Mental health of nursing professionals during the COVID-19 pandemic: a cross-sectional study
DOI:
https://doi.org/10.11606/s1518-8787.2022056004122Palavras-chave:
Nursing, Team, psychology, COVID-19, nursing, Mental Disorders, epidemiology, Mental Health, Occupational Health, Cross-Sectional StudiesResumo
OBJECTIVE To identify the prevalence of and factors associated with: (1) major depressive episodes; (2) minor psychiatric disorders (MPDs); and (3) suicidal ideation among nursing professionals from a municipality in southern Brazil. METHODS Using a cross-sectional design, we recruited 890 nursing professionals linked to 50 Primary Care units, 2 walk-in clinics, 2 hospital services, 1 emergency room service, 1 mobile emergency care service, and 1 teleconsultation service, in addition to the municipal epidemiological surveillance service and the vacancy regulation center between June and July 2020. We used the Patient Health Questionnaire-9 and the Self-Reporting Questionnaire to evaluate the studied outcomes. Associations between the outcomes and variables related to sociodemographic profile, work, health conditions, and daily life were explored using Poisson regression models with robust variance estimators. RESULTS The observed prevalence of depression, MPDs, and suicidal ideation were 36.6%, 44%, and 7.4%, respectively. MPDs were associated with the assessment of support received by the service as ‘regular’ (PR: 1.48; 95% CI: 1.19–1.85) or ‘poor’ (PR: 1.54; 95% CI: 1.23–1.94), with a reported moderate (PR: 1.63; 95% CI: 1.29–2.07), or heavy (PR: 2.54; 95% CI: 2.05–3.15) workload, and with suspected COVID-19 infection (PR: 1.44; 95% CI: 1.25–1.66). Major depressive episodes were associated with a reported lack of personal protective equipment (PR: 1.20; 95% CI: 1.01–1.42), whereas suicidal ideation was inversely related to per capita income > 3 minimum monthly wages (PR: 0.28; 95% CI: 0.11–0.68), and positively related to the use of psychotropic drugs (PR: 3.14; 95% CI: 1.87–5.26). CONCLUSION Our results suggest that nursing professionals’ working conditions are associated with their mental health status. The need to improve working conditions through adequate dimensioning, support and proper biosafety measures is only heightened in the context of the COVID-19 pandemic.
Referências
World Health Organization. Coronavirus Disease (COVID-19): events as they happen. Geneva (CH): WHO; 2020 [cited 2020 Oct 29]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
World Health Organization. Global strategic directions for strengthening nursing and midwifery 2016-2020. Geneva (CH): WHO; 2016 [cited 2020 Oct 29]. Available from: https://www.who.int/hrh/nursing_midwifery/global-strategic-midwifery2016-2020.pdf
Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: a large-scale cross-sectional study. EClinicalMedicine. 2020;24:100424. https://doi.org/10.1016/j.eclinm.2020.100424
Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry. 2020;7(4):e15-16. https://doi.org/10.1016/S2215-0366(20)30078-X
Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954. https://doi.org/10.1016/j.psychres.2020.112954
Lai J, Ma S, Wang Y, Ca Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to Coronavirus Disease 2019. JAMA Network Open. 2020;3(3):e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7. https://doi.org/10.1016/j.bbi.2020.05.026
Hacimusalar Y, Kahve AA, Yasar AB, Aydin MB. Anxiety and hopelessness levels in COVID-19 pandemic: a comparative study of healthcare professionals and other community sample in Turkey. J Psychiatric Res. 2020;129:181-8. https://doi.org/10.1016/j.jpsychires.2020.07.024
Zhu Z, Xu S, Wang H. COVID-19 in Wuhan: immediate psychological impact on 5062 health workers. EClinical Medicine.2020 [cited 2020 Oct 29];24:100443. Available from: https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370(20)30187-5.pdf
Greenberg N, Tracy D. What healthcare leaders need to do to protect the psychological well-being of frontline staff in the COVID-19 pandemic.
