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Gil-Almagro F, Carmona-Monge FJ, García-Hedrera FJ, Peñacoba-Puente C. Post-Pandemic Insomnia in Healthcare Workers: A Prospective Study including Sociodemographic, Occupational and Psychosocial Variables. J Clin Med 2024; 13:3498. [PMID: 38930028 PMCID: PMC11205185 DOI: 10.3390/jcm13123498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: Previous research points to the prevalence of insomnia during the COVID-19 pandemic among healthcare workers (HCWs). However, longitudinal studies on its evolution, including the post-pandemic stage, are less abundant, with a special lack of research about possible psychosocial risk factors. The aim of the current study is to analyze the evolution of insomnia in Spanish HCWs from the beginning of the pandemic until two years later, examining the influence of sociodemographic, occupational and psychosocial variables. Methods: This was a prospective longitudinal design with three data collection periods in which insomnia was assessed using the Insomnia Severity Index (ISI), in addition to sociodemographic, occupational and psychosocial (i.e., social support, self-efficacy, resilience and cognitive fusion) variables in HCWs (n = 216) who were in direct contact with COVID-19 patients. Results: High scores were observed for insomnia, with a clear decrease throughout the periods studied (F = 30.198, p < 0.001). An association was observed between insomnia and certain sociodemographic and occupational variables (i.e., work category, p = 0.001; availability of Personal Protective Equipment (PPE), p < 0.001; workload, p < 0.001; worry about self or family contagion, p = 0.002, p = 0.003, respectively). Insomnia had negative relationships with social support (p = 0.014), self-efficacy (p < 0.001) and resilience (p < 0.001) and positive relationships with cognitive fusion (p < 0.001). Interaction effects between the evolution of insomnia and social support from friends (p = 0.024, ƞ2 = 0.34) and between the evolution of insomnia and cognitive fusion (p = 0.047; ƞ2 = 0.25) were found. Conclusions: Social support, self-efficacy and resilience act as buffers for insomnia. Cognitive fusion acts as a clear precipitator of insomnia as well as directly influencing its evolution. Social support from friends also affects the evolution of insomnia. Within the specific circumstances of the COVID-19 pandemic, a long-term effect of social support from friends and a short-term effect of cognitive fusion on the evolution of insomnia was observed. The findings emphasize the need to implement specific interventions to promote the mental well-being of HCWs, particularly in crisis contexts that involve an increase in occupational stress, emphasizing the role of certain psychosocial variables as protective factors.
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Affiliation(s)
- Fernanda Gil-Almagro
- Psychology Department, Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Av. de Atenas, s/n, 28922 Madrid, Spain;
- Nurse Intensive Care Unit, Hospital Universitario Fundación Alcorcón, Budapest, 1, 28922 Madrid, Spain;
| | | | | | - Cecilia Peñacoba-Puente
- Psychology Department, Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Av. de Atenas, s/n, 28922 Madrid, Spain;
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2
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Corrigan JP, Browne D, Gilsenan J, Irons C. Evaluating a brief online compassion-focused intervention for intensive care nurses. Nurs Crit Care 2024; 29:303-306. [PMID: 36428235 DOI: 10.1111/nicc.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/16/2022] [Accepted: 11/02/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND High levels of stress have been found within health care staff, particularly in the nursing population, which is somewhat attributed to the Covid-19 pandemic. The development of self-compassion, a protective psychological construct, may promote well-being in the health care staff population. As part of a service development project, the authors delivered and evaluated a brief online compassion-focused intervention with nurses working within Intensive Care Units (ICUs). AIMS Aims were to explore feasibility within the ICU nursing population and consider potential benefits to psychological well-being. METHODS ICU nurses registered for an online, 4 week, compassion-focused intervention as part of a service development project. Measures of compassion, burnout, trauma, and the emotional climate of their work environment were analysed in two groups; those who completed the intervention and those who did not. Baseline and post-intervention measures were analysed to infer the potential benefits of the intervention. RESULTS Compared with their baseline scores, those who completed the intervention showed improvements on measures of compassion, soothing in emotional climate, and reductions in burnout, trauma and threat in emotional climate. At baseline, those who did not complete the intervention scored lower on measures of compassion and soothing within their emotional climate, as well as higher levels of trauma and threat within the emotional climate, compared with those who engaged with the intervention. CONCLUSIONS Brief online compassion-focused interventions may be a useful platform to promote well-being in ICU nurses, but possibly only for those who have a pre-established level of self-compassion. RELEVANCE TO CLINICAL PRACTICE This study demonstrates the value of offering online interventions to improve the mental health of nursing staff. The findings suggest that nurses may benefit from being offered online interventions as welll as traditional psychological interventions. This may shape further service provision by offering nurses who require support a wider range of treatment options.
