Search

Background: Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5-50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs., Methods: From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings., Results: Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23-53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs., Conclusions: In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF., Competing Interests: Declarations Ethics approval and consent to participate All the protocols of the present study were ethically approved by ethical committee of Pasteur Institute of Iran (approval code: IR.PII.REC.1402.039) and the need for informed consent to participate was waived by ethical committee of Pasteur Institute of Iran. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Although several training courses for Health Care Workers (HCWs) on COVID-19 were conducted in Yemen, no evaluation has been done to assess the effectiveness of such training on the Knowledge, Attitude and Practice (KAP) of HCWs. Therefore, this study aimed to assess the effectiveness of training on the KAP of HCWs toward infection prevention and control (IPC) for COVID-19, determine the relationship between the change in the KAP of HCWs, and identify the associated factors with the change in KAP., Methodology: A cross-sectional study was conducted from April to December 2021. It was conducted among 186 HCWs working at COVID-19 isolation centers and caring for COVID-19 patients, in all Yemen's governorates. The data were collected one week before and immediately after the training session. SPSS version 26 was used for data entry and analysis. The median, interquartile range (IQR) and median difference were calculated. The Wilcoxon Signed Ranks Test was used to estimate the significant difference between KAP pre- and post-training scores. Kurskal-Wallis and Mann-Whitney U tests were used to assess the associated factors. Spearman's correlation coefficient test was used to assess the statistical relationship between the change in KAP. A P value < 0.05 was considered statistically significant., Results: Out of 186 HCWs, 181 HCWs filled the pre- and post-assessment, with a response rate of 97.3%. The median difference (IQR) in the KAP scores were 3.0 (1.0 and 6.0), 1.0 (-1.0 and 4.0) and 2.0 (-1.0 and 5.0), respectively. However, there are statistical difference in the KAP scores between the pre- and post-training (p value = 0.000, 0.004 and 0.000, respectively). There are significant positive correlations between the change in knowledge, attitude and practice (all p values < 0.01). A significantly change in knowledge was found among those working in epidemiological surveillance (p value = 0.031)., Conclusions: This evaluation concludes that the training program is effective in improving the KAP of HCWs toward IPC for COVID-19. It provides scientific evidence about the importance of training courses for HCWs during the COVID-19 pandemic. Further study is recommended to evaluate the retention of the KAP after a period of training., Competing Interests: Declarations Ethics approval and consent to participate This study was approved by the Research and Ethics Committee at MoPHP in the Republic of Yemen (Registration number: 2656- 15/03/2021). Methods were performed in accordance with the Declaration of Helsinki. The aim of the study was explained to all study participants. Informed consent was obtained from all participants. Their participation was entirely voluntary through answering question consent before starting the questionnaire. The collected information remained anonymous. Confidentiality of data was assured and ensured. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: The occupational stress that contributes to the development of burnout syndrome remains one of the greatest scientific challenges. Despite years of research into burnout and its determinants, burnout continues to attract the attention of researchers, and healthcare workers (HCWs) continue to experience burnout in large numbers. Burnout has a significant impact on both the mental and physical well-being of HCWs and reduces patient-centered healthcare. This review aims to identify the factors affecting healthcare workers' burnout (FAHCWB) and their conceptual models., Methods: The review was conducted according to Arksey and O'Malley's framework using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Searches were conducted in PubMed, Scopus, Wiley, ProQuest, Sage, Science Direct, and EBSCO using the following keywords: healthcare professionals, burnout, and internal/external factors. Empirical, qualitative, quantitative, and mixed-design research articles published in English with full-text access in peer-reviewed journals that investigated the FAHCWB were included. For an in-depth analysis of the included articles, the authors developed a data synthesis table, and thematic analysis was applied to the analysis., Results: According to the inclusion criteria, 38 articles were selected for further data analysis. Six main themes were identified: (1) FAHCWB; (2) conceptual models of FAHCWB; (3) research tools for studying FAHCWB; (4) findings on FAHCWB in the context of different models; (5) differences between findings from different models; (6) what is known and not known about FAHCWB. The results of the review show that most researchers conduct research on factors affecting burnout (FAB) based on factors related to the work environment, with fewer studies based on individual factors, including personality factors. Most of the research is based on the model developed by Maslach et al. The Maslach Burnout Inventory (MBI) has been used in most studies., Conclusions: Despite years of research, burnout continues to evolve rapidly, indicating that scientific research needs to be re-focused. Research should be conducted using different conceptual models and new research tools that allow the syndrome to be studied from a multidimensional perspective, including both the work environment and individual factors., (© 2024. The Author(s).)

Scorpion envenomation (SE) is a critical and immediate medical emergency. It represents a major public health concern with significant cause of illness and death, particularly in rural regions where scorpions are more prevalent. Of note, administering appropriate first aid to scorpion sting victims is one of the most effective ways to reduce mortality. Therefore, it is crucial to understand the level of knowledge of the healthcare workers in managing such cases. This work aims to assess the levels of knowledge on the diagnosis and management of scorpion stings, as well as the attitudes toward scorpion stings, among doctors and nurses in the Ouarzazate region of Morocco. Our results showed that the prevalent health care age group is 30-39 years, and in terms of experience, the majority had less than 5 years. Additionally, the majority of the participants had no knowledge regarding scorpions' identification. Moreover, only half participants (healthcare workers) received basic training in the management of scorpion stings and almost all of them have not benefited from continuing training. Hence, the current study showed that the understanding of scorpion sting management among healthcare providers in Ouarzazate province is inadequate to ensure proper care for sting patients, and thus including scorpion sting management in the university programs of health care provides along with clinical practice are highly required., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection. Despite widespread vaccination, some HCWs develop frequent symptomatic infection. We hypothesised that HCWs with frequent symptomatic COVID-19 have impaired T and B cell mediated immunity to SARS-CoV-2. Vaccinated HCWs with no prior COVID infection (n = 9), asymptomatic recent infection (n = 10), and frequent recent infection (n = 15) were recruited from a longitudinal HCW cohort study. Whole blood stimulation with SARS-CoV-2 variants (Wuhan, B.1.617, BA.2, BA.2.75, BA.4/5, XBB.1.5, BQ.1.1) was performed, with IFNγ and IL-2 responses, total IgG produced, and anti-Spike antibody neutralising capacity measured. Frequent infections had similar IFNγ and IL-2 responses to the never infected group, with significantly higher responses in the asymptomatic group. The frequent cohort had higher IgG responses to Delta and BA.4/5 and higher neutralising capacity against Omicron variants. An immune signature of blunted IL-2 and IFNγ in frequent infections may identify HCWs at increased risk of further infection., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Healthcare workers have an increased risk of depression and anxiety, and medical staff have faced a wide variety of challenges, especially during the COVID-19-pandemic. The aim of the VOICE study was to investigate risk and protective factors for workplace-related stress experience and mental health., Method: A multicentre, web-based and prospective survey (VOICE study) was initiated in the spring of 2020 by a network of five psychosomatic university clinics (Erlangen, Ulm, Bonn, Cologne and Dresden). More than 25,000 respondents took part in the study at five measurement points., Results: Of 3678 employees examined in a hospital setting during the first wave of the pandemic, 17.4% and 17.8% of physicians, 21.6% and 19.0% of nurses and 23.0% and 20.1% of medical-technical assistants (MTA) were affected by symptoms of depression and anxiety, respectively, to a clinically relevant extent. The most important risk factors for depressive and anxiety symptoms were insufficient relaxation during leisure time, increased alcohol consumption, lower trust in colleagues in difficult work situations and increased fear of becoming ill with COVID-19. Predictors for increased post-traumatic symptoms were increased generalized anxiety and depression as well as increased fear of infecting family members. Sense of coherence, social support, optimism and reward level acted as protective factors., Discussion: The psychological effects of workplace-related stress during the pandemic were found to be significant. Therefore, regular mental health screening and prevention programmes for healthcare workers are indicated., (© 2024. The Author(s).)

