A Resilience-Building App to Support the Mental Health of Health Care Workers in the COVID-19 Era: Design Process, Distribution, and Evaluation (Preprint)

BACKGROUND The COVID-19 pandemic has resulted in increased strain on health care systems and negative psychological effects on health care workers. This is anticipated to result in long term negative mental health effects on the population, with health care workers (HCWs) representing a particularly vulnerable group. The scope of the COVID-19 pandemic necessitates the development of a scalable mental health platform to provide services to large numbers of at risk or affected individuals. The Mount Sinai Health System in New York City was at the epicenter of the pandemic in the United States. OBJECTIVE To address the current and anticipated psychological impact the pandemic has had on the HCWs in the health system, a Center for Stress, Resilience, and Personal Growth (CSRPG) was created. The mission of the Center is twofold; it aims to offer (1) resilience workshops and (2) mental health resources and institutional support to all employees. Our aim was to build a mobile application to support the newly founded Center in its mission. METHODS We built the app as a standalone intervention platform that hosts a suite of tools which users can interact with on a daily basis. With consideration for the Center’s aims, we determined the overall vision, initiatives, and goals for the Wellness Hub app, followed by specific milestone tasks and deliverables for development. We defined the app’s primary features based on the mental health assessment and needs of HCWs. Feature definition was informed by the results of a resilience survey widely distributed to Mount Sinai HCWs, and by the resources offered at CSRPG, including workshop content. RESULTS We launched our app over the course of 2 phases, the first phase being a “soft” launch and the second being a broader launch to all of Mount Sinai. Of the 231 health care workers who downloaded the app, 173 completed our baseline assessment of all mental health screeners in the app. Results from the baseline assessment show that more than half of users demonstrate a need for support in at least one psychological area. As of three months after the phase 2 launch, approximately 55% of users re-entered the app after their first opening to explore additional features, with an average of 4 app openings per person. CONCLUSIONS To address the mental health needs of HCWs during the COVID-19 pandemic, the Wellness Hub app was built and deployed throughout the Mount Sinai Health System. To our knowledge, this is the first resilience app of its kind. The Wellness Hub app is a promising proof of concept, with room to grow, for those who wish to build a secure mobile health app to support their employees, communities, or others in managing and improving mental and physical well-being. It is a novel tool offering mental health support broadly.

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COVID-19 is having a destructive impact on health-care workers’ mental well-being

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzaa158 ◽

2020 ◽

Author(s):

Kris Vanhaecht ◽

Deborah Seys ◽

Luk Bruyneel ◽

Bianca Cox ◽

Gorik Kaesemans ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Residential Care ◽

Health Care Workers ◽

Well Being ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Care Workers ◽

Sources Of Support ◽

Mental Well Being

Abstract Background The coronavirus disease 2019 (COVID-19) may aggravate workplace conditions that impact health-care workers’ mental health. However, it can also place other stresses on workers outside of their work. This study determines the effect of COVID-19 on symptoms of negative and positive mental health and the workforce’s experience with various sources of support. Effect modification by demographic variables was also studied. Methods A cross-sectional survey study, conducted between 2 April and 4 May 2020 (two waves), led to a convenience sample of 4509 health-care workers in Flanders (Belgium), including paramedics (40.6%), nurses (33.4%), doctors (13.4%) and management staff (12.2%). About three in four were employed in university and acute hospitals (29.6%), primary care practices (25.7%), residential care centers (21.3%) or care sites for disabled and mental health care. In each of the two waves, participants were asked how frequently (on a scale of 0–10) they experienced positive and negative mental health symptoms during normal circumstances and during last week, referred to as before and during COVID-19, respectively. These symptoms were stress, hypervigilance, fatigue, difficulty sleeping, unable to relax, fear, irregular lifestyle, flashback, difficulty concentrating, feeling unhappy and dejected, failing to recognize their own emotional response, doubting knowledge and skills and feeling uncomfortable within the team. Associations between COVID-19 and mental health symptoms were estimated by cumulative logit models and reported as odds ratios. The needed support was our secondary outcome and was reported as the degree to which health-care workers relied on sources of support and how they experienced them. Results All symptoms were significantly more pronounced during versus before COVID-19. For hypervigilance, there was a 12-fold odds (odds ratio 12.24, 95% confidence interval 11.11–13.49) during versus before COVID-19. Positive professional symptoms such as the feeling that one can make a difference were less frequently experienced. The association between COVID-19 and mental health was generally strongest for the age group 30–49 years, females, nurses and residential care centers. Health-care workers reported to rely on support from relatives and peers. A considerable proportion, respectively, 18 and 27%, reported the need for professional guidance from psychologists and more support from their leadership. Conclusions The toll of the crisis has been heavy on health-care workers. Those who carry leadership positions at an organizational or system level should take this opportunity to develop targeted strategies to mitigate key stressors of health-care workers’ mental well-being.

