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BackgroundNeedle stick injury (NSI) is one of the most common and severe occupational hazards for healthcare workers (HCWs), leading to both physical harm and psychological distress and ultimately affecting patient safety. Previous studies on NSI were predominantly focused on general clinical practice, and limited research has targeted specifical NSI occurring in acupuncture practice in China, which has the greatest use of acupuncture.ObjectiveThis study aimed to investigate NSI and associated factors among acupuncture practitioners in China.MethodsA cross-sectional online survey was conducted among acupuncture practitioners across 98 hospitals in southwest China from April to May 2024. A researcher-developed questionnaire was used to collect participants’ experiences of NSI, general information, and knowledge, behavior, and risk perception related to occupational exposure. Multivariate logistic regression was employed to examine factors associated with NSI.ResultsA total of 578 acupuncture practitioners completed the questionnaire, among whom 34.3% experienced at least one NSI in the past three years, yet 46.0% of these incidents were not reported. Factors associated with an increased risk of NSIs included postgraduate education or higher (OR = 2.174, 95% CI: 1.020, 4.634), high probability of occupational exposure (OR = 2.940, 95% CI: 1.826, 4.735), moderate perception of exposure severity (OR = 9.149, 95% CI: 1.948, 42.97), and high perception of exposure severity (OR = 7.025, 95% CI: 1.497, 32.969). Conversely, factors associated with a reduced risk of NSIs included females (OR = OR = 0.576, 95% CI: 0.379, 0.876), nurses (OR = 0.396, 95% CI: 0.210, 0.746), working in other professions (OR = 0.362, 95% CI: 0.151, 0.868), adherence to standard preventive measures (OR = 0.396, 95% CI: 0.210, 0.746), and consistent adherence to post-exposure procedures (OR = 0.092, 95% CI: 0.021, 0.398).ConclusionNSI is common among acupuncture practitioners in Chinese medical institutions, and under-reporting is significant. Our findings suggest that standard prevention strategies, adherence to exposure protocols, enhanced training, and effective reporting policies may help reduce NSI and improve reporting rates.

IntroductionThe health sector is a field where employees are frequently exposed to occupational injuries due to high-risk working conditions. This study aimed to examine the distribution and causes of occupational injuries experienced by healthcare workers in the last 5 years in Turkey.Materials and methodsIn this population-based and national-scale study, occupational injuries reported to the Ministry of Health from healthcare organizations in 81 provinces of Turkey between 01.01.2019 and 31.12.2023 were retrospectively analyzed. Variables such as age, gender, title, place of employment, types of injuries, causes, and outcomes of occupational injuries were evaluated.ResultsA total of 68,563 occupational injuries were reported between the years analyzed. 64.5% of the injuries affected female workers. Occupational injuries occurred most frequently during the summer months and in hospitals. According to age groups, the highest rate of occupational injuries was observed in the 20–29 age group with 39.3%. Among the types of occupational injuries, sharps injuries were the most common, with 55.3%. It was followed by slips, trips, and falls (13.2%). As a result of occupational injuries, 76.2% of healthcare workers were able to return to work without long-term absence. Over the 5 years, 61 healthcare workers lost their lives due to occupational injuries. Nurses and midwives were the occupational groups most exposed to injuries, followed by cleaning staff.ConclusionTurkey's healthcare workers have a high exposure rate to occupational injuries. Women and young workers are the most affected groups. Strengthening the occupational safety culture and providing safe working environments is necessary.

BackgroundGenetic testing in psychiatry has gained attention, raising questions about its application and impact. Understanding stakeholders’ perspectives, including healthcare providers and patients, is vital for informed policy development. The aim of this systematic review was to focus on the perceptions and concerns of patients and healthcare workers in psychiatry regarding the use of genetic testing.MethodsWe conducted a systematic review following PRISMA guidelines, for the period 1/2/2014, to 1/1/2024, via PubMed and Embase databases identifying 50 articles in total. After excluding duplicates (n = 12), 38 articles went through screening. After careful full-text article assessment for eligibility and applying the inclusion and exclusion criteria, only fifteen (n = 15) of the articles were included.ResultsAmong 15 selected studies involving 3,156 participants (2,347 healthcare professionals; 809 patients), thematic analysis identified four primary themes: Organizational-implementation concerns, Ethical Considerations, Concerns on changes in clinical praxis, and Legal implications. Despite these concerns, seven out of eleven studies indicated that healthcare workers viewed genetic testing in psychiatry positively. Patients’ perspectives varied, with two of the four studies reflecting positive attitudes. No pervasive negative sentiment was observed.ConclusionOur review highlights the multidimensional perspectives of healthcare professionals and patients surrounding the application of genetic testing in psychiatry. These considerations need to be addressed to facilitate the implementation of genetic testing in clinical praxis in psychiatry. Further research is needed for validation of the results and to guide policies and clinicians in the integration of genetic testing into mental healthcare practice.

BackgroundIn resource-limited areas, especially in conflict-affected settings, managing the risk of hospital-acquired infections is difficult due to the destruction of essential facilities in healthcare settings. The study aimed to assess adherence to Infection prevention practices and associated factors among healthcare workers in Northeastern Ethiopia following the Northern Ethiopia conflict.Methods and materialsA facility-based cross-sectional study was done with 408 healthcare workers. The survey data was collected using a structured questionnaire based on published articles. Data entry and analysis was done using Epi-Data version 4.6 and SPSS version 25.0, respectively. Binary logistic regression was used to determine the association between dependent and outcome variables, with a cut-off p value 0.05 at 95% confidence interval with a p-value less than 0.05 and a 95% confidence interval for determining factors associated with adherence to infection prevention practices among study participants.ResultsThe study included 408 healthcare workers with a response rate of 96.7%. The majority of participants were women 206 (50.5%), married 250 (61.3%), Orthodox followers 211 (51.7%), and educational status of master holder and above with a master’s degree or higher 177 (43.4%). Slightly more than half, 53.7% (219) of the respondents demonstrated safe infection prevention practices. Respondents who received training on infection prevention practices (AOR = 2.662, 95% CI: 1.361, 5.120) had an active infection prevention committee (AOR = 2.203, 95% CI: 1.359, 3.572), use infection prevention guidelines in working departments (AOR = 2.090, 95% CI: 1.013, 4.312), and access to adequate personal protective equipment (AOR = 2.773, 95% CI: 1.560, 4.929) were factors significantly associated with adherence to infection prevention practices.ConclusionOverall, only half of the respondents practiced safe infection prevention practices. Receive training on infection prevention guidelines, presence of active infection prevention committee and working guidelines, and the availability of personal protective equipment were factors of infection prevention. Hence, essential facilities like Personal protective equipment, working guidelines should be supplied by donors.

BackgroundProfound intellectual multiple disabilities or polyhandicap (PLH) is defined as a combination of profound mental retardation and serious motor deficits resulting in extreme dependence. Support for these patients is multidisciplinary, complex, and time-consuming. Thus, institutional health care workers (HCWs) face specific working conditions: frequent physical tasks, distressed families, and restricted feedback.ObjectivesWe aimed to identify determinants of quality of life (QoL) of HCWs and to study longitudinal evolution.MethodsThe study used data from the French cohort EVAL-PLH. The participants were institutional HCWs of persons with PLH (age ≥ 3 years at the time of inclusion; age at onset of cerebral lesion

BackgroundThis study evaluates the knowledge, attitudes, and practices (KAP) of hand hygiene among healthcare workers, crucial for preventing healthcare-associated infections (HAIs) in medical facilities.MethodologyThis cross-sectional study assessed hand hygiene KAP among healthcare workers across various settings in Hubei, China utilizing a stratified random sampling approach from, December 25, 2023-to-April 25, 2024. A bilingual electronic survey, adapted from validated tools, was disseminated via email and social media to ensure a broad reach. Participants included diverse healthcare professionals who met specific inclusion criteria. Responses were analyzed using R software, employing descriptive and inferential statistics to identify key predictors of hand hygiene behavior and to confirm the reliability of the survey instrument.ResultsThe survey of 2,265 healthcare workers revealed that 77% demonstrated comprehensive knowledge of hand hygiene, 80% exhibited positive attitudes, and 94% practiced effective hand hygiene. Notable findings include a significant understanding of hand hygiene’s role in preventing respiratory illnesses (58%) and HAIs (41% agreed, 39% unsure). High compliance in practices like washing hands for at least 20 s was evident (84%), though gaps in confidence about hand hygiene techniques were noted (33% confident, 56% unsure). Binary logistic regression analysis indicated that younger healthcare workers (21–30 years) were more likely to exhibit both knowledge (OR = 7.4, 95% CI = 1.44–136, p = 0.059) and positive attitudes (OR = 4.48, 95% CI = 1.73–11.8, p

