Special Issue "COVID-19 Pandemics: Impact on Health Care and Health Care Professions"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: 30 September 2021.

Special Issue Editors

Prof. Dr. Thomas Volken
E-Mail Website
Guest Editor
ZHAW School of Health Professions, Institute of Health Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland
Interests: health service research; public health; epidemiology
Dr. Annina Zysset
E-Mail Website
Guest Editor
ZHAW School of Health Professions, Institute of Health Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland
Interests: mental health; child & youth public health; child development

Special Issue Information

Dear Colleagues,

On 11 March 2020, the World Health Organization declared the rapidly spreading coronavirus outbreak a pandemic. By the end of November, more than 58 million people worldwide had been infected with the SARS-CoV2 virus and more than 1.4 million had died. As a result, healthcare systems around the world have faced unprecedented challenges. However, there has been limited research into the impact of the pandemic on healthcare and health professionals.

On the one hand, there is a lack of knowledge about the extent to which pandemic-induced medical, administrative, organizational, social, psychological or regulatory changes have affected the scope, quantity, and quality of outpatient and inpatient health care for different patient populations, e.g., different age groups (children, adolescents, adults) or patients with different diseases. Moreover, there is little knowledge on how these changes have influenced and will influence patient outcomes in the short and long run. On the other hand, there is a lack of differentiated knowledge about the extent to which the physical and mental health and wellbeing of health professionals have been affected by the pandemic and its related changes in professional and private environments, and the extent to which there are differences between individual health professions. Papers addressing these topics are invited for this Special Issue, especially those combining a high academic standard coupled with a focus on practical implications.

Prof. Dr. Thomas Volken
Dr. Annina Zysset
Guest Editors

Manuscript Submission Information

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Keywords

  • SARS-CoV2
  • COVID-19
  • pandemic
  • health care
  • health professions
  • health
  • mental health

Published Papers (23 papers)

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Research

Article
The Effect of Vaccination Rates on the Infection of COVID-19 under the Vaccination Rate below the Herd Immunity Threshold
Int. J. Environ. Res. Public Health 2021, 18(14), 7491; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147491 - 14 Jul 2021
Viewed by 350
Abstract
Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than [...] Read more.
Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than 1%. This article aims to explore the impact of vaccination on the spread of the COVID-19 pandemic. As the herd immunity of almost all countries in the world has not been reached, several countries were selected as sample cases by employing the following criteria: more than 60 vaccine doses per 100 people and a population of more than one million people. In the end, a total of eight countries/regions were selected, including Israel, the UAE, Chile, the United Kingdom, the United States, Hungary, and Qatar. The results find that vaccination has a major impact on reducing infection rates in all countries. However, the infection rate after vaccination showed two trends. One is an inverted U-shaped trend, and the other is an L-shaped trend. For those countries with an inverted U-shaped trend, the infection rate begins to decline when the vaccination rate reaches 1.46–50.91 doses per 100 people. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Occupational Therapy in Mental Health via Telehealth during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(13), 7138; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137138 - 03 Jul 2021
Viewed by 600
Abstract
The COVID-19 pandemic has brought about changes in mental health occupational therapy. Research into these changes and the associated risks of relapse is insufficient. To explore the changes that have taken place in forms of occupational intervention (face-to-face and online) during the pandemic, [...] Read more.
The COVID-19 pandemic has brought about changes in mental health occupational therapy. Research into these changes and the associated risks of relapse is insufficient. To explore the changes that have taken place in forms of occupational intervention (face-to-face and online) during the pandemic, and to analyze their association with subsequent relapses, a multicenter retrospective cohort study was carried out of 270 patients with mental disorder diagnoses under follow-up in day hospitals during 2020. Our results show that the frequency of face-to-face occupational therapy interventions decreased during lockdown and subsequently recovered. Interventions via telehealth increased during lockdown and have since been continued to a greater extent than before lockdown. Patients who received occupational intervention via telehealth relapsed less in the following six months (10.7% vs. 26.3%; χ2 = 10.372; p = 0.001), especially those who received intervention via videoconferencing (4.2% vs. 22%; χ2 = 5.718; p = 0.017). In conclusion, lockdown subsequent to the COVID-19 outbreak led to a reduction in face-to-face occupational therapy interventions, putting people with prior mental disorders at risk, while the implementation of telehealth tools helped reduce relapses. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
Article
Implementation of Triage System and Shortening Patient Journey Time to Prevent COVID-19 Transmission in a University Hospital during a Pandemic
Int. J. Environ. Res. Public Health 2021, 18(13), 6996; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136996 - 30 Jun 2021
Viewed by 407
Abstract
To explore the characteristics of the patient under investigation (PUI), and the routes and the patient journey time in our outpatient service, we examined the demographic data, presenting symptoms, risks of contact with COVID-19 cases, and the results of real-time polymerase chain reaction [...] Read more.
