Healthcare Worker Mental Health After the Initial Peak of the COVID-19 Pandemic: a US Medical Center Cross-Sectional Survey

Abstract

BACKGROUND: There is a paucity of data on the mental health impact of the Coronavirus disease 2019 (COVID-19) pandemic on United States (US) healthcare workers (HCWs) after the first surge in the spring of 2020. OBJECTIVE: To determine the impact of the pandemic on HCWs, and the relationship between HCW mental health and demographics, occupational factors, and COVID-19 concerns. DESIGN: Cross-sectional survey in an urban medical center (September-November 2020) in Baltimore, MD, in the United States. PARTICIPANTS: A total of 605 HCWs (physicians, nurse practitioners, nurses, physician assistants, patient care technicians, respiratory therapists, social workers, mental health therapists, and case managers). MAIN MEASURES: Measures of mental health (Patient Health Questionnaire-2, Generalized Anxiety Disorder-7, PROMIS Sleep Disturbance 4a, Impact of Event Scale-Revised, Maslach Burnout Inventory-2 item, Connor-Davidson Resilience Scale-2 item), demographics, occupational factors, and COVID-19 related concerns. KEY RESULTS: Fifty-two percent of 1198 HCWs responded to the survey and 14.2% reported depression, 43.1% mild or higher anxiety, 31.6% sleep disturbance, 22.3% posttraumatic stress symptoms, 21.6% depersonalization, 46.0% emotional exhaustion, and 23.1% lower resilience. Relative to HCWs providing in-person care to COVID-19 infected patients none of their working days, those doing so all or most days were more likely to experience worse depression (adjusted odds ratio, 3.9; 95% CI, 1.3-11.7), anxiety (aOR, 3.0; 95% CI, 1.4-6.3), possible PTSD symptoms (aOR, 2.6; 95% CI, 1.1-5.8), and higher burnout (aOR, 2.6; 95% CI, 1.1-6.0). Worse mental health in several domains was associated with higher health fear (aORs ranged from 2.2 to 5.0), job stressors (aORs ranged from 1.9 to 4.0), perceived social stigma/avoidance (aORs ranged from 1.8 to 2.9), and workplace safety concerns (aORs ranged from 1.8 to 2.8). CONCLUSIONS: US HCWs experienced significant mental health symptoms eight months into the pandemic. More time spent providing in-person care to COVID-19infected patients and greater COVID-19-related concerns were consistently associated with worse mental health.

Single-center investigation on central-line–associated bloodstream infections and blood-culture contamination during the early months of the coronavirus disease 2019 (COVID-19) pandemic

“…[6][7][8] Fourth, healthcare worker burnout is an important factor that was not assessed and could have affected outcomes. 9 Finally, differing COVID-19 policies and PPE availability during the pandemic's first wave make these results difficult to extrapolate to non-pandemic-related scenarios.…”

Changing patterns of the prevalence of burnout and secondary traumatic stress in health‐system pharmacists throughout the COVID‐19 pandemic

“…Pharmacists reported that working overtime, medication supply and patient incivility were factors that affected work. This has been shown in several recent studies in nurses, physicians, and other health care professionals throughout the world 11‐18 . A recent study assessed the psychological response in 467 nurses early in the COVID‐19 pandemic and showed that 54.6% of nurses reported traumatic stress, 54.6% reported depressive symptoms, 32.4% reported insomnia, and 37.3% reported anxiety 17 .…”

“…This has been shown in several recent studies in nurses, physicians, and other health care professionals throughout the world. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 A recent study assessed the psychological response in 467 nurses early in the COVID‐19 pandemic and showed that 54.6% of nurses reported traumatic stress, 54.6% reported depressive symptoms, 32.4% reported insomnia, and 37.3% reported anxiety. 17 Another study in 605 health care workers (physicians, nurse practitioners, nurses, physician assistants, patient care technicians, respiratory therapists, social workers, mental health therapists, and case managers) early in the pandemic showed that 14.2% reported depressive symptoms, 43.2% reported mild or high anxiety, 22.3% reported posttraumatic stress disorder (PTSD) symptoms, 46% reported emotional exhaustion, 21.6% reported depersonalization, and 23.1% reported lower resilience.…”

“…A recent study assessed the psychological response in 467 nurses early in the COVID‐19 pandemic and showed that 54.6% of nurses reported traumatic stress, 54.6% reported depressive symptoms, 32.4% reported insomnia, and 37.3% reported anxiety 17 . Another study in 605 health care workers (physicians, nurse practitioners, nurses, physician assistants, patient care technicians, respiratory therapists, social workers, mental health therapists, and case managers) early in the pandemic showed that 14.2% reported depressive symptoms, 43.2% reported mild or high anxiety, 22.3% reported posttraumatic stress disorder (PTSD) symptoms, 46% reported emotional exhaustion, 21.6% reported depersonalization, and 23.1% reported lower resilience 18 . Health care workers who cared for COVID‐19 infected patients in‐person were more likely to experience worse depression, anxiety, possible PTSD, and higher burnout.…”

Knowledge mapping analysis of mental health research on COVID-19

“…In addition to physicians and nurses, healthcare workers also include patient care technicians, respiratory therapists, mental health therapists, etc. In the face of clinical uncertainty, in addition to feeling mental stress, they also have a fear of the unknown, perceived social stigma, and workplace safety concerns ( 28 ). Social and family support can effectively alleviate these negative emotions.…”