A Longitudinal Study on the Changes in Mental Health of Healthcare Workers during the COVID-19 Pandemic.

Objective: This study examines Argentinean health care workers in order to 1) test self-perceived job performance levels and the presence of psychological symptoms compatible with common mental disorders, and 2) examine within-person changes in general discomfort and psychological distress, adjusting for demographic factors, region, and health-related factors during two time points of the COVID-19 pandemic.Method: This longitudinal study comprised 305 healthcare workers who completed a survey at two time points approximately 4 months apart. We used the General Health Questionnaire and the Kessler Psychological Distress Scale to measure mental health outcomes. To address the first aim we calculated differences (Student's t test for paired samples) and correlations (Pearson's r coefficient). To address the second aim we used fixed effects model by means of a multilevel approach, a linear model that considers dependency in the data.Results: Self-perceived job performance deteriorated across time. From the first measurement to the four-month follow-up, more health care workers presented common mental disorders (40% vs 45.57%), depression, and/or anxiety (52.46% vs 62.62%). A meaningful worsening of mental health was observed in healthcare workers who expressed concern about being infected with COVID-19, whether asymptomatic (greater general discomfort and psychological distress) or symptomatic (greater general discomfort). Likewise, there were significant interactions between a history of mental disorder and concern about COVID-19 infection.Conclusions: Among healthcare workers, the uncertainty about the COVID-19 infection may have larger negative mental health impacts than actually being infected.

Changes in Healthcare Workers' Anxiety During Two Time Points of the COVID-19 Pandemic: Evidence From a Longitudinal Study.

Evidence on the within-person changes of healthcare workers' mental health across waves of COVID-19 cases during this pandemic is absent. The aim of this study is to examine the within-person changes of anxiety in Argentinean healthcare workers, adjusting for main demographic factors, region of residence, mental disorder history, and COVID-19 contagion, during the COVID-19 pandemic. A longitudinal web survey (N = 305) was conducted during two time points of the pandemic, one of which was an infection peak. Anxiety significantly increased across time. However, there were significant interaction effects modulating anxiety levels. The largest anxiety increases occurred in healthcare workers who were not sure if they had contracted COVID-19 while symptomatic. Irrespective of the time point, anxiety was the highest in healthcare workers from a region inside the country who were not sure if they had contracted COVID-19, either asymptomatic or symptomatic. An interaction effect between the mental disorder history and the COVID-19 contagion suggested that the anxiety outcomes were mainly due to the concern about the COVID-19 contagion, rather than due to pre-existing mental health vulnerabilities. Regardless of the starting point in anxiety levels, an increasing anxiety outcome may be expected among healthcare workers as the pandemic progresses. The uncertainty regarding COVID-19 contagion is a preventable and modifiable interacting factor to produce the worst anxiety outcomes among healthcare workers.

Factores de deserción laboral de una guardia de salud mental en Hospital General de Jujuy / Factors of labor desertion of a mental health guard in Hospital General de Jujuy

INTRODUCCIÓN En julio de 2012 se implementó la primera Guardia de Salud Mental (GSM) con cobertura 24 horas en hospital general de Jujuy que contó con un psicólogo y un psiquiatra por turno. En 2017 hubo gran cantidad de renuncias y el dispositivo quedó casi sin posibilidad de brindar cobertura. OBJETIVO de este estudio fue indagar las razones de dicha deserción laboral de la GSM. MÉTODOS El muestreo fue intencional de n = 28 psicólogos y psiquiatras que trabajaron en la GSM (entre julio/2012 y septiembre/2017). Se elaboró un cuestionario ad-hoc para recolectar los datos (33 ítems con opciones de respuesta fijas). Se realizaron análisis estadísticos descriptivos. RESULTADOS Las dificultades para desempeñar la labor se relacionaron con aspectos; institucionales (edilicios y vinculares), contractuales, salariales y de la red de salud, principalmente. Dichas dificultades motivaron la decisión de desvinculación de la GSM, o bien, la motivarían en el futuro. La mayoría de profesionales vivenció estrés, enojo, desánimo y angustia de forma reactiva a la labor en la GSM. DISCUSIÓN Las motivaciones más subjetivas que llevaron a elegir trabajar en la GSM (i.e. vocación, búsqueda de crecimiento profesional), fueron afectadas por dificultades de tipo objetivo (i.e. infraestructura edilicia de la institución, aspectos contractuales y salariales, fallas operativas y carencias del sistema de salud). Son necesarias políticas públicas que resuelvan las dificultades señaladas