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Interventions for Improving Health Care Workers’ Retention in Epidemics – a Scoping Review

10.21203/rs.3.rs-951428/v1 ◽

2021 ◽

Author(s):

Zahra Zarei Jelyani ◽

Sadra Valiee ◽

Mohammad Kia ◽

Ali jajarmizadeh ◽

Sajad Delavari

Keyword(s):

Health Care ◽

Human Resources ◽

Health System ◽

Human Health ◽

Scoping Review ◽

Health Care Workers ◽

Health Resources ◽

The United States ◽

Human Beings ◽

Care Workers

Abstract Introduction: Generally, in Epidemics, such as COVID-19, health care workers (HCWs) faces many problems which lead to a shortage and weakening of human resources in the health system. Therefore, using effective strategies to retain human resources is one of the most important issues during outbreaks. This study aims to collect and classify the proposed interventions to strengthen human health resources and their sustainability during epidemics through scoping review.Methods: In this scoping review study, 2300 studies were retrieved through searching international databases –PubMed, Embase, Scopus and Web of Science. The retrieved studies were screened, and finally, 50 studies were included for analysis. The strategies were classified using inductive qualitative content analysis.Results: Most of the studies were conducted in the United States and the United Kingdom. The target population in 39 studies was all health workers; five studies were on physicians, five studies on nurses, and only one study on dentists. The proposed interventions were classified into five categories: preparation, protection, support, treatment, and feedback. Discussion: Most studies focused on providing interventions in one or two dimensions of human resources, but these interventions were summarized and categorized in this review. Therefore, this study has a holistic view of various dimensions of strengthening and maintaining human health resources during epidemics by providing a thematic map. Considering that human beings are multidimensional, policymakers and managers of the health system should use a set of interventions that simultaneously cover different aspects of their needs to strengthen and maintain HCWs.

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Health Care Workers’ Mental Health During the First Weeks of the SARS-CoV-2 Pandemic in Switzerland – A Cross-Sectional Study

10.1101/2020.05.04.20088625 ◽

2020 ◽

Cited By ~ 2

Author(s):

Sonja Weilenmann ◽

Jutta Ernst ◽

Heidi Petry ◽

Monique C. Pfaltz ◽

Onur Sazpinar ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Network Analysis ◽

