Occurrences of post-traumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study

Roger, Claire; Ling, Lowel; Petrier, Mélissa; Elotmani, Loubna; Atchade, Enora; Allaouchiche, Bernard; Aubrun, Frédéric; Constantin, Jean-Michel; Dahyot-Fizelier, Claire; Delhaye, Nathalie; Dupont, Hervé; Fischer, Marc-Olivier; Garnier, Marc; Gayat, Etienne; Ichai, Carole; Jaber, Samir; Morel, Jérome; Plaud, Benoit; Rimmelé, Thomas; Robin, Sylvaine; Saba, Renee; Joynt, Gavin M.; Lefrant, Jean-Yves; Fabbro-Peray, Pascale; Lipman, Jeffrey; Conejero, Ismael; Laupland, Kevin

doi:10.1186/s12991-023-00488-5

Annals of General Psychiatry

Table 3 Associated factors with the emotional exhaustion, depersonalization, and personal accomplishment scores

From: Occurrences of post-traumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study

N = 525^*	Score mean (SD)^ƚƚ	Median (IQR)^ǂǂ	Univariate analysis^ǂ		Multivariate analysis^* (N = 525)
N = 525^*	Score mean (SD)^ƚƚ	Median (IQR)^ǂǂ	β^§§	p-value	β^§§	p-value
Emotional exhaustion
Factors
Type of hospital
University hospital (n = 470)	22.9 (13.7)	22.0 (23.0)	1 [Reference]	.03	NA^**	NA
Public hospital (n = 52)	27.3 (13.1)	25.0 (25.0)	4.5	.03	NA	NA
Private hospital (n = 3)	36.0 (15.6)	44.0 (28.0)	12.8
Gender
Male (n = 146)	20.9 (14.0)	19.0 (22.0)	1 [Reference]	.002	NA	NA
Female (n = 379)	24.5 (13.5)	24.0 (23.0)	4.0	.002	NA	NA
Age (years)
< 30 (n = 171)	25.2 (13.5)	25.0 (24.0)	1 [Reference]	.09	NA	NA
30–39 (n = 187)	23.0 (13.7)	21.0 (22.0)	- 1.9		NA	NA
40–49 (n = 101)	23.1 (14.5)	21.0 (25.0)	- 2.2		NA	NA
≥ 50 (n = 66)	20.8 (13.0)	19.5 (22.0)	- 4.9		NA	NA
Usually, live alone
No (n = 400)	22.7 (13.7)	20.0 (23.0)	1 [Reference]	.04	1 [Reference]	.03
Yes (n = 125)	26.1 (13.4)	29.0 (23.0)	2.9	.04	2.9	.03
Living with a partner
No (n = 147)	25.2 (13.9)	25.0 (25.0)	1 [Reference]	.10	NA	NA
Yes (n = 378)	22.8 (13.6)	26.0 (24.5)	- 2.1	.10	NA	NA
Financially impacted during the pandemic
No (n = 443)	22.8 (13.6)	21.0 (23.0)	1 [Reference]	.007	NA	NA
Yes (n = 82)	27.3 (13.5)	29.0 (21.0)	4.3	.007	NA	NA
Occupation
Caregiver (n = 511)	23.2 (13.6)	22.0 (22.0)	1 [Reference]	.02	1 [Reference]	.02
Non-caregiver (n = 14)	32.1 (15.2)	37.0 (22.0)	8.2	.02	7.8	.02
Theoretical or practical training on individual preventive measures for managing COVID-19 patient
Yes (n = 391)	22.7 (13.3)	21.0 (22.0)	1 [Reference]	.01	NA	NA
No (n = 134)	25.7 (14.7)	25.0 (26.0)	3.5	.01	NA	NA
Hands-on training in the management of a COVID-19 patient
Yes (n = 291)	22.8 (13.3)	21.0 (21.0)	1 [Reference]	.01	NA	NA NA
No (n = 234)	24.4 (14.2)	23.5 (25.0)	3.0	.01	NA	NA NA
Regularly information on the evolution of the pandemic
Yes (n = 396)	22.0 (13.3)	20.0 (21.0)	1 [Reference]	< .0001	1 [Reference]	.0002
No (n = 129)	28.1 (14.1)	30.0 (25.0)	5.8	< .0001	5.0	.0002
Sufficient training to manage COVID-19 patient
Yes (n = 310)	21.7 (13.2)	20.0 (21.0)	1 [Reference]	.0001	1 [Reference]	.01
No (n = 215)	26.0 (14.0)	27.0 (24.0)	4.6	.0001	3.0	.01
Sufficient information for managing COVID-19 patient
Yes (n = 346)	21.8 (13.5)	20.0 (22.0)	1 [Reference]	< .0001	NA	NA
No (n = 179)	26.7 (13.6)	27.0 (24.0)	5.0	< .0001	NA	NA
Sufficient personal protective equipment
Yes (n = 345)	22.3 (13.8)	20.0 (23.0)	1 [Reference]	.01	NA	NA
No (n = 180)	25.8 (13.3)	26.0 (22.0)	3.3	.01	NA	NA
Management of COVID-19 patient
Yes (n = 486)	23.2 (13.6)	22.0 (22.0)	1 [Reference]	.12	NA	NA
No (n = 39)	27.0 (14.8)	29.0 (25.0)	3.5	.12	NA	NA
Agree to manage COVID-19 patient
Yes (n = 416)	22.3 (13.5)	20.5 (23.0)	1 [Reference]	< .0001	1 [Reference]	< .0001
No (n = 109)	28.0 (13.6)	29.0 (22.0)	8.5	< .0001	7.1	< .0001
Fear of managing COVID-19 patient
No (n = 249)	21.0 (13.4)	18.0 (21.0)	1 [Reference]	< .0001	1 [Reference]	< .0001
Yes (n = 276)	25.8 (13.6)	26.0 (22.0)	5.4	< .0001	4.5	< .0001
Request for moving from the unit
No (n = 503)	23.3 (13.8)	22.0 (24.0)	1 [Reference]	.11	NA	NA
Yes (n = 22)	27.2 (11.9)	29.5 (21.0)	4.7	.11	NA	NA
SARS-COV-2 contamination
No (n = 404)	23.1 (13.6)	21.0 (22.5)	1 [Reference]	.13	NA	NA
Yes (n = 121)	24.9 (14.0)	27.0 (24.0)	2.1	.13	NA	NA
Comorbidity at risk of severe COVID-19
No (n = 437)	23.0 (13.6)	21.0 (23.0)	1 [Reference]	.13	NA	NA
Yes (n = 88)	25.9 (14.1)	26.0 (24.0)	2.4	.13	NA	NA

