High-stress Environments Research Articles

The Impact of Anxiety and Depressive Symptomatology on Greek Practicing Lawyers’ Self-Esteem

Background/Objectives: This study examines the impact of anxiety and depressive symptomatology on self-esteem among Greek practicing lawyers. The high-stress environment of the legal profession is known to heighten the risk of mental health issues, yet limited research exists on Greek lawyers. The study aims to explore associations between anxiety, depressive symptoms, and self-esteem, hypothesizing that increased anxiety and depression correlate with reduced self-esteem. Method: The study utilized a correlational design with a sample of 80 Greek lawyers, recruited through professional associations. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Rosenberg Self-Esteem Scale (RSES). Descriptive statistics, correlation analysis, and multiple regression were used to assess the relationships between anxiety, depression, and self-esteem. Results: The findings indicated significant negative correlations between self-esteem and both depressive (r = −0.631, p < 0.001) and anxiety symptoms (r = −0.405, p < 0.001). Multiple regression analysis demonstrated that both depression (β = −0.558, p < 0.001) and anxiety (β = −0.225, p = 0.014) were significant predictors of lower self-esteem, explaining approximately 44% of the variance in self-esteem scores. Conclusions: The study concludes that higher levels of anxiety and depressive symptoms significantly lower self-esteem among Greek lawyers, underscoring the need for mental health support within this profession. Addressing mental health issues in legal professionals may promote better self-esteem and overall well-being, with potential benefits for both lawyers and their clients.

Cognitive Behavioral Therapy in the Treatment of Sleep Disorders: Theoretical Foundations, Research Methods and Analysis of Effectiveness

Sleep disorders are not just a disruption of a person’s normal recovery process and a deterioration in life quality. It has been repeatedly demonstrated that insomnia is an independent factor that worsens the course of somatic diseases and leads to psycho-emotional disorders of varying severity. Research into cognitive behavioural therapy for insomnia aims to provide answers to these questions. The most effective non-pharmacological treatments for insomnia are behavioural and psychotherapeutic methods that improve sleep and do not cause side effects or addiction. The chosen research topic is also relevant in the context of the increasing prevalence of insomnia due to the profound shocks of the Russian-Ukrainian war among internally displaced persons, various other stresses and interpersonal conflicts. All these and many other factors can cause acute insomnia. Patients with insomnia often have increased emotional reactivity, which can also lead to disorders. The findings of the research help understand the psychological factors involved in the processes of researching cognitive behavioural therapy for sleep disorders and can be used by practitioners who are faced with the need to treat patients with insomnia; it will help to understand traumatic experiences and emotional needs better. In conclusion, cognitive behavioural therapy is a practical, non-pharmacological approach to the treatment of sleep disorders, including insomnia. The study highlights the importance of addressing psychological factors, such as emotional reactivity and traumatic experiences, which are often associated with insomnia. As well as providing valuable information for practitioners, this study highlights the importance of individualised therapeutic interventions, particularly in high-stress environments such as those resulting from war and displacement. cuments in various Scopus indexed journals was examined bibliometrically, for the years 2014-2024.

Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data.

Intensive care unit (ICU) residents are exposed to high stress levels due to the intense nature of their work, which can impact their mental health and job performance. Heart rate measured through wearable devices has the potential to provide insights into residents' self-reported stress and aid in developing targeted interventions. This exploratory study aims to analyze continuous heart rate data and self-reported stress levels and stressors in ICU residents to examine correlations between physiological responses, stress levels, and daily stressors reported. A secondary data analysis was conducted on heart rate measurements and stress assessments collected from 57 ICU residents over a 3-week period using Fitbit Charge 3 devices. These devices captured continuous physiological data alongside daily surveys that assessed stress levels and identified stressors. The study used Spearman rank correlation, point-biserial correlation analysis, 2-tailed paired t tests, and mixed-effect models to analyze the relationship between heart rate features and stress indicators. The findings reveal complex interactions between stress levels and heart rate patterns. The correlation analysis between stress levels and median heart rate values across different percentile ranges showed that lower percentile heart rates (bottom 5%, 10%, 25%, and 50%) had modest correlations with stress, whereas higher percentiles (top 50%, 25%, 10%, and 5%) did not correlate significantly (all P>.05). The 2-tailed paired t test indicated significant differences in stress levels reported in midday versus end-of-day surveys (P<.001), although these changes in stress levels were not consistently reflected in heart rate patterns. Additionally, we explored and found that stressors related to "other health" issues had the highest positive correlation with stress level changes from midday to end-of-day surveys. However, the weak effect of these stressors on peak heart rate suggests that their impact on physiological measures like heart rate is not yet clear. According to our mixed-effects model, stress levels significantly influenced heart rate variations when hierarchical data were taken into account (P=.03), meaning that as the stress level increased, there was a significant increase in mean heart rate. This study highlights the complexity of using heart rate as an indicator of stress, particularly in high-stress environments like the ICU. Our findings suggest that while heart rate is found to correlate with self-reported stress in the mixed-effect model, its impact is modest, and it should be combined with other physiological and psychological measures to obtain a more accurate and comprehensive assessment of residents' stress levels.

