Characteristics of Hospital Workers Using a Wellbeing Center Implemented During the COVID-19 Pandemic to Prevent the Emotional Impacts of the Crisis

Marguerite d'Ussel, Frédéric Adam, Audrey Fels, Gilles Chatellier, François Philippart, Marguerite d'Ussel, Frédéric Adam, Audrey Fels, Gilles Chatellier, François Philippart

Abstract

Introduction: The COVID-19 pandemic has posed an unprecedented challenge worldwide for healthcare workers (HCWs) and other hospital employees. Disruptions in work and personal life may have led to mental health problems. To prevent or limit the severity of such issues, a local initiative has been implemented in a French hospital: a dedicated lounge, also called "Bulle" (literally bubble and meaning safe space) has been created to provide a quiet caring environment and health support. Other similar wellbeing centers have been implemented in other countries, but very little data are available on their practical effectiveness. The purpose of our study was to assess what type of hospital workers have frequented the Bulle and to describe their psychological state in terms of anxiety, depression, and post-traumatic stress disorder (PTSD) just after the first wave, compared to those who had not come to the Bulle.

Methods: From 15 July to 1 October 2020, a cross-sectional survey was conducted among all workers, collecting demographic information, professional data (experience and satisfaction), emotional experience during the first wave of COVID-19, and psychological specificities, including a history of burnout or symptoms of anxiety, depression, and PTSD. We asked them if they had accessed the Bulle or not.

Results: A total of 675 employees (out of 2,408; 28.0%) fully completed the survey. Approximately 199 respondents (29%) reported having accessed the Bulle during the first wave of the pandemic. Significant symptoms of anxiety, depression, and PTSD were reported by, respectively, 41, 20, and 14% of the participants. Logistic regression analysis showed no relationship between the use of the Bulle and the prevalence of later psychological symptoms. However, employees who benefit from the solicitation of the psychological support team in their hospital unit were secondarily more prone to come to the Bulle [odds ratio (OR), 2.24; 95% confidence interval (95% CI): 1.09; 4.59].

Conclusion: Anxiety, depression, and PTSD were common after the first part of the COVID-19 pandemic, and the attendance in quiet and wellbeing spaces seemed easier with direct internal proactive intervention by psychological teams.

Keywords: COVID-19; anxiety; burnout; depression; healthcare workers; mental health; post-traumatic stress disorder; wellbeing center.

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 © 2022 d'Ussel, Adam, Fels, Chatellier and Philippart.

