Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

  1. Danielle Lamb
  2. Sam Gnanapragasam
  3. Neil Greenberg
  4. Rupa Bhundia
  5. Ewan Carr
  6. Matthew Hotopf
  7. Reza Razavi
  8. Rosalind Raine
  9. Sean Cross
  10. Amy Dewar
  11. Mary Docherty
  12. Sarah Dorrington
  13. Stephani Hatch
  14. Charlotte Wilson-Jones
  15. Daniel Leightley
  16. Ira Madan
  17. Sally Marlow
  18. Isabel McMullen
  19. Anne-Marie Rafferty
  20. Martin Parsons
  21. Catherine Polling
  22. Danai Serfioti
  23. Helen Gaunt
  24. Peter Aitken
  25. Joanna Morris-Bone
  26. Chloe Simela
  27. Veronica French
  28. Rachel Harris
  29. Sharon A M Stevelink
  30. Simon Wessely

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Abstract

This study reports preliminary findings on the prevalence of, and factors associated with, mental health and well-being outcomes of healthcare workers during the early months (April–June) of the COVID-19 pandemic in the UK.

Methods

Preliminary cross-sectional data were analysed from a cohort study (n=4378). Clinical and non-clinical staff of three London-based NHS Trusts, including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire. Secondary outcomes are probable anxiety (seven-item Generalised Anxiety Disorder), depression (nine-item Patient Health Questionnaire), post-traumatic stress disorder (PTSD) (six-item Post-Traumatic Stress Disorder checklist), suicidal ideation (Clinical Interview Schedule) and alcohol use (Alcohol Use Disorder Identification Test). Moral injury is measured using the Moray Injury Event Scale.

Results

Analyses showed substantial levels of probable CMDs (58.9%, 95% CI 58.1 to 60.8) and of PTSD (30.2%, 95% CI 28.1 to 32.5) with lower levels of depression (27.3%, 95% CI 25.3 to 29.4), anxiety (23.2%, 95% CI 21.3 to 25.3) and alcohol misuse (10.5%, 95% CI 9.2 to 11.9). Women, younger staff and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one’s moral code) was strongly associated with increased levels of probable CMDs, anxiety, depression, PTSD symptoms and alcohol misuse.

Conclusions

Our findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.

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  1. Version published to 10.1136/oemed-2020-107276
  2. ScreenIT

    SciScore for 10.1101/2021.01.21.20240887: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Participants provided online informed consent before starting the online survey.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: The NHS CHECK multi-site study provides findings from three different NHS Trusts, including acute and mental health services. The sites are located in London, which had a high regional case burden of COVID-19 during the first wave when recruitment commenced. This study represents a large sample size (n=4,378) relative to existing literature, with similar demographic characteristics to the overall NHS workforce in terms of age and sex [17], while London Trusts typically have a higher proportion of staff from racial and ethnic minority groups than other areas of the country, which is represented in our weighted data. We had detailed population-level HR information and were able to estimate response rates and the extent of non-response bias. These are notable methodological strengths compared with existing literature which have largely not reported response rates or assessed for related bias.[19] This study was uniquely inclusive in having gathered data from all staff employed by the NHS Trusts, including non-clinical, ancillary, lower-paid, and temporary staff. To our knowledge, this is also the only study that considers moral injury in the context of COVID-19 in HCWs. However, there are some limitations. Firstly, despite substantial recruitment efforts as outlined above, the response rate was 12% and therefore it is inevitable that findings are open to selection bias, with those for whom the survey had greatest salience (i.e. those who were distresse...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.01.21.20240887 on medRxiv