«СОФТ СКІЛЗ» У ПРОФЕСІЙНІЙ ДІЯЛЬНОСТІ ПРАЦІВНИКІВ ДЕРЖАВНОЇ КРИМІНАЛЬНО-ВИКОНАВЧОЇ СЛУЖБИ УКРАЇНИ

The article explores the significance of soft skills for the professional activities of employees of the State Penitentiary Service of Ukraine. It examines key components such as communication skills, emotional intelligence, and stress resistance, which are essential for effective work in high-stress environments and complex interpersonal interactions. The author emphasize the importance of developing these skills to ensure safety, reduce conflicts, and maintain high levels of professionalism. The article highlights the need for investment in training and development of soft skills to enhance the efficiency of the service and improve the atmosphere in correctional facilities. Key words: soft skills, communication skills, emotional intelligence, stress resistance, professional activities, State Penitentiary Service of Ukraine.

Enhancing Prehospital Decision-Making: Exploring User Needs and Design Considerations for Clinical Decision Support Systems.

In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have found to cause workflow disruptions and usability issues. Therefore, it is critical to investigate how to design CDSS that meet the needs of prehospital providers while accounting for the unique characteristics of prehospital workflows. We conducted semi-structured interviews with 20 prehospital providers recruited from four emergency medical services (EMS) agencies in an urban area in the northeastern U.S. The interviews focused on the decision-making challenges faced by prehospital providers, their technological needs for decision support, and key considerations for the design and implementation of a CDSS that can seamlessly integrate into prehospital care workflows. The data were analyzed using content analysis to identify common themes. Our qualitative study identified several challenges in prehospital decision-making, including limited access to diagnostic tools, insufficient experience with certain critical patient conditions, and a lack of cognitive support. Participants highlighted several desired features to make CDSS more effective in the dynamic, hands-busy, and cognitively demanding prehospital context, such as automatic prompts for possible patient conditions and treatment options, alerts for critical patient safety events, AI-powered medication identification, and easy retrieval of protocols and guidelines using voice commands. Key considerations for successful CDSS adoption included prioritizing alerts to reduce alert fatigue and workflow disruptions, facilitating real-time data collection and documentation to enable decision generation, and ensuring trust and accountability while preventing over-reliance when using CDSS. This study provides empirical insights into the challenges prehospital providers face and offers design recommendations for developing CDSS solutions that align with prehospital workflows.

A Review of Psychological and Moral Challenges Faced by Medical Staff in High-Stress Environments

Healthcare professionals often operate in high-stress environments that expose them to significant psychological and moral challenges. This review examines the prevalent stressors impacting medical staff, including burnout, anxiety, depression, and moral distress, as well as the coping mechanisms and institutional supports that mitigate these pressures. In exploring psychological factors, such as emotional exhaustion, and moral challenges, like ethical dilemmas and moral injury, this article highlights the compounded toll on staff well-being and patient care quality. Evidence suggests that these pressures negatively impact healthcare outcomes, leading to increased errors, higher turnover rates, and diminished staff retention. The review further discusses strategies to support healthcare workers, including peer support, institutional programs, ethics training, and resilience-building initiatives, emphasizing the need for systemic changes to foster a sustainable, compassionate healthcare environment. Addressing these challenges is essential to ensuring high-quality patient care and a resilient healthcare workforce.

