Prevalence of post-traumatic symptomatology and anxiety among residential nursing and care home workers following the first COVID-19 outbreak in Northern Italy

Abstract

The current COVID-19 pandemic has been officially linked to the deaths of hundreds of thousands of people across the globe in just a few months. It is particularly lethal for the elderly in general, as well as for populations residing in long-term stay facilities. By this time, those working and caring for high-risk populations have been exposed to very intense and sudden levels of physical and psychological strain. The situation has taken a particularly tragic turn in residential nursing and care homes (NCH), which were hit hard by the pandemic. In residential NCH, neither residents nor workers tend to have immediate access to the same expertise, medication and equipment as in hospitals, which exacerbates an already tense situation. Among the mental health conditions related to exposure to potentially traumatic events, post-traumatic stress disorder and anxiety are the most prevalent and scientifically recognized. In this survey-based epidemiological study, we test the prevalence of anxiety and post-traumatic symptomatology in residential nursing and care home workers—a group of individuals that has been largely neglected but who nonetheless plays a very important and sensitive role in our society. We do this by focusing on the North of Italy, the most affected region during the first COVID-19 outbreak in Italy. Using a single-stage cluster design, our study returns an estimate for the prevalence of moderate-to-severe anxiety and/or post-traumatic symptomatology of 43% (s.e. = 3.09; 95% CI [37–49]), with an 18% (s.e. = 1.83; 95% CI [14–22]) prevalence of comorbidity among workers of Northern Italian NCH between 15 June and 25 July 2020 (i.e. 12–52 days after the end of national lockdown). Women and workers who had recently been in contact with COVID-19-positive patients/colleagues are more likely to report moderate-to-severe symptoms, with odds ratios of 2.2 and 1.7, respectively.

Psychosoziale Auswirkungen der Pandemie auf Pflegekräfte und Bewohner von Pflegeheimen sowie deren Angehörige – Ein systematisches Review

“…Insgesamt wurden 7224 Studienteilnehmende aus 14 Ländern berücksichtigt. Drei Studien schlossen Bewohner [ 3 , 12 , 28 ] und 4 Studien Angehörige ein [ 14 , 17 , 28 , 30 ], 10 Studien befragten Mitarbeitende [ 1 , 15 , 19 – 22 , 24 , 25 , 28 , 29 ]. Die Stichprobengröße reichte von 24 bis 1997 Teilnehmenden.…”

“…B. durch Einschränkung der Sozialkontakte, Verzicht auf Freizeitaktivitäten sowie Konflikte im professionellen Handeln, etwa den eigenen Pflegestandards weiter zu genügen. Fehlendes Personal, unzureichende Schutzausrüstung [ 1 , 15 , 21 , 22 ], häufige Begegnung mit Sterben und Leid sowie aktive COVID-19-Fälle innerhalb der Einrichtung [ 1 , 19 ] erwiesen sich dabei als Faktoren, die mit einem schlechteren psychischen Befinden assoziiert waren. Infizierte Mitarbeitende in den USA fühlten sich im Stich gelassen und waren wütend über den unzureichenden Schutz [ 22 ].…”

“…Die Aushandlung von Ausnahmen von Besuchsverboten in den Niederlanden stellte für die dort tätigen Ärzte ein frustrierendes Dilemma dar, welches zu Unsicherheit und Schuldgefühlen führte [ 24 ]. Vor dem Hintergrund außerordentlicher Belastungen in Norditalien und Spanien sehen 2 Studien das Pandemiegeschehen innerhalb von stationären Altenhilfeeinrichtungen als Ursache einer sekundären Traumatisierung von Mitarbeitenden [ 1 , 19 ]. Zudem berichten Mitarbeitende über eine erhöhte Arbeitsbelastung [ 25 , 29 ].…”

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

“…The global spread of SARS-CoV-2 infection has deeply affected the world. The increasing numbers of patients and outbreak-affected countries have elicited public worry and thus increased the risk of mental health problems (insomnia, anxiety, depression, and stress-related disorders, including the post-traumatic stress disorder (PTSD)) [ 1 , 2 , 3 , 4 , 5 , 6 ].…”

“…The psychological burden of healthcare workers (HCWs) has received heightened awareness, with research continuing to show high rates of mental disorders among them in most countries, including China, the U.K., U.S.A., India, and Italy [ 3 , 4 , 5 , 6 ]. Thus, nearly 58% of HCWs in the U.K. met the threshold for clinically significant PTSD, anxiety, or depression [ 3 ]; in China, the prevalence rates of these conditions were estimated at 9.8–50.4%, 27.1–44.6%, and 15.0–25.0%, respectively [ 7 , 8 ]; and in Italy, about 22% and 40% of HCWs reported moderate-to-severe symptoms of anxiety and PTSD, respectively [ 5 ]. In the U.S.A. and Australia, more than half of HCWs screened positive for PTSD symptoms, almost half screened positive for depression, and one-third screened positive for anxiety [ 9 , 10 ].…”