Quality of Life (QoL) is a multidimensional estimate of biopsychosocial health and wellbeing.1 The COVID-19 pandemic led to an abrupt change in our lifestyle, demanding resilience and coping mechanisms2. Health care providers are in the frontline of COVID-19 patients’ diagnosis, treatment, and rehabilitation, and there is a well-documented impact of this context on their physical and mental health2. This might impact their wellbeing and reduce their quality of life. In this research letter, we investigated which factors are associated with QoL in Brazilian healthcare professionals. We aim to investigate both protective and risk factors for the four main aspects of QoL: physical, psychological, social relations, and environment. We assessed 97.771 Brazilian adults, most (92.3%) health professionals of different professions from all the five-country regions. All included individuals agreed in a written consent to participate. Participants showed an average of 35.45 years old (±9.49) and were predominantly female (80%). They answered an online questionnaire about sociodemographic aspects, measures of mental health, and quality of life in the first semester of 2020. A detailed description of the sample and procedures can be found elsewhere3. All participants answered the WHOQoL-BREF, a standardized tool for QoL assessment developed by the World Health Organization. Stepwise linear regression analysis was used to assess the role of sociodemographic factors, previously diagnosed mental disorders, COVID-19 related symptoms as well a series of specific questions regarding participants worries and perceptions about the pandemic, including the protective behaviors' adoption (social distancing, usage of masks and sanitizer, among others). A full list of variables (64 in total) is available on the SAMBE webpage (http://abpbrasil.org.br/pcabp/). Since we have a large sample size our statistical power is about 99% (alpha=0.01) to detect small effect sizes. To simplify our results and allow a more direct application to real-life settings we only included significant predictors which showed at least 1% of adjusted explained variance in the stepwise models. The stepwise regression model was summarized in the figure below. All regression models were significant (p<0.001) as well all the predictors reported in the Figure. Total explained variance was 26% for Physical QoL, 27% for Psychological, 13% for Social Relations, and 19% for Environmental. A history of previous depression, presence of Headache, and the perception of worsening in home relationships were risk factors for lower QoL in all four domains. Our results suggest a multidimensional pattern of determinants of QoL in health care professionals in the early days of the pandemic. Interesting features emerged as predictors of QoL such as changes in home relationships, worsening in work productivity, and mental health. Expected and new predictors may shed light on which factors should be considered in interventions aiming at the development of mitigation of impact QoL in these populations.
The depression paradigm and beyond
