A single-item measure of self-rated mental health and psychological distress. In what situations can a single-item measure be useful?

OBJECTIVE: To examine the association between self-rated mental health (SRMH) and psychological distress (PD) at multiple periods and subsequently assess the potential of SRMH as a screening tool. METHOD: Staff working at a designated COVID-19 hospital in Sydney, Australia during March to May 2020 completed the SRMH and Kessler Psychological Distress Scale (K10) within a larger survey examining the pandemic's impact on health and well-being. SRMH was assessed before the pandemic (baseline), during its first peak in 2020 (time 2) and several months later (time 3). K10 was assessed for time 2 and time 3. All assessments took place at time 3. RESULTS: At time 2, 80% of respondents with high PD and 25% with low PD reported poor SRMH (χ2 = 21.3, p < .0001). At time 3, 90% with low PD reported good SRMH. Risk of high PD was greater for respondents with persistently poor SRMH (time 2: OR = 18.2, 95% CI = 7.7-42.8; time 3: OR = 14.4, 95% CI = 6.9-29.9) and, to a lesser extent, for those whose SRMH declined (time 2: OR = 11.6, 95% CI = 6.6-20.4; time 3: OR = 13.8, 95% CI = 2.9-66.9), compared to those with persistently good SRMH. CONCLUSIONS: During a crisis SRMH can identify the majority of those most likely to benefit from additional assessment and support. Persistently poor SRMH indicates highest risk, detectable from routine screening.

Managing COVID-19 in an Australian designated isolation facility: Implications for current and future healthcare crises based on in-depth interviews.

Health care workers' (HCWs) lived experiences and perceptions of the pandemic can prove to be a valuable resource in the face of a seemingly persistent Novel coronavirus disease 2019 (COVID-19)-to inform ongoing efforts, as well as identify components essential to a crisis preparedness plan and the issues pertinent to supporting relevant, immediate change. We employed a phenomenological approach and, using purposive sampling, conducted 39 semi-structured interviews with senior healthcare professionals who were employed at a designated COVID-19 facility in New South Wales (NSW), Australia during the height of the pandemic in 2020. Participants comprised administrators, heads of department and senior clinicians. We obtained these HCWs' (i) perspectives of their lived experience on what was done well and what could have been done differently and (ii) recommendations on actions for current and future crisis response. Four themes emerged: minimise the spread of disease at all times; maintain a sense of collegiality and informed decision-making; plan for future crises; and promote corporate and clinical agility. These themes encapsulated respondents' insights that should inform our capacity to meet current needs, direct meaningful and in situ change, and prepare us for future crises. Respondents' observations and recommendations are informative for decision-makers tasked with mobilising an efficacious approach to the next health crisis and, in the interim, would aid the governance of a more robust workforce to effect high quality patient care in a safe environment.

Pandemic Loneliness in Healthcare Workers. Does It Predict Later Psychological Distress?

Increased loneliness associated with the COVID-19 pandemic has been widely reported, with healthcare workers at increased risk compared to the general population. Pre-pandemic research indicates that loneliness has long-term detrimental effects on mental well-being, but the effect of loneliness in the context of COVID-19 is not clear. We conducted an online survey of healthcare workers (HCWs) at a large teaching hospital in Sydney, Australia after the peak of the first wave of the pandemic in 2020. Over one-third experienced loneliness at the peak of the first wave. An observed association with high psychological distress in subsequent months was attenuated after adjusting for status of mental well-being during the peak and before the pandemic. Mental well-being during the peak of the pandemic and, to a lesser extent, mental well-being before the pandemic were the strongest predictors of later distress. Increased conflict at home was also predictive of later distress. The mental health of HCWs is an important consideration at any time and is especially so in the face of crises such as the current global pandemic. Strategies to enhance baseline mental well-being and bolster well-being during crisis situations should assist HCWs cope with unexpected stressors and reduce the associated detrimental psychological consequences.

Using the Experiences and Perceptions of Health Care Workers to Improve the Health Care Response to the COVID-19 Pandemic.

BACKGROUND: We sought the opinions of health care workers (HCWs) at a designated COVID-19 facility receiving the first cases to identify workplace modifications and inform effective changes to maximize health and safety at the onset of a crisis. METHODS: A cross-sectional study utilized open- and close-ended questions gathered demographic and work details, experiences and perspectives on infection control, communication, support, and the workplace. Qualitative data were analyzed thematically and quantitative were analyzed using descriptive statistics. FINDINGS: Of 340 HCWs, most approved of the organization's response to minimizing risk (81.0%), infection control training (81.1%), and supplies (74.3%). Key actions included up-to-date guidelines (93.6%) and specialized infectious diseases clinics (94.9%). Conclusions: HCWs rated the organization's adaptive changes highly, noting areas for improvement such as transparency and timeliness of communication. Incorporating input from HCWs when responding to health crises was beneficial to maximize staff health and safety and consequently that of patients.