Improvements to the bonding condition of ultra-thin concrete overlays for airport rigid pavements

ABSTRACT Ultra-thin concrete overlay (UTO) is an effective solution for repairing functional deficiencies in airport rigid pavements, with interface bonding properties critical to pavement performance and longevity. This study systematically investigates methods to enhance UTO interface bond strength under heavy dynamic loads. Aircraft dynamic simulations were performed to analyze stress states during landing, taxiing, and turning, identifying the required ultimate bond strength to prevent interface failure. Laboratory tests measured the shear and pull-out strengths of new and old concrete interfaces. A styrene–butadiene rubber (SBR) modified cement quartz mortar adhesive was developed with optimal curing conditions, and the effects of grooving intervals on bonding strength were assessed. Results demonstrated that the interface treatment increased the safety factor for tensile failure from 0.69 to 1.25 and for shear resistance from 0.61 to 1.12 under dynamic loads. This research provides a scientific basis for enhancing UTO applications in the functional rehabilitation of airport rigid pavements, offering a practical solution to improve safety and durability in high-stress environments.

Sheet-laminated additive manufacturing of bacterial cellulose nanofiber-reinforced hydrogels

Three-dimensional (3D) printing of hydrogels offers promising potential for creating intricate, customizable structures with superior elasticity, softness, and biocompatibility. However, due to their high-water content, hydrogels often suffer from reduced mechanical strength, which is further decreased when they absorb water, limiting their use in environments requiring high mechanical durability. To address this, we developed a novel 3D printing technique to fabricate bacterial cellulose (BC) nanofiber-reinforced hydrogels, which we term sheet-laminated additive manufacturing (SLAM). SLAM is based on digital light processing (DLP) 3D printing technology and involves a process of sequentially layering BC nanofiber sheets impregnated with a photocrosslinkable monomer. The BC nanofiber sheets provide a unique 3D network, resulting in a significant enhancement of the mechanical strength of various photocrosslinkable hydrogels. A unique aspect of BC sheets is their ability to further improve mechanical properties by inducing nanofiber alignment or adjusting nanofiber density through stretching and compression pretreatments. The printed BC nanofiber-reinforced hydrogels maintained their strength after swelling and demonstrated exceptional performance in applications requiring high mechanical robustness. Our SLAM approach successfully created complex 3D structures, such as BC-reinforced hydrogel earthworm structures and pressure sensors, demonstrating its potential for advanced applications in high-stress environments.

Flight Hours and Depression in Flight Attendants During the COVID-19 Pandemic

INTRODUCTION: Flight attendants are constantly exposed to high-stress environments that could lead to the development of depression. The COVID-19 pandemic brought out new risk factors that could affect flight attendants’ mental health, such as reduced flight hours and fear of the disease itself, which other studies have shown was associated with depression. We aimed to find out whether reduced flight hours, fear of COVID-19, and other factors were associated with depression in flight attendants during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted at the Directorate General Civil Aviation Medical Center Indonesia and Garuda Sentra Medika in 2022. We included flight attendants who were still employed before and after the start of the pandemic. Data were collected using several questionnaires, including the General Health Questionnaire-12 to screen for depression and Fear of COVID-19 for fear levels. RESULTS: We obtained data from 159 respondents, of whom 25.2% of them had depression. Multivariate analysis showed that the reduction of flight hours 1 yr after the start of the pandemic and fear of COVID-19 were found to significantly increase the likelihood of depression by 2.3 times and 3.9 times, respectively. DISCUSSION: During the pandemic, depression was found to be highly prevalent among flight attendants and was associated with the reduction of flight hours and fear of COVID-19. Sutrisno AB, Agustina A, Sosrosumihardjo D, Sugiharto A, Zulaecha SI, Khoe LC. Flight hours and depression in flight attendants during the COVID-19 pandemic. Aerosp Med Hum Perform. 2024; 95(11):826–830.

