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ObjectiveTo describe the epidemic characteristics of COVID-19 after policy adjustment from “Category B notifiable disease with category A management” to “Category B notifiable disease with category B management”， and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection.MethodsHealthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4， 2022 to January 11， 2023. Data on demographic characteristics， clinical symptoms， medical history， and COVID-19 vaccination history were collected. We determined the epidemiological curve and characteristics， and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects.ResultsA total of 2 704 cases were included in the study， of which 45 had reinfection， 605 （22.4%）were males， 608 （22.5%）were doctors， 1 275 （47.2%） were nurses， and 2 351 （86.9%） received ≥3 doses of COVID-19 vaccination. The average age of these healthcare workers was （34.9±9.1） years old. The number of cases with mild/moderate illness， asymptomatic infection， fever， headache， dry cough， expectoration， and chest tightness were 2 704 （100.0%）， 92 （3.4%）， 2 385 （88.2%）， 2 066 （76.4%）， 1 642 （60.7%）， 1 807 （66.8%）， and 439 （16.2%）， respectively. Reinfection was a protective factor for fever （OR=0.161， P

Abstract Purpose To identify the key infection processes and risk factors in Computed Tomography (CT) examination process within the standard prevention and control measures for the COVID-19 epidemic, aiming to mitigate cross-infection occurrences in the hospital. Method The case hospital has assembled a team of 30 experts specialized in CT examination. Based on the CT examination process, the potential failure modes were assessed from the perspective of severity (S), occurrence probability (O), and detectability (D); they were then combined with corresponding risk prevention measures. Finally, key infection processes and risk factors were identified according to the risk priority number (RPN) and expert analysis. Results Through the application of RPN and further analysis, four key potential infection processes were identified, including “CT request form (A 1),” “during the scan of CT patient (B 2),” “CT room and objects disposal (C 2),” and “medical waste (garbage) disposal (C 3)”. In addition, eight key risk factors were also identified, including “cleaning personnel does not wear masks normatively (C 32),” “nurse does not select the vein well, resulting in extravasation of the peripheral vein for enhanced CT (B 25),” “patient cannot find the CT room (A 13),” “patient has obtained a CT request form but does not know the procedure (A 12),” “patient is too unwell to continue with the CT scan (B 24),” “auxiliary staff (or technician) does not have a good grasp of the sterilization and disinfection standards (C 21),” “auxiliary staff (or technician) does not sterilize the CT machine thoroughly (C 22),” and “cleaning personnel lacks of knowledge of COVID-19 prevention and control (C 33)”. Conclusion Hospitals can publicize the precautions regarding CT examination through various channels, reducing the incidence of CT examination failure. Hospitals’ cleaning services are usually outsourced, and the educational background of the staff employed in these services is generally not high. Therefore, during training and communication, it is more necessary to provide a series of scope and training programs that are aligned with their understanding level. The model developed in this study effectively identifies the key infection prevention process and critical risk factors, enhancing the safety of medical staff and patients. This has significant research implications for the potential epidemic of major infectious diseases.

Abstract Purpose To evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyse risk factors for long-lasting COVID-19 sequelae among a cohort of hospital employees (HEs). Methods We conducted a survey regarding persistent COVID-19 related symptoms with all HEs from three medical centres in Cologne, Germany, who were tested SARS-CoV-2 PCR positive from March 2020 until May 2021. Duration of symptoms and possible risk factors for protracted COVID-19 course were analysed. Results Of 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] 1.05; 95% confidence interval (95%CI) 1.01–1.09; p = 0.019). The occurrence of breathlessness within the first ten days (OR 7.89; 95%CI 1.87–41.43; p = 0.008), an initial Ct value under 30 (OR 3.36; 95%CI 1.22–9.94; p = 0.022) as well as the occurrence of anosmia or ageusia within the first ten days (OR 3.01; 95%CI 1.10–8.84; p = 0.037) showed a statistically significant association with increased odds of illness duration over 90 days. Conclusion About half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Predictive factors could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future.

Aim: The aim of this study was to explore the implementation of appreciative management from the perspective of healthcare workers in selected Estonian healthcare organizations. Design: The study was conducted as a cross-sectional study. Methods: Data were collected from healthcare workers (n = 215) using an Appreciative Management Scale in two different sized hospitals and two healthcare centers. Data were analyzed using non-parametric tests. The study was reported according to STROBE guidelines. Results: Appreciative management was implemented very well. Of the dimensions of appreciative management, equality of employees was the best implemented and systematic management was the least well implemented. Appreciative management had a statistically significant connection with intention to change workplace and with experience of appreciation from first-line managers and upper managers. Conclusion: With the help of appreciative management, it may be possible to increase commitment to work. The appreciation offered by managers to healthcare workers seems to improve healthcare workers' evaluation of the implementation of appreciative management. In health care, it is important to recognize appreciative management and the benefits it creates for healthcare workers' commitment to their work and profession.

In a retrospective, cohort study at 4 medical centers with high coronavirus disease 2019 vaccination rates, we evaluated breakthrough severe acute respiratory syndrome coronavirus 2 Delta variant infections in vaccinated healthcare workers. Few work-related secondary cases were identified. Breakthrough cases were largely due to unmasked social activities outside of work.

Hesitancy to receive the COVID-19 vaccine among healthcare workers (HCWs) in low-resource settings, such as the Democratic Republic of the Congo (DRC), is a major global health challenge. This study identifies changes in willingness to receive vaccination among 588 HCWs in the DRC and reported influences on COVID-19 vaccination intentions. Up to 25 repeated measures were collected from participants between August 2020 to August 2021. Among the overall cohort, between August 2020 and mid-March 2021, the proportion of HCWs in each period of data collection reporting COVID-19 vaccine hesitancy ranged from 8.6% (95% CI: 5.97, 11.24) to 24.3% (95% CI: 20.12, 28.55). By early April 2021, the proportion reporting hesitancy more than doubled (52.0%; 95% CI: 46.22, 57.83). While hesitancy in the cohort began to decline by late-June 2021, 22.6% (95% CI: 18.05, 27.18) respondents indicated hesitancy in late-August 2021 which remains greater than the proportion of hesitancy at any time prior to early-March 2021. Patterns in reported influences on COVID-19 vaccination were varied with the proportion reporting some influences (e.g., no serious side effects, country of vaccine production) remaining stable throughout the year and other factors (e.g., recommendation of Ministry of Health, ease of vaccination) falling in popularity among respondents. Agreement that the national vaccination schedule should be followed apart from the COVID-19 vaccine remained high among respondents throughout the study period. This study shows that, among a cohort of HCWs in the DRC who have likely been influenced by regional, national, and global factors, COVID-19 vaccine hesitancy has fluctuated during the pandemic and should not be treated as a static factor. Additional research to determine which factors most influence HCWs' willingness to receive the COVID-19 vaccine offers opportunities to reduce vaccine hesitancy among this important population through tailored public health messaging.

