Decisional conflict among health care workers regarding the covid 19 vaccine

Introduction The introduction of the covid 19 vaccine was a long-awaited event. However, many concerns accompanied this vaccine and the decision to be vaccinated was conflicting, especially among the most vulnerable population at that time, the health care workers. Objectives Evaluate the decisional conflict among health care workers concerning the launch of the covid19 vaccination campaign. Methods This is a descriptive study conducted by a questionnaire posted on social networks using Google Forms targeting groups of health professionals before the launch of the vaccination campaign in Tunisia from January 16, 2021 to March 6, 2021. We collected sociodemographic data and the attitudes of health care workers about COVID 19 vaccination. We used SURE score to screen the decisional conflict related to COVID 19 vaccine. Results Our study included 168 health care workers represented mainly by medical personnel (81% of the respondents). The average age was 34 ±10 years and sex ratio was 0.22. Sixty percent (60%) of population were hesitant about the COVID 19 vaccine. Scientific sources were consulted by 61% and non-scientific sources were referred to by 19%. Seven percent (7%) did not use any information source. The SURE decisional conflict score: the mean was 2.26 ± 1.35. The majority of our population (74.4%) had SURE scores in favour of a decisional conflict. We found that decisional conflict was significantly related to information sources. This conflict was highest amoung health care workers who did not use scientific information sources to inquire about the vaccine. Conclusions The announcement of the covid 19 vaccination campaigns raised a significant decisional conflict among the health care workers. Screening for decisional conflict among this population is important. Specific interventions to reduce this conflict are recommended by incorporating decision support tools (Decison Aids) and the shared decision making approach. Disclosure of Interest None Declared

Introduction: Fear of sleep (nyctophobia), has been attributed to myriad conditions ranging from benign nocturnal panic attacks and Morvan's syndrome (Ekambaram, 2021).Positional dependent hyposmia as an origin of nyctophobia has not heretofore been described.Objectives: Increase awareness for correlation between nyctophobia and hyposmia in individuals with COVID-19.Methods: This 52-year-old woman presented with sudden onset of loss of smell and taste with COVID-19, which returned to 85% of normal.Five months prior to presentation she was reinfected with COVID-19, and her smell and taste dropped to 20-50% of normal which improved.However, her symptoms worsened when she would lie down, to 30% of normal, but would improve with standing, moving and sitting.Even reclining for a short nap caused her sense of smell to drop, requiring her to stand for hours before her sense of smell would return leading to her nyctophobia that forced her to move around all the time.She altered her lifestyle and assiduously avoided lying down.When so overwhelmed by tiredness she would sleep sitting up.Prior to her chemosensory problems she slept well without any fear of lying down or sleeping.Results: Psychiatric exam: speech: coherent, relevant without circumstantiality, normal pace and volume.Mood: normal.Oriented x 3. Able to remember 7 digits forward and 5 backwards.Able to recall 3/4 objects without reinforcement.Interpretation of similar-ities: normal.Proverbs: normal.Calculation: normal.Neuropsychiatric testing: Clock Drawing Test: 4/4 (normal).Animal Fluency Test: 22 (normal).Conclusions: Nyctophobia, fear of positional dependent loss of smell, highlights the importance of smell to narcissistic perception of self.More than just one of senses, olfaction is important for mood regulation, memories and quality of life.Associated with chemosensory dysfunction, this is associated with 96% incidence of DSM-IIIR Axis I or II diagnoses, with the most common Axis I diagnosis being generalized anxiety disorder and dysthymia (Hirsch, 1996).This can be understood that the olfactory lobe is anatomically part of limbic system (MacLean, 1973).Smell fascilitates socialisation as well as maintaining interelationships; sexual dysfunctioning is seen in 17% of the population with olfactory loss (Hirsch, 1998).Deposition of memory engrams are facilitated as manifest with olfactory evoked nostalgia seen in 84% of the general population (Hirsch, 1992).Quality of life is reduced in 68% of patients who demonstrate smell loss (Deems, 1991).The importance of smell is thus intrinsic to an individual's wellbeing, and the threat of loss of such sensation with change in position with sleep, was the precipitating event leading to nyctophobia in this subject.Assessing for fear of loss of smell in those with nyctophobia, especially with past COVID-19 infection, allows for increased understanding of etiology and indicates potential treatment approaches.

