Psychological impact of COVID 19 on Healthcare Workers of Lautoka Hospital, Fiji - a descriptive cross-sectional study from March 2020 - October 2021
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Keywords
health professionals , COVID-19, Mental Health, frontline
Abstract
Background: The COVID-19 pandemic has had a significant effect on the psychological well-being of healthcare workers globally. Life began to return to the new normal, national and international travel restrictions were lifted and there seemed to be more awareness and conversations of and about mental health.
Aim: This study aimed to evaluate the psychological impact of the COVID-19 pandemic on the health workers at the Lautoka Hospital in Fiji when life returned to “normal” following easing of COVID-19 restrictions by the Ministry of Health and Medical Services.
Methodology: A descriptive cross-sectional study was conducted from April to September 2022, 6 months after COVID-19 restrictions were lifted by the Fiji Ministry of Health and Medical Services. Validated questionnaires were utilised to assess for psychological well-being of doctors, nurses and midwives of varying professional seniority. Those who worked as front-line staff during Fiji’s COVID-19 outbreak from March 2020 to October 2021 were invited to participate. The Insomnia Severity Index (ISI), The Patient Health Questionnaire-9 (PHQ-9) and The Generalized Anxiety Disorder (GAD) were distributed electronically to participants and completed anonymously in context of COVID-19.
Results: In all, 127 people responded to the survey (57 nurses/midwives, 70 doctors). Doctors were further classified into junior doctors (42), registrars (20) and consultants/specialists (8). Almost 82% reported some form of insomnia on the ISI (36.2% moderate insomnia; 3.9% severe insomnia). The PHQ-9 revealed that 81% of respondents had some form of depression (41% moderate to severe depression; 40.2% mild depression). With regards to self-harm, 25.2% reported having thoughts of hurting themselves or feeling that they were better off dead, whilst 11.8% had these thoughts on several days. The GAD scale revealed that 77% of respondents had some form of anxiety (19.7% moderate anxiety; 19.7% severe anxiety).
Conclusion: Approximately 40% of the health professionals surveyed had some episodes of depression, anxiety or insomnia and 25% had thoughts of self-harm or being better off dead. Whether the past experience of working with COVID-19 contributed to these significant mental health findings cannot be established. This was the initial intention of the project. Regardless, it is critical that workplace mental health support systems including practical and appropriate resources and interventions are made available and accessible without risk for discrimination during times of global crisis like pandemics and regional environmental events like floods and cyclones. Further validation through real-time studies conducted during a pandemic, rather than post-event, would strengthen the findings and provide more reliable data.
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Min Kim, Medical Intern Year 2 with Fiji Ministry of Health
Dr Min Jung Kim graduated with an MBBS from the College of Medicine Nursing and Health Sciences, Fiji National University in 2020. The COVID-19 pandemic significantly impacted Min's final year of medical training when all academic institutions were closed and transitioned to full online learning. The second wave occurred during her first year of internship where in addition to the stress of life as a junior doctor, she also learned to navigate medicine in a pandemic. Min has a special interest in women's health and is currently awaiting a position in the Obstetrics and Gynaecology Department at Lautoka Hospital.
Huma Rashid, Medical Intern Year 2 Fiji Ministry of Health
Dr Huma Rashid graduated from the College of Medicine, Nursing and Health Sciences, at the Fiji National University in 2020. Her final year of medical training and first year as a junior doctor were also impacted upon significantly when COVID arrived in Fiji in 2020 and again 2021. Huma has a special interest in women's health and, like Min, has begun clinical attachments in Obstetrics and Gynaecology while awaiting a formal placement in the Department at Lautoka Hospital.
Shonal Kumar, Medical Intern Year 2 Fiji Ministry of Health
Dr Shonal Kumar completed his MBBS in 2020 graduating from the College of Medicine, Nursing and Health Sciences at the Fiji National University. He too learned to navigate through the challenges of final year medical school assessments and junior doctor internship amidst the COVID waves in Fiji in 2020 and 2021. Shonal has a special interest in internal medicine and is awaiting a posting with the Internal Medicine Department at the Lautoka Hospital.
Amanda Noovao-Hill, Pacific Society for Reproductive Health
Amanda has previously worked with MJK, HR and SSK as an academic and clinical supervisor. She continued to closely support their research after relocating from Fiji to Australia in mid 2021. She has recently taken on the role of Head of Secretariat for the Pacific Society for Reproductive Health. One of the Society themes is self care and looking after the carer. The underlying theme from the Research project is one of taking care of the carer.