Positive mental health, depression and burnout in healthcare workers during the second wave of COVID-19 pandemic.
COVID‐19 pandemic
burnout
depression
flourishing
health workers
mental health
resilience
Journal
Journal of psychiatric and mental health nursing
ISSN: 1365-2850
Titre abrégé: J Psychiatr Ment Health Nurs
Pays: England
ID NLM: 9439514
Informations de publication
Date de publication:
19 Aug 2024
19 Aug 2024
Historique:
revised:
03
03
2024
received:
28
01
2023
accepted:
07
08
2024
medline:
19
8
2024
pubmed:
19
8
2024
entrez:
19
8
2024
Statut:
aheadofprint
Résumé
WHAT IS KNOWN ON THE SUBJECT?: In the past 2 years, the COVID-19 pandemic had a robust negative impact on the mental health of healthcare providers, with increasing rates of depression, anxiety, acute stress and burnout. Healthcare workers experiencing poor mental health are reluctant to seek help and treatment because they are afraid of being stigmatized and excluded by their colleagues and employers. During the pandemic positive emotions, resilience and psychological well-being buffered distress and burnout in healthcare workers. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes positive mental health, depression, anxiety and burnout in healthcare workers during the second wave of the pandemic. Forty-eight per cent of healthcare workers were flourishing (high levels of positive emotions and well-being), 10% languishing (absence of well-being and positivity). Flourishing individuals reported lower levels of depression, anxiety and burnout. These findings documented a relevant number of resilient healthcare workers, who restored/maintained their well-being also under stressful conditions. Vulnerable healthcare workers were less than 20%, and they reported severe anxiety, depression and burnout. No differences emerged between languishing and moderate mental health groups in their levels of anxiety, depression and burnout. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The condition of flourishing is the only one that provides protection from depression and anxiety and burnout, while moderate mental health does not differ substantially from the languishing state. The study confirms the importance of maintaining and/or promoting the well-being of healthcare workers. Interventions for promoting positive mental health of vulnerable workers are needed. Mental health nurses can have the skills and expertise for evaluating early symptoms of psychological distress and for implementing interventions for promoting and restoring well-being. These interventions may include informational campaign (i.e. preparing and distributing pamphlets and guidelines) and emotional support programmes (psychoeducation and training, mental health support team, peer support and counselling) that can be delivered also via digital platforms. INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic. To evaluate the protective role of well-being in buffering burnout and psychological distress. We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout. Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing. This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout. The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : European Commission
ID : Erasmus+KeyActivity3,Projectn.592247
Informations de copyright
© 2024 The Author(s). Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.
Références
Akay, A. (2022). The local and global mental health effects of the Covid‐19 pandemic. Economics and Human Biology, 45, 101095. https://doi.org/10.1016/j.ehb.2021.101095
Anozie, O. B., Nwafor, J. I., Nwokporo, E. I., Esike, C. U., Ewah, R. L., Eze, J. N., Azuogu, B. N., & Ukaegbe, C. I. (2020). Mental health impact of COVID‐19 pandemic on health care workers in Ebonyi State, southeast, Nigeria. International Journal of Innovative Research in Medical Science, 5(9), 400–406. https://doi.org/10.23958/ijirms/vol05‐i09/955