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Affiliation(s)
- J P Corrigan
- Department of Clinical Psychology, Occupational Health Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Dympna Browne
- Department of Clinical Psychology, Occupational Health Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Jane Gilsenan
- Department of Psychology, Queens University Belfast, Belfast, Northern Ireland
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Lövenmark A, Hammar LM. Being used for the greater good while fighting on the frontline: care staff's experiences of working with older people during the COVID-19 pandemic in Sweden. BMC Geriatr 2024; 24:135. [PMID: 38321402 PMCID: PMC10848549 DOI: 10.1186/s12877-023-04644-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/27/2023] [Indexed: 02/08/2024] Open
Abstract
BAKGROUND Worldwide, older people were more severely affected during the COVID-19 pandemic than others. In Sweden, those living in residential care facilities had the highest mortality rate, followed by those receiving home care services. The Swedish and international literature on the working environment for assistant nurses and care aides during the pandemic shows an increase in stress, anxiety, depression and post-traumatic stress syndromes. Care organisations were badly prepared to prevent the virus from spreading and to protect the staff from stress. In order to be better prepared for possible future pandemics, the health and well-being of the staff, the care of older people and the experiences of the staff both during and after a pandemic are important aspects to take into account. Therefore, this study aims to describe the experiences of assistant nurses and care aides working in the care of older people during the COVID-19 pandemic in Sweden, their working conditions and the impact all this had on their lives. METHODOLOGY The study has a qualitative, descriptive design. The data was collected in four focus group interviews with 21 participants and analysed using qualitative content analysis. RESULTS The results revealed the theme, Being used for the greater good while fighting on the frontline, which was then divided into three categories: portrayed as a risk for older people, not being valued and being burnt out. The worsening working conditions that the pandemic contributed to resulted in a high degree of stress and risk of burnout, with staff members both wanting to and actually leaving their employment. After the pandemic they felt forgotten again and left to cope in an even worse situation than before. CONCLUSIONS The pandemic had a major effect on assistant nurses and care aides in terms of their working environment and their private lives. To be better prepared for future pandemics or disasters, organisations with responsibility for the care of older people will need to ensure that their staff have the necessary competencies and that there is adequate staffing in place. This also means that adequate government funding and multiple interventions will be needed.
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Affiliation(s)
- Annica Lövenmark
- The School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
| | - Lena Marmstål Hammar
- The School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- The School of Health and Welfare, Dalarna University, Falun, Sweden
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Cleary M, West S, Hungerford C. Resilience: One Part of a Larger Toolkit for Managing Stress. Issues Ment Health Nurs 2024; 45:114-117. [PMID: 37672763 DOI: 10.1080/01612840.2023.2239913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, Australia
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O'Dowd E, Lydon S, Ward ME, Kane M, Geary U, Rudland C, O'Connor P. The impact of the COVID-19 pandemic on patient complaints within one Irish teaching hospital. Ir J Med Sci 2023; 192:2563-2571. [PMID: 36787028 PMCID: PMC9926407 DOI: 10.1007/s11845-023-03282-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/12/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic dramatically impacted the delivery of hospital care in terms of quality and safety. OBJECTIVES To examine complaints from two time points, quarter 4 (Q4) 2019 (pre-pandemic) and Q4 2020 (second wave), and explore whether there was a difference in the frequency and/or content of complaints. METHODS A retrospective analysis of complaints from one Irish hospital was conducted using the Healthcare Complaints Analysis Tool (HCAT). Within each complaint, the content, severity, harm reported by the patient, and stage of care were categorised. The complaints were analysed using descriptive statistics and chi-square tests of independence. RESULTS There were 146 complaints received in Q4 2019 and 114 in Q4 2020. Complaint severity was significantly higher in Q4 2019 as compared to Q4 2020. However, there were no other significant differences. Institutional processes (e.g. staffing, resources) were the most common reason for complaints (30% in Q4 2019 and 36% in Q4 2020). The majority of complaints were concerned with care on the ward (23% in Q4 2019 and 31% in Q4 2020). CONCLUSIONS The severity of complaints was significantly higher in Q4 2019 than in Q4 2020, which requires further exploration as the reasons for this are unclear. The lack of a difference in the frequency and content of complaints during the two time periods was unexpected. However, this may be linked to a number of factors, including public support for the healthcare system, existing system-level issues in the hospital, or indeed increased staff collaboration in the context of the COVID-19 crisis.
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Affiliation(s)
- Emily O'Dowd
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland.
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Galway, Ireland.
- Department of Surgical Affairs, RCSI, Dublin, Ireland.
| | - Sinéad Lydon
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Marie E Ward
- Quality and Safety Improvement Directorate, St James's Hospital, Dublin, Ireland
- University of Dublin, Dublin, Ireland
| | - Maria Kane
- Quality and Safety Improvement Directorate, St James's Hospital, Dublin, Ireland
| | - Una Geary
- Quality and Safety Improvement Directorate, St James's Hospital, Dublin, Ireland
| | - Chris Rudland
- National Complaints Governance and Learning Team, Health Service Executive, Catherine Street, Limerick, Ireland
| | - Paul O'Connor
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Galway, Ireland
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6
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De Kock JH, Latham HA. Will we ever be the same again? The mental health impact of the COVID-19 pandemic on health care staff and institutions. Cytopathology 2023; 34:450-455. [PMID: 37128960 DOI: 10.1111/cyt.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
As a group, health care workers (HCWs) were vulnerable to poor mental health (MH) prior to the COVID-19 pandemic. The added burdens of COVID-19 have put extra stressors on the health system and its most precious resource-its workers. This pandemic has exacerbated already poor MH in HCWs, leading to a workforce that is burnt out and struggling to cope with growing demands. Throughout the COVID-19 pandemic, risk factors for poor HCW mental health have been identified. The changes in practices brought about by the COVID-19 pandemic and identified as risk factors for poor MH that were experienced in other areas of health care and medical establishments were also witnessed by HCWs working in cytology. Indeed, all health care staff have been affected by this pandemic, and we now know that MH problems in HCWs are negatively impacting the public health response to the COVID-19 pandemic and its aftermath as they adversely influence quality of care. The question is then rightfully asked: Will we, as health care staff working in medical establishments, ever be the same again, or has COVID-19 forever changed our working lives? Fortunately, protective factors and multi-level interventions associated with adaptive MH outcomes during the COVID-19 pandemic have also been identified. In this article, we conclude that whilst working life is unlikely to return to pre-pandemic practices, the health care system now has an opportunity to promote individual and systemic growth by adhering to the principles that protect HCWs' MH and mitigate burnout during these challenging times.
