The impact of SARS-CoV-2 on the mental health of healthcare workers in a hospital setting-A Systematic Review

Experiences of academic and professional burn-out in medical students and residents during first COVID-19 lockdown in Belgium: a mixed-method survey

COVID-19 has presented a substantial burden on students and healthcare staff. This mixed-method, descriptive and correlational study aimed to: 1) describe academic; and 2) professional burnout levels; 3) their associations with working in COVID-19-related care; and 4) with perceived COVID-19 impact on studies and internships among medical students and residents. We hypothesized burnout levels to be high; those involved in COVID-19 care to experience higher impact of COVID-19 on studies and work, and to experience higher levels of academic and professional burnout than those not involved in COVID-19 care; academic and professional burnout to be higher when perceived burden due to COVID-19 was higher. During first lockdown in Belgium, a mixed-method cross-sectional survey assessed academic burnout (MBI-SS) and professional burnout in relation to internships and residency (MBI-HSS). Correlations and t-tests tested associations of burnout with involvement in COVID-19-related care and perceived impact of COVID-19 on studies and work (SPSS). Participants provided open-ended comments which were thematically analysed (NVivo). In total, 194 medical students and residents participated (79.5% female, M age = 24.9 ± 2.5). Emotional exhaustion and depersonalisation were high in professional burnout, but moderate in academic burnout. Those involved in COVID-19 related care perceived a higher impact of COVID-19 on their studies and internship/residency and have higher professional burnout, but do not show a higher academic burnout. Those who have a higher perceived impact of COVID-19 on their studies scored higher on academic burnout. Participants mentioned an increased workload (e.g., having to be constantly available and constantly adapt), distress (e.g., uncertainty, fatigue, fear for impact on significant others), fewer learning opportunities (e.g., cancelled internships, changing learning methods), lack of relatedness with patients and supervisors (e.g., lack of respect and understanding from supervisors, distance created by phone consultations with patients) and cynicism towards remote care or non-medical tasks (e.g., considering what they do is not useful or not what they trained for). Students and residents showed indications of professional and academic burnout in relation to the COVID-19 situation. Interventions are needed that can meet the needs of achieving learning outcomes, managing extreme situations and relatedness.

Through the eyes of hospital-based healthcare professionals: exploring their lived experience during the COVID-19 pandemic

Objective

The spread of the COVID-19 virus has caused an unforeseen strain on the healthcare system and particularly on healthcare workers (HCW). In this study, 1 year after the COVID-19 pandemic began, we used photovoice, a visual photographic approach, to understand HCW needs, concerns and resilience and to determine improvement strategies aligned with the HCW-described challenges.

Methods

Using a qualitative design, HCW were recruited from a single Western Canadian hospital, voluntarily submitting a photographic image and narrative that depicts their experiences. An artist artistically enhanced the photovoice submissions, which were then displayed at the hospital-based art gallery for public display. A survey was used to collect feedback from gallery viewers. Inductive thematic analysis was completed identifying themes from the photovoice narratives and survey comments, aiding the identification of recommendations.

Results

There were 25 submissions, and 1281 individuals viewed the art exhibit. Six themes emerged: (1) hopeful and resilient, (2) pandemic fatigue-negative mental and physical states, (3) personal protective equipment is our armour but masks who we are, (4) human connection, (5) responsibility, preparation and obligation and (6) technology surge. According to survey results from the art exhibit, the use of photovoice was a creative method that personalised the HCW experience and validated viewers’ perceptions of the difficulties faced by HCW. Ten improvement strategies that were aligned with the described challenges were identified.

Conclusion

The ongoing COVID-19 pandemic continues to strain HCW. Photovoice has great potential in the professional clinical setting to provide unique insights that narrative language alone cannot capture. Future research exploring the longitudinal impact of COVID-19, reviewing photographs at different timepoints could be beneficial. Using this method as a creative outlet intervention and evaluating participation artistic experience may offer additional insights to further support both HCW and patients.

Relationship between COVID-19-specific occupational stressors and mental distress in frontline and non-frontline staff

This study investigated the difference in the severity of mental distress and factors contributing to mental distress in frontline and non-frontline healthcare professionals during the coronavirus disease (COVID-19) pandemic. A cross-sectional web-based survey of medical staff collected by snow-ball sampling was performed in Japan in October 2020 using the Kessler Psychological Distress Scale (K6) as an outcome measure for mental distress. Originally developed items asking about the degree of change in psychological and physical burdens, COVID-19-related fear, and experience of discrimination were obtained. The median score of the K6 was 7 in the frontline staff group (n = 86) and 6 in the non-frontline staff group (n = 504), without a statistically significant difference. Multiple regression analyses showed that among the participants, an increase in psychological burden and COVID-19-related fear was significantly associated with mental distress in both groups. Experience of discrimination was significantly associated with mental distress only in the frontline staff group. However, an increase in physical burden was significantly associated with mental distress only in the non-frontline staff group. The results indicate that the factors contributing to mental distress between frontline and non-frontline staff can be different, although the severity of mental distress is comparable between them.

The mental health of healthcare workers in GCC countries during the COVID-19 pandemic: A systematic review and meta-analysis

Objectives

The aim of this study was to summarize the available evidence on the prevalence of stress, burnout, anxiety and depression among healthcare providers in the Gulf Cooperation Council (GCC) countries (KSA, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates) during the COVID-19 pandemic.

Methods

We searched PubMed, PsycINFO, Scopus, and Google scholar for related studies published between January 2020 and April 2021 and conducted a systematic review and meta-analysis.

Results

Of the 1815 identified studies, 29 met the inclusion criteria, and 19 studies were included in the meta-analysis. The pooled estimate of prevalence for moderate to severe anxiety as reported using GAD-7 was 34.57% (95% CI = 19.73%, 51.12%), that for moderate to severe depression using PHQ-9 was 53.12% (95% CI = 32.76%, 72.96%), and that for moderate to severe stress using the 10-item Perceived Stress Scales was 81.12% (95% CI = 72.15%, 88.70%). Meta-analysis was not performed for burnout due to the small number of identified studies and the different tools used; however, the highest prevalence was reported at 76% (95% CI = 64%, 85%). Overall, a positive trend was observed over time for moderate to severe anxiety and depression, p = 0.0059 and 0.0762, respectively. Of note, the heterogeneity was significant among the studies, and many studies were of poor quality.

Conclusion

The prevalence of mental health disorders during the current pandemic among healthcare workers in GCC countries is high. However, the results could be affected by the high heterogeneity and low quality studies.

The Impacts of COVID-19 Pandemic on the Food Sector and on Supermarket Employees in France during the First Lockdown Period

During the first lockdown period due to the COVID-19 pandemic, from the 17 March 2020 to the 11 May 2020 in France, essential professionals (nursing staff, police officers, supermarket staff, etc.) continued to be physically present at their workplaces. The present study focuses on exploring impacts of the pandemic on supermarket staff and on the food sector in France: COVID transmission among supermarket workers, working conditions, food supply, etc. For that, two anonymous surveys were addressed to supermarket employees and to supermarket supervisors. In total, 1746 responses from employees and 171 responses from supervisors were recorded all over France. Over 70% of employees and almost 50% of supervisors were women and over 50% of employees were between 25 and 40 years old. The following main trends in terms of physical and psychological impacts are revealed: 7% of employees working during the lockdown reported having COVID, although a still poorly developed screening and lack of diagnostic tests during the first lockdown should be kept in mind. The working conditions changed; higher work load, a more stressful environment, inappropriate client attitude, a lack of recognition, fatigue, and shortages were reported. A lack of government recognition, namely no prime allocations to supermarket staff during the lockdown period, is also often mentioned. Finally, no priority was given for store employees in terms of childcare.

COVID-19 and the labour market: What are the working conditions in critical jobs?

The COVID-19 pandemic has focused public attention on occupational groups that ensure the maintenance of critical infrastructure, provision of medical care and supply of essential goods. This paper examines the working conditions in critical jobs based on representative data from the German BAuA Working Time Survey 2019. Our analyses reveal that essential workers are more likely to perform unskilled or semiskilled activities and work in cleaning, transport and logistics, health care occupations as well as IT and natural science services. Regarding the working conditions, essential workers are paid comparatively less and are more physically proximate to others at work than nonessential workers. They more often work atypical hours, such as day and night shifts and on weekends, and have less autonomy in their working time. Additionally, critical jobs are characterised by muscular and skeletal strain due to working positions and carrying heavy loads significantly more often. Thus, our findings strongly suggest that work-related risks accumulate in critical jobs.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12651-022-00315-6.

Examining the Mental Health, Wellbeing, Work Participation and Engagement of Medical Laboratory Professionals in Ontario, Canada: An Exploratory Study

Objectives

The overall objective of this proposed project is to examine the impact of the COVID-19 pandemic on the mental health, functioning and wellbeing of medical laboratory technologists (MLT) and medical laboratory technicians/assistants (MLT/A) in Ontario, Canada.

