Mental Health of Flying Cabin Crews: Depression, Anxiety, and Stress Before and During the COVID-19 Pandemic

Effects of Post-COVID-19 Syndrome on Quality of Life Among Airline Crew

Background: Interest in post-coronavirus disease 2019 (COVID-19) syndrome following COVID-19 infection has been increasing. Maintaining quality of life (QoL) is vital for airline crews because they work in a special environment, where they are responsible for the passengers' safety. This study aims to closely investigate factors affecting the QoL of airline crews, including post-COVID-19 syndrome. Methods: This study was designed as a cross-sectional survey, comprising 167 crews. Findings: Age-specific significant differences were observed in social, overall, and total QoL scores. The physical domain QoL was significantly higher in the cockpit crews than that in the cabin crews. Significant differences were found in psychological and overall QoL depending on years of continuous service. Social domain and environmental QoL were lower in those who had no symptoms after being diagnosed with COVID-19 than in those who were symptomatic. Among the participants, 4.2% had post-COVID-19 syndrome, indicating significant differences in the physical domain, depending on whether they exhibit post-COVID-19 syndrome. Conclusion: It is urgent to develop measures to increase the QoL of airline crews, investigate post-COVID-19 syndrome before returning to work, and develop strategies to manage it. Application to practice: The QoL among airline crews differed not only by the demographic characteristics of the participants but also by the presence of symptoms during COVID-19 diagnosis and post-COVID-19 syndrome. Higher QoL among airline crews is associated with the safety of both airline crews and passengers. Therefore, it is necessary to establish a systematic management protocol for airline crews returning to work after following COVID-19 infection.

A Grounded Theory Exploration of Addictions Treatment Within a Commercial Airline Setting

INTRODUCTION: An Australasian Airline's Alcohol and Other Drug (AOD) Program demonstrates abstinence rates that exceed those of general AOD programs. The reasons for this are unclear. The purpose of this research was to develop a theory as to why this program is successful.METHODS: A qualitative examination following grounded theory methodology was undertaken. AOD program patients and healthcare professionals were interviewed until content saturation was reached. Data analysis followed grounded theory to identify the key concepts associated with the program's success.RESULTS: The core theory that emerged highlighted the pivotal roles of a strong employee-company relationship, shared values, and a safety-focused culture in explicating the program's success. This moves beyond the "carrot and stick" model of motivation, where belonging to this organization and safety consciousness serve as powerful drivers for abstinence. Challenges and barriers highlighted some unique challenges to the program in managing the coronavirus pandemic and the difference in approach to substance use in community spaces versus safety-critical employment.DISCUSSION: This research expands the understanding of this AOD program's success in a safety-critical industry, emphasizing the elements of a working relationship that are beyond positive or negative reinforcement. Future research should work to quantify and test the generalizability of these findings.Nairn J, Bell E, Myers J, Higgins M, Johnston B, Newton-Howes G. A grounded theory exploration of addictions treatment within a commercial airline setting. Aerosp Med Hum Perform. 2024; 95(6):313-320.

Creativity and productivity during the COVID-19 pandemic

This study explored impacts of the COVID-19 pandemic on creativity and productivity and how personality variables moderated these impacts. Two online self-report surveys were conducted. 863 (spring 2020) and 421 (spring 2021) participants were asked how the corona crisis affected their creativity and productivity. In addition, personality variables, namely the Big Five (openness, conscientiousness, extraversion, agreeableness, neuroticism), as well as interpersonal trust, need for cognition, risk-taking, and life satisfaction, were assessed. As a result of the crisis, the group of participants appeared more creative in 2020, while no significant group effect of the pandemic was found for productivity. In 2021, however, the crisis had a negative impact on creativity and productivity. In 2020, predictors for an improved creativity were openness, conscientiousness, neuroticism, and life satisfaction; predictors for improved productivity were conscientiousness, negative interpersonal trust, and life satisfaction. In 2021, only life satisfaction predicted improved creativity, while improved productivity was predicted by conscientiousness, negative neuroticism, and life satisfaction. At its beginning, the COVID-19 pandemic had, on average, a positive effect on creativity and a neutral one on productivity. Later, the impact turned negative on both creativity and productivity. Here, lower life satisfaction was particularly relevant.

