key: cord-0713393-o3f4mfwh
authors: Wadoo, Ovais; Latoo, Javed; Iqbal, Yousaf; Chandrappa, Nirvana Swamy Kudlur; Chandra, Prem; Masoodi, Naseer Ahmad; Al-Maslamani, Muna A. Rahman S.; Alabdulla, Majid
title: Mental wellbeing of frontline healthcare workers during COVID-19 pandemic in Qatar
date: 2020-12-25
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102517
sha: d728427465f36d302e5c0568215d31047a625b6c
doc_id: 713393
cord_uid: o3f4mfwh

nan

The Coronavirus disease 2019 began with initial cases in China in December 2019 and by January 2020, World Health Organization (WHO) declared it as a Public Health Emergency of International Concern (WHO Director-General's opening remarks at the media briefing on COVID-19 -11 March, 2020 n.d.) . In the current pandemic concerns about vulnerability of healthcare workers was reported (Lai et al., 2020; Rajkumar, 2020) . This is no different from research studies from previous epidemics, where healthcare workers exposed to the frontlines were reported to be vulnerable to poor mental health outcomes. The editorial of this journal (Tandon, 2020) reiterated the importance of health care systems identifying vulnerable groups and creating mitigation strategies to ensure psychological wellbeing of its health care workers.

There has been no systematic evaluation of the psychological impact of COVID-19 on healthcare workers in the Arabian Gulf region. The aim of the current study was to evaluate mental wellbeing of the front line healthcare workers in a well-resourced hospital designated to manage COVID-19 patients in the early phase of the outbreak in Qatar. The study is a single center, cross-sectional, exploratory web-based survey. The protocol for the research project was approved by Institutional Review Board. A total of 194 of 610 contacted staff members completed the survey, with a participation rate of 32 %. The primary outcome of interest in the study was mental wellbeing as measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) (Stewart-Brown et al., 2011) . Demographic data were self-reported by the participants, including age, gender, ethnicity, occupation and living arrangement. A total of 142 (83 %) of participants were male. Of all the participants, 110 (64.3 %) were less than 35 years old, 27.5 % were aged 35-44 and 8.2 % were aged 45-65. The participants included 29 (17 %) physicians, 110 (64.3 %) nurses and 32 (18.7 %) allied healthcare workers. The participants were from diverse ethnic backgrounds with majority being Indian 64 (37.4 %) and Philippine 62 (36.3 %). Approximately 30 % (29.2 %, 95 % CI 22.9, 36.5 %) of the participants had wellbeing scores of less than 45 indicating sub-optimal wellbeing and high risk of psychological distress and depression. Out of these, 35 (20 %) had wellbeing scores of less than 40 indicating high risk of major depression. Chi-square statistical analysis showed participants in the age group of 34-44, females, not living with family, Arab ethnicity, and non-nurses to be positively associated with well-being outcomes, however most of these differences were statistically insignificant (P > 0.05). Similar trend was observed when we compared actual mean WEMWBS scores across various participants' characteristics. The results of univariate and multivariate logistic regression analysis testing for each predictor and their possible association with low WEMWBS scores (score cutoff value Table 1 Logistic regression analysis to determine potential predictors and risk factors associated with low WEMWBS scores. Table 1 . Finally, we computed a prediction model to evaluate the discriminative ability of potential significant variables with statistical P < 0.10 on the occurrence of lower score cutoff values (WEMWBS score <45 score) that inversely effect mental well-being. Multivariate logistic regression indicated that the final model demonstrated a modest fit (area under the curve (AUC) = 0.716, 95 % CI 0.63, 0.80) and included the potential predictors and risk factors as shown in Table 1 . Ours is the first study to evaluate impact on healthcare workers from mental wellbeing perspective in the region. Qatar represents a unique state funded healthcare system, which made significant changes in its functioning in response to the pandemic Karim et al., 2020) . Approximately 30 % of the participants had wellbeing scores of less than 45 on WEMWBS indicating suboptimal wellbeing. This is consistent with the broader literature showing that most healthcare workers are resilient and do not succumb to overwhelming distress, however some are more vulnerable leading to suboptimal wellbeing and vulnerability to possible depressive or anxiety disorders. Psychological distress has been attributed to long working hours, risk of infection, and shortages of protective equipment, loneliness, physical fatigue, and separation from families. All the studies in this area including ours report nurses to be more vulnerable than physicians. This can be attributed to prolonged contact with patients. The factors like 'not living with the family' is associated with better outcomes and can be attributed to participants being less fearful of passing the infection to their loved ones. It was interesting to note in our study that participants belonging to Arab ethnicities fare well on mental wellbeing outcomes. Of importance to note is that unlike other international research, our study shows females to be less vulnerable than men.

All authors contributed to the design, data collection, data analysis and interpretation of the results.

YI & NC led data collection. PK led data analysis. OW, JL, MA, NM and MM led interpretation and presentation of results.

OW wrote the initial draft of the manuscript. All the authors read and approved the final manuscript.

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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We are thankful to all healthcare workers who participated in this research during this unprecedented pandemic. We would also like to thank Mr. Yassine Khalladi, Head Nurse Mental Health Services, Hazm Mebaireek General Hospital, Hamad Medical Corporation for his support during this research project.