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OBJECTIVES: This study aimed to evaluate the independent and interactive effects of changes in overtime and night shifts on burnout among nurses during the COVID-19 pandemic. METHODS: Nurses working in an Italian university hospital (N=317) completed the Maslach Burnout Inventory in September 2019 and again in December 2020. Based on hospital administrative data, changes in overtime and night shifts in the same years were categorized into three groups each. Linear regressions were used to estimate 2020 burnout differences between exposure groups, controlling for 2019 burnout levels, demographic and work-related characteristics, and to test the interaction between the two exposures. RESULTS: Nurses in the onset of high overtime group had higher emotional exhaustion [4.33, 95% confidence interval (CI) 1.74-6.92], depersonalization (2.10, 95% CI 0.49-3.71), and poor personal accomplishment (2.64, 95% CI 0.55-4.74) compared to stable low overtime nurses. Nurses in the increase in night shifts group had lower emotional exhaustion (-4.49, 95% CI -7.46- -1.52) compared to no night shift nurses. Interaction analyses revealed that this apparently paradoxical effect was limited to stable low overtime nurses only. Moreover, increases in night shifts were associated with higher depersonalization and poor personal accomplishment in nurses in the stable high overtime group. CONCLUSIONS: Increase in overtime is an independent risk factor for burnout among nurses, highlighting the need for specific regulations and actions to address it. Long-standing guidelines for the assignment of night shifts might have contributed to attenuate the impact of their increase on nurses' mental health.
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OBJECTIVES: The main objective of the study is to investigate the short-term efficacy of Acceptance and Commitment Therapy (ACT) on the simultaneous modification of biological indicators of risk and psychological well-being in patients with coronary heart disease attending cardiac rehabilitation (CR). DESIGN: This was a two-arm randomised controlled trial comparing a brief, manualised, ACT-based intervention with usual care (UC). SETTING: The study was conducted in an outpatient CR unit in Italy. Data collection took place from January 2016 to July 2017. PARTICIPANTS: Ninety-two patients were enrolled and randomised, following an unbalanced randomisation ratio of 2:1 to the ACT group (n=59) and the control group (n=33). Eighty-five patients completed the ACT (n=54) and the UC (n=31) interventions and were analysed. INTERVENTIONS: The control group received UC, a 6 weeks multidisciplinary outpatient CR programme, encompassing exercise training, educational counselling and medical examinations. The experimental group, in addition to UC, participated in the Acceptance and Commitment Therapy on HEART disease (ACTonHEART) intervention encompassing three group sessions based on ACT. OUTCOMES: The primary outcomes were Low Density Lipoproteins (LDL)cholesterol, resting systolic blood pressure, body mass index (BMI) and psychological well-being measured by the Psychological General Well-Being Index (PGWBI). Outcome measures were assessed at baseline and at the end of CR. RESULTS: Based on linear mixed models, no significant group × time interaction was observed for either the primary outcomes (ß, 95% CI: PGWBI =-1.13, -6.40 to -4.14; LDL cholesterol =-2.13, -11.02 to -6.76; systolic blood pressure =-0.50, -10.76 to -9.76; diastolic blood pressure =-2.73, -10.12 to -4.65; BMI =-0.16, -1.83 to -1.51, all p values >0.05) or the secondary outcomes (all p values >0.05). A significant time effect was found for the PGWBI total (beta=4.72; p=0.03). CONCLUSIONS: Although analyses revealed null findings, the results can inform the design of future ACT-based CR interventions and can help researchers to strike a balance between the idealised implementation of an ACT intervention and the structural limitations of existing CR programmes. TRIAL REGISTRATION NUMBER: NCT01909102.
