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      Psychological Distress, Fear of COVID-19, and Resilient Coping Abilities among Healthcare Workers in a Tertiary First-Line Hospital during the Coronavirus Pandemic

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          Abstract

          The COVID-19 pandemic is causing a heavy burden in hospital healthcare workers (HCW) in terms of increased work, organizational changes, risk exposure, and social stigma. The present study aims at evaluating the psychological outcome among HCWs at the final stages of the first wave of the COVID-19 pandemic. This cross-sectional and survey-based study was conducted during June 2020 among 996 HCWs of the University Hospital of Padova. All the subjects completed questionnaires investigating the perception of risk of infecting or being infected by COVID-19, psychopathological variables, and coping abilities. Compared to physicians and healthcare assistants, nurses showed higher levels of depression ( p = 0.002), insomnia ( p < 0.001), and generalized anxiety ( p = 0.001). Females reported increased concerns about the possibility of infecting others ( p = 0.046), greater anxiety ( p < 0.001), COVID-19 related fears ( p < 0.001), depression ( p < 0.001), and post-traumatic distress ( p < 0.001) than males. Being employed in a COVID-19 unit, being transferred to other units, and living with children and the elderly were factors associated with higher levels of psychological distress. Greater coping abilities were detected in physicians, and in those HCWs employed in COVID units. Our findings evidenced that the psychological consequences of the pandemic were non-homogeneously distributed across HCWs categories and pointed out the presence of specific in-hospital and out-of-hospital risk factors.

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          Most cited references37

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

              Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                02 April 2021
                April 2021
                : 10
                : 7
                : 1465
                Affiliations
                [1 ]Department of Neurosciences, University of Padua, 35128 Padova, Italy; valentina.meregalli@ 123456studenti.unipd.it
                [2 ]Department of Directional Hospital Management, Padua University Hospital, 35128 Padova, Italy; annamaria.saieva@ 123456aopd.veneto.it (A.M.S.); cristian.girotto@ 123456aopd.veneto.it (C.G.); giovanni.carretta@ 123456aopd.veneto.it (G.C.); derisgianni.boemo@ 123456aopd.veneto.it (D.G.B.); greta.bordignon@ 123456aopd.veneto.it (G.B.); alfio.capizzi@ 123456aopd.veneto.it (A.C.); cristina.contessa@ 123456aopd.veneto.it (C.C.); mariavittoria.nesoti@ 123456aopd.veneto.it (M.V.N.); daniele.donato@ 123456aopd.veneto.it (D.D.)
                [3 ]Padua Neuroscience Center, University of Padua, 35128 Padova, Italy
                [4 ]Associazione Novilunio Onlus, 35020 Ponte San Nicolò (PD), Italy; luca.flesia@ 123456ordinepsicologiveneto.it
                Author notes
                Author information
                https://orcid.org/0000-0002-6730-1778
                https://orcid.org/0000-0003-0016-1237
                https://orcid.org/0000-0001-7346-9334
                https://orcid.org/0000-0003-2482-789X
                https://orcid.org/0000-0003-0841-5174
                https://orcid.org/0000-0002-6540-5194
                Article
                jcm-10-01465
                10.3390/jcm10071465
                8038142
                33918169
                f9d89ad1-c5c5-4f44-8f17-11630fbcc9ab
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 26 February 2021
                : 26 March 2021
                Categories
                Article

                coronavirus,covid-19,health care workers,mental health,depression,anxiety,insomnia,coping abilities

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