Long-term psychological effects of COVID-19 pandemic in hospital workers in a North Italian Hospital
Accepted: 23 December 2022
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Objectives. The aim of this study is to explore the long-term psychological impact of COVID-19 on health workers and other professional workers in the “SS Antonio e Biagio e Cesare Arrigo” Hospital located in Alessandria. Materials and Methods. A monocentric prospective observational study was conducted on 112 hospital workers by completing an on-line survey. Data were collected from 1st to 30th April 2021. The survey assessed self-reported socio-demographic, clinical, work and COVID-19 related information and risk perception. Moreover, it included an online version of validated questionnaires in Italian language: Impact of Event Scale-Revised (IES-R), Depression, Anxiety and Stress Scale (DASS-21), Insomnia Severity Index (ISI), Coping Orientation to the Problems Experienced: New Italian Version (COPE-NVI-25), and Professional Quality of Life Scale (ProQOl-5). Results. Data analysis reveals that hospital workers show moderate percentages of post-traumatic stress (40,2%), depression (40,2%), anxiety (28,6%), stress (44.6%) and insomnia (16.1%) symptoms. Administrative staff shows higher anxiety and post-traumatic stress symptoms. Most common strategies used by responders are positive attitude, problem solving and social support. A subgroup of healthcare workers providing direct care to patients shows moderate levels of compassion-satisfaction and low levels of secondary traumatic stress and burn-out. Conclusions. Healthcare workers and other professionals working in hospital show psychological effect that last more than one year after the beginning of the pandemic.
WHO Coronavirus (COVID-19) Dashboard. Available from: https://covid19.who.int
Italian Ministry of Health. 2020. Available from: http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?menu=notizie&id=4605
Epicentro. 2021. Available from: https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_21-aprile-2021
WHO. Pneumonia of unknown cause. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2020-DON229
Decessi e cause di morte: cosa produce l’Istat. 2022. Available from: https://www.istat.it/it/archivio/240401
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:E9096. DOI: https://doi.org/10.3390/ijerph17239096
Manchia M, Gathier AW, Yapici-Eser H, et al. The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves. Eur Neuropsychopharmacol. 2022;55:22–83. DOI: https://doi.org/10.1016/j.euroneuro.2021.10.864
Cai H, Tu B, Ma J, et al. Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID‑19) in Hubei, China. Med Sci Monit. 2020;26:e924171. DOI: https://doi.org/10.12659/MSM.924171
Carmassi C, Foghi C, Dell’Oste V, et al. PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic. Psychiatry Res. 2020;292:113312. DOI: https://doi.org/10.1016/j.psychres.2020.113312
Dai Y, Hu G, Xiong H, et al. Psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on healthcare workers in China. Infectious Diseases (except HIV/AIDS); 2020. Available from: http://medrxiv.org/lookup/doi/10.1101/2020.03.03.20030874 DOI: https://doi.org/10.1101/2020.03.03.20030874
Huang L, Lei W, Xu F, et al. Emotional responses and coping strategies in nurses and nursing students during Covid-19 outbreak: A comparative study. PLoS One. 2020;15:e0237303. DOI: https://doi.org/10.1371/journal.pone.0237303
Lai J, Ma S, Wang Y, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3:e203976. DOI: https://doi.org/10.1001/jamanetworkopen.2020.3976
Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Res. 2020;288:112936. DOI: https://doi.org/10.1016/j.psychres.2020.112936
Cabarkapa S, Nadjidai SE, Murgier J, Ng CH. The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review. Brain Behav Immun Health. 2020;8:100144 DOI: https://doi.org/10.1016/j.bbih.2020.100144
Di Tella M, Romeo A, Benfante A, Castelli L. Mental health of healthcare workers during the COVID-19 pandemic in Italy. J Eval Clin Pract. 2020;26:1583–7. DOI: https://doi.org/10.1111/jep.13444
Vagni M, Maiorano T, Giostra V, Pajardi D. Protective Factors against Emergency Stress and Burnout in Healthcare and Emergency Workers during Second Wave of COVID-19. Social Sciences. 2021;10:178. DOI: https://doi.org/10.3390/socsci10050178
Babore A, Lombardi L, Viceconti ML, et al. Psychological effects of the COVID-2019 pandemic: Perceived stress and coping strategies among healthcare professionals. Psychiatry Res. 2020;293:113366. DOI: https://doi.org/10.1016/j.psychres.2020.113366
Kang L, Ma S, Chen M, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav Immun. 2020;87:11–7. DOI: https://doi.org/10.1016/j.bbi.2020.03.028
Bozdağ F, Ergün N. Psychological Resilience of Healthcare Professionals During COVID-19 Pandemic. Psychol Rep. 2021;124:2567–86. DOI: https://doi.org/10.1177/0033294120965477
Chen S, Bonanno GA. Psychological adjustment during the global outbreak of COVID-19: A resilience perspective. Psychol Trauma. 2020;12:S51–4 DOI: https://doi.org/10.1037/tra0000685
Zager Kocjan G, Kavčič T, Avsec A. Resilience matters: Explaining the association between personality and psychological functioning during the COVID-19 pandemic. Int J Clin Health Psychol. 2021;21:100198. DOI: https://doi.org/10.1016/j.ijchp.2020.08.002
