scholarly journals COVID-19 and mental well-being of nurses in a tertiary facility in Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254074
Author(s):  
Sayed K. Ali ◽  
Jasmit Shah ◽  
Zohray Talib

Background The 2019 coronavirus disease (COVID-19) epidemic is a global health emergency which has been shown to pose a great challenge to mental health, well-being and resilience of healthcare workers, especially nurses. Little is known on the impact of COVID-19 among nurses in sub-Saharan Africa. Methods A cross sectional study was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. The survey questionnaire consisted of six components- demographic and work title characteristics, information regarding care of COVID-19 patients, symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardized questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders. Results Of 255 nurses, 171 (67.1%) consented to complete the survey. The median age of the participants was 33.47 years, 70.2% were females and 60.8% were married. More than half, 64.9% were frontline workers directly engaged in COVID-19 care. Only 1.8% reported a prior history or diagnosis of any mental health disorder. Depression, anxiety, insomnia, distress, and burnout were reported in 45.9%, 48.2%, 37.0%, 28.8% and 47.9% of all nurses. Frontline nurses reported experiencing more moderate to severe symptoms of depression, distress and burnout. Furthermore, females reported more burnout as compared to males. Multivariate logistic regression analysis showed that after adjustment, working in the frontlines was an independent risk variable for depression and burnout. Conclusion This is one of the few studies looking at mental health outcomes among nurses during the COVID-19 pandemic in Kenya. Similar to other studies from around the world, nurses directly involved with COVID-19 patients reported higher rates of mental health symptoms. Burnout threatens to exacerbate the pre-existing severe nursing workforce shortage in low-resource settings. Cost-effective and feasible mitigating strategies, geared to low-middle income countries, are urgently needed to help cope with mental health symptoms during such a pandemic.

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050316
Author(s):  
Jasmit Shah ◽  
Aliza Monroe-Wise ◽  
Zohray Talib ◽  
Alphonse Nabiswa ◽  
Mohammed Said ◽  
...  

BackgroundCOVID-19 is an international global health emergency and has posed a great challenge to mental well-being and resilience. Little is known about the mental health impact of COVID-19 among healthcare workers (HCWs) in sub-Saharan Africa or other low-resource settings.MethodsWe conducted a cross-sectional study between August and November 2020 among HCWs recruited from three major hospitals in Kenya. The survey questionnaire consisted of six components: demographic and work title characteristics; information regarding care of patients with COVID-19; and symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardised questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders.ResultsA total of 433 (65.2% response rate) individuals participated in the survey. Median age was 32.75 years, 58.4% were females and 68.8% were front-line workers. Depression, anxiety, insomnia, distress and burnout were reported in 53.6%, 44.3%, 41.1%, 31.0% and 45.8% of all participants, respectively. Front-line HCWs, females and doctors were at higher risk of mental health symptoms. Nearly half of participants reported inadequate resources or training to care for patients with COVID-19, and those in the government hospital were more likely to report mental health symptoms.ConclusionsThis is among the first studies examining mental health outcomes among HCWs during the COVID-19 pandemic in Kenya. Similar to other studies from around the world, HCWs directly involved with patients with COVID-19 reported higher rates of mental health symptoms. Mitigating strategies specific to Kenyan HCWs are urgently needed to help them cope with mental health symptoms during the pandemic.


2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Saifur Rahman Chowdhury ◽  
Tachlima Chowdhury Sunna ◽  
Dipak Chandra Das ◽  
Humayun Kabir ◽  
Ahmed Hossain ◽  
...  

Abstract Background The coronavirus disease-19 (COVID-19) pandemic has wreaked havoc on healthcare staff and caused serious psychological distress. We aimed to determine the effects of the COVID-19 pandemic on the mental health of Bangladeshi nurses, as well as the relationship between occupational factors and mental health symptoms. We conducted a cross-sectional study among registered nurses in Bangladesh. We used the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Impact of Event Scale-Revised (IES-R) to assess mental health symptoms. Results Among the 547 nurses included in the study, the prevalence of mild to extremely severe depression, anxiety, and stress was 50.5%, 51.8%, and 41.7% respectively, and 61.9% of the respondents reported mild to severe psychological impact for COVID-19. Psychological symptoms were more prevalent among female nurses than male nurses (p <0.05). Linear regression revealed that having complete personal protective equipment (PPE) during working was significantly associated with lower levels of depression, anxiety, and stress (p <0.05). Facing any emotional abuse working in the COVID-19 pandemic situation was significantly associated with higher levels of depression, anxiety, and stress and greater psychological impact of the outbreak (p <0.05). Conclusions A high prevalence of mental health symptoms was observed in nurses. We recommend the implementation of mental well-being interventions and ensuring a proper work environment for nurses during the pandemic.


