Worsening of mental health outcomes in nursing home staff during the COVID-19 pandemic in Ireland.
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Authors
Brady, Conan
Shackleton, Ellie
Fenton, Caoimhe
Loughran, Orlaith
Hayes, Blánaid
Hennessy, Martina
Higgins, Agnes
Leroi, Iracema
Shanagher, Deirdre
McLoughlin, Declan M
Issue Date
2023-09-26
Type
Journal Article
Language
en
Keywords
Alternative Title
Abstract
Mental health issues in nursing home staff during the COVID-19 pandemic have been significant; however, it is not known if these issues persist following widespread vaccination and easing of restrictions.
To quantify the mental health of nursing home staff at different timepoints during the COVID-19 pandemic in the Republic of Ireland.
Two identical, online, cross-sectional, nationwide, anonymous surveys of Republic of Ireland nursing home staff at two timepoints (survey 1 (S1, n = 390): November 2020 to January 2021; survey 2 (S2, N = 229: November 2021 to February 2022) during the COVID-19 pandemic. Convenience sampling was used with staff self-selecting for participation. Methods included the World Health Organisation's Well-Being Index (WHO-5), the Impact of Events Scale-Revised (IES-R), the Moral Injury Events Scale (MIES), two Likert-scale items regarding suicidal ideation and planning, the Work Ability Score (WAS), the Brief Coping Orientation to Problems Experienced (Brief-COPE) Scale, and a 15-item questionnaire assessing perceptions of the outbreak with one additional Likert-scale item on altruism. Descriptive analysis examined differences between staff based on their classification in one of three groups: nurses, healthcare assistants (HCA) and nonclinical staff. Pseudonymous identifiers were used to link responses across surveys.
An insufficient number of participants completed both surveys for linked analyses to be performed; therefore, we performed an ecological comparison between these two independent surveys. More staff reported moderate-severe post-traumatic stress symptoms (S1 45%; S2 65%), depression (S1: 39%; S2 57%), suicidal ideation (S1: 14%; S2 18%) and suicidal planning (S1: 9%; S2 15%) later in the pandemic. There was a higher degree of moral injury at S2 (S1: 20.8 standard deviation (SD) 9.1; S2: 25.7 SD (11.3)) and use of avoidant (maladaptive) coping styles at S2 (S1: 20.8 (6.3); S2 23.0 (6.3)) with no notable differences found in the use of approach (adaptive) coping styles. Staff reported more concerns at S2 regarding contracting COVID-19, social stigma, job stress, doubts about personal protective equipment and systems and processes.
In comparison to our previous survey, mental health outcomes appear to have worsened, coping did not improve, and staff concerns, and worries appear to have increased as the pandemic progressed. Follow-up studies could help to clarify is there are any lingering problems and to assess if these issues are related to the pandemic and working conditions in nursing homes.
To quantify the mental health of nursing home staff at different timepoints during the COVID-19 pandemic in the Republic of Ireland.
Two identical, online, cross-sectional, nationwide, anonymous surveys of Republic of Ireland nursing home staff at two timepoints (survey 1 (S1, n = 390): November 2020 to January 2021; survey 2 (S2, N = 229: November 2021 to February 2022) during the COVID-19 pandemic. Convenience sampling was used with staff self-selecting for participation. Methods included the World Health Organisation's Well-Being Index (WHO-5), the Impact of Events Scale-Revised (IES-R), the Moral Injury Events Scale (MIES), two Likert-scale items regarding suicidal ideation and planning, the Work Ability Score (WAS), the Brief Coping Orientation to Problems Experienced (Brief-COPE) Scale, and a 15-item questionnaire assessing perceptions of the outbreak with one additional Likert-scale item on altruism. Descriptive analysis examined differences between staff based on their classification in one of three groups: nurses, healthcare assistants (HCA) and nonclinical staff. Pseudonymous identifiers were used to link responses across surveys.
An insufficient number of participants completed both surveys for linked analyses to be performed; therefore, we performed an ecological comparison between these two independent surveys. More staff reported moderate-severe post-traumatic stress symptoms (S1 45%; S2 65%), depression (S1: 39%; S2 57%), suicidal ideation (S1: 14%; S2 18%) and suicidal planning (S1: 9%; S2 15%) later in the pandemic. There was a higher degree of moral injury at S2 (S1: 20.8 standard deviation (SD) 9.1; S2: 25.7 SD (11.3)) and use of avoidant (maladaptive) coping styles at S2 (S1: 20.8 (6.3); S2 23.0 (6.3)) with no notable differences found in the use of approach (adaptive) coping styles. Staff reported more concerns at S2 regarding contracting COVID-19, social stigma, job stress, doubts about personal protective equipment and systems and processes.
In comparison to our previous survey, mental health outcomes appear to have worsened, coping did not improve, and staff concerns, and worries appear to have increased as the pandemic progressed. Follow-up studies could help to clarify is there are any lingering problems and to assess if these issues are related to the pandemic and working conditions in nursing homes.
Description
Citation
Brady, C., Shackleton, E., Fenton, C., Loughran, O., Hayes, B., Hennessy, M., Higgins, A., Leroi, I., Shanagher, D., & McLoughlin, D. M. (2023). Worsening of mental health outcomes in nursing home staff during the COVID-19 pandemic in Ireland. PloS one, 18(9), e0291988. https://doi.org/10.1371/journal.pone.0291988
Publisher
License
Copyright: © 2023 Brady et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Journal
PloS one
Volume
18
Issue
9
PubMed ID
DOI
10.1371/journal.pone.0291988
10.1787/b966f837-en
10.1016/j.envres.2021.110856
10.1073/pnas.2015455118
10.1016/S2666-7568(20)30012-X
10.1016/j.jamda.2020.11.022
10.21953/lse.mlre15e0u6s6
10.1136/bmj.n1868
10.1098/rsos.210219
10.1017/S0033291721004360
10.1098/rsos.200880
10.7205/MILMED-D-13-00017
10.1002/da.22614
10.1002/ajim.23157
10.1136/oemed-2020-107276
10.1002/ajim.23157
10.1016/j.brat.2003.07.010
10.1159/000376585
10.1176/appi.ajp.2011.10111704
10.1207/s15327558ijbm0401_6
10.1097/01.psy.0000145673.84698.18
10.1176/ps.2008.59.1.91
10.1177/070674370905400504
10.1186/1472-6963-12-292
10.3389/fpsyt.2021.804525
10.1002/gps.5562
10.1192/bjo.2021.42
10.1136/bmjopen-2018-025433
10.1016/j.jad.2021.09.098
10.1787/b966f837-en
10.1016/j.envres.2021.110856
10.1073/pnas.2015455118
10.1016/S2666-7568(20)30012-X
10.1016/j.jamda.2020.11.022
10.21953/lse.mlre15e0u6s6
10.1136/bmj.n1868
10.1098/rsos.210219
10.1017/S0033291721004360
10.1098/rsos.200880
10.7205/MILMED-D-13-00017
10.1002/da.22614
10.1002/ajim.23157
10.1136/oemed-2020-107276
10.1002/ajim.23157
10.1016/j.brat.2003.07.010
10.1159/000376585
10.1176/appi.ajp.2011.10111704
10.1207/s15327558ijbm0401_6
10.1097/01.psy.0000145673.84698.18
10.1176/ps.2008.59.1.91
10.1177/070674370905400504
10.1186/1472-6963-12-292
10.3389/fpsyt.2021.804525
10.1002/gps.5562
10.1192/bjo.2021.42
10.1136/bmjopen-2018-025433
10.1016/j.jad.2021.09.098
ISSN
1932-6203