1
|
Li CJ, Zheng Y, Gan Y, Du Z, Cai X, Li Y, Wang W, Jiang T, Zhang Q, Niu L, Tao TJ, Hou WK. Mental health of primary health care physicians and nurses following prolonged infection control rules: a national survey in China. Front Public Health 2024; 12:1392845. [PMID: 39247229 PMCID: PMC11377233 DOI: 10.3389/fpubh.2024.1392845] [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: 02/28/2024] [Accepted: 07/18/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction This study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the post-pandemic period in 2022. Method Region-stratified sampling was conducted to recruit a national sample of 4,246 respondents from 31 July 2022 to 12 August 2022. A total of 692 primary healthcare institutions were identified in 30 provincial-level administrative regions of China. An online questionnaire was used for assessing probable mental health disorders using Symptoms Checklist-90-Revised (SCL-90-R) and PTSD Checklist for DSM-5 (PCL-5), and sleeping problems using Insomnia Severity Index (ISI). Data on demographics and work were also collected. Bivariate analysis and multiple logistic regression were conducted to identify significant correlates of probable mental health disorders. Results A total of 4,246 valid questionnaires were identified. Results showed that relative to the prevalence of probable mental health disorders among health care workers at the early stage of the pandemic in China, there was an overall decreased prevalence except for somatization, PHO, and OCD among the current PHC physicians and nurses. Multiple logistic regressions showed that significant risk factors of common probable mental health disorders, namely psychological distress, SOM, DEP, ANX, PHO, OCD, PTSD, and insomnia, were female gender, multimorbidity, history of psychiatric disorders, quarantine experience, never asking anyone for help, and overtime work. Conclusion Attention should be given to preexisting psychiatric and multimorbid conditions, social support, and work-related stressors. Regular assessment and psychological interventions are needed to enhance the mental health of PHC professionals even after public health crisis.
Collapse
Affiliation(s)
- Crystal Jingru Li
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yanling Zheng
- Shouyilu Street Community Health Service Center, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhaohui Du
- Department of Administrative Management, Shanggang Community Health Service Center, Shanghai, China
| | - Xuemin Cai
- Department of Administrative Management, Laoshan Community Health Service Center, Qingdao, Shandong, China
| | - Yongjin Li
- Department of Administrative Management, Jinsong Community Health Service Center, Beijing, China
| | - Wei Wang
- Department of Administrative Management, Xinhua Shaocheng Community Health Service Center, Chengdu, Sichuan, China
| | - Tianwu Jiang
- Department of Administrative Management, Tianshui Wulin Street Community Health Service Center, Hangzhou, Zhejiang, China
| | - Qingyu Zhang
- Department of Administrative Management, Jiexin Village Community Health Service Center, Lanzhou, Gansu, China
| | - Lei Niu
- Department of Administrative Management, Xinglin Street Community Health Service Center, Hefei, Anhui, China
| | - Tiffany Junchen Tao
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
2
|
Walsh R, Telner D, Butt DA, Krueger P, Fleming K, MacDonald S, Pyakurel A, Greiver M, Jaakkimainen L. Factors associated with plans for early retirement among Ontario family physicians during the COVID-19 pandemic: a cross-sectional study. BMC PRIMARY CARE 2024; 25:118. [PMID: 38637731 PMCID: PMC11025226 DOI: 10.1186/s12875-024-02374-9] [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: 07/11/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Higher numbers of family physicians (FPs) stopped practicing or retired during the COVID-19 pandemic, worsening the family doctor shortage in Canada. Our study objective was to determine which factors were associated with FPs' plans to retire earlier during the COVID-19 pandemic. METHODS We administered two cross-sectional online surveys to Ontario FPs asking whether they were "planning to retire earlier" as a result of the pandemic during the first and third COVID-19 pandemic waves (Apr-Jun 2020 and Mar-Jul 2021). We used logistic regression to determine which factors were