Changes of working conditions and job-related challenges due to the SARS-CoV-2 pandemic for medical assistants in general practices in Germany: a qualitative study.

In Germany, general practices are usually contacted first by patients with health complaints, including symptoms characteristic of SARS-CoV-2. Within general practices, medical assistants (MAs) are the first contact person for patients and perform various tasks in close physical patient contact. Working conditions of MAs have been characterized as challenging, e.g., due to low salaries, a high workload, time pressure and frequent interruptions. The potential changes of working conditions and job-related challenges experienced by MAs due to the SARS-CoV-2 pandemic have not been fully explored. We aimed to address this knowledge gap among MAs working in general practices in Germany. Semi-structured telephone interviews were conducted between March and April 2021 with 24 MAs. Medical assistants of legal age, who worked in general practices in Germany, and who were continuously employed and without change of employer in 2020 were eligible for participation. Interview recordings were transcribed verbatim and content-analyzed using MAXQDA, using deductive and inductive coding. The SARS-CoV-2 pandemic posed great challenges for MAs, including a dramatic increase in workload, changes in occupational tasks, increased hygiene measures, rearrangements of work organization, childcare issues, and structural and personnel challenges within their practice. Participants described both improved but also worsened collaboration with their employers and colleagues due to the pandemic. Many MAs complained about issues regarding SARS-CoV-2-related billing processes and an increase in unpleasant patient behavior, including disregard of practice rules or frequent verbal insults. Many also did not feel adequately appreciated by politics, media, or society for their efforts during the pandemic. Positive changes were perceived to be the expansion of digital communication channels and a growing social cohesiveness of practice teams. Our study suggests that the SARS-CoV-2 pandemic posed great challenges for MAs. The pandemic seems to have worsened MAs' working conditions, which had been described as challenging already prior to the pandemic. In order to improve job satisfaction and to prevent loss of healthcare personnel, measures must be taken to improve working conditions of MAs in general practices.

Dreher A ，Mambrey V ，Loerbroks A 《-》

Pandemic-related attitudes, stressors and work outcomes among medical assistants during the SARS-CoV-2 ("Coronavirus") pandemic in Germany: A cross-sectional Study.

Dreher A ，Pietrowsky R ，Loerbroks A 《PLoS One》

Beliefs and practices among primary care physicians during the first wave of the COVID-19 pandemic in Baden-Wuerttemberg (Germany): an observational study.

Roth C ，Breckner A ，Moellinger S ，Schwill S ，Peters-Klimm F ，Szecsenyi J ，Stengel S ，Wensing M ... -  《BMC Family Practice》

Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study.

The COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact and involvement in various high-risk dental procedures. This study aimed to investigate attitudes, stressors and work outcomes among DAs from all over Germany at the peak of cases in spring 2020. Cross-sectional study. Descriptive analysis and logistic regression. Dental, maxillofacial surgery and orthodontic practices across Germany, April 2020. Participants aged 18 years and above and currently working as DAs in Germany. A self-devised online questionnaire was employed comprising questions on SARS-CoV-2-related attitudes, stressors and work outcomes. Validated scales assessed symptoms of depression and anxiety. Among 1481 participating DAs (median age 35 years, 98.4% female, 91.8% working in dental practices), major stressors were uncertainty about the pandemic's temporal scope (97.9% agreement, n=1450), uncertainty about one's financial situation (87.8%, n=1301), uncertainty about how to act correctly (87.6%, n=1298) and thoughts about a possible infection during work (83.8%, n=1241). Forty-two per cent of DAs (n=622) felt sufficiently prepared for dealing with patients with SARS-CoV-2. Only 17.5% (n=259) agreed that material for personal protection was sufficiently available. Multivariable logistic regression analyses suggested that working in a dental practice, compared with orthodontic and maxillofacial surgery practices, was significantly associated with uncertainty about one's financial situation (OR 2.13 (95% CI 1.33 to 3.44)) and with the reported availability of personal protective equipment (PPE) (0.55 (0.36 to 0.84)). Training about correct behaviour of DAs during future infectious disease outbreaks is needed, especially for DAs working in dental practices. In the future, it will also be necessary to strengthen supply chains to ensure that PPE is sufficiently available in a timely manner.

Dreher A ，Pietrowsky R ，Loerbroks A 《BMJ Open》

Leaving the profession as a medical assistant: a qualitative study exploring the process, reasons and potential preventive measures.

Mambrey V ，Dreher A ，Loerbroks A 《BMC HEALTH SERVICES RESEARCH》