Taking Care of Those Who Care: Attending Psychological Needs of Health Workers in a Hospital in Madrid (Spain) During the COVID-19 Pandemic

Mónica Jiménez-Giménez, Adela Sánchez-Escribano, Marta María Figuero-Oltra, Javier Bonilla-Rodríguez, Belén García-Sánchez, Natalia Rojo-Tejero, Miguel Ángel Sánchez-González, Laura Muñoz-Lorenzo, Mónica Jiménez-Giménez, Adela Sánchez-Escribano, Marta María Figuero-Oltra, Javier Bonilla-Rodríguez, Belén García-Sánchez, Natalia Rojo-Tejero, Miguel Ángel Sánchez-González, Laura Muñoz-Lorenzo

Abstract

Purpose of review: We aim to review evidence of the psychological impact of the COVID-19 pandemic on healthcare professionals and the effects of the psychological crisis interventions and measures implemented to manage stress.

Recent findings: Mental health problems are frequently encountered in health professionals during emergencies and often prevail over the following years. Results show health professionals exhibited symptoms of depression, anxiety, emotional distress, burnout, post-traumatic stress and poor sleep quality. In response to acute responses to stress, it is crucial to provide psychoeducation, mindfulness and coping resources. These interventions can improve resilience and self-efficacy of professionals, as well as help to prevent anxiety, depression and quality of sleep. The need for intervention programmes targeting the mental health of vulnerable populations has been widely acknowledged. We described a psychological support plan designed and implemented with the aim of providing mental health care for health professionals. Such programmes should be easily accessible to professionals, preferably in their own work environments.

Keywords: COVID-19; Healthcare workers; Psychological impact; Psychological intervention; Trauma.

