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

Mediavilla, Roberto, Monistrol-Mula, Anna, McGreevy, Kerry R., Felez-Nobrega, Mireia, Delaire, Audrey, Nicaise, Pablo, Palomo-Conti, Santiago, Bayón, Carmen, Bravo-Ortiz, María-Fe, Rodríguez-Vega, Beatriz, Witteveen, Anke, Sijbrandij, Marit, Turrini, Giulia, Purgato, Marianna, Vuillermoz, Cécile, Melchior, Maria, Petri-Romão, Papoula, Stoffers-winterling, Jutta, Bryant, Richard A., McDaid, David ORCID: 0000-0003-0744-2664, Park, A-La ORCID: 0000-0002-4704-4874 and Ayuso-Mateos, José Luis (2022) Mental health problems and needs of frontline healthcare workers during the COVID-19 pandemic in Spain: a qualitative analysis. Frontiers in Public Health, 10. ISSN 2296-2565

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Identification Number: 10.3389/fpubh.2022.956403


Background: Healthcare 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 methods: Following 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). Results: We 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. Conclusions: In 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.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Personal Social Services Research Unit
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
B Philosophy. Psychology. Religion > BF Psychology
Date Deposited: 28 Jul 2022 15:51
Last Modified: 04 Dec 2023 04:03

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