Monitoring stress-induced brittle rock mass damage for preventative support maintenance

Stress-induced brittle fracturing near an excavation boundary results in a volume increase, known as bulking. Excessive bulking places added demand on the rock support, which, if not detected and addressed through preventative support maintenance (i.e., proactively added reinforcement), can cause the support to fail, leading to a safety hazard and costly production delays for underground mining operations. For caving mines, these project risks are exacerbated during cave establishment due to the large abutment stress from undercutting that redistributes and concentrates stresses near excavations critical for production. This paper reports the findings from research conducted to develop and improve geotechnical monitoring practices to support preventative support maintenance in deep mining operations. This research uses a unique geotechnical monitoring database collected for the Deep Mill Level Zone panel cave mine. The data was collected across a large footprint during the mine's ramp-up period and represents an initial step toward best practices for data collection at cave mines operating in high-stress environments. Borehole camera surveys supplemented by multi-point borehole extensometers have been used to determine the depth of stress fracturing in pillar walls as a function of the distance away from the undercut. Convergence measurements and LiDAR scanning are used to characterize the corresponding rock mass bulking. The results show that the interpretation of monitoring data can be used to identify the long-term depth of stress fracturing and bulking trends in response to undercut advances. These show that direct measures of stress-induced fracturing damage provide an early indication of excavations vulnerable to bulking and that LiDAR scanning is an effective method for capturing the onset of bulking and anticipating local areas likely to experience greater deformation demand as bulking progresses. Proactive and strategic geotechnical monitoring based on the long-term depth of stress-induced fracturing trends is proposed to assist with preventative support maintenance practices.

Psychological Entitlement and Behavioral Outcomes: An Integrated Model in Beijing's Service Sector

This paper explores the relationship between psychological entitlement and various behavioral outcomes, including job performance, turnover intentions, and interpersonal conflict, within Beijing’s service sector. The study proposes an integrated model that examines entitlement as a key factor influencing these outcomes, with potential mediating variables such as job satisfaction and moderating factors like organizational culture. The framework highlights how entitlement-driven attitudes can negatively impact employee behavior and organizational performance, particularly in high-stress service environments. The paper also suggests future empirical research to test the model across different service industries in urban centers and emphasizes the need for longitudinal studies to understand the long-term effects of psychological entitlement on employee behavior. This interdisciplinary approach offers valuable insights for managing entitlement perceptions and improving workplace dynamics.

57 Resident education in the NICU: A curriculum innovation project

Abstract Background For paediatrics residents, much of newborn care is learned during Neonatal Intensive Care Unit (NICU) rotations. However, the NICU is a high-stress and specialized learning environment. Today’s residents often have less NICU exposure during their training than in the past, leading to concerns from trainees that they are inadequately prepared for neonatal care and resuscitation upon graduation. Objectives We aimed to develop, implement and evaluate a paediatric residency NICU curriculum aimed to augment and improve learning on rotation. Design/Methods We utilized Kern’s Six Step Approach for Curriculum Development. Step 1: We identified that our paediatric residents consistently expressed dissatisfaction with the quality and quantity of learning opportunities on their NICU rotations. Step 2: A collaborative working group of residents, paediatricians, and neonatologists identified learning needs. Step 3: Needs were mapped to specific general paediatrics educational objectives within the Royal College Competency Based Medical Education (CBME) curriculum. Step 4: Suitable learning strategies were selected including simulation, procedural skill training, embedded time with the neonatal resuscitation team, and lunch and learn seminars. Steps 5 and 6: The curriculum was piloted during the 2021-2022 academic year and resident reactions evaluated. Results The detailed curriculum is shown in Table 1. At the start of each NICU rotation, all paediatrics residents on rotation attended a half-day simulation based “boot-camp” consisting of a didactic Neonatal Resuscitation Program (NRP) refresher course, relevant procedural skills stations (intubation, UVC placement, needle thoracocentesis), and simulated neonatal resuscitation scenarios. Junior residents were scheduled for protected time to attend deliveries with a dedicated multidisciplinary resuscitation team to ensure familiarity and begin to solidify skills. Learning was further augmented by weekly, resident-led lunch and learn sessions on topics mapped to level of training. To evaluate this curriculum, resident satisfaction was assessed using surveys post bootcamp and at the end of their rotation. Overall, the curriculum was well received. Bootcamp was the highest rated element; 96% of residents agreed or strongly agreed that the session was useful for their education (Figure 1). Post curriculum implementation, there was significant improvement in resident NICU rotation feedback; residents expressed that the NICU learning environment and resident experience has improved. Conclusion We successfully implemented a NICU curriculum for paediatrics residents, with high satisfaction ratings and improved overall rotation feedback. This program shows promise in addressing a long standing educational gap. More research is needed to investigate whether it leads to improved competency in practice.

