Italian Healthcare Workers Research Articles

“To Be or Not to Be” a Conscientious Objector to Voluntary Abortion: An Italian Web-Survey of Healthcare Workers

Background and Objectives: Conscientious objection to voluntary abortion remains a hot debate topic. This could affect the accessibility to pregnancy termination. Our aim is to evaluate the possible aspects related to an operators’ choice about objection for voluntary abortion, such as the following: the abolition of the time limit, the instruction of a multi-collegiate commission, the introduction of pharmacological rather than surgical procedures, the fetal/maternal illness and the case of sexual violence. Materials and Methods: This is an observational, descriptive study that involves a cohort of Italian healthcare workers who answered a web-survey. Results: Of the total 352 respondents, only 20.8% affirmed to be objectors versus 79.2% of non-objectors. For the objectors, 72.2% declared that they would not change status in case of pharmacological abortion; 79.7% would not suspend their choice for interruption in the second trimester; 63.3% would suspend the objection with a multi-collegiate commission, and 69.0% would discontinue their objection in the case of sexual violence. 72.0% of the total participants declared that the abolition of the time limit could have a resecuring impact on women’s choice. Conclusions: Most operators declared that the abolition of the time limit could have beneficial effects. Among the objectors, the status would change especially with the introduction of a multi-collegiate commission, and in case of serious maternal/fetal illness and/or sexual violence.

Antibiotic use and resistance: knowledge, attitudes and practices in Italian healthcare workers

Abstract Background Antimicrobial resistance (AMR) is one of the most significant public health challenges globally. The misuse or incorrect use of antibiotics has led to the emergence of resistant bacteria, making it increasingly difficult to treat infections. This study aims to identify knowledge, attitudes, and practices among Italian healthcare workers (HWs) - medical doctors (MDs) and nurses - regarding antibiotics, antibiotic use, and antibiotic resistance. Methods Cross-sectional study; a validated questionnaire from the European Centre for Disease Prevention and Control was distributed via web survey starting from April 2024 to a voluntary sample of healthcare workers employed in Italy. Descriptive analysis and multivariable logistic regression were performed to investigate predictors of knowledge regarding antibiotic use and AMR. Ethical approval was obtained from the local ethics committee. Results So far, 154 HWs were enrolled, of which 132 were nurses (85.7%). The average level of knowledge regarding AMR and antibiotic use was 6.8/7 (± 0.2) for MDs and 6.1/7 (± 0.2) for nurses, with an overall score, among HWs of 6.19 (± 0.99), compared to a European average of 6.35. The multivariable analysis highlighted that the medical profession reported higher knowledge regarding prudent antibiotic use and AMR (aOR 6.90; 95% CI 1.83-26.01, p-value = 0.004), while concerning professional practice, the unavailability and difficulty of access to guidelines seemed to increase the risk of reporting inadequate knowledge (aOR 2.04; 95% CI 1.01-4.13, p-value = 0.046). Conclusions Our preliminary results provide an insight into the importance of structuring and actively disseminating procedures/protocols and guidelines to deepen the issues of AMR and prudent antibiotic use. Also, there appears to be a need to enhance the delivery of refresher courses targeting HWs, with particular attention to settings at high infection transmission risk. EU funding: Project no. PE00000007, INF-ACT. Key messages • Although a higher knowledge about prudent antibiotic use and AMR, more efforts are needed to increase access to guidelines. • Constant updating of knowledge and practices is necessary to face the challenges of antibiotic resistance in public health.

Stigma towards people with mental conditions in healthcare workers: an Italian cross-sectional study