associated with early retirement planning, adjusting for age. RESULTS The age-adjusted proportion of FP respondents planning to retire earlier was 8.2% (of 393) in the first-wave and 20.5% (of 454) in the third-wave. Planning for earlier retirement during the third-wave was associated with age over 50 years (50-59 years odds ratio (OR) 5.37 (95% confidence interval (CI):2.33-12.31), 60 years and above OR 4.18 (95% CI: 1.90-10.23)), having difficulty handling increased non-clinical responsibilities (OR 2.95 (95% CI: 1.79-4.94)), feeling unsupported to work virtually (OR 1.96 (95% CI: 1.19-3.23)) or in-person (OR 2.70 (95% CI: 1.67-4.55)), feeling unable to provide good care (OR 1.82 (95% CI: 1.10-3.03)), feeling work was not valued (OR 1.92 (95% CI: 1.15-3.23)), feeling frightened of dealing with COVID-19 (OR 2.01 (95% CI: 1.19-3.38)), caring for an elderly relative (OR 2.36 (95% CI: 1.69-3.97)), having difficulty obtaining personal protective equipment (OR 2.00 (95% CI: 1.16-3.43)) or difficulty implementing infection control practices in clinic (OR 2.10 (95% CI: 1.12-3.89)). CONCLUSIONS Over 20% of Ontario FP respondents were considering retiring earlier by the third-wave of the COVID-19 pandemic. Supporting FPs in their clinical and non-clinical roles, such that they feel able to provide good care and that their work is valued, reducing non-clinical (e.g., administrative) responsibilities, dealing with pandemic-related fears, and supporting infection control practices and personal protective equipment acquisition in clinic, particularly in those aged 50 years or older may help increase family physician retention during future pandemics.
Collapse
Affiliation(s)
- Rachel Walsh
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
| | - Deanna Telner
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Michael Garron Hospital, Toronto, ON, Canada
| | - Debra A Butt
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Scarborough Health Network, Scarborough, ON, Canada
| | - Paul Krueger
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Karen Fleming
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Aakriti Pyakurel
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Michelle Greiver
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, North York General Hospital, Toronto, ON, Canada
| | - Liisa Jaakkimainen
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
3
|
Yang YP, Pan SJ, Zhang MX, Chen HX, Tung TH. The impact of COVID-19 pandemic on healthcare workers under the "Ten New Guidelines" in Taizhou, China. Prev Med Rep 2024; 37:102550. [PMID: 38179442 PMCID: PMC10765108 DOI: 10.1016/j.pmedr.2023.102550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
Purpose We explored the influence of the "Ten new guidelines" on healthcare workers' preparedness, work impact, personal life impact, concerns, and support in Taizhou, China. Methods A hospital-based self-administered online survey was conducted to investigate the levels of COVID-19 related experience among healthcare workers in December 2022. In total, 472 out of 2080 healthcare workers (22.7 % response rate) completed the questionnaires with valid responses. Stepwise linear regression was used to investigate the independence of factors associated with preparedness, work impact, personal life impact, concerns, and support. Results The results revealed that working position (p < 0.001), pressure (p = 0.005), and negative affect (p < 0.001) were significantly associated with preparedness. Working position (p = 0.015), number of children (p = 0.040), working years (p = 0.019), COVID-19 risk perception (p < 0.001), work overload (p < 0.001), and negative affect (p < 0.001) were significantly associated with work impact. In addition, COVID-19 risk perception (p < 0.001), work overload (p < 0.001), pressure (p = 0.002), history of COVID-19 infection (p = 0.008), and awareness of possible infectious time (p = 0.031) were significantly associated with personal life impact. COVID-19 risk perception (p < 0.001), negative affect (p < 0.001), and work overload (p = 0.020) were significantly associated with concerns. Sex (p = 0.020) and negative affect (p = 0.016) were significantly associated with support. Conclusion Negative affect was the most significant factor associated with COVID-19 related questions among healthcare workers under "Ten new guidelines" during COVID-19 pandemic.
