Aim
Determine levels of depression, anxiety and stress symptoms and factors associated with psychological burden amongst critical care health care workers in the early stages of the coronavirus disease (2019) (COVID-19) pandemic.
Methods
Anonymous web-based survey distributed in April 2020. All health care workers employed in a critical care setting were eligible to participate. Invitations to the survey were distributed through Australian and New Zealand critical care societies and social media platforms. The primary outcome was the proportion of health care workers that reported moderate to extremely severe scores on the Depression Anxiety Stress Scale-21 (DASS-21)
Results
Of the 3770 complete responses, 3039 (80.6%) were from Australia. A total of 2871 respondents (76.2%) were female; median age was 41 years old. Nurses made up 2269 (60.2%) of respondents with most [2029 (53.8%)] working in Intensive Care Units.Overall, 813 (21.6%) respondents reported moderate to extremely severe depression, 1078 (28.6%) reported moderate to extremely severe anxiety and 1057 (28.0%) moderate to extremely severe stress scores. Mean ± standard deviation DASS-21 depression, anxiety and stress scores amongst woman vs men were: 8.0 ± 8.2 vs 7.1 ± 8.2 (p=0.003); 7.2 ± 7.5 vs 5.0 ± 6.7 (p<0.001); and 14.4 ± 9.6 vs 12.5 ± 9.4 (p<0.001) respectively.After adjusting for significant confounders, clinical concerns associated with higher DASS-21 scores included; not being clinically prepared (β 4.2, p<0.001), an inadequate workforce (β 2.4, p=0.001), having to triage patients due to lack of beds and or equipment (β 2.6, p=0.001), virus transmission to friends and family (β 2.1, p=0.009), contracting COVID-19 (β 2.8, p=0.011), being responsible for other staff (β 3.1, p<0.001), and being asked to work in an area that was not in the respondents expertise (β 5.7, p<0.001).
Conclusion
In this survey of critical care health care workers, between 22 and 29% of respondents reported moderate to extremely severe depression, anxiety and stress symptoms with females reporting higher scores compared to men. Although female gender appears to play a role, modifiable factors also contribute to psychological burden and should be studied further.
Background
Critical care health care professionals are a key part of any pandemic response and are at increased risk for physical and psychological harm, yet their self-reported suggestions to ameliorate the negative effects of pandemics on their wellbeing have rarely been sought.
Objectives
To explore and interpret themes of critical care health care professionals’ responses to the question ‘What do you think could assist your wellbeing during the COVID-19 crisis?’.
Methods
A descriptive study using an online survey, performed in April 2020, investigating pandemic preparedness and psychological burden during the early stages of the COVID-19 pandemic among critical care professionals. Informal snowball sampling was used. Thematic analysis of qualitative data from an open-ended survey item was informed by Braun and Clark.
Findings
Eighty percent (2,387/3,770) of respondents completed the open-ended question. Three themes were generated from the synthesis: adequate resourcing for the role; consistent, clear information and prioritised communications; the need for genuine kindness and provision of support for HCP wellbeing.
Conclusions
There is merit for considering the perceptions, concerns and suggestions of critical care clinicians during a pandemic. Suggestions included simple measures to maintain physical and mental health, clear messaging, consistent information, trust in health and political leaders, supportive working environments, specific training, and allowances for personal circumstances. This information is important for health and political leaders and policy makers to implement strategies to reduce the burden associated with delivering care in the context of a pandemic.
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