Purpose: To identify the key infection processes and risk factors in Computed Tomography (CT) examination process within the standard prevention and control measures for the COVID-19 epidemic, aiming to mitigate cross-infection occurrences in the hospital. Method: The case hospital has assembled a team of 30 experts specialized in CT examination. Based on the CT examination process, the potential failure modes were assessed from the perspective of severity (S), occurrence probability (O), and detectability (D); they were then combined with corresponding risk prevention measures. Finally, key infection processes and risk factors were identified according to the risk priority number (RPN) and expert analysis. Results: Through the application of RPN and further analysis, four key potential infection processes were identified, including "CT request form (A1)," "during the scan of CT patient (B2)," "CT room and objects disposal (C2)," and "medical waste (garbage) disposal (C3)". In addition, eight key risk factors were also identified, including "cleaning personnel does not wear masks normatively (C32)," "nurse does not select the vein well, resulting in extravasation of the peripheral vein for enhanced CT (B25)," "patient cannot find the CT room (A13)," "patient has obtained a CT request form but does not know the procedure (A12)," "patient is too unwell to continue with the CT scan (B24)," "auxiliary staff (or technician) does not have a good grasp of the sterilization and disinfection standards (C21)," "auxiliary staff (or technician) does not sterilize the CT machine thoroughly (C22)," and "cleaning personnel lacks of knowledge of COVID-19 prevention and control (C33)". Conclusion: Hospitals can publicize the precautions regarding CT examination through various channels, reducing the incidence of CT examination failure. Hospitals' cleaning services are usually outsourced, and the educational background of the staff employed in these services is generally not high. Therefore, during training and communication, it is more necessary to provide a series of scope and training programs that are aligned with their understanding level. The model developed in this study effectively identifies the key infection prevention process and critical risk factors, enhancing the safety of medical staff and patients. This has significant research implications for the potential epidemic of major infectious diseases. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyse risk factors for long-lasting COVID-19 sequelae among a cohort of hospital employees (HEs). Methods: We conducted a survey regarding persistent COVID-19 related symptoms with all HEs from three medical centres in Cologne, Germany, who were tested SARS-CoV-2 PCR positive from March 2020 until May 2021. Duration of symptoms and possible risk factors for protracted COVID-19 course were analysed. Results: Of 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] 1.05; 95% confidence interval (95%CI) 1.01–1.09; p = 0.019). The occurrence of breathlessness within the first ten days (OR 7.89; 95%CI 1.87–41.43; p = 0.008), an initial Ct value under 30 (OR 3.36; 95%CI 1.22–9.94; p = 0.022) as well as the occurrence of anosmia or ageusia within the first ten days (OR 3.01; 95%CI 1.10–8.84; p = 0.037) showed a statistically significant association with increased odds of illness duration over 90 days. Conclusion: About half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Predictive factors could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future. [ABSTRACT FROM AUTHOR]

A person's spirituality in the workplace can be defined as their understanding and practice of religious principles as they pertain to the workplace, with the goal of fostering positive connections with coworkers, increasing productivity, and enhancing overall morale. At the present time, health services are crucial for both health workers and the officers who assist them in performing their tasks. It is imperative that health care providers and those who assist them have a healthy work-life balance, which includes practicing good spirituality both personally and collectively. Finding out how spirituality affects the productivity of healthcare professionals and hospital staff was the primary goal of the study. Using primary data collected from hospital staff, this study was carried out in Annisa Hospital Cikarang, Indonesia. A total of ninety-six people filled out a questionnaire that measured workplace spirituality and employee performance; the methodology was quantitative. Simple regression analysis in SPSS was used to examine the gathered data. The computed t-value is bigger than the table t-value (7.133>1.9855), as the results demonstrated a computed t-value of 7.133 with a significance value of 0.000. Employees' performance at Annisa Hospital is positively and significantly impacted by workplace spirituality, as the significance value is less than 0.05 (0.000<0.05). In order to advance healthcare organisations' human resource management practices, this study's findings shed light on the connection between spirituality in the workplace and employee performance in hospitals. Organisational leaders and managers in the health care sector can benefit practically from this study. All of the hospital's staff can benefit from a more upbeat and productive work atmosphere if spirituality is more recognised and supported in the workplace. This, in turn, will improve patient care. [ABSTRACT FROM AUTHOR]

Purpose: As climate change accelerates, healthcare workers (HCW) are expected to be more frequently exposed to heat at work. Heat stress can be exacerbated by physical activity and unfavorable working requirements, such as wearing personal protective equipment (PPE). Thus, understanding its potential negative effects on HCW´s health and working performance is becoming crucial. Using wearable sensors, this study investigated the physiological effects of heat stress due to HCW-related activities. Methods: Eighteen participants performed four experimental sessions in a controlled climatic environment following a standardized protocol. The conditions were (a) 22 °C, (b) 22 °C and PPE, (c) 27 °C and (d) 27 °C and PPE. An ear sensor (body temperature, heart rate) and a skin sensor (skin temperature) were used to record the participants´ physiological parameters. Results: Heat and PPE had a significant effect on the measured physiological parameters. When wearing PPE, the median participants' body temperature was 0.1 °C higher compared to not wearing PPE. At 27 °C, the median body temperature was 0.5 °C higher than at 22 °C. For median skin temperature, wearing PPE resulted in a 0.4 °C increase and higher temperatures in a 1.0 °C increase. An increase in median heart rate was also observed for PPE (+ 2/min) and heat (+ 3/min). Conclusion: Long-term health and productivity risks can be further aggravated by the predicted temperature rise due to climate change. Further physiological studies with a well-designed intervention are needed to strengthen the evidence for developing comprehensive policies to protect workers in the healthcare sector. [ABSTRACT FROM AUTHOR]

Background: Suicide is a leading cause of death in the United States. Worldwide, over 700,000 people die by suicide each year. Healthcare workers are more vulnerable to suicide risk factors than the general population. The global COVID‐19 pandemic presents additional workplace and health concerns that relate to suicide risk factors in healthcare workers. It is important to recognise suicide risk factors in healthcare workers and to implement strategies to reduce these risk factors. Objectives: This study describes the impact of the global COVID‐19 pandemic on risk factors for suicide in healthcare workers and identifies evidence‐based strategies and resources to reduce suicide risk factors in healthcare workers. Design: The authors conducted a thematic analysis and narrative review of the literature. Methods: Using health science databases, the authors searched the literature, selected and analyzed studies, identified themes, synthesised findings and created a narrative review. The STROBE checklist was used in this study. Results: Two themes were identified (1) The impact of the COVID‐19 pandemic on work‐related suicide risk factors in healthcare workers; (2) The impact of the COVID‐19 pandemic on mental health‐related suicide risk factors in healthcare workers. The pandemic has affected suicide risk factors in healthcare workers. Many studies discussed evidence‐based strategies and resources that can be used to reduce suicide risk factors. Conclusion: The global COVID‐19 pandemic has negatively impacted suicide risk factors in healthcare workers. It is time for individuals and healthcare delivery systems to implement suicide risk prevention strategies to protect healthcare workers now and in the future. Relevance to Clinical Practice: This review increases awareness of the pandemic's impact on healthcare workers' risk factors for suicide and identifies evidence‐based suicide risk prevention strategies and resources for healthcare workers. Patient or Public Contribution: Library services supported this research by generating search strategies and providing resources and tools. [ABSTRACT FROM AUTHOR]

Objectives: Chest imaging, particularly computed tomography, plays a crucial role in the evaluation of patients with Coronavirus disease 2019 (COVID-19) infection. This study aimed to assess physicians' knowledge about chest imaging findings in COVID-19 patients in Goma, North Kivu Province (Democratic Republic of the Congo). Materials and Methods: This was a cross-sectional study involving 202 physicians who responded to the survey questionnaire. Performance was tested in terms of the mean score and proportions of correct answers for each questionnaire item. Multiple logistic regressions were used to identify factors associated with good knowledge. Results: The mean score obtained by respondents was 8.55 ± 2.49 out of 16 points. The proportion of physicians with more than 60% correct answers was 37.13%. There was no significant statistical association between good knowledge and the demographic and professional characteristics of the respondents (P > 0.05). Conclusion: This study found that physicians' knowledge about chest imaging findings in COVID-19 patients is poor. This lack of sufficient information on the part of healthcare workers indicates the need to develop continuing education programs. [ABSTRACT FROM AUTHOR]