References

    1. Pereira-Sanchez V, Adiukwu F, El Hayek S, Bytyçi DG, Gonzalez-Diaz JM, Kundadak GK, et al. . COVID-19 effect on mental health: patients and workforce. Lancet Psychiatry. (2020) 7:e29–30. 10.1016/S2215-0366(20)30153-X
    1. Ransing R, Ramalho R, Orsolini L, Adiukwu F, Gonzalez-Diaz JM, Larnaout A, et al. . Can COVID-19 related mental health issues be measured? Brain Behav Immun. (2020) 88:32–4. 10.1016/j.bbi.2020.05.049
    1. Adiukwu F, Orsolini L, Gashi Bytyçi D, El Hayek S, Gonzalez-Diaz JM, Larnaout A, et al. . COVID-19 mental health care toolkit: an international collaborative effort by early career psychiatrists section. Gen Psychiatry. (2020) 33:e100270. 10.1136/gpsych-2020-100270
    1. Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur Psychiatry J Assoc Eur Psychiatr. (2020) 63:e32. 10.1192/j.eurpsy.2020.35
    1. Fiorillo A, Sampogna G, Giallonardo V, Del Vecchio V, Luciano M, Albert U, et al. . Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: results from the COMET collaborative network. Eur Psychiatry J Assoc Eur Psychiatr. (2020) 63:e87. 10.1192/j.eurpsy.2020.89
    1. Cooke JE, Eirich R, Racine N, Madigan S. Prevalence of posttraumatic and general psychological stress during COVID-19: a rapid review and meta-analysis. Psychiatry Res. (2020) 292:113347. 10.1016/j.psychres.2020.113347
    1. Krishnamoorthy Y, Nagarajan R, Saya GK, Menon V. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. (2020) 293:113382. 10.1016/j.psychres.2020.113382
    1. Moccia L, Janiri D, Pepe M, Dattoli L, Molinaro M, De Martin V, et al. . Affective temperament, attachment style, and the psychological impact of the COVID-19 outbreak: an early report on the Italian general population. Brain Behav Immun. (2020) 87:75–9. 10.1016/j.bbi.2020.04.048
    1. Park CL, Russell BS, Fendrich M, Finkelstein-Fox L, Hutchison M, Becker J. Americans' COVID-19 stress, coping, and adherence to CDC guidelines. J Gen Intern Med. (2020) 35:2296–303. 10.1007/s11606-020-05898-9
    1. Pierce M, Hope H, Ford T, Hatch S, Hotopf M, John A, et al. . Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry. (2020) 7:883–92. 10.1016/S2215-0366(20)30308-4
    1. Sheraton M, Deo N, Dutt T, Surani S, Hall-Flavin D, Kashyap R. Psychological effects of the COVID 19 pandemic on healthcare workers globally: a systematic review. Psychiatry Res. (2020) 292:113360. 10.1016/j.psychres.2020.113360
    1. Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. . Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. (2020) 277:55–64. 10.1016/j.jad.2020.08.001
    1. Simon NM, Saxe GN, Marmar CR. Mental health disorders related to COVID-19-related deaths. JAMA. (2020) 324:1493–4. 10.1001/jama.2020.19632
    1. Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA. (2020) 323:1439–40. 10.1001/jama.2020.3972
    1. Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res. (2020) 290:113129. 10.1016/j.psychres.2020.113129
    1. De Kock JH, Latham HA, Leslie SJ, Grindle M, Munoz S-A, Ellis L, et al. . A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health. (2021) 21:104. 10.1186/s12889-020-10070-3
    1. Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, et al. . Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. (2020) 66:1–8. 10.1016/j.genhosppsych.2020.06.007
    1. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic–a review. Asian J Psychiatry. (2020) 51:102119. 10.1016/j.ajp.2020.102119
    1. Batra K, Singh TP, Sharma M, Batra R, Schvaneveldt N. Investigating the psychological impact of COVID-19 among healthcare workers: a meta-analysis. Int J Environ Res Public Health. (2020) 17:9096. 10.3390/ijerph17239096
    1. Ford S . Trusts Setting Up ‘Wobble Rooms’ to Give Nursing Staff Some Covid-19 Respite. Nurs Times (2020). Available online at: (accessed January 24, 2022.
    1. Gurney L, Lockington J, Quinn L, MacPhee M. Why do we need wobble rooms during COVID-19? Nurs Leadersh Tor Ont. (2020) 33:45–50. 10.12927/cjnl.2021.26421
    1. Blake H, Yildirim M, Wood B, Knowles S, Mancini H, Coyne E, et al. . COVID-well: evaluation of the implementation of supported wellbeing centres for hospital employees during the COVID-19 pandemic. Int J Environ Res Public Health. (2020) 17:9401. 10.3390/ijerph17249401
    1. Lefèvre H, Stheneur C, Cardin C, Fourcade L, Fourmaux C, Tordjman E, et al. . The Bulle: support and prevention of psychological decompensation of health care workers during the trauma of the COVID-19 epidemic. J Pain Symptom Manage. (2021) 61:416–22. 10.1016/j.jpainsymman.2020.09.023
    1. Pollock A, Campbell P, Cheyne J, Cowie J, Davis B, McCallum J, et al. . Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev. (2020) 11:CD013779. 10.1002/14651858.CD013779
    1. Putrino D, Ripp J, Herrera JE, Cortes M, Kellner C, Rizk D, et al. . Multisensory, nature-inspired recharge rooms yield short-term reductions in perceived stress among frontline healthcare workers. Front Psychol. (2020) 11:560833. 10.3389/fpsyg.2020.560833