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Affiliation(s)
- Johannes H De Kock
- Department of Clinical Psychology, New Craigs Psychiatric Hospital, Inverness, UK
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7
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Lowry D, Hevey D, Wilson C, O' Doherty V, O' Sullivan S, Finnerty C, Pender N, D'Alton P, Mulhern S. Wellbeing and mental health outcomes amongst hospital healthcare workers during COVID-19. Ir J Psychol Med 2023; 40:402-410. [PMID: 36782404 DOI: 10.1017/ipm.2023.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Global healthcare systems have been particularly impacted by the COVID-19 pandemic. Healthcare workers (HCWs) are widely reported to have experienced increased levels of baseline psychological distress relative to the general population, and the COVID-19 pandemic may have had an additive effect. However, previous studies are typically restricted to physicians and nurses with limited data available on hospital HCWs. We aimed to conduct a cross-sectional, psychological evaluation of Irish HCWs during COVID-19. METHODS HCWs across five adult acute level-4 Dublin-based hospitals completed an online survey of wellbeing and COVID-19 experience. RESULTS There were 1898 HCWs who commenced the survey representing 10% of the total employee base. The sample comprised nurses (33%), doctors (21%), Health and Social Care Professionals (HSCPs) (24%) and 'Other' disciplines (22%), and 81% identified as female. Clinical levels of depression, anxiety and PTSD symptoms were endorsed by 31%, 34% and 28% of respondents, respectively. Professional grouping effects included: nurses reporting significantly greater levels of COVID-19 exposure, infection, COVID-fear, moral injury, and post-traumatic distress; HSCPs were significantly less likely to report mood dysfunction. In terms of gender, males were significantly less likely to report negative pandemic experiences, low resilience, and significantly more likely to endorse 'minimal' depression, anxiety, and traumatic distress. Logistic regression modelling revealed mental health outcomes (depression, anxiety and PTSD symptoms) were associated with increased frontline exposure, fewer career years' experience, elevated pre-pandemic stress, and female gender. DISCUSSION To our knowledge, this is the largest evaluation of psychological wellbeing amongst HCWs in acute hospitals in the Dublin region. Our findings have implications for healthcare workforce wellbeing and future service delivery.
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Affiliation(s)
- D Lowry
- Department of Psychology, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - D Hevey
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland
| | - C Wilson
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland
| | - V O' Doherty
- Department of Psychology, Tallaght University Hospital, Dublin 24, Ireland
| | - S O' Sullivan
- Department of Psychological Medicine, St James's Hospital, Dublin 8, Ireland
| | - C Finnerty
- Department of Psychology, Mater Misericordiae University Hospital, Dublin 7, Ireland
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland
| | - N Pender
- Department of Psychology, Beaumont University Hospital, Dublin 3, Ireland
| | - P D'Alton
- Department of Psychology, St Vincent's University Hospital, Dublin 4, Ireland
| | - S Mulhern
- Department of Psychology, Mater Misericordiae University Hospital, Dublin 7, Ireland
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8
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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, Aragón-Peña A, Aragonès E, Asúnsolo Del Barco Á, Campos M, Del Cura-González I, Espuga M, González-Pinto A, Haro JM, Larrauri A, López-Fresneña N, Martínez de Salázar A, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig T, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Mortier P. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci 2023; 32:e50. [PMID: 37555258 PMCID: PMC10465320 DOI: 10.1017/s2045796023000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 08/10/2023] Open
Abstract
AIM To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. METHODS This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). RESULTS Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. CONCLUSIONS TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Asociación instituto de investigación en sistemas de salud Biosistemak, Barakaldo, País Vasco, España
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Benedikt L. Amann
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Centre Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Department of Health Services Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department for Psychiatry and Psychotherapy, Hospital of the Ludwig-Maximilians-University Munich, Germany
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Department of Atenció Primària Camp de Tarragona, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel Del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- BIOARABA, UPV-EHU, Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
| | - Josep M. Haro
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Department Facultat de Medicina y Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Amparo Larrauri
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nieves López-Fresneña
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Juan D. Molina
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M. Ortí-Lucas
- Department of Preventive MedicineDepartment, Hospital Clínic Universitari, Valencia, Spain
| | - Mara Parellada
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José M. Pelayo-Terán
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Aurora Pérez-Zapata
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - José I. Pijoan
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Clinical Epidemiology Unit, Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - Nieves Plana
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rius
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Consol Serra
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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9
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Woods EH, Zhang Y, Roemer EC, Kent KB, Davis MF, Goetzel RZ. Addressing Psychosocial, Organizational, and Environmental Stressors Emerging From the COVID-19 Pandemic and Their Effect on Essential Workers' Mental Health and Well-being: A Literature Review. J Occup Environ Med 2023; 65:419-427. [PMID: 36701793 PMCID: PMC10171099 DOI: 10.1097/jom.0000000000002802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study aimed to identify stressors faced by essential workers amid the coronavirus disease pandemic and effective interventions mitigating these stressors. METHODS We reviewed literature on psychosocial, organizational, and environmental stressors faced by essential workers during the pandemic, the consequences of those stressors, and interventions to improve worker health and well-being. FINDINGS Stressors included elevated risk of coronavirus disease 2019 exposure, fear of spreading the virus, lack of social and organizational supports, and financial insecurity. Negative outcomes included burnout, depression, and high turnover. Promising interventions included robust safety protocols, increased wages, childcare benefits, enhanced access to mental health services, and frequent leadership communications. CONCLUSION Stress has taken a heavy toll on essential workers' physical and emotional health, productivity, and job satisfaction. To effectively protect Total Worker Health, employers should adopt evidence-based interventions promoting psychosocial, organizational, and environmental health and safety.
