Episode 018 – How stressed are healthcare providers during the COVID-19 pandemic?

Episode 18. How stressed are healthcare providers during the COVID-19 pandemic? I’m your host Karma Chavez. And we’re continuing with our series on research conducted by faculty research, scientists and other affiliates of the Latino research Institute. Today, we’re talking with professor Nelly Salgado de Snyder research fellow with the LRI professor Salgado is a professor and senior researcher in medical sciences at the national Institute of public health of Mexico. She holds a doctorate in social welfare from UCLA and a BA and master’s degree in psychology from the national autonomous university of Mexico.

She is the founder of the global health program of the national Institute of public health of Mexico and the Latin American global health. Her research has focused on the interface of health sciences and social and behavioral sciences and the study of vulnerable populations in context of social inequity.

In recent research, professor Salgado and colleagues conducted a study to describe and evaluate levels of stress, anxiety, and depressive, symptomatology, and coping behaviors among healthcare workers and providers who serve underprivileged groups, such as immigrants, refugees, people living in poverty, homeless, and other socially vulnerable populations amid the COVID-19 pandemic in the United.

Today professor Salgado will discuss the findings and implications of this important research professor Salgado. Welcome to LatinXperts.

Thank you. Thank you for this invitation. And I am very happy to be here with you

well, I wonder if you could just tell us a little bit about what prompted you to conduct this study on stress in healthcare workers and provide.

Well, the main reason for this, you know, we were seeing increasing numbers of COVID cases and, uh, at the same time, you know, You see patients on nurses on healthcare workers in general were overworked on under a lot of stress, tending to the needs of just all the patient population. And this particular project was with dose providers.

And the health care workers who attended needs to own their privilege, socially underprivileged groups, as you just mentioned, some of those groups. So, uh, it has been reported in the literature vast these providers suffer a lot more stress and anxiety because oftentimes they do, they feel they do not have the necessary resources to help, uh, their clients, uh, therefore the you’re exposed to increasing levels of stress, anxiety, and even the depressive of symptomatology.

So I wanted to know how the COVID-19. And Dimmick was impacting the functioning, the psychosocial functioning, the wellbeing of these healthcare workers and service providers.

And who are these service providers? Demographically. Is it largely women? Are they people of color? Who are the people that are in this study?

Okay in this study? Uh, well, let me just briefly mention that, that we invited. People who are affiliated you start Confucius on in general, just the providers like health care workers, a few mediated with two national organizations. Uh, if you’ve got three states providing services to these, uh, vulnerable groups.

So it was a large group of people. And, uh, in terms of profession, most, some of them, uh, about 50% roughly were community health workers. Um, the rest were either nurses decisions, case managers, uh, behavioral health providers, medical assistants, or dieticians, And yes, most of them were women. Uh, about 86% were women and, 75% happened to be Latinas.

Uh, most of them were married with children and the family size of about 2.5 people. so unveil of course, most of them at least award in the Southwestern states of the United States,

And so most of the folks are probably, or many of the folks are here in Texas could be friends and neighbors, people that you’re interacting with on a daily basis. If you’re living here in Austin, correct.

correct.

Yes, absolutely.

And so when you give us an overview of what you found, what’s the gist of the findings in this study?

Okay. So what we found is that in general these healthcare workers and service providers had high levels of. Personal and job related stress that was associated with working. Over time that, uh, they were many of them as being burned out. Some of them, their, uh, spouse had lost the job.

The children were at home. So it was a combination of personal issues , job related issues and just in general self-rated mental health was worse than physical health. We also found a high proportion of these people, of these providers with high levels of anxiety and depressive symptoms which could turn into serious mental health problems, if they’re not attended.

Most of those presenting his problems were women under the age of 50 and, uh, had a graduate degree and reported working additional hours during the pandemic. So basically that’s what it was. Uh, perceived general stress was low to moderate with about 15% experiencing high levels of stress during the previous 14 days of the.

And so in experiencing both of those low and the high levels, were there specific catalysts that were leading to the anxiety and stress and depressive symptoms? Or was it just the general experience of living through this pandemic as a healthcare leader?

I think it was just a social Unrest the concern that, uh, he’s there, you know, during the pandemic. But as I mentioned before, some of them were going through some personal issues, such as, their spouse losing their job, or being afraid of bringing the virus home and infecting the members of the family.

So, other issues had to do with, uh, perceiving that they were not completely protected as far as personal protection equipment and that they felt that risk. So these added some stress to what they already were feeling.

Right. Right. And are these normally considered stressful jobs? In other words, do the people in your study, would they normally test for high levels of sex?

So I would say yes, because when you provide services to others, of course, there is certain level of stress involved. But when it comes to serving those who are already marginalized by society. Such as people living in poverty, uh, refugees, migrants, homeless, farm workers. It’s hard because they need.

Much more resources of the general population when your institution or your agency or yourself, if you’re not able to provide all those services, there is a sense of frustration that adds to the regular working responsibilities.

Yeah, that makes a lot of sense. And then what’s your particular study? What do you think was the most surprising thing that you found? Was there anything that really kind of stood out?

Well, uh, perhaps the morsel pricing thing is that in spite of the fact that duke were health workers, um, Uh, they I’m assuming they knew about the importance of seeking mental health support or taking care of themselves, or maybe a few sub mental health supports or reporting. One of the findings is that almost 7% seek in person mental health support.