Methods

A cross-sectional study included a self-reported questionnaire for MLT and MLT/A in Ontario. The questionnaire included questions about demographics and occupational characteristics. Questions about mental health, functioning, well-being and psychosocial work environments were also included using validated questionnaires.

Results

There were 551 MLT and 401 MLT/A in the analytic sample. Most of the respondents were women. The mean age and standard deviation of the overall sample were 42.0 ± 11.8. MLT demonstrated higher quantitative demands, possibilities for development, and organizational justice compared to MLT/A. The scores of work pace, emotional demands, role conflicts, job insecurity, insecurity over working conditions and negative acts were higher for MLT/A than MLT. The WHODAS 2.0 scores of the respondents were 20.80 ± 6.68, higher than approximately 92% average people. For both groups, most respondents scored the COPSOQ-III domains as worse since COVID-19.

Conclusion

The study provides preliminary evidence regarding the workplace mental health outcomes of medical laboratory professionals in Ontario, Canada. The findings suggest that MLT and MLT/A experience psychosocial work conditions that impact mental health, functioning and disability. Accordingly, additional research is necessary to understand the experiences of medical laboratory professionals.

"We were building the plane as we were flying it, and we somehow made it to the other end": syringe service program staff experiences and well-being during the COVID-19 pandemic

BACKGROUND

Syringe service programs (SSPs) provide essential harm reduction and prevention services for people who inject drugs in the USA, where SSP coverage is expanding. During the COVID-19 pandemic, US SSPs underwent unprecedented shifts in operational procedures (e.g., closures of physical sites, staff redeployment into pandemic response efforts). Given the critical role of US SSP workers in the pandemic, we sought to explore the occupational experiences and well-being of SSP staff to inform future emergency response efforts.

METHODS

From July-October 2020, we conducted semi-structured interviews with staff members of four SSPs in diverse regions of Massachusetts. Trained interviewers administered qualitative interviews virtually. Interviews were coded in NVivo v12 and thematic analysis identified common occupational experiences and related impacts on staff well-being in the context of the COVID-19 pandemic.

RESULTS

Among 18 participants, 12 (67%) had client-facing roles such as harm reduction specialists and six (33%) worked in program management or leadership. We found that staff were frequently anxious about SARS-CoV-2 transmission, which contributed to staff turnover. SSPs rapidly adapted and expanded their services to meet increasing client needs during the pandemic (e.g., food distribution, COVID-19 testing), leading to staff overexertion. Simultaneously, public health measures such as physical distancing led to staff concerns about reduced social connections with clients and coworkers. Through these challenges, SSPs worked to protect staff well-being by implementing flexible and tangible COVID-19-related policies (e.g., paid sick leave), mental health resources, and frequent communication regarding pandemic-related operational changes.

CONCLUSION

SSPs in the USA adapted to the COVID-19 pandemic out of necessity, resulting in operational changes that threatened staff well-being. Despite the protective factors revealed in some narratives, our findings suggest that during prolonged, complex public health emergencies, SSPs may benefit from enhanced occupational supports to prevent burnout and promote wellness for this essential public health workforce.

COVID-19 as moral breakdown: Entangled ethical demands experienced by hospital-based nurses in the early onset of the pandemic

2020 saw the rapid onset of a global pandemic caused by the SARS-CoV-2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical challenges related to "being a nurse" during the COVID-19 pandemic was experienced and understood by Danish hospital-based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands.

Impact of the COVID-19 pandemic on the development of burnout syndrome in healthcare providers: prevalence and predictive factors

BACKGROUND

In Tunisia, the pandemic is still ongoing, resulting in the burnout of healthcare providers.

AIMS

This study aimed to assess the impact of the management of COVID-19 patients on the physical and mental health of healthcare providers, and to identify the independent and predictive variables for the three components of severe burnout: emotional exhaustion, depersonalization, and lack of personal accomplishment at work.

METHODS

It was a cross-sectional survey. Data were collected between February 8, and April 11, 2021. Healthcare providers, who were positive for COVID, completed the questionnaire. The primary endpoint was to assess the degree of burnout in healthcare providers by adopting the original version of the severe Maslach Burnout Inventory: emotional exhaustion (≥30), depersonalization (≥12), and lack of personal accomplishment at work (≤ 33). A descriptive analysis followed by a bi- and multivariate analysis was performed to identify independent and predictive factors for each component of burnout.

RESULTS

700 healthcare providers were audited. Emotional exhaustion was ≥ 30 in 86%, depersonalization was ≥ 12 in 61%, and lack of personal accomplishment at work was ≤ 33 in 69%. Of the 700 healthcare providers, 93% were working at the same time in the COVID units, 85% had not received compensatory rest. Healthcare provider who had been infected by COVID-19 was the only independent predictive variable of severe emotional exhaustion and severe depersonalization. Healthcare provider who had been infected by COVID-19 and did not have a compensatory rest were two independent predictive variables of severe lack of personal accomplishment at work.

CONCLUSION

Healthcare provider who had been infected by COVID-19 was the only predictive variable of severe emotional exhaustion and severe depersonalization. Healthcare provider who had been infected by COVID-19 and did not have a compensatory rest were two independent and predictive variables of severe lack of personal accomplishment at work.

Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review

Background

Burnout has been prevalent among healthcare workers (HCWs). However, the effect of the Coronavirus Disease (COVID-19) pandemic on this phenomenon in HCWs is unclear.

Objective

This systematic review aims to evaluate the impact of COVID-19 on burnout of HCWs using Maslach Burnout Inventory (MBI).

Methods

A systematic search was performed on PubMed database for articles published between 1 December 2019 and 30 June 2021. Search strategy combined terms for HCWs, COVID-19, burnout, and MBI. The main outcome of interest was burnout, including both mean prevalence and MBI scores for high emotional exhaustion (EE), high depersonalisation (DP) and low personal accomplishment (PA).

Results

Four cohort studies, 90 cross-sectional studies and one randomised-controlled trial were included for review. Only one cohort study compared burnout data among HCWs before and during COVID-19. It reported a statistically significant increase in mean EE and PA scores from 21.9 to 24.8 ( p = .001), and 42.7 to 48.7 ( p = .001), respectively. The remaining studies only evaluated burnout data during COVID-19 but were missing burnout data prior to the pandemic for comparison. Across these studies, the overall mean prevalence of burnout among HCWs was 39.95%, with mean MBI EE scores of 22.07, DP scores of 7.83, and PA scores of 32.53. Burnout outcomes were generally comparable across specific healthcare professions such as doctors and nurses.

Conclusion

Whilst quality research elucidating the effect of pandemic on burnout is lacking, current burnout prevalence among HCWs during COVID-19 is notable.

Three Mental Health Symptoms of Frontline Medical Staff Associated With Occupational Stressors During the COVID-19 Peak Outbreak in China: The Mediation of Perceived Stress and the Moderation of Social Support

The outbreak of COVID-19 epidemic has increased work demands for medical staff and has a certain impact on their mental health. The present study aimed to examine the role of perceived stress and social support in explaining the association between the occupational stressors and three mental health symptoms (i.e., anxiety, depression, and insomnia) of frontline medical staff. Five hundred twenty five frontline medical staff were investigated online after the outbreak of the COVID-19 (16 February, 2020-2 March, 2020) in China. The results found that the prevalence of anxiety, depression, and insomnia among frontline medical staff were 39.8, 29.9, and 37.9%, respectively. Occupational stressors were associated with anxiety, depression, and insomnia symptoms. Perceived stress significantly mediated this link. Social support moderated the second half of the indirect effect of occupational stressors on anxiety and depression symptoms. Under the epidemic situation of COVID-19, for frontline medical staff, high perceived stress and low social support may increase vulnerability for mental health symptoms triggered by occupational stressors. Thus, improving the social support and promoting the cognitive reappraisal of perceived stress may help to maintain mental health among medical staff.

The Psychological Well-Being of Southeast Asian Frontline Healthcare Workers during COVID-19: A Multi-Country Study

Objectives: This study examined the prevalence of anxiety, depression, and job burnout among frontline healthcare workers (HCWs) across six Southeast Asian countries (Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam) during the COVID-19 pandemic in 2021. We also investigated the associated risk and protective factors. Methods: Frontline HCWs (N = 1381) from the participating countries participated between 4 January and 14 June 2021. The participants completed self-reported surveys on anxiety (GAD-7), depression (PHQ-8), and job burnout (PWLS). Multivariate logistic regressions were performed with anxiety, depression, and job burnout as outcomes and sociodemographic and job characteristics and HCW perceptions as predictors. Results: The average proportion of HCWs reporting moderate anxiety, moderately severe depression, and job burnout across all countries were 10%, 4%, and 20%, respectively. Working longer hours than usual (Odds ratio [OR] = 1.82; 3.51), perceived high job risk (1.98; 2.22), and inadequate personal protective equipment (1.89; 2.11) were associated with increased odds of anxiety and job burnout while working night shifts was associated with increased risk of depression (3.23). Perceived good teamwork was associated with lower odds of anxiety (0.46), depression (0.43), and job burnout (0.39). Conclusion: Job burnout remains a foremost issue among HCWs. Potential opportunities to improve HCW wellness are discussed.

