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Longitudinal Assessment of Mental Health Consequences of the COVID-19 Pandemic Long-Term Exposure on Health Care Workers from a North West Italian Hospital

Published online by Cambridge University Press:  09 March 2023

Valeria Caramello Open the ORCID record for Valeria Caramello [Opens in a new window] ,
Valeria Gariglio ,
Gabriele Di Salvo ,
Giuseppe Maina  and
Adriana Boccuzzi
Valeria Caramello*
Affiliation:
Emergency Department and High Dependency Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Turin, Orbassano, Italy
Valeria Gariglio
Affiliation:
Emergency Department and High Dependency Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Turin, Orbassano, Italy
Gabriele Di Salvo
Affiliation:
Psychiatric Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Turin, Orbassano, Italy
Giuseppe Maina
Affiliation:
Psychiatric Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Turin, Orbassano, Italy
Adriana Boccuzzi
Affiliation:
Psychiatric Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Turin, Orbassano, Italy
*
Corresponding author: Valeria Caramello, Email: [email protected]/[email protected].
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Abstract

Objective:

To assess individual variation in anxiety, stress disorder, depression, insomnia, burnout, and resilience in health care workers (HCWs), 12 and 18 months after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

Methods:

Prospective longitudinal study.

Results:

A total of 207 HCWs (74% female, 46% physicians, 44% nurses) answered; 50% scored over the cut-off for anxiety (GAD-7), 66% for PCL-C, 41% for depression (PHQ-9), 25% for ISI, and 15% started sleep inducers; 52% showed emotional exhaustion (EE), 68% detachment (DE), 39% professional efficacy (EF) at MBI; 27% completed the follow-up questionnaire 6 months later, showing a significant reduction in nearly all scores (GAD-7 median 11[5-15] vs 7[4-12] (P < 0.001); PCL-C 43[30-58] vs 37[24-50] (P < 0.05); PHQ-9 10[4-16] vs 6[3-12] (P < 0.001); ISI 10[4-15] vs 7[5-12](NS); MBI EE 25[16-35] vs 23 [15-31] (NS), DE 13[8-17] vs 12[8-17], EF 29[25-34] vs 30[25-34]. Living in a flat (OR 2.27 [1.10-4.81], high-intensity-of-care working (2.83 [1.15-7.16] increased risk of anxiety (GAD-7); age between 31-40 y (OR 2.8 [1.11-7.68], being a nurse (OR 3.56 [1.59-8.36] and high-intensity-of-care working (OR 8.43 [2.92-26.8] increased risk of pathological stress (PCL-C).

Conclusions:

Nearly half of HCWs showed psychological distress, especially nurses, women, and the youngest. A mandatory job change, increasing intensity of care, working in a COVID-19 department, and being infected were negative factors; having a partner and living in a detached house were protective. Six months later, all the psychological domains showed individual improvement.

Keywords

Health care workersStress PsychologicalBurnout, DisastersCOVID-19
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e378
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

Galli, F, Pozzi, G, Ruggiero, F, et al. A systematic review and provisional meta-analysis on psychopathologic burden on health care workers of coronavirus outbreaks. Front Psychiatry. 2020;11:568664. doi: 10.3389/fpsyt.2020.568664 CrossRefGoogle ScholarPubMed
Chirico, F, Crescenzo, P, Sacco, A, et al. Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study. Ind Health. 2021;59(2):117-127. doi: 10.2486/indhealth.2020-0246 CrossRefGoogle ScholarPubMed
Chirico, F, Sacco, A, Nucera, G, et al. Lockdown measures and COVID-19 related deaths during the first and second COVID-19 waves in Italy: a descriptive study. J Health Soc Sci. 2021;6(3):379-390. doi: 10.19204/2021/lckd1 Google Scholar
Chirico, F, Nucera, G, Szarpak, L. COVID-19 mortality in Italy: the first wave was more severe and deadly, but only in Lombardy region. J Infect. 2021;83(1):e16. doi: 10.1016/j.jinf.2021.05.006 CrossRefGoogle ScholarPubMed
Magnavita, N, Chirico, F, Garbarino, S, et al. SARS/MERS/SARS-CoV-2 outbreaks and burnout syndrome among healthcare workers. An umbrella systematic review. Int J Environ Res Public Health. 2021;18(8):4361. doi: 10.3390/ijerph18084361 CrossRefGoogle ScholarPubMed
Magnavita, N, Soave, PM, Antonelli, M. A one-year prospective study of work-related mental health in the intensivists of a COVID-19 hub hospital. Int J Environ Res Public Health. 2021;18(18):9888. doi: 10.3390/ijerph18189888 CrossRefGoogle ScholarPubMed
Ranieri, J, Guerra, F, Perilli, E, et al. Prolonged COVID-19 outbreak and psychological response of nurses in Italian healthcare system: cross-sectional study. Front Psychol. 2021;12:608413. doi: 10.3389/fpsyg.2021.608413 CrossRefGoogle ScholarPubMed
Di Monte, C, Monaco, S, Mariani, R, Di Trani, M. From resilience to burnout: psychological features of Italian general practitioners during COVID-19 emergency. Front Psychol. 2020;11:567201. doi: 10.3389/fpsyg.2020.567201 CrossRefGoogle ScholarPubMed
Lasalvia, A, Bodini, L, Amaddeo, F, et al. 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. Int J Environ Res Public Health. 2021;18(24):13374. doi: 10.3390/ijerph182413374 CrossRefGoogle Scholar
Ciuluvica Neagu, C, Gualdi, G, Dal Canton, M, et al. Mental health consequences of the COVID-19 pandemic long-term exposure in Italian dermatologists. Int J Environ Res Public Health. 2021;18(21):11239. doi: 10.3390/ijerph182111239 CrossRefGoogle ScholarPubMed
Chigwedere, OC, Sadath, A, Kabir, Z, Arensman, E. The impact of epidemics and pandemics on the mental health of healthcare workers: a systematic review. Int J Environ Res Public Health. 2021;18(13):6695. doi: 10.3390/ijerph18136695 CrossRefGoogle ScholarPubMed
Cai, CZ, Lin, YL, Hu, ZJ, Wong, LP. Psychological and mental health impacts of COVID-19 pandemic on healthcare workers in China: a review. World J Psychiatry. 2021;11(7):337-346. doi: 10.5498/wjp.v11.i7.337 CrossRefGoogle ScholarPubMed
Sriharan, A, Ratnapalan, S, Tricco, AC, et al. Occupational stress, burnout, and depression in women in healthcare during COVID-19 pandemic: rapid scoping review. Front Glob Womens Health. 2020;1:596690. doi: 10.3389/fgwh.2020.596690 CrossRefGoogle ScholarPubMed
Xiong, J, Lipsitz, O, Nasri, F, et al. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. 2020;277:55-64. doi: 10.1016/j.jad.2020.08.001 CrossRefGoogle ScholarPubMed
Stocchetti, N, Segre, G, Zanier, ER, et al. Burnout in intensive care unit workers during the second wave of the COVID-19 pandemic: a single center cross-sectional Italian study. Int J Environ Res Public Health. 2021;18(11):6102. doi: 10.3390/ijerph18116102 CrossRefGoogle ScholarPubMed
Gambaro, E, Gramaglia, C, Marangon, D, et al. The mediating role of gender, age, COVID-19 symptoms and changing of mansion on the mental health of healthcare workers operating in Italy during the first wave of the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(24):13083. doi: 10.3390/ijerph182413083 Google ScholarPubMed
Fiabane, E, Gabanelli, P, La Rovere, MT, et al. Psychological and work-related factors associated with emotional exhaustion among healthcare professionals during the COVID-19 outbreak in Italian hospitals. Nurs Health Sci. 2021;23(3):670-675. doi: 10.1111/nhs.12871 CrossRefGoogle ScholarPubMed
Gualano, MR, Sinigaglia, T, Lo Moro, G, et al. The burden of burnout among healthcare professionals of intensive care units and emergency departments during the COVID-19 pandemic: a systematic review. Int J Environ Res Public Health. 2021;18(15):8172. doi: 10.3390/ijerph18158172 CrossRefGoogle ScholarPubMed
Farì, G, de Sire, A, Giorgio, V, et al. Impact of COVID-19 on the mental health in a cohort of Italian rehabilitation healthcare workers. J Med Virol. 2022;94(1):110-118. doi: 10.1002/jmv.27272 CrossRefGoogle Scholar
Carmassi, C, Pedrinelli, V, Dell’Oste, V, et al. Work and social functioning in frontline healthcare workers during the COVID-19 pandemic in Italy: role of acute post-traumatic stress, depressive and anxiety symptoms. Riv Psichiatr. 2021;56(4):189-197. doi: 10.1708/3654.36346 Google ScholarPubMed
Manfredi, P. Is this all COVID-19’s Fault? a study on trainees in one of the most affected Italian cities. Int J Environ Res Public Health. 2022;19(20):13136. doi: 10.3390/ijerph192013136 CrossRefGoogle Scholar