Author(s):  
Kris Vanhaecht ◽  
Deborah Seys ◽  
Luk Bruyneel ◽  
Bianca Cox ◽  
Gorik Kaesemans ◽  
...  

Abstract Background The coronavirus disease 2019 (COVID-19) may aggravate workplace conditions that impact health-care workers’ mental health. However, it can also place other stresses on workers outside of their work. This study determines the effect of COVID-19 on symptoms of negative and positive mental health and the workforce’s experience with various sources of support. Effect modification by demographic variables was also studied. Methods A cross-sectional survey study, conducted between 2 April and 4 May 2020 (two waves), led to a convenience sample of 4509 health-care workers in Flanders (Belgium), including paramedics (40.6%), nurses (33.4%), doctors (13.4%) and management staff (12.2%). About three in four were employed in university and acute hospitals (29.6%), primary care practices (25.7%), residential care centers (21.3%) or care sites for disabled and mental health care. In each of the two waves, participants were asked how frequently (on a scale of 0–10) they experienced positive and negative mental health symptoms during normal circumstances and during last week, referred to as before and during COVID-19, respectively. These symptoms were stress, hypervigilance, fatigue, difficulty sleeping, unable to relax, fear, irregular lifestyle, flashback, difficulty concentrating, feeling unhappy and dejected, failing to recognize their own emotional response, doubting knowledge and skills and feeling uncomfortable within the team. Associations between COVID-19 and mental health symptoms were estimated by cumulative logit models and reported as odds ratios. The needed support was our secondary outcome and was reported as the degree to which health-care workers relied on sources of support and how they experienced them. Results All symptoms were significantly more pronounced during versus before COVID-19. For hypervigilance, there was a 12-fold odds (odds ratio 12.24, 95% confidence interval 11.11–13.49) during versus before COVID-19. Positive professional symptoms such as the feeling that one can make a difference were less frequently experienced. The association between COVID-19 and mental health was generally strongest for the age group 30–49 years, females, nurses and residential care centers. Health-care workers reported to rely on support from relatives and peers. A considerable proportion, respectively, 18 and 27%, reported the need for professional guidance from psychologists and more support from their leadership. Conclusions The toll of the crisis has been heavy on health-care workers. Those who carry leadership positions at an organizational or system level should take this opportunity to develop targeted strategies to mitigate key stressors of health-care workers’ mental well-being.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 722
Author(s):  
Yusuke Ito ◽  
Hidetaka Wakabayashi ◽  
Shinta Nishioka ◽  
Shin Nomura ◽  
Ryo Momosaki

The object of this study is to determine the impact of the rehabilitation dose on the nutritional status at discharge from a convalescent rehabilitation ward in malnourished patients with hip fracture. This retrospective case-control study involved malnourished patients with hip fracture aged 65 years or older who had been admitted to a convalescent rehabilitation ward and whose data were registered in the Japan Rehabilitation Nutrition Database. The primary outcome was nutritional status at discharge. Patients were classified according to whether nutritional status was improved or not at discharge, according to the Mini Nutritional Assessment-Short Form® (MNA-SF) score. The association between improved nutritional status and rehabilitation dose was assessed by a logistic regression analysis. Data were available for 145 patients (27 men, 118 women; mean age 85.1 ± 7.9 years). Daily rehabilitation dose was 109.5 (median 94.6–116.2) min and the MNA-SF score at admission was 5 (median 4–6). Nutritional status was improved in 97 patients and not improved in 48. Logistic regression analysis showed the following factors to be independently associated with nutritional status at discharge: Functional Independence Measure score (OR 1.042, 95% CI 1.016–1.068), energy intake (OR 1.002 CI 1.000–1.004), daily rehabilitation dose (OR 1.023, 95% CI 1.002–1.045), and length of hospital stay (OR 1.026, 95% CI 1.003–1.049). The daily rehabilitation dose in malnourished patients with hip fracture may positively impact nutritional status at discharge.


