Mental health, risk perception, and coping strategies among healthcare workers in Egypt during the COVID-19 pandemic.

BACKGROUND: Coronavirus disease-19 emerged in December 2019. Healthcare workers were exposed to this highly infectious virus during the pandemic and suffered several social and psychological consequences, such as anxiety, psychological distress, and burnout. OBJECTIVES: To assess the psychological distress, anxiety, depression, coping strategies, risk perception, and attitude toward interprofessional teamwork among Egyptian healthcare workers during the COVID-19 pandemic. METHODS: We conducted a cross-sectional online survey which consisted of five sections. The primary outcomes were anxiety (GAD-7), depression (PHQ-9), risk perception towards COVID-19, interprofessional teamwork attitude, and coping strategies during the Coronavirus disease-19 pandemic. The web-based questionnaire was distributed to Egyptian healthcare workers from the 20th of April 2020 to the 20th of May 2020. A snowball sampling method was used. Regression analysis was conducted to test the relationship between the socioeconomic characteristics and the previously mentioned outcomes. RESULTS: A total of 403 participants responded to the online questionnaire. The majority were females (70.5%) and within the age group of 26-40 years (77.7%), with 2-5 years of work experience (43.2%). Most participants were pharmacists (33%) and physicians (22.1%). Eighty-two participants (21%) reported moderate to severe anxiety, and 79 participants reported (19.4%) moderate to severe depressive symptoms. In the univariate model, the marital status was associated with depression (OR 0.47, 95% CI 0.28-0.78), anxiety (OR 0.52, 95% CI 0.32-0.85), and an attitude toward interprofessional teamwork (ß = -1.96 95% CI -2.72 to -1.2). Providing direct care to the patients was associated with lower anxiety symptoms (AOR 0.256, 95% CI 0.094-0.697). More severe anxiety and depressive symptoms were associated with difficulties in everyday life and the professional work environment (AOR 4.246 and 3.3, P = 0.003 and 0.01, respectively). Availability of mental health facilities at the workplace was associated with a lower risk perception towards COVID-19 (ß = -0.79, 95% CI -1.24 to -0.34) and a more positive attitude towards teamwork (ß = 2.77 95% CI 1.38-4.15). CONCLUSIONS: According to our results, the COVID-19 pandemic was associated with mild anxiety and depression among healthcare workers in Egypt, especially pharmacists and physicians. We recommend more research targeting the mental health of healthcare workers in Egypt. If proven cost-effective and needed, wide-scale mental health screening and public health campaigns can facilitate effective prevention and treatment strategies. In addition, the availability of mental health facilities at the workplace could alleviate some of the risk perception associated with health emergencies and improve interprofessional teamwork.

Chest Ultrasound in Predication of Weaning Failure.

AIM: Failure of weaning from mechanical ventilation (MV) is a common problem that faces the intensivist despite having some prediction indices. Application of chest ultrasonography (US) may help in weaning and prediction of its outcome. METHODS: 100 patients on invasive MV fulfilling criteria of weaning shifted to spontaneous breathing trial (SBT) (using PSV 8 cm H2O) for 1 hour. Weaning failure was defined as; Failed SBT, reintubation and/or ventilation or death within 48 hours. Echocardiography was used to get Ejection fraction, E/A ratio, Doppler tissue imaging (DTI) &, lung ultrasound (LUS) was used to assess LUS score, diaphragm ultrasound was used to assess diaphragmatic thickening fraction (DTF). RESULTS: Mean age 57.1 ± 14.5, 62% were males. Weaning was successful in 80% of patients. LUS score was significantly higher in the failed weaning group: (10.8 ± 4.2) vs (16.5 ± 4.2 cm), (p: 0.001). (DTF) Was significantly higher in the successful weaning group: (43.0 ± 10.7) vs (28.9 ± 2.8 cm), (p: 0.001). DTF can predict successful weaning using Receiver operating characteristic (ROC) curves with the cutoff value: ≥ 29.5 with sensitivity 88.0% and specificity 80.0% with a p-value < 0.001.LUS score can predict weaning failure by using a ROC curve with cutoff value: ≥ 15.5 with sensitivity 70.0% and specificity 82.5 % with a p-value < 0.001.). CONCLUSION: The use of bedside chest US (to assess lung and diaphragm) of great benefit throughout the weaning process.