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10
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Myran D, Milani C, Pugliese M, Hensel JM, Sood M, Kendall CE, Kendzerska T, Tanuseputro P. Physician benzodiazepine self-use prior to and during the COVID-19 pandemic in Ontario, Canada: a population-level cohort study. BMJ Open 2023; 13:e062742. [PMID: 37085307 PMCID: PMC10123848 DOI: 10.1136/bmjopen-2022-062742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate physician benzodiazepine (BZD) self-use pre-COVID-19 pandemic and to examine changes in BZD self-use during the first year of the pandemic. DESIGN Population-based retrospective cohort study using linked routinely collected administrative health data comparing the first year of the pandemic to the period before the pandemic. SETTING Province of Ontario, Canada between March 2016 and March 2021. PARTICIPANTS INTERVENTION: Onset of the COVID-19 pandemic in March 2020. OUTCOMES MEASURES The primary outcome measure was the receipt of one or more prescriptions for BZD, which was captured via the Narcotics Monitoring System. RESULTS In a cohort of 30 798 physicians (mean age 42, 47.8% women), we found that during the year before the pandemic, 4.4% of physicians had 1 or more BZD prescriptions. Older physicians (6.8% aged 50+ years), female physicians (5.1%) and physicians with a prior mental health (MH) diagnosis (12.4%) were more likely than younger (3.7% aged <50 years), male physicians (3.8%) and physicians without a prior MH diagnosis (2.9%) to have received 1 or more BZD prescriptions. The first year of the COVID-19 pandemic was associated with a 10.5% decrease (adjusted OR (aOR) 0.85, 95% CI: 0.80 to 0.91) in the number of physicians with 1 or more BZD prescriptions compared with the year before the pandemic. Female physicians were less likely to reduce BZD self-use (aORfemale=0.90, 95% CI: 0.83 to 0.98) compared with male physicians (aORmale=0.79, 95% CI: 0.72 to 0.87, pinteraction=0.046 during the pandemic. Physicians presenting with an incident MH visit had higher odds of filling a BZD prescription during COVID-19 compared with the prior year. CONCLUSIONS Physicians' BZD prescriptions decreased during the first year of the COVID-19 pandemic in Ontario, Canada. These findings suggest that previously reported increases in mental distress and MH visits among physicians during the pandemic did not lead to greater self-use of BZDs.
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Affiliation(s)
- Daniel Myran
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Bruyere Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | - Christina Milani
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Michael Pugliese
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | | | - Manish Sood
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Claire E Kendall
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Tetyana Kendzerska
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Respirology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
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11
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Stanislawski ER, Saali A, Magill EB, Deshpande R, Kumar V, Chan C, Hurtado A, Charney DS, Ripp J, Katz CL. Longitudinal Mental Health Outcomes of Third-year Medical Students Rotating Through the Wards During COVID-19. Psychiatry Res 2023; 320:115030. [PMID: 36623426 PMCID: PMC9791716 DOI: 10.1016/j.psychres.2022.115030] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/27/2022]
Abstract
This study investigated third year medical students' psychological well-being during clinical rotations at Mount Sinai hospitals in New York City during the COVID-19 pandemic. All students (n = 147) starting rotations (psychiatry, surgery, obstetrics-gynecology, neurology, pediatrics, and medicine) could participate in quarterly, online, anonymous surveys comprised of validated screeners for: psychological symptoms, risk, coping, and protective factors, demographics, COVID-19 worries, and stressful clerkship-related events. Associations between variables were examined with Chi-squared, Fisher's exact, t-, Wilcoxon Rank Sum, one-way ANOVA, and McNemar tests. Significant univariate predictors of psychological distress were included in stepwise multivariable linear regression models. The baseline survey was completed by 110 (74.8%) students; ninety-two (62.6%) completed at least one other survey. During the year, 68 (73.9%) students screened positive for depression, anxiety, or PTSD. The prevalence of psychiatric symptoms peaked in June 2020 without significant changes in average scores over time. COVID-19 worries decreased over time but did not influence psychological symptoms at year-end. Eighty-three students (90.2%) experienced stressful clerkship-related events, which were traumatic and/or COVID-19-related for 26 (28.3%) and 22 students (24.0%), respectively. Baseline psychological distress, childhood emotional abuse, and resilience predicted depression, anxiety, and/or PTSD by year-end. This study highlights the importance of recognizing psychological distress and implementing interventions to support students' well-being.
