Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy

Ghio, Lucio; Patti, Sara; Piccinini, Giulia; Modafferi, Cinzia; Lusetti, Eleonora; Mazzella, Massimo; Sette, Massimo Del

doi:10.3390/ijerph18189929

Cited by 29 publications

(25 citation statements)

References 48 publications

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“…A survey conducted within the framework of the COVID-19 HEROES initiative in Spain, a country close to Italy in terms of geography, culture, and organization of services, found that 27% of the HCWs interviewed screened positive at the PHQ-9 and 74% at the GHQ-12 ( 36 ). The lower estimates in our study can be explained by the fact that we collected data during the re-opening phase after lockdown, when the number of COVID-19 cases and thus the workload of HCWs were decreasing, while in Spain and the other studies cited data were collected during the first wave ( 36 , 41 , 42 ) or at the beginning of the second wave ( 43 , 44 ). Furthermore, we decided to adopt a very high cut-off both for the PHQ-9 (scores ≥ 15) and the GHQ-12 (scores ≥ 4 using the bimodal scoring method), while for instance, the Spanish group adopted lower cut-offs (PHQ-9 > 9 and GHQ-12 > 2) ( 36 ).…”

Section: Discussioncontrasting

confidence: 58%

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

et al. 2022

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IntroductionItaly is one of the high-income countries hit hardest by Covid-19. During the first months of the pandemic, Italian healthcare workers were praised by media and the public for their efforts to face the emergency, although with limited knowledge and resources. However, healthcare workers soon had to face new challenges at a time when the national health system was working hard to recover. This study focuses on this difficult period to assess the impact of the COVID-19 pandemic on the mental health of Italian healthcare workers.Materials and MethodsHealthcare workers from all Italian regions [n = 5,502] completed an online questionnaire during the reopening phase after the first wave lockdown. We assessed a set of individual-level factors (e.g., stigma and violence against HCWs) and a set of workplace-level factors (e.g., trust in the workplace capacity to handle COVID-19) that were especially relevant in this context. The primary outcomes assessed were score ≥15 on the Patient Health Questionnaire-9 and score ≥4 on the General Health Questionnaire-12, indicators of clinically significant depressive symptoms and psychological distress, respectively. Logistic regression analyses were performed on depressive symptoms and psychological distress for each individual- and workplace-level factor adjusting for gender, age, and profession.ResultsClinically significant depressive symptoms were observed in 7.5% and psychological distress in 37.9% of HCWs. 30.5% of healthcare workers reported having felt stigmatized or discriminated, while 5.7% reported having experienced violence. Feeling stigmatized or discriminated and experiencing violence due to being a healthcare worker were strongly associated with clinically significant depressive symptoms [OR 2.98, 95%CI 2.36–3.77 and OR 4.72 95%CI 3.41–6.54] and psychological distress [OR 2.30, 95%CI 2.01–2.64 and OR 2.85 95%CI 2.16–3.75]. Numerous workplace-level factors, e.g., trust in the workplace capacity to handle COVID-19 [OR 2.43, 95%CI 1.92–3.07] and close contact with a co-worker who died of COVID-19 [OR 2.05, 95%CI 1.56–2.70] were also associated with clinically significant depressive symptoms. Similar results were found for psychological distress.ConclusionsOur study emphasizes the need to address discrimination and violence against healthcare professionals and improve healthcare work environments to strengthen the national health system's capacity to manage future emergencies.

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Section: Discussioncontrasting

confidence: 58%

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

et al. 2022

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“…In particular, burnout is a common syndrome in HCWs amid the pandemic. While burnout syndrome is not included in the list of mental disorders in the 10th revision of the International Classification of Diseases, a study suggested its association with major mental disorders such as insomnia, depression, anxiety, and post-traumatic symptoms [ 7 ]. We previously reported that HCWs who engaged in care of COVID-19 patients had significantly higher burnout rates (50.0%) than those who did not, and those working in the intensive care unit were more likely to have experienced burnout than those in floors [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Burnout of Healthcare Workers Amid the COVID-19 Pandemic: A Follow-Up Study

Nishimura

Miyoshi

Sato

et al. 2021

IJERPH

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The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to the modern healthcare system and led to increased burnout among healthcare workers (HCWs). We previously reported that HCWs who engaged in COVID-19 patient care had a significantly higher prevalence of burnout (50.0%) than those who did not in November 2020 (period 1). We performed follow-up surveys in HCWs in a Japanese national university hospital, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks, and the Maslach Burnout Inventory in February 2021 (period 2) and May 2021 (period 3). Periods 1 and 3 were amid the surges of COVID-19 cases, and period 2 was a post-surge period with a comparatively small number of COVID-19 patients requiring hospitalization. Response rates to the surveys were 33/130 (25.4%) in period 1, 36/130 (27.7%) in period 2, and 56/162 (34.6%) in period 3, respectively. While no consistent tendency in the prevalence of burnout based on variables was observed throughout the periods, the prevalence of burnout tends to be higher in periods 1 and 3 in those who engaged in COVID-19 patient care in the last 2 weeks (50.0%, 30.8%, 43.1% in period 1, 2, and 3, respectively). Given the prolonged pandemic causing stigmatization and hatred against HCWs leading to increased prevalence of burnout, high-level interventions and supports are warranted.

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“…These excellent results on users' and MHW' satisfaction were recorded in Italy, while the health staff of non-psychiatric agencies experienced stress and frustration [34]; Lasalvia et al [35] found that 53.8% (95% CI [51.0-56.6%]) of health care workers showed symptoms of post-traumatic distress, 50.1% (95% CI [47.9-52.3%]) symptoms of clinically relevant anxiety and 26.6% (95% CI [24.7-28.5%]) of at least moderate depression. Similarly, Rossi et al [36] found that 49.4% of health workers showed symptoms of post-traumatic stress disorder, 24.7% symptoms of depression, and 19.8% symptoms of anxiety; at the same time there was a substantial distrust of the population towards the health system as a whole [37].…”

Section: Discussionmentioning

confidence: 85%

Why Was the Perception of Human Rights Respect and Care Satisfaction So High in Users of Italian Mental Health Services during the COVID-19 Pandemic?

Carta

Sancassiani

Ganassi

et al. 2022

JCM

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The aim of this study was to compare users’ and mental health workers’ (MHW) perception of respect of human rights and job/care satisfaction in mental health services in Italy during the COVID-19 pandemic. A sample of users and MHW of Sardinia, Italy, fulfilled the “Well-Being at work and respect for human rights questionnaire” (WWRR). The study included 240 MHW and 200 users. Users showed a higher level of satisfaction of care than MHW of work, and a higher perception of the satisfaction of users and human rights respected for health workers. Both user and MHW responses were about 85% of the maximum score, except for satisfaction with resources. Responses were higher for users, but users and MHW both showed high levels of satisfaction. In previous surveys, MHW of Sardinia showed higher scores in all items of WWRR, except for satisfaction with resources, compared with workers from other health sectors of the same region, and with MHW from other countries. The low score for satisfaction with resources (in users and staff) is consistent with a progressive impoverishment of resources for mental health care in Italy. The study, although confirming the validity of the Italian model, fully oriented towards community, sets off an alarm bell on the risks resulting from the decrease in resources.

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Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy

Cited by 29 publications

References 48 publications

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

Burnout of Healthcare Workers Amid the COVID-19 Pandemic: A Follow-Up Study

Why Was the Perception of Human Rights Respect and Care Satisfaction So High in Users of Italian Mental Health Services during the COVID-19 Pandemic?

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