The world is social distancing and compulsory confinement has caused stress, psychological instability, stigmatization, fear, and discrimination in the general population. In this cross-sectional survey study, we administered the Fear of COVID-19 Scale (FCV-19S) to hospital medical and nonmedical personnel. A total of 1,216 participants were included in the study. We found that the global FCV-19S mean score was 16.4 ± 6.1, with a significant difference between women and men’s scores. Medical students presented higher scores than experienced medical personnel. As the medical and nursing personnel scored higher on the FCV-19S than the nonmedical hospital staff, our findings suggest that greater knowledge of medicine or infectious diseases could decrease the overall psychological impact of the pandemic disease.
The presence of COVID-19 has had psychological consequences among health personnel; these include fear, anxiety, and depression. In the current study, we used the Fear of COVID-19 Scale (FCV-19S) to assess the response to fear within health staff in Mexico. This was a cross-sectional survey study in which we administered the FCV-19S to hospital staff. A total of 2,860 participants—1,641 female and 1,218 male personnel from three hospitals—were included in the study. We found a global FCV-19S mean score of 19.3 ± 6.9, with a significant difference in scores for women and men. There was a high correlation between items 3, 5, 6, and 7, suggesting that these items could indicate the physiological responses to fear, and a high correlation between items 1, 2, and 4, suggesting these items could represent the emotional responses to fear. Our survey shows a significantly higher level of fear in nursing and administrative personnel, which may be explained by the nursing staff being in close contact with infected patients and the administrative staff lacking understanding of the possible implications of the infection, compared with non-clinical hospital personnel. The FCV-19S showed validity and reliability in our population to assess fear in response to COVID-19. Our results are consistent with those of other researchers.
Background There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2–15.1], 13 J/min [IQR 10–17], and 14 J/min [IQR 11–20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14–1.30) and HD3 (1.38, 95% CI 1.23–1.53), reintubation on HD1 (1.64; 95% CI 1.57–1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18–1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56–2.78) and HD3 (1.76; 95% CI 1.41–2.22). Conclusions Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation.
BackgroundThe incidence of mental disorders during major events is higher in prenatal and postnatal women than in the general population. The COVID-19 pandemic, subsequent lockdown, and social distancing may have caused changes in newborn mothers’ mental health, postpartum depression (PPD), and breastfeeding practices. There is no information about this topic in Mexican mothers who have delivered newborns during the COVID-19 pandemic lockdown. The objective of this study was to explore whether quarantine measures, social distancing, and hospital containment policies altered the incidence rates of PPD, breastfeeding adherence, and skin-to-skin contact (SSC) in women giving birth during the COVID-19 pandemic.MethodsThis cross-sectional study included women who delivered a healthy baby at term in February to July 2020 during the COVID-19 pandemic. Participants completed an anonymous online survey incorporating the Edinburgh Postnatal Depression Scale.ResultsA total of 211 participants were included; their mean age was 30.5 ± 4.6 years and the gestational age at the time of delivery was 38.3 ± 2.0 weeks. Sixty (28.4%) participants reported PPD, and 196 (92.9%) reported breastfeeding their baby during COVID-19. Mothers with PPD had lower levels of exclusive breastfeeding (P = 0.66) and breastfeeding with formula (P = 0.29). Only 23 participants (10.9%) stopped breastfeeding because of issues with latching (30.4%). SSC was reported by 63% of participants and was more frequent immediately after birth (46%). Mothers with PPD reported less frequent SSC (P = 0.001) and later initiation of SSC (P = 0.001) after childbirth. Mothers who initiated SSC used exclusive breastfeeding more frequently during the first 48 h after birth (P = 0.004).ConclusionsWe found a higher prevalence of PPD in new mothers during the pandemic. Mothers reporting PPD were less likely to initiate SSC after birth. These findings suggest that the pandemic and the measures adopted to fight its spread may have harmed maternal well-being during pregnancy and after delivery. Women giving birth during the COVID-19 pandemic represent a vulnerable population that may need focused health care. SSC is a simple, cost-effective intervention that may help reduce the incidence of PPD.Trial registrationThis cross-sectional study is registered with ClinicalTrials.gov (NCT04769700).
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