Imagine going into a hospital to ask for help, but there are no doctors or nursing staff there. You may think that would be outrageous, but the fact is NHS healthcare workers (HCWs) consistently left their jobs during the COVID-19 pandemic.
Throughout the pandemic, HCWs have suffered from numerous challenges, including increased workloads and witnessing patients’ infections or death. Substantial research evidence shows these challenges are associated with an increased risk of burnout and post-traumatic stress disorder (PTSD). Burnout refers to prolonged physical and psychological work-related exhaustion, whereas PTSD is a mental health issue triggered by having experienced traumatic events.
Why should we consider the mental health of research staff during the pandemic?
Most research in this field focuses on doctors and nurses, while other HCWs such as research staff receive very little attention. But during the pandemic, the work duties of research staff are more important and difficult than can be imagined.
Due to the urgency of the pandemic, numerous research nurses had to suspend their original research and switch to research related to Covid, which often required contacting patients to collect virus samples. Due to workforce shortage, numerous research staff was redeployed to other positions, including ICU. Considering the mental health status of doctors during the pandemic, it was likely that research staff had also experienced work-related burnout and PTSD symptoms.
The poor mental health of HCWs is associated with lower work quality and increased turnover rate, thus causing the development of interventions for COVID-19 to be suspended. Currently, the impact of COVID-19 and its variants such as Omicron is still widespread. To ensure patients can get high-quality interventions when they are sick, and remove COVID-19 as soon as possible, it is crucial to understand research staff’ mental well-being during the pandemic.
What factors put HCWs at higher risk of burnout and PTSD?
Evidence shows that HCWs who are female, redeployed, younger and have fewer years of working, have a higher risk of mental health issues during the pandemic. What makes these characteristics stand out? While it is difficult to fully explain the underlying mechanisms, I listed several possible explanations below.
- Females’ menstrual period and pregnancy can lead to anxiety and burnout, which can be amplified in a stressful environment.
- Younger HCWs with fewer years of working typically have lower resilience. Resilience is the process and outcome of successfully adapting to challenging life experiences, which can protect people against mental health problems. Older HCWs with more years of working are more likely to have had similar experiences, such as fighting the SARS pandemic, and thus be less stressed and anxious when facing the COVID-19 pandemic.
- Redeployment frequently leads to HCWs working in unfamiliar or even high-risk units, which increases their burnout and stress.
What did we study?
Our research investigated the level of burnout and psychological stress of research staff during the pandemic, and the relationship between their characteristics and mental well-being. We hypothesized that research staff would get higher scores on burnout and PTSD measurement tools than cut-off scores; being female, younger, redeployed and with fewer working years would score a higher level of burnout and PTSD compared to research staff who are male, older, not redeployed and have worked for longer.
133 NHS research staff was recruited to complete the survey which contains a demographic form, Copenhagen Burnout Inventory (CBI), and the Impact of Event Scale-Revised (IES-R). Demographic form collected data inclusive of age, gender, years of working, and redeployment status. CBI was used to measure the level of burnout and IES-R was used to measure PTSD symptoms.
Results
1: The average score of CBI was 42.46, which represented a low level of burnout; the average score of IES-R was 16.66, which represented a mild level of PTSD symptoms. The clinical cutoff point of IES-R was 33, a score of 33 or above was recommended as the provisional diagnosis of PTSD.
2: We found a positive correlation with small strength between age and CBI scores, and a positive correlation with small strength was found between age and IES-R scores. These represent the younger age group, the lower level of burnout and PTSD symptoms. Nevertheless, these two correlations were not statistically significant, because these relationships may be observed by chance. There were no statistically significant differences in burnout and PTSD levels between males and females; redeployed and no redeployed; short or long work years.
What we learnt from the findings and implications.
Our findings did not support our hypothesis, in which the average scores of CBI and IES-R were low to mild. This may be because the worst wave of the pandemic has passed. Although the pandemic still affects people, the healthcare system may have recovered from exhaustion. Nevertheless, some research staff still experience moderate to high levels of burnout and PTSD symptoms. Healthcare institutions should pay attention and provide them with interventions if needed.
Gender, redeployment status, age, and years of work did not affect the level of burnout and PTSD of research staff, which was inconsistent with previous findings. This is understandable as most prior studies focus on doctors and nurses, and the job differences between doctors and research staff may result in gaps in findings. Future research should aim to examine other key characteristics such as marital status and history of mental illness.
What did we improve and what can we do better.
- Our study was the first to focus on the mental health of research staff during the pandemic. Future studies could pay attention to other HCWs who receive less academic attention.
- We used standardised tools, CBI and IES-R, which allowed comparison between our data and data of studies not using these tools.
- Only quantitative data were collected; qualitative data to gather the thoughts of research staff is lacking.
- Our study only recruited participants from Britain, which will limit the generalizability of the findings to research staff in other countries.
References
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