The Mental Health of Healthcare Staff during the COVID-19 Pandemic: It Depends on How Much They Work and Their Age

BackgroundHealthcare staff are the forefront of fight against COVID-19 and they are under enormous pressure due to the fast growth in the number and severity of infected cases. This creates their mental issues such as distress, depression and anxiety. Exploring healthcare staffs mental health during the pandemic contributes to improving their persistence in the growing challenges created by COVID-19 and enabling effective management of their mental health. MethodsAn online survey of 280 healthcare staff in all the 31 provinces of Iran was conducted during April 5-20, 2020. The survey assessed staffs distress, depression and anxiety in the COVID-19 pandemic. ResultsNearly a third of healthcare staff suffered from distress, depression and anxiety. Females and more educated healthcare staff were more likely to experience distress. Compared to personnel who did not have COVID-19, those who were unsure whether they had COVID-19 were more likely to experience distress and depression. The number of COVID-19 cases among the staffs colleagues or friends positively predicted their anxiety. Compared to radio technologists, doctors were less likely to experience distress and anxiety. Technicians and obstetrics experienced less anxiety. Analysis the interaction between weekly working days and age of the staff indicated the chance of experiencing distress and depression varied greatly by working days among younger but not older healthcare staff. ConclusionThe predictors of mental health issues assists healthcare organizations to identify healthcare staff with mental health issues in sever crises such as the COVID-19 pandemic. Our research highlight the need to identify more working characteristics as predictors for healthcare staff at different ages. FundingThis work was supported by Tsinghua University-INDITEX Sustainable Development Fund (No. TISD201904).

The curvilinear relationship between the age of adults and their mental health in Iran after its peak of COVID-19 cases

The emerging body of research on the predictors of mental health in the COVID-19 pandemic has revealed contradictory findings, which prevent effective psychiatry screening for mental health assistance. This study aims to identify the predictors of nonsomatic pain, depression, anxiety, and distress, especially focusing on age as a nonlinear predictor. We conducted a survey of 474 adults in Iran during April 1-10, 2020, when Iran had just passed its first peak of the COVID-19 pandemic with new confirmed cases. We found that Age had a curvilinear relationship with nonsomatic pain, depression, and anxiety. Age was associated with pain, depression, and anxiety disorders negatively among adults younger than 45 years, but positively among seniors older than 70 years. Adults who were female, unsure about their chronic diseases, and exercised less per day were more likely to have mental health issues. This study advances the use of age as an effective predictor by uncovering a curvilinear relationship between individuals age and mental health issues by using a sample of adults across a wide spectrum of ages. We hope future research on mental health during COVID-19 pays more attention to nonlinear predictors.

Belief in Conspiracy Theory about COVID-19 Predicts Mental Health and Well-being -- A Study of Healthcare Staff in Ecuador

BackgroundSocial media are becoming hotbeds of conspiracy theories, which aim to give resolute explanations on the cause of COVID-19 pandemic. Yet, no research has investigated whether individuals belief in conspiracy theory about COVID-19 is associated with mental health and well-being issues. This association enables an assessable channel to identify and reach people with mental health and well-being issues during the pandemic. ObjectiveWe aim to provide the first evidence of belief in conspiracy theory regarding the COVID-19 virus as a predictor of the mental health and well-being of healthcare workers. MethodsWe conducted a survey of 252 healthcare workers in Ecuador from April 10 to May 2, 2020. We analyzed the data of distress and anxiety caseness with logistic regression and life and job satisfaction with linear regression. ResultsAmong the sampled healthcare workers in Ecuador, 24.2% believed that the virus was developed intentionally in a lab; 32.54% experienced distress disorder, and 28.17% had anxiety disorder. Compared to healthcare workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab were more likely to have distress disorder and anxiety disorder and had lower levels of job satisfaction and life satisfaction. ConclusionsThis paper identifies belief in a COVID-19 conspiracy theory as an important predictor of distress, anxiety, and job and life satisfaction of healthcare workers. It enables mental health services to better target and help mentally vulnerable healthcare workers during the ongoing COVID-19 pandemic.

Succumbing to the COVID-19 Pandemic: Healthcare Workers not Satisfied and Intend to Leave Their Jobs

BackgroundHealthcare workers are under such a tremendous amount of pressure during the COVID-19 pandemic that many have become concerned about their jobs and even intend to leave them. It is paramount for healthcare workers to feel satisfied with their jobs and lives during a pandemic. MethodsBetween 10 to 30 April, 2020, 240 healthcare workers in Bolivia completed a cross-sectional online survey, which assessed their job satisfaction, life satisfaction, and turnover intention in the ongoing COVID-19 pandemic. ResultsThe results revealed that their number of office days predicted job satisfaction, life satisfaction, and turnover intention, but the relationships varied by their age. For example, healthcare workers office days negatively predicted job satisfaction for the young (e.g. at 25 years old: b=-0.21; 95% CI: -0.36 to -0.60) but positively predicted job satisfaction for the old (e.g. at 65 years old: b=0.25; 95% CI: 0.06 to 0.44). ConclusionsThese findings provide evidence to enable healthcare organizations to identify staff concerned about job satisfaction, life satisfaction, and turnover intention to enable early actions so that these staff can remain motivated to fight the prolonged COVID-19 pandemic.

