Background Intensive care workers are known for their stressful work environment and for a high prevalence of mental health outcomes. The aim of this study was to evaluate the mental health, well-being and changes in lifestyle among intensive care unit (ICU) healthcare workers (HCW) during the first wave of the COVID-19 pandemic and to compare these results with those of HCW in other hospital units. Another objective was to understand which associated factors aggravate their mental health during the COVID-19 outbreak. Methods This cross-sectional survey collected socio-demographic data, lifestyle changes and mental health evaluations as assessed by the Generalized Anxiety Disorder 7 items (GAD-7), the Patient Health Questionnaire 9 items (PHQ-9), the Peritraumatic Distress Inventory (PDI) and the World Health Organization Well-Being Index (WHO-5) from the 28th May to 7th July 2020. The study was carried out at Geneva University Hospitals, a group of eight public hospitals in Switzerland. ICU HCW were analyzed for mental health outcomes and lifestyles changes and then compared to non-ICU HCW. A series of linear regression analyses were performed to assess factors associated with mental health scores. Results A total of 3461 HCW were included in the study, with 352 ICU HCW. Among ICU HCW, 145 (41%) showed low well-being, 162 (46%) symptoms of anxiety, 163 (46%) symptoms of depression and 76 (22%) had peritraumatic distress. The mean scores of GAD-7, PHQ-9 and WHO-5 were worse in ICU HCW than in non-ICU HCW (p < 0.01). Working in the ICU rather than in other departments resulted in a change of eating habits, sleeping patterns and alcohol consumption (p < 0.01). Being a woman, the fear of catching and transmitting COVID-19, anxiety of working with COVID-19 patients, work overload, eating and sleeping disorders as well as increased alcohol consumption were associated with worse mental health outcomes. Conclusion This study confirms the suspicion of a high prevalence of anxiety, depression, peritraumatic distress and low well-being during the first COVID-19 wave among HCW, especially among ICU HCW. This allows for the identification of associated risk factors. Long-term psychological follow-up should be considered for HCW.

The COVID-19 pandemic’s first wave required considerable adaptation efforts on the part of healthcare workers. The literature on resilient healthcare describes how the collective regulation strategies implemented by frontline employees make essential contributions to institutions’ abilities to cope with major crises. The present mixed-methodology study was thus conducted among a large sample of employees in a variety of Swiss healthcare institutions and focused on problematic real-world situations experienced by them and their managers during the pandemic’s first wave. It highlighted the anticipatory and adaptive strategies implemented by institutions, teams and individuals. The most frequently cited problematic situations involved organisational changes, interpersonal conflicts and workloads. In addition to the numerous top-down measures implemented by institutions, respondents also identified personal or team regulation strategies such as increasing staff flexibility, prioritising tasks, interprofessional collaboration, peer support or creating new communication channels to families. The present findings underlined the importance of taking greater account of healthcare support staff and strengthening managerial capacity to support interprofessional teams including those support staff.

Background: Little research exists on the effectiveness of workplace visits by labour inspectors in relation to psychosocial risks. The study aimed to produce a consistent and transferable evidence-based framework. Methods: We conducted a systematic literature review using the realist synthesis approach. Searches in three electronic databases, systematic hand-searches in five specialised journals and iterative purposive searches yielded 25 publications. The initial search included any study between 2000 and 2015 containing information on labour inspectorates and psychosocial risks or stress at work. We conducted a complementary search to identify publications from French-speaking authors. Results: The synthesis yielded a conceptual model relating public intervention measures, mechanisms of action, outcomes and contexts. Publications indicate positive outcomes in 4 cases, possibly positive in 2, mixed outcomes in 4, and no or poor effects in 10. Studies from Nordic countries show some positive outcomes of inspection activities based on dialogue with employers, group interviews with employees, repeated visits and combinations with other communication and information channels, in the context of highly organised labour markets. Conversely, other studies highlight the limitations of intervention strategies that rely on an ''enlightenment" principle, in a context of increasingly precarious and flexible work situations. Conclusion: The synthesis suggests the possibility of positive outcomes of inspectors' interventions on psychosocial risks in supportive contexts and with appropriate training and resources. However, strong evidence is lacking and more evaluation studies are necessary. A comprehensive conceptual framework may help to analyse the wide range of factors influencing the effectiveness of workplace visits by inspectors.

Workplace responses to labour inspectorate interventions regarding psychosocial risks at work are not well known. This study aimed to assess the effects of inspection visits at company level. A survey was conducted in two groups of companies. In one group, companies were visited by a labour inspector some days after the survey, and in the other group, not. The survey was repeated one year later in both groups. It relied on a structured phone interview with the person within the company who best knew about occupational health and safety. We collected information about health and safety management, worker participation, as well as ability, willingness and measures for the prevention of psychosocial risks. Two kinds of prevention measures were distinguished: specific psychosocial risk management measures on one side, and more general improvements of working conditions on the other side. 185 companies with an inspection visit and 161 companies without took part in the study. The results were encouraging, since inspected companies improved their management of health and safety, increased their ability in psychosocial issues, and demonstrated a stronger willingness to act. To a lesser extent, they implemented specific psychosocial risk management measures. However, visits did not lead to improvements regarding scores for employee participation or general improvements of working conditions, such as work organisation, working schedules or staffing levels. A further step for regulatory initiatives would be to emphasise more strongly the need for a prevention approach grounded in the assessment and improvement of job designs, content and organisation.

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