A Qualitative Exploration on Psychological Stressors and Coping Mechanisms in Medical Laboratory Personnel

Healthcare professionals, particularly those working in high-stress environments like hospitals, are frequently exposed to significant psychological challenges. This study explores the psychological stressors and coping mechanisms of medical laboratory personnel at the People's Hospital of Keyouqianqi, Inner Mongolia, China. Using a qualitative research design, data was collected through semi-structured interviews with 10 participants, focusing on their experiences of stress and the strategies they use to manage it. The findings reveal that the most significant stressors include high workloads, time pressure, the responsibility for diagnostic accuracy, and interpersonal conflicts within the workplace. Additionally, personal and social stressors, such as balancing work with family responsibilities, further compounded their stress levels. Participants employed a variety of coping mechanisms, both problem-focused and emotion-focused, with effective strategies including building strong professional relationships, engaging in physical activities, and practicing mindfulness. However, some participants resorted to ineffective coping strategies, such as avoidance behaviors and unhealthy habits, which often exacerbated their stress. This study highlights the complex interplay between individual coping strategies and the cultural and institutional context in which these professionals operate. The findings have important implications for practice and policy, offering insights into how healthcare institutions can better support the mental health and well-being of their staff.

Platinum Nanozyme-Loaded Dissolving Microneedles Scavenge ROS and Promote Lineage Progression for Androgenetic Alopecia Treatment.

Androgenetic alopecia (AGA) is a prevalent issue affecting the physical and mental health of individuals but with fewer current treatments. Platinum nanozymes (PtNZs) are known for their excellent ability to reduce and modulate the high oxidative stress environment in AGA pathology. And microneedles are used to overcome the skin barrier due to the poor permeability of PtNZs. Herein, dissolving microneedles loaded with PtNZs (Pt-MNs) are designed and successfully induced hair regeneration in the AGA model. Pt-MNs possessed adequate mechanical strength to breach the skin barrier for effective PtNZs delivery. In vivo, PtNZs first reduced reactive oxygen species (ROS) to oxygen, which recovered the AGA pathological environment. And the oxygen then increased oxidative phosphorylation, promoting the differentiation of hair follicle stem cells to achieve hair regeneration. The group treated with Pt-MNs with a dosing frequency of once every three days achieved faster hair growth than the daily application of the positive drug minoxidil. Further safety experiments showed that the application of Pt-MNs locally opened temporary and recoverable skin channels, with no retention of Pt in major organs, indicating high safety. In conclusion, this study indicated the potential of Pt-MNs as an effective method for treating AGA.

Promoting a culture of respect in cardiothoracic surgery: navigating challenges in understanding unethical behaviour

Unprofessional behaviour in the workplace, such as bullying, harassment, and discrimination, remains common in the cardiothoracic surgery unit. Despite its prevalence, there is little consensus on what constitutes unprofessional behaviour in the workplace of a cardiothoracic surgeon. In this review, we aim to narrow down the definition of unprofessional behaviour among cardiothoracic surgeons, identify its prevalence and the factors contributing to it, as well as explore potential preventive and support measures. We searched the MEDLINE and Web of Science databases (2000-2022), focusing on publications within psychology, medicine, general surgery, and cardiothoracic surgery for inclusion in a focused review. The current review identified 89 papers that highlight the complexity of defining unprofessional behaviour and its prevalence in cardiothoracic surgery units. Psychosocial professional challenges, hierarchical relationships within the medical team, and a high-stress environment may prompt unprofessional behaviour, which can manifest in both overt and covert actions. Such behaviour negatively mpacts medical services for patients, the psycho-emotional state of employees, and the overall functioning of the medical institution. The most effective support measures are characterized by being proactive, anticipating potential problems before they occur. Unprofessional behaviour should be considered an organizational concern, not merely an issue between individual team members. This perspective is essential for fostering a healthy work environment. The leaders of cardiothoracic surgery, given their high status and authority, play a pivotal role in this regard; their focus on inclusiveness of employees with lower status or responsibility is crucial for promoting a culture of psychosocial safety. This culture should be characterized by trust, honesty, and mutual respect, ensuring that every team member feels valued and respected. By prioritizing these values, leaders can minimize the risk of unprofessional behaviour, ultimately leading to an improvement in the quality of medical services for patients, an improvement in the psycho-emotional state of employees and the functioning of the organization as a whole.

