Healthcare professionals' perspective on psychosocial support: Lessons learned during a pandemic

Purpose/Background

Assessing the level of psychosocial assistance provided for healthcare workers (HCWs) at and outside of work is crucial. This study aimed to evaluate the psychosocial support provided to HCWs and analyze its effectiveness during COVID-19 at one of the biggest hospitals in Saudi Arabia, King Abdulaziz Medical City, Riyadh. In this study, we hypothesized that psychosocial support for HCWs will enhance their performance and total welfare.

Methods

This study followed a cross-sectional analytic design, and its sample comprised 380 HCWs from many specialties. Two well-known psychosocial scales, DASS-21 and MSPSS, were used to assess the availability of institutional psychosocial support and the levels of depression, anxiety, and stress among HCWs.

Results

The majority of HCWs reported a tremendous increase in working hours and level of anxiety during COVID-19, and they denied receiving institutional support at work. Moreover, the majority reported receiving support from family and friends. Primarily, the most statistically significant finding in this study was that female HCWs had much higher levels of stress and anxiety during COVID-19 than their equivalent male colleagues. In addition, a significant difference was found regarding the presence of immediate supervisors for HCWs and its effectiveness in burden relief.

Conclusions

The results show a marginally significant association between psychosocial support and the mental health of HCWs during COVID-19. However, we found a slightly favorable effect on the minority of HCWs who received regular check-ins or targeted interventions or had immediate supervisors.

Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations

BACKGROUND

Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR).

METHODS

We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes.

RESULTS

The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted.

DISCUSSION

PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.

The association between experience of COVID-19-related discrimination and psychological distress among healthcare workers for six national medical research centers in Japan

BACKGROUND

Discrimination is an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan.

METHODS

This cross-sectional study conducted a health survey among 5703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress (≥ 13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified factors associated with discrimination.

RESULTS

Of the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.28-1.55), had high vs. low viral exposure (AOR = 2.31, 95% CI = 1.81-2.93), and worked for 11 or more hours/day vs. 8 or less hours/day (AOR = 1.42, 95% CI = 1.35-1.49) were more likely to have experienced COVID-19-related discrimination. The AOR (95% CI) of severe psychological distress was 1.83 (1.29-2.59) among those who experienced discrimination. In the stratified analysis by sociodemographic and job-related factors, all the interactions did not reach statistical significance (p for interaction > 0.20).

CONCLUSION

Experience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.

COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.

AIM

To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.

METHODS

We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.

RESULTS

Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.

CONCLUSION

As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.

The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes

COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.

Factors Affecting the Psychological Well-Being of Health Care Workers During the COVID-19 Crisis

Background

Health care workers (HCWs) are a group that especially suffered during the COVID-19 pandemic. In addition to facing the stress of dealing with patients and social isolation, they had to worry about being infected themselves and transmitting the infection to their families. This study evaluated the fear, anxiety, and depression experienced by HCWs during the COVID-19 crisis.

Subjects and Methods

The sample size was 541 HCWs. Data collection was done using an online validated questionnaire through Google Docs, sent to HCWs by email and WhatsApp groups. We assessed depression and anxiety with the 4-item Patient Health Questionnaire-4 (PHQ-4), while evaluating fear with the Fear of COVID-19 Scale (FCV-19S).

Results

A statistically significant difference was found in the perception of fear between married and unmarried people, and between those with colleagues who had died from COVID-19 infection and those without. There was a significant relation between HCWs’ anxiety and a history of death from COVID-19 infection, either of friends or of close relatives. The prevalence of depression was 18.48% in the tested sample of HCWs. Participants who had close relatives or friends infected with COVID-19 showed a significantly higher degree of depression. The age group <30 and those working 20 to 30 hours weekly showed higher degrees of anxiety and depression.

Conclusion

Sociodemographic variables such as age, marital status, and working area had a significant impact on the mental and psychological health of HCWs during the COVID-19 crisis. HCWs who lost patients due to COVID-19 had a significantly higher prevalence of fear, depression, and anxiety.

Factors Associated to Psychological Distress During the COVID-19 Pandemic Among Healthcare Workers in Ecuador

Objective: The global COVID-19 pandemic has challenged health systems. Healthcare professionals had to face harsh conditions that have caused psycho-emotional consequences. Ecuador has been one of the countries hit hardest by the pandemic in Latin America. The objective of this study was to analyse the levels of psychological distress among healthcare workers in Ecuador during the COVID-19 pandemic.

