Health Care Professionals’ Experience of PTSD Symptoms While Working During COVID-19

Researchers compared the Impact of Event Scale-Revised and Insomnia Severity Index scores among 348 health care professionals and 350 control individuals at a hospital treating patients for COVID-19 in Turkey.

Providing psychological support to health care professionals (HCPs) helps facilitate rapid social recovery and control pandemics. Incidence of post-traumatic stress disorder (PTSD) was higher in HCPs — especially among nurses, women, and married HCPs — working during the COVID-19 pandemic than control group participants, a Turkish study published in The International Journal of Clinical Practice found.

The researchers included nurses and specialists who work in 4 departments for the follow-up and treatment of patients with suspected and diagnosed COVID-19 in the Van Training and Research Hospital in Van, Turkey. They compared these health care workers with control individuals who were patients who had sought care at the infectious diseases, clinical microbiology and urology outpatient clinics, had not previously had COVID-19, and did not have known comorbidities or regularly use drugs.

Participants (348 HCPs and 350 control individuals) completed the Impact of Event Scale-Revised (IES-R) and the Insomnia Severity Index (ISI).

Of the HCPs, 132 (67 doctors, 65 nurses) worked in the suspected patient area (SPA), 147 in the quarantine-treatment units (QTUs), and 69 in the intensive care unit (ICU) for COVID-19 patients. A total of 93 nurses and 123 doctors worked in the final diagnosis area (FDA), which consisted of the QTUs and the ICU.

Symptoms of stress disorder were seen in 134 HCP and 44 control individuals while insomnia was seen in 61 HCP and 45 control individuals. Stress disorder symptoms were higher among the HCPs (P <.001). Stress disorder symptoms were seen in 66 (34.8%) doctors and 68 nurses (43.1%). Insomnia was seen in 22 (11.6%) doctors and 21 (13.3%) nurses.

Median value of IES-R was significantly higher among the HCP group compared with the control individuals (23, 9, respectively, P <.001); among the nurses compared with the doctors (24, 21, respectively, P =.003); among women compared with men (24,18, respectively, P =.003); among married participants compared with single, divorced and widowed individuals (24, 14.5, respectively, P <.001); and among those working in the FDA compared with those working in the SPA (24, 13.5, respectively, P <.001).

Multivariate logistic regression analysis identified that nursing ([Odds ratio (OR) 2.55, 95% CI, 1.45–4.46 and P =.001]), being a woman (OR, 2.74, 95% CI, 1.55–4.86 and P =.001), being married (OR, 3.65, 95% CI, 1.84– 7.25 and P <.001) and working in the FDA (OR, 2.59, 95% CI, 1.40–4.77 and P =.002) were risk factors for stress disorder.

Limitations to the study include that the Turkish versions of the IES-R and ISI were used to evaluate the symptoms of PTSD and insomnia. Also, the fact that practically all of the HCPs working in the hospital in Van were employed in COVID-19-related units during the outbreak resulted in an inability to compare the staff working in the quarantine areas to those working outside. In addition, the study participants were composed of only HCPs working in the Van Training and Research Hospital, therefore, findings cannot be generalized to other regions.

“The higher rate of PTSD and insomnia symptoms among nurses shows that the nursing profession should receive more attention in terms of both psychological support and in-service training. …If measures are taken early on to address anxiety and psychological stress by providing psychological support and arranging in-service training to increase the awareness and experience of the HCPs, the impacts of the outbreak can be minimized and support can be optimal when combating major future outbreaks,” the study authors said.


Bulut D, Sayar MS, Koparal B, Bulut EC, Çelik S. Which of us were more affected by the pandemic? The psychiatric impacts of the COVID-19 pandemic on health care professionals in the province where the first quarantine units were established in Turkey. International J of Clin Practice. Published April 17, 2021. doi:10.1111/ijcp.14235