Are healthcare workers particularly vulnerable to loneliness? The role of social relationships and mental well-being during the COVID-19 pandemic.

Loneliness is a major public health issue with renewed prominence due to the COVID-19 pandemic and associated social restrictions. Healthcare workers (HCWs) may be at heightened risk, but research is lacking. We measured the prevalence of loneliness among HCWs during the pandemic in 2020 and examined pre-pandemic predictors and pandemic experiences associated with loneliness. HCWs at a designated COVID-19 hospital in Sydney, Australia completed an online survey examining health and well-being before and during the pandemic and changes to work, family and social experiences. Loneliness had negatively affected the well-being of 129 (39%) respondents (n â€‹= â€‹330). Pre-pandemic factors predicting loneliness were younger age (<30years compared to ≥50years), having ever been told you had a mental health problem and living alone. These became non-significant when pandemic-related factors were added to the regression. Less contact with family and friends, increased conflict at home, and living alone or with family but not a partner, increased the odds of loneliness, while a sense of camaraderie with colleagues had the opposite effect. Psychological distress and poor mental health during the pandemic were also positively associated with loneliness. Efforts to promote congenial social contacts may be effective in averting loneliness among HCWs.

Effects of the COVID-19 Pandemic on the Use of Telehealth for Antenatal Care.

Aims: To determine changes in the use of telehealth and face-to-face consultations for antenatal care (ANC) associated with the COVID-19 pandemic and to identify the groups of women most affected. Materials and Methods: Routine administrative data from three public hospitals in a Local Health District in New South Wales, Australia, were analyzed. Data from 19,171 women who gave birth before the pandemic started (January 2018-January 2020) were compared with data of 5,479 women who gave birth after the pandemic started (December 2020-June 2021). Results: One in eight antenatal services after the pandemic started was a telehealth consultation. The average number of telehealth consultations per woman increased by 0.6 (0.7-1.3, adjusted incidence rate ratio [IRR] = 1.71, p < 0.001), while face-to-face visits decreased by 1.4 (10.6-9.2, adjusted IRR = 0.87, p < 0.001), resulting in an overall reduction of 0.8 (11.3-10.5, p < 0.001) services (7.1%). The increase in telehealth consultations was evident in all groups, but was greatest among women attending the smallest hospital, younger women, and Indigenous women. Most groups of women experienced a reduction in the number of face-to-face and total consultations, but the greatest reductions were among women who attended the largest hospital, received shared care, were older than 35 years, or had conceived through in vitro fertilization. Conclusions: Use of telehealth accounted for a small proportion of total ANC services; its increase did not compensate for the reduction in face-to-face visits, which might have resulted from the lack of suitable equipment, access to facilities, and skills or willingness to engage in telehealth. Ultimately there was an overall reduction of service utilization, which was not uniform among different groups of women.

Detrimental changes to the health and well-being of healthcare workers in an Australian COVID-19 hospital.

BACKGROUND: Most studies examining the psychological impact of COVID-19 on healthcare workers (HCWs) have assessed well-being during the initial stages or the peak of the first wave of the pandemic. We aimed to measure the impact of COVID-19 and potential changes over time in its impact, on the health and well-being of HCWs in an Australian COVID-19 hospital. METHODS: An online questionnaire assessed current and retrospective physical and mental health; psychological distress (Kessler Psychological Distress Scale); lifestyle behaviours; and demographics, providing measures of health and wellbeing at three phases of the pandemic. Targeted staff were invited to participate via email and in-person. Additional promotional activities were directed to all staff. Changes in general health, mental health and psychological distress were examined using McNemar's Chi-square. Associations between other categorical variables were tested using Chi-Square or non-parametric equivalents as appropriate. Logistic regression explored risk factors for current distress. RESULTS: Four hundred thirty-three eligible HCWs answered all (74 %) or part of the questionnaire. Current self-rated health and mental health were significantly better than during the height of the pandemic, but had not returned to pre-pandemic levels. Psychological distress was significantly more common during the height of the pandemic (34.2 %) than currently (22.4 %), and during the height of the pandemic distress was significantly more common among younger than older HCWs. Females were significantly more likely to be distressed that males currently, but not during the height of the pandemic. High distress during the height of the pandemic was more likely to be maintained by HCWs who were less physically active than usual during the height of the pandemic (OR = 5.5); had low self-rated mental health before the pandemic (OR = 4.8); and who had 10 or more years of professional experience (OR = 3.9). CONCLUSIONS: The adverse effects of the pandemic on HCWs have lessened with the easing of pandemic demands, but health and well-being have not reverted to pre-pandemic levels. This indicates continued exposure to elevated levels of stress and/or a sustained effect of earlier exposure. Initiatives that provide ongoing support beyond the pandemic are needed to ensure that HCWs remain physically and mentally healthy and are able to continue their invaluable work.