Clinical Decision Making During COVID-19 Linked to Stress Symptoms in Health Care Professionals

The COVID-19 pandemic has challenged the mental health of healthcare professionals (HCPs) by creating difficult situations for them to operate in. A rapid rise in the number of patients in contrast with the scarce availability of resources required HCPs to make important clinical decisions, classified as potentially traumatic events. While such ‘traumatic’ decision making events are known to have occurred during the COVID-19 pandemic, it is not clear if they resulted in the occurrence of mental health disorders in HCPs.

In this study, researchers from Japan sought to validate these claims by examining the link between clinical decision making for patients with COVID-19 and the incidence of post-traumatic stress symptoms (PTSS) among HCPs.

The research team surveyed 515 HCPs belonging to the two major disaster relief teams in Japan. The study was conducted as a part of the Japanese survey of the COVID-19 HEalth care wOrkErS (HEROES), and included physicians, nurses, and other HCPs as respondents.

The team found that around one in three HCPs had to make clinical decisions for patients during COVID-19. Moreover, the experience of clinical decision making for patients with COVID-19 and the fear of acquiring infections were the only major factors underlying PTSS among HCPs.

Interestingly though, clinical decision making was strongly associated with PTSS only among nurses, and not among physicians and other HCPs. The researchers suggest that this association may be influenced by the trauma of making unfamiliar and difficult clinical decisions for patients during the COVID-19 outbreak.

In contrast to the previous findings, no other factor was found to be associated with mental health of HCPs.

Moreover, the association between clinical decision making and PTSS was not influenced by past contact with patients with COVID-19, suggesting that mental health care may be important for HCPs irrespective of prior experience.

To sum up, this study identified a key factor associated with the mental health of HCPs during the COVID-19 pandemic, which was previously unknown. Going ahead, comprehensive mental health training programs and care for HCPs, especially for nurses should be encouraged to reduce the incidence of PTSS in HCPs. As a countermeasure, hospital managers must also ensure safe working environments to reduce the risk of infection in HCPs.

Link to the original journal article:
https://www.jstage.jst.go.jp/article/eohp/4/1/4_2022-0018-OA/_article/-char/en