Zum Inhalt springen
Sponsorship
Die MVF-Knowledge-HubsFrisch aus der Forschung. Täglich aktualisiert!

Suchen Sie in Hunderten nationaler und internationaler Datenbanken nach dem neuesten Studienwissen der angegebenen Themengebiete und/oder lassen Sie sich werktäglich per Newsletter informieren. Die Newsfeeds werden auf deutsch übersetzt and nach Übertragbarkeit auf das deutsche Gesundheits-/Versorgungssystem ausgewählt:

Zu den Knowledge-Hubs

Top original article

Cite Download PDF TXT - Download CC BY 4.0

Impact of the Covid-19 pandemic on the mental health of medical staff

Prof. Dr. med. Matthias David / Matthias Cyliax

Results of a selective literature search

Read more
First publication date: 05.06.2023
Prof. Dr. med. Matthias DavidProf. Dr. med. Matthias DavidMatthias CyliaxMatthias Cyliax

DOI

http://doi.org/10.24945/MVF.03.23.1866-0533.2517

Downloads

Full article as PDF
Full article as PDF (English - automatic translation)
Plain text as TXT

Abstract: Auswirkungen der Covid-19-Pandemie auf die psychische Gesundheit des medizinischen Personals

A selective literature search focusing on European countries was intended to clarify whether and how the Covid-19 pandemic has influenced the psychological well-being of medical staff. Of the 14 publications ultimately taken into account, five came from Germany and two from Switzerland. The majority of studies found more psychological symptoms and perceived stress among many respondents. Younger employees with less work experience had more anxiety and depressive symptoms. Other risk factors appear to be previous (mental) illnesses or previous stresses. Nurses tend to show symptoms more often than doctors. The critical pros and cons assessment of the pandemic measures in Germany that is now beginning should also include their possible short- and long-term consequences for the mental health of healthcare workers.

Abstract: Impact of the Covid-19-pandemic on the mental health of health workers? Results of a selective literature search

A selective literature search with a focus on European countries was intended to clarify whether and how the COVID-19 pandemic affected the mental health of medical staff. Of the 14 publications considered, five came from Germany and two from Switzerland. Most of the studies found more psychological symptoms and perceived distress in many respondents. Younger employees with less work experience had more anxiety and depressive symptoms. Other risk factors seem to be (mental) previous illnesses or previous stresses. Nurses tend to show symptoms more often than doctors. The critical pros and cons assessment of the pandemic measures in Germany that is now beginning should also include their possible short- and long-term consequences for the mental health of healthcare workers.

Keywords (German)

Covid-19 pandemic, medical staff, mental health, Risk factors

Keywords (English)

