{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:25:20Z","timestamp":1784132720509,"version":"3.55.0"},"reference-count":47,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"QualityRights Sardinia","award":["CUP E77G23000370002"],"award-info":[{"award-number":["CUP E77G23000370002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The COVID-19 pandemic severely impacted healthcare systems globally, with Italian healthcare professionals experiencing heightened stress, organizational challenges, and a significant psychological burden. This study investigates the frequency of depressive symptoms and health-related quality of life (H-QoL) among outpatient healthcare workers in Italy, comparing pre-pandemic (2017) and post-pandemic (2025) periods. Methods: A cross-sectional study was conducted in 2025, including 97 healthcare professionals from five outpatient departments at the University Hospital of Cagliari. Participants completed demographic surveys, the Short Form Health Survey (SF-12), and the Patient Health Questionnaire (PHQ-9) to assess H-QoL and depressive symptoms. Data were compared with previously published data from the same facility collected in 2017 and with pre-pandemic Italian community surveys. Results: Compared to 2017, there was a statistically significant increase in depressive episodes (38.1% vs. 33.2%, p = 0.01) and a higher proportion of individuals with low H-QoL (62.9% vs. 43.5%, p &lt; 0.0001) in 2025. After age- and sex-standardization, both depressive symptoms and low H-QoL were significantly more prevalent among healthcare professionals in 2025 compared with the general population before the pandemic. Within the 2025 sample, non-medical healthcare workers showed a significantly higher prevalence of depressive symptoms than medical doctors, while female healthcare workers were more likely to report low H-QoL. Conclusions: Despite the pandemic\u2019s end, healthcare workers, especially those in outpatient settings, continue to face elevated psychological distress. Specific professional and gender-related vulnerabilities persist, and structural challenges, such as staff shortages and organizational issues, may exacerbate this burden. Sustained mental health support and targeted systemic interventions remain crucial to mitigate the long-term impact on the healthcare workforce.<\/jats:p>","DOI":"10.3390\/jcm15020874","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:31:46Z","timestamp":1769009506000},"page":"874","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health-Related Quality of Life and Frequency of Depressive Episodes Among Healthcare Professionals in an Outpatient Health Facility in Italy: A Comparison Between 2017 (Pre-COVID) and 2025 (Post-COVID)"],"prefix":"10.3390","volume":"15","author":[{"given":"Antonio","family":"Urban","sequence":"first","affiliation":[{"name":"PhD Program in Capacities Building for Global Health, University of Cagliari, 09124 Cagliari, Italy"},{"name":"Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Atzeni","sequence":"additional","affiliation":[{"name":"Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"},{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1245-016X","authenticated-orcid":false,"given":"Giulia","family":"Cossu","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9155-4740","authenticated-orcid":false,"given":"Massimo","family":"Tusconi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1566-1974","authenticated-orcid":false,"given":"Cesar Ivan","family":"Aviles Gonzales","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Kore, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3059-9865","authenticated-orcid":false,"given":"Gabriele","family":"Finco","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8940-6987","authenticated-orcid":false,"given":"Clelia","family":"Madeddu","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8105-1402","authenticated-orcid":false,"given":"Laura","family":"Atzori","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8223-6791","authenticated-orcid":false,"given":"Caterina","family":"Ferreli","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Cotti","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Division of Dentistry, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Carzedda","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Lorrai","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Deidda","sequence":"additional","affiliation":[{"name":"Center for Palliative Care and Pain Management, University Hospital of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bertolino","sequence":"additional","affiliation":[{"name":"Center for Palliative Care and Pain Management, University Hospital of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3437-8664","authenticated-orcid":false,"given":"Pedro Jos\u00e9","family":"Fragoso Castilla","sequence":"additional","affiliation":[{"name":"PhD Program in Tropical Medicine, Universidad Popular del Cesar, Valledupar 200004, Colombia"},{"name":"Microbiology