    1. Rimmer A, Chatfield C. What organisations around the world are doing to help improve doctors' wellbeing. BMJ. (2020) 369:m1541. 10.1136/bmj.m1541
    1. Buselli R, Corsi M, Veltri A, Baldanzi S, Chiumiento M, Lupo ED, et al. . Mental health of health care workers (HCWs): a review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19. Psychiatry Res. (2021) 299:113847. 10.1016/j.psychres.2021.113847
    1. Chen L, Michalsen A. Management of chronic pain using complementary and integrative medicine. BMJ. (2017) 357:j1284. 10.1136/bmj.j1284
    1. Nguyen CT. Integrative medicine as a bridge to physician wellness. Otolaryngol–Head Neck Surg. (2018) 158:987–8. 10.1177/0194599818765126
    1. Lin Y-C, Wan L, Jamison RN. Using integrative medicine in pain management: an evaluation of current evidence. Anesth Analg. (2017) 125:2081–93. 10.1213/ANE.0000000000002579
    1. Maunder R. The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned. Philos Trans R Soc Lond B Biol Sci. (2004) 359:1117–25. 10.1098/rstb.2004.1483
    1. Guétin S, Brun L, Deniaud M, Clerc J-M, Thayer JF, Koenig J. Smartphone-based music listening to reduce pain and anxiety before coronarography: a focus on sex differences. Altern Ther Health Med. (2016) 22:60–3.
    1. Chong M-Y, Wang W-C, Hsieh W-C, Lee C-Y, Chiu N-M, Yeh W-C, et al. . Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry J Ment Sci. (2004) 185:127–33. 10.1192/bjp.185.2.127
    1. Su T-P, Lien T-C, Yang C-Y, Su YL, Wang J-H, Tsai S-L, et al. . Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan. J Psychiatr Res. (2007) 41:119–30. 10.1016/j.jpsychires.2005.12.006
    1. Lin C-Y, Peng Y-C, Wu Y-H, Chang J, Chan C-H, Yang D-Y. The psychological effect of severe acute respiratory syndrome on emergency department staff. Emerg Med J EMJ. (2007) 24:12–7. 10.1136/emj.2006.035089
    1. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. . The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry Rev Can Psychiatr. (2009) 54:302–11. 10.1177/070674370905400504
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. (1983) 67:361–70. 10.1111/j.1600-0447.1983.tb09716.x
    1. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res. (2002) 52:69–77. 10.1016/S0022-3999(01)00296-3
    1. Olssøn I, Mykletun A, Dahl AA. The hospital anxiety and depression rating scale: a cross-sectional study of psychometrics and case finding abilities in general practice. BMC Psychiatry. (2005) 5:46. 10.1186/1471-244X-5-46
    1. Lépine JP, Godchau M, Brun P, Lempérière T. [Evaluation of anxiety and depression among patients hospitalized on an internal medicine service]. Ann Med Psychol. (1985) 143:175–89.
    1. Razavi D, Delvaux N, Farvacques C, Robaye E. Screening for adjustment disorders and major depressive disorders in cancer in-patients. Br J Psychiatry J Ment Sci. (1990) 156:79–83. 10.1192/bjp.156.1.79
    1. Bocéréan C, Dupret E. A validation study of the hospital anxiety and depression scale (HADS) in a large sample of French employees. BMC Psychiatry. (2014) 14:354. 10.1186/s12888-014-0354-0
    1. Yao S-N, Cottraux J, Note I, De Mey-Guillard C, Mollard E, Ventureyra V. [Evaluation of post-traumatic stress disorder: validation of a measure, the PCLS]. L'Encephale. (2003) 29:232–8.
    1. Bah AJ, James PB, Bah N, Sesay AB, Sevalie S, Kanu JS. Prevalence of anxiety, depression and post-traumatic stress disorder among Ebola survivors in northern Sierra Leone: a cross-sectional study. BMC Public Health. (2020) 20:1391. 10.1186/s12889-020-09507-6
    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; (2013).
    1. Délibération n° 2018-155 du 3 mai 2018 portant homologation de la méthodologie de référence relative aux traitements de données à caractère personnel mis en œuvre dans le cadre des recherches n'impliquant pas la personne humaine, des études et évaluations dans le domaine de la santé (MR-004) - Légifrance . Available online at: (accessed September 24, 2021).
    1. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. . Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: a large-scale cross-sectional study. EClinicalMedicine. (2020) 24:100424. 10.1016/j.eclinm.2020.100424
    1. Azoulay E, Cariou A, Bruneel F, Demoule A, Kouatchet A, Reuter D, et al. . Symptoms of anxiety, depression, and peritraumatic dissociation in critical care clinicians managing patients with COVID-19. A Cross-Sectional Study Am J Respir Crit Care Med. (2020) 202:1388–98. 10.1164/rccm.202006-2568OC
    1. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. . Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. (2020) 3:e203976. 10.1001/jamanetworkopen.2020.3976
    1. Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland SØ, et al. . The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: a rapid systematic review. Psychiatry Res. (2020) 293:113441. 10.1016/j.psychres.2020.113441
    1. Maharaj S, Lees T, Lal S. Prevalence and risk factors of depression, anxiety, and stress in a cohort of australian nurses. Int J Environ Res Public Health. (2018) 16:61. 10.3390/ijerph16010061
