Distress and pleasure indicators in health care workers on the COVID-19 front line

Baptista, Patrícia Campos Pavan; Lourenção, Daniela Campos de Andrade; Silvestre Silva-Junior, João; Cunha, Arthur Arantes da; Gallasch, Cristiane Helena

doi:10.1590/1518-8345.5707.3519

Patrícia Campos Pavan Baptista

Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil.

http://orcid.org/0000-0003-1433-6456

Daniela Campos de Andrade Lourenção ^** Corresponding author Daniela Campos de Andrade Lourenção E-mail: danielalourencao@usp.br

Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil.

Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

http://orcid.org/0000-0002-3050-0378

João Silvestre Silva-Junior

Centro Universitário São Camilo, Departamento de Medicina, São Paulo, SP, Brazil.

http://orcid.org/0000-0001-7541-5946

Arthur Arantes da Cunha

Universidade Federal do Amapá, Departamento de Ciências Biológicas e da Saúde, Macapá, AP, Brazil.

http://orcid.org/0000-0002-9975-0498

Cristiane Helena Gallasch

Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Rio de Janeiro, RJ, Brazil.

http://orcid.org/0000-0002-0823-0818

* Corresponding author
Daniela Campos de Andrade Lourenção E-mail: danielalourencao@usp.br

Associate Editor

Maria Lúcia do Carmo Cruz Robazzi

Authors’ contribution

Study concept and design: Patrícia Campos Pavan Baptista, Daniela Campos de Andrade Lourenção, João Silvestre Silva-Junior, Cristiane Helena Gallasch. Obtaining data: Patrícia Campos Pavan Baptista, Daniela Campos de Andrade Lourenção, João Silvestre Silva-Junior, Arthur Arantes da Cunha, Cristiane Helena Gallasch. Data analysis and interpretation: Patrícia Campos Pavan Baptista, Daniela Campos de Andrade Lourenção, João Silvestre Silva-Junior, Arthur Arantes da Cunha, Cristiane Helena Gallasch. Statistical analysis: Patrícia Campos Pavan Baptista, Daniela Campos de Andrade Lourenção, João Silvestre Silva-Junior, Arthur Arantes da Cunha, Cristiane Helena Gallasch. Drafting the manuscript: Patrícia Campos Pavan Baptista, Daniela Campos de Andrade Lourenção, João Silvestre Silva-Junior, Arthur Arantes da Cunha, Cristiane Helena Gallasch. Critical review of the manuscript as to its relevant intellectual content: Patrícia Campos Pavan Baptista, Daniela Campos de Andrade Lourenção, João Silvestre Silva-Junior, Cristiane Helena Gallasch. All authors approved the final version of the text.

Conflict of interest

The authors have declared that there is no conflict of interest.

Variable (n)	n (%)
*Gender (434^)**
Male	126 (29.0)
Female	308 (71.0)
Age group in years old (437)
20 - 29	90 (20.6)
30 - 39	161 (36.8)
40 - 49	124 (28.4)
50 - 59	49 (11.2)
60 or more	13 (3.0)
Region (437)
North	79 (18.1)
Northeast	30 (6.9)
Midwest	8 (1.8)
Southeast	300 (68.6)
South	20 (4.6)
Profession (437)
Nurses	243 (55.6)
Nursing Tech./Assist.^†	41 (9.4)
Physicians	69 (15.8)
Physiotherapists	22 (5.0)
Psychologists	15 (3.4)
Others	47 (10.8)
*Number of institutions where they work (435^)**
One	265 (60.9)
Two	129 (29.7)
Three	24 (5.5)
Four or more	17 (3.9)
*Nature of the institution (432^)**
Only public	303 (70.1)
Only private	79 (18.3)
Mixed	50 (11.6)
*Type of employment contract (435^)**
Only statutory	136 (31.3)
Only permanent	145 (33.3)
Only temporary	45 (10.3)
Statutory and celetary	16 (3.7)
Others	93 (21.4)
*Health care level (428^)**
Primary	135 (31.5)
Secondary	79 (18.5)
Tertiary	129 (30.1)
Quaternary	20 (4.7)
More than one level	65 (15.2)
*Weekly working hours (434^)**
< 20	17 (3.9)
20 - 39	88 (20.3)
40 - 59	214 (49.3)
60 or more	115 (26.5)
Morbidity (437)
Yes	158 (36.2)
No	279 (63.8)
Mental distress (437)
Yes	269 (61.6)
No	168 (38.4)
Demand-control (437)
Active work	58 (13.3)
Passive work	128 (29.3)
High-strain	104 (23.8)
Low-strain	147 (33.6)
Support at work (437)
High	206 (47.1)
Low	231 (52.9)