Aim: SSI is one of the most prevalent healthcare‐associated infections and is associated with extended hospital stays, increased need for reoperation and higher hospital readmission rates. Implementing systematic SSI surveillance can reduce these adverse outcomes. Implementing a surveillance system into a hospital is a complex intervention requiring that staff involved in a patient's perioperative journey have the knowledge of SSI prevention, the data required for surveillance, an understanding of how data informs quality improvement initiatives and their role in surveillance. The aim of this study was to evaluate the impact of a complex intervention on the knowledge and attitudes of healthcare professionals towards surgical site infection (SSI), SSI prevention and surveillance in a university hospital setting. Design: The study used a quasi‐experimental pre‐test–post‐test design. Method: The impact of a complex intervention was evaluated by measuring healthcare professionals' (n = 74) knowledge of and attitudes towards SSI and surveillance. Normalisation process theory (NPT) guided the study and the development of the intervention. Results: There was a statistically significant increase in scores on the knowledge of SSI and prevention from pre‐intervention to post‐test. The knowledge of risk factors scores at post‐test was significantly higher than that at pre‐intervention. Overall attitudes to SSI prevention and surveillance were good both pre‐intervention and post‐test but there was a significant change in the attitude of participants. The findings reveal an overall positive impact of the complex intervention on the knowledge and attitude of healthcare professionals relating to SSI, SSI prevention and surveillance; however, the extent of the change varied across items measured. [ABSTRACT FROM AUTHOR]

This study aims to (1) characterize healthcare professionals' (HCPs') experiences related to the prevention and management of pressure injuries (PIs) and (2) explore the educational needs of individuals with a past or current history of PIs and their caregivers from the perspective of HCPs. This is a qualitative descriptive study. HCPs (n = 18) were interviewed using a semi‐structured interview guide. Interviews were audio‐recorded, transcribed verbatim and coded using NVivo. Three overarching themes encompassing various dimensions were identified: (1) Facilitators related to PI prevention and management, (2) Challenges related to PI prevention and management and (3) Recommendations for improving patient and caregiver PI education. HCPs identified a greater number of challenges than facilitators related to PI care. This study emphasizes the importance of a patient‐centred and interprofessional approach to patient education for PI prevention and management. Meaningful interventions focused on the patient may improve health literacy and empower patients and caregivers in PI care. Investing in preventive measures and raising awareness are crucial to reducing PI incidence. The findings have implications for HCPs and researchers seeking to enhance patient care and promote effective PI prevention strategies. [ABSTRACT FROM AUTHOR]

Objectives: To assess the knowledge and acceptability of COVID-19 vaccines among HCWs. Design: A descriptive cross-sectional study was conducted in March 2021 among eligible HCWs using a self-administered questionnaire. Setting: The study was conducted in a southern Nigerian tertiary hospital. Participants: All HCWs not on annual or study leave were eligible to participate. The number of HCWs in each occupational category was determined by proportional allocation. HCWs were selected by stratified sampling technique. Main outcome measures: Knowledge of COVID-19 vaccines was assessed using 25 questions. The minimum and maximum scores were 0 and 25, respectively. Scores were converted to percentages. Scores of 50% and above were rated as good knowledge. Participants were also asked if they were willing to receive the vaccine. Results: The mean age of 512 participating HCWs was 33.4±7.8 with an M:F ratio of 1:1.1. Overall, 399 (76.6%) had good knowledge. Occupation and exposure to COVID-19 were predictors of knowledge. Three hundred and twentyeight respondents (63.0%) were willing to take the vaccine. Predictors of willingness to accept vaccination were age, sex, number of years in employment and knowledge about the vaccines (p< 0.05). Conclusions: Most HCWs had good knowledge and were disposed to accepting the COVID-19 vaccine. Educational interventions are necessary to improve HCWs knowledge as they may provide vaccine-related information to the general public. [ABSTRACT FROM AUTHOR]

COVID-19 has led to marked increases in healthcare worker distress. Studies of these phenomena are often limited to a particular element of distress or a specific subset of healthcare workers. We administered the Moral Injury Symptom Scale for Healthcare Professionals, Copenhagen Burnout Inventory, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 via online survey to 17,000 employees of a large academic medical center between December 2021 and February 2022. A total of 1945 participants completed the survey. Across all roles, the prevalence of moral injury, burnout, depression, and anxiety were 40.9%, 35.3%–60.6%, 25.4%, and 24.8%, respectively. Furthermore, 8.1% had been bothered by thoughts that they would be better off dead or of hurting themselves for "several days" or more frequently. Healthcare workers across all roles and practice settings are experiencing unsustainable levels of distress, with 1 in 12 regularly experiencing thoughts of self-harm. [ABSTRACT FROM AUTHOR]

Aims: To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting. Design: Scoping review. Data Sources: A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty‐five studies met the inclusion criteria. Review Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Scoping Review checklist. Results: Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non‐normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient‐to‐nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages. Conclusion: Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics. Impact: Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID‐19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to evaluate the immunization status of healthcare workers in Suleyman Demirel University Research and Training Hospital and factors affecting immunization. Material and Method This research, planned as a cross-sectional and analytical type, was carried out between February 2020 and July 2020. The population for the research comprised healthcare workers at Suleyman Demirel University Research and Training Hospital (1827 people). The sample size was calculated as 397 for an unknown prevalence of 50%, 95% confidence level, absolute precision of 5% and a design effect of 1.25. Dependent variables were immunization status for influenza, hepatitis B, MMR, tetanus, varicella, and hepatitis A vaccines. Independent variables included features that might be related to sociodemographic features and immunization status. The statistical significance level was accepted as p<0.05. Results The study reached 382 (96.2%) healthcare workers. Healthcare workers' vaccination percentages were 6.3% for influenza, 62.3% for tetanus, 67.5% for hepatitis B, 20.1% for hepatitis A, 28.8% for varicella, and 39.5% for MMR. Most of the workers indicated that their occupation is risky for infectious diseases (85.6%), and they found that vaccination was necessary for their profession (76.4%). Physicians had 9.4 times more influenza vaccinations, 3.5 times more hepatitis B vaccinations and 2.8 times more MMR vaccinations (p=0.002 CI:2.278-38.520, p<0.001 CI:1.827-6.807, p=0.002 CI:1.464-5.205, respectively). Being a nonphysician assistant healthcare worker increased the vaccination rate for varicella vaccine by 2.8 times (p=0.018 Cl:1.190-6.510). Conclusion Vaccination programs may ensure an increase in the vaccination rates through training and awareness studies for healthcare professionals. The content of the interventions should be different for each vaccine and the characteristics of the occupational groups should be considered. [ABSTRACT FROM AUTHOR]

Background: Holistic care interventions include support for healthcare worker grief in a relationship-based care paradigm. Few programs support oncology healthcare worker grief and renewal prior to and during the COVID-19 pandemic. Objective: Describe "knowledge of" and "engagement with" a program about grief and resilience, Remembrance & Renewal (R&R). Method: An anonymous, electronic survey was available to healthcare workers at an academic, comprehensive cancer center. Demographic questions were analyzed against "knowledge of" and "engagement with." Results: Of 105 responding to "awareness of," 81 knew about R&R and 48 had "engaged with" the program. Statistically significant relationships between a characteristic and awareness were found for education (p =.03), setting (p <.01), and the frequency of learning about a death (p =.04). Statistically significant relationships between a characteristic and level of participation were found for profession (p =.02) and length of time in job (p =.03). Open-ended questions asked about impact of patient death (n = 93), barriers to participation (n = 54), and feelings after "engagement with" (n = 45). Responses to impact, barriers, and feelings were respectively: sadness (75.3%); time (77.8%); and calm (75.6%). Conclusion: This study describes "knowledge of" and "engagement with" a holistic grief and renewal program. Further study will add to healthcare worker holistic self-care. [ABSTRACT FROM AUTHOR]

