Psychological Health in Intensive Care Unit Health Care Workers after the COVID-19 Pandemic

Abstract

Background: Although the COVID-19 pandemic had an impact on the general population, health care workers (HCWs) constituted one of the groups that were most adversely affected by the associated risks, owing to the significant consequences on their mental health. This study examined these psychological effects on HCWs who cared for COVID-19 patients who were admitted to the intensive care unit in an Italian hospital. Methods: Subjects were administered several self-reported questionnaires: Kessler 10 Psychological Distress Scale (K10), Perceived Stress Scale-10 (PSS), Impact of Event Scale Revised (IES-R), and Post-traumatic Growth Inventory (PTGI), as well as two open-ended questions oriented toward understanding their positive and negative emotional experience and differentiating between two phases of the emergency. Results: Overall, 45% of HCWs showed medium-to-high anxiety/depressive symptoms, whereas 60% presented with medium-to-high levels of perceived stress. In addition, 37% of subjects developed symptoms of PTSD and 50% showed post-traumatic growth in the “appreciation of life” and “new possibilities” dimensions. With regard to the open-ended questions, three themes were identified: quality of workplace relationships, sense of emotional-relational competence, and sense of clinical-technical competence. In addition, two macrocategories of responses were identified in the answers: growth and block. Conclusions: The mental health of HCWs who are involved in the front line of COVID-19 was significantly impacted by this experience, showing high levels of post-traumatic stress and anxiety and depressive symptoms more than 1 year after the emergency began. A qualitative analysis of staff experiences can be a useful guide for structuring interventions and prevention.

Posttraumatic growth of medical staff during COVID-19 pandemic: A scoping review

“… Qualitative research Korea 18 nurses working in a COVID-19-designated hospital In-depth individual telephone interviews Nine themes were identified: pushed onto the battlefield without any preparation, struggling on the frontline, altered daily life, low morale, unexpectedly long war, ambivalence toward patients, forces that keep me going, giving meaning to my work, and taking another step in one’s growth. Carola et al [ 49 ] To examine the psychological effects on HCWs who cared for COVID-19 patients who were admitted to the intensive care unit in an Italian hospital. Mixed research Italy 35 COVID-19 intensive care unit HCWs PTGI, Two open-ended questions 1) 50% showed PTG in the “appreciation of life” and “new possibilities” dimensions.…”

“…Six qualitative studies [ 27 , 35 , 40 , 46 , 48 , 54 ] described the specific experiences of HCWs when confronted with or diagnosed with COVID-19 through three periods of stress/negativity, adjustment to adaptation, and growth, presenting PTG occurrence. The qualitative part of another mixed study [ 49 ] identified three themes: quality of workplace relationships, sense of emotional-relational competence, and clinical-technical competence. Each theme has two broad macro categories: growth and block.…”

“…Additionally, the experience of being a patient after a COVID-19 diagnosis also influences how HCWs treat patients, and role reversal and empathy improve the relationship with patients to some extent [ 27 , 54 ]. During this particular time, colleagues’ help, care, and encouragement in caring for infected patients promote teamwork and interpersonal relationships [ 27 , 35 , 48 , 49 , 54 ].…”

“…At the professional level, HCWs had a positive attitude toward gaining work experience related to a new infectious disease [ 48 , 49 ]. They viewed their current experience as a valuable opportunity to learn new skills and enhance their work, gradually moving from unfamiliarity at the beginning to completing the work previously given to the nurse aides and being able to quickly shift and focus on enhancing the quality of care and improving patient well-being.…”

Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review

“…Indeed, following the crisis, the prevalence of PTSD has increased to 73.3% among intensive care professionals. More than 1 year after the COVID crisis began, the prevalence of the disorder remains high (13, 7% [ 23 ] and 37% [ 24 ]). This prevalence of PTSD among ICU caregivers appears in the majority of studies in our review to exceed the prevalence of the population of health professionals, all specialties combined during the COVID crisis [ 25 ] and of the general population, which, outside the COVID period, is 8.3% over a lifetime in US [ 26 ], and more specifically in France in 2008 at 0.7% with an almost equal frequency between men and women [ 27 ].…”