Background: We describe an epidemiological investigation of a SARS-CoV-2-XBB.1 outbreak among healthcare workers (HCWs) returning from a 5-days educational tour abroad., Methods: We prospectively followed participants for symptoms and sampled blood for neutralization assays of four SARS-CoV-2 variants (wild type, XBB, EG.5.1, and BA.2.86) at 1, 3, and 6 months after their return. When available, samples from the 3 months preceding the outbreak were also tested. We compared geometric mean titers (GMT) of neutralizing antibodies of infected versus uninfected HCWs and febrile versus afebrile infected HCWs., Results: Nineteen (10%) of 181 HCWs were infected, all had mild COVID-19, 90% (17/19) had symptoms, and 16% (3/19) reported fever. Infected individuals tended to have lower pre-exposure XBB-neutralizing antibody titers (GMT of 32 versus 107 ID50, P = 0.248). Neutralization against XBB and newer subvariants peaked at 3 months and was higher among infected individuals (GMT 702 versus 156 [P < 0.001], 558 versus 163 [P = 0.001], and 558 vs. 182 [P = 0.002], ID50 for XBB, EG.5.1., and BA.2.86, respectively). By six months, these differences were no longer observed. Fever was positively associated with XBB neutralization (GMT 3474 versus 485, ID50 P = 0.005)., Conclusions: Recently infected individuals are protected from reinfection with newer subvariants. However, protection is likely short lived., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Influenza infection is a highly contagious viral disease. It may cause several nosocomial outbreaks. This study aimed to evaluate the knowledge and attitudes of healthcare workers (HCWs) about influenza vaccination and to identify factors associated with the uptake of influenza vaccination., Methods: We conducted a cross-sectional study over 5 months between November 2021 and March 2022. Data was collected using an anonymous self-administered questionnaire. We included all HCWs at Taher Sfar University Hospital who were willing to participate in the study., Results: A total of 395 HCWs were included. They were mainly women (78.7%) with an average age of 27 years. The medical personnel was the largest group (67.8%). Most respondents considered the vaccination to be optional and knew that it should be renewed every year, but 97.5% of them judged the efficacy of the vaccine to be low. The influenza vaccination uptake was only 20.2%. The main reasons for accepting vaccination were to protect patients and families. However, misconceptions about the severity and the risk of influenza and the belief that barrier measures were sufficient to prevent infection were the main causes of avoiding vaccination. The factors associated with adherence to vaccination were being a medical professional, old age, longer professional experience, and considering vaccination to be mandatory for HCWs., Conclusion: Our study showed a low adherence to influenza vaccination with misconceptions about vaccine efficacy and safety. More efforts are needed to improve the knowledge of HCW about the vaccine and boost the adherence rates., (Copyright © 2024. Published by Elsevier B.V.)

Over the course of the last year and a half, the Coronavirus has swept across the world causing death and devastation to our geriatric population residing in long term care facilities, also known as nursing homes. This paper explores the complicated grief responses exhibited by individuals who were affected by nursing home resident COVID-19 deaths. Nursing home resident survivors, families of the deceased residents, and healthcare workers in this situation have experienced a wide variety of complicated grief responses that need to be addressed. To address this need, an application will follow regarding the usage of a garden memorial ritual and ceremony to help these grievers in their first steps of mourning., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Working in healthcare often involves stressful situations and a high workload, and many healthcare workers experience burnout complaints or suffer from mental or physical problems. This also affects the overall quality of health care. Many previous workplace interventions focused on knowledge exchange instead of other health cognitions, and were not particularly effective. Multicomponent lifestyle interventions may offer the potential in improving lifestyle and well-being of healthcare professionals. This study aims to evaluate the impact of a multicomponent lifestyle intervention "Healthy and Vital" for healthcare professionals on several health-related outcomes., Methods: A pre- (multiple) post-pilot study has been conducted using data from 2012 to 2018 to evaluate the lifestyle intervention in 126 female healthcare professionals. Measurements were conducted before, directly after the intervention (at 3 months), and 6 months after finishing the intervention (at 9 months). Participants filled out questionnaires and anthropometrics measurements were conducted by a dietitian. The intervention is based on the ASE-model, theory of planned behavior, and motivational interviewing techniques. The intervention included workshops related to stress, eating, sleep, and individual meetings with a dietitian. Multilevel linear mixed models with a random intercept and fixed slope were used to evaluate the impact on lifestyle self-efficacy, eating behavior, anthropometric outcomes and quality of life., Results: Improvements were observed for lifestyle self-efficacy (total: beta= 1.32 95%CI 0.94;1.48, I know: beta= 1.19 95%CI 0.92;1.46, and I can: beta= 1.46 95%CI 1.19;1.73), eating behavior (emotional eating: beta=-0.33 95%CI-0.44;-0.23, external eating: beta=-0.35 95%CI -0.44;-0.26, and diet/restrictive behavior: beta= 0.41 95%CI 0.30;0.51), anthropometric outcomes (weight: beta=-5.03 95%CI -5.93;-4.12, BMI: beta=-1.873 95%CI -2.06;-1.41, waist circumference: beta=-6.83 95%CI -8.00;-5.65, and body fat percentage: beta=-1.80 95%CI -2.48;-1.17) and multiple outcomes of quality of life (physical functioning: beta= 4.43 95%CI 1.98;6.88, vitality: beta= 7.58 95%CI 4.74;10.42, pain: beta=4.59 95%CI 0.91;1.827, general health perception: beta= 7.43 95%CI 4.79;10.07, and health change: beta= 21.60 95%CI 16.41;28.80) directly after the intervention. The improvements remained after a six-month follow-up., Conclusions: Multicomponent interventions such as "Healthy and Vital" for healthcare professionals may be useful for improving the health of healthcare workers. More research using other designs with a control group, such as a stepped-wedge or RCT, is needed to verify our findings., Trial Registration: Retrospectively registered on May 1 2024 at the Open Science Framework Registries ( https://doi.org/10.17605/OSF.IO/Z9VU5 )., (© 2024. The Author(s).)

Introduction: Influenza, a globally significant respiratory illness with pandemic potential, affects around 1 billion individuals annually, leading to increased risk for severe illness and mortality. Despite recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) and MoH prioritization, influenza vaccination coverage rate among HCWs in Kyrgyzstan remains low, ranging between 16 % and 46 % over the past five years. Understanding the Knowledge, Attitudes, and Practices (KAP) dynamics of HCWs regarding influenza vaccinations, both before and during the COVID-19 pandemic is crucial for refining national strategies and institutional approaches to enhance vaccination coverage rates in this important risk group., Method: This study employed cross sectional investigations aimed at assessing KAPs among HCWs regarding influenza disease and vaccination. Conducted prior to and during the initial phase of the COVID-19 pandemic, the project involved 2400 participants from diverse medical disciplines. EPI Info was utilized to run biostatistical analyses, with descriptive and logistic regression models, to elucidate the dynamics of KAP over time., Results: The findings indicate that HCWs with over 5 years of experience were more likely to get vaccinated or recommend it to patients (p = 0.000). Low confidence in vaccine effectiveness influenced on recommendations of influenza vaccination in pre-pandemic time, where insufficient (95 %CI 0.08-0.6; p = 0.003) or uncertain assurance in vaccine effectiveness (95 %CI 0.007-0.18; p = 0.000) was a barrier for vaccine promotion during the pandemic. The study underscores to consider mandatory influenza vaccination for HCWs which may impact on likelihood of flu vaccination (p = 0.001). Priority groups for influenza vaccination shifted during the COVID-19 period, emphasizing older adults, individuals with existing conditions, and HCWs, compared to the pre-pandemic focus on HCWs, children, and patients with pre-existing conditions., Conclusion: Our investigation provides valuable insights into HCWs KAP concerning influenza vaccination in Kyrgyzstan, highlighting the need for targeted interventions addressing factors influencing vaccine acceptance. The study suggests policy implications, advocating for the revision of national strategies to strengthen capacity building for medical staff., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Across various stages of the COVID-19 pandemic and related vaccine recommendations in France, we assessed the association of the 7C-psychological antecedents with vaccine uptake/intention for booster vaccination among healthcare-sector workers (HCSWs). We also assessed whether 7C-antecedent profiles changed over time., Methodology: The Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES) conducted three repeated web-surveys which were disseminated by email chain-referral among HCSWs throughout France. The questionnaires waves took place: July-November 2021, February-March 2022 and January-March 2023 (P2, P3 and P4). We also reanalysed data from a prior similar study conducted late 2020-early 2021 (Moirangthem et al. (2022)) (P1). To evaluate the association of 7C-items with vaccine uptake-intention for future vaccination, we estimated adjusted prevalence ratios (aPR) using robust variance Poisson regression. We report the 7C-item population attributable loss in vaccine intention., Results: The four surveys (P1-P4) encompassed 5234, 339, 351 and 437 participants. At earlier stages of the vaccine campaign, the principal antecedents of vaccine intention were favorable perception of vaccination benefit-risk-balance (BRB) (vs. unfavorable, aPR: 2.32), reactance to employer encouragement for vaccination (motivates vs. dissuades-me, aPR:2.23), vaccine confidence (vs. not-being-confident, aPR: 1.71) and social conformism towards vaccination (favorable vs. skeptical opinion in private environment, aPR: 1.33). Under a vaccine mandate for HCSWs, only perceiving vaccination as a collective action was associated with current vaccine status (agree vs. disagree, aPR: 2.19). At later stages of the epidemic, hypothetical booster vaccine intentions were strongly associated with BRB perception (favorable vs. unfavorable, aPR: 2.07) and perceiving vaccination as a collective action (agree vs. disagree, aPR: 1.69). Fearing a severe side effect from vaccination decreased population vaccine intention by 26.2 %., Conclusion: Our results suggest that both 7C-antecedents and their association with vaccine behaviour can change over time, and underscore the importance of assuring confidence in vaccine safety., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Emerging infectious diseases like the Ebola Virus Disease (EVD) pose significant global public health threats. Uganda has experienced multiple EVD outbreaks, the latest occurring in 2022. Frontline healthcare workers (HCWs) are at increased risk, yet there is insufficient evidence of existing knowledge of EVD of these HCWs. We aimed to assess the readiness of Uganda's emergency HCWs to manage EVD and identify their training needs to inform targeted capacity-building interventions for future outbreaks., Methods: This multicentre nationwide cross-sectional study was conducted from July to September 2023 among HCWs providing emergency care in 14 secondary and tertiary hospitals across Uganda. Participants were consecutively recruited using the probability-proportional-to-size sampling technique, and data was collected using a self-reported questionnaire. Factors associated with EVD knowledge were identified through a mixed-effect linear model., Results: Data from 691 eligible HCWs with a median age of 32 (IQR: 28-38) was analyzed (response rate: 92%). Only one-third (34.4%, n = 238) had received EVD training in the past year. The median EVD knowledge score was 77.4% (IQR: 71.2 - 83.4%). EVD knowledge was associated with longer professional experience in years (β: 0.21, 95% CI: 0.03 to 0.39, p = 0.024) and higher level of education: diploma (β: 3.37, 95% CI: 1.49 to 5.25, p < 0.001), undergraduate degree (β: 6.45, 95% CI: 4.11 to 8.79) and postgraduate degree (β: 7.13, 95% CI: 4.01 to 10.25, p < 0.001). Being a doctor (β: 2.55, 95% CI: 0.35 to 4.74, p = 0.023), providing care in the obstetrics/gynecology department (β: -1.90, 95% CI: -3.47 to - 0.32, p = 0.018), previous EVD training (β: 2.27, 95% CI: 0.96 to 3.59, p = 0.001) and accessing EVD information through social media (β: 2.52, 95% CI: 1.17 to 3.88, p < 0.001) were also significantly associated with EVD knowledge. HCWs were mostly interested in training on management (92.9%), infection prevention and control (87.1%), and clinical presentation (84.1%), and preferred physical (51.5%) and hybrid (38.2%) training modes., Conclusion: Our study shows that the readiness of HCWs in Uganda to respond to EVD outbreaks varies by individual factors and information sources. We recommend targeted training and suggest future research on educational innovations and social media's potential to fill knowledge gaps., (© 2024. The Author(s).)

