Abstract
ContextNon-technical skills such as leadership, communication, or situation awareness should lead to effective teamwork in a crisis. This study aimed to analyse the role of these skills in the emotional response of health professionals to the COVID-19 pandemic.MethodsBefore the 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 was invited to participate in a survey exploring stress, anxiety, and depression, using the PSS-14 (Perceived Stress Scale) and the 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 a 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 a doctor [0.39(0.16–0.95)], and being a 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 the 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 to 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 tended towards higher levels of anxiety and depression and fewer levels of stress, during the COVID-19 pandemic.
Highlights
On March 11, 2020, the World Health Organization declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak a pandemic disease [1]
In the intervention group (IG), the Hospital Anxiety and Depression Scale (HADS) score mean was 14.23 (SD 7.41) and in the control group (CG) was 12.08 (SD 6.66), mean difference − 2.15
Perceived Stress Scale-14 (PSS-14) score mean was 23.92 (SD 8.65) in the IG and 24.33 (SD 9.00) in the CG, mean difference 0.41
Summary
On March 11, 2020, the World Health Organization declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak a pandemic disease [1] Traumatic experiences such as this pandemic can cause stress-related disorders [2, 3]. It has been observed that in simulation scenarios, biological stress markers are detected [11] and that the performance of the team in stressful situations is a function of the non-technical skills of the leader [12] This suggests that simulation can be a powerful ally to prepare HP for better coping in stressful situations, even showing a decrease in work stress levels in nurses from intensive care units, keeping the positive effects at 6 months of follow-up [13]
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