Well-being Of Healthcare Providers Research Articles

Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis.

COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic. We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI. We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8-41.3), anxiety 39.7(95%CI: 34.3-45.1), stress 36.4% (95%CI: 23.2-49.7), fear 71.3% (95%CI: 54.6-88.0), burnout 68.3% (95%CI: 54.0-82.5), and low resilience was 16.1% (95%CI: 12.8-19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30-1.68) and nurses (OR = 1.21; 95%CI = 1.02-1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49-1.85), (Nurse: OR = 1.36; 95%CI = 1.16-1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28-1.97). In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.

Beyond Burnout: Responding to the COVID-19 Pandemic Challenges to Self-care.

Purpose of ReviewThis paper is a review of the self-care challenges of the COVID-19 pandemic on the physical and emotional health and well-being of healthcare providers. New self-care practices are presented.Recent FindingsGlobally, thousands of health care practitioners and staff have been infected; many have died. Research studies reveal that this pandemic has threatened the health of healthcare staff, their families, and communities in many unique ways, such as fear of infecting family (lack of safety at home), moral injury, witnessing the suffering of the “innocent,” coping with a problem too big to solve (the enormity problem), and racial trauma.SummaryThe COVID-19 pandemic has impacted the global population in ways not seen in a century. The unique self-care challenges of COVID-19 while enhancing the symptoms of burnout, i.e., physical, and mental exhaustion, despair, helplessness, and suicidal thinking, need to be addressed directly. This paper offers a new COVID-19 self-care model and approach.

Quantifying Electronic Health Record Data: A Potential Risk for Cognitive Overload.

To quantify and describe patient-generated health data. This is a retrospective, single-center study of patients hospitalized in the pediatric cardiovascular ICU between February 1, 2020, and February 15, 2020. The number of data points generated over a 24-hour period per patient was collected from the electronic health record. Data were analyzed by type, and frontline provider exposure to data was extrapolated on the basis of patient-to-provider ratios. Thirty patients were eligible for inclusion. Nineteen were hospitalized after cardiac surgery, whereas 11 were medical patients. Patients generated an average of 1460 (SD 509) new data points daily, resulting in frontline providers being presented with an average of 4380 data points during a day shift (7:00 am to 7:00 pm). Overnight, because of a higher patient-to-provider ratio, frontline providers were exposed to an average of 16 060 data points. There was no difference in data generation between medical and surgical patients. Structured data accounted for >80% of the new data generated. Health care providers face significant generation of new data daily through the contemporary electronic health record, likely contributing to cognitive burden and putting them at risk for cognitive overload. This study represents the first attempt to quantify this volume in the pediatric setting. Most data generated are structured and amenable to data-optimization systems to mitigate the potential for cognitive overload and its deleterious effects on patient safety and health care provider well-being.

Anxiety amongst physicians during COVID-19: cross-sectional study in Pakistan

BackgroundEnsuring safety and wellbeing of healthcare providers is crucial, particularly during times of a pandemic. In this study, we aim to identify the determinants of anxiety in physicians on duty in coronavirus wards or quarantine centers.MethodsWe conducted a cross-sectional quantitative survey with an additional qualitative item. Five constructs of workload, exhaustion, family strain, feeling of protection, and anxiety were measured using items from two validated tools. Modifications were made for regional relevance. Factor analysis was performed showing satisfactory Cronbach alpha results. Overall, 103 physicians completed the questionnaire.ResultsT-test results revealed significant associations between gender and anxiety. Structural equation modeling identified that high workload contributed to greater exhaustion (β = 0.41, R2 = 0.17, p < 0.001) and greater family strain (β = 0.47, R2 = 0.22, p < 0.001). Exhaustion (β = 0.17, p < 0.005), family strain (β = 0.34, p < 0.001), and feelings of protection (β = − 0.30, p < 0.001) significantly explained anxiety (R2 = 0.28). Qualitative findings further identified specific needs of physicians with regard to protective equipment, compensation, quarantine management, resource allocation, security and public support, governance improvement, and health sector development.ConclusionsIt is imperative to improve governmental and social support for physicians and other healthcare providers during the corona pandemic. Immediate attention is needed to reduce anxiety, workload, and family strain in frontline practitioners treating coronavirus patients, and to improve their (perceptions of) protection. This is a precondition for patient safety.