Collapse
Affiliation(s)
- Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Shuang-Jun Pan
- Department of Neurosurgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Mei-Xian Zhang
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Hai-Xiao Chen
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| |
Collapse
|
4
|
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
|
5
|
Jefferson L, Heathcote C, Bloor K. General practitioner well-being during the COVID-19 pandemic: a qualitative interview study. BMJ Open 2023; 13:e061531. [PMID: 36813497 PMCID: PMC9950583 DOI: 10.1136/bmjopen-2022-061531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic presented new challenges for general practitioners' (GPs') mental health and well-being, with growing international evidence of its negative impact. While there has been a wide UK commentary on this topic, research evidence from a UK setting is lacking. This study sought to explore the lived experience of UK GPs during COVID-19, and the pandemic's impact on their psychological well-being. DESIGN AND SETTING In-depth qualitative interviews, conducted remotely by telephone or video call, with UK National Health Service GPs. PARTICIPANTS GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis. RESULTS We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, team working and wider collaboration and personal challenges. GPs described potential facilitators of their well-being, including sources of support and plans to reduce clinical hours or change career path, and some described the pandemic as offering a catalyst for positive change. CONCLUSIONS A range of factors detrimentally affected the well-being of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed.
Collapse
Affiliation(s)
- Laura Jefferson
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Claire Heathcote
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Karen Bloor
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| |
Collapse
|
6
|
Adanaqué-Bravo I, Escobar-Segovia K, Gómez-Salgado J, García-Iglesias JJ, Fagundo-Rivera J, Ruiz-Frutos C. Relationship Between Psychological Distress, Burnout and Work Engagement in Workers During the COVID-19 Pandemic: A Systematic Review. Int J Public Health 2023; 67:1605605. [PMID: 36686389 PMCID: PMC9849247 DOI: 10.3389/ijph.2022.1605605] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: The psychological distress that the COVID-19 pandemic has produced has generated negative effects on workers, and in one way or another this has affected their work engagement within companies. The aim of this research was to assess the relationship between psychological distress, burnout and work engagement in workers during the COVID-19 pandemic. Methods: A systematic review was carried out following the PRISMA methodology, taking articles from the Scopus, Pubmed, and Web of Science databases from the beginning of the pandemic until November 2022. The methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomised studies. Results: 24 articles were selected. All the articles found an association between psychological distress, burnout or other factors and work engagement. Conclusion: The COVID-19 pandemic has had an impact on work engagement and a negative relationship with psychological distress and burnout, hence the importance of companies taking measures to minimise levels of psychological distress and burnout.
Collapse
Affiliation(s)
- Ingrid Adanaqué-Bravo
- Faculty of Engineering in Mechanics and Production Sciences, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Kenny Escobar-Segovia
- Faculty of Engineering in Earth Sciences, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
| | - Javier Fagundo-Rivera
- Centro Universitario de Enfermería Cruz Roja, Universidad de Sevilla, Sevilla, Spain
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| |
Collapse
|
7
|
Voth J, Jaber L, MacDougall L, Ward L, Cordeiro J, Miklas EP. The presence of psychological distress in healthcare workers across different care settings in Windsor, Ontario, during the COVID-19 pandemic: A cross-sectional study. Front Psychol 2022; 13:960900. [PMID: 36110267 PMCID: PMC9469090 DOI: 10.3389/fpsyg.2022.960900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Few studies have examined psychological distress in healthcare workers (HCWs) across the care continuum. This study describes distress levels reported by HCWs across care settings and factors associated with distress. Methods A cross-sectional survey of HCWs from Windsor, Ontario, was conducted between May 30th, 2020, and June 30th, 2020. The survey included the Kessler Psychological Distress Scale (K10), sociodemographic, frontline status, perceptions of training, protection, support, respect among teams, and professional and personal stressors. Univariate analyses were used to compare across settings and multivariate logistic regression assessed factors associated with distress. Results Four hundred and three HCWs from the hospital (49.4%), community health and social service (18.4%), first responder (14.7%), primary care (7.9%), home (6.0%), and long-term care (LTC; 4.0%) participated in the survey. Common concerns included fear of transmitting COVID-19 to family, safety on the job, and balancing personal care with work demands. LTC and home-care HCWs reported greater concern about workload and staffing levels, whereas community health workers were more anxious about their financial security. Overall, 228 (74.2%) HCWs who completed the K10 reported high distress, with greater rates among hospital and LTC HCWs. Distress was more likely in HCWs who identified as female, younger than 55, perceived lower respect among team, and experienced greater worry about physical and mental health and managing high workloads. Conclusion Results showed a high degree of distress experienced by HCWs across care settings and the impact of the COVID-19 pandemic on personal and work-related stress. Promoting self-care and supportive and collaborative healthcare teams are promising avenues for mitigating symptoms of distress.