Congelation- and dehydration-tolerant, mechanically robust hydrogel electrolyte for durable iontronic sensors operating in open air and freezing temperatures over wide strain and pressure ranges

Conventional hydrogels have limitations in mechanical properties and are susceptible to loss of elasticity and conductivity caused by congelation and dehydration, limiting their practical uses for application in high-stress environments, open air, and freezing temperatures. This study introduces a mechanically robust, dehydration- and congelation-tolerant, and ionically conductive hydrogel electrolyte, practical for iontronic sensors working in wide pressure and strain ranges under open-air and freezing temperatures. This hydrogel electrolyte is fabricated through a reconstruction process comprising a drying-induced densification of double-network hydrogel of alginate and polyacrylamide, a structure fixation by Fe3+ crosslinking, and a Li+ infiltration. The resultant hydrogel electrolyte is tolerant to dehydration and congelation and mechanically robust, with strength and elastic modulus of a few mega-pascals comparable to those of non-conductive elastomers/rubbers used as dielectric materials. Therefore, the hydrogel electrolyte-based iontronic sensors demonstrate exceptional sensitivity and stability under compression and tension and across a wide temperature range. Further, the sensor demonstrates their practical applicability in high-stress environments from kg-range human weight to ton-range car weight. These achievements evince that iontronic sensors, based on mechanically robust and ionically conductive hydrogel electrolytes tolerant to congelation and dehydration, can be employed for practical applications.

Dietary Habits and Perceived Barriers of Healthy Eating among Healthcare Workers in a Tertiary Hospital in Egypt: A Cross Sectional Study

Abstract Background Healthcare professionals often possess a strong awareness of the significance of good dietary habits due to their knowledge of nutrition and health. However, their demanding schedules, high-stress environments, and irregular working hours can pose significant barriers to maintaining healthy eating habits. Patients and Methods The current cross-sectional study was conducted to measure the prevalence among a sample of 373 Health Care Workers (HCWs)at Children’s Cancer Hospital Egypt. Data was collected using structured an interview questionnaire that includes socio-demographic characteristics, Job characteristics, history of chronic diseases, assessment of the dietary habits of the participants using the validated Rapid Eating Assessment for Participants - Shortened Version (REAPS), and barriers of healthy eating. Results Approximately half of the participants failed to adhere to the dietary recommendations for whole grains, vegetables, fruits, and dairy products. More than half of them usually and sometimes consume fried foods and added sugars during the week. The total mean score of dietary habits of the studied group was 26.55 with sd. 3.71 and range (15 - 37), suggestive of a lower diet quality than the average general population in the US. The average REAP-S score for a U.S. omnivorous diet is 32 with higher scores indicating healthier diet. The existing study results demonstrated that there is high significant correlation between studied group total score of dietary habits and their age. There is also significant difference between studied group total score of dietary habits and their working hours as the total score decreases within group who work more than 8 hours. On the other hand, there is no statistically significant difference between studied group total score of dietary habits and the rest of other demographic data. The current study results showed that according to HCWs; two fifth of the participants reported busy lifestyle (48.9%) and irregular work hours (39.8%), around one quarter of them reported willpower (27.4%) and healthy options are not as readily available as unhealthy (21.5%) and only (17.9%) of them reported price of healthy foods as barriers of healthy eating. Conclusion according to the results of the present study, there is a need for initiatives to promote healthier eating habits among healthcare personnel. The current work processes and policies should be reviewed in order to organize workload in ways that allow for enough break times for HCWs, introduce mandatory regular checkups for HCWs in each practice setting to monitor their health and adopt hospital-wide electronic applications that help HCWs to plan for and monitor their diet plans.

