Nursing home staff mental health during the Covid‐19 pandemic in the Republic of Ireland

Abstract

Background Nursing homes for older adults have been disproportionately affected by the Covid‐19 pandemic with increased mortality of residents and staff distress. Objective To quantify the mental health of nursing home staff during the Covid‐19 pandemic in the Republic of Ireland. Design/Methods Cross‐sectional anonymous study of Republic of Ireland nursing home staff ( n = 390) during the third wave of the Covid‐19 pandemic. Online survey collecting demographic information, Covid‐19 exposure history and mental health measures. Results There were significant differences between nurses, healthcare assistants (HCA) and non‐clinical staff history in age, ethnicity, years' experience, history of Covid‐19 infection and contact with Covid‐19 positive acquaintances. Moderate–severe post‐traumatic stress disorder symptoms were found in 45.1% (95% confidence interval [CI] 40.2%–50.1%) of all staff. A World Health Organisation‐5 (WHO‐5) wellbeing index score ≤32, indicating low mood, was reported by 38.7% (95% CI, 33.9%–43.5%) of staff; significantly more nurses reported low mood. Suicidal ideation and suicide planning were reported, respectively, by 13.8% (95% CI, 10.4%–17.3%) and 9.2% (95% CI, 6.4%–12.1%) of participants with no between‐group differences. HCAs reported a significantly higher degree of moral injury than non‐clinical staff. Nurses were more likely to use approach coping styles than non‐clinical staff. Work ability was insufficient in 24.6% (95% CI 20.3%–28.9%) of staff. Conclusion Nursing home staff report high levels of post‐traumatic stress, mood disturbance and moral injury during the Covid‐19 pandemic. Differences in degree of moral injury, wellbeing and coping styles were found between staff groups, which need to be incorporated into planning supports for this neglected workforce.

Prevalence, Predictors, and Experience of Moral Suffering in Nursing and Care Home Staff during the COVID-19 Pandemic: A Mixed-Methods Systematic Review

“…Of the eight studies included, two studies used quantitative cross-sectional designs [ 28 , 46 ], four studies employed qualitative designs using a general qualitative inquiry, phenomenological, or explorative approach [ 47 , 48 , 49 , 50 ], and two studies were of a mixed-methods design employing a cross-sectional survey design and general qualitative inquiry approach for quantitative and qualitative aspects, respectively [ 51 , 52 ].…”

“…With regard to the presence of the terms MI and MD in studies, only one study explicitly used the term MI, whilst three other studies used MD or the term “moral dilemma” explicitly [ 28 , 46 , 47 , 49 ]. The remaining studies implied the concepts of MI and MD in their research focus and findings [ 48 , 50 , 51 , 52 ].…”

“…Only one study of those included directly measured MI levels in N&CH staff [ 28 ]. In the cross-sectional study conducted in the Republic of Ireland, Brady and colleagues administered the Moral Injury Events Scale (MIES) to N&CH staff and found the average score for MIES in a sample size of 390 to be 20, higher than MIES scores previously found in international hospital workers during the pandemic.…”

“…Despite N&CH staff being under immense and unremitting pressures, the subject of MI and MD in the N&CH population during COVID-19 is relatively unexplored [ 3 , 28 ] in comparison to forms of anxiety; the prevalence of moderate-to-severe posttraumatic stress disorder (PTSD) and/or anxiety symptomology in N&CH staff during the first wave of the pandemic has been estimated to be as high as 43% [ 29 ]. Due to the implications this has on N&CH staff mental health and well-being, and in turn service delivery and quality of care provided to residents, the identified research space necessitates further exploration [ 9 , 30 ].…”

Job Demands, Work Functioning and Mental Health in Dutch Nursing Home Staff during the COVID-19 Outbreak: A Cross-Sectional Multilevel Study

“…The implementation of guidelines and the emotional burden were experienced as additional sources of stress. Other studies report prevalence rates of several mental health outcomes in nursing home staff, such as anxiety, post-traumatic stress disorders, mood disturbance, satisfaction and moral injury [ 18 , 19 , 20 ]. The prevalence of burnout and depression is especially interesting in nursing home staff.…”