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      Covid-19 pandemic? Mental health implications among nurses and Proposed interventions

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          Abstract

          Background

          With its abrupt and huge health and socio-economic consequences, the coronavirus disease (COVID-19) pandemic has led to a uniquely demanding, intensely stressful, and even traumatic period. Healthcare workers (HCW), especially nurses, were exposed to mental health challenges during those challenging times.

          Objectives

          Review the current literature on mental health problems among nurses caring for COVID-19 patients.

          Methods

          This is a narrative review and critical evaluation of relevant publications.

          Results

          Nurses experienced higher levels of stress, burnout, anxiety, depression, frustration, stigma, and depersonalization compared to other HCW. Factors that increased this symptomatology included concerns about infection or infection of family members, inadequate staff protective equipment, extended working hours, insufficient information, a reduced sense of security, and post-traumatic stress disorder. The factors that improved the psychopathology included a general positive attitude, job satisfaction, adequate information and education, harmonious group relationships, post-traumatic development, emotional intelligence, psychological counseling, mindfulness-based stress reduction, stable leadership, guidance, and moral and practical administrative support.

          Conclusions

          Recent studies clearly show that nurses, especially women, are the most vulnerable subgroup among HCW and are particularly prone to mental health impacts during the COVID-19 pandemic. The documented mental health vulnerability of frontline nursing staff during the COVID-19 pandemic requires preventive nursing management actions to increase resilience and to develop relevant defense mechanisms.

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          Most cited references87

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          Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

          Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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            Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

            Highlights • At least one in five healthcare professionals report symptoms of depression and anxiety. • Almost four in 10 healthcare workers experience sleeping difficulties and/or insomnia. • Rates of anxiety and depression were higher for female healthcare workers and nursing staff. • Milder mood symptoms are common and screening should aim to identify mild and sub-threshold syndromes.
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              Stress and disorders of the stress system.

              All organisms must maintain a complex dynamic equilibrium, or homeostasis, which is constantly challenged by internal or external adverse forces termed stressors. Stress occurs when homeostasis is threatened or perceived to be so; homeostasis is re-established by various physiological and behavioral adaptive responses. Neuroendocrine hormones have major roles in the regulation of both basal homeostasis and responses to threats, and are involved in the pathogenesis of diseases characterized by dyshomeostasis or cacostasis. The stress response is mediated by the stress system, partly located in the central nervous system and partly in peripheral organs. The central, greatly interconnected effectors of this system include the hypothalamic hormones arginine vasopressin, corticotropin-releasing hormone and pro-opiomelanocortin-derived peptides, and the locus ceruleus and autonomic norepinephrine centers in the brainstem. Targets of these effectors include the executive and/or cognitive, reward and fear systems, the wake-sleep centers of the brain, the growth, reproductive and thyroid hormone axes, and the gastrointestinal, cardiorespiratory, metabolic, and immune systems. Optimal basal activity and responsiveness of the stress system is essential for a sense of well-being, successful performance of tasks, and appropriate social interactions. By contrast, excessive or inadequate basal activity and responsiveness of this system might impair development, growth and body composition, and lead to a host of behavioral and somatic pathological conditions.
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                Author and article information

                Journal
                AIMS Public Health
                AIMS Public Health
                PublicHealth
                AIMS Public Health
                AIMS Press
                2327-8994
                11 March 2024
                2024
                : 11
                : 1
                : 273-293
                Affiliations
                [1 ] Department of Research, Quality Control and Continuing Education, University General Hospital of Alexandroupolis
                [2 ] First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, “Agia Sophia” Children's Hospital
                [3 ] Department of Nursing School of Health Sciences University of Peloponnese
                [4 ] Department of Nursing, ‘Aghia Sophia’ Children's Hospital, Athens, Greece
                [5 ] Department of Nursing, “Sotiria” General Hospital, Athens, Greece
                [6 ] Department of Nursing, National and Kapodistrian University of Athens
                Author notes
                * Correspondence: Email: vgeorgousopoulou@ 123456yahoo.gr ; Tel: +306942618174.
                Article
                publichealth-11-01-014
                10.3934/publichealth.2024014
                11007424
                193fe85c-950d-484d-be11-e0cbc0396175
                © 2024 the Author(s), licensee AIMS Press

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0)

                History
                : 27 October 2023
                : 28 February 2024
                : 29 February 2024
                Categories
                Review

                healthcare workers,stress response,psychopathology,psychological problems,covid-19,mental health,nurses

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