Mental health impact of COVID-19 in frontline healthcare workers in a Belgian Tertiary care hospital: a prospective longitudinal study

ABSTRACT

Objectives

A prospective longitudinal single-centre study to assess the mental health impact of COVID-19 on nurses working in the frontline during the first wave of COVID-19 hospitalizations in Belgium, 2020.

Patients and Methods

The study was performed between April 1^st and 30 June 2020. Nurses who were actively and daily involved in the care of COVID-19 patients on selected intensive care units (ICU) and non-ICU wards were included. Depression, somatization, anxiety and distress scores were calculated using the Four-Dimensional Symptom Questionnaire (4DSQ). The Impact of Event Scale-Revised (IES-R) and Brief-COPE questionnaires were used to assess respectively the psychological impact and coping strategies. Participants were asked to fill in the questionnaire at the start of inclusion, 4 weeks later and 8 weeks later.

Results

In total, 39/42 included nurses participated in the study. 4DSQ results showed low rates of depression, anxiety and somatization with a declining trend over time. Distress scores however were high throughout the study period. A past history of stress symptoms was significantly associated with higher distress scores at the inclusion and one month follow-up. As major psychological impact, more participants experienced ‘intrusion’ compared to ‘avoidance’ specifically among nurses working on ICU. In 10% of participants, IES-R-scores were predictive for post-traumatic stress disorder.

Conclusion

Healthcare workers dealing with COVID-19 patients during the pandemic reported high and enduring distress scores and experienced a major impact on mental health, especially when employed at ICU. These results highlight the importance of psychological support and proper long-term follow-up to mitigate this impact.

KEYWORDS:

• COVID-19
• mental health impact
• nursing
• distress
• coping

Disclosure statement

The authors declare no conflicts of interest related to this study

Authors’ contributions

EV and PM designed the study, analyzed and interpret the data in addition to writing the manuscript. EV and SG were involved in collecting the data. EV, PM, SG and JS were involved in writing the manuscript. All authors read and approved the final manuscript.

Availability of data and materials

The dataset used during the current study is available from the corresponding author on reasonable request.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Jessa Hospital, Hasselt, Belgium. Written informed consent was obtained from all participants.

Additional information

Funding

No specific funding was obtained for the study.