Program, Universidad Popular del Cesar, Valledupar 200004, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4838-5993","authenticated-orcid":false,"given":"Shellsyn","family":"Giraldo Jaramillo","sequence":"additional","affiliation":[{"name":"Faculty of Health, Universidad Popular del Cesar, Valledupar 200004, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1659-6083","authenticated-orcid":false,"given":"Fernanda","family":"Velluzzi","sequence":"additional","affiliation":[{"name":"Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"},{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Montisci","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5049-4614","authenticated-orcid":false,"given":"Elisa","family":"Cantone","sequence":"additional","affiliation":[{"name":"PhD Program in Capacities Building for Global Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-0980","authenticated-orcid":false,"given":"Enzo","family":"Tramontano","sequence":"additional","affiliation":[{"name":"Department of Life and Environmental Sciences, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Bert","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatrics Sciences, University of Torino, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3764-3179","authenticated-orcid":false,"given":"Viviana","family":"Forte","sequence":"additional","affiliation":[{"name":"PhD Program in Capacities Building for Global Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-7148","authenticated-orcid":false,"given":"Marcello","family":"Nonnis","sequence":"additional","affiliation":[{"name":"Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0706-9687","authenticated-orcid":false,"given":"Mauro Giovanni","family":"Carta","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"},{"name":"PhD Program in Tropical Medicine, Universidad Popular del Cesar, Valledupar 200004, Colombia"},{"name":"Department of Nursing, Universidad Popular del Cesar, Valledupar 200004, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref_1","first-page":"7868","article-title":"Comparing the Responses of Countries and National Health Systems to the COVID-19 Pandemic: A Critical Analysis with a Case-Report Series","volume":"27","author":"Carta","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100197","DOI":"10.1016\/j.glmedi.2025.100197","article-title":"Global COVID-19 Vaccination Challenges: Inequity of Access and Vaccine Hesitancy","volume":"6","author":"Dagovetz","year":"2025","journal-title":"J. Med. Surg. Public Health"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bliss, D.Z. (2025). Impact of the COVID-19 Pandemic on Nursing Care and Patients with Incontinence. Management of Fecal Incontinence for the Advanced Practice Nurse: Under the Auspices of the International Continence Society, Springer.","DOI":"10.1007\/978-3-031-94526-7"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Dobrowolska, B., Chiappinotto, S., Cabrera, E., Chloubov\u00e1, I., Kane, R., Kennedy, S., Lovri\u0107, R., Stanisavljevi\u0107, S., Riklikiene, O., and Palese, A. (2025). Changes and Continuities in Undergraduate Nursing Education during and after COVID-19: A European Comparative Study from the Perspective of Health Science. BMC Med. Educ., 25.","DOI":"10.1186\/s12909-025-07407-0"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S2215-0366(21)00203-0","article-title":"Long-Acting Injectable versus Oral Antipsychotics for Schizophrenia\u2014Authors\u2019 Reply","volume":"8","author":"Kishimoto","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"ref_6","first-page":"e7405","article-title":"Focus on Mental Health During the Coronavirus (COVID-19) Pandemic: Applying Learnings from the Past Outbreaks","volume":"12","author":"Shah","year":"2020","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1192\/bji.2020.39","article-title":"Protecting the Mental Health of Healthcare Workers during the COVID-19 Emergency","volume":"18","author":"Chirico","year":"2021","journal-title":"BJPsych Int."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Moro, M.F., Calamandrei, G., Poli, R., Di Mattei, V., Perra, A., Kurotschka, P.K., Restrepo, A., Romano, F., La Torre, G., and Preti, E. (2022). The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.867080"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jpsychires.2020.09.021","article-title":"COVID-19 and Mental Health in Brazil: Psychiatric Symptoms in the General Population","volume":"132","author":"Goularte","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Barili, E., Bertoli, P., Grembi, V., and Rattini, V. (2022). Job Satisfaction among Healthcare Workers in the Aftermath of the COVID-19 Pandemic. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0275334"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kidanemariam, Y.T., Abebe, F., Girma, E., Addisse, A., Birhanu, Z., Hassen, K., Taye, A., Amdisa, D., Lake, E.A., and Guta, M.T. (2025). Impact of COVID-19 Pandemic on Non-Communicable Diseases Care and Service Deliveries in Sub-Saharan Africa: A Systematic Review. BMC Health Serv. Res., 25.","DOI":"10.1186\/s12913-025-13270-y"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"22799036221107060","DOI":"10.1177\/22799036221107060","article-title":"Respect for Service Users\u2019 Human Rights, Job Satisfaction, and Wellbeing Are Higher in Mental Health Workers than in Other Health Workers: A Study in Italy at Time of the Covid Pandemic","volume":"11","author":"Carta","year":"2022","journal-title":"J. Public Health Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Muriithi, M., Oleche, M., Kiarie, F., and Mwangi, T. (2025). Healthcare Financing Vulnerability and Service Utilization in Kenya During the COVID-19 Pandemic, with a Focus on Policies to Protect Human Capital. Economies, 13.","DOI":"10.3390\/economies13080242"},{"key":"ref_14","first-page":"1464","article-title":"When Structure and Content of Socioscientific Argumentation Develop in an Unbalanced Way: A Case Study","volume":"109","author":"Tang","year":"2025","journal-title":"Sci. Educ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"156","DOI":"10.2174\/1745017901713010156","article-title":"Risk for Depression, Burnout and Low Quality of Life Among Personnel of a University Hospital in Italy Is a Consequence of the Impact One Economic Crisis in the Welfare System?","volume":"13","author":"Carta","year":"2017","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2174\/1745017901208010169","article-title":"Quality of Life and Urban\/Rural Living: Preliminary Results of a Community Survey in Italy","volume":"8","author":"Carta","year":"2012","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1007\/s10488-014-0604-y","article-title":"Whom to Ask for Professional Help in Case of Major Depression? Help-Seeking Recommendations of the Sardinian Public","volume":"42","author":"Moro","year":"2015","journal-title":"Adm. Policy Ment. Health Ment. Health Serv. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med. Care"},{"key":"ref_19","unstructured":"Ware, J., Kosinski, M., and Keller, S. (1996). SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales. SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales, The Health Institute, New England Medical Center. [2nd ed.]."},{"key":"ref_20","first-page":"6624378","article-title":"Criterion Validity and Reliability of SF-12 Health Survey Version 2 (SF-12v2) in a Student Population during COVID-19 Pandemic: A Cross-Sectional Study","volume":"2021","author":"Ruotolo","year":"2021","journal-title":"Depress. Res. Treat."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1001\/jama.282.18.1737","article-title":"Validation and Utility of a Self-Report Version of PRIME-MD. The PHQ Primary Care Study","volume":"282","author":"Spitzer","year":"1999","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). American Psychiatric Association DSM-5 Diagnostic and Statistical Manual of Mental Disorders (DSM-5), American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1017\/S0033291799002512","article-title":"The Personal Health Questionnaire: A new screening instrument for detection of ICD-10 depressive disorders in primary care","volume":"30","author":"Rizzo","year":"2000","journal-title":"Psychol. Med."},{"key":"ref_25","first-page":"235","article-title":"II Patient Health Questionnaire (PHQ) per lo screening dei disturbi psichiatrici: Uno studio di validazione nei confronti della Intervista Clinica Strutturata per il DSM-IV asse I (SCID-I)","volume":"9","author":"Mazzone","year":"2003","journal-title":"J. Psychopathol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Sun, P., Wang, M., Song, T., Wu, Y., Luo, J., Chen, L., and Yan, L. (2021). The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.626547"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e17450179327231","DOI":"10.2174\/0117450179327231240924054645","article-title":"Factors Associated with Stress among Healthcare Personnel after COVID-19 in Northeast Thailand: A Cross-Sectional Study","volume":"20","author":"Chupanich","year":"2024","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1108\/JHOM-11-2023-0346","article-title":"Pandemic Scars: Long-Term Impact of COVID-19 on Work Stress among Healthcare Workers in China","volume":"39","author":"Qian","year":"2024","journal-title":"J. Health Organ. Manag."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e70401","DOI":"10.1111\/hex.70401","article-title":"High Psychological Impact of COVID-19 on French Healthcare Workers: An Observational Cohort Study of PTSD, Depression and Burn-Out","volume":"28","author":"Blanchin","year":"2025","journal-title":"Health Expect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e70412","DOI":"10.2196\/70412","article-title":"Health Care Workers\u2019 Experience With a Psychological Self-Monitoring App During the COVID-19 Pandemic: Mixed Methods Study","volume":"13","author":"Khaldoun","year":"2025","journal-title":"JMIR mHealth uHealth"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Popa, M.V., Gurzu, I.L., Handra, C.M., Mandanach, C., Gurzu, B., M\u00eendru, D.E., Duceac (Covrig), M., Ciuhodaru, M.I., and Duceac, L.D. (2025). Long COVID in Healthcare Workers from a Pediatric Hospital in Romania: A Cross-Sectional Study of Prevalence, Symptom Burden, and the Role of Vaccination and Reinfection. J. Clin. Med., 14.","DOI":"10.3390\/jcm14165782"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12960-025-01012-4","article-title":"Prevalence and Risk Factors of Burnout Symptoms among Nurses during the COVID-19 Pandemic: An Updated Systematic Review and Meta-Analysis","volume":"23","author":"Harb","year":"2025","journal-title":"Hum. Resour. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e0289454","DOI":"10.1371\/journal.pone.0289454","article-title":"Mental health status and related factors influencing healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis","volume":"19","author":"Huang","year":"2024","journal-title":"PLoS ONE"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"8149","DOI":"10.1038\/s41598-024-58884-0","article-title":"Impact of COVID-19 First Wave on the Mental Health of Healthcare Workers in a Front-Line Spanish Tertiary Hospital: Lessons Learned","volume":"14","author":"Molina","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e378","DOI":"10.1017\/dmp.2023.42","article-title":"Longitudinal Assessment of Mental Health Consequences of the COVID-19 Pandemic Long-Term Exposure on Health Care Workers from a North West Italian Hospital","volume":"17","author":"Caramello","year":"2023","journal-title":"Disaster Med. Public Health Prep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jad.2021.11.031","article-title":"Long-Term Effects of COVID-19 on Mental Health: A Systematic Review","volume":"299","author":"Bourmistrova","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e071203","DOI":"10.1136\/bmjopen-2022-071203","article-title":"Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: A systematic review","volume":"13","author":"Cohen","year":"2023","journal-title":"BMJ Open"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e17450179349117","DOI":"10.2174\/0117450179349117241211094816","article-title":"Are Nurses Working in Mental Health in a Time of Changing Approaches More Exposed to Stress than Other Professionals? Job Satisfaction and Perception of Respect for the Rights of Users in Seven Different Countries Worldwide","volume":"20","author":"Kalcev","year":"2024","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e174501792212200","DOI":"10.2174\/18740179-v18-e221221-2022-2","article-title":"Fear of COVID-19, Stress and Coping Strategies among Nurses during the COVID-19 Pandemic\u2019s Second Wave: A Quasi-Intervention Study","volume":"19","author":"Omar","year":"2023","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_40","unstructured":"(2025, September 08). Nurse24.it Gli Infermieri Italiani Pagati Meno Della Media Europea, Non Valorizzati e Troppo Pochi. Available online: https:\/\/www.nurse24.it\/infermiere\/attualita-infermieri\/gli-infermieri-italiani-pagati-meno-della-media-europea-non-valorizzati-e-troppo-pochi.html."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1186\/s12913-025-12888-2","article-title":"Organizational interventions to support and promote the mental health of healthcare workers during pandemics and epidemics: A systematic review","volume":"25","author":"Belita","year":"2025","journal-title":"BMC Health Serv. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e17450179277976","DOI":"10.2174\/0117450179277976231115070100","article-title":"Illness Anxiety Disorder and Distress among Female Medical and Nursing Students","volume":"19","author":"Hawamdeh","year":"2023","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Gualano, M.R., Lo Moro, G., Voglino, G., Bert, F., and Siliquini, R. (2020). Effects of COVID-19 Lockdown on Mental Health and Sleep Disturbances in Italy. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17134779"},{"key":"ref_44","unstructured":"AGENAS (2025, September 08). Relazione Sulla Performance, Available online: https:\/\/www.agenas.gov.it\/images\/agenas\/trasparenza\/performance\/Relazione_annuale_sulla_performance_2024.docx.pdf."},{"key":"ref_45","unstructured":"World Medical Association (1976). Declaration of Helsinki. Recommendations Guiding Physicians in Biomedical Research Involving Human Subjects. Bull. World Health Organ., 54, 151\u2013153."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_47","unstructured":"World Medical Association (2025, September 08). Ethical Principles for Medical Research Involving Human Participants. Available online: https:\/\/www.wma.net\/policies-post\/wma-declaration-of-helsinki\/."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/874\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:44:04Z","timestamp":1769010244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":47,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020874"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020874","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]}}}