Understanding COVID-19-related Burnout in Qatar's Community Pharmacists using the Job Demands-Resources Theory

Community pharmacists are one of the most accessible front-liners against the COVID-19 pandemic. Whilst playing a vital role in medication supply and patient education, exposure to pandemic demands and prolonged stressors such as risk of infection increases their risk of burnout. Using the Job Demands-Resources theory, this research aims to identify factors affecting community pharmacists' COVID-19-related burnout, their coping strategies against it, and recommendations on interventions to mitigate it. This is a qualitative study in which Qatar community pharmacists, with informed consent, took part in semi-structured focus groups/interviews which were recorded, transcribed, and analyzed using inductive/deductive analysis. Twelve themes emerged from six focus groups, six dyadic interviews and mini focus groups, and four individual interviews. The contributing factors to community pharmacist' burnout were identified as practical job demands, and emotional demands such as fear of infection. However, government and workplace-specific resources, pharmacists' personal characteristics such as resiliency and optimism, as well as implementation of coping strategies, reduced their stress and burnout. This is the first study to explore the contributing factors to community pharmacists' COVID-19-related burnout using the job-demands resource model. In turn, individual, organizational, and national recommendations can be made to mitigate burnout in community pharmacists during the pandemic

Exploring QU Health Students' Experiences of Burnout, Anxiety, and Empathy during the COVID-19 Pandemic: A Mixed Method Study

Background Students' mental health is a growing concern. COVID-19 pandemic resulted in academic and non-academic challenges which caused students' burnout, anxiety, and reduced empathy. Objectives The study objectives were to assess burnout amongst QU Health students, determine the relationship between burnout and anxiety, and burnout and empathy, and to determine the students coping strategies. Methods A convergent mixed-methods design was used: (1) a cross-sectional survey using validated instruments. Maslach Burnout Inventory-General Students Survey (MBI-GS(S)) to measure burnout, Generalized Anxiety Disorder 7-item Scale (GAD-7) to measure anxiety, and Interpersonal Reactivity Index (IRI) to measure empathy; (2) focus groups to get a deeper insight of the students' experiences and coping strategies. Descriptive and multivariate statistical analyses were used for the survey while the focus groups were analysed using deductive thematic analysis following the coping reserve model. Results 21.45% of students responded to the survey. Burnout was reported according to the subscales. MBI-Exhaustion (MBI-EX) subscale (mean= 4.07, SD= 1.56), MBI-Cynicism (MBI-CY) subscale (mean= 2.63, SD= 1.53), and MBI-Professional Efficacy (MBI-PE) subscale (mean= 3.97, SD= 1.22). MBI-EX and MBI-CY were associated with GAD-7 scores. MBI-EX and MBI-CY were associated with IRI-Empathic Concern (IRI-EC) and IRI-Personal Distress (IRI-PD) while MBI-PE was associated with IRI-Perspective Talking (IRI-PT) and IRI-EC. The students used many coping strategies to build resilience. Conclusion QU Health students experienced burnout during the spring 2020 semester. Many burnout causes and coping strategies were identified. It is suggested for QU to start mentorship programs and mental health initiatives to promote students' resilience

Burnout and Resilience in Community Pharmacists in Qatar during the COVID-19 Pandemic: a Cross Sectional Study

Objective: The main aim of this study is to illustrate the prevalence of burnout and resilience among community pharmacists in Qatar during the COVID-19 pandemic. Methods: This is a cross-sectional study design that included the collection and analysis of quantitative data from community pharmacists in Qatar using a cross-sectional survey. Results: Overall, participants had a moderate level of burnout as illustrated in the mean scores of the three dimensions; 22.11±13.053 for emotional exhaustion, 7.17±6.55 for depersonalization, and 35.94±11.47 for personal accomplishment. The findings demonstrated that 15.2%, 15.6%, and 5.4% of community pharmacists had moderate levels of depression, anxiety, and stress, respectively. Further, they showed high resilience (35.7±8.57). Mental health outcomes were statistically positively correlated with fear while age was negatively correlated with depersonalization. Conclusion: This study is the first study to report the prevalence of mental health outcomes among community pharmacists during COVID-19 in Qatar. The pharmacists experienced moderate burnout but high resilience which indicates their high potential to overcome difficulties. Future interventions at the personal, national and organizational levels are needed to improve mental health during this pandemic by preventing and managing stress, improving self-efficacy and resilience, and providing adequate social support

The role of community pharmacists in depression management: a survey of attitudes, practices and perceived barriers

