LAUSR

Background: Poor management in healthcare institutions can have significant consequences for the workplace and for the physical and mental health of its workers. The exposure to unsustainable pressure and demand can impair the worker's performance and the quality of care provided. Four common issues are sleeping troubles, stress, burnout, and depressive symptoms. Several of these risks were exacerbated during the COVID-19 pandemic, especially among healthcare workers working with patients either suspected of, or confirmed, COVID-19 infection. Methods: Using the Copenhagen Psychosocial Questionnaire (COPSOQ) II questionnaire, we aimed to assess the psychosocial risks among a sample of 235 healthcare workers deployed in COVID-19-related services in the Local Health Unit of Baixo Alentejo (Portugal). The participants filled out a questionnaire, which comprised ten sociodemographic questions and the Euro-Portuguese medium version of the COPSOQ II questionnaire. Data collection occurred February 15th-28th 2021. As recommended by the COPSOQ authors, tertiles cut-off points of 33.3 and 66.6 (percentage scale) were used, rendering a traffic light risk classification where green represents a favourable situation, red a health risk and yellow an intermediate risk. [1] The results were processed with qualitative and quantitative descriptive statistical analysis. To compare groups relative to each outcome, t-tests were used for variables with two categories. Whenever data was not normally distributed, Mann-Whitney tests were used. For variables with more than two groups non-parametric Kruskal-Wallis was applied. Bonferroni correction was also applied, testing each individual hypothesis at the level of significance of αi=0.05/29. Note that a statistically significant difference between two groups does not necessarily yield a different risk colour. The mean (and categorial) values of the COPSOQ's sleep, stress, burnout and depressive symptoms domains were also compared to a dataset from a previous assessment (same institution) performed in 2017 [2]. Results: Except for depressive symptoms in the paediatric and general emergency services, domains such as stress, burnout, sleep issues and depressive symptoms showed an intermediate health risk. The burnout domain showed the highest level of risk among nurses and operational assistants working in the Intensive Care Unit. Several associations, with sociodemographic variables, are also discussed, such as a statistically significant association between the burnout domain and the number of hours spent in COVID-19 services, as well as (in medical doctors) time of service with COVID-19 patients, or between stress and age group. Overall, comparing with a similar evaluation made in 2017 [1], depressive symptoms worsened in nurses, slightly ameliorated in medical doctors, while the rest of the four domains remained in the yellow risk category, even though most of them exhibited a numerical aggravation, though not sufficient to change risk category. Conclusions: Working in COVID-19 services can worsen sleep troubles, stress, burnout and depressive symptoms among health care workers. These results support the assessment of psychosocial stressors in healthcare units, to promote risk reduction policies in healthcare workers through workplace reforms. Accessible occupational services, therapeutic and rehabilitative strategies are also crucial. Neuropharmaceuticals may play a role in improving some health hazards in unhealthy workplaces. No conflict of interest