Eggleton, K, Bui, N, Goodyear-Smith, F. COVID-19 impact on New Zealand general practice: rural-urban differences. Rural Remote Health. 2022;22(1):7185. doi: 10.22605/RRH7185 Google Scholar
Rossi, R, Socci, V, Jannini, TB, et al. Mental health outcomes among Italian health care workers during the COVID-19 pandemic. JAMA Netw Open. 2021;4(11):e2136143. doi: 10.1001/jamanetworkopen.2021.36143 Google ScholarPubMed
Cuschieri, S. The STROBE guidelines. Saudi J Anaesth. 2019;13(Suppl 1):S31-S34. doi: 10.4103/sja.SJA_543_18 CrossRefGoogle ScholarPubMed
Spitzer, RL, Kroenke, K, Williams, JB, Löwe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-1097. doi: 10.1001/archinte.166.10.1092 CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146(5):317-325. doi: 10.7326/0003-4819-146-5-200703060-00004 Google ScholarPubMed
Weathers, FW, Huska, JA, Keane, TM. PCL-C for DSM-IV. National Center for PTSD-Behavioral Science Division; 1991.Google Scholar
Blevins, CA, Weathers, FW, Davis, MT, et al. The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489-498. https://doi-org.bibliopass.unito.it/10.1002/jts.22059 CrossRefGoogle ScholarPubMed
Levis, B, Benedetti, A, Thombs, BD; DEPRESsion Screening Data (DEPRESSD) Collaboration. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476. doi: 10.1136/bmj.l1476 (Erratum in: BMJ. 2019;365:l1781)CrossRefGoogle ScholarPubMed
Morin, CM, Belleville, G, Bélanger, L, Ivers, H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34(5):601-608. doi: 10.1093/sleep/34.5.601 CrossRefGoogle ScholarPubMed
Castronovo, V, Galbiati, A, Marelli, S, et al. Validation study of the Italian version of the Insomnia Severity Index (ISI). Neurol Sci. 2016;37(9):1517-1524. doi: 10.1007/s10072-016-2620-z CrossRefGoogle ScholarPubMed
Lin, CY, Alimoradi, Z, Griffiths, MD, Pakpour, AH. Psychometric properties of the Maslach Burnout Inventory for Medical Personnel (MBI-HSS-MP). Heliyon. 2022;8(2):e08868. doi: 10.1016/j.heliyon.2022.e08868 CrossRefGoogle ScholarPubMed
Sirigatti, S, Stefanile, C. Per una scala di misurazione di burnout. Bollettino di Psicologia Applicata. 1988: 187-188:29-32.Google Scholar
Chirico, F, Nucera, G, Leiter, M. Measuring burnout syndrome requires reliable and standardized measures. Hong Kong J Emerg Med. 2022;29:1-2. doi: 10.1177/10249079221096920 CrossRefGoogle Scholar
Connor, KM, Davidson, JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi: 10.1002/da.10113 CrossRefGoogle ScholarPubMed
R version 4.0.0. “Arbor Day.” The R Foundation for Statistical Computing. April 24, 2020.Google Scholar
Chirico, F, Afolabi, AA, Ilesanmi, OS, et al. Prevalence, risk factors and prevention of burnout syndrome among healthcare workers: an umbrella review of systematic reviews and meta-analyses. J Health Soc Sci. 2021;6(4):465-491. doi: 10.19204/2021/prvl3 Google Scholar
Chirico, F, Afolabi, AA, Ilesanmi, OS, et al. Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review. J Health Soc Sci. 2022;7(1):14-35. doi: 10.19204/2022/WRKP2 Google Scholar
Bekele, F, Hajure, M. Magnitude and determinants of the psychological impact of COVID-19 among health care workers: a systematic review. SAGE Open Med. 2021;9:20503121211012512. doi: 10.1177/20503121211012512 CrossRefGoogle ScholarPubMed
Vitale, E, Galatola, V, Mea, R. Observational study on the potential psychological factors that affected Italian nurses involved in the COVID-19 health emergency. Acta Biomed. 2021;92(S2):e2021007. doi: 10.23750/abm.v92iS2.11305 Google ScholarPubMed
Collantoni, E, Saieva, AM, Meregalli, V, et al. Psychological distress, fear of COVID-19, and resilient coping abilities among healthcare workers in a tertiary first-line hospital during the coronavirus pandemic. J Clin Med. 2021;10(7):1465. doi: 10.3390/jcm10071465 CrossRefGoogle Scholar
Wang, J, Mann, F, Lloyd-Evans, B, et al. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry. 2018;18(1):156. doi: 10.1186/s12888-018-1736-5 CrossRefGoogle ScholarPubMed
McQuaid, RJ, Cox, SML, Ogunlana, A, Jaworska, N. The burden of loneliness: implications of the social determinants of health during COVID-19. Psychiatry Res. 2021;296:113648. doi: 10.1016/j.psychres.2020.113648 CrossRefGoogle ScholarPubMed
Chirico, F, Sacco, A, Ferrari, G. “Total worker health” strategy to tackle the COVID-19 pandemic and future challenges in the workplace. J Health Soc Sci. 2021;6(4):452-457. doi: 10.19204/2021/ttlw1 Google Scholar
Chirico, F. Spirituality to cope with COVID-19 pandemic, climate change and future global challenges. J Health Soc Sci. 2021;6(2):151-158. doi: 10.19204/2021/sprt2 Google Scholar
Chirico, F, Leiter, M. Tackling stress, burnout, suicide, and preventing the “Great resignation” phenomenon among healthcare workers (during and after the COVID-19 pandemic) for maintaining the sustainability of healthcare systems and reaching the 2030 Sustainable Development Goals. J Health Soc Sci. 2022;7(1):9-13. doi: 10.19204/2022/TCKL1 Google Scholar
Schreiber, M, Cates, DS, Formanski, S, King, M. Maximizing the resilience of healthcare workers in multi-hazard events: lessons from the 2014-2015 Ebola response in Africa. Mil Med. 19;184(Suppl 1):114-120. doi: 10.1093/milmed/usy400 Google Scholar