Search Results (3,106)

Introduction: The work-related quality of life affects employee satisfaction and organizational effectiveness, with a direct impact on the quality of healthcare. This study aims to investigate the work-related quality of life (WRQoL) among nurses in tertiary healthcare, as perceived by the nurses themselves, in relation to their demographic and professional characteristics. At the same time, it seeks to highlight the way in which the individual dimensions of WRQoL influence their sexual and mental health. Materials and Methods: A descriptive cross-sectional study was conducted in 2023 in a General Hospital in Greece. Data were collected using structured questionnaires assessing sociodemo-graphic and occupational characteristics, WRQoL, mental health (Depression, Anxiety and Stress Scale—DASS-21), and female sexual function (Female Sexual Function Index—FSFI-19). Pearson correlation analysis and multiple linear regression analysis were performed. The regression model was adjusted for age, marital status, number of children, and work experience. Results: The results demonstrated a significant negative association between depression and sexual function (β = −0.388, p = 0.029), while stress was positively associated with sexual function (β = 0.371, p = 0.038). The overall regression model was statistically significant (p = 0.001), explaining 18.6% of the variance in sexual function. Conclusions: The findings highlight the close interrelationship between work-related quality of life, mental health, and sexual function among nurses. Poorer psychological well-being was associated with reduced sexual function, emphasizing the impact of occupational and emotional burden on nurses’ overall health. These results underline the importance of supportive workplace environments and targeted interventions to promote mental and sexual well-being among healthcare professionals. Full article

Background: In the context of a multi-stakeholder program promoted by Regione Lombardia in collaboration with Fondazione The Bridge and the University of Pavia, the present study investigates the organization and availability of hospital-based vaccination services for high-risk patients. Framing hospitals as strategic hubs for vaccination delivery, the study aimed to map service availability, operational settings and dedicated pathways across the region. Methods: A structured questionnaire was administered in 2025 to 40 healthcare organizations, encompassing 114 hospital facilities, including Local Health and Social Care Authorities (ASSTs) and both public and private Scientific Institutes for Research, Hospitalization and Healthcare (IRCCSs). Descriptive and inferential statistical analyses were performed, and findings were compared with those from the 2023 and 2024 editions of the same survey, developed within the “Vaccination—an opportunity for high-risk patients” project, using Pearson’s chi-square test. Results: In 2025, 99 facilities (86.8% of respondents) reported providing vaccination services for at-risk individuals. Dedicated vaccination pathways were generally available in more than 50% of facilities for nearly two-thirds of the risk categories considered. Vaccination services for diabetic patients were available in 70.7% of facilities. Among healthcare workers, influenza (93%) and SARS-CoV-2 (89.5%) vaccines were the most frequently offered, with rates approximately ten percentage points higher than those of other vaccines. Conclusions: Overall, these findings indicate a regional model progressively consolidating hospital-based vaccination for high-risk groups, with a consistent upward trend in service availability from 2023 to 2025. Full article

Background: Shift-working healthcare workers (HCWs) are at elevated cardiovascular (CV) risk due to chronic circadian disruption; however, gender-stratified data on CV risk profiles and modifiable risk factor distribution by occupational exposure duration remain scarce in the Italian hospital setting. This cross-sectional study aimed to characterise the 10-year CV risk profile and the distribution of modifiable risk factors in a hospital-based sample of shift-working HCWs. Methods: A retrospective cross-sectional study was conducted using data from routine occupational health surveillance of shift-working HCWs at a large Italian hospital in Salento, Southern Italy (survey year: 2025). The 10-year CV risk was estimated using the CUORE Project algorithm, validated for the Italian population. Risk was stratified by gender, age group, and shift work duration. Multivariable logistic regression models, adjusted for age, marital status, and presence of children at home, evaluated associations between selected risk factors and CV risk category. The study was reported in accordance with STROBE guidelines. Results: Of 765 HCWs included (320 males, 445 females; mean age 49.3 ± 8.5 years), male workers showed a significantly higher mean 10-year CV risk score (4.98 ± 2.8 vs. 1.34 ± 0.9; p < 0.05). Among male workers, the odds of moderate/high CV risk increased progressively with shift work duration (aOR 6.4 for >30 years). Males also showed significantly higher prevalence of arterial hypertension, overweight, and obesity across all strata. Conclusions: Male shift-working HCWs represent a higher-risk subgroup, characterised by a greater burden of modifiable cardiovascular risk factors. Integration of validated risk assessment tools into occupational health surveillance may support targeted preventive strategies in hospital settings. Full article

