1
|
Maliwichi L, Kondowe F, Mmanga C, Mchenga M, Kainja J, Nyamali S, Ndasauka Y. The mental health toll among healthcare workers during the COVID-19 Pandemic in Malawi. Sci Rep 2024; 14:10327. [PMID: 38710775 DOI: 10.1038/s41598-024-61216-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/02/2024] [Indexed: 05/08/2024] Open
Abstract
The COVID-19 pandemic has affected the mental health of healthcare workers worldwide, with frontline personnel experiencing heightened rates of depression, anxiety, and posttraumatic stress. This mixed-methods study aimed to assess the mental health toll of COVID-19 on healthcare workers in Malawi. A cross-sectional survey utilising the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) was conducted among 109 frontline healthcare workers. Additionally, in-depth interviews were conducted with 16 healthcare workers to explore their experiences and challenges during the pandemic. The results indicated a high prevalence of COVID-19-related depression (31%; CI [23, 41]), anxiety (30%; CI [22, 40]), and PTSD (25%; CI [17, 34]) among participants. Regression analysis revealed significantly higher rates of depression, anxiety, and PTSD among healthcare workers in city referral hospitals compared to district hospitals. Qualitative findings highlighted the emotional distress, impact on work and personal life, and experiences of stigma and discrimination faced by healthcare workers. The stress process model provided a valuable framework for understanding the relationship among pandemic-related stressors, coping resources, and mental health outcomes. The findings underscore the urgent need for interventions and support systems to mitigate the mental health impact of COVID-19 on frontline healthcare workers in Malawi. Policymakers should prioritise the assessment and treatment of mental health problems among this critical workforce to maintain an effective pandemic response and build resilience for future crises.
Collapse
|
2
|
Laposa JM, Cameron D, Corace K, Quick N, Rowa K, Kogan C, Carter S, Milosevic I, de la Salle S, Stergiopoulos V, Pellizzari J, Haber E, Kurdyak P, McCabe RE. A Rapid Access Brief Psychotherapy Intervention to Respond to Healthcare Workers in Ontario Whose Mental Health was Negatively Impacted During the COVID-19 Pandemic. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:89-99. [PMID: 37448375 PMCID: PMC10345831 DOI: 10.1177/07067437231187462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Although the coronavirus disease 2019 (COVID-19) pandemic has had widespread negative impacts on the mental health of healthcare workers (HCWs), there has been little research on psychological interventions during the pandemic for this population. The current study examines whether a brief coping-focused treatment intervention delivered in a virtual individual format would be associated with positive changes in Canadian HCWs' mental health during the pandemic. METHOD Three hundred and thirty-three HCWs receiving the intervention at 3 large specialty tertiary care hospitals in Ontario, Canada, completed measures of anxiety, depression, perceived stress, work/social impairment, insomnia and fear of COVID-19. After completing treatment, HCWs rated their satisfaction with the treatment. RESULTS The intervention was associated with large effect size improvements in anxiety, depression, perceived stress, insomnia and fear of COVID-19, and moderate effect size improvements in work/social impairment. At treatment session 1, prior mental health diagnosis and treatment were both significantly correlated with depression, anxiety, and work/social impairment scores. Secondary analyses of data from one of the sites revealed that treatment-related changes in anxiety, depression, perceived stress and work/social impairment were independent of age, gender, occupational setting, profession and the presence of a previous mental health diagnosis or treatment, with the exception that nurses improved at a slightly greater rate than other professions in terms of work/social impairment. HCWs were highly satisfied with the treatment. CONCLUSIONS A large number of HCWs experiencing significant distress at baseline self-referred for assistance. Timely and flexible access to a brief virtual coping-focused intervention was associated with improvements in symptoms and impairment, and treatment response was largely unrelated to demographic or professional characteristics. Short-term psychological interventions for HCWs during a pandemic may have a highly positive impact given their association with improvement in various aspects of HCWs' mental health improvement.
