Role Of Healthcare Workers Research Articles

Knowledge, Attitude, and Practice of Healthcare Workers in Ekiti State, Nigeria on Prevention of Cervical Cancer

Purpose: The role of healthcare workers in cervical cancer prevention is pivotal because healthcare workers’ recommendations have been reported to be a key motivational factor for cervical cancer screening among women in Nigeria. Assessing their knowledge, attitudes, and practices on cervical cancer prevention is necessary. Patients and methods: This is a cross-sectional survey involving healthcare workers in Ekiti State, Nigeria. A questionnaire designed for the study was used to obtain data about the knowledge, attitudes, and practices of the healthcare workers. Logistic regression was used to assess the determinants of practice and a p - value of less than 0.05 was taken as statistically significant. Results: Out of 188 participants that completed the study, 165(90.7%) had good knowledge about the prevention of cervical cancer while 24(13.2%) had good practice concerning the prevention of cervical cancer. positive attitude (Odds ratio 1.24, 95% CI 1.14 - 1.35, p < 0.001) increased the odds of good practice. Conclusion: There was no association between the knowledge of cervical cancer prevention and the practice of the healthcare workers. Further research is required to explore the incongruence between knowledge and practice of cervical cancer prevention and its practice.

Epidemiology of carbapenem-resistant Acinetobacter baumannii colonization in neonatal intensive care units: A systematic review and meta-analysis

BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) in neonatal intensive care units (NICUs) represents an escalating challenge in healthcare settings, particularly in managing hospital-acquired infections (HAIs). Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs, with rates as high as 41.7 cases per 1000 patients in ICUs, accounting for 13.6% of all HAIs. These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii . A particularly concerning aspect of CRAB colonization is its asymptomatic nature, enabling its transmission through healthcare workers (HCWs) or the NICU environment to vulnerable neonates with developing immune systems. AIM To explore the prevalence of CRAB colonization in NICUs, focusing on neonates, healthcare workers, and the environmental samples, to enhance epidemiological understanding and inform targeted interventions. METHODS We conducted according to PRISMA 2020 checklist guidelines, a comprehensive literature search across multiple databases including MEDLINE (Ovid), EMBASE (Ovid), Global Health (Ovid), Web of Science, and Global Index Medicus. Studies were selected based on predetermined criteria, primarily involving neonates, HCWs, and environmental swabs, using culture or molecular methods to detect CRAB colonization. We excluded studies that did not specifically focus on NICUs, were duplicates, or lacked necessary data. The study selection and quality assessment were conducted independently by two reviewers. Data extraction involved collecting comprehensive details about each study. Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals, stratifying results by regional location. We assessed study heterogeneity using Cochran's Q statistic and I ² statistic, with regression tests employed to evaluate potential publication bias. RESULTS We analyzed 737 records from five databases, ultimately including 13 studies from ten countries. For neonates, the pooled prevalence was 4.8% (95%CI: 1.1% to 10.5%) with the highest rates observed in South-East Asia (10.5%; 95%CI: 2.4% to 23.3%). Among HCWs, a single Indian study reported a 3.3% prevalence. Environmental samples showed a prevalence of 2.3% (95%CI: 0% to 9.3%), with the highest rates in South-East Asia (10%; 95%CI: 4.2% to 17.7%). Significant heterogeneity was found across studies, and no publication bias was detected. CONCLUSION This systematic review highlights a significant prevalence of CRAB colonization in neonates across various regions, particularly in South-East Asia, contrasting with lower rates in high-income countries. The study reveals a gap in research on HCWs colonization, with only a single study from India reporting moderate prevalence. Environmental samples indicate moderate levels of CRAB contamination, again higher in South-East Asia. These findings underscore the need for more extensive and focused research on CRAB colonization in NICUs, including exploring the roles of HCWs and the environment in transmission, understanding antimicrobial resistance patterns, and developing effective prevention measures.

