Prevalence and factors associated with post-traumatic stress disorder in healthcare workers exposed to COVID-19 in Wuhan, China: a cross-sectional survey

Abstract

Background The COVID-19 pandemic has posed significant threats to both the physical and psychological health of healthcare workers working in the front-line combating COVID-19. However, studies regarding the medium to long term impact of COVID-19 on mental health among healthcare workers are limited. Therefore, we conducted this cross-sectional survey to investigate the prevalence, factors and impact of post-traumatic stress disorder (PTSD) in healthcare workers exposed to COVID-19 8 months after the end of the outbreak in Wuhan, China. Methods A web-based questionnaire was delivered as a link via the communication application WeChat to those healthcare workers who worked at several COVID-19 units during the outbreak (from December 2019 to April 2020) in Wuhan, China. The questionnaire included questions on social-demographic data, the post-traumatic stress disorder checklist-5 (PCL-5), the family care index questionnaire (Adaptation, Partnership, Growth, Affection and Resolve, APGAR), and the quality-of-life scale (QOL). The prevalence, risk and protective factors, and impact of PTSD on healthcare workers were subsequently analyzed. Results Among the 659 participants, 90 healthcare workers were still suffering from PTSD 8 months after the end of the outbreak of COVID-19 in Wuhan, in which avoidance and negative impact were the most affected dimensions. Suffering from chronic disease, experiencing social isolation, and job dissatisfaction came up as independent risk factors for PTSD, while obtaining COVID-19 related information at an appropriate frequency, good family function, and working in well-prepared mobile cabin hospitals served as protective factors. The impact of PTSD on COVID-19 exposed healthcare workers was apparent by shortened sleeping time, feeling of loneliness, poorer quality of life and intention to resign. Conclusions Eight months after the end of the COVID-19 outbreak in Wuhan, the level of PTSD in healthcare workers exposed to COVID-19 was still high. Apart from the commonly recognized risk factors, comorbid chronic disease was identified as a new independent risk factor for developing PTSD. For countries where the pandemic is still ongoing or in case of future outbreaks of new communicable diseases, this study may contribute to preventing cases of PTSD in healthcare workers exposed to infectious diseases under such circumstances.

Nurse's Psychological Experiences of Caring for Severe COVID-19 Patients in Intensive Care Units: A Qualitative Meta-Synthesis

“…ICUs are the main battleground for treating patients with severe COVID-19. The critical nursing team has a precise and skilled professional level in the treatment and care of critically ill patients and can grasp the operation skills of various rescue and life support equipment proficiently ( 41 ). During the pandemic, nurses gained positive and negative psychological experiences but always prioritized the patient's treatment.…”

Psychological distress of frontline healthcare workers in the intensive care unit during the early stage of the COVID-19 pandemic: a qualitative study from China

“…19 Similar to our findings on external support, previous studies also highlighted the importance of support from social mechanisms, positive public news, the positive atmosphere of a team, support from group leaders or team members, and support from family members. 28 A recent study claimed that psychological Open access resources in the media or positive news help them through the epidemic. 15 Correspondingly, support from supervisors and colleagues has been proven to be an effective way to overcome psychological burdens.…”

The North Italian Longitudinal Study Assessing the Mental Health Effects of SARS-CoV-2 Pandemic Health Care Workers—Part II: Structural Validity of Scales Assessing Mental Health

“…The absence of scalar invariance of the refined version MBI over the pandemic waves has some consequences. Cross-sectional studies have shown that burnout after the pandemic has a very high prevalence, and longitudinal studies that burnout levels have increased as a result of the pandemic [ 8 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. If the lack of longitudinal scalar invariance that was found in this study is generalized to other countries and populations, it might be hard to disentangle the presence of true differences in the levels of burnout from differences in how HCWs respond to the items of the MBI from the pandemic on.…”

“…The COVID-19 pandemic seems to have exacerbated this issue due to repeated exposure to life-threatening situations, fear of contagion, shift overload and changes in work organization [ 8 , 9 ]. The results of longitudinal studies and the comparison between the estimates of the studies performed before and during the pandemic show a high prevalence and a marked increase of the levels of anxiety, with estimates from studies performed during the pandemic ranging from 22% to 31%, depression (from 17% to 36%), PTSD symptoms (from 13% to 37%) and burnout (from 36% to 52%) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Among the protective factors, studies have shown that resilience and post-traumatic growth helped to buffer the impact of the pandemic, suggesting that these factors should be taken into account in order to describe the mental health of HCWs [ 18 , 19 ].…”