Risk and Protective Factors for the Mental Health of Brazilian Healthcare Workers in the Frontline of COVID-19 Pandemic

Abstract

The objective was to compare the mental health indicators of health workers providing care to individuals with COVID-19 in Brazil, considering sociodemographic and occupational variables and the risk perception of contamination by the Sars-CoV-2 of workers from different professions, identifying risk and protective factors. A sample of 916 health workers was assessed: physicians, nursing workers, and workers from other professions (psychologists, physical therapists, nutritionists, speech therapists, occupational therapists, dentists, pharmacists, and social workers). REDCAP software was used to collect data online, using standardized instruments to assess anxiety, depression, posttraumatic stress, and insomnia, and one questionnaire addressed risk and protective variables. Statistical techniques for comparing groups were used along with logistic regression analysis. The results revealed that all the groups presented indicators of significant mental health problems (>36%), especially the nursing group. A larger percentage of participants, regardless of the profession, presented a high rate of insomnia disorders, while posttraumatic stress was the least expressive. Occupational variables stand out as risk factors for mental health, with specificities among the different groups. A protective factor for all the groups was having positive professional prospects. The protective factors for the physicians group included support provided by co-workers, being older and a man, while being satisfied with physical protective measures implemented by the employing institution was a protective factor for the groups composed of nursing workers and other professionals. These findings are relevant for devising mental health care strategies.

Marital Status and Gender Differences as Key Determinants of COVID-19 Impact on Wellbeing, Job Satisfaction and Resilience in Health Care Workers and Staff Working in Academia in the UK During the First Wave of the Pandemic

“…Social support has also shown to be a protective factor for mental health in HCWs during the pandemic ( 53 ). Female responders, regardless of marital status perceived their wellbeing as lower than their male counterparts during the COVID-19 pandemic ( 6 – 8 , 11 , 16 – 18 , 20 ). Our study also provided evidence that single females self-reported lower levels of wellbeing when compared to married women and men alike, similarly to another study from Italy ( 19 ).…”

“…Risk factors associated with poorer psychological wellbeing in HCWs throughout the pandemic included age, sex and marital status. Being younger ( 9 , 14 – 18 ) as well as older ( 19 ) correlated with poorer outcomes, while almost consistently, being a female had a negative impact of mental health during the pandemic ( 6 – 8 , 11 , 16 – 18 , 20 ). Being single was more commonly associated with negative outcomes ( 19 , 21 , 22 ); however, one study focused on HCWs from the Eastern Mediterranean region reported alternative findings that being married was associated with reduced psychological wellbeing ( 23 ).…”

“…Other studies found differences in wellbeing between occupational groups. Several studies have identified nurses to be the profession most at risk ( 7 , 8 , 13 , 16 , 17 , 24 , 25 ), while only a few studies have found physicians to have a higher level of stress ( 23 ) and depression ( 26 ) than other HCWs during the COVID-19 pandemic. Numerous studies have found an association between working on the frontline and lower psychological wellbeing ( 5 , 7 , 9 , 10 , 18 , 27 ).…”

Hand hygiene performance in an intensive care unit before and during the COVID-19 pandemic

“…We hypothesize that a substantial increase in the workload during the COVID-19 pandemic might have negatively affected the quality of hand hygiene 8 . This low adherence might have been associated with inadequate training for taking care of COVID-19 infected patients and/or increased mental health issues among HCWs due to a critical situation in Brazil early in the pandemic 8 , 9 . Not only the COVID-19 pandemic but the emergence of other infectious diseases including Zika and dengue infection have been burdening the Brazilian healthcare system 10 .…”

Dimensions of emotional distress among Brazilian workers in a COVID-19 reference hospital: A factor analytical study

“…Likewise, a high frequency of symptoms of burnout was also reported in over one-third of Italian healthcare professionals[ 7 ]. Regarding the Brazilian context, a study composed of Brazilian HCWs from different regions also found high rates of anxiety (43.3%), depression (40.2%), trauma (36%), and insomnia (61.5%)[ 8 ]. Nevertheless, these rates present large fluctuations because data collection relies on individual and contextual aspects of vulnerability, such as socio-demographic characteristics, social support, time of data collection, institutional infrastructure, and public responses, among other factors.…”