Healthcare Workers' Perceptions and Medically Approved COVID-19 Infection Risk: Understanding the Mental Health Dimension of the Pandemic. A German Hospital Case Study

  1. Ellen Kuhlmann
  2. Georg M. N. Behrens
  3. Anne Cossmann
  4. Stefanie Homann
  5. Christine Happle
  6. Alexandra Dopfer-Jablonka

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Abstract

This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organizational measures. The aim is to explore “blind spots” of pandemic protection and make mental health needs of HCWs visible.

Methods

We have chosen an “optimal-case” scenario of a high-income country with a well-resourced hospital sector and low HCW infection rate at the organizational level to explore governance gaps in HCW protection. A German multi-method hospital study at Hannover Medical School served as empirical case; document analysis, expert information and survey data ( n = 1,163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care.

Results

The results reveal a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed “some” to “very strong” fear of acquiring infection at the workplace. Individual protective behavior and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived “no” or “little” protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behavior, but nursing was correlated with higher levels of personal risk estimations and fear of infection.

Conclusions

A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through better information, training/education and risk communication and through investment in mental health and inclusion in pandemic preparedness plans.

Article activity feed

  1. Version published to 10.3389/fpubh.2022.898840
  2. ScreenIT

    SciScore for 10.1101/2022.03.28.22273029: (What is this?)

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

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Empirically, we draw on material from the COVID-19 Contact (CoCo) Study, a multi-method study carried out at Hannover Medical School.
    CoCo
    suggested: (CoCo, RRID:SCR_010947)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: Our study reveals important gaps in HCW protection and health workforce governance. However, it has several limitations, which have been described in relation to the clinical part of the study (48,49). To summarise the major arguments: data on anti-SARS-CoV-2 IgG is only partially representative for Hannover Medical School and we do not know the source of infection in anti-SARS-CoV-2 IgG-positive HCWs (49). More specifically related to our selected survey data, the respondents might be biased; employees who are more concerned about their health and a COVID-19 infection might have been more interested in the study than those who do not care about potential health risks. We also do not know how the experience of an organisational environment characterised by low infection rates intersects with the individual sphere, and how different sources of information impact in individual perceptions. Further research and qualitative methodology would be necessary to provide in-depth information. Finally, the lessons that can be learned from an ‘optimal-case scenario’ in relation to individual perceptions and institutional/organisational conditions of HCW protection are generally limited and must be viewed with caution, because cross-country comparative data and in-depth organisational comparison are lacking. Our results may help to highlight the need for, and benefit of more comprehensive research and policy investigation into mental health of HCWs.

    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.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.03.28.22273029v1 on medRxiv