Evaluating the psychological impacts related to COVID-19 of healthcare workers and some associated factors in Hanoi in 2020

-■c -ÍM Qỉ ugc V Hl ACKNOWLEDGMENT First and foremost I would like to acknowledge to my thesis advisorAssoc Prof Le Thi Thanh Xuan who had directly guided and created necessary conditions for me to participate in Illis research With her dedication, patience, intellectual guidance I had a precious opportunity to learn more about academic skills along with accomplishing my final thesis My journey along with this research allowed me to come in contact with medical managers and healthcare workers Their thorough, objective renews contributed immeasurably in the desired outcome of this work My sincere appreciation also goes to the health workers in range of departments in Hanoi’s health care facilities, for participating and providing data for the research The successful navigation through the university met various obstacles that would not have been suipassed without the guidance from all lecturers of Hanoi Medical University; particularly lectureis from School of Preventive Medicine and Public HealtíL Last but not least, mam' thanks were given to my family and friends who encourage me throughout the period of difficulties Hanoi 25* May 2021 Tran Thỉ Thuy Lỉnh r-u -ÍM Qỉ ugc V Hl DECLARATION Respectfully addressed to: Department of Under- Graduation Training Hanoi Medical University - Department of Occupational Health School of Preventive Medicine and Public Health - Board of Dissertation Assessment I guarantee that this study is my scientific research which I carried out as one of the main investigators The- results and figures in this research collected are accurate and have not been published and reported in any other publications I will be responsible for any delusion detected Hanoi 25* May 2021 The Author Tran Thí Thuy Linh CONTENTS 3.1 Some factors associated with mental health problems of respondents 29 REFERENCES APPENDIX APPENDIX -■c -ÍM Qỉ ugc V Hl ABBREMATIOXS ARDS CDC Acute Respiratory Distress Syndrome Disease Control Center IES-R ILO Impact of Event Scale - Revised International Labor Organization MERS-CoV PPE Middle East Coronavirus Respiratory Syndrome Personal Protective Equipment SARS Severe Acute Respiratory Syndrome SARS-CoV-2 WHO Corona\irus-2 Acute Respiratory Syndrome World Health Organization PTSD Post Traumatic Stress Disorder LIST OF TABLES Table 3.11 Association between mental health problems and education levels 31 Table 3.12 Association between mental health problems and marital status 31 Table 3.13 Association between mental health problems and person liũng with 32 Table 3.14 Association between mental health problems and level of hospital 33 Table 3.21 Association between mental health problems and perception at LIST OF FIGURES r-u -ÍM CỊỈ ugc V Hl ABSTRACT Reasonale : The COVID-19 pandemic has affected the economy, politics in general, and people worldwide The global problem is how to cure patients with COVID-19 and keep the disease under control This issue is not only a challenging and urgent problem for the state, senior officials, and even the people Besides, few people concerned about healthcare workers' mental health the frontline force of disease prevention and treatment Problem: The study aimed to determine tire mental health issues of healthcare workers in Vietnam during the COVID-19 pandemic because this issue lias not been paid much attention in Vietnam Meanwhile there are a lot of research on this issue in tire health force around the world I hope that this study will help policy makers have a timely solution to discover and support by their medical staff and medical managers Methods: We conducted n = 2157 healthcare workers in Hanoi through an online survey using snowball sampling technique Results: The degree of symptoms of depression anxiety, insomnia, and distress was assessed by the 22-item Impact of Event Scale-Revised Three crucial factors related to the mental health of healthcare