Background Community pharmacists play a significant role in depression care. Depression is a health priority in national health strategies around the world, including in Qatar. Objective To describe current practices, attitudes and perceived barriers of community pharmacists towards depression care, and to investigate factors associated with these practices. Setting Community pharmacies in Qatar. Method A cross-sectional online survey using an adapted survey instrument. Scores were measured on a five-point Likert scale. Descriptive univariate and bivariate analyses of study outcomes, followed by multivariate regression examining the association between pharmacists’ practices and their attitudes, socio-demographic and professional characteristics. Main outcome measure Pharmacists’ scores on self-reported attitudes towards depression and depression care practices and the number of perceived barriers for depression care. Result: 358 pharmacists (response rate 39%) completed the questionnaire. Pharmacists’ attitudes to depression were moderately positive (mean score = 3.41, SD = 0.26) but involvement in depression care was very low (mean score = 2.64, SD = 0.94). Three major barriers were lack of access to patients’ medical records (83.21%), lack of patients’ insight on depression and the importance of treatment (81.85%), and lack of knowledge and training on mental health (79.63%). Female pharmacists and those graduated more than 10 years prior were significantly less involved in depression care compared to their counterparts (practice scores (95% CI) −4.36 (−7.46 to −1.26) and -7.51 (−15.10 to −1.35), respectively), while those who had access to private counselling area were more involved (practice score 3.39 (0.20 to 6.59). Pharmacists’ depression practice score was positively associated with attitudes (p = 0.001). Conclusion Pharmacists’ moderately positive attitudes were not reflected in their suboptimal depression-care practices. Action from policymakers is needed to improve pharmacists’ practices and attitudes to depression.This study was partially funded by a Qatar University Post-Graduate Student Grant (QUST-2-CHS-2019-15)

Barriers to Diabetes Adherence (BDA): Translation and Cultural Adaptation of the Instrument into Arabic Context

Objectives: Barriers to Diabetes Adherence (BDA) instrument is a measure developed in English to assess barriers to adherence in adolescents with type 1 diabetes (T1DM). The main objectives of the present study were to translate and culturally adapt the BDA tool into Arabic for the assessment of barriers to adherence in adolescents with T1DM in Arabic-speaking populations. Methods: The International Society for Pharmacoeconomics and Outcomes Research guidelines for the translation and cultural adaptation of patient-reported outcome measures were used for the process. Permission to use the instrument was obtained from the developers. This was followed by 2 forward translations of the tool into Arabic. The 2 Arabic versions were combined into a reconciled Arabic version that was then back-translated into English. This was then tested against the original tool. The resultant Arabic version underwent a cognitive debriefing process to assess its comprehension and appropriateness among potential users, and this resulted in further refinements, leading to the final Arabic version of the tool. Results: The translation and cognitive debriefing processes revealed issues related to the cultural or conceptual equivalence of the tool that were addressed and resolved by rewording, restructuring, or addition or elimination of words or phrases that in certain circumstances necessitated communications with the developers for further clarifications of the intended meaning of relevant items. This process generated an easy, comprehensive, clear, and culturally acceptable tool as proven by the cognitive debriefing and clinical review processes. Conclusion: A culturally acceptable Arabic translation of the BDA tool was developed to be used in adolescent Arabic population with T1DM. 2020 ISPOR-The professional society for health economics and outcomes researchScopu

Evaluation of Health Literacy Levels and Associated Factors Among Patients with Acute Coronary Syndrome and Heart Failure in Qatar

Purpose: To determine the prevalence of inadequate health literacy and its associated risk factors among patients with acute coronary syndrome (ACS) and/or heart failure (HF) in Qatar. Patients and Methods: This cross-sectional observational study was conducted among patients with ACS and/or HF attending the national Heart Hospital in Qatar. Health literacy was assessed using the abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and the Three-item Brief Health Literacy Screen (3-item BHLS). Results: Three hundred patients with ACS and/or HF, majority male (88%) and non-Qatari (94%), participated in the study. The median (IQR) age of the participants was 55 (11) years. The prevalence of inadequate to marginal health literacy ranged between 36% and 54%. There were statistically significant differences in health literacy level between patients based on their marital status (p=0.010), education (p≤0.001), ability to speak any of Arabic, English, Hindi, Urdu, Malayalam, or other languages (p-values ≤0.001 to 0.035), country of origin (p≤0.001), occupation (p≤0.001), and receiving information from a pharmacist (p=0.008), a physiotherapist (p≤0.001), or a nurse (p=0.004). Conclusion: Inadequate health literacy is common among patients with ACS and/or HF. This study suggests a need for developing strategies to assist healthcare professionals in improving health literacy skills among patients with ACS and HF. A combination of interventions may be needed to improve patients’ understanding of their disease and medications, and ultimately overall health outcomes.This research was funded by Qatar University under Student Grant number QUST–2–CPH–2017–15 [Approved amount QAR 20,000.00 (US$ 5480)]