Background: Healthcare systems globally continue to experience persistent workforce and system-level challenges as increased workloads, lasting wellbeing impacts, and retention issues remain following the pandemic. To inform strategies and interventions to address these issues, this paper explored the workplace experiences of Victorian (Australia) frontline healthcare workers with parenting responsibilities during the COVID-19 pandemic. Methods: A total of 39 frontline healthcare workers from a large metropolitan hospital were interviewed between October 2020 and February 2021. Reflexive thematic analysis was used to analyse transcripts. Results: Three superordinate themes and five subordinate themes were identified. Themes highlighted the significant pressure that rapid workplace changes placed on healthcare staff and leaders, affecting their physical, mental, and relational health. Support from peers and supervisors was protective, though this increased demands on supervisors themselves. While many staff reported pride in their work, some experienced reduced career satisfaction and concerns about lasting psychological impacts. Conclusions: This study identifies how workplace supports operate through communication transparency, leadership capacity, and protected peer-support space, translating to organisational priorities for the post-pandemic workforce. In the context of ongoing workforce shortages and heightened demands post-pandemic, these findings underscore the importance of strengthening leadership capacity, embedding sustainable workplace supports, and addressing the psychological needs of healthcare staff. Such system-level responses are essential for pandemic recovery, improving workforce retention and staff wellbeing in the modern healthcare environment. Full article

Background/Objectives: Low back and neck pain are common musculoskeletal complaints among healthcare workers, including anesthesia providers. This study aims to quantify the prevalence of back and neck pain amongst anesthesiology providers to identify risk factors, mechanisms of injury, and recovery practices to guide preventative measures. Methods: A cross-sectional survey of anesthesiology clinicians in a multi-site academic healthcare system in New York City was administered using REDCap version 12.5.9. The recorded survey results were aggregated to determine percentages for each question. Descriptive statistics were used to determine the nature of low back and neck pain and detail causes. Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores were calculated. Results: The survey instrument was distributed to 380 anesthesiology clinicians at four separate institutions and yielded 191 responses for a response rate of 50.3%. Fifty-three-point-nine percent of survey respondents reported having current back or neck pain, with the majority reporting that it was chronic (87.4%). A substantial proportion of respondents reported not having back or neck pain prior to training (58.3%), and the majority reported that their back or neck pain was work-related (54.1%). Only 14.1% of respondents reported having had training in back or neck pain prevention. The most common location of pain was lumbar (81.6%). The most common inciting event for work-related pain was patient transfer/transport (68.6%). For ODI scoring, 98% of clinicians within the health system were classified as minimal disability and 2% of clinicians as moderate disability. For NDI scoring, 95.8% of clinicians were classified as minimally disabled, with 2.6% classified as moderate disabled. Conclusions: Back and neck pain are common pathologies amongst anesthesia providers. For most clinicians, the pain began to occur during training. Common inciting events include patient transfer/transport, procedure performance, and room setup. This provides a framework with which preventative practices can take place to reduce the prevalence of back and neck pain in anesthesiology and other related health care disciplines. Full article

