Distress and resilience of healthcare professionals during the COVID-19 (coronavirus) pandemic

ISRCTN ISRCTN13694948
DOI https://doi.org/10.1186/ISRCTN13694948
Secondary identifying numbers DARVID1
Submission date
01/04/2020
Registration date
01/04/2020
Last edited
19/07/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
COVID-19 is a condition caused by the coronavirus (called SARS-CoV-2) that was first identified in late 2019. This virus can infect the respiratory (breathing) system. Some people do not have symptoms but can carry the virus and pass it on to others. People who have developed the condition may develop a fever and/or a continuous cough among other symptoms. This can develop into pneumonia. Pneumonia is a chest infection where the small air pockets of the lungs, called alveoli, fill with liquid and make it more difficult to breathe.

In 2020, the virus has spread to many countries around the world and neither a vaccine against the virus or specific treatment for COVID-19 has yet been developed. As of March 2020, it is advised that people minimize travel and social contact, and regularly wash their hands to reduce the spread of the virus.

Groups who are at a higher risk from infection with the virus, and therefore of developing COVID-19, include people aged over 70 years, people who have long-term health conditions (such as asthma or diabetes), people who have a weakened immune system and people who are pregnant. People in these groups, and people who might come into contact with them, can reduce this risk by following the up-to-date advice to reduce the spread of the virus.

Despite containment measures, the virus spread exponentially. On March 11, 2020, the World Health Organization announced a pandemic. In Europe, the first clusters appeared on the 22nd of February 2020 in Northern Italy and soon the health system in Northern Italy could not cope with the massive amount of new patients with respiratory failure needing invasive ventilation support. The long-working hours, need for “hard triage” for ventilation support and the strong restrictions in daily life implemented by the government had serious effects on healthcare workers and the general population.

Front-line healthcare workers directly involved in the diagnosis, treatment and care of COVID-19 patients are despite getting infected and are under particular risk of developing psychological distress and other mental health symptoms. A recent study from China showed a high prevalence of mental health symptoms among healthcare professionals, including depression, insomnia, anxiety or trauma stress disorder (Lai et al., 2020), similar to those found in military personnel after having been at war. Feelings of vulnerability to disease, concerns about spread of the virus to family members or friends, need for self-isolation and changes in the work sense of coherence are purported to play a role in the development of such symptoms. These negative stress outcomes can impact not only on the wellbeing of health professionals, but also on their ability to care effectively for others (Barnett, et al., 2007). Additionally, they affect all healthcare workers, irrespective of culture. On the other hand, individuals with a strong sense of coherence are less prone to burn-out and are mentally healthier. Moreover, adopting resilience-enhancing strategies may improve day-to-day performance at work and at home.

This study investigates the relationship between work sense of coherence and individual resilience on healthcare professionals' mental health during this COVID-19 pandemic. No other study addresses this gap in knowledge.
1. Is there a relationship between individual resilience and work sense of coherence and the development of anxiety, depression and traumatic stress disorder in frontline health care personnel during the pandemic outbreak?
2. Does contamination anxiety and COVID-19 anxiety differ over time, across countries in frontline health care personnel?
3. How does resilience and work sense of coherence influence the development of anxiety, depression and traumatic stress disorder in these health care workers during the pandemic outbreak?

Who can participate?
Healthcare professionals, >18 years of age, willing to participate.

What does the study involve?
Healthcare professionals will be asked to fill in a number of online questionnaires at three timepoints during a six-month period.

What are the possible benefits and risks of participating?
None anticipated.

Where is the study run from?
Department of Anaesthesia and Pain Medicine, Inselspital, Bern University Hospital, Bern (Switzerland). Data will be collected from hospitals in Europe, USA, and New Zealand.

When is the study starting and how long is it expected to run for?
April 2020 to May 2021 (updated 05/01/2021, previously: January 2021)

Who is funding the study?
Department of Anaesthesia and Pain Medicine, Inselspital, Bern University Hospital, Bern (Switzerland)

Who is the main contact?
Dr Alexander Fuchs, alexander.fuchs@insel.ch

Contact information

Dr Alexander Fuchs
Scientific

Department of Anaesthesia and Pain Medicine
Inselspital
Bern University Hospital
Freiburgstrasse 8-10
Bern
3010
Switzerland

ORCiD logoORCID ID 0000-0001-7188-1683
Phone +41 31 632 88 35
Email alexander.fuchs@insel.ch

