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Psychological distress among healthcare workers accessing occupational health services during the COVID-19 pandemic in Zimbabwe.
Chingono, Rudo M S; Nzvere, Farirayi P; Marambire, Edson T; Makwembere, Mirriam; Mhembere, Nesbert; Herbert, Tania; Maunganidze, Aspect J V; Pasi, Christopher; Chiwanga, Michael; Chonzi, Prosper; Ndhlovu, Chiratidzo E; Mujuru, Hilda; Rusakaniko, Simbarashe; Olaru, Ioana D; Ferrand, Rashida A; Simms, Victoria; Kranzer, Katharina.
  • Chingono RMS; Biomedical Research and Training Institute, Harare, Zimbabwe; Institute of Global Health, University College London, London, UK.
  • Nzvere FP; Biomedical Research and Training Institute, Harare, Zimbabwe; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Marambire ET; Biomedical Research and Training Institute, Harare, Zimbabwe.
  • Makwembere M; Counselling Services Unit, Harare, Zimbabwe.
  • Mhembere N; Counselling Services Unit, Harare, Zimbabwe.
  • Herbert T; Counselling Services Unit, Harare, Zimbabwe.
  • Maunganidze AJV; Parirenyatwa Hospital, Harare, Zimbabwe.
  • Pasi C; Sally Mugabe Central Hospital, Harare, Zimbabwe.
  • Chiwanga M; Chitungwiza Hospital, Chitungwiza, Zimbabwe.
  • Chonzi P; Harare City Health, Harare, Zimbabwe.
  • Ndhlovu CE; Internal Medicine Unit, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
  • Mujuru H; Department of Paediatrics and Child Health, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
  • Rusakaniko S; Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Olaru ID; Biomedical Research and Training Institute, Harare, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
  • Ferrand RA; Biomedical Research and Training Institute, Harare, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
  • Simms V; Biomedical Research and Training Institute, Harare, Zimbabwe; International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: Victoria.simms@lshtm.ac.uk.
  • Kranzer K; Biomedical Research and Training Institute, Harare, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK; Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany.
Compr Psychiatry ; 116: 152321, 2022 07.
Article in English | MEDLINE | ID: covidwho-1814287
ABSTRACT

BACKGROUND:

Healthcare workers (HCWs) have experienced anxiety and psychological distress during the COVID-19 pandemic. We established and report findings from an occupational health programme for HCWs in Zimbabwe that offered screening for SARS-CoV-2 with integrated screening for comorbidities including common mental disorder (CMD) and referral for counselling.

METHODS:

Quantitative outcomes were fearfulness about COVID-19, the Shona Symptom Questionnaire (SSQ-14) score (cutpoint 8/14) and the number and proportion of HCWs offered referral for counselling, accepting referral and counselled. We used chi square tests to identify factors associated with fearfulness, and logistic regression was used to model the association of fearfulness with wave, adjusting for variables identified using a DAG. Qualitative data included 18 in-depth interviews, two workshops conducted with HCWs and written feedback from counsellors, analysed concurrently with data collection using thematic analysis.

RESULTS:

Between 27 July 2020-31 July 2021, spanning three SARS-CoV-2 waves, the occupational health programme was accessed by 3577 HCWs from 22 facilities. The median age was 37 (IQR 30-43) years, 81.9% were women, 41.7% said they felt fearful about COVID-19 and 12.1% had an SSQ-14 score ≥ 8. A total of 501 HCWs were offered referral for counselling, 78.4% accepted and 68.9% had ≥1 counselling session. Adjusting for setting and role, wave 2 was associated with increased fearfulness over wave 1 (OR = 1.26, 95% CI 1.00-1.60). Qualitative data showed high levels of anxiety, psychosomatic symptoms and burnout related to the pandemic. Mental wellbeing was affected by financial insecurity, unmet physical health needs and inability to provide quality care within a fragile health system.

CONCLUSIONS:

HCWs in Zimbabwe experience a high burden of mental health symptoms, intensified by the COVID-19 pandemic. Sustainable mental health interventions must be multisectoral addressing mental, physical and financial wellbeing.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychological Distress / COVID-19 / Occupational Health Services Type of study: Prevalence study / Prognostic study / Qualitative research / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Male Country/Region as subject: Africa Language: English Journal: Compr Psychiatry Year: 2022 Document Type: Article Affiliation country: J.comppsych.2022.152321

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychological Distress / COVID-19 / Occupational Health Services Type of study: Prevalence study / Prognostic study / Qualitative research / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Male Country/Region as subject: Africa Language: English Journal: Compr Psychiatry Year: 2022 Document Type: Article Affiliation country: J.comppsych.2022.152321