The natural infection rates of vaccine-preventable diseases among children: A literature review

Background: Indonesia currently faces a triple burden of various disease problems, outbreaks of infectious diseases, and an increase in long-standing infectious diseases, new infectious diseases, and non-communicable diseases (NCDs). A report released in 2020 by the United Nations International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) indicated that during the Covid-19 pandemic, the postponement of routine vaccinations resulted in approximately 80 million children aged less than or equal to 12 months being susceptible to diphtheria, measles, and polio.Purpose: To review previous research in analyzing the relationship between incomplete basic vaccination and the occurrence of vaccine-preventable disease (VPD) cases.Method: This study employed a literature review design, conducting a systematic review by selecting relevant articles pertaining to the research objective. The literature study selection process was adapted from the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Inclusion criteria for this research encompassed originality, usage of both English and Indonesian languages, keywords covering basic vaccination, adverse events following vaccination, Integrated Healthcare Centervisits, education, and the role of Integrated Healthcare Centercadres.Results: Generally, community knowledge, attitudes, family support, and the role of cadres correlated with vaccination coverage achievement. However, some studies indicated no correlation between specific variables and the infants' basic vaccination status. To enhance vaccination coverage and client satisfaction, improving community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, as well as increasing vaccine availability and vaccination guidelines, are necessary.Conclusion: To improve vaccination coverage and client satisfaction, enhancements in community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, alongside increased vaccine availability and vaccination guidelines, are essential.Suggestion: It is advisable for the community to enhance knowledge, attitudes, and support for vaccination, especially among mothers and families. The active involvement of cadres in vaccination programs and public dialogue regarding the moral ethics of vaccination also need improvement.

Vaccination willingness, vaccine hesitancy, and estimated coverage of SARS-CoV-2 vaccine among healthcare workers in Tanzania: A call for action.

The global COVID-19 pandemic presented an immense obstacle to public health, with vaccination emerging as a crucial measure to curb transmission. This study aimed to evaluate the willingness, hesitancy, and coverage of SARS-CoV-2 vaccines among healthcare workers (HCWs) in Tanzania and reveal their concerns about SARS-CoV-2 vaccines and the reasons that might prevent them from getting vaccinated. We conducted a cross-sectional study using an anonymous online survey from October to November 2022. The multivariate logistic regression model explored the factors associated with SARS-CoV-2 vaccine willingness, hesitancy, and coverage. The study included 560 HCWs, with the largest group being doctors (47.9%), followed by nurses (26.9%) and other HCWs (25.2%). A total of 70.5% of HCWs reported being vaccinated against SARS-CoV-2. The primary driver for SARS-CoV-2 vaccination was collective responsibility. A total of 81.4% of HCWs reported being willing to accept SARS-CoV-2 vaccines, while 62.5% of HCWs reported vaccine hesitancy. HCWs with higher educational qualifications were likelier to take the vaccine, while the respondents aged 18-30 years had the highest SARS-CoV-2 vaccination refusal (71.9%). We also investigated the role of HCWs as a source of information to promote COVID-19 vaccine uptake. 79.4% of HCWs provided information and advice on SARS-CoV-2 vaccines. To increase vaccine acceptance among HCWs and the general population, targeted messaging is needed to deliver transparent information on vaccine safety, efficacy, and development.

Perinatal Cannabis Use and Cannabis Use during Breastfeeding: the Role of Health Care Workers.

This study aimed to estimate the proportion of perinatal women reporting a health care worker (HCW) discussed cannabis use during pregnancy or breastfeeding with them and to evaluate the association between HCWs' discussions and perinatal cannabis use and cannabis use while breastfeeding. Data from Health eMoms (a longitudinal, state-representative survey of Colorado mothers, collected from 2018 to 2020 [n = 3,193]) were utilized in logistic regressions assessing the relationship between HCW discussions about cannabis and perinatal cannabis use and cannabis use while breastfeeding at two time points postpartum, adjusting for sociodemographic factors. A total of 5.8% of the sample reported cannabis use either during their most recent pregnancy or while breastfeeding at 3 to 6 months' postpartum. A total of 67.8% of the sample reported an HCW-discussed cannabis at prenatal visits. Women reporting perinatal use were more likely to report HCW discussing cannabis compared with nonusers (82.2 vs. 65.3%, p < 0.01). There was not a significant association between HCW discussions and cannabis use while breastfeeding at either time point postpartum. Compared with nonusers, women using perinatally were more likely to report cannabis Web sites (28.9 vs. 6.5%), cannabis stores (15.7 vs. 3.8%), or word-of-mouth (28.4 vs. 17.1%) as trusted sources of cannabis-related information. HCW discussions about cannabis use during pregnancy or breastfeeding are not universally reported. This study highlights the need for further encouragement of universal HCW discussions of cannabis use during pregnancy and breastfeeding, strengthening of messaging around cannabis use during these periods, and improved delivery of reliable cannabis-related health information to this population. · HCW discussions of perinatal cannabis use are not universally reported by women.. · Women reporting perinatal use were more likely to report HCW discussions of cannabis.. · Women reporting perinatal cannabis use were more likely to trust word-of-mouth or cannabis stores or Web sites..

