An Acute Stress Scale for Health Care Professionals Caring for Patients With COVID-19: Validation Study

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Clinical uncertainty, the shortage of equipment and the difficulties in maintaining the supply chain, constant changes in instructions, the interruption of all non-delayable care, the increased perception of self-risk and the experience of isolation of admitted patients has affected healthcare workers mental health. During the first outbreak, the exceptionality and urgency of the situation demanded measures and a specific screening tool to support healthcare workers identifying their stress levels that affected their wellbeing. Objective: This study designed and validated in the first days of the outbreak in Spain a scale to measure acute stress experienced by healthcare workforce during the care of patients with COVID-19 (EASE scale). Methods: Item development, scale development, and scale evaluation were considered. Qualitative research was conducted to produce reactive items, assure their legibility, and content assess content validity. Internal consistency was calculated using Cronbach's Alpha and McDonald's Omega. Confirmatory Factorial Analysis, and Mann-Whitney-Wilcoxon test were used to assess construct validity. Lineal Regression was applied to assess criterion validity. Back translation methodology was used to adapt the scale into Portuguese, and English. Results: A total of 228 health professionals from the Spanish public health system responded to the ten items, of the EASE scale. Internal consistency was 0.87 (McDonald’s Omega). Goodness-of-fit indices confirmed a two factors structure, explaining 55% of the variance. As expected, the highest level of stress was found among professionals working in health services who accumulated a higher number of deaths from COVID-19 (P<.05). Conclusions: EASE gathers adequate metric properties regarding consistency and construct validity. Its systematic use would allow the identification of professionals with a higher risk of developing affective/anxiety disorders and Moral injury that could limit that patients received safety and integrated care.