Collapse
Affiliation(s)
- Judith M. Laposa
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
- Department of Psychiatry, University of Toronto, Canada
| | | | - Kim Corace
- Royal Ottawa Mental Health Centre, Canada
- Department of Psychiatry, University of Ottawa, Canada
| | - Natalie Quick
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
| | - Karen Rowa
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Cary Kogan
- Royal Ottawa Mental Health Centre, Canada
- Department of Psychiatry, University of Ottawa, Canada
| | - Stephanie Carter
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
| | - Irena Milosevic
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | | | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Joseph Pellizzari
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Erika Haber
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Paul Kurdyak
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Canada
- Department of Psychiatry, University of Toronto, Canada
- ICES, Canada
| | - Randi E. McCabe
- St. Joseph's Healthcare Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| |
Collapse
|
3
|
Calderwood CJ, Marambire E, Nzvere FP, Larsson LS, Chingono RMS, Kavenga F, Redzo N, Bandason T, Rusakaniko S, Mujuru HA, Simms V, Khan P, Gregson CL, Ndhlovu CE, Ferrand RA, Fielding K, Kranzer K. Prevalence of chronic conditions and multimorbidity among healthcare workers in Zimbabwe: Results from a screening intervention. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002630. [PMID: 38261562 PMCID: PMC10805297 DOI: 10.1371/journal.pgph.0002630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/27/2023] [Indexed: 01/25/2024]
Abstract
The burden of non-communicable diseases (NCDs) in southern Africa is expanding and is superimposed on high HIV prevalence. Healthcare workers are a scarce resource; yet are vital to health systems. There are very limited studies on the burden of chronic conditions among healthcare workers in Africa, and none exploring multimorbidity (≥2 chronic conditions). We describe the epidemiology of infectious (HIV) and non-communicable chronic conditions, and multimorbidity, among Zimbabwean healthcare workers. Healthcare workers (≥18 years) in eight Zimbabwean provinces were invited to a voluntary, cross-sectional health-check, including HIV, diabetes, hypertension and mental health screening. Statistical analyses described the prevalence and risk factors for multimorbidity (two or more of HIV, diabetes, hypertension or common mental disorder) and each condition. Missing data were handled using multiple imputation. Among 6598 healthcare workers (July 2020-July 2022) participating in the health-check, median age was 37 years (interquartile range 29-44), 79% were women and 10% knew they were living with HIV. Half had at least one chronic condition: 11% were living with HIV, 36% had elevated blood pressure, 12% had elevated HbA1c and 11% had symptoms of common mental disorder. The overall prevalence of multimorbidity was 15% (95% CI: 13-17%); 39% (95% CI: 36-43%) among people aged 50 and older. Whilst most HIV was diagnosed and treated, other chronic conditions were usually undiagnosed or uncontrolled. Limiting our definition of multimorbidity to two or more screened conditions sought to reduce bias due to access to diagnosis, however, may have led to a lower reported prevalence than that found using a wider definition. Half of healthcare workers screened were living with a chronic condition; one in seven had multimorbidity. Other than HIV, most conditions were undiagnosed or untreated. Multisectoral action to implement contextually relevant, chronic disease services in Africa is urgently needed. Specific attention on health workers is required to protect and retain this critical workforce.
Collapse
Affiliation(s)
- Claire Jacqueline Calderwood
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Edson Marambire
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | - Farirai Peter Nzvere
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Leyla Sophie Larsson
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | - Rudo M. S. Chingono
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Fungai Kavenga
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Nicole Redzo
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Hilda A. Mujuru
- Faculty of Medicine and Health Sciences, Child and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Victoria Simms
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Data Science Unit, Africa Health Research Institute, Durban, South Africa
| | - Palwasha Khan
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Data Science Unit, Africa Health Research Institute, Durban, South Africa
| | - Celia Louise Gregson
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Global Health and Ageing Research Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Chiratidzo E. Ndhlovu
- Internal Medicine Unit, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rashida Abbas Ferrand
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Katherine Fielding
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Katharina Kranzer
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| |
Collapse
|
4
|
Marambire ET, Chingono RMS, Calderwood CJ, Larsson L, Sibanda S, Kavenga F, Nzvere FP, Olaru ID, Simms V, McHugh G, Bandason T, Redzo N, Gregson CL, Maunganidze AJV, Pasi C, Chiwanga M, Chonzi P, Ndhlovu CE, Mujuru H, Rusakaniko S, Ferrand RA, Kranzer K. Evaluation of a comprehensive health check offered to frontline health workers in Zimbabwe. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002328. [PMID: 38190397 PMCID: PMC10773946 DOI: 10.1371/journal.pgph.0002328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
Health workers are essential for a functioning healthcare system, and their own health is often not addressed. During the COVID-19 pandemic health workers were at high risk of SARS-CoV-2 infection whilst coping with increased healthcare demand. Here we report the development, implementation, and uptake of an integrated health check combining SARS-CoV-2 testing with screening for other communicable and non-communicable diseases for health workers in Zimbabwe during the COVID-19 pandemic. Health checks were offered to health workers in public and private health facilities from July 2020 to June 2022. Data on the number of health workers accessing the service and yield of screening was collected. Workshops and in-depth interviews were conducted to explore the perceptions and experiences of clients and service providers. 6598 health workers across 48 health facilities accessed the service. Among those reached, 5215 (79%) were women, the median age was 37 (IQR: 29-44) years and the largest proportion were nurses (n = 2092, 32%). 149 (2.3%) healthcare workers tested positive for SARS-CoV-2. Uptake of screening services was almost 100% for all screened conditions except HIV. The most common conditions detected through screening were elevated blood pressure (n = 1249; 19%), elevated HbA1c (n = 428; 7.7%) and common mental disorder (n = 645; 9.8%). Process evaluation showed high acceptability of the service. Key enablers for health workers accessing the service included free and comprehensive service provision, and availability of reliable point-of-care screening methods. Implementation of a comprehensive health check for health workers was feasible, acceptable, and effective, even during a pandemic. Conventional occupational health programmes focus on infectious diseases. In a society where even health workers cannot afford health care, free comprehensive occupational health services may address unmet needs in prevention, diagnosis, and treatment for chronic non-communicable conditions.
