Purpose: This study aims to analyze from a gender perspective the psychological distress experienced by the medical workforce during the peak of the pandemic.
Introduction: The COVID-19 pandemic has been a source of distress for the medical workforce. In our region, the pandemic was particularly distressful, as Spain ranked first in the number of healthcare workers infections during the period of our study. However, multiple studies on the psychological impact of the pandemic show that the levels of distress are not equally distributed, and women are more severely affected than men. Most studies found significant differences in stress and anxiety symptoms by gender and job category (2,3,4,5,6,7,8,9,10,11); the latter is usually subject to gender segregation, as women tend to occupy lower-paid jobs such as nursing. Meta-analytic studies demonstrate that being a woman and lower-paid jobs, such as nursery, are risk factors for higher psychological distress during the pandemic (12,13,14,15,16,17).
Methods: This is a single-center, observational analytic study that took place during May and June 2020. The study population comprised all associated health workers of the Cruces University Hospital, invited by email. It consisted of a questionary with four parts: the first included demographic data, followed by the general health questionary-28 (GHQ-28), the perceived stress scale (PSS-14), and finally, a survey for coping methods. A gender analysis was used to design and interpret data following the Sex and Gender Equity in Research (SAGER) guidelines. Statistical analysis was carried out using IBM® SPSS® Statistics version 25.0 (IBM GmbH, Ehningen, Germany). Categorical data were presented as frequencies and percentages, and continuous variables as median and standard deviation. The non-parametric Mann-Whitney U test and Kruskal-Wallis were applied to compare two or more groups, respectively. We conducted a Spearman's Rho correlation test between age and the PSS-14 score. A p-value of <0,05 was considered statistically significant.
Results: Women made 74,6% of our sample, but their proportion was higher in lower-paid positions such as nursery (89,9%). The percentage of women categorized as cases with the GHQ-28 was 78,4%, a proportion significantly higher than in the male population (61,3%, p<0,001). We found significant differences in the Perceived Stress Scale respecting gender (e.g., median PSS scores among females vs. males: 10.44 [6.34] vs. 7.06 [6.33], p<0,01). Orderly staff had the highest scores among all job categories, differences that were statistically significant.
The multivariant regression analysis showed that being female, lower-paid jobs, and having a past psychiatric history were risk factors for higher scores in both the GHQ-28 and PSS-14. The effect of gender was not influenced by age, marital status, or covid-19 infection.
Conclusion: Females and lower-paid positions are at risk of higher psychological distress and worse quality of life within the medical workforce due to the pandemic. Gender analysis must be incorporated to analyze better and explain this fact.
No conflict of interest
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