Mental health assessment of Spanish healthcare workers during the SARS-CoV-2 pandemic. A cross-sectional study

Abstract

Introduction The SARS-CoV-2 outbreak is posing unprecedented care scenarios, increasing the psychological distress among healthcare workers while reducing the efficiency of health systems. This work evaluated the psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers of two tertiary hospitals. Material and methods Healthcare workers were recruited from the medical units designated for the care of Covid-19 patients. The psychological assessment consisted of an individual, face-to-face session where gold-standard psychometric tests were administered to assess stress (VASS & PSS-10), anxiety (STAI), depression (PHQ-2) and posttraumatic stress disorder (PCL-5). Regression models were also fitted to identify predictors of psychological distress. Results Overall, almost 13% of healthcare workers showed severe anxiety, while more than 26% had high levels of perceived stress. More than 23% presented severe posttraumatic stress symptoms, and another 13% had PHQ-2 scores equal to or above 3, compatible with Major Depressive Disorder (MDD) diagnosis, respectively. Women, stress-related medication, overworking, performing in Covid-19 wards, and substance abuse were risk factors for increased psychological distress. Instead, practising exercise reduced the burden. Conclusion This study outlines the severe psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers. The stress, depression and anxiety levels found were similar to those reported in similar works but much higher than in Wuhan healthcare workers. Knowledge of risk factors for increased psychological distress may help to develop comprehensive intervention strategies to prevent, control and reduce the mental health exacerbation of healthcare workers, thereby maintaining the effectiveness of health systems in critical scenarios.

Mental health and the effects on methylation of stress-related genes in front-line versus other health care professionals during the second wave of COVID-19 pandemic: an Italian pilot study

“…However, this aspect even supports more the deleterious effect of frontline work on mental well-being of health workers as these subjects were basically less vulnerable to the development of psychiatric disorders than non-frontline professionals. Similar results were reported in a study conducted in Barcelona, where a significant number of frontline healthcare workers suffered from significant depression and anxiety during the pandemic, but few of them showed a history of anxiety and depression before COVID-19 outbreak [51].…”

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic

“…In frontline healthcare workers, the lack of resources alongside the overcrowded care wards, quarantines, increased workload, use of personal protective equipment (PPE), physical exhaustion, and fear of transmitting the disease, among others, have become risk factors for increased stress, anxiety, depression, sleep problems, and even suicide rate. 2 In other words, the wide range of physical, psychological and emotional stressors to which healthcare workers are constantly exposed when coping with the day-to-day situations of the Covid-19 pandemic have challenged and endangered their mental health and life quality, 3 thus interfering with the care quality and efficiency of health systems. 4 …”

“…On the one hand, no precise tools objectively measure the intensity with which a stressor affects an individual. 3 Physiological evaluation of symptoms is both complex and invasive, making follow-up difficult. On the other hand, psychometric questionnaires cannot determine the effect of the stressor on the person's health or even whether the stressor is being overcome.…”

“…On the other hand, psychometric questionnaires cannot determine the effect of the stressor on the person's health or even whether the stressor is being overcome. 3 , 5 Furthermore, learning effects and the desirability response bias often limit psychometric questionnaire results, as with online surveys. 6 …”

“… 7 , 8 Severe anxiety, depression and posttraumatic stress symptoms (PTSS), with prevalence of these disorders across medical personnel ranging from 9 to 90%, 5 to 21% and 11% to 16%, respectively. 3 , 9 , 10 …”