scholarly journals Surviving SARS and living through COVID-19: Healthcare worker mental health outcomes and insights for coping

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258893
Author(s):  
Rima Styra ◽  
Laura Hawryluck ◽  
Allison Mc Geer ◽  
Michelle Dimas ◽  
Jack Sheen ◽  
...  

Objective Explore how previous work during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak affects the psychological response of clinical and non-clinical healthcare workers (HCWs) to the current COVID-19 pandemic. Methods A cross-sectional, multi-centered hospital online survey of HCWs in the Greater Toronto Area, Canada. Mental health outcomes of HCWs who worked during the COVID-19 pandemic and the SARS outbreak were assessed using Impact of Events—Revised scale (IES-R), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9). Results Among 3852 participants, moderate/severe scores for symptoms of post- traumatic stress disorder (PTSD) (50.2%), anxiety (24.6%), and depression (31.5%) were observed among HCWs. Work during the 2003 SARS outbreak was reported by 1116 respondents (29.1%), who had lower scores for symptoms of PTSD (P = .002), anxiety (P < .001), and depression (P < .001) compared to those who had not worked during the SARS outbreak. Multivariable logistic regression analysis showed non-clinical HCWs during this pandemic were at higher risk of anxiety (OR, 1.68; 95% CI, 1.19–2.15, P = .01) and depressive symptoms (OR, 2.03; 95% CI, 1.34–3.07, P < .001). HCWs using sedatives (OR, 2.55; 95% CI, 1.61–4.03, P < .001), those who cared for only 2–5 patients with COVID-19 (OR, 1.59; 95% CI, 1.06–2.38, P = .01), and those who had been in isolation for COVID-19 (OR, 1.36; 95% CI, 0.96–1.93, P = .05), were at higher risk of moderate/severe symptoms of PTSD. In addition, deterioration in sleep was associated with symptoms of PTSD (OR, 4.68, 95% CI, 3.74–6.30, P < .001), anxiety (OR, 3.09, 95% CI, 2.11–4.53, P < .001), and depression (OR 5.07, 95% CI, 3.48–7.39, P < .001). Conclusion Psychological distress was observed in both clinical and non-clinical HCWs, with no impact from previous SARS work experience. As the pandemic continues, increasing psychological and team support may decrease the mental health impacts.

2020 ◽  
Author(s):  
Muna Alshekaili ◽  
Walid Hassan ◽  
Nazik Al Said ◽  
Fatima Alsulaimani ◽  
Sathish Kumar Jayapal ◽  
...  

OBJECTIVE: This study aims to assess and compare demographic and psychological factors and sleep status of frontline HCWs in relation to non-frontline HCWs DESIGN, SETTINGS, AND PARTICIPANTS This cross-sectional study was conducted using an online survey from the 8th to the 17th of April 2020 across varied health care settings in Oman accruing 1139 HCWS. MAIN OUTCOMES AND MEASURES Mental health status was assessed using Depression, Anxiety, and Stress Scales (DASS-21), and insomnia was evaluated by the Insomnia Severity Index (ISI). Samples were categorized into the frontline and non-frontline groups. Chi-square, odds ratio, and independent t-tests were used to compare groups by demographic and mental health outcomes. Results This study included 1139 HCWs working in Oman. There was a total of 368 (32.3%), 388 (34.1%), 271 (23.8%), and 211 (18.5%) respondents reported to have depression, anxiety, stress, and insomnia, respectively while working during the pandemic period. HCWs in the frontline group were 1.4 times more likely to have anxiety (OR=1.401, p=0.007) and stress (OR=1.404, p=0.015) as compared to those working in the non-frontline group. On indices of sleep-wake cycles, HCWs in the frontline group were 1.37 times more likely to report insomnia (OR=1.377, p=0.037) when compared to those working in the non-frontline group. No significant differences in depression status between workers in the frontline and non-frontline groups were found (p=0.181). CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on different grades of HCWs. This study suggests that frontline HCWs are disproportionally affected compared to non-frontline HCWs. The problem with managing sleep-wake cycles and anxiety symptoms were highly endorsed among frontline HCWs. As psychosocial interventions are likely to be constrained owing to the pandemic, mental health care must first be directed to frontline HCWs.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040620 ◽  
Author(s):  
Ru Jia ◽  
Kieran Ayling ◽  
Trudie Chalder ◽  
Adam Massey ◽  
Elizabeth Broadbent ◽  
...  

ObjectivesPrevious pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4–6 weeks of social distancing measures being introduced.DesignCross-sectional online survey.SettingCommunity cohort study.ParticipantsN=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors putting them at increased risk of COVID-19.Main outcome measuresDepression, anxiety and stress scores.ResultsMean scores for depression (x- =7.69, SD=6.0), stress (x- =6.48, SD=3.3) and anxiety (x- = 6.48, SD=3.3) significantly exceeded population norms (all p<0.0001). Analysis of non-modifiable factors hypothesised to be associated with mental health outcomes indicated that being younger, female and in a recognised COVID-19 risk group were associated with increased stress, anxiety and depression, with the final multivariable models accounting for 7%–14% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54%–57% of total variance.ConclusionsIncreased psychological morbidity was evident in this UK sample and found to be more common in younger people, women and in individuals who identified as being in recognised COVID-19 risk groups. Public health and mental health interventions able to ameliorate perceptions of risk of COVID-19, worry about COVID-19 loneliness and boost positive mood may be effective.


2016 ◽  
Vol 26 (3) ◽  
pp. 276-286 ◽  
Author(s):  
L. Saxon ◽  
N. Makhashvili ◽  
I. Chikovani ◽  
M. Seguin ◽  
M. McKee ◽  
...  

Aims.Adults who experienced the 1992 and 2008 armed conflicts in the Republic of Georgia were exposed to multiple traumatic events and stressors over many years. The aim was to investigate what coping strategies are used by conflict-affected persons in Georgia and their association with mental disorders.Method.A cross-sectional survey was conducted with 3600 adults, representing internally displaced persons (IDPs) from conflicts in the 1990s (n = 1200) and 2008 (n = 1200) and former IDPs who returned to their homes after the 2008 conflict (n = 1200). Post-traumatic stress disorder, depression, anxiety and coping strategies were measured using the Trauma Screening Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety and adapted version of the Brief Coping Inventory, respectively. Descriptive and multivariate regression analyses were used.Results.Coping strategies such as use of humour, emotional support, active coping, acceptance and religion were significantly associated with better mental health outcomes. Coping strategies of behavioural and mental disengagement, denial, venting emotions, substance abuse and gambling were significantly associated with poorer mental health outcomes. The reported use of coping strategies varied significantly between men and women for 8 of the 15 strategies addressed.Conclusions.Many conflict-affected persons in Georgia are still suffering mental health problems years after the conflicts. A number of specific coping strategies appear to be associated with better mental health and should be encouraged and supported where possible.


Work ◽  
2020 ◽  
Vol 67 (2) ◽  
pp. 285-293
Author(s):  
Stefanie Mache ◽  
Monika Bernburg ◽  
David Groneberg ◽  
Volker Harth

