Psychosocial distress amongst Canadian intensive care unit healthcare workers during the acceleration phase of the COVID-19 pandemic

Abstract

Intensive care unit healthcare workers (ICU HCW) are at risk of mental health issues during emerging disease outbreaks. A study of ICU HCW from France revealed symptoms of anxiety and depression in 50.4% and 30.4% of workers at the peak of the first wave of the pandemic. The level of COVID-19 exposure of these ICU HCW was very high. In Canada, ICU HCW experienced variable exposure to COVID-19 during the first wave of the pandemic, with some hospitals seeing large numbers of patients while others saw few or none. In this study we examined the relationship between COVID-19 exposure and mental health in Canadian ICU HCW. We conducted a cross-sectional cohort study of Canadian ICU HCW in April 2020, during the acceleration phase of the first wave of the pandemic. Psychosocial distress was assessed using the 12-item General Health Questionnaire (GHQ-12). Participants were asked about sources of stress as well as about exposure to COVID-19 patients and availability of personal protective equipment (PPE). Factors associated with clinically-relevant psychosocial distress were identified. Responses were received from 310 Canadian ICU HCW affiliated with more than 30 institutions. Of these, 64.5% scored ≥ 3 points on the GHQ-12 questionnaire, indicating clinically-relevant psychosocial distress. The frequency of psychosocial distress was highest amongst registered nurses (75.7%) and lowest amongst physicians (49.4%). It was also higher amongst females (64.9%) than males (47.6%). Although PPE availability was good (> 80% of participants reported adequate availability), there was significant anxiety with respect to PPE availability, with respect to the risk of being infected with COVID-19, and with respect to the risk of transmitting COVID-19 to others. In multivariable regression analysis, Anxiety with respect to being infected with COVID-19 (OR 1.53, CI 1.31–1.81) was the strongest positive predictor of clinically-relevant psychosocial distress while the Number of shifts with COVID-19 exposure (OR 0.86, CI 0.75–0.95) was the strongest negative predictor. In summary, clinically-relevant psychosocial distress was identified amongst a majority of ICU HCW during the acceleration phase of the first wave of the COVID-19 pandemic, including those with minimal or no exposure to COVID-19. Strategies to support mental health amongst ICU HCW are required across the entire healthcare system.

The impact of the COVID-19 pandemic on intensive care unit workers: a nationwide survey

“…The finding that women and nurses are at greater risk of psychological distress than men are is consistent across most studies. 6 , 15 , 24 , 25 , 27 , 28 , 30 – 33 This may reflect greater and more prolonged direct exposure of nurses than other HCPs to COVID-19 patients, which may be intensified by the disproportionate burden of family and domestic responsibilities shouldered by women. 34 …”

Psychosocial Impact of the COVID-19 Pandemic on Healthcare Workers and Initial Areas of Action for Intervention and Prevention—The egePan/VOICE Study

“…This observation fits with the findings of Zhang et al, who found a higher prevalence of mental stress symptoms, such as anxiety and depression, in healthcare workers with direct contact to COVID-19-infected patients (N = 927) compared with nonmedical healthcare workers (N = 1255) [ 49 ]. A study on 310 Canadian HCWs also showed that the prevalence of psychosocial stress was highest among registered nurses (75.7%) and lowest among physicians (49.4%) [ 50 ]. Additionally, a systematic review by Busch et al also found that frontline staff were primarily concerned about infecting themselves (47%) or passing the virus to family members (60%) [ 34 ].…”

Analysis of Psychological Trends and Policy Recommendations of Medical Staff in Northern China in the Latter Stages of the COVID-19 Pandemic

“…The rates of anxiety and depression were 14 and 19% in the general public in Hong Kong, respectively (Choi et al, 2020 ; Tang et al, 2020 ). For medical staff, a certain percentage of medical staff had anxiety, depression, burnout or clinically-relevant psychosocial distress, confirmed by investigation studies conducted in other countries such Kenya, Japan, and Canada (Binnie et al, 2021 ; Kwobah et al, 2021 ; Matsuo et al, 2021 ). In this study, the rates of anxiety and depression were 21.1 and 43.9% in the whole sample, respectively, which were lower than those in COVID-19 patients or the people with a special background and higher than those in other populations.…”

“…Previous studies have also found that the occurrence of adverse psychological problems coexists with obvious gender and work position characteristics. For example, the occurrence rate of adverse psychological problems in nurses was higher than doctors, and the occurrence of adverse psychological problems in women was higher than men (Huang et al, 2020 ; Binnie et al, 2021 ; Kwobah et al, 2021 ). However, in this study, the rates of anxiety (20.7 vs. 21.2%) and depression (43.1 vs. 44.1%) in men and women were similar, and the rates of anxiety (21.3 vs. 21.0%) and depression (44.8 vs. 43.5%) in doctors and nurses were also similar.…”