Abstract
The COVID-19 pandemic has had a considerable impact on the mental health of the general population.Reference Pierce, Hope, Ford, Hatch, Hotopf and John1 However, there is also concern that the mental health of healthcare professionals (HCPs) has been disproportionately affectedReference Hacimusalar, Kahve, Yasar and Aydin2-Reference Luo, Liu, Chen, Huang, Chen and Yang4 because of the stress related to caring and working with patients with COVID-19,Reference Kisely, Warren, McMahon, Dalais, Henry and Siskind5-Reference Siddiqui, Aurelio, Gupta, Blythe and Khanji8 increased exposure to COVID-19, concern regarding infecting family members,Reference Billings, Ching, Gkofa, Greene and Bloomfield9-Reference Han, Choi, Cho, Lee and Yun11 and other unique stressors such as moral injuryReference Williamson, Murphy, Phelps, Forbes and Greenberg12 and stigma.Reference Han, Choi, Cho, Lee and Yun11 This is likely in addition to the mental health impact related to the growing economic insecurityReference Kousoulis, McDaid, Crepaz-Keay, Solomon, Lombardo and Yap13 and financial problemsReference Kwong, Pearson, Adams, Northstone, Tilling and Smith14 faced by the general public, and issues such as staff shortages resulting from cuts to public health services in the UK. The mental health impact is likely to result in increased work absences and significant attrition in some job roles, thus it is a priority to broadly understand the impact, dimensions and severity of the COVID-19 pandemic on the mental health of HCPs.Reference Billings, Ching, Gkofa, Greene and Bloomfield9 Nonetheless, there is conflicting data regarding the relative impact on the mental health of front-line HCPs (those who work with patients) compared with ‘non-front-line’ HCPs, or HCPs compared with non-HCPs, during this pandemic.Reference Alshekaili, Hassan, Al Said, Al Sulaimani, Jayapal and Al-Mawali15-Reference Norhayati, Che Yusof and Azman18 Largely these studies have been cross-sectional only,Reference Hacimusalar, Kahve, Yasar and Aydin2,Reference Li, Ge, Yang, Feng, Qiao and Jiang17-Reference Buselli, Corsi, Baldanzi, Chiumiento, Del Lupo and Dell'Oste19 or, in the case of the few longitudinal studies, have not repeatedly sampled the same population,Reference Mosolova, Sosin and Mosolov20 thereby limiting our understanding of the evolution of mental health changes throughout the pandemic. [...]although there has been great media interest in burnout, this has not been systematically evaluated in the different professional groups described above over time. Aims To address these gaps, we devised the COVID-19 Disease and Physical and Emotional Wellbeing of Health Care Professionals (CoPE-HCP) studyReference Khanji, Maniero C, Siddiqui, Gupta and Crosby21 as an international, observational cohort study assessing mental health, well-being and burnout in HCPs and non-HCPs across three distinct phases for evaluation of multiple domains over time. The validated mental health, burnout and well-being measures asked at all phases were as follows: the nine-item Patient Health Questionnaire (PHQ-9) to measure depression;Reference Kroenke, Spitzer and Williams22 the seven-item Generalised Anxiety Disorder (GAD-7) to measure anxiety;Reference Spitzer, Kroenke, Williams and Lowe23 the seven-item Insomnia Severity Index (ISI) to measure clinical insomnia;Reference Morin, Belleville, Belanger and Ivers24 burnout was measured with single-item indicators of emotional exhaustion and depersonalisation, abbreviated from the Maslach Burnout Inventory;Reference Li-Sauerwine, Rebillot, Melamed, Addo and Lin25 and the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) to measure well-being.Reference Tennant, Hiller, Fishwick, Platt, Joseph and Weich26 These measures were selected because they are widely used and freely available, allowing comparable rates with similar research elsewhere, and have validated cut-off points.