Despite the relatively small amounts produced, medical waste is a significant issue for the government and the healthcare industry primarily because it poses threats to persons and the environment. Healthcare wastes pose threats to the environment and public health, but knowledge of these concerns and how they relate to management techniques is still lacking. Evaluating waste management practices and healthcare staff expertise is critical to identify shortcomings and lower risk levels. The study was conducted at three selected private hospitals. These three hospitals contain 462 beds, all together with 184 healthcare workers. The study was designed as a descriptive cross-sectional study, and three private healthcare institutions in the study region were evaluated. These 100 healthcare workers were chosen by purposive sampling. The hospitals under consideration include general surgical, Gynecological, pediatric, and various specialty treatments. Data was gathered for the study utilizing a quantitative questionnaire, which includes closed-ended structured questionnaires. The results showed that most healthcare workers practice waste segregation at source. Chemical cross-linking was very poor. However, waste shredding technology is being used substantially. Risk perception among Healthcare workers regarding polymer help waste management showed more of average to high risk. The study concluded that despite the existence of policies and plans, execution is still subpar at private healthcare institutions. The creation of guidelines for hospital waste management, their distribution to other institutions, and their encouragement to do a critical self-evaluation should all be required by the government. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence, duration, and factors associated with ENT symptoms according to COVID-19 among healthcare workers at Venerable Thawisak Jutindharo Hospital. Materials and Methods: A cross-sectional study was conducted on the healthcare workers whose PCR and ATK nasopharyngeal swabs were positive for COVID-19. All patients were employed at Venerable Thawisak Jutindharo Hospital in Bangkok, Thailand, between January 1 and October 31, 2022. Demographic data and clinical manifestations were collected. Descriptive statistics were performed, followed by Chi-square and multiple logistic regressions to determine associated factors for ENT symptoms according to COVID-19. Results: Two hundred and ten cases were included. Most of them were females with 167 cases (79.5%). Cough was the most common presenting symptom at 81.8%. After acute phase, 147 cases (70%) of post-COVID-19 ENT symptoms were reported. Subgroup analysis was conducted based on symptomatology and showed laryngological symptoms in 63.8%, followed by rhinological symptoms in 25.7%, and otological symptoms in 6.6%. Most symptoms were recovered within four weeks after the infection. Some lasted more than twelve weeks, such as cough in seven cases, sore throat in two cases, and rhinorrhea in one case. The patients recovered from all symptoms by week 13. The risk associated with increasing post-COVID-19 ENT symptoms was age. Age less than fifty years had a significantly higher risk of post-COVID-19 ENT symptoms than age greater than fifty years (adjusted OR 2.33, 95% CI 1.08 to 5.00). Conclusion: Cough was the most common ENT symptom in early and post-COVID infection period. Most cases recovered within four weeks after infection. Age was the key factor that causes ENT symptoms in COVID-19. Antiviral drug, severity of COVID infection, and other factors do not result in post-COVID ENT symptom. [ABSTRACT FROM AUTHOR]

Objectives. At present, the mechanism of distributive justice leading to presenteeism is still unclear. We aim to explore the relationship among distributive justice, organization-based self-esteem, presenteeism and organizational support among Chinese medical workers by building a moderated mediation model. Methods. We employed a cross-level research design that aggregated organizational support to the organizational level. Medical staff from 50 different hospitals in China were invited to participate in the survey, and 1122 valid data questionnaires were obtained. We used hierarchical linear modelling to test this cross-level moderated mediation model. Results. Our results suggest that, at the individual level, organization-based self-esteem partially mediates the distributive justice-presenteeism relationship, and at the individual level, organizational support moderates the relationship between distributive justice and organization-based self-esteem. Conclusions. Distributive justice enhances individuals' organization-based self-esteem, which is associated with a reduction in presenteeism, and underscores the importance of organizations shaping an organizational support climate. [ABSTRACT FROM AUTHOR]

Since the beginning of the COVID-19 pandemic various studies have reported that healthcare workers (HCWs) are not only at risk of exposure but also experiencing psychological distress. However, less is known about the mental health outcome of HCWs after their clinical recovery from COVID-19 infection. This study addresses a critical gap in our understanding by focusing on the mental health outcomes of HCWs in Pakistan after their clinical recovery from COVID-19 infection and the resumption of their duties. This cross-sectional, study was conducted among 272 HCWs who had recovered COVID-19 infection. The symptoms of depression were assessed by Patient Health Questionnaire-9. Multivariable logistic regression was performed to identify factors associated with depression. The findings revealed a depression prevalence of 33.82% among the HCWs in the study. Factors such as being female, middle-aged, having lower income, and working in COVID-19 wards increased the risk of depression. Moreover, those who perceived less social support from coworkers and supervisors and experienced an increased workload after resuming duties showed higher depression rates. In conclusion, the study emphasizes that clinical recovery from COVID-19 infection does not guarantee functional recovery for HCWs. To support their psychological well-being and resilience, it underscores the importance of enhanced social support in the workplace for who resume their duties after recovering from COVID-19 infection.

BackgroundThe strain on workers of the healthcare system and education sector increased psychological distress and burnout. This study aimed to distinguish the occupational group that is the most affected by occupational burnout and to reveal the scope of psychosocial risk factors among each occupational group.MethodsThis is a cross-sectional study that analyzed burnout syndrome among 1,046 participants of different occupational groups in association with psychosocial work environment factors in Lithuania. The anonymous questionnaire was composed of the standardized Job Content Questionnaire (JCQ), and the Copenhagen Burnout Inventory (CBI). To find out associations between psychosocial work environment factors and burnout dimensions, a multiple logistic regression model using the stepwise method was applied.ResultsThe burnout levels in all three dimensions (personal, work-related, and client-related burnout) were significantly higher in physicians’ and nurses’ groups compared with public health professionals, teachers, and managers (p

Abstract Background and Aims Job satisfaction of healthcare workers from conventional and university hospitals (or teaching hospitals) might be different due to several factors, for example medical staff required to carry out multiple clinical and teaching tasks simultaneously. Our study aimed to determine how the job satisfaction among healthcare workers in university hospitals is different from those in conventional hospitals. Methods A cross‐sectional study was conducted by using the validated and contextualized job satisfaction tool for the Vietnamese context to survey 216 healthcare workers at a university hospital in Vietnam from January to March 2020 with online Google forms. Results The results indicated low overall job satisfaction (43.1%) in our study university hospital with the score cutoff of 80%. However, healthcare workers still reported high job satisfaction rates in certain aspects, such as personal empathy (70.8%), discipline, and reward (67.6%), co‐worker collaboration (65.3%), training and promotion (63%), workplace environment (57.4%), and salary and allowance (44.9%). Subgroup analysis revealed statistically significant differences in job satisfaction (p

Abstract Background Breast cancer (BC) is the most prevalent cancer among women, and it typically presents late in developing countries like the Democratic Republic of the Congo (DRC), leading to higher mortality rates. Late detection at advanced stages of breast cancer can be attributed to the absence of appropriate screening programs and low levels of awareness. Aims To evaluate the level of BC knowledge among healthcare workers (HCWs) and identify determinants of good BC knowledge. Methods and results An analytical cross‐sectional survey was conducted from March 1 to 31, 2022 involving HCWs practicing in Kinshasa, DRC. Data were collected using a questionnaire administered through direct interviews. Bivariate and multivariate regression techniques were applied. The study interviewed 543 HCWs, with a median age of 35 years (interquartile range: 29–43). Of these, 61% had good BC knowledge, while 39% had poor BC knowledge. Multivariate analysis revealed that HCWs aged 50 years and over (adjusted odds ratio [aOR] = 2.3 [1.2–4.5]), female HCWs (aOR = 1.8 [1.1–2.4]), HCWs working in public healthcare facilities (aOR = 1.5 [1.1–2.5]), and HCWs who had received training on BC (aOR = 1.9; 95% CI: 1.5–3.3) were determinants of good BC knowledge. Conclusion This study found that 61% of the surveyed HCWs had good BC knowledge. However, there is still room for improvement in terms of knowledge dissemination. Therefore, it is important to implement continuing medical education programs that focus on raising awareness and improving BC knowledge among HCWs.