Study information

Study designMixed-methods observational
Primary study designObservational
Secondary study designQualitative research
Study setting(s)Internet/virtual
Study typeOther
Participant information sheet https://psyunibe.qualtrics.com/jfe/form/SV_3WYgbkLWqiDPDG5
Scientific titleDistress And Resilience of healthcare professionals during the COVID-19 pandemic
Study acronymDARVID
Study hypothesis1. COVID-19 anxiety and contamination anxiety do not remain stable over time, across countries, and relate to the proximity with infected patients.
2. There is a relationship between individual resilience and work sense of coherence and the development of mental symptoms in front liners during pandemic outbreaks
Ethics approval(s)Approved 01/04/2020, Gesundheits- und Fürsorgedirektion des Kantons Bern, Kantonale Ethikkomission für die Forschung Bern (Ethics Committee of the Canton of Bern, Murtenstrasse 31, 3010 Bern, Switzerland; +41 31 633 7070; info.kek.kapa@gef.be.ch), ref: Req-2020-00355
ConditionIndividual resilience and work sense of coherence and the development of mental symptoms during a pandemic scenario
InterventionMatched longitudinal internet-based survey with pre-existing, validated self-questionnaires (Work-SoC, PHQ-9, IES-6, PVD, SFI, CD-RISC 10), at 3 time periods of 2 weeks over 6 months, with the option to prolong depending on the development of the pandemic.

Semi-structured interviews with focus groups after the last period of the survey.
Intervention typeOther
Primary outcome measureCOVID-19 Anxiety (adapted SARS-Anxiety-Scale) at 3 time periods of 2 weeks over 6 months
Secondary outcome measuresAt 3 time periods of 2 weeks over 6 months:
1. Contamination anxiety (PVS)
2. Anxiety to get infected at work measured with a single generated Item («I am afraid I will become infected with COVID-19 while on the job») on a visual analog scale from «0 = Not at all» to «10 = Extremely»
3. Depression (PHQ-9)
4. Traumatic Stress (IES-6)
5. Work Coherence (Work-SoC)

Qualitative measures:
6. Influence of resilience and work sense of coherence on the development of anxiety, depression and trauma stress disorder in frontliners during pandemic outbreak measured using structured interview.
Overall study start date15/03/2020
Overall study end date01/05/2021

Eligibility

Participant type(s)Health professional
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants400
Total final enrolment520
Participant inclusion criteria1. Healthcare professionals
2. >18 years of age
3. Willing to participate
Participant exclusion criteriaDoes not meet inclusion criteria
Recruitment start date02/04/2020
Recruitment end date16/04/2020

Locations

Countries of recruitment

  • Australia
  • Austria
  • Belgium
  • Brazil
  • Bulgaria
  • Croatia
  • Cyprus
  • Czech Republic
  • Denmark
  • Finland
  • France
  • French Southern Territories
  • Germany
  • Greece
  • Ireland
  • Isle of Man
  • Israel
  • Italy
  • Lebanon
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Malta
  • Netherlands
  • New Zealand
  • Norway
  • Portugal
  • Slovakia
  • Slovenia
  • South Africa
  • Spain
  • Sweden
  • Switzerland
  • Türkiye
  • United Kingdom
  • United States of America

Study participating centre

Bern University Hospital
Department of Anaesthesiology and Pain Therapy
Inselspital
Freiburgstrasse 8-10
Bern
3010
Switzerland

Sponsor information

University Hospital of Bern
Hospital/treatment centre

Department of Anaesthesia and Pain Medicine
Inelspital
Freiburgstrasse 8-10
Bern
3010
Switzerland

Phone +41 31 632 88 35
Email robert.greif@insel.ch
Website http://www.anaesthesiologie.insel.ch
ROR logo "ROR" https://ror.org/01q9sj412

Funders

Funder type

Hospital/treatment centre

University Hospital of Bern

No information available

Results and Publications

Intention to publish date31/03/2021
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPublication of results in the dedicated journals - first trimester 2021.
IPD sharing planThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Dr. Phil. Sandra Abegglen (sandra.abegglen@psy.unibe.ch). Both qualitative and quantitative data are expected to be available as from March 2021, for a period of 10 years. Data originating from questionnaires will be stored in a secure online site accessible to the investigators only. All researchers will comply with the Data Protection Act and the Swiss Law for Human Research. All data will be destroyed 10 years after the end of the project.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 31/07/2020 04/08/2020 Yes No
Preprint results psychological health results 07/06/2022 21/06/2022 No No
Results article Work-related sense of coherence results 16/05/2022 21/06/2022 Yes No
Results article 30/06/2022 19/07/2022 Yes No

Editorial Notes

19/07/2022: Publication references added.
21/06/2022: The following changes have been made:
1. Publication references added.
2. The total final enrolment number has been added from the reference.
05/01/2021: The following changes were made to the trial record:
1. The overall end date was changed from 01/01/2021 to 01/05/2021.
2. The plain English summary was updated to reflect these changes.
04/08/2020: Publication reference added.
27/07/2020: The following changes were made to the trial record:
1. The recruitment end date was changed from 16/10/2020 to 16/04/2020.
2. The ethics approval was added.
03/04/2020: The trial contact name has been corrected.
01/04/2020: Trial’s existence confirmed by Swiss Ethics.