Barello, S., Palamenghi, L., & Graffigna, G. (2020). Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID‐19 pandemic. Psychiatry Research, 290, 113129. https://doi.org/10.1016/j.psychres.2020.113129
Bassi, M., Negri, L., Delle Fave, A., & Accardi, R. (2021). The relationship between post‐traumatic stress and positive mental health symptoms among health workers during COVID‐19 pandemic in Lombardy, Italy. Journal of Affective Disorders, 280, 1–6. https://doi.org/10.1016/j.jad.2020.11.065
Brennan, J. (2020). Heroes in healthcare; what's wrong with that? International Journal for Quality in Health Care, 32(9), 567–568. https://doi.org/10.1093/intqhc/mzaa100
Buselli, R., Corsi, M., Veltri, A., Baldanzi, S., Chiumiento, M., Lupo, E. D., Marino, R., Necciari, G., Caldi, F., Foddis, R., Guglielmi, G., & Cristaudo, A. (2021). Mental health of health care workers (HCWs): A review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID‐19. Psychiatry Research, 299, 113847. https://doi.org/10.1016/j.psychres.2021.113847
Butler, R. M. (2022). Serious mental illness in healthcare and academia: A lived experience. Journal of Psychiatric and Mental Health Nursing, 29(5), 624–629. https://doi.org/10.1111/jpm.12862
Capone, V., Caso, D., Donizzetti, A. R., & Procentese, F. (2020). University student mentalwell‐being during COVID‐19 outbreak: What are the relationships between information seeking, perceived risk and personal resources related to the academic context? Sustainability, 12(17), 7039. https://doi.org/10.3390/su12177039
Carmassi, C., Cerveri, G., Bertelloni, C. A., Marasco, M., Dell'Oste, V., Massimetti, E., Gesi, C., & Dell'Osso, L. (2021). Mental health of frontline help‐seeking healthcare workers during the COVID‐19 outbreak in the first affected hospital in Lombardy, Italy. Psychiatry Research, 298, 113763. https://doi.org/10.1016/j.psychres.2021.113763
Cox, C. L. (2020). ‘Healthcare heroes’: Problems with media focus on heroism from healthcare workers during the COVID‐19 pandemic. Journal of Medical Ethics, 46(8), 510–513. https://doi.org/10.1136/medethics‐2020‐106398
Crocker, K. M., Gnatt, I., Haywood, D., Butterfield, I., Bhat, R., Lalitha, A. R. N., Jenkins, Z. M., & Castle, D. J. (2022). The impact of COVID ‐19 on the mental health workforce: A rapid review. International Journal of Mental Health Nursing, 32, 420–445. https://doi.org/10.1111/inm.13097
Doré, I., O'Loughlin, J., Sylvestre, M.‐P., Sabiston, C. M., Beauchamp, G., Martineau, M., & Fournier, L. (2020). Not flourishing mental health is associated with higher risks of anxiety and depressive symptoms in college students. Canadian Journal of Community Mental Health, 39(1), 34–48. https://doi.org/10.7870/cjcmh‐2020‐003
Dyrbye, L. N., Harper, W., Moutier, C., Durning, S. J., Power, D. V., Massie, F. S., Eacker, A., Thomas, M. R., Satele, D., Sloan, J. A., & Shanafelt, T. D. (2012). A multi‐institutional study exploring the impact of positive mental health on medical Students' professionalism in an era of high burnout. Academic Medicine: Journal of the Association of American Medical Colleges, 87(8), 1024–1031. https://doi.org/10.1097/ACM.0b013e31825cfa35
Elgohary, H. M., Sehlo, M. G., Bassiony, M. M., Youssef, U. M., Elrafey, D. S., & Amin, S. I. (2021). Depression among health workers caring for patients with COVID‐19 in Egypt. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 57(1), 139. https://doi.org/10.1186/s41983‐021‐00394‐1
Fiorilli, C. (2015). Copenhagen burnout inventory (CBI): A validation study in an Italian teacher group. TPM: Testing, Psychometrics, Methodology in Applied Psychology, 22(4), 537–551. https://doi.org/10.4473/TPM22.4.7