Petzold MB, Bendau A, Plag J, et al. Risk, resilience, psychological distress, and anxiety at the beginning of the COVID-19 pandemic in Germany. Brain Behav. 2020;10:e01745. DOI: https://doi.org/10.1002/brb3.1745
Sterpone R, Manfredi V, Cassinari A, et al. Psychological effects of COVID-19 outbreak in hospital workers during the Italian third phase. Working Paper of Public Health. 2021;9:9457. DOI: https://doi.org/10.4081/wpph.2021.9457
Pietrantonio F, De Gennaro L, Di Paolo MC, Solano L. The Impact of Event Scale: validation of an Italian version. J Psychosom Res. 2003;55:389–93. DOI: https://doi.org/10.1016/S0022-3999(02)00638-4
Weiss DS & Marmar . The Impact of Event Scale: Revised. In: Wilson JP, Tang CS kum, editors. Cross-Cultural Assessment of Psychological Trauma and PTSD. Boston, MA, USA: Springer US; 2007. p. 219–38. Available from: http://link.springer.com/10.1007/978-0-387-70990-1_1 DOI: https://doi.org/10.1007/978-0-387-70990-1_10
Bottesi G, Ghisi M, Altoè G, et al. The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples. Compr Psychiatry. 2015;60:170–81. DOI: https://doi.org/10.1016/j.comppsych.2015.04.005
Castronovo V, Galbiati A, Marelli S, et al. Validation study of the Italian version of the Insomnia Severity Index (ISI). Neurol Sci. 2016;37:1517–24. DOI: https://doi.org/10.1007/s10072-016-2620-z
Morin CM. Insomnia Severity Index. American Psychological Association; 2014. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/t07115-000
Caricati L, Foà C, Fruggeri L, Tonarelli A. COPE-NVI-25: validazione italiana della versione ridotta della Coping Orientation to the Problems Experienced (COPE-NVI). PSICOLOGIA DELLA SALUTE. 2015. Available from: http://www.francoangeli.it/riviste/Scheda_Riviste.asp?IDArticolo=54267 DOI: https://doi.org/10.3280/PDS2015-002007
Sica C, Magni C, Ghisi M, et al. Coping Orientation to Problems Experienced-Nuova Versione Italiana (COPE-NVI): uno strumento per la misura degli stili di coping. 2008. Available from: https://www.scinapse.io
Hundall Stamm B. Professional Quality of Life Measure: Compassion, Satisfaction, and Fatigue Version 5 (ProQOL). 2009. Available from: https://ncvc.dspacedirect.org/handle/20.500.11990/1329
Stamm BH. The Concise ProQOL Manual: The concise manual for the Professional Quality of Life Scale , 2nd Edition. 2010. Available from: https://img1.wsimg.com/blobby/go/dfc1e1a0-a1db-4456-9391-18746725179b/downloads/ProQOL%20Manual.pdf?ver=1622839353725
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics. 2009;42:377–81. DOI: https://doi.org/10.1016/j.jbi.2008.08.010
Harvey LA. REDCap: web-based software for all types of data storage and collection. Spinal Cord. 2018;56:625. DOI: https://doi.org/10.1038/s41393-018-0169-9
Patridge EF, Bardyn TP. Research Electronic Data Capture (REDCap). jmla. 2018;106. Available from: http://jmla.pitt.edu/ojs/jmla/article/view/319 DOI: https://doi.org/10.5195/jmla.2018.319
Patridge E, Ruhl D. Open Source Ticketing at UW HSL: TRAIL Support for REDCap. Presented at UW Libraries Council Meeting. In Seattle, WA, USA; 2018. Available from: https://hsl.uw.edu/trail
Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12:1924–32. DOI: https://doi.org/10.3201/eid1212.060584
Honarmand K, Yarnell CJ, Young-Ritchie C, et al. Personal, professional, and psychological impact of the COVID-19 pandemic on hospital workers: A cross-sectional survey. PLoS One. 2022;17:e0263438. DOI: https://doi.org/10.1371/journal.pone.0263438
Lixia W, Xiaoming X, Lei S, et al. A cross-sectional study of the psychological status of 33,706 hospital workers at the late stage of the COVID-19 outbreak. J Affect Disord. 2022 Jan 15;297:156–68. DOI: https://doi.org/10.1016/j.jad.2021.10.013
Maunder RG, Heeney ND, Kiss A, et al. Psychological impact of the COVID-19 pandemic on hospital workers over time: Relationship to occupational role, living with children and elders, and modifiable factors. Gen Hosp Psychiatry. 2021;71:88–94. DOI: https://doi.org/10.1016/j.genhosppsych.2021.04.012
Hallman DM, Januario LB, Mathiassen SE, et al. Working from home during the COVID-19 outbreak in Sweden: effects on 24-h time-use in office workers. BMC Public Health. 2021;21:528. DOI: https://doi.org/10.1186/s12889-021-10582-6
Morilla-Luchena A, Muñoz-Moreno R, Chaves-Montero A, Vázquez-Aguado O. Telework and Social Services in Spain during the COVID-19 Pandemic. Int J Environ Res Public Health. 2021;18:E725. DOI: https://doi.org/10.3390/ijerph18020725
Proserpio P, Zambrelli E, Lanza A, et al. Sleep disorders and mental health in hospital workers during the COVID-19 pandemic: a cross-sectional multicenter study in Northern Italy. Neurol Sci. 2022;43:2241–51. DOI: https://doi.org/10.1007/s10072-021-05813-y
Pappa S, Ntella V, Giannakas T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity. 2020;88:901–7. DOI: https://doi.org/10.1016/j.bbi.2020.05.026
González-Sanguino C, Ausín B, Castellanos MÁ, et al. Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun. 2020;87:172–6. DOI: https://doi.org/10.1016/j.bbi.2020.05.040
Copyright (c) 2023 Valentina Manfredi, Rossella Sterpone, Antonella Cassinari, Marta Betti, Monica Franscini, Marinella Bertolotti, Simona Giribone, Antonio Pepoli, Patrizia Valorio, Carolina Pelazza, Antonio Maconi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.