Background: The COVID-19 pandemic resulted in significant mortality and morbidity globally. The introduction of various COVID-19 vaccines at record time generated hope among people and doubts and apprehension regarding their safety. The study was done to estimate the incidence of COVID-19 vaccine breakthrough infections among Health Care Workers working in a tertiary care hospital and evaluate the outcome of these infections. Methods: A prospective Cohort study was conducted among 6342 healthcare workers in a tertiary care hospital having received at least one dose of any COVID-19 vaccine. They were followed up for COVID-19 vaccine breakthrough infection for one year by epidemiological investigations. Data on COVID-19-positive healthcare workers was obtained through personal interviews and case records. Results: 490 (7.9%) developed COVID-19 vaccine breakthrough infection during the study period. The majority of them (96.7%) were asymptomatic, and 16 (3.3%) of them developed complications needing hospitalization with 2 deaths. A statistically significant association was found in sex, healthcare worker categories, co-morbidities, and Blood groups. Conclusion: COVID-19 vaccination among healthcare workers reduces the incidence, severity, and complications of COVID-19 vaccine breakthrough infections. The risk of acquiring COVID-19 vaccine breakthrough infections was higher among males, partially vaccinated individuals, people with co-morbidities, and those involved in the regular care of COVID-19 patients. COVID-19-appropriate behaviour and receiving all the primary doses of vaccine will be instrumental in COVID-19 control.

Background: The COVID-19 pandemic significantly impacted people’s mental health significantly. Frontline healthcare workers (HCWs) were arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is important to inform interventions for social and psychological support for future pandemics. Aim: This study explored the experiences of frontline HCWs in South Africa during the COVID-19 pandemic. Setting: The sample included HCWs from various professions and health sectors who worked with COVID-19 patients across South Africa. Methods: An exploratory descriptive qualitative design was used. Semi-structured interviews were conducted with 11 frontline HCWs recruited via purposive sampling. Data were analysed using principles of inductive thematic analysis. Results: Four major themes were identified in the data: (1) Working during COVID-19 was an emotional rollercoaster; (2) Working during COVID-19 was physically and mentally exhausting; (3) Participants held negative attitudes towards the Department of Health; and (4) COVID-19 had a transformative impact on the daily life of HCWs. Conclusion: HCWs’ experiences were diverse and marked by contradictions. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants. Qualitative methodologies provided depth and insights into the diverse realities of frontline HCWs. Contribution: This study provides significant insights into the experiences of a diverse group of frontline South African HCWs during COVID-19. It demonstrates a shift in the definition of a ‘frontline’ HCW and highlights the need for greater psychological support and individualised public health interventions during future pandemics.

Abstract Aim To systematically evaluate empirical studies investigating the influences of healthcare workers' behaviours towards infection prevention and control practices in the Coronavirus clinical space, and to appraise and synthesise these findings. Design A systematic review of the literature. Methods The review used a five‐step framework described by Khan et al. (Journal of the Royal Society of Medicine, 2003, 96 and 118) of Framing questions for a review; Identifying relevant work; Assessing the quality of studies; Summarising the evidence; and Interpreting the findings. Searches were conducted in CINHAL, MEDLINE, PsychINFO, Scopus, and Google Scholar databases to retrieve relevant peer‐reviewed literature published in English between 2019 and 2023. Covidence and Joanna Briggs Quality appraisal tools were used for critical assessment. To improve transparent reporting, this review used a Synthesis Without Meta‐analysis (SWiM) in systematic review guidelines, as informed by Campbell et al. (BMJ, 2020, 368). Results Twenty studies were included in this review, identifying nine themes describing factors influencing HCWs' behaviours towards IPC practices in the coronavirus environment. The overarching influences emerged as knowledge‐oriented, person‐oriented, and environment‐oriented. Conclusion Healthcare workers' responsibilities at point‐of‐care involve providing direct care to patients with highly transmissible infections and working in clinical settings that may be ill‐designed for IPC practices, increasing the risk of transmission. Given the lack of a definitive solution to eradicate new mutant viruses and that IPC practices are the mainstay of prevention and control of transmissible, measures to improve are imperative. The identified HCWs' domains on behaviours towards IPC are critical in strategies to mitigate risks and further set an opportunity for developing an IPC model congruent with the rapid response required for HCWs during emerging or re‐merging mutant virus outbreaks. This is significant, given that HCWs' preparedness with IPC practices at point‐of‐care is central to patient care, the workforce and community safety.

BackgroundEmergency department (ED) workers have an increased seroprevalence of SARS-CoV-2 antibodies. However, breakthrough infections in ED workers have led to a reduced workforce within a strained healthcare system. By measuring levels of IgG antibodies to the SARS-CoV-2 nucleocapsid and spike antigens in ED workers, we determined the incidence of infection and described the course of antibody levels. We also measured the antibody response to vaccination and examined factors associated with immunogenicity.MethodsWe conducted a prospective cohort study of ED workers conducted at a single ED from September 2020-April 2021. IgG antibodies to the SARS-CoV-2 nucleocapsid antigen were measured at baseline, 3, and 6 months, and IgG antibodies to the SARS-CoV-2 spike antigen were measured at 6 months.ResultsAt baseline, we found 5 out of 139 (3.6%) participants with prior infection. At 6 months, 4 of the 5 had antibody results below the test manufacturer's positivity threshold. We identified one incident case of SARS-COV-2 infection out of 130 seronegative participants (0.8%, 95% CI 0.02-4.2%). In 131 vaccinated participants (125 BNT162b2, 6 mRNA-1273), 131 tested positive for anti-spike antibodies. We identified predictors of anti-spike antibody levels: time since vaccination, prior COVID-19 infection, age, and vaccine type. Each additional week since vaccination was associated with an 11.1% decrease in anti-spike antibody levels. (95% CI 6.2-15.8%).ConclusionED workers experienced a low incidence of SARS-CoV-2 infection and developed antibodies in response to vaccines and prior infection. Antibody levels decreased markedly with time since infection or vaccination.