To explore the characteristics of the patient under investigation (PUI), and the routes and the patient journey time in our outpatient service, we examined the demographic data, presenting symptoms, risks of contact with COVID-19 cases, and the results of real-time polymerase chain reaction (PCR) tests in PUI cases from March to May 2020. The contact time, transfer time and total journey time of patient journey routes in our hospital were also explored. The results were shown in numbers, percentages and medians (interquartile range, IQR). A total of 334 PUI cases were identified from our triage system. The median (IQR) age was 35 (27, 47) years. Cough was the most common presenting symptom (56.2%), while fever (≥37.5 °C) was found in only 19.8% of the cases. The median (IQR) time of onset of the presenting symptoms was 3 (1, 5) days. The most common risk of contact with COVID-19 cases found during the triage was living in or returning from an outbreak area. Fifteen (4.5%) of the PUI cases had positive real-time PCR tests. The contact time and transfer time were longest in the PUI ward and from the Emergency Department (ED) to the PUI ward, respectively. Plans and actions to shorten the transfer time between the ED and the PUI ward and the total journey time should be developed. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Perceptions and Experiences of the COVID-19 Pandemic amongst Frontline Nurses and Their Relatives in France in Six Paradoxes: A Qualitative Study
Int. J. Environ. Res. Public Health 2021, 18(13), 6977; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136977 - 29 Jun 2021
Viewed by 623
Abstract
Due to their frontline position to fight the coronavirus disease 2019 (COVID-19), the professional and personal life of nurses was severely disrupted. To understand and describe their lived experiences and perceptions during the pandemic’s first wave in France, we interviewed 49 nurses, including [...] Read more.
Due to their frontline position to fight the coronavirus disease 2019 (COVID-19), the professional and personal life of nurses was severely disrupted. To understand and describe their lived experiences and perceptions during the pandemic’s first wave in France, we interviewed 49 nurses, including 16 nursing students, and 48 of their family members from June to July 2020. Using a purposeful sampling, the semi-structured interviews were scripted according to Abric’s method with probing questions. The interview analysis led to the identification of six paradoxical perceptions concerning the pandemic’s consequences: the Silence Paradox, the Hero Paradox, the Workforce Paradox, the Learning Paradox, the Symbolic Exchange Paradox, and the Uncertainty Paradox. However, despite different experiences, the nurses perceived their frontline position both as a burden jeopardizing their safety and well-being and as a spotlight of nurses’ tough working conditions. Indeed, because they were in the frontline position, nurses and nursing students were psychologically vulnerable, even more so when they felt alone and inadequately protected. Besides, their families were vulnerable too, as they were also exposed to the consequences of the nurses’ frontline engagement. Thus, to preserve their safety and well-being, institutions should also provide them with better organizational support and inclusive leadership, without neglecting their families. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Dental Education during the COVID-19 Pandemic in a German Dental Hospital
Int. J. Environ. Res. Public Health 2021, 18(13), 6905; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136905 - 27 Jun 2021
Viewed by 499
Abstract
Due to the SARS-CoV-2 pandemic, dental treatment performed by undergraduate students at the University of Marburg/Germany was immediately stopped in spring 2020 and stepwise reinstalled under a new hygiene concept until full recovery in winter 2020/21. Patient treatment in the student courses was [...] Read more.
Due to the SARS-CoV-2 pandemic, dental treatment performed by undergraduate students at the University of Marburg/Germany was immediately stopped in spring 2020 and stepwise reinstalled under a new hygiene concept until full recovery in winter 2020/21. Patient treatment in the student courses was evaluated based on three aspects: (1) Testing of patients with a SARS-CoV-2 Rapid Antigen (SCRA) Test applied by student assistants (SA); (2) Improved hygiene regimen, with separated treatment units, cross-ventilation, pre-operative mouth rinse and rubber dam application wherever possible; (3) Recruitment of patients: 735 patients were pre-registered for the two courses; 384 patients were treated and a total of 699 tests with the SCRA test were performed by SAs. While half of the patients treated in the course were healthy, over 40% of the patients that were pre-registered but not treated in the course revealed a disease being relevant to COVID (p < 0.001). 46 patients had concerns to visit the dental hospital due to the increase of COVID incidence levels, 14 persons refused to be tested. The presented concept was suitable to enable patient treatment in the student course during the SARS-CoV-2 pandemic. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
School Nurses’ Experience of Working in School Health Service during the COVID-19 Pandemic in Sweden
Int. J. Environ. Res. Public Health 2021, 18(13), 6713; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136713 - 22 Jun 2021
Viewed by 777
Abstract
The COVID-19 pandemic has had a vast influence on Swedish society. Related recommendations and political decisions have greatly affected schools. This study aimed to describe school nurses’ experience working in Sweden during the pandemic in 2020. The study used a qualitative method with [...] Read more.
