Predicting Role of Resilience and Meaning in Life in Perceived Stress of Frontline Health Care Workers during COVID-19 Outbreak

This paper investigates the predicting role of resilience and meaning in life on perceived stress of frontline health care workers treating patients with COVID-19. To measure the variables, a set of online questionnaires including Perceived Stress Questionnaire (PSS), Meaning of Life Questionnaire (MLQ), and Resilience Questionnaire (CD_RISC) was prepared. Presence of meaning, search for meaning, notion of personal competence, tolerance and trust in intuition, acceptance and secure relationships, control, and spiritual influences were examined as predictors of perceived stress. Several frontline health care workers were included in the final study. To analyze the data, regression analysis method was used with SPSS-20 software. The results showed that: 1) the regression model of resilience and the presence of meaning in the life of health care workers on their perceived stress was significant (F (6,229)=45.14, p<0.0001); 2) the predictive variables, in total, could explain 53% of the variance of perceived stress; 3) perceived stress correlated negatively with presence of meaning (β = −0.380, p<0.05), with acceptance and secure relationships (β = −0.620, p< 0.05), with control (β = −0.609, p<0.05), and positively correlated with spiritual influences (β = 0.465, p<0.05). Finding and maintaining meaning in life and improving acceptance, secure relationships, and sense of control would reduce perceived stress of frontline health care workers.

Distinct Vaccine Efficacy Rates Among Health Care Workers During a COVID-19 Outbreak in Jordan

BACKGROUND: We aimed to assess the efficacy of 3 COVID-19 vaccines in a population of health care workers at a tertiary cancer center in Amman, Jordan. METHODS: We evaluated the records of 2855 employees who were fully vaccinated with 1 of 3 different vaccines and those of 140 employees who were not vaccinated. We measured the number of SARS-CoV-2 infections that occurred at least 14 days after the second vaccine dose. RESULTS The 100-day cumulative incidence of PCR-confirmed SARS-CoV-2 infections was 19.3% +/- 3.3% for unvaccinated employees and 1.7% +/- 0.27% for fully vaccinated employees. The 100-day cumulative infection rates were 0.7% +/- 0.22% in BNT162b2 vaccine recipients (n = 1714), 3.6% +/- 0.77% in BBIBP-CorV recipients (n = 680), and 2.3% +/- 0.73% in ChAdOx1 recipients (n = 456). We used Cox regression analyses to compare the risks of SARS-CoV-2 infection among the different vaccine recipient groups and found a significantly higher infection risk in BBIBP-CorV (hazard ratio [HR] = 2.9 +/- 0.31) and ChAdOx1 recipients (HR = 3.0 +/- 0.41) compared to BNT162b2 recipients (P = .00039 and .0074, respectively). Vaccinated employees who had no previously confirmed SARS-CoV-2 infections were at a markedly higher risk for breakthrough infections than those who experienced prior infections (HR = 5.7 +/- 0.73, P = .0178). CONCLUSIONS: Our study offers a real-world example of differential vaccine efficacy among a high-risk population during a national outbreak. We also show the important synergism between a previous SARS-CoV-2 infection and vaccination.

Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

Background Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no test. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG tests’ value depends on test timing and immunity characteristics, however it is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

Correlates of COVID-19 vaccination drop-out among health care workers in a tertiary Care hospital of West Bengal

The Government of India launched “COVID-19 vaccination drive” on 16th January, 2021 and health care workers were the first to be prioritised for vaccination. However, the uncertainty regarding safety and efficacy of the vaccine was the major concern amongst them. These led to vaccine hesitancy and ultimately drop out.To estimate the proportion of drop out of COVID-19 vaccination among vaccine-hesitant health care workers (HCWs) of a tertiary care hospital and to find out their perception and other background characteristics responsible for drop out. A facility based descriptive type of observational study, cross-sectional in design was carried out among 329 HCWs of a tertiary care hospital in Kolkata from 16th March- 12thApril, 2021using a pre-designed, pre-tested, structured questionnaire. The study population selected by simple random sampling technique. Data was analysed using Microsoft Excel 2010 and SPSS v25.0 in the form of descriptive statistics and binary logistic regression. About 44.1% of the study population didn’t take the COVID-19 vaccine. Socio-demographic factors like age, gender, religion, education, occupation,perception regarding necessity of vaccination, vaccine efficacy, dose and contraindication, safety in humans and role in future infections were significantly associated with drop out. There was a high proportion of vaccine drop out among health care workers. Different modifiable perceptions with socio-demographic factors had played important roles in COVID-19 vaccination drop out. As the global threat of COVID-19 continues, greater efforts through campaigns that target HCWs are needed to improve the intention of professionals’ vaccine acceptance.