BackgroundEffective management of diabetes mellitus (DM) involves comprehensive knowledge, attitudes, and practices (KAP) by nurses, which is essential for optimal patient care and aiding patients in their self-management of the condition.MethodThis survey evaluates nurses' self-assessed knowledge, attitudes, and practices (KAP) related to diabetes management, focusing on their perceptions of personnel expertise and care approaches. Using a stratified sampling method, the survey was disseminated across various online platforms from January 2023 to February 2024 within China, including WeChat and Sina Weibo. We employed binary logistic regression and Chi-square tests to explore the statistical correlates of KAP related to DM.ResultsA total of 4,011 nurses participated, revealing significant perceived knowledge deficiencies in specialized DM management areas, with only 34% (n = 1,360) proficient in current pharmacological treatments. Attitudinal assessments showed that 54% (n = 2,155) recognized the importance of cultural competence in dietary counseling. Practices were strong in routine glucose monitoring (96%, n = 3,851) but weaker in psychological support (68%, n = 2,736). Regression analysis indicated significant effects of experience on KAP, where nurses with 1–5 years of experience were more likely to show better knowledge (OR = 1.09; p = 0.08), and those with advanced degrees demonstrated higher competence (OR = 1.52; p = 0.028). Marital status influenced attitudes, with single nurses more likely to exhibit positive attitudes (OR = 0.49; p < 0.001), and work environment impacted knowledge, with hospital-based nurses more knowledgeable (OR = 1.15; p = 0.14). Additionally, gender differences emerged, with male nurses showing greater knowledge (OR = 1.65; p = 0.03) and better practices in diabetes care (OR = 1.47; p = 0.04).ConclusionThe study underscores the critical need for targeted educational programs and policy interventions to enhance nursing competencies in DM management. While the study provides valuable insights into nurses' perceptions of their competencies, future research should incorporate objective knowledge assessments to ensure a comprehensive understanding of their actual capabilities. Interestingly, the data also suggests a substantial opportunity to leverage technology and inter-professional collaboration to further enhance DM management efficacy among nurses, fostering an integrated care approach.

BackgroundThe aging population has led to a surge in demand for home care, which has developed rapidly in China in recent years. However, there has been less empirical research into the needs of healthcare workers about providing home care. The purpose of this study was to explore the latent classes of healthcare workers' needs in primary health care institutions and to identify associated factors.MethodsFrom August 2021 to June 2022, a convenience sampling method was adopted to conduct a questionnaire survey on the workers of 62 primary healthcare institutions in Sichuan Province. Latent class analysis was used to categorize home care needs by Mplus 8.3. Multinomial logistic regression analysis was adopted to explore the influencing factors using SPSS 25.0.ResultsA total of 1,152 healthcare workers were included in the study. Their needs for home care were classified into four latent classes: overall high need group (18.0%); overall low need group (34.8%); high training and low support need group (29.9%), and the high security and low training need group (17.3%). The factors influencing the different need categories included working area, professional title, role of medical workers, had participated in training about home care, and feelings about home care, with Class 1 as the reference group.ConclusionOur findings indicate that primary healthcare workers have multifaceted needs for providing home care. Paying attention to their diverse needs can help optimize home care and enhance service capacity. Exploring the factors affecting needs can provide targeted support to healthcare workers to ensure the quality and continuity of home care services.

AimsThis study aims to assess the status and related factors among healthcare workers (HCWs) in designated quarantine-hospital-site (DQHS) based on the model of health ecology.MethodsThe cross-sectional study was conducted from April to May, 2022, which included 351 valid samples. We measured sleep quality using the Pittsburgh Sleep Quality Index, which encompasses seven dimensions: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each dimension is scored individually, contributing to an overall sleep quality score. Factors associated with the sleep quality of HCWs in DQHS were divided into individual, behavioral, interpersonal and social dimensions. Hierarchical linear regressions were conducted to identify the potential factors associated with sleep quality among HCWs in DQHS.ResultsHCWs in DQHS had a statistically higher sleep quality than the Chinese national norm. HCWs who were female, afraid of Coronavirus disease, had more negative emotions, frequently worked overtime, were married, and had a higher income were more likely to experience worse sleep quality (p

ObjectivesThe study was conducted to identify and compile gaps in the Knowledge, Attitudes, and Practices (KAP) regarding Antimicrobial Resistance (AMR) among healthcare workers in India.MethodsA systematic review of published literature from PubMed, Google Scholar, and Scopus databases was conducted in compliance with the PRISMA guidelines. The inclusion criteria focused on studies evaluating KAP toward AMR among various healthcare workers in India without restricting context to specific diseases. We included articles published from inception to December 2023.ResultsFollowing the inclusion criterion, 19 studies were selected for the review. The study has a cumulative sample size of 4,544 healthcare providers across India. We found that doctors and medical students have significant knowledge about AMR, followed by nurses and pharmacists. However, the attitudes toward AMR were higher among informal providers, followed by doctors and medical students. The study also observed a gap between theoretical knowledge and practical application of AMR principles among healthcare providers in India.ConclusionThe study highlights the need for targeted training and policy interventions to bridge the gap between KAP regarding AMR. Healthcare providers can significantly contribute to mitigating AMR threat by improving KAP related to AMR. This systematic review provides a foundation for developing and implementing effective evidence-based strategies to enhance AMR containment in India.

BackgroundThe fear of clinical errors among healthcare workers (HCW) is an understudied aspect of patient safety. This study aims to describe this phenomenon among HCW and identify associated socio-demographic, professional, burnout and mental health factors.MethodsWe conducted a nationwide, online, cross-sectional study targeting HCW in France from May to June 2021. Recruitment was through social networks, professional networks, and email invitations. To assess the fear of making clinical errors, HCW were asked: “During your daily activities, how often are you afraid of making a professional error that could jeopardize patient safety?” Responses were collected on a 7-point Likert-type scale. HCW were categorized into “High Fear” for those who reported experiencing fear frequently (“once a week,” “a few times a week,” or “every day”), vs. “Low Fear” for less often. We used multivariate logistic regression to analyze associations between fear of clinical errors and various factors, including sociodemographic, professional, burnout, and mental health. Structural equation modeling was used to explore how this fear fits into a comprehensive theoretical framework.ResultsWe recruited a total of 10,325 HCW, of whom 25.9% reported “High Fear” (95% CI: 25.0–26.7%). Multivariate analysis revealed higher odds of “High Fear” among males, younger individuals, and those with less professional experience. High fear was more notable among physicians and nurses, and those working in critical care and surgery, on night shifts or with irregular schedules. Significant associations were found between “High Fear” and burnout, low professional support, major depressive disorder, and sleep disorders.ConclusionsFear of clinical errors is associated with factors that also influence patient safety, highlighting the importance of this experience. Incorporating this dimension into patient safety culture assessment could provide valuable insights and could inform ways to proactively enhance patient safety.

IntroductionThe outbreak of the Coronavirus Disease 2019 pandemic has presented significant difficulties for healthcare workers worldwide, resulting in a higher tendency to quit their jobs. This study aims to investigate the correlation between organizational support, work-family-self balance, job satisfaction, and turnover intention of healthcare professionals in China’s public hospitals.MethodsA cross-sectional survey was conducted on 5,434 health workers recruited from 15 public hospitals in Foshan municipality in China’s Guangdong province. The survey was measured by organizational support, work-family-self balance, job satisfaction, and turnover intention using a five-point Likert scale. The association between organizational support, work-family-self balance, job satisfaction, and turnover intention was investigated using Pearson correlation analysis and mediation analysis through the PROCESS macro (Model 6).ResultsOrganizational support indirectly affected turnover intention through three pathways: the mediating role of work-family-self balance, job satisfaction, and the chain mediating role of both work-family-self balance and job satisfaction.ConclusionHealth administrators and relevant government sectors should provide sufficient organizational support, enhance work-family-self balance and job satisfaction among healthcare workers, and consequently reduce their turnover intentions.