Ghio, L., Patti, S., Piccinini, G., Modafferi, C., Lusetti, E., Mazzella, M., & Del Sette, M. (2021). Anxiety, depression and risk of post‐traumatic stress disorder in health workers: The relationship with burnout during covid‐19 pandemic in Italy. International Journal of Environmental Research and Public Health, 18(18), 9929. https://doi.org/10.3390/ijerph18189929
Gonzalez, A., Cervoni, C., Lochner, M., Marangio, J., Stanley, C., & Marriott, S. (2020). Supporting health care workers during the COVID‐19 pandemic: Mental health support initiatives and lessons learned from an academic medical center. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S168–S170. https://doi.org/10.1111/inm.12942
Gray, M., Monti, K., Katz, C., Klipstein, K., & Lim, S. (2021). A “mental health PPE” model of proactive mental health support for frontline health care workers during the COVID‐19 pandemic. Psychiatry Research, 299, 113878. https://doi.org/10.1016/j.psychres.2021.113878
Huberty, C. J., (2002). A History of Effect Size Indices. Educational and Psychological Measurement, 62(2), 227–240. https://doi.org/10.1177/0013164402062002002
Hurst, K. T., Ballard, E. D., Anderson, G. E., Greenstein, D. K., Cavanaugh, G. W., Dwyer, E., Swartz, K., Zarate, C. A., Chung, J. Y., & Park, L. T. (2022). The mental health impact of contact with COVID‐19 patients on healthcare workers in the United States. Psychiatry Research, 308, 114359. https://doi.org/10.1016/j.psychres.2021.114359
Iasiello, M., van Agteren, J., Keyes, C. L. M., & Cochrane, E. M. (2019). Positive mental health as a predictor of recovery from mental illness. Journal of Affective Disorders, 251, 227–230. https://doi.org/10.1016/j.jad.2019.03.065
Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222. https://doi.org/10.2307/3090197
Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73(3), 539–548. https://doi.org/10.1037/0022‐006X.73.3.539
Keyes, C. L. M. (2006). Mental health in adolescence: Is America's youth flourishing? American Journal of Orthopsychiatry, 76(3), 395–402. https://doi.org/10.1037/0002‐9432.76.3.395
Keyes, C. L. M., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health, 100(12), 2366–2371. https://doi.org/10.2105/AJPH.2010.192245
Keyes, C. L. M., Eisenberg, D., Perry, G. S., Dube, S. R., Kroenke, K., & Dhingra, S. S. (2012). The relationship of level of positive mental health with current mental disorders in predicting suicidal behavior and academic impairment in college students. Journal of American College Health, 60(2), 126–133. https://doi.org/10.1080/07448481.2011.608393
Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen burnout inventory: A new tool for the assessment of burnout. Work & Stress, 19(3), 192–207. https://doi.org/10.1080/02678370500297720
Labrague, L. J., De los Santos, J. A. A., & Fronda, D. C. (2021). Perceived COVID‐19‐associated discrimination, mental health and professional‐turnover intention among frontline clinical nurses: the mediating role of resilience. International Journal of Mental Health Nursing, 30(6), 1674–1683. https://doi.org/10.1111/inm.12920
Liang, L., Yuan, T., Guo, X., Meng, C., Lv, J., Fei, J., & Mei, S. (2022). The path of depression among frontline nurses during COVID‐19 pandemic: A fuzzy‐set qualitative comparative analysis. International Journal of Mental Health Nursing, 31(5), 1239–1248. https://doi.org/10.1111/inm.13033
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005‐7967(94)00075‐u
Maunder, R., Hunter, J., Vincent, L., Bennett, J., Peladeau, N., Leszcz, M., Sadavoy, J., Verhaeghe, L. M., Steinberg, R.,& Mazzulli, T. (2003). The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital, 168(10), 1245–1251.