Examining healthcare worker willingness to promote COVID-19 vaccines in South Africa: the importance of a clear evidence base

Background Studies have shown that healthcare workers (HCWs) are considered trusted sources of coronavirus disease 2019 (COVID-19) information in their communities, ideally placing them as effective vaccine advocates. However, limited data exist on the role of HCWs in the promotion of vaccines, and whether they feel adequately equipped to fulfil this role. This study therefore aimed to determine the willingness of HCWs in promoting COVID-19 vaccines, how this correlated with their own vaccination behaviour and attitudes to alternative therapies, and whether they felt they had adequate knowledge and skills to communicate effectively with patients. Methods A mixed-methods design was adopted, involving an online web-based survey and in-depth interviews (IDIs). HCWs were recruited for the online survey from an integrated health system database in South Africa using voluntary response sampling, with follow-up qualitative interviews conducted with HCWs who indicated interest in participating in an interview. Univariate and multivariate logistical regression models were used to understand how demographic characteristics, HCW roles, vaccination status, attitudes and practices around alternative medications, and information on COVID-19 vaccines were related to the willingness of HCWs to recommend vaccination to their patients. Results Most of the survey sample were vaccinated (90.7%) and indicated that they would recommend vaccination (81.7%). However, a significant proportion of the sample (58.6%) felt that they did not have enough information on COVID-19 vaccines, while 59.8% felt that they required additional guidance on how to educate their patients on COVID-19 vaccines. Vaccinated HCWs were more likely to recommend vaccination (OR=10.63 [95% CI: 6.53-17.31]) than their unvaccinated counterparts. The qualitative results provide further insights into why HCWs were willing or unwilling to administer and promote vaccines, with three themes emerging: (i) HCWs’ belief in the value of vaccines and their promotion strategies; (ii) challenges facing HCWs in fulfilling their mandate of administering and promoting COVID-19 vaccination; and (iii) the rationale for HCWs discouraging vaccination and promoting alternative medicines for COVID-19 prevention and treatment. Conclusions This study posits that if HCWs are key to the success of national vaccination programmes, then they will need to be provided with clear, contextual, up-to-date information in order to enhance patient communication and vaccine uptake.

Humanization Guide of the Spanish Society of Hospital Pharmacy for patients with inflammatory immune-mediated diseases

ObjectiveThis study reports on the results of a project conducted by the Spanish Society of Hospital Pharmacy with patients with immune-mediated inflammatory diseases, with the following objectives: to understand the experience of patients living with these diseases and the role of healthcare workers in such experience, and to identify opportunities to promote or boost humanization in hospital pharmacy units. MethodA user-centered design methodology was used, implementing exploratory and qualitative research tools. Led by a managing team made up of experts in the methodology, a variety of people participated in this project. The team comprised representatives of patients with immune-mediated inflammatory diseases, healthcare workers responsible for their care, members of the immune-mediated inflammatory disease working group of the Spanish Society of Hospital Pharmacy, and members of two patient advocacy organizations (Spanish Association of Persons with Chronic Immune-Mediated Inflammatory Diseases and the Spanish Association of Patients with Psoriasis). The research tools used included in-depth interviews, patients’ diaries, ethnographic studies, and co-creation workshops. ResultsFive initiatives were identified as best practices to be implemented: The creation of functional or comprehensive care units; shared medical records; integration of patient-reported outcomes with patient experiences; implementation of the “capacity, motivation, opportunity” pharmaceutical care model; and a closer interaction with patient advocacy organizations. Six opportunities to improve the current situation were selected as priority areas for hospital pharmacy departments: spreading knowledge about immune-mediated inflammatory diseases; promoting a multidisciplinary approach to these diseases; generating awareness on the role of hospital pharmacists; revisiting the internal organization of pharmacy departments; establishing closer relationships with patients; and seeing things from the patients’ point of view. Ten smart humanization initiatives were proposed and classified in an impact-effort matrix: “Demystifying IMID”, “IMID teen challenge”, “Patient-care academy”, “Satellite consultation”, “IMID network”, “A click away from the pharmacy”, Medicines poker”, “Patient-to-patient consultation”, “Pharma-friendly consultation”, and “Patient-centered IMID sessions”. ConclusionsThis Annex to the Spanish Society of Hospital Pharmacy’s Guidelines for the Humanization of Hospital Pharmacy Units intends to promote a humanizing culture, bringing to the fore the unique value of every single patient suffering from an immune-mediated inflammatory disease, including their family and friends and their beliefs and needs, preserving their dignity.