N = 525	Score mean (SD)	Median (IQR)	Univariate analysis		Multivariate analysis (N = 525)
N = 525	Score mean (SD)	Median (IQR)	β	p-value	β	p-value
Depersonalization
Factors
Age (years)
< 30 (n = 171)	11.0 (6.8)	10.0 (11.0)	1 [Reference]	< .0001	1 [Reference]	< .0001
30–39 (n = 187)	9.5 (7.2)	8.0 (10.0)	- 1.3		- 1.3
40–49 (n = 101)	7.4 (6.6)	5.0 (9.0)	- 3.3		- 3.1
≥ 50 (n = 66)	5.8 (5.6)	3.5 (8.0)	- 5.0		- 4.4
Type of housing
House (n = 251)	8.1 (6.6)	6.0 (9.0)	1 [Reference]	.07	NA	NA
Apartment (n = 274)	10.0 (7.2)	8.0 (11.0)	1.2	.07	NA	NA
Looking after a child
No child to support/Not concerned/No (n = 395)	9.4 (7.2)	8.0 (12.0)	1 [Reference]	.14	NA	NA
Yes (n = 130)	8.1 (6.2)	6.0 (8.0)	- 1.0	.14	NA	NA
Living separately from his/her partner during the pandemic
Not concerned/No (n = 463)	8.9 (6.8)	7.0 (10.0)	1 [Reference]	.06	NA	NA
Yes (n = 62)	10.8 (7.8)	9.0 (14.0)	1.7	.06	NA	NA
Occupation
Caregiver (n = 511)	9.0 (7.0)	8.0 (11.0)	1 [Reference]	.12	NA	NA
Non-caregiver (n = 14)	12.1 (7.7)	11.5 (15.0)	2.9	.12	NA	NA
SARS-COV-2 contamination
No (n = 404)	8.5 (6.8)	7.0 (10.0)	1 [Reference]	.004	1 [Reference]	.01
Yes (n = 121)	11.0 (7.2)	10.0 (12.0)	2.1	.004	1.7	.01
Usually, live alone
No (n = 400)	8.6 (6.8)	7.0 (10.0)	1 [Reference]	.03	NA	NA
Yes (n = 125)	10.6 (7.5)	9.0 (11.0)	1.5	.03	NA	NA
Hands-on training in the management of a COVID-19 patient
Yes (n = 291)	8.9 (6.7)	8.0 (10.0)	1 [Reference]	.10	NA	NA
No (n = 234)	9.4 (7.3)	8.0 (12.0)	1.0	.10	NA	NA
Regularly information on the evolution of the pandemic
Yes (n = 396)	8.4 (6.6)	7.0 (10.0)	1 [Reference]	< .0001	1 [Reference]	.0003
No (n = 129)	11.3 (7.8)	10.0 (13.0)	2.8	< .0001	2.5	.0003
Sufficient training to manage COVID-19 patient
Yes (n = 310)	8.5 (7.3)	7.0 (10.0)	1 [Reference]	.009	NA	NA
No (n = 215)	9.9 (7.3)	9.0 (12.0)	1.6	.009	NA	NA
Sufficient information for managing COVID-19 patient
Yes (n = 346)	8.6 (6.6)	7.0 (10.0)	1 [Reference]	.01	NA	NA
No (n = 179)	10.1 (7.6)	8.0 (12.0)	1.6	.01	NA	NA
Sufficient personal protective equipment
Yes (n = 345)	8.6 (6.7)	7.0 (10.0)	1 [Reference]	.16	NA	NA
No (n = 180)	10.0 (7.4)	8.5 (12.0)	0.9	.16	NA	NA
Refusal to admit patients to the ICU even with available beds according to predefined criteria
No (n = 295)	8.2 (6.5)	7.0 (9.0)	1 [Reference]	.04	NA	NA
Yes (n = 309)	9.7 (7.3)	9.0 (12.0)	1.2	.04	NA	NA
Refusal to admit patients to the ICU because of unavailable beds	6.1 (5.8)	5.0 (7.5)
No (n = 216)	7.4 (6.4)	6.0 (10.0)	1 [Reference]	.007	NA	NA
Yes (n = 230)	7.2 (6.6)	5.0 (9.0)	1.7	.007	NA	NA

