Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy

Abstract

Aims Healthcare workers exposed to coronavirus 2019 (COVID-19) patients could be psychologically distressed. This study aims to assess the magnitude of psychological distress and associated factors among hospital staff during the COVID-19 pandemic in a large tertiary hospital located in north-east Italy. Methods All healthcare and administrative staff working in the Verona University Hospital (Veneto, Italy) during the COVID-19 pandemic were asked to complete a web-based survey from 21 April to 6 May 2020. Symptoms of post-traumatic distress, anxiety and depression were assessed, respectively, using the Impact of Event Scale (IES-R), the Self-rating Anxiety Scale (SAS) and the Patient Health Questionnaire (PHQ-9). Personal socio-demographic information and job characteristics were also collected, including gender, age, living condition, having pre-existing psychological problems, occupation, length of working experience, hospital unit (ICUs and sub-intensive COVID-19 units vs. non-COVID-19 units). A multivariable logistic regression analysis was performed to identify factors associated with each of the three mental health outcomes. Results A total of 2195 healthcare workers (36.9% of the overall hospital staff) participated in the study. Of the participants, 35.7% were nurses, 24.3% other healthcare staff, 16.4% residents, 13.9% physicians and 9.7% administrative staff. Nine per cent of healthcare staff worked in ICUs, 8% in sub-intensive COVID-19 units and 7.6% in other front-line services, while the remaining staff worked in hospital units not directly engaged with COVID-19 patients. Overall, 63.2% of participants reported COVID-related traumatic experiences at work and 53.8% (95% CI 51.0%–56.6%) showed symptoms of post-traumatic distress; moreover, 50.1% (95% CI 47.9%–52.3%) showed symptoms of clinically relevant anxiety and 26.6% (95% CI 24.7%–28.5%) symptoms of at least moderate depression. Multivariable logistic regressions showed that women, nurses, healthcare workers directly engaged with COVID-19 patients and those with pre-existing psychological problems were at increased risk of psychopathological consequences of the pandemic. Conclusions The psychological impact of the COVID-19 pandemic on healthcare staff working in a highly burdened geographical of north-east Italy is relevant and to some extent greater than that reported in China. The study provides solid grounds to elaborate and implement interventions pertaining to psychology and occupational health.

The “Healthcare Workers’ Wellbeing (Benessere Operatori)” Project: A Picture of the Mental Health Conditions of Italian Healthcare Workers during the First Wave of the COVID-19 Pandemic

“…Moreover, physicians and nurses who worked in COVID wards reported worse working conditions even compared to other healthcare workers who worked in COVID wards. These results are in line with the literature showing that working in COVID wards is an independent risk factor for higher levels of anxiety, burnout, insomnia, and PTSD symptoms [ 7 , 18 , 19 , 22 , 25 ]. Indeed, working in COVID wards entails the risk of contracting the infection and spending several hours under uncomfortable working conditions without taking a break [ 7 ].…”

“…In particular, nurses reported higher levels of anxiety, depression, and PTSD symptoms than did other groups of healthcare workers and clerical staff [ 5 , 7 , 15 , 24 ]. These differences are probably related to the amount of time spent in contact with patients [ 25 ].…”

Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study

“…Anxiety and depression symptoms were more common among nurses than doctors. Our findings are comparable to those of an Italian study [ 38 ] conducted on HCW during COVID-19 that demonstrated that staff working in ICUs or sub-intensive COVID-19 units had a significantly increased risk of developing adverse psychological outcomes (more specifically, post-traumatic distress symptoms and depression), independent of any other factor, and that nurses had a considerably greater risk of adverse psychological outcomes than physicians. One study conducted in the UK on ICU workers during the pandemic [ 39 ] showed that higher levels of anxiety and depression were reported in females and in nurses than physicians.…”

Impact of the coronavirus disease 2019 pandemic on healthcare workers: systematic comparison between nurses and medical doctors

“…A more detailed overview of all investigated outcome measures can be found in Table 1 [ 3 , 8 ▪ , 10 , 11 ▪ , 12 ▪ , 13 , 14 ▪ , 15 – 20 , 21 ▪ , 22 ▪ , 23 , 24 , 25 ▪ , 26 , 27 , 28 ▪ , 29 ▪ , 30 , 31 – 34 ].…”