The COVID-19 pandemic has had a vast influence on Swedish society. Related recommendations and political decisions have greatly affected schools. This study aimed to describe school nurses’ experience working in Sweden during the pandemic in 2020. The study used a qualitative method with an inductive approach. Interviews with 17 school nurses in five focus groups and one individual interview were conducted. Qualitative content analysis was used. The impact of the pandemic on school nurses can be described through three categories: “Changes in working methods in relation to the students/guardians”, “Impact on cooperation with school staff”, and “The school nurse’s prerequisites for major changes.” Overall, school nurses experienced a transition to a digital way of working. Policies and decisions on global and local levels affected the work situations of school nurses as well as the school nurses’ social, cultural, and professional experience. The highest priority for school nurses is students, and school nurses adapted their working methods to give support to students during the changing circumstances. School nurses are both pragmatic and highly creative. Cooperation with other school professions is critical, as is support and guidance during crisis situations. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
The COVID-19 Pandemic in Spain: Experiences of Midwives on the Healthcare Frontline
Int. J. Environ. Res. Public Health 2021, 18(12), 6516; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126516 - 17 Jun 2021
Viewed by 500
Abstract
Background: Midwives look after women during pregnancy, childbirth and puerperium. In Spain, the first wave of COVID was particularly virulent. There are few studies about the experiences of midwives providing care during the COVID pandemic and very few have been undertaken in the [...] Read more.
Background: Midwives look after women during pregnancy, childbirth and puerperium. In Spain, the first wave of COVID was particularly virulent. There are few studies about the experiences of midwives providing care during the COVID pandemic and very few have been undertaken in the countries of southern Europe such as Spain. This article sets out to take a more in-depth look at the experiences of midwives who were on the frontline of care during the early months of the COVID-19 pandemic as well as to identify new needs and resilience strategies that can help midwives. Methods: A qualitative methodology of phenomenological tradition was used, interviewing 10 midwives from primary care, hospital and independent care. Results: After content analysis, three central categories emerged: (a) cascade of emotions; (b) professional occupation and concern for the women; (c) resisting the day-to-day; resilience and resistance strategies. Conclusions: Despite the difficulties, midwives are concerned about the loss of rights and autonomy and about the increased vulnerability of women. Midwives have become aware of the power they have in their actions both in health management and administration, as well as in the care of women, creating strategies to provide dignified care to their users. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study
Int. J. Environ. Res. Public Health 2021, 18(11), 6102; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116102 - 05 Jun 2021
Viewed by 822
Abstract
The COVID-19 pandemic had a massive impact on the Italian healthcare systems, which became overwhelmed, leading to an increased risk of psychological pressure on ICU workers. The present study aimed to investigate the prevalence of distress (anxiety, depression and insomnia symptoms), burnout syndrome [...] Read more.
The COVID-19 pandemic had a massive impact on the Italian healthcare systems, which became overwhelmed, leading to an increased risk of psychological pressure on ICU workers. The present study aimed to investigate the prevalence of distress (anxiety, depression and insomnia symptoms), burnout syndrome and resilience in healthcare workers during the COVID-19 pandemic and to detect potential factors associated with their psychological response. This cross-sectional, survey-based study enrolled 136 healthcare workers assisting COVID-19 patients in the new COVID-19 ward (Intensive Care Unit), at Milano Fiera, Lombardy. Participants completed an online survey that comprised different validated and standardized questionnaires: Maslach Burnout Inventory (MBI), Resilience Scale for adults (RSA), Hospital Anxiety and Depression scale (HADS) and Insomnia Severity Index (ISI). Socio-demographic and work characteristics were also collected. Out of 136 ICU specialists, there were 84 nurses (62%) and 52 physicians (38%). Over half (60%) met the criteria for burnout, with nearly the same percentages among nurses and physicians. Nurses reported significantly higher scores of anxiety and insomnia levels. Forty-five percent of participants reported symptoms of depression (of whom 13.9% in the clinical range) and most of the staff showed moderate to high levels (82.4%) of resilience. The COVID-19 pandemic can have a significant impact on ICU staff. Effective interventions are needed to maintain healthcare professionals’ mental health and relieve burnout. Follow-up and tailored procedures should be provided to alleviate the psychological burden in the frontline staff at highest risk. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Provision of Psychotherapy One Year after the Beginning of the COVID-19 Pandemic in Austria
Int. J. Environ. Res. Public Health 2021, 18(11), 5843; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115843 - 29 May 2021
Viewed by 703
Abstract
A previous study revealed that the majority of Austrian psychotherapists switched to remote settings during the first months of the COVID-19 pandemic. The current study investigated whether this change in treatment format was maintained after one year of the COVID-19 pandemic. From 16 [...] Read more.
