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Wan H, Li H, Luan S, Zhang C. Risk factors of developing psychological problems among frontline healthcare professionals working in the COVID-19 pandemic era: a meta-analysis. BMC Public Health 2023; 23:1991. [PMID: 37828476 PMCID: PMC10571421 DOI: 10.1186/s12889-023-16820-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND This study sought to evaluate the risk factors behind developing psychological problems as per specific mental health assessment instruments. This study focuses specifically on frontline healthcare professionals of the COVID-19 pandemic era, and evaluated the psychological assessment of frontline healthcare professionals. METHODS Studies reporting on the psychological assessment of frontline healthcare professionals were retrieved from the PubMed, Embase, Web of Science, Ovid, EBSCO, and Cochrane Library databases. The recommended method was used to assess the risk of bias of the included studies. The random-effects method was applied when significant heterogeneity was observed. RESULTS The combined results from the 20 included articles indicated that frontline healthcare professionals had a higher risk of developing anxiety in comparison with non-frontline healthcare workers, with similar levels of depression scoring were observed. Healthcare providers aged > 40 years had a lower probability of developing anxiety and seemed to experience minimal depression. Conversely, frontline workers had a higher incidence of anxiety than that of depression. Being single (not in a relationship) could influence the PHQ-9 scores instead of those concerning the GAD-7. The gender gap was not proven to be significantly wide between healthcare professionals with or without anxiety; however, being male was proven to be positively correlated with depression. CONCLUSION In general, the risk factors for susceptibility to psychological problems among frontline healthcare professionals during the COVID-19 pandemic concerned those of a lower age, being single, being male, and being engage in frontline healthcare work.
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Affiliation(s)
- Hongquan Wan
- Department of Mental Health, the First Hospital of Jilin University, No.1 Xinmin Road, Changchun, 130021, China
| | - He Li
- Department of Pain Medicine, the First Hospital of Jilin University, No.1 Xinmin Road, Changchun, 130021, China
| | - Shuxin Luan
- Department of Mental Health, the First Hospital of Jilin University, No.1 Xinmin Road, Changchun, 130021, China.
| | - Chunguo Zhang
- Department of Pain Medicine, the First Hospital of Jilin University, No.1 Xinmin Road, Changchun, 130021, China.
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Deltour V, Poujol AL, Laurent A. Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Ann Intensive Care 2023; 13:66. [PMID: 37477706 PMCID: PMC10361923 DOI: 10.1186/s13613-023-01145-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The ICU (intensive care unit) involves potentially traumatic work for the professionals who work there. This narrative review seeks to identify the prevalence of post-traumatic stress disorder (PTSD) among ICU professionals; how PTSD has been assessed; the risk factors associated with PTSD; and the psychological support proposed. METHODS Three databases and editorial portals were used to identify full-text articles published in English between 2009 and 2022 using the PRISMA method. RESULTS Among the 914 articles obtained, 19 studies met our inclusion criteria. These were undertaken primarily during the Covid-19 period (n = 12) and focused on nurses and assistant nurses (n = 10); nurses and physicians (n = 8); or physicians only (n = 1). The presence of mild to severe PTSD among professionals ranged from 3.3 to 24% before the pandemic, to 16-73.3% after the pandemic. PTSD in ICU professionals seems specific with particularly intense intrusion symptoms. ICU professionals are confronted risk factors for PTSD: confrontation with death, unpredictability and uncertainty of care, and insecurity related to the crisis COVID-19. The studies show that improved communication, feeling protected and supported within the service, and having sufficient human and material resources seem to protect healthcare professionals from PTSD. However, they also reveal that ICU professionals find it difficult to ask for help. CONCLUSION ICU professionals are particularly at risk of developing PTSD, especially since the Covid-19 health crisis. There seems to be an urgent need to develop prevention and support policies for professionals.
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Affiliation(s)
- Victoire Deltour
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Anne-Laure Poujol
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Alexandra Laurent
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France.
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France.