Evaluating the Impact of the Pandemic Crisis on the Aviation Industry

This paper investigates the intellectual structure of the literature addressing "epidemic/pandemic" and "aviation industry" through a bibliometric approach to the literature from 1991 to 2021. The final count of 856 publications was collected from Web of Science and analyzed by CiteSpace (version 5.8.R1) and VOS Viewer. Visualization tools are used to perform the co-citation, co-occurrence, and thematic-based cluster analysis. The results highlight the most prominent nodes (articles, authors, journals, countries, and institutions) within the literature on "epidemic/pandemic" and "aviation industry." Furthermore, this study conceptualizes and compares the growth of literature before theCOVID-19 pandemic and during the COVID-19 ("hotspot") era. The conclusion is that the aviation industry is an engine for global economics on the road to recovery from COVID-19, in which soft (human) resources can play an integral part.

Pilot mental health during the COVID-19 pandemic: prevalence rates from semi-structured interviews, and associated vulnerability and protective factors

Introduction

Pilots are a unique occupational group who perform a specialised job and face significant stressors. Pilot mental health has received increased attention since Germanwings Flight 9525; however, this research has largely focused on general anxiety, depression, and suicide and relied on a questionnaire-based methodology. This approach is likely to miss various mental health issues that may affect pilot wellbeing, leaving the prevalence of mental health issues in aviation unclear. In addition, the COVID-19 pandemic is likely to have a particular impact on the mental health and wellbeing of pilots, who experienced the devastating effect of COVID-19 on the industry.

Method

In the present study, we conducted a comprehensive assessment of 73 commercial pilots during the COVID-19 pandemic, using the DIAMOND semi-structured diagnostic interview and explored possible associated vulnerability and protective factors, including life event stressors, personality, passion, lifestyle factors, and coping strategies.

Results

The COVID-19 pandemic had a significant impact on aviation during the time of this study, affecting 95% of participants. The diagnostic results revealed over one third of pilots had symptoms of a diagnoseable mental health disorder. Anxiety disorders were the most commonly found disorders, followed by Attention Deficit Hyperactivity Disorder (ADHD), Adjustment Disorder, and Depressive Disorders. Pilots' high life event scores placed them at an increased risk for the development of stress-related illness, though did not explain which pilots had mental health difficulties in this study. Regression analysis supported a diathesis-stress model for pilot mental health, with disagreeableness and obsessive passion contributing to pilots' development of mental health issues, and nutrition as the most important protective factor.

Discussion

This study, though limited to the COVID-19 pandemic, provides a valuable precedent for a more thorough assessment of pilot mental health, and contributes to the broader understanding of pilot mental health, including suggestions to target factors associated with the development of mental health issues.

COVID-19 Anxiety and Wellbeing at Work in Finland during 2020-2022: A 5-Wave Longitudinal Survey Study