Background: The nursing profession is recognized as a high-risk occupation, with the emotional toll on healthcare workers reaching a critical point. A complex interplay of anger and cynicism, often stemming from systemic pressures and chronic moral injury, seems to increasingly affect nurses’ professional and personal lives. This psychological strain does not end when the shift ends; rather, it often manifests as insomnia and nightmare distress, creating a vicious cycle of exhaustion and emotional instability. This article explores how anger, cynical distrust, nightmare distress and insomnia are interrelated and jeopardize the well-being of nursing staff and what these “invisible” symptoms reveal about the current state of healthcare by confirming their prevalence rates. Methods: This cross-sectional study was conducted online in October 2025 and included 441 hospital nurses who completed the Dimensions of Anger Reactions-5 (DAR-5), the 8-item Cynical Distrust scale (CDS-8), the Nightmare Distress Questionnaire (NDQ) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of anger, nightmare distress and insomnia were 41.5%, 6.6%, and 62.1%, respectively. Based on the CDS-8 scores, a notable proportion (20.9%) of nurses fell within the highest quartile of CDS-8 scores (CDS-8 > 29), indicating relatively elevated cynical distrust within this sample; this threshold is sample-derived and does not correspond to a validated clinical cut-off. Hierarchical multiple regression analysis indicated that the DAR-5 explained 22.1% of the variance in AIS, while an additional 10.2% was explained by NDQ and another 1.5% by the CDS-8. Both cynical distrust and nightmare distress displayed a chain mediation pattern in the association between anger and insomnia; however, given the cross-sectional design, the temporal order of these variables cannot be confirmed. Conclusions: Anger exhibited significant direct and indirect associations with insomnia, with cynical distrust and nightmare distress acting as serial mediators in this cross-sectional model. Findings from this cross-sectional study tentatively suggest that future intervention efforts targeting insomnia in nurses might benefit from addressing anger alongside nightmare distress and cynical attitudes; however, experimental studies are needed to confirm whether such interventions would be effective. Full article

Background/objective: The Immunisation Agenda 2030, led by the World Health Organization, aims to ensure that people of all ages benefit from vaccination. South Africa remains committed to these goals, strengthening childhood immunisation largely through the Expanded Programme on Immunisation. However, despite progress, the number of unvaccinated and partially vaccinated children continues to rise in some urban settings. This study sought to identify barriers to childhood immunisation in selected zero-dose urban communities in Gauteng Province. Methods: A qualitative exploratory–descriptive design was used to examine factors influencing childhood immunisation. Data were collected through seven focus group discussions and fifteen key informant interviews with purposively selected caregivers, community leaders, community health workers and healthcare workers involved in routine immunisation services at public healthcare facilities across the Cities of Johannesburg, Ekurhuleni, and Tshwane. Thematic analysis was conducted using NVivo^® software. Results: The study identified multiple demand-side and supply-side barriers. Demand-side barriers included limited parental knowledge, lack of trust in the government and immunisation services, religious beliefs, migration, and perceptions of caregiver substance use. Supply-side barriers involved distance to the facility, negative healthcare worker attitudes, long queues and waiting times, and frequent vaccine stock-outs. These barriers collectively contributed to missed opportunities and decreased uptake of immunisation services. Conclusions: Childhood immunisation remains a critical and cost-effective public health intervention. The findings demonstrate the complex interplay of individual and system-level factors influencing vaccine demand, uptake and persistent zero-dose status in urban Gauteng communities. Addressing these barriers requires a comprehensive approach that strengthens community trust, improves caregiver vaccine literacy, and ensures accessible, responsive, and respectful immunisation services. Full article

Background: Nurses’ job satisfaction is an important factor associated with motivation, retention, and performance, potentially influencing the quality and safety of healthcare delivery. Identifying organizational and professional determinants of job satisfaction is essential for the sustainability of healthcare systems. Objective: This study aims to describe nurses’ job satisfaction across its multiple dimensions and examine differences in job satisfaction dimensions across sociodemographic and professional groups. Methods: A quantitative, cross-sectional, descriptive–correlational study was conducted with 153 nurses. Data were collected between October and December 2024 using an online questionnaire, with a response rate of 28.9%, which included the Escala de Satisfação dos Enfermeiros com o Trabalho (ESET). Descriptive and inferential statistical analyses were performed, with the significance level set at 0.05. Results: Moderate levels of job satisfaction predominated among participants (75.8%), with 5.2% of participants reporting low satisfaction. The highest mean scores were observed in satisfaction with co-workers and professional recognition, while the lowest scores were found in the recognition and remuneration dimension. Statistically significant differences in mean job satisfaction scores were observed across groups defined by variables such as work setting, work schedule, weekly workload, and employment across multiple workplaces. Conclusions: Nurses’ job satisfaction is multidimensional and varies across different professional and organizational groups. These findings highlight areas of lower job satisfaction that may represent priorities for future organizational assessment and management attention. Full article