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Kissel KA, Filipek C, Folz E, Jenkins J. The Impact of a 3-Tiered Model of Nursing Redeployment During the COVID-19 Pandemic: A Cross-Sectional Study. Intensive Crit Care Nurs 2023; 77:103431. [PMID: 37060812 PMCID: PMC10027952 DOI: 10.1016/j.iccn.2023.103431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
Objective The COVID-19 pandemic resulted in extreme system pressures, requiring redeployment of nurses to intensive care units (ICUs). We aimed to assess the impacts of a 3-tiered pandemic surge model on nurses working in ICUs during the COVID-19 pandemic. Methodology In this cross-sectional study, 931 nurses (464 ICU and 467 redeployed nurses) who worked within 4 adult ICUs in Western Canada during pandemic surge(s) were invited via email to participate in a survey. The survey explored the impact of redeployment, rapid ICU orientations, just-in-time training, and the 3-tiered model of nursing during pandemic surge. Burnout was measured utilizing the Copenhagen Burnout Inventory questionnaire. Results A total of 191 survey responses were retained (59 ICU nurses and 132 redeployed). Survey results are reported by tier, with outcomes varying based on team leadership, ICU, and redeployment nursing roles. Burnout in personal and workplace domains was present amongst all nursing tiers, while only team leadership roles experienced burnout in the patient domain. Overall, team leadership roles and permanent ICU nurses experienced the highest rates of burnout. Redeployed nurses reported numerous aids to success including support from colleagues, prior experience, and educational supports. Skill-based orientation, ongoing education, optimized scheduling, role clarity, and mitigators of psychological impacts were identified by respondents as potential facilitators of redeployment and surge models. Conclusion Nurses working within this tiered model experienced high degrees of burnout, with highest prevalence amongst team leads and ICU nurses. Optimization of support for and interventions aimed at improving well-being are important considerations going forward.
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Affiliation(s)
- Katherine A Kissel
- Department of Critical Care Medicine, Alberta Health Services, Alberta, Canada. https://twitter.com/@kissel_katie
| | - Christine Filipek
- Department of Critical Care Medicine, Alberta Health Services, Alberta, Canada.
| | - Emma Folz
- Department of Critical Care Medicine, Alberta Health Services, Alberta, Canada. https://twitter.com/@emma_folz
| | - Jessica Jenkins
- Department of Critical Care Medicine, Alberta Health Services, Alberta, Canada; Clinical Associate, Faculty of Nursing, University of Calgary, Alberta, Canada. https://twitter.com/@jessjenkinsNP
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Abstract
BACKGROUND The COVID-19 pandemic resulted in significant system strain, requiring rapid redeployment of nurses to intensive care units. Little is known about the impact of the COVID-19 pandemic and surge models on nurses. OBJECTIVE To identify the impact of the COVID-19 pandemic on nurses working in intensive care units. METHODS A scoping review was performed. Articles were excluded if they concerned nurses who were not caring for critically ill adult patients with COVID-19, did not describe impact on nurses, or solely examined workload or expansion of pediatric intensive care units. RESULTS This search identified 417 unique records, of which 55 met inclusion criteria (37 peer-reviewed and 18 grey literature sources). Within the peer-reviewed literature, 42.7% of participants were identified as intensive care unit nurses, 0.65% as redeployed nurses, and 72.4% as women. The predominant finding was the prevalence of negative psychological impacts on nurses, including stress, distress, anxiety, depression, fear, posttraumatic stress disorder, and burnout. Women and members of ethnic minority groups were at higher risk of experiencing negative consequences. Common qualitative themes included the presence of novel changes, negative impacts, and mitigators of harm during the pandemic. CONCLUSIONS Nurses working in intensive care units during the COVID-19 pandemic experienced adverse psychological outcomes, with unique stressors and challenges observed among both permanent intensive care unit and redeployed nurses. Further research is required to understand the impact of these outcomes over the full duration of the pandemic, among at-risk groups, and within the context of redeployment roles.