Figures

Fig. 1
Fig. 1
Attendance at group sessions

References

    1. Organization WH. Estimating mortality from COVID-19: Scientific brief, 4 August 2020. World Health Organization; 2020.
    1. Legido-Quigley H, Mateos-García JT, Campos VR, Gea-Sánchez M, Muntaner C, McKee M. The resilience of the Spanish health system against the COVID-19 pandemic. Lancet Public Health. 2020;5(5):e251–e252. doi: 10.1016/S2468-2667(20)30060-8.
    1. Vieta E, Pérez V, Arango C. Psychiatry in the aftermath of COVID-19. 2020;13(2):105–10.
    1. Tsamakis K, Rizos E, Manolis AJ, Chaidou S, Kympouropoulos S, Spartalis E, et al. [Comment] COVID-19 pandemic and its impact on mental health of healthcare professionals. Exp Ther Med. 2020;19(6):3451–3453.
    1. Ornell F, Halpern SC, Kessler FHP, de Magalhães Narvaez JC. The impact of the COVID-19 pandemic on the mental health of healthcare professionals. Cad Saúde Pública. 2020;36:e00063520. doi: 10.1590/0102-311x00063520.
    1. DePierro J, Lowe S, Katz C. Lessons learned from 9/11: Mental health perspectives on the COVID-19 pandemic. Psychiatry Res. 2020;288:113024. doi: 10.1016/j.psychres.2020.113024.
    1. Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet. 2007;370(9590):841–850. doi: 10.1016/S0140-6736(07)61414-7.
    1. Wang Y-X, Guo H-T, Du X-W, Song W, Lu C, Hao W-N. Factors associated with post-traumatic stress disorder of nurses exposed to corona virus disease 2019 in China. Medicine (Baltimore). 2020;99(26).
    1. Dutheil F, Mondillon L, Navel V. PTSD as the second tsunami of the SARS-Cov-2 pandemic. Psychol Med. 2020:1–2.
    1. Forte G, Favieri F, Tambelli R, Casagrande M. COVID-19 pandemic in the Italian population: validation of a post-traumatic stress disorder questionnaire and prevalence of PTSD symptomatology. Int J Environ Res Public Health. 2020;17(11):4151. doi: 10.3390/ijerph17114151.
    1. Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental health outcomes among frontline and second-line health care workers during the coronavirus disease 2019 (COVID-19) pandemic in Italy. JAMA Netw Open. 2020;3(5):e2010185–5.
    1. Yin Q, Sun Z, Liu T, Ni X, Deng X, Jia Y, et al. Posttraumatic stress symptoms of health care workers during the corona virus disease 2019 (COVID-19). Clin Psychol Psychother. 2020:1–12.
    1. • Vinkers CH, van Amelsvoort T, Bisson JI, Branchi I, Cryan JF, Domschke K, et al. Stress resilience during the coronavirus pandemic. Eur Neuropsychopharmacol. 1 de junio de 2020;35:12–6. This article highlights the need to increase our focus on strategies to enhance resilience.
    1. •• Domínguez-Salas S, Gómez-Salgado J, Andrés-Villas M, Díaz-Milanés D, Romero-Martín M, Ruiz-Frutos C. Psycho-Emotional approach to the psychological distress related to the COVID-19 pandemic in Spain: A Cross-Sectional Observational Study: En: Healthcare. Multidisciplinary Digital Publishing Institute; 2020. p. 190. This cross-sectional observational study examines the influence of psychological distress on preventive behaviours regarding the spread of COVID-19.
    1. Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, Cabrera-Troya J, Carmona-Rega MI, Ortega-Galán ÁM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs [Internet]. [citado 2 de octubre de 2020];n/a(n/a). Disponible en: .
    1. Rodríguez-Rey R, Garrido-Hernansaiz H, Collado S. Psychological impact and associated factors during the initial stage of the coronavirus (COVID-19) pandemic among the general population in Spain. Front Psychol. 2020;11:1540. doi: 10.3389/fpsyg.2020.01540.
    1. Hyun J, You S, Sohn S, Kim S-J, Bae J, Baik M, et al. Psychosocial support during the COVID-19 outbreak in Korea: activities of multidisciplinary mental health professionals. J Korean Med Sci [Internet]. 4 de junio de 2020 [citado 22 de septiembre de 2020];35(22). Disponible en: .
    1. Ransing R, Adiukwu F, Pereira-Sanchez V, Ramalho R, Orsolini L, Teixeira AS, et al. Mental health interventions during the COVID-19 pandemic: a conceptual framework by early career psychiatrists. Asian J Psychiatry. 2020;51.