IntroductionNon-communicable diseases (NCDs), the leading cause of death globally, are estimated to overtake communicable diseases in sub-Sahara Africa, where healthcare workers (HCWs) play a crucial role in prevention and treatment, but are in extreme shortage, thereby increasing the burden of NCDs among this specific population. To provide evidence for policy-making, we assessed the NCD burden, associated factors and treatment among HCWs in four sub-Saharan African countries.Materials and methodsWe conducted a cross-sectional study across four sub-Saharan African countries [Côte d'Ivoire (CIV), Democratic Republic of the Congo (DRC), Madagascar (MDG), and Nigeria (NIG)] between February and December 2022. In a standardized questionnaire, sociodemographic, chronic disease and treatment data were self-reported. We estimated the prevalence of (1) at least one chronic disease, (2) hypertension, and used backward elimination logistic regression model to identify risk factors.ResultsWe recruited a total of 6,848 HCWs. The prevalence of at least one chronic disease ranged between 9.7% in NIG and 20.6% in MDG, the prevalence of hypertension between 5.4% in CIV and 11.3% in MDG. At most, reported treatment rates reached 36.5%. The odds of each of both outcomes increased with age (at least one chronic disease adjusted odds ratio: CIV: 1.04; DRC: 1.09; MDG: 1.06; NIG: 1.10; hypertension: CIV: 1.10; DRC: 1.31; MDG: 1.11; NIG: 1.11) and with BMI (at least one chronic disease: CIV: 1.10; DRC: 1.07; MDG: 1.06; NIG: 1.08; hypertension: CIV: 1.10; DRC: 1.66; MDG: 1.13; NIG: 1.07). Odds of both outcomes were lower among males, except in CIV. In NIG, the odds of both outcomes were higher among medical doctors and odds of hypertension were higher among those working in secondary care. In MDG, working in secondary care increased and working as auxiliary staff decreased the odds of at least one chronic disease.ConclusionThe prevalence of self-reported chronic disease varied across the four sub-Saharan countries with potentially very low treatment rates. We identified several individual (age, sex, and BMI) and occupational (profession, level of healthcare) factors that influence the odds of NCDs. These factors should be taken into account when developing interventions addressing the burden and management of NCDs among HCWs.

BackgroundHealthcare workers play a central role in communicating information to the public regarding vaccines. Most of the literature has focused on healthcare workers’ hesitancy and doubts about getting the flu vaccine themselves. However, few studies have dealt with how they perceive their role in communicating information regarding vaccines, especially following the COVID-19 pandemic.Objectives(1) To identify the communication strategies used by the Israeli Ministry of Health regarding vaccines during epidemic crises (before and after the COVID-19 pandemic); (2) To identify the communication strategies used by healthcare workers regarding vaccines before and after the COVID-19 pandemic.MethodsA qualitative study based on in-depth interviews was conducted among healthcare workers and used a semi-structured protocol as a research tool. A total of 18 healthcare workers were sampled using purposeful and snowball sampling.ResultsDespite healthcare workers’ perception that there has been a decrease in trust in the Israeli Ministry of Health among the public following the COVID-19 outbreak, they still rely on the Israeli Ministry of Health as their primary source of information and use the same communication strategies (such as fear appeals and correcting information) as of the Israeli Ministry of Health to communicate with the public, healthcare providers, and other relevant stakeholders.ConclusionHealthcare workers have been shaped by the professional socialization processes within the health system, leading to a predominant reliance on established communication strategies and informational channels. This reliance underscores the importance of evolving these methods to better engage with the public. To address this, there is a compelling need to innovate and adopt new communication techniques that emphasize effective dialogue and transparent interactions. By doing so, healthcare professionals can ensure that their outreach is not only informative but also responsive to the diverse needs and preferences of the community.

IntroductionAn increased incidence of human Monkeypox (Mpox) cases was recently observed worldwide, including in Cameroon. To ensure efficient preparedness and interventions in the health system, we sought to assess the knowledge of Mpox's transmission, prevention, and response among healthcare workers (HCWs) in Cameroon.MethodsA cross-sectional online survey was conducted among HCWs in Cameroon using 21-item questions adapted from the United States Centers for Disease Control and Prevention (US-CDC) standard questionnaire on Mpox. The overall knowledge of Mpox was assessed by cumulative score and categorized as excellent (≥80%, 17/21) or good (≥70%, ≥15/21) knowledge. The regression analysis was used to identify the predictors of Mpox knowledge.ResultsThe survey enrolled 377 participants, but only responses from 342 participants were analyzed. Overall, 50.6% were female participants, and 59.6% aged 30 years or younger. The majority of the participants were medical doctors (50.3%); most worked in central-level hospitals (25.1%) and had 1–5 years of experience (70.7%). A total of up to 92.7% were aware of Mpox, with social media (58.7%) and radio/television (49.2%) as the main sources. The mean knowledge score was 14.0 ± 3.0 (4 to 20), with only 12.9% having excellent knowledge (≥80%) and 42.1% having good knowledge of Mpox. Younger age (26–30 years old) was associated with good knowledge, while workplace type was associated with excellent knowledge of Mpox (aOR [95% CI]: 4.01 [1.43–11.24]). Knowledge of treatment/management of Mpox was generally poor across the different professional categories.ConclusionKnowledge of Mpox among HCWs is substandard across different professionals. Thus, for optimal preparedness and immediate interventions for Mpox and similar emerging pathogens, capacity-strengthening programs should be organized for HCWs while encouraging scientific literature and organizational social media websites.

ObjectivesWorkplace violence (WPV) against healthcare workers (HCWs) has reached significant levels globally, impeding the quality and accessibility of healthcare systems. However, there is limited available knowledge regarding the determinants linked with WPV among HCWs and the discrepancies observed across various levels of hospitals in China. The objective of the present research was to investigate the factors linked to WPV and job satisfaction among HCWs in China.MethodsA self-developed questionnaire based on WeChat was employed to collect data. The questionnaire consisted of demographic information as well as occupational factors. To measure WPV, the Chinese version of the Workplace Violence Scale was utilized. Career satisfaction was assessed through two questions regarding career choices. The collected data was analyzed using descriptive analyses, chi-square tests, and multivariate logistic regressions.ResultsA total of 3,781 valid questionnaires (1,029 doctors and 2,752 nurses) were collected. Among all participants, 2,201 (58.2%) reported experiencing at least one form of WPV in the past year, with emotional abuse being the most frequent occurrence (49.7%), followed by threats (27.9%). The multivariate logistic regression analysis revealed several risk factors associated with WPV, including male gender, shift work, senior professional title, bachelor’s degree education, employment in secondary-level hospitals, and working over 50 h per week (p

IntroductionDuring the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors.MethodsThe survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire.ResultsHCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information.DiscussionThe survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.

IntroductionProtection of health care workers (HCWs) is a fundamental aspect of an effective pandemic response. During the COVID-19 pandemic, frequency, and duration of Personal Protective Equipment (PPE) use increased. The experience of PPE-related side-effects has potential to contribute to decreased compliance resulting in breaches in infection prevention and increasing risk of HCW exposure. This study aims were to measure the frequency of PPE-related side-effects amongst HCW in Australia, and to establish if an increased frequency of adverse reactions was related to the significant increase in use and extended duration of time spent in PPE.MethodsA descriptive cross-sectional survey was used.ResultsOf the 559 respondents the majority were female (83.7%), aged 31–45 years old (33.6%). A pre-existing skin condition was reported by 266 (47.6%). Frequency of PPE related side-effects were: pressure-related 401 (71.7%), skin 321 (57.4%) and respiratory 20 (3.6%). Surgical mask use was significantly associated with pre-exiting skin conditions (β = 1.494 (SE 0.186), df (1), p

BackgroundPositive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment.ObjectiveThis study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service.MethodsA descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale.ResultsHigh scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background.ConclusionHealthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.

BackgroundInfection prevention and control (IPC) is a set of practices that are designed to minimize the risk of healthcare-associated infections (HAIs) spreading among patients, healthcare workers, and visitors. Implementation of IPC is essential for reducing infection incidences, preventing antibiotic use, and minimizing antimicrobial resistance (AMR). The aim of the study was to assess IPC practices and associated factors in Pediatrics and Child Health at Tikur Anbessa Specialized Hospital.MethodsIn this study, we used a cross-sectional study design with a simple random sampling method. We determined the sample size using a single population proportion formula with the assumption of a 55% good IPC practice, a 5% accepted margin of error, and a 15% non-response rate and adjusted with the correction formula. The final sample size was 284 healthcare workers. The binary logistic regression model was used for analysis. The World Health Organization (WHO) Infection Prevention and Control Assessment Framework (IPCAF) tool was used to assess IPC core components.ResultA total of 272 healthcare workers participated in the study, with a response rate of 96%. Of the total participants, 65.8% were female and 75.7% were nurses. The overall composite score showed that the prevalence of good IPC practices among healthcare workers was 50.4% (95% CI: 44.3–56.5). The final model revealed that nursing professionals and healthcare workers who received IPC training had AORs of 2.84 (95% CI: 1.34–6.05) and 2.48 (95% CI: 1.36–4.52), respectively. The final average total IPCAF score for the IPC level was 247.5 out of 800 points.ConclusionThe prevalence of good IPC practice was suboptimal. The study participants, who were nursing professionals and healthcare workers who received IPC training, showed a statistically significant association with the IPC practice level. The facility-level IPCAF result showed a “Basic” level of practice based on the WHO categorization. These evidences can inform healthcare workers and decision-makers to identify areas for improvement in IPC practice at all levels. Training of healthcare workers and effective implementation of the eight IPC core components should be strengthened to improve suboptimal practices.

