Frontiers in Public Health (Jul 2022)

Mental health problems and needs of frontline healthcare workers during the COVID-19 pandemic in Spain: A qualitative analysis

  • Roberto Mediavilla,
  • Roberto Mediavilla,
  • Roberto Mediavilla,
  • Anna Monistrol-Mula,
  • Anna Monistrol-Mula,
  • Kerry R. McGreevy,
  • Kerry R. McGreevy,
  • Mireia Felez-Nobrega,
  • Mireia Felez-Nobrega,
  • Audrey Delaire,
  • Pablo Nicaise,
  • Santiago Palomo-Conti,
  • Carmen Bayón,
  • Carmen Bayón,
  • Carmen Bayón,
  • María-Fe Bravo-Ortiz,
  • María-Fe Bravo-Ortiz,
  • María-Fe Bravo-Ortiz,
  • María-Fe Bravo-Ortiz,
  • Beatriz Rodríguez-Vega,
  • Beatriz Rodríguez-Vega,
  • Beatriz Rodríguez-Vega,
  • Beatriz Rodríguez-Vega,
  • Anke Witteveen,
  • Marit Sijbrandij,
  • Giulia Turrini,
  • Marianna Purgato,
  • Cécile Vuillermoz,
  • Maria Melchior,
  • Papoula Petri-Romão,
  • Jutta Stoffers-Winterling,
  • Richard A. Bryant,
  • David McDaid,
  • A-La Park,
  • José Luis Ayuso-Mateos,
  • José Luis Ayuso-Mateos,
  • José Luis Ayuso-Mateos,
  • RESPOND Consortium,
  • Giovanni Corrao,
  • Josep Maria Haro,
  • Antonio Lora,
  • Raffael Kalisch,
  • Vincent Lorant,
  • Ellenor Mittendorfer-Rutz,
  • Brenda Penninx,
  • Henrik Walter,
  • Rinske Roos

DOI
https://doi.org/10.3389/fpubh.2022.956403
Journal volume & issue
Vol. 10

Abstract

Read online

BackgroundHealthcare workers (HCWs) from COVID-19 hotspots worldwide have reported poor mental health outcomes since the pandemic's beginning. The virulence of the initial COVID-19 surge in Spain and the urgency for rapid evidence constrained early studies in their capacity to inform mental health programs accurately. Here, we used a qualitative research design to describe relevant mental health problems among frontline HCWs and explore their association with determinants and consequences and their implications for the design and implementation of mental health programs.Materials and methodsFollowing the Programme Design, Implementation, Monitoring, and Evaluation (DIME) protocol, we used a two-step qualitative research design to interview frontline HCWs, mental health experts, administrators, and service planners in Spain. We used Free List (FL) interviews to identify problems experienced by frontline HCWs and Key informant (KI) interviews to describe them and explore their determinants and consequences, as well as the strategies considered useful to overcome these problems. We used a thematic analysis approach to analyze the interview outputs and framed our results into a five-level social-ecological model (intrapersonal, interpersonal, organizational, community, and public health).ResultsWe recruited 75 FL and 22 KI interviewees, roughly balanced in age and gender. We detected 56 themes during the FL interviews and explored the following themes in the KI interviews: fear of infection, psychological distress, stress, moral distress, and interpersonal conflicts among coworkers. We found that interviewees reported perceived causes and consequences across problems at all levels (intrapersonal to public health). Although several mental health strategies were implemented (especially at an intrapersonal and interpersonal level), most mental health needs remained unmet, especially at the organizational, community, and public policy levels.ConclusionsIn keeping with available quantitative evidence, our findings show that mental health problems are still relevant for frontline HCWs 1 year after the COVID-19 pandemic and that many reported causes of these problems are modifiable. Based on this, we offer specific recommendations to design and implement mental health strategies and recommend using transdiagnostic, low-intensity, scalable psychological interventions contextually adapted and tailored for HCWs.

Keywords