Collapse
Affiliation(s)
- Jennifer Voth
- Hôtel-Dieu Grace Healthcare, Windsor, ON, Canada
- Faculty of Human Kinetics, University of Windsor, Windsor, ON, Canada
| | - Lindsey Jaber
- Faculty of Education, University of Windsor, Windsor, ON, Canada
| | | | - Leslee Ward
- Hôtel-Dieu Grace Healthcare, Windsor, ON, Canada
| | | | - Erica P. Miklas
- Faculty of Education, University of Windsor, Windsor, ON, Canada
| |
Collapse
|
8
|
Aragonès E, Cura-González ID, Hernández-Rivas L, Polentinos-Castro E, Fernández-San-Martín MI, López-Rodríguez JA, Molina-Aragonés JM, Amigo F, Alayo I, Mortier P, Ferrer M, Pérez-Solà V, Vilagut G, Alonso J. Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study. Br J Gen Pract 2022; 72:e501-e510. [PMID: 35440468 PMCID: PMC9037185 DOI: 10.3399/bjgp.2021.0691] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Enric Aragonès
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona
| | - Isabel Del Cura-González
- Research Network on Health Services in Chronic Diseases, Madrid; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid; Primary Care Research Unit (GAAP-SERMAS), Madrid Health Service, Madrid; Gregorio Marañón Health Research Institute, Madrid
| | | | - Elena Polentinos-Castro
- Research Network on Health Services in Chronic Diseases, Madrid; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid; Primary Care Research Unit (GAAP-SERMAS), Madrid Health Service, Madrid; Gregorio Marañón Health Research Institute, Madrid
| | | | - Juan A López-Rodríguez
- Research Network on Health Services in Chronic Diseases, Madrid; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid; Primary Care Research Unit (GAAP-SERMAS), Madrid Health Service, Madrid; Gregorio Marañón Health Research Institute, Madrid
| | | | - Franco Amigo
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Itxaso Alayo
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Philippe Mortier
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Montse Ferrer
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona
| | - Víctor Pérez-Solà
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona; CIBER Mental Health (CIBERSAM), Madrid; Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona
| | - Gemma Vilagut
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Jordi Alonso
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona
| |
Collapse
|
9
|
Jefferson L, Golder S, Heathcote C, Avila AC, Dale V, Essex H, van der Feltz Cornelis C, McHugh E, Moe-Byrne T, Bloor K. GP wellbeing during the COVID-19 pandemic: a systematic review. Br J Gen Pract 2022; 72:e325-e333. [PMID: 35314428 PMCID: PMC8966782 DOI: 10.3399/bjgp.2021.0680] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/31/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Doctors' organisations in the UK have reported worrying levels of work-related stress and burnout in the GP workforce for some time, and the COVID-19 pandemic has presented clear new challenges. AIM To synthesise international evidence exploring the impact of COVID-19 on primary care doctors' mental health and wellbeing, and identify risk factors associated with their psychological wellbeing during this time. DESIGN AND SETTING Mixed-methods systematic review. METHOD Six bibliographic databases, Google Scholar, and MedRxiv were searched on 19 November 2020 and 3 June 2021 to identify studies of GP psychological wellbeing during the pandemic. Reference checking was also conducted. Two reviewers selected studies, extracted data, and assessed the quality of studies using standardised tools. Heterogeneity in outcomes, setting, and design prohibited statistical pooling; studies were combined using a convergent integrated thematic synthesis. RESULTS Thirty-one studies were included. Multiple sources of stress were identified including changed working practices; risk, exposure, and inadequate personal protective equipment (PPE); information overload; pandemic preparedness; and cohesion across sectors. Studies demonstrated an impact on psychological wellbeing, with some GPs experiencing stress, burnout, anxiety, depression, fear of COVID-19, lower job satisfaction, and physical symptoms. Studies reported gender and age differences: women GPs had poorer psychological outcomes across all domains, and older GPs reported greater stress and burnout. Use of outcome measures and reporting practice varied greatly. CONCLUSION This review of international evidence demonstrates that the COVID-19 pandemic has adversely affected GPs' wellbeing around the world. Further research could explore gender and age differences, identifying interventions targeted to these groups.
