Cross-Sectional Study of the Psychological Well-Being of Healthcare Workers in a Large European University Hospital after the COVID-19 Initial Wave

Main Article Content

Emma Sala
Emilio Paraggio
Maria Angela Abrami
Cesare Tomasi
Emanuela Tomasini
Emanuele Sansone
Stefano Barlati
Antonio Vita
Giuseppe De Palma

Keywords

Health care workers, COVID-19, DASS-21, PSS, IES-R, Anxiety, Depression, Stress-related disorders, Psychological support

Abstract

Background: The SARS-CoV-2 pandemic greatly impacted healthcare workers (HCWs) dedicated to caring for COVID-19 patients. The study was conducted in a large European hospital to study the psychological distress of HCWs engaged in COVID-19 wards in the early phase of the pandemic. Methods: A questionnaire was sent to 1229 HCWs aimed at collecting the following information: 1) sociodemographic data; 2) depression, anxiety, and stress scales (DASS-21); 3) event impact scale (IES-R); 4) perceived stress scale (PSS); and 5) work interface analysis. The responses were collected through Google® forms and then statistically analyzed. Regardless of the outcome of the questionnaire, all subjects were offered psychological support voluntarily. Results: Approximately two-thirds of the workers reported no symptoms according to the DASS-21 scales, while the IES-R and PSS scales showed 36% and 43%, respectively. There were no statistically significant differences in the levels of depression investigated through the different scales in the various occupational categories. Symptoms of anxiety, stress, and depression were more pronounced in women, while the highest stress levels were observed in the younger age groups. The highest scores were observed on the DAS-21 scales of anxiety and IES-R but not on the others. Only 51 workers, most of them with previous SARS-CoV-2 infection, sought clinical psychological counseling, and more than half received subsequent psychological support. Conclusions. Our results agree with most of the literature data that anxiety, depression, and stress are associated with gender (female), age (18-44 vs. over 55), and having cared for patients with COVID-19.

Abstract 313 | PDF Downloads 356

References

1. Galea S, Merchant RM, Lurie N. The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention. JAMA Intern Med. 2020;180(6):817-818.
2. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912-920. Doi: 10.1016/S0140-6736(20)30460-8. Epub 2020 Feb 26. PMID: 32112714; PMCID: PMC7158942.
3. Vindegaard N, Michael Eriksen Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020;89:531-542.
4. Rodríguez BO, Sánchez TL. Int Braz. The Psychosocial Impact of COVID-19 on health care workers. J Urol. 2020;46(suppl.1):195-200.
5. Walton M, Murray E, Christian MD. Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. Eur Heart J Acute Cardiovasc Care. 2020;9(3):241-247.
6. Pappa S, Ntella V, Timoleon Giannakas T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907.
7. Raudenská J, Steinerová V, Javůrková A, et al. Occupational burnout syndrome and posttraumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic. Best Pract Res Clin Anesthesiol. 2020;34(3):553-560.
8. Danet A. Psychological impact of COVID-19 pandemic in Western frontline healthcare professionals. A systematic review. Med Clin (Barc). 2021;156(9):449-458. English, Spanish. Doi: 10.1016/j.medcli.2020.11.009. Epub 2021 Jan 1. PMID: 33478809; PMCID: PMC7775650.
9. Norton PJ. Depression Anxiety and Stress Scales (DASS-21): psychometric analysis across four racial groups. Anxiety Stress Coping. 2007;20(3):253-65. Doi: 10.1080/10615800701309279. PMID: 17999228
10. Christianson S, Marren J. The impact of event scale – revised (IES-R) Medsurg. Nurs. 2012;21:321-322.
11. Chew NWS, Lee GKH, Tan BYQ, et al. A multinational, multicenter study on the psychological outcomes and associated physical symptoms among healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88:559-565. Doi: 10.1016/j.bbi.2020.04.049. Epub 2020 Apr 21. PMID: 32330593; PMCID: PMC7172854.
12. Bohlken J, Schömig F, Lemke MR, Pumberger M, Riedel-Heller SG. [COVID-19 Pandemic: Stress Experience of Healthcare Workers - A Short Current Review] Psychiatr Prax. 2020;47(4):190-197.
13. Cohen S, Kamarck T, Mermelstein RA. Global measure of perceived stress. J Health Soc Behav. 1983;24:385‐396.
14. Cohen S, Williamson G. Perceived stress in a probability sample of the United States. The Social Psychology of Health: Claremont Symposium on Applied Social Psychology, 1988; 31-67.
15. Sansone E, Sala E, Albini E, et al. Effectiveness of a digital data gathering system to manage the first pandemic wave among healthcare workers in a main European coronavirus disease 2019 (COVID-19) tertiary-care hospital. Antimicrob Steward Healthc Epidemiol. 2022;e66:1-5.
16. Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020;3.
17. Liang Y, Chen M, Zheng X, Liu J. Screening for Chinese medical staff mental health by SDS and SAS during the outbreak of COVID-19. J Psychosom Res. 2020;133:1101-1102.
18. Cai H, Tu B, Ma J, et al. Psychological impact and coping strategies of frontline medical staff in Hunan between January and March 2020 during the outbreak of coronavirus disease 2019 (COVID19) in Hubei, China. Med Sci Monit. 2020;26-
19. Shah M, Roggenkamp M, Ferrer L, Burger V, Brassil KJ. Mental Health and COVID-19: The Psychological Implications of a Pandemic for Nurses. Clin J Oncol Nurs. 2021;25(1):69-75. Doi: 10.1188/21.CJON.69-75. PMID: 33480882
20. Ralph J, Freeman LA, Ménard AD, Soucie K. Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic. J Health Organ Manag. 2021 Aug 31; ahead-of-print(ahead-of-print). Doi: 10.1108/JHOM-02-2021-0051. PMID: 34455733.
21. Cunningham T, Çayir E. Nurse Leaders Employ Contemplative Practices to Promote Healthcare Professional Well-being and Decrease Anxiety. J Nurs Adm. 2021;51(3):156-161. Doi: 10.1097/NNA.0000000000000987. PMID: 33570373.
22. Labrague LJ. Psychological resilience, coping behaviors and social support among health care workers during the COVID-19 pandemic: A systematic review of quantitative studies. J Nurs Manag. 2021;29(7):1893-1905. Doi: 10.1111/jonm.13336. Epub 2021 Apr 28. PMID: 33843087; PMCID: PMC8250179.
23. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian J Psychiatr. 2020;51:102119.