Day to Day and Environmental Risk Factors for Psychological Distress Among Healthcare Workers: A Mixed Methods
Kaitlyn Atkins1, Erin E Cooney, Soim Park
1From the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (K.A.); Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (K.A., E.E.C., S.P., S.C., P.J.S., H.C.M.); Johns Hopkins School of Nursing, Baltimore, Maryland (S.S.-F.); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health (L.G.K., J.T.); Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland (L.G.K.); Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (T.G.V.); and Center for Health Security, Johns Hopkins University, Baltimore, Maryland (T.G.V.).
Workplace factors significantly increased psychological distress for health and hospital workers during COVID-19, especially nonclinical staff. Mental health support reduced this distress, highlighting the need for institutional support during crises.
Area of Science:
- Occupational Health
- Psychology
- Public Health
Background:
- Limited research exists on psychological distress among nonclinical healthcare staff during the COVID-19 pandemic.
- Workplace inequalities may significantly contribute to distress in health and hospital workers (HHWs).
Purpose of the Study:
- To examine workplace factors influencing psychological distress in diverse clinical, nonclinical, and other HHWs.
- To identify risk factors for severe psychological distress among HHWs during the pandemic.
Main Methods:
- Convergent parallel mixed-methods study utilizing online surveys (n=1127) and interviews (n=73).
- Data collected from August 2020 to January 2021 in a US hospital system.
- Thematic analysis of interviews and log binomial regression to identify risk factors for severe psychological distress (PHQ-4 score ≥ 9).
Main Results:
- Qualitative findings revealed daily stressors, fear, anxiety, and feelings of betrayal due to workplace environments and leadership.
- Distress was linked to burnout, financial concerns, and lack of institutional support.
- Nonclinical (service) roles showed a higher risk for severe distress (aPR=2.04), while access to workplace mental health support reduced risk (aPR=0.52).
Conclusions:
- The COVID-19 pandemic exacerbated existing inequalities, increasing distress among vulnerable HHWs.
- Workplace mental health initiatives are crucial for supporting HHWs during crises and beyond.
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