Collapse
Affiliation(s)
| | - Su Golder
- Department of Health Sciences, University of York, York
| | | | | | - Veronica Dale
- Department of Health Sciences, University of York, York
| | - Holly Essex
- Department of Health Sciences, University of York, York
| | | | | | | | - Karen Bloor
- Department of Health Sciences, University of York, York
| |
Collapse
|
10
|
Ben-Arye E, Gressel O, Samuels N, Stein N, Eden A, Vagedes J, Kassem S. Complementary and integrative medicine intervention in front-line COVID-19 clinicians. BMJ Support Palliat Care 2022:bmjspcare-2021-003333. [PMID: 35383045 PMCID: PMC9002254 DOI: 10.1136/bmjspcare-2021-003333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/08/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the impact of a multidisciplinary complementary and integrative medicine (CIM) intervention on physical and emotional concerns among front-line COVID-19 healthcare providers (HCPs). METHODS A multimodality CIM treatment intervention was provided by integrative practitioners to HCPs in three isolated COVID-19 departments. HCPs' two main concerns were scored (from 0 to 6) before and following the CIM intervention using the Measure Yourself Concerns and Wellbeing questionnaire. Postintervention narratives identified reflective narratives specifying emotional and/or spiritual keywords. RESULTS Of 181 HCPs undergoing at least one CIM treatment, 119 (65.7%) completed post-treatment questionnaires. While HCPs listing baseline emotional-related concerns benefited from the CIM intervention, those who did not express emotional or spiritual concerns improved even more significantly following the first session, for both leading concerns (p=0.038) and emotional-related concerns (p=0.023). Nevertheless, it was shown that following subsequent treatments HCPs who expressed emotional and spiritual concerns improved more significantly than those who did not for emotional-related concerns (p=0.017). CONCLUSIONS A CIM intervention for front-line HCPs working in isolated COVID-19 departments can significantly impact emotional-related concerns, more so after the first treatment and among HCPs not using emotional-spiritual keywords in post-treatment narratives. Referral of HCPs to CIM programmes for improved well-being should avoid referral bias to those not expressing emotional/spiritual concerns.
Collapse
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel
- Ruth and Bruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Arieh Eden
- Lady Davis Carmel Medical Center, Haifa, Israel
| | - Jan Vagedes
- Department of Pediatrics, University Hospital Tubingen, Tubingen, Germany
| | - Sameer Kassem
- Department of Internal Medicine, Lady Davis Carmel Medical Center, Haifa, Israel
| |
Collapse
|
11
|
Ali SK, Shah J, Du K, Leekha N, Talib Z. Mental health disorders among post graduate residents in Kenya during the COVID-19 pandemic. PLoS One 2022; 17:e0266570. [PMID: 35377909 PMCID: PMC8979452 DOI: 10.1371/journal.pone.0266570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/12/2022] [Indexed: 12/23/2022] Open
Abstract
Background
Healthcare workers, including residents, are prone to various mental health disorders especially given the context of the COVID-19 pandemic. Residents, particularly, are already under undue stress due to their respective training program demands.
Methods
This cross-sectional, online survey-based study from August to November 2020 collected demographic and mental health measurements from all residents at the Aga Khan University Hospital, Nairobi. The questionnaire investigated demographic variables, information regarding direct care of COVID-19 patients, prior history of mental health and mental health outcomes using the Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, Impact of Event Scale–Revised Questionnaire and Stanford Professional Fulfillment Index Questionnaire.
Results
A total of 100 residents completed the survey (participation rate 77.5%). Participants were about equal in gender (women [53%]), with a median age of 31.28 years, and majority were single (66.7%). A total of 66 participants (66%) were directly engaged in COVID-19 care. Depression: 64.3%, anxiety: 51.5%, insomnia: 40.5%, distress: 35.4%, and burnout: 51.0% were reported in all participants. Statistical significance was found in median depression, professional fulfillment and interpersonal disengagement when comparing frontline resident directly involved in care of COVID-19 patient versus second line residents.
