Background The coronavirus disease 2019 (COVID-19) outbreak has been associated with stress and challenges for healthcare professionals, especially for those working in the front-line of treating COVID-19 patients. This study aimed to: 1) assess changes in well-being and perceived stress symptoms of Dutch emergency department (ED) staff in the course of the first COVID-19 wave, and 2) assess and explore stressors experienced by ED staff since the COVID-19 outbreak. Methods We conducted a cross-sectional study. An online questionnaire was administered during June–July 2020 to physicians, nurses and non-clinical staff of four EDs in the Netherlands. Well-being and stress symptoms (i.e., cognitive, emotional and physical) were scored for the periods pre, during and after the first COVID-19 wave using the World Health Organization Well-Being Index (WHO-5) and a 10-point Likert scale. Stressors were assessed and explored by rating experiences with specific situations (i.e., frequency and intensity of distress) and in free-text narratives. Quantitative data were analyzed with descriptive statistics and generalized estimating equations (GEE). Narratives were analyzed thematically. Results In total, 192 questionnaires were returned (39% response). Compared to pre-COVID-19, the mean WHO-5 index score (range: 0–100) decreased significantly with 14.1 points ( p < 0.001) during the peak of the first wave and 3.7 points (< 0.001) after the first wave. Mean self-perceived stress symptom levels almost doubled during the peak of the first wave (≤0.005). Half of the respondents reported experiencing more moral distress in the ED since the COVID-19 outbreak. High levels of distress were primarily found in situations where the staff was unable to provide or facilitate necessary emotional support to a patient or family. Analysis of 51 free-texts revealed witnessing suffering, high work pressure, fear of contamination, inability to provide comfort and support, rapidly changing protocols regarding COVID-19 care and personal protection, and shortage of protection equipment as important stressors. Conclusions The first COVID-19 wave took its toll on ED staff. Actions to limit drop-out and illness among staff resulting from psychological distress are vital to secure acute care for (non-)COVID-19 patients during future infection waves. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06555-5.
【저자키워드】 COVID-19, coronavirus, mental health, emergency department, Well-being, 【초록키워드】 coronavirus disease, Perceived stress, protocol, Stress, cross-sectional, equipment, healthcare professionals, Symptom, COVID-19 outbreak, outbreak, Patient, Psychological distress, Physicians, First wave, Care, questionnaire, Likert scale, Frequency, distress, Nurse, Netherlands, emotional, Support, World Health Organization, stressors, intensity, cognitive, index, Stressor, supplementary material, narrative, future infection, treating COVID-19 patients, Administered, physical, limit, fear of contamination, Course, Result, resulting, analyzed, significantly, reported, conducted, facilitate, changes in, the mean, returned, Action, estimating equation, scored, secure, stress symptom, were assessed, 【제목키워드】 COVID-19 outbreak, Psychological distress, cross-sectional survey, Course,