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Eichenberg C, Schneider R, Auvera P, Aranyi G, Huber K. Risk and protection factors of mental stress among medical staff in the third year of the COVID-19 pandemic. Front Psychiatry 2024; 15:1334552. [PMID: 38585477 PMCID: PMC10995372 DOI: 10.3389/fpsyt.2024.1334552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 04/09/2024] Open
Abstract
Background The COVID-19 pandemic placed an extraordinary burden on health care workers (HCW), who are reported to suffer from great mental stress. The current study investigates the mental health of HCW in the later phases of the pandemic. Methods HCW completed the following questionnaires online (06/2021-02/2022, N=159): demographics (age, gender, profession, ward), Impact of Event Scale (IES-R, posttraumatic stress), State Trait Anxiety Inventory (STAI-S, state anxiety), stress-coping questionnaire (SVF-78), and bespoke corona-specific stress and protective-factor questions (5 items each). We used factor analysis to test scale properties and regression-type methods (t-tests, ANOVA, multiple regression) for hypothesis tests and effect-size estimation. Results/discussion Mental stress in HCW is influenced by similar factors as described for earlier phases. However, differences to earlier phases were found in ward affiliation which is no longer a variable of concern for explaining differences in mental health of HCW. Further, even if nurses are the occupational group with the highest mental stress as in prior research, detailed analysis shows that medical specialists with close proximity to patients with a high-level of responsibility are the most burdened sub-group. Unlike nurses, they suffer from high levels of anxiety in addition to high levels of post-traumatic and COVID-specific stress. Analyses showed further that COVID-specific stress is the strongest predictor of mental stress, wherein COVID-specific stress factors remain the same as reported in literature on the early pandemic phases. HCW showed to use still more positive than negative coping strategies. Negative strategies increased as expected mental stress, whereas positive strategies alleviated only anxiety. Additionally, we found that doctors benefited from many protective factors while nurses had access to fewer protective factors like earlier waves. Conclusion Data show that HCW still suffer from mental stress in the third year of the pandemic. HCW of all hospital wards may be affected by mental stress and need attention and protective measures. Medical specialists are the most burdened subgroup. Detailed analyses show that properties other than occupation, gender, or ward affiliation are more appropriate to evaluate mental stress of HCW. The findings have implications for developing specialized protection strategies for the post-pandemic phase and future pandemics.
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Affiliation(s)
- Christiane Eichenberg
- Faculty of Medicine, Institute of Psychosomatics, Sigmund Freud Private University, Vienna, Austria
| | - Raphaela Schneider
- Faculty of Medicine, Institute of Psychosomatics, Sigmund Freud Private University, Vienna, Austria
| | - Phillip Auvera
- Sigmund Freud Private University, Medical Faculty, Vienna, Austria
| | - Gabor Aranyi
- Faculty of Psychotherapy Science, Sigmund Freud Private University, Vienna, Austria
- Institute of Education and Psychology at Szombathely, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Kurt Huber
- Sigmund Freud Private University, Medical Faculty, Vienna, Austria
- 3rd Dept. of Medicine, Cardiology and Internal Intensive Care Medicine, Clinic Ottakring (former Wilhelminenhospital), Vienna, Austria
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Schmidt-Stiedenroth K, Guthardt L, Genrich M, Köhne M, Stiawa M, Erschens R, Junne F, Maatouk I, Gündel H, Angerer P, Müller A. What helps hospital staff in times of crisis: qualitative results of a survey on psychosocial resources and stressors in German hospitals during the COVID-19 pandemic. Front Public Health 2023; 11:1260079. [PMID: 37869202 PMCID: PMC10585258 DOI: 10.3389/fpubh.2023.1260079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/07/2023] [Indexed: 10/24/2023] Open
Abstract
Background Even before the COVID-19 pandemic, hospital workers faced a tremendous workload. The pandemic led to different and additional strain that negatively affected the well-being of employees. This study aims to explore psychosocial resources and strategies that were used by hospital staff. Methods In the context of an intervention study, employees of three German hospitals were questioned in writing in summer and fall 2020. Five open-ended questions about the pandemic were asked to capture corresponding effects on daily work routine. Answers of 303 participants were evaluated using structuring qualitative content analysis. Results Significant stressors and resources were identified in the areas of work content and task, social relations at work, organization of work, work environment and individual aspects. Stressors included, for example, emotional demands, conflicts, an increased workload, time and performance pressure. Important resources mentioned were, among others, the exchange with colleagues and mutual support. Sound information exchange, clear processes and guidelines and a positive work atmosphere were also important. In addition, the private environment and a positive mindset were perceived as helpful. Conclusion This study contributes to a differentiated understanding of existing psychosocial resources of hospital staff in times of crisis. Identifying and strengthening these resources could reduce stress and improve well-being, making hospital staff better prepared for both normal operations and further crisis situations.
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Affiliation(s)
- Kira Schmidt-Stiedenroth
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Lisa Guthardt
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - Mara Köhne
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
- University Hospital for Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Imad Maatouk
- Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | | | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Duisburg, Germany
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Sommerlatte S, Lugnier C, Schoffer O, Jahn P, Kraeft AL, Kourti E, Michl P, Reinacher-Schick A, Schmitt J, Birkner T, Schildmann J, Herpertz S. Mental burden and moral distress among oncologists and oncology nurses in Germany during the third wave of the COVID-19 pandemic: a cross-sectional survey. J Cancer Res Clin Oncol 2023; 149:6211-6223. [PMID: 36700979 PMCID: PMC9878480 DOI: 10.1007/s00432-023-04580-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/07/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE There is evidence for mental burden and moral distress among healthcare workers during the pandemic. However, there is scarcity of analyses regarding possible correlations of mental burden and moral distress in this context. This study provides data to quantify mental burden and possible associations with moral distress among physicians and nurses working in oncology in Germany. METHODS We conducted a cross-sectional online survey with physicians and nurses working in oncology in Germany between March and July 2021. Next to sociodemographic characteristics and working conditions, mental burden and moral distress were assessed using standardized instruments. Binary multivariate logistic regression using the enter method was performed in order to explore the relationship between mental burden and moral distress. RESULTS 121 physicians and 125 nurses were included in the study. Prevalence of clinically relevant depressive symptoms, anxiety, somatic symptoms, burnout symptoms and moral distress was 19.2, 14.5, 12.7, 46.0 and 34.7% in physicians and 41.4, 24.0, 46.8, 46.6 and 60.0% in nurses respectively. Mental burden was significantly associated with moral distress, being female/diverse, younger age < 40 and increase in workload. Nurses who felt sufficiently protected from COVID-19 reported significantly less moral distress. CONCLUSION To improve pandemic resilience, there is a need to ensure safe working environment including psychosocial support. Further evidence on risk and protective factors for moral distress is needed to be able to develop and implement strategies to protect healthcare workers within and beyond the pandemic.
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Affiliation(s)
- Sabine Sommerlatte
- Faculty of Medicine, Institute for History and Ethics of Medicine, Interdisciplinary Centre for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
| | - Celine Lugnier
- Department of Hematology, Oncology and Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Olaf Schoffer
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Patrick Jahn
- Health Services Research Working Group, Department of Internal Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Anna-Lena Kraeft
- Department of Hematology, Oncology and Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Eleni Kourti
- Department of Hematology, Oncology and Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Patrick Michl
- Department of Medicine, Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - Anke Reinacher-Schick
- Department of Hematology, Oncology and Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Thomas Birkner
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jan Schildmann
- Faculty of Medicine, Institute for History and Ethics of Medicine, Interdisciplinary Centre for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic, Ruhr University Bochum, Bochum, Germany
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Mai T, Franke V, Todisco L, Schilder M, Rohde G. [The situation of physicians in acute hospitals during the second wave of the SARS-CoV-2 pandemic: An online survey]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 174:52-58. [PMID: 36209033 PMCID: PMC9534542 DOI: 10.1016/j.zefq.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/28/2022] [Accepted: 08/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The SARS-CoV-2 pandemic has an impact on the wellbeing of health care workers. The influence of a work-related sense of coherence as well as perceived organizational support on the level of burnout and the intention to leave the job is largely unknown, especially for physicians in German hospitals. METHOD In December 2020 and January 2021, physicians of 81 hospitals in Hessian (Germany) participated in an online survey using the BAT (Burnout Assessment Tool), Work-SoC (Work-related Sense of Coherence), the POS-s (Perceived Organizational SUPPORT - short version) and literature-based items based. RESULTS Of 181 physicians, 34% showed a moderate or high burnout level, 21% would leave the job after the pandemic. The higher the work-SoC (β = -0.560; p < 0.001) and the higher the POS-s (β = -0.125; p < 0.05), the lower the burnout level. Not being able to care sufficiently for their patients has a negative impact on the sense of coherence. 46.4% reported that they did not feel sufficiently prepared by their employer during the pandemic. They wished to have support in the form of the mindfulness and resilience trainings (45%), emergency childcare (41%) and a crisis counselor in their team (32%). CONCLUSION Regardless of the pandemic, health-promoting work conditions have to be developed that facilitate coherent work and prevent "moral injuries" or enable physicians to deal with them.
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Affiliation(s)
- Tobias Mai
- Stabsstelle Pflegentwicklung, Pflegedirektion, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland.
| | - Vanessa Franke
- Stabsstelle Pflegentwicklung, Pflegedirektion, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Laura Todisco
- Stabsstelle Pflegentwicklung, Pflegedirektion, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Michael Schilder
- Fachbereich Pflege- und Gesundheitswissenschaft ev. Hochschule Darmstadt, Darmstadt, Deutschland
| | - Gernot Rohde
- Leiter des Schwerpunktes Pneumologie/ Allergologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
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