Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

Abstract

ObjectivesThis study reports preliminary findings on the prevalence of, and factors associated with, mental health and well-being outcomes of healthcare workers during the early months (April–June) of the COVID-19 pandemic in the UK.MethodsPreliminary cross-sectional data were analysed from a cohort study (n=4378). Clinical and non-clinical staff of three London-based NHS Trusts, including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire. Secondary outcomes are probable anxiety (seven-item Generalised Anxiety Disorder), depression (nine-item Patient Health Questionnaire), post-traumatic stress disorder (PTSD) (six-item Post-Traumatic Stress Disorder checklist), suicidal ideation (Clinical Interview Schedule) and alcohol use (Alcohol Use Disorder Identification Test). Moral injury is measured using the Moray Injury Event Scale.ResultsAnalyses showed substantial levels of probable CMDs (58.9%, 95% CI 58.1 to 60.8) and of PTSD (30.2%, 95% CI 28.1 to 32.5) with lower levels of depression (27.3%, 95% CI 25.3 to 29.4), anxiety (23.2%, 95% CI 21.3 to 25.3) and alcohol misuse (10.5%, 95% CI 9.2 to 11.9). Women, younger staff and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one’s moral code) was strongly associated with increased levels of probable CMDs, anxiety, depression, PTSD symptoms and alcohol misuse.ConclusionsOur findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.

COVID-19 Staff Wellbeing Survey: longitudinal survey of psychological well-being among health and social care staff in Northern Ireland during the COVID-19 pandemic

“…Worldwide studies have demonstrated very significant levels of anxiety, depression, insomnia and post-traumatic stress in healthcare workers with estimates of caseness ranging from 15 to 27% for depression, 12 to 23% for general anxiety and 30 to 35% for post-traumatic stress symptoms. 2,6 However, we do note a recent review of populations affected by COVID 17 that found no significant differences between healthcare workers and other populations affected by COVID-19 on measures of depression, anxiety and Fig. 1 Proportion of respondents with moderate-to-severe symptoms in the time 1 and 2 cross-sectional samples.…”

“…1 Unsurprisingly, these figures are elevated for UK healthcare workers because of the considerable professional demands placed on them over a long-term period, with estimates of 'caseness' (i.e. moderate-to-severe symptoms) at 27% for depression, 23% for general anxiety and 30% for post-traumatic stress symptoms 2 throughout the early stages of the pandemic. During the same time period, lower caseness estimates for depression (15%) and anxiety (12%), but higher rates of post-traumatic stress (35%) were reported among medical and nursing staff in China.…”

“…Exposure to unique stressors and wider organisational strain, including 'moral injury' a source of psychological distress related to clinical pressures and decision-making that violates a staff member's moral or ethical code 3 may partially account for these enhanced mental health difficulties in healthcare staff. 2 Data from previous outbreaks and the current COVID-19 crisis suggest that both organisational and individual factors can mitigate the psychological impact of the pandemic on health workers.…”

“…There is also a widely acknowledged need to move away from stand-alone cross-sectional studies and towards longitudinal methodologies examining the mechanism and course of mental health symptoms in staff over time. 2 Moreover, risk factors and protective buffers within healthcare staff and their parent organisations need to be identified and tracked in order to ensure the development of timely, nuanced staff well-being support strategies.…”

Burnout in Hospital-Based Healthcare Workers during COVID-19

“…Moral distress has been a prominent theme for healthcare workers during the pandemic. [134][135][136][137] In a study in the Netherlands, two sources of moral distress that increased in COVID-19 (scarcity of resources and the perception of colleagues acting unsafely) were significant predictors of burnout. 103 In a Toronto hospital, moral distress was strongly related to emotional exhaustion and accounted for most of the difference in burnout between roles (nurses vs. other health professionals vs. other staff with regular patient contact; Hunter J, personal communication).…”