In December 2019, an outbreak of a novel coronavirus pneumonia hit China, sparking a pandemic crisis around the world. During the last year, the COVID-19 pandemic put all the healthcare workers around the world at risk of physical and psychological sequelae. The first aim of the present research was to provide quantitative evidence on the psychological impact of epidemic/pandemic outbreaks (i.e., SARS, MERS, COVID-19, ebola, and influenza A) on healthcare workers through a systematic review of the literature. Our findings indicate that between 11% and 73.4% of healthcare workers, primarily physicians, nurses, and auxiliary staff, reported post-traumatic stress symptoms during outbreaks, with symptoms lasting after 1–3 years in 10–40% of cases. Depressive symptoms were reported in 27.5–50.7% of healthcare workers, insomnia symptoms in 34–36.1%, and severe anxiety symptoms in 45%. General psychiatric symptoms and work-related stress were reported in a wide range of cases (17.3-75.3% and 18.1-80.1%, respectively). Several individual and work-related features can be considered risk or protective factors, such as personality characteristics, the level of exposure to affected patients, and organizational support. The second purpose of the present research was to assess the mental health of Italian healthcare workers during the COVID-19 outbreak to identify high-risk groups, as well as risk and protective factors that could inform data-driven interventions. The “Healthcare workers’ wellbeing [Benessere Operatori]” project is a web-based longitudinal study administered in three times (i.e., after the first wave of the outbreak, during the second wave, and after the third wave) by means of questions on socio-demographic and work-related information, the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, the Maslach Burnout Inventory, the Multidimensional Scale of Perceived Social Support, and the Brief Cope. One thousand fifty-five healthcare workers took part in the study. Our findings highlight that during the first year of the pandemic healthcare workers experienced subclinical depression, anxiety, stress, and insomnia symptoms, as well as medium and high levels of burnout. Throughout the outbreak, these symptoms remained mostly unchanged, with an increase in depression and emotional exhaustion scores at the second follow-up. Nurses and healthcare workers who worked in COVID-19 wards were at higher risk of experiencing psychological distress compared to other groups of healthcare workers. Specific risk factors have been identified, including higher levels of worry, worse working conditions, working in COVID-19 wards, a previous history of psychiatric illness, being a nurse, and avoidant and emotion-focused coping strategies. Conversely, higher levels of perceived social support, the attendance of an emergency training, problem-focused coping strategies, appreciation from hospital direction and the community, and adequate attention to healthcare workers’ wellbeing from hospital direction had a protective role for healthcare workers’ mental health. Despite the subthreshold distress scores obtained by our sample, subsyndromal symptoms can cause distress, impair functioning, and affect the quality of care, necessitating intervention. Recommendations should include the assessment and promotion of coping strategies; programs for the development of self-efficacy in emergency situations; special attention to nurses, healthcare professionals working in COVID-19 wards, healthcare workers with a previous history of psychiatric illness and current high levels of worry; the promotion of adequate working conditions; the expression of appreciation to healthcare workers; and the organization of online support services.

A dicembre 2019, un focolaio di casi di polmonite da coronavirus ha colpito la Cina, innescando una crisi pandemica, che ha messo a rischio di conseguenze fisiche e psicologiche gli operatori sanitari di tutto il mondo. Il primo obiettivo della presente ricerca è stato fornire dati quantitativi relativi all'impatto psicologico di epidemie/pandemie sugli operatori sanitari attraverso una revisione sistematica della letteratura. I nostri risultati indicano che tra l'11% e il 73,4% degli operatori, principalmente medici, infermieri e personale ausiliario, hanno riportato sintomi di stress post-traumatico durante le epidemie, con sintomi che si sono mantenuti fino a 1-3 anni nel 10-40% dei casi. Sintomi depressivi sono stati segnalati nel 27,5-50,7% degli operatori, sintomi di insonnia nel 34-36,1% e sintomi severi di ansia nel 45%. Sintomi psichiatrici generali e stress lavoro-correlato sono stati riportati in un ampio range di casi (rispettivamente 17,3-75,3% e 18,1-80,1%). Diverse caratteristiche possono essere considerate fattori di rischio o protezione, come le caratteristiche di personalità, il livello di esposizione a pazienti infetti e il supporto organizzativo. Il secondo scopo della ricerca è stato valutare la salute mentale degli operatori sanitari italiani durante la pandemia per identificare i gruppi ad alto rischio e i fattori di rischio e protezione che possono guidare la pianificazione di interventi. Il progetto “Benessere Operatori” è uno studio longitudinale in tre tempi (dopo la prima ondata di COVID-19, durante la seconda e dopo la terza) in cui sono stati somministrati questionari ad hoc relativi a dati socio-demografici e lavorativi, la Depression Anxiety Stress Scale-21, l'Insomnia Severity Index, l’Impact of Event Scale-Revised, lo State-Trait Anger Expression Inventory-2, il Maslach Burnout Inventory, la Multidimensional Scale of Perceived Social Support e il Brief Cope. 1055 operatori sanitari hanno partecipato allo studio. I risultati evidenziano che, durante il primo anno della pandemia, gli operatori sanitari hanno sperimentato sintomi subclinici di depressione, ansia, stress e insonnia, e livelli medi e alti di burnout. Durante la pandemia, questi sintomi sono rimasti per lo più invariati, con un aumento dei punteggi di depressione ed esaurimento emotivo al secondo follow-up. Gli infermieri e gli operatori che hanno lavorato nei reparti COVID sono risultati a più alto rischio di distress psicologico rispetto ad altri gruppi di operatori sanitari. Sono stati identificati fattori di rischio, tra cui livelli più elevati di preoccupazione, condizioni di lavoro peggiori, lavoro nei reparti COVID, una precedente storia psichiatrica, la professione infermieristica e l’utilizzo di strategie di coping incentrate sull'evitamento e sulle emozioni. Livelli più elevati di supporto sociale percepito, la partecipazione a un training sulle situazioni di emergenza, l’uso di strategie di coping focalizzate sul problema, l’apprezzamento da parte della direzione dell'ospedale e della comunità e un'adeguata attenzione al benessere degli operatori sanitari da parte della direzione dell'ospedale hanno avuto un ruolo protettivo per la salute mentale degli operatori. Nonostante i punteggi sottosoglia ottenuti dal nostro campione, i sintomi subclinici possono comunque causare sofferenza, compromettere il funzionamento e influenzare la qualità dell'assistenza, richiedendo un intervento. I nostri dati suggeriscono di includere la valutazione e la promozione di strategie di coping; dei programmi per lo sviluppo dell'autoefficacia in situazioni di emergenza; un'attenzione particolare agli infermieri, agli operatori sanitari che lavorano nei reparti COVID, agli operatori con una precedente storia psichiatrica e alti livelli attuali di preoccupazione; la promozione di condizioni di lavoro adeguate; l'espressione di apprezzamento agli operatori sanitari; l'organizzazione di supporto online.