workers found in tire study are fear of infection, fear of infecting to family members, and fear of suffering the disease This problem drew the lesson that not only citizents but also healthcare workers have concerns about COVID-19 in general Conclusion: Our findings observed healthcare workers faced with mental health problems and therefore, theyare also needed support from the authorities, medical managers, and families in terns of mental health Key words : The COVID-19 pandemic, healthcare workers, mental health INTRODUCTION The outbreak of a new coronavirus infection (COVID-19) on 31 December 2019 among humans in Wuhan (China) spread quickly to others locations in both China and over the world ! Coronaviruses can cause cold with major symptoms, such as fever, and a sore throat from swollen adenoids The human coronavirus discovered in 2003 SARS-CoV which causes severe acute respiratory syndrome (SARS) lias a unique pathogenesis because it causes both upper and lower respiratory' tract infections It is estimated that in the early’ stages, the mortality rate of epidemics worldwide is estimated to be about 2% with the majority of deaths occuning in special populations such as background pathology, weakened immune system and the elderly people ’ In the face of the complexity of the epidemic, on March 11 2020 WHO officially declared the outbreak of acute respiratory infections caused by the new sttain of the Corona virus as a “Global Pan-Epidemic" and as of mid-April 2020 more Ilian 200 countries have recorded epidemics with the total number of cases having reached millions and hundreds of thousands of deaths As of 20 April 2021 there have been at least 032 124 confirmed deaths and more than 142 238 073 confirmed cases in the COVID- 19 pandemic and occuring in all countries in die world6 COVID-19 raises an increasing amount of information and concerns are impacting on global mental health Global media, local and international health organizations (including World Health Organization), epidemiologists, virologists and opinion-makers put out information, recommendations and minute-byminute updates on COVID-19 spreading and lethality Nevertheless, the burden of this infection on the global mental health is currently neglected even if it may challenge patients, general population, as well as policy makers and health care workers Although there have been many- studies on mental health during the COVID-19 epidemic, most are concentrated in countries with large outbreaks such as the Brazil UK China ' In Vietnam on May 19 2021 there were 4.543 cases of COVID-19; 37 deaths and 2.687 recovery cases Hanoi Da Nang, Quang Nam and Ho C1Ú Minh City are the provinces with the highest number of COVID-19 cases in Vietnam Thus, we conducted research “Evaluating the psychological impacts related to COVTD-19 of healthcare workers and associated factors in Hanoi 2020" with two following objectives: To describe the psychological impacts of healthcare workers during the cot 1D-19 pandemic in Hanoi, 2020 To (f escribe some of relative factors with in theHanoi, 2020 psychological impacts healthcare workers responses to the novel 2019 coronaxinis (2019-nCoV) in Japan: Mental health consequences and target populations Psychiatry and clinical neurosciences Apr 2020:74(4):281-282 doi: 10.1111/pcn 1298S 51 Zandifar A Badríàm R Iranian mental health during the COVID-19 epidemic Asian J Psychiatr Jun 2020:51:101990 doi: 10.1016/ j.ajp.2020.101990 52 Tsang HW, Scudds RJ Chan EY Psychosocial impact of SARS Emerging infectious diseases Jul 2004; 10(7): 1326-7 doi:10 3201/ eidl 007.040090 53 Nickell LA Crighton EJ Tracy cs et al Psychosocial effects of SARS on hospital staff: survey of a large tertiary’ care institution CMAJ : Canadian Medical Association journal = journal de I'Association medicale canadienne Mar 2004:170(5):793-8 doi: 10.1503 /cmaj 1031077 54 Sim K Huak Clan Y Chong PN Chua HC Wen Soon s Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease Journal of psychosomatic research