Higher Subjective Burden in Psychiatric Compared to Somatic Healthcare Workers in Germany During the first wave of the COVID-19 Pandemic

Abstract

The COVID-19 pandemic has posed unprecedented challenges for health care workers (HCWs) worldwide. While the adverse effects of the pandemic on the well-being of HCWs in general have now been established, little is known about the impact on HCWs of psychiatric hospitals (PHCWs). PHCWs are of special interest, given that they faced both an increase in infection rates among psychiatric patients as well as in mental strain of the general public due to consequences of the pandemic. The aim of the present study was to investigate how the pandemic affected PHCWs as well as possible differences between PHCWs and other health care workers (OHCWs) in Germany during the first wave of the pandemic. We conducted a country-wide anonymous online survey early during the first pandemic wave between April 15th and May 1st, 2020, to assess different aspects of subjective burden and perceived stress using 5-point Likert-scale questions. We analysed data of 1530 PHCWs and 2114 OHCWs and showed that PHCWs reported higher subjective burden and stress compared to OHCWs (p<0.001). Overall, nurses from both groups of HCWs showed higher ratings in subjective burden and stress than physicians. These higher ratings for subjective burden were even more pronounced for nurses working in psychiatric hospitals. Future research is needed to investigate the causes for PHCWs’ increased stress and subjective burden, especially when taking into account the long-term effects of the pandemic, which may lead to further challenges and an ever-increasing workload, especially for PHCWs.

Zusammenfassung

Die COVID-19-Pandemie stellte medizinisches Personal weltweit vor ungeahnte Herausforderungen. Während die negativen Folgen der Pandemie auf das Wohlbefinden des medizinischen Personals (HCWs) im Allgemeinen bereits nachgewiesen wurden, ist über die Auswirkungen auf das Gesundheitspersonal in psychiatrischen Krankenhäusern (PHCWs) wenig bekannt. PHCWs sind von besonderem Interesse, da jene Berufsgruppe sowohl mit einem Anstieg der Infektionsraten bei psychiatrischen Patient:innen als auch mit der psychischen Belastung der Allgemeinbevölkerung durch die Folgen der Pandemie konfrontiert waren. Ziel der vorliegenden Studie war die Untersuchung der Folgen der Pandemie auf PHCWs sowie der Unterschiede zwischen PHCWs und anderem medizinischen Personal (OHCWs) in Deutschland während der ersten Welle der Pandemie. Wir führten eine bundesweite, anonyme Online-Befragung zu Beginn der ersten Pandemiewelle zwischen dem 15. April und dem 1. Mai 2020 durch, um verschiedene Aspekte der subjektiven Belastung und des wahrgenommenen Stresses anhand von Fragen auf einer 5-Punkte-Likert-Skala zu erfassen. Wir analysierten die Daten von 1530 PHCWs und 2114 OHCWs und konnten zeigen, dass PHCWs im Vergleich zu OHCWs eine höhere subjektive Belastung und Stress aufwiesen (p<.001). Insgesamt bewertete pflegerisches Personal aus beiden Gruppen die subjektive Belastung und den Stress höher als ärztliches Personal. Die höchsten Werte subjektiver Belastung wiesen Pflegekräfte in psychiatrischen Krankenhäusern auf. Weitere Studien sind erforderlich, um die Ursachen für den erhöhten Stress und die subjektive Belastung von PHCWs zu untersuchen. Dabei sollten insbesondere die langfristigen Auswirkungen der Pandemie, die zu weiteren Herausforderungen und einer kontinuierlich ansteigenden Arbeitsbelastung führen könnten, berücksichtigt werden.

Key words

healthcare workers - COVID-19 - mental health - stress - psychiatry

Schlüsselwörter

Medizinisches Personal - COVID-19 - Psychische Gesundheit - Psychische Belastung - Psychiatrie

