Abstract
BackgroundThe COVID-19 pandemic has had a major impact on the mental health of healthcare workers, yet studies in primary care workers are scarce.AimTo investigate the prevalence of and associated factors for psychological distress in primary care workers during the first COVID-19 outbreak.Design and settingThis was a multicentre, cross-sectional, web-based survey conducted in primary healthcare workers in Spain, between May and September 2020.MethodHealthcare workers were invited to complete a survey to evaluate sociodemographic and work-related characteristics, COVID-19 infection status, exposure to patients with COVID-19, and resilience (using the Connor–Davidson Resilience Scale), in addition to being screened for common mental disorders (depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder). Positive screening for any of these disorders was analysed globally using the term ‘any current mental disorder’.ResultsA total of 2928 primary care professionals participated in the survey. Of them, 43.7% (95% confidence interval [CI] = 41.9 to 45.4) tested positive for a current mental disorder. Female sex (odds ratio [OR] 1.61, 95% CI = 1.25 to 2.06), having previous mental disorders (OR 2.58, 95% CI = 2.15 to 3.10), greater occupational exposure to patients with COVID-19 (OR 2.63, 95% CI = 1.98 to 3.51), having children or dependents (OR 1.35, 95% CI = 1.04 to 1.76 and OR 1.59, 95% CI = 1.20 to 2.11, respectively), or having an administrative job (OR 2.24, 95% CI = 1.66 to 3.03) were associated with a higher risk of any current mental disorder. Personal resilience was shown to be a protective factor.ConclusionAlmost half of primary care workers showed significant psychological distress. Strategies to support the mental health of primary care workers are necessary, including designing psychological support and resilience-building interventions based on risk factors identified.
Highlights
The outbreak of the COVID-19 pandemic in March of 2020 saturated the capacity of the Spanish healthcare system and forced organisational changes at all levels of care to adapt to the changing conditions imposed by the pandemic.[1]
Establishing support strategies for the mental health of primary care workers is necessary, by designing psychological support and resilience-building interventions based on the identified risk factors
In Spain, primary care was responsible for the screening and diagnosis of COVID-19 patients, non-hospital treatment of most of the infected patients and, in the initial moments of the collapse of the healthcare system, even complex home care of COVID-19 patients
Summary
The outbreak of the COVID-19 pandemic in March of 2020 saturated the capacity of the Spanish healthcare system and forced organisational changes at all levels of care to adapt to the changing conditions imposed by the pandemic.[1]. There was an important and abrupt change in the working conditions of primary care staff to meet new requirements, having to tolerate uncertainties, organisational shortcomings, and a shortage of protective equipment.[2]. Many primary care professionals took on occupational relocations and new tasks, such as nursing homes, COVID-19-specific field hospitals, and relocations to hospital services.[3,4]. Overload and changes in working conditions, facing new and unfamiliar situations, lack of resources, fear of contagion, or fear of infecting family members generated significant stress in healthcare professionals. The psychological distress affecting healthcare workers impacts on their well-being, and their professional performance, quality of care, and patient safety.[8]. The COVID-19 pandemic has had a major impact on the mental health of healthcare workers.
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