Medical Health Workers Research Articles

Study of correlates of depression among health care workers during COVID-19 epidemic

Aim of the studyStudy aimed to find out the prevalence and risk factors of depression among the health care workers during COVID-19 outbreak.Subject or material and methodsThis was a three month, cross-sectional, observational, single center study of heath care workers of a notified COVID-19 hospital. Study objectives were explained to health care workers, and written consent was obtained. Patient health questionnaire-9 (PHQ-9), DSM-5 Criterion of major depressive disorder and Structured Clinical Interview for DSM-5 were used to diagnose the depression. Descriptive statistics, chi-square test and binary logistic regression were used for analysis of variablesResultsOverall 18.78% health workers reported major depressive disorder.Nearly three fourth of the old age participants had moderate to severe depression. 20.69% of married subjects had major depression. Medical health workers reported more depression . One third of the front line workers had major depression. 51% of the participants with medical co-morbidity reported Major depression as compared to only 12% in those without any medical co-morbidity.33% of subjects watching COVID-19 news very frequently in a day had major depressionDiscussionThe prevalence of depression ranges from 9 to 35% in various studies. . Among them living in joint family, married, elderly, presence of medical illness, frontline work, frequently watching COVID-19 news, excessive fear of COVID-19, and medical health worker emerged as statistically significant variables associated with major depressionConclusionsThe prevalence of depression is high among health care workers while performing duties during COVID-19 outbreak. Early diagnosis and treatment of depression would be crucial during this difficult time.

Stress and anxiety among healthcare workers during the COVID-19 pandemic in russia

IntroductionMental health of medical workers treating patients with COVID-19 is an issue of increasing concern worldwide, since previous epidemics have shown high levels of anxiety and stress in front-line healthcare professionals. The available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet.ObjectivesTo evaluate stress and anxiety symptoms among healthcare workers directly involved in the diagnosis and treatment of patients with COVID-19 during the peak of disease outbreak in Russia.MethodsThe study was a cross-sectional hospital-based anonymous on-line survey in May 2020 of 1,090 healthcare workers practicing treatment of patients with COVID-19. Stress and anxiety symptoms were assessed using the Russian versions of Stress and Anxiety to Viral Epidemic scale (SAVE-9) and Generalized Anxiety Disorder (GAD-7) scales. Logistic regression analysis was performed to determine the influence of different variables.ResultsThe median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 49.1% respondents had moderate and 21.9% had severe anxiety according to SAVE-9. 12.3% had severe anxiety, 13.2% had moderate according to GAD-7. Female gender and younger age were associated with higher level of anxiety according to regression model.ConclusionsOur study has shown that healthcare workers in Russia practicing treatment of patients with COVID-19 reported high rates of stress and anxiety similar to other countries. Female gender, younger age and being a physician were associated with higher levels of anxiety. These results demonstrate the importance of supportive programs for health care workers fighting COVID-19.DisclosureNo significant relationships.

Risk Factors for Anxiety in Medical Health Workers during Coronavirus Disease 2019 in Medan, Indonesia

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a virus outbreak that is infecting many people almost all over the world, including Indonesia. The impact of this pandemic also affects medical health workers who are in charge of treating COVID-19 patients where they are at high risk of being infected. This causes psychological disorders such as anxiety and many factors that can become a risk for anxiety. AIM: The aim of the study was to investigate risk factors for anxiety in medical health workers who treat COVID-19 patients. MATERIALS AND METHODS: This study was conducted in Haji Adam Malik Hospital and its satellites in Medan, North Sumatera, cross-sectional through online survey using hospital anxiety and depression scale, anxiety subscale, from May 2020 to July 2020, 129 participants. RESULTS: Four risk factors have a relationship to the occurrence of anxiety, such as gender, marital status, history of organic diseases, and duration of work caring for COVID-19 patients. CONCLUSIONS: By knowing the risk factors that can cause anxiety in medical health workers, it is hoped that both the hospital management and individual medical health workers can pay more attention to and anticipate so that medical health workers can feel more secure in carrying out their duties treating for COVID-19 patients.