Conclusion
Residents directly involved with caring for COVID-19 patients had statistically higher incidences of depression and interpersonal disengagement and lower professional fulfillment compared to second line residents. Keeping in mind the limited resources in sub-Saharan Africa, urgent and geographically specific strategies are needed to help combat mental health disorders in this specific population.
Collapse
Affiliation(s)
- Sayed K. Ali
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
- * E-mail:
| | - Jasmit Shah
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Katie Du
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Nidhi Leekha
- Department of Radiology, Aga Khan University Hospital, Nairobi, Kenya
| | - Zohray Talib
- Department of Medical Education, California University of Science and Medicine, Colton, CA, United States of America
| |
Collapse
|
12
|
McAndrew NS, Strong Y, Morris KJ, Sannes TS, Pirl WF, Cole S, Mohanraj L, Knight JM. Impact of the COVID-19 pandemic on cancer patients and psycho-oncology providers: Perspectives, observations, and experiences of the American Psychosocial Oncology Society (APOS) membership. Psychooncology 2022; 31:1031-1040. [PMID: 35102653 DOI: 10.1002/pon.5894] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To understand: (1) psycho-oncology providersX2019; perspectives on and observations of the psychological responses of their cancer patients during the pandemic, and (2) psycho-oncology providersX2019; own experiences delivering care. METHODS In this concurrent mixed methods study, a survey was distributed to psychosocial providers who were members of the American Psychosocial Oncology Society (APOS). Survey respondents were invited to participate in a one-on-one audio-recorded interview via phone or secure ZoomX00AE;. RESULTS 76 self-identified psycho-oncology providers responded to the survey and 11 participated in a one-on-one interview. Approximately half reported that patients responded in unique ways to COVID-19 stress relative to other populations. Three themes emerged from qualitative analyses: (1) unique burden on patients, (2) cancer patientsX2019; pandemic response and its relationship to their cancer experience, and (3) unexpected positive changes. Providers emphasized that the cancer experience may have prepared patients for the existential distress of the pandemic and described patientsX2019; resiliency. Two themes emerged regarding delivery of care: (1) new professional and personal challenges and (2) provider resiliency. CONCLUSIONS Although providers observed that the pandemic placed new burdens on patients, they emphasized that the cancer experience may have prepared patients for the existential distress of the pandemic and described patientsX2019; resiliency. To overcome challenges, psycho-oncology providers used innovative strategies to support patients and foster their own mental health. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Natalie S McAndrew
- University of Wisconsin X02013; Milwaukee, College of Nursing, Milwaukee, United States.,Froedtert & the Medical College of Wisconsin, United States
| | | | | | - Timothy S Sannes
- Dana-Farber/Harvard Cancer Institute, Harvard Medical School, Boston, United States
| | - William F Pirl
- Dana-Farber/Harvard Cancer Institute, Harvard Medical School, Boston, United States
| | - Steve Cole
- David Geffen School of Medicine at UCLA, Departments of Psychiatry and Biobehavioral Sciences and Medicine, Division of Hematology-Oncology, Los Angeles, United States
| | - Lathika Mohanraj
- Department of Adult Health and Nursing Systems, Virginia Commonwealth University, Richmond, United States
| | - Jennifer M Knight
- Medical College of Wisconsin, Department of Psychiatry, Medicine, and Microbiology & Immunology, Milwaukee, WI, USA, United States, United States
| |
Collapse
|
13
|
Lee Y, Wang LJ, Chou WJ, Chiang MC, Huang S, Lin YC, Lin JY, Chiu NM, Chen CH, Lee IK, Kung CT, Wang CC, Chong MY. Psychological Reactions of Hospital Workers to a Pandemic: A Comparison of SARS-CoV-2 in 2020 and SARS in 2003. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020833. [PMID: 35055654 PMCID: PMC8775670 DOI: 10.3390/ijerph19020833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023]
Abstract
Epidemic viral infections, including the outbreak of severe acute respiratory syndrome (SARS) in 2003 and SARS-CoV-2 in 2019, have brought tremendous loss to people across the nations. The aim of this study was to compare the psychological impact of the SARS-CoV-2 pandemic in 2020 and the SARS pandemic in 2003 on hospital workers. Hospital workers at a medical center in Southern Taiwan (n = 1816) were invited to complete questionnaires (SARS-CoV-2 Exposure Experience, the Impact of Event Scale, the Chinese Health Questionnaire, and the Distress Thermometer). The current data were compared to the data collected from hospital workers (n = 1257) at the same medical center during the SARS pandemic in 2003. We found the psychological impact on hospital workers during the SARS-CoV-2 pandemic was significantly lower than that during the previous SARS period. During the SARS-CoV-2 pandemic period, hospital workers with SARS experience were more accepting of the risk, felt a greater responsibility to take care of the SARS-CoV-2 patients, and were more likely to perceive the danger of becoming infected. The associated factors of psychiatric morbidity in hospital workers with SARS experience were being female, the degree of intrusion severity, and severity of psychological distress. Proper management strategies and lessons learned from the SARS experience might have led to low psychiatric morbidity during the SARS-CoV-2 pandemic.
