Well-being Of Healthcare Workers Research Articles

Naar een nieuw geïntegreerd gemengd financieringsmodel voor de huisartspraktijk

A new integrated mixed payment model for general practitioners in Belgium Belgian primary care faces a number of challenges, exacerbated by the COVID-19 pandemic: an increasing percentage of elderly people, changing family structures, a shrinking labour market, health inequities, rapid and sometimes costly technological innovations, etc. The ‘quintuple aim’ was set as a goal to organise equitable and cost-effective, high-quality care to secure the health of citizens and the well-being of healthcare workers. There’s a growing consensus that a dominantly fee-for-service system is not fit to respond to the challenges. This article proposes a third mixed payment model, besides the 2 existing models, i.e. a fee for service and a capitation model. In this new model, the general practitioner’s income will be based for 60/70% on capitation and for 40/30% on fee for service. The income via capitation will depend on the characteristics of the patient population (age, socioeconomic status and maybe gender). Important conditions to implement this new model are a complete registration of all citizens in a primary care practice as well as monitoring of the number of consultations and home visits. Importantly, all forms of teleconsultations will be paid under the capitation part and the face-to-face encounters under the fee-for-service system. This new mixed model may cause some income shifts between general practitioners. Therefore, a thorough simulation at practice and care provider level is necessary before implementation.

Pilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers

The COVID-19 pandemic has significantly impacted the mental well-being of health care workers (HCWs). This study assessed the feasibility, acceptability, and preliminary efficacy of two psychological interventions, gratitude journaling or cognitive strategies, on pediatric HCWs. A pilot randomized parallel repeated measures design was used, with a convenience sample of 59 HCWs. Data were collected before and after the intervention period, 2 weeks after, and again 6 months later. Outcomes included depression, anxiety, meaning and purpose, feasibility, and acceptability. Thirty-seven participants completed the study. The majority were nurses (registered nurses and advanced practice registered nurses) and physicians. In both groups, depression and anxiety scores diminished, but changes were not statistically significant. The study was feasible to conduct, and subjects reported high acceptability. Gratitude journaling and cognitive strategies may help mental well-being in HCWs; however, future studies with larger samples are needed.

Working conditions during the COVID-19 pandemic in primary and tertiary healthcare: a comparative cross-sectional study.

The COVID-19 pandemic has globally affected healthcare workers' (HCWs) health and wellbeing. Most studies on COVID-19 have focused on tertiary healthcare. The aim of this study was to increase the knowledge on the effects of the pandemic on working conditions in tertiary and primary healthcare. The comparative cross-sectional study consisted of an online questionnaire sent to HCWs of the City of Helsinki (primary healthcare) and Helsinki University Hospital (tertiary healthcare). Altogether 1580 HCWs with direct patient contact participated in the study: 895 from tertiary and 685 from primary healthcare. Statistical analysis used SPSS 25 from IBM. The tests used were the χ2 test, Fisher's exact test, and binary logistic regression analysis. Primary HCWs were less likely to treat COVID-19 patients (OR = 0.45, 95% CI: 0.37-0.56). However, both groups reported a similar number of COVID-19 infections, primary HCWs 4.9% and tertiary HCWs 5.0%, and workrelated quarantine was significantly more prevalent (OR = 1.96, 95% CI: 1.38-2.79) among primary HCWs. In addition, work-related wellbeing was poorer among primary HCWs than tertiary HCWs in terms of feeling more stressed at work (OR = 3.20, 95% CI: 2.55-4.02), not recovering from work (OR = 0.49, 95% CI: 0.39-0.62), reported mental wellbeing below normal levels (OR: 1.59, 95% CI: 1.26-2.00), and increased working hours (OR = 1.63, 95% CI: 1.25-2.12). The study demonstrates how the pandemic has affected the wellbeing and working conditions of not only tertiary but also less studied primary HCWs. The authors' findings suggest that the challenges identified during the COVID-19 pandemic in the health and wellbeing of healthcare workers are even greater in primary care than in tertiary care. Int J Occup Med Environ Health. 2023;36(1):139-50.