BACKGROUND: Previous research studies have demonstrated that neuro-enhancement, the use of legal or illegal drugs by healthy individuals to improve their job performance, is practiced among employees. Researchers discussed possible reasons for employees to consider the use of substances for neuro-enhancement. OBJECTIVE: The aim of this study was to identify the prevalence of usage and motives for practicing neuro-enhancement among a sample of German junior physicians. The secondary objective was to determine associations between neuro-enhancement, mental health outcomes and quality of life. METHODS: This cross-sectional study included an online survey to analyze junior physicians’ neuro-enhancement stimulant use and their motives for usage (n = 873). Second, mental health outcomes and quality of life were assessed. Descriptive and analytic (Kruskal Wallis test, logistic regression) statistics were obtained. RESULTS: Of the 873 junior physicians, 18% reported having used stimulants for neuro- enhancement. 8% of the physicians have taken prescription stimulants (e.g. modafinil) or illicit drugs (e.g. cannabis) at least once in their lifetime. The most common reasons for taking stimulants were to enhance concentration, to relax and to increase alertness. Neuro-enhancement was associated with emotional exhaustion (p < 0.01), lower quality of life (p < 0.05) and work-related stress (p < 0.01). CONCLUSIONS: Our study results give an overview on the actual situation regarding frequency and motives for taking performance-enhancing substances. The prevalence rate was low in comparison to current public debates. Decreasing the prevalence of neuro-enhancement among physicians requires the implementation of strategies targeting stress reduction and workload management.


Author(s):  
Natasha Smallwood ◽  
Amy Pascoe ◽  
Leila Karimi ◽  
Marie Bismark ◽  
Karen Willis

Background: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic. Methods: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout. Results: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19. Conclusions: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.


Author(s):  
Lily O'Hara ◽  
Hanan Abdul Rahim ◽  
Zumin Shi

Introduction: Trust in government to take care of its citizens may affect mental health outcomes such as anxiety and depression, particularly as measures become more stringent. The study aimed to investigate the associations between stringency of COVID-19 social distancing policies and mental health outcomes, and the moderating effects of trust in government and gender. Methods: The study consisted of secondary analysis of publicly available cross sectional data from a global online survey COVID-19 survey conducted between 20 March and 7 April 2020. There were 106,497 adult participants (18 years of age and over) from 58 countries. The main outcome measures were indices for depression and worries. The exposure measure was the stringency index. The effect modifier measures were gender and trust in government. Multivariable regression was conducted to determine the three-way interaction between the exposure, modifier and outcome measures, adjusting for age, income and education. Results: The median age of participants (56.4% women) was 37 years. Women had higher worries and depression than men. The proportion of people trusting (44%) and distrusting (45%) the government was almost the same. Among those who strongly trusted the government, an increase in policy stringency was associated with an increase in worries. Among men who distrusted the government, an increase in policy stringency was associated with an increase in depression, but in distrusting women there was an inversed Ushaped association between policy stringency and both worries and depression. Once policies exceeded the 50-point mark on the stringency index, women benefited from the most stringent policies, yet men did not, particularly men who strongly trust or distrust the government. Conclusion: As the stringency of public health measures increases, so too do depression and worries. For safe and effective public health measures, governments should develop strategies to increase trust in their actions.


2021 ◽  
Vol 19 (9) ◽  
pp. 121-131
Author(s):  
Angela Chia-Chen Chen, PhD, RN, PMHNP-BC ◽  
SeungYong Han, PhD ◽  
Wei Li, PhD ◽  
Karen J. Leong, PhD ◽  
Lihong Ou, MSN, RN

Introduction: Our research addressed double victimization among Asian Americans by COVID-19 and anti-Asian racial discrimination during the pandemic. Guided by the Vulnerable Populations framework that argues that health status reflects the dynamic interplay between resource availability and relative risk, we investigated time-sensitive questions that explored relative risk (perceived racial discrimination, fear of COVID-19), resources (COVID-19 prevention knowledge, resilience), and mental health status (post-traumatic stress disorder (PTSD), depression) in Asian American undergraduate and graduate students during the pandemic.Methods: A mixed-methods research was conducted to examine the relationships among the relative risk, resources, and mental health outcomes in this population. We adapted questions from valid and reliable measures to assess key variables. Descriptive and regression analyses along with content analysis were used to analyze the quantitative and qualitative data.Results: Our sample included 74 Asian American students (AA students) who participated in the online survey (53 complete cases were included in the statistical analysis) and an additional 10 AA students who were interviewed via Zoom. The results of hierarchical regression models confirmed a positive association between fear of COVID-19 and both mental health outcomes (PTSD and depression), and a negative association between COVID-19 prevention knowledge and mental health outcomes. Perceived racial discrimination was significantly and positively associated with PTSD and depression while controlling for sociodemographic variables. However, its association with outcomes diminished when fear of COVID-19 and COVID-19 prevention knowledge were added to the models. Our interview results supported the survey findings with more nuanced details not revealed in the survey.Conclusion: The findings of this research will help public health officials and universities identify practices useful for promoting culturally congruent safety and protection in response to pandemics and other health emergencies.


