The experience of European hospital-based health care workers on following infection prevention and control procedures and their wellbeing during the first wave of the COVID-19 pandemic
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Abstract
Working under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. A better understanding of HCWs’ experiences of following local infection prevention and control (IPC) procedures during COVID-19 is urgently needed to inform strategies for protecting the psychical and psychological health of HCWs. The objective of this study was therefore to capture the perceptions of hospital HCWs on local IPC procedures and the impact on their emotional wellbeing during the first wave of the COVID-19 pandemic in Europe.
Methods
Participants were recruited in two sampling rounds of an international cross-sectional survey. Sampling took place between 31 March and 17 April 2020 via existing research networks and between 14 May and 31 August 2020 via online convenience sampling. Main outcome measures were behavioural determinants of HCWs’ adherence to IPC guidelines and the WHO-5 Well-Being Index, a validated scale of 0–100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.
Results
2289 HCWs from 40 countries in Europe participated. Mean age was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n = 1699) of HCWs were directly treating patients with COVID-19, of which 32% (n = 527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This feeling was more common among junior than senior HCWs (46% versus 38%, P value < .01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2–1.8).
Conclusions
In Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.
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SciScore for 10.1101/2020.12.23.20248793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable To assess differences in wellbeing between male and female HCWs we estimated the independent effect of gender on a WHO-5 Well-Being Index below 50 points using logistic regression, including predefined control variables for age, living situation (i.e. living alone or sharing a household), European region, job role, hospital type and providing COVID-19 patient care. Table 2: Resources
Software and Algorithms Sentences Resources All analyses were performed with Statistical Package for Social Sciences V.25.0.2 (SPSS, Chicago, Illinois, USA) and R Version … SciScore for 10.1101/2020.12.23.20248793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable To assess differences in wellbeing between male and female HCWs we estimated the independent effect of gender on a WHO-5 Well-Being Index below 50 points using logistic regression, including predefined control variables for age, living situation (i.e. living alone or sharing a household), European region, job role, hospital type and providing COVID-19 patient care. Table 2: Resources
Software and Algorithms Sentences Resources All analyses were performed with Statistical Package for Social Sciences V.25.0.2 (SPSS, Chicago, Illinois, USA) and R Version 3.4.1. SPSSsuggested: (SPSS, RRID:SCR_002865)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are important limitations of the current study that should be acknowledged. First, in round 1 we chose to rapidly recruit HCWs from existing research networks where we could accurately describe our study base population, limiting the number of HCWs we could invite for participation. Along with data collection taking place during the peak of the pandemic in Europe and restricting to a single reminder because of high clinical workload of HCWs, this ultimately led to small sample size. Therefore, round 2 was performed using convenience sampling, leading to different sampling methods used in the current study. Still, we excluded HCWs that possibly participated twice, and therefore do not expect that this influenced our results. Second, inherent to our survey design there is a risk of response bias, both on the level of demographic characteristics as well as on personal views. Third, this was a cross-sectional observational study using quantitative data, we therefore cannot draw conclusions on the direction of effects. Lastly, we were unable to triangulate responses with actual local PPE supplies and hospital infection rates.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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