Friday, June 26, 2020

COVID-19 Takes Toll on Mental Health of Hospital Health Professionals

The COVID-19 pandemic is taking a psychological toll on health care professionals who work in large, urban medical centers, raising their risk for poor health down the road, suggests a study in General Hospital Psychiatry. Nearly 6 in 10 health professionals in the COVID-19 Healthcare Provider Study, an ongoing survey of health care workers at Columbia University Irving Medical Center in New York, screened positive for symptoms of acute stress. Nearly half screened positive for symptoms of depression, and a third screened positive for symptoms of anxiety.

“Sustained COVID-19-related psychological distress is expected to have downstream impacts on health care workers' physical health,” wrote Ari Shechter, Ph.D. of the Columbia University Irving Medical Center and colleagues. “There is an association between clinical workplace environmental stressors and long-term cardiometabolic risk, and stress can influence health in ways that are both direct (systemic inflammation, arterial damage, increased blood pressure) and indirect (maladaptive coping such as substance use, poor sleep). Sustained psychological distress and poor sleep may disturb the body's physiological stress response system, thereby contributing to further health risk.”

The findings are based on an analysis of responses from 657 physicians, residents/fellows, nurses, nurse practitioners, and physician assistants who completed the survey between April 9 and April 24. The survey was designed to assess the participants’ COVID-related stress as well as their sense of meaning and purpose, their coping behaviors, and the kind of wellness resources they were interested in receiving. Researchers also used standard screening tools such as the Primary Care PTSD screen, the Patient Health Questionnaire-2, and the 2-item Generalized Anxiety Disorder scale.

Among participants, 74% reported great distress over fears of transmitting the virus to their family and friends; 71% reported sleep disturbances and getting less than six hours of sleep per night; 65% reported feeling lonely at least several days a week; and more than 60% reported concerns over the health of their family and friends, maintaining social distancing from family, and uncertainty over their colleagues’ COVID-19 status. However, 61% reported feeling a greater sense of meaning or purpose.

Participants used a range of coping behaviors to manage their stress, with 59% turning to physical activity and exercise; roughly 25% engaging in talk therapy, yoga, faith-based religion and/or spirituality; and/or meditating, and 16% participating in virtual provider support groups. Approximately 14% did not engage in any of the coping behaviors listed in the survey. Roughly 33% of participants expressed interest in online-self-guided counseling with access to a therapist, and 28% expressed interest in traditional individual counseling or therapy.

“These findings should inform the development and implementation of interventions to mitigate the impact of sustained psychological distress on long-term mental and physical well-being in health care workers,” the researchers wrote. “The lessons learned from the COVID-19 pandemic should help decision-makers at all levels of government, hospital management, and the community to promote readiness to protect health care workers as we navigate this and future public health crises.”

(Image: iStock/whyframestudio)

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Psychological Stress May Not Be Only Route Of COVID-19’s Psychiatric Burden

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