Collapse
Affiliation(s)
- Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (Y.L.); (N.-M.C.)
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
- Correspondence: (L.-J.W.); (M.-Y.C.); Tel.: +886-77-31-7123 (ext. 8753) (L.-J.W. & M.-Y.C.); Fax: +886-77-32-6817 (L.-J.W. & M.-Y.C.)
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ming-Chu Chiang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Shan Huang
- Administrative Offices, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.H.); (Y.-C.L.); (J.-Y.L.)
| | - Yi-Chun Lin
- Administrative Offices, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.H.); (Y.-C.L.); (J.-Y.L.)
| | - Jie-Yi Lin
- Administrative Offices, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.H.); (Y.-C.L.); (J.-Y.L.)
| | - Nien-Mu Chiu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (Y.L.); (N.-M.C.)
| | - Chih-Hung Chen
- Division of General Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ing-Kit Lee
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Chia-Te Kung
- Department of Emergency, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Chih-Chi Wang
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (Y.L.); (N.-M.C.)
- Correspondence: (L.-J.W.); (M.-Y.C.); Tel.: +886-77-31-7123 (ext. 8753) (L.-J.W. & M.-Y.C.); Fax: +886-77-32-6817 (L.-J.W. & M.-Y.C.)
| |
Collapse
|
14
|
Abstract
ABSTRACT The biopsychosocial model provides a useful perspective for understanding the development and characteristics of the COVID-19 pandemic and its anticipated long-term consequences for society as well as individuals. This article provides a biopsychosocial perspective on the COVID pandemic and an editorial comment on the articles in this Special Issue of Psychosomatic Medicine. Based on analysis of the PubMed database, it is shown that the attention to psychological and social factors is 74% higher in COVID-19-related articles compared to all other health-related scientific articles published during the same time-period (between 1/1/2020 and 4/18/2021). Specifically, 18.6% of the ≈123,500 articles addressing COVID-19-related topics also included psychological or social factors in their content vs. 10.7% of articles that did not address COVID-19. The biopsychosocial model is relevant to understanding the interrelationships among risk factors and the multidimensional clinical and psychosocial COVID-19 outcomes. Clinical outcomes directly related to COVID-19 range from severe but rare events (mortality and intensive care treatment) to less severe common outcomes such as positive screening tests for COVID-19 with or without symptoms. In addition, psychosocial outcomes range in severity from frequently observed reduced psychological wellbeing to less common clinical mood and anxiety disorders and, in rare cases, suicidality. The COVID-19 pandemic is characterized by an unusually strong and short-term link between social factors and biological aspects of the disease, without mediating psychological factors. After a review of the articles presented in this Special Issue, this editorial concludes with suggestions for biopsychosocial models in research on COVID-19 and other large-scale health threats.
Collapse
Affiliation(s)
- Willem J Kop
- From the Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Center of Research on Psychology and Somatic diseases ( CoRPS ), Tilburg, the Netherlands
| |
Collapse
|