Professional quality of life and psychopathological symptoms among first-line healthcare workers facing COVID-19 pandemic: an exploratory study in an Italian southern hospital
Background
The COVID-19 pandemic has significantly affected the mental health of healthcare workers, who have taken on the major problems triggered by the emergency. The mental consequences concern high levels of insomnia, anxiety, depression and burnout, which inevitably affect their professional quality of life too.
Objective
The aim of this study was to analyze the relationship between psychopathological symptoms (tested with the Depression Anxiety Stress Scale, DASS-21) and professional quality of life (measured with the Professional Quality of Life Scale, ProQol) in a hospital of southern Italy.
Methods
204 healthcare workers were recruited by non-probabilistic sampling and divided by age, gender, work roles (physicians, nurses and intermediate care technicians) and clinical departments (Cardio-medicine, Infectious Diseases, Emergency Medicine, First Aid, Obstetrics and Pneumology).
Results
The results showed higher levels of Secondary Traumatic Stress, Depression, Anxiety and Stress in women than in men. Physicians and nurses experienced lower levels of Compassion Satisfaction but higher Burnout than intermediate care technicians; likewise, nurses were more anxious than physicians. The Emergency Medicine had higher scores in Compassion Satisfaction than Infectious Disease, Pneumology, Obstetrics and Cardio-Medicine.
Conclusion
In light of what has been said so far, it appears essential to intervene on the first mild signs of Burnout and Secondary Traumatic Stress, because they precede the onset of Depression, Stress and Anxiety in healthcare workers.
1. Rozenfeld M, Peleg K, Givon A, et al. COVID-19 Changed the Injury Patterns of Hospitalized Patients. Prehosp Disaster Med. 2021;36(3):251-259. doi:10.1017/s1049023x21000285
2. World Health Organization(WHO). Therapeutics and COVID-19: living guideline. Published 2022. Accessed July 1, 2022. https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2022.3
3. Lapolla P, Mingoli A, Lee R. Deaths from COVID-19 in healthcare workers in Italy-What can we learn? Infect Control Hosp Epidemiol. 2021;42(3):364-365. doi:10.1017/ice.2020.241
4. Shaukat N, Ali DM, Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: a scoping review. Int J Emerg Med. 2020;13(1):40. doi:10.1186/s12245-020-00299-5
5. Sahin MK, Aker S, Sahin G, Karabekiroglu A. Prevalence of Depression, Anxiety, Distress and Insomnia and Related Factors in Healthcare Workers During COVID-19 Pandemic in Turkey. J Community Health. 2020;45(6):1168-1177. doi:10.1007/s10900-020-00921-w
6. Rossi R, Socci V, Pacitti F, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019(COVID-19) Pandemic in Italy. JAMA Netw Open. 2020;3(5):e2010185. doi:10.1001/jamanetworkopen.2020.10185
7. di Tella M, Romeo A, Benfante A, Castelli L. Mental health of healthcare workers during the COVID-19 pandemic in Italy. J Eval Clin Pract. 2020;26(6):1583-1587. doi:10.1111/jep.13444
8. Luigi G, Serena G, Marzia G, et al. The COVID-related mental health load of neonatal healthcare professionals: a multicentre study in Italy. medRxiv. Published online 2021. http://www.epistemonikos.org/documents/07a0f9430a94255959c2e023c62bf179c0e6d80f
9. Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Research. 2020;290:113129. doi:10.1016/j.psychres.2020.113129
10. Salari N, Khazaie H, Hosseinian-Far A, et al. The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression. Hum Resour Health. 2020;18(1):100. doi:10.1186/s12960-020-00544-1
11. da Silva Neto RM, Benjamim CJR, de Medeiros Carvalho PM, Neto MLR. Psychological effects caused by the COVID-19 pandemic in health professionals: A systematic review with meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2021;104:110062. doi:10.1016/j.pnpbp.2020.110062
12. Kailey H. Burnout and Interventions for Healthcare workers to cope during COVID-19. BJPsych Open. 2021;7(S1):S143-S143. doi:10.1192/bjo.2021.404
13. Khosravi M, Ghiasi Z, Ganjali A. A narrative review of research on healthcare staff's burnout during the COVID-19 pandemic. Proceedings of Singapore Healthcare. Published online September 2, 2021:201010582110405. doi:10.1177/20101058211040575
14. Stamm BH. Professional quality of life: Compassion satisfaction and fatigue subscales, Version V (ProQOL). Published 2009. Accessed July 1, 2022. https://proqol.org/#6d43dca3-1f06-414d-a26e-6ea9ef18c7d4
15. Palestini L, Prati G, Pietrantoni L, Cicognani E. The professional quality of life in accident and emergency work: A contribution to the Italian validation of the Professional Quality of Life Scale (ProQOL). Psicoterapia Cognitiva e Comportamentale. 2009;15(2).
16. Stamm BH. The Concise ProQOL Manual. ProQOL org; 2010.
17. Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. Vol 56.; 1995.
