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      Determination of stress, depression and burnout levels of front‐line nurses during the COVID‐19 pandemic

      research-article
      , MSN, RN 1 , , , PhD, RN 1 , , PhD, RN 2
      International Journal of Mental Health Nursing
      John Wiley and Sons Inc.
      COVID‐19, depression, mental health, nurses, stress

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          Abstract

          All healthcare professionals, especially nurses, are affected psychosocially due to reasons such as uncertainty and work intensity experienced during the COVID‐19 pandemic. In this descriptive study, it was aimed to determine the stress, depression and burnout levels of front‐line nurses. Data were obtained from 705 nurses who worked at hospitals during the COVID‐19 pandemic between May and July 2020, using a Personal Information Form, the Perceived Stress Scale, Beck Depression Inventory and Maslach Burnout Inventory. The data collection tools were sent online to nurse managers, requesting front‐line nurses to answer the forms and scales. The nurses were mostly women and had bachelor’s degrees, single and worked as nurses for between 1 and 10 years. They had high levels of stress and burnout and moderate depression. Those who were younger and had fewer years of work experience felt inadequate about nursing care and had higher levels of stress and burnout. More burnout was detected in nurses who had a positive COVID‐19 test and did not want to work voluntarily during the pandemic. The authors suggest that preventive and promotive interventions in mental health should be planned and implemented to improve the mental health and maintain the well‐being of front‐line nurses during the pandemic, and to prepare nurses who may work during pandemics in the future.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              Is Open Access

              Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

              Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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                Author and article information

                Contributors
                Role: Research Assistantsmmurat@biruni.edu.tr , murat.merve@yahoo.com
                Role: Assistant Professor
                Role: Professor
                Journal
                Int J Ment Health Nurs
                Int J Ment Health Nurs
                10.1111/(ISSN)1447-0349
                INM
                International Journal of Mental Health Nursing
                John Wiley and Sons Inc. (Hoboken )
                1445-8330
                1447-0349
                21 November 2020
                : 10.1111/inm.12818
                Affiliations
                [ 1 ] Department of Nursing Health Sciences Faculty Biruni University Istanbul Turkey
                [ 2 ] Vice Rector Biruni University Istanbul Turkey
                Author notes
                [*] [* ] Correspondence: Merve Murat, Biruni University, Health Sciences Faculty, Department of Nursing, Istanbul, Turkey 10. Yıl Caddesi Protokol Yolu No: 45 34010 Topkapı/İstanbul. Emails: mmurat@ 123456biruni.edu.tr ; murat.merve@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0002-5704-6814
                https://orcid.org/0000-0003-4958-6228
                https://orcid.org/0000-0003-3251-8712
                Article
                INM12818
                10.1111/inm.12818
                7753629
                33222350
                150caeb6-c768-49a7-9aef-735915dcd258
                © 2020 Australian College of Mental Health Nurses Inc.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 28 September 2020
                : 27 October 2020
                : 02 November 2020
                Page count
                Figures: 0, Tables: 4, Pages: 11, Words: 17372
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.6 mode:remove_FC converted:22.12.2020

                Nursing
                covid‐19,depression,mental health,nurses,stress
                Nursing
                covid‐19, depression, mental health, nurses, stress

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