Role of access to personal protective equipment, treatment prioritization decisions, and changes in job functions on health workers' mental health outcomes during the initial outbreak of the COVID-19 pandemic

JOURNAL OF AFFECTIVE DISORDERS

卷:295

Article

Mediavilla, Roberto^1,2  Fernandez-Jimenez, Eduardo^2,3  Martinez-Ales, Gonzalo^3,4,14  Moreno-Kustner, Berta^5,6,7  Martinez-Morata, Irene^8,9  Jaramillo, Fabiola^10,11  Moran-Sanchez, Ines^9,12  Minue, Sergio¹⁰  Torres-Cantero, Alberto^9,13  Alvarado, Ruben¹¹  Luis Ayuso-Mateos, Jose^1,14,15  Mascayano, Franco^4,16  Susser, Ezra^4,16  Bravo-Ortiz, Maria-Fe^1,2,3,14 

[1] Univ Autonoma Madrid UAM, Dept Psychiat, Madrid, Spain

[2] Hosp La Paz Inst Hlth Res IdiPAZ, Madrid, Spain

[3] La Paz Univ Hosp, Dept Psychiat Clin Psychol & Mental Hlth, Madrid, Spain

[4] Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, 722 W 168th St Suite 712, New York, NY 10032 USA

[5] Univ Malaga, Dept Personal Assessment & Psychol Treatment, Malaga, Spain

[6] Andalusian Grp Psychosocial Res GAP, Andalucia, Spain

[7] Biomed Res Inst Malaga IBIMA, Malaga, Spain

[8] Columbia Univ, Dept Environm Hlth Sci, Mailman Sch Publ Hlth, New York, NY 10032 USA

[9] Inst Biomed Res Murcia IMIB Arrixaca, Murcia, Spain

[10] Andalusian Sch Publ Hlth, Andalucia, Spain

[11] Univ Chile, Program Mental Hlth, Santiago, Chile

[12] Hlth Serv Murcia, Cartagena Mental Hlth Ctr, Murcia, Spain

[13] Virgen Arrixaca Hosp, Dept Prevent Med, Murcia, Spain

[14] Inst Hlth Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain

[15] La Princesa Univ Hosp, Inst Invest Sanitaria Princesa IIS Princesa, Dept Psychiat, Madrid, Spain

[16] New York State Psychiat Inst & Hosp, New York, NY 10032 USA

关键词: Healthcare workers;    Covid-19;    Mental health;    Depression;    Protective equipment;    Triage;   

DOI  :  10.1016/j.jad.2021.08.059

来源: Elsevier

【 摘 要 】

Background: During the initial COVID-19 outbreak, organizational changes were required to ensure adequate staffing in healthcare facilities. The extent to which organizational changes impacted the mental wellbeing of healthcare workers (HCWs) remains unexplored. Here we analyzed the association between three work-related stressors (reported access to protective equipment, change in job functions, and patient prioritization decision-making) and mental health outcomes (depression symptoms, psychological distress, suicidal thoughts, and fear of infection) in a large sample of Spanish HCWs during the initial COVID-19 outbreak. Methods: We conducted a cross-sectional study including HCWs from three regions of Spain between April 24th and June 22nd, 2020. An online survey measured sociodemographic characteristics, work-related stressors, fear of infection, and mental health outcomes (depression [PHQ-9], psychological distress [GHQ-12], death wishes [C-SSRS]). We conducted mixed-effects regression models to adjust all associations for relevant individual- and region-level sources of confounding. Results: We recruited 2,370 HCWs. Twenty-seven percent screened positive for depression and 74% for psychological distress. Seven percent reported death wishes. Respondents were more afraid of infecting their loved ones than of getting infected themselves. All work-related stressors were associated with depression symptoms and psychological distress in adjusted models. Limitations: Non-probabilistic sampling, potential reverse causation. Conclusions: Modifiable work-related stressors are associated with worse mental health among HCWs. Our results suggest that workplace prevention strategies for HCWs should provide sufficient protective equipment, minimize changes in job functions, favor the implementation of criteria for patient triage and on-call bioethics committees, and facilitate access to stepped-care, evidence-based mental health treatment.

【 授权许可】

Free