Factors associated with peritraumatic stress symptoms among the frontline healthcare workers during the outbreak of COVID-19 in China

Abstract

ObjectivesThis study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China.Design and settingAn online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19.Outcomes measuresPTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs’ PTSS scores.ResultsA total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores.ConclusionsDuring the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.

The other side of COVID-19: A cross-sectional study on mental health in a sample of Italian nurses during the second wave

“…According to a meta-review of systematic reviews, GAD and PTSD were the most prevalent COVID-19 pandemic-related mental health conditions affecting HCWs, especially nurses (8). Several more detailed studies, conducted after the first wave of the pandemic in China, reported that HCWs suffered from anxiety and stress-related symptoms, with prevalence ranging from 28.5 to 36.1% and 24 to 73.4%, respectively (9)(10)(11). In addition, some studies have reported high levels of anxiety and acute stress disorders in nurses more than a year after the start of the pandemic (12,13).…”

Sleep Quality Worsens While Perceived Stress Improves in Healthcare Workers over Two Years during the COVID-19 Pandemic: Results of a Longitudinal Study

“…Several cross-sectional studies have shown that healthcare workers experienced a considerable escalation in perceived stress as a result of the COVID-19 pandemic [ 4 , 5 , 6 ]. Results of a systematic review and meta-analysis of mental health problems during the early stages of the COVID-19 pandemic showed that approximately one in every three healthcare workers had experienced moderate–severe stress [ 7 ].…”

“…The same review concluded that stress and sleep disturbances were the most common complaints among healthcare workers, accounting for 33% and 37%, respectively [ 7 ]. The commonly identified work stressors were: workflow disruptions, increased workloads, increased time constraints and fear of contracting or passing the infection to family members [ 4 , 5 , 6 , 7 ].…”

Degraded Psychophysiological Status in Caregivers and Human Resources Staff during a COVID-19 Peak Unveiled by Psychological and HRV Testing at Workplace

“…Although implementing occasional mobility in this context is a likely cause of exhaustion, professional stress, and absenteeism, typically, these aspects have been largely ignored by necessity during the COVID-19 pandemic, to let emerge a new and flexible organization among departments and allow receiving patients in a massive and urgent manner [2]. The above-described situation gives rise to two phenomena that have not been addressed with equivalent level of attention: first, the comparison of frontline and second-line COVID-19 healthcare workers [3] has shown higher anxiety and depression levels [4] associated with deteriorated sleep quality and long-term post-traumatic stress in frontline workers [5]; second, the densification of adequate management of the mobility has deeply impacted the mission of human resources teams, with possible consequences on their health. Although managers are aware of mobility-associated drawbacks, they had to deal with both an increased workload and complicated decision making, which does not exempt them from occupational stress.…”