The Role of Health Care Workers of Kedungrejo Public Health Center in Stunting Reduction Strategy

Introduction: Banyuwangi Regency experienced the increase of stunting number as many as 8,2% from 2019. Stunting is not only affecting toddlers’ health, but also obstructing the development and the progress of a nation in the future. This case relates to the role of the health human resources in solving stunting. The role of health human resources towards stunting reduction strategy is crucial, in which using specific and sensitive nutritional intervention strategies. The current study aims to analyse the role of health human resources towards stunting reduction strategy.&#x0D; Methods: The study performed an analitical observational research with a cross sectional approach. The sample was 55 mothers possessing 0-23-month toddlers taken by clustered random sampling. The research variable was the basic role of the health human resources with some indicators applying specific and sensitive nutritional intervention. The data were analysed using descriptive method and logistic regression test.&#x0D; Results: The role of the communicator was mostly in a good category (61.8%), the motivator was mostly in good category (80%), the facilitator was mostly in not really good category (54.4%), the counselor was mostly in good category (76.4%). The communicator and the motivator influenced the specific nutritional intervention. The motivator and the facilitator influenced the sensitive nutritional intervention.&#x0D; Conclusion: The role of the communicator and motivator influenced the specific nutritional intervention as the stunting reduction strategy. Also, the motivator and facilitator influenced sensitive nutritional intervention.

Young adults who self-harm: Barriers to and facilitators of seeking help

In Portugal, the lifetime prevalence of DSH in adolescents is situated between 16% and 35% (Duarte et al., 2020a; Gouveia-Pereira et al., 2016). Help-seeking is an important facilitator to stop these behaviors, although it is known that most individuals who engage in self-harm do not ask for help (Rowe et al., 2014). Study one (n = 222) examines the differences between two groups of young adults with a history of deliberate self-harm (participants who asked for help and participants who did not ask for help) regarding these behaviors’ severity and diversity, suicidal ideation, and family conflicts. Participants completed a self-report questionnaire which included an open-ended question focused on the reasons that may or may not contribute for seeking help. Significant differences between the two groups were found for all variables and are further discussed, followed by a qualitative analysis concerning the help-seeking motives. Study two (n = 110) used a self-report questionnaire to analyze the expectations of young adults with a history of deliberate self-harm concerning their social support network and the role of healthcare workers when they asked or thought about asking for help. These expectations included contents related with problem-solving, confidentiality, understanding and trust, support, and unburdening.Identifying facilitators and barriers to help-seeking can be a relevant step in planning and managing interventions within deliberate self-harm. Future directions and limitations are discussed.

Early Initiation Breastfeeding Determinant Among Postpartum Mother in Tangerang City

Background: The decline in exclusive breastfeeding coverage of 32% in 2018 needs concern from all sectors. The practice of early initiation breastfeeding (EIBF) needs to be increased because it is associated with the success of exclusive breastfeeding. EIBF rate in Tangerang City in 2020 is 30,6% far below the 2018 national rate (58,2%), even though EIBF can prevent infant mortality by 22% .&#x0D; Objective: The study aims to analyse the factors associated with EIBF practice among postpartum mothers in Tangerang City. &#x0D; Method: The research was conducted using a cross-sectional study design with a quantitative analysis approach. A total of 84 post-partum mothers involved as respondents who were taken using purposive sampling technique. Data were analysed using chi- square test statistic.&#x0D; Result: : Age, education, occupation, history of covid 19, knowledge, health worker support and health services are factors that are significantly related. Logistic regression test showed that the dominant factor associated with EIBF practice was health worker support factor (p value = 0.013, Exp (B)=25.73 CI: 1,996-332,245).&#x0D; Conclusion: The role of health care worker and provider in supporting EIBF practices should be encouraged by strengthening the implementation of the baby-friendly hospital policy and the 10 steps to successful breastfeeding.