The COVID-19 pandemic impacted workers globally during 2020-2022 and it has had major psychological implications for workers' wellbeing. This longitudinal study analyzed risk and protective factors predicting COVID-19 anxiety among workers in Finland. Longitudinal national sample of Finnish workers (n = 685) participated in a five-wave study conducted in 2020-2022, covering multiple waves of the COVID-19 pandemic and its aftermath. Our outcome measure was COVID-19 anxiety. Predictors were psychological distress, work exhaustion, technostress, and loneliness. Models also controlled for self-regulation; social support at work and remote working; and socio-demographic background factors. Both within-person and between-person effects were analyzed using multilevel hybrid regression models. COVID-19 anxiety varied between time points which is explained by changes in circumstances during the pandemic. Highest anxiety was expressed in the middle of the Delta variant surge and lockdown in spring 2021. Within-person changes in psychological distress, work exhaustion, technostress, self-regulation, and perceived loneliness were all associated with COVID-19 anxiety. Between-person results showed that distressed, exhausted, technostressed, and lonely workers expressed more anxiety than others. Remote workers reported higher anxiety over time than others. Those who had reported high self-regulation reported lower anxiety than others. Female gender and younger age were associated with higher anxiety. COVID-19 anxiety continues to be an important phenomenon with a magnitude of consequences on people and numerous industries. This study showed that general mental health and work stressors predict COVID-19 anxiety. Promoting social support and workers' self-regulation skills can be beneficial for overcoming anxiety during and after the pandemic.

Exploring relationships between health-related lifestyle habits and fatigue among flight attendants and trainees

BACKGROUND

Fatigue in flight attendants is an important issue concerning flight safety and occupational health. It is well known that work-related factors and certain lifestyle habits can cause fatigue. But very few studies have focused on the difference between having work experience flight attendants and no flight experience trainees.

OBJECTIVE

The present study was performed to compare and investigate the relationships between fatigue and health-related lifestyle habits among flight attendants and trainees.

METHODS

A questionnaire-based cross-sectional study with convenience sampling was conducted. A total of 107 flight attendants and 109 trainees were recruited in an international airline. The research was using a self-developed health-related lifestyle habits questionnaire and the Checklist Individual Strength (CIS) scale. The relationships between health-related lifestyle habits and fatigue were examined by Pearson's chi-square test and Fisher's exact test. Logistic regression was used to identify factors predicting fatigue among flight attendants and trainees.

RESULTS

Nearly half of the participants had fatigue and poor health-related lifestyle habits. Logistic regression showed that trainees with sleeping hours less than 7 hours, had a higher probability of fatigue than those who sleep more than 7 hours. In addition, the flight attendants with an irregular sleep pattern, unbalanced diet, sedentary leisure-time, no use relaxation technique, and an exercise frequency below once a week had a higher probability of fatigue.

CONCLUSION

The flight attendants' sleep patterns, diet, activity, and relaxation had a more significant impact on fatigue than trainees. Therefore, a healthy lifestyle is important in this population for good workplace performance.

Associations of suffering with facets of health and well-being among working adults: longitudinal evidence from two samples

Suffering is an experiential state that every person encounters at one time or another, yet little is known about suffering and its consequences for the health and well-being of nonclinical adult populations. In a pair of longitudinal studies, we used two waves of data from garment factory workers (Study 1 [T1: 2017, T2: 2019]: n = 344) and flight attendants (Study 2 [T1: 2017/2018, T2: 2020]: n = 1402) to examine the prospective associations of suffering with 16 outcomes across different domains of health and well-being: physical health, health behavior, mental health, psychological well-being, character strengths, and social well-being. The primary analysis involved a series of regression analyses in which each T2 outcome was regressed on overall suffering assessed at T1, adjusting for relevant sociodemographic characteristics and the baseline value (or close proxy) of the outcome assessed at T1. In Study 1, associations of overall suffering with worse subsequent health and well-being were limited to a single outcome on each of the domains of physical health and mental health. Overall suffering was more consistently related to worse subsequent health and well-being in Study 2, with associations emerging for all but two outcomes. The pattern of findings for each study was largely similar when aspects of suffering were modeled individually, although associations for some aspects of suffering differed from those that emerged for overall suffering. Our findings suggest that suffering may have important implications for the health and well-being of worker populations.

