Italian study: COVID-19 health care workers at high risk for post-traumatic stress

A group of Italian medical researchers has issued a "call for action" to the medical community to protect frontline health care workers from heavy psychological stress in dealing with COVID-19 patients.

The researchers identified the most-vulnerable categories of workers and suggested how health care systems could minimize the risks of post-traumatic stress syndrome (PTSS) and prevent it from "degenerating into chronic PTSD," post-traumatic stress disorder, "as has already occurred in past outbreaks."

After reviewing literature from around the world on the subject, the researchers selected 17 papers to identify which categories of hospital workers were most at risk. They found that "female gender, young age, low work experience, not living with a partner, and lack of training" were related to a high risk of PTSS.

Risk factors for PTSS include lack of medical training on COVID-19, and "low social support at work, heavy workload, working in unsafe settings [e.g., lack of personal protective equipment], passive coping, anxiety and burnout."

The study appears in the Jan. 12 issue of the International Journal of Environmental Research and Public Health.

The researchers reported that one study of hospital staff in Singapore found that the previous epidemic of severe acute respiratory syndrome (SARS) could have made them more prepared to implement infection control procedures for COVID-19.

The paper offers some urgent guidelines for health care managers to remedy the problem.

To mitigate the increased risk for newer and less-skilled nurses, "nurse managers should increase training and support related to COVID-19 care for younger, less experienced nurses...."

The researchers also suggest that "management should be proactive in and supportive of improving working conditions to avoid burnout risks." This includes training and technical updates on COVID-19 for health care workers, providing an adequate supply of personal protective equipment, banning excessive working hours, and making counseling services available.

In particular, hospital management should train health care workers in how to cope with stressful events, and how to support their co-workers after traumatic events, the study advises.

The researchers urge an "urgent intervention" to prevent PTSD from occurring as a secondary effect of the COVID-19 stress. They recommend screening for PTSS, and identifying and treating PTSD. They also urge "new health care policies devoted to preventive and management strategies toward PTSS and the related psychic sequelae."

The study notes its limitations in comparing data from the literature, including the timing of the studies the researchers reviewed and the different healthcare settings involved. Also, they say, most of the articles reviewed were from Southeast Asia, China and Western Europe. There were only two from the United States and Mexico.