Supporting Mental Health and Psychological Resilience Among the Health Care Workforce: Gaps in the Evidence and Urgency for Action.

Since the COVID-19 pandemic started, health care workers have faced various challenges to their mental health due to extreme working conditions. Yet these workers have continued to deliver care in the face of stressors and death among their patients, family, and social networks. The pandemic highlighted weaknesses within our health care work environment, especially pertaining to a need to provide increased psychological resilience to clinicians. There has been little research to determine the best practices for psychological health in workplaces and interventions to improve psychological resilience. Although some studies have attempted to provide solutions, there are noteworthy gaps in the literature on effective interventions to use in the time of crisis. The most common include an absence of preintervention data concerning the overall mental well-being of health care workers, inconsistent application of interventions, and a lack of standard assessment tools across studies. There is an urgent need for system-level strategies that not only transform the way workplaces are organized, but also destigmatize, recognize, support, and treat mental health conditions among health care workers. There is also need for more evidence-based resources to improve resilience on the job, and thereby increase clinicians' capacity to address new medical crises. Doing so may mitigate rates of burnout and other psychological conditions in times of crisis among health care workers.

The moderating effect of the COVID-19 pandemic on the mental wellbeing of health care workers on sustainable employability: A scoping review.

Sustainable employability (SE) amongst healthcare workers (HCW) is an important asset for healthcare institutions. However, SE is under strain due to high work pressure, a shortage of employees, and absenteeism amongst employees based on mental problems. These developments had already started before the COVID-19 pandemic. The aim of this review is to explore whether there is a moderating effect of the COVID-19 pandemic on the mental wellbeing of HCW in the context of SE. A double blinded systematic review was conducted for this article in accordance with preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were subjected to quality evaluation and narrative synthesis. The analysis of the selected literature led to the understanding that mental problems amongst HCW were already abundantly present before the COVID-19 pandemic. Mental health problems have increased in prevalence, severity, and variation. In general, a negative relation between (mental) health and SE exists. Our findings show that mental health problems have heavily impacted the SE of HCW: absenteeism has increased and perspective on work has changed. It is time to prioritize the mental health of HCW to prevent acute care capacity from declining even further and ending up in a vicious circle.

The safety, health, and well-being of healthcare workers during COVID-19: A scoping review.

The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID-19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care.

Being a technician during COVID-19: a qualitative cross-sectional survey on the experiences of clinical neurophysiology technicians.

During the Sars-CoV-2 virus pandemic, Italy faced an unrivaled health emergency. Its impact has been significant on the hospital system and personnel. Clinical neurophysiology technicians played a central role (but less visibly so compared to other healthcare workers) in managing the COVID-19 pandemic. This research aims to explore the experiences of clinical neurophysiology technicians during the pandemic and contribute to the debate on the well-being of healthcare workers on the front line. We implemented a cross-sectional survey across Italy. It contained questions that were open-ended for participants to develop their answers and acquire a fuller perspective. The responses were analyzed according to the framework method. One hundred and thirty-one responses were valid, and the following themes were generated: technicians' experiences in their relationship with patients, technicians' relationship with their workgroup and directors, and technicians' relationship with the context outside of their work. The first theme included sub-themes: fear of infection, empathy, difficulty, a sense of obligation and responsibility, anger, and sadness. The second theme contained selfishness/solidarity in the workgroup, lack of protection/collaboration from superiors, stress, and distrust. The last theme included fear, stress/tiredness, serenity, sadness, and anger. This study contributes to building a humanized perspective for personnel management, bringing attention to the technical work of healthcare professionals in an emergency and the emotional and relational dimensions. These are the starting points to define proper, contextually adequate support.

