Mental health experiences of HIV/TB healthcare workers during the COVID-19 pandemic - lessons for provider well-being and support from a qualitative study in seven South African provinces.

BACKGROUND: COVID-19 has substantially reshaped health service delivery. Healthcare workers have had to serve more clients, work longer shifts, and operate in conditions of uncertainty. They have experienced multiple stressors related to the additional 'labour of care', including managing the frustration of inadequate therapeutic or symptom relief options, witnessing clients dying, and having to give this news to clients' family members. Ongoing psychological distress among healthcare workers can severely undermine performance, decision-making and well-being. We sought to understand the impact of the COVID-19 pandemic on the mental health experiences of healthcare workers delivering HIV and TB services in South Africa. METHODS: We used a pragmatic and exploratory design to understand HCWs' mental health experiences with in-depth qualitative data. We implemented the study in ten high HIV/TB burden districts across seven of South Africa's nine provinces among healthcare workers employed by USAID-funded implementing partners. We conducted in-depth interviews (virtual) with 92 healthcare workers across 10 cadres. RESULTS: Healthcare workers reported experiencing a range of extreme and rapidly fluctuating emotions because of COVID-19 that negatively impacted on their well-being. Among these, many healthcare workers report experienced a great deal of guilt at their inability to continue to provide quality care to their clients. In addition, a constant and pervasive fear of contracting COVID-19. Healthcare workers' stress coping mechanisms were limited to begin with, and often further interrupted by COVID-19 and non-pharmaceutical response measures e.g., 'lockdowns'. Healthcare workers reported a need for greater support for managing the everyday burden of work - not only when experiencing a mental well-being 'episode'. Further, that whenever they were exposed to stressor events, e.g., supporting a child living with HIV who reports sexual abuse to the healthcare worker, that this this would trigger additional support interventions and not rely on the healthcare worker seeking this out. Further, that supervisors spend more effort demonstrating appreciation toward staff. CONCLUSIONS: The COVID-19 epidemic has added significant mental health burden for healthcare workers in South Africa. Addressing this requires broad and cross-cutting strengthening of everyday support for healthcare workers and centring staff's mental well-being as core to delivering quality health services.

Disentangling relations between attention to the eyes and empathy.

Social interactions involve an interplay between lower-level social perceptual biases and higher-level cognition and affect. One particularly important building block of social interaction is attention to others' eyes. Previous research has found links between individual differences in eye-looking and complex social capacities, including empathy. Such research, however, has predominately used nonnaturalistic stimuli and has not addressed the directional relation between these processes. In this study, a large sample of adults (N = 164) were eye-tracked while watching naturalistic videos of complex social interactions. Additionally, participants completed measures of empathy and spontaneous and explicit mentalizing. To disentangle relations between variables, participants were assigned to one of three conditions: first, a baseline condition with no instructions; second, an eye-looking condition, where participants were told to look at the eyes of the characters; and, third, an empathy condition, where participants were told to become involved with the characters' thoughts and feelings. In the baseline condition, we found no relation between mentalizing and eye-looking, yet found that eye-looking and empathy were positively related. Inducing one behavior, however, did not affect the other. That is, participants in the eye-looking condition showed increased eye-looking but not increased empathy, and participants in the empathy condition scored more highly on empathy and mentalizing measures with no corresponding changes in eye-looking. These results suggest that the relations between visual attention and social cognition are complex and difficult to manipulate. Future research should examine the developmental links between these behaviors, as understanding their emergence has implications for social disabilities and interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Plasticity in animal personality traits: does prior experience alter the degree of boldness?

Theoreticians predict that animal 'personality' traits may be maladaptive if fixed throughout different contexts, so the present study aimed to test whether these traits are fixed or plastic. Rainbow trout (Onchorhyncus mykiss) were given emboldening or negative experiences in the forms of watching bold or shy individuals responding to novelty or winning or losing fights to examine whether prior experience affected boldness. Bold individuals that lost fights or watched shy demonstrators became more shy by increasing their latency to approach a novel object, whereas shy observers that watched bold demonstrators remained cautious and did not modify their responses to novelty. Shy winners became bolder and decreased their latency to approach a novel object, but shy losers also displayed this shift. In comparison, control groups showed no change in behaviour. Bold fishes given negative experiences reduced their boldness which may be an adaptive response; however, shy fishes may base their strategic decisions upon self-assessment of their relative competitive ability and increase their boldness in situations where getting to resources more quickly ensures they outcompete better competitors.