Abstract Background Stigma towards people with mental disorders (MD) in healthcare workers (HCWs) can negatively influence the quality of care provided and hinder patients from accessing healthcare. The aim of this study was to analyze stigma and its determinants among physicians and nurses in Italy, as a basis for future strategies to reduce its extent. Methods A cross-sectional study was conducted from April to September 2023. A sample of 1053 physicians and nurses working in Italy answered an online 52-item questionnaire. Variables explored demographic data, work context, burnout symptoms, and personal or family history of MD. The Opening Minds Scale for Health Care Providers (OMS-HC) was used to assess the level of stigma (score from 20 to 100, higher scores represent higher levels). Descriptive analysis and multivariable linear regression were performed. Results Females were 69.5% and median age was 48 years (IQR=37-58). Physicians were 60.5%. A total of 20% of the sample worked in psychiatric settings. Burnout symptoms were reported by 23.5%. Results showed a median OMS-HC score of 49 (IQR=43-54). Positive associations with stigmatizing attitudes were found for being a nurse (p = 0.020) and being in burnout (p = 0.017), while working in a psychiatric setting (p < 0.001) and having personal or family history of MD (p < 0.001) had negative associations. Conclusions This research unveiled a notable amount of stigma among Italian HCWs towards individuals with MD. Since people with MD experience higher rates of disability and mortality, it has to be a public health priority to develop targeted strategies to reduce stigma in HCWs, as it discourages patients from accessing healthcare. Future interventions should be tailored for different professionals and dealing with HCWs burnout. Key messages • Future interventions should consider that healthcare workers in burnout and nurses tend to have more stigma toward patients with mental conditions. • Healthcare professionals working in psychiatric settings and having personal or family history of mental disorders showed lower stigma.

What Mattered Most: Personal, Work-Related, and Psychopathological Characteristics Associated with Healthcare Workers’ Impairment of Functioning during COVID-19

Background: The COVID-19 pandemic greatly impacted healthcare workers (HWs) around the world. Italy was the first Western country hit by the pandemic, and several studies have been published targeting the mental health burden held by Italian HWs. Notwithstanding, only a few studies focused on the impact of COVID-19 on HWs’ levels of functioning. Methods: An online survey was distributed to HWs in Italy through physicians’ and nurses’ associations, social networks, and researchers’ direct contacts, between 4 April and 13 May 2020. Participants provided sociodemographic, work-related, and pandemic-related data and filled out a set of psychometric questionnaires (Patient Health Questionnaire-9—PHQ-9, General Anxiety Disorder-7—GAD-7, Impact of Event Scale—Revised—IES-R, and Work and Social Adjustment Scale—WSAS). Results: The final sample included 1041 HWs (mean age 45.01 ± 11.62, 63.9% females). In total, 58.1% of the subjects screened positive on the GAD-7, 27.5% on the PHQ-9, and 25.9% on the IES-R. Furthermore, 67.4% showed a significant level of impairment in functioning according to the WSAS, while 35.8% reached scores of moderate or worse impairment. In the multiple linear regressions, screening positive on any of the psychometric scales and being exposed to unusual suffering significantly predicted worse scores in all WSAS domains (p < 0.05). Having a history of mental disorders significantly predicted worse scores in the WSAS domain of work ability (p = 0.002), while being the parent of children younger than 18 years significantly predicted worse WSAS family functioning scores (p < 0.001). Conclusions: Our results corroborate extant data about the impact of the COVID-19 pandemic on HWs’ mental health and shed light on its detrimental effect on functioning. Tailored interventions should be designed in order to support HWs during times of crisis.

Emotional and Work-Related Factors in the Self-Assessment of Work Ability among Italian Healthcare Workers.

The Work Ability Index (WAI) is the most commonly used tool for evaluating work capacity. Self-assessments made by workers can be influenced by various occupational and emotional factors. We wanted to study the association of work-related factors, such as work annoyance, stress, overcommitment, job satisfaction, social support, and emotional factors, such as anxiety, depression, and happiness, with work ability, in a sample of 490 healthcare workers from an Italian public health company. A principal component analysis indicated the presence of two components of the WAI questionnaire; the first expresses "subjectively estimated work ability" (SEWA), and the second refers to "ill-health-related work ability" (IHRWA). Using stepwise multiple hierarchical linear regression, we identified the factors that best predicted the total score on the WAI and on the two components. The total score was negatively predicted by anxiety, depression, a lack of happiness, low job satisfaction, overcommitment, and work annoyance. Age, being female, anxiety, and occupational stress were associated with a reduction in the IHRWA component score, while overcommitment, work annoyance, a lack of social support, depression, and a lack of happiness were negatively associated with the SEWA component. These results can help interpret those of epidemiological studies and provide guidance on ways to improve work ability.

Positive mental health, depression and burnout in healthcare workers during the second wave of COVID-19 pandemic.

INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic. To evaluate the protective role of well-being in buffering burnout and psychological distress. We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout. Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing. This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout. The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.

COVID-19 Symptoms and Mental Health Outcomes among Italian Healthcare Workers: A Latent Class Analysis.

The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a "psychological pandemic". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal-Wallis (KW) test with Dunn's multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs.