Health Care Workers ◽

Well Being ◽

Perceived Support ◽

Independent Effect ◽

Cross Sectional ◽

Care Workers ◽

Anxiety Depression

AbstractBackgroundThe current SARS-CoV-2 pandemic poses various challenges for health care workers (HCWs), which may impair their mental health. First evidence from China suggests that HCWs are at risk for anxiety and depression. However, generalizability to western countries is limited. The current study aimed at exploring HCWs’ mental health during the SARS-CoV-2 pandemic in Switzerland. In addition, we conducted a network analysis to investigate the independent effect of risk and protective factors on HCWs’ mental health and their interplay.MethodsIn an exploratory, cross-sectional, nation-wide online survey, we assessed demographics, work characteristics, COVID-19 exposure, and anxiety, depression, and burnout in 857 physicians and 553 nurses during the pandemic in Switzerland. At the time of data collection, Switzerland had among the highest per capita rate of COVID-19 cases in the world.ResultsOverall symptom levels of anxiety, depression, and burnout were elevated. Women, nurses, frontline staff and HCWs exposed to COVID-19 patients reported more symptoms than their peers. However, these effects were all small and, in the network analysis, most of them did not remain significant after controlling for the other factors. Whereas COVID-19 exposure was only partially associated with mental health, perceived support by the employer independently predicted anxiety and burnout.ConclusionsOur finding that HCWs had elevated levels of anxiety, depression, and burnout underscores the importance to systematically monitor HCWs’ mental health during this ongoing pandemic. Because perceived support and mental health impairments were negatively related, we encourage the implementation of supportive measures for HCWs’ well-being during this crisis.

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Advancing Mental Health and Psychological Support for Health Care Workers Using Digital Technologies and Platforms (Preprint)

10.2196/preprints.22075 ◽

2020 ◽

Author(s):

Jiancheng Ye

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Workers ◽

Digital Technologies ◽

Well Being ◽

Psychological Problems ◽

Health Issues ◽

Psychological Issues ◽

Mental Health Issues ◽

Care Workers

BACKGROUND The COVID-19 pandemic is a global public health crisis that has not only endangered the lives of patients but also resulted in increased psychological issues among medical professionals, especially frontline health care workers. As the crisis caused by the pandemic shifts from acute to protracted, attention should be paid to the devastating impacts on health care workers’ mental health and social well-being. Digital technologies are being harnessed to support the responses to the pandemic, which provide opportunities to advance mental health and psychological support for health care workers. OBJECTIVE The aim of this study is to develop a framework to describe and organize the psychological and mental health issues that health care workers are facing during the COVID-19 pandemic. Based on the framework, this study also proposes interventions from digital health perspectives that health care workers can leverage during and after the pandemic. METHODS The psychological problems and mental health issues that health care workers have encountered during the COVID-19 pandemic were reviewed and analyzed based on the proposed MEET (Mental Health, Environment, Event, and Technology) framework, which also demonstrated the interactions among mental health, digital interventions, and social support. RESULTS Health care workers are facing increased risk of experiencing mental health issues due to the COVID-19 pandemic, including burnout, fear, worry, distress, pressure, anxiety, and depression. These negative emotional stressors may cause psychological problems for health care workers and affect their physical and mental health. Digital technologies and platforms are playing pivotal roles in mitigating psychological issues and providing effective support. The proposed framework enabled a better understanding of how to mitigate the psychological effects during the pandemic, recover from associated experiences, and provide comprehensive institutional and societal infrastructures for the well-being of health care workers. CONCLUSIONS The COVID-19 pandemic presents unprecedented challenges due to its prolonged uncertainty, immediate threat to patient safety, and evolving professional demands. It is urgent to protect the mental health and strengthen the psychological resilience of health care workers. Given that the pandemic is expected to exist for a long time, caring for mental health has become a “new normal” that needs a strengthened multisector collaboration to facilitate support and reduce health disparities. The proposed MEET framework could provide structured guidelines for further studies on how technology interacts with mental and psychological health for different populations.

