Stress experiences of healthcare assistants in family practice at the onset of the COVID-19 pandemic: a mixed methods study

Abstract

BackgroundAt the beginning of the pandemic in 2020, healthcare assistants in general practices were confronted with numerous new challenges. The aim of the study was to investigate the stress factors of healthcare assistants in March/April 2020 as well as in the further course of the pandemic in 2020.MethodsFrom August to December 2020, 6,300 randomly selected healthcare assistants in four German states were invited to participate in the study. We performed a mixed methods design using semi-structured telephone interviews and a cross-sectional survey with quantitative and open questions. The feeling of psychological burden was assessed on a 6-point likert-scale. We defined stress factors and categorized them in patient, non-patient and organizational stress factors. The results of the three data sets were compared within a triangulation protocol.ResultsOne thousand two hundred seventy-four surveys were analyzed and 28 interviews with 34 healthcare assistants were conducted. Of the participants, 29.5% reported experiences of a very high or high feeling of psychological burden in March/April 2020. Worries about the patients’ health and an uncertainty around the new disease were among the patient-related stress factors. Non-patient-related stress factors were problems with the compatibility of work and family, and the fear of infecting relatives with COVID-19. Organizational efforts and dissatisfaction with governmental pandemic management were reported as organizational stress factors. Support from the employer and team cohesion were considered as important resources.DiscussionIt is necessary to reduce stress among healthcare assistants by improving their working conditions and to strengthen their resilience to ensure primary healthcare delivery in future health crises.

The Predominance of the Health-Promoting Patterns of Work Behavior and Experience in General Practice Teams—Results of the IMPROVEjob Study

“…These identified differences in the AVEM dimensions can be explained by the different areas of work of the professional groups. Practice assistants are probably confronted with more dissatisfied patients than practice owners [38] and, therefore, receive less recognition for their work. Thus, lower scores for "experience of success at work" and "satisfaction with life" in this group are not surprising.…”

Infection prevention and control in Dutch general practices before and during the COVID-19 pandemic and its implications for pandemic preparedness and seasonal respiratory epidemics: a qualitative study on lessons learned

“…The identified contextual challenges in this study are similar to prior studies; challenges include staff shortages as a result of infections and subsequent sick leave [ 13 ], the availability of PPE including medical masks [ 14 ], and the frequently changing IPC requirements and regulations during the pandemic [ 8 , 21 , 36 ]. The development and implementation of supportive policies, surveillance and reporting system activation (e.g., dashboards), availability of PPE, staff training, and workforce augmentation have been recommended to enhance pandemic preparedness of primary care [ 18 , 37 ]. In addition, previous qualitative findings have demonstrated an experienced lack of clarity and ambiguity in the guidelines during the pandemic [ 36 ].…”

“…In addition, GPs experienced high workload and work pressure during the pandemic, due to the overwhelming COVID-19 care and administrative burdens [ 3 , 15 – 17 ]. Moreover, medical assistants experienced high feelings of psychological burden during the first wave of the pandemic [ 18 ]. Next to these contextual challenges related to the pandemic, previous studies have identified practice and system factors to hinder IPC during the pandemic, such as inadequate GP practice building layout, limited IPC resources and materials, infrastructure constraints, and rapidly changing guidelines [ 19 – 21 ].…”