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      Bienestar psicológico en enfermeras que realizan terapia de reemplazo renal en tiempos de COVID-19 Translated title: Psychological well-being in nurses performing renal replacement therapy in times of COVID-19 pandemic

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          Abstract

          RESUMEN Introducción: La pandemia por COVID-19 ha generado deterioro de la salud mental en los profesionales del sector salud, siendo desconocida su situación en las enfermeras al cuidado de pacientes con enfermedad renal crónica. Objetivo: Identificar el bienestar psicológico y sus diferencias de acuerdo a las variables demográficas y profesionales en enfermeras que realizan hemodiálisis en tiempos de COVID-19. Material y Método: Estudio cuantitativo, descriptivo transversal, realizado en 52 enfermeras que realizan terapia de reemplazo renal en unidades de cuidado intensivo y de terapia renal en tiempos de COVID-19. Fueron obtenidas variables de tipo sociodemográfico, académico, laboral y se empleó la escala PGWBI para establecer los niveles de bienestar psicológico. Se utilizó el test de Mann-Whitney y Kruskall-Wallis realizando el post test de Dunn para comparar diferencias entre las variables estudiadas. Resultados: La edad promedio fue de 36,56±6,95 años. Los niveles de bienestar psicológico fueron positivos en todas las categorías de la escala, con excepción de la ansiedad y la depresión. De igual forma, se encontró que las variables género, estado civil, estabilidad, antigüedad laboral, remuneración salarial y formación académica, muestran comportamiento diferenciado en las categorías que evalúa el instrumento. Conclusiones: Se identificaron altos niveles de bienestar psicológico en enfermeras que prestan cuidados en pacientes en terapia de reemplazo renal en tiempos de pandemia por COVID-19, donde factores como el estado civil, formación post gradual y tener estabilidad laboral con mejores ingresos salariales, influencian positivamente las categorías que contribuyeron a los resultados de bienestar psicológico de las enfermeras evaluadas.

          Translated abstract

          ABSTRACT Introduction: The COVID-19 pandemic has led to deterioration of mental health in health care professionals, and the situation of nurses caring for patients with chronic kidney disease is currently unknown. Objective: To identify psychological well-being and differences according to demographic and professional variables in nurses performing haemodialysis in times of the COVID-19 pandemic. Method: Quantitative, descriptive, cross-sectional study carried out on 52 nurses performing renal replacement therapy in intensive care and renal therapy units in COVID-19 times, who gave their consent. Sociodemographic, academic and work-related variables were obtained and the PGWBI scale was used to establish levels of psychological well-being. The Mann-Whitney and Kruskall-Wallis tests were used, and Dunn's post-test was performed to compare differences between the variables studied. Results: The mean age of the nurses studied was 36.56±6.95 years. The levels of psychological well-being were positive in all the categories of the scale, with the exception of anxiety and depression. Similarly, it was found that the variables gender, marital status, job stability, length of service, salary remuneration and academic training showed differential behaviour in the categories assessed by the instrument. Conclusions: High levels of psychological well-being were identified in nurses providing care in renal replacement therapy patients in times of COVID-19 pandemic, where factors such as marital status, post-graduate training and having job stability with better salary income positively influence the categories that contributed to the psychological well-being scores of the nurses assessed.

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          Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore

          Background: In response to the coronavirus 2019 (COVID-19) pandemic, Singapore raised its Disease Outbreak Response System Condition alert to “orange,” the second highest level. Between 19 February and 13 March 2020, confirmed cases rose from 84 to 200 (34.2 per 1 000 000 population), with an increase in patients in critical condition from 4 to 11 (5.5%) and no reported deaths in Singapore (1). Understanding the psychological impact of the COVID-19 outbreak among health care workers is crucial in guiding policies and interventions to maintain their psychological well-being. Objective: We examined the psychological distress, depression, anxiety, and stress experienced by health care workers in Singapore in the midst of the outbreak, and compared these between medically and non–medically trained hospital personnel. Methods and Findings: From 19 February to 13 March 2020, health care workers from 2 major tertiary institutions in Singapore who were caring for patients with COVID-19 were invited to participate with a self-administered questionnaire. In addition to information on demographic characteristics and medical history (Table 1), the questionnaire included the validated Depression, Anxiety, and Stress Scales (DASS-21) and the Impact of Events Scale–Revised (IES-R) instrument (2, 3). Health care workers included “medical” (physicians, nurses) and “nonmedical” personnel (allied health professionals, pharmacists, technicians, administrators, clerical staff, and maintenance workers). The primary outcome was the prevalence of depression, stress, anxiety, and posttraumatic stress disorder (PTSD) among all health care workers (Table 2). Secondary outcomes were comparison of the prevalence of depression, anxiety, stress, and PTSD, and mean DASS-21 and IES-R scores between medical and nonmedical health care workers. The Pearson χ2 test and Student t test were used to compare categorical and continuous outcomes, respectively, between the 2 groups. Multivariable regression was used to adjust for the a priori defined confounders of age, sex, ethnicity, marital status, presence of comorbid conditions, and survey completion date. Table 1. Participant Characteristics at Baseline Table 2. Prevalence of Depression, Anxiety, Stress, and PTSD and Mean DASS-21 and IES-R Scores in Medical and Nonmedical Health Care Personnel (N = 470) Of 500 invited health care workers, 470 (94%) participated in the study; baseline characteristics are shown in Table 1. Sixty-eight (14.5%) participants screened positive for anxiety, 42 (8.9%) for depression, 31 (6.6%) for stress, and 36 (7.7%) for clinical concern of PTSD. The prevalence of anxiety was higher among nonmedical health care workers than medical personnel (20.7% versus 10.8%; adjusted prevalence ratio, 1.85 [95% CI, 1.15 to 2.99]; P = 0.011), after adjustment for age, sex, ethnicity, marital status, survey completion date, and presence of comorbid conditions. Similarly, higher mean DASS-21 anxiety and stress subscale scores and higher IES-R total and subscale scores were observed in nonmedical health care workers (Table 2). Discussion: Overall mean DASS-21 and IES-R scores among health care workers were lower than those in the published literature from previous disease outbreaks, such as the severe acute respiratory syndrome (SARS). A previous study in Singapore found higher IES scores among physicians and nurses during the SARS outbreak, and an almost 3 times higher prevalence of PTSD, than those in our study (4). This could be attributed to increased mental preparedness and stringent infection control measures after Singapore's SARS experience. Of note, nonmedical health care workers had higher prevalence of anxiety even after adjustment for possible confounders. Our findings are consistent with those of a recent COVID-19 study demonstrating that frontline nurses had significantly lower vicarious traumatization scores than non–frontline nurses and the general public (5). Reasons for this may include reduced accessibility to formal psychological support, less first-hand medical information on the outbreak, less intensive training on personal protective equipment and infection control measures. As the pandemic continues, important clinical and policy strategies are needed to support health care workers. Our study identified a vulnerable group susceptible to psychological distress. Educational interventions should target nonmedical health care workers to ensure understanding and use of infectious control measures. Psychological support could include counseling services and development of support systems among colleagues. Our study has limitations. First, data obtained from self-reported questionnaires were not verified with medical records. Second, the study did not assess socioeconomic status, which may be helpful in evaluating associations of outcomes and tailoring specific interventions. Finally, the study was performed early in the outbreak and only in Singapore, which may limit the generalizability of the findings. Follow-up studies could help assess for progression or even a potential rebound effect of psychological manifestations once the imminent threat of COVID-19 subsides. In conclusion, our study highlights that nonmedical health care personnel are at highest risk for psychological distress during the COVID-19 outbreak. Early psychological interventions targeting this vulnerable group may be beneficial.
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              Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China

              Background Healthcare workers fighting against the coronavirus disease 2019 (COVID-19) pandemic are under tremendous pressure, which puts them at an increased risk of developing psychological problems. Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers (ie, physicians, medical residents, nurses, technicians and public health professionals) during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis. Methods A cross-sectional, web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic. Psychological problems were assessed using the Generalized Anxiety Disorder Scale, Patient Health Questionnaire and Insomnia Severity Index. Logistic regression analyses were used to explore the factors that were associated with psychological problems. Results The prevalence of symptoms of anxiety, depression, insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%, 44.37%, 28.75% and 56.59%, respectively. The prevalence of the overall psychological problems in physicians, medical residents, nurses, technicians and public health professionals was 60.35%, 50.82%, 62.02%, 57.54% and 62.40%, respectively. Compared with healthcare workers who did not participate in front-line work, front-line healthcare workers had a higher risk of anxiety, insomnia and overall psychological problems. In addition, attention to negative or neutral information about the pandemic, receiving negative feedback from families and friends who joined front-line work, and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems. Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic. Receiving negative information and participating in front-line work appear to be important risk factors for psychological problems. The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.
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                Author and article information

                Journal
                enefro
                Enfermería Nefrológica
                Enferm Nefrol
                Sociedad Española de Enfermería Nefrológica (Madrid, Madrid, Spain )
                2254-2884
                2255-3517
                March 2022
                : 25
                : 1
                : 46-52
                Affiliations
                [1] Cúcuta-Norte de Santander Norte del Santander orgnameUniversidad Francisco de Paula Santander orgdiv1Facultad Ciencias de la Salud Colombia
                Article
                S2254-28842022000100046 S2254-2884(22)02500100046
                10.37551/s2254-28842022005
                1903bbb9-b627-46a1-9cd0-de233d1042be

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 October 2021
                : 28 December 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 7
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                SciELO Spain

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                COVID-19,renal replacement therapy,nurses,psychological distress,mental health,terapia de reemplazo renal,enfermeras y enfermeros,distrés psicológico,salud mental

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