Based on the Job Demands–Resources theory, this research investigates how organisational resources shape employee resilience and, in turn, influence work engagement among nurses in the Lithuanian healthcare sector. The paper explores three organisational resources: co-worker support, staffing and recruitment adequacy, and dignified treatment for healthcare employees. Data were collected through a survey (n = 443) from nurses employed in public and private healthcare institutions and analysed using Partial Least Squares Structural Equation Modelling. The results indicate that co-worker support (β = 0.328, p < 0.001) and dignified treatment (β = 0.270, p < 0.001) are significant positive aspects of developing employee resilience, while staffing and recruitment adequacy did not have an impact on employee resilience. Employee resilience demonstrated a strong positive effect on work engagement (β = 0.488, p < 0.001). These findings help to understand the relations and structural antecedents of nurse resilience, demonstrating that social and interpersonal resources have a strong influence on employee engagement. The study has practical implications for healthcare human resource management in contexts of systemic workforce shortage and high occupational demand. Full article

Background: Among healthcare personnel, longitudinal studies have shown high levels of stress before, during and after the pandemic. The aim of this study was to examine the relationship between stress, psychological resilience, and sense of coherence in healthcare professionals. Subjects and Methods: In total, 203 healthcare professionals (63 physicians and 140 nurses) completed the Perceived Stress Scale (PSS), the Brief Resilience Scale (BRS), and the Sense of Coherence Questionnaire (SOC-13). The age, sex, and profession of the participants were recorded. Results: Women exhibited higher levels of perceived stress compared to males (18.450 ± 7.232 vs. 15.116 ± 5.662, t-test p < 0.05), as well as lower scores on the sense of coherence scale (57.525 ± 13.716 vs. 65.535 ± 12.481, t-test p < 0.05). No differences were observed with respect to profession. High levels of stress were recorded in 12.3% of workers and moderate values in 58.7%. The PSS demonstrated a negative correlation with both the SOC-13 and the BRS. The BRS showed a positive correlation with the SOC-13 (Pearson p < 0.01). Age showed no significant correlation. Linear regression analysis indicated that 49% of the variance in PSS was explained by SOC-13 and 3% by BRS. We subsequently investigated the hypothesis that the BRS may function as a mediator in the relationship between SOC-13 and PSS. Mediation analysis revealed that the BRS acts as a mediator in the relationship between SOC-13 and PSS. The indirect effect of BRS was statistically significant [b = −0.0770, 95% CI (−0.1312, −0.0216), p ≤ 0.01]. Furthermore, even in the presence of BRS mediation, the direct effect of SOC-13 on PSS remained significant [b = −0.2796, 95% CI (−0.3450, −0.2142), p ≤ 0.001]. Conclusions: High rates of stress, particularly in women healthcare professionals, appear to be intrinsically associated with the healthcare profession. It is likely that sense of coherence and psychological resilience can reduce stress, with resilience acting as a mediator. Full article

