who survived Covid-19 infection in sub-Saharan Africa. MethodsA descriptive phenomenological approach was used to study the lived experiences of registered nurses who survived Covid-19 disease. In-depth interviews were conducted among nurses diagnosed with Covid-19 from two hospitals in Kenya between March and May, 2021. Purposive and snowball sampling were used to recruit registered nurses. Data were analyzed using Giorgi's steps of analysis. ResultsThe study included ten nurses between 29 and 45 years of age. Nurses' experiences encompassed three themes: diagnosis reaction, consequences, and coping. Reactions to the diagnosis included fear, anxiety, and sadness. The consequence of the diagnosis and isolation was stigma, isolation, and loneliness. Nurses coping mechanisms included acceptance, creating routines, support, and spirituality. ConclusionOur findings aid in understanding how nurses experienced Covid-19 infection as patients and will provide evidence-based content for supporting nurses in future pandemics. Moreover, as we acknowledge the heroic contribution of frontline healthcare workers during the Covid-19 pandemic, it is prudent to recognize the considerable occupational risk as they balance their duty to care, and the risk of infection to themselves and their families.

Communication in a Medical Emergency: The Influence of Intergroup Communication on Frontline Healthcare Workers’ Mental Health

Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. In particular, Frontline healthcare workers (HCWs) is clinical workplaces in which doctors are involved in many social groups, including representatives of different professions, clinical specialities and workplace teams under crisis handling condition. A web-based cross-sectional survey was carried out between 1 and 12 December 2022 on a Jakarta area sample of 53 HCWs in Indonesia. The study questionnaire included 7 questions on the mental health of HCWs post-COVID-19 crisis and was analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-speciality professional identity and professionalism may be viewed in terms of self-categorisation rather than simply attainment. The salience of different identities may be considered as influences on teamwork and interprofessional learning, and issues in communication and assessment may be considered in terms of intergroup biases. These results contribute to the growing literature on communication organization and offer new practical insights on how to improve overall efficiency and work performance under crisis conditions.

Role of safety-specific transformational leadership in fostering extra-role behaviors through psychological contract fulfillment among frontline workers during COVID-19

Objectives. The emergence of COVID-19 has drastically changed the safety outlook of how the work world is viewed by leaders and followers. In this backdrop, the current study aimed at extending the safety leadership literature in the context of organizations operating in crisis situations by investigating the impact of safety-specific transformational leadership on the followers’ extra-role behaviors through the mediation of psychological contract fulfillment. Methods. Using a time-lagged and multisource design, data were collected from 384 frontline rescue and healthcare workers dealing with COVID-19-related situations. Results. Results revealed that safety-specific transformational leadership behavior positively affects extra-role behaviors of frontline employees by enhancing their innovative work behavior, knowledge sharing behavior and organizational citizenship behavior. Also, psychological contract fulfillment plays a bridging role in translating the impact of safety-specific transformational leadership behavior on extra-role behaviors. Conclusion . The followers working in an unsafe context view the safety concern of their leader as a fulfillment of their unwritten expectations from their employers. Implications of these findings along with limitations and future research directions are also delineated.

Frontline healthcare workers’ lived experiences of healthcare work during the COVID-19 pandemic

Abstract Background The COVID-19 pandemic changed the face of modern healthcare, with impacts felt by staff and organisations alike. Globally, hospital-based healthcare workers have identified increased stress, anxiety, insomnia, and reduced wellbeing related to their work roles. Hospitals have been plagued by increased demand, poor staff retention and a reduction in the working hours of remaining staff. This paper sought to explore the unique experiences of frontline healthcare workers (FHWs) with parenting responsibilities working in Australian hospitals during the COVID-19 pandemic. Methods Thirty-nine FHWs with parenting responsibilities from Australian public hospitals were interviewed from October 2020 and February 2021. Reflexive thematic analysis was used to interrogate transcripts arising from extended interviews with participants regarding their experiences with healthcare work and the workplace support they received during the COVID-19 pandemic. Results Key themes indicate that workplace changes during the early stages of the pandemic were rapid and placed significant burden on healthcare staff and leaders, impacting their physical, mental and social health. Support from leaders was seen as protective for staff but placed an additional burden on staff in leadership roles. Additionally, when leaders considered family safety and were flexible when family demands surged, staff reported better wellbeing and feelings of support. While staff felt a sense of pride in their role during this time and were motivated by family members, they reported reduced career enjoyment and were concerned about long-term mental health consequences. Conclusions The challenges and fatigue associated with healthcare work during a pandemic can impact FHWs in varied ways. However, findings during the COVID-19 pandemic sheds light on important areas that can be bolstered and enhanced during pandemic planning that can prevent negative impacts in future pandemics. Key messages • The COVID-19 pandemic has demonstrated how a pandemic significantly impact healthcare roles and the wellbeing of staff, indicating a need for better pandemic planning in the future. • Important factors to consider during future pandemic planning are proper management of workplace changes, managing staff's work life balance and family safety, and enhancing support from leaders.