Empathy in Healthcare Professionals during the Coronavirus Pandemic.

BACKGROUND: Empathy is important for successful interactions. The aim of the present study was to determine whether the cognitive component (Perspective taking) and affective components (Empathic concern and Personal distress) of empathy in health professionals were related to the degree of perceived threat of coronavirus, difficulties in doing work, difficulties in getting along with people, the health condition (current or past coronavirus disease), as well as with some socio-demographic characteristics. Fantasy as the cognitive component of empathy was not the focus of the present study as more irrelevant to clinical practice. SUBJECTS AND METHODS: A study of 296 health care workers through the Interpersonal Reactivity Index and a survey on perceived coronavirus threat, difficulties in work and getting along with people found that perceiving coronavirus as a stronger threat reduced both the cognitive component of empathy Perspective taking and the affective component of empathy Personal distress. RESULTS: As the affective components of empathy Empathic concern and Personal distress increased, the reported work difficulties were reduced. As the cognitive component of empathy Perspective taking and the affective component of empathy Personal distress increased, the reported difficulties in having a good relationship with other people were reduced. Some socio-demographic differences in the components of empathy in health workers were also established. CONCLUSION: These findings revealed the importance of Personal Distress (experienced anxiety, worry, discomfort, and apprehension when observing another person's negative experiences), as well as the joint manifestation of several aspects of empathy for successful work and maintaining good relationships in health care. Emotionality is a normal part of human interactions, so manifestations of cognitive empathy should not be only considered as appropriate, and emotional empathy should not be ruled out as unnecessary in clinical practice during the coronavirus pandemic.

Subjective well-being among psychotherapists during the coronavirus disease pandemic: A cross-cultural survey from 12 european countries.

OBJECTIVE: The aim of this study is to examine the amount of the total variance of the subjective well-being (SWB) of psychotherapists from 12 European countries explained by between-country vs. between-person differences regarding its cognitive (life satisfaction) and affective components (positive affect [PA] and negative affect [NA]). Second, we explored a link between the SWB and their personal (self-efficacy) and social resources (social support) after controlling for sociodemographics, work characteristics, and COVID-19-related distress. METHODS: In total, 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Satisfaction with Life Scale (SWLS), the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF), the General Self-Efficacy Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: Cognitive well-being (CWB; satisfaction with life) was a more country-dependent component of SWB than affective well-being (AWB). Consequently, at the individual level, significant correlates were found only for AWB but not for CWB. Higher AWB was linked to being female, older age, higher weekly workload, and lower COVID-19-related distress. Self-efficacy and social support explained AWB only, including their main effects and the moderating effect of self-efficacy. CONCLUSIONS: The results highlight more individual characteristics of AWB compared to CWB, with a more critical role of low self-efficacy for the link between social support and PA rather than NA. This finding suggests the need for greater self-care among psychotherapists regarding their AWB and the more complex conditions underlying their CWB.

Burnout among psychotherapists: a cross-cultural value survey among 12 European countries during the coronavirus disease pandemic.

The aim of this study was to examine cross-cultural differences, as operationalized by Schwartz's refined theory of basic values, in burnout levels among psychotherapists from 12 European countries during the coronavirus disease (COVID-19) pandemic. We focused on the multilevel approach to investigate if individual- and country-aggregated level values could explain differences in burnout intensity after controlling for sociodemographic, work-related characteristics and COVID-19-related distress among participants. 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Maslach Burnout Inventory-Human Service Survey, the revised version of the Portrait Values Questionnaire, and a survey questionnaire on sociodemographic, work-related factors and the COVID-19 related distress. In general, the lowest mean level of burnout was noted for Romania, whereas the highest mean burnout intensity was reported for Cyprus. Multilevel analysis revealed that burnout at the individual level was negatively related to self-transcendence and openness-to-change but positively related to self-enhancement and conservation values. However, no significant effects on any values were observed at the country level. Male sex, younger age, being single, and reporting higher COVID-19-related distress were significant burnout correlates. Burnout among psychotherapists may be a transcultural phenomenon, where individual differences among psychotherapists are likely to be more important than differences between the countries of their practice. This finding enriches the discussion on training in psychotherapy in an international context and draws attention to the neglected issue of mental health among psychotherapists in the context of their professional functioning.

