Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak

Mediavilla, Roberto; Fernández-Jiménez, E.; Andreo, Jorge; Morán-Sánchez, Inés; Muñoz-Sanjosé, Ainoa; Moreno‐Küstner, Berta; Mascayano, Franco; Ayuso-Mateos, José Luís; Bravo-Ortiz, María-Fé; Martínez-Alés, Gonzalo

doi:10.1016/j.rpsm.2021.06.001

Cited by 22 publications

(17 citation statements)

References 15 publications

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“…In a few weeks, they went from heroes to negligent professionals in the eyes of many persons, while a number of lawyers and prosecutors started to put their decisions and treatment choices under judiciary scrutiny ( 16 ). Although studies from other countries have shown the negative impact of stigma and violence related to COVID-19 on HCWs' mental wellbeing ( 17 , 18 ), these factors have been neglected in previous research conducted in Italy. In the present paper, we used a large national sample of Italian HCWs to examine whether their mental wellbeing during the challenging reopening phase after lockdown was related to 1) individual-level factors such as stigma and violence against HCWs, and 2) workplace-level factors related to COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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 fact, it has been reported that between 28-38% suffered anxiety, 15-36 % from depression and 25-46% from sleep problems ( Luo et al, 2020 ; Pappa et al, 2020 ; Rodriguez-Menéndez et al, 2021 ; Wu et al, 2021 ). Moreover, a significant proportion of HCW facing COVID-19 pandemic have experienced discrimination and/or stigmatization which has been demonstrated to impact negatively on the mental health status of HCW ( Mediavilla et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Trauma and stressor-related disorders among health care workers during COVID-19 pandemic and the role of the gender: A prospective longitudinal survey.

Canal‐Rivero

Armesto-Luque

Rubio-García

et al. 2022

Journal of Affective Disorders

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Introduction Health-care Workers (HCW) are facing a critical situation caused by Coronavirus Disease 2019 (COVID-19) which could impact on their mental health status. In addition, HCW women have been identified as a group at high-risk of developing psychological distress, although no previous longitudinal studies have explored this issue in a sample of HCW. Aims The main aim of the study was to observe the temporal pattern of the stress reactions among HCW as well as to explore its potential predictors of poor outcome. Moreover, we analyzed possible gender differences in stress reaction responses. Methods One thousand for hundred and thirty-two HCW responded an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Bivariate and multivariate analyses as well as repeated measures analyses were used to achieve the aims of the study. Results The proportion of HCW who fulfilled Acute Stress Disorder criteria did not change over the follow-up period, although we observed a significant improvement in stress reactions responses among HCW. Proximal factors were the most salient predictors of traumatic reactions. Repeated analyses revealed significant gender differences in acute stress reactions. In addition, women showed significantly greater improvement than men in re-experiencing the traumatic event and hyperarousal dimensions. Conclusions Monitoring of working conditions as well as emotional reactions in HCW facing major disasters should be carried out to prevent the development of peritraumatic stress reactions. In addition, HCW women are characterized by a different pattern of progression in stress responses.

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“…Multiple social and economic consequences have already been reported (e.g., spiking unemployment rates), while others are expected to occur in the following months, and they have been increasing social divides and inequalities across the world [ 6 ]. There has also been a diversity of responses to HCWs, ranging from public cheering and gratitude to stigma and assault [ 7 ], especially in some low-and-middle-income countries (LIMCs).…”

Section: Introductionmentioning

confidence: 99%

“…These may lead to moral injury [ 15 ], which may be internalized and compound the acute stress of working during a pandemic [ 16 , 17 ]. Moreover, social exposures such as stigma and harassment toward HCWs may worsen effects on mental health, though these have not been carefully studied yet [ 7 ]. To assess the risk and predictors of mental health disorders among HCWs during COVID-19 individual factors must be accounted for, as well as the potential impact of workplace and social conditions and policies, which are potentially modifiable conditions.…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

Mascayano

Ven

Moro

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Background Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. Methods Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country's income level. Results As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. Conclusions This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings.

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Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak

Cited by 22 publications

References 15 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

Trauma and stressor-related disorders among health care workers during COVID-19 pandemic and the role of the gender: A prospective longitudinal survey.

The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

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