    1. • Inchausti F, MacBeth A, Hasson-Ohayon I, Dimaggio G. Psychological intervention and COVID-19: what we know so far and what we can do. J Contemp Psychother. 2020:1–8. This article presents a number of important points to consider in identifying and offering support to three groups at risk for psychological morbidity during and after the COVID-19 pandemic.
    1. Ovejero S, Baca-García E, Barrigón ML. Coronovirus infection as a novel delusional topic. Schizophr Res. 2020;222:541–542. doi: 10.1016/j.schres.2020.05.009.
    1. Sánchez-González MÁ. The role of Consultation-Liaison Psychiatry in the COVID-19 pandemic. Prim Care Companion CNS Disord. 2020;22(3).
    1. Sanchez-Alonso S, Ovejero S, Barrigon ML, Baca-Garcia E. Psychotic relapse from COVID-19 quarantine, a case report. Psychiatry Res. 2020;290:113114. doi: 10.1016/j.psychres.2020.113114.
    1. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008;136(7):997–1007. doi: 10.1017/S0950268807009156.
    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. 2009;54(5):302–311. doi: 10.1177/070674370905400504.
    1. Stuijfzand S, Deforges C, Sandoz V, Sajin C-TC-T, Jaques C, Elmers J, et al. Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: A rapid review. BMC Public Health. 2020;20:1230. doi: 10.1186/s12889-020-09322-z.
    1. Braquehais MD, Vargas-Cáceres S, Gómez-Durán E, Nieva G, Valero S, Casas M, et al. The impact of the COVID-19 pandemic on the mental health of healthcare professionals. QJM Int J Med. 2020;113(9):613–617. doi: 10.1093/qjmed/hcaa207.
    1. •• Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological impact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep. 10 de 2020;22(8):43. This theoretical review of the psychological impact of pandemic outbreaks on healthcare workers emphasizes the importance of the assessment and promotion of coping strategies and resilience.
    1. Cabello IR, Meneses Echavez JF, Serrano-Ripoll MJ, et al. medRxiv. April 2020.
    1. •• Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ. 2020;369. This is a comprehensive review and metaanalysis of psychological effects on medical staff and successful measures to manage stress and psychological distress.
    1. Cheah SL, Jackson E, Touyz S, Hay P. Prevalence of eating disorder is lower in migrants than in the Australian-born population. Eat Behav. 2020;37:101370. doi: 10.1016/j.eatbeh.2020.101370.
    1. Liu C-Y, Yang Y, Zhang X-M, Xu X, Dou Q-L, Zhang W-W, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect. 2020:1–17.
    1. Mcfee RB. IX. COVID–19 mental health considerations for health care workers and patients: A brief overview. Dis Mon. 2020.
    1. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun [Internet]. 30 de mayo de 2020 [citado 22 de septiembre de 2020]; Disponible en: .
    1. Xiang Y-T, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228–229. doi: 10.1016/S2215-0366(20)30046-8.
    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(23):9096. doi: 10.3390/ijerph17239096.
    1. Dosil Santamaría M, Ozamiz-Etxebarria N, Redondo Rodríguez I, Jaureguizar Alboniga-Mayor J, Picaza GM. Impacto psicológico de la COVID-19 en una muestra de profesionales sanitarios españoles. Rev Psiquiatr Salud MentBarc Ed Impr. 2020.
    1. Erquicia J, Valls L, Barja A, Gil S, Miquel J, Leal-Blanquet J, et al. Impacto emocional de la pandemia de Covid-19 en los trabajadores sanitarios de uno de los focos de contagio más importantes de Europa. Med Clin (Barc) 2020;155(10):434–440. doi: 10.1016/j.medcli.2020.07.006.
    1. Luceño-Moreno L, Talavera-Velasco B, García-Albuerne Y, Martín-García J. Symptoms of posttraumatic stress, anxiety, depression, levels of resilience and burnout in spanish health personnel during the COVID-19 Pandemic. Int J Environ Res Public Health. 2020;17(15):5514. doi: 10.3390/ijerph17155514.
    1. Alonso Caballero J, Vilagut Saiz G, Mortier P, Ferrer M, Alayo I, Sanz F, et al. Mental health impact of the first wave of COVID-19 pandemic on Spanish healthcare workers: A large cross-sectional survey. Rev Psiquiatr Salud Ment 2020 Dec 10 S1888-9891(20):30128-32.
    1. •• Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occup Environ Med. 2018;60(3):248–57. This systematic review aims to identify relevant actions to minimize the psychological impact of future outbreaks of infectious diseases.
    1. López-Atanes M, Recio-Barbero M, Sáenz-Herrero M. Are women still “the other”? Gendered mental health interventions for health care workers in Spain during COVID-19. Psychol Trauma Theory Res Pract Policy. 2020;12(S1):S243. doi: 10.1037/tra0000751.
    1. García-Fernández L, Romero-Ferreiro V, López-Roldán PD, Padilla S, Calero-Sierra I, Monzó-García M, et al. Mental health impact of COVID-19 pandemic on Spanish healthcare workers. Psychol Med. 2020:1–3.
    1. Havaei F, Ma A, Staempfli S, MacPhee M. Nurses’ workplace conditions impacting their mental health during COVID-19: A cross-sectional survey study: En: Healthcare. Multidisciplinary Digital Publishing Institute; 2021. p. 84.
    1. Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, et al. 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. 2020;87:11–17. doi: 10.1016/j.bbi.2020.03.028.
    1. Li Z, Ge J, Yang M, Feng J, Qiao M, Jiang R, et al. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immun [Internet]. 10 de marzo de 2020 [citado 12 de mayo de 2020]; Disponible en: .
    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. 2 de marzo de 2020;3(3):e203976–6.
    1. Restauri N, Sheridan AD. Burnout and PTSD in the COVID-19 pandemic: Intersection, impact and interventions. J Am Coll Radiol. 2020;17(7):921–926. doi: 10.1016/j.jacr.2020.05.021.
    1. Martínez-López JÁ, Lázaro-Pérez C, Gómez-Galán J, del Mar Fernández-Martínez M. Psychological impact of COVID-19 emergency on health professionals: Burnout incidence at the most critical period in Spain. J Clin Med. 2020;9(9):3029. doi: 10.3390/jcm9093029.
    1. Almaguer AC, Alvarez AKG, Santos EZ. Gestión de seguridad psicológica del personal sanitario en situaciones de emergencia por COVID-19 en el contexto hospitalario o de aislamiento. 30 de abril de 2020 [citado 11 de mayo de 2020]; Disponible en: .
    1. Fagiolini A, Cuomo A, Frank E. COVID-19 diary from a psychiatry department in Italy. J Clin Psychiatry. 2020;81(3):20com13357. doi: 10.4088/JCP.20com13357.
    1. Moreno C, Wykes T, Galderisi S, Nordentoft M, Crossley N, Jones N, et al. How mental health care should change as a consequence of the COVID-19 pandemic. Lancet Psychiatry. 2020.
    1. Miotto K, Sanford J, Brymer MJ, Bursch B, Pynoos RS. Implementing an emotional support and mental health response plan for healthcare workers during the COVID-19 pandemic. Psychol Trauma Theory Res Pract Policy. 2020;12(S1):S165. doi: 10.1037/tra0000918.
    1. Arango C. Lessons learned from the coronavirus health crisis in Madrid, Spain: How COVID-19 has changed our lives in the last 2 weeks. Biol Psychiatry. 2020;88(7):e33–e34. doi: 10.1016/j.biopsych.2020.04.003.
    1. Inchausti F, García Poveda NV, Prado Abril J, Sánchez Reales S, Inchausti F, García Poveda NV, et al. La psicología clínica ante la pandemia COVID-19 en España. Clínica Salud. 2020;31(2):105–107. doi: 10.5093/clysa2020a11.
    1. Tracy DK, Tarn M, Eldridge R, Cooke J, Calder JD, Greenberg N. What should be done to support the mental health of healthcare staff treating covid-19 patients? Br J Psychiatry:1–6.
    1. Organization WH. Mental health and psychosocial considerations during the COVID-19 outbreak. World Health Organization. 18 March 2020:2020.
    1. Ricci Cabello I, Meneses-Echavez JF, Serrano-Ripoll MJ, Fraile-Navarro D, Fiolde Roque MA, Pastor Moreno G, et al. Impact of viral epidemic outbreaks on mental health of healthcare workers: A rapid systematic review and meta-analysis. Available SSRN 3569883. 2020;
    1. Gilmartin H, Goyal A, Hamati M, Mann J, Saint S, Chopra V. Brief mindfulness practices for healthcare providers - a systematic literature review. Am J Med. 1 de julio de 2017;130.
