TABLE 4.
Nursing home staff mental health outcomes, by role
| Total | Nurses | HCAs | Nonclinical | Chi‐square | |||
|---|---|---|---|---|---|---|---|
| n = 390 | n = 120 | n = 172 | n = 98 | χ2 | p | p (adj.) c | |
| IES‐R 22, moderate/severe symptoms, % (95% CI) a | 45 (40–50) | 48 (39–57) | 42 (35–50) | 46 (36–56) | 1.02 | 0.599 | 0.579 |
| WHO‐5 a | |||||||
| Poor wellbeing, % (95% CI) | 39 (34–44) | 52 (43–61) | 70 (63–77) | 58 (48–68) | 12.38 | 0.015 | 0.005 |
| Likely major depression, % (95% CI) | 20 (16–24) | 23 (16–31) | 15 (9–20) | 26 (17–34) | 5.904 | 0.052 | 0.069 |
| Suicidal ideation, % (95% CI) b | 14 (10–17) | 13 (7–19) | 15 (9–20) | 13 (7–20) | 0.12 | 0.941 | 0.764 |
| Suicidal planning, % (95% CI) b | 9 (6–12) | 7 (2–11) | 11 (6–16) | 9 (3–15) | 1.60 | 0.445 | 0.972 |
| WAS, insufficient, % (95% CI) a | 25 (20–29) | 27 (19–35) | 26 (19–33) | 20 (12–28) | 1.29 | 0.524 | 0.444 |
| One‐way ANOVA | |||||||
|---|---|---|---|---|---|---|---|
| F | p | p (adj.) c | |||||
| IES‐R, Mean (SD) | |||||||
| Total | 25.9 (17.6) | 27.8 (16.5) | 25.1 (18.0) | 18.3 (1.8) | 1.00 | 0.369 | 0.522 |
| Avoidance | 9.7 (6.8) | 9.9 (6.4) | 9.5 (6.9) | 9.6 (7.2) | 0.12 | 0.890 | 0.619 |
| Hyperarousal | 5.5 (4.7) | 5.9 (4.4) | 5.3 (4.9) | 5.3 (4.5) | 0.67 | 0.369 | 0.503 |
| Intrusion | 9.6 (6.8) | 10.8 (6.6) | 9.1 (6.8) | 9.0 (7.0) | 2.46 | 0.087 | 0.345 |
| MIES, Mean (SD) | |||||||
| Total | 20.8 (9.1) | 22.5 (10.5) | 22.5 (10.5) | 19.1 (9.3) | 3.66 | 0.027 | 0.038 |
| Transgression ‐ others | 5.9 (3.0) | 5.7 (3.0) | 6.3 (3.1) | 5.4 (3.0) | 3.53 | 0.030 | 0.048 |
| Transgression ‐ self | 7.9 (4.8) | 7.5 (4.3) | 8.4 (5.0) | 7.4 (4.8) | 1.93 | 0.146 | 0.066 |
| Betrayal | 7.4 (4.0) | 7.6 (4.1) | 7.8 (4.2) | 6.4 (3.4) | 3.69 | 0.026 | 0.078 |
| Brief‐COPE, Mean (SD) | |||||||
| Avoidant | 20.8 (6.3) | 21.3 (6.1) | 20.9 (6.2) | 20.2 (6.6) | 0.82 | 0.442 | 0.463 |
| Approach | 28.8 (8.1) | 30.7 (8.0) | 28.8 (8.0) | 26.5 (7.9) | 7.50 | 0.001 | 0.045 |
| Religion | 3.7 (2.0) | 4.0 (2.1) | 3.8 (2.1) | 3.3 (1.7) | 3.04 | 0.049 | 0.116 |
| Humour | 3.4 (1.8) | 3.3 (1.6) | 3.4 (1.8) | 3.3 (1.8) | 0.05 | 0.949 | 0.612 |
| Covid‐19 perceptions, Mean (SD) | |||||||
| Health fear | 4.5 (1.2) | 4.4 (1.3) | 4.6 (1.2) | 4.5 (1.3) | 0.99 | 0.371 | 0.634 |
| Social isolation/avoidance | 3.5 (1.2) | 3.4 (1.2) | 3.5 (1.1) | 3.5 (1.2) | 0.69 | 0.500 | 0.052 |
| Job stress | 4.2 (1.2) | 4.2 (1.1) | 4.1 (1.2) | 4.3 (1.2) | 0.53 | 0.591 | 0.766 |
| Doubts about protection | 1.8 (0.8) | 1.7 (0.8) | 1.8 (0.8) | 1.7 (0.7) | 0.49 | 0.615 | 0.977 |
| Dissatisfaction with system/processes | 2.2 (0.9) | 2.2 (1.0) | 2.2 (0.9) | 2.3 (0.9) | 0.32 | 0.730 | 0.061 |
| Altruism perception, Mean (SD) | 4.8 (1.3) | 4.7 (1.4) | 4.9 (1.3) | 4.8 (1.4) | 0.91 | 0.405 | 0.840 |
Note: WHO‐5, World Health Organisation‐Five Wellbeing Index: maximum of 100; score of 33 or more indicates normal wellbeing over the past 2 weeks; 20 or less indicates likely major depression over the past 2 weeks. IES‐R: Impact of events scale revised (22 items); cut‐off of 26 or more indicates moderate to severe symptoms of post‐traumatic stress over the past 7 days. Work Ability Score: maximum of 10; cut‐off of 6 or more indicates current sufficient perceived work ability. MIES: Moral Injury Events Scale. Higher scores denote higher intensity of moral injury over the course of the Covid‐19 outbreak. Brief‐COPE: abbreviated version of the COPE (Coping Orientation to Problems Experienced) Inventory. Higher scores indicate higher reliance on this coping style over the course of the pandemic. Perceptions of health fear, social isolation and avoidance, job stress, dissatisfaction with system/processes, doubts about protection and altruism: Higher scores indicate increased identification with each domain over the course of the Covid‐19 outbreak.
Abbreviations: 95% CI, 95% confidence Interval; HCAs, healthcare assistants; SD, standard deviation.
Item dichotomised for analysis using cut‐off score.
Items are dichotomised for analysis (any suicidal ideation/planning vs. none).
Following regression analysis adjusting for age, ethnicity, years' experience, personal Covid‐19 contact history and history of Covid‐19 infection.