Psychological impact of the COVID-19 pandemic on hospital workers over time: Relationship to occupational role, living with children and elders, and modifiable factors

Abstract

Objective: The COVID-19 pandemic is expected to have a sustained psychological impact on healthcare workers. We assessed individual characteristics related to changes in emotional exhaustion and psychological distress over time.

Methods: A survey of diverse hospital staff measured emotional exhaustion (Maslach Burnout Inventory) and psychological distress (K6) in Fall 2020 (T₁) and Winter 2021 (T₂). Relationships between occupational, personal, and psychological variables were assessed using repeated measures ANOVA.

Results: Of 539 T₁ participants, 484 (89.9%) completed T₂. Emotional exhaustion differed by occupational role (F = 7.3, p < .001; greatest in nurses), with increases over time in those with children (F = 8.5, p = .004) or elders (F = 4.0, p = .047). Psychological distress was inversely related to pandemic self-efficacy (F = 110.0, p < .001), with increases over time in those with children (F = 7.0, p = .008). Severe emotional exhaustion occurred in 41.1% (95%CI 36.6-45.4) at T₁ and 49.8% (95%CI 45.4-54.2) at T₂ (McNemar test p < .001). Psychological distress occurred in 9.7% (95%CI 7.1-12.2) at T₁ and 11.6% (95%CI 8.8-14.4) at T₂ (McNemar test p = .33).

Conclusions: Healthcare workers' psychological burden is high and rising as the pandemic persists. Ongoing support is warranted, especially for nurses and those with children and elders at home. Modifiable protective factors, restorative sleep and self-efficacy, merit special attention.

Keywords: Burnout; Covid-19; Healthcare workers; Mental health; Nursing; Occupational health.

Fig. 1

Significant relationships between emotional exhaustion in September–November 2020 (T₁) and January–February 2021 (T₂) and occupational or personal variables (as reported at T₁). The cut-off for severe burnout (≥27), measured using the emotional exhaustion scale of the Maslach Burnout Inventory, is indicated by a dashed line on each panel.

Fig. 2

Significant relationships between psychological distress in September–November 2020 (T₁) and January–February 2021 (T₂) and occupational or personal variables (as reported at T₁). The cut-off for severe psychological distress (≥13), as measured by the Kessler K6, is indicated by a dashed line and darker shaded region on each panel. The cut-off for medium distress (5 ≤ K6 < 13) is indicated by a dashed line and a lighter shaded region on each panel.