Mental Health, Burnout, and Job Stressors Among Healthcare Workers During the COVID-19 Pandemic in Iran: A Cross-Sectional Survey

Introduction

The COVID-19 pandemic has caused increasing levels of mental health problems such as anxiety and depression among doctors, nurses and other healthcare workers in hospitals or health centers. The main objective of this study was to assess the mental health, job stressors, and burnout among healthcare workers in Iran.

Materials and Methods

A cross-sectional study was performed in the primary healthcare centers and hospitals affiliated with six of the medical universities in Iran. The selection of participants was done using multi-center convenient sampling. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Copenhagen Burnout Inventory were used for gathering data through an online platform. Data related to job stressors were obtained using a validated checklist. Data analysis was performed using Chi-square and multiple regression tests and the phi coefficient.

Results

The results of our study showed that 53% of the healthcare workers of the hospitals and primary healthcare centers enrolled in our study either had generalized anxiety disorder or major depressive disorder or both disorders. Moderate and high levels of burnout were seen among 48.9% of the study participants. The prevalence of mental disorders and burnout were significantly higher among the female healthcare workers compared to the male (p = 0.0001) and a higher rate of mental disorder and burnout was also seen among healthcare workers of hospitals compared to those working in primary healthcare centers (p = 0.024). "Worry about children and old members of family," "family worries for my health condition" and "lack of specific effective treatment for COVID-19" were found to be predictive of mental disorder and burnout. The most prevalent job stressor among the total sample was "low payment or income during the COVID-19 period".

Conclusion

The results of our study revealed high psychological distress and burnout among healthcare workers of the hospitals during the fourth peak of the COVID-19 pandemic in Iran. This study highlights the need for health officials to pay attention to the job stressors of healthcare workers and obliges them to perform effective interventions to address their needs and concerns.

Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study

OBJECTIVES

Evidence-based guidelines recommend physiotherapy for respiratory treatment and physical rehabilitation of patients with COVID-19. It is unclear to what extent physiotherapy services are used in the front-line management of COVID-19 in Nigeria. This study aimed to explore the experiences of front-line physiotherapists managing patients with COVID-19 in Nigeria.

DESIGN

Qualitative interview-based study.

SETTING

ICU and hospital COVID-19 wards, COVID-isolation and treatment centres in Nigeria, between August 2020 and January 2021.

PARTICIPANTS

Eight out of 20 physiotherapists managing patients with COVID-19 in the front line were recruited using purposive and snowball sampling.

METHODS

Qualitative in-depth semistructured telephone interviews of all consenting physiotherapists managing patients with COVID-19 in the front line in Nigeria were conducted and transcribed verbatim. Transcripts were thematically analysed.

RESULTS

Eight front-line physiotherapists (three neurological physiotherapists, two orthopaedic physiotherapists, one cardiopulmonary physiotherapist, one sports physiotherapist and one rotational physiotherapist) provided consent and data for this study. Four themes and 13 subthemes were generated illustrating discriminatory experiences of front-line physiotherapists, particularly from COVID-19 team leads; lack of multidisciplinary teamwork within COVID-19 teams; wide ranging stigmatisation from extended family members, colleagues, friends and the general public; material and psychosocial personal losses; lack of system support and suboptimal utilisation of physiotherapy in the management of COVID-19 in Nigeria. Personal agency, sense of professionalism, previous experience managing highly infectious diseases and being a cardiopulmonary physiotherapist were the factors that made the front-line physiotherapists to become involved in managing patients with COVID-19. However, discriminatory experiences made some of these physiotherapists to stop being involved in the management of patients with COVID-19 in the front line. Most front-line physiotherapists were not cardiopulmonary physiotherapists which may have influenced their level of expertise, multidisciplinary involvement and patient outcomes.

CONCLUSIONS

There is suboptimal involvement and support for physiotherapists, particularly cardiopulmonary physiotherapists treating patients with COVID-19 in the front line in Nigeria.

Analysis of the Psychosocial Impact of the COVID-19 Pandemic on the Nursing Staff of the Intensive Care Units (ICU) in Spain

(1) The public health emergency, caused by COVID-19, has resulted in strong physical and mental exhaustion in healthcare workers. This research has been designed with the aim to describe the psychosocial impact of the COVID-19 pandemic on nurses working in intensive care units (ICU) and identify the related risk factors. (2) This is a cross-sectional study, in which a self-administered questionnaire was designed to cover the dimensions of interest associated with psychosocial factors during the pandemic and their factor risks. (3) A total of 456 nursing professionals participated, and 88.4% were women. Most of the professionals had a temporary contract (71.3%) and person at risk close to them (88.8%). Regarding psychosocial factors, there was a worsening in most of the associated variables, especially in sleep problems, anxiety, stress, and job performance. Female nurses were more prone to anxiety. Those under 30, as well as those with temporary contracts, were more unfocused. Professionals with a person at risk in their environment felt much more worried. The degree of exposure was associated with greater fear. (4) Those nurses who were female, younger, and with a temporary employment contract were shown to be more vulnerable to the impact of the pandemic on their psychosocial health. Because of this, it is necessary to adopt effective strategies for the protection of nurses’ health, focusing on the specific risk factors identified.

Effect of distance learning on the quality of life, anxiety and stress levels of dental students during the COVID-19 pandemic

BACKGROUND

The long-term psychological effects of COVID-19 on dental students are unclear. The aim of this cross-sectional online study was to investigate the psychological effects of the COVID-19 pandemic on dental students.

METHOD

The Quality of Life Scale (WHOQOL-BREF) was sent to all dental students through Google Forms to evaluate their quality of life (QoL), and the DASS-21 scale was used to evaluate their psychosocial status due to distance learning during the COVID-19 pandemic. The answers were analyzed both on the basis of year of education and type of education (online versus classroom learning). One-way ANOVA was used for comparison of students in the different years of education; post hoc LSD test was used for pairwise comparisons. Sample t-test was used to compare the two groups separated as classroom/face-to-face learning and distance/online learning.

RESULT

The questionnaire was completed by 580 students with a response rate of 87.74%. According to the QoL scale results, there was no significant difference between the groups regarding general health, physical health, and psychology, both between different years and learning methods (p > 0.05). According to the results of the DASS-21 scale, anxiety and depression in the 3rd year students were significantly higher than the other years. The stress level of the 2nd year students was statistically significantly different from the other years (p < 0.05). Evaluation of anxiety, stress and the QoL showed an overall detrimental effect of distance learning on the dental students, although the evaluation did not reach statistical significance.

CONCLUSION

Anxiety, stress and factors affecting the quality of life negatively affected dental students who received online/distance learning, although the difference did not reach statistical significance when compared to students who received in-classroom learning.

The "Healthcare Workers' Wellbeing [Benessere Operatori]" Project: A Longitudinal Evaluation of Psychological Responses of Italian Healthcare Workers during the COVID-19 Pandemic

Background: COVID-19 forced healthcare workers to work in unprecedented and critical circumstances, exacerbating already-problematic and stressful working conditions. The “Healthcare workers’ wellbeing (Benessere Operatori)” project aimed at identifying psychological and personal factors, influencing individuals’ responses to the COVID-19 pandemic. Methods: 291 healthcare workers took part in the project by answering an online questionnaire twice (after the first wave of COVID-19 and during the second wave) and completing questions on socio-demographic and work-related information, the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, the Maslach Burnout Inventory, the Multidimensional Scale of Perceived Social Support, and the Brief Cope. Results: Higher levels of worry, worse working conditions, a previous history of psychiatric illness, being a nurse, older age, and avoidant and emotion-focused coping strategies seem to be risk factors for healthcare workers’ mental health. High levels of perceived social support, the attendance of emergency training, and problem-focused coping strategies play a protective role. Conclusions: An innovative, and more flexible, data mining statistical approach (i.e., a regression trees approach for repeated measures data) allowed us to identify risk factors and derive classification rules that could be helpful to implement targeted interventions for healthcare workers.

