Work and social functioning in frontline healthcare workers during the covid-19 pandemic in Italy: role of acute post-traumatic stress, depressive and anxiety symptoms

Jul 26, 2021Rivista di psichiatria

Work and social challenges in frontline healthcare workers during COVID-19 in Italy linked to stress, depression, and anxiety symptoms

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Abstract

Among 265 frontline healthcare workers, higher levels of functioning impairment were observed in those with moderate to severe post-traumatic stress symptoms, depression, and anxiety.

Individuals with moderate to severe acute post-traumatic stress symptoms (PTSS) experienced greater impairment in work and social functioning compared to those without such symptoms.
Depressive symptoms were predictive of impairment across all analyzed domains of functioning.
Anxiety symptoms were associated with difficulties in both work-related tasks and home management activities.
Frontline healthcare activity was linked to reduced engagement in private and social leisure activities.

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BACKGROUND: Evidence highlights healthcare workers (HCWs) facing outbreaks, particularly the ongoing covid-19 pandemic, are at increased risk of negative mental health outcomes, particularly post-traumatic stress symptoms (PTSS), anxiety and depression. Data from previous outbreaks highlighted the risk for a negative impact on HCWs' social and occupational functioning, but scant data have investigated this issue in the framework of the covid-19 pandemic. A number of effective interventions have been proposed to support mental health and well-being of HCWs in emerging infectious outbreaks, but it is important to acknowledge the differential impact of mental disorders on different dimensions of functioning.

METHODS: The study explored the associations between work and social functioning and PTSS, depression and anxiety in a sample of 265 frontline HCWs employed at a major university hospital in Italy (Pisa), facing the first period of the covid-19 pandemic. Individuals were assessed by means of the Impact of Event Scale-Revised (IES-R) for PTSS, the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the General Anxiety Disorder-7 Item (GAD-7) for anxiety symptoms and the Work and Social Adjustment Scale (WSAS) to assess work and social functioning.

RESULTS: Higher levels of functioning impairment were found among individuals with moderate to severe acute PTSS, depressive and anxiety symptoms with respect to those without. Acute PTSS and depressive symptoms were predictive factors of impairment in each domain of functioning analyzed. Anxiety symptoms were associated with impairment in both work and home management activities. Frontline activity was associated with impairment in both private and social leisure activities.

CONCLUSIONS: Long-term perspective studies are warranted to better investigate the psychopathological burden on HCWs' work and social functioning and to promote adequate intervention strategies.

Work and social functioning in frontline healthcare workers during the covid-19 pandemic in Italy: role of acute post-traumatic stress, depressive and anxiety symptoms

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