    1. Rodriguez-Vega B, Palao Á, Muñoz-Sanjose A, Torrijos M, Aguirre P, Fernández A, et al. implementation of a mindfulness-based crisis intervention for frontline healthcare workers during the covid-19 outbreak in a Public General Hospital in Madrid, Spain. Front Psychiatry [Internet]. 2020 [citado 15 de marzo de 2021];11. Disponible en: .
    1. Reyes AT. A mindfulness mobile app for traumatized COVID-19 healthcare workers and recovered patients: a response to “the use of digital applications and COVID-19”. Community Ment Health J. 2020;56(7):1204–1205. doi: 10.1007/s10597-020-00690-9.
    1. Kanekar A, Sharma M. COVID-19 and mental well-being: guidance on the application of behavioral and positive well-being strategies. En: Healthcare. Multidisciplinary Digital Publishing Institute; 2020. p. 336.
    1. •• NPT P, Shoesmith WD, James S, Nor Hadi NM, EKB Y, Lin LJ. Ultra brief psychological interventions for COVID-19 pandemic: introduction of a locally-adapted brief intervention for mental health and psychosocial support service. Malays J Med Sci MJMS. marzo de 2020;27(2):51–6. This original article describes the ultra-brief psychological interventions that can be delivered within a short period, used with healthcare providers dealing with COVID-19.
    1. Bäuerle A, Graf J, Jansen C, Musche V, Schweda A, Hetkamp M, et al. E-mental health mindfulness-based and skills-based ‘CoPE It’intervention to reduce psychological distress in times of COVID-19: study protocol for a bicentre longitudinal study. BMJ Open. 2020;10(8):e039646. doi: 10.1136/bmjopen-2020-039646.
    1. Moring JC, Dondanville KA, Fina BA, Hassija C, Chard K, Monson C, et al. Cognitive processing therapy for posttraumatic stress disorder via Telehealth: practical considerations during the COVID-19 pandemic. J Trauma Stress. 2020. 10.1002/jts.22544.
    1. Wu PE, Styra R, Gold WL. Mitigating the psychological effects of COVID-19 on health care workers. CMAJ. 2020;192(17):E459–E460. doi: 10.1503/cmaj.200519.
    1. Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ. 2020;368.
    1. Roycroft M, Wilkes D, Fleming S, Pattani S, Olsson-Brown A. Preventing psychological injury during the covid-19 pandemic. BMJ. 2020;369.
    1. Maben J, Bridges J, et al. J Clin Nurs. 2020;29(15-16):2742–2750. doi: 10.1111/jocn.15307.
    1. •• 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. 2020:2048872620922795. This article details the effect on medical staff, and addresses some of the organisational, team and individual considerations for supporting the staff during this pandemic.
    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;113129.
    1. • Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun [Internet]. 21 de abril de 2020 [citado 12 de mayo de 2020]; Disponible en: . This study shows a significant association between depression, anxiety, stress, and PTSD and the prevalence of physical symptoms experienced in the preceding month.
    1. Cruz-Vargas JADL. Protegiendo al personal de la salud en la pandemia Covid-19. Rev Fac Med Humana. 2020;20(2):3–3.
    1. de Pablo GS, Serrano JV, Catalan A, Arango C, Moreno C, Ferre F, et al. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. J Affect Disord. 2020.
    1. Heath C, Sommerfield A, von Ungern-Sternberg BS. Resilience strategies to manage psychological distress among healthcare workers during the COVID-19 pandemic: a narrative review. Anaesthesia. 2020;75(10):1364–1371. doi: 10.1111/anae.15180.
    1. Huffman EM, Athanasiadis DI, Anton NE, Haskett LA, Doster DL, Stefanidis D, et al. How resilient is your team? Exploring healthcare providers’ well-being during the COVID-19 pandemic. Am J Surg. 2021;221(2):277–284. doi: 10.1016/j.amjsurg.2020.09.005.
    1. Pan Cui P, pan Wang P, Wang K, Ping Z, Wang P, Chen C. Post-traumatic growth and influencing factors among frontline nurses fighting against COVID-19. Occup Environ Med. 2021;78(2):129–35.
    1. Bender AE, Berg KA, Miller EK, Evans KE, Holmes MR. “Making sure we are all okay”: healthcare workers’ strategies for emotional connectedness during the COVID-19 pandemic. Clin Soc Work J [Internet]. 11 de enero de 2021 [citado 15 de marzo de 2021]; Disponible en: 10.1007/s10615-020-00781-w.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa