Assessing the Psychological Impact of COVID-19 on Intensive Care Workers: A Single-centre Cross-sectional UK-based Study

ABSTRACT

Introduction: The COVID-19 pandemic presents a unique set of stressors for healthcare professionals across the globe.1 The challenges facing intensive care workers in the United Kingdom (UK) have not previously been seen on this scale. There is a dearth of research establishing the psychological impact of the virus among intense care workers specifically, who may be at the greatest risk of adverse outcomes. Protecting the psychological wellbeing of healthcare workers caring for patients with COVID-19 is essential for the long-term capacity of the health workforce. Objectives: The objectives of this study were to establish the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) among a cohort of intensive care workers within the United Kingdom during the COVID-19 pandemic. Methods: An anonymous questionnaire was designed to incorporate validated screening tools for anxiety (Generalised Anxiety Disorder Scale, GAD-7),2 depression (Patient Health Questionnaire, PHQ-9)3 and post-traumatic stress disorder (Impact of Event Scale-Revised, IES-R).4 Participants were also asked to highlight any factors in particular that contributed significantly to their own perceived mental health status. Additionally, awareness of any available mental health support services was established. All intensive care workers at the Countess of Chester Hospital, UK, were eligible and data was collected over a three week period during the months of June and July 2020 Results: The majority of the 131 respondents were nurses (52.7% [69/131]) or doctors (32.8% [43/141]). Almost onethird (29.8% [39/131]) reported a significant or extreme impact of COVID-19 on their mental health. In total, 16% (21/131) had symptoms of moderate depression, 11.5% (15/131) moderately severe depression and 6.1% (8/131) severe depression. Females had a significantly higher mean PHQ-9 score than males (8.8 and 5.68 respectively, p=0.009). Furthermore, 18.3% (24/131) had moderate anxiety with 14.5% (19/131) having severe anxiety. Mean GAD-7 scores were higher among females than males (8.69 and 6.26 respectively, p=0.028). Additionally, 28.2% (37/ 131) had symptoms of PTSD (IES-R ≥33). The most commonly cited contributory factors to participants' selfrated impact on mental health, was the effect of COVID-19 on family (78.6% [103/131]) followed by being busier at work (60.3% [79/131]), the personal risk of contracting COVID-19 (56.5% 74/131]), change in working environment (51.1% [67/131]) and change in working hours (43.5% [57/131]). The majority (58% [76/131]) of participants were either unaware or only vaguely aware of available mental health support services. Surprisingly, only 3.1% (4/131) had accessed support services at the time of data collection. Conclusion: The psychological impact of COVID-19 on intensive care workers is significant. Healthcare systems are currently ill-prepared to cope with the increased demand for support5. Specific focus and attention must be directed accordingly in order to safeguard the mental health of this key sector of the workforce, who play a crucial role in the fight against COVID-19. Determining and acknowledging the scale of the problem is the first step towards achieving this.