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Terapia de Aceitação e Compromisso , Reabilitação Cardíaca , Doença das Coronárias , Humanos , Masculino , Feminino , Terapia de Aceitação e Compromisso/métodos , Pessoa de Meia-Idade , Doença das Coronárias/reabilitação , Doença das Coronárias/psicologia , Reabilitação Cardíaca/métodos , Idoso , Itália , Resultado do Tratamento , LDL-Colesterol/sangueRESUMO
INTRODUCTION: Aging is associated with an increased burden of multi-morbidity and disease related functional loss and disability, widely impacting patients and health care systems. Frailty is a major actor in age-related disability and is an important target for rehabilitation interventions, considering that is a reversible condition. EVIDENCE ACQUISITION: A working group of members of the ISPRM, responding to WHO 2030 call for action to strengthen rehabilitation, was established to assess the quality and implementability of the existing guidelines for the rehabilitation of frailty. Guidelines were retrieved using a systematic search on Pubmed, Scopus and Web of Science and from the reference lists of screened articles. The included guidelines were evaluated using the AGREE II to assess their quality and using the AGREE-REX to assess their clinical credibility and implementability. Guidelines with a score >4 in the AGREE II item evaluating the overall quality of the guideline were considered for endorsement. Finally, nine external reviewers evaluated the applicability of each recommendation from the endorsed guidelines, providing comments about the barriers and facilitators for their implementation in their country. EVIDENCE SYNTHESIS: Ten guidelines were retrieved and evaluated by the working group, of which four guidelines, i.e. the WHO Guidelines on Integrated Care for Older People, the FOCUS guidelines, the Asia-Pacific Clinical Practice Guidelines for the Management of Frailty and the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty, were considered for endorsement. All these guidelines were rated as of adequate quality and implementability. CONCLUSIONS: The WHO Guidelines on Integrated Care for Older people (24) the ICFSR International Clinical Practice Guidelines for Identification and management of Frailty (15), the FOCUS guidelines (25) and the Asia Pacific Clinical Practice Guidelines (14) for the Management of Frailty have the best quality and applicability of the existing guidelines on the management of frailty, we suggest that should be employed to define the standards of care for patients with frailty. There are barriers for their implementation, as stated by our experts, to take into account, and some of them are country- or region-specific. Screening for frailty, exercise, nutrition, pharmacological management, social and psychological support, management of incontinence, and an overall comprehensive clinical management are the best tools to face upon frailty.
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Fragilidade , Guias de Prática Clínica como Assunto , Humanos , Idoso , Fragilidade/reabilitação , Idoso Fragilizado , Avaliação Geriátrica/métodos , Idoso de 80 Anos ou mais , Medicina Física e Reabilitação/normasRESUMO
OBJECTIVES: This study aimed to assess the associations of pre-pandemic perceived work stressors and work satisfaction among nurses, including nurse assistants, with burnout profiles and their transitions in response to the pandemic. METHODS: Three hundred and thirty-seven nurses working in an Italian University hospital participated in a longitudinal study including a survey in August 2019 investigating perceived work stressors (assessed using the HSE Indicator Tool), work satisfaction (Work Satisfaction Scale), and burnout (Maslach Burnout Inventory), and a second survey in December 2020 assessing burnout. Using latent transition analysis, we identified burnout profiles and then estimated the associations between work stressors and satisfaction on profiles and transitions. RESULTS: We identified three pre-pandemic profiles, namely engaged (67%), ineffective (15%), and burnout (18%); and three pandemic profiles, namely engaged (37%), exhausted (51%), and severe burnout (12%). The severe burnout profile consisted of 70% nurses classified in the burnout profile before the pandemic. Overall, work stressors and satisfaction were associated with both pre-pandemic and pandemic burnout profiles. Among nurses not in the burnout profile prior to COVID-19, pre-pandemic hostile relationships increased [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05-1.34] and work satisfaction decreased (OR 0.82, 95% CI 0.68-0.98) the probability to transition to exhausted. Moreover, work satisfaction (OR 0.54, 95% CI 0.32-0.91) and participation in work organization (OR 0.69, 95% CI 0.51-0.93) protected from transitioning to severe burnout. The association between peer support and the transition to exhausted needs further investigation. CONCLUSIONS: Pre-pandemic work stressors and satisfaction were associated with pandemic burnout and burnout transitions. To enhance preparedness for future crises, healthcare managers should carefully assess and tackle work-related constraints affecting nurses.
