The mental health of staff working on Intensive Care Units over the COVID-19 winter surge of 2020 in England: a cross sectional survey

Hall, Clifton L.; Milward, Joanna; Spoiala, Cristina; Bhogal, Jaskiran Kaur; Weston, Dale; Potts, Hww; Caulfield, Tristan; Toolan, Micheal; Kanga, Kate; El-Sheikha, Sarah; Fong, Kevin; Greenberg, Neil

doi:10.1101/2022.01.13.22269151

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…The majority of studies across different countries have shown that nurses [23 ▪▪ ,34,41 ▪▪ ,42,51–53,58–60] and female HCW [23 ▪▪ ,40,42,43,45 ▪▪ ,55 ▪▪ ,57,61–63] are at higher risk for experiencing symptoms of PTSD, burnout, anxiety and depression. Some studies have suggested younger age [41 ▪▪ ,59] as a risk factor for developing symptoms of mental health disorders, with mixed results regarding the amount of prior work experience [32 ▪▪ ,36,57,59].…”

Section: Resultsmentioning

confidence: 99%

Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers

Wahlster

Hartog

2022

Current Opinion in Critical Care

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Purpose of reviewWe aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. Recent findingsThe pandemic has resulted in a multitude of closely intertwined professional and personal challenges for ICU HCW. High rates of posttraumatic stress disorder (14--47%), burnout (45--85%), anxiety (31--60%), and depression (16--65%) have been reported, and these mental health symptoms are often interrelated. Most studies suggest that nurses and female HCW are at highest risk for developing mental health symptoms. The main personal concerns associated with reporting mental health symptoms among ICU HCW were worries about transmitting COVID-19 to their families, worries about their own health, witnessing colleagues contract the disease, and experiencing stigma from their communities. Major modifiable work-related risk factors were experiencing poor communication from supervisors, perceived lack of support from administrative leadership, and concerns about insufficient access to personal protective equipment, inability to rest, witnessing hasty end-of-life decisions, and restriction of family visitation policies.

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Section: Resultsmentioning

confidence: 99%

Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers

Wahlster

Hartog

2022

Current Opinion in Critical Care

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“…However, there were methods in place (i.e., second review of full text screening by a second reviewer, regular research team meetings to discuss concerns about papers and ndings) to provide robustness to the process. Thirdly, current literature has established that working throughout the pandemic results in a negative impact on mental health (51)(52)(53), which makes it di cult to disentangle the effect that working from home speci cally has on mental health. However, in the current review, homeworking was reported to result in worsened mental health when it was carried out, or continued, for a long period of time in comparison to hybrid working or for those working from home for a short period.…”

Section: Limitationsmentioning

confidence: 99%

The impact of Homeworking during COVID-19 on Mental Health and Productivity: A Systematic Review

Hall

Davidson²,

Brooks

et al. 2022

Preprint

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Background As of March 2020, the UK public were instructed to work from home and as a result, nearly half of those in employment did so during the following month. Pre-pandemic, around 5% of workers chose to work from home; it was often seen as advantageous, for example due to eliminating commuting time and increasing flexibility. However, homeworking also had negative connotations, for example, blurred boundaries between work and home life due to a sense of constant connectivity to the workplace. Therefore, understanding the psychological impact of working from home in an enforced and prolonged manner due to the COVID-19 pandemic is important. Therefore, this review sought to establish the impact of working from home in terms of mental health and productivity. Methods In January 2022, literature searches were conducted across four electronic databases: Medline, Embase, PsycInfo and Web of Science. In February 2022 grey literature searches were conducted using Google Advanced Search, NHS Evidence; Gov.uk Publications; and the British Library directory of online doctoral theses. Published and unpublished literature which collected data after March 2020, included participants who experienced working from home for at least some of their working hours, and detailed the impact of homeworking in relation to mental health or productivity were included. Results In total 6,906 citations were screened and 25 papers from electronic databases were included. Grey literature searching resulted in two additional papers. Therefore, 27 studies were included in this review. Findings suggest the impact of homeworking on mental health and productivity varies considerably, suggesting a complex relationship, with many factors having an influence on the relationship. Conclusion We found that there was no clear consensus as to the impact of working from home on mental health or productivity. However, there are indications that those who start homeworking for the first time during a pandemic are at risk of poor productivity, as are those who experience poor mental health. Suggestions for future research are suggested.

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“…Due to the COVID-19 pandemic, around 40% of healthcare workers in UK hospitals reported a level of symptoms consistent with a diagnosis of PTSD as of June/July 2020 [4] - five times higher than in 2015 [5]. Reports of mental health disorders in healthcare workers increased further to 64% in winter 2020 of the pandemic [6].…”

Section: Introductionmentioning

confidence: 99%

Treating intrusive memories after trauma in healthcare workers: a Bayesian adaptive randomised trial developing an imagery-competing task intervention

Ramineni¹,

Millroth

Iyadurai

et al. 2022

Preprint

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Intensive care unit (ICU) staff continue to face recurrent work-related traumatic events throughout the COVID-19 pandemic. Intrusive memories (IMs) of such traumatic events comprise sensory image-based memories. Harnessing research on preventing IMs with a novel behavioural intervention on the day of trauma, here we take critical next steps in developing this approach as a treatment for ICU staff who are already experiencing IMs days, weeks, or months post-trauma. To address the urgent need to develop novel mental health interventions, we used Bayesian statistical approaches to optimise a brief imagery-competing task intervention to reduce the number of IMs. We evaluated a digitised version of the intervention for remote, scalable delivery. We conducted a two-arm, parallel-group, randomised, adaptive Bayesian optimisation trial. Eligible participants worked clinically in a UK NHS ICU during the pandemic, experienced at least one work-related traumatic event, and at least three IMs in the week prior to recruitment. Participants were randomised to receive immediate or delayed (after four weeks) access to the intervention. Primary outcome was the number of IMs of trauma during week 4, controlling for baseline week. Analyses were conducted on an intention-to-treat basis as a between-group comparison. Prior to final analysis, sequential Bayesian analyses were conducted (n=20,23,29,37,41,45) to inform early stopping of the trial prior to the planned maximum recruitment (n=150). Final analysis (n=75) showed strong evidence for a positive treatment effect (Bayes factor, BF=1.25 × 106): the immediate arm reported fewer IMs (median=1, IQR=0-3) than the delayed arm (median=10, IQR=6-16.5). With further digital enhancements, the intervention (n=28) also showed a positive treatment effect (BF=7.31). Sequential Bayesian analyses provided evidence for reducing IMs of work-related trauma for healthcare workers. This methodology also allowed us to rule out negative effects early, reduced the planned maximum sample size, and allowed evaluation of enhancements. Trial Registration NCT02044809 (www.clinicaltrials.gov).

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The mental health of staff working on Intensive Care Units over the COVID-19 winter surge of 2020 in England: a cross sectional survey

Cited by 5 publications

References 37 publications

Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers

Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers

The impact of Homeworking during COVID-19 on Mental Health and Productivity: A Systematic Review

Treating intrusive memories after trauma in healthcare workers: a Bayesian adaptive randomised trial developing an imagery-competing task intervention

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