Depression, Anxiety, Stress and Anger of the Cabin Crew during the COVID-19 Pandemic in South Korea

This study examines the levels of depression, anxiety, stress, and state and trait anger of cabin crews, as well as the differences in the main variables and general characteristics between the depression and anxiety groups, during the COVID-19 pandemic. This descriptive cross-sectional study used data from 161 Korean cabin crew members. Data were analyzed using descriptive analysis, independent t-tests, and chi-square tests. Of the participants, 62.7% were women, and 52.2% and 46.6% were classified into the depression and anxiety groups, respectively. No differences in the general characteristics between the non-depression and depression groups were found. However, in the anxiety group, there were significant differences in age, marital status, position, and work type during the COVID-19 pandemic. Additionally, the anxiety group showed a higher anger state (approximately 6.76 times higher than the normal group) than the depression group (approximately 4.90 times higher than the normal group). In a pandemic, airlines should screen cabin crews for depression and anxiety. The development and applications of mental health education for high-risk groups should include anger intervention.

Bibliometric visualisation of industrial and organisational psychology during COVID-19 pandemic: Insight for future research

Orientation

Industrial and organisational psychology (IOP) researchers have shown their contribution to solving COVID-19 pandemic in the workplace through the enormous number of studies.

Research purpose

This study intended to map IOP research related to the COVID-19 crisis to provide the research issues that have emerged and potential for future research.

Motivation for the study

All the IOP levels (worker, team and organisation) were impacted by COVID-19, and they continuously change. Researchers must be careful in directing their research and avoid focusing on certain levels or problems.

Research approach/design and method

A bibliometric visualisation analysis method was adopted in this study.

Main findings

The bibliometric results showed that the prominent keywords in IOP research-related COVID-19 are ‘human(s)’, ‘COVID-19’, keywords related to subject characteristics and mental health. Six clusters on the map showed the prominent themes: mental health, health care workers as the research subject, specific workplace issues, digital technology, methodologies used, and country. Furthermore, in every cluster, the depth overview of study results is presented. The top issues were at the worker-level, while the organisational-level issues gained limited attention.

Practical/managerial implications

For practitioners and managers, this study provides a complete picture of emerging issues during COVID-19 crisis ranging from causes, risk factors and solutions. For researchers, this study can provide insight for further research.

Contribution/value-add

This study provides a comprehensive overview of the IOP issues related-COVID-19 that will be beneficial as the basis for policymaking and recommendations for future potential areas.

Sleep Quality and Mental Health Consequences of COVID-19 Pandemic in the Aviation Community in Greece

OBJECTIVE

The aim of this study was to assess the mental health and sleep quality of aviation workers in Greece during the pandemic.

METHODS

A cross-sectional study of aviation workers in Greece was conducted.

RESULTS

Sleep disturbances were observed in 25.4% of our 548 participants, whereas 8.2% and 5.8% reported at least mild depressive and anxiety symptoms, respectively. The impact of the pandemic on their mental health was their primary concern, which increased for many active pilots according to their workload. Those infected mainly faced daily tiredness and fatigue. Smoking habits and high body mass index were a predisposition for more physical symptoms. Cabin crew and women generally yielded worse scores than the other groups.

CONCLUSION

Fear of infection could explain mental health issues, whereas physical symptoms of those infected could be attributed to long-COVID (coronavirus disease) syndrome. Flight attendants' lower ratings may be due to more occupational exposure.

The case for change: aviation worker wellbeing during the COVID 19 pandemic, and the need for an integrated health and safety culture

The workplace is an important setting for health protection, health promotion and disease prevention. Currently, health and wellbeing approaches at an aviation organisational level are not addressing both human and safety needs. This issue has been intensified since the COVID 19 pandemic. This paper reports on the findings of a survey pertaining to aviation worker wellbeing and organisational approaches to managing wellbeing and mental health. The survey was administered at two different time periods during the COVID 19 pandemic (2020 and 2021). Collectively, feedback was obtained from over 3000 aviation workers. Survey feedback indicates that aviation workers are experiencing considerable challenges in relation to their health and wellbeing. These challenges are not being adequately addressed at an organisational level, which creates risk both from an individual and flight safety perspective. The descriptive findings of both surveys along with a regression analysis is used to make a principled case for augmenting the existing approach to managing aviation worker wellbeing (including mental health), at both an organisational and regulatory level. It is argued that aviation organisations, with the support of the regulator should implement a preventative, ethical and evidence-based strategy to managing wellbeing and mental health risk. Critically, aviation organisations need to advance and integrated health, wellbeing, and safety culture. This necessitates an alignment of human, business, and safety objectives, as articulated in concepts of corporate social responsibility (CSR) and responsible work. Critically, this approach depends on trust and the specification of appropriate protections, so that aviation workers feel safe to routinely report wellbeing levels and challenges, and their impact on operational safety.