2021 ◽  
pp. 002076402110272
Author(s):  
Dana Alonzo ◽  
Marciana Popescu ◽  
Pinar Zubaroglu-Ioannides

Background: On March 5th, Guatemala declared a ‘State of Calamity’ in response to the COVID-19 pandemic and strict lockdown measures were initiated. The psychological consequences of these measures are yet to be fully understood. There is limited research on the psychological impact of the virus in the general population, and even less focused on Latin America and high-risk communities characterized by poverty, limited mental health resources, and high rates of stigma around mental illness. The goal of this study is to examine the psychological impact of COVID-19 across several highly vulnerable districts in Guatemala. Methods: A semi-structured phone interview was conducted of 295 individuals in multiple districts in Guatemala City to assess self-perceived mental health consequences related to the pandemic. Sociodemographic, medical, and mental health data were collected. Chisquares and t-tests used for categorical and continuous variables, as appropriate, to describe the sample. Binary logistic regressions were estimated to examine associations between sociodemographic characteristics and mental health symptoms (anxiety, stress, depression, burnout, escalation of pre-existing mental health symptoms, and a sense of safety). Results: The results indicate high levels of anxiety and stress in all target communities. Significant differences based on gender, age, and the number of children in the household were identified: women and older adults experience higher rates of stress and anxiety associated with the pandemic; while families with greater number of children experience higher levels of burnout. Conclusion: Contextualizing the current pandemic as a complex emergency can help inform further studies focusing on socioeconomic challenges and higher vulnerabilities as preconditions affecting the impact of the pandemic on mental health. Given the limited available resources for mental health care in Guatemala, informal networks of care may play an important role in meeting the needs of those individuals experiencing increased psychological distress resulting from the pandemic.


2015 ◽  
Vol 43 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Cheng-Yu Li ◽  
Shiao-Yuan Lu ◽  
Bi-Kun Tsai ◽  
Keh-Yuan Yu

In recent years, personality variables, such as extraversion and sensation seeking, have been used to investigate tourist preferences and behaviors. For this study, we classified tourist roles into three types: the familiarized mass tourist, the organized mass tourist, and the independent tourist. We investigated the impact of extraversion and sensation seeking on tourist roles in a large-scale survey of Taiwanese citizens (N = 1,249) aged 20 years and older. Using logistic regression analysis, the results indicated that sensation seeking was a significant predictor of tourist role, but extraversion was not. Compared to familiarized mass tourists, people who are sensation-seeking are more likely to become independent tourists rather than organized mass tourists. We provide suggestions for tourism marketing.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Seong-Joon Lee ◽  
Yang-Ha Hwang ◽  
Ji Man Hong ◽  
Jin Wook Choi ◽  
Dong-Hun Kang ◽  
...  

Introduction: Given the recent positive endovascular therapy trials for acute ischemic stroke (AIS), this therapeutic strategy is now being increasingly incorporated into routine clinical practice. Identifying prognostic factors among AIS patients receiving endovascular revascularization treatments (ERT) in the real world could be important for clinicians and patients. While the impact of diabetes mellitus (DM) on IV thrombolytic outcomes after AIS has been extensively investigated, there is a paucity of data assessing effects of DM on ERT outcomes after AIS. We evaluated the impact of comorbid DM on ERT for AIS. Methods: From Jan 2011 to Feb 2016, patients with AIS who underwent ERT for cervicocephalic occlusions were consecutively enrolled into the Acute Stroke due to Intracranial Atherosclerotic occlusion and Neurointervention - Korean Retrospective (ASIAN KR) registry from 3 hospitals. Patients were excluded if onset to puncture time over 8 hours, in-hospital stroke, or unavailable 3-month mRS. DM was diagnosed if a patient had the history, or hemoglobin A1c on admission was over 6.5. Univariate analysis was performed to compare the characteristics between DM and non-DM population. Multiple logistic regression analysis was used to validate the effect of comorbid DM on 3 month outcomes. Results: Of 721 patients, 667 (93%) were finally included, with 233 DM patients and 434 non-DM patients. In the univariate analysis, comorbidity with hypertension (71.2% vs. 58.3%, p=0.001) and dyslipidemia (36.7% vs. 26.7%, p=0.012) were more frequent in the DM population. Periprocedural factors such as target vessels, intravenous thrombolysis, and final reperfusion grades did not differ. Good outcomes with mRS 0-2 were less frequent in the DM population (43.3% vs. 53.7%, p=0.011). In the logistic regression analysis adjusting age, male sex, initial NIHSS, premorbid mRS, hypertension history, atrial fibrillation, intravenous thrombolysis, onset to puncture time and successful reperfusion, DM was an independent predictor of poor outcomes (mRS 3-6; 1.933, 1.274-2.933, p=0.002). Conclusion: In patients receiving ERT for AIS due to cervicocephalic artery occlusions, the presence of DM as a comorbidity confers greater odds of a poor functional outcome.


