Work-Related and Personal Factors Associated With Mental Well-Being During the COVID-19 Response: Survey of Health Care and Other Workers

  1. Bradley A Evanoff
  2. Jaime R Strickland
  3. Ann Marie Dale
  4. Lisa Hayibor
  5. Emily Page
  6. Jennifer G Duncan
  7. Thomas Kannampallil
  8. Diana L Gray

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Abstract

The response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has created an unprecedented disruption in work conditions. This study describes the mental health and well-being of workers both with and without clinical exposure to patients with coronavirus disease (COVID-19).

Objective

The aim of this study is to measure the prevalence of stress, anxiety, depression, work exhaustion, burnout, and decreased well-being among faculty and staff at a university and academic medical center during the SARS-CoV-2 pandemic and describe work-related and personal factors associated with their mental health and well-being.

Methods

All faculty, staff, and postdoctoral fellows of a university, including its medical school, were invited in April 2020 to complete an online questionnaire measuring stress, anxiety, depression, work exhaustion, burnout, and decreased well-being. We examined associations between these outcomes and factors including work in high-risk clinical settings and family/home stressors.

Results

There were 5550 respondents (overall response rate of 34.3%). Overall, 34% of faculty and 14% of staff (n=915) were providing clinical care, while 61% of faculty and 77% of staff were working from home. Among all workers, anxiety (prevalence ratio 1.37, 95% CI 1.09-1.73), depression (prevalence ratio 1.28, 95% CI 1.03-1.59), and high work exhaustion (prevalence ratio 1.24, 95% CI 1.13-1.36) were independently associated with community or clinical exposure to COVID-19. Poor family-supportive behaviors by supervisors were also associated with these outcomes (prevalence ratio 1.40, 95% CI 1.21-1.62; prevalence ratio 1.69, 95% CI 1.48-1.92; and prevalence ratio 1.54, 95% CI 1.44-1.64, respectively). Age <40 years and a greater number of family/home stressors were also associated with these poorer outcomes. Among the subset of clinicians, caring for patients with COVID-19 and working in high-risk clinical settings were additional risk factors.

Conclusions

Our findings suggest that the pandemic has had negative effects on the mental health and well-being of both clinical and nonclinical employees. Mitigating exposure to COVID-19 and increasing supervisor support are modifiable risk factors that may protect mental health and well-being for all workers.

Article activity feed

  1. Version published to 10.2196/21366
  2. Version published to 10.2196/preprints.21366
  3. ScreenIT

    SciScore for 10.1101/2020.06.09.20126722: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the institutional review board of Washington University in St. Louis. Survey Instrument: The survey was designed to take less than 10 minutes to complete (Supplementary Materials).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    We categorized race and ethnicity as “under-represented groups” (those identifying as Black/African American, Native American, Hawaiian/Pacific Islander or Hispanic) and as “other.
    Islander
    suggested: (Islander, RRID:SCR_007758)

    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:
    Limitations of this study include its cross-sectional design, so associations between potential risk factors and health and well-being outcomes may not be causal. The overall response rate of 34.5% means that the respondents may not be fully representative of all university employees. Since the survey was anonymous, our study relies entirely on self-reported data. We studied employees of one university, who may not be representative of other workforces. The St. Louis region was an early adopter of physical distancing and has had a later peak of SARS-CoV-2 and a lower incidence of COVID-19 patients than some other areas of the US. Strengths of the study include its large size, examination of employees who are not in health care, and evaluation of both family/home stressors and workplace factors including supervisor support. To our knowledge this is the first large American study of mental health and well-being outcomes related to the pandemic outside of HCW. We will conduct repeated surveys over time to track changes in individual health and well-being over time, and to allow more robust causal inferences. Our findings among clinical workers, both faculty (primarily physicians) and staff (primarily nurses) are broadly consistent with findings from other cross-sectional studies of HCW caring for COVID patients. A study of 1257 HCW in China1 used different instruments and found higher prevalence of depression and anxiety than seen in our study. Their study reported that HCW dire...

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.06.09.20126722v1 on medRxiv