Covid-19 pandemic, health workers, Mental Health, risk factors

Literature

1. Ditzen, B. Social distance: When the protective effects of social proximity are limited. Psychother Psych Med 2020; 70: 219–220 https://doi.org/10.1055/a-1158-0202 2. Federal Government. Corona protective measures are expiring. https://www.bundesregierung.de/breg-de/suche/coroanregelen-laufen-aus-2182106 (accessed on April 7, 2023) 3. First ordinance amending the Protective Measures Suspension Ordinance of February 24, 2023. Federal Law Gazette. Part 1. No. 50, 2023. Issued in Bonn on February 27, 2023. https://www.recht.bund.de/bgbl/1/2023/50/VO.html (accessed on April 7, 2023) 4. Schug, C. / Morawa, E. / Geiser, F. / Hiebel, N. / Beschoner, P. / Jerg-Bretzke, L. / Albus, C. / Weidner, K. / Steudte-Schmiedgen, S. / Borho , A. / Lieb, M. / Erim, Y. Social Support and Optimism as Protective Factors for Mental Health among 7765 Healthcare Workers in Germany during the Covid-19 Pandemic: Results of the VOICE Study. Int. J. Environ. Res. Public Health 2021, 18(7), 3827; https://doi.org/10.3390/ijerph18073827 5. Beschoner, P. / Jarczok, M. / Kempf, M. / Weimer, K. / Geiser, F. / Hiebel, N. / Erim, Y. / Morawa, E. / Steudte-Schmiedgen, S. / Albus, C. / Jerg-Bretzke, L. egePan-VOICE study on the psychosocial stress caused by the Covid-19 pandemic among medical-technical assistants, Z Psychosom Med Psychother 68/ 2022, 250-268; https://doi.org/10.13109/zptm.2021.67.oa15 6. Zerbini, G. / Ebigbo, A. / Reicherts, P. / Kunz, M. / Messmann, H. Psychosocial stress on employees in the health system during Covid -19 pandemic - results of a survey at the University Hospital Augsburg; GMS Ger Med Sci 2020;18:Doc05; GMS | GMS German Medical Science – an Interdisciplinary Journal | Psychosocial burden of healthcare professionals in times of Covid-19 – a survey conducted at the University Hospital Augsburg (egms.de) 7. Röthke, N. / Wollschläger, D. / Kunzler, A. / Rohde, A. / Molter, S . / Bodenstein, M. / Reif, A. / Walter, H. / Lieb, K. / Tüscher, O. Psychological stress, resilience and tendency to absenteeism among health workers in Germany during the first COVID-19 pandemic wave in spring 2020; The Neurologist volume 92, pages 579–590 (2021); https://link.springer.com/article/10.1007/s00115-021-01132-x 8. Krammer, S. / Augstburger, R. / Haeck, M. / Maercker, A. Adjustment disorder, depression, stress symptoms, Corona-related Concerns and coping strategies during the Corona pandemic (Covid-19) among Swiss hospital staff; Psychother Psychosom Med Psychol 2020; 70(07): 272-282, https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1192-6608 9. Vanhaecht, K. / Seys, D. / Bruyneel, L. / Cox, B. / Kaesemans, G. / Cloet, M. / Van Den Broeck, K. / Cools, O. / De Witte, A. / Lowet, K. / Hellings, J. / Bilsen, J. / Lemmens , G. / Claes, S. Covid-19 is having a destructive impact on health-care workers' mental well-being; Int J Qual Health Care 2021 Feb 20;33(1):mzaa158., https://pubmed.ncbi.nlm.nih.gov/33270881/ 10. Valaine, L. / Ancane, G. / Utinans, A. / Brigis, G. Mental Health and Associated Demographic and Occupational Factors among Health Care Workers during the Covid-19 Pandemic in Latvia, Medicina 2021, 57(12), 1381, https://www.mdpi.com/1648-9144/ 57/12/1381 11. Schmuck, J. / Hiebel, N. / Kriegsmann-Rabe, M. / Schneider, J. / Matthias, J.-K. / Erim, Y. / Morawa, E. / Jerg-Bretzke, L. / Beschoner, P. / Albus, C. / Weidner, K. / Radbruch, L. / Hauschildt, E. / Geiser, F. Individual Stress Burden and Mental Health in Health Care Workers during the COVID-19 Pandemic: Moderating and Mediating Effects of Resilience, Int J Environ Res Public Health. 2022 May 27;19(11):6545, https://pubmed.ncbi.nlm.nih.gov/35682131/ 12. Mattila, E. / Peltokoski, J. / H Neva, M. / Kaunonen, M. / Helminen, M. / Parkkila, AK. Covid-19: anxiety among hospital staff and associated factors; Ann Med. 2021 Dec, 53(1):237-246, https://pubmed.ncbi.nlm.nih.gov/33350869/ 13. Hummel, S. / Oetjen, N. / Du, J. / Posenato, E. / Resende de Almeida, RM / Losada, R. / Ribeiro, O. / Frisardi, V. / Hopper, L. / Rashid, A. / Nasser, H. / König, A. / Rudofsky, G. / Weidt , S. / Zafar, A. / Gronewold, N. / Mayer, G. / Schultz, J.-H. Mental Health Among Medical Professionals During the Covid-19 Pandemic in Eight European Countries: Cross-sectional Survey Study; J Med Internet Res. 2021 Jan 18,23(1):e24983, https://pubmed.ncbi.nlm.nih.gov/33411670/ 14. Rodriguez-Jiménez, M. / Guerrero-Barona, E. / Garcia- Gómez, A Mental health and psychological capital among Spanish health care workers during Covid-19 pandemic; Med Clinic (Barc). 2021 Apr 9;156(7):357-358, https://www.sciencedirect.com/science/article/pii/S2387020621001157 15. Spiller, TR / Méan, M. / Ernst, J. / Sazpinar, O. / Gehrke, S. / Paolercio, F. / Petry, H. / Pflaltz, MC / Morina, N. / Aebischer, O./ Gachoud, D. / von Känel, R. / Weilenmann, S. Development of health care workers ' mental health during the SARS-CoV-2 pandemic in Switzerland: two cross-sectional studies; Psychol Med. 2022 May; 52(7):1395-1398, https://pubmed.ncbi.nlm.nih.gov/32787976/ 16. Fountoulakis, KN / Apostolidou, MK / Atsiova, MB / Filippidou, AK / Florou, AK / Gousiou, DS / Katsara, AR / Mantzari, SN / Padouva-Markoulaki, M. / Papatriantafyllou, EI / Sacharidi, PI / Tonia, AI / Tsagalidou, EG / Zymara, VP / Prezerakos, PE / Koupidis, SA / Fountoulakis, NK / Konsta, A. / Tsapakis, EM / Theodorakis, PN / Mossialos, E. Mental health and conspiracy in health care professionals during the spring 2020 Covid-19 lockdown in Greece; Acta Neuropsychiatr. 2022 Jun;34(3):132-147, https://pubmed.ncbi.nlm.nih.gov/34886920/ 17. Rossi, R. / Socci, V. / Jannini, TB / Pacitti, F. / Siracusano , A. / Rossi, A. / Di Lorenzo, G. Mental Health Outcomes Among Italian Health Care Workers During the Covid-19 Pandemic; JAMA Netw. Open. 2021 Nov 1;4(11):e2136143, https://pubmed.ncbi.nlm.nih.gov/34817580/ 18. https://www.bundesgesundheitsministerium.de/themen/gesundheitswesen/gesundheitswirtschaft/gesundheitswirtschaft-als-jobmotor .html (accessed on February 2, 2023) 19. https://de.statista.com/statistics/data/study/1029877/umfrage/dispersion-of-pflegekraefte-in-deutschland-nach-pflegeart-und-genex/ ( accessed on February 2nd, 2023) 20. https://www.psychosomatik.uk-erlangen.de/forschung/Schwpointen/arbeitsfaehigkeit-des-medizinen-personals/voice-online-survey/ (accessed on January 20th, 2023) 21. Mascayano , F. / van der Ven, E. / Moro, MF / Schilling, S. / Alarcon, S. / Al Barathie, J. / Alnasser, L. / Asaoka, H. / Ayinde, O. / Balalian, A. / Basagoitia, A. / Brittain, K. / Dohrenwend, B. / Durand-Arias, S. / Eskin, M. / Fernandez-Jimenez, E. / Freytes Frey, MI / Gimenez, L. / Gisle, L. / Hoek, HW / Ezequiel Jaldo, R. / Lindert, J. / Maldonado, H. / Martinez-Ales, G. The impact of the Covid-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth care wOrkErS (HEROES) study; Soc Psychiatry Psychiatr Epidemiol. 2022 Mar;57(3):633-645; https://pubmed.ncbi.nlm.nih.gov/35064280/ 22. https://covid19.who.int/ (accessed on January 30, 2023.) 23. Alfonsi, V.; Scarpelli, S.; Gorgoni, M.; Couyoumdjian, A.; Rosiello, F.; Sandroni, C.; Corsi, R.; Pietrantonio, F.; De Gennaro, L. Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians. Int. J. Environ. Res. Public Health 2023, 20, 1410; https:// doi.org/10.3390/ijerph20021410 (accessed April 10, 2023) 24. Eibschutz, LS, Bruckhaus, AA, Bennett, A., Duncan, D., Sackett. C,, Dave, K., Cherukury et al. Mental Health Effects of the Covid-19 Pandemic on Healthcare Professionals. In: Coronavirus Disease 2019 (Covid-19): A Clinical Guide. Editor(s): Ali Gholamrezanezhad, Michael P. Dub. DOI:10.1002/978111978974; 2023 John Wiley & Sons Ltd.; pp. 554-579 (accessed April 13, 2023).

