When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak

Neto, Modesto Leite Rolim; Almeida, Hiure Gomes; Esmeraldo, Joana D'arc; Nobre, Camila Bezerra; Pinheiro, Woneska Rodrigues; Oliveira, Cícera Rejane Tavares de; Sousa, Itamara da Costa; Lima, Onélia Maria Moreira Leite; Lima, Nádia Nara Rolim; Moreira, Marcial Moreno; Lima, Carlos Kennedy Tavares; Júnior, Jucier Gonçalves; Silva, Claúdio Gleideston Lima da

doi:10.1016/j.psychres.2020.112972

Cited by 261 publications

(293 citation statements)

References 13 publications

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“…Similar adverse psychological reactions were reported among health care workers in previous studies during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak [9,10]. The increasing number of con rmed cases and deaths, work burden, inadequate personal protective equipment (PPE), media coverage, lack of speci c treatment, vulnerability to infection and having to stay in quarantine, as well as feelings of being inadequately supported in the workplace, can contribute to the mental burden of health workers [11].…”

Section: Introductionsupporting

confidence: 53%

“…It has seven items each for measurement of anxiety and depression which are scored from 0-21. The total scores of these tools were interpreted as normal (0-7), borderline abnormal (8-10) and abnormal (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). For analysis, score more than 7 was considered as the presence of anxiety and depression.…”

Section: Data Collection Measuresmentioning

confidence: 99%

“…For analysis, score more than 7 was considered as the presence of anxiety and depression. Similarly, the score of ISI which records sleep outcome in the past two weeks was categorised as no clinically signi cant insomnia (0-7), subthreshold insomnia (8)(9)(10)(11)(12)(13)(14), moderate clinical insomnia (15)(16)(17)(18)(19)(20)(21) and severe clinical insomnia (22)(23)(24)(25)(26)(27)(28) as in studies done elsewhere [8,[23][24][25][26]. For further analysis, a cut-off score of 10 was used to categorise the presence or absence of insomnia as suggested by Morin CM et al [27].…”

Section: Data Collection Measuresmentioning

confidence: 99%

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Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Khanal

Devkota

Dahal

et al. 2020

Preprint

130

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Background: Health care workers exposed to COVID-19 might be at increased risk of developing mental health problems. The study aimed to identify factors associated with anxiety, depression and insomnia among health workers involved in COVID-19 response in Nepal. Methods: This was a cross-sectional web-based survey conducted between April 26 and May 12, 2020. A total of 475 health workers participated in the study. Anxiety and depression were measured using a 14-item Hospital Anxiety and Depression Scale (HADS: 0- 21) and insomnia was measured by using a 7-item Insomnia Severity Index (ISI: 0-28). Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes. Results: Overall, 41.9% of health workers had symptoms of anxiety, 37.5% had depression symptoms and 33.9% had symptoms of insomnia. Stigma faced by health workers was significantly associated with higher odds of experiencing symptoms of anxiety (AOR: 2.47; 95% CI: 1.62-3.76), depression (AOR: 2.05; 95% CI: 1.34-3.11) and insomnia (AOR: 2.37; 95% CI: 1.46-3.84). History of medication for mental health problems was significantly associated with a higher likelihood of experiencing symptoms of anxiety (AOR: 3.40; 95% CI:1.31-8.81), depression (AOR: 3.83; 95% CI: 1.45-10.14) and insomnia (AOR: 3.82; 95% CI: 1.52-9.62) while inadequate precautionary measures in the workplace was significantly associated with higher odds of exhibiting symptoms of anxiety (AOR: 1.89; 95% CI: 1.12-3.19) and depression (AOR: 1.97; 95% CI: 1.16-3.37). Nurses (AOR: 2.33; 95% CI: 1.21-4.47) were significantly more likely to experience anxiety symptoms than other health workers. Conclusion: The study findings revealed a considerate proportion of anxiety, depression and insomnia symptoms among health workers during the early phase of the pandemic in Nepal. Health workers facing stigma, those with history of medication for mental health problems, and those reporting inadequate precautionary measures in their workplace were more at risk of developing mental health outcomes. A focus on improving mental wellbeing of health workers should be immediately initiated with attention to reduction of stigma, ensuring an adequate support system such as personal protective equipments, and family support for those with history of mental health problems.