Moral injury has emerged as a construct of interest in healthcare workers' (HCW) occupational stress and health. We conducted one of the first multidisciplinary, longitudinal studies evaluating the relationship between exposure to potentially morally injurious events (PMIEs), burnout, and turnover intentions. HCWs (N = 473) completed surveys in May of 2020 (T1) and again in May of 2021 (T2). Generalized Linear Models (robust Poisson regression) were used to test relative risk of turnover intentions, and burnout at T2 associated with PMIE exposure, controlling for T1 covariates. At T1, 17.67% reported they had participated in a PMIE, 41.44% reported they witnessed a PMIE and 76.61% reported feeling betrayed by healthcare or a public health organization. In models including all T1 PMIE exposures and covariates, T2 turnover intentions were increased for those who witnessed a PMIE at T1 (Relative Risk [RR] = 1.66, 95% Confidence Interval [CI] 1.17-2.34) but not those that participated or felt betrayed. T2 burnout was increased for those who participated in PMIE at T1 (RR = 1.38, 95%CI 1.03-1.85) but not those that witnessed or felt betrayed. PMIE exposure is highly prevalent among HCWs, with specific PMIEs associated with turnover intentions and burnout. Organizational interventions to reduce and facilitate recovery from moral injury should account for differences in the type of PMIE exposures that occur in healthcare work environments., (© 2024. The Author(s).)

Background: Profound 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., Objectives: We aimed to identify determinants of quality of life (QoL) of HCWs and to study longitudinal evolution., Methods: The 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 <3 years old). Two populations were used: (1) cross sectional study: the sample 1 includes the HCWs assessed at T2 (2020-2021); (2) longitudinal study: the sample 2 includes the HCWs assessed at both T1 (2015-2016) and T2 (2020-2021). The data collected included: sociodemographics, health status, professional variables, and psycho-comportemental aspects. QoL was assessed using WHOQOL-BREF which provides 4 scores., Results: In comparison with French norms, the physical and social scores of QoL were significantly lower while the psychological score was significantly higher for (i) the 223 HCWs (participation rate 62%) assessed at T2 and (ii) the 61 HCWs assessed at T1 and T2. The main factors modulating QoL were age, marital status, self-perceived financial difficulties, personal chronic disease, anxiety-mood disorders, nature of coping strategies, and burnout., Conclusion: This study confirms the mixed (negative and positive) impact of caring persons with PLH on the institutional HCWs' QOL. Main determinants of the HCW's QOL were: older age, single status, perceived financial difficulties, altered health status, burn out and coping strategies. Clinical trial registration number : NCT02400528., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer HB declared a past co-authorship with the authors M-CR to the handling editor., (Copyright © 2024 Rousseau, Beltran, Hamouda, Aim, Felce, Lind, Khaldi, El Ouazzani, Auquier, Villemeur and Baumstarck.)

Background: Hypertension is one of the main risk factors for cardiovascular disease impacting over a billion people worldwide. Work environment factors could adversely affect workers' cardiovascular health, including contributing to hypertension. Healthcare workers who treat patients are also affected. In the Democratic Republic of Congo, limited studies explored the work environment factors associated with hypertension. This study aimed to examine hypertension prevalence and determine the associated risk factors among healthcare workers in Kinshasa., Methods: A cross-sectional study was conducted in Kinshasa's healthcare facilities from December 2023 to January 2024 among healthcare workers selected by multistage stratified random sampling. Data was collected through a structured questionnaire using a modified WHO STEPwise approach and Karasek questionnaire. Anthropometric parameters, blood pressure, and fasting blood sugar were measured. The prevalence of hypertension was assessed. All sociodemographic, occupational, and lifestyle variables associated with hypertension were included in multivariable logistic regression analysis at the 5% significance level., Results: The study encompassed 614 participants, comprising 55.2% females and 44.8% males. The mean age of participants was 38.8 ± 10.4 years, ranging from 20 to 78 years. The prevalence of hypertension was 22.6% and over half of those with hypertension (56.1%) were unaware of their condition. Of the known hypertensive participants before the study, 60.7% had uncontrolled blood pressure. In the multivariable analysis, identified risk factors for hypertension were age ≥ 40 years (aOR = 2.75, 95% CI: 1.64-4.61), seniority ≥ 10 years (aOR = 2.65, 95% CI: 1.54-4.58), multiple job holding (aOR = 3.11, 95% CI: 1.81-5.34), job stress (aOR = 1.84, 95% CI: 1.17-2.89), physical inactivity (aOR = 1.67, 95% CI: 1.03-2.68), overweight (aOR = 1.75, 95% CI: 1.06-2.90) and obesity (aOR = 3.75, 95% CI: 2.10-6.70)., Conclusion: Our results underline an important prevalence of hypertension among healthcare workers in Kinshasa, despite their medical knowledge of the causes and the risks. A healthy lifestyle among healthcare workers is fundamental for ensuring the efficiency and productivity of the healthcare system. Regulating multiple job holding and implementing a hypertension prevention intervention encompassing their holistic support is crucial for reducing job stress and promoting well-being., (© 2024. The Author(s).)