The coronavirus pandemic (COVID-19) has placed incredible demands on healthcare workers (HCWs) and adversely impacted their well-being. Throughout the pandemic, organizations have sought to implement brief and flexible mental health interventions to better support employees. Few studies have explored HCWs’ lived experiences of participating in brief, online mindfulness programming during the pandemic using qualitative methodologies. To address this gap, we conducted semi-structured interviews with HCWs and program facilitators (n = 13) who participated in an online, four-week, mindfulness-based intervention program. The goals of this study were to: (1) understand how participants experienced work during the pandemic; (2) understand how the rapid switch to online life impacted program delivery and how participants experienced the mindfulness program; and (3) describe the role of the mindfulness program in supporting participants’ mental health and well-being. We utilized interpretive phenomenological analysis (IPA) to elucidate participants’ and facilitators’ rich and meaningful lived experiences and identified patterns of experiences through a cross-case analysis. This resulted in four main themes: (1) changing environments; (2) snowball of emotions; (3) connection and disconnection; and (4) striving for resilience. Findings from this study highlight strategies for organizations to create and support wellness programs for HCWs in times of public health crises. These include improving social connection in virtual care settings, providing professional development and technology training for HCWs to adapt to rapid environmental changes, and recognizing the difference between emotions and emotional states in HCWs involved in mindfulness-based programs.

ObjectiveThe aim of this study was to investigate the obsessive-compulsive and depressive symptoms of healthcare workers in a case-control setting as longitudinal.MethodIn this study included 49 healthcare workers and 47 non-health workers. A sociodemographic data form, the Maudsley Obsessive-Compulsive Inventory (MOCI), the Symptom Checklist-90 (SCL-90), and the Hamilton Depression Rating Scale (HAM-D) were used to assess individuals between June 1, 2020 and June 30, 2021. We assessed the same healthcare workers after 12 months on June 30, 2021 using MOCI, HAM-D, and SCL-90.ResultsMOCI and SCL-90 obsessive-compulsive subscale scores were significantly higher in the healthcare workers than in the non-health workers. When we assessed MOCI, HAM-D, and SCL-90 obsessive-compulsive subscale scores after 12 months, there was a statistically significant decrease in the scores of all three scales among the healthcare workers.ConclusionThe results of the study showed that healthcare workers were more likely to have obsessive-compulsive symptoms than non-health workers in the early part of the pandemic on June 1, 2020, as shown by their scores on MOCI and the obsessive-compulsive subscale of SCL-90. When we assessed the same participants after 12 months (June 30, 2021), both MOCI and SCL-90 obsessive-compulsive subscale scores had decreased significantly. In contrast to these results, HAM-D scores significantly increased.

BackgroundDifferent from the very early stages of the COVID-19 pandemic, burnout and chronic mental health problems among health care workers (HCWs) has become a challenge. Research is lacking on the relationship between burnout, stress, emotional distress and sleep quality.MethodsThe Chinese center has been involved in the Cope-Corona project since the second survey (T2). Named after the project, a total of three cross-sectional surveys were distributed: T2 (February 16–20, 2021), T3 (May 10–14, 2022), and T4 (December 20–24, 2022). Burnout, depression, anxiety, sleep quality, workplace factors and individual resources were measured. Using the T4 data, we conducted structural equation model (SEM) to examine the mediating role of burnout in predicting emotional distress and sleep quality.Results96, 124, and 270 HCWs were enrolled at T2, T3, and T4, respectively. In line with the epidemic trends, the level of perceived COVID-19 related risks was significantly higher at T4, while the feeling of health and safety decreased significantly. At T4, the percentages of participants with clinically significant levels of depression and anxiety symptoms were 18.9% (51/270) and 9.3% (25/270), respectively, while 30.4% (82/270) of them reported poor or very poor sleep quality. According to the SEM, individual resources and workplace factors mainly had an indirect effect in predicting depression and anxiety via burnout. However, neither burnout nor stress was a mediator or predictor of sleep quality. Instead, individual resources, positive workplace factors, and younger age had a direct effect in predicting good sleep quality.ConclusionMeasures designed to enhance workplace factors and individual resources should be implemented to improve psychosomatic wellbeing of HCWs.

IntroductionIn times of epidemic outbreaks, healthcare workers (HCWs) emerge as a particularly vulnerable group. This cross-sectional study endeavors to assess the COVID-19 infection rate among the primary HCWs in Jiangsu Province subsequent to the implementation of adjusted epidemic prevention and control strategies.MethodsFrom January 17 to February 2, 2023, an extensive survey was conducted among primary HCWs in Jiangsu Province, employing a self-designed questionnaire. Logistic regression analysis was utilized to identify the factors associated with COVID-19 infection.ResultsThe overall infection rate among primary HCWs stood at 81.05%, with a 95% confidence interval (CI) of 80.61–81.48%. Among those afflicted, cough, fatigue, and fever emerged as the three most prevalent symptoms, each with an incidence rate exceeding 80%. In the context of multivariate logistic regression, an elevated risk of COVID-19 infection was observed in correlation with female gender (adjusted odds ratio [aOR] = 1.12, 95% CI: 1.04–1.21), possessing a bachelor’s degree or higher (aOR = 1.32, 95% CI: 1.23–1.41), accumulating over 10 years of work experience (aOR = 1.28, 95% CI: 1.11–1.47), holding a middle-level cadre position (aOR = 1.22, 95% CI: 1.11–1.35), assuming the role of a unit leader (aOR = 1.30, 95% CI: 1.11–1.54), and working in a fever clinic for 1 to 10 days per month (aOR = 1.42, 95% CI: 1.29–1.57). Conversely, advanced age (aOR = 0.76, 95% CI: 0.70–0.82), being underweight (aOR = 0.78, 95% CI: 0.69–0.90), current smoking (aOR = 0.64, 95% CI: 0.57–0.71), receiving 4 doses of COVID-19 vaccine (aOR = 0.49, 95% CI: 0.37–0.66), and pregnancy or perinatal status (aOR = 0.85, 95% CI: 0.72–0.99) were associated with a diminished risk of infection.ConclusionFollowing the implementation of adjusted policies, a substantial proportion of primary HCWs in Jiangsu province contracted COVID-19. Female gender and younger age emerged as risk factors for COVID-19 infection, while no discernible link was established between professions and COVID-19 susceptibility. The receipt of COVID-19 vaccines demonstrated efficacy in curtailing the infection rate, underscoring the significance of bolstering prevention knowledge and heightening self-protective awareness among primary HCWs.

IntroductionHealthcare workers risk of exposure to the influenza virus in their work, is a high-risk group for flu infections. Thus WHO recommends prioritizing flu vaccination for them–an approach adopted by >40 countries and/or regions worldwide.MethodsCross-sectional studies on influenza vaccination rates among healthcare workers were collected from PubMed, EMBASE, CNKI, and CBM databases from inception to February 26, 2023. Influenza vaccination rates and relevant data for multiple logistic regression analysis, such as odds ratios (OR) and 95% confidence intervals (CI), were extracted.ResultsA total of 92 studies comprising 125 vaccination data points from 26 countries were included in the analysis. The meta-analysis revealed that the overall vaccination rate among healthcare workers was 41.7%. Further analysis indicated that the vaccination rate was 46.9% or 35.6% in low income or high income countries. Vaccination rates in the Americas, the Middle East, Oceania, Europe, Asia, and Africa were 67.1, 51.3, 48.7, 42.5, 28.5, and 6.5%, respectively. Influencing factors were age, length of service, education, department, occupation, awareness of the risk of influenza, and/or vaccines.ConclusionThe global influenza vaccination rate among healthcare workers is low, and comprehensive measures are needed to promote influenza vaccination among this population.Systematic review registrationwww.inplysy.com, identifier: 202350051.