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Esgotamento Profissional , Enfermeiras e Enfermeiros , Testes Psicológicos , Autorrelato , Humanos , Pandemias , Estudos Longitudinais , Esgotamento Psicológico , Satisfação no Emprego , Inquéritos e Questionários , Atenção à SaúdeRESUMO
BACKGROUND: This study aimed to examine whether dyadic coping (DC) is associated with relationship satisfaction (RS) among couples facing cardiac diseases. Furthermore, the moderating role of both partners' anxiety and depression was tested. METHODS: One hundred cardiac patients (81.5% men) and their partners (81.5% women) completed a self-report questionnaire during hospitalization. The Actor-Partner Interdependence Model (APIM) and moderation analyses were used to assess the above associations. RESULTS: Results showed that positive DC was significantly related to higher levels of RS, and negative DC was related to lower levels of RS. Furthermore, patient and partner psychological distress significantly moderated the link between DC and RS: patient-perceived positive DC was associated with higher partner RS when partner depression was high; partner-perceived positive DC was associated with higher patient RS when patient anxiety was low; patient-perceived negative DC has associated with lower patient RS when patient anxiety and depression were high. CONCLUSION: This study showed that positive DC is associated with a more satisfying relationship and identified under what conditions of cardiac-related distress this can happen. Furthermore, this study underlined the importance of examining DC in addition to the individual coping skills as a process pertaining to personal well-being and couple's outcomes.
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OBJECTIVE: Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity-a risk factor for suicidal ideation per se-could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation. METHODS: In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected. RESULTS: 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation. DISCUSSION: The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation.
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Fibromialgia , Feminino , Humanos , Fibromialgia/epidemiologia , Ideação Suicida , Prevalência , Comorbidade , Dor , Obesidade/epidemiologiaRESUMO
BACKGROUND: Monitoring workplace violence (WPV) against health care workers (HCWs) through incident reporting is crucial to drive prevention, but the actual implementation is spotty and experiences underreporting. OBJECTIVE: This study aims to introduce a systematic WPV surveillance in 2 public referral hospitals in Italy and assess underreporting, WPV annual rates, and attributes "before" (2016-2020) and "after" its implementation (November 2021 to 2022). METHODS: During 2016-2020, incident reporting was based on procedures and data collection forms that were neither standardized between hospitals nor specific for aggressions. We planned and implemented a standardized WPV surveillance based on (1) an incident report form for immediate and systematic event notification, adopting international standards for violence definitions; (2) second-level root cause analysis with a dedicated psychologist, assessing violence determinants and impacts and offering psychological counseling; (3) a web-based platform for centralized data collection; and (4) periodic training for workforce coordinators and newly hired workers. We used data from incident reports to estimate underreporting, defined as an observed-to-expected (from literature and the "before" period) WPV ratio less than 1, and the 12-month WPV rates (per 100 HCWs) in the "before" and "after" periods. During the latter period, we separately estimated WPV rates for first and recurrent events. RESULTS: In the "before" period, the yearly observed-to-expected ratios were consistently below 1 and as low as 0.27, suggesting substantial violence underreporting of up to 73%. WPV annual rates declined in 1 hospital (from 1.92 in 2016 to 0.57 in 2020) and rose in the other (from 0.52 to 1.0), with the divergence being attributable to trends in underreporting. Available data were poorly informative to identify at-risk HCW subgroups. In the "after" period, the observed-to-expected ratio rose to 1.14 compared to literature and 1.91 compared to the "before" period, consistently in both hospitals. The 12-month WPV rate was 2.08 (95% CI 1.79-2.42; 1.52 and 2.35 in the 2 hospitals); one-fifth (0.41/2.08, 19.7%) was due to recurrences. Among HCWs, the youngest group (3.79; P<.001), nurses (3.19; P<.001), and male HCWs (2.62; P=.008) reported the highest rates. Emergency departments and psychiatric wards were the 2 areas at increased risk. Physical assaults were more likely in male than female HWCs (45/67, 67.2% vs 62/130, 47.7%; P=.01), but the latter experienced more mental health consequences (46/130, 35.4% vs 13/67, 19.4%; P=.02). Overall, 40.8% (53/130) of female HWCs recognized sociocultural (eg, linguistic or cultural) barriers as contributing factors for the aggression, and 30.8% (40/130) of WPV against female HCWs involved visitors as perpetrators. CONCLUSIONS: A systematic WPV surveillance reduced underreporting. The identification of high-risk workers and characterization of violence patterns and attributes can better inform priorities and contents of preventive policies. Our evaluation provides useful information for the large-scale implementation of standardized WPV-monitoring programs.
