Medical staff in hospitals were faced with great stress as a result of COVID-19’s sudden and severe occurrence, which makes investigating their resilience essential.

Using qualitative and quantitative research methods, this research studied medical staff (n = 403) working in a hospital during the COVID-19 pandemic and followed four main goals: First was evaluating the psychometric properties of the Persian version of Adult Resilience Measure-Revised (ARM-R). The second goal was investigating the personal, relational, social, and organizational issues facing the medical staff during the COVID-19 using semi-structural interviews. The third goal was to determine predictive effects of demographic and work-related variables on resilience using stepwise regression analysis. And the fourth was comparing resilience of three groups of the medical staff (coronavirus group consisted of the medical staff in direct contact with COVID-19 patients; emergency group who work in the emergency department who deal with both COVID and non-COVID patients; and non-coronavirus group who had no contact with COVID-19 patients) using one-way ANOVA.

Results showed that internal reliability/consistency, content, and face validity of the Persian version of the ARM-R are acceptable. The construct validity of the test was also verified using exploratory factor analysis and indicated the two factors of personal and relational resilience. The content of the interviews was analyzed using manifest content analysis, and the results were divided into 27 subcategories and 3 main categories including personal, organizational, and family categories. Moreover, regression analysis revealed that the marital status and age of children can explain resilience variance in some medical staff groups. The results of ANOVA and post hoc test also showed that the total resilience of the non-coronavirus group was greater than the coronavirus and emergency groups; the relational resilience of the coronavirus and non-coronavirus groups was greater than the emergency, and non-coronavirus group’s personal resilience was greater than the emergency group.

The highly infectious novel coronavirus disease (COVID-19) emerged in Wuhan, China in late 2019 and soon became a global pandemic. COVID-19 is escalating medical staff psychological stress and creating an increasingly heavy professional burden. Fear of transmitting the virus to family, community perception of frontline workers as potential disease carriers, extreme workloads and moral dilemmas add additional stressors. In Novi Sad Clinical Centre of Vojvodina (CCV) for the past 2 years there has been a continuous struggle against the COVID-19 crisis. Both senior specialist doctors and newly hired young doctors, some without work experience, were hired immediately after completing their studies.

To investigate the mental health of clinical first-line medical staff in COVID-19 pandemic.

This is a cross-sectional study involving CCV staff who worked in the first line of patient treatment during the COVID-19 pandemic. They were given a self-administered questionnaire which included information on demographic and socio-economic characteristics and the validated Depression, Anxiety, and Stress Scales (DASS-21) and the Impact of Events Scale–Revised (IES-R) instrument. A total of 190 medical workers were involved.

Sixty-two (32,6%) participants screened positive for anxiety, 38 (20%) for depression, 68 (35,8%) for stress, and 22 (11,5%) for clinical concern of PTSD. The most endangered are young nurses and doctors with less than 6 months of previous work experience.

In conclusion, our results suggest frontline medical staff involved in treatment of COVID-19 patients should be closely monitored as a high-risk group for depression and anxiety, and given proper training before deployment.

No significant relationships.

With the global spreading of Coronavirus disease (COVID-19), many primary care medical workers have been infected, particularly in the early stages of this pandemic. Although extensive studies have explored the COVID-19 transmission patterns and (non-) pharmaceutical intervention to protect the general public, limited research has analysed the measures to prevent nosocomial transmission based upon detailed interpersonal contacts between medical staff and patients.

This paper aims to develop and evaluate proactive prevention measures to contain the nosocomial transmission of COVID-19. The specific objectives are (1) to understand the virus transmission via interpersonal contacts among medical staff and patients; (2) to define proactive measures to reduce the risk of infection of medical staff and (3) evaluate the effectiveness of these measures to control the COVID-19 epidemic in hospitals.

We observed the operation of a typical primary hospital in China to understand the interpersonal contacts among medical staff and patients. We defined effective distance as the indicator for risk of transmission. Then three proactive measures were proposed based upon the observations, including a medical staff rotation system, the establishment of a separate fever clinic and medical staff working alone. Finally, the impacts of these measures are evaluated with a modified Susceptible-Exposure-Infected-Removed model accommodating the situation of hospitals and asymptomatic and latent infection of COVID-19. The case study was conducted with the hospital observed in December 2019 and February 2020.

The implementation of the medical staff rotation system has the most significant impact on containing the epidemic. The establishment of a separate fever clinic and medical staff working alone also benefits from inhibiting the epidemic outbreak. The simulation finds that if effective prevention and control measures are not taken in time, it will lead to a surge of infection cases in all asymptomatic probabilities and incubation periods.

Epidemics lead to an increase in occupational stress and psychological strain among medical staff (cf. Mulfinger et al. 2020). However, there are no validated questionnaires to measure stress caused by an epidemic such as Covid-19, instead self-constructed questions are used frequently.

The aim was to develop items for the assessment of specific workload in epidemics which can be used to obtain longitudinal data.

A sample of N=8078 persons working in the health care sector in Germany participated in the VOICE, EviPan online survey addressing the burden of Covid-19 pandemic during the 2nd quarter of 2020. We used 15 self-constructed items to examine whether these items can represent Covid-19 specific topics. A total of N=7549 (24% males) had complete data to run a confirmatory factor analysis using SEM procedure in Stata 14.2.

