West Virginia Medical Journal - 2022 - Quarter 1 | Page 31

( 64 %) reported direct contact with patients , while 37 % of employees reported direct contact with a patient known to have COVID-19 or a patient under investigation for COVID-19 , while 18 % of employees reported that they were unsure if they had had contact with a patient with COVID-19 . This study occurred at a time when the healthcare system in this area had not reached its maximum capacity and had not yet seen a peak in cases .

Tables 2-4 display analyses regarding the impact of COVID-19 on psychological distress . There was a significant difference in GAD-7 scores in employees who had contact with patients versus those who had no contact with patients ( P <. 01 ). Those participants who were unsure about their contact also expressed more anxiety than those with no contact based on GAD-7 scores . PHQ-9 scores showed a similar distribution with employees who had contact with any patients or with COVID-19 patients indicating more evidence of depression and more evidence of moderate to severe depression ( P <. 001 ). Those participants who were unsure if they had contact with COVID-19 patients again showed higher scores on the PHQ-9 . Having contact with any patients or with infected patients also resulted in higher IES-R scores ( P <. 01 and P <. 001 , respectively ). In addition , results indicate that prior psychologic distress was a risk factor for further distress during a pandemic . Those participants with a prior history of anxiety had higher GAD-7 scores compared to those with no prior history of anxiety ( P <. 001 ). Those participants with a prior history of depression had higher PHQ-9 scores compared to those with no prior history of depression ( P <. 001 ). Consistent with this , participants with a prior history of PTSD scored higher on the IES-R scale compared to those with no history of PTSD ( P <. 001 ). Gender did not play a major role in terms of the outcomes with one exception . Participants identifying as female did have higher scores on the PHQ-9 than their male counterparts ( P <. 01 )

Findings also indicated that both increased prior work experience and religious practice or spirituality may serve to mitigate risk for psychologic distress . Of survey respondents , 79 % reported that they practiced a specific faith , religion , or system of spiritual beliefs , and 63 % reported that they agreed or strongly agreed that faith is important during times of stress or crisis . Those participants who reported that they practiced a specific faith , religion , or system of spiritual beliefs scored lower on the GAD-7 ( P <. 001 ) and on the PHQ-9 ( P <. 01 ), indicating fewer symptoms . There was no statistically significant difference in IES-R scores in those who practiced a specific faith , religion , or system of spiritual beliefs ( P =. 896 ). Analyses of the impact of work experience on our main dependent variables revealed that less than five years of experience in healthcare was associated with higher GAD-7 ( P <. 001 ), IES-R ( P <. 05 ), and PHQ-9 ( P <. 01 ) scores .

DISCUSSION

Our work is one of the first studies about COVID-19 and its impact on healthcare workers to use validated instruments that measure psychologic distress , and it adds information specifically about healthcare workers in the mid-Atlantic region of the United States . Several of the main measures of psychologic distress on healthcare workers were impacted by patient exposure , prior history of psychologic distress , and spiritual beliefs , supporting the evidence from prior studies of healthcare workers experiencing distress during pandemic crises . The finding of the importance of years of work experience in protecting employees from distress was unexpected .

Limitations of the study include the response rate of employees and the sample size . Although our sample size was similar to or greater than that of prior stud-

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