Purpose: This study mainly focused on the long-term effect of different risk exposure levels and prior anti-epidemic experience of healthcare workers in mitigating COVID-19 on their work stress in the post-COVID era., Design/methodology/approach: The study sample included 359 physicians, 619 nurses, 229 technicians and 212 administrators, for a total of 1,419 healthcare workers working in the Lanzhou area during the investigation. Data were analyzed by multivariate regression models., Findings: Our findings indicated that the interaction between pandemic effect mitigation experience and high-risk exposure significantly affected healthcare workers in the post-COVID era by increasing their work stress ( p  < 0.001) and reducing their rest time ( p  < 0.001). Healthcare workers may have experienced worse outcomes in the long term if they had higher levels of risk exposure and more experience in fighting epidemics. Furthermore, poor mental health ( p  < 0.001) and prior experience with SARS ( p  < 0.001) further amplified these adverse effects. However, surprisingly, we did not observe any effect of prior anti-epidemic experience or high-risk exposure on the mental health of healthcare workers in the post-COVID era ( p  > 0.1)., Research Limitations/implications: The adverse impact of COVID-19 may have left long-lasting effects on Health professionals (HPs), particularly those with high Risk exposure (RE) and more mitigation experience. Poor Mental health (MH) and previous experience in mitigating previous similar outbreaks (such as SARS) are risk factors that should be considered. Support programs must be designed and promoted to help HPs respond and improve their performance., Originality/value: Our study presents compelling evidence that the COVID-19 pandemic will have long-term detrimental effects on the work stress of healthcare workers., (© Emerald Publishing Limited.)

Healthcare workers face greater risks for mental health conditions and chronic stress due to the demanding nature of their roles. The COVID-19 pandemic exacerbated these challenges and increased vulnerabilities to long-term mental health conditions. The present study adapts an existing resilience-based educational workshop program to address the time constraints and unique needs of the healthcare workforce in a post-COVID-19 world. Expanded from its initial focus on resilience, the workshop curriculum incorporates psychoeducation on common mental health issues. Between July 2022 and June 2024, a 15 min "huddle" format offered on-site training to equip HCWs in a large urban health system with coping strategies to prevent, manage, and recover from stress. Attendance and anonymous feedback were collected at each session via brief electronic surveys. Participant responses ( n = 1403) obtained immediately post-huddle suggested positive impact on stress management, perceived leadership support, and resilience. Findings show the potential of brief huddles to improve mental health and resilience in healthcare workers and similar workforces. Our findings support the efficacy of brief, evidence-based educational huddles in enhancing resilience, mental health awareness, and coping skills among HCWs. This model holds significant potential for widespread implementation across healthcare and other high-stress workplaces.

Background: In 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 Materials: A 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., Results: The 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., Conclusion: Overall, 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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Berihun, Gizeyiatu, Berhanu, Sewunet, Ambaw, Walle, Abebe and Gasheya.)

Few studies have explored the association between residential noise exposure and burnout. In this study, we investigated the association between residential noise exposure and burnout prevalence among 5416 health-care workers in Taiwan from 2012 to 2017. Burnout was evaluated using the Mandarin version of the Copenhagen Burnout Inventory by considering both continuous and binary measures. We applied ordinary Kriging models to calculate the annual average residential noise exposure at an individual level. Multivariable linear regression models and logistic regression models were employed. Restricted cubic splines were used to explore dose-response relationships. The median age of the health-care workers was 31.5 years. In the multivariable linear regression models, exposure to residential noise (per 1 dBA) was associated with increases in personal burnout and work-related burnout scores by 1.59 ± 0.25 and 1.38 ± 0.20, respectively. In the multivariable logistic regression models, the adjusted odds ratios were 1.24 (95% confidence interval [CI]: 1.16, 1.32) for personal burnout and 1.19 (95% CI: 1.13, 1.26) for work-related burnout per 1-dBA increase in residential noise exposure. Linear dose-response associations of burnout with residential noise level were detected. Our findings suggest that exposure to residential noise may increase the risk of burnout among health-care workers., (© 2024. The Author(s).)

Background: Genetic 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., Methods: We 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., Results: Among 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., Conclusion: Our 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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ioannou, Constantinidou and Chatzittofis.)

Objective: During pandemic periods, mental health issues are highly prevalent, particularly among healthcare workers who are at a higher risk of developing psychiatric disorders. The aim of this study is to evaluate the mental health status of the intensive care unit (ICU) healthcare workers, who play a vital role in managing the COVID-19 pandemic, in terms of the quality of sleep, levels of depressive and anxiety symptoms, stress and to determine the factors that affect their mental health., Methods: The research was conducted in April 2020 and incorporated a total of 79 participants working in an university hospital ICUs in Turkey. Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale 42 (DASS-42), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied., Results: Among the participants, 58 individuals comprising 73.4% of the cohort were working in the ICUs, managing patients infected with COVID-19. Those working in ICUs with COVID-19 patients had significantly higher DASS-S, BAI, and BDI scores. Doctors' BDI scores were significantly lower compared to both nurses and other healthcare workers. Participants exhibiting COVID-19 symptoms manifested significantly higher BAI scores in compared to those without such symptoms., Conclusion: Healthcare workers involved in ICUs with COVID-19 patients were more significantly affected psychologically, doctors had lower depressive symptoms as compared to other healthcare workers. In addition, individuals with COVID-19 symptoms demonstrated significantly higher levels of anxiety. The findings of our study emphasize the significance of providing psychological support to healthcare workers throughout pandemics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Meriç Özgündüz, Bıçakçıoğlu, Sahin Tutak and Özgündüz.)

The purpose of the study is to identify the features of the emotional component of professional deformation (burnout) of healthcare workers in the post-covid period. A survey was conducted of 658 healthcare workers with characteristics of the emotional component of professional deformation (burnout) in the post-covid period. Questionnaires of emotional burnout and self-assessment of emotional states were used. Mathematical and statistical processing included the K. Pearson correlation criterion and the Chaddock-Snedecor scale.

COVID-19 vaccination recommendations include healthcare workers (HCWs). We measured COVID-19 vaccine effectiveness (CVE) of the autumn 2023 dose against laboratory-confirmed SARS-CoV-2 infection in a prospective cohort study of 1,305 HCWs from 13 European hospitals. Overall CVE was 22% (95% CI: -17 to 48), 49% (95% CI: -8 to 76) before and -11% (95% CI: -84 to 34) after the start of BA.2.86/JN.1 predominant circulation. Autumn 2023 COVID-19 vaccination led to a moderate-to-low reduction in SARS-CoV-2 infection incidence in HCWs. Monitoring of CVE is crucial for COVID-19 prevention.

Background: Public health emergencies, such as the Covid-19 pandemic, put great pressure on healthcare workers (HCW) across the world, possibly increasing the risk of experiencing ethically challenging situations (ECS). Whereas experiencing ECS as a HCW in such situations is likely unavoidable, mitigation of their adverse effects (e.g., moral distress) is necessary to reduce the risk of long-term negative consequences. One possible route of mitigation of these effects is via work environmental factors., Objectives: The current study aimed to examine: [1] risk factors associated with ECS among HCW [2], intensity of moral distress associated with ECS across various occupational factors (i.e., profession, degree of exposure to patients with Covid-19), and [3] the impact of work environmental factors on this association, in a sample of HCW during the pandemic., Methods: We employed multiple logistic and linear regression to self-report data from 977 HCWs at four Norwegian hospitals responding to a survey at the fourth wave of the pandemic., Results: About half of HCW in this study had experienced ECS during the pandemic, and levels of moral distress associated with such were higher than in previous studies using similar assessment methods. Younger age, female sex, geographical work area (mid-north of Norway), and profession (nurse) were all associated with higher odds (range of OR: 1.30-2.59) of experiencing ECS, as were direct contact with patients with Covid-19. Among those participants who reported that they had experienced ECS during the pandemic, moral distress levels when recalling those situations were moderate (Mean 5.7 on a 0-10 scale). Men reported somewhat lower intensity of moral distress (partial eta squared; ηp 2  = 0.02). Reporting a manageable workload (ηp 2  = 0.02), and greater opportunity to work according to best practice (ηp 2  = 0.02), were associated with lower levels of moral distress., Conclusions: Our findings suggest that moral distress could potentially be mitigated on an organizational level, particularly by focusing on ensuring a manageable workload, and an ability to work according to best practice. To build sustainable healthcare systems robust enough to withstand future public health emergencies, healthcare organizations should implement measures to facilitate these aspects of HCWs' work environment., (© 2024. The Author(s).)

