Nursing home staff mental health during the Covid-19 pandemic in the Republic of Ireland

Presenter: Conan Brady (Trinity College Dublin)

Abstract for the International workshop on COVID-19 and Long-Term Care systems: What have we learnt and what policies do we need to strengthen LTC systems?, 6 and 7th December 2021

Abstract

Background: Nursing homes for older adults have been disproportionately affected by the Covid-19 pandemic with increased mortality of residents and staff distress. 

Objective: To quantify the mental health of nursing home staff during the Covid-19 pandemic in the Republic of Ireland. 

Design and setting: Cross sectional anonymous survey of nursing home staff in the Republic of Ireland during the third wave of the Covid-19 pandemic.

Methods: Online, anonymous survey collecting demographic information, Covid-19 exposure history and mental health measures.

Results: There were significant differences between nurses, healthcare assistants (HCA) and nonclinical staff history in age, ethnicity, years’ experience, history of Covid-19 infection and contact with Covid-19 positive acquaintances. Moderate-severe post-traumatic stress disorder (PTSD) symptoms were found in 45.1% (95% CI 40.2-50.1%) of all staff. A World Health Organisation-5 (WHO-5) wellbeing index score ?32, indicating low mood, was reported by 38.7% (33.9-43.5%) of staff; significantly more nurses reported low mood. Suicidal ideation and suicide planning were reported respectively by 13.8% (10.4-17.3%) and 9.2% (6.4-12.1%) of participants with no differences between groups.  HCAs reported a significantly higher degree of moral injury than nonclinical staff. Nurses were more likely to use approach coping styles than nonclinical staff.

Conclusion: Nursing home staff report high levels of post-traumatic stress, mood disturbance and moral injury during the Covid-19 pandemic. Significant differences in the degree of moral injury, wellbeing and coping styles were found between staff groups, which need to be incorporated into planning support services for this neglected workforce.  

Key points:

  • The prevalence of symptoms of post-traumatic stress disorder and the degree of moral injury in Irish nursing home staff was significantly higher than that of hospital staff internationally during the Covid-19 pandemic. 
  • High prevalences of suicidal ideation (13.8%) and planning (9.2%) were reported during the previous week.
  • Significantly more nurses reported poor wellbeing. 
  • Health care assistants reported significantly higher levels of moral injury than nonclinical staff.
  • Nurses were significantly more likely to utilise adaptive coping styles than nonclinical staff. 

Authors: Conan Brady (ORCID iD: 0000-0002-4110-8566)1, Caoimhe Fenton1, Orlaith Loughran1, Blánaid Hayes2, Martina Hennessy3, Agnes Higgins4, Iracema Leroi (ORCID iD: 0000-0003-1822-3643)5, Deirdre Shanagher6, Declan M. McLoughlin

1Dept. of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick’s University Hospital, Dublin 8, Ireland

2Beaumont Hospital, Dublin 9, Royal College of Surgeons, Dublin 2, Ireland

3WellcomeTrust/Health Research Board Clinical Research Facility, Trinity College Dublin, St James’s Hospital, Dublin 8, Ireland

4School of Nursing and Midwifery, Trinity College Dublin, Ireland

5Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland 

6Nursing Homes Ireland, Dublin 24, Ireland

Publication:

Brady C, Fenton C, Loughran O, Hayes B, Hennessy M, Higgins A, Leroi I, Shanagher D, McLoughlin DM. Nursing home staff mental health during the Covid-19 pandemic in the Republic of Ireland. Int J Geriatr Psychiatry. 2021 Nov 2. doi: 10.1002/gps.5648. Epub ahead of print. PMID: 34729818.

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