Supporting MRT mental health: Through COVID-19 and beyond

The COVID-19 pandemic has had an exceptional impact on the healthcare profession, and in particular, on the mental health and wellbeing of healthcare workers. The Canadian Association of Medical Radiation Technologists (CAMRT) has been working on ways to prioritize the mental health of their members while increasing advocacy efforts. Conducting a national survey on mental health and interviewing medical radiation technologists (MRTs) highlighted the challenges that exist while also informing which support system components are most needed to improve wellbeing. The purpose of the research is to share the lived experience of Canadian MRTs in relation to their mental health during the pandemic. It adds to the knowledge gained from the survey by exploring in depth accounts of what MRTs felt and experienced during COVID-19. Understanding this challenging time period may aid in developing additional resources and support for MRTs in the workplace. The overall message in healthcare should be, optimize your wellbeing and your patients will be taken care of too. Recommendations to foster this message includes empowering MRTs to advocate for their mental health and wellbeing, promoting timely and adequate supports, monitoring the mental health of our professional landscape and welcoming others to join the conversation. This paper examines what mental health supports are recommended by the MRTs who were interviewed, and the information gathered from the CAMRT Mental Health of Medical Radiation Technologists in Canada 2021 Survey.

Health-oriented leadership’s impact on the well-being of healthcare workers: Assessment with a mediated model

. In the face of growing stress in the workplace, employers are particularly interested in management practices focused on maintaining the psychological health of employees. This study examines the effect of the perception of health-oriented leadership (HoL) on the well-being of healthcare workers who have severe psychosocial working conditions in order to increase interest in employee well-being and provide leadership with a central role in this regard. The paper examined psychological wellbeing (PWB), job satisfaction, and life satisfaction together while attempting to determine whether HoL directly and indirectly (via PWB) affected work and life satisfaction based on the JD-R model. The methodological basis of the study was the provisions of the human resource theory management and the theory of leadership. Data was collected from 187 employees (convenience sampling) of a healthcare organization operating in a province in Turkey with the survey technique and analyzed using the SPSS and Smart PLS software. The findings revealed that HoL affects job satisfaction and life satisfaction both directly and through PWB. Therefore, the perception of HoL increased PWB, which in turn increased job satisfaction and life satisfaction. The study ultimately deducted that it was important to exhibit HoL behaviors for employee well-being. Among possible directions for further research could be a longitudinal design of analysis, as well as expanding the sample by including private healthcare organizations and additional locations.

Mental Well-Being of Health Care Workers in Vietnam During the Fourth Wave of COVID-19 Pandemic: Impact of COVID-19 Exposure, Anxiety, and Resilience Capacity.

Mental Well-Being of Health Care Workers in Vietnam During the Fourth Wave of COVID-19 Pandemic: Impact of COVID-19 Exposure, Anxiety, and Resilience Capacity.

Health Care Organization Policies for Employee Safety and COVID-19 Pandemic Response: A Mixed-Methods Study.

The coronavirus (COVID-19) pandemic impacted the well-being of health care workers. We examined the association between prepandemic perceptions of perceived organizational support for safety (using NOSACQ-50), safety hazards and the pandemic's impact on individual workers and institutions. Questionnaires from health care staff of five public health care facilities were collected in 2018 ( n = 1059) and 2021 ( n = 1553). In 2021, 17 workers were interviewed from the same facilities. Interviewees reported that their organizations struggled to communicate due to changing guidelines, inadequate personal protective equipment, training, and infection control, early in the pandemic. Questionnaire reports of decreased staffing and increased workload during the pandemic were associated with lower baseline NOSACQ scores. Survey findings predicted some variation in organizational response to the pandemic. Better organizational policies for employee safety and pandemic planning could improve health care institutions' preparedness.