The Role of Fulfilment and Disillusion in the Relationship between Burnout and Career Satisfaction in Italian Healthcare Workers

Healthcare workers’ stress, burnout, and job dissatisfaction were exacerbated by the COVID-19 pandemic, whose mid-term negative effects are still present. The aim of this work was to consider the effects of burnout (psychophysical exhaustion, relational deterioration, and professional inefficacy) on the career satisfaction of healthcare workers. These relationships were evaluated by considering the direct and mediated effects of disillusion. For these purposes, the Link Burnout Questionnaire (LBQ) and the Career Satisfaction Scale (Occupational Stress Indicator—OSI) were administered to 295 healthcare professionals working at three Italian public hospitals in Cagliari, Italy. The analyses were conducted using the Partial Least Square Structural Equation Model (PLS-SEM) method. Outcomes highlighted that healthcare workers were in a condition of work distress, high risk of burnout, and career dissatisfaction. Also recognized was the direct negative effect of burnout dimensions on career satisfaction. Finally, the mediated negative effect of disillusion in the relationship between burnout and career satisfaction was identified. This study underlines the relevance of the dimension of disillusion, and its “bright side” fulfilment, in healthcare workers, specifically referring to the disregarded relationship between burnout and career satisfaction.

Second Victim Symptoms and Desired Support Strategies Among Italian Health Care Workers in Friuli-Venezia Giulia: Cross-Sectional Survey and Latent Profile Analysis.

The second victim (SV) phenomenon concerns health care workers (HCWs) whose involvement in a medical error, as well as non-error patient safety events, has affected their well-being. Its prevalence ranges from 10% to 75% and can predispose HCWs to burnout, increasing the probability of committing errors. The primary aim of our study was to determine the prevalence of HCWs involved in an adverse patient safety event in Friuli Venezia Giulia Region (Italy). The secondary aims were to use latent profile analysis to identify profiles of SVs and factors influencing profile membership, and to evaluate the relationship between the severity of symptoms and desired support options. A cross-sectional survey through the Italian version of the Second Victim Experience and Support Tool tool was conducted in 5 local health authorities. Descriptive statistics were conducted for all variables. Associations and correlations were assessed with statistical tests, as appropriate. Latent profile analysis was based on the scores of dimensions measuring SVs' symptoms. Factors affecting profile membership were assessed through multinomial logistic regression. A total of 733 HCWs participated. Of them, 305 (41.6%) experienced at least 1 adverse event. Among dimensions measuring SVs' symptoms, psychological distress had the highest percentage of agreement (30.2%). Three latent profiles were identified: mild (58.7%), moderate (24.3%), and severe (17.0%) symptoms. Severe symptoms profile was positively associated with the agreement for extraoccupational support and negatively associated with the agreement for organizational support. A respected colleague with whom to discuss the details of the incident (78.7%) and free counseling outside of work (71.2%) were the support options most desired by HCWs. The severity of symptoms was directly associated with the desire for support strategies. The prevalence of HCWs involved in adverse events is consistent with the literature. Three latent profiles have been identified according to SV symptoms, and the higher the severity of symptoms, the greater the reliance on extraoccupational support.

Impact of Work Motivation on Occupational Health in Healthcare Workers

Objectives: The present cross-sectional study investigated, in a group of Italian healthcare workers (HCWs), the association between work motivation and occupational health and the impact of socio-demographic and job-related variables on this association. Methods: A total of 656 subjects (nurses, technicians, midwives and physiotherapists) completed the survey. Linear regression models were used to correlate motivation types (by Scale of Motivation At Work) with health indicators (general health, depression, professional exhaustion, satisfaction and turnover intention) and burnout’s subscales (emotional exhaustion, depersonalization and reduced professional achievement). Findings: Autonomous motivation correlated positively with general health and work satisfaction and negatively with depression, exhaustion and turnover intention. Scoring high on intrinsic/integrated regulation was associated with better health and job satisfaction and with turnover intention, depression and emotional exhaustion. Controlled motivation, demotivation and external regulation nourished burnout’s indicators, while autonomous motivation was protective. Operating in intensive care or surgical areas negatively affected general health; working as a nurse manager or midwife increased one’s depressive risk and reduced satisfaction; being older than 60 increased emotional exhaustion and turnover intention; having a master’s degree protected from exhaustion and depression. Implications: Collectively, our findings extend evidence on the role of work motivation in shaping occupational health and underline the importance for healthcare organizations of promoting actions to reinforce autonomous motivation at work.