Indicators and factors (n)	Mean	Standard Deviation	Classification
Pleasure	3.9	±1.2	Critical
Professional fulfillment	4.1	±1.3	Satisfactory
Freedom of expression	3.8	±1.3	Critical
Distress	3.4	±1.4	Critical
Professional exhaustion	4.0	±1.3	Severe
Lack of recognition	2.9	±1.7	Critical

Variable (n)	Pleasure			p-value	Distress			p-value
Variable (n)	Satisfactory	Critical	Severe	p-value	Satisfactory	Critical	Severe	p-value
*Gender (434^)**				0.390^†				0.602^†
Male	72	43	11		27	55	44
Female	161	126	21		54	146	108
Age group in years old (437)				0.054^†				0.041^†
20 - 29	48	38	4		19	42	29
30 - 39	81	63	17		25	74	62
40 - 49	63	56	5		19	56	49
50 - 59	31	12	6		12	25	12
60 or more	10	3	0		6	7	0
Region (437)				0.397^‡				0.197^‡
North	46	30	3		15	40	24
Northeast	19	9	2		7	14	9
Midwest	2	5	1		0	4	4
Southeast	155	119	26		59	132	109
South	11	9	0		0	14	6
Profession (437)				0.046^†				0.005^†
Nurses	129	97	17		41	118	84
Nursing Tech./Assist.^‡	16	20	5		2	19	20
Physicians	44	21	4		19	32	18
Physiotherapists	8	11	3		2	10	10
Psychologists	13	1	1		8	4	3
Others	23	22	2		9	21	17
*Number of institutions where they work (435^)**				0.416^†				0.799^†
One	134	110	21		52	127	86
Two	71	51	7		20	57	52
Three	15	7	2		4	11	9
Four or more	12	3	2		4	8	5
*Nature of the institution (432^)**				0.739^†				0.581^†
Only public	163	120	20		53	145	105
Only private	38	34	7		19	31	29
Mixed	29	17	4		8	25	17
*Type of employment contract (435^)**				0.690^†				0.912^†
Only statutory	71	56	9		22	65	49
Only permanent	72	63	10		27	68	50
Only temporary	25	15	5		9	20	16
Statutory and celetary	9	7	0		2	6	8
Others	56	31	6		20	45	28
*Health care level (428^)**				0.042^†				0.925^†
Primary	71	55	9		23	67	45
Secondary	42	34	3		15	37	27
Tertiary	70	53	6		23	61	45
Quaternary	10	5	5		5	6	9
More than one level	36	21	8		14	29	22
*Weekly working in hours (434^)**				0.548^†				0.164^†
< 20	9	6	2		6	7	4
20 - 39	40	39	9		17	37	34
40 - 59	116	82	16		41	109	64
60 or more	66	44	5		17	50	48
Morbidity (437)				0.711^†				0.022^†
Yes	80	66	12		24	66	68
No	153	106	20		57	138	84
Mental distress (437)				<0.001^†				<0.001^†
Yes	107	136	26		17	117	135
No	126	36	6		64	87	17
Demand-control model (437)				<0.001^†				<0.001^†
Active work	34	20	4		8	26	24
Passive work	53	64	11		15	68	45
High-strain	29	59	16		3	36	65
Low-strain	117	29	1		55	74	18
Support at work (437)				<0.001^†				<0.001^†
High	159	44	3		64	103	39
Low	74	128	29		17	101	113