Feb 2010;68(2):195-202 doi:10 1016/ j.jpsychores 2009 04.004 Parmet WE Sinha MS Covid-19 - The Law and Limits of9 2020:382(15):e28 Quarantine The New doi: England 10.1056'NEJMp2004211 journal of medicine Apr 55 pfefferbaum B North cs Mental Health and the Covid-19 Pandemic 2020;383(6):510-512 doi: 10.1056/NE JMp2008017 56 Rubin GJ Wessely s The psychological effects of quarantining a city (Clinical research ed) Jan 28 2020;368:m313 doi: 10.1136/ bmj.m313 57 Brooks SK Webster RK Smith LE et al The psychological impact of quarantine and how to reduce it: rapid review of the evidence Lancet (Landon England) Mar 14 2020;395(10227):912-920 doi: 10.1016/ SO 1406736(20)30460-8 58 Ozamiz-Etxebarria N Idoiaga Mondragon N Dosil Santamaria M Picaza Gorrotxategi M Psychological Symptoms During the Two Stages of Lockdown in Response to the COVID-19 Outbreak: An Investigation in a Sample of Citizens in Northern Spain Frontiers in psychology 2020;l 1:1491 doi:10.3389/fpsyg.2020.01491 59 Roy D Tripathy s Kai' SK Shanna N Verma SK Kaushal V Study of -c -ÍM CỊỈ ugc V Hl knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic Asian J Psychiatr 2020;51:102083102083 doi: 10.1016/j.ajp.2020.102083 60 Giorgi G Lecca LI Alessio F et al CO\TD-19-Related Mental Health Effects in the Workplace: A Narrative Review Int J Environ Res Public Health Oct 27 2020;17(21)doi:10.3390/ijeiphl7217857 61 Li DJ, Ko NY Chen YL et al COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey hit J Diviron Res Public Health Jun 22 2020; 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S24682667(20)30061-X 73 d'Ettorre G Ceccarelli G Santinelli L et al Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review ỉnt J Environ Res Public Health 2021:18(2):601 doi: 10.3390/ijerphl 8020601 74 Creamer M Bell R Failla s Psychometric properties of the Impact of Event Scale - Revised Behaviour research and therapy Dec 2003;41(12): 14S9-96 doi: 10.1016/j.brat.2003.07.010 75 D.s w The Impact of Event Scale: Revised Cross-Cultural Assessment of Psychological Trauma and PTSD: a practitioner’s handbook 2007;(2nd ed):168lS9 springer Boston MA doi: https:// doi.org/ 10.1007/978-0-387-70990-1_ 10 76 Wu KK Chan KS The development of the Chinese version of Impact of Event Scale Reused (CIES-R) Social Psychiatry and Psychiatric Epidemiology 2003/02/01 2003;38(2):94-98 doi: 10.1007/S00127-003- 0611-x 77 Nguyen Văn Tuyên Thực trạng vã số yếu tố liên quan đến cảng tháng cua Điều dưỡng viên lảm sàng Bệnh viện da khoa tinh Bính Định, nãnt 2015 (In English: Situation and some stress-related factors of Clinical Nurse of Binh Dinh General Hospital 2015) Luận vàn Thục Si' Y Tề Cơng cộng ỉ)ạĩ hục Ytề Cóng Cụng 2015: 78 Phạm Minh Khuê HTG Sự căng thằng nghề nghiệp nhàn viên y tế cua bệnh viện da khoa tuyền tinh Hai Phòng, nâm 2011 (In English: Occupational -c -ÍM CỊỈ ugc V Hl stress among medical staff of a provincial general hospital in Hai Phong 2011) Tợp chi Y tể dự phòng 2014;152(3):85 so Weathers F Litz B Herman D Huska JA Keane T The PTSD Checklist (PCL): Reliability validity, and diagnostic utility Paper Presented at the Annual Convention of the International Society for Traumatic Stress Studies 01/01 1993; SI Foa EB Cashman L Jaycox L & Perry K (1997) The validation of a selfreport measure of post traumatic stress disorder: The Posttraumatic Diagnostic Scale Psychological Assessment APA PsycArticies 1997;9(4);44 5-451 doi: https://doi.org/10.1037/1040-3590.9.4.445 82 Hoàng Thị Giang Sự câng tháng nghề nghiệp nhân viên y tế cùa bệnh viện da khoa tuyến tinh Hai Phòng, năm 2011 (In English: Occupational stress at the medical staff- of a provincial general hospital in Hai Phong, in 2011) Tạp chi Y tề dự phòng 2014; 152(3):S5 S3 Đặng Kim Oanh Thực ưạng stress nghề nghiệp nhân vicn điều dường Bệnh viện Đại học Y Hà Nội (In English: Occupational stress situation in nursing staff at Hanoi Medical University Hospital) Luận vàn Bác st" y học Dự phòng 2017; 84 Nguyền Thu Hà DNH Điều tra stress nghề nghiệp nhàn viên y tế (In English: Occupational stress investigation in healthcare workers) Vỉỷn sire khỏe nghề nghiệp mủi trưởng 2016: 85 Al-Tawfiq JA Auwaerter PG Healthcare-associated infections: the hallmark of Middle East respiratory- syndrome coronavirus with review of the literature The Journal of hospital infection Jan 2019; 101( l):20- 29 doi:10.1016/j.jhin.2018.05.021 86 Bhadelia N Sonti R McCarthy JW et al Impact of the 2009 influenza A (HINT) pandemic on healthcare workers at a tertiary care center in New York City Infection control and hospital epidemiology Aug 2O13;34(8):825-31 doi: 10.1086/671271 -c -ÍM CỊỈ ugc V Hl 87 Nurses catch novel coronavirus in Vietnam Tuồi rre News Friday March 20 2020 2020; 88 Wong TW Yau JK Chan CL et aL The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope European journal of emergency medicine : official Journal of the European Society for Emergency Medicine Feb 2005; 12(1): 13-8 doi: 10.1097/00063110- 200502000-00005 89 Choi SH Chung JW Jeon MH Lee MS Risk factors for pandemic HINT 2009 infection in healthcare personnel of four general hospitals The Journal of infection Oct 20U;63(4):267-73 doi: 10 1016/ j.jinf.2011.04.009 90 Ma H Qiao H Qu H et al Role stress, social support and occupational burnout among physicians in China: a path analysis approach International health May 2020;12(3):l57-163 doi: 10 1093/ intbealth/ihz054 91 Huremovic D Social Distancing Quarantine, and Isolation 2019:85-94 92 Iversen AC Fear NT Ehlers A et al Risk factors for post-traumatic stress disorder among UK Armed Forces personnel Psychological medicine Apr 2OO8;38(4):511-22 doi:10.1017/s0033291708002778 93 Devnani M Factors associated with the willingness of health care personnel to work during an influenza public health emergency: an integrative review Prehospital and disaster medicine Dec 2012;27(6):551-66 doi:10.1017/sl049023x!2001331 Aiello 2011:31 hospital A workers Khayeri in MY anticipation Raja doi:10.1002/chp.20096 s etin al of an Resilience influenza training pandemic for The Winter Journal of continuing (1): 15-20 education the health professions APPENDIX Variables Classi fication Definition Tool Demographic characteristics Gender Male/ Female Calculated by subưacting Questionnaire Questionnaire the year 2020 from the year Age of birth Ethnic Yes/ No -c -ÍM CỊỈ ugc V Hl Questionnaire Noreligion Buddhism Religion Questionnaire Christianity Protestant Marital status: single, Questionnaire married, divorced, widowed Marriage status Currently living status: Questionnaire living with family / relatives / friends, living alone in a Living status rental house The number of children Questionnaire each paticipants have: 1-2 Haring children >2 The highest education level Questionnaire according to the division of Education the Ministry of Education Levels of qualifications: Professional qualifications doctor, nurse, pharmacist, ambulance driver -c -ÍM CỊỈ ugc V Hl Questionnaire receptionist, adminisưative staff Name of department: Questionnaire emergency department, Department internal medicine, surgery, obstetiics pediatrics Number of sears from Questionnaire starting work to the time of Length of service research: 1- years and over wars Currait job status Current job status: official, full-time contract (8h / day) without term a full-time contract with a term a part-time contract Questionnaire Risk of exposu re to COVID-19 Level of supposing that “At work place, having ability to expose to virus COVID19 through breathing air” Level of supposing that “At work place I have ability to expose to virus COV1D- 19 through colleague who exposed to infected COVID-19 patients” Level of supposing that "Accept if a colleague quit because they are afraid of COV1D-I9” Level of supposing that “Feel that the job put you at high risk of being exposed to COVID-19 ' Likert scale (l=Absolutely not; 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire -c -ÍM CỊỈ ugc V Hl Level of supposing tliat •‘Fear of being infected with the virus COVID-19” Level of supposing