Adherence with infection prevention and control measures among Italian healthcare workers: Lessons from the COVID-19 pandemic to tackle future ones

BackgroundTo tackle future health threats, the study aimed to assess healthcare workers’ (HCWs) adherence to infection prevention and control (IPC) measures and to evaluate whether knowledge and concerns related to COVID-19 could be its potential predictors. A secondary aim was to explore how and how much healthcare facilities support HCWs to implement IPC practices. MethodsThis cross-sectional study was conducted between June and September 2021 in Southern Italy using a self-administered questionnaire. Socio-demographic and professional characteristics, COVID-19 preparedness and response plan in the facilities, knowledge about COVID-19’s transmission and non-pharmaceutical interventions (NPIs), concerns about the possibility of transmitting COVID-19 to family members and patients, adherence to IPC practices, and sources of information were investigated. ResultsAmong the 492 enrolled HCWs, the overall knowledge median score was 6 out of a maximum score of 8 and predictors of good knowledge were practicing in a facility that organized training courses about IPC measures and having more years in practice. HCWs were more concerned about the possibility of transmitting the infection to their family members (64.4%) than to negative patients (38.9%). A sizable proportion claimed to take off the face mask by touching only the straps or ties (76.3%) and to replace the face mask when it was wet (70.7%). Only 26.2% never/rarely touched the face mask while wearing it. Good adherence to preventative practices was more likely in HCWs other than physicians and practicing in a facility that organized training courses about IPC measures and in regional hospitals compared with those practicing in district hospitals. ConclusionsThe study findings produce information about what worked well and where gaps were identified during COVID-19 pandemic, along with data useful for hospitals and health systems in general to better prepare and put in place appropriate interventions in case of similar future events.

Evaluation of Adverse Effects after the Second Dose of BNT162b2 Mrna Vaccination for COVID-19: A Survey-based Analysis among Italian Healthcare Workers

Backgrounds and Aims: Since the start of the SARS-CoV-2 pandemic, healthcare workers have been at elevated risk of contracting COVID-19. Although COVID-19 vaccines have contributed to the eradication of, or substantial decreases in, the incidence of lethal diseases, the major determinant of COVID-19 vaccine hesitancy is a fear of associated adverse effects. Here, we performed a survey assessing the reactogenicity and safety of BNT162b2 in a real-world setting. Methods: Data were collected from March 1 and June 14, 2021. A total of 206 hospital employees undergoing BNT162b2 mRNA vaccination completed the survey. These hospital workers received a questionnaire to collect the common and uncommon adverse effects developing 2–6 days after the second dose of the Pfizer-BioNTech vaccine. Results: After the second dose, female sex was found to be associated with a higher risk of vaccine-related severe systemic adverse effects than male sex (odds ratio [OR] 3.116, 95% CI 2.365–7.113). We also observed that the anti-SARS-CoV-2 receptor-binding domain titer, determined on the day when the second dose of the Pfizer-BioNTech vaccine was administered, was significantly higher in participants with severe systemic effects than those without such effects (OR 1.017, 95% CI 1.001–1.034). Conclusion: Our study suggested that healthy female healthcare workers had a three-fold higher risk than healthy male healthcare workers of developing severe adverse effects after the second dose of the Pfizer-BioNTech vaccine. Further research is warranted to determine whether a high anti-SARS-CoV-2 RBD titer determined at the time of the second vaccination might indicate a disproportionate inflammatory systemic reaction leading to severe adverse effects. Our findings might contribute to a decrease in the disappearance of COVID-19 vaccine hesitancy.

The relationship among posttraumatic stress disorder, posttraumatic growth, and suicidal ideation among Italian healthcare workers during the first wave of COVID-19 pandemic.