Mental Health Outcomes in Australian Healthcare and Aged-Care Workers during the Second Year of the COVID-19 Pandemic

Objective: the COVID-19 pandemic has incurred psychological risks for healthcare workers (HCWs). We established a Victorian HCW cohort (the Coronavirus in Victorian Healthcare and Aged-Care Workers (COVIC-HA) cohort study) to examine COVID-19 impacts on HCWs and assess organisational responses over time. Methods: mixed-methods cohort study, with baseline data collected via an online survey (7 May–18 July 2021) across four healthcare settings: ambulance, hospitals, primary care, and residential aged-care. Outcomes included self-reported symptoms of depression, anxiety, post-traumatic stress (PTS), wellbeing, burnout, and resilience, measured using validated tools. Work and home-related COVID-19 impacts and perceptions of workplace responses were also captured. Results: among 984 HCWs, symptoms of clinically significant depression, anxiety, and PTS were reported by 22.5%, 14.0%, and 20.4%, respectively, highest among paramedics and nurses. Emotional exhaustion reflecting moderate–severe burnout was reported by 65.1%. Concerns about contracting COVID-19 at work and transmitting COVID-19 were common, but 91.2% felt well-informed on workplace changes and 78.3% reported that support services were available. Conclusions: Australian HCWs employed during 2021 experienced adverse mental health outcomes, with prevalence differences observed according to occupation. Longitudinal evidence is needed to inform workplace strategies that support the physical and mental wellbeing of HCWs at organisational and state policy levels.

A longitudinal study of the psychological impact of the COVID-19 pandemic on frontline perioperative healthcare staff in an Australian tertiary public hospital

OBJECTIVE

This longitudinal study examined changes in psychological outcomes of perioperative frontline healthcare workers at one of Australia's most COVID-19 affected hospitals, following the surge and decline of a pandemic wave.

METHOD

A single-centred longitudinal online survey was conducted between 26 May and 17 November 2020. Recruitment was via poster advertisement and email invitation. The survey was sent out every 4 weeks, resulting in seven time-points.

RESULTS

In total, 385 survey results were analysed from 193 staff (about 64% response rate), 72 (37%) of whom completed the survey more than once. The prevalence of moderate-to-severe anxiety and depressive symptoms peaked at 27% and 25%, respectively, during the pandemic surge. Up to 35% displayed post-traumatic stress disorder (PTSD) symptoms. Although not statistically significant, the trend of depressive and PTSD symptoms worsened over time, especially among females and anaesthetic/surgical trainees, despite subsidence of the pandemic curve. Technicians and anaesthetic/scrub nurses were the at-risk groups with worst psychological outcomes.

CONCLUSION

We found persistent mental health impacts on frontline perioperative HCWs despite subsidence of the pandemic wave. Further research is needed to determine the extent and trajectory of such impacts with larger sample sizes to determine generalisability to frontline HCWs in general.

Factors Associated With Psychological Outcomes Among Vaccinated and Unvaccinated Health Care Workers Against COVID-19 Infection in Bangladesh

Background

Vaccination of healthcare workers (HCWs) is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their patients, as well as to encourage their patients to get immunized. The present study aimed to investigate the psychological outcomes and associated factors among vaccinated and unvaccinated HCWs against COVID-19 infection in Bangladesh.

Methods

From March to August 2021, an online nationwide survey was conducted with a total of 2,038 Bangladeshi HCWs. The frequency of symptoms of general health problems, depression, anxiety, stress, post-traumatic stress disorder, insomnia, and loneliness was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and UCLA-LS scales, respectively.

Results

Compared with unvaccinated HCWs (n = 1,058), vaccinated HCWs (n = 980) had a statistically significant lower prevalence of general health problems (16.7 vs. 59.1%), depression (15.6 vs. 31.9%), post-traumatic stress disorder (22.3 vs. 30.8%), insomnia (23.8 vs. 64.9%), and loneliness symptoms (13.9 vs. 21.8%). Among vaccinated HCWs, females were significantly associated with a higher risk of symptoms of general health problems (AOR, 2.71; 95% CI, 0.97-7.60), anxiety (AOR, 2.17; 95% CI, 1.14-4.13), and loneliness (AOR, 2.52; 95% CI, 1.11-5.73). Except for anxiety and post-traumatic stress disorder symptoms, participants living in urban areas had a significantly lower risk of all psychological outcomes (e.g., depression: AOR, 0.43; 95% CI, 0.27-0.67; stress: AOR, 0.64; 95% CI, 0.47-0.88). Respondents who were married were significantly less likely to experience symptoms of general health problems (AOR, 0.10; 95% CI, 0.02-0.39), depression (AOR, 0.31; 95% CI, 0.22-0.82), insomnia (AOR, 0.46; 95% CI, 0.20-1.03), and loneliness (AOR, 0.31; 95% CI, 0.10-0.92). Participants who worked as doctors were significantly less chance of experiencing symptoms of general health problems (AOR, 0.18; 95% CI, 0.08-0.37), depression (AOR, 0.51; 95% CI, 0.30-0.87), and anxiety (AOR, 0.54; 95% CI, 0.37-0.78). On the other hand, unvaccinated HCWs who were 18-29 years old and had <5 years of work experience were significantly associated with a higher risk of all psychological outcomes except anxiety and insomnia symptoms (e.g., depression among 18-29 years old: AOR, 1.83; 95% CI, 0.27-2.60; stress among those with <5 years of work experience: AOR, 2.37; 95% CI, 0.93-6.07). Participants who worked as nurses were significantly more likely to suffer from depression (AOR, 1.44; 95% CI, 0.84-2.46), anxiety (AOR, 1.42; 95% CI, 0.24-1.73), and stress (AOR, 1.55; 95% CI, 0.31-0.89) symptoms. Except for anxiety and stress symptoms, respondents who worked as frontline workers and provided direct care to infected patients were the significantly higher chance of experiencing all psychological outcomes (e.g., depression among who worked as frontline workers: AOR, 2.41; 95% CI, 0.23-3.73; insomnia among those who provide direct care to infected patients: AOR, 2.60; 95% CI, 0.34-3.06). Participants who were infected with COVID-19 had a significantly less chance of experiencing symptoms of general health problems (AOR, 0.89; 95% CI, 0.65-1.22), depression (AOR, 0.66; 95% CI, 0.48-0.92), and anxiety (AOR, 0.63; 95% CI, 0.46-0.87).

Conclusions

To control the infection and improve psychological outcomes, this study suggests emphasizing the vaccinated to unvaccinated HCWs as soon as possible. They also required special attention, health-related education, and psychological support.

Health care workers' experiences during the COVID-19 pandemic: a scoping review

BACKGROUND

COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included.

RESULTS

161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries.

DISCUSSION

This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances.

CONCLUSIONS

Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.

Factors associated with burnout among medical laboratory professionals in Ontario, Canada: An exploratory study during the second wave of the COVID‐19 pandemic

Objective

The objective of this study was to examine factors associated with burnout among medical laboratory technologists (MLT) in Ontario, Canada during the second wave of coronavirus disease 2019 pandemic.

Methods

We employed a cross‐sectional design and used a self‐reported questionnaire designed for MLT in Ontario, Canada.

Results

There were 441 (47.5% response rate) MLT who were included in the analytic sample. Most of the respondents were women, with a mean age of 43.1 and a standard deviation of 11.7. The prevalence of experiencing burnout was 72.3% for MLT. In the adjusted demographic model, those ≥50 (OR = 0.36, 95% CI: 0.22–0.59) were 0.36 or about one third as likely to experience burnout as those under 50. Similarly, those who held a university degree were less likely to experience burnout compared with high school degree (OR = 0.35, 95% CI: 0.15–0.79). In the adjusted occupational model, high quantitative demands (OR = 2.15, 95% CI: 1.21–3.88), high work pace (OR = 2.21, 95% CI: 1.25–3.98), high job insecurity (OR = 2.56, 95% CI: 1.39–4.82), high work life conflict (OR = 5.08, 95% CI: 2.75–9.64) and high job satisfaction (OR = 0.43, 95% CI: 0.20–0.88), high self‐rated health (OR = 0.32, 95% CI: 0.17–0.56) were significant.

Conclusion

This study provides preliminary evidence regarding the factors associated with burnout in MLT. Additional research is needed to understand their relationship with workers health and well‐being and in the delivery of health services.

This study examined burnout among medical laboratory technologist in Ontario

medical laboratory technologists (MLT) experience high rates of burnout during the pandemic

Demographic factors associated with burnout include education attainment and age

Occupational factors associated with burnout include high work demands, job demands, low job satisfaction and high self‐regulated health

Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study

Background

The COVID-19 pandemic has had a major impact on the mental health of healthcare workers, yet studies in primary care workers are scarce.

Aim

To investigate the prevalence of and associated factors for psychological distress in primary care workers during the first COVID-19 outbreak.

Design and setting

This was a multicentre, cross-sectional, web-based survey conducted in primary healthcare workers in Spain, between May and September 2020.