Impacts of Education's Intervention on Solid Medical Waste Management in Improving Knowledge, Attitude, and Behavior of Medical Health Workers

The purpose of this study was to determine the effect of providing education on increasing knowledge, attitudes, and behavior of medical officers in solid medical waste management at the Regional General Hospital dr. Zainoel Abidin Banda Aceh, Indonesia. The research design used was a quasi experiment with the Wilcoxon comparison test. The research sample was the medical officer of dr. Zainoel Abidin Banda Aceh as many as 94 people who were divided into treatment and control groups. Knowledge, attitude, and the behavior of medical personnel was measured by interview using a questionnaire. The results showed that there was an effect of educational interventions on increasing the knowledge, attitudes, and behavior of medical personnel in the management of medical solid waste in the treatment and control groups (p <0.05). The results of the Wilcoxon test between the treatment groups on knowledge, attitudes, and behavior before and after the educational intervention showed a significant difference (p = 0.000), whereas in the control group between before and after the educational intervention did not show a difference with the p-value of knowledge (p = 0.102); attitude and behavior (p = 0.157). In the control group, the level of knowledge, attitudes and behavior tends to remain at a sufficient level. The conclusion of this study shows that educational interventions can provide an increase in the knowledge, attitudes and behavior of medical personnel in implementing solid medical waste management at dr. Zainoel Abidin Banda Aceh.

Безпека праці медичних працівників в умовах поширення пандемії COVID-19 (аналіз практичних рекомендацій міжнародних організацій)

The article deals with the specificity of the occupational safety of medical workers in the modern conditions of thedevelopment of society. It was emphasized that the organization and provision of medical care at the proper level occupiesa leading place in the national health care system, labor protection of medical workers during the performance of theirprofessional duties and the implementation and receipt by the latter of legally defined guarantees is quite acute. It wasdetermined that the main directions of the proper functioning of the occupational health and safety system in the medicalsphere should be: occupational health and safety management; training and professional training of special subjects onlabor protection in medical institutions, regardless of the form of ownership; prevention and prophylaxis of accidents,industrial injuries and occupational diseases; control over compliance with safety and labor protection standards. Analyzedthe acts of the World Health Organization and the International Labor Organization on the safety and health of medicalworkers in the fight against COVID-19 and investigated the risks in which infection of these subjects is possible. Basedon the analysis, measures are highlighted that can prevent the transmission of the virus. It has been proven that sucha work environment must be created for healthcare workers to optimize the provision of appropriate health care andquality services. It was determined that in order to achieve these goals, it is necessary to finalize, develop and adoptnational, sectoral and local regulatory legal acts related to labor protection and social protection of medical workers.Keywords: COVID-19 pandemic, labor safety, labor protection, medical workers, health care institutions, properworking conditions.

Anxiety, depression, and stress risk among medical staff during COVID-19 pandemic: a single-center experience

Background The widespread pandemic of coronavirus disease 2019 (COVID-19) virus has caused major psychological effects, especially among health care workers who are exposed to high viral load. The aim was to investigate the psychological effects of COVID-19 on health care workers and factors affecting them. The study was carried out with an online questionnaire distributed through Google Forms for medical staff at Faculty of Medicine, Fayoum University, Egypt. The questionnaire included sociodemographic questions; validated psychometric tools for the assessment of depression, anxiety, and stress (Depression Anxiety Stress Scales-21); and the Impact of Event Stress Scale-Revised (IES-R).Results The total number of the participants was 115 respondents. IES-R showed that 28.7% had high posttraumatic stress disorder. By Depression-Anxiety-Stress Scale, 13% had severe, 26.1% had extremely severe depression, 10.4% had severe, and 13.9% had extremely severe anxiety, and stress level was severe in 16.5% and very severe in 13.9%. The factor ‘work-years less than 5 years’ was significantly associated with the presence of stress. Personal psychiatric history of anxiety was significantly associated with abnormal IES and depression.Conclusions During the COVID-19 outbreak, medical health workers had psychosocial problems and risk factors for developing them. They were in need of attention and recovery programs.

How to keep mental health of medical health workers who are fighting against COVID-19?

How to keep mental health of medical health workers who are fighting against COVID-19?