A KAP STUDY ON AWARENESS OF IMMUNIZATION SCHEDULE AMONG PARENTS OF CHILDREN UPTO THE AGE OF 5 YEARS VISITING IMMUNIZATION CLINIC AT TERTIARY CARE TEACHING HOSPITAL OF VADODARA, GUJARAT

Introduction: Vaccination is one of the most cost-effective child survival (especially 0-5 years) interventions practiced throughout the world. Parental awareness and decisions regarding immunization are essential for increasing the rate of immunization and compliance. This study is conducted to know the knowledge, attitude and practice (KAP) of parents regarding their understanding of immunization in a tertiary care teaching hospital. Material &amp;Methods: This study was an observational, cross - sectional study, carried out at immunization clinic at tertiary care teaching hospital. In this study parents of children upto age of 5 years were included. Study was carried over a period of one and a half month with pretested, structured, and interviewer-administered questionnaire in regional languages for their easy understanding. Result: At the end of study duration, a total of 215 participants were included in the study. Out of them 78.6% were aware that vaccines are mainly used for prevention of diseases. 87% of study participants felt that vaccines are beneficial for their children. Because of awareness only 10.7% delayed childÂ’s vaccination for reasons other than illness or allergy. Conclusion: From our study we concluded that irrespective of parentsÂ’ education, due to the role of health care workers in rural areas, parents had equal awareness of immunization. Furthermore, with continuous efforts of healthcare workers working in rural areas and those present at immunization clinic, 100% awareness can be achieved regarding immunization.

A Review Article on Monkeypox, Infection Transmission, Prevention, Vaccination and Role of Health Care

Monkeypox is a zoonotic infection that causes painful or pruritic dermatologic lesions on the face, trunk, limbs, genitals, and mucosal surfaces. Monkeypox cases increased exponentially in 2022, prompting the World Health Organization and the United States Department of Health and Human Services to proclaim it a public health emergency. The role of community health nurses towards monkeypox prevention and control in transmission. We searched various databases like World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), American Nurses Association (ANA), EMBASE, Web of Science, CINAHL, PubMed, and Cochrane databases were comprehensively searched. This review article focuses on the monkeypox pandemic, the transmission of the infection, vaccination and the role of healthcare workers. The healthcare role is crucial in preventing and promoting the monkeypox pandemic. These results can be consolidated when policymakers plan to increase the implementation of the healthcare worker in the face of monkeypox and future global threats.

Peran Kepemimpinan Transformational dan Partisipasi Tenaga Kesehatan Terhadap Peningkatan Komitmen Implementasi Keselamatan dan Kesehatan Kerja (K3) di RSUD Mardi Waluyo Kota Blitar

Background: The leader is a real symbol of power. The success of an organization in achieving its goals is largely determined by the ability of its leaders. Every workforce is entitled to protection for occupational safety and health (K3) in doing work. The purpose of the study is to analyze the influence between transformational leadership and health worker participation on the improvement of K3 implementation commitment at Mardi Waluyo Blitar Hospital.Methods: Design observational research with a cross-sectional approach. The population of all health workers in Mardi Waluyo Hospital in Blitar City amounted to 834 people, while sampling techniques were conducted by probability sampling technique using Proportionate Stratified Random Sampling. The samples were obtained from Kerjcie and Morgan's table of 260 people with total sampling techniques. Independent variables are transformational leadership and the role of healthcare workers. The dependent variable is the K3 implementation commitment. The analyses used are univariate, bivariate and multivariate.Results: The results showed that there was a co-influence between transformational leadership (p=0.000) and health worker participation (p=0.021) on the increased commitment to K3 implementation at Mardi Waluyo Blitar Hospital. Multivariate analysis shows the most dominant variables are transformational leadership with significance levels p=0.000 and B=0.274.Conclusions: By participating in the research, it is expected that respondents can improve the quality of health services in hospitals by improving the implementation of K3 as a guideline or standard in providing quality health services and prioritizing patient safety and preventing occupational accidents in health workers.

