Rachel Hennein1,2, Emma J Mew3, Sarah R Lowe4. 1. Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America. 2. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America. 3. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America. 4. Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America.
Abstract
BACKGROUND: Healthcare workers are at increased risk of adverse mental health outcomes during the COVID-19 pandemic. Studies are warranted that examine socio-ecological factors associated with these outcomes to inform interventions that support healthcare workers during future disease outbreaks. METHODS: We conducted an online cross-sectional study of healthcare workers during May 2020 to assess the socio-ecological predictors of mental health outcomes during the COVID-19 pandemic. We assessed factors at four socio-ecological levels: individual (e.g., gender), interpersonal (e.g., social support), institutional (e.g., personal protective equipment availability), and community (e.g., healthcare worker stigma). The Personal Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise scales assessed probable major depression (MD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD), respectively. Multivariable logistic regression models were used to assess unadjusted and adjusted associations between socio-ecological factors and mental health outcomes. RESULTS: Of the 1,092 participants, 72.0% were female, 51.9% were frontline workers, and the mean age was 40.4 years (standard deviation = 11.5). Based on cut-off scores, 13.9%, 15.6%, 22.8%, and 42.8% had probable MD, GAD, PTSD, and AUD, respectively. In the multivariable adjusted models, needing more social support was associated with significantly higher odds of probable MD, GAD, PTSD, and AUD. The significance of other factors varied across the outcomes. For example, at the individual level, female gender was associated with probable PTSD. At the institutional level, lower team cohesion was associated with probable PTSD, and difficulty following hospital policies with probable MD. At the community level, higher healthcare worker stigma was associated with probable PTSD and AUD, decreased satisfaction with the national government response with probable GAD, and higher media exposure with probable GAD and PTSD. CONCLUSIONS: These findings can inform targeted interventions that promote healthcare workers' psychological resilience during disease outbreaks.
BACKGROUND: Healthcare workers are at increased risk of adverse mental health outcomes during the COVID-19 pandemic. Studies are warranted that examine socio-ecological factors associated with these outcomes to inform interventions that support healthcare workers during future disease outbreaks. METHODS: We conducted an online cross-sectional study of healthcare workers during May 2020 to assess the socio-ecological predictors of mental health outcomes during the COVID-19 pandemic. We assessed factors at four socio-ecological levels: individual (e.g., gender), interpersonal (e.g., social support), institutional (e.g., personal protective equipment availability), and community (e.g., healthcare worker stigma). The Personal Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise scales assessed probable major depression (MD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD), respectively. Multivariable logistic regression models were used to assess unadjusted and adjusted associations between socio-ecological factors and mental health outcomes. RESULTS: Of the 1,092 participants, 72.0% were female, 51.9% were frontline workers, and the mean age was 40.4 years (standard deviation = 11.5). Based on cut-off scores, 13.9%, 15.6%, 22.8%, and 42.8% had probable MD, GAD, PTSD, and AUD, respectively. In the multivariable adjusted models, needing more social support was associated with significantly higher odds of probable MD, GAD, PTSD, and AUD. The significance of other factors varied across the outcomes. For example, at the individual level, female gender was associated with probable PTSD. At the institutional level, lower team cohesion was associated with probable PTSD, and difficulty following hospital policies with probable MD. At the community level, higher healthcare worker stigma was associated with probable PTSD and AUD, decreased satisfaction with the national government response with probable GAD, and higher media exposure with probable GAD and PTSD. CONCLUSIONS: These findings can inform targeted interventions that promote healthcare workers' psychological resilience during disease outbreaks.
Authors: David Koh; Meng Kin Lim; Sin Eng Chia; Soo Meng Ko; Feng Qian; Vivian Ng; Ban Hock Tan; Kok Seng Wong; Wuen Ming Chew; Hui Kheng Tang; Winston Ng; Zainal Muttakin; Shanta Emmanuel; Ngan Phoon Fong; Gerald Koh; Chong Teck Kwa; Keson Beng-Choon Tan; Calvin Fones Journal: Med Care Date: 2005-07 Impact factor: 2.983
Authors: Mark P Breazzano; Junchao Shen; Aliaa H Abdelhakim; Lora R Dagi Glass; Jason D Horowitz; Sharon X Xie; C Gustavo de Moraes; Alice Chen-Plotkin; Royce Ws Chen Journal: J Clin Invest Date: 2020-09-01 Impact factor: 14.808
Authors: Douglas A Mata; Marco A Ramos; Narinder Bansal; Rida Khan; Constance Guille; Emanuele Di Angelantonio; Srijan Sen Journal: JAMA Date: 2015-12-08 Impact factor: 56.272
Authors: Josefine Hansson; Mikael Nordenmark; Åsa Tjulin; Bodil J Landstad; Stig Vinberg Journal: Int J Environ Res Public Health Date: 2022-06-26 Impact factor: 4.614
Authors: Junjie Peng; Wing Han Wu; Georgia Doolan; Naila Choudhury; Puja Mehta; Ayesha Khatun; Laura Hennelly; Julian Henty; Elizabeth C Jury; Lih-Mei Liao; Coziana Ciurtin Journal: Front Public Health Date: 2022-06-27
Authors: Sarah L McGuinness; Josphin Johnson; Owen Eades; Peter A Cameron; Andrew Forbes; Jane Fisher; Kelsey Grantham; Carol Hodgson; Peter Hunter; Jessica Kasza; Helen L Kelsall; Maggie Kirkman; Grant Russell; Philip L Russo; Malcolm R Sim; Kasha P Singh; Helen Skouteris; Karen L Smith; Rhonda L Stuart; Helena J Teede; James M Trauer; Andrew Udy; Sophia Zoungas; Karin Leder Journal: Int J Environ Res Public Health Date: 2022-04-19 Impact factor: 3.390
Authors: Andrea Aguglia; Andrea Amerio; Alessandra Costanza; Nicolò Parodi; Francesco Copello; Gianluca Serafini; Mario Amore Journal: Int J Environ Res Public Health Date: 2021-06-18 Impact factor: 3.390
Authors: Melanie Schubert; Julia Ludwig; Alice Freiberg; Taurai Monalisa Hahne; Karla Romero Starke; Maria Girbig; Gudrun Faller; Christian Apfelbacher; Olaf von dem Knesebeck; Andreas Seidler Journal: Int J Environ Res Public Health Date: 2021-06-08 Impact factor: 4.614