American Indian and Alaska Native (AI/AN) communities experienced disproportionate COVID-19 morbidity and mortality, particularly in rural areas with limited public health infrastructure. This study examined primary COVID-19 information sources among AI/AN adults in rural Michigan and evaluated how trust in these sources relates to health knowledge, attitudes, and vaccination behaviors. We conducted a prospective, randomized pre-post interventional study among 273 adults at a tribal health clinic in rural Isabella County, Michigan (2022–2024). Participants were assigned to receive a culturally tailored educational video or infographic, and surveys assessed COVID-19 knowledge, vaccine attitudes, information sources, and perceived reliability. Social media was the most frequently used information source but was rated as less reliable, whereas healthcare workers (HCWs) were considered the most trusted. Reliance on HCWs and personal relationships was associated with higher baseline vaccine knowledge and greater uptake of influenza vaccination. Both educational formats resulted in modest improvements in COVID-19 knowledge and vaccine attitudes. While no consistent differences were observed between formats overall, infographic-based education was associated with greater gains in select vaccine knowledge domains among participants who relied on trusted interpersonal or clinical information sources. These findings highlight a “usage-trust gap” in rural AI/AN health communication, where frequently used information channels are not necessarily the most trusted. Culturally tailored messaging delivered through trusted clinical and interpersonal networks may enhance the effectiveness of public health communication and support vaccine uptake in underserved communities. Full article

Background: The use of personal protective equipment (PPE) is essential to ensure infection prevention, healthcare worker safety, and reduce healthcare-associated infections in clinical settings. Innovative training approaches, such as virtual reality (VR), may enhance competency and clinical preparedness compared with traditional video-based instruction, supporting safer patient care practices. Methods: Participants were 84 students, with 42 participants in each group. The study was conducted at a public university in Saudi Arabia. The video-based group viewed a standardized educational video on PPE procedures, whereas the VR group engaged in a 13-min immersive 360° training module. Both groups completed pre- and post-intervention assessments to evaluate PPE competency. Primary outcomes included the PPE Knowledge Questionnaire and the Satisfaction and Self-Confidence in Learning Scale scores. Statistical analyses were conducted using SPSS. Results: Both instructional approaches significantly improved PPE-related competency, supporting infection prevention in clinical settings. The VR group demonstrated slightly higher post-intervention scores than the video-based group (p < 0.001). The magnitude of this difference was large (Cohen’s d ≈ 0.87; partial η² = 0.163), indicating a practical advantage of VR-based instruction over video-based learning. High satisfaction and self-confidence were reported among VR participants, indicating positive perceptions of clinical preparedness, although these were not significantly associated with competency gains. Conclusions: Both VR- and video-based training significantly enhanced PPE competency, supporting improved infection prevention practices. VR demonstrated a marginal advantage and was associated with high levels of satisfaction and confidence, highlighting its value as an effective training approach to strengthen healthcare workforce preparedness and patient safety. Full article

Background: An outbreak of Marburg virus in Jinka Town, Southern Ethiopia, has raised significant concern regarding the potential spreading of disease throughout the country. Healthcare workers play a crucial role in early prevention and control of such an outbreak. However, the knowledge, attitudes, and preparedness of healthcare workers regarding Marburg virus disease have not been assessed yet, despite these factors being critical for early prevention and control of an outbreak. This study aimed to assess the knowledge, attitude, and preparedness regarding Marburg virus disease among healthcare workers in Awi Zone public hospitals, northwest Ethiopia, in 2026. Methods: An institutional-based cross-sectional study was conducted among healthcare workers in Awi Zone public hospitals from 26 December 2025 to 10 January 2026. A simple random sampling technique was used to select 394 participants. The data were collected using a pre-tested, structured self-administered questionnaire. The data were entered into Epi-data version 4.6 and analyzed using SPSS version 25. Results: A total of 394 healthcare workers participated in this study. The mean age of the participants was 32.9 ± 4.87 years. The study revealed that 47.7% (95% CI: 42.78–52.62%) and 61.2% (95% CI: 56.4–66%) of participants had good knowledge and a positive attitude towards Marburg virus disease, respectively. However, only 20.3% (95% CI: 16.34–24.26%) demonstrated good preparedness for the Marburg virus outbreak. Conclusions: The study revealed that the majority of healthcare workers had positive attitudes and suboptimal knowledge but critically low preparedness regarding Marburg virus disease prevention and control in Awi Zone public hospitals, northwest Ethiopia. Hence, healthcare workers who are frontline staff for outbreak prevention and control, Awi zone health departments and hospital administrators should be provided with targeted training preparation, training for implementing emergency preparedness plans, and essential infection prevention protocols to improve readiness for a potential outbreak. Full article

