Longitudinal Study Comparing Mental Health Outcomes in Frontline Emergency Department Healthcare Workers through the Different Waves of the COVID-19 Pandemic

Abstract

As countries transition from the COVID-19 pandemic to endemic status, healthcare systems continue to be under pressure. We aimed to quantify changes in depression, anxiety, stress and post-traumatic stress disorder (PTSD) between 3 cohorts (2020, 2021 and 2022) of our Emergency Department (ED) healthcare workers (HCWs) and those who had worked through all 3 phases of the pandemic; and identify factors associated with poorer mental health outcomes (MHOs). In this longitudinal single-centre study in Singapore, three surveys were carried out yearly (2020, 2021 and 2022) since the COVID-19 outbreak. Depression, anxiety and stress were measured using DASS-21, and PTSD was measured using IES-R. A total of 327 HCWs (90.1%) participated in 2020, 279 (71.5%) in 2021 and 397 (92.8%) in 2022. In 2022, ED HCWs had greater concerns about workload (Mean score ± SD: 2022: 4.81 ± 0.86, vs. 2021: 4.37 ± 0.89, vs. 2020: 4.04 ± 0.97) and perceived to have less workplace support (2022: 4.48 ± 0.76, vs. 2021: 4.66 ± 0.70, vs. 2020: 4.80 ± 0.69). There was overall worsening depression (27.5% in 2020, 29.7% in 2021 and 32.2% in 2022) and stress (12.2% in 2020, 14.0% in 2021 and 17.4% in 2022). Healthcare assistants as a subgroup had improving MHOs. ED HCWs who were female and had psychiatric history, were living with the elderly, and had concerns about their working environment, workload and infection had poorer MHOs. This study will guide us in refining existing and devising more focused interventions to further support our ED HCWs’ wellbeing.

Worsening psychological wellbeing of Australian hospital clinical staff during three waves of the coronavirus (COVID-19) pandemic

“…Some other longitudinal studies have also reported persistent mental health impacts on frontline healthcare workers despite changes in, and subsidence of, pandemic waves. 4,13,14 In contrast, others have found variation in healthcare worker wellbeing over the duration of the pandemic. A recent Australian study reported a slight improvement in healthcare worker wellbeing after the initial 2 years 18 and a study in the UK found the proportion of healthcare workers reporting common mental disorders was greater during periods when demands on the healthcare system increased due to factors such as higher COVID-19 case numbers and associated staff shortages.…”

“…[10][11][12][13] Few have collected data over a longer time period, and these have mostly focused on a particular group of healthcare workers. 4,[14][15][16] These studies suggest that healthcare workers have experienced psychological distress at various timepoints during the COVID-19 pandemic 4,10,11,13 and their wellbeing deteriorated as the pandemic continued. 10,[13][14][15] Although these studies provide important evidence about the immediate impact of the pandemic on healthcare workers, little is known about the longer-term impacts.…”

“…4,[14][15][16] These studies suggest that healthcare workers have experienced psychological distress at various timepoints during the COVID-19 pandemic 4,10,11,13 and their wellbeing deteriorated as the pandemic continued. 10,[13][14][15] Although these studies provide important evidence about the immediate impact of the pandemic on healthcare workers, little is known about the longer-term impacts. Longitudinal studies that collect data over different waves of the pandemic are required to understand the long-term impacts on hospital clinical staff including whether the effects are chronic or transient.…”

COVID-19 aus Sicht der Gastroenterologie

“…Risikofaktoren für einen schweren COVID- 19 VondenBefragtengaben67 %einmoderates oder hohes Level an psychologischem Stress an [11]. Eine Studie aus Singapur belegt eine Zunahme der Prävalenz depressiver Veränderungen, Stress und Angst bei Mitarbeitern in Notaufnahmen mit zunehmender Dauer der Pandemie [39]. Alarmierende Daten zu Burn-out-Raten bei Angestellten im Gesundheitssystem werden aber ebenso aus Europa berichtet [9,41].…”

Changes in hospital staff’ mental health during the Covid-19 pandemic: longitudinal results from the international COPE-CORONA study

“…This finding suggests that the burden for the hospitals during the COVID-19 pandemic had a long-term impact on HCWs' emotional distress. Previous longitudinal studies have shown that HCWs have experienced high levels of anxiety, depression, burnout, and posttraumatic stress disorder (PTSD) as a result of their work during the pandemic [42][43][44]. The prolonged nature of the pandemic, as well as long working hours, exposure to critically ill patients, and the risk of contracting the virus itself, added to the stress and emotional toll on HCWs [45].…”