Variable (n)	Univariate						Multiple
	Critical			Severe			Critical			Severe
	OR^*	95% CI^†	p-value	OR^*	95% CI^†	p-value	OR^*	95% CI^†	p-value	OR^*	95% CI^†	p-value
Gender
Male	0.75	0.43 - 1.31	0.319	0.81	0.46 - 1.46	0.489	0.87	0.47 - 1.62	0.665	1.15	0.55 - 2.41	0.711
Female	1	---	---	1	---	---	1	---	---	1	---	---
Age group in years old
Up to 37	1.3	0.77 - 2.18	0.32	1.39	0.81 - 2.39	0.235	0.99	0.56 - 1.77	0.975	0.97	0.49 - 1.92	0.925
38 or more	1	---	---	1	---	---	1	---	---	1	---	---
Profession
Nursing Tech./Assist.^‡	4.06	0.92 - 17.83	0.064	5.98	1.36 - 26.30	0.018	3.78	0.80 - 17.85	0.093	7.15	1.39 - 36.67	0.018
Others	1	---	---	1	---	---	1	---	---	1	---	---
Mental distress
Yes	5.06	2.77 - 9.25	<0.001	29.9	14.33 - 62.36	<0.001	4.03	2.14 - 7.61	<0.001	19.89	8.94 - 44.29	<0.001
No	1	---	---	1	---	---	1	---	---	1	---	---
Demand-control
High-strain	5.57	1.66 - 18.65	0.005	19.42	5.87 - 64.31	<0.001	4.48	1.27 - 15.81	0.02	12.22	3.34 - 44.71	<0.001
Others	1	---	---	1	---	---	1	---	---	1	---	---
Support at work
High	1	---	---	1	---	---	1	---	---	1	---	---
Low	3.69	2.02 - 6.73	<0.001	10.91	5.71 - 20.83	<0.001	2.84	1.51 - 5.35	0.001	6.36	3.05 - 13.24	<0.001

Variable (n)	Univariate						Multiple
	Critical			Severe			Critical			Severe
	OR^*	95% CI^†	p-value	OR^*	95% CI^†	p-value	OR^*	95% CI^†	p-value	OR^*	95% CI^†	p-value
Gender
Male	0.76	0.49 - 1.19	0.233	1.17	0.54 - 2.56	0.691	0.87	0.52 - 1.46	0.594	1.39	0.58 - 3.30	0.459
Female	1	---	---	1	---	---	1	---	---	1	---	---
Age group in years old
Up to 37	1.14	0.77 - 1.69	0.518	1.37	0.65 - 2.88	0.412	0.97	0.61 - 1.54	0.891	1.33	0.58 - 3.02	0.499
38 or more	1	---	---	1	---	---	1	---	---	1	---	---
Profession
Nursing Tech./Assist.^‡	1.78	0.89 - 3.55	0.1	2.51	0.85 - 7.40	0.095	1.82	0.82 - 4.07	0.142	3.36	0.99 - 11.39	0.052
Others	1	---	---	1	---	---	1	---	---	1	---	---
Demand-control
High-strain	3.67	2.23 - 6.06	<0.001	7.03	3.18 - 15.67	<0.001	2.55	1.46 - 4.47	0.001	4.57	1.93 - 10.84	<0.001
Others	1	---	---	1	---	---	1	---	---	1	---	---
Mental distress
Yes	4.45	2.84 - 6.97	<0.001	5.1	2.02 - 12.86	<0.001	2.83	1.71 - 4.66	<0.001	2.41	0.88 - 6.58	<0.001
No	1	---	---	1	---	---	1	---	---	1	---	---
Support at work
High	1	---	---	1	---	---	1	---	---	1	---	---
Low	6.25	4.03 - 9.70	<0.001	20.77	6.13 - 70.37	<0.001	4.65	2.91 - 7.44	<0.001	16.82	4.75 - 59.58	<0.001

[1] * Corresponding author
Daniela Campos de Andrade Lourenção E-mail: danielalourencao@usp.br

Brasil

Brasil

Distress and pleasure indicators in health care workers on the COVID-19 front line

Abstract

Objective

Method

Results

Conclusion