Impact of Indonesian Healthcare Worker in Stunting Eradication

Even though the number of cases has reduced yearly, stunting is still a significant condition affecting Indonesian children. The fight against stunting includes attention to sensitive and specific interventions addressing the direct and indirect causes of stunting. Healthcare workers, as front liners, play a significant role in the intervention and eradication of stunting and are actively involved in the prevention, education, advocation, and data gathering surrounding stunting. Though vital, the role of healthcare workers in the fight against stunting and its impacts have never been discussed extensively, partly due to the vast variation of healthcare workers and layers of medical services (from primary care to advance hospitalization) included in the care for stunting. This review aims to look at available literature resources that fully describe the numerous roles and the impact healthcare workers had on eradicating stunting in Indonesia. While the healthcare roles in providing intervention of stunting (e.g., medical doctors in the prescription of ONS) is essential, it is crucial to equip healthcare (and the community) with sufficient knowledge of stunting.

The Effect of Perceived Stress, Family Companionship, and Mental Health on the Subjective Happiness of Chinese Healthcare Workers: A Mixed Research Method.

Aim: This study aimed to understand the impact of perceived stress on the subjective happiness of Chinese healthcare workers (HCWs) and to further explore the chain-mediating role of family companionship and mental health. Background: In the face of tense doctor–patient relationships; a heavy workload; long working hours; seemingly endless shifts; potential professional title promotions; work performance assessments; and the difficult balance between family, work, and other aspects of life, HCWs are often under great pressure, which can endanger mental health and reduce subjective happiness. However, the role of healthcare workers’ active participation in family companionship in mental health and subjective happiness is not clear. Method: We used a mixed research design to collect data in two locations (Hospital A and Hospital B) in Wuhan, China. A self-distributed questionnaire was assigned to HCWs through the Research Electronic Data Capture survey. A total of 368 valid surveys were obtained. Results: Hospital A’s perceived stress level and mental health problems were more severe, while Hospital B had a higher subjective happiness score and more time to spend with their families. Subjective happiness was affected by children, education, occupation, health status, commuting time, and the scores of perceived stress and depression. The scores of perceived stress and mental health were significantly negatively associated with subjective happiness and family companionship, and there was a significant positive correlation between subjective happiness and family companionship. The results also showed that family companionship and mental health acted as serial mediators between perceived stress and subjective happiness. However, family companionship did not play a mediating role between perceived stress and subjective happiness. Most HCWs had work–family conflicts, and a high amount of work pressure and feelings of powerlessness and not having sufficient time were common when they accompanied their families. Conclusions: HCWs had a high level of perceived stress and psychological distress, and their subjective happiness score was lower than that of the general population. Many HCWs experienced negative emotions when taking care of their families. Only a small number of people had enough time to spend time with their families and perform more prominently in busier hospitals. More importantly, perceived stress can indirectly have an impact on subjective happiness through a chain-mediating effect of family companionship and mental health, and family companionship may not always promote subjective happiness unless mental health is maintained. Therefore, in the future, we can consider carrying out interventions based on family companionship and mental health among HCWs to promote the healthy and harmonious development of individuals, families, and hospitals.

Emotional Exhaustion Among US Health Care Workers Before and During the COVID-19 Pandemic, 2019-2021