Abstract Purpose The COVID-19 pandemic has transformed the way of life of many individuals, especially those working at the frontlines, such as healthcare workers. Our study aims to examine the impact of COVID-19 on the socio-economic status, quality of life, and sleep quality when Vietnam was experiencing the 4th wave of the COVID-19 pandemic. Methods A cross-sectional study was conducted on 604 healthcare workers using snowball sampling from October through to November 2021. Our study examined the impact of the government’s COVID-19 prevention policy including personal protective measures (5K measures), directive 15, directive 16, and directive 16 plus. The EQ-5D-5L and EQ-VAS were used to measure health-related quality of life and a scale of 1 to 10 was used to rate sleep quality of healthcare workers. Results A total of 604 respondents, most people were female (57.9%), and working as civil servants (75.3%). Very few participants were able to increase their earnings during the pandemic. Participants who did not have monthly allowance amounts had the highest proportion (60.1%), followed by those under 2 million VND (21.2%). In the univariate regression model, people with high government policy scores tend to have lower quality of life and sleep quality scores. In addition, in the multivariable regression model, people with high scores on government policies tend to have lower quality of life (EQ-5D) scores. Conclusion The COVID-19 prevention measures had a negative impact on quality of life, sleep quality, and daily demands of healthcare workers. These findings should help guide future policy implementations.

Abstract Background Burnout and psychosocial distress are serious and growing issues for healthcare workers (HCWs) and healthcare systems across the globe. Exacerbated by changes in healthcare delivery during and following the Covid-19 pandemic, these issues negatively affect HCW wellbeing, clinical outcomes and patient safety. Art Therapy has demonstrated promise as a suitable but under researched intervention, warranting further investigation. This systematic review aims to ascertain what art therapy-based interventions used to address burnout and / or psychosocial distress in HCWs have been reported in the health and social care literature and how these have been evaluated. Methods Six databases (PubMed, PsycINFO, MEDLINE, EMBASE, CINAHL, ProQuest Central), Google Scholar and three clinical trial registries (CENTRAL, ICTRP and ClinicalTrials.gov) were searched for studies using art therapy-based methods to engage with burnout risk or psychosocial distress in HCWs. Following screening for eligibility study characteristics and outcomes were extracted by two reviewers independently. Studies were evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Outcomes were grouped for analysis. Quantitative and qualitative results were synthesised and integrated using narrative synthesis. Results Twenty-seven studies, drawn from thirteen countries, spanning five continents were selected for inclusion. Fifty percent were published in the last five years, indicating growing global research in the field. Fourteen studies used quantitative research methods and thirteen used qualitative methods. A total of 1580 participants took part in the studies, with nurses most broadly represented (59%). Interventions were mostly delivered in groups (95%) and by an art therapist (70%). Heterogeneity and insufficient randomised controlled trials precluded the possibility of meta-analysis. However, a review of available data showed evidence of medium to large effects for emotional exhaustion (burnout), work-related stress and common mental health issues. A content analysis of qualitative data of perceived effect complemented quantitative findings. Conclusion Global research into the use of art therapy-based methods to address burnout and psychosocial distress in HCWs is growing. Whilst further high-quality evidence such as randomised controlled trials would be beneficial, findings suggest that art therapy-based methods should be strongly considered as an acceptable and effective treatment for symptoms of emotional exhaustion (burnout) and psychosocial distress in HCWs.

OBJECTIVES: This study aimed to evaluate effects of night and shift work patterns on type 2 diabetes (T2D) and hypertension in a longitudinal study, with detailed information on working hours. METHODS: The cohort comprised about 28 000 nurses and nursing assistants employed for more than one year 2008–2016 in Stockholm, Sweden. The employee register held detailed individual information on daily working hours. Information on diagnoses came from national and regional registers. Hazard ratios (HR) and confidence intervals (CI) were estimated by discrete-time proportional hazard models, adjusting for sex, age, country of birth, and profession. RESULTS: During follow-up in 2013–2017, we identified 232 cases of T2D and 875 of hypertension. We observed an increased risk of T2D, but not hypertension, among employees who worked only night shifts the previous year (HR 1.59, 95% CI 1.02–2.43) and those with intensive shift work (>120 afternoon and/or night shifts the previous year: HR 1.67, 95% CI 1.11–2.48) compared to only day work. There was a non-significantly increased risk of T2D related to mixed day and afternoon shifts (HR 1.34, 95% CI 0.97–1.88). We observed tendencies in increased risk of T2D related to frequent spells of ≥3 consecutive night shifts and with number of years with exclusive (but not mixed) night work. CONCLUSIONS: Permanent night work and frequent afternoon and/or night shifts were associated with an increased risk of T2D the following year, but not hypertension. The T2D risk was, to some extent, affected by frequent spells of several night shifts in a row and by cumulative years with permanent night work.

Abstract Aim Our aim was to gain insight into how the relatives of family members with dementia have experienced their family members' transition from home to permanent nursing home placement. Design Our research was a qualitative case study. Methods Inspired by Kvale and Brinkmann's phenomenological‐hermeneutic approach, we performed the thematic analysis of semi‐structured interviews describing how the relatives of family members with dementia have experienced the dementia trajectory. Results Twelve relatives of family members with dementia living in nursing homes agreed to participate. The descriptions of relatives' experiences indicated four primary themes: mismatches between healthcare services and the family members' needs, witnessing the family members' cognitive decline, the effects of the experiences on the relatives' health and well‐being and what matters to the relatives during their family members' transition to nursing home. Mismatches between available resources in the municipalities and the family members' healthcare needs were the most distressing experiences, along with the family members' gradual cognitive decline. In response, the relatives stressed individualized support, continuity in follow‐up care and regular information‐sharing between them and staff members caring for their family members. They also highlighted the importance of facilitating seamless transitions from home to nursing homes.

Background: Deisolation of persons infected with SARS-CoV-2, the virus that causes COVID-19, presented a substantial challenge for healthcare workers and policy makers, particularly during the early phases of the pandemic. Data to guide deisolation of SARS-CoV-2-infected patients remain limited, and the risk of transmitting and acquiring infection has changed with the evolution of SARS-CoV-2 variants and population immunity from previous vaccination or infection, or both. Aims: This review examines the evidence to guide the deisolation of SARS-CoV-2-infected inpatients within the hospital setting when clinically improving and also of healthcare workers with COVID-19 prior to returning to work. Methods: A review was performed using relevant search terms in Medline, EMBASE, Google Scholar, and PubMed. Results and Discussion: The evidence is reviewed with regards to the nature of SARS-CoV-2 transmission, the role of testing to guide deisolation, and the impact of SARS-CoV-2-specific immunity. A paradigm and recommendations are proposed to guide deisolation for inpatients and return to work for healthcare workers.

A retrospective cohort study at four academic medical centers with high COVID-19 vaccination rates evaluated breakthrough SARS-CoV-2 Delta variant (B.1.617.2) infections in vaccinated healthcare workers. Few work-related secondary cases were identified. Breakthrough cases were largely due to unmasked social activities outside of work.

Abstract Background Previous research has shown the impact of pandemic communicable diseases on the mental health of healthcare providers. This study examined the relationship between general health, spiritual health, anxiety associated with COVID-19, job satisfaction, and the mediating role of sex in healthcare providers in Iran in 2021. Methods This was a descriptive-analytical and cross-sectional study performed on 163 healthcare providers of which 71.8% were female and 28.2% were male with an age range between 21 and 58 years, an average work experience of 9.5 years, and working as nurses, doctors, laboratory technicians, etc. in some hospitals in Sanandaj. Data were collected using COVID-19 Anxiety, General Health, job satisfaction, and Spiritual Health questionnaires. Then, the data were analyzed using SPSS-22 software, regression test, and path analysis. Results Although women averaged lower levels of general health, job satisfaction, and anxiety associated with COVID-19, and higher scores in spiritual health than men, none of these differences were statistically significant, and sex didn’t play a significant role here. Also, general health and spiritual health could significantly predict 17.1% of the variance in job satisfaction in the path analysis. However, sex and Covid-19 anxiety could not significantly predict this variable. Conclusion The results showed that there was not a significant difference between the male and female workers’ general health when facing such pandemics. However, we may prepare interventions to promote their general and spiritual health and to promote healthcare providers’ job satisfaction during such pandemics.