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Violência no Trabalho , Feminino , Masculino , Humanos , Violência no Trabalho/prevenção & controle , Estudos Prospectivos , Local de Trabalho , Análise por Conglomerados , Pessoal de SaúdeRESUMO
Objective: This scoping review aims to provide an accessible summary of available evidence on the efficacy of psychological couple-based interventions among patients with heart disease and their partners focusing on specific aspects and strategies by assessing different emotional and physical cardiac-related outcome measures. Methods: A literature search was performed in PubMed, Scopus, Medline, PsycINFO, and Web of Science databases using the keywords "heart diseases" and "couple-based intervention." A literature search using systematic methods was applied. Data were extracted to address the review aims and were presented as a narrative synthesis. Results: The database search produced 11 studies. Psychological couple-based interventions varied in terms of the type of intervention, personnel, format (group or individual, phone or in person), number of sessions, and duration. Most of the contributions also lacked adequate details on the training of professionals, the contents of the interventions, and the theoretical models on which they were based. Finally, although partners were involved in all the treatment, in most studies, the psychological strategies and outcomes were focused on the patient. Conclusion: The variability of the psychological couple-based interventions of included studies represents a challenge in summarizing the existing literature. Regarding their impact, psychological interventions for patients with cardiovascular disease and their partners were found to moderately improve patients' and partners' outcomes.
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Mortality of candidemia in coronavirus disease 2019 (COVID-19) patients has not been deeply studied despite evidence suggesting an increased occurrence. We performed a systematic review and meta-analysis to summarize the available evidence about these patients' mortality and length of stay. Data about the in-hospital, all-cause and 30-day mortality, and length of stay were pooled. Subgroup analyses were performed to assess sources of heterogeneity. Twenty-six articles out of the 1915 records retrieved during the search were included in this review. The pooled in-hospital mortality was 62.62% (95% CI, 54.77% to 69.86%), while the mortality in intensive care unit (ICU) was 66.77% (95% CI, 57.70% to 74.75%). The pooled median in-hospital length of stay was 30.41 (95% CI, 12.28 to 48.55) days, while the pooled median length of stay in the ICU was 28.28 (95% CI, 20.84 to 35.73) days. The subgroup analyses did not identify the sources of heterogeneity in any of the analyses. Our results showed high mortality in patients with candidemia and COVID-19, suggesting the need to consider screening measures to prevent this life-threatening condition.
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The aim of this study was to identify how previously existing burnout and its changes during the pandemic contributed to PTSD symptoms and psychological distress in a cohort of 388 healthcare workers (HCWs). Each HCW was surveyed in Sep 2019 (before COVID-19) and again in Dec 2020-Jan 2021 (during the pandemic) to assess burnout (MBI); and in the second wave only to assess PTSD (PCL-5-SF), psychological distress (GHQ-12) and resilience (CD-RISC-10). Changes in emotional exhaustion (EE) and depersonalisation (DEP) were stronger in HCWs with lower EE and DEP baseline values. HCWs with higher baseline poor personal accomplishment (PPA) improved more than those with lower baseline values. In multivariable-adjusted models, pre-pandemic EE and its changes were equally associated to both outcomes: standardised-ßs of 0.52 and 0.54 for PTSD, respectively; and 0.55 and 0.53 for psychological distress. Changes in DEP were associated with PTSD only (0.10). Changes in PPA had a higher association with psychological distress (0.29) than pre-pandemic PPA (0.13). Resilience was associated with lower psychological distress (-0.25). Preventive actions aimed at reducing EE, e.g., addressing organisational dysfunctions, are needed to mitigate the impact of future crises, whereas improving personal accomplishment levels is a key target to protect HCWs from mental health disorders during a pandemic.
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Esgotamento Profissional , COVID-19 , Humanos , Saúde Mental , Pandemias , Esgotamento Psicológico , Surtos de Doenças , Pessoal de Saúde , Esgotamento Profissional/epidemiologiaRESUMO
OBJECTIVES: A two-arm parallel randomised controlled trial was conducted to evaluate the efficacy of a group acceptance-based treatment (ABT) in improving pain acceptance, pain catastrophising, kinesiophobia, pain intensity and physical functioning compared to treatment as usual in patients with fibromyalgia (FM) and comorbid obesity. METHODS: Female individuals diagnosed with FM and obesity (n = 180) were randomly assigned to either a three-weekly group acceptance-based treatment plus treatment as usual (ABT+TAU) or only TAU. The variables of interest were assessed at baseline (T0) and after the interventions (T1). The treatment protocol for the ABT+TAU condition, designed for an inpatient rehabilitation context, is based on acceptance and commitment therapy but focuses specifically on pain acceptance, a crucial factor in fostering a more functional adaptation to chronic pain. RESULTS: Participants in the ABT+TAU group showed significant improvements in pain acceptance (i.e. the primary outcome), but also in pain catastrophising, kinesiophobia, and performance-based physical functioning (i.e. the secondary outcomes) compared to those in the TAU group. However, there were no significant differences in pain intensity between the two groups. CONCLUSIONS: These findings indicate that a brief group-based ABT intervention is effective in enhancing pain acceptance, reducing pain catastrophising and kinesiophobia, and improving performance-based physical functioning. Furthermore, the observed improvements in kinesiophobia and physical functioning may have particular relevance for individuals with comorbid obesity, as they can facilitate greater adherence to physical activity and promote weight loss.
