Psychological Distress Among Healthcare Providers During the COVID-19 Pandemic: Patterns over Time

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2024 Oct 10

PMID 39390447

Authors

Iris Gutmanis

Brenda L Coleman

Kelly Ramsay

Robert Maunder

Susan J Bondy

Allison McGeer

Affiliations

Soon will be listed here.

Abstract

Background: COVID-19 added to healthcare provider (HCP) distress, but patterns of change remain unclear. This study sought to determine if and how emotional distress varied among HCP between March 28, 2021 and December 1, 2023.

Methods: This longitudinal study was embedded within the 42-month prospective COVID-19 Cohort Study that recruited HCP from four Canadian provinces. Information was collected at enrollment, from annual exposure surveys, and vaccination and illness surveys. The 10-item Kessler Psychological Distress Scale (K10) was completed approximately every six months after March 28, 2021. Linear mixed effects models, specifically random intercept models, were generated to determine the impact of time on emotional distress while accounting for demographic and work-related factors.

Results: Between 2021 and 2023, the mean K10 score fell by 3.1 points, indicating decreased distress, but scores increased during periods of high levels of mitigation strategies against transmission of SARS-CoV-2, during winter months, and if taking antidepression, anti-anxiety or anti-insomnia medications. K10 scores were significantly lower for HCP who were male, older, had more children in their household, experienced prior COVID-19 illness(es), and for non-physician but regulated HCP versus nurses. A sensitivity analysis that included only those who had submitted at least five K10 surveys consisted of the factors in the full model excluding previous COVID-19 illness, occupation, and season, after adjustment. Models were also created for K10 anxiety and depression subscales.

Conclusions: K10 scores decreased as the COVID-19 pandemic continued but increased during periods of high mitigation and the winter months. Personal and work-place factors also impacted HCP distress scores. Further research into best practices in distress identification and remediation is warranted to ensure future public health disasters are met with healthcare systems that are able to buffer HCP against short- and long-term mental health issues.

References

Kameno Y, Nishimura T, Naito Y, Asai D, Inoue J, Mochizuki Y . Time-course changes in mental distress and their predictors in response to the coronavirus disease 2019 (COVID-19) pandemic: A longitudinal multi-site study of hospital staff. PLoS One. 2023; 18(10):e0292302. PMC: 10553228. DOI: 10.1371/journal.pone.0292302. View

Lagace-Wiens P, Bullard J, Cole R, Van Caeseele P . Seasonality of coronaviruses and other respiratory viruses in Canada: Implications for COVID-19. Can Commun Dis Rep. 2021; 47(3):132-138. PMC: 8109286. DOI: 10.14745/ccdr.v47i03a02. View

Cobb B, Coryell W, Cavanaugh J, Keller M, Solomon D, Endicott J . Seasonal variation of depressive symptoms in unipolar major depressive disorder. Compr Psychiatry. 2014; 55(8):1891-9. PMC: 4254297. DOI: 10.1016/j.comppsych.2014.07.021. View

Styra R, Hawryluck L, McGeer A, Dimas M, Lam E, Giacobbe P . Support for health care workers and psychological distress: thinking about now and beyond the COVID-19 pandemic. Health Promot Chronic Dis Prev Can. 2022; 42(10):421-430. PMC: 9584174. DOI: 10.24095/hpcdp.42.10.01. View

Carazo S, Pelletier M, Talbot D, Jauvin N, De Serres G, Vezina M . Psychological Distress of Healthcare Workers in Québec (Canada) During the Second and the Third Pandemic Waves. J Occup Environ Med. 2022; 64(6):495-503. PMC: 9275796. DOI: 10.1097/JOM.0000000000002487. View

Maunder R, Heeney N, Kiss A, Hunter J, Jeffs L, Ginty L . Psychological impact of the COVID-19 pandemic on hospital workers over time: Relationship to occupational role, living with children and elders, and modifiable factors. Gen Hosp Psychiatry. 2021; 71:88-94. PMC: 8096521. DOI: 10.1016/j.genhosppsych.2021.04.012. View

Braddock A, Malm-Buatsi E, Hicks S, Harris G, Alafaireet P . Healthcare Workers' Perceptions of On-Site Childcare. J Healthc Manag. 2023; 68(1):56-67. DOI: 10.1097/JHM-D-22-00007. View

Sampasa-Kanyinga H, Zamorski M, Colman I . The psychometric properties of the 10-item Kessler Psychological Distress Scale (K10) in Canadian military personnel. PLoS One. 2018; 13(4):e0196562. PMC: 5919406. DOI: 10.1371/journal.pone.0196562. View

Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D . Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ. 2020; 369:m1642. PMC: 7199468. DOI: 10.1136/bmj.m1642. View

10.

Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D . Nurses' burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis. J Adv Nurs. 2021; 77(8):3286-3302. PMC: 8250618. DOI: 10.1111/jan.14839. View

11.

Jerg-Bretzke L, Kempf M, Jarczok M, Weimer K, Hirning C, Gundel H . Psychosocial Impact of the COVID-19 Pandemic on Healthcare Workers and Initial Areas of Action for Intervention and Prevention-The egePan/VOICE Study. Int J Environ Res Public Health. 2021; 18(19). PMC: 8508196. DOI: 10.3390/ijerph181910531. View

12.

Vogel L . Even resilient doctors report high levels of burnout, finds CMA survey. CMAJ. 2018; 190(43):E1293. PMC: 6205827. DOI: 10.1503/cmaj.109-5674. View

13.

Andrews G, Slade T . Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust N Z J Public Health. 2002; 25(6):494-7. DOI: 10.1111/j.1467-842x.2001.tb00310.x. View

14.

Neelam K, Duddu V, Anyim N, Neelam J, Lewis S . Pandemics and pre-existing mental illness: A systematic review and meta-analysis. Brain Behav Immun Health. 2020; 10:100177. PMC: 7683956. DOI: 10.1016/j.bbih.2020.100177. View

15.

Maunder R . The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned. Philos Trans R Soc Lond B Biol Sci. 2004; 359(1447):1117-25. PMC: 1693388. DOI: 10.1098/rstb.2004.1483. View

16.

Zhang W, Walkover M, Wu Y . The challenge of COVID-19 for adult men and women in the United States: disparities of psychological distress by gender and age. Public Health. 2021; 198:218-222. PMC: 8299224. DOI: 10.1016/j.puhe.2021.07.017. View

17.

Kessler R, Barker P, Colpe L, Epstein J, Gfroerer J, Hiripi E . Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003; 60(2):184-9. DOI: 10.1001/archpsyc.60.2.184. View

18.

Sakeah J, Apatinga G, Adda E, Apanga P, Vlassoff C, Chen Y . The joint effect of female sex and food insecurity on self-reported mood disorder among Canadian adults: the Canadian community health survey. BMC Nutr. 2023; 9(1):91. PMC: 10362737. DOI: 10.1186/s40795-023-00750-9. View

19.

Stelnicki A, Carleton R . Mental Disorder Symptoms Among Nurses in Canada. Can J Nurs Res. 2020; 53(3):264-276. DOI: 10.1177/0844562120961894. View

20.

Gutmanis I, Sanni A, McGeer A, Maunder R, Robertson N, Coleman B . Level of patient contact and Impact of Event scores among Canadian healthcare providers during the COVID-19 pandemic. BMC Health Serv Res. 2024; 24(1):947. PMC: 11334392. DOI: 10.1186/s12913-024-11426-w. View