Impact of a Yogic Breathing Technique on the Well-Being of Healthcare Professionals During the COVID-19 Pandemic.

BackgroundThe COVID-19 pandemic has created unprecedented challenges for healthcare globally, the brunt of which has been borne by the health care providers (HCPs). These challenges are felt more keenly in India, as they stretch an insufficiently resourced healthcare system. The long hours, cross over of responsibilities, lack of resources to adequately care for patients, and concerns around safety of self and loves ones, have led to a spike in anxiety, depression, insomnia and other stress – related disorders in healthcare providers. Sudarshan Kriya Yoga (SKY) is a mind-body intervention that has been studied in multiple clinical populations. Prior to this study, there has been no exploration of the impact of SKY on healthcare providers, specifically the impact of a mind-body intervention like SKY on HCPs during a pandemic.ObjectiveThis study aims to investigate the impact of SKY on the well-being of HCPs during the COVID-19 pandemic.MethodsWe conducted a pilot feasibility study with a single arm pre-post design. SKY was taught to participants in a 4-day online breath and meditation workshop. We measured outcomes related to depression, anxiety, resilience, life satisfaction, and quality of sleep.ResultsNinety-two subjects completed the study survey before and after the intervention. A significant reduction was observed in the levels of stress, anxiety and depression immediately after the program. In addition, the participants reported sig1nificant improvement in life satisfaction, resilience, and the quality of their sleep.ConclusionThe results indicate that SKY breathing technique had a positive impact on the well-being of healthcare professionals during the pandemic. Participants experienced improved quality of sleep, enhanced satisfaction with life, and increased resilience after SKY. This pilot study provides important data for future multi-site randomized controlled trials to study the impact of yogic techniques on well-being of the HCPs.

A mixed-methods approach to understanding the role of religion and spirituality in healthcare provider well-being.

A mixed-methods approach to understanding the role of religion and spirituality in healthcare provider well-being.

Supporting the well-being of health care providers during the COVID-19 pandemic: The CopeColumbia response

ObjectiveCOVID-19 is an international public health crisis, putting substantial burden on medical centers and increasing the psychological toll on health care workers (HCW). MethodsThis paper describes CopeColumbia, a peer support program developed by faculty in a large urban medical center's Department of Psychiatry to support emotional well-being and enhance the professional resilience of HCW. ResultsGrounded in evidence-based clinical practice and research, peer support was offered in three formats: groups, individual sessions, and town halls. Also, psychoeducational resources were centralized on a website. A Facilitator's Guide informed group and individual work by including: (1) emotional themes likely to arise (e.g., stress, anxiety, trauma, grief, and anger) and (2) suggested facilitator responses and interventions, drawing upon evidence-based principles from peer support, stress and coping models, and problem-solving, cognitive behavioral, and acceptance and commitment therapies. Feedback from group sessions was overwhelmingly positive. Approximately 1/3 of individual sessions led to treatment referrals. ConclusionsLessons learned include: (1) there is likely an ongoing need for both well-being programs and linkages to mental health services for HCW, (2) the workforce with proper support, will emerge emotionally resilient, and (3) organizational support for programs like CopeColumbia is critical for sustainability.

Development and Initial Psychometric Testing of the Midwifery Practice Climate Scale - Part 2.

