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Influence of COVID-19 on Stress at Work During the First Wave of the Pandemic Among Emergency Health Care Workers

Published online by Cambridge University Press:  03 August 2023

Marie Dupuy ,
Frédéric Dutheil ,
Al’ai Alvarez ,
Thomas Godet ,
Oluwaseun John Adeyemi ,
Maëlys Clinchamps ,
Jeannot Schmidt ,
Céline Lambert  and
Jean-Baptiste Bouillon-Minois
Marie Dupuy
Affiliation:
Université Clermont Auvergne, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
Frédéric Dutheil
Affiliation:
Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Clermont-Ferrand, France
Al’ai Alvarez
Affiliation:
Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
Thomas Godet
Affiliation:
CHU Clermont-Ferrand, Department of Anesthesiology and Critical Care, Reproduction and Developmental Diseases (R2D2) Unit, EA 7281, Clermont-Ferrand, France
Oluwaseun John Adeyemi
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York University Langone Health, New York, NY, USA
Maëlys Clinchamps
Affiliation:
Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
Jeannot Schmidt
Affiliation:
Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
Céline Lambert
Affiliation:
CHU Clermont-Ferrand, DRCI, Biostatistics unit, Clermont-Ferrand, France
Jean-Baptiste Bouillon-Minois*
Affiliation:
Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
*
Corresponding author: Jean-Baptiste Bouillon-Minois; Email: jbbouillon-minois@chu-clermontferrand.fr
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Abstract

Objectives:

For more than 2 years, coronavirus disease (COVID-19) has forced worldwide health care systems to adapt their daily practice. These adaptations add to the already stressful demands of providing timely medical care in an overcrowded health care system. Specifically, the COVID-19 pandemic added stress to an already overwhelmed emergency and critical care health care workers (HCWs) on the front lines during the first wave of the pandemic.

This study assessed comparative subjective and objective stress among frontline HCWs using a visual analog scale and biometric data, specifically heart rate variability (HRV).

Methods:

This is a prospective, observational study using surveys and heart rate monitoring among HCWs who work in 3 frontline health care units (emergency department, mobile intensive care unit, and intensive care unit) in the University Hospital of Clermont-Ferrand, France. Two sessions were performed: 1 during the first wave of the pandemic (April 10 to May 10, 2020) and 1 after the first wave of the pandemic (June 10 to July 15, 2020).

The primary outcome is the difference in stress levels between the 2 time points. Secondary objectives were the impact of overcrowding, sociodemographics, and other variables on stress levels. We also assessed the correlation between subjective and objective stress levels.

Results:

Among 199 HCWs, 98 participated in biometric monitoring, 84 had biometric and survey data, and 12 with only biometric data. Subjective stress was higher during the second time point compared to the first (4.39 ± 2.11 vs 3.16 ± 2.34, P = 0.23). There were higher objective stress levels with a decrease in HRV between the first and the second time points. Furthermore, we found higher patient volumes as a source of stress during the second time point. We did not find any significant correlation between subjective and objective stress levels.

Conclusion:

HCWs had higher stress levels between the 2 waves of the pandemic. Overcrowding in the emergency department is associated with higher stress levels. We did not find any correlation between subjective and objective stress among intensive care and emergency HCWs during the first wave of the pandemic.

Keywords

COVID-19emergency departmentheart rate variabilitypandemicstressvisual analog scale
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e455
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the Society for Disaster Medicine and Public Health

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Footnotes

Key points: Does the appearance of a new pandemic induce more stress than a daily job among emergency health care workers?

Findings: Emergency health care workers had higher stress levels between the 2 waves of the pandemic, considered the “control” period. But this period also had a higher level of daily admission.

Meaning: Overcrowding of an emergency department induces more stress than a new pandemic. Taking care of our health care workers should be a priority for all politics.

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