Assess the changes in post-traumatic stress disorder (PTSD), burnout, anxiety, depression, jobstrain, and isostrain levels over time among healthcare workers in emergency departments (EDs) after successive outbreaks of COVID-19. A prospective, multicenter study was conducted in 3 EDs and an emergency medical service. Healthcare workers who participated in our previous study were invited to participate in a follow-up 16 and 18 months and completed the questionnaires to assess symptoms of PTSD, burnout, anxiety, depression, jobstrain, and isostrain. Among the 485 healthcare workers asked to participate, 211 (43.5%) completed the survey at inclusion (122 were followed up at 3 months) and 59 participate to the follow-up study. At 16 months, 10.9% of healthcare workers had symptoms of PTSD and 17.4% at 18 months. At inclusion, 33.5% and 11.7% of healthcare workers had symptoms of anxiety and depression, respectively. A decrease in anxiety between inclusion and 16 months (p = 0.02) and an increase between 16 and 18 months (p = 0.009) was observed. At inclusion, 40.8% of all healthcare workers had symptoms of burnout. There was an increase in symptoms of burnout between inclusion and 18 months (p = 0.006). At inclusion, 43.2% and 29.5% of healthcare workers were exposed to jobstrain and isostrain, respectively. Jobstrain were higher among paramedics and administrative staff compared to physicians (p = 0.001 and p = 0.026, respectively). Successive outbreaks of COVID-19 led to long-term mental health consequences among ED healthcare workers that differed according to occupation. This must be taken into account to rethink the management of teams., (© 2024 The Author(s). Stress and Health published by John Wiley & Sons Ltd.)

Objectives: Despite the critical value of healthcare workers (HCWs) demonstrated during the COVID-19 pandemic, there remains a noted global surge in violence against this population. The present meta-analysis aimed to gather data on the prevalence of workplace violence (WPV) against HCWs and to determine if there is any difference based on gender., Study Design: This was a systematic review and meta-analysis., Methods: A thorough search of PubMed/MEDLINE, Lilacs, and Cochrane Collaboration databases was conducted from the start of the COVID-19 pandemic until March 8, 2023. Two authors independently carried out screening, data extraction, and quality assessment, followed by statistical analysis using random-effects meta-analysis and subgroup analysis to assess heterogeneity., Results: We included 22 studies with 44,357 participants, of which 79.37% were women. The analysis revealed an overall prevalence of WPV similar in both women (51.86%, 95% confidence interval [CI]: 41.39-62.33) and men (51.45%, 95% CI: 40.95-61.95). There were considerable differences in gender-based WPV across geographic regions. Aggressions tend to be higher toward men in Asia (odds ratio [OR] 0.79, 95% CI 0.74-0.85, P < 0.001). Conversely, in Latin America, WPV prevalence was higher in women (OR 1.20, 95% CI 1.01-1.4, P = 0.035). HCWs from low- middle-income-level countries suffered a higher incidence of violence irrespective of gender compared with high- and upper-middle-income countries (72.36% vs 47.35%)., Conclusions: Our data indicate that more than half of HCWs experienced WPV during the COVID-19 pandemic. In addition, women and HCWs in low-middle-income countries were notably vulnerable to WPV. A deeper understanding of the nuances behind violence against HCWs will help to facilitate tailored strategies for different demographical contexts., Registration: PROSPERO ID: CRD42023403970., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Aims: This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID-19 pandemic. Additionally, we explored the association of such levels with personal and professional variables., Design: Cross-sectional study., Methods: Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work-related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested., Results: In total, 18.8% of the sample scored above the cut-off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%-53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work-related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre-pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID-19., Conclusion: Healthcare workers showed high levels of psychological impact during the COVID-19 pandemic. Such impact was predicted from some work-stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression., Impact: Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health., Patient or Public Contribution: No patient or public contribution., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

The emergence of the COVID-19 pandemic resulted in substantial pressures for healthcare workers across the world. The association between fear of COVID-19 and psychological distress, and the role of psychological resilience have gained research interest. The current study aimed to investigate the cross-sectional association between fear of COVID-19 and psychological distress, in Australian rural/regional healthcare workers and determine whether resilience modifies this association. Most participants were nurses (38.0%), mean age was 44.9 years, and 80.5% were female (N = 1313). An adjusted logistic regression analysis showed that the highest tertile of the Fear of COVID-19 scale was associated with higher odds of moderate to severe symptoms of anxiety (OR = 3.72, 95% CI = 2.27, 6.11; p < 0.001) and depression (OR = 3.48, 95% CI = 2.30, 5.28; p < 0.001). Healthcare workers with high level of fear of COVID-19 and low level of resilience were much more likely to report moderate to severe symptoms of anxiety (OR = 12.27, 95% CI = 6.65-22.65, p < 0.001) and depression (OR = 12.21, 95% CI = 6.93-21.50, p < 0.001) when compared to healthcare workers with low level of fear of COVID-19 and high level of resilience. A cross-sectional design was used and therefore cause and effect between fear of COVID-19 and psychological distress cannot be inferred. Longitudinal research is needed to investigate the possible causal relationship. These findings highlight the potential mental health effects of fear of COVID-19 on HCWs and demonstrate the importance of resilience as a possible moderator of these effects., (© 2024 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

The COVID-19 pandemic has had a negative impact on the mental health of healthcare workers participating in the prevention and control of the pandemic, thereby reducing their quality of life and affecting the quality of patient outcomes. This study aims to explore and deeply understand the mental health problems among healthcare workers participating in the prevention and control of COVID-19 in Ho Chi Minh City, Vietnam. A mixed methods study was undertaken with a descriptive cross-sectional survey of 2870 healthcare workers who have been participating in the prevention and control of COVID-19 in Ho Chi Minh City in 2021, followed by a qualitative descriptive phenomenological study comprised of in-depth interviews with a purposively sampled subset of 40 healthcare workers. Results showed that of the 2870 survey participants, the majority (60.6%) were female, and the average age was 35.1 (SD = 8.6). The prevalence of stress, anxiety and depression was 17.2%, 20.8%, and 17.6%, respectively. The findings from in-depth interviews revealed that the participants were under extreme mental health issues such as worries, stress, and negative emotions. The worrying was related to risk of infection, being shunned, stigmatised, or assaulted by the community. Stress was due to excessive pressure from work. Negative emotions were identified as sadness, self-pity, feelings of loneliness, entrusting fate, feelings of guilt, anxiety, confusion, obsession, disorientation, physical and mental exhaustion. Promoting mental health among healthcare workers who participated in the crisis is necessary and urgent., (© 2024 John Wiley & Sons Australia, Ltd.)

Introduction: The purpose of this research was to investigate the outcomes of coronavirus disease 2019 (COVID-19) infection in healthcare workers, assess the incidence of infection among them, and identify factors linked to the severity of the disease., Methodology: This cross-sectional study was conducted retrospectively in Duhok city, Kurdistan Region of Iraq, from September 2021 to January 2023., Results: The study included 1,958 participants, of whom 1,338 (68.33%) contracted the infection. Among them, 830 (62.03%) and 372 (27.81%) patients experienced mild and moderate infections, respectively, while 136 (10.1%) had severe infections. The results indicated that several factors, including maintaining a healthy lifestyle, avoiding obesity, having a chronic condition, working consecutive hours, and being in an overwhelmed work environment were significantly associated with a higher severity of infection (p < 0.05). However, factors such as smoking habits, adherence to preventive health guidelines, direct exposure to COVID-19 patients, work days and patterns, family members with COVID-19, and hand/glove sterilization did not appear to have a significant effect on the severity of infection (p > 0.05)., Conclusions: These findings may offer valuable insights for clinicians and public health officials, and aid in the development of effective strategies to manage COVID-19 patients based on their risk factors for infection severity., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Nawfal R Hussein, Ronahi Y Ibrahim, Shameran S Daniel, Majeed H Mustafa, Salar N Jakhsi, Shilan MT Husamaldeen, Khalid H Haleem, Ibrahim A Naqid, Zana SM Saleem, Ahmed S Mahdi, Nashwan MR Ibrahim, Ameen M Mohammad, Avan S Saleh, Rasheed M Ameen, Dildar H Musa, Rojan S Saleh, Selah S Haji.)

Background: This study evaluates the knowledge, attitudes, and practices (KAP) of hand hygiene among healthcare workers, crucial for preventing healthcare-associated infections (HAIs) in medical facilities., Methodology: This 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., Results: The 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 < 0.001) compared to other age groups. Significant associations were found between higher income levels and positive attitudes toward hand hygiene (OR for ≥80,000 = 3.19, 95% CI = 2.05-5.02, p < 0.001), and between knowledge and practices, suggesting that well-informed individuals are more likely to adhere to recommended practices., Conclusion: The findings reveal robust hand hygiene knowledge but uncover critical confidence gaps among healthcare workers, urging immediate, targeted educational interventions to fortify adherence and prevent infection outbreaks., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hong and Xu.)

