Mental health and stress among ICU healthcare professionals in France according to intensity of the COVID-19 epidemic

Abstract

Background We investigated the impact of the COVID-19 crisis on mental health of professionals working in the intensive care unit (ICU) according to the intensity of the epidemic in France. Methods This cross-sectional survey was conducted in 77 French hospitals from April 22 to May 13 2020. All ICU frontline healthcare workers were eligible. The primary endpoint was the mental health, assessed using the 12-item General Health Questionnaire. Sources of stress during the crisis were assessed using the Perceived Stressors in Intensive Care Units (PS-ICU) scale. Epidemic intensity was defined as high or low for each region based on publicly available data from Santé Publique France. Effects were assessed using linear mixed models, moderation and mediation analyses. Results In total, 2643 health professionals participated; 64.36% in high-intensity zones. Professionals in areas with greater epidemic intensity were at higher risk of mental health issues (p < 0.001), and higher levels of overall perceived stress (p < 0.001), compared to low-intensity zones. Factors associated with higher overall perceived stress were female sex (B = 0.13; 95% confidence interval [CI] = 0.08–0.17), having a relative at risk of COVID-19 (B = 0.14; 95%-CI = 0.09–0.18) and working in high-intensity zones (B = 0.11; 95%-CI = 0.02–0.20). Perceived stress mediated the impact of the crisis context on mental health (B = 0.23, 95%-CI = 0.05, 0.41) and the impact of stress on mental health was moderated by positive thinking, b = − 0.32, 95% CI = − 0.54, − 0.11. Conclusion COVID-19 negatively impacted the mental health of ICU professionals. Professionals working in zones where the epidemic was of high intensity were significantly more affected, with higher levels of perceived stress. This study is supported by a grant from the French Ministry of Health (PHRC-COVID 2020).

The Burden of Burnout among Healthcare Professionals of Intensive Care Units and Emergency Departments during the COVID-19 Pandemic: A Systematic Review

“…Furthermore, during the pandemic, nurses faced a disruption in their everyday activity, as they found themselves in the position of caring closely for patients suddenly deprived of their families, causing a significant emotional burden and a feeling of inadequacy. This situation inevitably led to an increase of psychological distress [43]. As described by Laurent et al [44], when dealing with end-of-life decisions, nurses tend to consider themselves as simple executing agents, in order to dissociate themselves from decisions in which they did not participate.…”

A qualitative study of reinforcement workers’ perceptions and experiences of working in intensive care during the COVID-19 pandemic: A PsyCOVID-ICU substudy

“…The authors explained this by the fact that regular ICU staff had to both deal with the first wave of the pandemic and train the reinforcement, with greater responsibility for any potential errors committed by the support staff, thus profoundly disturbing the usual working conditions. Conversely, in the PsyCOVID-ICU study [5], involving 77 hospitals throughout France, our group previously showed that support staff redeployed to the ICU were at higher risk of psychological distress as compared to permanent ICU staff.…”

Impact of the COVID-19 pandemic on the mental health of professionals in 77 hospitals in France

“…Numerous studies have investigated the impact of the COVID-19 pandemic on healthcare workers in units dedicated to the care of COVID-19 patients, reporting high levels of anxiety, depression, burnout, insomnia and psychological distress [5][6][7][8][9][10]. Among health professionals, meta-analyses reveal a frequency of 12.2-36% for depression and 13-37% for anxiety [11][12][13][14].…”