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Terapia de Aceitação e Compromisso , Dor Crônica , Fibromialgia , Humanos , Feminino , Fibromialgia/diagnóstico , Fibromialgia/terapia , Dor Crônica/diagnóstico , Dor Crônica/terapia , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/terapia , Exercício Físico , Resultado do TratamentoRESUMO
Objective: The Left Ventricular Assist Device (LVAD) has increasingly become a primary therapeutic option for longer-waiting heart transplant lists. Although survival rates are growing, the device requires complex home care. Therefore, the presence of a caregiver trained in the LVAD management is important for the success of the therapy. The LVAD leads both patients and their caregivers to experience new challenges and adapt to new lifestyle changes and limitations - but their subjective beliefs before home management remained little explored. Design: This study identified, using a phenomenological hermeneutic approach, the main components of the LVAD experience of six patient-caregiver dyads interviewed during cardiac rehabilitation. Results: We identified 4 master themes: Being between life and death, Being human with a heart of steel, Sharing is caring (and a burden), and Being small and passive. Conclusion: The knowledge from this study can be used as a guide for healthcare providers in counseling LVAD recipients and their caregivers.
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[This corrects the article DOI: 10.3389/fpsyg.2021.818659.].
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Chronic stress may represent one of the most important factors that negatively affects the health and performance of athletes. Finding a way to introduce psychological strategies to manage stress in everyday training routines is challenging, particularly in junior teams. We also must consider that a stress management intervention should be regarded as "efficacious" only if its application results in improvement of the complex underlying pathogenetic substratum, which considers mechanistically interrelated factors, such as immunological, endocrine and autonomic controls further to psychological functioning and behavior. In this study, we investigated the feasibility of implementing, in a standard training routine of the junior team of the Italian major soccer league, a stress management program based on mental relaxation training (MRT). We evaluated its effects on stress perception and cardiac autonomic regulation as assessed by means of ANSI, a single composite percentile-ranked proxy of autonomic balance, which is free of gender and age bias, economical, and simple to apply in a clinical setting. We observed that the simple employed MRT intervention was feasible in a female junior soccer team and was associated with a reduced perception of stress, an improved perception of overall health, and a betterment of cardiac autonomic control. This data may corroborate the scientific literature that indicates psychological intervention based on MRT as an efficacious strategy to improve performance, managing negative stress effects on cardiac autonomic control.
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Relaxamento , Futebol , Estresse Psicológico , Feminino , Humanos , Atletas , Nível de Saúde , Coração , Percepção , Intervenção Psicossocial , Estresse Psicológico/terapia , Saúde MentalRESUMO
BACKGROUND: Narcolepsy type 1 (NT1) is a rare neurological sleep disorder caused by the loss of neurons that produce hypocretin-a peptide that plays a crucial role in addictive behaviors. We aimed to compare, for the first time, levels of problematic online gaming, problematic social media use, and compulsive Internet use between NT1 patients and healthy controls (HC), and to evaluate the association between anxiety, depression, and emotion dysregulation with addictive online behaviors in NT1 patients. METHODS: A total of 43 patients with NT1 and 86 sex- and age-matched HC participated in an online cross-sectional survey. RESULTS: NT1 patients did not differ from HC in terms of problematic social media use and compulsive Internet use but displayed higher levels of problematic online gaming compared to HC. Higher levels of emotion dysregulation were significantly associated with higher levels of problematic social media use and compulsive Internet use, while none of the tested factors were associated with problematic online gaming. CONCLUSION: NT1 patients and HC had similar levels of problematic social media use and compulsive Internet use, but NT1 patients showed higher levels of problematic online gaming. Emotion dysregulation might be an intervention target for reducing compulsive Internet use and problematic social media use.
