The Health Behaviour of German Outpatient Caregivers in Relation to the COVID-19 Pandemic: A Mixed-Methods Study

Abstract

The COVID-19 pandemic has affected outpatient caregivers in a particular way. While the German population becomes increasingly older, the number of people in need of care has also increased. The health and, thus, the health behaviour of employees in the outpatient care become relevant to maintain working capacity and performance in the long term. The aims of the study were (1) to examine the health behaviour and (2) to explore pandemic-related perceived change of health behaviour among outpatient caregivers during the COVID-19 pandemic. In a mixed-methods study, 15 problem-centred interviews and a web-based cross-sectional survey (N = 171) were conducted with outpatient caregivers working in Northern Germany. Interviewees reported partially poorer eating behaviour, higher coffee consumption, lower physical activity, skipping breaks more often and less sleep duration and quality during the pandemic. Some quantitative findings indicate the same tendencies. A majority of participants were smokers and reported higher stress perception due to the pandemic. Preventive behaviour, such as wearing PPE or hand hygiene, was increased among interviewees compared to the pre-pandemic period. Our findings indicate that the COVID-19 pandemic could negatively affect outpatient caregivers’ health behaviour, e.g., eating/drinking behaviour and physical activity. Therefore, employers in outpatient care should develop workplace health promotion measures to support their employees in conducting more health-promoting behaviours during the COVID-19 pandemic.

The Role of Health Literacy among Outpatient Caregivers during the COVID-19 Pandemic

“…Similarly, physical activity had not decreased due to the COVID-19 pandemic according to a German panel survey [60]. However, a systematic review reports decreased physical activity during the COVID-19 pandemic lockdown [61], which is also consistent with the findings of the mixed-methods study among outpatient caregivers [40]. Although there are no cut-off values for the PSS-10 since it is not a diagnostic instrument [57], the average score may be considered a moderate stress perception when compared to mean values of the general US population [58,62].…”

“…The MEDAS score as a measurement for overall dietary quality revealed slightly lower values compared to the general Italian population during the COVID-19 lockdown [59], although a generally higher adherence to the Mediterranean diet could be expected in their sample due to the geographical location and cultural aspects. In agreement with these results, a mixed-methods study from the COVID-19 context, outpatient caregivers in Germany showed unchanged or slightly deteriorating eating behaviour [40]. Similarly, physical activity had not decreased due to the COVID-19 pandemic according to a German panel survey [60].…”

“…Further study results show that job demands increased during the COVID-19 pandemic, and thus, stress perception, as a negative strain reaction of outpatient caregivers, also increased [39]. A current mixed-methods study from the COVID-19 context even provides insights of higher levels of perceived stress among outpatient caregivers during the pandemic [40]. In a study among hospital staff within the context of the A/H1N1 influenza pandemic, participants' perceived information sufficiency was significantly associated with their degree of worry about the pandemic.…”

“…However, the question as to why there is no significant effect with regard to physical activity remains unanswered. This is possibly related to the high level of job-related physical activity or restrictions such as the closure of gyms during the lockdown, as suggested by German outpatient caregivers in another study [40].…”

“…However, the ongoing pandemic can also represent a stressor, leading to changes in health behaviours [59,75]. While the findings of a pre-COVID-19 Polish study among nurses (n = 1080) indicate that lower psychophysical mood was associated with a greater tendency to develop improper eating habits in a non-pandemic context [76], findings by a recent mixed methods-study among outpatient caregivers from Germany revealed unchanged or deteriorating eating behaviour for the majority of participants, as well as less physical activity during the COVID-19 pandemic [40].…”