1.L. Workshop: Building capacity for a resilient and healthy post-COVID health workforce

Abstract Background The COVID-19 pandemic added new challenges to health workforce resilience. High workload, increased risk of COVID infection and continuing stress threaten the health and wellbeing of healthcare workers (HCWs) and increase existing (gendered) inequalities, thus reinforcing health labour market problems. Investment in the health workforce and prioritisation of the health and wellbeing needs of healthcare workers in health policy and pandemic recovery plans is therefore called for by the WHO, the European Union and others. However, health systems and policymakers across countries have not sufficiently understood the importance of HCWs. Objectives This workshop brings health workforce needs onto the health policy agenda. It seeks to build capacity for a resilient and healthy health workforce, setting the focus on protection and preparedness of HCWs and their individual wellbeing, and reduction of gendered inequalities. The following major questions will be addressed: What do we know about COVID-19 and the health and wellbeing of HCWs? What skills are needed to respond to new demands? What policy approaches are available to improve protection, preparedness and mental health support of HCWs? How to integrate gender equality and the situation of migrant/refugee HCWs in these approaches, and finally build capacity for effective health workforce governance and its implementation. The workshop introduces novel results drawn from European comparative research and country case studies. It connects policy and practice, as well as health system and individual HCW needs. A number of important policy recommendations are emerging from the research. (1) The health and wellbeing of the health workforce must be addressed systematically across all levels of health policy and governance, including the organisation settings. (2) Health systems must take responsibility and leadership in responding to health workforce needs. (3) Important lessons to be learned from HCWs’ experiences should guide future health workforce policy and pandemic recovery plans. (4) Participatory governance and inclusion of HCWs must be strengthened, including gender equality and diversity. The workshop will stimulate critical debate and improve knowledge exchange across countries and between researchers. It will contribute to strengthen resilience of the health workforce and health systems, and to build back better after COVID-19 in a fair and equitable manner. Key messages • Health workforce needs and mental health support must become policy priorities and addressed as part of health system resilience. • Action has to be taken to strengthen participatory health workforce governance sensitive to new needs.

Mental wellbeing among Danish employees during the COVID-19 pandemic: results from a longitudinal study on the role of industry and working environment.

The COVID-19 pandemic has had a profound impact on working life. Previous studies have primarily focused on the mental health and wellbeing of healthcare workers and are mostly based on cross-sectional data from non-representative samples. The aim of this study was to investigate mental wellbeing trajectories among employees from different industries, and to longitudinally identify factors that affect mental wellbeing during the COVID-19 pandemic, including job insecurity, fear of COVID-19, working from home or being discharged with wage compensation and management quality. Baseline data were obtained from the Danish Health and Wellbeing Survey in 2019 (September-December), with follow-up in September-November 2020. We included 1995 respondents, who completed the questionnaire in both waves and were employed in 2020 and measured mental wellbeing using the Short Warwick-Edinburgh Mental Well-Being Scale. Mental wellbeing declined among employees in all industries. Employees working from home and employees unsatisfied with management experienced a greater decline in mental wellbeing. We found no differences in mental wellbeing trajectories in relation to fear of infecting others or contracting COVID-19, job insecurity and being discharged with wage compensation. Mental wellbeing declined among employees in all industries with no difference between industries. Employees working from home may have been particularly vulnerable, and the analyses show that managers play a key role in mitigating the negative consequences of the pandemic by ensuring adequate information and involvement of employees.

Die Situation der Ärztinnen und Ärzte in Akutkrankenhäusern während der zweiten Welle der SARS-CoV-2-Pandemie: eine Onlinebefragung

BackgroundThe SARS-CoV-2 pandemic has an impact on the wellbeing of health care workers. The influence of a work-related sense of coherence as well as perceived organizational support on the level of burnout and the intention to leave the job is largely unknown, especially for physicians in German hospitals. MethodIn December 2020 and January 2021, physicians of 81 hospitals in Hessian (Germany) participated in an online survey using the BAT (Burnout Assessment Tool), Work-SoC (Work-related Sense of Coherence), the POS-s (Perceived Organizational SUPPORT – short version) and literature-based items based. ResultsOf 181 physicians, 34% showed a moderate or high burnout level, 21% would leave the job after the pandemic. The higher the work-SoC (β = −0.560; p < 0.001) and the higher the POS-s (β = −0.125; p < 0.05), the lower the burnout level. Not being able to care sufficiently for their patients has a negative impact on the sense of coherence. 46.4% reported that they did not feel sufficiently prepared by their employer during the pandemic. They wished to have support in the form of the mindfulness and resilience trainings (45%), emergency childcare (41%) and a crisis counselor in their team (32%). ConclusionRegardless of the pandemic, health-promoting work conditions have to be developed that facilitate coherent work and prevent “moral injuries” or enable physicians to deal with them.