Author(s):  
Jisu Jeong ◽  
Seunghui Han

PurposeCitizen trust in police is important in terms of citizen consent to government policies and of police achieving their organizational goals. In the previous study, improvements in police policy, organizational operation and policing activities were developed to clarify which factors influence trust in police and how trust can be improved. This research raises the question, would changes in trust in police have an impact on trust in government? In this paper, this research question is discussed theoretically and the causal relationship analyzed empirically by applying OLS, ordered logistic, 2SLS and logistic regressions.Design/methodology/approachThe basic analysis methods are to apply the OLS and the ordered logistic regression. OLS regression analysis is an analytical method that minimizes an error range of a regression line. The assumptions for OLS are: linearity, independence, equilibrium, extrapolation and multicollinearity issues. These problems were statistically verified and analyzed, in order to confirm the robustness of the analysis results by comparing the results of the ordered logistic regression because of the sequence characteristic of the dependent variable. The data to be used in this study is the Asia Barometer Survey in 2013.FindingsTrust in police and citizen perception of safety are analyzed as important factors to increase trust in the government. The effects of trust in police are more significant than the effects of control variables, and the direction and strength of the results are stable. The effect of trust in police on trust in government is strengthened by the perception of safety (IV). In addition, OLS, ordered logistic regression analysis, which analyzed trust in central government and local government, and logistic regression analysis categorized by trust and distrust show the stability.Research limitations/implicationsThis paper has implications in terms of theoretical and empirical analysis of the relationship between trust in police and trust in government. In addition, the impact of perception of safety on trust in police can be provided to police officers, policymakers and governors who are seeking to increase trust in government. This paper is also meaningful in that it is the microscopic research based on the citizens' survey. One of the limitations of macroscopic research is that it does not consider the individual perceptions of citizens.Practical implicationsThe results of this paper can confirm the relationship of the virtuous cycle, which is perception of safety – trust in police – trust in government. The police will need to provide security services to improve citizens' perception of safety and make great efforts to create safer communities and society. Trust in police formed through this process can be an important component of trust in government. By making citizens feel safer and achieving trust in police, ultimately, trust in government will be improved.Originality/valueThe police perform one of the essential roles of government and are one of the major components of trust in government, but the police sector has been neglected compared to the roles of the economic and political sectors. These influences of macro factors are too abstract to allow specific policy directions to be suggested. If we consider trust in police, and factors that can improve trust in government, we can suggest practical policy alternatives.


BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Liu ◽  
Zhankun Wang ◽  
Shuai Liu ◽  
Yu Yao ◽  
Yong Liu ◽  
...  

Abstract Background Performance of urinary cytology is recommended as the part of a standard diagnostic workup and base surveillance regimens in upper tract urothelial carcinoma (UTUC). However, the effect of positive voided urine cytology (VUC) on UTUC prognosis, compared with negative VUC, has not been fully demonstrated. This study aimed to evaluate the impact of preoperative VUC on predicting intravesical recurrence, disease recurrence, and mortality in patients with UTUC who underwent nephroureterectomy (RNU). Methods Clinicopathological information was collected from 315 UTUC patients treated with RNU. The association between VUC and oncological outcomes was analyzed using the Kaplan–Meier method with log-rank test and Cox proportional hazards regression models. Multiple logistic regression analysis was performed to identify the influence of VUC on tumor grade. Results Preoperative positive VUC, presenting in 101 patients (32%), was significantly associated with tumor multifocality (P = 0.017) and higher tumor grade (P = 0.010). On multivariable Cox regression analyses, preoperative positive VUC was an independent prognostic factor of intravesical recurrence-free survival (RFS) (hazard ratio [HR] = 2.21, 95% confidence interval [CI] 1.06–4.64; P = 0.035), RFS (HR = 1.80, 95% CI 1.08–2.99; P = 0.023), and cancer-specific survival (CSS) (HR = 1.87, 95% CI 1.10–3.18; P = 0.020), but not overall survival (HR = 1.32, 95% CI 0.80–2.18; P = 0.28). Logistic regression analysis revealed that VUC was related to high tumor grade in UTUC (odds ratio = 2.23, 95%CI 1.15–4.52). Conclusion Preoperative positive VUC significantly increases the risk of intravesical recurrence in UTUC patients undergoing RNU. In addition, positive VUC is an adverse predictor of RFS and CSS, which might be due to the association between positive VUC and high tumor grade.


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