PurposeIn March 2020, the WHO declared COVID-19 a pandemic. Previous virus outbreaks, such as the SARS outbreak in 2003, appeared to have a great impact on the mental health of healthcare workers. The aim of this study is to examine to what extent mental health of healthcare workers differed from non-healthcare workers during the first year of the COVID-19 pandemic.MethodsWe used data from a large-scale longitudinal online survey conducted by the Corona Behavioral Unit in the Netherlands. Eleven measurement rounds were analyzed, from April 2020 to March 2021 (N = 16,615; number of observations = 64,206). Mental health, as measured by the 5-item Mental Health Inventory, was compared between healthcare workers and non-healthcare workers over time, by performing linear GEE-analyses.ResultsMental health scores were higher among healthcare workers compared to non-healthcare workers during the first year of the pandemic (1.29 on a 0–100 scale, 95%-CI = 0.75–1.84). During peak periods of the pandemic, with over 100 hospital admissions or over 25 ICU admissions per day and subsequently more restrictive measures, mental health scores were observed to be lower in both healthcare workers and non-healthcare workers.ConclusionDuring the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. To be better prepared for another pandemic, future research should investigate which factors hinder and which factors support healthcare workers to maintain a good mental health.

BackgroundDuring the COVID-19 pandemic, many healthcare workers faced extreme working conditions and were at higher risk of infection with the coronavirus. These circumstances may have led to mental health problems, such as anxiety, among healthcare workers. Most studies that examined anxiety among healthcare workers during the COVID-19 pandemic were cross-sectional and focused on the first months of the pandemic only. Therefore, this study aimed to investigate the longitudinal association between working in healthcare and anxiety during a long-term period (i.e., 18 months) of the COVID-19 pandemic.MethodsData were used from online questionnaires of the Lifelines COVID-19 prospective cohort with 22 included time-points (March 2020–November 2021). In total, 2,750 healthcare workers and 9,335 non-healthcare workers were included. Anxiety was assessed with questions from the Mini-International Neuropsychiatric Interview, and an anxiety sum score (0–7) was calculated. Negative binomial generalized estimating equations (GEE), adjusted for demographic, work and health covariates, were used to examine the association between working in healthcare and anxiety.ResultsAnxiety sum scores over time during the COVID-19 pandemic were similar for healthcare workers and non-healthcare workers. No differences between the anxiety sum scores of healthcare workers and non-healthcare workers were found [incidence rate ratio (IRR) = 0.97, 95% CI = 0.91–1.04].ConclusionThis study did not find differences between healthcare workers and non-healthcare in perceived anxiety during the COVID-19 pandemic.

BackgroundThe COVID-19 pandemic has disrupted the healthcare and public health sectors. The impact of working on the frontlines as a healthcare or public health professional has been well documented. Healthcare organizations must support the psychological and mental health of those responding to future public health emergencies.ObjectiveThis systematic review aims to identify effective interventions to support healthcare workers’ mental health and wellbeing during and following a public health emergency.MethodsEight scientific databases were searched from inception to 1 November 2022. Studies that described strategies to address the psychological impacts experienced by those responding to a public health emergency (i.e., a pandemic, epidemic, natural disaster, or mass casualty event) were eligible for inclusion. No limitations were placed based on study design, language, publication status, or publication date. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal tools. Discrepancies were resolved through discussion and a third reviewer when needed. Results were synthesized narratively due to the heterogeneity of populations and interventions. Outcomes were displayed graphically using harvest plots.ResultsA total of 20,018 records were screened, with 36 unique studies included in the review, 15 randomized controlled trials, and 21 quasi-experimental studies. Results indicate that psychotherapy, psychoeducation, and mind–body interventions may reduce symptoms of anxiety, burnout, depression, and Post Traumatic Stress Disorder, with the lowest risk of bias found among psychotherapy interventions. Psychoeducation appears most promising to increase resilience, with mind–body interventions having the most substantial evidence for increases in quality of life. Few organizational interventions were identified, with highly heterogeneous components.ConclusionPromoting healthcare workers’ mental health is essential at an individual and health system level. This review identifies several promising practices that could be used to support healthcare workers at risk of adverse mental health outcomes as they respond to future public health emergencies.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=203810, identifier #CRD42020203810 (PROSPERO).

IntroductionBioterrorism is an important issue in the field of biosecurity, and effectively dealing with bioterrorism has become an urgent task worldwide. Healthcare workers are considered bioterrorism first responders, who shoulder essential responsibilities and must be equipped to deal with bioterrorism. This study aims to extract and summarize the main research components of the bioterrorism knowledge, attitude, and practice dimensions among healthcare workers.MethodThis study utilized a systematic review research design based on the PRISMA 2020 guidelines. A literature search was conducted in the PubMed, Web of Science, and Scopus databases for peer-reviewed literature, and the Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of the literature.ResultA total of 16 studies were included in the final selection. Through the analysis and summary of the included studies, three main aspects and 14 subaspects of the knowledge dimension, three main aspects and 10 subaspects of the attitude dimension, and two main aspects and six subaspects of the practice dimension were extracted.ConclusionThis study conducted a literature review on bioterrorism knowledge, attitudes, and practices for healthcare workers based on the PRISMA 2020 guidelines. The findings can guide improvements in health literacy and provide beneficial information to professional organizations that need to respond effectively to bioterrorism.

IntroductionSurgeons may experience physical and mental health problems because of their jobs, which may lead to chronic muscle damage, burnout, or even withdrawal. However, these are often ignored in camera-holder assistants during laparoscopic surgery. We aimed to analyze the differences between operating surgeons and camera-holder assistants.MethodsFrom January 1, 2022, to December 31, 2022, a cross-sectional survey was conducted to evaluate the muscle pain, fatigue, verbal scolding, and task load for operating surgeons and camera-holder assistants. The Nordic Musculoskeletal Questionnaire, the Space Administration Task Load Index, and the Surgical Task Load Index (SURG-TLX) were combined in the questionnaire.Results2,184 operations were performed by a total of 94 operating surgeons and 220 camera assistants. 81% of operating surgeons and 78% of camera-holder assistants reported muscle pain/discomfort during the procedure. The most affected anatomic region was the shoulders for operating surgeons, and the lower back for camera-holder assistants. Intraoperative fatigue was reported by 41.7% of operating surgeons and 51.7% of camera-holder assistants. 55.2% of camera-holder assistants reported verbal scolding from the operating surgeons, primarily attributed to lapses in laparoscope movement coordination. The SURG-TLX results showed that the distributions of mental, physical, and situational stress for operating surgeons and camera-holder assistants were comparable.ConclusionLike operating surgeons, camera-holder assistants also face similar physical and mental health impairments while performing laparoscopic surgery. Improvements to the working conditions of the camera-holder assistant should not be overlooked.

BackgroundThe COVID-19 pandemic has become an important cause of morbimortality, and healthcare workers are at the highest risk of infection. As a result, policies and guidelines have been issued, and behavioral changes have been crucial in hospitals. Among these measures, the implementation of personal protective equipment (PPE) and its appropriate use in the workplace is key to avoiding contagion, as is understanding new measures regarding patient admission, distribution, constant education on virtual platforms, among others, and changing conduct to reduce contagion. However, behavioral change interventions in healthcare workers are challenging as contextual characteristics, attributes of the intervention, and psychological factors are involved.Study objectivesThe issue under investigation is the impact of COVID-19 on frontline healthcare workers in the emergency department of the Fundación Cardioinfantil (FCI). The objective was to describe their behavioral changes by studying and monitoring SARS-CoV-2 infection and their relationship through the tracing process in 2020.MethodsWe conducted a case study to identify and relate the SARS-CoV-2 infection rate within the personnel in the department and the response of healthcare workers to the implementation and adherence to the use of PPE through the analysis of the different variables that contributed to behavioral change. Data were collected by a single author and analyzed by two authors using both the individual-level logic model technique and the triangulation of information, with approval from the institutional review board.DiscussionSeveral interventions for behavior change were registered in the data collection process. The data obtained indicated that implementation, embedding, and integration were perceived as collective and individual behavioral processes. This was supported by evidence from healthcare interventions, such as education, incentivization, training, restriction, environmental restructuring, modeling, and enablement.ConclusionBehavioral science should be part of public health responses, as the theoretical basis suggests that change may modify the response to avoid the transmission of infectious diseases. Therefore, individuals at the highest risk appear to adopt guidance with targeted behavior adaptation interventions. Efforts to inform, instruct, and motivate healthcare workers must be continuous, and actions at the community level must be strengthened, as it is human behavior that determines the spread and mortality of infectious diseases, where community compliance to preventive behaviors plays a crucial role.