A supportive practice climate is demonstrated to improve patient outcomes, health care provider well-being, and workforce stability. Midwives are an integral component to improving maternal health care; however, there has been limited research into the qualities and measurement of a supportive practice climate for midwives. The Midwifery Practice Climate Scale is a self-report instrument designed to measure midwives' perceptions of their work environments. We tested the scale's validity and reliability in multiphase, national cross-sectional survey of the full roster of certified nurse-midwives and certified midwives practicing in the United States. To test structural validity and reliability testing, 2 subsamples of 330 participants were randomly extracted from the sample of 2887 for exploratory and confirmatory factor analyses and internal consistency determination. Convergent validity was tested in the remaining sample of 1673 respondents. Exploratory factor analysis revealed 2 5-subscale structures consistent with the loading values and theoretical structure. Confirmatory factor analysis revealed a mediocre fit of the models identified in the exploratory analysis. Consequently, items were systematically reviewed for redundancy, skew, and generalizability and 24 items were removed from the scale. The resulting structure is a 10-item scale comprising 2 subscales: Practice Leadership and Participation and Support for the Midwifery Model of Care. The revised Midwifery Practice Climate Scale was a good fit with the data demonstrating adequate construct validity (χ2 = 60.397, df = 34, P < 0.001; comparative fit index, 0.987; root mean square of approximation, 0.049) and internal consistency (α = 0.89-0.84). These findings indicate that the Midwifery Practice Climate Scale accurately and reliably measures the midwives' perceptions of their practice environment. The next steps include determining the scale's sensitivity to change and assessing the relationship with maternal health outcomes.

Principal Component Analysis of the Well-Being at Work and Respect for Human Rights Questionnaire (WWRRR) in the Mediterranean Region.

Background:The Well-Being at Work and Respect for human Rights Questionnaire (WWRR) was conceived based on the hypothesis that the perception of respect for users' rights is an essential element of well-being in the workplace in healthcare. The objective of the study is to examine the principal components of the WWRR.Methods:A random sample representative of a set of professionals working in three different healthcare networks in Tunisia, North-Macedonia, and Italy was enrolled (n=426). Each professional completed a questionnaire on sociodemographic data and the WWRR. The WWRR consists of six items on beliefs about: satisfaction at work, users’ satisfaction, organization at work, respect of users’ and staff human rights, adequacy of resources. A seventh item assesses the perceived needs of personnel. Correlation between the items was evaluated by analysing the principal components with Varimax rotation and Kaiser normalization (which included all components with an Eigen value> 1).Results:A single factor covered over 50% of the variance, all the items of the questionnaire were closely related and compose a single factor. Tunisia presented some differences regarding the item about the human rights of staff.Conclusion:Satisfaction with the respect for the rights of users is strongly correlated with the other factors that are part of the concept of the organizational well-being of health care providers. The WWRR provides a means of measuring this important and often neglected dimension.

The Neurocritical Care Society of India (NCSI) and the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) Joint Position Statement and Advisory on the Practice of Neurocritical Care during the COVID-19 Pandemic

AbstractThe COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) has rapidly spread across the world including India. Management of patients complicated with neurological illness requiring neurocritical care is challenging during this time. Patients with neurological disease may develop COVID-19 infection or there could be independent neurological manifestations of COVID-19. Critically ill neurological patients are more vulnerable to contracting SARS-CoV-2 infection. Also, neurological patients with comorbidities and multisystem involvement are at increased risk of adverse outcomes. Though SARS-CoV-2 predominantly affects the pulmonary system, it can complicate the assessment and management of neurological patients. With increasing COVID-19 numbers, the hospitalizations of both non-COVID and COVID-19 neurological patients will bring significant strain on the hospital and neurocritical care facilities. Streamlining work pattern, understanding the pathophysiology of COVID-19 and its impact on neurological function, establishing general and specific neurocritical care management strategies, ensuring protection and well-being of health care providers, and implementing effective infection control policies are key elements of efficient neurocritical care management during this pandemic. This joint position statement and advisory on the practice of neurocritical care during the COVID-19 pandemic by the Neurocritical Care Society of India and the Indian Society of Neuroanaesthesiology and Critical Care has been developed to guide clinicians providing care to the critically ill neurological patients in the neurocritical care unit during the current pandemic. As the situation from this novel disease is rapidly evolving, readers must constantly update themselves with newly emerging evidence to provide the best possible care to the critically ill neurological patients.

