Sources of psychological distress among primary care physicians during the COVID-19 pandemic's first wave in Spain: a cross-sectional study.

Cebrián-Cuenca, Ana; Mira, José Joaquín; Caride-Miana, Elena; Fernández-Jiménez, Antonio; Orozco-Beltrán, Domingo

BACKGROUND The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. OBJECTIVES This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). METHODS A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the 'Self-applied Acute Stress Scale' (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. RESULTS In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (-0.77 (-1.52, -0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. CONCLUSIONS A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.