    1. Zhang R, Hou T, Kong X, Wang G, Wang H, Xu S, et al. . PTSD among healthcare workers during the COVID-19 outbreak: a study raises concern for non-medical staff in low-risk areas. Front Psychiatry. (2021) 12:696200. 10.3389/fpsyt.2021.696200
    1. Erquicia J, Valls L, Barja A, Gil S, Miquel J, Leal-Blanquet J, et al. . Emotional impact of the Covid-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe. Med Clin Engl Ed. (2020) 155:434–40. 10.1016/j.medcli.2020.07.006
    1. Buselli R, Baldanzi S, Corsi M, Chiumiento M, Del Lupo E, Carmassi C, et al. . Psychological care of health workers during the COVID-19 outbreak in Italy: preliminary report of an occupational health department (AOUP) responsible for monitoring hospital staff condition. Sustainability. (2020) 12:5039. 10.3390/su12125039
    1. Mellins CA, Mayer LES, Glasofer DR, Devlin MJ, Albano AM, Nash SS, et al. . Supporting the well-being of health care providers during the COVID-19 pandemic: the copecolumbia response. Gen Hosp Psychiatry. (2020) 67:62–9. 10.1016/j.genhosppsych.2020.08.013
    1. Saqib A, Rampal T. Quality improvement report: setting up a staff well-being hub through continuous engagement. BMJ Open Qual. (2020) 9:e001008. 10.1136/bmjoq-2020-001008
    1. Wang M, Zhao Q, Hu C, Wang Y, Cao J, Huang S, et al. . Prevalence of psychological disorders in the COVID-19 epidemic in China: a real world cross-sectional study. J Affect Disord. (2021) 281:312–20. 10.1016/j.jad.2020.11.118
    1. Zhang H, Shi Y, Jing P, Zhan P, Fang Y, Wang F. Posttraumatic stress disorder symptoms in healthcare workers after the peak of the COVID-19 outbreak: a survey of a large tertiary care hospital in Wuhan. Psychiatry Res. (2020) 294:113541. 10.1016/j.psychres.2020.113541
    1. Evanoff BA, Strickland JR, Dale AM, Hayibor L, Page E, Duncan JG, et al. . Work-related and personal factors associated with mental well-being during the COVID-19 response: survey of health care and other workers. J Med Internet Res. (2020) 22:e21366. 10.2196/21366
    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) 180:817–8. 10.1001/jamainternmed.2020.1562
    1. Cawcutt KA, Starlin R, Rupp ME. Fighting fear in healthcare workers during the COVID-19 pandemic. Infect Control Hosp Epidemiol. (2020) 41:1192–3. 10.1017/ice.2020.315
    1. Mohsin SF, Agwan MA, Shaikh S, Alsuwaydani ZA, AlSuwaydani SA. COVID-19: Fear and anxiety among healthcare workers in Saudi Arabia. A cross-sectional study Inquiry. (2021) 58:1–8. 10.1177/00469580211025225
    1. Taylor S, Landry CA, Rachor GS, Paluszek MM, Asmundson GJG. Fear and avoidance of healthcare workers: an important, under-recognized form of stigmatization during the COVID-19 pandemic. J Anxiety Disord. (2020) 75:102289. 10.1016/j.janxdis.2020.102289
    1. Fang M, Xia B, Tian T, Hao Y, Wu Z. Drivers and mediators of healthcare workers' anxiety in one of the most affected hospitals by COVID-19: a qualitative analysis. BMJ Open. (2021) 11:e045048. 10.1136/bmjopen-2020-045048
    1. Alessi EJ, Martin JI. Conducting an internet-based Survey: benefits, pitfalls, and lessons learned. Soc Work Res. (2010) 34:122–8. 10.1093/swr/34.2.122
    1. DSM . Available online at: (accessed June 3, 2022).
    1. Dutheil F, Mondillon L, Navel V. PTSD as the second tsunami of the SARS-CoV-2 pandemic. Psychol Med. (2021) 51:1773–4. 10.1017/S0033291720001336
    1. Underner M, Perriot J, Peiffer G, Jaafari N. COVID-19 et trouble de stress post-traumatique (TSPT) chez les professionnels de santé. Rev Mal Respir. (2021) 38:216–9. 10.1016/j.rmr.2020.11.014
    1. Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. Development and initial validation of the COVID Stress Scales. J Anxiety Disord. (2020) 72:102232. 10.1016/j.janxdis.2020.102232
    1. Shevlin M, Hyland P, Karatzias T. Is posttraumatic stress disorder meaningful in the context of the COVID-19 Pandemic? a response to van overmeire's commentary on Karatzias et al. (2020). J Trauma Stress. (2020) 33:866–8. 10.1002/jts.22592
    1. Kaseda ET, Levine AJ. Post-traumatic stress disorder: a differential diagnostic consideration for COVID-19 survivors. Clin Neuropsychol. (2020) 34:1498–514. 10.1080/13854046.2020.1811894
    1. Van Overmeire R. The methodological problem of identifying criterion a traumatic events during the COVID-19 Era: a commentary on Karatzias et al. (2020). J Trauma Stress. (2020) 33:864–5. 10.1002/jts.22594
    1. Xu J, Zheng Y, Wang M, Zhao J, Zhan Q, Fu M, et al. . Predictors of symptoms of posttraumatic stress in Chinese university students during the 2009 H1N1 influenza pandemic. Med Sci Monit Int Med J Exp Clin Res. (2011) 17:PH60–4. 10.12659/MSM.881836
    1. Park J-S, Lee E-H, Park N-R, Choi YH. Mental health of nurses working at a government-designated hospital during a MERS-CoV outbreak: a cross-sectional study. Arch Psychiatr Nurs. (2018) 32:2–6. 10.1016/j.apnu.2017.09.006

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