Additional Information

Citation: Cyliax, M., David, M.: “Impact of the Covid-19 pandemic on the mental health of medical staff? Results of a selective literature search”, in: “Monitor Health Services Research” (03/23), pp. 67–71. http://doi.org/10.24945/MVF.03.23.1866-0533.2517

Plain Text

Impact of the Covid-19 pandemic on the mental health of medical staff

Results of a selective literature search

The legal nationwide framework for the so-called Corona protective measures expired on April 7, 2023, i.e. i.e., the last remaining obligations, especially wearing an FFP2 mask when visiting a hospital or nursing home, were no longer applicable, as stated in the “First Ordinance Amending the Ordinance on Suspension of Protective Measures” of February 24, 2023 by the German federal government had been decided. The (self-)critical assessment of the corona pandemic should begin now at the latest on a scientific basis with regard to the successes, consequences and errors in combating the pandemic. An attempt will be made below to draw an interim conclusion on the possible consequences and repercussions of the Covid-19 pandemic and the resulting (health) policy measures for medical staff with a focus on psychological issues, using the presentation and interpretation of data from current publications to draw well-being.

>> The following research questions should be clarified with a selective literature search: Is it in or due to the Covid-19
19 pandemic led to a demonstrable deterioration in the psychological well-being of the hospital staff? What are risk factors for worsening mental health status; what are essential protective or resilience factors?
The selective literature search included studies in the PubMed, Google Scholar and Livivo databases. The search was carried out in several search runs between November 25th, 2022 and January 10th, 2023. The following inclusion criteria were chosen: 1.) The study deals with the mental health of medical staff during the corona pandemic; 2.) comparative data from before the pandemic or from a comparison population from the general population are used; 3.) the survey is carried out using the usual or evaluated examination instruments with which typical symptoms of stress, depression, anxiety and overwork can be identified and quantified; 4.) the study is published in German and/or English; 5.) the publication refers to Europe to ensure comparability in terms of the healthcare system and the way it deals with stress and mental health.
Results
Of the 10,690 “first hits” of the literature search, 52 were shortlisted after a selection process, of which 14 could be included taking into account the inclusion criteria. Of these publications, five came from Germany and two from Switzerland.
Table 1 summarizes the study results, names the measuring instruments and questionnaires used, but also significant limitations of the published studies.

Stress and additional workload
Basically, all studies that have examined the parameter of stress find evidence of increased stress levels among employees of the healthcare system. Beschoner et al. report that moderate to severe stress was detectable in 87.6% of the medical-technical assistants surveyed [5]. There appears to be a connection between increased stress levels and fear of contracting the virus [6]. In the work of Rodríguez-Jiménez et al. 94.5% of the hospital employees surveyed stated that they constantly felt overwhelmed and stressed [14].

depression
Various studies have found evidence of high rates of depressive symptoms among healthcare workers. Valaine et al. describe symptoms of clinically relevant depression in 24.8% of the study participants; they also found male gender, young age and higher education or higher educational qualifications as risk factors [10]. Valaine et al. state that 65% of those surveyed had no or mild symptoms, 18% moderately severe, and 17% severe depressive symptoms [10]. Fountoulakis et al. found depressive symptoms in 10.8% of women and 5.6% of men. They describe a more frequent occurrence among nursing staff compared to other professional groups in the healthcare sector [16].
The results of the VOICE study found a connection between the occurrence of depressive symptoms and previous psychological illnesses, the female gender and low social support. There was no significant difference between employees with and those without direct Covid-19 patient contact [4]. In contrast, Zerbini et al. Higher levels of depression among employees with direct contact with patients suffering from or infected with Covid-19 [6]. Krammer et al. found depression in 15% of the survey participants; here too, previous illnesses and female gender were described as the main risk factors [8].