Maideen, A. A., Idris, D. R., Lupat, A., Chung, Y. F., Haji‐Badarudin, H., Suhai, H., Abdullah, H. N., Omar, H., Kisut, R., Abdul Rahman, H., & Abdul‐Mumin, K. H. (2022). Nurses' mental health and coping strategies throughout COVID ‐19 outbreak: A nationwide qualitative study. International Journal of Mental Health Nursing, 31(5), 1213–1227. https://doi.org/10.1111/inm.13031
Mascayano, F., van der Ven, E., Moro, M. F., Schilling, S., Alarcón, S., Al Barathie, J., Alnasser, L., Asaoka, H., Ayinde, O., Balalian, A. A., Basagoitia, A., Brittain, K., Dohrenwend, B., Durand‐Arias, S., Eskin, M., Fernández‐Jiménez, E., Freytes Frey, M. I., Giménez, L., Gisle, L., … HEROES group. (2022). The impact of the COVID‐19 pandemic on the mental health of healthcare workers: Study protocol for the COVID‐19 HEalth caRe wOrkErS (HEROES) study. Social Psychiatry and Psychiatric Epidemiology, 57(3), 633–645. https://doi.org/10.1007/s00127‐021‐02211‐9
Mendez‐Pinto, I., Antuña‐Casal, M., & Mosteiro‐Diaz, M. P. (2023). Psychological disorders among Spanish nursing students three months after COVID‐19 lockdown: A cross‐sectional study. International Journal of Mental Health Nursing, 32, 479–489. https://doi.org/10.1111/inm.13086
Merino‐Godoy, M. Á., Yot‐Domínguez, C., Conde‐Jiménez, J., Ramírez Martín, P., & Lunar‐Valle, P. M. (2022). The influence of emotional burnout and resilience on the psychological distress of nursing students during the COVID‐19 pandemic. International Journal of Mental Health Nursing, 31(6), 1457–1466. https://doi.org/10.1111/inm.13046
Morgan, T. L., McFadden, T., Fortier, M. S., Tomasone, J. R., & Sweet, S. N. (2020). Positive mental health and burnout in first to fourth year medical students. Health Education Journal, 79(8), 948–962. https://doi.org/10.1177/0017896920944206
Narita, Z., Okubo, R., Sasaki, Y., Takeda, K., Takao, M., Komaki, H., Oi, H., Mizoue, T., Miyama, T., & Kim, Y. (2023). COVID ‐19‐related discrimination, PTSD symptoms, and psychological distress in healthcare workers. International Journal of Mental Health Nursing, 32(1), 139–146. https://doi.org/10.1111/inm.13069
O'Higgins, M., Rojas, L. A., Echeverria, I., Roselló‐Jiménez, L., Benito, A., & Haro, G. (2022). Burnout, psychopathology and purpose in life in healthcare workers during COVID‐19 pandemic. Frontiers in Public Health, 10, 926328. https://doi.org/10.3389/fpubh.2022.926328
Pang, Y., Fang, H., Li, L., Chen, M., Chen, Y., & Chen, M. (2021). Predictive factors of anxiety and depression among nurses fighting coronavirus disease 2019 in China. International Journal of Mental Health Nursing, 30(2), 524–532. https://doi.org/10.1111/inm.12817
Petrillo, G., Capone, V., Caso, D., & Keyes, C. L. M. (2015). The Mental Health Continuum–Short Form (MHC–SF) as a measure of well‐being in the Italian context. Social Indicators Research, 121(1), 291–312. https://doi.org/10.1007/s11205‐014‐0629‐3
Sampaio, F. M. C., Sequeira, C. A., da, C., & Lluch Canut, M. T. (2015). Nursing psychotherapeutic interventions: a review of clinical studies. Journal of Clinical Nursing, 24(15–16), 2096–2105. Portico. https://doi.org/10.1111/jocn.12808
Sani, G., Janiri, D., Moccia, L., Albert, U., Carrà, G., Carmassi, C., Cirulli, F., Dell'Osso, B., Menculini, G., Nanni, M. G., Pompili, M., Volpe, U., & Fiorillo, A. (2022). Psychopathological burden and coping strategies among frontline and second‐line Italian healthcare workers facing the COVID‐19 emergency: Findings from the COMET collaborative network. Journal of Affective Disorders, 311, 78–83. https://doi.org/10.1016/j.jad.2022.05.006