The COVID-19 pandemic impacted mental health across different groups, including healthcare workers (HWs). To date, few studies focused on potential positive aspects that may follow the exposure to the pandemic. We investigated the prevalence of posttraumatic stress disorder (PTSD) in Italian HWs and whether posttraumatic growth (PTG) dimensions affected the risk of suicidal ideation (SI) during the first COVID-19 wave. An online self-report survey was conducted between April and May 2020. Sociodemographic data, information about COVID-19-related stressful events, Impact of the Event Scale-revised, and Post-Traumatic Growth Inventory-Short Form (PTGI-SF) scores were collected and compared between participants. Patient Health Questionnaire-9 scores were also collected to assess SI through item 9. Multivariate logistic regression was used to assess the relationship between PTGI and SI. Among 948 HWs, 257 (27.0%) reported a provisional PTSD diagnosis. The median PTGI-SF score was 24. Participants reporting PTSD symptoms had higher scores in the Spiritual change, Appreciation of life, and New possibilities domains, and in the total PTG scale. A total of 100 HWs (10.8%) screened positive for SI. Improvements in Relating to others domain of PTGI-SF (odds ratioOR: .46; 95% confidence interval: .25-.85) were associated with lower odds of SI. COVID-19 pandemic has been indicated as a risk factor for SI, also among HWs. PTG may have a protective role on suicide risk. Improvements in Relating to others domain reduced odds of SI, consistently with the role of loneliness and lack of connectedness with others in enhancing suicidal risk.

Measles vaccine uptake among Italian medical students compared to the pre-COVID-19 era

ABSTRACT The COVID-19 pandemic has severely affected health systems worldwide and raised the issue of vaccine hesitancy. In 2022, the World Health Organization reported an outbreak of measles infection among people over 20 years of age in the European Region. Previous studies found low rates of measles immunization among Italian healthcare workers (HCWs) and medical students. Vaccine hesitancy is a relevant cause of low immunization rate among HCWs and the general population. We aim to evaluate the measles vaccine uptake among medical students of a large teaching hospital, compared to the pre-pandemic period. This is a retrospective observational study, that evaluated the immune status and the vaccine acceptance rate for measles in medical students at the University of Tor Vergata, Rome, who underwent occupational health surveillance from 1 January to 1 December 2022. We also compared the data with the results of a pre-pandemic survey conducted in 2018. Vaccine uptake among unprotected medical students was 59.5%. The data showed no significant difference in vaccine uptake compared with the pre-COVID-19 period. Conversely, the rate of serologically immune subjects to measles increased from 89.66% in 2018 to 97.45% in 2022 as a result of the recent mandatory vaccination policy. Despite efforts to tackle vaccine hesitancy during the COVID-19 pandemic, measles vaccine uptake is still low among young adults starting their medical training, and their compliance with free workplace vaccination offers is suboptimal. Occupational health services should raise awareness among workers and work together to implement strategies to achieve comprehensive measles vaccination coverage among occupational health workers.

Genome-wide association studies of response and side effects to the BNT162b2 vaccine in Italian healthcare workers: Increased antibody levels and side effects in carriers of the HLA-A*03:01 allele.

The remarkable variability of response to vaccines against SARS-CoV-2 is apparent. The present study aims to estimate the extent to which the host genetic background contributes to this variability in terms of immune response and side effects following the administration of the BNT162b2 vaccine. We carried out a genome wide association study (GWAS) by genotyping 873 Italian healthcare workers who underwent anti-SARS-CoV-2 vaccination with the BNT162b2 vaccine and for whom information about anti-SARS-CoV-2 spike antibodies titers and vaccine side effects were available. The GWAS revealed a significant association between the HLA locus and the anti-SARS-CoV-2 Spike antibodies level at 2 months following the first dose of vaccine (SNP: rs1737060; p = 9.80 × 10-11 ). In particular, we observed a positive association between the antibody levels and the presence of the HLA-A*03:01 allele. The same allele was found associated with a 2-2.4-fold increased risk of experiencing specific side effects such as fever, chills and myalgia and a 1.5-1.8-fold increased risk of joint pain, nausea, fatigue, headache and asthenia, independently of age and sex. This study confirms that the heterogeneity in the immune response to the BNT162b2 vaccine and in its side effects are at least partially influenced by genetic variants. This information, integrated with individual biological and lifestyle-related correlates, could be of use in the definition of algorithms aimed at the identification of subjects in which the administration of additional vaccine doses would be particularly beneficial to maintain immunity against the virus.

Pertussis immunization during pregnancy: results of a cross-sectional study among Italian healthcare workers.