And about 21%, it was virtual. So they did not perceive the need of seeking mental health when they in fact were on there. A lot of stress, also, not all of them involved in self care behaviors, such as meditation exercise, so relaxation. To me it’s sort of surprising because I just, I assume that if you are in, in a job in Quitch, uh, you are exposed to so many stressors and you are aware of that.

You try to find spaces for , releasing that stress, find help if necessary. But of course, I can also understand that the pressure from work is there perhaps there is no time to attend to the, uh, uh, Pressures and family pressures. And then, taking care of the needs of the personnel needs is, is going to be very, very hard for these providers, um, healthcare workers.

Well, and I, I don’t know that your research looked at this, but I I’m interested to hear your thoughts because I can’t help, but feel that there’s clearly something about gender socialization. That’s at play here in that women carry the weight. World on their shoulders kind of generally. And so they’re constantly other oriented towards their families, towards the people they’re caring for, et cetera.

Do you think gender has any explanation here in our explanatory power?

Oh, yes, absolutely. I just, the fact that 86% of our respondents were women. So we know in general that women are over-represented in shelf, professionals cause we tend to take. Well, everyone families, uh, you know, I would call Morgus just the arts of the gender socialization practices that we have, particularly in Latino culture.

So Yeah, I believe that gender has some explanatory power here because most of these were women. In fact, the ones that had higher ratings of anxiety, the purchase of symptomatology and stress, where were women. And it’s precisely related to the fact that we have multiple roles for women. And we try to take care of everything when it’s, uh, you know, assume on, take on us responsibilities that perhaps, uh, do not respond to us.

All of us, all of them, the women. But, uh, but yes, definitely gender is closely related to this.

Yeah, it makes sense. And I guess maybe. That leads me to another question that’s connected to these previous two. And so, you know, mentioning the fact that a lot of folks weren’t taking care of their mental health, or weren’t maybe doing some things that they could have done to support their mental health.

Um, so what would you say based on your research then if someone is a healthcare worker or provider, or if someone listening is a loved one of someone in the health professions, what should they take away from your study? Or, or what can people individually do to alleviate some of their stress in these countries?

Yeah.

I think something, uh, very important that most of them were already doing that is socializing, you know, trying to find support in friends and family. that is very important. Developing social networks and maintaining these strong networking, uh, you know, support system is extremely important for, uh, service providers.

Um, the old slimeball rent each other self care behaviors, such as a regular routine exercise meditation. Yeah.

Uh, and of course the depression , but all of these are behaviors that will help to control the stress. And that’s in general just, uh, to improve the wellbeing.

And I want to make sure we don’t just reduce this to a question of personal behavior, because of course there are bigger policy implications of your study. Um, and so beyond the individuals who are suffering stress, who should take action, should it only be clinics and employers and professional associations, or do state and local groups.

Also have a responsibility.

I think we should all be responsible for maintaining the health of the population, but yes, of course, uh, the results study have also been occasions for Boise makers and for organizations, for institutions, agencies where they have, , healthcare workers,

Learning new healthy coping mechanisms and that just providing the spaces and providing the resources so that health care workers and providers. Con thinking of their meant by health. Uh, definitely these health care facilities and organizations, associations of healthcare professionals on health workers.

Uh, they should get involved as I said in promoting these, healthier behaviors, but also in providing the, uh, personal protection equipment that is necessary for them to feel that.

And so you offered a number of possibilities. There was some, uh, online workshops and other kinds of resources are, are these hypothetical or are there already clinics and other organizations that are in fact providing these kinds of services, uh, for their employees who are healthcare workers and provide.

No, these aren’t all hypothetical. In fact, that organizations that are already providing these types of services to their affiliates, for instance, migrant munitions network, which is one of the organization we’ve seen a whole, we work with, these, there, there are many online resources that have been developed in the last, I want to say the last three months, on the resources that are available and we know that these resources do help to decrease the stress levels and to perform better in their job.

And so with that in mind, if there is one primary audience that you really hope reads this research and does something with it, who would be that.

I would say healthcare facilities. The employers and associations of healthcare professionals. Basically these recommendations would go.

And so what’s next then with this research project. So are you continuing to do this type of study as the pandemic goes on? Or where does this research go for?

The findings of the research are important even after the epidemic because we may be facing. Uh, another pandemic, another situation that has a high demand on time and resources of, uh, health personnel. So if you see boards have to be ready to be prepared.

So what he SPC is the first part we are conducting, but we’ve already collected a second one. Uh, data and we are finding on comparing the first wave, uh, with the results of the second wave. That is six months later, we’re working on that. So that should give us an idea or quad, uh, if there were any changes.

You know, in the last six months from the time of one to do the second way. Um, so that would be important to be prepared for the future and the implications. Not only for COVID, as I said, not only for public health, emergencies, uh, are there to take care of the mental health of these,of these providers.

Well, it seems to me that part of what you’re saying to professor Salgado is that, uh, what happens in COVID times, which seem unusual, maybe was less unusual and just put pressure points on some of the weak spots that were already there. And so these services not being present, for example, or some stressors already existing, just got exacerbated in the pandemic.

And that’s why the lessons from the pandemic remain so important in this context is that fair to say.

Yes, definitely.

Well, professor Salgado. I really appreciate having this conversation with you today. That brings us to the end of our time. Uh, but thank you so much.

Thank you. Thank you for this invitation.

And our guest today was Dr. Nelly Salgado, D Snyder. Who’s a senior research fellow with the Latino Research Institute, and I’ve been your host, Karma Chavez. And this is LatinXperts.