IntroductionThe outbreak of coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) had significant effects on the mental well-being in general, particularly for healthcare professionals. This study examined the prevalence of depression, anxiety, and stress, and identified the associated risk factors amongst healthcare workers during the COVID-19 outbreak in a tertiary hospital located in Vietnam.MethodsWe conducted a cross-sectional study at a tertiary-level hospital, where the Depression Anxiety and Stress Scale 21 (DASS-21) web-based questionnaire was employed. We analyzed the determinant factors by employing multivariate logistic models.ResultsThe prevalence of depression, anxiety, and stress symptoms were 19.2%, 24.7%, and 13.9%, respectively. Factors such as engaging in shift work during the pandemic, taking care of patients with COVID-19, and staff’s health status were associated with mental health issues among health professionals. In addition, having alternate rest periods was likely to reduce the risk of stress.ConclusionThe prevalence of mental health problems in healthcare workers during the COVID-19 pandemic was relatively high. Having resting periods could potentially mitigate the development of stress among health professionals. Our findings could be taken into account for improving mental health of the health professional population.

BackgroundHospital-acquired infections (HAIs) are significant public health issues, especially in low-and middle-income countries (LMICs). Hand hygiene and low-level disinfection of equipment practices among healthcare workers are some of the essential measures to reduce HAIs. Various infection prevention and control (IPC) interventions to reduce HAI incidence have been developed. However, effective interventions have not been well developed in the LMICs context. Therefore, this protocol aims to develop, pilot, and assess the feasibility and acceptability of an IPC intervention in Cambodia and the Lao People’s Democratic Republic.MethodsThis study will consist of four phases guided by the Medical Research Council (MRC) Framework. Three hospitals will be purposely selected – each from the district, provincial, and national levels – in each country. The gap analysis will be conducted in Phase 1 to explore IPC practices among healthcare workers at each hospital through desk reviews, direct observation of hand hygiene and low-level disinfection of equipment practices, in-depth interviews with healthcare workers, and key informant interviews with stakeholders. In Phase 2, an IPC intervention will be developed based on the results of Phase 1 and interventions selected from a systematic literature review of IPC interventions in LMICs. In Phase 3, the developed intervention will be piloted in the hospitals chosen in Phase 1. In Phase 4, the feasibility and acceptability of the developed intervention will be assessed among healthcare workers and representatives at the selected hospitals. National consultative workshops in both countries will be conducted to validate the developed intervention with the national technical working groups.DiscussionThe MRC Framework will be employed to develop and evaluate an intervention to reduce HAIs in two LMICs. This theoretical framework will be used to explore the factors influencing hand hygiene compliance among healthcare workers. The gap analysis results will allow us to develop a comprehensive IPC intervention to reduce HAI incidence in Cambodia and Lao People’s Democratic Republic. Findings from this protocol will feed into promising IPC interventions to reduce HAI incidence in other resource-limited settings.Clinical trial registrationClinicalTrial.Gov, identifier NCT05547373.

The COVID-19 pandemic highlighted hurdles for healthcare delivery and personnel globally. Vaccination has been an important tool for preventing severe illness and death in healthcare workers (HCWs) as well as the public at large. However, vaccination has resulted in some HCWs requiring time off work post-vaccination to recover from adverse events. We aimed to understand which HCWs needed to take time off work post-vaccination, for which vaccine types and sequence, and how post-vaccination absence impacted uptake of booster doses in a cohort of 26,267 Canadian HCWs. By March 31, 2022, more than 98% had received at least two doses of the approved COVID-19 vaccines, following a two-dose mandate. We found that recent vaccination and longer intervals between doses were associated with significantly higher odds of time-loss, whereas being a medical resident and receiving the BNT162b2 vaccine were associated with lower odds. A history of lab-confirmed SARS-CoV-2 infection was associated with lower odds of receiving a booster dose compared with no documented infection, aOR 0.61 (95% CI: 0.55, 0.68). Similarly, taking sick time following the first or second dose was associated with lower odds of receiving a booster dose, aOR 0.83 (95% CI: 0.75, 0.90). As SARS-CoV-2 becomes endemic, the number and timing of additional doses for HCWs requires consideration of prevention of illness as well as service disruption from post-vaccination time-loss. Care should be taken to ensure adequate staffing if many HCWs are being vaccinated, especially for coverage for those who are more likely to need time off to recover.

ObjectiveTo explore the current status and interaction of perceived stress, job burnout and mental health among healthcare workers after the opening of COVID-19 which occurred in December 2022.MethodsA cross-sectional study of 792 healthcare workers from three tertiary hospitals in Wuxi was conducted from January 2023 to February 2023. Sociodemographic questionnaire, Perceived Stress Scale, Burnout Scale and Mental Health Self-Assessment Questionnaire were used for investigation. SPSS 26.0 was used to conduct data analysis. The significance of mediation was determined by the PROCESS macro using a bootstrap method.ResultsThe results showed that (1) The average scores of the participants for perceived stress, mental health and job burnout were 22.65 (7.67), 3.85 (4.21) and 1.88 (1.03), respectively. (2) The perceived stress score, mental health score and job burnout score of healthcare workers were positively correlated (r = 0.543–0.699, p

BackgroundThe effectiveness of pre-exposure prophylaxis has been extensively documented. However, there are substantial gaps between the actual implementation of pre-exposure prophylaxis and the ideal goal, especially in low-and middle-income countries. Healthcare workers play critical roles in the pre-exposure prophylaxis implementation, and they have more multi-level experiences about the barriers of pre-exposure prophylaxis implementation and how to facilitate it. However, the evidence aiming to synthesize their experiences is limited.ObjectiveThis study aims to aggregate the healthcare workers’ experiences of providing pre-exposure prophylaxis in low-and middle-income countries, and find the barriers, facilitators, and recommendations of pre-exposure prophylaxis implementation.MethodsThe ENTREQ (Enhancing transparency in reporting the synthesis of qualitative research) statement was used to guide the design and reporting of this qualitative meta-synthesis. A comprehensive search was conducted from inception of databases to 16th March 2023 in four databases: PubMed, CINAHL Plus with Full Text, Embase, Web of Science. The quality appraisal was conducted using the Joanna Briggs Institute Critical Appraisal Checklist. JBI’s meta-aggregation approach was used to guide the data extraction and synthesis, and the JBI ConQual approach was used to evaluate the evidence level of the synthesized findings.ResultsFourteen articles with good methodological quality were included in this review. A total of 122 findings were extracted and 117 findings with credibility ratings of “unequivocal” or “equivocal” were included in this meta-synthesis. The eligible findings were aggregated into 13 new categories and subsequently developed into 3 synthesized findings: the barriers, facilitators, and recommendations of pre-exposure prophylaxis implementation in low-and middle-income countries. The overall ConQual score of all three synthesized findings was rated as “low.”ConclusionThis review aggregated the experience of health care workers implementing pre-exposure prophylaxis in low-and middle-income countries and we could focus on the following key points to promote the uptake of pre-exposure prophylaxis: improve knowledge about pre-exposure prophylaxis, create a supportive environment, address medication-related barriers, increase the human resources and financial investments, and diversify the providing models.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/. The protocol of this review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023411604).

ObjectiveGastrointestinal cancer is the leading cause of cancer-related death in China, and its early screening is largely recommended by healthcare workers. This study investigated the knowledge, attitudes, and practice (KAP) of healthcare workers on early gastrointestinal cancer (EGC).MethodsThis cross-sectional study was conducted on healthcare workers who volunteered to participate from 30 hospitals in China between September and December 2022. A self-administered questionnaire including 37 questions was developed.ResultsA total of 545 completed questionnaires were finally obtained. Healthcare workers had moderate knowledge level [9.22 ± 1.80 (65.88±12.89%), total score: 14], positive attitude [21.84 ± 2.67 (91.01 ± 11.14%), total score: 24], and excellent practice level [19.07 ± 4.43 (79.47 ± 18.44%), total score: 24] on EGC. Pearson's correlation analysis suggested that knowledge score was positively correlated with attitude (r = 0.264, P < 0.001) and practice score (r = 0.140, P = 0.001), and higher attitude score was significantly correlated with higher practice score (r = 0.380, P < 0.001), which were supported and reinforced by structural equation modeling. In addition, subgroup analysis showed that knowledge scores might be influenced by sex, age, education, type of hospital, type of occupation, professional title, and years of working (all P < 0.05); attitude scores might be influenced by years of working (P < 0.05); and practice scores were statistically distinct among groups of different sex, department, and years of working (all P < 0.05).ConclusionHealthcare workers have moderate knowledge level, positive attitude, and excellent practice levels on EGC. Good knowledge and positive attitude might be correlated with excellent practice. KAP level might be influenced by sociodemographic characteristics.