18. Bottesi G, Ghisi M, Altoè G, Conforti E, Melli G, Sica C. The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples. Comprehensive Psychiatry. 2015;60:170-181. doi:10.1016/j.comppsych.2015.04.005
19. Wilson W, Raj JP, Rao S, et al. Prevalence and Predictors of Stress, anxiety, and Depression among Healthcare Workers Managing COVID-19 Pandemic in India: A Nationwide Observational Study. Indian Journal of Psychological Medicine. 2020;42(4):353-358. doi:10.1177/0253717620933992
20. Lai J, Ma S, Wang Y, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976
21. Kolakowsky-Hayner SA, Goldin Y, Kingsley K, et al. Psychosocial impacts of the COVID-19 quarantine: A study of gender differences in 59 countries. Medicina (Lithuania). 2021;57(8):789. doi:10.3390/medicina57080789
22. Laufer A, Shechory Bitton M. Gender differences in the reaction to COVID-19. Women & Health. 2021;61(8):800-810. doi:10.1080/03630242.2021.1970083
23. Ruiz-Fernández MD, Ramos-Pichardo JD, Ibanez-Masero O, Cabrera-Troya J, Carmona-Rega MI, Ortega-Galán AM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. Journal of Clinical Nursing. 2020;29(21-22):4321-4330. doi:10.1111/jocn.15469
24. Cai H, Tu B, Ma J, et al. Psychological impacts and coping strategies of front-line medical staff during COVID-19 outbreak in Hunan, China. Med Sci Monit. 2020;26. doi:10.12659/msm.924171
25. Mohindra R, R R, Suri V, Bhalla A, Singh SM. Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients. Asian Journal of Psychiatry. 2020;51:102084. doi:10.1016/j.ajp.2020.102084
26. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian Journal of Psychiatry. 2020;51:102119. doi:10.1016/j.ajp.2020.102119
27. Darias V. Impacto Psicologico de la Covid-19 en profesionales de enfermeria en primera linea en la comunidad canaria. Facultad de Psicologia y Logopedia. Published online 2020.
28. Sierra S, Diaz-Castrillon CE. Inteligencia Emocional y practica clinica en tiempos de pandemia. CES Med. 2020;34:59-68. doi:10.21615/cesmedicina.34.covid-19.9
29. Vasquez-Trespalacios EM. Sindrome de burnout en los trabajadores de la salud en la era del COVID-19. CES Med. 2020;34:126-127. doi:10.21615/cesmedicina.34.covid-19.17
30. Harker R, Didgeon AM, Klaassen F, King S. Exploring resilience and mindfulness as preventative factors for psychological distress, burnout and secondary traumatic stress among human service professionals. Work. 2016;54(3):631-637. doi:10.3233/wor-162311
31. Yip SYC, Mak WWS, Chio FHN, Law RW. The Mediating Role of Self-Compassion Between Mindfulness and Compassion Fatigue Among Therapists in Hong Kong. Mindfulness (NY). 2017;8(2):460-470. doi:10.1007/s12671-016-0618-5
32. Duarte J, Pinto-Gouveia J. Mindfulness, self-compassion and psychological inflexibility mediate the effects of a mindfulness-based intervention in a sample of oncology nurses. Journal of Contextual Behavioral Science. 2017;6(2):125-133. doi:10.1016/j.jcbs.2017.03.002
33. Zakeri MA, Hossini Rafsanjanipoor SM, Zakeri M, Dehghan M. The relationship between frontline nurses' psychosocial status, satisfaction with life and resilience during the prevalence of COVID-19 disease. Nursing Open. 2021;8(4):1829-1839. doi:10.1002/nop2.832
34. Coco M, Guerrera CS, Santisi G, et al. Psychosocial Impact and Role of Resilience on Healthcare Workers during COVID-19 Pandemic. Sustainability. 2021;13(13):7096. doi:10.3390/su13137096
35. Castellano S, Platania GA, Varrasi S, Pirrone C, di Nuovo S. Assessment tools for risky behaviors: Psychology and health. Health Psychol Res. 2020;8(2). doi:10.4081/hpr.2020.9235
36. Varrasi S, Castellano S, Platania GA, Guerrera CS, Caponnetto P, Pirrone C. “Don’t Touch Your Face!” The Contribution of Habit Reversal in the COVID-19 Pandemic. Health Psychol Res. 2022;10(4). doi:10.52965/001c.39650
37. Pirrone C, Varrasi S, Platania GA, Castellano S. Face-to-face and online learning: The role of technology in students' metacognition. In: CEUR Workshop Proceedings. Vol 2817.; 2021.
38. Pirrone C, di Corrado D, Privitera A, Castellano S, Varrasi S. Students' Mathematics Anxiety at Distance and In-Person Learning Conditions during COVID-19 Pandemic: Are There Any Differences? An Exploratory Study. Educ Sci (Basel). 2022;12(6):379. doi:10.3390/educsci12060379