Publikationsverlauf

Eingereicht: 23. Dezember 2022

Angenommen: 24. Juni 2023

Artikel online veröffentlicht:
11. August 2023

• References

• 1 Chutiyami M, Cheong AMY, Salihu D. et al. COVID-19 Pandemic and Overall Mental Health of Healthcare Professionals Globally: A Meta-Review of Systematic Reviews. Front. Psychiatry 2021; 12: 804525 DOI: 10.3389/fpsyt.2021.804525.
• 2 Chigwedere OC, Sadath A, Kabir Z. et al. The Impact of Epidemics and Pandemics on the Mental Health of Healthcare Workers: A Systematic Review. Int J Environ Res Public Health 2021; 18 DOI: 10.3390/ijerph18136695.
• 3 Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr 2020; 51: 102119 DOI: 10.1016/j.ajp.2020.102119.
• 4 Dutta A, Sharma A, Torres-Castro R. et al. Mental health outcomes among health-care workers dealing with COVID-19/severe acute respiratory syndrome coronavirus 2 pandemic: A systematic review and meta-analysis. Indian J Psychiatry 2021; 63: 335-347 DOI: 10.4103/psychiatry.IndianJPsychiatry_1029_20.
• 5 Who Headquarters. Mental Health and COVID-19: Early evidence of the pandemic’s impact: Scientific brief, 2 March 2022. World Health Organization, 02.03.2022. Im Internet: https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1; Stand: 06.09.2022
• 6 Mann S, Cowburn J. Emotional labour and stress within mental health nursing. Journal of Psychiatric and Mental Health Nursing 2005; 12: 154-162 DOI: 10.1111/j.1365-2850.2004.00807.x.
• 7 Rössler W. Stress, burnout, and job dissatisfaction in mental health workers. Eur Arch Psychiatry Clin Neurosci 2012; 262: S65-S69 DOI: 10.1007/s00406-012-0353-4.
• 8 Acker GM. Burnout among mental health care providers. Journal of Social Work 2012; 12: 475-490 DOI: 10.1177/1468017310392418.
• 9 Cabarkapa S, Nadjidai SE, Murgier J. et al. The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review. Brain, Behavior, & Immunity - Health 2020; 8: 100144 DOI: 10.1016/j.bbih.2020.100144.
• 10 Froessl LJ, Abdeen Y. The Silent Pandemic: The Psychological Burden on Frontline Healthcare Workers during COVID-19. Psychiatry J 2021; 2021: 2906785 DOI: 10.1155/2021/2906785.
• 11 Jokić-Begić N, Lauri Korajlija A, Begić D. Mental Health of Psychiatrists and Physicians of Other Specialties in Early COVID-19 Pandemic: Risk ind Protective Factors. Psychiatr Danub 2020; 32: 536-548 DOI: 10.24869/psyd.2020.536.
• 12 Öğütlü H, McNicholas F, Türkçapar H. Stress and Burnout in Psychiatrists in Turkey during COVID-19 Pandemic. Psychiatr Danub 2021; 33: 225-230 DOI: 10.24869/psyd.2021.225.
• 13 Eissazade N, Shalbafan M, Saeed F. et al. The Impact of the COVID-19 Pandemic on Iranian Psychiatric Trainees’ and Early Career Psychiatrists’ Well-being, Work Conditions, and Education. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry 2022; DOI: 10.1007/s40596-022-01674-5.
• 14 Alexiou E, Steingrimsson S, Akerstrom M. et al. A Survey of Psychiatric Healthcare Workers’ Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden. Front. Psychiatry 2021; 12: 770955 DOI: 10.3389/fpsyt.2021.770955.
• 15 Li M, Xia L, Yang Y. et al. Depression, Anxiety, Stress, and Their Associations With Quality of Life in a Nationwide Sample of Psychiatrists in China During the COVID-19 Pandemic. Frontiers in psychology 2022; 13: 881408 DOI: 10.3389/fpsyg.2022.881408.
• 16 Narendra Kumar MK, Francis B, Hashim AH. et al. Prevalence of Anxiety and Depression among Psychiatric Healthcare Workers during the COVID-19 Pandemic: A Malaysian Perspective. Healthcare 2022; 10: 532 DOI: 10.3390/healthcare10030532.
• 17 Anzola D, Limoges J, McLean J. et al. Effects of the COVID-19 Pandemic on the Mental Health of Healthcare Providers: A Comparison of a Psychiatric Hospital and a General Hospital. Front. Psychiatry 2021; 12: 720693 DOI: 10.3389/fpsyt.2021.720693.
• 18 Arentz C, Wild F. Vergleich europäischer Gesundheitssysteme in der Covid-19-Pandemie. 2020, 3. WIP-Analyse. Köln: WIP – Wissenschaftliches Institut der PKV. 2020
• 19 Rovers JJE, van de Linde LS, Kenters N. et al. Why psychiatry is different – challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care. Antimicrob Resist Infect Control 2020; 9: 190 DOI: 10.1186/s13756-020-00853-z.
• 20 Kramer V, Papazova I, Thoma A. et al. Subjective burden and perspectives of German healthcare workers during the COVID-19 pandemic. Eur Arch Psychiatry Clin Neurosci 2021; 271: 271-281 DOI: 10.1007/s00406-020-01183-2.
• 21 Li L. Challenges and Priorities in Responding to COVID-19 in Inpatient Psychiatry. Psychiatr Serv 2020; 71: 624-626 DOI: 10.1176/appi.ps.202000166.
• 22 Batra K, Singh TP, Sharma M. et al. Investigating the Psychological Impact of COVID-19 among Healthcare Workers: A Meta-Analysis. Int J Environ Res Public Health 2020; 17: 9096 DOI: 10.3390/ijerph17239096.
• 23 Finke B, Ott K, Wischmeyer N. Corona in Deutschland: Keine Masken und Schutzkleidung. Süddeutsche Zeitung, 30.03.2020. Im Internet: https://www.sueddeutsche.de/politik/coronavirus-masken-handschuhe-deutschland-1.4861983; Stand: 01.09.2022
• 24 Luo M, Guo L, Yu M. et al. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Res 2020; 291: 113190 DOI: 10.1016/j.psychres.2020.113190.
• 25 Martínez-López JÁ, Lázaro-Pérez C, Gómez-Galán J. et al. Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain. J Clin Med 2020; 9 DOI: 10.3390/jcm9093029.
• 26 Wanigasooriya K, Palimar P, Naumann DN. et al. Mental health symptoms in a cohort of hospital healthcare workers following the first peak of the COVID-19 pandemic in the UK. BJPsych Open 2020; 7: e24 DOI: 10.1192/bjo.2020.150.
• 27 Arnetz JE, Goetz CM, Sudan S. et al. Personal Protective Equipment and Mental Health Symptoms Among Nurses During the COVID-19 Pandemic. Journal of Occupational and Environmental Medicine 2020; 62: 892-897 DOI: 10.1097/JOM.0000000000001999.
• 28 Sun P, Wang M, Song T. et al. The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis. Frontiers in psychology 2021; 12: 626547 DOI: 10.3389/fpsyg.2021.626547.
• 29 Mahmud S, Hossain S, Muyeed A. et al. The global prevalence of depression, anxiety, stress, and, insomnia and its changes among health professionals during COVID-19 pandemic: A rapid systematic review and meta-analysis. Heliyon 2021; 7: e07393 DOI: 10.1016/j.heliyon.2021.e07393.