(2022). THE “HEALTHCARE WORKERS’ WELLBEING [BENESSERE OPERATORI]” PROJECT: A THREE-WAVE LONGITUDINAL EVALUATION OF PSYCHOLOGICAL RESPONSES OF ITALIAN HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC. (Tesi di dottorato, Università degli Studi di Milano-Bicocca, 2022).

THE “HEALTHCARE WORKERS’ WELLBEING [BENESSERE OPERATORI]” PROJECT: A THREE-WAVE LONGITUDINAL EVALUATION OF PSYCHOLOGICAL RESPONSES OF ITALIAN HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC

PEREGO, GAIA
2022

Abstract

In December 2019, an outbreak of a novel coronavirus pneumonia hit China, sparking a pandemic crisis around the world. During the last year, the COVID-19 pandemic put all the healthcare workers around the world at risk of physical and psychological sequelae. The first aim of the present research was to provide quantitative evidence on the psychological impact of epidemic/pandemic outbreaks (i.e., SARS, MERS, COVID-19, ebola, and influenza A) on healthcare workers through a systematic review of the literature. Our findings indicate that between 11% and 73.4% of healthcare workers, primarily physicians, nurses, and auxiliary staff, reported post-traumatic stress symptoms during outbreaks, with symptoms lasting after 1–3 years in 10–40% of cases. Depressive symptoms were reported in 27.5–50.7% of healthcare workers, insomnia symptoms in 34–36.1%, and severe anxiety symptoms in 45%. General psychiatric symptoms and work-related stress were reported in a wide range of cases (17.3-75.3% and 18.1-80.1%, respectively). Several individual and work-related features can be considered risk or protective factors, such as personality characteristics, the level of exposure to affected patients, and organizational support. The second purpose of the present research was to assess the mental health of Italian healthcare workers during the COVID-19 outbreak to identify high-risk groups, as well as risk and protective factors that could inform data-driven interventions. The “Healthcare workers’ wellbeing [Benessere Operatori]” project is a web-based longitudinal study administered in three times (i.e., after the first wave of the outbreak, during the second wave, and after the third wave) by means of questions on socio-demographic and work-related information, the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, the Maslach Burnout Inventory, the Multidimensional Scale of Perceived Social Support, and the Brief Cope. One thousand fifty-five healthcare workers took part in the study. Our findings highlight that during the first year of the pandemic healthcare workers experienced subclinical depression, anxiety, stress, and insomnia symptoms, as well as medium and high levels of burnout. Throughout the outbreak, these symptoms remained mostly unchanged, with an increase in depression and emotional exhaustion scores at the second follow-up. Nurses and healthcare workers who worked in COVID-19 wards were at higher risk of experiencing psychological distress compared to other groups of healthcare workers. Specific risk factors have been identified, including higher levels of worry, worse working conditions, working in COVID-19 wards, a previous history of psychiatric illness, being a nurse, and avoidant and emotion-focused coping strategies. Conversely, higher levels of perceived social support, the attendance of an emergency training, problem-focused coping strategies, appreciation from hospital direction and the community, and adequate attention to healthcare workers’ wellbeing from hospital direction had a protective role for healthcare workers’ mental health. Despite the subthreshold distress scores obtained by our sample, subsyndromal symptoms can cause distress, impair functioning, and affect the quality of care, necessitating intervention. Recommendations should include the assessment and promotion of coping strategies; programs for the development of self-efficacy in emergency situations; special attention to nurses, healthcare professionals working in COVID-19 wards, healthcare workers with a previous history of psychiatric illness and current high levels of worry; the promotion of adequate working conditions; the expression of appreciation to healthcare workers; and the organization of online support services.
MADEDDU, FABIO
DI MATTEI, VALENTINA ELISABETTA
COVID-19; pandemia; operatori sanitari; salute mentale; burnout
COVID-19; pandemic; healthcare workers; mental health; burnout
M-PSI/08 - PSICOLOGIA CLINICA
English
20-mag-2022
PSICOLOGIA, LINGUISTICA E NEUROSCIENZE COGNITIVE
34
2020/2021
embargoed_20250520
(2022). THE “HEALTHCARE WORKERS’ WELLBEING [BENESSERE OPERATORI]” PROJECT: A THREE-WAVE LONGITUDINAL EVALUATION OF PSYCHOLOGICAL RESPONSES OF ITALIAN HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC. (Tesi di dottorato, Università degli Studi di Milano-Bicocca, 2022).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/378810
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