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      Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study

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          Abstract

          The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49–2.95), nurse (OR 1.38; 95% CI 1.04–1.84), and ‘other clinical’ (OR 2.02; 95% CI 1.45–2.82); being redeployed (OR 1.27; 95% CI 1.02–1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98–2.99), anxiety (OR 4.87; 95% CI 3.92–6.06) and depression (OR 4.06; 95% CI 3.04–5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51–0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22–0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.

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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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            The Hospital Anxiety and Depression Scale

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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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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysis
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: Formal analysisRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
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                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 April 2021
                2021
                16 April 2021
                : 16
                : 4
                : e0238666
                Affiliations
                [1 ] Department of Surgery and Cancer, Imperial College London, London, United Kingdom
                [2 ] Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [3 ] Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
                [4 ] Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [5 ] Department of Cardiology, National University Heart Centre, Singapore, Singapore
                [6 ] Pioneer Polyclinic, National University Polyclinic, National University Health System, Singapore, Singapore
                [7 ] Institute of Mental Health, Singapore, Singapore
                [8 ] Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [9 ] Department of Forensic Psychiatry, Institute of Mental Health, Singapore, Singapore
                [10 ] Division of Healthy Ageing, Alexandra Hospital, Singapore, Singapore
                [11 ] Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
                [12 ] Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [13 ] Emergency Medicine Department, National University Hospital, Singapore, Singapore
                [14 ] Polish Hospital Federation, Poland
                [15 ] Department of Economics of Health and Medical Law, Medical University of Warsaw, Poland
                University of North Texas Health Science Center, UNITED STATES
                Author notes

                Competing Interests: JK has received an educational grant from Johnson and Johnson. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                https://orcid.org/0000-0001-6215-6885
                https://orcid.org/0000-0002-1230-8497
                https://orcid.org/0000-0003-1824-9077
                https://orcid.org/0000-0002-5559-4534
                https://orcid.org/0000-0003-2448-4866
                https://orcid.org/0000-0003-4621-9756
                https://orcid.org/0000-0002-5759-962X
                https://orcid.org/0000-0003-1495-7746
                https://orcid.org/0000-0002-4595-8402
                https://orcid.org/0000-0002-8927-0829
                https://orcid.org/0000-0003-0666-1603
                https://orcid.org/0000-0002-2145-6977
                https://orcid.org/0000-0002-7835-4322
                https://orcid.org/0000-0003-3958-2856
                https://orcid.org/0000-0001-5644-627X
                https://orcid.org/0000-0001-5789-2773
                https://orcid.org/0000-0003-0187-8328
                https://orcid.org/0000-0002-0427-7643
                Article
                PONE-D-20-27673
                10.1371/journal.pone.0238666
                8051812
                33861739
                8a63e0d3-f64d-45bf-96fb-0002aa0088b8
                © 2021 Denning et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 September 2020
                : 21 March 2021
                Page count
                Figures: 2, Tables: 4, Pages: 18
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100004331, Johnson and Johnson;
                Award Recipient :
                JK has received an educational grant from Johnson and Johnson.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Biology and Life Sciences
                Psychology
                Psychological Attitudes
                Social Sciences
                Psychology
                Psychological Attitudes
                Medicine and Health Sciences
                Epidemiology
                Pandemics
                People and places
                Geographical locations
                Europe
                European Union
                Poland
                People and Places
                Geographical Locations
                Asia
                Singapore
                Custom metadata
                All relevant data are within the manuscript ad its Supporting information files.
                COVID-19

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                Uncategorized

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