Social and hygienic aspects of assessment of working conditions and health status of medical workers in the Samara Region

Introduction. Due to the increased psychoemotional load, the emergence of new sources of chemical, physical and microbiological effects on the health of medical workers, the study of the incidence of this category of workers is becoming increasingly important. The aim of study is to study social and hygienic issues related to the assessment of working conditions and health status of medical workers in the Samara Region. Materials and methods. Retrospective analysis of the results of medical and social monitoring of working conditions, health status and occupational morbidity of medical workers in the Samara Region. Results. Based on the analysis of data from the sanitary and epidemiological service and the Ministry of Health of the Samara Region on demographic and socio-economic situations, morbidity, and labor characteristics of medical workers in the Samara Region, a socio-hygienic assessment of working conditions of medical workers at the regional level was carried out. The high informative value of medical and demographic indicators in relation to the assessment of the impact of factors of the production environment on the health of health care workers and social services is shown. It is established that medical organizations generally do not meet the requirements of the current sanitary legislation in terms of ensuring safe working conditions for employees who come into contact with carcinogenic substances. Conclusions. The study of the demographic, socio-economic situation, and morbidity of medical workers with a hygienic assessment of health risk is a priority and serves as the basis for a comparative analysis of their morbidity and material for comprehensive hygiene studies.

The sequel to COVID-19: the antithesis to life

The sequel to COVID-19: the antithesis to life

COVID-19 pandemic: study on simple, easy, and practical relaxation techniques while wearing medical protective equipment.

No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment. This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance. Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6). Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.

Fallacies and Facts Around COVID-19: The Multifaceted Infection.

It has been 5 months since the identification of first cases of coronavirus disease 2019 (COVID-19), however, unveiling clinical characteristics and modes of transmission of the disease is not complete yet. The initially identified clinical sign of COVID-19 was respiratory in nature in the form of pneumonia with possible fatal consequences due to severe acute lung fibrosis. Extrapulmonary symptoms of the disease are now well recognized with involvement of the liver, kidney, and even multisystem organ failure and acute cardiac arrest. Symptoms related to the gastrointestinal tract are particularly interesting and these could represent a mode of transmission requiring more attention from researchers and clinicians. Prevalence of diarrhea, nausea, vomiting, or abdominal discomfort is estimated to be approximately 5%.1 The possible multiple routes of transmission could be explained by the fact that angiotensin converting enzyme 2 protein presents in abundance on lung alveolar epithelial cells and enterocytes of small intestine remarkably.2 During the first days of the disease, a fallacy was distributed mainly through social media. Drinking hot drinks was promoted as a means to eradicate the virus before it goes beyond the pharynx; however, as more studies were conducted, it was revealed that SARS-CoV-2 can withstand temperatures up to 56°C.3 On the contrary to this fallacy, an important fact is related to the possibility of the fecal-oral route of transmission which has been identified in multiple case studies and clinical settings. The nucleic acid of the virus has been detected in the feces and anal swabs of some COVID-19 patients, and live virions were shown to exist in fecal specimens in patients with negative oropharyngeal specimen, which indicates that viral infection of the gastrointestinal tract and the potential fecal-oral transmission can outlast the viral clearance in the respiratory tract.4 An observation that needs further investigation was actually reported from clinicians caring for infected patients, whereby expulsion of excess colonic gas which has an unpleasant odor with or without diarrhea has been noticed (unpublished data). Although this observation is not yet documented, it should be further analyzed and investigated. Whether abdominal gases in COVID-19 patients with gastrointestinal manifestations can be a potential mode of transmission of the virus needs to be ascertained. Other fallacies that relate to the size of the virus claimed that airborne spread is not possible due to the large size of the virus which makes it drop onto surfaces after 3 hours. It was also claimed that COVID-19 primarily spreads through the respiratory tract, by droplets, respiratory secretions, and direct contact and is not transmitted by aerosol, therefore, only infection control precautions and social distancing for at least 1 m would suffice to prevent the spread of the infection. However, the most recent studies reported that it could be transmitted as an airborne infection for distances exceeding 4 m.5 Within this context, there has been some confusion about the types of masks that should be used among healthcare teams caring for COVID-19 patients. Several developing countries have adopted the use of regular surgical masks among healthcare workers caring for COVID-19 patients early in the course of the disease. Medical health workers who primarily use this type of masks are susceptible to infection. Although this is not documented yet, but many healthcare workers in developing countries like Egypt and other countries like Italy and Saudi Arabia have been infected and unfortunately were deceased due to COVID-19. These types of masks alone without complete face shield are not adequate for protection against COVID-19.6 Within the context of cross-infection control, we would like to stress that donning and doffing of personal protective equipment (PPE) should be conducted in a particular order to prevent infection. The recommended sequence involves removal of the high level maximum protective masks as the last step in doffing of PPE. Handling the contaminated mask itself may transmit the virus and hence cause infection.7 A suggestion to prevent transmission while doffing involves that PPE undergoes disinfection in a special room or to utilize a specific equipment for disposal of used PPE before doffing. In conclusion, more facts about COVID-19 transmission and effective preventive measures should be revealed and disseminated among the medical community to preserve the precious lives of healthcare team members. The aim of this correspondence is to draw attention of healthcare workers caring for COVID-19 patients especially those working in developing countries to the possibility of transmission of infection through the gastrointestinal route with particular reference to colonic gases. We further warn them against the use of conventional surgical masks because it is useless in the clinical setting, and also warn them against handling of the contaminated masks during doffing of PPE. Here we suggest the use of disinfection of PPE before removal and the proper way of disposal.

