CoPE-HCP: COVID19 and Physical and Emotional wellbeing of HCP [COVID-19]
Research type
Research Study
Full title
Effect of COVID-19 on immediate and mid-term physical, behavioural and mental health of healthcare professionals: A cohort study of doctor, nurses and other health care professionals
IRAS ID
284686
Contact name
Ajay Gupta
Contact email
Sponsor organisation
Joint Research Management Office
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Research summary
The current COVID-19 pandemic has affected more than 3 million people worldwide across more than 200 countries. In the United Kingdom alone, there are almost 160,000 confirmed cases with more than 20,000 deaths. This has undoubtedly had significant physical and economical impact on the public.\n\nHealthcare workers are at high risk of developing life-threatening infectious diseases with increased exposure to patients’ blood and bodily fluids. As such, health care workers arguably experience heightened anxiety and are predisposed to greater negative psycho-social impact from the current COVID-19 pandemic.\n\nThe aim of this study is to evaluate the physical and psychological impact of COVID-19 on healthcare workers. This will be performed in two phases. In phase 1, we will collect information to evaluate the current psychiatric symptom profile (in particular, screening for anxiety or depression related symptoms), alcohol use, sleep-related complaints and overall well-being among healthcare workers who participate in this survey (with a focus on junior doctors). In addition, we will assess the association of these mental health and behavioural parameters with the prevalence of stressful occasions, such as long-hours, unpredictability of work / redeployment, availability of personal protection equipment and concerns regarding family/relationship and self.\n\nIn phase 2, we will then reassess for the development or progression of psychiatric symptoms, use of alcohol and other substances, behavioural or interpersonal relationship changes as well as physical well-being at 6 weeks and 4- months. Physical well-being is assessed through the presence of suspected or confirmed COVID-19 infection and absence from work. Specifically, we will study the impact of variable provision of personal protection equipment (supply and training), extended working hours, and concern for well-being of family members, on work morale and anxiety levels. We aim to also study the longer term mental health consequences of the current pandemic on health care workers.Lay summary of study results
Thank you to the study participants. This study was carried out by researchers based in William Harvey Research Institute (Queen Mary University of London) and Barts Health NHS Trust. Funding for this study was supported by Barts Charity.
The aims of this study were to evaluate the psychological impact of the COVID-19 pandemic on healthcare workers, to examine potential disparities in mental health between different professional roles, and to identify the potential strategies to help mitigate adverse mental health and burnout amongst these staff.
1,574 healthcare professionals and 147 non-healthcare professionals took part in the online survey (July-September 2020) and were followed up 6-weeks (October 2020), and 4-months later (December 2020-March 2021). 400 healthcare professionals also completed a 3-year follow-up survey (August 2023). Each survey included validated screening tools for mental health, wellbeing, and burnout, and gathered data on lifestyle and information about their work.
Firstly, we found an increased risk of burnout amongst healthcare professionals as compared to non-healthcare professionals, and this elevated risk of burnout increased over the 4-month period. We also found that, amongst healthcare professionals, those in patient facing roles had an increased risk of burnout as compared to those in non-patient facing roles.
Secondly, as compared to medical doctors, we found that nurses were at an increased risk of depression and insomnia, and allied health professionals (e.g. pharmacists) were at an increased risk of depression and burnout. Over the 4-month period, the risk of adverse mental health, poor mental wellbeing, and burnout amongst nurses as compared to medical doctors increased. These findings will help the prioritization and tailoring of mental health and burnout interventions for specific healthcare roles in a pandemic scenario.
Third, regarding potential strategies to help mitigate adverse mental health in healthcare professionals, we found that improvement in the perceived level of workplace support was associated with improved mental health and burnout during the pandemic. The participants also described what constitutes effective workplace support in a pandemic setting: a genuine understanding for welfare from managers, clear and transparent information, appropriate levels of staffing and PPE, visible leadership, and peer support.
Fourth, we found that improved lifestyle was associated with improved depression, anxiety, and mental wellbeing over a 4-month period, indicating that improvements in lifestyle (e.g. increased physical activity) should be encouraged as a possible strategy to support the mental health of healthcare professionals.
Fifth, building on the findings concerning workplace support and using data collected post-pandemic (August 2023), we showed that greater levels of the perceived level of peer support, genuine understanding for welfare from managers, and visible leadership were associated with reduced adverse mental health amongst healthcare professionals, and hence important components of workplace support.
Finally, we showed that improvements in the perceived level of workplace support over a 3-year period was associated with a 15% reduced risk of intending to leave work, and that higher levels of depression are associated with a 10% increased risk of intending to leave work.
To summarise our learnings from the CoPE-HCP study, we recommend that healthcare employers implement programmes to help improve coping and resilience, facilitating healthy lifestyle, and ensure availability of clinical therapeutic strategies delivered by trained mental health professionals. In addition, we recommend that employers ensure good quality workplace support, primarily facilitating collegial support and ensuring good leadership qualities: managers showing genuine understanding for the welfare of their staff, and visible and approachable leadership. Investment in these strategies will help reduce staff attrition in the long-term and may bring subsequent cost-benefit to healthcare systems.
REC name
East of England - Cambridge East Research Ethics Committee
REC reference
20/EE/0166
Date of REC Opinion
15 Jul 2020
REC opinion
Further Information Favourable Opinion