A previous study revealed that the majority of Austrian psychotherapists switched to remote settings during the first months of the COVID-19 pandemic. The current study investigated whether this change in treatment format was maintained after one year of the COVID-19 pandemic. From 16 February until 2 April 2021, a total of 238 Austrian psychotherapists completed an online survey. They were asked about the number of patients currently treated in-person, via telephone and via the internet. Psychotherapists rated three different aspects of psychotherapy (ability to actively listen to patients, ability to understand what is going on in the patients and ability to support patients emotionally) for three different formats (in-person with facemasks, telephone and internet) separately. The results show that, after one year of the pandemic, the majority (78.4%) of patients were treated in-person (compared to 21.7% during the first months of the COVID-19 pandemic; p < 0.001). This change in the treatment format was accompanied by a strong increase in the total number of patients treated by 77.2% on average (p < 0.001). Psychotherapists reported no differences between in-person psychotherapy with facemasks and psychotherapy via the internet with regard to the three investigated aspects of psychotherapy, while the surveyed aspects were rated less favorably for psychotherapy conducted via telephonic communication (p < 0.05). Further studies are needed to investigate the reasons why most psychotherapists switched back to the in-person format with the continuation of the COVID-19 pandemic. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
Article
COVID-19 among Healthcare Workers in the University Clinical Hospital in Wroclaw, Poland
Int. J. Environ. Res. Public Health 2021, 18(11), 5600; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115600 - 24 May 2021
Viewed by 592
Abstract
Efforts to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among hospital healthcare staff are crucial for controlling the Coronavirus Disease 19 (COVID-19) pandemics. The study aimed to explore the prevalence and clinical presentations of COVID-19 in healthcare workers (HCWs) at the [...] Read more.
Efforts to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among hospital healthcare staff are crucial for controlling the Coronavirus Disease 19 (COVID-19) pandemics. The study aimed to explore the prevalence and clinical presentations of COVID-19 in healthcare workers (HCWs) at the University Clinical Hospital (UCH) in Wroclaw with 1677 beds. The retrospective study was performed in 2020 using a self-derived structured questionnaire in a sample of HCWs who were diagnosed with SARS-CoV-2 infection confirmed using a PCR double gene test and consented to be enrolled into the study. The significance level for all statistical tests was set to 0.05. The study showed that of the 4998 hospital workers, among 356 cases reported as COVID-19 infected, 70 consented to take part in the survey: nurses (48.5%), doctors (17.1%), HCWs with patient contact (10.0%), other HCWs without patient contact (7.1%), and cleaning personnel (5.7%). HCWs reported concurrent diseases such as hypertension (17.1%), bronchial asthma (5.7%), and diabetes (5.7%). Failure to keep 2 m distancing during contact (65.5%) and close contact with the infected person 14 days before the onset of symptoms or collection of biological material (58.6%) were identified as the increased risks of infection. A large part of infections in hospital healthcare staff were symptomatic (42.9%). The first symptoms of COVID-19 were general weakness (42.9%), poor mental condition (41.4%), and muscle pain (32.9%); whereas in the later stages of the illness, general weakness (38.6%), coughing (34.3%), lack of appetite (31.4%), and loss of taste (31.4%) were observed. In about 30% of the infected HCWs, there was no COVID-19 symptoms whatsoever. The vast majority of the patients were treated at home (85.7%). In conclusion, the majority of the SARS-CoV-2 infections in the hospital HCWs were asymptomatic or mildly symptomatic. Therefore, successful limitation of COVID-19 infection spread at hospitals requires a close attention to future cross-infections. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
The Impact of Pandemic Management on the Quality of Life of Slovak Dentists
Int. J. Environ. Res. Public Health 2021, 18(10), 5484; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105484 - 20 May 2021
Cited by 1 | Viewed by 731
Abstract
Pandemic management increases the burden on healthcare workers to provide care and also affects their personal lives, with dentists being at particular risk. Therefore, we aim to describe the quality of life (QoL) and limitations experienced due to pandemic management-related measures (PanMan), as [...] Read more.
Pandemic management increases the burden on healthcare workers to provide care and also affects their personal lives, with dentists being at particular risk. Therefore, we aim to describe the quality of life (QoL) and limitations experienced due to pandemic management-related measures (PanMan), as well as to assess the association of PanMan with QoL during the first lockdown after the coronavirus outbreak. We obtained data from 500 dentists (33.2% males, M/SD = 43.8) registered with the Slovak Chamber of Dentists using an online questionnaire. We categorized PanMan as the availability of personal protective equipment (PPE) and the ability to implement anti-pandemic measures, information overload, pandemic-related limitations and QoL in terms of their impact on family life and activities, housekeeping, relationships with relatives, financial situation and mental well-being. PanMan mainly affected financial situation, mental well-being and housekeeping. Factors contributing most towards the worsening of QoL were information overload (odds ratio/95% confidence interval, OR/CI: 5.79/2.64–12.71) and several pandemic-related limitations. These consisted of (OR/CI): a lack of PPE (5.17/2.48–10.77), infection risks in the work environment (3.06/1.57–5.95), obligatory safety measures (3.02/1.47–6.21), lack of staff (2.85/1.30–6.25) and client concerns (3.56/1.70–7.49). Pandemic management has led to a considerable worsening of dentists’ QoL. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
Article
The “Healthcare Workers’ Wellbeing (Benessere Operatori)” Project: A Picture of the Mental Health Conditions of Italian Healthcare Workers during the First Wave of the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(10), 5267; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105267 - 15 May 2021
Viewed by 692
Abstract
During the last year, the COVID-19 outbreak put all the healthcare workers around the world at risk of physical and psychological sequelae. The general purpose of the present study was to assess the mental health of Italian healthcare workers during the COVID-19 outbreak [...] Read more.