Croatian Society of Clinical Embryologists – guidelines on the epidemiological framework for the implementation of medically assisted reproduction (MAR) procedures during the COVID-19 pandemic regarding the safety of patients and medical health workers

Due to the high virulence of the SARS-CoV-2 virus, the infection rate in the community has led to a state of pandemic, leading to the introduction of new emergency measures all over the world. With the aim of controlling and preventing the SARS-CoV-2 viral epidemic, the health institutions performing medically assisted reproduction (MAR) suspended any new MAR treatments in order to reduce the burden on the health care system and implement current social distancing recommendations. Considering the favorable epidemiological situation in Croatia, our perspective is that it is time to conceive, plan and bring forth guidelines for restarting work in MAR centres, taking into account the selection of patients and organization of good laboratory and clinical practices with emphasis on the safety of patients and health workers. In regard to epidemiological knowledge, it is important to establish the reorganization of work in MAR centres including epidemiological measures of reducing unnecessary stays in closed spaces, the usage of protective gear by patients and health workers and disinfection of the working spaces and equipment.

Patterns of care for inflammatory bowel disease in China during the COVID-19 pandemic

Patterns of care for inflammatory bowel disease in China during the COVID-19 pandemic

Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China

Objective: We explored whether medical health workers had more psychosocial problems than nonmedical health workers during the COVID-19 outbreak. Methods: An online survey was run from February 19 to March 6, 2020; a total of 2,182 Chinese subjects participated. Mental health variables were assessed via the Insomnia Severity Index (ISI), the Symptom Check List-revised (SCL-90-R), and the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). Results: Compared with nonmedical health workers (n = 1,255), medical health workers (n = 927) had a higher prevalence of insomnia (38.4 vs. 30.5%, p < 0.01), anxiety (13.0 vs. 8.5%, p < 0.01), depression (12.2 vs. 9.5%; p< 0.04), somatization (1.6 vs. 0.4%; p < 0.01), and obsessive-compulsive symptoms (5.3 vs. 2.2%; p < 0.01). They also had higher total scores of ISI, GAD-2, PHQ-2, and SCL-90-R obsessive-compulsive symptoms (p ≤ 0.01). Among medical health workers, having organic disease was an independent factor for insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms (p < 0.05 or 0.01). Living in rural areas, being female, and being at risk of contact with COVID-19 patients were the most common risk factors for insomnia, anxiety, obsessive-compulsive symptoms, and depression (p < 0.01 or 0.05). Among nonmedical health workers, having organic disease was a risk factor for insomnia, depression, and obsessive-compulsive symptoms (p < 0.01 or 0.05). Conclusions: During the COVID-19 outbreak, medical health workers had psychosocial problems and risk factors for developing them. They were in need of attention and recovery programs.

Influence of psycho-emotional factors on health of medical workers

In medical specialties there are psycho-social factors. Among the distress factors prevail physiological. The main factor contributing to the formation of the CMEA among medical workers is a lack of free time, which leads to fatigue and reduced interest in work.

Hygienic assessment of working conditions and health of medical workers of children’s dental polyclinic

The article contains the results analysis of data of out-patient cards of employees of children’s dental polyclinic of Kazan, revealed in the course of research, violations of requirements on filling of documentation and hygienic recommendations.

A study of the factors of the production environment of medical personnel of medical organizations of the Samara Region

Working conditions can adversely affect the health of medical workers. According to the results of a special assessment of working conditions (SOUT), carried out in medical organizations, general practitioners were given class 2 of working conditions for chemical and physical factors, for biological factors - 3.2; surgeons - 2 class of working conditions for chemical factors, 3.1 for physical (light), for biological factors - 3.3.