Author(s):  
Edward Magalhaes ◽  
Alexis Stoner ◽  
Joshua Palmer ◽  
Robert Schranze ◽  
Savannah Grandy ◽  
...  

AbstractIn late 2019, the first case of COVID-19 was reported in Wuhan, China. Soon after, cases began to spread globally. This study aimed to examine the psychological impact of the COVID-19 pandemic on the adult population in the United States. We conducted an exploratory cross-sectional study using an anonymous online survey methodology distributed to participants across 13 states. The data collected included demographical information and outcomes from validated mental health screeners (GAD-7, PHQ-9, and IES-R) to assess levels of anxiety, depression, and stress. A total of 1356 participants completed the survey. GAD-7, PHQ-9, and IES-R levels differed significantly (p < 0.05) according to age, gender, and educational level. There was also significant difference between GAD-7 level as well as IES-R level between healthcare and non-healthcare workers (p = 0.02 and p = 0.028). Overall, this study has helped to garner a better understanding of COVID-19’s impact on mental health outcomes.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047828
Author(s):  
Xin Guo ◽  
Robert McCutcheon ◽  
Toby Pillinger ◽  
Atheeshaan Arumuham ◽  
Jianhua Chen ◽  
...  

ObjectivesTo assess the magnitude of mental health outcomes and associated factors among psychiatric professionals in mental health services during COVID-19 in China.Design, setting and participantsThis cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from psychiatric professionals in 34 hospitals between 29 January and 7 February 2020, in China. Hospitals equipped with fever clinics or deployed on wards for patients with COVID-19 were eligible.Primary outcome and measuresThe severity of symptoms of depression, anxiety, insomnia and distress were assessed by the Chinese versions of 9-item Patient Health Questionnaire, 7-item Generalised Anxiety Disorder, 7-item Insomnia Severity Index and 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression and structural equation modelling was performed to identify factors associated with mental health outcomes.ResultsA total of 610 psychiatric professionals were included. 29.8% were employed in Wuhan, and 22.5% were frontline workers. A considerable proportion of participants reported symptoms of depression (461 (75.6%)), anxiety (282 (46.2%)), insomnia (336 (55.1%)) and mental stress (481 (78.9%)). Psychiatric symptoms were associated with worrying about infection (eg, OR 2.36 (95% CI 1.27 to 4.39) for anxiety), risks of exposure to COVID-19 (eg, having inadequate personal protection equipment, OR 2.43 (1.32 to 4.47) for depression) and self-perceived physical health (eg, OR 3.22 (2.24 to 4.64) for mental stress). Information sources of COVID-19 were also found to be both positively (eg, information from relatives, OR 2.16 (1.46 to 3.21) for mental stress) and negatively (eg, information from TV, OR 0.52 (0.35 to 0.77) for mental stress) associated with mental stress. There is preliminary evidence that mental health might benefit from greater availability of mental healthcare services. The structural equation model analysis indicated that worrying about infection may be the primary mediator via which risk of exposure to COVID-19 pandemic affects the mental health of psychiatric professionals.ConclusionsThe current findings demonstrate several pathways via which the COVID-19 pandemic may have negatively affected the mental health of psychiatric professionals in China.


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