Arrowhead Regional Medical Center, Department of Psychiatry, Colton, California.
Western University of Health Sciences, Graduate College of Biomedical Sciences, Pomona, California.
West J Emerg Med. 2021 Feb 8;22(2):346-352. doi: 10.5811/westjem.2020.11.49015.
The coronavirus 2019 (COVID-19) pandemic has created a mental health crisis among hospital staff who have been mentally and physically exhausted by uncertainty and unexpected stressors. However, the mental health challenges and complexities faced by hospital staff in the United States has not been fully elucidated. To address this gap, we conducted this study to examine the prevalence and correlates of depression and anxiety among hospital staff in light of the COVID-19 pandemic.
The design is a single-center, cross-sectional, online survey evaluating depression and anxiety among all hospital employees (n = 3,500) at a safety-net hospital with a moderate cumulative COVID-19 hospitalization rate between April 30-May 22, 2020. We assessed depression with the Patient Health Questionnaire-9. Anxiety was measured with the Generalized Anxiety Disorder-7 scale. Logistic regression analyses were calculated to identify associations with depression and anxiety.
Of 3,500 hospital employees, 1,246 (36%) responded to the survey. We included 1,232 individuals in the final analysis. Overall, psychological distress was common among the respondents: 21% and 33% of staff reported significant depression and anxiety, respectively, while 46% experienced overwhelming stress due to COVID-19. Notably, staff members overwhelmed by the stress of COVID-19 were seven and nine times more likely to suffer from depression and anxiety, respectively. In addition to stress, individuals with six to nine years of work experience were two times more likely to report moderate or severe depression compared to those with 10 or more years of work experience. Moreover, ancillary staff with direct patient contact (odds ratio [OR] 8.9, confidence interval (CI), 1.46, 173.03) as well as administrative and ancillary staff with indirect patient contact (OR 5.9, CI, 1.06, 111.01) were more likely to be depressed than physicians and advanced providers.
We found that a considerable proportion of staff were suffering from psychological distress. COVID-19-associated depression and anxiety was widespread among hospital staff even in settings with comparatively lower COVID-19 hospitalization rates. Ancillary staff, administrative staff, staff with less job experience, and staff overwhelmed by the stress of COVID-19 are particularly susceptible to negative mental health outcomes. These findings will help inform hospital policymakers on best practices to develop interventions to reduce the mental health burden associated with COVID-19 in vulnerable hospital staff.
2019 年冠状病毒（COVID-19）大流行给医院工作人员带来了心理健康危机，他们因不确定性和意外压力而身心疲惫。然而，美国医院工作人员面临的心理健康挑战和复杂性尚未得到充分阐明。为了解决这一差距，我们进行了这项研究，以检查 COVID-19 大流行期间医院工作人员的抑郁和焦虑的患病率和相关性。
该设计是一项单中心、横断面、在线调查，评估了一家安全网医院所有医院员工（n=3500）的抑郁和焦虑情况，该医院在 2020 年 4 月 30 日至 5 月 22 日期间 COVID-19 住院率中等。我们使用患者健康问卷-9 评估抑郁，使用广泛性焦虑症-7 量表评估焦虑。使用逻辑回归分析计算与抑郁和焦虑相关的关联。
在 3500 名医院员工中，有 1246 名（36%）对调查做出了回应。我们最终分析纳入了 1232 人。总体而言，受访者中存在常见的心理困扰：分别有 21%和 33%的员工报告有明显的抑郁和焦虑，而 46%的员工因 COVID-19 而感到压力过大。值得注意的是，因 COVID-19 压力而不堪重负的员工患抑郁和焦虑的可能性分别高出 7 倍和 9 倍。除了压力之外，工作经验在 6 到 9 年之间的个体患中度或重度抑郁的可能性是工作经验 10 年或以上的个体的两倍。此外，与直接接触患者的辅助人员（比值比[OR]8.9，置信区间[CI]1.46，173.03）以及与间接接触患者的行政和辅助人员（OR 5.9，CI 1.06，111.01）相比，医生和高级提供者更有可能抑郁。
我们发现相当一部分员工正在遭受心理困扰。即使在 COVID-19 住院率相对较低的环境中，医院工作人员中也普遍存在 COVID-19 相关的抑郁和焦虑。辅助人员、行政人员、工作经验较少的人员以及因 COVID-19 压力而不堪重负的人员特别容易出现负面心理健康结果。这些发现将有助于为医院政策制定者提供信息，以制定最佳实践，以减轻 COVID-19 期间弱势医院工作人员的心理健康负担。