Healthcare-associated infection prevention and control practices in Israel: results of a national survey

BackgroundHealthcare-associated infection (HAI) is a common and largely preventable cause of morbidity and mortality. The COVID-19 pandemic has presented unprecedented challenges to health systems. We conducted a national survey to ascertain hospital characteristics and the use of HAI prevention measures in Israel.MethodsWe e-mailed surveys to infection prevention and control (IPC) leads of acute care hospitals in Israel. The survey included questions about the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). The survey also assessed COVID-19 impact and healthcare worker well-being.ResultsIPC leads from 15 of 24 invited hospitals (63%) completed the survey. Only one-third of respondents reported strong support for IPC from hospital leadership. Although several prevention practices were used by all hospitals (e.g., maximum sterile barrier precautions for CLABSI and real-time assessment of environmental cleaning for CDI), use of other practices was suboptimal—particularly for CAUTI and VAP. COVID-19 had a profound impact on Israeli hospitals, with all hospitals reporting opening of new units to care for COVID patients and most reporting moderate to extreme financial hardship. All hospitals reported highly successful plans to vaccinate all staff and felt confident that the vaccine is safe and effective.ConclusionWe provide a status report of the IPC characteristics and practices Israeli hospitals are currently using to prevent HAIs during the COVID-19 era. While many globally accepted IPC practices are widely implemented, opportunities to increase the use of certain IPC practices in Israeli hospitals exist.

Remote Monitoring of COVID-19 Patients Using Multisensor Body Area Network Innovative System.

As of late 2019, the COVID19 pandemic has been causing huge concern around the world. Such a pandemic posed serious threats to public safety, the well-being of healthcare workers, and the overall health of the population. If automation can be implemented in healthcare systems, patients could be better cared for and health industries could be less burdened. To combat such challenges, e-health requires apps and intelligent systems. Using WBAN sensors and networks, a doctor or medical professional can advise patients on the best course of action. Patients' fitness could be assessed using WBAN sensors without interfering with their daily activities. When designing a monitoring system, system performance reliability for competent healthcare is critical. Existing research has failed to create a large device capable of handling a large network or to improve WBAN topologies for fast transmitting and receiving patient data. As a result, in this research, we create a multisensor WBAN (MSWBAN) intelligent system for transmitting and receiving critical patient data. To gather information from all cluster nodes and send it to multisensor WBAN, a novel additive distance-threshold routing protocol (ADTRP) is proposed. In small networks where data are managed by the transmitting node and the best data route is determined, this protocol has less redundancy. An edge-cutting-based routing optimization (ES-EC-R ES-EC-RO) is used to find the best route. The Trouped blowfish MD5 (TB-MD5) algorithm is used to encrypt and decrypt data, and the encrypted data are stored in a cloud database for security. The performance metrics of our proposed model are compared to current techniques for the best results. End-to-end latency is 63 ms, packet delivery is 95%, security is 95.7%, and throughput is 9120 bps, according to the results. The purpose of this article is to encourage engineers and front-line workers to develop digital health systems for tracking and controlling virus outbreaks.

Risk Perception Related to COVID-19 and Future Affective Responses Among Healthcare Workers in Switzerland: A Mixed-Methods Longitudinal Study.

