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Health care workers report anxiety, moral distress, unclear work delegation, preliminary COVID-19 research finds

Frontline mental health investigations supported by U of T's action fund for pandemic
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Dr. Rima Styra and Dr. Elizabeth Peter are both studying the impact of COVID-19 on the mental health of frontline health care workers. COURTESY OF RAYSON HOCCO/WIKIMEDIA
Dr. Rima Styra and Dr. Elizabeth Peter are both studying the impact of COVID-19 on the mental health of frontline health care workers. COURTESY OF RAYSON HOCCO/WIKIMEDIA

This spring, U of T created the almost-$9 million Toronto COVID-19 Action Fund to support high-impact research that helps fight COVID-19 and its economic and societal consequences. Funded projects range from attempts to develop new diagnostic tools for the disease to controlling outbreaks in long-term care homes.

The Varsity interviewed two recipients of the fund: Dr. Rima Styra, who is a part of the psychiatry department at the Faculty of Medicine and a Clinician Investigator at the Toronto General Hospital Research Institute, and Dr. Elizabeth Peter from the Bloomberg Faculty of Nursing. Both are studying the impact of COVID-19 on the mental health of frontline health care workers.

Styra’s ongoing research focuses on hospital-based health care workers and evaluates “the psychological impact of the COVID-19 pandemic” on them as well as the “risk factors that may place [health care workers] at higher risk of negative effects on their mental health.” The study consists of a cross-sectional online survey containing multiple choice and short answer questions conducted in several hospitals, and the participants are from both high-risk units — like emergency departments and COVID-19 units — and low-risk units. 

“The challenge of online research compared to in-person research is that there is not as great an opportunity to allow the participant to elaborate on their responses or for the researcher to ask further questions to dig deeper,” Styra wrote.

Although the researchers have not started to analyze their data yet, Styra wrote that the feelings of depression, anxiety, and post traumatic stress experienced by Canadian health professionals are similar to those expressed by their Chinese counterparts.

Peter’s team is studying the mental health impact of COVID-19 on nurses. According to Peter, nurses are currently experiencing significant moral distress, “which is the experience of not being able to do the right thing as result of constraining circumstances.” Her study aims to identify strategies that can reduce this moral stress. 

The team, consisting of four researchers including Peter, is interviewing nurses via Microsoft Teams. Although it is harder to establish rapport with the participants, Peter appreciates being able to reach nurses across Canada without having to travel anywhere.

According to Peter, the preliminary findings are that many nurses have been redirected to work in areas they are not used to, leading to concerns that they might not be “able to provide the best care possible.” Nurses also worry that they might be unable to protect their own health and well-being and that they may infect someone at home.

The uncertainty of working amidst the pandemic is also taking a toll on nurses. Even though they try to support patients themselves and use technology to connect patients to their families, many nurses are distressed when they witness someone die of COVID-19 alone.

Many nurses value the support of their coworkers and public recognition, and some seek help from professionals to help them deal with the aforementioned stress. “The creation of predictable and consistent work responsibilities would be very helpful along with the inclusion of frontline nurses in the decision-making regarding the delivery of health care services,” Peter wrote.