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Affiliation(s)
- Katherine A Kissel
- Katherine A. Kissel is a clinical nurse specialist, Department of Critical Care Medicine, Alberta Health Services, Alberta, Canada
| | - Christine Filipek
- Christine Filipek is a clinical nurse educator, Department of Critical Care Medicine, Alberta Health Services
| | - Jessica Jenkins
- Jessica Jenkins is a nurse practitioner, Department of Critical Care Medicine, Alberta Health Services, and a clinical associate, Faculty of Nursing, University of Calgary, Alberta, Canada
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Abstract
PURPOSE OF REVIEW We aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. RECENT FINDINGS The pandemic has resulted in a multitude of closely intertwined professional and personal challenges for ICU HCW. High rates of posttraumatic stress disorder (14-47%), burnout (45-85%), anxiety (31-60%), and depression (16-65%) have been reported, and these mental health symptoms are often interrelated. Most studies suggest that nurses and female HCW are at highest risk for developing mental health symptoms. The main personal concerns associated with reporting mental health symptoms among ICU HCW were worries about transmitting COVID-19 to their families, worries about their own health, witnessing colleagues contract the disease, and experiencing stigma from their communities. Major modifiable work-related risk factors were experiencing poor communication from supervisors, perceived lack of support from administrative leadership, and concerns about insufficient access to personal protective equipment, inability to rest, witnessing hasty end-of-life decisions, and restriction of family visitation policies. SUMMARY The COVID-19 pandemic has severely impacted ICU HCW worldwide. The psychological trauma, manifesting as posttraumatic stress disorder, burnout, anxiety, and depression, is substantial and concerning. Urgent action by lawmakers and healthcare administrators is required to protect ICU HCW and sustain a healthy workforce.
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Carola V, Vincenzo C, Morale C, Cecchi V, Rocco M, Nicolais G. Psychological Health in Intensive Care Unit Health Care Workers after the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:2201. [PMID: 36360545 PMCID: PMC9690339 DOI: 10.3390/healthcare10112201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Although the COVID-19 pandemic had an impact on the general population, health care workers (HCWs) constituted one of the groups that were most adversely affected by the associated risks, owing to the significant consequences on their mental health. This study examined these psychological effects on HCWs who cared for COVID-19 patients who were admitted to the intensive care unit in an Italian hospital. METHODS Subjects were administered several self-reported questionnaires: Kessler 10 Psychological Distress Scale (K10), Perceived Stress Scale-10 (PSS), Impact of Event Scale Revised (IES-R), and Post-traumatic Growth Inventory (PTGI), as well as two open-ended questions oriented toward understanding their positive and negative emotional experience and differentiating between two phases of the emergency. RESULTS Overall, 45% of HCWs showed medium-to-high anxiety/depressive symptoms, whereas 60% presented with medium-to-high levels of perceived stress. In addition, 37% of subjects developed symptoms of PTSD and 50% showed post-traumatic growth in the "appreciation of life" and "new possibilities" dimensions. With regard to the open-ended questions, three themes were identified: quality of workplace relationships, sense of emotional-relational competence, and sense of clinical-technical competence. In addition, two macrocategories of responses were identified in the answers: growth and block. CONCLUSIONS The mental health of HCWs who are involved in the front line of COVID-19 was significantly impacted by this experience, showing high levels of post-traumatic stress and anxiety and depressive symptoms more than 1 year after the emergency began. A qualitative analysis of staff experiences can be a useful guide for structuring interventions and prevention.
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Affiliation(s)
- Valeria Carola
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Cristina Vincenzo
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Chiara Morale
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Valentina Cecchi
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Giampaolo Nicolais
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy
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Salluh JIF, Kurtz P, Bastos LSL, Quintairos A, Zampieri FG, Bozza FA. The resilient intensive care unit. Ann Intensive Care 2022; 12:37. [PMID: 35471746 PMCID: PMC9038989 DOI: 10.1186/s13613-022-01011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background The COVID-19 pandemic tested the capacity of intensive care units (ICU) to respond to a crisis and demonstrated their fragility. Unsurprisingly, higher than usual mortality rates, lengths of stay (LOS), and ICU-acquired complications occurred during the pandemic. However, worse outcomes were not universal nor constant across ICUs and significant variation in outcomes was reported, demonstrating that some ICUs could adequately manage the surge of COVID-19. Methods In the present editorial, we discuss the concept of a resilient Intensive Care Unit, including which metrics can be used to address the capacity to respond, sustain results and incorporate new practices that lead to improvement. Results We believe that a resiliency analysis adds a component of preparedness to the usual ICU performance evaluation and outcomes metrics to be used during the crisis and in regular times. Conclusions The COVID-19 pandemic demonstrated the need for a resilient health system. Although this concept has been discussed for health systems, it was not tested in intensive care. Future studies should evaluate this concept to improve ICU organization for standard and pandemic times.