During the last year, the COVID-19 outbreak put all the healthcare workers around the world at risk of physical and psychological sequelae. The general purpose of the present study was to assess the mental health of Italian healthcare workers during the COVID-19 outbreak and to identify high-risk groups. Here, we present results from the baseline assessment of the “Healthcare workers’ wellbeing (Benessere Operatori)” project on a sample of 1055 healthcare workers. Participants completed the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, and the Maslach Burnout Inventory. Healthcare workers who worked in COVID wards reported higher levels of anxiety, insomnia, post-traumatic stress, anger, and burnout, compared to those reported by the healthcare workers who worked in non-COVID wards. Moreover, nurses, both in COVID and non-COVID wards, were at higher risk of experiencing psychological distress compared to other groups of healthcare workers. These findings highlight the importance of implementing targeted psychological interventions for healthcare workers operating in COVID wards and nurses, who seem to be the most vulnerable categories. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
Article
Socioeconomic and Behavioral Correlates of COVID-19 Infections among Hospital Workers in the Greater Jakarta Area, Indonesia: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(10), 5048; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105048 - 11 May 2021
Viewed by 828
Abstract
(1) Background: because of close contacts with COVID-19 patients, hospital workers are among the highest risk groups for infection. This study examined the socioeconomic and behavioral correlates of COVID-19 infection among hospital workers in Indonesia, the country hardest-hit by the disease in the [...] Read more.
(1) Background: because of close contacts with COVID-19 patients, hospital workers are among the highest risk groups for infection. This study examined the socioeconomic and behavioral correlates of COVID-19 infection among hospital workers in Indonesia, the country hardest-hit by the disease in the Southeast Asia region. (2) Methods: we conducted a cross-sectional study, which collected data from 1397 hospital staff from eight hospitals in the Greater Jakarta area during April–July 2020. The data was collected using an online self-administered questionnaire and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) tests. We employed descriptive statistics and adjusted and unadjusted logistic regressions to analyze the data of hospital workers as well as the subgroups of healthcare and non-healthcare workers. (3) Results: from a total of 1397 hospital staff in the study, 22 (1.6%) were infected. In terms of correlates, being a healthcare worker (adjusted odds ratio (AOR) = 8.31, 95% CI 1.27–54.54) and having a household size of more than five (AOR = 4.09, 1.02–16.43) were significantly associated with a higher risk of infection. On the other hand, those with middle- and upper-expenditure levels were shown to have a lower risk of infection (AOR = 0.06, 0.01–0.66). Behavioral factors associated with COVID-19 infection among healthcare and non-healthcare workers included knowledge of standard personal protective equipment (PPE) (AOR = 0.08, 0.01–0.54) and application of the six-step handwashing technique (AOR = 0.32, 0.12–0.83). (4) Conclusion: among hospital staff, correlates of COVID-19 infection included being a healthcare worker, household size, expenditure level, knowledge and use of PPE, and application of appropriate hand washing techniques. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Dealing with COVID-19 Epidemic in Italy: Responses from Regional Organizational Models during the First Phase of the Epidemic
Int. J. Environ. Res. Public Health 2021, 18(9), 5008; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18095008 - 09 May 2021
Viewed by 718
Abstract
As the COVID-19 outbreak traveled through various Italian regions, all national and local administrations issued measures to counter the spread of the contagion and organize healthcare. The Italian healthcare system is, indeed, a decentralized system with 21 regional health systems (RHSs), with different [...] Read more.
As the COVID-19 outbreak traveled through various Italian regions, all national and local administrations issued measures to counter the spread of the contagion and organize healthcare. The Italian healthcare system is, indeed, a decentralized system with 21 regional health systems (RHSs), with different models of healthcare service delivery and organization. This study investigates whether a different organization of RHSs would have led to different management of the COVID-19 epidemic, and evaluates the effect of different approaches in epidemic management on the COVID-19 epidemiological trend. A set of indicators is identified by conducting an online synchronous Focus Group, involving an experts panel. A Pearson’s correlation test was performed on the values assumed by the historical series of indicators investigate correlations among the trends represented by the indicators or between them and external factors. The comparison between the experiences of the different Italian regions, regarding the management of the epidemic, has helped to confirm and emphasize the importance of a community-based approach in health care—integrated with the hospital’s functions for the care of complex conditions and the need for specialized assistance. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Communication
The Impact of the COVID-19 Pandemic on the Cognition of People with Dementia
Int. J. Environ. Res. Public Health 2021, 18(8), 4285; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084285 - 18 Apr 2021
Viewed by 975
Abstract
(1) Background: To limit the COVID-19 outbreak, the Italian government implemented social restrictions that may have had psychological and cognitive repercussions on people with dementia. We aimed to analyze cognitive decline during the pandemic year in people evaluated in a memory clinic in [...] Read more.