Background: Healthcare workers are a high-risk group for COVID-19 and protecting them is crucial for healthcare delivery. Limited studies have explored compliance with infection prevention and control (IPC) practices among Somali healthcare workers. This study aimed to determine compliance with IPC practices among healthcare workers in De Martino Public Hospital, Somalia., Methods: A cross-sectional study was conducted at the De Martino Public Hospital, Mogadishu, Somalia from August to October 2022, with the participation of 204 healthcare workers (response rate = 97%). Compliance was assessed using responses to 25 questions on a five-point Likert-type scale, and a median score of 20 was used to dichotomize compliance scores. A chi-square test and logistic regression analysis were performed to check the associations between healthcare workers' socio-demographic information, IPC-related factors, work conditions and practices on COVID-19, and IPC compliance during healthcare interventions using SPSS 23 version., Results: In total, 58.3% of the participants had good compliance with IPC. There were significant associations between IPC compliance and the type of healthcare worker (doctors and doctor assistants: 72.3%, nurses and paramedical staff: 67.3%, non-clinical staff: 5.7%, p < 0.01). After adjusting for potential confounding factors, compared to non-clinical staff, doctors and doctor assistants (OR: 12.11, 95% CI: 2.23-65.84) and nurses and paramedical staff (OR: 21.38, 95% CI: 4.23-108.01) had higher compliance with IPC measures. There were no significant associations between compliance and sex, marital status, vaccination status, or smoking (p > 0.05 for all)., Conclusions: Low levels of compliance with COVID-19 IPC measures were observed among hospital workers. Prioritizing awareness campaigns and behavior change interventions, especially among non-clinical staff, is crucial for effective COVID-19 infection prevention and control within hospitals., (© 2024. The Author(s).)

Introduction: Long COVID (LC) occurs when people experience symptoms for weeks, months or even years after a COVID-19 infection. This review looks at research exploring the LC definitions, prevalence, symptoms, risk factors, and associated impacts in research on healthcare workers (HCWs)., Data Sources: We systematically searched five electronic databases (CINAHL, EMBASE, Medline, PsycInfo and PubMed) and compiled a narrative literature review based on 56 relevant studies., Areas of Agreement: LC is prevalent among HCWs who become infected by COVID-19. Many of the most frequent symptoms associated with LC in the general population are also reported among HCWs. Some risk factors for LC are also similar to those in the general population, such as female sex, older age, and having a pre-existing respiratory illness., Areas of Controversy: The mechanism(s) responsible for LC remains unknown. A variety of terms, timeframes and symptoms are used to define LC, creating difficulties in comparing results across studies. Much of the research is cross-sectional and fails to explore the impacts that prolonged symptoms have on HCWs' personal and professional lives., Growing Points: The need to support HCWs with LC is clear. Identifying the mechanism(s) responsible for LC is a key priority, as this will inform treatments., Areas for Developing Research: Future research should move towards a standard definition for LC. Greater attention should be paid to longitudinal and qualitative studies, which could give insights into prognosis, lived experience and work participation. Finally, studies evaluating treatments suitable for people with LC are timely., (© The Author(s) 2024. Published by Oxford University Press.)

Background: Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic., Methods: Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint)., Results: The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0-3), control Mdn = 5.0 (IQR = 1-17); p < 0.0001, IRR = 0.30; 95% CI = 0.17-0.53] and led to fewer post-traumatic stress-related symptoms at 1, 3 and 6 month follow-ups (secondary endpoints). Participants and statisticians were blinded to allocation. Adverse events data were acquired throughout the trial, demonstrating safety. There was high adherence and low attrition., Conclusions: This brief, single-symptom, repeatable digital intervention for subclinical-to-clinical samples after trauma allows scalability, taking a preventing-to-treating approach after trauma., Trial Registration: 2020-07-06, ClinicalTrials.gov identifier: NCT04460014., (© 2024. The Author(s).)

Studies on the prevalence and factors of depression, and anxiety symptoms from a work-ascribed or causal perspective are not available and studies on the prevalence of occupational stress in Ethiopia are limited. Therefore, this study aimed to determine the prevalence of occupational depression, job anxiety, and occupational stress, and to identify their determinants in healthcare workers. We conducted a multicenter cross-sectional study in selected public hospitals in the Central and Southern Ethiopia from 16th January to 28th February 2023. We used stratified random sampling to select 9 public hospitals from three strata: primary, general and tertiary hospitals. We collected data using scales of perceived occupational stress, occupational depression inventory, and job anxiety. We performed a confirmatory factor analysis followed by determining the prevalence of those mental symptoms and identifying independent factors using multiple ordinal logistic regression. Among 1426 healthcare workers, the overall prevalence of occupational depressive, job anxiety, and occupational stress symptoms were 39.0%, 57.6%, and 68.0%, respectively. Females, medical specialists, participants with a history of disease or injury, those with low job dissatisfaction, higher sleeping disorder scores, higher life-threatening events (LTEs) scores, and longer working hours were more likely to report occupational depressive symptoms. Participants with poor perceived health significantly increased the odds of reporting job anxiety symptoms. Participants with low job satisfaction, a history of workplace verbal violence, higher scores for sleep disorders, and higher LTEs score had significantly greater odds of reporting both job anxiety and occupational stress symptoms. Younger participants were also more likely to report occupational stress symptoms. Our study highlights the need to prioritize workplace mental health interventions for healthcare workers. The study also suggested the need to address gender, educational level, job satisfaction, and sleep hygiene, develop coping mechanisms for LTEs, prevent workplace violence, and manage of working hours per week to enhance the mental well-being of healthcare workers in Ethiopia., (© 2024. The Author(s).)

Objective: The persistent symptoms arising from COVID-19 infection pose a substantial threat to patients' health, carrying significant implications. Amidst the evolving COVID-19 control strategies in China, healthcare workers (HCWs) endure considerable stress. This study aims to evaluate the prevalence of long COVID infections and their influencing factors among primary HCWs after epidemic control policy adjustment in Jiangsu., Methods: A self-designed questionnaire was administered through on-site surveys among primary HCWs in five counties and districts within Jiangsu Province from July 4 to July 20, 2023. Logistic regression analysis was employed to identify factors associated with long COVID., Results: The prevalence of long COVID among primary HCWs stood at 12.61%, with a 95% confidence interval (CI) of 11.67-13.55%. Among those affected, the most common long COVID symptoms were hypomnesia (4.90%, 95%CI: 4.29-5.51%), sleep difficulties (2.73%, 95%CI: 2.27-3.19%), fatigue (2.35%, 95%CI: 1.92-2.78%), disturbances in the reproductive system (1.93%, 95%CI: 1.54-2.32%), hair loss (1.85%, 95%CI: 1.47-2.23%), and myalgia/arthralgia (1.51%, 95%CI: 1.16-1.86%). Multivariate logistic regression revealed that older age groups (30-45 years (adjusted odds ratio (aOR) = 1.93, 95%CI: 1.44-2.58), 45-60 years (aOR = 2.82, 95%CI: 2.07-3.84)), females (aOR = 1.26, 95%CI: 1.03-1.55), and higher work stress (high stress (aOR = 1.52, 95%CI: 1.24-1.86), extremely high stress (aOR = 1.37, 95%CI: 1.03-1.82)) were more prone to long COVID. Conversely, individuals with educational attainment below the bachelor's degree (aOR = 0.67, 95%CI: 0.55-0.82) and those who received four or more doses of the COVID-19 vaccine (aOR = 0.55, 95%CI: 0.33-0.92) were at a reduced risk., Conclusion: This study investigates the prevalence of long COVID among primary HCWs and identifies key influencing factors. These findings are crucial for assisting in the early identification of COVID-19 patients at risk for long-term complications, developing targeted interventions aimed at optimizing healthcare resource allocation and enhancing the work conditions and quality of life of HCWs. To mitigate the prevalence of long COVID, healthcare providers and local authorities should implement effective measures, such as optimizing work-rest schedules and actively advocating for vaccination., (© 2024. The Author(s).)