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Affiliation(s)
- Jorge I F Salluh
- D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30 - 3º andar, Rio de Janeiro, RJ, Brazil.,Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Pedro Kurtz
- D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30 - 3º andar, Rio de Janeiro, RJ, Brazil.,Hospital Copa Star, Rio de Janeiro, RJ, Brazil.,Paulo Niemeyer State Brain Institute (IECPN), Rio de Janeiro, RJ, Brazil
| | - Leonardo S L Bastos
- Department of Industrial Engineering (DEI), Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
| | - Amanda Quintairos
- D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30 - 3º andar, Rio de Janeiro, RJ, Brazil. .,Department of Critical and Intensive Care Medicine, Academic Hospital Fundación Santa Fe de Bogota, Bogota, Colombia.
| | - Fernando G Zampieri
- D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30 - 3º andar, Rio de Janeiro, RJ, Brazil.,HCor Research Institute, Sao Paulo, Brazil
| | - Fernando A Bozza
- D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30 - 3º andar, Rio de Janeiro, RJ, Brazil.,National Institute of Infectious Disease Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil
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8
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Perraud F, Ecarnot F, Loiseau M, Laurent A, Fournier A, Lheureux F, Binquet C, Rigaud JP, Meunier-Beillard N, Quenot JP. A qualitative study of reinforcement workers' perceptions and experiences of working in intensive care during the COVID-19 pandemic: A PsyCOVID-ICU substudy. PLoS One 2022; 17:e0264287. [PMID: 35245297 PMCID: PMC8896724 DOI: 10.1371/journal.pone.0264287] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/07/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE During the COVID pandemic, many hospitals had to mobilize reinforcement healthcare workers, especially in intensive care (ICUs). We investigated the perceptions and experiences of reinforcement workers deployed to ICUs, and the impact of deployment on their personal and professional lives. METHODS For this qualitative study, a random sample of 30 reinforcement workers was drawn from 4 centres participating in the larger PsyCOVID-ICU study. Individual semi-structured interviews were held, recorded, transcribed and analyzed by thematic analysis. RESULTS Thirty interviews were performed from April to May 2021 (22 nurses, 2 anesthesiology nurses, 6 nurses' aides). Average age was 36.8±9.5 years; 7 participants had no ICU experience. Four major themes emerged, namely: (1) Difficulties with integration, especially for those with no ICU experience; (2) lack of training; (3) difficulties with management, notably a feeling of insufficient communication; (4) Mental distress relating to the unusual work and fear of contaminating their entourage. CONCLUSION Healthcare workers deployed as reinforcements to ICUs at the height of the pandemic had a unique experience of the crisis, and identified important gaps in organisation and preparation. They also suffered from a marked lack of training, given the stakes in the management of critically ill patients in the ICU.
