The Sustained Psychological Impact of the COVID-19 Pandemic on Health Care Workers One Year after the Outbreak—A Repeated Cross-Sectional Survey in a Tertiary Hospital of North-East Italy

Abstract

This study aimed to evaluate the mental health outcomes of health care workers (HCWs) of the Verona academic hospital trust (Italy) one year after the outbreak of COVID-19 and to identify predicted risk factors. A web-based survey was conducted from mid-April to mid-May 2021 on hospital workers one year after the first evaluation performed during the lock-down phase of the COVID-19 pandemic. Post-traumatic stress, general anxiety, depression, and burnout were assessed by using, respectively, the impact of event scale (IES-R), the self-rating anxiety scale (SAS), the patient health questionnaire (PHQ-9) and the Maslach burnout inventory-general survey (MBI-GS). Multivariate logistic regression analysis was performed to identify factors associated with each of the four mental health outcomes one year after the COVID-19 outbreak. A total of 1033 HCWs participated. The percentage of HCWs scoring above the cut-off increased from 2020 to 2021 in all of the outcome domains (anxiety, 50.1% vs. 55.7, p < 0.05; depression, 26.6% vs. 40.6%, p < 0.001; burnout, 28.6% vs. 40.6%, p < 0.001; chi-square test), with the exception of post-traumatic distress. There was also an increase when stratifying by occupation and workplace, with a greater increase for depression and burnout. Multivariate analysis revealed that, one year after the COVID-19 outbreak, nurses were at the greatest risk of anxiety and depression, whereas residents were at the greatest risk of burnout (in terms of low professional efficacy). Working in intensive care units was associated with an increased risk of developing severe emotional exhaustion and a cynical attitude towards work.

Prevalence of Depression and Anxiety in Nurses during the First Eleven Months of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

“…A replication cross-sectional study one year after the COVID-19 outbreak to assess the mental health outcomes of HCW (n = 1 033) at an academic hospital in Verona (Italy) found that the percentage of HCW above the cut-off point increased from 2020 to 2021 across all performance domains (anxiety, 50.1% vs. 55.7, p < 0.05; depression, 26.6% vs. 40.6%, p < 0.001). In turn, a multivariate analysis showed that one year after the COVID-19 outbreak, nurses were more likely to experience anxiety and depression than other HCWs [51].…”

How do Vaccinators Experience the Pandemic? Lifestyle Behaviors in a Sample of Italian Public Health Workers during the COVID-19 Era

“…Anyway, a second evaluation is foreseen during the next SItI national congress that will be held in Padua in November 2022, as part of a repeated two-point cross-sectional survey. This methodology has been already used in previous stud-ies, enabling to follow variations over time in the response of HCWs to the pressure posed by the COVID-19 pandemic [13][14][15]. Third, due to the reference population considered, the findings cannot be extended to the whole population of HCWs in Italy.…”

“…It was demonstrated that HCWs living in the most affected regions had a prevalence of psychological distress higher than their colleagues from the rest of the country; moreover, significant differences related to life changes were associated with the lockdown [12]. Another study revealed that one year after the beginning of COVID-19 emergency, Italian nurses were at the greatest risk of anxiety and depression, whereas residents were at the greatest risk of burnout, and working in intensive care units was associated with an increased risk of developing severe emotional exhaustion and a cynical attitude towards work [13].…”

SARS-CoV-2 Omicron variant: exploring healthcare workers’ awareness and perception of vaccine effectiveness: a national survey during the first week of WHO variant alert

“…As new variants emerge, HCWs must continue to serve COVID-19 and non-COVID patients while still fulfilling personal commitments for their families and themselves[14-16]. Burnout, emotional exhaustion, mental distress, depression and psychological stress have been linked to HCWs during this pandemic, and research continues to reveal high rates of infection [17]. In addition to patient care, HCWs must keep up with any developments in relation to emerging variants and their effects on clinical presentation, management, and measures of prevention—mainly vaccination and infection prevention practices[18,19].…”

“…Burnout, emotional exhaustion, mental distress, depression and psychological stress have been linked to HCWs during this pandemic, and research continues to reveal high rates of infection [17].…”