Mental Health Outcomes in Healthcare Workers in COVID-19 and Non-COVID-19 Care Units: A Cross-Sectional Survey in Belgium

Julien Tiete, Magda Guatteri, Audrey Lachaux, Araxie Matossian, Jean-Michel Hougardy, Gwenolé Loas, Marianne Rotsaert, Julien Tiete, Magda Guatteri, Audrey Lachaux, Araxie Matossian, Jean-Michel Hougardy, Gwenolé Loas, Marianne Rotsaert

Abstract

Background: The literature shows the negative psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on frontline healthcare workers. However, few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not.

Objectives: This survey assessed differences in mental health in physicians and nurses working in COVID-19 or non-COVID-19 medical care units.

Design: A cross-sectional mixed-mode survey was used to assess burnout, insomnia, depression, anxiety, and stress.

Setting: A total of 1,244 physicians and nurses from five general hospitals in Belgium, working in COVID-19 care units (CCU), non-COVID-19 care units (NCCU), or both (CCU + NCCU) were informed of the study.

Participants: Six hundred forty-seven healthcare workers participated in the survey (response rate = 52%).

Measurements: Validated instruments were used to assess the outcomes: the PFI (burnout/professional fulfillment), the ISI (insomnia), and the DASS-21 (depression, anxiety, and stress).

Results: Results showed high prevalence of burnout, insomnia, depression, and anxiety among participants. After adjusting for confounders, multivariate analysis of variance showed no differences between CCU, NCCU, and CCU + NCCU workers. Univariate general linear models showed higher level of burnout, insomnia, and anxiety among nurses in comparison to physicians. Being a nurse, young, isolated, with an increased workload were risk factors for worse mental health outcomes.

Limitations: The mental health of the tested sample, before the outbreak, is unknown. Moreover, this cross-sectional design provides no information on the evolution of the mental health outcomes over time.

Conclusion: Directly caring for patients with COVID-19 is not associated with worse mental health outcomes among healthcare workers in general hospitals. High prevalence of burnout, insomnia, depression, and anxiety among physicians and nurses requires special attention, and specific interventions need to be implemented.

Protocol registration: ClinicalTrials.gov, identifier NCT04344145.

Keywords: COVID-19; Health Psychology; burnout; distress; healthcare workers.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Tiete, Guatteri, Lachaux, Matossian, Hougardy, Loas and Rotsaert.