Collapse
Affiliation(s)
- Edson T. Marambire
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- CIH Center for International Health, University Hospital, LMU Munich, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | - Rudo M. S. Chingono
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Claire J. Calderwood
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Leyla Larsson
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | - Sibusisiwe Sibanda
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Fungai Kavenga
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- National TB Programme, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Farirai P. Nzvere
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ioana D. Olaru
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Victoria Simms
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Grace McHugh
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Nicol Redzo
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Celia L. Gregson
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Global Health and Ageing, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | | | | | | | - Chiratidzo E. Ndhlovu
- Internal Medicine Unit, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Hilda Mujuru
- Department of Paediatrics and Child Health, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rashida A. Ferrand
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Katharina Kranzer
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
5
|
Arias-Ulloa CA, Gómez-Salgado J, Escobar-Segovia K, García-Iglesias JJ, Fagundo-Rivera J, Ruiz-Frutos C. Psychological distress in healthcare workers during COVID-19 pandemic: A systematic review. JOURNAL OF SAFETY RESEARCH 2023; 87:297-312. [PMID: 38081703 DOI: 10.1016/j.jsr.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/09/2023] [Accepted: 07/27/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES Healthcare workers serving during the COVID-19 pandemic may have been exposed to high work overload, which may have had an impact on their physical, mental, and social health. The aim of this study was to assess the risk factors associated with psychological distress among healthcare workers serving during the COVID-19 pandemic from January 2020 to December 2022. METHODS A systematic review was conducted based on the 2020 PRISMA statement. Articles were searched in the Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO databases. RESULTS A total of 59 articles were included in this systematic review. It was observed that the prevalence of psychological distress during the COVID-19 pandemic was high. Female sex, being a nurse, being young, living alone/being single, and having a chronic disease or psychiatric disorder history are the main risk factors at the personal level. Other occupational and pandemic-related factors such as having many years of work experience, the presence of COVID-19 symptoms and contact history, not enough sleep, having lower family support and limited social relationships, fear of infecting friends and family, having a reduced perception of protection by personal protective equipment, working on the frontline, and having longer service duration were found to be factors influencing the development of psychological distress during the COVID-19 pandemic. CONCLUSIONS There are personal, interpersonal, and organizational risk factors that can lead to the occurrence of psychological distress among healthcare staff working during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Cristian Arturo Arias-Ulloa
- Faculty of Engineering in Mechanics and Production Sciences, Escuela Superior Politécnica del Litoral, 090902 Guayaquil, Ecuador.
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador.
| | - Kenny Escobar-Segovia
- Faculty of Engineering in Earth Sciences, Escuela Superior Politécnica del Litoral, 090902 Guayaquil, Ecuador.
| | - Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain.
| | - Javier Fagundo-Rivera
- Centro Universitario de Enfermería Cruz Roja, Universidad de Sevilla, 41009 Sevilla, Spain.
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador.
| |
Collapse
|
6
|
Abdulah DM, Piro RS, Liamputtong P. The lived experience of hospitalized and non-hospitalized health care providers of COVID-19 pandemic: a qualitative study. Monaldi Arch Chest Dis 2022; 93. [PMID: 36562639 DOI: 10.4081/monaldi.2022.2448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
This paper explores the lived experience and any mental health issues of COVID-19 survivors throughout the disease crisis using a qualitative method. The semi-structured interviewing method was conducted with COVID-19 patients who were admitted and non-admitted to hospitals in Kurdistan, Iraq. The patients had positive and negative perceptions of the COVID-19 pandemic and disease, including beliefs and thoughts about COVID-19, conspiracy thinking, and concerns toward the family and their children. The patients were affected by the disease in different ways including physical consequences of COVID-19 infection, social isolation, life changes, and mental wellbeing. But they had some coping strategies to overcome the disease, such as seeking help, preventive measures, and coping techniques. The patients had some concerns about health settings and therapeutic procedures, including lack of sufficient care, receptiveness, hospital environment, and infection guidelines. This study showed that the COVID-19 disease had devastating effects on patients either physically or psychologically.
Collapse
Affiliation(s)
| | - Rasoul Sabri Piro
- Pediatric and Psychiatric Nursing Unit, College of Nursing, University of Duhok.
| | | |
Collapse
|