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Affiliation(s)
- Florian Perraud
- Service d’Accueil des Urgences, University Hospital Dijon, and Université de Bourgogne Franche-Comté, Dijon, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Besançon, 25000 Besançon, France
- EA3920, University of Burgundy-Franche-Comté, 25000 Besançon, France
| | - Mélanie Loiseau
- Service de Médecine Légale, Cellule d’Urgence Médico-Psychologique de Bourgogne Franche-Comté, University Hospital Dijon, Dijon, France
| | - Alexandra Laurent
- Laboratoire de Psychologie: Dynamiques Relationnelles Et Processus Identitaires (PsyDREPI), Université Bourgogne Franche-Comté, Dijon, France
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Dijon, Dijon, France
| | - Alicia Fournier
- Laboratoire de Psychologie: Dynamiques Relationnelles Et Processus Identitaires (PsyDREPI), Université Bourgogne Franche-Comté, Dijon, France
| | - Florent Lheureux
- Laboratoire de Psychologie, University of Burgundy-Franche-Comté, 25000 Besançon, France
| | - Christine Binquet
- Inserm CIC1432, module Épidémiologie Clinique (CIC-EC)- CHU Dijon-Bourgogne, UFR des Sciences de Santé, Dijon, France
| | - Jean-Philippe Rigaud
- Service de Médecine Intensive-Réanimation, Hospital Centre of Dieppe, Dieppe, France
- Espace de Réflexion Éthique de Normandie, Université de Caen, Caen, France
| | - Nicolas Meunier-Beillard
- CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
- Direction de la Recherche Clinique et de l’Innovation, University Hospital Dijon, Dijon, France
| | - Jean-Pierre Quenot
- Inserm CIC1432, module Épidémiologie Clinique (CIC-EC)- CHU Dijon-Bourgogne, UFR des Sciences de Santé, Dijon, France
- Service de Médecine Intensive-Réanimation, University Hospital Dijon, Dijon, France
- Equipe Lipness, centre de recherche INSERM UMR1231 et LabEx LipSTIC, université de Bourgogne-Franche Comté, Dijon, France
- Espace de Réflexion Éthique Bourgogne Franche-Comté (EREBFC), Dijon, France
- * E-mail:
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Napoli G. Stress and depressive symptoms among Italian mental health nurses during the COVID-19 pandemic, a cross-sectional study. Arch Psychiatr Nurs 2022; 36:41-47. [PMID: 35094824 PMCID: PMC8616576 DOI: 10.1016/j.apnu.2021.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 05/22/2021] [Revised: 07/16/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022]
Abstract
This study used the cross-sectional web survey methodology to assess how the COVID-19 pandemic affected Italian psychiatric nurses in terms of stress levels and depressive symptoms. A total of 266 nurses belonging to the Italian Mental Health Departments were interviewed and they were subjected to two validated scales respectively PSS-10 (for the evaluation of stress) and PHQ-9 (for the evaluation of depressive symptoms). Statistical analysis showed moderate stress levels and a prevalence of sub-threshold (borderline) depressive symptoms among responding nurses. Logistic regression analysis reported that frontline nurses on COVID-19 positive patients are at greater risk of reporting higher levels of stress and major depressive symptoms, as are female nurses and juvenile nurses. age. Monitoring and managing the psychological well-being of nursing staff are to be considered among the priorities of mental health service managers and are part of a process that aims to increase individual and organizational well-being but above all to improve the outcomes resulting from assistance.
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Affiliation(s)
- Giovanni Napoli
- Dipartimento di Salute Mentale, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
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10
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Lucas D, Brient S, Eveillard BM, Gressier A, LeGrand T, Pougnet R, Dewitte JD, Loddé B. Health impact of work stressors and psychosocial perceptions among French hospital workers during the COVID-19 outbreak: a cross-sectional survey. BMJ Open 2022; 12:e053638. [PMID: 34983765 PMCID: PMC8727685 DOI: 10.1136/bmjopen-2021-053638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To compare global health, mental health impact of work stressors and psychosocial perception of healthcare workers (HCWs) and non-HCWs in a hospital after the first peak of the COVID-19 outbreak in France. METHODS A validated version of the SATIN (Santé Au Travail Inrs université Nancy 2)questionnaire with adapted scoring was used to collect data on health and impact of work stressors. This questionnaire was sent to all workers at a hospital in July 2020 and was self-administered online. In a multinomial regression model, we included HCW status, age, gender and front-line worker status as covariates. RESULTS Data from a total of 1405 participants were included. We found that being an HCW, male and front-line worker was a risk factor for negative perception of work demand (OR 7.35, 95% CI 4.2 to 11.47; OR 2.55, 95% CI 1.11 to 5.89; OR 1.78, 95% CI 1.04 to 3.06). Being an HCW was a predictive factor for stress (OR 1.47, 95% CI 1.04 to 2.08), poor global health (OR 1.71, 95% CI 1.14 to 2.55) and negative perception of work activity environment (OR 1.9, 95% CI 1.3 to 2.8). CONCLUSION We have shown that all HCWs suffered from some health impact shortly after the first peak of the COVID-19 outbreak. We underline some stressors with high impact, including work demand, work abilities and organisational context, and emphasise the need for risk management.
