Health Care Workers' Mental Health During the First Weeks of the SARS-CoV-2 Pandemic in Switzerland—A Cross-Sectional Study

  1. Sonja Weilenmann
  2. Jutta Ernst
  3. Heidi Petry
  4. Monique C. Pfaltz
  5. Onur Sazpinar
  6. Samuel Gehrke
  7. Francesca Paolercio
  8. Roland von Känel
  9. Tobias R. Spiller

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Abstract

Objective: The current SARS-CoV-2 pandemic poses various challenges for health care workers (HCWs). This may affect their mental health, which is crucial to maintain high quality medical care during a pandemic. Existing evidence suggests that HCWs, especially women, nurses, frontline staff, and those exposed to COVID-19 patients, are at risk for anxiety and depression. However, a comprehensive overview of risk and protective factors considering their mutual influence is lacking. Therefore, this study aimed at exploring HCWs' mental health during the SARS-CoV-2 pandemic in Switzerland, investigating the independent effect of various demographic, work- and COVID-related factors on HCWs' mental health.

Methods: In an exploratory, cross-sectional, nation-wide online survey, we assessed demographics, work characteristics, COVID-19 exposure, and anxiety, depression, and burnout in 1,406 HCWs during the beginning of the SARS-CoV-2 pandemic in Switzerland. Network analysis was used to investigate the associations among the included variables.

Results: Women (compared to men), nurses (compared to physicians), frontline staff (compared to non-frontline workers), and HCWs exposed to COVID-19 patients (compared to non-exposed) reported more symptoms than their peers. However, these effects were all small. Perceived support by the employer independently predicted anxiety and burnout after adjustment for other risk factors.

Conclusion: Our finding that some HCWs had elevated levels of anxiety, depression, and burnout underscores the importance to systematically monitor HCWs' mental health during this ongoing pandemic. Because perceived support and mental health impairments were negatively related, we encourage the implementation of supportive measures for HCWs' well-being during this crisis.

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  1. Version published to 10.3389/fpsyt.2021.594340
  2. ScreenIT

    SciScore for 10.1101/2020.05.04.20088625: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The ethics committee of the canton Zurich assessed the study and officially declared that the study did not fall within the scope of the Human Research Act (BASEC-Nr. Req-2020-00471).
    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:
    Notwithstanding these limitations, our study has clinical and scientific implications. Our finding that 25.9% of the investigated HCWs had clinically relevant symptoms of anxiety and 20.7% clinically relevant symptoms of depression underscores the importance to systematically monitor HCWs’ mental health during this ongoing pandemic. Furthermore, given that perceived support and higher levels of anxiety and burnout were negatively related, we encourage the implementation of supportive measures for HCWs’ well-being during this crisis. Such measures should address key concerns of HCWs identified in previous research (e.g., sufficient access to personal protective equipment and access to child-care during increased work hours13). Most importantly, however, HCWs themselves can best express their individual needs. Hence, besides a systematic monitoring of HCWs’ mental health, we encourage managers and regulators to actively engage with the health care force and hear them and their concerns. Due to the well-documented negative effect of impaired mental health of HCWs on their provided care,6,9–12 these measures not only support HCWs themselves but also serve patients by ensuring continuation of high-quality care, especially during a public health crisis. Regarding future research, our study implies the need to address remaining questions with adequately designed studies. For example, changes in symptoms during different stages of the pandemic should be addressed by longitudinal stud...

    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.

  3. ScreenIT

    SciScore for 10.1101/2020.05.04.20088625: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementThe ethics committee of the canton Zurich assessed the study and officially declared that the study did not fall within the scope of the Human Research Act (BASEC-Nr. Req2020-00471).Randomizationnot detected.Blindingnot detected.Power AnalysisTo maximize power of the network analysis and due to intercorrelation among some of the assessed variables , we had to select items for the network analysis .Sex as a biological variableThis is majority were German-speaking ( n = 1124 , 79.7 % ) , women ( n = 934 , 66.2 % ) , had a median age of 34 years [ 29-46 ] and median professional experience of 10 years [ 420] .

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Descriptive statistics and comparison of independent groups were conducted using JASP version 0.11.30 To explore the complex relationships among demographic data , work characteristics , COVID-19 exposure , and symptoms of anxiety , depression , and burnout , we conducted a network analysis .
    JASP
    suggested: (JASP, SCR_015823)

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

    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 is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.05.04.20088625v1 on medRxiv