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Mediavilla R, Fernández-Jiménez E, Martínez-Alés G, Moreno-Küstner B, Martínez-Morata I, Jaramillo F, Morán-Sánchez I, Minué S, Torres-Cantero A, Alvarado R, Ayuso-Mateos JL, Mascayano F, Susser E, Bravo-Ortiz MF. Role of access to personal protective equipment, treatment prioritization decisions, and changes in job functions on health workers' mental health outcomes during the initial outbreak of the COVID-19 pandemic. J Affect Disord 2021; 295:405-409. [PMID: 34507219 PMCID: PMC8403068 DOI: 10.1016/j.jad.2021.08.059] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND During the initial COVID-19 outbreak, organizational changes were required to ensure adequate staffing in healthcare facilities. The extent to which organizational changes impacted the mental wellbeing of healthcare workers (HCWs) remains unexplored. Here we analyzed the association between three work-related stressors (reported access to protective equipment, change in job functions, and patient prioritization decision-making) and mental health outcomes (depression symptoms, psychological distress, suicidal thoughts, and fear of infection) in a large sample of Spanish HCWs during the initial COVID-19 outbreak. METHODS We conducted a cross-sectional study including HCWs from three regions of Spain between April 24th and June 22nd, 2020. An online survey measured sociodemographic characteristics, work-related stressors, fear of infection, and mental health outcomes (depression [PHQ-9], psychological distress [GHQ-12], death wishes [C-SSRS]). We conducted mixed-effects regression models to adjust all associations for relevant individual- and region-level sources of confounding. RESULTS We recruited 2,370 HCWs. Twenty-seven percent screened positive for depression and 74% for psychological distress. Seven percent reported death wishes. Respondents were more afraid of infecting their loved ones than of getting infected themselves. All work-related stressors were associated with depression symptoms and psychological distress in adjusted models. LIMITATIONS Non-probabilistic sampling, potential reverse causation. CONCLUSIONS Modifiable work-related stressors are associated with worse mental health among HCWs. Our results suggest that workplace prevention strategies for HCWs should provide sufficient protective equipment, minimize changes in job functions, favor the implementation of criteria for patient triage and on-call bioethics committees, and facilitate access to stepped-care, evidence-based mental health treatment.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Malaga, Spain,Andalusian Group of Psychosocial Research (GAP), Andalusia, Spain,Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Irene Martínez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States,Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Andalusia, Spain,Program of Mental Health, Universidad de Chile, Santiago de Chile, Chile
| | - Inés Morán-Sánchez
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain,Cartagena Mental Health Centre, Health Service of Murcia, Murcia, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Andalusia, Spain
| | - Alberto Torres-Cantero
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain,Department of Preventive Medicine, Virgen de la Arrixaca Hospital, Murcia, Spain
| | - Rubén Alvarado
- Program of Mental Health, Universidad de Chile, Santiago de Chile, Chile
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States,New York State Psychiatric Institute, New York, NY, United States
| | - Ezra Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States,New York State Psychiatric Institute, New York, NY, United States
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain,Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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