Can we monitor and contain health professionals' work-related stress in an emergency? The experience acquired during the COVID-19 pandemic at the Local Health Unit Cuneo1 (Northern Italy)

Introduction: COVID-19 pandemic has a big impact on health professionals’ work load, at organizational/psychological level. The Local Health Unit Cuneo1 adopted a strategy to monitor its staff on work-related stress and to return specific alerts. Material and Methods: A survey was approved by the Direction as institutional task of personnel’s risk assessment. Step1-sept2020: a validated questionnaire to detect requests/resources imbalance. Data analysis assessed distress in specific groups (at 5% significance level), by an Analysis of Variance model with distress as outcome (>value, >pressure) and sex, age, profession as predictors. Step2-ongoing: structured interviews to managers of COVID-19 front-line structures, then descriptively analyzed. Results: Respondents were 1/3 of staff (1373/4155). General distress (range: -40;+92) reached a mean of 1.2, that was adverse being a positive value but slight. The model highlighted significant alerts. Women had more worries than men (mean: -3.0 vs -6.8;p=0.006). Older staff showed higher distress than 21-30yrs (-10.8): 41-50yrs (-3.1;p=0.006);51-60yrs (-4.1;p=0.024);>60yrs (-1.5;p=0.004). Nurses had high distress (1.8): 7 points higher (p=0.006) than physicians’ (-5.1);administrative staff (-2.0) and technicians (-3.0) had moderate distress;psychologists had the minor one (-12.6). A total of 9 interviews were done in step2: all showed a medium pressure level. Conclusions: These data allowed implementing focus groups and training to overcome organizational and psychological matters related to COVID-19 and to building robust readiness to face possible future health emergencies.