Schotanus‐Dijkstra, M., Keyes, C. L. M., de Graaf, R., & ten Have, M. (2019). Recovery from mood and anxiety disorders: The influence of positive mental health. Journal of Affective Disorders, 252, 107–113. https://doi.org/10.1016/j.jad.2019.04.051
Stab, N., & Hacker, W. (2020). A pilot study on the possibility of human‐centred participative redesign of work organization at psychiatric wards. Journal of Psychiatric and Mental Health Nursing, 27(5), 497–508. https://doi.org/10.1111/jpm.12598
Toh, W. L., Meyer, D., Phillipou, A., Tan, E. J., Van Rheenen, T. E., Neill, E., & Rossell, S. L. (2021). Mental health status of healthcare versus other essential workers in Australia amidst the COVID‐19 pandemic: Initial results from the collate project. Psychiatry Research, 298, 113822. https://doi.org/10.1016/j.psychres.2021.113822
Tomlin, J., Dalgleish‐Warburton, B., & Lamph, G. (2020). Psychosocial support for healthcare workers during the COVID‐19 pandemic. Frontiers in Psychology, 11, 1960. https://doi.org/10.3389/fpsyg.2020.01960
Vallée, A. (2023). Geoepidemiological perspective on COVID‐19 pandemic review, an insight into the global impact. Frontiers in Public Health, 11, 1242891. https://doi.org/10.3389/fpubh.2023.1242891
van Agteren, J., Iasiello, M., Lo, L., Bartholomaeus, J., Kopsaftis, Z., Carey, M., & Kyrios, M. (2021). A systematic review and meta‐analysis of psychological interventions to improve mental wellbeing. Nature Human Behaviour, 5(5), 631–652. https://doi.org/10.1038/s41562‐021‐01093‐w
Veitch, P., & Richardson, K. (2021). Nurses need support during Covid‐19 pandemic. Journal of Psychiatric and Mental Health Nursing, 28(2), 303–304. https://doi.org/10.1111/jpm.12666
Vescovelli, F., Cesetti, G., & Ruini, C. (2020). Optimal well‐being, depression, and caregiving: An explorative investigation. Clinical Gerontologist, 43(5), 572–584. https://doi.org/10.1080/07317115.2019.1702130
Wang, P., Tang, Y., Chen, Y., He, Y., Li, L., Han, X., Liu, Y., Liu, T., Liu, H., Jiang, F., & Zhu, J. (2023). Mental health status of mental health nurses in China: Results from a national survey. Journal of Psychiatric and Mental Health Nursing, 30(3), 547–557. https://doi.org/10.1111/jpm.12893
Webb, L. (2021). The psychosocial risk of being “extremely vulnerable” during COVID‐19 and the role of behaviour activation. Journal of Psychiatric and Mental Health Nursing, 28(3), 505. https://doi.org/10.1111/jpm.12684
Westerhof, G. J., & Keyes, C. L. M. (2010). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17(2), 110–119. https://doi.org/10.1007/s10804‐009‐9082‐y
Wilson, C. A., Metwally, H., Heavner, S., Kennedy, A. B., & Britt, T. W. (2022). Chronicling moral distress among healthcare providers during the COVID‐19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours. International Journal of Mental Health Nursing, 31(1), 111–127. https://doi.org/10.1111/inm.12942
Wood, A. M., & Joseph, S. (2010). The absence of positive psychological (eudemonic) well‐being as a risk factor for depression: A ten year cohort study. Journal of Affective Disorders, 122(3), 213–217. https://doi.org/10.1016/j.jad.2009.06.032
Zaçe, D., Hoxhaj, I., Orfino, A., Viteritti, A. M., Janiri, L., & Di Pietro, M. L. (2021). Interventions to address mental health issues in healthcare workers during infectious disease outbreaks: A systematic review. Journal of Psychiatric Research, 136, 319–333. https://doi.org/10.1016/j.jpsychires.2021.02.019
Zhang, X., Jiang, X., Ni, P., Li, H., Li, C., Zhou, Q., Ou, Z., Guo, Y., & Cao, J. (2021). Association between resilience and burnout of front‐line nurses at the peak of the COVID‐19 pandemic: Positive and negative affect as mediators in Wuhan. International Journal of Mental Health Nursing, 30(4), 939–954. https://doi.org/10.1111/inm.12847