Abstract
BackgroundThe literature shows the negative psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on frontline healthcare workers. However, few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not.ObjectivesThis survey assessed differences in mental health in physicians and nurses working in COVID-19 or non-COVID-19 medical care units.DesignA cross-sectional mixed-mode survey was used to assess burnout, insomnia, depression, anxiety, and stress.SettingA total of 1,244 physicians and nurses from five general hospitals in Belgium, working in COVID-19 care units (CCU), non-COVID-19 care units (NCCU), or both (CCU + NCCU) were informed of the study.ParticipantsSix hundred forty-seven healthcare workers participated in the survey (response rate = 52%).MeasurementsValidated instruments were used to assess the outcomes: the PFI (burnout/professional fulfillment), the ISI (insomnia), and the DASS-21 (depression, anxiety, and stress).ResultsResults showed high prevalence of burnout, insomnia, depression, and anxiety among participants. After adjusting for confounders, multivariate analysis of variance showed no differences between CCU, NCCU, and CCU + NCCU workers. Univariate general linear models showed higher level of burnout, insomnia, and anxiety among nurses in comparison to physicians. Being a nurse, young, isolated, with an increased workload were risk factors for worse mental health outcomes.LimitationsThe mental health of the tested sample, before the outbreak, is unknown. Moreover, this cross-sectional design provides no information on the evolution of the mental health outcomes over time.ConclusionDirectly caring for patients with COVID-19 is not associated with worse mental health outcomes among healthcare workers in general hospitals. High prevalence of burnout, insomnia, depression, and anxiety among physicians and nurses requires special attention, and specific interventions need to be implemented.Protocol RegistrationClinicalTrials.gov, identifier NCT04344145.
Highlights
The coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first reported in China in December 2019, which has spread globally, resulting in a worldwide pandemic (Li et al, 2020)
One has formally compared frontline workers to workers in usual care units and only for burnout (Wu Y. et al, 2020). Most of these studies have been conducted in Asia, and their results could be associated with cultural differences in healthcare system and how healthcare workers react to crises. To address these gaps in comparable data in healthcare workers’ mental health, this current study aimed to evaluate potential differences in burnout and mental health outcomes among COVID-19 healthcare workers and non-COVID-19 healthcare workers in five general hospitals in Belgium
Half (50.4%) of the participants worked in COVID-19 care unit (CCU), while the other half worked in nonCOVID-19 care units (NCCU) (38.2%) and in both CCU and NCCU (11.4%)
Summary
The coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first reported in China in December 2019, which has spread globally, resulting in a worldwide pandemic (Li et al, 2020). Previous studies have reported negative psychological impacts of the SARS outbreak (Maunder et al, 2003, 2006; Bai et al, 2004; Lee et al, 2007; Lancee et al, 2008; Lung et al, 2009) and the H1N1 influenza (Goulia et al, 2010; Matsuishi et al, 2012). Healthcare workers showed high levels of depression, anxiety, and stress up to 1 year post SARS outbreak (Lee et al, 2007), and higher levels of psychological distress and posttraumatic stress were reported among those who directly cared for patients with SARS (Maunder et al, 2006). Few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not
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