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Affiliation(s)
- Emma R. Stanislawski
- Department of Psychiatry, 22 Bramhall Street, Maine Medical Center, Portland, ME, United States of America,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America,Correspondence author
| | - Alexandra Saali
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Elizabeth B. Magill
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Richa Deshpande
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Vedika Kumar
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd St, Glen Oaks, New York, United States of America
| | - Chi Chan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America,Mental Illness Research, Education, and Clinical Center, James J. Peters VA Medical Center, 130 W Kingsbridge Rd, Bronx, NY, United States of America
| | - Alicia Hurtado
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Dennis S. Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Jonathan Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Craig L. Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
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12
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Canal-Rivero M, Montes-García C, Garrido-Torres N, Moreno-Mellado A, Reguera-Pozuelo P, Ruiz-Veguilla M, Crespo-Facorro B. The impact of COVID-19 pandemic on the psychological well-being among health care workers: A 6-month cohort longitudinal survey study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2023; 16:25-37. [PMID: 36039175 PMCID: PMC9400377 DOI: 10.1016/j.rpsm.2022.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/18/2022] [Indexed: 02/08/2023]
Abstract
Introduction Health care workers (HCW) have been identified as a risk group to suffer psychological burden derived from Coronavirus Disease 19 (COVID-19) pandemic. In addition, possible gender differences in the emotional reactions derived from COVID-19 pandemic have been suggested in this population. The aims of the study were to explore the impact of COVID-19 as well as possible gender differences on mental health status and suicidality in a cohort of HCW. Materials and methods One thousand four hundred and thirty-two HCW responded to an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Mental health status was measured by General Health Questionnaire 28 (GHQ-28) in both time periods. Results HCW informed of a worsening in somatic symptomatology over the follow up period. Gender differences were found in all GHQ-28 dimensions as well in the total score of the questionnaire. Post hoc analyses displayed significant interaction between the time and gender in somatic and anxiety dimensions as well as in GHQ-28 total score. Stress produced by COVID-19 spreading and the feeling of being overwhelmed at work resulted the main predictors of psychological distress although each domain is characterized by a specific set of predictors. Conclusions Somatic reactions represent the most sensitive dimension over the follow-up period. Moreover, women are characterized by a greater psychological distress at the beginning, although these differences tend to disappear over time. Finally, a complex network of factors predicted different dimensions of psychological distress, showing the complexity of prevention in high-risk populations facing major disasters.
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Affiliation(s)
- Manuel Canal-Rivero
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
- CIBERSAM, ISCIII (Spanish Network for Research in Mental Health), Spain
| | - Cristian Montes-García
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
| | - Nathalia Garrido-Torres
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
- CIBERSAM, ISCIII (Spanish Network for Research in Mental Health), Spain
| | - Amanda Moreno-Mellado
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
| | - Pablo Reguera-Pozuelo
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
| | - Miguel Ruiz-Veguilla
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
- CIBERSAM, ISCIII (Spanish Network for Research in Mental Health), Spain
- Department of Psychiatry, School of Medicine, University of Sevilla, Spain
| | - Benedicto Crespo-Facorro
- University Hospital Virgen del Rocio-IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Seville, Spain
- CIBERSAM, ISCIII (Spanish Network for Research in Mental Health), Spain
- Department of Psychiatry, School of Medicine, University of Sevilla, Spain
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13
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Cogan N, Kennedy C, Beck Z, McInnes L, MacIntyre G, Morton L, Tanner G, Kolacz J. ENACT study: What has helped health and social care workers maintain their mental well-being during the COVID-19 pandemic? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6656-e6673. [PMID: 36068667 PMCID: PMC9539329 DOI: 10.1111/hsc.13992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 07/07/2022] [Accepted: 08/20/2022] [Indexed: 06/01/2023]
Abstract
A growing body of research has highlighted the adverse impact of COVID-19 stressors on health and social care workers' (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental well-being of HSCWs during the third lockdown period in Scotland. Using a cross-sectional design, participants (n = 1364) completed an online survey providing quantitative data and free open-text responses. A multi-method approach to analysis was used. The majority of HSCWs were found to have low well-being scores, high levels of COVID-19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut-off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental well-being. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help-seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental well-being. Our findings illuminate the complexity of the effects of the COVID-19 pandemic on HSCWs' well-being and will inform future intervention development seeking to increase positive adaptation and improve staff well-being. Addressing barriers to mental health help-seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.
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Affiliation(s)
- Nicola Cogan
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Chloe Kennedy
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Zoe Beck
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Lisa McInnes
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Gillian MacIntyre
- School of Social Work & Social Policy, University of Strathclyde, Glasgow, UK
| | - Liza Morton
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Gary Tanner
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Jacek Kolacz
- Traumatic Stress Research Consortium (TSRC), Kinsey Institute, Indiana University, Bloomington, Indiana, USA
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14
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Newnham EA, Mergelsberg ELP, Chen Y, Kim Y, Gibbs L, Dzidic PL, Ishida DaSilva M, Chan EYY, Shimomura K, Narita Z, Huang Z, Leaning J. Long term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk and protective factors. Clin Psychol Rev 2022; 97:102203. [PMID: 36162175 DOI: 10.1016/j.cpr.2022.102203] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 07/29/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022]
Abstract
The patterns of long-term psychological response after disasters and pandemics remain unclear. We aimed to determine the trajectories for post-traumatic stress symptoms (PTSS), depression and anxiety prevalence following disasters and pandemic exposure; and identify associated risk and protective factors. A systematic review of the English, Chinese, and Japanese longitudinal mental health literature was conducted. We searched Cochrane, MEDLINE, ProQuest, PsycINFO, PubMed, Web of Science, and CINAHL (English), CNKI and SINOMED (Chinese) and CiNii (Japanese) for studies published between January 2000 and May 2022. Following a pre-specified protocol (PROSPERO: CRD42020206424), conditional linear growth curve models and ANOVA analyses were conducted. The search identified 77,891 papers, with a final sample of 234: 206 English, 24 Chinese, and 4 Japanese-language papers. PTSS rates improved for all ages (p = .018, eta2 = 0.035). In contrast, depression and anxiety prevalence remained elevated for years following exposure (p = .424, eta2 = 0.019 and p = .051, eta2 = 0.064, respectively), with significantly higher rates for children and adolescents (p < .005, eta2 > 0.056). Earthquakes and pandemics were associated with higher prevalence of PTSS (p < .019, eta2 > 0.019). Multi-level risk and protective factors were identified. The chronicity of mental health outcomes highlights a critical need for tailored, sustainable mental health services, particularly for children and adolescents, in disaster- and pandemic-affected settings.