This study aimed to assess whether Italian healthcare workers (HCWs) recommend the reduced antigen content tetanus-diphtheria-acellular pertussis vaccination (Tdap) to pregnant people, as well as what variables could predict their decision to advise and recommend immunization to pregnant people. This cross-sectional study took place between August 2021 and June 2022 in a sample of obstetricians-gynecologists, midwives, and primary-care physicians in two regions of Southern Italy. A self-administered questionnaire was used to gather the data. The results showed 91.3% (379) of participants knew that receiving the Tdap vaccine during pregnancy protects against pertussis in both the expectant person and the newborn before active immunization. Only 68.9% (286) knew that the Tdap vaccination has to be administered during the third trimester of gestation. A small but still significant proportion of participants (14.7%) (61) believed that the potential risks of vaccines administered during pregnancy outweighed the benefits. An improvable proportion of HCWs regularly provided information [71.8% (298)] and recommended [81% (336)] Tdap vaccination to pregnant people. The strongest factors that drove HCWs to inform pregnant people about the Tdap vaccination were to be aware that vaccinating those in close contact with newborns is an effective strategy to prevent pertussis (OR: 2.38; 95% CI: 1.11-5.13) and that the Tdap vaccine is provided only in the third trimester of pregnancy (OR: 1.74; 95% CI: 1.06-2.86). Informing pregnant people about the possibility of receiving the Tdap vaccine during pregnancy (OR: 60.13; 95% CI: 23.50-153.8) was the strongest predictor of having recommended the Tdap vaccination during pregnancy. Educational and informative interventions to improve HCWs' knowledge about the importance of the Tdap vaccine and their communication skills to properly counsel pregnant people are needed. Beyond vaccine recommendations, how well immunization strategies are implemented in real-world situations impacts vaccination uptake. Therefore, during regular care visits, expecting people must have easy access to vaccines. Prenatal immunizations should become common practice, and there should be no conceptual doubt about vaccinations among HCWs to safeguard pregnant people and their unborn children from vaccine-preventable diseases.

Sense of Coherence (SOC) of Italian healthcare workers during the COVID-19 pandemic: analysis of associated factors.

The COVID-19 pandemic has posed significant challenges for healthcare workers worldwide, potentially affecting their sense of coherence (SOC) and overall well-being. This study aimed to identify factors associated with different levels of SOC among healthcare workers, exploring demographic characteristics, work-related factors, changes in relationships and social habits, and the overall well-being. A cross-sectional study was conducted among 628 healthcare workers. SOC scores were assessed using a standardized questionnaire. Statistical analyses were performed to identify associations between these factors and SOC. Healthcare workers had a lower average SOC score (mean: 57.1) compared to the national average in Italy (mean: 60.3). Younger age and shorter length of service were associated with a higher risk of low SOC (p < 0.0001). Healthcare workers in the northwestern regions of Italy had an increased risk of low SOC compared to their counterparts in the northeastern regions (p = 0.0336). Adverse pandemic-related experiences and worsening social relationships were also associated with a higher risk of low SOC (p < 0.0001). This study highlights the unique challenges and stressors faced by healthcare workers during the COVID-19 pandemic and their impact on SOC. Age, length of service, geographic location, and social status were significant factors influencing SOC levels. Targeted interventions are needed to enhance SOC and well-being, particularly for younger and newly employed healthcare workers. Strategies promoting social connections, work-life balance, and psychological support services are crucial to support healthcare workers' resilience and coping abilities.

Second victim phenomenon in Italian healthcare workers: IT-SVEST survey and latent profile analysis

Second victim phenomenon in Italian healthcare workers: IT-SVEST survey and latent profile analysis

Workplace health promotion initiatives for Italian healthcare workers demonstrate an investment for workers, the organization and the society in the context of total worker health

Workplace health promotion initiatives for Italian healthcare workers demonstrate an investment for workers, the organization and the society in the context of total worker health

Analysis of healthcare workers' mental health during the COVID-19 pandemic: Evidence from a three-wave longitudinal study.

The "Healthcare workers' wellbeing [Benessere Operatori]" project is an exploratory longitudinal study assessing healthcare workers' mental health at three different time points over a 14-month period during the COVID-19 pandemic. We collected socio-demographic and work-related information and assessed the perceived social support, coping strategies, and levels of depression, anxiety, insomnia, anger, burnout, and PTSD symptoms. In total, 325 Italian healthcare workers (i.e. physicians, nurses, other healthcare workers, and clerks) participated in the first initial survey and either the second or third subsequent survey. Participants reported subclinical levels of psychiatric symptoms that remained mostly unchanged across time, except for an increase in stress, depression, state anger, and emotional exhaustion symptoms. Despite subclinical levels, healthcare workers' distress can adversely affect the quality of care, patient satisfaction, and medical error rates. Therefore, implementing interventions to improve healthcare workers' wellbeing is required.