Extraordinary strain from COVID-19 has negatively impacted health care worker (HCW) well-being. To determine whether HCW emotional exhaustion has increased during the pandemic, for which roles, and at what point. This survey study was conducted in 3 waves, with an electronic survey administered in September 2019, September 2020, and September 2021 through January 2022. Participants included hospital-based HCWs in clinical and nonclinical (eg, administrative support) roles at 76 community hospitals within 2 large health care systems in the US. Safety, Communication, Organizational Reliability, Physician, and Employee Burnout and Engagement (SCORE) survey domains of emotional exhaustion and emotional exhaustion climate. The percentage of respondents reporting emotional exhaustion (%EE) in themselves and a climate of emotional exhaustion (%EEclim) in their colleagues. Survey items were answered on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree); neutral or higher scores were counted as "percent concerning" for exhaustion. Electronic surveys were returned by 37 187 (of 49 936) HCWs in 2019, 38 460 (of 45 268) in 2020, and 31 475 (of 41 224) in 2021 to 2022 for overall response rates of 74.5%, 85.0%, and 76.4%, respectively. The overall sample comprised 107 122 completed surveys. Nursing was the most frequently reported role (n = 43 918 [40.9%]). A total of 17 786 respondents (16.9%) reported less than 1 year at their facility, 59 226 (56.2%) reported 1 to 10 years, and 28 337 (26.9%) reported 11 years or more. From September 2019 to September 2021 through January 2022, overall %EE increased from 31.8% (95% CI, 30.0%-33.7%) to 40.4% (95% CI, 38.1%-42.8%), with a proportional increase in %EE of 26.9% (95% CI, 22.2%-31.8%). Physicians had a decrease in %EE from 31.8% (95% CI, 29.3%-34.5%) in 2019 to 28.3% (95% CI, 25.9%-31.0%) in 2020 but an increase during the second year of the pandemic to 37.8% (95% CI, 34.7%-41.3%). Nurses had an increase in %EE during the pandemic's first year, from 40.6% (95% CI, 38.4%-42.9%) in 2019 to 46.5% (95% CI, 44.0%-49.1%) in 2020 and increasing again during the second year of the pandemic to 49.2% (95% CI, 46.5%-51.9%). All other roles showed a similar pattern to nurses but at lower levels. Intraclass correlation coefficients revealed clustering of exhaustion within work settings across the 3 years, with coefficients of 0.15 to 0.17 for emotional exhaustion and 0.22 to 0.24 for emotional exhaustion climate, higher than the .10 coefficient typical of organizational climate (a medium effect for shared variance), suggestive of a social contagion effect of HCW exhaustion. This large-scale survey study of HCWs spanning 3 years offers substantial evidence that emotional exhaustion trajectories varied by role but have increased overall and among most HCW roles since the onset of the pandemic. These results suggest that current HCW well-being resources and programs may be inadequate and even more difficult to use owing to lower workforce capacity and motivation to initiate and complete well-being interventions.

Burnout in hospital healthcare workers after the second COVID-19 wave: Job tenure as a potential protective factor.

Burnout is an impactful occupational health phenomenon to which doctors and nurses have been more exposed during the COVID-19 pandemic. The objectives of this study were to measure the dimensions of burnout—emotional exhaustion, depersonalization and personal accomplishment—in a hospital healthcare population after the second COVID-19 wave and to study their association with sociodemographic variables and previous COVID-19 infection. We invited 112 healthcare professionals (doctors and nurses) who attended the occupational health department of a tertiary hospital in March–July 2021. Emotional exhaustion, depersonalization and personal accomplishment were measured by the Maslach Burnout Inventory. Linear-regression analyses were conducted to explore relationships between burnout dimensions and sociodemographic variables. Differences between groups according to previous COVID-19 infection were verified using the t-test and when appropriate the Mann–Whitney test (for continuous variables), the chi-square test and when appropriate the Fisher exact test (for categorical variables). We surveyed 106 subjects (95% response rate). High emotional exhaustion and depersonalization were reported by 33.0 and 18.4% of participants, respectively; 21.4% reported low personal accomplishment. Job tenure was associated with depersonalization and personal accomplishment. For each 1-year increase in job tenure, depersonalization decreases 0.14 (95% CI [−0.23, −0.04]) and personal accomplishment increases 0.16 (95% CI [0.06, 0.25]). Gender was associated with emotional exhaustion (being male increases emotional exhaustion 5.62-fold [95% CI: 1.33; 9.92]). The prevalence of high emotional exhaustion, high depersonalization and low personal accomplishment after the second COVID-19 wave was relevant and should not be overlooked. Our findings suggest that job tenure may play a protective role in healthcare workers’ burnout.

COVID-19 Vaccination Intent, Barriers and Facilitators in Healthcare Workers: Insights from a Cross-Sectional Study on 2500 Employees at LMU University Hospital in Munich, Germany.