(1) Background: To limit the COVID-19 outbreak, the Italian government implemented social restrictions that may have had psychological and cognitive repercussions on people with dementia. We aimed to analyze cognitive decline during the pandemic year in people evaluated in a memory clinic in northern Italy, the epicenter of COVID-19 spread. (2) Methods: A single-center retrospective study was carried out, including individuals with annual follow-up evaluated in three different years (2020-GROUP, 2019-GROUP, 2018-GROUP). We performed an intergroup comparison of cognitive decline over a one-year follow-up, and an intragroup comparison in the 2020-GROUP to analyze the five-year cognitive decline trajectory, as measured by the MMSE. (3) Results: The 2020-GROUP showed a significant loss of MMSE points per year in the considered follow-up period compared with the 2019-GROUP and 2018-GROUP (p = 0.021). Demographics, clinical features, and the other analyzed variables, including rate of diagnosis, therapy, and comorbidities, did not significantly differ between groups. The five-year cognitive decline trajectory confirmed a significant worsening of cognitive decline between 2019 and 2020 (p < 0.001), while the decrease in MMSE scores was not statistically significant between previous time points. (4) Conclusions: COVID-19 pandemic measures have induced a significant worsening of cognitive decline in people with dementia, needing more careful assistance to minimize the adverse effects of social isolation in case of future lockdowns. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Perspectives from Dentists, Dental Assistants, Students, and Patients on Dental Care Adapted to the COVID-19 Pandemic: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2021, 18(8), 3940; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083940 - 09 Apr 2021
Cited by 1 | Viewed by 900
Abstract
Dental care has been affected by SARS-CoV-2 (COVID-19) worldwide. In contrast to other dental clinics, the Justus-Liebig-University Giessen (Germany) decided not to limit dental treatment to emergencies alone, but to continue dental care for all patients, with increased safety measures. As such, health [...] Read more.
Dental care has been affected by SARS-CoV-2 (COVID-19) worldwide. In contrast to other dental clinics, the Justus-Liebig-University Giessen (Germany) decided not to limit dental treatment to emergencies alone, but to continue dental care for all patients, with increased safety measures. As such, health care professionals may be exposed to additional physical and mental stress. The aim of this study was to assess the perspectives of all persons involved in dental care (dentists, dental assistants, students, and patients) regarding the aspects of safety measures, anxiety about self-infection and infecting others, and other prospects in the period March to December 2020 using a questionnaire. Data collection was performed between 14 December 2020 and 23 January 2021. A total of 35 dentists (response rate of 79.5%), 23 dental assistants (65.7%), 84 students (80%), and 51 patients (21.8%) completed the survey. The patients did not notice any changes in the care received. Dentists and dental assistants reported a higher workload due to additional safety measures. The majority of dentists, students, and patients agreed that normal patient care was maintained. One-third of dental assistants would have preferred emergency treatment alone and expressed significantly higher anxiety about COVID-19 infection than all other groups (p < 0.05). In conclusion, all groups showed a predominantly positive perspective on dental care, and anxiety about self-infection and infecting others was especially low. However, additional measures are time-consuming and compound daily patient care. This concept, based on well-established infection control, might be a viable proposal for current and future pandemics. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
SARS-CoV-2 Seroprevalence among Health Care Workers—A Voluntary Screening Study in a Regional Medical Center in Southern Germany
Int. J. Environ. Res. Public Health 2021, 18(8), 3910; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083910 - 08 Apr 2021
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Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with a potentially severe clinical manifestation, coronavirus disease 2019 (COVID-19), and currently poses a worldwide challenge. Health care workers (HCWs) are at the forefront of any health care system and thus especially at risk for [...] Read more.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with a potentially severe clinical manifestation, coronavirus disease 2019 (COVID-19), and currently poses a worldwide challenge. Health care workers (HCWs) are at the forefront of any health care system and thus especially at risk for SARS-CoV-2 infection due to their potentially frequent and close contact with patients suffering from COVID-19. Serum samples from 198 HCWs with direct patient contact of a regional medical center and several outpatient facilities were collected during the early phase of the pandemic (April 2020) and tested for SARS-CoV-2-specific antibodies. Commercially available IgA- and IgG-specific ELISAs were used as screening technique, followed by an in-house neutralization assay for confirmation. Neutralizing SARS-CoV-2-specific antibodies were detected in seven of 198 (3.5%) tested HCWs. There was no significant difference in seroprevalence between the regional medical center (3.4%) and the outpatient institution (5%). The overall seroprevalence of neutralizing SARS-CoV-2-specific antibodies in HCWs in both a large regional medical center and a small outpatient institution was low (3.5%) at the beginning of April 2020. The findings may indicate that the timely implemented preventive measures (strict hygiene protocols, personal protective equipment) were effective to protect from transmission of an airborne virus when only limited information on the pathogen was available. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Job Demands, Resources and Strains of Outpatient Caregivers during the COVID-19 Pandemic in Germany: A Qualitative Study
Int. J. Environ. Res. Public Health 2021, 18(7), 3684; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073684 - 01 Apr 2021
Cited by 2 | Viewed by 857
Abstract
The COVID-19 pandemic has affected health professionals in a special way, as they are responsible for the care of vulnerable groups. Little is known about how outpatient caregivers perceive their working conditions during the pandemic in Germany and about the difficulties they face. [...] Read more.