Effects of animated pedagogical agent-guided loving-kindness meditation on flight attendants’ spirituality, mindfulness, subjective wellbeing, and social presence

Loving-kindness meditation (LKM) was first practiced by Buddhists and then developed by clinical psychologist. Previous studies on LKM have mainly focused on the impact of real person-guided meditation on depression, anxiety, and other negative psychology. During the COVID-19 pandemic, this study explored the effect and mechanism of media-guided LKM on the improvement of social presence, mindfulness, spirituality, and subjective wellbeing (SWB). From the viewpoint of positive psychology, this study compared the different media effects of animated pedagogical agent (APA)-guided LKM and audio-guided LKM. A total of 82 flight attendants were recruited from airlines; then, they were randomly assigned to two groups: APA group (41 participants) and audio group (41 participants), which both underwent an 8-week LKM training intervention. The aforementioned four main variables were measured pre and post the meditation experiment. The results indicated that both APA-guided meditation and audio-guided meditation significantly improved subjects’ spirituality and SWB. Compared with audio-guided meditation, APA-guided meditation significantly improved the subjects’ spirituality, SWB, and social presence. Audio-guided meditation has no significant effect on social presence. This study highlights APA-guided meditation has a positive effect on spirituality, SWB, and social presence, which may provide individuals with a simple and easy method to improve their mental health.

COVID-19 countermeasures at the workplace, psychological well-being, and mental health - a nationally representative latent class analysis of Luxembourgish employees

The COVID-19 pandemic has massively changed people's working lives all over the world. While various studies investigated the effects from pandemic-induced unemployment and telecommuting, there is a lack of research regarding the impact of workplace COVID-19 countermeasures on well-being and mental health for employees who are still working on site. Thus, the aim of the present study was to investigate the prevalence of workplace COVID-19 countermeasures in organizations in Luxembourg. A person-centered approach was applied in order to explore how employees' psychological well-being and health (i.e., general psychological well-being, vigor, work satisfaction, work-related burnout, somatic complaints, fear of COVID-19 infection) are impacted by organizational countermeasures and whether there are certain employee groups that are less protected by these. Results of a latent class analysis revealed four different classes (Low level of countermeasures, Medium level of countermeasures, High level of countermeasures, High level of countermeasures low distance). Employees working in a healthcare setting were more likely than employees working in a non-healthcare setting to be members of the High level of countermeasures low distance class. Class membership was meaningfully associated with all well-being outcomes. Members of the High level of countermeasures class showed the highest level of well-being, whereas Members of the Low level of countermeasures class and the High level of countermeasures low distance class showed the lowest level of well-being. Policy makers and organizations are recommended to increase the level of COVID-19 countermeasures as an adjunctive strategy to prevent and mitigate adverse mental health and well-being outcomes during the COVID-19 pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03377-4.

