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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Stress responses and health complaints in hospital personnel during the Covid-19 pandemic

Alternative title: Stress og helseplager hos sykehuspersonell under Covid-19 pandemien

Awarded: NOK 5.2 mill.

AIMS OF THE PROJECT The aim of the study is to gain new knowledge about what strains health personnel in hospitals experience during a pandemic, what consequences the experiences have for the individual and point out important measures to reduce stress and health problems. During a pandemic, the efforts of health care personnel are invaluable to maintain adequate care and save lives of critical ill patients in hospitals. The effort can also be very demanding. Knowledge of what health personnel experience during the pandemic and what consequences the experiences have for the individual is necessary to be able to improve working conditions, ensure access to help and support for hospital personnel and contribute to maintaining good preparedness in the health service during crises. The study maps the extra strains and tasks the pandemic entails as well as possible stress reactions, physical and mental symptoms. The project is also concerned with registering positive experiences in the treatment of the sick and what works well in the work situation. In stressful work situations, sleep and rest can be greatly affected, and the study maps both sleep difficulties and fatigue during the four Covid-19 infection peaks in Norway. COOPERATION NATIONALLY AND INTERNATIONALLY Covid-19 is a national and global challenge. Four University Hospitals in Norway (Oslo University Hospital (OUS), Akershus University Hospital (Ahus), St Olav's Hospital and the University Hospital in Northern Norway (UNN) participated in the project. The project also collaborate with a similar study in the US. METHODS 2501 hospital staff participated; In April / June 2020 (T1, N = 689), December 2020 (T2, N = 1089), April 2021 (T3, N = 832), and January 2022 (T4, N = 979). The study is online with identified login and approved by REK (No. 130944). The data collection was carried out in the four infection peaks in Norway. The questionnaire maps contact with infected and sick patients, treatment responsibility for seriously ill Covid-19 patients, training in work tasks and self-care, work situation, access to necessary equipment and infection control and access to social support. All participants were asked if they themselves had been infected with Covid-19, had somatic disorders, symptoms of post-traumatic stress, anxiety and depression and burnout. The study also mapped what health professionals were most proud of having achieved. RESULTS Of 2501 participants, 75% were women, 43.6 (SD = 10.9), 19% were doctors, 46% nurses and 35% other employees. 69% were employees at OUS and Ahus, 31% at St Olavs Hospital and UNN. At T1, the average age was 43 years and on average they had 16 years of clinical experience. Half of the participants had had their work tasks changed during the pandemic. Work environment Most stated that through the pandemic they performed work of high professional quality (best practice) and that they were part of a supportive social environment. At the same time, many reported little access to help and support for stress management. Hospital staff who had worked with patients with Covid-19 reported inadequate competence; lack of predictability and structure; problems with infection control equipment; overwhelming workload; and lack of security compared to colleagues who had not been involved in such work. Personnel involved in the treatment of seriously ill Covid-19 patients more often reported unfavorable working conditions. Health At all four time points, 16-20% of participants reported high or very high levels of somatic health problems, such as headaches, back pain, neck, arm and leg pain, or fainting. Furthermore, approximately 20% reported significant anxiety and depressive symptoms, and 12-17% a high level of burnout symptoms. Approximately 8% met 3 or 4 of 4 PTSD criteria, indicating significant clinical symptoms. The importance of the working environment for health Good working environment was associated with better health among the participants. Being infected with covid-19 in the early stages of the pandemic, as well as experiencing severe covid-19 disease in a close colleague, family or friend, showed an increased risk of PTSD and other mental health problems. In a qualitative part of the study, the participants answered a question about what they were proud to achieve at work. They emphasized that staying in work despite challenging working conditions, helping to deal with the crisis, providing good treatment and care, building preparedness and efficiency in the organization and contributing to collegial cohesion were what they were particularly proud of. Implications for practice The results indicate that the pandemic has greatly affected the working environment and health of employees at Norwegian hospitals. To ensure sustainability, hospitals must proactively counteract these consequences. webinar : https://www.nkvts.no/tv/helsepersonellstudien-covid-19-pandemiens-pavirkning-pa-sykehuspersonells-arbeid

Outcomes In recruitment the project focused on giving short and consistent information of the aims of the project, how to login to the digital platform and to keep the questionnaire as short as possible. Feedback from users shows that even in a very stressful work situation, workers found it useful to participate and have appreciated that the study focus on their situation. Impact: The study has documented important shortcomings in preparedness, both equipment and procedures and clearly documents how this induces extra stress in their already demanding work situation. Workers have described how social support and team based support helped them to carry on during the four waves, but the study also document that the conditions they worked under impacted their somatic and mental health over time.

Background The COVID-19 pandemic is currently spreading rapidly, and critically ill patients are increasingly admitted to hospitals, putting a heavy toll on already highly pressured healthcare systems worldwide. In response to the crisis, there is an urgent need to identify measures to adequately support critical personnel`s efforts and safeguard their physical and psychological health and well-being. Objective This study aims to map Covid-19 related work strain factors and critical incidents and investigate the potential impact on levels of distress and health condition during the outbreak. During the critical phases of the outbreak the study will identify risk factors for distress and health complaints and suggest measures needed to be implemented to reduce their impact. Methods The study recruits health care personnel involved in treatment of hospitalized patients infected of Covid-19 in different hospital units in four regional university hospital in Norway. Participants report on Covid-19 work strain and critical incidents at work, individual and work place related factors, work schedules, levels of psychological distress and health complaints including headache, musculoskeletal pain, sleep problems and burn-out. Sensors measuring activity and rest compliment self-reported data of sleep and rest. In analyses of the data we will apply a mixed methods approach, using qualitative and quantitative data. Participation in the study is based on informed written consent and measures will be taken to protect privacy and ensure voluntary participation. Results This study will provide urgently needed knowledge on how the Covid-19 outbreak impact health care personnel`s work load during the phases of the pandemic and provide critical information to stake holders on risk factors needed to be addressed to reduce work-related stress.

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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester