@misc{SchulzeMerzThieretal., author = {Schulze, Susanne and Merz, Sibille and Thier, Anne and Tallarek, Marie and K{\"o}nig, Franziska and Uhlenbrock, Greta and N{\"u}bling, Matthias and Lincke, Hans-Joachim and Rapp, Michael A. and Spallek, Jacob and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic: a cross-sectional study with quantitative and qualitative data}, series = {BMC health services research}, volume = {22}, journal = {BMC health services research}, issn = {1472-6963}, doi = {10.1186/s12913-022-08333-3}, pages = {1 -- 13}, abstract = {Background: The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods: We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results: Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. Conclusions: Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.}, language = {en} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Did the COVID-19 pandemic affect depressive symptoms? Longitudinal analysis of health worker data}, series = {European Journal of Public Health,16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023}, volume = {33}, journal = {European Journal of Public Health,16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023}, number = {2}, issn = {1101-1262}, doi = {10.1093/eurpub/ckad160.334}, abstract = {Background Health workers play a vital role in response to outbreaks under pandemic circumstances, but are also highly vulnerable to stress-related mental health issues (e.g., due to pandemic workload). There are knowledge gaps regarding temporal development of the emergence of depressive symptoms among health workers during the COVID-19 pandemic and their determinants. This study examined the trajectory of depressive symptoms and their association with a) stress perception, b) own COVID-19 infection and c) COVID-19 exposure at work. Methods This cohort study with 91 health workers (90\% female, x⎯⎯=45 years) from a German general hospital included (1) medical, nursing and therapeutic staff and (2) administrative staff. Data were collected longitudinally every month from July to December 2020. Linear multilevel models were used to evaluate associations between trajectories of depression scores (German 'General Depression Scale') with perceived stress ('Perceived Stress Scale'). Laboratory-confirmed COVID-19 infection was tested as a moderator of depressive symptom development. Trajectoires of depressive symptom modalities (e.g., somatic, emotional) were analysed stratified by COVID-19 exposure at work. Results Depression scores increased across the study period (b=.03, .02-.05). Perceived stress was associated with depression scores (b=.12, .10-.14). The presence of health workers' own COVID-19 infection was associated with a higher increase (b=.06, .01-.10). Somatic symptoms of depression increased over time only among health workers directly exposed to COVID-19 patients at work (b=.25, .13-.38). Conclusions The increase in depressive symptomatology among health workers exposed to COVID-19 in the workplace points to the need for further research. Since the infection with COVID-19 is associated with an increase of depressive symptoms across time, awareness should be raised about measures to protect against virus transmission, especially during a pandemic. Exposure to COVID-19 in the workplace is associated with increased somatic depressive symptoms.}, language = {en} } @misc{UhlenbrockSchulzeSappletal., author = {Uhlenbrock, Greta and Schulze, Susanne and Sappl, Isabella and Rapp, Michael A. and Tallarek, Marie and Spallek, Jacob and Holmberg, Christine}, title = {Sorge vor Covid-19-Infektion und das Risiko f{\"u}r Burnout-Symptome: eine Studie zur Belastung von Pflegekr{\"a}ften in Brandenburger Pflegeheimen w{\"a}hrend der Covid-19-Pandemie}, series = {Psychiatrische Praxis}, volume = {50}, journal = {Psychiatrische Praxis}, number = {7}, issn = {1439-0876}, doi = {10.1055/a-2019-6495}, pages = {353 -- 360}, abstract = {Ziel der Studie Untersuchung der Assoziation von Sorge vor eigener Infektion oder der Infektion von Freunden, Familie und Pflegebed{\"u}rftigen mit Covid-19 und Burnout-Symptomen von Pflegekr{\"a}ften in Brandenburger vollstation{\"a}ren Altenpflegeeinrichtungen. Methodik Querschnittliche Befragung von Pflegekr{\"a}ften (n=195) in Brandenburger Pflegeheimen zwischen August und Dezember 2020 hinsichtlich ihrer psychosozialen Belastung am Arbeitsplatz. Ergebnisse Das Vorliegen der Sorge, sich selbst, Familie und/oder Freunde oder Pflegebed{\"u}rftige mit Covid-19 infiziert zu haben, ist mit einer erh{\"o}hten Auspr{\"a}gung von Burnout-Symptomen assoziiert (b=0,200, t(155)=2,777, p=0,006). Schlussfolgerung Ein erh{\"o}htes Erleben von Burnout-Symptomen durch die Sorge eines Infektionsrisikos mit Covid-19 am Arbeitsplatz spricht f{\"u}r den Bedarf umfassender Unterst{\"u}tzungsmaßnahmen sowie nachhaltiger Konzepte zum Umgang mit psychosozialer Belastung f{\"u}r Pflegekr{\"a}fte in der Altenpflege.}, language = {de} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Hufert, Frank and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers}, series = {International Journal of Social Psychiatry}, volume = {70}, journal = {International Journal of Social Psychiatry}, number = {1}, issn = {0020-7640}, doi = {10.1177/00207640231196737}, pages = {87 -- 98}, abstract = {Background: Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. Methods: The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95\% confidence interval). Results: Depression scores increased significantly during the study period (β = .03, 95\% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95\% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95\% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95\% CI [0.13, 0.38]), but not in administrators (β = .03, 95\% CI [-0.04, 0.11]). Conclusion: Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.}, language = {en} } @misc{TschornSchulzeFoerstneretal., author = {Tschorn, Mira and Schulze, Susanne and F{\"o}rstner, Bernd R. and Holmberg, Christine and Spallek, Jacob and Heinz, Andreas and Rapp, Michael A.}, title = {Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe}, series = {Aging \& Mental Health}, volume = {27 (2023)}, journal = {Aging \& Mental Health}, number = {5}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2076208}, pages = {1001 -- 1010}, abstract = {Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4\% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.}, language = {en} } @misc{SchulzeMerzLinckeetal., author = {Schulze, Susanne and Merz, Sibille and Lincke, Hans-Joachim and N{\"u}bling, Matthias and Rapp, Michael A. and Spallek, Jacob and Tallarek, Marie and Thier, Anne Kathrin and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic}, series = {21. Deutscher Kongress f{\"u}r Versorgungsforschung (DKVF) : 05.10.-07.10.2022, Potsdam}, journal = {21. Deutscher Kongress f{\"u}r Versorgungsforschung (DKVF) : 05.10.-07.10.2022, Potsdam}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkvf025}, abstract = {Background: Nurses' work-related strain and psychological burden increased during the Covid-19 pandemic, resulting in high prevalences of mental health problems among nurses worldwide. Nurses in long-term care facilities seem to be particularly prone to overall heightened burden and poor mental health. Research question: We investigated which work-related psychosocial burdens and potential positive aspects nurses working in nursing homes experience during the Covid-19 pandemic. Method: We conducted a mixed-methods study. Eligible for participation were nurses and nursing assistants working in nursing homes within the state of Brandenburg, Germany. Between August and October 2020, we distributed an anonymous survey containing the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses, drawn from the German COPSOQ databank and kindly shared by the Freiburg Research Centre for Occupational Science. In June 2021, we also conducted semi-structured interviews with geriatric nurses to reach a deeper understanding of their experiences on work-related changes and burdens during the first phases of the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results: Our survey sample (n=177) differed significantly from the reference group in 14 out of 31 COPSOQ scales. Amongst others, our sample scored significantly worse regarding the scales 'support at work', 'recognition', 'quantitative demands', 'hiding emotions', 'role conflicts', 'intention to leave profession', 'burnout' and 'inability to relax'. The interviews (n=17) revealed five main themes related to nurses' psychosocial stress: 'overall working conditions under the hygiene measures', 'concern for isolated residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' and 'meaning of work' were identified as positive effects of the pandemic. Discussion: Results indicate that nurses in nursing homes experience enhanced psychosocial and work-related strain. The comparisons with the pre-pandemic reference group suggest that the situation further aggravated during the pandemic. Nurses exhibited high psychosocial burden, e.g., due to strongly impeded possibilities to fulfill the emotional and social dimensions of care and the constant fear of infection or transmission. Deteriorated working conditions (e.g., higher workload through staff shortages and additional tasks) further exacerbated these burdens. Few positive aspects of the pandemic may be important sources of resilience. Practical implications: The reduction of nurses' strain through psychosocial support and the improvement of working conditions is crucial for the protection of nurses' health. Appeal for practice in one sentence: Political players as well as care facilities should take measures to improve nurses' situation in order to maintain a healthy workforce and high-quality care.}, language = {en} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Hufert, Frank and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Depressive Symptome bei Besch{\"a}ftigten im Gesundheitswesen w{\"a}hrend der COVID-19-Pandemie: Ergebnisse einer Kohortenstudie in einem Krankenhaus der Regelversorgung in Deutschland}, series = {Gesundheitswesen}, volume = {85}, journal = {Gesundheitswesen}, number = {809}, doi = {10.1055/s-0043-1770597}, abstract = {Einleitung Bisher liegen in Deutschland wenig empirische Ergebnisse zu den Auswirkungen der COVID-19 Pandemie auf die seelische Gesundheit von Besch{\"a}ftigten im Gesundheitswesen vor. In dieser Studie wird die zeitliche Entwicklung depressiver Symptome und der Zusammenhang mit a) der Stresswahrnehmung, b) der eigenen COVID-19-Infektion und c) der arbeitsplatzbezogenen COVID-19-Exposition untersucht. Methoden Die Kohortenstudie mit 91 Besch{\"a}ftigten (90\% wbl, x̅=45 Jr) eines Krankenhauses schloss (1) medizinisches, pflegerisches und therapeutisches sowie (2) administratives Personal im Zeitraum von Juli 2020 bis Dezember 2020 ein. Gemischte Modelle analysierten zeitliche Depressionswerte ('Allg. Depressionsskala') mit wahrgenommenem Stress ('Perceived Stress Scale'). Eine eigene COVID-19-Infektion (Laborbefund) wurde als Moderator getestet. Die zeitliche Entwicklung von Symptommodalit{\"a}ten (u.a. somatisch) wurde nach beruflicher Exposition analysiert. Ergebnisse Die Depressionswerte stiegen insgesamt w{\"a}hrend des Studienzeitraums an (b=.03, .02-.05). Stressempfinden war mit depressiven Symptomen assoziiert (b=.12, .10-.14). Eine eigene Infektion war mit einem h{\"o}heren Anstieg assoziiert (b=.06, .01-.10). Somatische Depressionssymptome nahmen nur bei beruflichem Kontakt mit COVID-19 zu (b=.25, .13-.38). Schlussfolgerung Die Zunahme somatischer depressiver Symptome bei Besch{\"a}ftigten mit beruflichem Kontakt zu COVID-19 zeigt einen Bedarf an Forschung {\"u}ber und Ressourcen f{\"u}r Gesundheitsschutz und -f{\"o}rderung. Das Bewusstsein f{\"u}r Schutzmaßnahmen sollte gest{\"a}rkt werden.}, language = {de} }