Psychosocial factors and mental health in Mexican healthcare workers during the COVID-19 pandemic
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Abstract
Objective. To identify levels of stress, burnout, anxiety, and depression and their relationship with negative psychosocial stressors and positive psychosocial resources in healthcare workers in Mexico during the COVID-19 pandemic.
Method. As a part of a larger project in certain Latin American countries, 269 health workers from various Mexican clinics and hospital centers initially participated in a non-experimental, cross-sectional correlational design. Participants were recruited by targeted sampling. Various ultra-brief measures were used to measure symptoms of depression, anxiety, burnout, and stress and a mixed-methods exploration technique was used to identify associated psychosocial factors, which were also explored with cluster analysis.
Results. We found high levels of depressive and anxiety symptoms (56.9% and 74.7%), as well as burnout and stress (49.8% and 46.8%). Although the stressors “infection of self” and “family infection” (38.3% and 30.9%) and the resources “family” and “personal protective equipment” (34.6% and 24.5%) were the most frequent, there were more than 20 factors in each category differentially associated with mental health. Cluster analysis made it possible to identify representative sets of psychosocial variables.
Discussion and conclusion. The increased risk in mental health for health care workers is confirmed in a preliminary way and the stressors and resources to be considered in preventive strategies to address COVID-19 pandemic in Mexico are identified.
References
Agren, D. (2020). Understanding Mexican health worker COVID-19 deaths. The Lancet, 396(10254), 807. doi: 10.1016/s0140-6736(20)31955-3
Aguirre Hernández, R., López Flores, J. F., & Flores Flores, R. C. (2011). Prevalencia de la ansiedad y depresión de médicos residentes de especialidades médicas. Revista Fuente. Universidad Autónoma de Nayarit, 3(8), 28-33.
Badrfam, R., Zandifar, A., & Arbabi, M. (2020). Mental health of medical workers in COVID-19 pandemic: Restrictions and barriers. Journal of Research in Health Sciences, 20(2), e00481. doi: 10.34172/jrhs.2020.16
Bakker, A. B., & Demerouti, E. (2013). La teoría de las demandas y los recursos laborales. Revista de Psicología del Trabajo y de las Organizaciones, 29(3), 107-115. doi: 10.5093/tr2013a16
Ballester Arias, A. R., & García, A. M. (2017). Asociación entre la exposición laboral a factores psicosociales y la existencia de trastornos musculoesqueléticos en personal de enfermería: revisión sistemática y meta-análisis. Revista Española de Salud Pública, 91, 1-27. https://www.redalyc.org/pdf/170/17049838028.pdf
Bong, C.-L., Brasher, C., Chikumba, E., McDougall, R., Mellin-Olsen, J., & Enright, A. (2020). The COVID-19 Pandemic: Effects on Low- and Middle-Income Countries. Anesthesia & Analgesia, 131(1):86-92. doi: 10.1213/ANE.0000000000004846
Chen, Q., Liang, M., Li, Y., Guo, J., Fei, D., Wang, L., … Zhang, Z. (2020). Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry, 7(4), E15-E16. doi: 10.1016/S2215-0366(20)30078-X
Chew, N. W. S., Lee, G. K. H., Tan, B. Y. Q., Jing, M., Goh, Y., Ngiam, N. J. H., … Sharma, V. K. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, Behavior, and Immunity, 88, 559-565. doi: 10.1016/j.bbi.2020.04.049
Cohen, J. (1988). 2.2 - The Effect Size Index: d. In Statistical Power Analysis for the Behavioral Sciences (2nd. ed.), (pp. 20-26). Hillsdale, NJ: Lawrence Erlbaum Associates. Retrieved from https://www.scirp.org/(S(lz5mqp453edsnp55rrgjct55))/reference/ReferencesPapers.aspx?ReferenceID=2041144
Elo, A.-L., Leppänen, A., & Jahkola, A. (2003). Validity of a single-item measure of stress symptoms. Scandinavian Journal of Work, Environment & Health, 29(6), 444-451. doi: 10.5271/sjweh.752
Flores-Jiménez, C. A., & Juárez-García, A. (2016). Factores psicosociales y síndrome de Burnout en instructores comunitarios: una aproximación desde un análisis mixto. Rev Mex Sal Trab, 8(18), 3-9. Retrieved from https://www.imbiomed.com.mx/1/1/articulos.php?method=showDetail&id_articulo=108055&id_seccion=4340&id_ejemplar=10523&id_revista=277
Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Research, 288, 112954. doi: 10.1016/j.psychres.2020.112954
Juárez García, A., & Camacho Ávila, A. (2011). Factores psicosociales de la salud en el trabajo: Análisis de su concepción y base teórica. In Juárez García, A., & Camacho Ávila, A. (Coord). Reflexiones teórico-conceptuales de lo psicosocial en el trabajo (pp. 187-210). México: Juan Pablos Editor / Universidad Autónoma del Estado de Morelos.
Juárez García, A., Flores, C., & Hindrichs, I. (2019). Exploración de factores psicosociales del trabajo mediante una técnica de análisis mixto: La transformación de categorías en variables. In Hindrichs I., (Ed.). Entre el campo y la teoría: Estrategias de categorización inductiva y deductiva en investigación cualitativa. México: El Colegio Mexiquense.
Juárez-García, A. (2007). Factores psicosociales laborales relacionados con la tensión arterial y síntomas cardiovasculares en personal de enfermería en México. Salud Pública de México, 49(2), 109-117.