The coronavirus (COVID-19) pandemic necessitated unprecedented regulatory responses that enabled rapid therapeutic deployment. The integrated medico-legal framework—comprising the FD&C Act Section 564 (Emergency Use Authorization/EUA), PREP Act (liability immunity), and CICP (injury compensation)—facilitated emergency response while protecting all stakeholders. This normative legal and policy analysis examines nirmatrelvir/ritonavir (Paxlovid) as a case study, integrating emerging pharmacokinetic evidence demonstrating its passage across the blood–brain and blood–placenta barriers. The EUA-PREP-CICP framework achieved notable results: nirmatrelvir/ritonavir’s authorization enabled deployment approximately 1 year after trials began, demonstrating an 89% reduction in the risk of hospitalization or death and potentially preventing thousands of hospitalizations. The PREP Act enabled focused pharmaceutical development and protected frontline healthcare workers during the crisis, though access barriers and transparency concerns remain areas warranting ongoing attention. The CICP provided administrative compensation for qualifying injuries, with acknowledged limitations in filing timelines and causation standards. Pharmacokinetic studies published after authorization revealed biological barrier crossing, representing normal scientific progress through continued investigation. The EUA-PREP-CICP nexus functioned as an integrated system: EUA enabled rapid evidence-based access, PREP immunity facilitated development and deployment, and CICP provided injury remedy. Based on this experience, this study proposes targeted enhancements to further strengthen this framework: systematic post-authorization surveillance timelines, enhanced special population monitoring through registries, modest procedural refinements to CICP, and improved surveillance infrastructure. These evidence-based improvements would build on the framework’s demonstrated strengths, optimizing performance for future emergencies while preserving the essential functions that helped address the COVID-19 pandemic. Full article

Background: Antibiotic resistance (ABR) is a critical global health threat, disproportionately affecting low- and middle-income countries (LMICs) where systemic constraints, economic pressures and sociocultural factors drive inappropriate antibiotic use. While quantitative studies describe prevalence patterns, they fail to capture the underlying motivations and contextual barriers influencing prescribing and dispensing behaviors. This systematic review synthesizes qualitative evidence on the perceptions of healthcare professionals, patients, and caregivers regarding antibiotic use and explores the barriers and facilitators for implementing antibiotic stewardship programs in LMIC healthcare settings. Methods: We conducted a systematic review following PRISMA 2020 guidelines, based on a registered protocol in PROSPERO ID: CRD42024583749. Searches were performed in Medline, Embase, Cochrane Library, Web of Science, and Google Scholar for English-language studies published between 2014 and 2024. Qualitative and mixed-method studies examining stakeholder perspectives on antibiotic use and antibiotic stewardship implementation in LMICs were included. Studies were excluded if they focused exclusively on pediatric or neonatal populations, veterinary medicine, or quantitative outcomes without qualitative components. The data were analyzed using thematic analysis to identify and categorize codes and identify themes following methodological quality assessment of included studies using the Critical Appraisal Skills Programme Qualitative Studies Checklist by two independent reviewers. Results: Out of 2214 studies screened, a total of 119 studies from 33 LMICs were included, encompassing over 4000 participants across hospital, primary care, and community settings. Five interlinked themes emerged: (1) antibiotic use as a pragmatic response to diagnostic uncertainty and resource constraints; (2) financial and commercial drivers shaping prescribing and dispensing practices; (3) the disconnect between knowledge, sociocultural norms, and clinical behavior; (4) multi-level structural and professional barriers to antibiotic stewardship implementation; and (5) the critical role of health system vulnerabilities in perpetuating misuse. Conclusions: Inappropriate antibiotic use in LMICs reflects rational adaptations to systemic limitations rather than isolated knowledge gaps. Effective ABS strategies must address structural deficiencies, economic incentives, and sociocultural norms, while integrating context-specific interventions that strengthen health systems and engage all levels of care. The findings should, however, be evaluated in light of the geographic unevenness of the evidence base, the exclusion of non-English and gray literature, and lack of certainty assessments for synthesized themes. Full article