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      Risk perceptions and preventive practices of COVID-19 among healthcare professionals in public hospitals in Addis Ababa, Ethiopia

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          Abstract

          Healthcare professionals are at higher risk of contracting the new coronavirus disease 2019 (COVID-19). Although appropriate preventive measures are the most important interventions to prevent coronavirus infection among healthcare workers, they are also highly concerned about the consequences of the pandemic. The aim of this cross-sectional study was to assess preventive practices, perceived risk and worry about COVID-19 crisis among healthcare professionals at six public hospitals in Addis Ababa, Ethiopia. A systematic random sampling technique was used to select 1,134 respondents (52.6% females). Data were collected between 9 th and 20 th June 2020 using self-administered questionnaires. Descriptive statistics were used to summarize the data. A multiple linear regression analysis was performed to identify factors associated with worry about COVID-19 crisis. The highest percentage of respondents were nurses (39.3%) and physicians (22.2%), followed by interns (10.8%) and midwives (10.3%). Wearing facemask (93%) and frequent hand washing (93%) were the commonly reported preventive practices. Perceived risk of becoming infected with coronavirus (88%) and the potential risk of infection to their family (91%) were very high. The mean (median) worry score about COVID-19 crisis was 2.37 (3.0), on 1 to 3 scale, with 1 (not worried) and 3 (highly worried). The majority worried a lot about the health system being overwhelmed by COVID-19 patients (92%), the health of their loved ones (90%) and losing someone due to COVID-19 (89%). Respondents who had previously provided clinical care to Ebola, SARS and cholera patients had significantly lower levels of worry about COVID-19 crisis than participants who had not (β = -1.38, P<0.001). Our findings reveal respondents’ widespread practice of preventive measures, highest levels of perceived risk and worry about the COVID-19 crisis. Increased perceived risk and worry about COVID-19 might enable healthcare workers to adopt appropriate preventive measures more effectively against the disease.

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          The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus

          In December, 2019, a novel coronavirus outbreak of pneumonia emerged in Wuhan, Hubei province, China, 1 and has subsequently garnered attention around the world. 2 In the fight against the 2019 novel coronavirus (2019-nCoV), medical workers in Wuhan have been facing enormous pressure, including a high risk of infection and inadequate protection from contamination, overwork, frustration, discrimination, isolation, patients with negative emotions, a lack of contact with their families, and exhaustion. The severe situation is causing mental health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear. These mental health problems not only affect the medical workers' attention, understanding, and decision making ability, which might hinder the fight against 2019-nCoV, but could also have a lasting effect on their overall wellbeing. Protecting the mental health of these medical workers is thus important for control of the epidemic and their own long-term health. The local government of Wuhan has implemented policies to address these mental health problems. Medical staff infected with 2019-nCoV while at work will be identified as having work-related injuries. 3 As of Jan 25, 2020, 1230 medical workers have been sent from other provinces to Wuhan to care for patients who are infected and those with suspected infection, strengthen logistics support, and help reduce the pressure on health-care personnel. 4 Most general hospitals in Wuhan have established a shift system to allow front-line medical workers to rest and to take turns in high-pressured roles. Online platforms with medical advice have been provided to share information on how to decrease the risk of transmission between the patients in medical settings, which aims to eventually reduce the pressure on medical workers. Psychological intervention teams have been set up by the RenMin Hospital of Wuhan University and Mental Health Center of Wuhan, which comprise four groups of health-care staff. Firstly, the psychosocial response team (composed of managers and press officers in the hospitals) coordinates the management team's work and publicity tasks. Secondly, the psychological intervention technical support team (composed of senior psychological intervention experts) is responsible for formulating psychological intervention materials and rules, and providing technical guidance and supervision. Thirdly, the psychological intervention medical team, who are mainly psychiatrists, participates in clinical psychological intervention for health-care workers and patients. Lastly, the psychological assistance hotline teams (composed of volunteers who have received psychological assistance training in dealing with the 2019-nCoV epidemic) provide telephone guidance to help deal with mental health problems. Hundreds of medical workers are receiving these interventions, with good response, and their provision is expanding to more people and hospitals. Understanding the mental health response after a public health emergency might help medical workers and communities prepare for a population's response to a disaster. 5 On Jan 27, 2020, the National Health Commission of China published a national guideline of psychological crisis intervention for 2019-nCoV. 4 This publication marks the first time that guidance to provide multifaceted psychological protection of the mental health of medical workers has been initiated in China. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese Government and authorities around the world.
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            Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic

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              The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study

              Summary Background In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. Methods We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. Findings We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was “being fully responsible for patients' wellbeing—‘this is my duty’”. Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was “challenges of working on COVID-19 wards”. Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was “resilience amid challenges”. Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. Interpretation The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. Funding National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                25 June 2021
                2021
                25 June 2021
                : 16
                : 6
                : e0242471
                Affiliations
                [1 ] Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                [2 ] Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                [3 ] Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                Health Services Academy Islamabad Pakistan, PAKISTAN
                Author notes

                Competing Interests: The authors declare no competing interests.

                Author information
                https://orcid.org/0000-0002-9712-2375
                Article
                PONE-D-20-33821
                10.1371/journal.pone.0242471
                8232450
                34170910
                66009ef3-b999-4bb5-bb41-b7a7fb38305e
                © 2021 Deressa et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 27 October 2020
                : 15 June 2021
                Page count
                Figures: 1, Tables: 6, Pages: 17
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100007941, Addis Ababa University;
                Award ID: RD/LT-312/2020
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100007941, Addis Ababa University;
                Award ID: RD/LT-312/2020
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100007941, Addis Ababa University;
                Award ID: RD/LT-312/2020
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100007941, Addis Ababa University;
                Award ID: RD/LT-312/2020
                Award Recipient :
                This study was funded by Addis Ababa University.
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