Healthcare professionals in COVID-19-intensive care units in Norway: preparedness and working conditions: a cohort study

Abstract

ObjectiveTo survey the healthcare professionals’ background and experiences from work with patients with COVID-19 in intensive care units (ICUs) during the first wave of the COVID-19 pandemic in Norway.DesignObservational cohort study.SettingCOVID-ICUs in 27 hospitals across Norway.ParticipantsHealthcare professionals (n=484): nurses (81%), medical doctors (9%) and leaders (10%), who responded to a secured, web-based questionnaire from 6 May 2020 to 15 July 2020.Primary and secondary measuresHealthcare professionals’: (1) professional and psychological preparedness to start working in COVID-ICUs, (2) factors associated with high degree of preparedness and (3) experience of working conditions.ResultsThe age of the respondents was 44.8±10 year (mean±SD), 78% were females, 92% had previous ICU working experience. A majority of the respondents reported professional (81%) and psychological (74%) preparedness for working in COVID-ICU. Factors significantly associated with high professional preparedness for working in COVID-19-ICU in a multivariate logistic model were previous ICU work experience (p<0.001) and participation in COVID-ICU simulation team training (p<0.001). High psychological preparedness was associated with higher age (p=0.003), living with spouse or partner (p=0.013), previous ICU work experience (p=0.042) and participation in COVID-ICU simulation team training (p=0.001). Working with new colleagues and new professional challenges were perceived as positive in a majority of the respondents, whereas 84% felt communication with coworkers to be challenging, 46% were afraid of being infected and 82% felt discomfort in denying access for patient relatives to the unit. Symptoms of sweating, tiredness, dehydration, headache, hunger, insecurity, mask irritation and delayed toilet visits were each reported by more than 50%.ConclusionsHealthcare professionals working during the first wave of COVID-ICU patients in Norway were qualified and prepared, but challenges and potential targets for future improvements were present.Trial registration numberNCT04372056.

Symptoms of Anxiety, Depression, and Post-Traumatic Stress Disorder in Health Care Personnel in Norwegian ICUs during the First Wave of the COVID-19 Pandemic, a Prospective, Observational Cross-Sectional Study

“…The baseline study questionnaire was a composite package of 181 questions divided into eight parts. A previously published paper presents the ICU-HCPs’ preparedness and working conditions [ 25 ]. For the present paper, to focus on psychological reactions and support measures, 69 items were relevant as shown in the Supplementary Material .…”

“…In a French study of critical care clinicians in 21 ICUs (n = 1058), six independent factors were associated with psychological reactions: fear of being infected; inability to rest; inability to care for family; struggling with difficult emotions; regret about the restrictions in visitation policies; and witnessing hasty end-of-life decisions [ 15 ]. Moreover, studies have shown an increase in psychological reactions in women [ 7 , 22 ], being a nurse [ 23 ], and worrying about self or family members being infected [ 7 , 16 , 24 , 25 ]. Other significant factors were anxiety with respect to the availability of personal protective equipment (PPE) [ 16 , 26 ], being responsible for other staff members, being asked to work outside one’s expertise area and not feeling supported in the work environment and team [ 13 ].…”

“…Moreover, HCPs experienced an increased sense of meaning and purpose (61%) in their work since the COVID-19 outbreak [ 28 ]. At the same time in Norway, 65% of HCPs experienced feeling lonely [ 25 ]. In a Swedish hospital, they rapidly implemented a comprehensive psychological support model for ICU frontline workers and support for managers, during the first wave of COVID-19 [ 29 ].…”

“…Moreover, we aimed to survey satisfaction with the respondents’ own professional work effort, disturbance of social life, and support measures. This report represents part II of a national COVID-19 intensive care study focusing on both data on physical preparedness and working conditions [ 25 ], and psychological reactions with the following objectives: What was the prevalence of probable clinical cases of anxiety, depression, and symptom-defined PTSD among COVID-ICU health care professionals, i.e., nurses, physicians, and leaders in Norway? What demographic characteristics were associated with the probable mental health disorder in COVID-ICU health care professionals?…”

COVID-19 frontline primary health care professionals’ perspectives on health system preparedness and response to the pandemic in the Mahalapye Health District, Botswana

“… 16 , 17 However, frontline COVID-19 health professionals are older in high-income countries than in low-income countries, with studies from the United States and Norway, reporting a mean age of 44 years. 18 , 19 With the COVID-19 pandemic, many developed countries are concerned about the ageing workforce in general, and in the healthcare sector, in particular. 20 This could be explained by the population pyramid difference amongst low-, middle- and high-income countries.…”