Worsening of mental health outcomes in nursing home staff during the COVID-19 pandemic in Ireland

• Published in: PloS one Vol. 18; no. 9; p. e0291988
• Main Authors: Brady, Conan, Shackleton, Ellie, Fenton, Caoimhe, Loughran, Orlaith, Hayes, Blánaid, Hennessy, Martina, Higgins, Agnes, Leroi, Iracema, Shanagher, Deirdre, McLoughlin, Declan M
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 26-09-2023; Public Library of Science (PLoS)
• Subjects: Altruism; Beliefs, opinions and attitudes; Care and treatment; Coping; COVID-19; COVID-19 vaccines; Depression, Mental; Disease transmission; Employees; Health aspects; Health services; Health surveys; Immunization; Job stress; Likert scale; Management; Medical personnel; Medicine and Health Sciences; Mental disorders; Mental health; Mental health care; Moral injury; Mortality; Nursing homes; Occupational health; Pandemics; People and places; Perceptions; Polls & surveys; Post traumatic stress disorder; Privacy; Protective equipment; Psychological aspects; Psychological stress; Research and Analysis Methods; Research ethics; Social interactions; Staff participation; Styles; Suicidal behavior; Surveys; Vaccination; Well being; Working conditions; World health; Ireland; United Kingdom; United Kingdom > UK; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0291988

Mental health issues in nursing home staff during the COVID-19 pandemic have been significant; however, it is not known if these issues persist following widespread vaccination and easing of restrictions. To quantify the mental health of nursing home staff at different timepoints during the COVID-19 pandemic in the Republic of Ireland. Two identical, online, cross-sectional, nationwide, anonymous surveys of Republic of Ireland nursing home staff at two timepoints (survey 1 (S1, n = 390): November 2020 to January 2021; survey 2 (S2, N = 229: November 2021 to February 2022) during the COVID-19 pandemic. Convenience sampling was used with staff self-selecting for participation. Methods included the World Health Organisation's Well-Being Index (WHO-5), the Impact of Events Scale-Revised (IES-R), the Moral Injury Events Scale (MIES), two Likert-scale items regarding suicidal ideation and planning, the Work Ability Score (WAS), the Brief Coping Orientation to Problems Experienced (Brief-COPE) Scale, and a 15-item questionnaire assessing perceptions of the outbreak with one additional Likert-scale item on altruism. Descriptive analysis examined differences between staff based on their classification in one of three groups: nurses, healthcare assistants (HCA) and nonclinical staff. Pseudonymous identifiers were used to link responses across surveys. An insufficient number of participants completed both surveys for linked analyses to be performed; therefore, we performed an ecological comparison between these two independent surveys. More staff reported moderate-severe post-traumatic stress symptoms (S1 45%; S2 65%), depression (S1: 39%; S2 57%), suicidal ideation (S1: 14%; S2 18%) and suicidal planning (S1: 9%; S2 15%) later in the pandemic. There was a higher degree of moral injury at S2 (S1: 20.8 standard deviation (SD) 9.1; S2: 25.7 SD (11.3)) and use of avoidant (maladaptive) coping styles at S2 (S1: 20.8 (6.3); S2 23.0 (6.3)) with no notable differences found in the use of approach (adaptive) coping styles. Staff reported more concerns at S2 regarding contracting COVID-19, social stigma, job stress, doubts about personal protective equipment and systems and processes. In comparison to our previous survey, mental health outcomes appear to have worsened, coping did not improve, and staff concerns, and worries appear to have increased as the pandemic progressed. Follow-up studies could help to clarify is there are any lingering problems and to assess if these issues are related to the pandemic and working conditions in nursing homes.