Method

Healthcare workers were invited to complete a survey to evaluate sociodemographic and work-related characteristics, COVID-19 infection status, exposure to patients with COVID-19, and resilience (using the Connor–Davidson Resilience Scale), in addition to being screened for common mental disorders (depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder). Positive screening for any of these disorders was analysed globally using the term ‘any current mental disorder’.

Results

A total of 2928 primary care professionals participated in the survey. Of them, 43.7% (95% confidence interval [CI] = 41.9 to 45.4) tested positive for a current mental disorder. Female sex (odds ratio [OR] 1.61, 95% CI = 1.25 to 2.06), having previous mental disorders (OR 2.58, 95% CI = 2.15 to 3.10), greater occupational exposure to patients with COVID-19 (OR 2.63, 95% CI = 1.98 to 3.51), having children or dependents (OR 1.35, 95% CI = 1.04 to 1.76 and OR 1.59, 95% CI = 1.20 to 2.11, respectively), or having an administrative job (OR 2.24, 95% CI = 1.66 to 3.03) were associated with a higher risk of any current mental disorder. Personal resilience was shown to be a protective factor.

Conclusion

Almost half of primary care workers showed significant psychological distress. Strategies to support the mental health of primary care workers are necessary, including designing psychological support and resilience-building interventions based on risk factors identified.

Experiences of the SARS-CoV-2 pandemic amongst Australian healthcare workers: from stressors to protective factors

BACKGROUND

The SARS-CoV-2 pandemic has critically challenged healthcare systems globally. Examining the experiences of healthcare workers (HCWs) is important for optimizing ongoing and future pandemic responses.

OBJECTIVES

In-depth exploration of Australian HCWs' experiences of the SARS-CoV-2 pandemic, with a focus on reported stressors vis-à-vis protective factors.

METHODS

Individual interviews were performed with 63 HCWs in Australia. A range of professional streams and operational staff were included. Thematic analysis was performed.

RESULTS

Thematic analysis identified stressors centred on paucity of, or changing, evidence, leading to absence of, or mistrust in, guidelines; unprecedented alterations to the autonomy and sense of control of clinicians; and deficiencies in communication and support. Key protective factors included: the development of clear guidance from respected clinical leaders or recognized clinical bodies, interpersonal support, and strong teamwork, leadership, and a sense of organizational preparedness.

CONCLUSIONS

This study provides insights into the key organizational sources of emotional stress for HCWs within pandemic responses and describes experiences of protective factors. HCWs experiencing unprecedented uncertainty, fear, and rapid change, rely on clear communication, strong leadership, guidelines endorsed by recognized expert groups or individuals, and have increased reliance on interpersonal support. Structured strategies for leadership and communication at team, service group and organizational levels, provision of psychological support, and consideration of the potential negative effects of centralizing control, would assist in ameliorating the extreme pressures of working within a pandemic environment.

Feasibility, psychological outcomes and practical use of a stress-preventive leadership intervention in the workplace hospital: the results of a mixed-method phase-II study

OBJECTIVES

Hospitals are psychologically demanding workplaces with a need for context-specific stress-preventive leadership interventions. A stress-preventive interprofessional leadership intervention for middle management has been developed. This phase-II study investigates its feasibility and outcomes, including work-related stress, well-being and transformational leadership.

DESIGN

This is a mixed-methods study with three measure points (T0: baseline, T1: after the last training session, T2: 3-month follow-up). Additionally, focus groups were conducted to assess participants' change in everyday work.

SETTING

A tertiary hospital in Germany.

PARTICIPANTS

N=93 leaders of different professions.

INTERVENTION

An interactive group setting intervention divided in five separate sessions ((1) self-care as a leader, (2) leadership attitudes and behaviour, (3) motives, needs and stressors of employees, (4) strengthen the resource 'team', (5) reflection and focus groups). The intervention was conducted between June 2018 and March 2020 in k=5 runs of the intervention.

OUTCOME MEASURES

Feasibility and acceptance were measured with a self-developed intervention specific questionnaire. Psychological outcomes were assessed with the following scales: work-related strain with the Irritation Scale, well-being with the WHO-5 Well-being Index and transformational leadership with the Questionnaire of Integrative Leadership.

RESULTS

After the intervention at T2, over 90% of participants reported that they would recommend the intervention to another coworker (92.1%, n=59) and all participants (n=64) were satisfied with the intervention and rated the intervention as practical relevant for their everyday work. Participants' self-rated cognitive irritation was reduced, whereas their well-being and transformational leadership behaviour were improved over time. Focus group discussions revealed that participants implemented intervention contents successfully in their everyday work.

CONCLUSIONS

This intervention was feasible and showed first promising intraindividual changes in psychological outcomes. Participants confirmed its practical relevance. As a next step, the intervention will be evaluated as part of a multicentre-randomised controlled trial within the project SEEGEN (SEElische GEsundheit am Arbeitsplatz KrankeNhaus).

Promoting resilience in healthcare workers during the COVID-19 pandemic with a brief online intervention

INTRODUCTION

The psychological wellbeing of healthcare workers has been impacted by the high levels of stress many have experienced during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to examine the feasibility and acceptability of a brief online course focused on introducing evidence-based skills that could increase resilience and decreases emotional distress in healthcare workers during the pandemic.

MATERIALS AND METHODS

Employees of a large healthcare system completed a mental health survey at baseline, and then one month and two months after some employees participated in an online resilience-enhancement course consisting of three 12-19 min videos focused on mindfulness, mentalization, and self-compassion.

RESULTS

A total of 554 participants completed the baseline survey, endorsing moderate to high levels of emotional distress. Of those who completed all three assessments and participated in the course (n = 38), significant improvements in resilience and reductions in emotional distress were found one and two months later, in comparison to those who did not participate in the course (n = 110).

DISCUSSION

These findings suggest that a brief, online intervention can improve the mental health of healthcare workers during a crisis such as the COVID-19 pandemic.

Early Mental Health and Quality of Life in Discharged Patients With COVID-19

Aim: This study aimed to analyze the early mental health (MH) and quality of life (QoL) of discharged patients with coronavirus disease 2019 (COVID-19), which can provide a scientific basis for the further development of intervention programs.

Methods: In total, 108 subjects participated in this study, including an experimental group (90 patients diagnosed with COVID-19 from March to April 2020 and hospitalized in Wuhan China Resources & WISCO General Hospital, Wuhan, China, 83.3%) and a control group (18 healthy participants, 16.7%). Their MH and QoL were measured through the 12-item Short Form Health Survey version 2 (SF-12v2), the Self-rating anxiety scale (SAS), the Self-rating depression scale (SDS), and the International Physical Activity Questionnaire (IPAQ). The results of questionnaires were compared between these two groups.

Results: (1) Comparison of anxiety status: among 90 discharged patients with COVID-19, 30 patients (33.3%) had a state of anxiety. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of anxiety and more severe anxiety symptoms (P < 0.05). (2) Comparison of depression status: among 90 discharged patients with COVID-19, 29 patients (32.2%) had a state of depression. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of depression and more severe depression symptoms (P < 0.05). (3) Comparison of QoL: 78 patients (86.7%) presented a decrease in physical health-related quality of life (HRQoL) and 73 patients (81.1%) presented a decrease in psychology-related QoL. The SF-12v2 physical component summary (PCS) and the SF-12v2 mental component summary (MCS) of patients were significantly lower than those of healthy people, especially in physical function (PF), vitality (VT), social function (SF), and mental health (MH) (all P < 0.05). (4) Gender differences in mental health and the QoL among patients with COVID-19: women had more severe anxiety/depression symptoms than men (P < 0.05). The scores of women in all dimensions of SF-12V2 were lower than those of men, and there were statistically significant differences between the two groups in PCS, PF, general health (GH), VT, and role-emotional (RE) (P < 0.05).

Conclusion: During the early phase after being discharged, patients with COVID-19 might experience negative emotions, such as anxiety or depression, and also problems with reduced QoL, especially among female patients. Therefore, an intervention plan should focus on strengthening psychological condition and improving physical function, and gender-specific rehabilitation programmes should be adapted to improve psychological status and QoL.

Depression and anxiety symptoms and perceived stress in health professionals in the context of COVID-19: Do adverse childhood experiences have a modulating effect?

BACKGROUND

Adverse childhood experiences (ACE) have a great impact on mental health outcomes of adults. However, little is known whether ACE may act as modulators of the mental health of health professionals caring for patients with COVID-19.

METHODS

Data were collected through an online cross-sectional survey administered to health professionals in Lima (Peru) between May and July 2020. The survey included standardized self-assessment instruments for anxiety, depression, acute stress (AS) and history of ACE.