Beyond predicting the number of infections: predicting who is likely to be COVID negative or positive

This study provides the first attempt to identify people at greater risk of COVID-19 infection, enabling more targeted infectious disease prevention and control, which are especially important in the ongoing shortage of COVID-19 testing. We conducted a primary survey of 521 adults on April 1-10, 2020 in Iran, where the official infection rate was 0{middle dot}08%. In our sample, 3% reported being COVID-19 positive and 15% were unsure of their status. This relatively high positive rate enabled us to conduct the analysis at the 5% significance level. At the time of the survey, 44% of the adults worked from home; 26% still went to work in their workplaces; 27% had stopped working due to the COVID-19 pandemic; and 3% were unemployed. Adults who exercised more were more likely to be COVID-19 negative. Each additional hour of exercise per day predicted a 78% increase in the likelihood of being COVID-19 negative. Adults with chronic medical illnesses were 48% more likely to be COVID-19 negative. In terms of work situation, those who worked from home were the most likely to be COVID-19 negative, and those who had stopped working were the most likely to be COVID-19 positive. Individuals in larger organizations were less likely to be COVID-19 positive. Given the testing shortage in many countries, we identify a novel approach to predict the likelihood of COVID-19 infection by a set of personal and work situation characteristics, in order to help to identify individuals with more or less risk of contracting the virus. We hope this research opens a new research avenue to identify the individual risk factors of COVID-19 infection to enable more targeted infectious disease prevention, communication, testing, and control to complement the effort to expand testing capacity.

When the storm is the strongest: The health conditions and job satisfaction of Healthcare staff and their associated predictors during the epidemic peak of COVID-19

This study reports the physical health, mental health, anxiety, depression, distress, and job satisfaction of healthcare staff in Iran when the country faced its highest number of total active COVID-19 cases. In a sample of 304 healthcare staff (doctors, nurses, radiologists, technicians, etc.), we found a sizable portion reached the cutoff levels of disorders in anxiety (28.0%), depression (30.6%), and distress (20.1%). Age, gender, education, access to PPE (personal protective equipment), healthcare institutions (public vs. private), and individual status of COVID-19 infection each predicted some but not all the outcome variables of SF-12, PHQ-4, K6, and job satisfaction. The healthcare workers varied greatly in their access to PPE and in their status of COVID-19 infection: negative (69.7%), unsure (28.0%), and positive (2.3%). The predictors were also different from those identified in previous studies of healthcare staff during the COVID-19 crisis in China. This study helps to identify the healthcare staff in need to enable more targeted help as healthcare staff in many countries are facing peaks in their COVID-19 cases.

First study on mental distress in Brazil during the COVID-19 crisis

ObjectiveWe aim to provide early evidence of mental distress and its associated predictors among adults one month into the COVID-19 crisis in Brazil. MethodsWe conducted an online survey of 638 adults in Brazil on March 25-28, 2020, about one month (32 days) cross-sectionally after the first COVID-19 case in South America was confirmed in Sao Paulo. The 638 adults were in 25 states out of the 26 Brazilian states, with the only exception being Roraima, the least populated state in the Amazon. Of all the participating adults, 24%, 20%, and 18% of them were located in Rio de Janeiro state, Santa Catarina state, and Sao Paulo state respectively. ResultsIn Brazil, 52% (332) of the sampled adults experienced mild or moderate distress, and 18.8% (120) suffered severe distress. Adults who were female, younger, more educated, and exercised less reported higher levels of distress. Each individuals distance from the Brazilian epicenter of Sao Paulo interacted with age and workplace attendance to predict the level of distress. The "typhoon eye effect" was stronger for people who were older or attended their workplace less. The most vulnerable adults were those who were far from the epicenter and did not go to their workplace in the week before the survey. ConclusionIdentifying the predictors of distress enables mental health services to better target finding and helping the more mentally vulnerable adults during the ongoing COVID-19 crisis.

The distress of Iranian adults during the Covid-19 pandemic - More distressed than the Chinese and with different predictors

Early papers on the mental health of the public during the Covid-19 pandemic surveyed participants from China. Outside of China, Iran has emerged as one of the most affected countries with a high death count and rate. The paper presents the first empirical evidence from Iranian adults during the Covid-19 pandemic on their level of distress and its predictors. On March 25-28, 2020, a dire time for Covid-19 in Iran, we surveyed 1058 adults from all 30 provinces in Iran using the Covid-19 Peritraumatic Distress Index (CPDI). The distress level of Iranian adults (mean: 34.54; s.d.: 14.92) was significantly higher (mean difference: 10.9; t=22.7; p<0.0001; 95% CI: 10.0 to 11.8) than that of Chinese adults (mean: 23.65; s.d.: 5.45) as reported in a prior study with the same measure of Covid-19 Peritraumatic Distress Index (CPDI). We also found the predictors of distress in Iran vary from those in China. Our findings that the predictors of distress in Iran vary from those in China suggest the need to study the predictors of mental health in individual countries during the Covid-19 pandemic to effectively identify and screen for those more susceptible to mental health issues. FundingNone