Abstract Background/Aims The aim of this study was to determine the rate of natural and breakthrough infection and related symptoms of Covid-19 amongst Iranian healthcare workers (HCWs) who were vaccinated by different non-mRNA-based vaccines at peak points. Methods In this cross-sectional study, the RT-PCR test was performed for a total of 10,581 HCWs suspicious of Covid-19 infection. For each HCW, the frequency of SARS-CoV-2 infection and the time of transmission based on vaccination administration time and schedule were examined during different waves of the pandemic. Based on these findings, the study patients were divided into three groups: natural, natural/breakthrough, and breakthrough. Results In total, 53% of the HCWs were exposed to SARS-CoV-2 infection between 1 and 5 times within two years after the current pandemic, while 20.7% and 32.3% experienced natural and breakthrough SARS-CoV-2 infection, respectively. Only 6% of the breakthrough-infected HCWs had naturally contracted SARS-CoV-2 infection during the initial waves. The highest natural peaks of infection occurred during the interval administration of the first and second dose of the first vaccination series, while the single highest peak of breakthrough infection belonged to the Omicron wave. It occurred simultaneously with the administration of the third vaccination dose. On the other hand, the highest rate of reinfection was observed amongst people who had received the Sinopharm and Bharat vaccines full-doses. Conclusion This study compared the clinical differences between the two peaks of Omicron and Delta. This study indicates the rates of natural and breakthrough SARS-CoV-2 infections according to vaccination schedules and different waves of the pandemic.

Background: Tuberculosis constitutes a worldwide problem in relation to its morbidity and mortality. The exposure to tuberculosis patients constituted a significant occupational exposure for healthcare workers. During the pandemic of COVID-19, the incidence of tuberculosis was reduced probably related to the high priority to provide care during the pandemic. Cases of health workers who after several months of caring for COVID-19 patients have had seroconversion of QuantiFERON TB gold (QFT) were described. The initial QTF test was performed in April 2020 (before providing care to COVID-19 cases), and a positive test was reported in August and December 2020 for the reported cases. The exposure to patients from countries with high incidence tuberculosis during the pandemic constituted the most probable source of infection. Also, the limited tuberculosis screening in patients and the staff's adherence to infection prevention practices among other factors will explain these findings, which will require strategies to prevent occupational exposure during the influx of communicable diseases to healthcare services.

Nouf A AlShamlan,1 Reem S AlOmar,1 Assim M AlAbdulKader,1 Faisal A AlGhamdi,2 Abdullah A Aldakheel,2 Saud A Al Shehri,2 Lyana Atif Felemban,3 Marwa Mahmoud Shafey,1 Malak A Al Shammari1 1Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3College of Medicine, Fakeeh College of Medical Sciences, Jeddah, Saudi ArabiaCorrespondence: Nouf A AlShamlan, Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, Tel +966 504901406, Email nashamlan@iau.edu.saPurpose: Epidemiologically, cervical cancer is the fourth most commonly diagnosed cancer among females globally and the third most commonly diagnosed gynecological cancer in Saudi Arabia. Screening is an important measure to prevent it. The current study aimed to assess, epidemiologically, female healthcare workers’ (HCWs) utilization of cervical cancer screening services and its association with their beliefs about cervical cancer and the screening test, as well as their personal characteristics.Methods: This cross-sectional study included female HCWs in Saudi Arabia. A predesigned, self-administered survey was used to collect data, and it included questions about sociodemographic and reproductive characteristics, self-utilization of cervical cancer screening services, and the Health Belief Model (HBM) scale. Regression analyses were conducted to identify predictors of cervical cancer screening service utilization.Results: A total of 1857 females participated. The cervical cancer screening test uptake was 24.6% of ever-married females. However, 45% of the participants were willing to have the test. The odds of utilizing a screening were significantly higher among older participants, those with a higher level of education, and those with a higher number of pregnancies. Furthermore, HCWs with a history of HPV infection, cervical cancer in the family, hormonal contraception, or immunocompromised diseases were more likely to have the screening. An increase in the mean scores of the perceived benefits and motives subscales of HBM was associated with an increase in the uptake of screening. However, an increase in perceived barrier scores was significantly associated with a lower likelihood of cervical cancer screening uptake.Conclusion: Low cervical screening uptake and slightly higher intentions to have the test exist among HCWs. Certain personal factors and health beliefs significantly affect the utilization of the screening test. Approaches that target perceived benefits, health motivation, and perceived barriers to improve the screening rates of cervical cancer among HCWs are recommended.Keywords: cervical cancer screening, health belief model, Pap smear, healthcare worker, utilizations, Saudi Arabia

INTRODUCTION: The COVID-19 pandemic has attracted all the attention due to the loss of workforce and deaths that it has caused in the world and in our country. Vaccine and drug studies are still going on to control the virus. The effectiveness of the vaccines is very important to apply in to conclude the pandemic. For this reason, we investigated the incidence of COVID-19 disease in the seasonal waves of autumn and spring in health personnel of Samsun Education and Research Hospital (SERH). METHODS: Health personnel diagnosed with PCR+, COVID-19 who applied to SERH occupational medicine unit between September 2020 and June 2021 were retrospectively scanned. Age, gender, occupational groups, working units, and vaccination status were examined. RESULTS: With the start of vaccination of risky groups in Türkiye, the first dose of COVID-19 vaccine was administered to health personnel in February 2021. A total of 854 health personnel were infected with COVID-19 in the date range were determined. Between September 1, 2020, and January 30, 2021, 659 (77.2%) patients were identified, who have not been vaccinated for COVID-19. After January 30, 2021, until June 31, 2021, 195 (22.8%). It was determined that the hospital staff caught COVID-19. DISCUSSION AND CONCLUSION: It was observed that the spring season of 2021 peak in Türkiye and Samsun province showed a more aggressive course than 2020 autumn season peak. It was determined that fewer health personnel were caught COVID-19 during the 3rd wave compared to the 2nd wave in the health personnel of SERH and vaccination has been shown to reduce the prevalence of COVID-19 infection. It has also been shown that the prevalence of contracting COVID-19 infection is the highest in the emergency room.

Background: A risk categorization tool for healthcare workers (HCWs) exposed to COVID-19 is crucial for preventing COVID-19 transmission and requires validation and modification according to local context. Methods: From January to December 2021, a prospective cohort study was conducted among Thai HCWs to evaluate the performance of the specifically-created risk categorization tool, which classified HCWs into low-risk (LR), intermediate-risk (IR), and high-risk (HR) groups based on types of activities, duration of exposure, and protective methods used during exposure. Subsequent measures were determined for the HCWs based on the risk categories. Results: 1891 HCWs were included; 52%, 25% and 23% were LR, IR, and HR, respectively. COVID-19 was diagnosed in 1.3%, 5.1% and 27.3% of LR, IR and HR HCWs, respectively (P