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

BackgroundPreventing infection in healthcare workers (HCWs) is crucial for protecting healthcare systems during the COVID-19 pandemic. Here, we investigated the seroepidemiology of SARS-CoV-2 in HCWs in Norway with low-transmission settings.MethodsFrom March 2020, we recruited HCWs at four medical centres. We determined infection by SARS-CoV-2 RT-PCR and serological testing and evaluated the association between infection and exposure variables, comparing our findings with global data in a meta-analysis. Anti-spike IgG antibodies were measured after infection and/or vaccination in a longitudinal cohort until June 2021.ResultsWe identified a prevalence of 10.5% (95% confidence interval, CI: 8.8–12.3) in 2020 and an incidence rate of 15.0 cases per 100 person-years (95% CI: 12.5–17.8) among 1,214 HCWs with 848 person-years of follow-up time. Following infection, HCWs (n = 63) mounted durable anti-spike IgG antibodies with a half-life of 4.3 months since their seropositivity. HCWs infected with SARS-CoV-2 in 2020 (n = 46) had higher anti-spike IgG titres than naive HCWs (n = 186) throughout the 5 months after vaccination with BNT162b2 and/or ChAdOx1-S COVID-19 vaccines in 2021. In a meta-analysis including 20 studies, the odds ratio (OR) for SARS-CoV-2 seropositivity was significantly higher with household contact (OR 12.6; 95% CI: 4.5–35.1) and occupational exposure (OR 2.2; 95% CI: 1.4–3.2).ConclusionWe found high and modest risks of SARS-CoV-2 infection with household and occupational exposure, respectively, in HCWs, suggesting the need to strengthen infection prevention strategies within households and medical centres. Infection generated long-lasting antibodies in most HCWs; therefore, we support delaying COVID-19 vaccination in primed HCWs, prioritising the non-infected high-risk HCWs amid vaccine shortage.

BackgroundA variety of circumstances can influence how widely vaccination during pregnancy is accepted. Healthcare workers (HCWs) are often seen as the main resource for recommending vaccination. The purpose of the current study was to determine whether Italian HCWs advise and recommend pregnant people to receive the influenza vaccinations, as well as what knowledge and attitudes affect their practices. A secondary aim of the study was to evaluate HCWs’ knowledge and attitudes towards COVID-19 vaccination.MethodsThis cross-sectional study, took place between August 2021 and June 2022 in a randomly selected sample of HCWs in three Italian regions. The target population comprised obstetricians-gynecologists, midwives and primary care physicians, who provide medical care to pregnant people. The questionnaire consisted of 19 items divided into 5 parts gathered information about the participants’ sociodemographic and professional characteristics, general knowledge about vaccinations during pregnancy, and vaccine-preventable diseases (VPDs), attitudes and practices towards immunization, and strategies to potentially increase vaccination uptake during pregnancy.ResultsAmong the participants, 78.3% knew that pregnant people are at increased risk of severe complications from influenza, 57.8% that the influenza vaccine is not provided only in the 2nd/3rd trimester of pregnancy and 60% that pregnancy is a risk factor for severe COVID-19 infection. Of the enrolled HCWs, 10.8% believed that the potential risks of vaccines administered during pregnancy are greater than the benefits. An even higher proportion of the participants was unsure (24.3%) or did not deem (15.9%) that vaccinating against influenza during pregnancy reduces the risk of preterm birth and abortion. Moreover, 11.8% of the sample did not believe or was uncertain that COVID-19 vaccine must be offered to all pregnant people. Among HCWs, 71.8% advised women about influenza vaccination during pregnancy, and 68.8% recommended getting vaccinated against influenza during pregnancy. Results showed that good knowledge and positive attitudes were the strongest factors positively associated with advising women about influenza vaccination during pregnancy.ConclusionThe gathered data showed that a sizable portion of the HCWs lacks up-to-date knowledge, underestimates the risks of contracting a VPD, and overestimates the risks of vaccine side effects during pregnancy. The findings shed light on such attributes useful to promote adherence to evidence-based recommendations among HCWs.

BackgroundDespite the availability of hepatitis B vaccines (HBV) in Tanzania, their uptake among healthcare workers (HCWs) in high-level facilities, such as tertiary hospitals where the vaccines are available, is low. However, their uptake among HCWs in primary health facilities remains understudied. The lack of this information limits the scaling up of HBV vaccination programs.MethodologyA cross-sectional analytical study was conducted between June and July 2022 among HCWs in the Misungwi and Ilemela districts, which were purposefully selected. The sample size was calculated using the Taro Yamane formula, and data were collected using a self-administered questionnaire and analyzed using IBM SPSS® version 25.ResultsA total of 402 HCWs were recruited, their mean age was 34.9 ± 7.77 years, and only 18% (76/402) reported being fully vaccinated. HCWs in Ilemela showed higher uptake (χ2 = 23.64, df = 1, p = 0.00) of the vaccine than HCWs in Misungwi. Being male (aOR = 2.38, 95% CI 1.28–4.45, p = 0.006), working in an urban setting (aOR = 5.75, 95% CI 2.91–11.35, p = 0.00), and having an employment duration of more than 2 years (aOR = 3.58, 95%CI 1.19–10.74, p = 0.023) were significantly associated with higher odds of vaccination. Moreover, high perceived susceptibility to HBV infection (aOR = 2.20, 95% CI1.02–4.75, p = 0.044) and history of needle prick injuries (aOR = 6.87, 95%CI 3.55–13.26, p = 0.00) were significantly associated with higher odds of HBV vaccination.ConclusionLow uptake of HBV vaccine among HCWs in primary health facilities was observed with a noteworthy difference between rural and urban settings. Therefore, advocacy campaigns and resource mobilization toward the promotion of HBV vaccination in primary health facilities are pivotal.

BackgroundThis study aimed to examine the associations between workload and satisfaction with working conditions and mental health (i.e., anxiety disorder, depression, and somatization) of healthcare workers collecting test samples during the local outbreaks of COVID-19, and explore satisfaction with working conditions as a moderator of these relationships.MethodsA total of 1,349 participants were obtained via an online survey in Zhengzhou, Henan Province, China. Multivariate regression was used to assess the associations between workload and satisfaction with working conditions and anxiety disorder, depression, and somatization. The simple slope analysis and Johnson-Neyman technique were used to assess the effect value and change trend of the moderator.ResultsThe prevalence of anxiety disorder, depression, and somatization were 8.6, 6.9, and 19.2% of healthcare workers collecting test samples, respectively. High levels of workload were associated with an increased risk of an anxiety disorder (OR = 1.81, 95%CI = 1.17–2.78), depression (OR = 1.92, 95%CI = 1.19–3.10), and somatization (OR = 1.90, 95%CI = 1.40–2.57), while high satisfaction of working conditions was associated with a reduction in the risk of these outcomes, and ORs (95%CI) were 0.35 (0.20–0.64), 0.27 (0.13–0.56), and 0.32 (0.21–0.48), respectively. The findings also indicated that a weaker association between workload and anxiety disorder, as well as depression and somatization, has been reported in those with a high level of satisfaction with working conditions.ConclusionWorkload significantly increased the risk of healthcare workers suffering from psychological problems, while satisfaction with working conditions alleviated these negative effects, and effective resource support was crucial for healthcare workers.

BackgroundCOVID-19 disease spread at an alarming rate, and was declared a pandemic within 5 months from the first reported case. As vaccines have become available, there was a global effort to attain about 75% herd immunity through vaccination. There is a need to address the issue of vaccine hesitancy to COVID-19 vaccines especially in places such as Sub-Saharan African countries which have a high rate of background vaccine hesitancy.ObjectiveTo determine the knowledge and acceptance of COVID-19 vaccines among healthcare workers (HCWs) in Enugu metropolis.MethodsA cross-sectional descriptive study of 103 HCWs in Enugu metropolis was done. Data was collected using structured online Google forms. Descriptive and inferential statistics was done using SPSS, and results were summarized into percentages and associations.ResultsAn acceptance rate of 56.2% was obtained among HCWs in Enugu metropolis. Positive predicators of acceptance include older age (p = 0.004, X2 = 13.161), marriage (p = 0.001, X2 = 13.996), and higher average level of income (p = 0.013, X2 = 10.766) as significant correlations were found. No significant association was found between educational level, religion, denomination nor occupation, and acceptance of vaccine. The major factor responsible for refusal was fear of side-effects.DiscussionThe acceptance rate of COVID-19 vaccines among HCWs is still less than optimal. This population represents the most enlightened population on health related matters, hence if acceptance rate remains merely average that in the general population is expected to be worse. There is a need to address the fear of vaccine side-effects by inculcating more open and interactive methods of information dissemination, while also addressing the misconceptions or myths surrounding COVID-19 vaccines.