Ultrasound as a harmful factor of working environment for health workers

Materials on the features of effect of ultrasound on the health of medical workers engaged in the maintenance of medical ultrasound equipment are presented. Main directions for optimizing working conditions of medical workers and preserving their health are proposed.

Counselling as a Tool for Tobacco Cessation in a Dental Institution: Insights from India.

Background:Tobacco related mortality and morbidity is a growing public health problem world over. Counselling has emerged as an important arsenal in the battle against tobacco. Involving experts other than traditional medical health workers may be critical. Aim of the present study was to explore various aspects related to Tobacco cessation counselling among Indian dental students. Methods: Overall, 241 undergraduate students from Manipal College of Dental Sciences, Mangalore participated in the present investigation. A structured, pretested, self-administered questionnaire was used to ascertain knowledge, attitude, behavior, perceived effectiveness and barriers and socio-demographic details. Willingness to counsel patients and undergo further training counselling was also assessed. Results:Mean knowledge, attitude, behavior, perceived effectiveness and barrier scores were 2.94 (±2.08), 51.84 (±5.63), 19.25 (±8.79), 16.17 (±1.96) and 42.39 (±5.65) respectively. Age was significantly correlated with knowledge; while year of study revealed significant correlations with knowledge and behavior (p<0.05). Lack of motivation, poor attitude of patients; lack of knowledge and skills emerged as barriers. Multiple logistic regression analysis indicated that year of study, attitude, behavior and barrier scores were significant predictors for respondents ever counselled their patients (p<0.05). Conclusions:Knowledge and behavior scores of the respondents towards Tobacco cessation counselling were low, but a majority of the subjects were willing to counsel and undergo training. Year of study, attitude, behavior and barrier scores emerged as significant predictors of counselling for Tobacco use. The present study has important policy implications and highlights curriculum changes in making Tobacco cessation counselling more relevant and effective among Indian dental students.

Effects of Devolution on Maternal Health Care: The Case of Level Four Hospitals in Nairobi City County, Kenya

Maternal healthcare is an integral part of the Millennium development goals. However, most developing countries have been experimenting with different types of interventions to increase access and utilization of maternal care services. Health care devolution was greeted with great anticipation in Kenya as a means of bringing services closer to the people. However, since the implementation of the recent devolution reforms, criticism has mounted, with evidence of corruption, poor management, late payment of county staff and considerable disaffection among service providers, especially health professionals. Thus, this study assessed the effects of devolution on maternal health care in Nairobi City County in Kenya. Particularly, the study examined the situation of maternal healthcare before and after devolution and how devolution as affected provision of maternal healthcare in Nairobi City County. The study also assessed how devolution affected maternal health care programs implementation and the challenges facing the devolved maternal health care in Nairobi City County. The study adopted the systems approach and the decentralization theorem. This study employed a descriptive research design and the population of the study was made up of the 4 level four hospitals in Nairobi County and all the 189 selected medical health workers in the hospitals. A sample of 57 respondents was selected through simple random sampling. Additionally, the study used questionnaires and an interviews guide to collect data. The questionnaires were administered to the sampled medical workers and the interviews schedules were administered to the key informants who comprised of the medical superintendent from every hospital. Quantitative data was collected through the use of the questionnaires was analyzed using descriptive statistics with the aid of the Statistical Package for Social Sciences. Qualitative data was analyzed using content analysis. The study found that the status of maternal healthcare infrastructure under devolution of health services in Nairobi was good. The findings also established that most health workers preferred that the national government should manage maternal health care infrastructure as opposed to county governments. The study further revealed that county governments had not instituted and implemented effective maternal healthcare programs formulated by the national government. Finally, the study concludes the major challenges influencing the implementation of maternal healthcare services include attitude and perception of health professionals, resistance of devolution by health workers, strikes by health workers, shortage of healthcare workers corruption and tribalism, increased pressure on hospital equipment and infrastructure and stock outs of essential commodities in the facilities affect devolved maternal health care. The study recommended that both the county and national government should work together and combine their efforts to enhance the devolved systems of healthcare so that they can enhance maternal healthcare.&#x0D; This is an open-access article published and distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License of United States unless otherwise stated. Access, citation and distribution of this article is allowed with full recognition of the authors and the source.