The COVID-19 pandemic has affected health professionals in a special way, as they are responsible for the care of vulnerable groups. Little is known about how outpatient caregivers perceive their working conditions during the pandemic in Germany and about the difficulties they face. The aims of this study were (1) to examine specific job demands of outpatient caregivers in regard to the COVID-19 pandemic, (2) to illuminate their job resources they can rely on and (3) to identify potential strain reactions they experience. Fifteen semi-structured telephone interviews were conducted with outpatient caregivers working in Northern Germany in the period May–June 2020. Interviews were analyzed by using qualitative content analysis. Outpatient caregivers experienced daily mask obligation, lack of personal protection equipment (PPE) and stricter hygiene regulations as demanding during the pandemic. They also described a higher workload and emotional demands such as fear of infection or infecting others. They perceived team spirit and communication as important work-related resources. Depressive symptoms and feelings of stress were described as strain reactions. Outpatient care services need to be better prepared for sudden pandemic situations and provide their employees with sufficient PPE and education to reduce pandemic-related job demands leading to negative strain reactions. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Blood Donations and Transfusions during the COVID-19 Pandemic in Spain: Impact According to Autonomous Communities and Hospitals
Int. J. Environ. Res. Public Health 2021, 18(7), 3480; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073480 - 27 Mar 2021
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Abstract
Worldwide, the COVID-19 pandemic has caused a decline in blood donations, between 30% and 70% in some of the most affected countries. In Spain, during the initial eight weeks after the State of Emergency was decreed on 14 March 2020, in the weekly [...] Read more.
Worldwide, the COVID-19 pandemic has caused a decline in blood donations, between 30% and 70% in some of the most affected countries. In Spain, during the initial eight weeks after the State of Emergency was decreed on 14 March 2020, in the weekly reports of the Health Ministry, an average decrease of 20% was observed between 11 and week 25 compared with the 2018 donation. We aimed to investigate the impact of the COVID-19 pandemic on blood donations and blood distribution in four autonomous communities, and to explore the evolution of the consumption of blood components (BCs) in ten hospitals of six autonomous communities. We performed a prospective study of grouped cohorts on the donation and distribution of blood in four regional transfusion centers in four autonomous communities in Spain, and a retrospective study of the consumption of blood components in ten hospitals in six autonomous communities. Regarding donations, there was no significant decrease in donations, with differences between autonomous communities, which started between 1 and 15 March 2020 (−11%). The increase in donations in phase II (from 26 May 2020) stands out. Regarding consumption, there was a significant reduction in the consumption of packed red blood cells (RBCs) (24.5%), plasma (45.3%), and platelets (25.3%) in the central period (16 March–10 May). The reduction in the consumption of RBCs was significant in the period from 1–15 March. Conclusions: The COVID-19 pandemic has affected the donation and consumption of BCs. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Facing the Coronavirus Pandemic: An Integrated Continuing Education Program in Taiwan
Int. J. Environ. Res. Public Health 2021, 18(5), 2417; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052417 - 02 Mar 2021
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Abstract
This study aimed to identify knowledge gaps regarding coronavirus disease 2019 (COVID-19) and develop an integrated educational program for healthcare workers. First, we designed and validated ten multiple-choice questions to identify knowledge gaps among healthcare workers. Within one month of the online test [...] Read more.
This study aimed to identify knowledge gaps regarding coronavirus disease 2019 (COVID-19) and develop an integrated educational program for healthcare workers. First, we designed and validated ten multiple-choice questions to identify knowledge gaps among healthcare workers. Within one month of the online test and curriculum offering, 5533 staff had completed the test, with a completion rate of 84.97%. There were 2618 healthcare workers who answered the pre-test 100% correctly. Those who did not answer the pre-test 100% correctly took multiple tests after learning through the online teaching materials. Eventually, 5214 staff passed the test (pre-test or post-test with 100% correct answers). The result showed that all staff had a low correct rate for personal protective equipment (PPE) use recommendations. The Infection Control Center conducted training sessions for hospital staff on how to wear protective clothing. Information on the selection and use of PPE for infection prevention was provided, and participants were allowed time to practice and familiarize themselves with the correct way to wear PPE. Moreover, the Department of Education and Research continued updating the online learning materials based on the most important updated peer-reviewed published articles. The attending teaching physicians helped to search, translate, and take notes on articles in the local language (traditional Chinese) for other colleagues to read easily. We expect to increase learning opportunities for healthcare workers, even during uncertain times such as the current coronavirus pandemic through (1) the hospital-wide course announcements, (2) the continuous placement of test questions and learning files on the digital learning platform, (3) the placement of journal highlights in cloud folders, and (4) the use of the digital learning platform on mobile phones accessible outside the hospital. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Community Pharmacy Practice in Italy during the COVID-19 (SARS-CoV-2) Pandemic: Regulatory Changes and a Cross-Sectional Analysis of Seroprevalence
Int. J. Environ. Res. Public Health 2021, 18(5), 2302; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052302 - 26 Feb 2021
Cited by 1 | Viewed by 875
Abstract
Pharmacists in the community and the essential requirement to safeguard their own health have become fundamental since the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aims of this paper were (I) to analyze the directives provided to pharmacists in [...] Read more.