RESULTS

A total of 542 health professionals completed the survey. Caring for patients with COVID-19 was significantly associated with depression and anxiety and when caring for patients with COVID-19 was combined with a history of early sexual abuse, its effect on the risk of anxiety increased (OR = 7.71, p = .010). Mental health problems were associated with female gender in almost all the analyses and with the majority of ACEs.

CONCLUSIONS

Health workers in the context of the COVID-19 pandemic presented a high risk of mental health disorders. Antecedents of sexual abuse acted as a potentiating factor of anxiety in professionals providing COVID-19 care. These findings suggest that the burden of ACE modulates mental health problems in health professionals during the pandemic.

EMOTIONAL IMPACT OF THE COVID-19 PANDEMIC ON HEALTHCARE WORKERS IN UKRAINE

OBJECTIVE

The aim: To study the emotional impact of the COVID-19 pandemic on healthcare workers in Ukraine.

PATIENTS AND METHODS

Materials and methods: 1087 healthcare workers across all regions of Ukraine completed an online questionnaire. Respondents were divided into two groups: A - 863 (79.4%), В - 224 (20.6%), according to whether or not they experienced anxiety/fear related to COVID-19.

RESULTS

Results: Such factors as risk of contracting COVID-19, news of new cases, insufficient staff in healthcare facilities, risk of transmission of COVID-19 to family or friends, risk of death from COVID-19, the threat of the spread of the COVID-19 pandemic were associated with high level of anxiety/fear among healthcare workers. Factors that facilitate coping with stress included absence of Covid-19 cases among staff, recovering patients, availability of gear and protective equipment and absence of COVID-19 infected among loved ones, relieving stress (relaxation, going info sports and so on), communication with family and friends to relieve stress and get support, avoidance of COVID-19 media reports in particular on deaths connected cases, getting information about the spread of Covid-19 only from legitimate sources.

CONCLUSION

Conclusions: The data obtained in this study indicate an urgent need for the development and implementation of preventive and rehabilitation measures aimed at stabilizing the psycho-emotional state of health workers and improving the quality of care in the special conditions of the COVID-19 pandemic. Achieving these goals will be facilitated by taking into account the specifics of the response to COVID-19 and measures to reduce the effects of stress while enhancing the effects of stressors among health care workers.

OUP accepted manuscript

Background

Hospital clinicians report poor psychosocial well-being during the COVID-19 pandemic. Few studies have reported data at more than one time point.

Aims

To compare psychosocial well-being among hospital clinicians at two different time points during the COVID-19 pandemic in 2020.

Methods

Participants included doctors, nurses, midwives and allied health clinicians at a multi-site, public health service in Melbourne, Australia. Data were collected via two cross-sectional, online surveys: May to June (wave 1; n = 638) and October to December 2020 (wave 2; n = 358). The Depression, Anxiety and Stress Scale (DASS-21) assessed psychological well-being in the past week. Investigator-devised questions assessed COVID-19 concerns and perceived work impacts. General linear models were used to assess impact of wave on psychological distress.

Results

There were no significant demographic differences between the two groups. Both positive (e.g. learning experience) and negative (e.g. risk of getting COVID-19) impacts were reported. In both waves, staff were most concerned about health risks to family members. Wave 2 respondents were significantly more likely than wave 1 respondents to indicate concerns about colleagues having COVID-19, increased workloads, leave cancellation and increased conflict at work (all P < 0.001). Adjusting for sex, age, self-rated health and discipline group, depression, anxiety and stress scores were significantly higher for respondents in the second than the first wave (all P < 0.001).

Conclusions

Psychological well-being of hospital clinicians was significantly worse during the second wave of the COVID-19 pandemic than the first. Sustained occupational and psychosocial support is recommended even when immediate COVID-19 concerns and impacts resolve.

The COVID-19 pandemic and mental health of healthcare workers in Serbia

The COVID-19 pandemic was a challenging experience for many professionals worldwide. Healthcare workers in particular had to invest a lot of efforts to cope with the stressors related to professional challenges, which can adversely affect their mental health and cause burnout syndrome. However, it is important to explore mental health outcomes of the pandemic among healthcare workers in the context of a specific country. This study examined the effects of increased professional and personal demands on the health workers' mental health after almost two years of dealing with the pandemic. A cross-sectional online anonymous survey was conducted during October 2021. The sample consisted of 286 healthcare workers (76.7% male) from all regions of Serbia. The questionnaire included socio-demographic data, professional and personal experiences during the pandemic, mental health difficulties, and burnout. The results indicate that more than half of the participants experienced a high or moderate level of depressive symptoms, anxiety and stress. Emotional exhaustion as a symptom of burnout was reported by almost all participants (91.9%), followed by moderate compassion fatigue (60.8%) and lower level of self-efficiency (23.8%). The most significant predictors of burnout and mental health difficulties referred to impaired working conditions and insufficient instructions from superiors, a high level of personal concern about the infection, and maladaptive coping strategies. The results point to the importance of providing psychosocial support to healthcare workers in order to prevent further mental health impairments. Still, interventions should be focused on the external organizational factors instead of addressing solely individual vulnerability.

Caring for COVID-19 infected patients admitted to redesignated coronavirus ICUs: Impact on nurse stress and burnout

OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic globally impacted healthcare due to surges in infected patients and respiratory failure. The pandemic escalated nursing burnout syndrome (NBS) across the workforce, especially in critical care environments, potentially leading to long-term negative impact on nurse retention and patient care. To compare self-reported burnout scores of frontline nurses caring for COVID-19 infected patients with burnout scores captured before the pandemic and in non-COVID-19 units from two prior studies.

METHODS

The descriptive study was conducted using frontline nurses working in eight critical care units based on exposure to COVID-19 infected patients. Nurses were surveyed in 2019 and in 2020 using Maslach Burnout Inventory (MBI), Well Being Instrument, and Stress-Arousal Adjective Checklist (SACL) instruments. Researchers explored relationships between survey scores and working in COVID-19 units.

RESULTS

Nurses working in COVID-19 units experienced more emotional exhaustion (EE) and depersonalization (DP) than nurses working in non-COVID units (p= .0001). Pre-COVID nurse burnout scores across six critical care units (EE mean = 15.41; p= .59) were lower than burnout scores in the COVID-19 intensive care units (EE mean = 10.29; p= .74). Clinical significance (p= .08) was noted by an EE subscale increase from low prepandemic to moderate during the pandemic.

CONCLUSION

Pinpointing associations between COVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Further research is required to establish causal relationships between sociodemographic and work-related psychological predictors of NBS.

A Survey Research on the Willingness of Gynecologists to Employ Mobile Health Applications

In gynecological care, mHealth (mobile health) technology may play an important role. Medical professionals' willingness to use this technology is the key to its acceptance. Most doctors utilize mobile health technology; however, there is still room for improvement in the use of mHealth. Gynecologists were asked to participate in this research to see how open they were to use mobile health technologies. In this descriptive-analytical investigation, the researchers determined the average scores for each variable. The overall mean for preparedness to embrace mobile medical technology is 1.8 out of 2, as shown in Table 1. When it came to their desire to embrace mobile health technology, doctors' years of experience correlated negatively with their age. According to our findings, the amount of interest in mobile health technology is high. Patients' private information must be protected throughout the usage of this technology though. Mobile health technology may effectively reach patients in remote areas, but it is not a substitute for face-to-face encounters with medical professionals.

Acute Stress in Health Workers during Two Consecutive Epidemic Waves of COVID-19

The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. We performed a study assessing acute stress in frontline health workers during two consecutive epidemic waves. After screening for trait anxiety/depression and dissociative experiences, we evaluated changes in acute stress, considering resilience, state anxiety, burnout, depersonalization/derealization symptoms, and quality of sleep as cofactors. During the first epidemic wave (April 2020), health workers reported acute stress related to COVID-19, which was related to state anxiety. After the first epidemic wave, acute stress decreased, with no increase during the second epidemic wave (December 2020), and further decreased when vaccination started. During the follow-up (April 2020 to February 2021), the acute stress score was related to bad quality of sleep. However, acute stress, state anxiety, and burnout were all related to trait anxiety/depression, while the resilience score was invariant through time. Overall, the results emphasize the relevance of mental health screening before, during, and after an epidemic wave of infections, in order to enable coping during successive sanitary crises.

The role of resilience and coping among Italian healthcare workers during the COVID-19 pandemic

Objective:

To evaluate the psychological state of healthcare workers (HCWs) in the field of rehabilitation during the COVID-19 pandemic.

Methods:

Cross-sectional observational study. Sample of 334 HCWs including: nurses, medical doctors, therapists, scientists, and clerical workers working at the IRCCS San Raffaele Roma rehabilitation hospital during the second wave of the COVID-19 pandemic. Anonymous web-based questionnaire included 14-item Resilience Scale, Brief-COPE, Hospital Anxiety Depression Scale, Fear of COVID-19 Scale. Occupational and sociodemographic characteristics.

