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PTSD Among Frontline Healthcare Workers: Who Has the Highest Risk?

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Key Takeaways

  • The traumatic events experienced by HCPs during the COVID-19 pandemic may cause symptoms of PTSD.
  • Female emergency HCPs are at highest risk of developing PTSD.
  • Approximately 23% of HCPs reported experiencing symptoms of PTSD during the COVID-19 pandemic.

PTSD, short for post-traumatic stress disorder, is a clinical term used to describe a stress reaction when someone experiences trauma.1 Historically, wat veterans were always thought of as having a high risk for PTSD, but after the events of the COVID-19 pandemic, healthcare providers (HCPs) may also be experiencing symptoms of the condition. PTSD typically is diagnosed by a mental health professional, and there are a variety of treatment options available to those with PTSD. Some common treatment strategies include medication, psychotherapy, and meditation. 

Who’s at Risk of Developing PTSD?

Not everyone who experiences a scary, traumatic, or catastrophic event will develop PTSD. However, certain vulnerability factors can increase a person’s risk of developing the condition. Individuals who are chronically exposed to intense, life-threatening, and scary situations may be at increased risk for PTSD. Veterans who have been in active combat, for example, are at risk of developing PTSD. What may be an uncommon population at risk of developing PTSD are HCPs.  Given the nature of their profession, emerging research has found that more HCPs than previously thought may develop PTSD, specifically those working on the frontlines of the COVID-19 pandemic.  

Physicians, nurses, and other frontline HCPs are at risk of developing PTSD because of their exposure to critically ill patients during COVID-19. Frontline workers are frequently faced with making stressful medical decisions, working with patients who are experiencing trauma, and witnessing patients die. Frontline HCPs also deal with their own feelings of helplessness, fear, and anxiety in relation to being exposed to the SARS-CoV-2 virus, becoming sick, and passing their symptoms onto friends and family members. Factors that influence the development of PTSD in HCPs include working role, age, virus exposure level, work and social support, marital status, gender, quarantine, job organization, and years of work experience.2

Research Finds Females More Vulnerable for PTSD Among HCPs  

Although more research for PTSD among HCPs needs to be conducted, the existing research suggests that emergency frontline workers, specifically  female emergency frontline workers, may be the most vulnerable to developing PTSD.2 Emergency frontline workers must navigate chronically stressful situations and make life-altering decisions very quickly. More specifically, emergency frontline workers deal with demanding caseloads on a daily basis, unpredictable scenarios, and having to manage both patients and patient’s families.

Additionally, a study conducted by PLoS One found that in a sample of 1773 healthcare workers and public service providers, 28.9% of the sample had clinical or subclinical symptoms of PTSD, and 21.2% and 20.5% were above the established cut-offs for anxiety and depression.3 For HCPs who worked in direct contact with COVID-19 patients, the rates of PTSD were significantly higher compared with those working indirectly. Worries about job and economy, negative metacognitions, burnout, health anxiety and emotional support were significantly associated with PTSD symptoms, after controlling for demographic variables and psychological symptoms.3

“[HCPs] are called to confront this new scenario under widespread media coverage and in a context of a persisting imbalance between needs and resources, increasing the decisional burden and the feelings of hopelessness; they are also forced to deal with challenging expectations of the patients and their relatives in a framework characterized by unusual communicative constraints,” according to a study published in Psychology Research.2  

PTSD in Frontline Healthcare Workers by the Numbers

A study conducted by Yale School of Public Health found that frontline workers are reporting high rates of depression, alcohol use, and PTSD symptoms.3 An online survey was completed by 1132 frontline workers across 25 healthcare systems across the United States, and the results reflected much higher rates of PTSD and alcohol use disorder (AUD) among frontline HCPs compared with the general population. More specifically, 23% of respondents reported PTSD symptoms as a result of their work in the healthcare field during the COVID-19 pandemic.

Unique factors in direct accordance with the COVID-19 pandemic may increase frontline workers’ risk of developing PTSD. As previously stated, unpredictable caseloads and fear of catching and transmitting the virus to family members are 2 unique factors. Other factors to consider include longer shifts, limited medical equipment and personal protective equipment, having to determine who receives essential medical devices, an increase in death rate in patients, and overcrowding in intensive care units and hospitals in general.

As time progresses and more research is conducted, the true impact of the pandemic on frontline HCPs will be better understood. It is important to recognize that PTSD among HCPs requires sufficient attention so that those on the frontlines of the pandemic will be sufficiently supported as they navigate life after COVID-19.

References
  1. National Institute of Mental Health. Post-traumatic stress disorder. Updated May 2019. Accessed December 28, 2020.  
  2. Carmassi C, Foghi C, Dell’Osso L. PTSD in healthcare workers facing the three coronavirus updates: what can we expect after the COVID-19 pandemicPsychiatry Res. 2020;292(1):1-31. 
  3. Johnson SU, Ebrahimi OV, Hoffart A. PTSD symptoms among health workers and public service providers during the COVID-19 outbreak. PLoS One. 2020;15(10):e0241032. 
  4. Gray S. Yale study examines the psychological toll of COVID-19 pandemic on healthcare workers. Yale News. Published November 20, 2020. Accessed December 23, 2020.  

One Response

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