Background: Hospitals should prepare for emerging diseases and protect healthcare workers (HCWs) from work-related infection. This study aims to assess public hospital preparedness for the coronavirus disease 2019 (COVID-19) a year after the Myanmar government began implementing COVID-19 prevention measures, and to identify factors associated with work-related COVID-19 infection among HCWs in Myanmar., Methods: In January 2021, data were collected from 101 hospitals and 706 HCWs who had COVID-19 in Myanmar in 2020. Data from the hospitals included basic information, the status of infection prevention and control (IPC), the preparedness for COVID-19 (guidelines, checklists, fever screening, patient pathway, and training), handwashing facilities, and availability of personal protective equipment (PPE). Data of COVID-19 infected HCWs included age, occupation, workplace, severity and source of COVID-19 infection, knowledge and practice of handwashing, and working environment. Chi-square test was performed to compare the preparedness for COVID-19 among three hospital levels (primary, secondary and tertiary levels). Logistic regression analysis was performed to identify the associated factors of work-related infection of HCWs., Results: The total number of beds, HCWs, and COVID-19 patients in 2020 at the 101 hospitals was 12,888, 14,421, and 19,835, respectively. The availability of PPE was high in hospitals at all levels. Approximately 80% of hospitals had functional status of IPC, set up fever screening and patient pathway, and provided training on IPC and COVID-19. However, only 39.6% of hospitals had developed COVID-19 guidelines and 55.4% had developed checklists. The percentage of hospitals that prepared each measurement was lowest at the primary level. The factors associated with work-related COVID-19 among HCWs were being 30-39 years old, working as a doctor, working at isolation wards, having disinfection technique training, and having enough PPE at the workplace., Conclusion: The preparedness for COVID-19 at public hospitals in Myanmar in January 2021 was insufficient, especially in the availability of the guidelines and checklists and at primary hospitals. A support system for hospital pandemic preparedness and monitoring of IPC implementation is needed. The government should prepare for emerging diseases and provide appropriate and adequate PPE and additional training to all HCWs, especially HCWs who work for isolation wards., (© 2024. The Author(s).)

Objectives: The study aimed to assess the mental health and well-being of Lithuanian healthcare workers by gathering demographic information, identifying common stressors affecting the work environment, evaluating mental health, and exploring directions for psychosocial care. Additionally, the research explored the prevalence of considering a career change among respondents., Material and Methods: The study included 1618 responders who completed an online survey in December 2021 - January 2022. Participants included in this study: physicians, nurses, residents and other healthcare workers. It evaluated their demographics, most common stressors affecting their work environment and mental health on the Depression, Anxiety and Stress Scale - 21 (DASS-21) scale. Lastly, all responders asked if they had considered changing their occupation to a non-medical job. Univariate analysis was performed using χ2 and Student's t test, and binary logistic regression evaluated career change predictors., Results: Career change was considered by 1081 (66.8%) responders. The main career change predictors were poor working conditions (OR 1.91, p < 0.001), direct contact with patients (OR 1.84, p < 0.001), lack of career perspectives (OR 1.95, p < 0.001), mobbing (OR 1.67, p = 0.001) and exhaustion (OR 1.51, p = 0.005). After evaluating DASS-21 scores, it was found that 23% of respondents had severe and extremely severe depression symptoms, 27.4% severe and extremely severe anxiety, and 21.4% had severe and extremely severe stress levels., Conclusions: Lithuanian healthcare workers are in high distress and have poor mental health. They are in need psychosocial assistance to avoid burnout and staff loss. Int J Occup Med Environ Health. 2024;37(3):287-99., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: The pandemic exacerbated burnout experienced by healthcare personnel, whose mental health had long been a public health concern before COVID-19. This study used the Copenhagen burnout inventory (CBI) tool to assess burnout and identify predictors among Indian healthcare workers managing COVID-19., Methods: A cross-sectional study was conducted from June to December 2022, after the third pandemic wave. A web-based, fillable Google form was used to recruit COVID-19 management professionals from multiple Jaipur district hospitals. Healthcare professionals provided socio-demographic, work-related, and CBI scores. Multiple linear regression was used to control for model covariant independent variables., Results: We evaluated the responses of a total of 578 participants with a mean age of 36.59 ± 9.1 years. Based on the CBI cut-off score of 50, 68.1% reported burnout. A total of 67.5%, 56.4%, and 48.6% of healthcare workers reported work-related, personal, and patient-related burnout, respectively. High burnout scores were significantly associated with the nursing profession ( β  = 7.89, 95% CI; 3.66, 12.11, p  < 0.0001). The p -value indicates the probability of observing the data if the null hypothesis is true, and the confidence interval shows the range within which we can be 95% confident that the true effect lies. An independent relationship exists between male gender and higher personal-related burnout scores ( β  = 4.45, 95% CI 1.9-6.9)., Conclusion: This study identified key indicators that need further emphasis and the need for organizational and individual-level burnout monitoring in healthcare delivery sectors. Health workers continue to experience burnout due to a combination of personal, professional, and patient-related factors. This underscores the need for targeted organizational and individual interventions. The findings also suggest that the CBI tool could identify healthcare worker burnout risk groups., Competing Interests: Faizan Zaffar Kashoo is an Academic Editor for PeerJ., (©2024 Sidiq et al.)

Background: The recent increase in human mpox (monkeypox) cases emphasizes the importance of early detection, prompt response and preventive management to control the spread of the disease. Healthcare workers (HCWs) play a crucial role in this process. This study aimed to determine the global knowledge and attitudes towards mpox among HCWs., Methods: This study searched multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, Embase, Springer and ProQuest, to locate various publications. The search was limited to English-language articles published between May 2022 (when the increase in mpox incidence was reported) and August 2023. The Joanna Briggs Institute (JBI) quality checklist was utilized to evaluate the quality of the included studies. Data were obtained using a Microsoft Excel spreadsheet and subsequently scrutinized through STATA software, version 14. The heterogeneity of the studies was assessed using the inverse variance and Cochran Q statistics based on the I2 test statistics. The Dersimonian and Liard random effects models were used where heterogeneity existed. Subgroup analysis and univariate and multivariable metaregression techniques were used to examine the causes of heterogeneity., Results: A total of 22 studies, including 22 studies for knowledge (27 731 HCWs) and 6 studies for attitudes (14 388 HCWs), were included in the meta-analysis. The pooled estimates for good knowledge and positive attitudes among HCWs were 26.0% (95% confidence interval [CI] 17.8 to 34.2) and 34.6% (95% CI 19.0 to 50.2), respectively. Moreover, the knowledge was 34.8% (95% CI 24.1 to 45.6) among HCWs with <5 y of work experience and 41.6% (95% CI 33.1 to 50) among individuals possessing >5 y of professional background., Conclusions: Good knowledge of HCWs is at a low level. It is suggested that training sessions should be tailored towards younger HCWs with less healthcare experience. Additionally, it is essential to identify strategies on how to improve the knowledge and attitudes for better practice about the disease in HCWs worldwide., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Gram-negative bacteria resistant to carbapenems are also known as critical antimicrobial resistant organisms. Their emergence at Colonial War Memorial Hospital (CWMH), the largest hospital in Fiji, is a major clinical concern. This study was conducted to determine the knowledge, attitudes, and readiness of healthcare workers (HCW) at CWMH regarding management of patients with infections caused by critical antimicrobial resistant organisms., Methods: A questionnaire was designed using a Likert scale to assess knowledge, attitudes, and readiness. Two cross-sectional studies were conducted, before and after the implementation of targeted educational activities which were informed by the pre-intervention study findings., Results: A total of 393 and 420 HCW participated in the pre- and post-intervention studies, respectively. The majority of respondents were female (77.3%) and 18-34 years of age (67%). HCW professional roles included nurses (56.3%), doctors (31.6%), and laboratory personnel (12.2%). In the post-intervention study, significantly more HCW reported having received infection prevention and control (IPC) and antimicrobial resistance education and training (26.8% in pre to 45.5% in post intervention, p < 0.001). The majority of nurses and doctors (> 85% to ≥ 95%) were aware of how AMR organisms spread in healthcare settings and knew the IPC measures to prevent transmission of AMR infections including hand hygiene, standard and transmission-based precautions. Attitudes towards AMR were positive, with 84.2% pre intervention and 84.8% of HCW post intervention expressing their willingness to change their work environment to assist with AMR prevention. Perceived readiness to address the problem showed mixed results. Improvements in laboratory AMR surveillance data availability were noted (29.4-52.4%, p < 0001). Modest improvement in the hospital's capacity for outbreak response (44-51.9%, p = 0.01), and treatment of AMR infections (38.9-44.4%, p = 0.01) was reported., Conclusions: Our data revealed high levels of staff awareness and knowledge about AMR and IPC. However, readiness for outbreak response and treatment of critical AMR infections requires more attention. Improving AMR prevention and containment in CWMH will likely require sustained and multisectoral interventions with strong administrative commitment., (© 2024. The Author(s).)