BackgroundWorkplace violence (WPV) is a notable issue facing healthcare services and workers globally. WPV impacts upon the well-being of staff and can put healthcare provision at risk with detrimental effects on patient care. This study aims to investigate and quantify, at national and regional levels, the incidence and trends of WPV within emergency departments (EDs).MethodsWe requested data relating to WPV from all 152 trusts with an ED in the United Kingdom from January 2017–March 2022. We applied interrupted time series and trend analysis to check for significant differences in WPV across the COVID-19 pandemic.ResultsWe conducted time series analysis on 58 million attendances and detected statistically significant increases in WPV in March 2020–5.06/100,000 attendances (95% CI 1.59/100,000–8.53/100,000 p

Human monkeypox is an infectious zoonotic disease and since May 2022, there has been a spike in cases worldwide. In this regard, a global health emergency has been declared by the World Health Organization (WHO) on July 23rd, 2022. Although there have been no confirmed human monkeypox cases in Nepal yet, the nation is undeniably at risk of an outbreak. Despite all preventive efforts and preparedness for monkeypox, there still remain several challenges including the literacy and knowledge of our healthcare workers regarding monkeypox. The aim of this study was to assess the level of knowledge and attitude of Nepalese healthcare workers regarding monkeypox. A cross-sectional study was performed on different healthcare workers at Tribhuvan University Teaching Hospital on the month of October 2022 using a set of validated questionnaires used previously in a Saudi Arabian study. An in-person survey was conducted where a total of 220 questionnaires were distributed. The response rate was 93%. Knowledge was categorized into high or low based on the mean knowledge score. The attitude was assessed using a 3-point Likert scale. The association of the knowledge and attitude of the respondents in accordance with their socio-demographics was statistically evaluated using Pearson’s Chi-square test. The mean knowledge score was 13. A larger proportion of the respondents (60.4%) demonstrated a high knowledge and 51.1% demonstrated a positive attitude. Studying monkeypox during medical education possessed a significant difference in the attitude (p = 0.025). Knowledge did not vary based on socio-demographic characteristics. Despite almost half a year into the monkeypox outbreak, Nepalese healthcare workers still have an unsatisfying degree of knowledge and a negative attitude regarding its control which shows the need for education and awareness.

Since the advent of coronavirus disease 2019 (COVID-19), healthcare workers (HCWs) wearing personal protective equipment (PPE) has become a common phenomenon. COVID-19 outbreaks overlap with heat waves, and healthcare workers must unfortunately wear PPE during hot weather and experience excessive heat stress. Healthcare workers are at risk of developing heat-related health problems during hot periods in South China. The investigation of thermal response to heat stress among HCWs when they do not wear PPE and when they finish work wearing PPE, and the impact of PPE use on HCWs’ physical health were conducted. The field survey were conducted in Guangzhou, including 11 districts. In this survey, HCWs were invited to answer a questionnaire about their heat perception in the thermal environment around them. Most HCWs experienced discomfort in their back, head, face, etc., and nearly 80% of HCWs experienced “profuse sweating.” Up to 96.81% of HCWs felt “hot” or “very hot.” The air temperature had a significant impact on thermal comfort. Healthcare workers’ whole thermal sensation and local thermal sensation were increased significantly by wearing PPE and their thermal sensation vote (TSV) tended towards “very hot.” The adaptive ability of the healthcare workers would decreased while wearing PPE. In addition, the accept range of the air temperature (Ta) were determined in this investigation. Graphical Abstract

ObjectiveThe objective of this study was to explore the sense of job security and its influencing factors among healthcare workers in Guangdong, China.MethodsThis cross-sectional study used stratified random sampling to enroll healthcare workers employed by hospitals across Guangdong province between September 2020 and October 2020.ResultsA total of 4,173 questionnaires were distributed, and 4,076 were returned for an effective recovery rate of 97.68%. The overall score for the sense of security was 64.85 ± 20.09, and the item means score was 2.95 ± 0.91. Multiple-linear regression analysis showed that work experience (years), education level, job position, specialty unit, employment type, marital status, job satisfaction, WPV frequency, daily sleep duration, weekly overtime hours, average monthly earnings (RMB), hospital level, and region were significantly associated with senses of poor security among healthcare workers (all P < 0.05).ConclusionsHospital workers in Guangdong reported relatively low levels of job security. Levels of job security were significantly associated with multiple factors which could be addressed by hospital practices to improve the sense of job security among healthcare workers.

IntroductionHealthcare workers (HCWs) have been continually exposed to patients with COVID-19 and are at higher risk of contracting the disease. Their psychological health is important for overall wellbeing and productivity, which could lead to a reduction in human errors during the pandemic crisis. This study aimed to measure the level of concerns, work practices, adequacy of preventive measures among HCWs, and the impacts on their life and work, including mental health status during the second wave of the COVID-19 pandemic in Malaysia.MethodsAn online questionnaire was distributed randomly to 1,050 HCWs from the Ministry of Health facilities in the Klang Valley who were involved directly in managing or screening COVID-19 cases from May to August 2020. The questionnaire was divided into five domains, which were concerns, impact on life and work, practice, perceived adequacy of preventive measures, and Revised Impact of Event Scale (IES-R). Logistic regression was used to identify sociodemographic predictors of the five domains.ResultsA total of 907 respondents (86.4%) participated in this survey. Approximately half of the respondents had a low concern (50.5%), most of them had a good practice (85.1%), with 67.5% perceiving there were adequate preventive measures, and they perceived the outbreak had a low impact (92%) on their life and work. From the IES-R domain, 18.6% of respondents potentially suffered from post-traumatic stress disorder (PTSD).ConclusionDuring the second wave of the COVID-19 outbreak in Malaysia, HCWs practiced high levels of precautions and preventive measures because they were aware of the risk of infection as an occupational hazard. With the adequate implementation of policy and control measures, the psychological wellbeing of the majority HCWs remained well and adequately supported.

BackgroundHealthcare workers were at high risk of psychological problems during the COVID-19 pandemic, but it remains not well-investigated in the post-pandemic era of COVID-19, with regular epidemic prevention and control embedded in burdened healthcare work. This study aimed to investigate the prevalence and potential risk factors of the symptoms of depression and anxiety among healthcare workers at a tertiary hospital in Shenzhen.MethodOur cross-sectional study was conducted among 21- to 64-year-old healthcare workers in December 2021 at a tertiary hospital in Shenzhen, using a simple random sampling strategy. A wide range of socio-demographic characteristics, individual information, and psychological condition of the subjects were extracted. Healthcare workers' psychological conditions were tested with the Center for Epidemiologic Studies Depression (CESD-10), General Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), Work-Family Conflict Scale (WFCS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and 17-item of Maslach's Burnout Inventory-Human Services Survey (MBI-HSS-17). Data were collected based on these questionnaires. Descriptive statistics were used to assess the difference between healthcare workers with depressive and anxiety symptoms among different groups. Hierarchical logistic regression analyses were conducted to investigate the association between focused variables and mental health outcomes.ResultsA total of 245 healthcare workers were enrolled. The proportion of depressive symptoms, anxiety symptoms and their co-occurrence were 34.7, 59.6, and 33.1%, respectively. Logistic regression showed that for the three outcomes, no history of receiving psychological help and self-rated good or higher health were protective factors, whereas more severe insomnia and job burnout were risk factors. Junior or lower job title and higher psychological resilience were related to a lower prevalence of depressive symptoms, while relatively longer working hours and larger work-family conflict were positively associated with the anxiety symptoms. Psychological resilience was inversely associated with the co-occurrence of depressive and anxiety symptoms.ConclusionsOur study revealed a high proportion of psychological problems and proved that several similar factors which were significant during the pandemic were also associated with the symptoms of depression and anxiety among healthcare workers in the post-pandemic era of COVID-19. These results provide scientific evidence for psychological interventions for healthcare workers.