Post-Covid-19 Emotional Aspects of Hospital Staff

Overview

The ongoing SARS-CoV2 or Covid-19 pandemic is causing a major global health crisis. In France, it prompted an urgent reorganization of the healthcare supply, mobilizing caregivers and hospital staff in a climate of uncertainty. Health services have been put to the test, some staff being on the front line, others having faced the reorganization of the health system necessitated by such a pandemic. Frontline caregivers have been compared to "fighters on the front lines." They encountered many difficulties, such as direct exposure to patients with a high viral load, exposure to the risk of contamination, physical exhaustion, reorganization of workspaces, adaptation to rigid work organizations, the management of the shortage of materials, the unusually high number of deaths among patients, colleagues or relatives, ethical questions relating to decision-making in a strained healthcare system. The psychological impact on these hospital staff is an indirect issue of such a pandemic in terms of mental health. The investigators have little data in the literature on the incidence of psychiatric episodes in the post-epidemic period. Work on the impact of two major pandemics of influenza A H1N1 (2009) and SARS-CoV-1 (2003) on the mental health of caregivers and other staff working in hospitals reports increased rates of mental disorders after discharge from anxiety-type crisis, depression and post-traumatic stress. This over-representation of mental disorders was still found several years after the epidemic. Similar results are emerging in recent studies involving hospital staff who were used in the Covid-19 crisis. These highlight a certain number of risk factors for the occurrence of these disorders (young age, nursing profession, underlying psychiatric pathology, exercise carried out in the first line of Covid).

At the Paris Saint-Joseph Hospital Group (GHPSJ), a multidisciplinary working group was early involved in psychological support for staff. This group proposed the establishment of on-call duty entrusted to a psychological support unit, made up of a doctor, a nurse and a psychologist who volunteered to carry out patrols in the various departments of the hospital. These visits, sometimes organized at the request of the management of the services and sometimes improvised, aimed to identify the difficulties encountered in the field, and to discuss with the teams. Concomitantly and complementary, the staff bubble opened at the Paris Saint-Joseph Hospital on March 27, to offer a decompression space to all staff (caregivers or not) with proposals for hypnosis, physiotherapy, sophrology sessions. , psychotherapy, but also informal discussions or a break in a relaxing armchair. As a continuation of this approach, the multidisciplinary working group plans to search in July 2020 for symptoms present in certain mental illnesses (anxiety, depression, post-traumatic stress syndrome) in all the staff of the Paris Saint-Joseph Hospital Group. , now that the crisis seems to be receding. This will make it possible to adapt the support offer for staff in the coming months. This inventory will be made on the basis of validated questionnaires: the Posttraumatic stress disorder CheckList-5 (PCL) questionnaire for post-traumatic stress and the Hospital Anxiety and Depression scale (HAD) score for mental disorders (anxiety, depression) . A 3rd questionnaire will collect additional data and provide feedback on the frequentation of the bubble