0410 Insufficient Sleep Among Healthcare Professionals

Abstract Introduction Insufficient sleep (IS) is a common problem among healthcare professionals, especially those who are shift workers. Evidence has shown that sleeping less than eight hours can lead to sleep debt. Sleep debt can have a negative impact on the mental, emotional and cognitive well-being of health care providers. In addition to sleep debt, having long shift hours reduces the opportunity for sleep because there is less time to recuperate. Methods We analyzed data gathered from healthcare workers (n=4,093) from the 2017 and 2018 National Health Interview Survey (NHIS), a nationally representative study of the US civilian non-institutionalized population. Sleep was categorized as short (≤6 hrs), normal/healthy (7-8 hrs), and long (≥9 hrs) sleep. Using STATA 15.0 for Windows, we report weighted frequencies and Chi square tests. Alpha of 0.05 was used for all significance levels. Results Of the sample, 18% were male and 82% were female. The mean age was 50.7±17.5. The majority of the sample was White (77%), 12% were Black and 9% were of other minority”. The proportion of women who reported short sleep (31%) and normal (45%) were significantly higher than men (p&amp;lt;0.000). Healthcare workers under 30 had the highest proportions of short sleep compared to any other age groups (p&amp;lt;0.000). Lower numbers were associated with long sleep among those who worked directly with patients compared to workers who did not (p&amp;lt;0.000). Healthy sleep was significantly associated with not having trouble falling asleep, staying asleep, not taking sleep medications, and feeling rested 7 or more times in the past week (p&amp;lt;0.000). Conclusion Our study explores sleep patterns among healthcare professionals. Previous studies have shown that this population is more susceptible to insufficient sleep which leads to sleep debt. We found that the current data suggest that this association may have changed for healthcare professionals today. Support This study was supported by funding from the NIH: R01MD007716, R01HL142066, K01HL135452, and K07AG052685.

Coronavirus-days ın dermatology.

Severe acute respiratory syndrome‐corona virus‐2, which causes coronavirus disease 2019 (COVID‐19), is highly contagious and a particularly popular problem in all around the World and also in all departments of every hospital. In order to protect the well‐being of health care providers while providing a sufficient workforce to respond to the COVID‐19 are vital for pandemic planning. In this article, we will discuss this problem from a dermatological aspect.

CORONAVIRUS‐DAYS IN DERMATOLOGY

Severe acute respiratory syndrome‐corona virus‐2 (SARS‐CoV‐2), which causes coronavirus disease 2019 (COVID‐19), is highly contagious and a particularly popular problem in all around the World and also in all departments of every hospital. In order to protect the well‐being of healthcare providers while providing a sufficient workforce to respond to the coronavirus disease (COVID‐19) are vital for pandemic planning. In this article, we will discuss this problem from a dermatological aspect.This article is protected by copyright. All rights reserved.

Rethinking the electronic health record through the quadruple aim: time to align its value with the health system

Electronic health records (EHRs) are considered as a powerful lever for enabling value-based health systems. However, many challenges to their use persist and some of their unintended negative impacts are increasingly well documented, including the deterioration of work conditions and quality, and increased dissatisfaction of health care providers. The “quadruple aim” consists of improving population health as well as patient and provider experience while reducing costs. Based on this approach, improving the quality of work and well-being of health care providers could help rethinking the implementation of EHRs and also other information technology-based tools and systems, while creating more value for patients, organizations and health systems.

Helping Patients and Health Care Providers Through the COVID-19 Pandemic: Empirically Based Tips and Strategies to Manage Mental and Physical Health

The COVID-19 pandemic is enacting a heavy mental health toll on people around the world. This article provides evidence-based information and techniques to promote and foster mental and physical health for our patients and health care providers. The article 1) reviews common emotional reactions faced by patients during the COVID-19 pandemic, 2) reviews how health care providers can help patients make sense of their experiences, and 3) teaches evidence-based skills that health care providers can use to support patients during the COVID-19 pandemic and care for themselves. The article provides tips and strategies that can be helpful in interacting with patients and supporting the well-being of health care providers. These strategies are based on empirically supported knowledge and skills drawn from literature on stress, coping, emotional management, chronic disease management, and behavior changes, and provides ways to discuss these tips with patients in applicable, understandable ways.

Examining the Rates of Anxiety, Depression, and Burnout Among Providers at a Regional Burn Center.