Background: This study is aimed at providing information about the timing of booster doses and antibody kinetics in healthcare workers., Methods: This research extends a prospective cohort study conducted at Dokuz Eylul University Hospital in Turkey, covering the period from March 2021 to December 2021. During this timeframe, the antibody levels of the health workers were measured at four different time points. The associations of antibody levels with gender, age, occupation, body mass index (BMI), chronic disease, and smoking were analyzed., Results: There was a significant difference between antibody levels in all four blood draws (p < 0.001). Antibody levels decreased in both those vaccinated with BNT162b2 (p < 0.001) and those vaccinated with CoronaVac (p = 0.002) until the fourth blood draw. There was a significant difference between those vaccinated with one and two doses of booster BNT162b2 before the third blood draw (p < 0.001), which continued at the fourth blood draw (p < 0.001). The antibody levels of those with an interval of 41-50 days between two vaccinations decreased significantly at the fourth blood draw (p < 0.001)., Conclusions: This study provides insight into the dynamics and persistence of antibody response after additional COVID-19 vaccine doses among healthcare workers. The longer the interval between booster doses may result in greater antibody levels being maintained over time, allowing for longer durations of protection., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Rationale, Aims and Objectives: Critical incident debriefing is an occupational health tool for supporting healthcare workers following critical incidents. Demand for debriefing has increased following the Covid-19 pandemic. There is now a need for more trained debrief facilitators to meet demand, but there is a dearth of literature regarding how best to train facilitators. This study addressed this by exploring participant experiences of an online critical incident debrief training programme., Methods: We conducted semi-structured interviews with 14 individuals who received a 5-day training programme based on the Critical Incident Stress Management model. Participants were recruited from a range of professional disciplines including psychology, nursing and human resources within one British healthcare system. Data were analysed using thematic analysis., Results: The analysis produced three themes. Managing trainee experiences and expectations suggested that disciplinary heterogeneity in training groups supported inter-participant knowledge exchange. However, this variation also meant that training materials did not meet the learning needs of all participants. Modality of training suggested that while online learning was acceptable for some, others experienced screen fatigue and found it hard to build rapport with other participants. Systematic and organisational obstacles to training access and delivery suggested that lack of managerial support and organisational mental health stigma may be barriers to accessing training., Conclusion: A 5-day online CISM-based training programme was acceptable to participants. Organisations implementing critical incident debrief training may benefit from (1) offering both in-person and online training options, and (2) tailoring course materials according to the disciplinary make-up of groups., (© 2024 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Healthcare workers (HCWs) are trusted sources of information for vaccination and their attitude toward vaccination is thus critical. We aimed to synthesize existing literature on healthcare workers' HPV vaccine confidence and their practices of recommending this vaccine. We conducted a systematic literature review and meta-analysis, with the search conducted last in March 2024. For the inclusion criteria, the studies needed to include healthcare worker practices or behaviors on recommending the HPV vaccination. Seventy-three articles were included. The proportions of HCWs recommending varied considerably by region and gender of the recipient, but there was no statistically significant difference in income level or pre- or post-HPV vaccine introduction into the national vaccination program. The main barriers to recommending HPV vaccination were concerns around safety and efficacy, cost, parental concerns, and systemic barriers. The results illustrate the importance of contextually adapted approaches to improving vaccine acceptance and recommendation.

Healthcare workers (HCWs) are at increased risk of exposure to the influenza virus in their daily clinical and disease prevention activities, making them a high-risk group for influenza infection. However, the vaccination rate among HCWs has always been low. This study investigated influenza vaccination uptake and willingness among HCWs in the context of the COVID-19 pandemic. The analysis revealed that the influenza vaccination uptake among HCWs was 67.5%, with 79.6% willing to receive the influenza vaccine in 2022/2023 A significant majority (92.7%) agreed that the COVID-19 pandemic increased their willingness to receive the influenza vaccine, and 94.8% agreed with the necessity of receiving the influenza vaccine even after COVID-19 vaccination. Binary logistic regression model identified key factors that influence vaccination intentions. HCWs who perceived a high risk of influenza and its threat to health, found vaccination convenient, and believed in the safety of the influenza vaccine were more likely to be vaccinated. Conversely, the high price of the influenza vaccine was a barrier, whereas those who considered the vaccine affordable were more likely to be vaccinated. Although Changchun Changsheng vaccine incident (The Changchun Changsheng Biotechnology Company was found to have violated good manufacturing practices in 2018, leading to widespread distribution of subpotent vaccines in China.) may not significantly impact the vaccination uptake among healthcare workers, some HCWs still harbor doubts about vaccine safety, which remains a key reason for vaccine hesitancy. This study emphasizes the importance of the strict monitoring and management of vaccines, conducting clinical studies to support vaccine safety, and implementing free influenza vaccine policies, workplace vaccination requirements, and organized mass vaccinations. Educational efforts to increase HCWs' understanding of influenza and influenza vaccines are crucial to increasing vaccination uptake. Furthermore, implementing comprehensive intervention measures is essential to effectively improve the influenza vaccination uptake.

Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge ( n  = 9), safety ( n  = 8), vaccine usefulness ( n  = 8), recommendation behavior ( n  = 8), and self-vaccination practice ( n  = 7). All, except one study, were conducted in high-income countries. There was variability in the quality of the validation process. There is limited existing literature on development and validation of tools for HCW vaccine confidence. Based on the tools currently available, the Pro-VC-Be tool is the most well validated. Further research needs to include low- and middle-income contexts.

Aim: To investigate the impact of public health emergencies on the prevalence of suicidal ideation among healthcare workers (HCWs) and medical students., Methods: The prevalence of suicidal ideation among HCWs and medical students was searched for analysis. The platforms included PubMed, medRVix, bioRvix, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Interrupted time-series analysis was employed to determine whether the COVID-19 pandemic influenced the prevalence and trends of suicidal ideation. To account for autocorrelation and heteroskedasticity, Newey-West standard errors were utilized with a lag of order one., Results: Seventy studies with 145,641 HCWs and medical students from 30 countries were included in the final analysis, with 30 studies before COVID-19 and 40 studies during the pandemic. Before the pandemic outbreak (April 2020), the monthly increasing rate was 0.063 % (95 % CI: -0.009 %, 0.135 %, z = 1.73, P = 0.084). The tendency of suicidal ideation prevalence increased by 1.116 % (95%CI: 0.888 %, 1.344 %, z = 9.60, P < 0.001). In other words, the calculated monthly growth rate of suicidal ideation after the pandemic outbreak is 1.179 % (95%CI: 0.968 %, 1.391 %, z = 10.93, P < 0.001) per month. The overall growing trend of prevalence of suicidal ideation during the pandemic is 1.896 % per month in America; 1.590 % in Europe; 0.443 % (95%CI: 0.213 %, 0.673 %, z = 3.77, P < 0.001) in Asia; 1.055 % in HCWs; and 0.645 % in medical students., Conclusion: This study highlights that the COVID-19 pandemic can significantly impact the prevalence of suicidal ideation among HCWs and medical students, and the prevalence showed an upward trend., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The study aimed to investigate nutrition-related health behaviors among nursing and medical students compared to healthcare workers (HCWs), including nurses and physicians. A cross-sectional survey was conducted between May and November 2022, using the I-MEDAS and lifestyle-related behavior questionnaires. The participants included nursing and medical students, nurses, and physicians, with a total of 384 participants: 16.9% physicians, 23.17% nurses, and 59.9% students, 93% of whom were nursing students. The average I-MEDAS score (out of 17) was 7 for physicians, 8 for nurses, and 8 for students, with no significant differences in lifestyle behavior scores between the groups (p = 0.11), although nurses tended to score lower. Nurses also had a significantly higher BMI compared to physicians and students (p < 0.001). Physicians and nurses reported lower engagement in leisure activities and household chores, fewer sleep hours, and poorer sleep quality. The findings highlight a decline in healthy lifestyle behaviors and poor adherence to the Mediterranean diet among HCWs and students, particularly nurses, emphasizing the need for interventions to promote healthier habits in these groups., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Bacground: Impaired venous return is observed in healthcare professionals who spend long periods standing and sitting. This descriptive cross-sectional study was conducted to evaluate varicose vein-related risk factors, exercise health beliefs, and venous refill time in healthcare professionals working in operating rooms and outpatient clinics by photoplethysmography., Method: The study sample consisted of 100 healthcare professionals without a diagnosis of peripheral venous insufficiency. Data were collected using a descriptive characteristics form, the Health Belief Model Scale for Exercise, the Short-Form McGill Pain Questionnaire, and photoplethysmography., Result: This study found that OR nurses had shorter venous refill times and experienced more pain due to prolonged standing, despite their high health beliefs about exercise., Conclusion: Healthcare professionals working in operating rooms should be screened for venous insufficiency and trained regarding the practices to prevent venous insufficiency, such as lying down, elevating legs, and using elastic stockings., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.