Abstract Background Discrete choice experiments (DCEs) are used to assess the strength of preferences and value of interventions. However, researchers using this approach have been criticized for not conducting or publishing rigorous studies to select the required attributes and levels. Proper specification of attributes and their levels determines the validity of DCE. Hence, our study aimed to identify and define attributes and levels for the design of a DCE to elicit patients’ and providers’ preferences for ART service in Northwest Ethiopia. Methods Four stages were followed to derive the final list of attributes and levels: (1) a literature review to derive conceptual attributes; (2) key informant interviews of 17 providers and in-depth interviews of 15 adult stable patients to identify context-specific attributes and attribute levels; (3) ranking survey among 31 HIV/AIDS program implementers and rating survey among 35 adult stable patients and 42 health workers providing antiretroviral therapy (ART) service to indicate participants’ preference of attributes; and (4) an expert opinion to reduce the list of attributes and levels. Results First, a literature review identified 23 candidate attributes. Second, individual-level analysis of the qualitative transcripts confirmed 15 of these 23 attributes. Third, the ranking and rating surveys put the importance of the 23 ART service attributes in order of preference. Fourth, through discussions with eight experts, 17 attributes were discarded based on multiple criteria. The six retained attributes were: the location of ART refills, the frequency of receiving ART refills, the person providing ART refills, the participants/others seen at the same ART refill visit, medication refill pick-up/delivery times, and the total cost of the visit during antiretroviral (ARV) medication refill. Finally, levels were assigned to these 6 attributes based on data from the literature, transcripts, and knowledge of the Ethiopian context. Conclusions This detailed description illuminates the attribute development process and provides the reader with a basis for evaluating the rigor of this phase of DCE construction. This paper contributes empirical evidence to the limited methodological literature on attributes and levels of development for DCE, thereby providing further empirical guidance on ART service preference, specifically among patients of low- and middle-income countries.

Abstract Aim SSI is one of the most prevalent healthcare‐associated infections and is associated with extended hospital stays, increased need for reoperation and higher hospital readmission rates. Implementing systematic SSI surveillance can reduce these adverse outcomes. Implementing a surveillance system into a hospital is a complex intervention requiring that staff involved in a patient's perioperative journey have the knowledge of SSI prevention, the data required for surveillance, an understanding of how data informs quality improvement initiatives and their role in surveillance. The aim of this study was to evaluate the impact of a complex intervention on the knowledge and attitudes of healthcare professionals towards surgical site infection (SSI), SSI prevention and surveillance in a university hospital setting. Design The study used a quasi‐experimental pre‐test–post‐test design. Method The impact of a complex intervention was evaluated by measuring healthcare professionals' (n = 74) knowledge of and attitudes towards SSI and surveillance. Normalisation process theory (NPT) guided the study and the development of the intervention. Results There was a statistically significant increase in scores on the knowledge of SSI and prevention from pre‐intervention to post‐test. The knowledge of risk factors scores at post‐test was significantly higher than that at pre‐intervention. Overall attitudes to SSI prevention and surveillance were good both pre‐intervention and post‐test but there was a significant change in the attitude of participants. The findings reveal an overall positive impact of the complex intervention on the knowledge and attitude of healthcare professionals relating to SSI, SSI prevention and surveillance; however, the extent of the change varied across items measured.

BackgroundThe prevalence of lung cancer, a major type of malignant tumor, has been increasing over the years greatly impacting the health of Chinese residents. This study investigates the epidemiological characteristics of lung cancer among healthcare workers in the Hunan Province, as well as the occupational risk factors.MethodsThe data analyzed in this study was collected from the largest tumor hospital in the province: the Hunan Provincial Tumor Hospital affiliated with Central South University, School of Medicine. The data collected encompasses input collected between the years of 2004 to 2013 of the population of healthcare workers who were hospitalized for lung cancer treatments. Information was obtained through statistical analysis and telephonic interviews.ResultsThe prevalence of lung cancer among healthcare workers was much higher than that of the general population, as revealed by the difference between number of healthcare worker cases per 1,000 cases and number of healthcare workers per 1,000 population in the decade from 2004 to 2013. Analysis of the data further demonstrates that lung cancer prevalence among healthcare workers increases exponentially with age. Although smoking has been shown to increase the incidence of lung cancer to some extent, it is most likely not the main cause of lung cancer. In addition, it appears that the highest rates of lung cancer incidence occurs in mainly in primary general practitioners, medical radiologists, and nurses. The lack of awareness of personal safety measures may place healthcare workers at a greater risk of lung cancer.

Summary: Background: The protection of fourth dose mRNA vaccination against SARS-CoV-2 is relevant to current global policy decisions regarding ongoing booster roll-out. We aimed to estimate the effect of fourth dose vaccination, prior infection, and duration of PCR positivity in a highly-vaccinated and largely prior-COVID-19 infected cohort of UK healthcare workers. Methods: Participants underwent fortnightly PCR and regular antibody testing for SARS-CoV-2 and completed symptoms questionnaires. A multi-state model was used to estimate vaccine effectiveness (VE) against infection from a fourth dose compared to a waned third dose, with protection from prior infection and duration of PCR positivity jointly estimated. Findings: 1298 infections were detected among 9560 individuals under active follow-up between September 2022 and March 2023. Compared to a waned third dose, fourth dose VE was 13.1% (95% CI 0.9 to 23.8) overall; 24.0% (95% CI 8.5 to 36.8) in the first 2 months post-vaccination, reducing to 10.3% (95% CI −11.4 to 27.8) and 1.7% (95% CI −17.0 to 17.4) at 2–4 and 4–6 months, respectively. Relative to an infection >2 years ago and controlling for vaccination, 63.6% (95% CI 46.9 to 75.0) and 29.1% (95% CI 3.8 to 43.1) greater protection against infection was estimated for an infection within the past 0–6, and 6–12 months, respectively. A fourth dose was associated with greater protection against asymptomatic infection than symptomatic infection, whilst prior infection independently provided more protection against symptomatic infection, particularly if the infection had occurred within the previous 6 months. Duration of PCR positivity was significantly lower for asymptomatic compared to symptomatic infection. Interpretation: Despite rapid waning of protection, vaccine boosters remain an important tool in responding to the dynamic COVID-19 landscape; boosting population immunity in advance of periods of anticipated pressure, such as surging infection rates or emerging variants of concern. Funding: UK Health Security Agency, Medical Research Council, NIHR HPRU Oxford, Bristol, and others.

Objectives: This research aims to explore healthcare workers knowledge and information about the National Transformation Program (NTP) 2020 and their readiness to apply the transformation agenda. Study design: A cross-sectional quantitative study. Methods: A questionnaire was developed and distributed randomly through social media and shared with various healthcare workers from around the kingdom of Saudi Arabia. Results: 202 health care workers responding from different cities and regions in the kingdom the study focused on the two main objectives, the healthcare workers knowledge about NTP and their readiness to change, and it has been shown that both objectives were positively related, the more the knowledge about NTP the more ready healthcare workers are to adopt and participate in this change. Conclusion: It was concluded that there is major importance of involving healthcare workers in the planning and development of this change to allow for an easy, supported change to the sector.

AbstractIntroduction Healthcare workers (HCWs) are on the frontlines of the COVID-19 pandemic, putting them at a higher risk of infection and disease than non-HCWs. We analysed the effects of government policies for the public and for HCWs on the likelihood of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and mortality among HCWs during the first 8 months of the pandemic in Jakarta province, the capital city and COVID-19 hotspot in Indonesia.Methods We conducted a retrospective cohort study using secondary data from the Jakarta provincial government from March to October 2020, which included sociodemographic characteristics, symptoms, comorbidities and COVID-19 diagnosis history for all cases. A generalized linear mixed-effect regression model was used to determine the effect of each month on the odds ratio (OR) of COVID-19 cases and deaths for HCW compared with non-HCW, assuming that monthly trends were influenced by varying government policies.Results A total of 894,487 suspected and confirmed COVID-19 cases in health facilities in Jakarta province were analysed. The OR of confirmed cases for HCW was 2.04 (95% CI 2.00–2.08; p