Social Network Analysis on the Mobility of Three Vulnerable Population Subgroups: Domestic Workers, Flight Crews, and Sailors during the COVID-19 Pandemic in Hong Kong

Background: Domestic workers, flight crews, and sailors are three vulnerable population subgroups who were required to travel due to occupational demand in Hong Kong during the COVID-19 pandemic. Objective: The aim of this study was to explore the social networks among three vulnerable population subgroups and capture temporal changes in their probability of being exposed to SARS-CoV-2 via mobility. Methods: We included 652 COVID-19 cases and utilized Exponential Random Graph Models to build six social networks: one for the cross-sectional cohort, and five for the temporal wave cohorts, respectively. Vertices were the three vulnerable population subgroups. Edges were shared scenarios where vertices were exposed to SARS-CoV-2. Results: The probability of being exposed to a COVID-19 case in Hong Kong among the three vulnerable population subgroups increased from 3.38% in early 2020 to 5.78% in early 2022. While domestic workers were less mobile intercontinentally compared to flight crews and sailors, domestic workers were 1.81-times in general more likely to be exposed to SARS-CoV-2. Conclusions: Vulnerable populations with similar ages and occupations, especially younger domestic workers and flight crew members, were more likely to be exposed to SARS-CoV-2. Social network analysis can be used to provide critical information on the health risks of infectious diseases to vulnerable populations.

Fatigue, Schedules, Sleep, and Sleepiness in U.S. Commercial Pilots During COVID-19

INTRODUCTION: COVID-19 has had a significant impact on the aviation industry. While reduced flying capacity may intuitively translate to reduced fatigue risk by way of fewer flights and duty hours, the actual impact of the pandemic on pilot fatigue is unknown.METHODS: We surveyed U.S. commercial airline pilots in late 2020 (N = 669) and early 2021 (N = 156) to assess the impact of COVID-19 on schedules and fatigue during the pandemic.RESULTS: Overall, pilots reported reduced flight and duty hours compared to prepandemic. Average sleep on workdays was slightly shorter in late 2020 (6.87 ± 1.14 h) and recovered to prepandemic levels in early 2021 (6.95 ± 1.11 h). Similarly, the frequency of sleepiness on days off and in-flight increased in late 2020, with 54% of pilots reporting an increase in in-flight sleepiness, then returned to prepandemic levels in early 2021. The use of in-flight sleepiness countermeasures remained the same across assessed time points. Pilots highlighted several factors which impacted their sleep and job performance, including limited access to nutritional food during duty days and layovers, reduced access to exercise facilities during layovers, increased stress due to job insecurity and health concerns, increased distractions and workload, and changes to scheduling.DISCUSSION: Despite a reduction in flights and duty days, COVID-19 led to increased sleepiness on days off and in flight, potentially due to the negative impact of lack of access to essential needs and heightened stress on sleep. Operators need to monitor the change in these COVID-19 related risks as the industry returns to full service.Hilditch CJ, Flynn-Evans EE. Fatigue, schedules, sleep, and sleepiness in U.S. commercial pilots during COVID-19. Aerosp Med Hum Perform. 2022; 93(5):433-441.

An Orientation to Aviation Psychiatry: With 30 Case Examples and a 10-Year Follow-up

ABSTRACT

This report orients general psychiatrists to assessment and care for "safety sensitive" aviation workers. Our case study of 30 sequential aviation patients consists of demographic, clinical, and aviation characteristics plus a 10-year follow-up. Relatively few pilots and other aviation workers self-identified their psychiatric condition. Aviation outcomes associated with psychiatric disorder included personnel injury and/or aircraft damage (three cases), imminent risk without injury or damage (nine cases), impaired aviation functioning without imminent risk (15 cases), and neither risk nor psychiatric disorder or impairment (three cases). Mood, anxiety, and substance use disorders comprised the most common diagnoses. Ten years later, 23 patients were employed (21 in aviation); seven were disabled or deceased. General psychiatrists will find aviation cases clinically familiar but requiring added evaluation for aviation safety and potential interaction with the Federal Aviation Agency and airline supervisors.

