Symptoms of post-traumatic stress disorder and affects in healthcare workers during the COVID-19 pandemic

Pereira, Jefferson Luiz; Ulisses, Sofia Marques Viana; Del Bianco, Omar Moreira; Lukasova, Katerina

doi:10.1590/1982-0275202340e200213

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Estudos de Psicologia (Campinas)

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Research Report – Health Psychology | Relato de Pesquisa – Psicologia da Saúde • Estud. psicol. (Campinas) 40 • 2023 • https://doi.org/10.1590/1982-0275202340e200213 copy

Symptoms of post-traumatic stress disorder and affects in healthcare workers during the COVID-19 pandemic

Sintomas de transtorno de estresse pós-traumático e afetos em profissionais da saúde durante a pandemia da COVID-19

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

This study aimed to evaluate symptoms of post-traumatic stress disorder and affects in health professionals during the COVID-19 pandemic.

Method:

Three hundred and seventy-four health professionals, among which 235 were front-line and 139 non-front-line workers, answered an online questionnaire consisting of socio-demographic data, identification of past mental disorders, personal experience facing the pandemic, the Impact of Event Scale, and the Positive and Negative Affect Schedule. The sample consisted mainly of physicians and nursing staff aged between 30 and 49 years.

Results:

The results demonstrate high scores of symptoms related to post-traumatic stress disorder, with greater expressiveness among front-line professionals, especially in the nursing staff, and a strong correlation of these results with negative affects.

Conclusion:

Psychological assistance and interventions directed to health professionals are urgent to mitigate the impacts caused by the COVID-19 pandemic.

Keywords:
Affect; COVID-19; Healthcare workers; Post-traumatic stress disorders

Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas Núcleo de Editoração SBI - Campus II, Av. John Boyd Dunlop, s/n. Prédio de Odontologia, 13060-900 Campinas - São Paulo Brasil, Tel./Fax: +55 19 3343-7223 - Campinas - SP - Brazil
E-mail: psychologicalstudies@puc-campinas.edu.br

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[1] Correspondence to: K. LUKASOVA. E-mail: <katerina.lukasova@ufabc.edu.br>.

Variables		FL (n = 235)		NFL (n = 139)		p-value
Variables		n	%	n	%	p-value
Age
	20 - 29	36	15.3	15	10.8	<0.001^a
	30 - 39	107	45.4	41	29.5
	40 - 49	70	30.0	47	33.8
	50 - 72	22	9.3	36	25.9
Gender
	Female	189	80.4	118	84.9	0.17^b
	Male	46	19.6	21	15.1	0.17^b
Marital status
	Single	74	31.5	34	24.5	0.31^a
	Married	135	57.4	91	65.4
	Divorced, separated, or widowed	26	11.1	14	10.1
Brazilian macroregion
	North	19	8.1	3	2.2	0.003^a
	Northeast	40	17.0	15	10.8
	Midwest	17	7.2	3	2.2
	Southeast	143	60.9	102	73.3
	South	16	6.8	16	11.5
Household
	Partner and/or children	159	67.6	93	66.9	0.41^a
	Relatives	43	18.3	33	23.7
	Alone or with friends	33	14.1	13	9.4
Profession
	Physician	57	24.3	39	28.1	< 0.001^a
	Nursing staff	138	58.7	57	41.0
	Physiotherapist	17	7.2	7	5.0
	Other	23	9.8	36	25.9
Type of institution
	Public	135	57.4	69	49.6	0.001^a
	Private	60	25.6	46	33.1
	Both public and private	40	17.0	24	17.3

Question		FL (n = 235)		NFL (n = 139)		p-value
Question		n	%	n	%	p-value
Has been infected with SARS-CoV-2?
	Yes (laboratorial diagnosis)	26	11.1	9	6.5	0.04^a
	No (laboratorial diagnosis)	40	17.0	26	18.7
	I do not know	169	71.9	104	74.8
Did your work institution provide or make available any psychological support service to the healthcare staff during the pandemic?
	No	117	49.8	75	54.0	0.01^a
	Yes (low adhesion)	79	33.6	27	19.4
	Yes (high adhesion)	39	16.6	37	26.6
Do you believe that the psychological distress caused by the COVID-19 pandemic affects the performance of the services provided by health professionals?
	No	5	2.1	1	0.7	0.47^a
	Yes	205	87.2	120	86.3
	Maybe	25	10.7	18	12.9
In your personal experience, what changes have caused the most discomfort or psychological suffering since the beginning of the COVID-19 pandemic?
	Concerns about transmitting the virus	112	47.7	46	33.1	0.004^b
	Distance from family	70	29.8	39	28.1	0.41^b
	Physical/psychosomatic changes	67	28.3	28	20.1	0.05^b
	Concerns about contracting the virus	58	24.5	59	42.4	< 0.001^b
	Concerns about workplace environment	38	16.0	26	18.7	0.31^b
	COVID-19 deaths	33	14.0	23	16.5	0.30^b
	Hostility of the population towards health professionals	22	9.3	6	4.3	0.10^b
	Changes in leisure or entertainment habits	11	4.7	5	3.6	0.42^b
	Relationship concerns	9	3.8	8	5.8	0.44^b
	Distance from friends	7	3.0	9	6.5	0.12^b
	Changes in physical activity	5	2.1	5	3.6	0.51^b
	Changes in religious activity	4	1.7	1	0.7	0.66^b

Instrument		FL (n = 235)		NFL (n = 139)		p-value^a	Effect size
Instrument		M (SD)	95% CI	M (SD)	95% CI	p-value^a	d _Cohen	95% CI
PANAS
	PA	28.6 (7.87)	27.6, 29.6	27.6 (6.89)	26.4, 28.7	0.20	-	-
	NA	28.0 (8.90)	26.9, 29.2	25.3 (8.63)	23.8, 26.7	0.004	0.31	0.10, 0.52
PANAS (highest scores)
	Alert	3.61 (0.97)	3.48, 3.73	3.45 (1.01)	3.28, 3.62	0.14	-	-
	Attentive	3.60 (1.03)	3.46, 3.73	3.54 (0.99)	3.37, 3.71	0.61	-	-
	Afraid	3.49 (1.25)	3.33, 3.65	3.15 (1.26)	2.94, 3.36	0.01	0.27	0.06, 0.48
	Active	3.43 (1.10)	3.29, 3.57	3.32 (1.05)	3.14, 3.49	0.33	-	-
	Jittery	3.31 (1.15)	3.16, 3.46	2.88 (1.27)	2.67, 3.10	0.001	0.36	0.15, 0.57
	Distressed	3.26 (1.30)	3.10, 3.43	2.96 (1.21)	2.76, 3.17	0.03	0.24	0.03, 0.45
	Upset	3.23 (1.28)	3.07, 3.40	2.86 (1.22)	2.66, 3.07	0.006	0.29	0.08, 0.50
	Nervous	3.18 (1.25)	3.02, 3.34	2.85 (1.21)	2.65, 3.05	0.01	0.27	0.06, 0.48
	Determined	3.16 (1.22)	3.00, 3.31	3.05 (1.14)	2.86, 3.24	0.40	-	-
	Irritable	3.06 (1.29)	2.89, 3.22	2.71 (1.25)	2.50, 2.92	0.01	0.27	0.06, 0.48
IES-R
	Intrusion	1.89 (0.93)	1.77, 2.01	1.56 (0.90)	1.40, 1.71	0.001	0.36	0.15, 0.57
	Avoidance	1.60 (0.75)	1.51, 1.70	1.38 (0.78)	1.25, 1.51	0.007	0.29	0.08,0.50
	Hyperarousal	1.84 (0.98)	1.71, 1.97	1.49 (0.98)	1.33, 1.66	0.001	0.36	0.15,0.57
	Total	39.0 (17.7)	36.7, 41.2	32.4 (17.6)	29.5, 35.4	0.001	0.37	0.16, 0.59

Variable 1	Variable 2	FL (n = 235)		NFL (n = 139)
Variable 1	Variable 2	r*	95% CI	r*	95% CI
IES-R Total	PANAS NA	0.73	0.63, 0.76	0.70	0.60, 0.77
IES-R Intrusion	PANAS NA	0.70	0.61, 0.74	0.65	0.54, 0.73
IES-R Avoidance	PANAS NA	0.52	0.40, 0.59	0.55	0.42, 0.65
IES-R Hyperarousal	PANAS NA	0.77	0.69, 0.80	0.71	0.62, 0.78
IES-R Hyperarousal	PANAS PA	-0.25	-0.35, -0.11	-	-
IES-R Total	PANAS NA - Nervous	0.67	0.59, 0.73	0.58	0.49, 0.66
IES-R Total	PANAS NA - Distressed	0.62	0.54, 0.70	0.65	0.57, 0.72
IES-R Total	PANAS NA - Afraid	0.61	0.52, 0.68	0.64	0.56, 0.71
IES-R Total	PANAS NA - Scared	0.60	0.51, 0.68	0.57	0.47, 0.65
IES-R Total	PANAS NA - Jittery	0.60	0.51, 0.68	0.67	0.59, 0.73
IES-R Total	PANAS NA - Upset	0.54	0.44, 0.63	0.50	0.40, 0.59
IES-R Total	PANAS NA - Irritable	0.50	0.40, 0.59	0.42	0.31, 0.52
IES-R Total	PANAS NA - Hostile	0.38	0.27, 0.49	0.34	0.23, 0.45
IES-R Total	PANAS NA - Guilty	0.37	0.26, 0.48	0.37	0.25, 0.47
IES-R Total	PANAS NA - Ashamed	0.35	0.24, 0.46	0.27	0.14, 0.38