N = 525	Score mean (SD)	Median (IQR)	Univariate analysis		Multivariate analysis (N = 525)
N = 525	Score mean (SD)	Median (IQR)	β	p-value	β	p-value
Personal accomplishment
Factors
Type of hospital
University hospital (n = 470)	35.7 (7.9)	37.0 (11.0)	1 [Reference]	.003	1 [Reference]	.002
Public hospital (n = 52)	31.7 (7.9)	31.0 (12.5)	- 3.9		- 3.8
Private hospital (n = 3)	35.0 (5.2)	32.0 (9.0)	- 0.6		0.3
Occupation
Healthcare staff (n = 511)	35.4 (7.9)	36.0 (11.0)	1 [Reference]	.06	NA	NA
Non-healthcare staff (n = 14)	31.5 (8.4)	33.0 (10.0)	- 3.9	.06	NA	NA
Usually works in an ICU
Yes (n = 484)	35.4 (7.8)	36.0 (11.0)	1 [Reference]	.20	NA	NA
No (n = 41)	33.9 (9.0)	33.0 (15.0)	- 1.6	.20	NA	NA
Theoretical or practical training on individual preventive measures for managing COVID-19 patient
Yes (n = 391)	36.3 (7.4)	37.0 (11.0)	1 [Reference]	< .0001	1 [Reference]	< .0001
No (n = 134)	32.2 (8.6)	34.0 (13.0)	- 4.1	< .0001	- 3.3	< .0001
Hands-on training in the management of COVID-19 patient
Yes (n = 291)	36.6 (7.3)	38.0 (11.0)	1 [Reference]	< .0001	NA	NA
No (n = 234)	33.7 (8.4)	35.0 (12.0)	- 2.9	< .0001	NA	NA
Sufficient training to manage COVID-19 patient
Yes (n = 310)	36.5 (7.4)	38.0 (10.0)	1 [Reference]	< .0001	NA	NA
No (n = 215)	33.4 (8.3)	34.0 (12.0)	- 3.1	< .0001	NA	NA
Sufficient information for managing COVID-19 patient
Yes (n = 346)	36.6 (7.3)	32.0 (13.0)	1 [Reference]	< .0001	1 [Reference]	< .0001
No (n = 179)	32.6 (8.5)	32.0 (11.0)	- 4.0	< .0001	- 3.1	< .0001
Comorbidity at risk of severe COVID-19
No (n = 437)	35.7 (7.7)	37.0 (12.0)	1 [Reference]	.004	1 [Reference]	.01
Yes (n = 88)	33.0 (8.6)	35.0 (10.0)	- 2.6	.004	- 2.1	.01

^*According to the order of appearance of the survey forms, an imbalance in the completion rate was noted between the first questionnaire (Personal life questionnaire) and the last form (Personal and Professional questionnaire used to research the factors associated with the psychological disorders studied) (higher completion rate for the first questionnaire). To evaluate the prevalence associated with psychological disorders, all the answers filled in for each scale of evaluation of the latter were taken into account, although the questionnaire was not completed in full. For this reason, a difference in the numbers analyzed (between those for the prevalence of post-traumatic stress, anxiety, and depression and those for the analysis of associated factors) is observed (see Fig. 1). The search for factors associated with the occurrence of psychological disorders was carried out on 525 people (those who completed all the survey forms)
^ƚNumber of observations / Total number of observations
^ǂThe results presented correspond to the pre-selection of variables at p-value < 20%. The second selection of variables was made at the 5% threshold and then integrated into the multivariate model
^§Adjusted odd ratio with a 95% confidence interval
^**Not applicable
^ƚƚStandard deviation
^ǂǂInterquartile range
^§§Regression coefficient

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ISSN: 1744-859X

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