Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice

  1. Norha Vera San Juan
  2. David Aceituno
  3. Nehla Djellouli
  4. Kirsi Sumray
  5. Nina Regenold
  6. Aron Syversen
  7. Sophie Mulcahy Symmons
  8. Anna Dowrick
  9. Lucy Mitchinson
  10. Georgina Singleton
  11. Cecilia Vindrola-Padros

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Abstract

Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear.

Aims

The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers’ needs and provide recommendations for supporting front-line staff during the current and future pandemics.

Method

This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK ( n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic ( n = 14).

Results

The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules.

Conclusions

Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.

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  1. Version published to 10.1192/bjo.2020.148
  2. ScreenIT

    SciScore for 10.1101/2020.07.21.20156711: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The findings of this study should be considered in light of its strengths and limitations. The rapid review and qualitative study were conducted by a multidisciplinary team, following strong systematic research methods and guidelines, and allowed for a rich discussion contrasting both sources of data to reveal gaps between guidelines and practice. Applicability of the findings outside the context of this study should be evaluated, whilst taking into consideration the rapidly changing circumstances of the current health emergency. New wellbeing guidelines may emerge later in the pandemic or changes affecting HCWs experiences may occur, which we will not be able to capture. Strategies were put in place to maximise rapport during interviews and acknowledge this potential bias at analysis stage. However, sensitive topics, in particular with relation to potential alcohol or drug consumption, were not present in participants’ answers. This should be taken into consideration due to the high relevance of this topic for wellbeing. To the authors’ knowledge this is the first study contrasting wellbeing guidelines and staff experiences in practice during the COVID-19 emergency. The findings in this study extend the understanding of wellbeing guidelines in the light of HCWs’ experiences in practice. Wellbeing guidelines should take additional steps beyond focusing on top-down clinical understandings of wellbeing, and rather explore staff’s needs and contextual characteristics affecting t...

    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 10.1101/2020.07.21.20156711v1 on medRxiv