IntroductionThis study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organizational measures. The aim is to explore “blind spots” of pandemic protection and make mental health needs of HCWs visible.MethodsWe have chosen an “optimal-case” scenario of a high-income country with a well-resourced hospital sector and low HCW infection rate at the organizational level to explore governance gaps in HCW protection. A German multi-method hospital study at Hannover Medical School served as empirical case; document analysis, expert information and survey data (n = 1,163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care.ResultsThe results reveal a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed “some” to “very strong” fear of acquiring infection at the workplace. Individual protective behavior and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived “no” or “little” protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behavior, but nursing was correlated with higher levels of personal risk estimations and fear of infection.ConclusionsA strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through better information, training/education and risk communication and through investment in mental health and inclusion in pandemic preparedness plans.
Background: Patients who are post-COVID-19 will require more treatment soon. Therefore, it is important to understand the root cause of their psychological and somatic conditions. Previous studies showed contradictory results on the influence of pre-existing mental conditions. The present study examines the influence of these pre-existing conditions and their pre-treatment on the severity of post-COVID-19 symptoms. Methods: This analysis employs questionnaire data from a large study sample in Germany. Overall, 801 participants were included. All participants rated their health status on a scale from 0 to 100. Fatigue, depression, and anxiety were measured using the FAS, PHQ-9, and GAD-7 scales. Results: All pre-pandemic values showed no significant differences between the groups. The current health status was rated similarly by the recovered patients (μ = 80.5 ± 17.0) and the control group (μ = 81.2 ± 18.0) but significantly worse by acutely infected (μ = 59.0 ± 21.5) and post-COVID-19 patients (μ = 54.2 ± 21.1). Fatigue, depression, and anxiety were similar for recovered patients and the control group. By contrast, there were significant differences between the control and the post-COVID-19 groups concerning fatigue (45.9% vs. 93.1%), depression (19.3% vs. 53.8%), and anxiety (19.3% vs. 22.3%). Conclusion: Fatigue and psychological conditions of post-COVID-19 patients are not associated with pre-existing conditions.
BACKGROUND Post COVID-19 condition (Long COVID) is a relatively novel disease comprising physical, psychological, and cognitive complaints persisting several weeks to months after acute infection with SARS-CoV-2. Around 10% of persons experiencing COVID-19 are affected by long-term symptoms. Thus far, effective treatment strategies against Long COVID are scarce. OBJECTIVE ErgoLoCo strives to develop and evaluate a novel, online-delivered occupational therapy for long COVID. The primary objective of this study is to assess the feasibility of online occupational therapy in long COVID. The secondary aims are the evaluation of online occupational therapy's effects on cognitive problems and occupational performance and data collection on the individual experiences of clients and medical professionals with digital occupational therapy. METHODS This randomized controlled interventional pilot study has parallel mixed-methods process analyses and a realist evaluation approach. We plan to enrol 80 long COVID clients aged 16 years or older in an interventional group. The control cohort consists of n=80 long COVID clients without digital occupational therapy. Treatment is provided through an online occupational therapy protocol (occupational therapy twice weekly over 12 weeks, delivered either via live online meetings (n=40) or in prerecorded video sessions (n=40). To analyze the central question of this pilot study (Is online occupational therapy feasible in long COVID?), quantitative questionnaires and qualitative interviews based on the Theoretical Framework of Acceptability (TFA) will be used. Furthermore, focus group meetings assess how helpful and acceptable the intervention was to occupational therapists. To assess neurocognitive impairments and limitations in mobility, self-care, usual activities, pain, disabilities, anxiety, as well as depression in Post COVID-19 condition (Long COVID) and the possible effects of online occupational therapy on these problems, standardized tests such as WIT-2, D2r, NeuroQual, COPM, and EQ-5D-5L will be used. The study is registered in the German Clinical Trial Registry (# DRKS00029990) and reviewed by the institutional review boards of participating sites. RESULTS We will assess whether digital occupational therapy is a feasible treatment for long COVID. We will furthermore test possible improvements in cognitive symptoms and performance in relevant daily activities after completion of the online occupational therapy program and analyze differences in occupational therapy acceptance when comparing personal care to prerecorded video therapy. CONCLUSIONS This randomized controlled pilot study is designed to evaluate the feasibility, acceptability and effectiveness of occupational therapy in long COVID and gain first insights into possible beneficial effects of digital occupational therapy in this disease. CLINICALTRIAL German Clinical Trial Registry (# DRKS00029990)
Background This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organisational measures. We aim to explore ‘blind spots’ of pandemic protection and identify mental health needs. Methods A German multi-method hospital study at Hannover Medical School serves as an ‘optimal-case’ scenario of a high-income country, well-resourced hospital sector and an organisation with low HCW infection rate serves to explore governance gaps in HCW protection. Document analysis, expert information and survey data (n = 1163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care. Results Our study reveals a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed ‘some’ to ‘very strong’ fear of acquiring infection at the workplace. Individual protective behaviour and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived ‘no’ or ‘little’ protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behaviour, but nursing was correlated with higher levels of personal risk estimations and fear of infection. Conclusions A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through improved information, risk communication and inclusion of mental health support in pandemic preparedness. Key messages • Healthcare workers’ perceptions of COVID-19 infection risks are much higher than medically approved infection risk. • Pandemic preparedness and protection plans must pay greater attention to information, risk communication and mental health needs.
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