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Affiliation(s)
- David Lucas
- Occupational Health Unit, CHU Brest, Brest, France
- Orphy Laboratory, Bretagne Occidentale University, Brest, France
| | | | | | | | | | | | | | - Brice Loddé
- Occupational Health Unit, CHU Brest, Brest, France
- Orphy Laboratory, Bretagne Occidentale University, Brest, France
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Romero-García M, Delgado-Hito P, Gálvez-Herrer M, Antonio Ángel-Sesmero J, Raquel Velasco-Sanz T, Benito-Aracil L, Heras-La Calle G. Moral distress, emotional impact and coping in intensive care units staff during the outbreack of COVID-19. Intensive Crit Care Nurs 2022; 70:103206. [PMID: 35120794 PMCID: PMC8776502 DOI: 10.1016/j.iccn.2022.103206] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 12/27/2022]
Abstract
Background From the beginning, the COVID-19 pandemic increased ICU workloads and created exceptionally difficult ethical dilemmas. ICU staff around the world have been subject to high levels of moral stress, potentially leading to mental health problems. There is only limited evidence on moral distress levels and coping styles among Spanish ICU staff, and how they influenced health professionals’ mental health during the pandemic. Objectives To assess moral distress, related mental health problems (anxiety and depression), and coping styles among ICU staff during the first wave of the COVID-19 pandemic in Spain. Design Cross-sectional. Settings and participants The study setting consisted of intensive care unit and areas converted into intensive care units in public and private hospitals. A total of 434 permanent and temporary intensive care staff (reassigned due to the pandemic from other departments to units) answered an online questionnaire between March and June 2020. Methods Sociodemographic and job variables, moral distress, anxiety, depression, and coping mechanisms were anonymously evaluated through a self-reported questionnaire. Descriptive and correlation analyses were conducted and multivariate linear regression models were developed to explore the predictive ability of moral distress and coping on anxiety and depression. Results Moral distress during the pandemic is determined by situations related to the patient and family, the intensive care unit, and resource management of the organisations themselves. intensive care unit staff already reached moderate levels of moral distress, anxiety, and depression during the first wave of the pandemic. Temporary staff (redeployed from other units) obtained higher scores in these variables (p = 0.04, p = 0.038, and p = 0.009, respectively) than permanent staff, as well as in greater intention to leave their current position (p = 0.03). This intention was also stronger in health staff working in areas converted into intensive care units (45.2%) than in normal intensive care units (40.2%) (p = 0.02). Moral distress, coupled with primarily avoidance-oriented coping styles, explains 37% (AdR2) of the variance in anxiety and 38% (AdR2) of the variance in depression. Conclusions Our study reveals that the emotional well-being of intensive care unit staff was already at risk during the first wave of the pandemic. The moral distress they experienced was related to anxiety and depression issues, as well as the desire to leave the profession, and should be addressed, not only in permanent staff, but also in temporary staff, redeployed to these units as reinforcement workers.