Pharmacists in the community and the essential requirement to safeguard their own health have become fundamental since the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aims of this paper were (I) to analyze the directives provided to pharmacists in 2020 regarding preventative safety measures to be adopted; (II) to determine the number of pharmacists who came into contact with SARS-CoV-2 in North-West Italy and relate this to the adopted preventative measures. The first aim was pursued by conducting a bibliographic research, consulting the principal regulatory sources. The second one was achieved with an observational study by administering a questionnaire and performing a serological test. The various protection measures imposed by national and regional legislation were analyzed. Two hundred and eighty-six pharmacists (about 8% of the invited ones) responded to the survey. Ten pharmacists reported a positive result to the serological test. Of the subjects who presented a positive result, three declared that they had not used a hand sanitizer, while two stated that they had not scheduled the cleaning and decontamination of surfaces. Two interviewees had not set up a system of quota restrictions on admissions. In four cases, a certified cleaning company had decontaminated the premises. The results of our study show that during the coronavirus disease 2019 (COVID-19) pandemic, the most pressing challenge for community pharmacists has been the protection of staff and clients inside the pharmacy; the challenge to be faced in the near future will probably be the management of new responsibilities. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
Telephone Emergency Service 142 (TelefonSeelsorge) during the COVID-19 Pandemic: Cross-Sectional Survey among Counselors in Austria
Int. J. Environ. Res. Public Health 2021, 18(5), 2228; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052228 - 24 Feb 2021
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Abstract
Telephone emergency services play an important role in providing low-threshold, anonymous crisis intervention free of cost. The current study aims to examine the mental well-being and perceived stress level of counselors as well as the main topics of helpline callers during the COVID-19 [...] Read more.
Telephone emergency services play an important role in providing low-threshold, anonymous crisis intervention free of cost. The current study aims to examine the mental well-being and perceived stress level of counselors as well as the main topics of helpline callers during the COVID-19 pandemic in Austria. In the current study, 374 counselors were recruited within the Austrian nationwide organization TelefonSeelsorge during the second wave of COVID-19 infection in Austria. The mental well-being (WHO-5) and perceived stress-level (PSS-10) were assessed and counselors were asked about the frequency of different topics thematized by callers and changes compared to pre-pandemic times. Compared to a reference group of the Austrian general population, counselors experienced less stress (13.22 vs. 16.42) and higher mental well-being (66.26 vs. 57.36; p < 0.001). The most frequent topics during the second wave of the COVID-19 pandemic in Austria were loneliness and mental health. More calls were registered in 2020 compared to 2019 and especially the topics loneliness, mental health, professional activities and relationships were reported to be thematized more often during the COVID-19 pandemic compared to the time before (p < 0.001). The results contribute to an understanding of the impact of the COVID-19 pandemic on telephone crisis intervention. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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Article
“We All Really Need to just Take a Breath”: Composite Narratives of Hospital Doctors’ Well-Being during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(4), 2051; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18042051 - 19 Feb 2021
Cited by 2 | Viewed by 1946
Abstract
The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the spread of the virus and prioritize healthcare for those who contracted it. This study interviewed 48 hospital doctors who worked in Ireland during the first wave of the pandemic and investigated their conceptualizations of their own well-being during that time (March–May 2020). Doctors were interviewed via Zoom™ or telephone. Interview transcripts were analyzed using structured thematic analysis. Five composite narratives are presented which have been crafted to illustrate themes and experiences emerging from the data. This study found that despite the risks of contracting COVID-19, many doctors saw some improvements to their physical well-being in the first wave of the pandemic. However, most also experienced a decline in their mental well-being due to anxiety, emotional exhaustion, guilt, isolation and poor support. These findings shed light on doctor well-being during COVID-19, and the ways in which they have been affected by the pandemic, both professionally and personally. The paper concludes by highlighting how doctors’ work life and well-being can be better supported during and after the COVID-19 pandemic. Full article
(This article belongs to the Special Issue COVID-19 Pandemics: Impact on Health Care and Health Care Professions)
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