that "My family believes that am at high risk for COVID19Level of supposing that “If infected with SARS-CoV2.1 believe that my chance of survival is low" Likert scale (l=Absolutely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire IES-R scale Has e emotion when Questionnaire Likert scale (l=Absolutely someone reminder about not; 5= too much) the CoVid-19 epidemic Level of insomnia status Likert scale (1 =Absolutely not: 5= too much) Level of obsessing by Likert scale (l=Absolutely Covid not: 5= too much) Likert scale (1 “Absolutely Level of getting angry when not: 5= too much) you think or hear about the CoVid-19 epidemic Level of avoiding stress Likert scale (l=Absolutelv when thinking about or not: 5= too much) being reminded of CoVid19 Level of thinking about Likert scale (i=Absolutely not; 5= too much) CoVid-19 even if it wasn't intended Level of feeling CoVid-19 Likert scale (l=Absolutely as unprecedented or untrue not: 5= too much) Level of thinking to stay Likert scale (1 “Absolutely away from hints of CoVidnot: 5= too much) 19 Level of Images of CoVidLikert scale (1 “Absolutely not: 5= too much) 19 outbreak show up in mind -c -ÍM CỊỈ ugc V Hl Questionnaire Questionnaire Questionnaire Questionnaire Questionnaire Questionnaire Questionnaire Questionnaire Level of being alarmed and startled (by the CoVid-19 epidemic) Level of being panic and shocked, tried not to think about CoVid-19 anymore Likert scale (l=Abso finely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire Level of having feelings about CoVid-19 but ignore them Level of lost emotion about the CoVid-19 epidemic Level of having actions and feelings when thinking were back during the CoVid-19 boom in Vietnam Likert scale (l=Absolutely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Likert scale (l=Absolutely not: 5= too much) Questionnaire Level of finding it difficult for sleeping Level of having strong emotion when it comes to CoVid-19 epidemic Level of Hying to remove CoVid-l epidemic out of mind of having trouble Level concentrating (because of CoVid-19 epidemic Level of having symptoms when someone reminders of Co Vid- 19(sweating difficulty breathing, nausea or pounding heart) Level of having dreams about CoVid-19 Level of having feeling alerted (by CoVid-19 pandemic) Level of trying not to talk about CoVid-19 pandemic Likert scale (1 =Absolutely not: 5= too much) Likert scale (l=Absolutely not; 5= too much) Questionnaire Likert scale (l=Absolutely not; 5= too much) Likert scale (l=Absolutely not; 5= too much) Questionnaire Likert scale (l=Absolutely not; 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Likert scale (l=Absolutely not: 5= too much) Questionnaire Likert scale (l=Absolutely not: 5= too much) Questionnaire APPENDIX -c -ÍM CỊỈ ugc V Hl Questionnaire Questionnaire Questionnaire Questionnaire CO VID 19 SURVEY QUESTIONNAIRE Investigation code: INTROD VCE Hello Sir Madam, I am - the enumerator of the survey: " At present, die situation of CoVid-19 is still complicated in Vietnam requiringhigh determination to prevent its spread as quickly as possible The survey hopes to identify perceptions of the risks, impacts and effectiveness ofCoVid-19 preventive measures, as well as health care workers' concerns Because medical staffs are a force always at the forefront of management, control and prevention of CoVid-19 outbreak Die information you provide will be used to improve existing preventive measures and address the general concerns of health care workers and is kept confidential, for research purposes only Do you agree to participate in this survey? Yes No (stop interviewing) ADMINISTRATION Date of interview: / Z2O2O Province/City: Hospital: Name of enumerator: Name of data cleaner: Name of the data entry personnel: Numerical Order Questions Answers A PERS ON AL PARTICULARS Al Full name A2 Phone number Year of birth A3 -c -ÍM CỊỈ ugc V Hl Notes (solar calendar) A4 Gender AS Ethnic group l.Male Female Kinh Other (please specify): A6 Religion No religion