Resumen
Introducción: existen factores laborales que influyen en la presencia de la depresión.
Objetivo: determinar la asociación entre la exposición a la COVID-19 y la depresión en médicos y enfermeras de los cuatro hospitales del Centro Médico Nacional Siglo XXI (CMN SXXI): Oncología, Especialidades, Cardiología y Pediatría.
Material y métodos: se realizó un estudio transversal, en enero del 2022, con 870 participantes pertenecientes a la población de médicos y enfermeras que laboraban en el CMN SXXI, se excluyó a los trabajadores que se encontraban con incapacidad, al personal temporal y/o con menos de un año de antigüedad laboral. A través de un cuestionario autoaplicable se interrogó sobre el grado de exposición laboral a la atención de pacientes con COVID-19, antecedentes de infección por la COVID-19 y el cuestionario de salud del paciente (PHQ-9). El análisis incluyo medidas de frecuencia simple y razón de Momios (RM), Chi cuadrada y regresión logística múltiple con p ≤ 0.05.
Resultados: la prevalencia de depresión en personal médico y de enfermería del CMN SXXI fue del 32.2% (grado moderado a severo). En la regresión múltiple se encontró asociación con no identificar apoyo por parte del Instituto (RM: 1.60, IC95%: 1.08-2.39, p = 0.02), alta exposición laboral (RM: 8.35, IC95%: 3.02-23.09, p ˂ 0.0001) y más de 5 días laborados a la semana atendiendo pacientes con la COVID-19 (RM: 2.51, IC95%: 1.35-4.49, p = 0.004) y como factor protector el que nunca se hayan enfermado de la COVID-19 (RM: 0.61, IC95%: 0.43-0.86, p = 0.01).
Conclusiones: la prevalencia de depresión fue mayor a la esperada y se asoció con el grado de exposición laboral en la atención de pacientes con la COVID-19.
Abstract
Background: There are many working factors to do with depression.
Objective: To determine the association between the exposure to COVID-19 and depression in physicians and nurses from the four hospitals at “Centro Médico Nacional Siglo XXI” (CMN SXXI) took part in: Oncology, Specialties, Cardiology and Pediatrics.
Material and methods: A cross-sectional study of 856 participants took place in January 2022, excluding workers, such as physicians and nurses from the CMN SXXI, disabled workers, staff with a union agreement, support staff and/or staff with less than one year of work labour. Through a self-administered questionnaire, the degree of occupational exposure to patients care with COVID-19, a history of COVID-19 infection, and the patient’s health quiz were asked (PHQ-9). The analysis included simple frequency measurements, odds ratio (OR), Chi squared and multiple logistics regression with p ≤ 0.05.
Results: The prevalence of depression in the medical and nursing staff at CMN SXXI was 32.2% (moderate to severe degree); In the multiple regression, an association was identified with not identifying support by the Institute (OR: 1.60, CI95%: 1.08-2.39, p = 0.02), high occupational exposure (OR: 8.35, CI95%: 3.02-23.09, p ˂ 0.0001), and more than 5 working days a week serving the COVID-19 patients (OR: 2.51, CI95%: 1.35-4.49, p = 0.004) and as a protective factor the fact that they have never had the COVID-19 (OR: 0.61, CI95%: 0.43-0.86, p = 0.01).
Conclusions: The prevalence of depression was higher than expected being associated with the degree of occupational exposure in the COVID-19 patients´ assistance.
Medina-Mora Icaza ME, Borges-Guimaraes G, Lara C, et al. Prevalencia de sucesos violentos y de trastorno por estrés postraumático en la población mexicana. Salud Pública Mex. 2005;47(1):8-22. doi: 10.1590/s0036-36342005000100004.
Organización Mundial de la Salud. Depresión [Internet]. 2020 [citado 2023 Jul 10]. Disponible en: https://www.who.int/es/ news-room/fact-sheets/detail/depression.
Murray CJL, Lopez AD, Jamison DT. La carga global de enfermedad en 1990: resumen de los resultados, análisis de la sensibilidad y orientaciones futuras. Bol Oficina Sanit Panam. 1995; 118(6):510-28.
Mingote-Adán JC, Gálvez-Herrera M, Pino-Cuadrado P, et al. El paciente que padece un trastorno depresivo en el trabajo. Med segur trab. 2009;55(214):41-63.
Gómez-Martínez S, Ballester-Arnal R, Beatriz Gil-J, et al. Ansiedad, depresión y malestar emocional en los profesionales sanitarios de las Unidades de Cuidados Intensivos. Anal Psicol. 2015;31(2):743-50. doi: 10.6018/analesps.31.2.158501.
Agerbo E, Gunnell D, Bonde JP, et al. Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences. Psychol Med. 2007;37(8):1131-40. doi: 10.1017/ S0033291707000487.
Dutheil F, Aubert C, Pereira B, et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS One. 2019 Dec 12;14(12):1-28. doi: 10.1371/journal. pone.0226361.