Factors Associated With Highest Symptoms of Anxiety During COVID-19: Cross-Cultural Study of 23 Countries.

The COVID-19 restrictions have impacted people's lifestyles in all spheres (social, psychological, political, economic, and others). This study explored which factors affected the level of anxiety during the time of the first wave of COVID-19 and subsequent quarantine in a substantial proportion of 23 countries, included in this study. The data was collected from May to August 2020 (5 June 2020). The sample included 15,375 participants from 23 countries: (seven from Europe: Belarus, Bulgaria, Croatia, Hungary, Italy, Romania, Russia; 11 from West, South and Southeast Asia: Armenia, India, Indonesia, Iran, Iraq, Jordan, Malaysia, Pakistan, Saudi Arabia, Thailand, Turkey; two African: Nigeria and Tanzania; and three from North, South, and Central America: Brazil, Canada, United States). Level of anxiety was measured by means of the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 20-item first part of The State-Trait Anxiety Inventory (STAI)-State Anxiety Inventory (SAI). Respondents were also asked about their personal experiences with COVID-19, attitudes toward measures introduced by governments, changes in attitudes toward migrants during a pandemic, family income, isolation conditions, etc. The factor analysis revealed that four factors explained 45.08% of variance in increase of anxiety, and these components were interpreted as follows: (1) personal awareness of the threat of COVID-19, (2) personal reaction toward officially undertaken measures and attitudes to foreigners, (3) personal trust in official sources, (4) personal experience with COVID-19. Three out of four factors demonstrated strong associations with both scales of anxiety: high level of anxiety was significantly correlated with high level of personal awareness of the threat of COVID-19, low level of personal reaction toward officially undertaken measures and attitudes to foreigners, and high level of presence of personal experience with COVID-19. Our study revealed significant main effects of sex, country, and all four factors on the level of anxiety. It was demonstrated that countries with higher levels of anxiety assessed the real danger of a pandemic as higher, and had more personal experience with COVID-19. Respondents who trusted the government demonstrated lower levels of anxiety. Finally, foreigners were perceived as the cause of epidemic spread.

Functional, Dysfunctional Impulsivity and Sensation Seeking in Medical Staff.

BACKGROUND: It is important to study impulsivity and sensation seeking in medical staff because they might shed light into the effectiveness of decision-making processes and performed responses. The aims of this study were to specify if functional impulsivity prevailed in medical staff compared to dysfunctional impulsivity; how strong the relationships between functional, dysfunctional impulsivity and sensation seeking were; furthermore, it aimed to differentiate functional and dysfunctional impulsivity, according to the size of the place where medical care was practised. SUBJECTS AND METHODS: A sample of 323 medical workers and 99 medical students filled in Radoslavova and Velichkov's (2005) questionnaire measuring sensation seeking, functional impulsivity and dysfunctional impulsivity. RESULTS: Sensation seeking and functional impulsivity in medical staff did not differ statistically significantly (t(421)=1.171, p=0.242), but functional impulsivity was significantly more intensive than dysfunctional impulsivity among medical personnel (t(421)=8.132, p<0.001). Sensation seeking was significantly more strongly expressed than dysfunctional impulsivity among medical specialists (t(421)=7.388, p<0.001). Correlation analysis revealed that sensation seeking in medical specialists was more strongly related to functional impulsivity than to dysfunctional impulsivity (p<0.001). The studied medical staff practicing in the capital were more prone to functional impulsivity than the medical staff practicing in towns up to 50,000 inhabitants (pTukey=0.007). CONCLUSIONS: This was the first study to reveal stronger relationships between functional impulsivity and sensation seeking in medical staff than between dysfunctional impulsivity and sensation seeking which were interpreted as an influencing factor of the quality of decision-making responses. Functional impulsivity prevailed over dysfunctional impulsivity in medical occupations, so decision-making in medical care should be more effective and timelier than inappropriate, especially for medical personnel working in the capital.

