Healthcare Workers at a High Risk of Clinical Depression Following Pandemic

New research shows work is a major risk factor related to depression rates, particularly during the COVID-19 pandemic.

“These results provide potential explanations for the likely causes of poor psychological health amongst HCWs,” the authors wrote. “We propose several potential interventions related to professional factors and health risk behaviors.”

A team, led by Guillaume Fond, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, determined the rate of clinical depression in a national sample of healthcare workers in France following the COVID-19 pandemic and identified related factors, including professional, individual, and health-related risk behaviors.

The Problem

In recent years, investigators have found that work is a major determinant of physical and mental health, with healthcare workers being especially prone to depression during the COVID-19 pandemic. This can have a direct impact on care quality and productivity.

In the study, the investigators sent a survey with a number of standardized scales to public and private healthcare facilitates through the mail or disseminated the surveys through emails from professional associations and social networks.

The investigators identified the related factors using a structural equation modelling analysis.

The Survey

Overall, the surveys were sent to 10,325 individuals, 30.2% (n = 3122; 95% CI, 29.4-31.1) of which met the likely diagnostic criteria for clinical depression.

The largest effect for clinical depression were professional factors (β = 0.57; burn-out, β = 0.74; sustained bullying at the workplace, β = 0.48 and decision-making latitude, β = -0.47). This was followed by individual factors (β = 0.30; the main individual factor was recurrent major depression, path coefficient = 0.67).

In addition, the survey results show professional factors had both a direct (path coefficient = 0.38) and indirect (through health risk behaviors, path coefficient = 0.19) effect on depression, as did individual factors (direct; path coefficient = 0.21; indirect: through health risk behaviors, path coefficient = 0.09).

On the other hand, health risk behaviors only had a direct effect on depression (path coefficient = 0.31).

“Our results suggest that improving organizational issues, reducing exposure to potentially morally injurious events, promoting brief naps at work and provision of evidence-based prevention approaches have been reported to be helpful in supporting the mental health of hospital staff not only relaxation or stress management but training in leadership aspects, increasing the knowledge and practice of giving efficient performance feedback, reducing conflicting demands and peer support programs such as Trauma Risk Management,” the authors wrote. “Our data suggest that developing caregivers reported experience and outcomes measures (CREMs/CROMs) would be helpful to monitor work environment and its effect on depression in healthcare workers.”

The study, “Depression in healthcare workers: results from the nationwide AMADEUS survey,” was published online in the International Journal of Nursing Studies.