The impact of the Covid-19 pandemic and previous natural disasters on the mental health of healthcare workers in Puerto Rico

Ruthmarie Hernández-Torres; Marijulie Martínez Lozano; Irma Torres; Ernesto Rosario-Hernández; Alíxida Ramos-Pibernus; Ana Soto; Luisa Ortiz; Franco Mascayano; Eliut Rivera-Segarra

doi:10.1371/journal.pgph.0001784

The impact of the Covid-19 pandemic and previous natural disasters on the mental health of healthcare workers in Puerto Rico

PLOS Glob Public Health. 2023 May 17;3(5):e0001784. doi: 10.1371/journal.pgph.0001784. eCollection 2023.

Affiliations

¹ Ponce Health Sciences University, Ponce, Puerto Rico.
² Clinical and Translational Institute, University of Rochester, New York, New York, United States of America.
³ University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
⁴ NeoMed Center Inc., Gurabo, Puerto Rico.
⁵ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America.
⁶ New York Psychiatric Institute, New York, New York, United States of America.

Abstract

The objective of this study was to assess the impact of COVID-19 pandemic worries (e.g., fear of contagion) and previous exposure to natural disasters (e.g., hurricanes) on Healthcare Workers (HCWs) mental health in Puerto Rico. Participants completed a self-administered online survey including items on sociodemographic information, working conditions, fears, and worries about the COVID-19 pandemic, past natural disaster experiences, depressive symptoms, and resilience. Logistic regressions models were performed to explain the relationship between depressive symptomatology and COVID-19 experiences and worries. 40.9% (n = 107) of the sample were classified as having some level (mild to severe) of depressive symptomatology (PHQ-8 ≥5). Results reflect normal to high levels of psychological resilience (BRS; M = 3.7, SD = 0.7). A significant association was found between depressive symptomatology and psychological resilience (OR = 0.44, 95% CI: 0.25-0.77). The odds of having depressive symptomatology were almost five times higher (OR = 4.79, 95% CI: 1.71-13.44) among those who reported emotional coping difficulties during the pandemic after experiencing a natural disaster compared to those that did not, when adjusting for psychological resilience and residence region. Despite normal to high psychological resilience levels, HCWs who reported emotional coping difficulties due to previous disasters were at risk of developing depressive symptomatology. Results suggest interventions to address the mental health of HCWs could benefit from considering other individual and environmental factors beyond resilience. Findings could inform future interventions to promote HCWs' well-being before, during, and after a natural disaster or pandemic outbreak.

Copyright: © 2023 Hernández-Torres et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

Dr. Rivera-Segarra and this publication were supported by the National Institute on Minority Health and Health Disparities under award U54MD007579. Dr. Rivera-Segarra is also supported by the National Institute of Mental Health under award R34MH120179. Dr. Hernández-Torres is supported by the University of Rochester CTSA award number TL1 TR002000 from the National Center for Advancing Translational Sciences of the National Institutes of Health. Dr. Ramos-Pibernus was supported by the National Cancer Institute under award 1R21CA233449. The content is solely the authors’ responsibility and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.