Fear
Valaine et al. describe that 17.2% of the test subjects had clinically significant anxiety symptoms [10], Mattila et al. 40% of the study participants have low to moderate anxiety symptoms, while 5% has a pronounced anxiety disorder [12]. In Hummel et al. These values are even higher: 15% have indications of moderate anxiety symptoms, 22% of pronounced anxiety symptoms. Also Rossi et al. describe more fear, especially among female employees [17].

Sick days and desire to change careers
Röthke et al. their study addresses, among other things, with sickness-related absences and a tendency to change careers. Almost 11% of those surveyed had thought about changing careers in the wake of the pandemic. A connection was found between increased psychological stress and an increased number of sick days absent as well as a desire to change careers [7].

Risk factors
Most studies describe more psychological symptoms in study participants [4,8,9,12,16,17]. As far as the age factor is concerned, younger employees apparently have a potentially worse starting position [10,11,12]. Less work experience may lead to more symptoms of anxiety and depression [10]. In the VOICE study, a change of job was also identified as a risk factor for symptoms of mental illness [4]. Furthermore, previous psychological illnesses or previous stresses appear to be associated with a higher risk [4,5,6]. Nurses tend to show symptoms more often than doctors [6,8].

Resilience factors
Not unexpectedly, optimism and a positive coping strategy as well as a positive reappraisal style seem to have a positive effect [7,4]. Good social support from family and friends and good integration into social structures are also associated with lower levels of anxiety [4]. In addition, more work experience and older age also seem to have a positive effect [10,11,12].
limitations
According to the Federal Ministry of Health, 5.8 million people work in the healthcare sector in Germany, which corresponds to around one in eight employed people [18]. Studies with only a few hundred participants are therefore unlikely to be representative [8]. In Germany, around 75% of healthcare workers are women [19]. There are also significantly more female participants described in the studies. It is possible that male employees are underrepresented; here too, there seems to be a possibility of selection bias.
The predominantly anonymous online survey methods also do not allow any conclusions to be drawn as to who actually took part. Are they particularly stressed?
In addition to a lack of representativeness and selection bias, the lack of comparability is problematic. Comparisons were rarely made at all and if so, then with a sample from the entire population. Pre-pandemic healthcare data was not available [7].
Accordingly, the role of the Covid-19 pandemic cannot be classified with certainty in relation to the reported increased psychological stress and the occurrence of depression or depressive symptoms. In this respect, it remains unclear whether the relatively poor mental health of healthcare workers found represents the current situation even without a pandemic, lockdown measures, etc.
Conclusion and recommendations
1.) The actual role of the pandemic on the mental health of medical staff cannot yet be classified with certainty. The evaluations of other large studies, such as the HEROES study, in which around 34,000 healthcare workers in 22 countries have been surveyed [21], remain to be seen.
2.) Regular screening of the mental health of hospital staff seems to make sense; The effectiveness of measures can be evaluated here, and comparative data is created that can be used in the event of another “health crisis” to identify and mitigate negative influences at an early stage.
3.) Future studies should take sociodemographic differences into account to assess their specific contribution to the observed differences and variations.
4.) Our results highlight the need for preventative programs for healthcare workers to improve their coping skills and prevent the long-term consequences of chronic stress. By identifying trends and variables that worsen the mental health outcomes of healthcare workers, interventions and strategies can be developed at local, regional, national and international levels [24,25].
5.) The critical pros and cons assessment of the pandemic measures in Germany must also include their possible short- and long-term consequences for the health of healthcare workers. <<

Quote
“It is basic knowledge in psychotherapy, psychosomatics and medical psychology that reliable and close social relationships promote mental and physical health. On a psychobiological level, the data is clear: social contact, close social relationships, physical touch, but also symbolic closeness buffer stress and prolong life..."
(Ditzen 2020).

Author's statement
The authors declare that there are no conflicts of interest.

 

Do you want to leave us already?

Subscribe to our newsletter quickly. Then you can be sure that you won't miss anything.