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[This corrects the article DOI: 10.3389/fpsyg.2022.861341.].
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BACKGROUND: Patients with Alzheimer's disease (AD) present with cognitive function deterioration, neuropsychiatric symptoms (NPS)-especially depression-and low quality of life (QoL). Management of AD remains difficult, especially in the elderly. Reminiscence therapy (RT) is a well-known cognitive rehabilitation intervention that can be adopted in nursing and residential care homes to restore autobiographical memory, ameliorate NPS, and improve the QoL of people with dementia. However, the evidence-based efficacy of RT for elderly patients with AD remains to be determined. METHODS: Here, we synthesized findings of randomized controlled trials (RCTs) exploring the effects of RT on cognition, depression, and QoL in elderly people with AD, according to the most recent PRISMA statement. We searched for RCTs in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials, and in trial registries (i.e., clinicaltrials.gov and International Clinical Trials Registry Platform of the World Health Organization). Two review authors extracted data of interest, with cognition, depression, and QoL measures as outcomes. RESULTS: A total of five articles were included in the final analysis. Findings globally showed that RT, both administered in individual or group sessions at least once a week for 30-35 min over a period of 12 weeks, is effective in supporting global cognition, ameliorating depression, and improving specific aspects of the QoL in elderly people with AD. CONCLUSIONS: RT has the potential to be a routine non-pharmacological therapy for elderly people with AD, thanks to its wider effects on the individual in terms of cognitive vitality and emotional status promotion, with positive implications for patient's daily life. Despite such evidences, caution should be used in findings' generalizability in relation to the paucity of existing RCTs with long-term follow-up.
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Literature on the impact of the SARS-CoV-2 pandemic on the mental health of Health Care Workers (HCWs) is mostly based on cross-sectional surveys. We designed a longitudinal study to assess work-related stress and mental health before and after the pandemic onset in a university-hospital in Lombardia region, Italy. We report on sample representativeness and structural validity of questionnaires assessing work stress (HSE Indicator Tool, HSE-IT) and work satisfaction (WS), which were not validated in the HCWs population. n = 1287 HCWs from 67 hospital wards/offices were invited to an online survey in summer 2019 (pre-COVID-19 wave) and again during winter 2020 (COVID-19 wave). Selected hospital wards/offices did not differ from the remaining wards for turn-over and down-sizing rates, overload, sick leaves, and night shifts (Wilcoxon rank tests p-values > 0.05). Participation rates were 70% (n = 805) and 60% (n = 431) in the pre-COVID-19 and COVID-19 waves, respectively. Socio-demographic and work-related characteristics did not impact data completeness nor participation to the COVID-19 wave. While confirming a 7-component structure for HSE-IT, we identified a new factor related to participation in work organization. A one-factor model for WS had satisfactory fit. Our longitudinal study based on a representative sample and adopting validated questionnaires is well-suited to elucidate the role of work conditions on the development of mental health disorders in HCWs.
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COVID-19 , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Pessoal de Saúde/psicologia , Humanos , Satisfação no Emprego , Estudos Longitudinais , Saúde Mental , Psicometria , SARS-CoV-2RESUMO
It is unclear if the factor structure of the questionnaires that were employed by studies addressing the impact of COVID-19 on the mental health of Healthcare Workers (HCW) did not change due to the pandemic. The aim of this study is to assess the factor structure and longitudinal measurement invariance of the Maslach Burnout Inventory (MBI) and the factor structure of the General Health Questionnare-12 (GHQ-12), PTSD Checklist for DSM-5-Short Form (PCL-5-SF), Connor-Davidson Resilience Scale-10 (CD-RISC-10) and Post-Traumatic Growth Inventory-Short Form (PTGI-SF). Out of n = 805 HCWs from a University hospital who responded to a pre-COVID-19 survey, n = 431 were re-assessed after the COVID-19 outbreak. A Confirmatory Factor Analysis (CFA) on the MBI showed adequate fit and good internal consistency only after removal of items 2, 6, 12 and 16. The assumptions of configural and metric longitudinal invariance were met, whereas scalar longitudinal invariance did not hold. CFAs and exploratory bifactor analyses performed using data from the second wave confirmed that the GHQ-12, the PCL-5-SF, the PTGI-SF and the CD-RISC-10 were unidimensional. In conclusion, we found support for a refined version of the MBI. The comparison of mean MBI values in HCWs before and after the pandemic should be interpreted with caution.