Juárez-García, A., Flores-Jiménez, C. A., & Pelcastre-Villafuerte, B. E. (2020). Factores psicosociales del trabajo y efectos psicológicos en comerciantes informales en Morelos, México: Una exploración mixta preliminar. Revisa Salud UIS, 52(4), 402-413. doi: 10.18273/revsal.v52n4-2020007
Justus, B., & Uma, A. D. (2016). Governance and Human Development in Gulu District: A Case Study of Gulu Municipality. Open Journal of Business and Management, 4(2), 361-375. doi: 10.4236/ojbm.2016.42039
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., … Hu, S. (2020). Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open, 3(3), e203976. doi: 10.1001/jamanetworkopen.2020.3976
Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., … Brähler, E. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122(1-2), 86-95. doi: 10.1016/j.jad.2009.06.019
Merino-Soto, C., Juárez-García, A., Altamirano-Bringas, A., & Velarde-Mercado, B. (2018). Una medida muy breve del burnout: evidencia de validez de constructo en trabajadores peruanos. Ansiedad y Estrés, 24(2-3), 131-135. doi: 10.1016/j.anyes.2018.07.001
Mommersteeg, P. M., Heijnen, C. J., Kavelaars, A., & van Doornen, L. J. (2006). Immune and endocrine function in burnout syndrome. Psychosomatic Medicine, 68(6), 879-886. doi: 10.1097/01.psy.0000239247.47581.0c
Organización Internacional del Trabajo [OIT]. (2020). Frente a la pandemia: Garantizar la seguridad y salud en el trabajo (pp. 1-56). Ginebra: OIT. Retrieved from https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_742732.pdf
Osorio Escobar, M. P. (2011). El trabajo y los factores de riesgo psicosociales: Qué son y cómo se evalúan. Revista CES Salud Pública, 2(1), 74-79. Retrieved from https://dialnet.unirioja.es/servlet/articulo?codigo=3677224
Palmer, A., Jiménez, R., & Montaño, J. J. (2000). Tutorial sobre coeficientes de correlación con una o dos variables categóricas. Revista Electrónica de Psicología, 4(2), 1-19. Retrieved from https://www.researchgate.net/publication/331640990_Tutorial_sobre_coeficientes_de_correlacion_con_una_o_dos_variables_categoricas
Pardo Merino, A., & Ruiz Diaz, M. A. (2002). SPSS 11: Guía para el análisis de datos. Mcgraw-Hill / Interamericana de España. Retrieved from https://www.researchgate.net/publication/231336531_SPSS_11_Guia_para_el_analisis_de_datos
Secretaría de Salud. (1987). Reglamento de la Ley General de Salud en Materia de Investigaciones para la Salud. Retrieved from http://www.salud.gob.mx/unidades/cdi/nom/compi/rlgsmis.html
Shanafelt, T. D., Balch, C. M., Bechamps, G., Russell, T., Dyrbye, L., Satele, D., ... Freischlag, J. (2010). Burnout and medical errors among American surgeons. Annals of Surgery, 251(6), 995-1000. doi: 10.1097/SLA.0b013e3181bfdab3
Spoorthy, M. S., Pratapa, S. K., & Mahant, S. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian Journal of Psychiatry, 51, 102119. doi: 10.1016/j.ajp.2020.102119
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509. doi: 10.1377/hlthaff.2011.1377
Toribio, L. (2020). Coronavirus - ‘Personal de salud se siente en riesgo’: encuesta de la UNAM. Excelsior. Retrieved from https://www.excelsior.com.mx/nacional/personal-de-salud-se-siente-en-riesgo-encuesta-de-la-unam/1387526
Tsamakis, K., Rizos, E., Manolis, A., Chaidou, S., Kympouropoulos, S., Spartalis, E., … Triantafyllis, A. (2020). [Comment] COVID-19 pandemic and its impact on mental health of healthcare professionals. Experimental and Therapeutic Medicine, 19(6), 3451-3453. doi: 10.3892/etm.2020.8646
United Nations [UN]. (2020). Policy Brief : COVID-19 and the Need for Action on Mental Health. Executive Summary: COVID-19 and the Need for Action on Mental Health. Geneva, Switzerland: World Health Organization. Retrieved from https://www.un.org/sites/un2.un.org/files/un_policy_brief-covid_and_mental_health_final.pdf
Vilà Baños, R., Rubio Hurtado, M., Berlanga Silvente, V., & Torrado Fonseca,M. (2014). Cómo aplicar un cluster jerárquico en SPSS. REIRE: Revista d’Innovació i Recerca en Educació, 7(1), 113-127. doi: 10.1344/reire2014.7.1717
World Health Organization [WHO]. (2020). Substantial investment needed to avert mental health crisis. WHO. Retrieved from https://www.who.int/news-room/detail/14-05-2020-substantial-investment-needed-to-avert-mental-health-crisis
World Medical Association [WMA]. (2013). Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres humanos. World Medical Association, Inc. doi: 10.1001/jama.2013.281053
Wu, P. E., Styra, R., & Gold, W. L. (2020). Mitigating the psychological effects of COVID-19 on health care workers. CMAJ, 192(17), E459-E460. doi: 10.1503/cmaj.200519
Zhang, W.-R., Wang, K., Yin, L., Zhao, W.-F., Xue, Q., Peng, M., … Wang, H.-X. (2020). Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China. Psychotherapy and Psychosomatics, 89(4):242-250. doi: 10.1159/000507639