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Belief in a COVID-19 Conspiracy Theory as a Predictor of Mental Health and Well-Being of Health Care Workers in Ecuador: Cross-Sectional Survey Study (Preprint)

10.2196/preprints.20737 ◽

2020 ◽

Author(s):

Xi Chen ◽

Stephen X Zhang ◽

Asghar Afshar Jahanshahi ◽

Aldo Alvarez-Risco ◽

Huiyang Dai ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Life Satisfaction ◽

Psychological Distress ◽

Anxiety Disorder ◽

Health Care Workers ◽

Well Being ◽

Conspiracy Theories ◽

Care Workers ◽

Health And Well Being

BACKGROUND During the coronavirus disease (COVID-19) pandemic, social media platforms have become active sites for the dissemination of conspiracy theories that provide alternative explanations of the cause of the pandemic, such as secret plots by powerful and malicious groups. However, the association of individuals’ beliefs in conspiracy theories about COVID-19 with mental health and well-being issues has not been investigated. This association creates an assessable channel to identify and provide assistance to people with mental health and well-being issues during the pandemic. OBJECTIVE Our aim was to provide the first evidence that belief in conspiracy theories regarding the COVID-19 pandemic is a predictor of the mental health and well-being of health care workers. METHODS We conducted a survey of 252 health care workers in Ecuador from April 10 to May 2, 2020. We analyzed the data regarding distress and anxiety caseness with logistic regression and the data regarding life and job satisfaction with linear regression. RESULTS Among the 252 sampled health care workers in Ecuador, 61 (24.2%) believed that the virus was developed intentionally in a lab; 82 (32.5%) experienced psychological distress, and 71 (28.2%) had anxiety disorder. Compared to health care workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab were more likely to report psychological distress and anxiety disorder and to have lower levels of job satisfaction and life satisfaction. CONCLUSIONS This paper identifies belief in COVID-19 conspiracy theories as an important predictor of distress, anxiety, and job and life satisfaction among health care workers. This finding will enable mental health services to better target and provide help to mentally vulnerable health care workers during the ongoing COVID-19 pandemic.

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Snapshot Impact of COVID-19 on Mental Wellness in Nonphysician Otolaryngology Health Care Workers: A National Study

OTO Open ◽

10.1177/2473974x20948835 ◽

2020 ◽

Vol 4 (3) ◽

pp. 2473974X2094883 ◽

Cited By ~ 1

Author(s):

Aman Prasad ◽

Alyssa M. Civantos ◽

Yasmeen Byrnes ◽

Kevin Chorath ◽

Seerat Poonia ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Health Care ◽

High Risk ◽

Health Care Workers ◽

The United States ◽

Assessment Tools ◽

Care Providers ◽

Event Scale ◽

Care Workers

Objective Nonphysician health care workers are involved in high-risk patient care during the COVID-19 pandemic, placing them at high risk of mental health burden. The mental health impact of COVID-19 in this crucial population has not been studied thus far. Thus, the objective of this study is to assess the psychosocial well-being of these providers. Study Design National cross-sectional online survey (no control group). Setting Academic otolaryngology programs in the United States. Subjects and Methods We distributed a survey to nonphysician health care workers in otolaryngology departments across the United States. The survey incorporated a variety of validated mental health assessment tools to measure participant burnout (Mini-Z assessment), anxiety (Generalized Anxiety Disorder–7), distress (Impact of Event Scale), and depression (Patient Health Questionnaire–2). Multivariable logistic regression analysis was performed to determine predictive factors associated with these mental health outcomes. Results We received 347 survey responses: 248 (71.5%) nurses, 63 (18.2%) administrative staff, and 36 (10.4%) advanced practice providers. A total of 104 (30.0%) respondents reported symptoms of burnout; 241 (69.5%), symptoms of anxiety; 292 (84.1%), symptoms of at least mild distress; and 79 (22.8%), symptoms of depression. Upon further analysis, development of these symptoms was associated with factors such as occupation, practice setting, and case load. Conclusion Frontline otolaryngology health care providers exhibit high rates of mental health complications, particularly anxiety and distress, in the wake of COVID-19. Adequate support systems must be put into place to address these issues.