Methods: A cross-sectional descriptive study was conducted with a convenience sample of 1,056 healthcare professionals, assessing their psychological distress, physical symptoms of COVID-19, state of health, the preventive measures adopted, and the history of contact with people infected with the SARS-CoV2 virus.

Results: showed that 66.0% of the participants manifested psychological distress, with significantly higher levels in women with symptoms of COVID-19 and previous contact with infected people or objects (p < 0.001). However, adherence to preventive measures and perception of health were associated with less psychological distress (p < 0.001).

Conclusions: The importance of monitoring the mental health of healthcare workers during the COVID-19 pandemic was confirmed, having identified factors associated with the development of psychological distress among professionals in Ecuador.

COVID-19 infection and the broader impacts of the pandemic on healthcare workers

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease or COVID-19 pandemic is associated with more than 230 million cases and has challenged healthcare systems globally. Many healthcare workers (HCWs) have acquired the infection, often through their workplace, with a significant number dying. The epidemiology of COVID-19 infection in HCWs continues to be explored, with manifold exposure risks identified, leading to COVID-19 being recognised as an occupational disease for HCWs. The physical illness due to COVID-19 in HCWs is similar to the general population, with some HCWs experiencing a long-term illness, which may impact their ability to return to work. HCWs have also been affected by the immense workplace and psychosocial disruption caused by the pandemic. The impacts on the psychological well-being of HCWs globally have been profound, with high prevalence estimates for mental health symptoms, including emotional exhaustion. Globally, governments, healthcare organisations and employers have key responsibilities, including: to be better prepared for crises with comprehensive disaster response management plans, and to protect and preserve the health workforce from the physical and psychological impacts of the pandemic. While prioritising HCWs in vaccine rollouts globally has been critical, managing exposures and outbreaks occurring in healthcare settings remains challenging and continues to lead to substantial disruption to the health workforce. Safeguarding healthcare workforces during crises is critical as we move forward on the new path of 'COVID normal'.

A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action

Infectious diseases, including COVID-19, are crucial public health issues and may lead to considerable fear among the general public and stigmatization of, and discrimination against, specific populations. This meta-analysis aimed to estimate the pooled prevalence of stigma in infectious disease epidemics. We systematically searched PubMed, PsycINFO, Embase, MEDLINE, Web of Science, and Cochrane databases since inception to June 08, 2021, and reported the prevalence of stigma towards people with infectious diseases including SARS, H1N1, MERS, Zika, Ebola, and COVID-19. A total of 50 eligible articles were included that contributed 51 estimates of prevalence in 92722 participants. The overall pooled prevalence of stigma across all populations was 34% [95% CI: 28-40%], including enacted stigma (36% [95% CI: 28-44%]) and perceived stigma (31% [95% CI: 22-40%]). The prevalence of stigma in patients, community population, and health care workers, was 38% [95% CI: 12- 65%], 36% [95% CI: 28-45%], and 30% [95% CI: 20-40%], respectively. The prevalence of stigma in participants from low- and middle-income countries was 37% [95% CI: 29-45%], which is higher than that from high-income countries (27% [95% CI: 18-36%]) though this difference was not statistically significant. A similar trend of prevalence of stigma was also observed in individuals with lower education (47% [95% CI: 23-71%]) compared to higher education level (33% [95% CI: 23-4%]). These findings indicate that stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging effects of the infodemics during infectious disease epidemics, including COVID-19, and reduce infectious disease-related stigma.

The personal recovery movement in Singapore - past, present and future

The personal recovery movement is beginning to gain traction within Singapore's mental healthcare systems. We believe it is timely to give a broad overview of how it developed and provide suggestions on how it can evolve further. From the early custodial care in the 1800s to the community-centric programmes of the 1900s and early 2000s, we now find ourselves at the forefront of yet another paradigm shift towards a more consumer-centric model of care. The following decades will allow personal recovery practitioners and researchers to innovate and identify unique but culturally appropriate care frameworks. We also discuss how the movement can continue to complement existing mental healthcare systems and efforts.