Fragile heroes. The psychological impact of the COVID-19 pandemic on health-care workers in Italy

Conti, Chiara; Fontanesi, Lilybeth; Lanzara, Roberta; Rosa, Ilenia; Porcelli, Piero

doi:10.1371/journal.pone.0242538

Cited by 108 publications

(137 citation statements)

References 64 publications

(79 reference statements)

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“…Results of descriptive statistics revealed prevalence rates of moderate to extremely severe symptoms ranging from 8 percent for depression to about 10 percent for anxiety. Participants of this study had lower levels of depression, anxiety, and stress than the prevalence reported by early studies involving healthcare workers ( Conti et al, 2020 ; Lai et al, 2020 ; Rossi et al, 2020 ). These findings could have depended on assisting patients with COVID-19 leading to an increased fear of being infected.…”

Section: Discussioncontrasting

confidence: 57%

“…Another study comprising a sample of 1379 Italian healthcare workers found that 49.38% expressed posttraumatic stress symptoms, 24.73% symptoms of depression, 19.80% symptoms of anxiety, and 21.90% high perceived stress ( Rossi et al, 2020 ). High psychological distress, anxiety, and depression accounted for the need for psychological support among professionals ( Conti et al, 2020 ). It was argued that promoting resilience should protect people from stress and psychopathological symptoms during the COVID-19 outbreak ( Khan et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Depression, Anxiety, and Stress Among Healthcare Workers During the COVID-19 Outbreak and Relationships With Expressive Flexibility and Context Sensitivity

et al. 2021

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This study aimed at investigating depression, anxiety, and stress symptoms among healthcare workers and examine the role of expressive flexibility and context sensitivity as key components of resilience in understanding reported symptoms. We hypothesized a significant and different contribution of resilience components in explaining depression, anxiety, and stress. A total sample of 218 Italian healthcare workers participated in this study through an online survey during the lockdown, consequently to the COVID-19. The Depression Anxiety Stress Scales-21 (DASS-21) was used to measure depression, anxiety, and stress; the Flexible Regulation of Emotional Expression (FREE) scale was used to measure the ability to enhance and suppress emotional expression; the Context Sensitivity Index (CSI) was used to measure the ability to accurately perceive contextual cues and determine cue absence. Demographic and work-related data were also collected. DASS-21 cut-off scores were used to verify the mental status among the respondents. Correlational analyses examined relationships between DASS-21, FREE, and CSI, followed by three regression analyses with depression, anxiety, and stress as dependent variables, controlling for age, gender, and work experience. Enhancement and suppression abilities, cue presence, and cue absence served as independent variables. The results showed a prevalence of moderate to extremely severe symptoms of 8% for depression, 9.8% for anxiety, and 8.9% for stress. Results of correlational analysis highlighted that enhance ability was inversely associated with depression and stress. Suppression ability was inversely associated with depression, anxiety, and stress. The ability to perceive contextual cues was inversely associated with depression and anxiety. The regression analysis showed that the ability to enhance emotional expression was statistically significant to explain depression among healthcare workers. In predicting anxiety, age, and the ability to accurately perceive contextual cues and determine cue absence made substantial contributions as predictors. In the last regression model, age, work experience, and the ability to suppress emotional expression were significant predictors of stress. This study’s findings can help understand the specific contributions of enhancement and suppression abilities and sensitivity to stressor context cues in predicting depression, anxiety, and stress among healthcare workers. Psychological interventions to prevent burnout should consider these relationships.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Depression, Anxiety, and Stress Among Healthcare Workers During the COVID-19 Outbreak and Relationships With Expressive Flexibility and Context Sensitivity

et al. 2021

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“…However, inadequate protection, perceived stigma, and negative feedback from patients can exacerbate COVID-19-related psychological distress [ 45 , 46 ]. Also, health-care workers who perceive high level of psychological distress, need psychological support [ 47 ]. Que et al [ 45 ] suggested that psychosocial interventions should be provided in the early stages of pandemics for health-care workers who are at risk of experiencing psychological distress.…”

Section: Discussionmentioning

confidence: 99%

Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers

et al. 2021

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The emergence of Coronavirus disease 2019 (COVID-19) has affected health-care workers’ psychological and mental health. Few studies have been conducted examining the psychological effect of COVID-19 on health-care worker psychological health in Jordan. Therefore, the present study aims to assess the respective levels of fear, anxiety, depression, stress, social support, and the associated factors, experienced by Jordanian health-care workers during the COVID-19 Pandemic. This study adopted a cross-sectional, correlational design to collect data from 365 health-care workers in Amman, Jordan, from August 16th to 23rd, 2020. Along with collecting sociodemographic characteristics, the Fear of COVID-19 Scale, the Depression, Anxiety, Stress Scale, and the Multidimensional Scale of Perceived Social Support electronically administered to participants. The majority of the participants (69.3%) were registered nurses. The mean overall score for the Fear of COVID-19 scale was 23.64 (SD + 6.85) which again exceeded the mid-point for the total score range (21), indicating elevated level fear of the COVID-19 pandemic. Participants had displayed extremely severe depression 40%, extremely severe anxiety 60%, and 35% severely distressed. Scores for depression (21.30 ± 10.86), anxiety (20.37 ± 10.80), stress (23.33 ± 10.87) were also high. Factors determined to be associated with psychological distress were being male, married, aged 40 years and older, and having more clinical experience. Assessment of social support indicated moderate-to-high levels of perceived support for all dimensions (significant other: 5.17 ± 1.28, family: 5.03 ± 1.30, friends: 5.05 ± 1.30). Weak significant correlations were found between social support and the other study variables (r < 0.22), indicating a weak association with fear, depression, anxiety, and stress, respectively. Overall, Jordanian health-care workers sample reported fear, depression, anxiety, and stress. The associated factors were being male, married, aged 40 years and older, and having more clinical experience. Regarding social support, participants primarily relied on support from their families, followed by support from friends.

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“…Notably, an examination of the levels of PTSD, anxiety, and depression symptoms among the study groups have revealed that dentists (who hold MD degrees), in contrast to other dental HCWs, had significantly higher PSS-SR re-experiencing, arousal, intrusions, and total scores, while dental assistants (persons without an MD degree), in contrast to other participants, had significantly higher IES-R avoidance scores. This is somewhat interesting, because nurses (which is the closest analog to dental assistant in general medicine) typically reported higher levels of symptoms and distress than doctors [ 3 , 6 , 8 , 52 ], with a few studies reporting no difference [ 53 , 54 ] and only one study reporting higher rates in doctors [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Psychological Distress and Post-Traumatic Symptomatology among Dental Healthcare Workers in Russia: Results of a Pilot Study

Sarapultseva

Zolotareva

Kritsky

et al. 2021

IJERPH

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The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3–24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1–29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.

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Fragile heroes. The psychological impact of the COVID-19 pandemic on health-care workers in Italy

Cited by 108 publications

References 64 publications

Depression, Anxiety, and Stress Among Healthcare Workers During the COVID-19 Outbreak and Relationships With Expressive Flexibility and Context Sensitivity

Depression, Anxiety, and Stress Among Healthcare Workers During the COVID-19 Outbreak and Relationships With Expressive Flexibility and Context Sensitivity

Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers

Psychological Distress and Post-Traumatic Symptomatology among Dental Healthcare Workers in Russia: Results of a Pilot Study

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