A total of 681 respondents (49.38%) endorsed PTSS 341 (24.73%), symptoms of depression 273 (19.80%), symptoms of anxiety 114 (8.27%), insomnia and 302 (21.90%), high perceived stress ( Table 1).Ī total of 18 participants (1.31%) were excluded from regression analysis because of missing data.
Sample characteristics are reported in Table 1. Statistical significance was set at P < .05, and all tests were 2-tailed.Ī total of 1379 HCWs completed the questionnaire the response rate could not be calculated. Analyses were conducted in Stata version 16 (StataCorp). The association between outcomes and potential risk factors was assessed by seemingly unrelated regression models that allow joint modelling of correlated outcomes. Age was standardized to a mean (SD) of 0 (1) and then reversed (ie, multiplied by −1) to show a positive coefficient.Ī multivariable logistic regression model was fitted to explore the association of the selected outcomes with sex, age, frontline working position, occupation, and self and colleagues’ exposure to contagion. Because no official cutoff for the PSS was available, a quartile split was used. Cutoffs were extracted from the original articles describing each measure. 6 Participants were classified as endorsing the previously listed symptoms according to the following cutoffs: at least 3 on the 5 item GPS–posttraumatic stress disorder subscale, at least 15 on the PHQ-9, at least 15 on the GAD-7, and at least 22 on the ISI. Frontline and second-line HCWs were defined by a single yes or no question, “Are you currently working with COVID-19 patients?” Key mental health outcomes were posttraumatic stress symptoms (PTSS), symptoms of depression, anxiety, insomnia, and perceived stress, assessed using the Italian version of the Global Psychotrauma Screen (GPS), 2 the 9-item Patient Health Questionnaire (PHQ-9), 3 the 7-item Generalized Anxiety Disorder scale (GAD-7), 4 the 7-item Insomnia Severity Index (ISI), 5 and the 10-item Perceived Stress Scale (PSS). The questionnaire investigated demographic variables, workplace characteristics (ie, being a frontline or second-line worker), and information regarding the direct consequences of COVID-19, including having colleagues infected or deceased. Because of the self-selected and nonprobabilistic nature of the sample, invitations and response rates could not be quantifiable, as reported by American Association for Public Opinion Research ( AAPOR) reporting guideline. All HCWs reporting that they work in Italy were eligible.
The sampling period corresponded to the days immediately preceding the COVID-19 contagion peak, associated with the highest level of health care system utilization. Online consent was obtained from the participants. Approval for this study was obtained from the local institutional review board at University of L’Aquila.
This cross-sectional, web-based study collected data between March 27 and March 31, 2020, using an online questionnaire spread via social networks using a snowball technique and sponsored social network advertisements. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.