Attitudes towards e-Health during the COVID-19 Pandemic: Untangling the Gordian Knot in Greece, Bulgaria and Romania in Healthcare Professionals and Students?

BACKGROUND: Until recent times, healthcare specialists lagged behind other fields in terms of computer networks and software usage, partly because they were uncomfortable with information and communication technologies. The rapid development of personal wearables, their easier connections with smartphones and other similar devices, and the possibilities of online or cloud storage of personal medical data led to improvements of eHealth services in terms of ease of access and reduced costs of delivery. SUBJECTS AND METHODS: The current research aimed to fill a research gap regarding attitudes towards e-Health during the COVID-19 pandemic in three Balkan countries: Greece, Bulgaria, and Romania. A total number of 775 adult participants (healthcare professionals and students in the field) were contacted in the winter of 2020 and asked to complete a questionnaire regarding their e-Health attitudes. RESULTS: The Greek participants had the most negative attitudes toward e-Health services. This may be due to forced use of eHealth applications during the pandemic crisis and the need for mastering the necessary technical skills to use them. CONCLUSIONS: It should be noted that in the scientific literature no research is found on this topic, therefore it is the first study aimed to assessing and comparing attitudes towards eHealth in these countries.

When is a person with dementia in need of palliative care? Opinions of healthcare professionals and university students from three South East European countries.

BACKGROUND: Recommendations of the European Association for Palliative Care have been proposed to strengthen the provision of palliative care and it is clear that people with dementia can benefit from palliative care, but no research so far addresses the beliefs of university students and professionals in the social, medical and other science fields in South East Europe regarding the need from palliative care. The objective of this study is to explore when students and professionals consider a person with dementia in need of palliative care and to compare their opinions in three South East European countries. SUBJECTS AND METHODS: An anonymized questionnaire was used based on van Riet Paap et al. (2015) case-vignette. A sample of 1287 participants (student nurses, professional nurses, psychology students, professional psychologists, student doctors, professional doctors, and students and professionals from other non-relevant to medical and social care sciences) was examined in Greece, Bulgaria and Romania. RESULTS: The open responses to the "when" question revealed the categories: after her diagnosis/after the first symptoms; when she and her family cannot cope; at the advance of symptoms; all the time; when she behaves aggressively; I am not sure/there is no specific point. Unexpectedly, age, professional status and field of studies were not found to be significant predictors, but only the country of origin was found to contribute to the differences in the participants' answers regarding the start of palliative care. CONCLUSION: Although professional-student status and relevancy of subject did not predict opinions, the country of origin predicted controversies for the proposed time point of considering a person with dementia in need of palliative care.

Sentimentality and Nostalgia in Elderly People in Bulgaria and Greece - Cross-Validity of the Questionnaire SNEP and Cross-Cultural Comparison.

Sentimentality and nostalgia are two similar psychological constructs, which play an important role in the emotional lives of elderly people who are usually focused on the past. There are two objectives of this study - making cross-cultural comparison of sentimentality and nostalgia among Bulgarian and Greek elderly people using a questionnaire, and establishing the psychometric properties of this questionnaire among Greek elderly people. Sentimentality and nostalgia in elderly people in Bulgaria and Greece were studied by means of Sentimentality and Nostalgia in Elderly People questionnaire (SNEP), created by Gergov and Stoyanova (2013). For the Greek version, one factor structure without sub-scales is proposed, while for the Bulgarian version of SNEP the factor structure had four sub-scales, besides the total score. Together with some similarities (medium level of nostalgia and sentimentality being widespread), the elderly people in Bulgaria and Greece differed cross-culturally in their sentimentality and nostalgia related to the past in direction of more increased sentimentality and nostalgia in the Bulgarian sample. Some gender and age differences revealed that the oldest male Bulgarians were the most sentimental. The psychometric properties of this questionnaire were examined for the first time in a Greek sample of elders and a trend was found for stability of sentimentality and nostalgia in elderly people that could be studied further in longitudinal studies.