Emotional Intelligence after Corporate Downsizing during Covid-19 Era: a Case Study of Thai Airways’ Flight Attendants

Firstly, this study aims to study the impact to air transport employee’s quality of life from corporate downsizing during covid -19 era according to the corporate rehabilitation plan of Thai Airways International Public Company Limited. Secondly, to study the approach to adjust an emotional intelligence of air transport employee after the corporate downsizing according to the rehabilitation plans of Thai Airways International Public Company Limited. Thirdly, to study the development of new professional life quality of the air transport employee after corporate downsizing according to the rehabilitation plan of Thai Airways International Public Company Limited. The results obtained from the study are detailed as follows.

The results showed that the guidelines for adjusting the emotional intelligence of flight attendants consist of 6 aspects as follows: the first aspect is understanding accepting and adapting to changes that occur due to conditions beyond the control of both the coronavirus (COVID-19) outbreak 19 and corporate downsizing according to the corporate rehabilitation plan of Thai Airways International Public Company Limited. The second aspect is a positive thinking in order to allow oneself to be successful in learning new experiences from the crisis that happened and stepped away from the traditional form of work (comfort zone) to new challenges. The third aspect is learning to deal with stress by doing various activities that interest oneself to relieve stress. The fourth aspect is self-empowering to realize self-worth, to build strength, to turn challenges into opportunities to continue in living. The fifth aspect is the use of dharma principles to stabilize one’s mood in order to find a solution for one’s life. The sixth aspect is to manage change in consistent with the uncontrollable changes by modifying behavior and developing oneself to survive well through this crisis.

Exploring the Relationship between the Fear of Covid-19, Job Insecurity, Employee Well-Being, and Job Involvement in Flight Personnel

The aviation industry has recently experienced several difficulties due to Covid-19. Especially flight personnel (pilots and cabin crews), who worked under the health-threatening effects of Covid-19, either lost their jobs or were faced with a dramatic decrease in their incomes. The aim of this research is to understand the impact of the fear of Covid-19 on the well-being of flight personnel, to reveal the mediating role of job insecurity on this relationship, and to observe the moderating role of job involvement on the relationship between job insecurity and well-being. The study was conducted with pilots (N=111) and cabin crew members (N=45) who worked for different airlines in Turkey. The total sample size was 154 participants. The results showed that job insecurity played a mediating role as fear of Covid-19 began to have a less significant impact on employee well-being. In addition, the analysis of the moderating role of job involvement showed that high job involvement exacerbates the negative effect of job insecurity on flight personnel's well-being. The results are discussed in relation to the organizational and human resources management practices in airline companies.

Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey

OBJECTIVES

During a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice suits among medical staff. This study aimed to investigate the occurrence of burnout, acute stress disorder, anxiety disorder and depressive disorder among healthcare providers at the third month of the COVID-19 pandemic.

DESIGN

A cross-sectional facility-based survey.

SETTING

Hospitals around the country with different levels of care.

PARTICIPANTS

A total of 1795 respondents, including 360 men and 1435 women who participated in the survey.

PRIMARY OUTCOME MEASURES

Burnout was assessed using the Physician Work Life Study. A score of ≥3 implied burnout.

RESULTS

Of the 1795 respondents, 723 (40.3%) reported burnout, and 669 (37.3%) cared for patients with COVID-19. Anxiety levels were mild in 185 (10.3%) respondents, moderate in 209 (11.6%) and severe in 1401 (78.1%). The mean Center for Epidemiologic Studies Depression Scale-10 score was 9.5±6.3, and 817 (45.5%) respondents were classified as having depression. Factors associated with burnout were working in acute and critical care (ACC) divisions (adjusted OR (aOR)=1.84, 95% CI 1.20 to 3.39, p=0.019), caring for patients with COVID-19 (aOR=3.90, 95% CI 1.14 to 13.37, p=0.031) and having depressive disorder (aOR=9.44, 95% CI 7.44 to 11.97, p<0.001).

CONCLUSIONS

Physicians and nurses are vulnerable to burnout during a pandemic, especially those working in ACC divisions. Anxiety disorder, depressive disorder and care of patients with COVID-19 may be factors that influence the occurrence of burnout among healthcare providers.