Considering the role of healthcare workers (HCW) in promoting vaccine uptake and previously recorded hesitancy among HCW, we aim to examine the COVID-19 vaccination intent and status of HCW through a cross-sectional anonymous online survey at LMU University Hospital in Munich. Data collection was informed by the Health Belief Model (HBM) and focused on vaccination intent, status and on potential factors affecting the decision-making process. In total, 2555 employees completed the questionnaire. Our data showed that an approving attitude towards recommended vaccines and having received an influenza vaccine in the previous winter were strongly associated with COVID-19 vaccination intent. Further, a positive COVID-19 vaccination status was associated with a higher likelihood of approving the extension of the validity of non-pharmaceutical interventions at the workplace. Our HBM-analysis demonstrated strong associations between the perceived benefits and barriers and COVID-19 vaccination intent. Unchanged or low perceived susceptibility and severity were associated with refusal or indecisiveness. Our findings highlight the factors associated with the decision regarding a COVID-19 vaccine and indicate a pattern-like behavior in the acceptance of novel vaccines by HCW. These insights can help inform the communication aims of vaccination campaigns among HCW within similar organizational contexts or in future outbreaks.

Internet-based interventions for perinatal depression and anxiety symptoms: an ethnographic qualitative study exploring the views and opinions of midwives in Switzerland

BackgroundMental disorders such as depression and anxiety are common during pregnancy and postpartum, but are frequently underdiagnosed and untreated. In the last decades, internet-based interventions have emerged as a treatment alternative showing similar effectiveness to face-to-face psychotherapy. We aimed to explore midwives’ perceptions of the acceptability of internet-based interventions for the treatment of perinatal depression and anxiety symptoms.MethodsIn this ethnographic qualitative study, semi-structured interviews were conducted with 30 midwives. We followed the Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). Audio-recorded interviews were transcribed verbatim and analysed using framework analysis. The identified framework categories were rated individually by two independent raters. Krippendorff’s alpha coefficient was used to ensure the reliability of the rating.ResultsFour main themes emerged: midwives’ experience with patients’ mental health issues; the role of healthcare workers in women’s utilisation of internet-based interventions in the perinatal period; the overall perception of internet-based interventions; and recommendation of internet-based interventions to perinatal women. Twenty-five of the 30 participants viewed internet-based interventions as an acceptable type of intervention, which they would recommend to a subgroup of patients (e.g. women who are well-educated or younger). All except for two midwives identified themselves and medical doctors as key figures regarding patients’ utilisation of internet-based interventions, although a third of the interviewees highlighted that they needed sufficient information about such interventions. Finally, several participants suggested features which could be relevant to develop more acceptable and feasible internet-based interventions in the future.DiscussionParticipants’ overall perception of internet-based interventions for perinatal depression and anxiety symptoms was positive. This study underlines the importance of considering midwives’ views about internet-based interventions for perinatal mental health care. Our findings have implications for the practice not only of midwives but also of other maternity care professionals. Future studies examining the views of other health professionals are warranted.

Knowledge on Causes and Consequences of Climate Change in a Cohort of Italian Students

Our study aims to understand how students of various backgrounds and academic fields retrieve information on Climate Change (CC) and highlights their knowledge on the main causes and consequences of CC, and on the role of healthcare workers in the fight towards this threat. A cross-sectional study was performed between January and December 2020 through an online questionnaire enrolling a total number of 480 university students. The questionnaire is divided in two sections with a total number of 20 questions. Univariable and multivariable analyses were performed to investigate the relationship between the answers and socio-demographic variables. Statistical significance was set at a p-value &lt; 5%. More than 80% of the sample identifies the increase in Earth's temperature (95.0%), melting of ice caps (89.4%), rising of sea levels (81.8%), and the more frequent occurrence of climate-related natural disasters as major consequences of CC. Across courses of study, the frequency on how CC is addressed differs (p&lt;0.001): students belonging to the medical field addressed the issue less frequently (31.5%) compared to humanities students (49.0%) and science and technology students (63.4%). The study shows that students of medical field are less prepared and less aware of the consequences and causes of CC than students in other faculties. Since CC will play a role in every aspect of patients' lives, barriers to health care will have to be overcome through the knowledge and skills acquired during undergraduate courses.