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Affiliation(s)
- Elizabeth A Newnham
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia; Curtin enAble Institute, Kent Street, Bentley, WA, Australia; FXB Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Enrique L P Mergelsberg
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia; Curtin enAble Institute, Kent Street, Bentley, WA, Australia
| | - Yanyu Chen
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia
| | - Yoshiharu Kim
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Lisa Gibbs
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne, Australia
| | - Peta L Dzidic
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia; Curtin enAble Institute, Kent Street, Bentley, WA, Australia
| | - Makiko Ishida DaSilva
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Emily Y Y Chan
- FXB Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, USA; Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Chinese University of Hong Kong, Hong Kong, China; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Kanji Shimomura
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Zui Narita
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Chinese University of Hong Kong, Hong Kong, China
| | - Jennifer Leaning
- FXB Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, USA
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15
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De Kock JH, Latham HA, Cowden RG. The mental health of healthcare workers during the COVID-19 pandemic: a narrative review. Curr Opin Psychiatry 2022; 35:311-316. [PMID: 35855506 DOI: 10.1097/yco.0000000000000805] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Mental health (MH) problems among healthcare workers (HCWs) have the potential to impact negatively on the capacity of health systems to respond effectively to COVID-19. A thorough understanding of the factors that degrade or promote the MH of HCWs is needed to design and implement suitable intervention strategies to support the wellbeing of this population. RECENT FINDINGS MH problems among HCWs were elevated prior to the COVID-19 pandemic. Accumulating evidence indicates that this public health crisis has had a disproportionately negative impact on the MH of specialised populations, including HCWs. Literature from prior health pandemics suggests that the adverse effects of the COVID-19 pandemic on the MH of HCWs are likely to persist in the aftermath of the public health crisis. Primary and secondary risk factors for adverse MH outcomes have been identified and should be considered when implementing interventions to protect the MH of HCWs. SUMMARY The MH of HCWs has been negatively impacted by the COVID-19 pandemic, which is having a detrimental influence on the public health response to COVID-19. Protecting the MH of HCWs both during and beyond this public health crisis should remain a top priority, with particular emphasis on multifaceted interventions that aim to balance the psychological needs of individual HCWs with organisational-level strategies that could be targeted to promote their wellbeing.
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Affiliation(s)
| | | | - Richard G Cowden
- Human Flourishing Program, Harvard University, Cambridge, Massachusetts, USA
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16
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Zhou P, Du N, Xiao Y, Li Y, Li C, Geng T. Mental health status of healthcare workers assisted in Hubei during the initial outbreak of COVID-19 and their influencing factors: a prospective cohort study. BMJ Open 2022; 12:e062664. [PMID: 36038167 PMCID: PMC9438106 DOI: 10.1136/bmjopen-2022-062664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The COVID-19 outbreak beginning in late 2019 has resulted in negative emotions among the public. However, many healthcare workers risked their lives by voluntarily travelling to the worst-hit area, Hubei Province, to support antipandemic work. This study explored the mental health changes in these healthcare workers and tried to discover the influencing factors. DESIGN A longitudinal online survey was begun on 8 February 2020, using the snowball sampling method, and this first phase ended on 22 February 2020 (T1). The follow-up survey was conducted from 8 February to 22 February 2021 (T2). SETTING Healthcare workers from outside of the Hubei area who went to the province to provide medical assistance. PARTICIPANTS 963 healthcare workers who completed both surveys. MEASURES Self-Rating Scale of Sleep (SRSS), Generalised Anxiety Scale (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9). RESULTS There were no significant differences in the SRSS scores or in the GAD-7 scores between T1 and T2 (t=0.994, 0.288; p>0.05). However, the PHQ-9 score at T2 was significantly higher than the score at T1 (t=-10.812, p<0.001). Through multiple linear regression analysis, we found that the following traits could predict higher GAD-7 and PHQ-9 scores at T2: male sex, single marital status, occupation of nurse, lower professional technical titles, healthcare workers having a history of psychosis, treating seriously ill patients, having relatively poor self-perceived health, caring for patients who died and having family members who had been infected with COVID-19. CONCLUSIONS The results indicate that the depression levels of these special healthcare workers increased in the long term, and the initial demographics and experiences related to the pandemic played an important role in predicting their long-term poor mental health. In the future, more appropriate psychological decompression training should be provided for these special healthcare workers.