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Section: Introductionsupporting

confidence: 53%

Section: Data Collection Measuresmentioning

confidence: 99%

Section: Data Collection Measuresmentioning

confidence: 99%

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Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Khanal

Devkota

Dahal

et al. 2020

Preprint

130

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“…In developing countries such as India, the lockdown also closed access to nearby registered and unregistered healthcare providers (HCP) in rural areas and urban slums, often the first point of contact for seeking medical advice (2). The medical professionals suddenly exposed to managing a deadly disease to which their own lives were at risk and of which they had no earlier experience, probably started viewing non-COVID-19 care as a burden (3). The fear of becoming infected with coronavirus at healthcare facilities forced people to prefer staying at home and suffer until their illnesses deteriorate significantly (4).…”

Section: Introductionmentioning

confidence: 99%

Near-fatal experience due to delayed diagnosis of type 1 diabetes during the COVID-19 pandemic

Dayal¹,

Gupta²,

Raithatha³

et al. 2020

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The focus of national governments and the medical profession on the pandemic of coronavirus disease 2019 (COVID-19) has resulted in neglect of care for children with new onset illnesses. Type 1 diabetes (T1D), the most common endocrine disorder in children, is prone to rapid deterioration if not diagnosed in time. We recently encountered a child who presented in a critical condition and was later diagnosed to have diabetic ketoacidosis. We discuss the circumstances arising out of the severe lockdown restrictions for COVID-19, which resulted in difficulties in accessing the healthcare services and caused significant delay in the diagnosis of T1D and a near-death experience. It is essential to keep the non-COVID healthcare services open for children with new onset illnesses and those with chronic conditions for timely access in order to reduce morbidity and mortality due to these conditions.

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“…HP taking care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms 21 . Numerous psychiatric or psychological departments, psychological counselling centers, and university psychology units have launched specialized programs to attend HP in hospitals, through telematic systems, telephone lines, and app's, to provide psychological treatment in crisis.…”

Section: Discussionmentioning

confidence: 99%

Impact of Simulation-Based Teamwork Training on COVID-19 Distress in Healthcare Professionals

Beneria¹,

Arnedo²,

Pérez-Carrasco³

et al. 2020

Preprint

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ContextNon-technical skills such as leadership, communication or situation awareness should lead to effective teamwork in a crisis situation. The aim of the study was to analyse the role of these skills on the emotional response of health professionals to the COVID-19 pandemic.MethodsBefore COVID-19 outbreak, 48 doctors and 48 nurses participated in a simulation-based teamwork training program based on teaching non-technical skills through simulation. In May 2020, this group of professionals from a COVID-19 referral hospital were invited to participate in a survey exploring stress, anxiety, and depression, using PSS-14 (Perceived Stress Scale) and HADS (Hospital Anxiety and Depression Scale) measures. A control group that did not receive the training was included. We conducted a logistic regression to assess whether having attended simulation-based teamwork training program modified the probability of presenting psychological distress (PSS-14>18 or HADS>12).ResultsA total of 141 healthcare professionals were included, 77 in the intervention group and 64 in the control group. Based on the PSS-14, 70.1% of the intervention group and 75% of the control group (p=0.342) had symptoms of stress. Having contact with COVID-19 patients [OR 4.16(1.64–10.52)]; having minors in charge [OR 2.75 (1.15–6.53)]; working as doctor [0.39(0.16 – 0.95)]; and being woman [OR 2.94(1.09–7.91)] were related with PSS14 symptoms. Based on the HADS, 54.6% of the intervention group and 42.2% of control group (p=0.346) had symptoms of anxiety or depression. Having contact with COVID-19 patients [OR 2.17(1.05 – 4.48)] and having minors in charge [OR 2.14(1.06 – 4.32)] were related with HADS symptoms. Healthcare professionals who attended COVID-19 patients showed higher levels of anxiety and depression [OR 2.56(1.03 – 6.36) (p=0.043)].ConclusionHealthcare professionals trained in non-technical skills through simulation had a tendency towards higher levels of anxiety and depression and less levels of stress, during the COVID-19 pandemic.

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When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak

Cited by 261 publications

References 13 publications

Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Near-fatal experience due to delayed diagnosis of type 1 diabetes during the COVID-19 pandemic

Impact of Simulation-Based Teamwork Training on COVID-19 Distress in Healthcare Professionals

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