BMJ Leader. 2020 May:leader-2020-000273. https://doi.org/10.1136/leader-2020-000273
Williamson V, Greenberg N, Bowden G, Rothenfluh D, Nnadi C, Reynolds J. The mental health impact of providing spine care during COVID-19. Spine J. 2020;20(9):1363-6. https://doi.org/10.1016/j.spinee.2020.04.019
Lamb D, Greenberg N, Stevelink S, Wessely S. Mixed signals about the mental health of the NHS workforce. Lancet Psychiatry. 2020;7(12):1009-11. https://doi.org/10.1016/S2215-0366(20)30379-5
Conselho das Secretarias Municipais de Saúde do Rio Grande do Sul. Regiões de Saúde do Rio Grande do Sul. Porto Alegre, RS: Cosemsrs; 2020 [cited 2020 Oct 29]. Available from: https://www.cosemsrs.org.br/regioes-de-saude
Santos IS, Tavares BF, Munhoz TN, Almeida LSP, Silva NTB, Tams BD, et al. Sensibilidade e especificidade do Patient Health Questionnaire-9 (PHQ-9) entre adultos da população geral. Cad Saude Publica. 2013;29(8):1533-43. https://doi.org/10.1590/0102-311X00144612
Santos KO, Araújo TM, Pinho PDS, Silva ACC. Avaliação de um instrumento de mensuração de morbidade psíquica: estudo de validação do Self-Reporting Questionnaire (SRQ-20). Rev Baiana Saude Publica. 2011 [cited 2020 Oct 29];34(3):544-60. Available from: http://files.bvs.br/upload/S/0100-0233/2010/v34n3/a1881.pdf
Treichel CAS, Jardim VMR, Kantorski LP, Lima MG. Prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders. J Clin Nurs. 2019;28(19-20):3470-7. https://doi.org/10.1111/jocn.14938
Maldonado G, Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol. 1993;138(11):923-36. https://doi.org/10.1093/oxfordjournals.aje.a116813
Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang WW, et. al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect. 2020;148:e98. https://doi.org/10.1017/S0950268820001107
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. https://doi.org/10.1016/j.psychres.2020.112936
Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel coronavirus disease outbreak. Front Psychiatry. 2020;11:306. https://doi.org/10.3389/fpsyt.2020.00306
Junqueira MAB, Santos MA, Araújo LB, Ferreira MCM, Giuliani CD, Pillon SC. et al. Depressive symptoms and drug use among nursing staff professionals. Esc Anna Nery. 2018;22(4):e20180129. https://doi.org/10.1590/2177-9465-EAN-2018-0129
Freire FO, Marcon SR, Espinosa MM, Santos HGB, Kogien M, Lima NVP, et al. Factors associated with suicide risk among nurses and physicians: a cross-section study. Rev Bras Enferm. 2020;73 Suppl 1:e20200352. https://doi.org/10.1590/0034-7167-2020-0352
Amin F, Sharif S, Saeed R, Durranni N, Jilani D. COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan. BMC Psychiatry. 2020;20:459. https://doi.org/10.1186/s12888-020-02864-x
Alves AP, Pedrosa LAK, Coimbra MAR, Miranzi MAS, Hass VJ. Prevalência de transtornos mentais comuns entre profissionais de saúde. Rev Enferm UERJ. 2015;23(1):64-9. https://doi.org/10.12957/reuerj.2015.8150
Rodrigues E, Rodrigues U, Oliveira L, Laudano R, Nascimento Sobrinho C. [Prevalence of common mental disorders in nursing workers at a hospital of Bahia]. Rev Bras Enferm. 2014;67(2):296-301. Portuguese. https://doi.org/10.5935/0034-7167.20140040
Czeisler ME, Lane RI, Petrosky E, Wiley JF, Christensen A, Njai R, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic - United States, June 24-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(32):1049- 57. https://doi.org/10.15585/mmwr.mm6932a1
Silva MRG, Marcolan JF. Working conditions and depression in hospital emergency service nurses. Rev Bras Enferm. 2020;73 Suppl 1:e20180952. https://doi.org/10.1590/0034-7167-2018-0952
Li J, Xu J, Zhou H, You H, Wang X, Li Y, et al. Working condition and health status of 6,317 front line public health workers across 5 provinces in China during the COVID-19 epidemic: a cross-sectional study. BMC Public Health. 2021;21:106. https://doi.org/10.1186/s12889-020-10146-0
Pouralizadeh M, Bostani Z, Maroufizadeh S, Ghanbari A, Khoshbakht M, Alavi SA, et al. Anxiety and depression and the related factors in nurses of Guilan University of Medical Sciences hospitals during COVID-19: a web-based cross-sectional study. Int J Afr Nurs Sci. 2020;13:100233. https://doi.org/10.1016/j.ijans.2020.100233
Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19: a survey conducted at the University Hospital Augsburg. GMS Ger Med Sci. 2020;18:Doc05. https://doi.org/10.3205/000281
Felice C, Di Tanna GL, Zanus G, Grossi U. Impact of COVID-19 outbreak on healthcare workers in Italy: results from a National E-Survey. J Commun Health. 2020;45(4):675-83. https://doi.org/10.1007/s10900-020-00845-5
Sampaio F, Sequeira C, Teixeira L. Nurses' mental health during the Covid-19 outbreak: a cross-sectional study. J Occup Environ Med. 2020;62(10):783-7. https://doi.org/10.1097/JOM.0000000000001987
VanderWeele TJ. Principles of confounder selection. Eur J Epidemiol. 2019;34(3):211-9. https://doi.org/10.1007/s10654-019-00494-6
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2022 Michele Mandagará de Oliveira, Carlos Alberto dos Santos Treichel, Ioannis Bakolis, Poliana Farias Alves, Valéria Cristina Christello Coimbra, Gustavo Pachon Cavada, Lilian Cruz Souto de Oliveira Sperb, Ariane da Cruz Guedes, Milena Hohmann Antonacci, Janaína Quinzen Willrich
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Como Citar
Dados de financiamento
-
Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul
Números do Financiamento Emergency Notice nº 06/2020 -
NIHR Maudsley Biomedical Research Centre