Buddhism Christian Protestant Other religion (please specify:) Single Married Divorced Separated Widowed Other (please specify:) A7 Marital status A8 I am presently With my family acquaintances friends Staying Alone in a rental room apartment Academic A9 level A10 Job title Primary school Secondary school High school Intermediate level College and university Other (specify): Doctor Nurse Technician (laboratory technician Xray technician, physiotherapist technician ) Pharmacist Emergency personnel Janitors Reception Administrative staff -c -ÍM CỊỈ ugc V Hl Other, specify: All The area of Accident & Emergency General work examination department Surgical department Internal medicine department Intensive care Radiographical services Laboratory services Administrative Infection control A12 A13 The length of my experience as a health care worker My cunent Others, specify: years Official work status Long term full-time contract (8 hours day) Short-term full-time contract Part-time contract B RISK OF EXPOSURE TO co VID-19 Bl At my place of work I am most likely at risk of getting from (Please circle only Strongl y' Disagre e Disagre e Not sure Agree I I Strongly agree one option for each Bl.l sentence) The air that I breathe Bl.2 Close contact with colleagues -c -ÍM CỊỈ ugc V Hl Notes exposed ỈO CoVid-19 patients With regard to the risk or contracting CoVid-19 myself B2 Strongl y Strongly Disagre e Not sure Agree I 5 •» 5 Disagre e agree I feel that my job puts me at great risk of exposure to Co Vid 19 B3 I am afraid of falling ill with Co Vid -19 B4 I consider it acceptable if my colleagues resign because of their fear of B5 CoVid-19 My family believes that I have a high risk of getting CoVid-19 B6 If I were to get CoVid191 believe that my chances of survival are poor -c -ÍM CỊỈ ugc V Hl Notes D IMPACT OF EVENTS sc ALE (IES) Below is a list of comments made by people during stressful life events For each item, please cross the approximate box which indicates how frequently these comments are true fcr you over the past one week with respect to COVID-19 in VIETNAM If they are not occurring, choose "Not at all" While answering the items, think of the event being referred to as the Co Vid-19 situation in Vietnam IES DI D2 D3 D4 D5 D6 D7 D8 D9 DIO ModeratNot at al Any remind® brought back feelings about it I had trouble staying asleep Oth® things kept making me think about it I felt irritable and angry I avoided letting myself get upset when I thought about it or was reminded of it I thought about it whai I didn't mean to I felt as if it hadn’t happened or Iwasn't stayedreal away from reminders of it Pictures about it popped into my mind I was jumpy and easily startled A title bit eh Quite a bit Extremely 4 4 4 4 4 *• DỈỈ I tried not to think about it D12 I was aware -c -ÍM CỊỈ ugc V Hl Notes that I still had a lot of feelings about it but I didn't deal with them D13 D14 My feelings about it wae kind of numb I found myself acting or feeling like I was back at that time 4 D15 I had trouble falling asleep D16 had waves of strong feelings about it 4 4 4 D17 D18 D19 D20 D21 D22 I tried to remove it from my memory I had trouble concentrating Remindas of it caused me to have physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart I had dreams about it I felt watchful and on-guard I tried not to talk about it Thank YOU ỉ Signature of enumerator -c -ÍM CỊỈ ugc V Hl ... objectives: To describe the psychological impacts of healthcare workers during the cot 1D-19 pandemic in Hanoi, 2020 To (f escribe some of relative factors with in theHanoi, 2020 psychological impacts healthcare. .. of COVID-19 cases in Vietnam Thus, we conducted research ? ?Evaluating the psychological impacts related to COVTD-19 of healthcare workers and associated factors in Hanoi 2020" with two following... to COVID-19 of healthcare workers and some associated factors to give appropriate recommendations to support managers to have solutions for improving the mental health of medical workers in Hanoi