References

    1. Antony M. M., Bieling P. J., Cox B. J., Enns M. W., Swinson R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychol. Assess. 10 176–181. 10.1037/1040-3590.10.2.176
    1. Bai Y., Lin C. C., Lin C. Y., Chen J. Y., Chue C. M., Chou P. (2004). Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr. Serv. 55 1055–1057. 10.1176/appi.ps.55.9.1055
    1. Cook T. M., El-Boghdadly K., McGuire B., McNarry A. F., Patel A., Higgs A. (2020). Consensus guidelines for managing the airway in patients with COVID-19. Anaesthesia 75 785–799. 10.1111/anae.15054
    1. Fahrenkopf A. M., Sectish T. C., Barger L. K., Sharek P. J., Lewin D., Chiang V. W., et al. (2008). Rates of medication errors among depressed and burnt out residents: prospective cohort study. Br. Med. J. 336 488–491. 10.1136/
    1. Goulia P., Mantas C., Dimitroula D., Mantis D., Hyphantis T. (2010). General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic. BMC Infect. Dis. 10:322. 10.1186/1471-2334-10-322
    1. Johns Hopkins Coronavirus Resource Center (2020). Mortality Analyses. Avaliable online at: (accessed December 15, 2020).
    1. Kang L., Ma S., Chen M., Yang J., Wang Y., Li R., et al. (2020). Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross-sectional study. Brain Behav. Immun. 87 11–17. 10.1016/j.bbi.2020.03.028
    1. Lai J., Ma S., Wang Y., Cai Z., Hu J., Wei H., et al. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw. Open 3:e203976. 10.1001/jamanetworkopen.2020.3976
    1. Lancee W. J., Maunder R. G., Goldbloom D. S. (2008). Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr. Serv. 59 91–95. 10.1176/ps.2008.59.1.91
    1. Lee A. M., Wong J. G., McAlonana G. M., Cheung V., Cheung C., Sham P. C., et al. (2007). Stress and psychological distress among SARS survivors 1 years after the outbreak. Can. J. Psychiatry. 52 233–240. 10.1177/070674370705200405
    1. Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., et al. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med. 382 1199–1207. 10.1056/NEJMoa2001316
    1. Linzer M., Visser M. R., Oort F. J., Smets E. M., McMurray J. E., de Haes H. C., et al. (2001). Predicting and preventing physician burnout: results from the United States and the Netherlands. Am. J. Med. 111 170–175. 10.1016/s0002-9343(01)00814-2
    1. Lovibond S. H., Lovibond P. F. (1995). Manual for the Depression Anxiety & Stress Scales (2nd Ed.). Sydney, NSW: Psychology Foundation.
    1. Lu W., Wang H., Lin Y., Li L. (2020). Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatry Res. 288:112936 10.1016/j.psychres.2020.112936
    1. Lung F. W., Lu Y. C., Chan Y. Y., Shu B. C. (2009). Mental symptoms in different health professionals during the SARS attack: a follow-up study. Psychiatric. Q. 80 107–116.
    1. Matsuishi K., Kawazoe A., Imai H., Ito A., Mouri K., Kitamura N., et al. (2012). Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe. Psychiatry Clin. Neurosci. 66 353–360. 10.1111/j.1440-1819.2012.02336.x
    1. Maunder R., Hunter J., Vincent L., Bennett J., Peladeau N., Leszcz M., et al. (2003). The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Can. Med. Assoc. J. 168 1245–1251.
    1. Maunder R., Lancee W. J., Balderson K. E., Bennett J. P., Borgundvaag B., Evans S., et al. (2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg. Infect. Dis. 12 1924–1932. 10.3201/eid1212.060584
    1. Meo S. A., Alhowikan A. M., Al-khlaiwi T., Meo I. M., Halepoto D. M., Iqbal M., et al. (2020). Novel coronavirus 2019-nCoV: prevalence, biological and clinical characteristics comparison with SARS-CoV and MERS-CoV. Eur. Rev. Med. Pharmacol. Sci. 24 2012–2019.
    1. Morin C. M. (1993). Insomnia: Psychological Assessment and Management. New York, NY: Guilford Press.
    1. Schaufeli W. B., Leiter M. P., Maslach C. (2009). Burnout: 35 years of research and practice. Career Dev. Int. 14 204–220. 10.1108/13620430910966406
    1. Sciensano (2020). COVID-19, Complete Dataset. Avaliable online at: (accessed December 15, 2020).
    1. Shanafelt T. D., Mungo M., Schmitgen J., Storz K. A., Reeves D., Hayes S. N., et al. (2016). Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin. Proc. 91 422–431. 10.1016/j.mayocp.2016.02.001
    1. Tan B., Chew N., Lee G., Jing M., Goh Y., Yeo L. L. L., et al. (2020). Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann. Intern. Med. 173 317–320. 10.7326/M20-1083
    1. Trockel M., Bohman B., Lesure E., Hamidi M. S., Welle D., Roberts L., et al. (2018). A brief instrument to assess both burnout and professional fulfillment in physicians: reliability and validity, including correlation with self-reported medical errors, in a sample of resident and practicing physicians. Acad. Psychiatry. 42 11–24. 10.1007/s40596-017-0849-3
    1. van der Heijden F., Dillingh G., Bakker A., Prins J. (2008). Suicidal thoughts among medical residents with burnout. Arch. Suicide Res. 12 344–346. 10.1080/13811110802325349
    1. Vandenbroeck S., Van Gerven E., De Witte H., Vanhaecht K., Godderis L. (2017). Burnout in Belgian physicians and nurses. Occup. Med. 67 546–554. 10.1093/occmed/kqx126
    1. West C. P., Huschka M. M., Novotny P. J., Sloan J. A., Kolars J. C., Habermann T. M., et al. (2006). Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA 296 1071–1078. 10.1001/jama.296.9.1071
    1. West C. P., Tan A. D., Habermann T. M., Sloan J. A., Shanafelt T. D. (2009). Association of resident fatigue and distress with perceived medical errors. JAMA 302 1294–1300. 10.1001/jama.2009.1389
    1. Wu Y., Wang J., Luo C., Hu S., Lin X., Anderson A. E., et al. (2020). A comparison of burnout frequency among oncology physicians and nurses working on the frontline and usual wards during the COVID-19 epidemic in Wuhan, China. J. Pain Symptom Manage. 60 e61–e65.
    1. Wu Y. C., Chen C. S., Chan Y. J. (2020). The outbreak of Covid-19: an overview. J. Chin. Med. Assoc. 83 217–220.
    1. Wurm W., Vogel K., Holl A., Ebner C., Bayer D., Mörkl S., et al. (2016). Depression-burnout overlap in physicians. PLoS One 11:e0149913. 10.1371/journal.pone.0149913

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit