Challenges facing essential workers: a cross-sectional survey of the subjective mental health and well-being of New Zealand healthcare and ‘other’ essential workers during the COVID-19 lockdown

ObjectivesTo compare psychological outcomes, experiences and sources of stress over the COVID-19 lockdown in New Zealand in essential workers (healthcare and ‘other’ essential workers) with that of workers in nonessential work roles.DesignOnline cross-sectional survey.SettingConducted in New Zealand over level 4 lockdown in April/May 2020.ParticipantsFindings from employed participants (2495) are included in this report; 381 healthcare workers, 649 ‘other’ essential workers and 1465 nonessential workers.Primary and secondary outcome measuresMeasures included psychological distress (Kessler Psychological Distress Scale (K10)), anxiety (Generalised Anxiety Disorder (GAD-7)), well-being (WHO-5), alcohol use, subjective experiences and sources of stress. Differences between work categories were quantified as risk ratios or χ2 tests.ResultsAfter controlling for confounders that differed between groups of essential and nonessential workers, those in healthcare and those in ‘other’ essential work were at 71% (95% CI 1.29 to 2.27) and 59% (95% CI 1.25 to 2.02) greater risk respectively, of moderate levels of anxiety (GAD-7 ≥10), than those in nonessential work. Those in healthcare were at 19% (95% CI 1.02 to 1.39) greater risk of poor well-being (WHO-5 <13). There was no evidence of differences across work roles in risk for psychological distress (K10 ≥12) or increased alcohol use. Healthcare and ‘other’ essential workers reported increased workload (p<0.001) and less uncertainty about finances and employment than those in nonessential work (p<0.001). Healthcare and nonessential workers reported decreased social contact. No difference by work category in health concerns was reported; 15% had concerns about participants’ own health and 33% about other people’s health.ConclusionsDuring the pandemic lockdown, essential workers (those in healthcare and those providing ‘other’ essential work) were at increased risk of anxiety compared with those in nonessential work, with those in healthcare also being at increased risk of poor well-being. This highlights the need to recognise the challenges this vital workforce face in pandemics.

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Psychological distress, loneliness, alcohol use and suicidality in New Zealanders with mental illness during a strict COVID-19 lockdown

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211034317 ◽

2021 ◽

pp. 000486742110343

Author(s):

Caroline Bell ◽

Jonathan Williman ◽

Ben Beaglehole ◽

James Stanley ◽

Matthew Jenkins ◽

...

Keyword(s):

Mental Illness ◽

Psychological Distress ◽

New Zealand ◽

Alcohol Use ◽

Well Being ◽

Psychological Outcomes ◽

Subjective Experiences ◽

Previous Diagnosis ◽

Increased Risk ◽

New Zealanders

Introduction: People with pre-existing mental health conditions may have been disproportionally impacted by the COVID-19 pandemic and associated public health restrictions. In this study, we compared psychological outcomes, experiences and sources of stress over the pandemic lockdown in New Zealanders with and without a previous diagnosis of mental illness. Methods: Two online surveys were conducted in New Zealand over the level 4 lockdown in April 2020 measuring psychological distress, anxiety, well-being, suicidality, alcohol use and subjective experiences. They included 3389 participants, of whom 18.4% reported having been previously diagnosed with a mental illness. Results: During the lockdown, people previously diagnosed with a mental illness had about twice the risk of reporting moderate-high levels of psychological distress (K10 ⩾ 12), at least moderate levels of anxiety (GAD-7 ⩾ 10) and poor well-being (WHO-5 ⩽ 12). They reported increased alcohol use and were about four times as likely to have experienced suicidal thoughts with 3% reporting having made a suicide attempt over the lockdown period. They reported less satisfaction with, and poorer relationships with people in their ‘bubble’, reduced social contacts and greater loneliness. They also reported higher levels of health and financial concerns. Conclusion: During the COVID-19 lockdown in New Zealand, people with a previous diagnosis of a mental illness were at increased risk of detrimental psychological outcomes. This highlights the importance of recognising this and the challenges people face in pandemics.

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Risk perception and psychological state of healthcare workers in referral hospitals during the early phase of the COVID-19 pandemic, Uganda

BMC Psychology ◽

10.1186/s40359-021-00706-3 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Richard Migisha ◽

Alex Riolexus Ario ◽

Benon Kwesiga ◽

Lilian Bulage ◽

Daniel Kadobera ◽

...

Keyword(s):

Psychological Distress ◽

Risk Perception ◽

Healthcare Workers ◽

General Health Questionnaire ◽

Multivariable Analysis ◽

Well Being ◽

Psychological State ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Referral Hospitals

Abstract Background Safeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda. Methods We conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score > 12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress. Results Among 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score > 12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress. Conclusions Forty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID-19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize patient care during the pandemic and future outbreaks, workplace management may consider identifying and addressing HCW concerns, ensuring sufficient PPE and training, and reducing infection-associated stigma.

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Chronic social disruption following a systemic fishery failure

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1913914116 ◽

2019 ◽

Vol 116 (46) ◽

pp. 22912-22914 ◽

Cited By ~ 5

Author(s):

Steven B. Scyphers ◽

J. Steven Picou ◽

Jonathan H. Grabowski

Keyword(s):

Psychological Distress ◽

New England ◽

Gulf Of Maine ◽

Classification Tree ◽

Well Being ◽

The United States ◽

Social Disruption ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Groundfish Fishery

In the United States, the iconic groundfish fishery for Gulf of Maine cod has endured several dramatic reductions in annual catch limits and been federally declared an economic disaster. Using a repeated cross-sectional survey of fishing captains to assess potential social impacts of the fishery failure, we found that psychological distress and social disruption were pervasive throughout New England fishing communities. For instance, our results indicate that 62% of captains self-reported severe or moderate psychological distress 1 y after the crisis began, and these patterns have persisted for 5 y. Using classification tree analyses, we found that low levels of trust in fisheries management was the most powerful predictor of both initial and chronic psychological distress. Distress was most severe among individuals without income diversity and those with dependents in the household. Compared to other aspects of fisheries, measuring and managing for noneconomic social outcomes and human well-being has lagged behind, even though it is a necessary component of mitigating the adverse impacts of fisheries disruptions.

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Psychological Distress and Social Support Availability in Different Family Caregivers of Latinas With Breast Cancer

Journal of Transcultural Nursing ◽

10.1177/1043659619896824 ◽

2019 ◽

pp. 104365961989682

Author(s):

Chris Segrin ◽

Terry Badger ◽

Alla Sikorskii

Keyword(s):

Breast Cancer ◽

Social Support ◽

Psychological Distress ◽

Family Caregivers ◽

Breast Cancer Survivors ◽

Well Being ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Diverse Range

Introduction: Latinas with breast cancer draw on a diverse range of family members for informal care. Latin cultures typically prescribe high levels of support and care for an ill family member that leave caregivers vulnerable to compromised well-being. Method: In this cross-sectional survey study, 258 family caregivers of Latinas with breast cancer completed reports of psychological distress, availability of social support, and acculturation. Results: Mothers who provide care to a daughter with breast cancer experience higher levels of psychological distress and report lower availability of informational support than most other types of family caregivers. Mothers’ lower levels of acculturation may at least partially explain these reductions in well-being. Discussion: This study highlights the diverse range of family and fictive kin who participate in family caregiving for Latina breast cancer survivors. Spousal caregivers may not represent a unique population, whereas mothers as caregivers are indeed distinct for their higher distress levels.

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Prevalence of simultaneous use of alcohol and prescription medication in older adults: findings from a cross-sectional survey (Health Survey for England 2013)

BMJ Open ◽

10.1136/bmjopen-2018-023730 ◽

2019 ◽

Vol 9 (6) ◽

pp. e023730 ◽

Cited By ~ 2

Author(s):

John Foster ◽

Swatee Patel

Keyword(s):

Older Adults ◽

Health Survey ◽

Prescription Drugs ◽

Prescription Medication ◽

Well Being ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Concurrent Use

ObjectivesTo investigate the concurrent use of ‘at-risk’ (AR) drinking (>10 units of alcohol per week) and prescription medications, while controlling for sociodemographic, and health-related factors, among older adults (aged 65–89 years).DesignCross-sectional survey.SettingData from Health Survey of England, 2013.InterventionsNone.ParticipantsGeneral population survey of 2169 adults aged 65–89 years.Primary outcome measuresAR drinking (>10 units per week). Secondary outcome was AR drinking defined as >14 units of alcohol per week limit (the cut-off used by the Department of Health for AT drinking).ResultsTwenty-seven per cent (n=568) of the sample were AR drinkers. Factors associated with alcohol consumption were gender, age, social class, marital status, rurality of dwelling, deprivation index, self-reported general health, cigarette smoking, body mass index, exercise level, health and well-being scores’ and number of prescription drugs. Logistic regression analysis showed that males were more likely to be AR drinkers (OR 3.44, 95% CI 2.59 to 4.57, p<0.0001) than females. Each year increase in age, lowered the probability of AR drinking by a factor of 0.95 (95% CI 0.93 to 0.98, p<0.0001). Using prescription drugs reduced AR drinking by a factor of 0.92 (95% CI 0.85 to 0.93, p=0.033), after controlling for age, sex and rurality of dwelling. No other predictors were significant. Similar results were obtained for AR drinking of >14units per week.ConclusionAR drinking is more likely in older men than women. The odds of AR drinking lessens, as individuals age, and using prescription drugs also reduces AR drinking.

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Sexual health and the Rugby World Cup 2011: a cross-sectional study of sexual health clinics in New Zealand

Sexual Health ◽

10.1071/sh12076 ◽

2012 ◽

Vol 9 (5) ◽

pp. 466 ◽

Cited By ~ 5

Author(s):

Rebecca Psutka ◽

Patricia Priest ◽

Nigel Dickson ◽

Jennie Connor ◽

Sunita Azariah ◽

...

Keyword(s):

New Zealand ◽

Sexual Health ◽

Chlamydial Infection ◽

Cross Sectional Study ◽

Health Clinic ◽

Cross Sectional Survey ◽

World Cup ◽

Cross Sectional ◽

Increased Risk ◽

Sexual Health Clinics

Background We aimed to describe the characteristics of sexual health clinic (SHC) attendance and sexually transmissible infection (STI) diagnoses during the Rugby World Cup (RWC) in New Zealand in 2011. Methods: SHC attendance and STI diagnoses around the time of the RWC were compared with the 5 preceding years. A cross-sectional survey conducted at SHCs in four New Zealand cities collected information from attendees having RWC-related sex. Results: Although there was no statistically significant increase in clinic attendance or STI diagnoses during the RWC compared with previous years, in these four cities, 151 individuals of 2079 attending SHCs for a new concern reported RWC-related sex. The most frequently diagnosed STIs were chlamydial infection (Chlamydia trachomatis), genital warts and genital herpes. Most attendees (74%) who had RWC-related sex had consumed three or more alcoholic drinks; 22% had used a condom. Seven percent of women reported nonconsensual sex. RWC-related sex was associated with an increased risk of STI diagnoses in men: gonorrhoea (Neisseria gonorrhoeae): relative risk (RR) = 4.9 (95% confidence interval (CI): 2.1–11.4); nonspecific urethritis: RR = 2.8 (95% CI: 1.3–5.9); chlamydial infection: RR = 1.8 (95% CI: 1.1–2.9). Using a condom was associated with a reduced risk (RR = 0.3, 95% CI: 0.1–0.9) of diagnosis with any STI among those having RWC-related sex. Conclusions: These findings highlight issues that are amenable to prevention. The continued promotion of condoms as well as a reduction in the promotion and availability of alcohol at such events may reduce sexual health risks as well as other harm.

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Holding the frontline: a cross-sectional survey of emergency department staff well-being and psychological distress in the course of the COVID-19 outbreak

BMC Health Services Research ◽

10.1186/s12913-021-06555-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gijs Hesselink ◽

Lise Straten ◽

Lars Gallée ◽

Anne Brants ◽

Joris Holkenborg ◽

...

Keyword(s):

Emergency Department ◽

Psychological Distress ◽

Perceived Stress ◽

Well Being ◽

Drop Out ◽

World Health ◽

Free Text ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Stress Symptoms

Abstract Background The coronavirus disease 2019 (COVID-19) outbreak has been associated with stress and challenges for healthcare professionals, especially for those working in the front-line of treating COVID-19 patients. This study aimed to: 1) assess changes in well-being and perceived stress symptoms of Dutch emergency department (ED) staff in the course of the first COVID-19 wave, and 2) assess and explore stressors experienced by ED staff since the COVID-19 outbreak. Methods We conducted a cross-sectional study. An online questionnaire was administered during June–July 2020 to physicians, nurses and non-clinical staff of four EDs in the Netherlands. Well-being and stress symptoms (i.e., cognitive, emotional and physical) were scored for the periods pre, during and after the first COVID-19 wave using the World Health Organization Well-Being Index (WHO-5) and a 10-point Likert scale. Stressors were assessed and explored by rating experiences with specific situations (i.e., frequency and intensity of distress) and in free-text narratives. Quantitative data were analyzed with descriptive statistics and generalized estimating equations (GEE). Narratives were analyzed thematically. Results In total, 192 questionnaires were returned (39% response). Compared to pre-COVID-19, the mean WHO-5 index score (range: 0–100) decreased significantly with 14.1 points (p < 0.001) during the peak of the first wave and 3.7 points (< 0.001) after the first wave. Mean self-perceived stress symptom levels almost doubled during the peak of the first wave (≤0.005). Half of the respondents reported experiencing more moral distress in the ED since the COVID-19 outbreak. High levels of distress were primarily found in situations where the staff was unable to provide or facilitate necessary emotional support to a patient or family. Analysis of 51 free-texts revealed witnessing suffering, high work pressure, fear of contamination, inability to provide comfort and support, rapidly changing protocols regarding COVID-19 care and personal protection, and shortage of protection equipment as important stressors. Conclusions The first COVID-19 wave took its toll on ED staff. Actions to limit drop-out and illness among staff resulting from psychological distress are vital to secure acute care for (non-)COVID-19 patients during future infection waves.

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The effect of lockdown due to COVID-19 on mentally ill patients and their caregivers: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210813 ◽

2021 ◽

Vol 8 (3) ◽

pp. 1276

Author(s):

Jayashree Janagam ◽

K. C. Muraleedharan ◽

Deepthi Gilla ◽

N. D. Mohan

Keyword(s):

Mental Health ◽

Mentally Ill ◽

Psychiatric Patients ◽

Psychological Impact ◽

Well Being ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Givers ◽

Increased Risk

Background: Pandemics are known to cause poor mental well-being and an increased risk of mental disorders. The foremost concern emerging from different aspects of COVID-19 is its impact on mental health. There were many surveys conducted on the general population related to the effect of COVID-19 and few studies on its psychological impact but there is sparse literature on how the containment measures affected the psychiatric patients. Objective of the study was to investigate whether the COVID-19 related lockdown affected the subjective mood and behavior of psychiatric patients and their caregivers. The secondary purpose is to assess the difficulties encountered in procuring medicines and the effect of non-availability of homoeopathic medicines if any.Methods: A cross-sectional survey was conducted on mentally ill patients and their care-givers in the Outpatient Department of Psychiatry in National Homoeopathy Research Institute in Mental Health (NHRIMH), Kottayam. Respondents were evaluated with a specially framed questionnaire containing 22 questions to assess the effect of lockdown on psychiatric patients and their caregivers, who attended the OPD after the COVID-19 related lockdown. The data generated through the study are analysed and presented in this article.Results: Out of the total 548 participants (M-65.9%, F-34.1%) who responded to the survey, 290 (53%) cases expressed that they were distressed to be under lockdown. 26.5% of the clients reported worsening of mental health conditions during lockdown compared to pre-lockdown. 54.2% of the patients found difficulty in procuring homoeopathic medicines during Lockdown.Conclusions: Authorities should consider the ways of limiting the effects of confinement on mentally ill patients and their caregivers by developing strategies to mitigate the adverse consequence of the pandemic.