Results:

High levels of resilience, low levels of anxiety, depression, and fear were observed in the study population; the most frequently used coping strategies in the Brief-COPE were acceptance, planning, and active coping. Specifically, 87% of the participants reported a moderate to high level of resilience, with the highest level observed in nurses while physicians show the lowest level. HCWs showed symptoms of anxiety (29%), depressive symptoms (10%), and fear caused by the COVID-19 pandemic (44%). Statistically significant differences were observed between different occupations for fear (p <0.05) and resilience (p <0.01). Levels of anxiety and fear appeared to be higher in female and younger workers. The latter group - who also reported higher levels of depression - showed lower levels of resilience.

Conclusions:

In our study hospital and non-hospital workers show different emotional, cognitive, and behavioural resources when facing stressful situations, like in the case of the SARS-CoV-2 pandemics. Our results support the role of resilience and the proper use of problem-focused and emotion-focused coping strategies as protective factors from psychological distress.

The Sustained Psychological Impact of the COVID-19 Pandemic on Health Care Workers One Year after the Outbreak-A Repeated Cross-Sectional Survey in a Tertiary Hospital of North-East Italy

This study aimed to evaluate the mental health outcomes of health care workers (HCWs) of the Verona academic hospital trust (Italy) one year after the outbreak of COVID-19 and to identify predicted risk factors. A web-based survey was conducted from mid-April to mid-May 2021 on hospital workers one year after the first evaluation performed during the lock-down phase of the COVID-19 pandemic. Post-traumatic stress, general anxiety, depression, and burnout were assessed by using, respectively, the impact of event scale (IES-R), the self-rating anxiety scale (SAS), the patient health questionnaire (PHQ-9) and the Maslach burnout inventory-general survey (MBI-GS). Multivariate logistic regression analysis was performed to identify factors associated with each of the four mental health outcomes one year after the COVID-19 outbreak. A total of 1033 HCWs participated. The percentage of HCWs scoring above the cut-off increased from 2020 to 2021 in all of the outcome domains (anxiety, 50.1% vs. 55.7, p < 0.05; depression, 26.6% vs. 40.6%, p < 0.001; burnout, 28.6% vs. 40.6%, p < 0.001; chi-square test), with the exception of post-traumatic distress. There was also an increase when stratifying by occupation and workplace, with a greater increase for depression and burnout. Multivariate analysis revealed that, one year after the COVID-19 outbreak, nurses were at the greatest risk of anxiety and depression, whereas residents were at the greatest risk of burnout (in terms of low professional efficacy). Working in intensive care units was associated with an increased risk of developing severe emotional exhaustion and a cynical attitude towards work.

Identifying Psychosocial Risks and Protective Measures for Workers’ Mental Wellbeing at the Time of COVID-19: A Narrative Review

The spread of the SARS-CoV-2 virus has caused crucial changes in the workplace. Almost two years after the start of the COVID-19 era, new and old psychosocial risks in the workplace threaten workers’ mental wellbeing and represent an occupational health challenge. The aim of this review is to identify the most relevant psychosocial factors, negative or protective, contributing to occupational stress during the current pandemic. A literature search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar and PsycINFO and a total of 51 articles were deemed suitable for inclusion in the review. Analysis of the retrieved articles revealed five main topics related to psychosocial wellbeing in the workplace: 1. Support from colleagues and organizations; 2. Home–work interface and balance; 3. Changes in workload and work demand; 4. Job competence and appropriate training; 5. Job insecurity and financial stress. All five themes were associated with occupational stress and poor mental outcomes, like anxiety, depression, and burnout symptoms. Peer and organizational support seem to have a major impact on workers’ mental wellbeing. Recognizing these factors and projecting interventions that mitigate their effects or boost their efficacy is a fundamental step towards dealing with COVID-19 in the workplace, or any such future emergencies.

Prediction of emotional exhaustion over the course of the COVID-19 pandemic in primary care dental staff: an intensive longitudinal study

Objective

To investigate the fatigue trajectory during a 6-month duration of the COVID-19 pandemic for dental health professionals in primary dental care and for those in training.

Design

A longitudinal intensive panel diary was conducted (July–December 2020) assessing weekly self-ratings of emotional fatigue.

Setting

Dental care services in Scotland.

Participants

Dental trainees and primary dental care staff (N=53). These data were merged with respondents’ replies to a cross-sectional baseline survey (Humphris et al). Recruitment was through ‘Portal’, an online tool administered by National Health Service Education for Scotland. Questback software was employed for data collection.

Primary and secondary outcome measures

The diary questionnaire, consisted of a three-item fatigue scale and, from the baseline survey, three multi-item scales including: preparedness (14 items of the Dental Professional Preparedness for Practice Scale), the 22-item Impact of Event Scale-Revised and depressive symptomatology using the Patient Health Questionnaire-2. Statistical analysis included estimating the variability of fatigue over the study duration using a multilevel linear growth model. In addition, a path analysis was performed to determine the ability of preparedness and COVID-19 pandemic trauma to predict fatigue trajectories directly, or mediated through depressive symptomatology.

Results

A large variation of fatigue trajectories (p<0.001) was found from staff who completed a mean of 11 weekly uploads of their diary (diary uploads: minimum 4–maximum 24). The average slope was positive (standardised estimate=0.13, 95% CI: 0.07 to 0.19, p<0.001). Slope variation was modelled successfully from baseline data showing direct and indirect effects from preparedness, trauma and depressive symptoms.

Conclusion

Staff who volunteered to participate over a significant period of the COVID-19 pandemic in Scotland displayed a highly significant variety of individual trajectories. The results show some consistency with a job demands-resources model of burnout development. Suitable resource structures are indicated for staff over periods of extensive public service change.

Ethical Conflict and Its Psychological Correlates among Hospital Nurses in the Pandemic: A Cross-Sectional Study within Swiss COVID-19 and Non-COVID-19 Wards

Background: During the Covid-19 pandemic, nurses experienced increased pressure. Consequently, ethical concerns and psychological distress emerged. This study aimed to assess nurses’ ethical conflict, resilience and psychological impact, and compare these variables between nurses who worked in Covid-19 wards and nurses who did not. Methods: Design—Multicentre online survey. Setting—Multi-site public hospital; all nursing staff were invited to participate. The survey included validated tools and a novel instrument to assess ethical conflict. Spearman’s rho coefficient was used to assess correlations between ethical conflict and psychological distress, logistic regressions to evaluate relationships between nurses’ characteristics and outcome variables, and the Mann–Whitney/t-test to compare groups. Results: 548 questionnaires out of 2039 were returned (275 = Covid-19; 273 = non-Covid-19). We found a low–moderate level of ethical conflict (median = 111.5 [76–152]), which emerged mostly for seeing patients dying alone. A moderate and significant positive correlation emerged between ethical conflict and psychological distress rs (546) = 0.453, p < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; p < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; p < 0.001) showed higher ethical conflict. Resilience was a protective factor for ethical conflict. Conclusions: Ethical conflict was significantly linked to psychological distress, while a higher level of resilience was found to be a protective factor. These results can be informative for nursing management in future similar crises.

Roles and Experiences of Registered Nurses on Labor and Delivery Units in the United States During the COVID-19 Pandemic

OBJECTIVE

To examine the roles and experiences of labor and delivery (LD) nurses during the COVID-19 pandemic.

DESIGN

Cross-sectional survey.

SETTING

Online distribution between the beginning of July and end of August 2020.

PARTICIPANTS

LD nurses (N = 757) responded to an open-ended question about changes to their roles during the COVID-19 pandemic as part of a larger national survey.

METHODS

We calculated descriptive statistics on respondents' characteristics and their hospitals' characteristics. We applied conventional content analysis to free-text comments.

RESULTS

We derived four major categories from the responses: Changes in Roles and Responsibilities, Adaptations to Changes, Psychological Changes, and Perceived Effects on LaborSupport. Nearly half (n = 328) of respondents reported changes in their roles and responsibilities during the COVID-19 pandemic. They described adaptations and responses to these changes and perceived effects on patient care. Infection control policies and practices as well as the stress of a rapidly changing work environment affected the provision of labor support and personal well-being.

CONCLUSION

The experiences described by respondents conveyed considerable changes in their roles and subsequent direct and indirect effects on quality of patient care and personal well-being. Policies and practices that can facilitate the ability of LD nurses to safely and securely remain at the bedside and provide high-touch, hands-on labor support are needed. The findings of our study can help facilitate the provision of labor support during times of disruption and foster the resiliency of the nursing workforce.

Prevalent, Incident, and Persistent Insomnia in a Population-Based Cohort Tested Before (2018) and During the First-Wave of COVID-19 Pandemic (2020)

Study Objectives

High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018).

Methods

Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April to May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments.