Objectives: Whereas early findings suggest that risk perceptions related to COVID-19 affect psychological well-being in healthcare workers (HCWs), the temporal associations between these variables need to be clarified and HCWs lived experience further explored. This study proposes a mixed evaluation of COVID-19-related risk perception and affective responses among HCWs. Methods: A longitudinal mixed-method study was conducted. HCWs (N = 138) completed measures of COVID-19 risk perceptions, depression, anxiety, burnout and secondary traumatic stress (STS) at baseline and 6 months later. A subsample (n = 20) participated in semi-structured interviews exploring both risk perceptions and affective responses. Results: Main quantitative findings showed positive associations between worry to contaminate others and depression (IRR = 1.04, p < 0.05), anxiety (IRR = 1.03, p < 0.01), STS (b = 0.3, p < 0.05), and perceptions of lacking protection (IRR = 1.04, p < 0.05) with anxiety scores. Four themes emerged from the thematic content analysis: 1) life was turned upside down; 2) skills were put in quarantine; 3) dealing with patient discomfort; 4) balance to be found between protection and restrictions. Conclusion: These findings emphasize the importance to develop tailored interventions, such as group discussion sessions, to optimize risk perception and help manage uncertainty.

The effect of social network diversity and social support on the thriving of healthcare workers

Aim: The well-being of healthcare workers is a critical indicator in the provision of high-quality care. Although researchers have stressed the importance of social interactions and social support, scarce data exist about their effects on healthcare workers’ well-being. In this study, we aim to advance the research on the relationships between social network diversity (SND), social support, and thriving.Methods: In a cross-sectional design, an anonymous online link was shared among healthcare workers in a university hospital. The survey included questions on demographics, medical diseases, items from the social network index, the multidimensional perceived social support scale, and the brief and comprehensive inventories of thriving scales.Results: A total of 103 individuals participated in the study (median age, min-max=33 (18-57); male/female = 33/70). Men and women did not differ in SND, perceived social support, or thriving scores. The brief inventory of thriving demonstrated healthcare workers older than 38 years exhibited higher scores in thriving compared to those younger than 27 years (p=0.001). According to comprehensive inventory of thriving, belonging (p=0.032), skills (p=0.006), self-worth (p=0.048), meaning and purpose (p&amp;lt;0.001), optimism (p=0.009), life-satisfaction (p=0.012), and positive emotions (p=0.042) differed by age groups. SND (r=.56, p&amp;lt;0.001) and perceived social support (r=.53, p&amp;lt;0.001) were positively correlated with thriving. After adjusting for potential confounders, SND, perceived social support, and age accounted for 46% of the total effects on thriving.Conclusion: This study expands on the literature and provides evidence that by increasing the diversity of social networks and improving the quality and functionality of social support, a significant and positive impact on HCWs’ well-being may be achieved.

Shared sources and mechanisms of healthcare worker distress in COVID-19: a comparative qualitative study in Canada and the UK

ABSTRACT Background: COVID-19 has had a significant impact on the wellbeing of healthcare workers, with quantitative studies identifying increased stress, anxiety, depression, insomnia, and PTSD in a wide range of settings. Limited qualitative data so far has offered in-depth details concerning what underlies these challenges, but none provide comprehensive comparison across different healthcare systems. Objective: To explore qualitative findings relating to healthcare worker distress from two different countries to understand the nuanced similarities and differences with respect to the sources and impact of distress relating to COVID-19. Method: A comparative interpretive thematic analysis was carried out between two qualitative data sets examining healthcare workers’ experiences of distress during the COVID-19 pandemic. Data from Canada and the UK were collected in parallel and analyzed in an iterative, collaborative process. Results: A number of sources of distress cut across both study settings including concerns about safety and patient care, challenges at home or in one’s personal life, communication issues, work environment, media and public perception, and government responses to the pandemic. These sit on a spectrum from individual to institutional sources and were mutually reinforcing. Our analysis also suggested that common mechanisms such as exacerbations in uncertainty, hypervigilance, and moral injury underpinned these sources, which contributed to how they were experienced as distressing. Conclusion: This is the first international collaboration utilising qualitative data to examine this pressing issue. Despite differences in the political, social, health service, and pandemic-related context, the sources and mechanisms of distress experienced by healthcare workers in Canada and the UK were remarkably similar. HIGHLIGHTS This international comparative qualitative study explores how mechanisms that lead to distress are shared across different geographies and cultures, even as the local context shapes the sources of distress themselves.

The angels and heroes of health care: Justified and appropriate, or harmful and destructive?

The angels and heroes of health care: Justified and appropriate, or harmful and destructive?