Incidence of Medication Errors and Most Common Drugs Involved during Management of Isolated Patients with COVID 19 in an Egyptian General Hospital

Abstract Background The second wave of the COVID-19 pandemic presented significant challenges to healthcare systems worldwide. This retrospective cohort study aimed to investigate incidence and type of medication errors among patients isolated in an Egyptian general hospital during the early months of 2021. Methods A total of 468 patient records were reviewed for medication errors. Data collection included patient demographics, comorbidities, admission details, and clinical pharmacist data. Medication errors were categorized based on ordering, administration, and monitoring processes. Statistical analysis included descriptive statistics, and visual representations of key variables. Results A total of 934 medication errors were found with a prevalence of 42 per 100 patient days and almost 2 errors per patient. All participants experienced drug therapy problems, with the most prevalent issues related to dosing regimen (31%), needs drugs (27%), and monitoring (18%). The main drugs involved in medication errors were anticoagulants (17.6%), antibiotics (12.3%), corticosteroids (10%) and antiviral drugs (9%). Conclusion This study highlights the very high incidence of medication errors among COVID-19 patients during the second wave of the pandemic. The main issues were related to “dosing regimen”, “needs a drug” and “needs monitoring”. Also, the main drug groups involved in theses errors were anticoagulants and antibiotics, followed by corticosteroids and antiviral drugs. Recommendations Addressing medication errors, especially in critical care settings, is crucial for improving patient safety and outcomes. Future interventions should focus on enhancing healthcare professionals' knowledge and communication, particularly in high-stress environments like ICUs. These findings can guide healthcare practice improvements and enhance patient care during pandemics and other healthcare crises.

Effectiveness of Coping Strategies-Based Counseling Program on Quality of Life among Nurses at European Gaza Hospital

Context: Nurses are the backbone of healthcare systems. They often work in high-stress environments that can significantly impact their quality of life. Addressing their well-being is crucial for maintaining effective healthcare services. Aim: This study investigates the effectiveness of a counseling program based on coping strategies to enhance the quality of life among nurses at European Gaza Hospital. Methods: The researchers used this quasi-experimental design, utilizing a single-group pretest-posttest design. Thirty-three nurses, comprising 20 males and 13 females, participated in the study. The researchers developed and implemented quality-of-life scales and a counseling program that applied to the nurses at European Gaza Hospital. Results: The results showed statistically significant differences between the pre-test and post-test scores of the experimental group across the quality-of-life subscales. The following changes were observed at the significance level (p≤0.05): Physical Health Subscale: Pre-test mean rank is 29.45±5.50, compared to post-test mean rank of 18.81±4.12, p-value = 0.000. Psychological Health Subscale: Pre-test mean rank is 36.81±5.35, compared to the post-test mean rank of 28.36±6.39, p-value = 0.000. Social Relationships Subscale: The pre-test mean rank is 20.39±3.30, compared to the post-test, the mean rank of 15.27±3.07, p-value = 0.000. Environmental Subscale: The pre-test mean rank is 19.18±3.30, compared to the post-test mean rank of 14.18±2.83, p-value = 0.000. Professional domain: The pre-test mean rank is 37.30±6.21, compared to post-test mean rank of 27.96±5.15, p-value = 0.000. Conclusion: These findings suggest the importance of prioritizing nurses' well-being through tailored counseling interventions. Recommendations include implementing psychological support programs, providing ongoing professional development, fostering a collaborative work environment, promoting self-care practices, and conducting regular program evaluations.

Influence of Online Work Viral Anxiety Mediates the Relationship between Intolerance of Uncertainty and Personal Injunctive Norms on Adherence to Physical Distancing among Bank Support Provider

This study investigates the role of viral anxiety as a mediator between personal injunctive norms, intolerance of uncertainty, and adherence to physical distancing among bank support staff in Pakistan. The research addresses a critical gap in understanding how psychological factors, exacerbated by the COVID-19 pandemic, influence employee behaviour in high-stress environments, particularly in the rapidly digitizing banking sector. Using a quantitative approach, data were collected from 150 bank support employees through a structured questionnaire. The findings reveal that viral anxiety significantly mediates the relationship between personal injunctive norms and physical distancing, indicating that anxiety about virus exposure is a key driver of compliance with safety protocols. However, the direct effects of personal injunctive norms and intolerance of uncertainty on physical distancing were not significant when viral anxiety was accounted for, suggesting that anxiety overshadows other psychological factors in influencing behaviour. These results highlight the need for organizations to address viral anxiety through targeted interventions to ensure employee well-being and adherence to health guidelines in the workplace. The study contributes to the theoretical understanding of health-related behaviours in organizational settings and offers practical implications for managing employee anxiety in the context of public health crises.