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Moreover, poor mental and physical health among staff might not only be detrimental to individuals but also may hinder professional performance and, in turn, the quality of care.
Psychological distress was reported to occur during previous virus outbreaks, and it contributed to the shortage of healthcare staff due to mental illness, sick leave or resignation. Increased mental and physical health problems among healthcare staff in the midst of the pandemic can endanger the accessibility and quality of acute care. Professionals were reported to have a high risk of experiencing mental health complaints, such as anxiety, stress, depression, sleep disturbance, loss of self-confidence, as well as physical health complaints. The COVID-19 outbreak has been associated with mental problems and challenges for many people, including healthcare professionals treating COVID-19 patients in the frontline. By November 2020, more than fifty million confirmed COVID-19 cases and 1.25 million deaths due to the coronavirus have been reported. On 30 January 2020, The World Health Organization declared the coronavirus disease (COVID-19) as a public health emergency of international concern. Actions to limit drop-out and illness among staff resulting from psychological distress are vital to secure acute care for (non-)COVID-19 patients during future infection waves. The first COVID-19 wave took its toll on ED staff. Analysis of 51 free-texts revealed witnessing suffering, high work pressure, fear of contamination, inability to provide comfort and support, rapidly changing protocols regarding COVID-19 care and personal protection, and shortage of protection equipment as important stressors.
High levels of distress were primarily found in situations where the staff was unable to provide or facilitate necessary emotional support to a patient or family. Half of the respondents reported experiencing more moral distress in the ED since the COVID-19 outbreak. Mean self-perceived stress symptom levels almost doubled during the peak of the first wave (≤0.005). Compared to pre-COVID-19, the mean WHO-5 index score (range: 0–100) decreased significantly with 14.1 points ( p < 0.001) during the peak of the first wave and 3.7 points (< 0.001) after the first wave. In total, 192 questionnaires were returned (39% response). Quantitative data were analyzed with descriptive statistics and generalized estimating equations (GEE). Stressors were assessed and explored by rating experiences with specific situations (i.e., frequency and intensity of distress) and in free-text narratives. Well-being and stress symptoms (i.e., cognitive, emotional and physical) were scored for the periods pre, during and after the first COVID-19 wave using the World Health Organization Well-Being Index (WHO-5) and a 10-point Likert scale. An online questionnaire was administered during June–July 2020 to physicians, nurses and non-clinical staff of four EDs in the Netherlands. This study aimed to: 1) assess changes in well-being and perceived stress symptoms of Dutch emergency department (ED) staff in the course of the first COVID-19 wave, and 2) assess and explore stressors experienced by ED staff since the COVID-19 outbreak. The coronavirus disease 2019 (COVID-19) outbreak has been associated with stress and challenges for healthcare professionals, especially for those working in the front-line of treating COVID-19 patients.
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