Burnout, defined by feelings of inefficacy, cynicism, and emotional exhaustion, affects the performance and well-being of health care providers. Burn care exposes providers to factors known to cause or worsen burnout, but no research has presented prevalence rates of burnout in this population. We estimate the rates of anxiety, depression, and burnout among nonphysician providers in a regional burn center and compare those rates to a reference population of critical care nurses. In our sample of 22 providers, 64% screened positive for anxiety; 32% for depression; 82% for emotional exhaustion; 18% for personal achievement burnout; and 54% for depersonalization. When compared with a national sample of critical care nurses, burn center providers demonstrated a significantly higher rate of anxiety (risk difference [RD]: 0.453, 95% confidence interval [CI] [0.244, 0.622]), a significantly higher rate of emotional exhaustion (RD: 0.207, 95% CI [0.001, 0.323]), and a significantly lower rate of personal achievement burnout (RD: -0.325, 95% CI [-0.442, -0.119]). These findings constitute the first evidence that many burn care providers meet criteria for burnout and that burnout in burn care providers may qualitatively differ from burnout in other critical care providers. Future research should identify burn care-specific predictors of burnout and determine the feasibility and efficacy of interventions to prevent and reduce burnout in burn care providers.

A Qualitative Study of a Compassion, Presence, and Resilience Training for Oncology Interprofessional Teams.

The well-being of health care providers may be challenged by their work, with evidence that oncology health care providers are a high-risk group for burnout. The present qualitative pilot study evaluated a mindfulness-based group intervention, referred to as Compassion, Presence, and Resilience Training (CPR-T), for oncology interprofessional teams. The purpose of this study was to elucidate the subjective experience of oncology health care providers receiving CPR-T and their perceptions of its benefits, risks, or challenges. The CPR-T was delivered to providers from two oncology teams in a large cancer center in Canada. Ten of these providers participated in semistructured interviews 1 to 5 months after completing the CPR-T. The interview transcripts were coded using a thematic analysis strategy. Five benefits of the CPR-T were identified: learning to pause, acquiring a working definition of stress and self-care, becoming fully present, building self-compassion, and receiving organizational acknowledgment and recognition of stress. In addition, two participant-identified challenges were recognized: sharing vulnerability within interprofessional teams and committing to a sitting meditation practice. These findings demonstrate positive transformations as a result of the CPR-T, as well as important challenges, and have important implications for holistic health care practice in oncology. Further research is necessary to validate the findings of this explorative study.

Perspectives on Healthcare Provider Well-Being: Looking Back, Moving Forward.

Recognizing the impact of healthcare professional (HCP) burnout has led to vigorous interest from organizations and individuals regarding how to most effectively promote HCP well-being. The present paper reviews the literature on HCP well-being and describes factors that impact well-being at various levels (i.e., system, institution, program, interpersonal, and individual). We propose that change must occur at all levels to have the greatest impact. Further, we highlight opportunities to advance research on HCP well-being (e.g., being more inclusive regarding study populations and designing longitudinal intervention studies).

The Problems With Burnout Research.

Burnout among physicians and physicians-in-training is well established as a potential threat to the health and well-being of health care providers and patients. However, there are myriad problems with current burnout research and its ongoing measurement that threaten the validity of the conclusions. For example, researchers have used differing ways of defining and measuring burnout. Those who have used the Maslach Burnout Inventory vary in recommended use of the instrument and cutoff scores. As a result, the authors suggest that the term "burnout" may be misused and recommend some reconsideration of the meaning of burnout. The measurement and discussion of burnout have strong implications for interventions and policy alike. In this article, the authors review the problems with burnout research and ask important questions about the future directions of research efforts. The authors recommend a consistent measurement approach and perhaps moving toward a focus on physician wellness from a positive psychology perspective.

Burnout syndrome among healthcare professionals.

The well-being of healthcare providers and the influence of healthcare provider mental health and wellness on patient safety have garnered national interest and attention, though the concept of burnout among healthcare professionals is not new.[1][1],[2][2] Healthcare, as an industry, places