Five factors were identified a priory: Factor (F) 1: Workload due to Covid-19 pandemic (4 items; Cronbachs’ alpha (α))=0.740); F 2: Fear, uncertainty of SarsCoV-2infection (self and others) (3 items; α= 0.741); F 3: Patient safety (3 items; α=0.533; F 4: Perception of protection concepts (2 items; α=0.590); F 5: Dysfunctional coping strategies (3 items; α=0.447). Fit-Indices: χ²(73)= 1373.849, p<.001, CFI=.946, TLI=.923, RMSEA=.0049, SRMR=.037)

We identified 5 factors associated with problems occurring during the Covid-19 pandemic with acceptable to good internal consistency. Most of the constructed items could therefore be used in further surveys to monitor stress, as a basis for recommendations in the area of stress prevention and interventions for medical staff during epidemics.

During previous pandemic outbreaks, medical staff have reported high levels of psychological distress. The aim of the current study was to report a snapshot of the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic and its correlated factors on medical staff in Guangdong, China.

On the 2nd and 3rd February 2020, soon after the start of the COVID-19 pandemic, we surveyed medical staff at four hospitals in Guangdong, China, to collect demographic characteristics, Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-14), and Insomnia Severity Index (ISI) scores.

Complete responses were received from 1045 medical staff. Respondents were divided into high- and low-risk groups according to their working environment of contacting with potential or confirmed COVID-19 cases. The proportion of staff with anxiety (55.4% v. 43.0%, p < 0.001) or depression (43.6% v. 36.8%, p = 0.028) was significantly higher in the high-risk group than the low-risk group. The percentage of staff with severe anxiety was similar in the two groups. Doctors were more susceptible to moderate-to-severe depressive symptoms. The high-risk group had higher levels of clinical insomnia (13.5% v. 8.5%, p = 0.011) and were more likely to be in the upper quartile for stress symptoms (24.7% v. 19.3%, p = 0.037) than the low-risk group. Additionally, work experience negatively correlated with insomnia symptoms.

It is important for hospitals and authorities to protect both the physical and psychological health of medical staff during times of pandemic, even those with a low exposure risk.

The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.

From March 2–13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).

About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.

About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.

The aim of this study was to compare self-estimates of the physical, psychological, and general well-being of patients with amyotrophic lateral sclerosis (ALS) and their next of kin with the assessment of the nurses and physician of these participants.

The well-being of 35 pairs of patients and their next of kin was rated by themselves, and by a physician and nurses. The well-being was examined over time, using a visual analogue scale (VAS). Patients' physical function was estimated at the same time with the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised and the Norris scale.

The correlations between the staff's estimates of the well-being of patients and next of kin were similar to their own estimates, even though staff to a higher degree estimated a decrease in well-being over time among the patients. The estimates by the nurses correlated better to that of the patients and next of kin in psychological and general well-being than the physicians' estimates did.

Even though the staff's estimates of participants were roughly equivalent to their self-estimates, there were some differences. This result calls attention to the importance of working in teams in which different professional roles are combined and integrated, making it possible to form a holistic view of the situation of each family. A concern overlooked by one member of staff might be covered by another, and different focuses on the family may give a better composite picture of their life situation, which could lead to better support to the family.

Stress levels among staff in the Mater Misericordiae University Hospital Emergency Department were studied by questionnaire in 2000, which demonstrated a high level of self reported stress. The aim of this study was to ascertain if stress levels had reduced following changes in the department.

The study was repeated using the same questionnaire in 2006, after changes had occurred.

There was a significant reduction in the percentage of staff that reported they were under severe or unbearable stress, from 37% in 2000 to 10% in 2006 (p = 0.002). A total of 60% felt the social environment of their work was satisfactory in 2006 compared to 40% in 2000 (p = 0.03). Compared to 2000, a significantly lower proportion reported they had a low degree of control over their job, and a significantly higher proportion reported a medium level of control over their job in 2006 (p = 0.03).

Compared with the results of the previous study, reported stress levels have reduced overall, which coincided with a significant increase in staffing levels in the department.

Mental stress management of medical staff in an international medical cooperation (IMC) is important for effective activities.

The authors examined the mental stress of of IMC medical staff that was experienced throughout three activity periods. The activity periods included: (1) “Period A”, from decision-to-participate to arrival in the field; (2) “Period B”, from arrival in the field to before going back home; and (3) “Period C”, after going back home to three months after going back home. Self-administered questionnaires were used to examine the type of mental care preferred by staff. Participants were 154 medical staff members who worked in a past IMC. The data of 89 medical staff members were analyzed. The period of data collection was between August 2007 and November 2008.

The results clarified that 66 (74.1%) staff felt stress during Period A, 69 (77.5%) during Period B, and 47 (52.8%) during Period C. Main stress factors during Period A included “difficulty of gathering information”, “schedule coordination”, and “rapid environmental changes”; In Period B, “ambiguity of information”, “unexpected circumstances”, and “human relationship”; and in Period C, “lots of works after return to the hospital”, “prepare the activities report”, and “lack of taking vacation after IMC”.

Stress levels and factors gradually changed during activity periods in IMC activities. It is important to establish effective mental stress management systems for the future success of IMCs.

Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing.

To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events.

Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadiums first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a “DRUG-ROCK” Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests.

Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5±22.5 minutes (± standard deviation; range: 5–150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (±2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1–4), with 27% rated as moderate (score = 5–9), and 6% severe (score >10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p <0.005).

The DRISS was useful in stratifying the acuity level of this patient population. This severity score may serve as a potential triage mechanism for future mass gatherings such as rock concerts.