Comparison of the Psychological Impact of COVID-19 on Self-Employed Private Healthcare Workers with Respect to Employed Public Healthcare Workers: Three-Wave Study during the COVID-19 Pandemic in Spain

Abstract

(1) Background: Coronavirus disease, also called COVID-19, is a worldwide pandemic with a major impact on all aspects of the individual (health status, psychological, and economic aspects, among others). The perception of health professionals in this situation has been influenced by their economic and psychosocial situations. On the economic level, self-employed workers have no state subsidies, with the added disadvantage of not having sufficient means to cope with contagion. This could potentially have an impact on their health and indirectly on their family members, creating additional stress. The aim of this study was to determine whether there are differences in the level of anxiety of health professionals working in private practice compared to healthcare workers working in public institutions during the first three waves of COVID-19. (2) Methods: A cohort study on 517 subjects comparing anxiety between a group of health workers and a group of health professionals working in the public sector at three key moments during the pandemic was performed. (3) Results: Statistically significant differences were found between self-employed private health professionals compared to those working as public health workers. The perception of impact was worse in the self-employed; however, a higher level of anxiety was evident in public employees in all assessed domains (cognitive, physiological, and motor, p = 0.001). (4) Conclusions: There were significant changes when comparing the first phase between both groups; employed public healthcare workers manifested a sense of lower risk of COVID-19 contagion than privately employed professionals, who had a higher level of anxiety. In the second and third waves, negative feelings improved for both groups, and the fear of showing anxiety to the patient decreased over the course of the waves.

Impact of COVID-19 first wave on the mental health of healthcare workers in a Front-Line Spanish Tertiary Hospital: lessons learned

“…Differences between public and private healthcare sectors has been also analyze previously. According to a recent study by Pabón-Carrasco, HCWs employed in publicly healthcare institutions reported a lower perceived risk of COVID-19 transmission compared to their counterparts in private institutions during the first wave 43 . However, anxiety levels were higher in public employed HCWs compared to those reported by those privately employed (more than 25% and ~ 20%, respectively).…”

“…However, anxiety levels were higher in public employed HCWs compared to those reported by those privately employed (more than 25% and ~ 20%, respectively). Both groups had high levels of anxiety, despite private sector was not considered first-line 43 .…”

“…Sociodemographic factors, such as gender and age have been previously related to a higher risk 38 . Female sex has been associated with a increased risk of mental disorders in several studies analyzing the impact of the COVID-19 pandemic on the mental health of HCWs 43 – 47 . A recent meta-analysis conducted by Lee and colleagues including 401 studies, has reported higher odds of probable mental health disorders in women, in particular depression, anxiety, PTSD and insomnia 48 .…”

“…The limited availability of personal protective equipment, the continuous exposure to infected patients, the rate of deaths, the absence of specific treatments, overwhelming workload are other factors contributing to the development of these mental issues 53 . Additionally, HCWs' rising anxiety about the spread of COVID-19 may be linked to the misinformation that circulated during the initial wave of the pandemic and the concern that they may be a possible risk of contagion to their partner and family 43 , 54 . Furthermore, herein it was observed that some job positions, specifically auxiliary nurses, have a higher risk of mental disorders ( p < 0.05).…”