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Affiliation(s)
- Peng Zhou
- Emergency Department, West China Hospital of Sichuan University, Chengdu, China
| | - Na Du
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Yu Xiao
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Yunge Li
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Chunya Li
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Ting Geng
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
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17
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Power N, Perreault M, Ferrari M, Boudreau P, Boivin DB. Sleep of Healthcare Workers During the COVID-19 Pandemic and the Role of Atypical Work Schedules: A Scoping Review. J Biol Rhythms 2022; 37:358-384. [PMID: 35773789 DOI: 10.1177/07487304221103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has negatively impacted the well-being of healthcare workers (HCWs). HCWs are highly exposed to shift work and their work schedules have been subject to increasing unpredictability since the start of the pandemic. This review aims to: (1) map the studies providing information about factors associated with sleep characteristics in HCWs working in the context of the COVID-19 pandemic during the first and second waves and (2) examine the state of the evidence base in terms of the availability of information on the influence of atypical work schedules. A literature search was performed in PubMed. Studies containing information about factors (demographic; psychological; occupational; COVID-19-specific; work schedule; lifestyle; medical; or other) associated with various sleep characteristics among HCWs working in the context of the COVID-19 pandemic were included. Particular attention was paid to the availability of information on the role of atypical work schedules on HCW sleep. Fifty-seven articles met the inclusion criteria. Most studies were reports of quantitative cross-sectional surveys using self-report measures. Associations between female sex, frontline HCW status, psychological factors, and poorer sleep were observed. Six studies included a measure of shift work in their analyses, 5 of which reported an association between shift work status and sleep. A wide range of factors were investigated, with female sex, frontline HCW status, and psychological factors repeatedly demonstrating associations with poorer sleep. Sleep was predominantly measured in terms of self-reported sleep quality or insomnia symptoms. Few studies investigated the influence of atypical work schedules on HCW sleep in the context of the COVID-19 pandemic. Research on this topic is lacking in terms of reliable and consistent measurements of sleep outcomes, longitudinal data, and knowledge about the influence of covariates such atypical work schedules, comorbidity, and medical history on HCW sleep.
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Affiliation(s)
- Niamh Power
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Michel Perreault
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada
| | - Manuela Ferrari
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada
| | - Philippe Boudreau
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada.,Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Diane B Boivin
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal QC, Canada.,Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Montreal, QC, Canada
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18
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Alonso J, Vilagut G, Alayo I, Ferrer M, Amigo F, Aragón-Peña A, Aragonès E, Campos M, del Cura-González I, Urreta I, Espuga M, González Pinto A, Haro JM, López Fresneña N, Martínez de Salázar A, Molina JD, Ortí Lucas RM, Parellada M, Pelayo-Terán JM, Pérez Zapata A, Pijoan JI, Plana N, Puig MT, Rius C, Rodriguez-Blazquez C, Sanz F, Serra C, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Mortier P. Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey. Epidemiol Psychiatr Sci 2022; 31:e28. [PMID: 35485802 PMCID: PMC9069586 DOI: 10.1017/s2045796022000130] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 01/10/2023] Open
Abstract
AIMS Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.
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Affiliation(s)
- J. Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - G. Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - I. Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M. Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - F. Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A. Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - E. Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tortosa, Spain
| | - M. Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Barcelona, Spain
| | - I. del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - I. Urreta
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital Universitario Donostia, San Sebastián, Spain
| | - M. Espuga
- Occupational Health Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A. González Pinto
- Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - J. M. Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - J. D. Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Francisco de Vitoria University, Madrid, Spain
| | - R. M. Ortí Lucas
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Clínic Universitari, Valencia, Spain
| | - M. Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J. M. Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - A. Pérez Zapata
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - J. I. Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - N. Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - M. T. Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - C. Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - C. Rodriguez-Blazquez
- National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- CIBER Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - F. Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES, Barcelona, Spain
| | - C. Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - E. Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain
| | - V. Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Parc de Salut Mar PSMAR, Barcelona, Spain
| | - P. Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - MINDCOVID Working group
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
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Mehta S, Yarnell C, Shah S, Dodek P, Parsons-Leigh J, Maunder R, Kayitesi J, Eta-Ndu C, Priestap F, LeBlanc D, Chen J, Honarmand K. The impact of the COVID-19 pandemic on intensive care unit workers: a nationwide survey. Can J Anaesth 2022; 69:472-484. [PMID: 34940952 PMCID: PMC8697539 DOI: 10.1007/s12630-021-02175-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To evaluate the impact of the COVID-19 pandemic on Canadian intensive care unit (ICU) workers. METHODS Between June and August 2020, we distributed a cross-sectional online survey of ICU workers evaluating the impact of the pandemic, coping strategies, symptoms of post-traumatic stress disorder (PTSD; Impact of Events Scale-Revised), and psychological distress, anxiety, and depression (Kessler Psychological Distress Scale). We performed regression analyses to determine the predictors of psychological symptoms. RESULTS We analyzed responses from 455 ICU workers (80% women; 67% from Ontario; 279 nurses, 69 physicians, and 107 other healthcare professionals). Respondents felt that their job put them at great risk of exposure (60%), were concerned about transmitting COVID-19 to family members (76%), felt more stressed at work (67%), and considered leaving their job (37%). Overall, 25% had probable PTSD and 18% had minimal or greater psychological distress. Nurses were more likely to report PTSD symptoms (33%) and psychological distress (23%) than physicians (5% for both) and other health disciplines professionals (19% and 14%). Variables associated with PTSD and psychological distress included female sex (beta-coefficient [B], 1.59; 95% confidence interval [CI], 1.20 to 2.10 and B, 3.79; 95% CI, 1.79 to 5.78, respectively; P < 0.001 for differences in scores across groups) and perceived increased risk due to PPE shortage or inadequate PPE training (B, 1.87; 95% CI, 1.51 to 2.31 and B, 4.88; 95% CI, 3.34 to 6.43, respectively). Coping strategies included talking to friends/family/colleagues (80%), learning about COVID-19 (78%), and physical exercise (68%). Over half endorsed the following workplace strategies as valuable: hospital-provided scrubs, clear communication and protocols by hospitals, knowing their voice is heard, subsidized parking, and gestures of appreciation from leadership. CONCLUSIONS This survey study shows that ICU workers have been impacted by the COVID-19 pandemic with high levels of stress and psychological burden. Respondents endorsed communication, protocols, and appreciation from leadership as helpful mitigating strategies.