Results

The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% 2 years later. There was a significant worsening of sleep quality, fatigue, anxiety, and depression (all ps < .005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress.

Conclusions

The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the COVID-19.

Psychological burden of attention-deficit/hyperactivity disorder traits on medical workers under the COVID-19 outbreak: a cross-sectional web-based questionnaire survey

OBJECTIVES

There are numerous reports on the psychological burden of medical workers after the COVID-19 outbreak; however, no study has examined the influence of developmental characteristics on the mental health of medical workers. The objective of this study was to examine whether the developmental characteristics of medical workers are associated with anxiety and depression after the COVID-19 outbreak.

DESIGN

We conducted an online cross-sectional questionnaire survey in October 2020.

PARTICIPANTS AND SETTING

The data of 640 medical workers were analysed. The questionnaire included items on sociodemographic data, changes in their life after the COVID-19 outbreak and symptoms of depression, anxiety, attention-deficit/hyperactivity disorder (ADHD) traits and autism spectrum disorder traits.

MAIN OUTCOMES

Depression symptoms were assessed by the Patient Health Questionnaire-9 and anxiety symptoms were assessed by the Generalised Anxiety Disorder-7. A series of hierarchical multiple regression analyses were performed to test the effects of developmental characteristics on depression and anxiety symptoms after controlling for sociodemographic factors and changes in participants' lives after the COVID-19 outbreak.

RESULTS

Increases in physical and psychological burden were observed in 49.1% and 78.3% of the subjects, respectively. The results of a multiple regression analysis showed that ADHD traits were significantly associated with both depression (β=0.390, p<0.001) and anxiety (β=0.426, p<0.001). Autistic traits were significantly associated with depression (β=0.069, p<0.05) but not anxiety. Increased physical and psychological burden, being female, medical workers other than physicians and nurses, fear of COVID-19 and experience of discrimination were also significantly associated with both depression and anxiety.

CONCLUSION

Globally, the burden on medical workers increased. This study suggested that medical workers with higher ADHD traits may need special attention during the COVID-19 pandemic.

'It's like juggling fire daily': Well-being, workload and burnout in the British NHS - A survey of 721 physicians

BACKGROUND

Physicians are at higher risk for burnout than workers in other fields. Burnout negatively impacts physician health, care delivery and healthcare cost. Existing studies quantify the workforce affected by burnout whilst qualitative studies use specific specialty groups limiting generalisability of solutions. This is important given increased stress during the COVID-19 pandemic.

OBJECTIVE

The study aimed to understand the causes of work-related burnout, identify what supportive resources physicians utilise, and to propose solutions.

METHODS

A questionnaire was circulated between March and May 2019 via the 'Doctors' Association UK' website and social media.

RESULTS

721 responses were received. 94%of respondents worked in the NHS, with over half being either general practitioners (GPs) or consultants. One in two (53%) respondents felt unable to raise workplace concerns regarding wellbeing, stress or workload. Almost all respondents (97%) felt the NHS has a culture of viewing excessive stress and workload as the norm. Three themes emerged from qualitative analysis: negative workplace culture; high workload and lack of resources; and generational change.

CONCLUSIONS

Respondents described system-level factors which negatively impacted their wellbeing whilst organisations focused on physician-level factors. The research literature supports multi-level change beyond the individual tackling work unit and organisational factors. These include providing infrastructure to allow delegation of administrative work and physical space for relaxation and flexible work with time for leave. At a national level, there is greater urgency for an increase in healthcare funding and resourcing especially during increased clinician workloads during a pandemic where burnout rates will increase.

Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy

During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW’s mental wellbeing. We analyzed the correlations between levels of burnout and other mental health disorders and we searched for the presence of specific risk factors of post-traumatic symptomatology related to the pandemic. A structured an on-line questionnaire and validated instruments were completed by a sample of HW from some hospitals in Genoa, Italy. Anxious, depressive, post-traumatic and other psychological symptoms were assessed and risk factors, related to the pandemic, were considered. Then, we investigated the correlation between levels of burnout and the risk of developing psychopathology. A total of 731 HW were screened, and we found increased levels of anxiety (61%), depression (62%), PTSD (34%) and high levels of burnout; especially emotional exhaustion (37%). A statistically significant association between burnout and insomnia, depression, anxiety, and post-traumatic symptoms was demonstrated. This study indicates that during the COVID-19 pandemic, HW showed high levels of psychological distress and that burnout is an important predictor of sufferance. These findings support the idea to provide psychological and psychiatric support for HW.

A One-Year Prospective Study of Work-Related Mental Health in the Intensivists of a COVID-19 Hub Hospital

The COVID-19 pandemic has severely tested the physical and mental health of health care workers (HCWs). The various stages of the epidemic have posed different problems; consequently, only a prospective study can effectively describe the changes in the workers' health. This repeated cross-sectional study is based on a one-year investigation (spring 2020 to spring 2021) of intensive care physicians in one of the two COVID-19 hub hospitals in Central Italy and aims to study the evolution of the mental health status of intensivists during the pandemic. Changes in their work activity due to the pandemic were studied anonymously together with their perception of organisational justice, occupational stress, sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and intention to quit. In May-June 2021, one year after the baseline, doctors reported an increased workload, isolation at work and in their social life, a lack of time for physical activity and meditation, and compassion fatigue. Stress was inversely associated with the perception of justice in safety procedures and directly correlated with work isolation. Occupational stress was significantly associated with anxiety, depression, burnout, dissatisfaction, and their intention to quit. Procedural justice was significantly associated with happiness. Doctors believed vaccinations would help control the problem; however, this positive attitude had not yet resulted in improved mental health. Doctors reported high levels of distress (73%), sleep problems (28%), anxiety (25%), and depression (64%). Interventions to correct the situation are urgently needed.

[Is this the parallel pandemic? : Measures to improve working conditions and stress levels among health care personnel]

Employee health and ability to perform is essential to a functioning health care system. Even before the coronavirus disease 2019 (COVID-19) pandemic, a substantial proportion of employees reported impaired mental health at work. This paper outlines the state of knowledge and evidence on interventions to promote mental health in the workplace, with particular focus on the organization of work and activities. In addition to an initial review of approaches, the factors facilitating successful and effective approaches are addressed.

Risk of burnout and stress in physicians working in a COVID team: A longitudinal survey

Background and aims

The COVID‐19 pandemic represents a source of stress and potential burnout for many physicians. This single‐site survey aimed at assessing perceived stress and risk to develop burnout syndrome among physicians operating in COVID wards.

Methods

This longitudinal survey evaluated stress and burnout in 51 physicians operating in the COVID team of Gemelli Hospital, Italy.

Participants were asked to complete the Maslach Burnout Inventory (MBI) and the Perceived Stress Questionnaire on a short run (PSQs) (referring to the past 7 days) at baseline (T0) and then for four weeks (T1‐T4). Perceived Stress Questionnaire on a long run (PSQl) (referring to the past 2 years) was completed only at T0.

Results

Compared with physicians board‐certified in internal medicine, those board‐certified in other disciplines showed higher scores for the Emotional Exhaustion (EE) score of the MBI scale (P < .001). Depersonalisation (DP) score showed a reduction over time (P = .002). Attending physicians scored lower than the resident physicians on the DP scale (P = .048) and higher than resident physicians on the Personal Accomplishment (PA) scale (P = .04). PSQl predicted higher scores on the EE scale (P = .003), DP scale (P = .003) and lower scores on the PA scale (P < .001). PSQs showed a reduction over time (P = .03). Attending physicians had a lower PSQs score compared with the resident physicians (P = .04).

Conclusions

Medical specialty and clinical position could represent risk factors for the development of burnout in a COVID team. In these preliminary results, physicians board‐certified in internal medicine showed lower risk of developing EE during the entire course of the study.

Mental Health Outcomes Among British Healthcare Workers-Lessons From the First Wave of the Covid-19 Pandemic

OBJECTIVE

To ascertain the level of psychological distress, using validated psychology tools, among British National healthcare workers (HCW) during the first wave of the Covid-19 crisis.

METHODS

A multi-centre, anonymized, all-comer staff survey across 3 hospitals in Lancashire, England during the Covid-19 first wave (April to June 2020), consisting of Patient Health Questionnaire (PHQ-9), Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder-7 (GAD-7), and Impact of Events Scale (IES-6).

RESULTS

Among 1113 HCW, median (IQR) PHQ-9, GAD-7, PSS-10, and IES-6 score was 7 (3 to 11), 6 (3 to 11), 19 (13 to 24), and 9 (5 to 14), respectively. Potential predictors of higher levels of psychological distress included living alone, disabled dependents, history of depression/anxiety, and being female.

CONCLUSIONS

The study indicates a high prevalence of psychological distress during the acute Covid-19 period among HCW, identifies groups at risk and areas of future research.