Psychosocial burden and working conditions during the COVID-19 pandemic in Germany: The VOICE survey among 3678 health care workers in hospitals

Abstract

Objective The aim of this cross-sectional web-based study was to examine self-reported mental distress, psychosocial burdens, working conditions and potential risk and protective factors for depressive and anxiety symptoms during the COVID-19 pandemic in health care workers (HCW). Methods In the largest survey on mental health of HCW conducted during the first wave of COVID-19 in Europe (N = 8071 HCW), we investigated depressive (Patient Health Questionnaire-2, PHQ-2), and anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), working conditions, and psychosocial burden of 3678 HCW of three health care professions in hospitals: physicians (n = 1061), nurses (n = 1275), and medical technical assistants (MTA, n = 1342). Results The prevalence of clinically significant levels of depressive and anxiety symptoms was 17.4% and 17.8% for physicians, 21.6% and 19.0% for nurses, and 23.0% and 20.1% for MTA, respectively. All three professions demonstrated significantly elevated PHQ-2 and GAD-2 scores, when compared with general German population before the pandemic, but lower scores in relation to that during the pandemic. Multiple linear regression analyses revealed that higher levels of depressive symptoms were associated with insufficient recovery during leisure time, increased alcohol consumption, and less trust in colleagues in difficult situations. In addition, elevated anxiety scores were related to increased fear of becoming infected with COVID-19. Conclusion During the pandemic HCW demonstrated a lower burden of mental distress compared to the general population. Nevertheless, a high percentage of HCW demonstrates psychosocial distress, so that the establishment of regular mental health screening and prevention programmes for HCW is indicated.

Sense of coherence, social support and religiosity as resources for medical personnel during the COVID-19 pandemic: A web-based survey among 4324 health care workers within the German Network University Medicine

“…These can include telephone calls, video conferences or online platforms [57]. The findings also suggest that interventions and future research should particularly target MTA, which had the lowest levels of resources in the current study and were found to be a vulnerable group among HCW in Germany [9]. Finally, there is a need to explore why the importance of SOC, social support, and religiosity differs across professional groups, which in turn could help tailor intervention approaches for HCW.…”

“…effort and reward imbalance at work. The results for these questionnaires have been [9,20] or will be analysed in other publications.…”

“…First explanations like a lower socioeconomic position and high pressure have been provided why MTA in Germany might be the most vulnerable group during the COVID-19 pandemic [9]. However, more research among groups of HCW is necessary to obtain comparable data and to investigate if those differences in resources already existed before the COVID-19 pandemic.…”

“…A recent meta-analysis of 62 studies revealed that the pooled prevalence of anxiety and depression in HCW was 26% and 25%, respectively [8]. In Germany, in an online survey (VOICE study), Morawa et al [9] found the prevalence across different groups of HCW ranging from 17.4% to 23.0% for depression symptoms and from 17.8% to 20.1% for anxiety symptoms. The data presented here originate from a subsample of this study.…”

“…Most research in the health sector so far has focused only on physicians and nurses. Due to their importance in the COVID-19 pandemic, we included MTA [9] and pastoral workers [32] as additional groups. The main objective of the study was to investigate the association of social support, SOC and religiosity on mental health and increase of subjective burden due to the COVID-19 pandemic in a large German sample of HCW taking occupational and workplace differences into account.…”