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Affiliation(s)
- Sangeeta Mehta
- Department of Medicine, Sinai Health; and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
| | - Christopher Yarnell
- Department of Medicine, Sinai Health; and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Sumesh Shah
- Department of Medicine, Sinai Health; and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Dodek
- Center for Health Evaluation and Outcome Sciences and Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeanna Parsons-Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Robert Maunder
- Department of Psychiatry, Sinai Health and University of Toronto, Toronto, ON, Canada
| | | | | | - Fran Priestap
- Department of Surgery, Trauma Program, London Health Sciences Centre, London, ON, Canada
| | - Danielle LeBlanc
- Department of Medicine, Division of Critical Care, Western University, London, ON, Canada
| | - Jennifer Chen
- Department of Medical Biophysics, Western University, London, ON, Canada
| | - Kimia Honarmand
- Department of Medicine, Division of Critical Care, Western University, London, ON, Canada
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20
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Abstract
This review covers the thematic series of 22 papers selected from among manuscripts published by BJPsych Open concerning coronavirus disease 2019 (COVID-19) and healthcare. We report nine papers that cover concepts and epidemiology relating to the public and patients. We review 11 papers about the impact of COVID-19 on healthcare services and their staff in 15 countries. Two papers consider the psychosocial impact on staff working in mental health services in the UK. Most papers report cross-sectional analyses of data collected from convenience samples by self-reported surveys conducted at single times. They have limitations of generalisability, do not enable conclusions about diagnosis or causality, and many are likely to have attendant bias and noise. BJPsych Open published these papers to meet requirements for early indications of the mental health impact of COVID-19 on the public and on healthcare staff. They claim high prevalence of symptoms of anxiety, depression and post-traumatic stress. We contrast these findings with selected reports of studies with different methodologies published elsewhere. We emphasise the need for longitudinal clinical studies with refined sampling and methodological rigour. We identify several longitudinal research programmes; two in this series. We advocate tuning advice offered about caring for the public and healthcare staff to the realities of their circumstances and their perceptions of need in the context of findings from further longitudinal studies. We draw attention to the importance of the social, relationship and environmental circumstances of the public and healthcare staff in order to understand their distress and their risks of developing mental health disorders.
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Affiliation(s)
- Richard Williams
- Professor Emeritus of Mental Health Strategy, Welsh Institute for Health and Social Care, University of South Wales, UK; Presidential Lead for COVID-19, Emergency Preparedness and Mental Health to the Royal College of Psychiatrists, UK; and Director of the Psychosocial and Mental Health Programme for the Faculty of Pre-Hospital Care, Royal College of Surgeons of Edinburgh, UK
| | - Kenneth R Kaufman
- Professor of Psychiatry, Neurology and Anesthesiology, Rutgers Robert Wood Johnson Medical School, USA; and Visiting Professor, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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21
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Riello M, Purgato M, Bove C, Tedeschi F, MacTaggart D, Barbui C, Rusconi E. Effectiveness of self-help plus (SH+) in reducing anxiety and post-traumatic symptomatology among care home workers during the COVID-19 pandemic: a randomized controlled trial. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210219. [PMID: 34849238 PMCID: PMC8611343 DOI: 10.1098/rsos.210219] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 11/08/2021] [Indexed: 05/16/2023]
Abstract
This article describes a randomized controlled trial to evaluate the effectiveness of a supervised online delivery of self-help plus (SH+), during the second wave of COVID-19 contagions in Northern Italy. The SH+ is a psychological intervention developed by the World Health Organization to increase a person's ability to deal with stress. In this trial, it was tested primarily as a tool to reduce anxiety and post-traumatic symptomatology in workers of residential nursing and care homes. In order to partial out non-specific effects of the intervention, the SH+ was compared to an equally supervised and structured alternative activity. Secondarily, in view of future emergencies, the potential of SH+ as a tool to reduce perceived stress, increase subjective well-being and foster individual resilience was explored. At post-intervention, the preregistered analysis revealed no difference in self-reported anxiety and/or post-traumatic symptomatology between the group receiving the SH+ and the group engaged in an alternative activity. Some specific and positive effects of the SH+ intervention were only found on self-reported intervention effectiveness and engagement in exploratory analyses. These findings raise the question whether the previously documented effectiveness of the SH+ on self-reported symptomatology and on the prevention of psychiatric conditions could be attributed mostly to non-specific rather than specific factors connected with participant enrolment in a psychological intervention. Indeed, the effects of the SH+ had been previously compared only to the effects of not being engaged in any alternative activity (often described in the literature as 'treatment as usual'-or 'enhanced treatment as usual', when some relevant information is given to the control group as a one-off). Given the negative findings of this study, before the SH+ is implemented in clinical practice, further studies should be conducted to examine its short- and long-term beneficial effects, by means of randomized studies that employ alternative but similarly structured interventions as control conditions, aiming to minimize the confounding effect of non-specific factors.
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Affiliation(s)
- Marianna Riello
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy
- Gruppo SPES, Trento, Italy
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Psychiatry, University of Verona, Verona, Italy
| | - Chiara Bove
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Psychiatry, University of Verona, Verona, Italy
| | - David MacTaggart
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Psychiatry, University of Verona, Verona, Italy
| | - Elena Rusconi
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy
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