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Development of health care workers' mental health during the SARS-CoV-2 pandemic in Switzerland: two cross-sectional studies

Psychological Medicine ◽

10.1017/s0033291720003128 ◽

2020 ◽

pp. 1-4

Author(s):

Tobias R. Spiller ◽

Marie Méan ◽

Jutta Ernst ◽

Onur Sazpinar ◽

Samuel Gehrke ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Workers ◽

Continuous Monitoring ◽

Working Hours ◽

Well Being ◽

Cross Sectional ◽

Care Workers ◽

Two Samples

Abstract Background Virus outbreaks such as the current SARS-CoV-2 pandemic are challenging for health care workers (HCWs), affecting their workload and their mental health. Since both, workload and HCW's well-being are related to the quality of care, continuous monitoring of working hours and indicators of mental health in HCWs is of relevance during the current pandemic. The existing investigations, however, have been limited to a single study period. We examined changes in working hours and mental health in Swiss HCWs at the height of the pandemic (T1) and again after its flattening (T2). Methods We conducted two cross-sectional online studies among Swiss HCWs assessing working hours, depression, anxiety, and burnout. From each study, 812 demographics-matched participants were included into the analysis. Working hours and mental health were compared between the two samples. Results Compared to prior to the pandemic, the share of participants working less hours was the same in both samples, whereas the share of those working more hours was lower in the T2 sample. The level of depression did not differ between the samples. In the T2 sample, participants reported more anxiety, however, this difference was below the minimal clinically important difference. Levels of burnout were slightly higher in the T2 sample. Conclusions Two weeks after the health care system started to transition back to normal operations, HCWs' working hours still differed from their regular hours in non-pandemic times. Overall anxiety and depression among HCWs did not change substantially over the course of the current SARS-CoV-2 pandemic.

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The mental health of health care workers in Oman during the COVID-19 pandemic

International Journal of Social Psychiatry ◽

10.1177/0020764020939596 ◽

2020 ◽

pp. 002076402093959 ◽

Cited By ~ 7

Author(s):

Abdallah Badahdah ◽

Faryal Khamis ◽

Nawal Al Mahyijari ◽

Marwa Al Balushi ◽

Hashil Al Hatmi ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Providers ◽

Health Care Workers ◽

Well Being ◽

World Health ◽

Accurate Information ◽

Care Providers ◽

Health Crisis ◽

Care Workers

Background: COVID-19 disease is one of the most destructive events that humanity has witnessed in the 21st century. It has impacted all aspects of life and all segments of populations, including already vulnerable health care providers. Aims: This study sought to detect the prevalence of mental health issues in sample of physicians and nurses working in several health facilities in Oman. Method: We gauged the mental health conditions of 509 physicians (38.1%) and nurses (61.9 %) using the Perceived Stress Scale, Generalized Anxiety Disorder Scale and World Health Organization Well-Being Index. Results: The study revealed a high prevalence of stress, anxiety and poor psychological well-being, especially among females, young health care workers and those who interacted with known or suspected COVID-19 patients. Conclusion: The outcomes of this study support the handful of studies published during this global health crisis that have found that the mental health of health care workers has been harshly affected and predicted that it will continue, to various degrees, to be affected in the foreseeable future. The results of this study highlight the urgency of providing administrative and psychological support as well as current and accurate information on COVID-19 to health care workers.

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Investigating the Impact of COVID-19 Pandemic on Mental Health Status and Factors Influencing Negative Mental Health among Health-Care Workers in Dubai, United Arab Emirates

Dubai Medical Journal ◽

10.1159/000518717 ◽

2021 ◽

pp. 1-9

Author(s):

Fatma AlGhufli ◽

Rayyan AlMulla ◽

Ola Alyedi ◽

Sham Zain AlAbdin ◽

Mohammed Moutaz Nakhal

Keyword(s):

Mental Health ◽

Health Care ◽

Linear Regression ◽

Health Care Workers ◽

Psychological Health ◽

Linear Regression Analysis ◽

Well Being ◽

Multivariate Linear Regression Analysis ◽

Care Workers ◽

The Impact

Aim: This study aimed to investigate the prevalence of psychological health outcomes and associated factors among health-care workers (HCWs) during COVID-19 pandemic. Subject and Methods: This observational cross-sectional study was conducted on 550 HCWs at 4 different clinics (fever, clean, telemedicine, and mixed clinics) in Dubai Health Authority from July 2020 to September 2020. Severity of depression, anxiety, and stress was examined by calculating the Depression Anxiety Stress Scale (DASS-21) for each subscale, while insomnia was determined by Insomnia Severity Index (ISI) score. Factors associated with psychological symptoms were identified by univariate (ANOVA and independent t test), and independent factors were detected by multivariate linear regression analysis after controlling other variables. p value of <0.05 was considered with significant results. Results: A total of 400 participants completed the survey. Majority of them were females (84.5%, n = 338) and aged between 18 and 31 (53.5%, n = 214). About 76.5% (n = 306) reported symptoms of depression, 315 (78.8%) anxiety, 254 (63.5%) stress-based, and 187 (46.8%) suffered from clinical insomnia. Frontline HCWs at fever clinic were at higher risk of developing burnout symptoms (p < 0.001). Furthermore, being younger, nonmarried, and nurse had no kids and changed accommodation during the crisis; all together were at higher risk of developing burnout symptoms (p < 0.05). Adjusted linear regression showed that age was the major independent factor affecting DASS-21 subscales without affecting the level of insomnia (<0.01). In addition, being worried about the family and loved ones independently influenced higher levels of depression and anxiety-based (<0.001). Conclusion: This study revealed that COVID-19 outbreak has a significant psychological impact on frontline HCWs and the most vulnerable groups to psychological distress. Efficient support and interventions are needed to protect HCWs from being infected and promote their well-being.

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Belief in a COVID-19 Conspiracy Theory as a Predictor of Mental Health and Well-Being of Health Care Workers in Ecuador: Cross-Sectional Survey Study

JMIR Public Health and Surveillance ◽

10.2196/20737 ◽

2020 ◽

Vol 6 (3) ◽

pp. e20737 ◽

Cited By ~ 5

Author(s):

Xi Chen ◽

Stephen X Zhang ◽

Asghar Afshar Jahanshahi ◽

Aldo Alvarez-Risco ◽

Huiyang Dai ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Life Satisfaction ◽

Psychological Distress ◽

Anxiety Disorder ◽

Health Care Workers ◽

Well Being ◽

Conspiracy Theories ◽

Care Workers ◽

Health And Well Being

Background During the coronavirus disease (COVID-19) pandemic, social media platforms have become active sites for the dissemination of conspiracy theories that provide alternative explanations of the cause of the pandemic, such as secret plots by powerful and malicious groups. However, the association of individuals’ beliefs in conspiracy theories about COVID-19 with mental health and well-being issues has not been investigated. This association creates an assessable channel to identify and provide assistance to people with mental health and well-being issues during the pandemic. Objective Our aim was to provide the first evidence that belief in conspiracy theories regarding the COVID-19 pandemic is a predictor of the mental health and well-being of health care workers. Methods We conducted a survey of 252 health care workers in Ecuador from April 10 to May 2, 2020. We analyzed the data regarding distress and anxiety caseness with logistic regression and the data regarding life and job satisfaction with linear regression. Results Among the 252 sampled health care workers in Ecuador, 61 (24.2%) believed that the virus was developed intentionally in a lab; 82 (32.5%) experienced psychological distress, and 71 (28.2%) had anxiety disorder. Compared to health care workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab were more likely to report psychological distress and anxiety disorder and to have lower levels of job satisfaction and life satisfaction. Conclusions This paper identifies belief in COVID-19 conspiracy theories as an important predictor of distress, anxiety, and job and life satisfaction among health care workers. This finding will enable mental health services to better target and provide help to mentally vulnerable health care workers during the ongoing COVID-19 pandemic.

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