Effects of Safety Zone Implementation on Perceptions of Safety and Well-being When Caring for COVID-19 Patients

Background In March 2020, the caseload of patients positive for COVID-19 in hospitals began increasing rapidly, creating fear and anxiety among health care workers and concern about supplies of personal protective equipment. Objectives To determine if implementing safety zones improves the perceptions of safety, well-being, workflow, and teamwork among hospital staff caring for patients during a pandemic. Methods A safety zone process was implemented to designate levels of contamination risk and appropriate activities for certain areas. Zones were designated as hot (highest risk), warm (moderate risk), or cold (lowest risk). Caregivers working in the safety zones were invited to complete a survey regarding their perceptions of safety, caregiver well-being, workflow, and teamwork. Each question was asked twice to obtain caregiver opinions for the periods before and after implementation of the zones. Results Significant improvements were seen in perceptions of caregiver safety (P &lt; .001) and collaboration within a multidisciplinary staff (P &lt; .001). Significant reductions in perceived staff fatigue (P = .03), perceived cross contamination (P &lt; .001), anxiety (P &lt; .001), and fear of exposure (P &lt; .001) were also seen. Teamwork (P = .23) and workflow (P = .69) were not significantly affected. Conclusions Safety zone implementation improved caregivers’ perceptions of their safety, their well-being, and collaboration within the multidisciplinary staff but did not improve their perceptions of teamwork or workflow.

Knowledge, Attitudes, and Practices on Tick-Borne Encephalitis Virus and Tick-Borne Diseases within Professionally Tick-Exposed Persons, Health Care Workers, and General Population in Serbia: A Questionnaire-Based Study

This study assessed the level of knowledge, attitudes, and practices (KAP) regarding tick-borne encephalitis virus (TBEV) and tick-borne diseases (TBDs) among different groups of people in Serbia. Professionally tick-exposed persons (PTEPs), health care workers (HCWs), and the general population (GP) were subjected to an anonymous, voluntary, online questionnaire using Microsoft Forms. A total of 663 questionnaire responses were collected (February–March 2021), while 642 were included in the analysis. The significant difference in knowledge in TBDs existed between GP and PTEPs, and HCWs (p < 0.001). The perception of risk-to-tick exposure and TBDs was generally high (42.4 (95% CI: 33.6–51.2) within GP, 44.9 (95% CI: 35.8–53.9) within PTEPs and 46.2 (95% CI: 38.0–54.5) within HCWs), while fear was low (13.7 (95% CI: 7.9–19.5) within GP, 12.6 (95% CI: 7.3–19.9) within PTEPs, and 13.5 (95% CI: 7.4–19.5) within HCWs). Protective practices differed across groups (F (2639) = 12.920, p < 0.001, η2 = 0.039), with both PTEPs (t = 3.621, Cohen d = 0.332, p < 0.001) and HCWs (t = 4.644, Cohen d = 0.468, p < 0.001) adhering to more protective practices than the GP, without differences between PTEPs and HCWs (t = 1.256, Cohen d = 0.137, p = 0.421). Further education about TBDs in Serbia is required and critical points were identified in this study.

Alcohol Consumption and COVID-19–Related Stress Among Health Care Workers: The Need for Continued Stress-Management Interventions

Objectives: Although a known association exists between stress and alcohol consumption among health care workers (HCWs), it is not known how the COVID-19 pandemic has affected this association. We assessed pandemic work-related stress and alcohol consumption of HCWs. Methods: We emailed a cross-sectional, anonymous survey in June 2020 to approximately 550 HCWs at an academic hospital in New Orleans, Louisiana. HCWs from all departments were eligible to complete the survey. Questions measured work-related stress and emotional reactions to the pandemic (using the Middle East Respiratory Syndrome [MERS-CoV] Staff Questionnaire), depressive symptoms (using the Patient Health Questionnaire–9 [PHQ-9]), coping habits (using the Brief COPE scale), and pre–COVID-19 (March 2020) and current (June 2020) alcohol consumption. We measured alcohol consumption using the Alcohol Use Disorders Identification Test–Consumption (AUDIT–C), with scores >3 considered positive. We asked 4 open-ended questions for in-depth analysis. Results: One-hundred two HCWs participated in the survey. The average AUDIT–C scores for current and pre–COVID-19 alcohol consumption were 3.1 and 2.8, respectively. The level of current alcohol consumption was associated with avoidant coping (r = 0.46, P < .001). Relative increases in alcohol consumption from March to June 2020 were positively associated with PHQ-9 score and greater emotional reactions to the pandemic. Availability of mental health services was ranked second to last among desired supports. Qualitative data demonstrated high levels of work-related stress from potential exposure to COVID-19 and job instability, as well as social isolation and negative effects of the pandemic on their work environment. Conclusions: Ongoing prevention-based interventions that emphasize stress management rather than mental or behavioral health conditions are needed.