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Identifying cut-off scores for job demands and job control in nursing professionals: a cross-sectional survey in Germany

BMJ Open ◽

10.1136/bmjopen-2017-021366 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021366 ◽

Cited By ~ 8

Author(s):

Sabrina Zeike ◽

Lena Ansmann ◽

Lara Lindert ◽

Christina Samel ◽

Christoph Kowalski ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Care ◽

Job Strain ◽

Job Demands ◽

Well Being ◽

Job Control ◽

Receiver Operating Curve ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional

ObjectivesNurses are generally found to be vulnerable to burnout, but nurses working in cancer care are even more so, since this profession is characterised by continuous confrontation with suffering and death. This study was designed to identify cut-off scores for job strain, that is, low job control and high job demands, for a sample of nurses working in breast cancer care. The main goal was to find cut-off scores, which predict the risk of nurses of developing a mental disorder from high job strain.DesignThe design was a cross-sectional survey study.SettingThe study is based on an employee survey in breast cancer centres in Germany.Participants688 nurses received a questionnaire; 329 nurses from 33 hospitals participated in the survey (return rate: 50.2%).Primary and secondary outcome measuresDependent variable: psychological well-being, measured by the WHO-5 Well-being Index; independent variables: job control and job demands, measured by the Job Content Questionnaire (JCQ).ResultsMultivariable analysis indicates that low job control and high job demands are prognostic factors for low well-being. In a receiver operating curve (ROC) analysis, the cut-off scores, which demonstrated a maximum Youden index, were 34.5 for job control and 31.4 for job demands. The combination of both scales from a logistic regression analysis resulted in an area under the curve of 0.778. Sensitivity and specificity are 70.3% and 74.2%, respectively. The total of correct classification was 63.3%.ConclusionThe determined cut-off scores indicate that there is a risk of becoming psychologically ill from a high workload when an individual reaches a score of ≤34.5 for job control and ≥31.4 for job demands. The described method of establishing risk-based cut-off scores is promising for nursing practice and for the field of occupational health. Transferability and generalisability of the cut-off scores should be further analysed.

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Worried, weary and worn out: mixed-method study of stress and well-being in final-year medical students

BMJ Open ◽

10.1136/bmjopen-2020-040245 ◽

2020 ◽

Vol 10 (12) ◽

pp. e040245

Author(s):

Abbie Lane ◽

Jack McGrath ◽

Eimear Cleary ◽

Allys Guerandel ◽

Kevin M Malone

Keyword(s):

Psychological Distress ◽

Medical Students ◽

Mixed Method ◽

Well Being ◽

Adverse Outcomes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Stress Scale ◽

College Support ◽

Future Work

ObjectiveAlthough there is much focus on burnout and psychological distress among doctors, studies about stress and well-being in medical students are limited but could inform early intervention and prevention strategies.DesignThe primary aim of this mixed-method, cross-sectional survey was to compare objective and subjective levels of stress in final-year medical students (2017) and to explore their perspectives on the factors they considered relevant to their well-being.SettingUniversity College Dublin, the largest university in Ireland.Participants161 of 235 medical students participated in this study (response rate 69%).Results65.2% of students scored over accepted norms for the Perceived Stress Scale (34.8% low, 55.9% moderate and 9.3% high). 35% scored low, 28.7% moderate and 36.3% high on the Subjective Stress Scale. Thematic analysis identified worry about exams, relationships, concern about the future, work–life balance and finance; one in three students reported worry, irritability and hostility; many felt worn out. Cognitive impacts included overthinking, poor concentration, sense of failure, hopelessness and procrastination. Almost a third reported sleep and appetite disturbance, fatigue and weariness. A quarter reported a ‘positive reaction’ to stress. Positive strategies to manage stress included connection and talking, exercise, non-study activity and meditation. Unhelpful strategies included isolation and substance use. No student reported using the college support services or sought professional help.ConclusionMedical students experience high levels of psychological distress, similar to their more senior doctor colleagues. They are disinclined to avail of traditional college help services. Toxic effects of stress may impact their cognition, learning, engagement and empathy and may increase patient risk and adverse outcomes. The focus of well-being in doctors should be extended upstream and embedded in the curriculum where it could prevent future burnout, improve retention to the profession and deliver better outcomes for patients.

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