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      Job satisfaction among healthcare workers in Ghana and Kenya during the COVID-19 pandemic: Role of perceived preparedness, stress, and burnout

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          Abstract

          The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. We conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.

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          A Global Measure of Perceived Stress

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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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              Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study

              Summary Background Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. Methods We did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509. Findings Among 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors. Interpretation In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed. Funding Zoe Global, Wellcome Trust, Engineering and Physical Sciences Research Council, National Institutes of Health Research, UK Research and Innovation, Alzheimer's Society, National Institutes of Health, National Institute for Occupational Safety and Health, and Massachusetts Consortium on Pathogen Readiness.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ResourcesRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: ValidationRole: Writing – review & editing
                Role: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                13 October 2021
                2021
                : 1
                : 10
                : e0000022
                Affiliations
                [1 ] Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
                [2 ] Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
                [3 ] Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America
                [4 ] Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, United States of America
                [5 ] Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong, SAR
                [6 ] Department of Community Health Systems, University of California, San Francisco, San Francisco, California, United States of America
                [7 ] Department of Obstetrics and Gynecology, The Aga Khan University Hospital, Nairobi, Kenya
                [8 ] Navrongo Health Research Centre, Navrongo, Ghana
                [9 ] Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
                [10 ] Tamale Teaching Hospital, Tamale, Ghana
                [11 ] Department of Human Anatomy, Obstetrics and Gynecology, The University of Nairobi, Nairobi, Kenya
                [12 ] School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
                [13 ] Sidney Kimmel Medical College, Philadelphia, PA, United States of America
                [14 ] Policy Planning Monitoring and Evaluation Division, Ghana Health Service, Accra, Ghana
                Muhlenberg College, UNITED STATES
                Author notes

                The authors declare that they have no competing interests.

                Author information
                https://orcid.org/0000-0002-6739-234X
                https://orcid.org/0000-0002-7562-6281
                https://orcid.org/0000-0001-5297-2512
                https://orcid.org/0000-0003-3394-6532
                https://orcid.org/0000-0002-4572-8543
                https://orcid.org/0000-0003-0642-9265
                https://orcid.org/0000-0001-6846-0028
                https://orcid.org/0000-0002-2116-2637
                https://orcid.org/0000-0003-2330-6144
                https://orcid.org/0000-0001-9741-2092
                https://orcid.org/0000-0001-8257-8807
                https://orcid.org/0000-0002-4749-7857
                https://orcid.org/0000-0002-1094-8212
                Article
                PGPH-D-21-00322
                10.1371/journal.pgph.0000022
                10021773
                36962085
                bf68b6f1-edbf-4b4a-9748-ffbbfd30df84
                © 2021 Afulani 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
                : 7 July 2021
                : 15 September 2021
                Page count
                Figures: 0, Tables: 4, Pages: 21
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100008069, University of California, San Francisco;
                Award ID: COVID-19 Related Rapid Research Pilot Initiative #2016796
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100008069, University of California, San Francisco;
                Award ID: COVID-19 Related Rapid Research Pilot Initiative #2016796
                Award Recipient :
                This study was funded by the University of California, San Francisco COVID-19 Related Rapid Research Pilot Initiative (Grant number #2016796), awarded to PAA and JJN. The funders had no role in the data collection, analysis, or decision to publish.
                Categories
                Research Article
                Social Sciences
                Political Science
                Labor Studies
                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
                Epidemiology
                Pandemics
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                People and Places
                Geographical Locations
                Africa
                Ghana
                People and Places
                Geographical Locations
                Africa
                Kenya
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Custom metadata
                The data used for the analysis is included in the Supporting information files.
                COVID-19

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