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12
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Baskin RG, Bartlett R. Healthcare worker resilience during the COVID-19 pandemic: An integrative review. J Nurs Manag 2021; 29:2329-2342. [PMID: 34182609 PMCID: PMC8420188 DOI: 10.1111/jonm.13395] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/20/2021] [Accepted: 06/01/2021] [Indexed: 12/13/2022]
Abstract
AIM The purpose of this review was to examine resilience among healthcare workers during the coronavirus-disease-2019 (COVID-19) pandemic. BACKGROUND The COVID-19 pandemic has caused an unprecedented strain on healthcare workers internationally. Rising infection rates, inadequate personal protective equipment, and the lack of availability of hospital beds has resulted in further deterioration of the already-fragile mental health of healthcare workers. Resilient workers have lower rates of burnout and improved patient outcomes. EVALUATION PubMed and the Cumulative Index to Nursing and Allied Health Literature databases were searched using the terms resilience, nurse and COVID-19 to identify studies on resilience during the COVID-19 pandemic. Results were organized by outcome measures for comparison. KEY ISSUES Resilience scores among frontline healthcare workers worldwide during the COVID-19 pandemic in the studies reviewed were overall found to be in the moderate range. Data from the United States showed a decrease in nurse resilience, whereas participants from China had increased resilience compared with pre-pandemic levels. CONCLUSIONS Building resilience in nurses and other healthcare workers can serve as a protective factor against negative outcomes related to the job, including burnout, anxiety and depression, and can improve patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT Strategies for building resilience in healthcare workers are discussed.
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Affiliation(s)
- Rachel G Baskin
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Robin Bartlett
- Capstone College of Nursing, University of Alabama, Tuscaloosa, Alabama, USA
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13
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Scruth E. 2020 the year we wish never was. Aust Crit Care 2021; 34:117-118. [PMID: 33712178 PMCID: PMC7943060 DOI: 10.1016/j.aucc.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Elizabeth Scruth
- NCAL KP Tele Critical Care Program, Clinical Quality Programs and Data Analytics, NCAL Quality - Kaiser Foundation Hospital and Health Plan, 1950 Franklin Street, Oakland, CA 94612, USA
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Flateau C, Noël C, Bonnafoux A, Fuentes E, de Pontfarcy A, Diamantis S. Psychological impact of the SARS-CoV-2 outbreak on the staff of a French hospital. Infect Dis Now 2021; 51:187-193. [PMID: 33495766 PMCID: PMC7816966 DOI: 10.1016/j.idnow.2021.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/04/2021] [Accepted: 01/11/2021] [Indexed: 12/24/2022]
Abstract
Background The outbreak of SARS-CoV-2 has resulted in anxiety, depression and post-traumatic stress disorder (PTSD) among hospital staff. The factors associated with this psychological impact remain to be determined. Methods A cross-sectional study using an online questionnaire completed by the staff of a French hospital, two months after the SARS-CoV-2 outbreak. Results Among the 353 participants (of whom 67% were healthcare professionals), 32% had symptoms of anxiety, 16% of depression and 16% of PTSD. Eleven per cent had initiated or increased treatment with sleeping pills, and 6% with anxiolytics. In a multivariate analysis, factors independently associated with anxiety were: change of professional team, having a relative infected by SARS-CoV-2 and a new/increased treatment with sleeping pills or anxiolytics. The only factor associated with depression was the feeling of risk during professional practice. The factors associated with PTSD were: having a relative infected by SARS-CoV-2, the feeling of risk during professional practice, the increase in smoking and treatment with sleeping pills. The observance of transmission preventive measures (TPM) was not associated with the psychological impact of SARS-CoV-2. A personal history of SARS-CoV-2 infection and age < 36 years were associated with insufficient use of protective equipment. Age < 36 years, and being a healthcare professional were associated with the non-observance of social distancing. Conclusion The hospital staff displayed psychological consequences, resulting in the use of anxiolytics and sleeping pills. Belonging to a group with low-risk of severe disease was associated with lower observance of TPM.
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Affiliation(s)
- C Flateau
- Service des maladies infectieuses, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - C Noël
- Équipe mobile opérationnelle d'hygiène, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - A Bonnafoux
- Pôle médecine, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - E Fuentes
- Pôle médecine, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - A de Pontfarcy
- Service des maladies infectieuses, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
| | - S Diamantis
- Service des maladies infectieuses, Santépôle, groupe hospitalier Sud Île-de-France, 270, avenue Marc-Jacquet, 77000 Melun, France
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