Psychological Care of Health Workers during the COVID-19 Outbreak in Italy: Preliminary Report of an Occupational Health Department (AOUP) Responsible for Monitoring Hospital Staff Condition

Abstract

The recent worldwide COVID-19 outbreak provided a timely demonstration of the mental health needs of health care workers on the front lines of the response to the pandemic. In addition to international guidelines, local institutions demand rapid and practical approaches easily replicable in different populations and contests. The principal aim of this paper is to highlight and share the experience of an Occupational Health Department responsible for monitoring hospital staff conditions during the SARS-COV-2 pandemic phase 1. The multidisciplinary team of the Occupational Health Department of a major university hospital in central Italy (AOUP) developed a specific protocol called PsicoCovid19 in order to provide targeted help, based on new psychosocial risk factors, to workers involved in the COVID-19 emergency to preserve hospital staff health. As of the date of this report, 106 workers (79 female, 27 male, mean age respectively, 51 ± 9.8, 45.7± 10.1) requested this service, reporting mild to moderate subjective distress. Approximately 81% of all the participants were already monitored before the outbreak of the pandemic. Among the total sample, 60% received a remodeling of a previous therapeutic program. Meanwhile, 7% passed from a psychiatric therapy to a combination therapy with the addition of a psychological treatment. The results demonstrate that those who asked for help were primarily female nurses who already presented with mental health vulnerabilities. A more gender-specific, clinical approach is needed.

Professional Quality of Life and Mental Health Outcomes among Health Care Workers Exposed to Sars-Cov-2 (Covid-19)

“…It is also possible that physicians with respect to others health care professionals may have felt closer to the key decision makers and have had access to more timely and accurate information [ 37 ]. They probably perceived more public support and less the weight of suffering [ 8 ]. Some Chinese authors reported corroborating findings.…”

“…HCWs reported conflicting thoughts and difficulties about balancing their professional roles and their familiar duties. They referred to the struggles of weighing responsibility and a sense of guilt [ 7 , 8 , 9 ].…”

“…Some studies reported that those HCWs who feared infection of their close one’s, reported experiencing high levels of stress, anxiety, and depression symptoms, which could have long-term psychological implications [ 8 , 11 ]. A multicenter cross-sectional study on more than 1000 Chinese HCWs evidenced percentages of distress, depression, anxiety, and insomnia of 71.5%, 50.4%, 44.6%, and 34.0%, respectively [ 11 , 12 ].…”

“…In light of what has emerged so far, we believe that the pandemic has brought changes in the HCWs working framework, which seems to be acting both positively and negatively on the psychological equilibrium of HCWs. These theories arise from the literature and from our own clinical experience, since we are a multidisciplinary team responsible for the well-being of hospital HCWs and therefore are in close contact with their psychic feedback, especially in the context of the first Italian emergency phase of the pandemic (Azienza OspedalieroUniversitaria Pisana psicocovid19 protocol ) [ 8 ].…”

Impacts of Layoffs and Government Assistance on Mental Health during COVID-19: An Evidence-Based Study of the United States

“…In addition, establishing psychological first aid interventions, which has been fulfilled within an Italian university public hospital, may help mental health professionals and promote health and individual and community resilience [45]. Furthermore, the mental well-being of health care workers who are on the front lines responding to COVID-19 is also a very important dimension [46], which needs the specific attention of the government to protect them from secondary trauma, like applying hardiness and coping strategies to stop unpleasant emotions and thoughts [47]. These interventions could either be government led or community led, as long as the essential public health standards, such as social distancing or limited capacity, are ensured.…”