McFarland DC, Hlubocky F, Susaimanickam B, et al. Addressing Depression, Burnout, and Suicide in Oncology Physicians. Am Soc Clin Oncol Educ Book. 2019; 39:590-8. doi: 10.1200/ EDBK_239087.
Mora-Magaña I, Lee SA, Maldonado-Castellanos I, et al. Coronaphobia among healthcare professionals in Mexico: A psychometric analysis. Death Stud. 2022; 46(2):280-9. doi:10. 1080/07481187.2020.1808762.
Shechter A, Diaz F, Moise N, et al. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007.
Secretaría del Trabajo y Previsión Social. Guía de Acción para los Centros de Trabajo ante el COVID-19. 2020 abr. [citado 2023 Jul 10]. Disponible en: https://www.gob.mx/cms/ uploads/attachment/file/548062/GUI_A_DE_ACCIO_N_PARA_LOS_CENTROS_DE_TRABAJO_ANTE_EL COVID-19_24_04_20_VF.pdf .
Bian C, Li C, Duan Q, et al. Reliability and validity of patient health questionnaire: Depressive syndrome module for out-patients. Sci Res Essays. 201;6(2):278–82. doi: 10.5897/ SRE10.638.
Ali EA, Sehlo MG, Hussein RA, et al. Prevalence and correlates of depressive symptoms among nurses during COVID-19 pandemic. Egypt J Neurol Psychiatr Neurosurg. 2023; 59(1):15. doi: 10.1186/s41983-023-00616-8.
Adhikari SP, Rawal N, Shrestha DB, et al. Prevalence of Anxiety, Depression, and Perceived Stigma in Healthcare Workers in Nepal During Later Phase of First Wave of COVID-19 Pandemic: A Web-Based Cross-Sectional Survey. Cureus. 2021; 13(6):1-15. doi: 10.7759/cureus.16037.
Backenstrass M, Frank A, Joest K, et al. A comparative study of nonspecific depressive symptoms and minor depression regarding functional impairment and associated characteristics in primary care. Compr Psychiatry. 2006;47(1):35-41. doi: 10.1016/j.comppsych.2005.04.007.
Löwe B, Kroenke K, Herzog W, et al. Measuring depression out-come with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord. 2004; 81(1):61-6. doi: 10.1016/S0165-0327(03)00198-8.
Lai J, Ma S, Wang Y, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020; 3(3):1- 12. doi: 10.1001/jamanetworkopen.2020.3976.
Guillen-Burgos HF, Gomez-Ureche J, Renowitzky C, et al. Prevalence and associated factors of mental health outcomes among healthcare workers in Northern Colombia: A cross-sectional and multi-centre study. J Affect Disord Rep. 2022; 10:1-8. doi: 10.1016/j.jadr.2022.100415.
ALGhasab NS, ALJadani AH, ALMesned SS, et al. Depression among physicians and other medical employees involved in the COVID-19 outbreak: A cross-sectional study. Medicine (Baltimore). 2021;100(15):1-7. doi: 10.1097/MD.0000000000025290.
Wozniak H, Benzakour L, Moullec G, et al. Mental health out-comes of ICU and non-ICU healthcare workers during the COVID-19 outbreak: a cross-sectional study. Ann Intensive Care. 2021;11(1):1-10. doi: 10.1186/s13613-021-00900-x.
Murat M, Köse S, Savaşer S. Determination of stress, depression and burnout levels of front-line nurses during the COVID-19 pandemic. Int J Ment Health Nurs. 2021;30(2):533-43. doi:10.1111/inm.12818.
Erquicia J, Valls L, Barja A, et al. Emotional impact of the COVID-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe. Med Clin (Engl Ed). 2020;155(10):434-40. doi: 10.1016/j.medcle.2020.07.010.
Gainer DM, Nahhas RW, Bhatt NV, et al. Factors associated with depression and anxiety symptoms among U.S. physicians during the first phase of the COVID-19 pandemic. Int J Health Promot Educ. 2022;1(17): 1463-5240. doi: 10.1080/ 14635240.2022.2028264.
Sampaio F, Sequeira C, Teixeira L. Nurses› Mental Health During the COVID-19 Outbreak: A Cross-Sectional Study. J Occup Environ Med. 2020 62(10):783-7. doi: 10.1097/JOM. 0000000000001987.
Arnetz JE, Goetz CM, Sudan S, et al. Personal Protective Equipment and Mental Health Symptoms Among Nurses During the COVID-19 Pandemic. J Occup Environ Med. 2020;62 (11):892-7. doi: 10.1097/JOM.0000000000001999.
Espinoza-Ascurra G, Gonzales-Graus I. Meléndez-Marón M et al. Prevalencia y factores asociados a depression en personal de salud durante la pandemia de SARS-CoV-2 en el departamento de Piura, Perú. Rev Colomb Psiquiat. 2022;30(20): 1-10. doi: 10.1016/j.rcp.2021.11.05.