EPV0364
Decisional conflict among health care workers regarding the covid 19 vaccine S. Dhakouani*, R. Lansari, N. Hamrouni, A. Larnaout W. melki Introduction: The introduction of the covid 19 vaccine was a longawaited event.However, many concerns accompanied this vaccine and the decision to be vaccinated was conflicting, especially among the most vulnerable population at that time, the health care workers.Objectives: Evaluate the decisional conflict among health care workers concerning the launch of the covid19 vaccination campaign.Methods: This is a descriptive study conducted by a questionnaire posted on social networks using Google Forms targeting groups of health professionals before the launch of the vaccination campaign in Tunisia from January 16, 2021 to March 6, 2021.We collected sociodemographic data and the attitudes of health care workers about COVID 19 vaccination.We used SURE score to screen the decisional conflict related to COVID 19 vaccine.Results: Our study included 168 health care workers represented mainly by medical personnel (81% of the respondents).The average age was 34 AE10 years and sex ratio was 0.22.Sixty percent (60%) of population were hesitant about the COVID 19 vaccine.Scientific sources were consulted by 61% and nonscientific sources were referred to by 19%.Seven percent (7%) did not use any information source.The SURE decisional conflict score: the mean was 2.26 AE 1.35.The majority of our population (74.4%) had SURE scores in favour of a decisional conflict.We found that decisional conflict was significantly related to information sources.This conflict was highest amoung health care workers who did not use scientific information sources to inquire about the vaccine.Conclusions: The announcement of the covid 19 vaccination campaigns raised a significant decisional conflict among the health care workers.Screening for decisional conflict among this population is important.Specific interventions to reduce this conflict are recommended by incorporating decision support tools (Decison Aids) and the shared decision making approach.

EPV0365
Intolerance of uncertainty and vaccine hesitancy of health care workers in response to covid 19 vaccination S. Dhakouani*, R. Lansari, N. hamrouni, A. Larnaout and W. melki Introduction: The covid 19 pandemic was a period of uncertainty.This uncertainty was sustained even after the advent of the vaccine against covid 19.Several concerns have emerged related to the vaccine and health care workers were at the centre of this uncertainty.
Objectives: Study intolerance of uncertainty and vaccine hesitancy among health care workers in relation to covid 19 vaccination Methods: This is a descriptive study conducted by a questionnaire posted on social networks using Google Forms targeting groups of health professionals before the launch of the vaccination campaign in Tunisia from January 16, 2021 to March 6, 2021.We collected sociodemographic data and the attitudes of health care workers about COVID 19 vaccination.We used Intolerance of Uncertainty Scale short form (IUS 12) to evaluate the intolerance of uncertainty related to COVID 19 vaccine Results: Our study included 168 health care workers represented mainly by medical personnel (81% of the respondents).The average age was 34 AE10 years and sex ratio was 0.22.Sixty percent (60%) of population were hesitant in front of the COVID 19 vaccine.This hesitancy was explained in 90% of cases by the insecurity of the new COVID19 vaccine.Thirty-seven percent (37%) doubted the efficacy of these vaccines and 22% trivialized COVID19 by expressing the worthlessness of preventing this disease.The mean score for intolerance of uncertainty was 26.57AE 9.68 and a median of 26.The minimum score was 10 and the maximum score was 50.We found a significant association between intolerance of uncertainty and vaccine hesitancy (p=0.034).Subjects with higher uncertainty intolerance scores were less hesitant in front of COVID19 vaccination.Methods: Presentation of case report Results: A 44-year-old woman with no personal history of chronic diseases and with no psychiatric family history.About her experience with covid 19, her mother died as a result of covid 19 infection and our patient had been hospitalized for 17 days for pulmonary infection covid 19, during her hospitalization in COVID 19 unit she presented insomnia and anxiety without behavioural disorders.She had a good evolution of the respiratory symptoms and she was discharged under corticotherapy and anticoagulants.She was admitted in our department after 45 days of her covid 19 infection for acute behavioural disorders.On physical examination: she was hemodynamically stable and well oriented.Neurological examination was with no abnormalities.Cerebral CT scan was normal and lumbar puncture was indicated and the analysis of the CSF did not reveal any anomalies.At the psychiatric interview she was extremely agitated, anxious and hallucinated, she had disorganised speech with derailment and neologisms, she was disinhibited and her mood was exalted.She presented also a delusion of grandeur and delusion of persecution.
Conclusions: Intolerance of uncertainty is a consideration when introducing a new covid 19 vaccine to health care workers and in a pandemic context Disclosure of Interest: None Declared EPV0366 First episode psychosis Post-COVID 19 infection : case report Introduction: During the course of COVID-19 pandemic, the respiratory system is the most commonly affected while many neuropsychiatric manifestations of the disease have been observed.Objectives: Emphasize the importance of detecting psychiatric symptoms in patients infected with Covid 19.
Conclusions: In individuals presenting with COVID-19 infection, consideration should be made for psychiatric manifestations because COVID-19 diagnosis predispose vulnerable patients to psychosis.Disclosure of Interest: None Declared EPV0367 IMPACT OF COVID-19 ON THE MENTAL HEALTH OF HOSPITAL STAFF