Anxiety, hope and burnout in caregivers of elderly psychotic patients during the COVID-19 pandemic

Introduction: The assessment and management of patients suffering from serious physical or psychological pathologies require an integrated diagnostic and therapeutic path.The Covid-19 pandemic has increased the workload of healthcare workers (HCWs). Working under stressful conditions has become harder for HCWs who take care of people affected by serious and chronic physical and psychic pathologies. Psychiatric pathologies in patients who are over 65 years old are responsible for important consequences on their healthcare workers’ psychic and physical health (anxiety, hopelessness, burnout)[1].

Aims: To evaluate the effects of work-related stress, hope on a group of HCWs who take care of psychiatric patients residing in psychiatric rehabilitation centers.

Methods: In our observational study, an exploratory design, fifty-seven (57) HCWs were included in the study (31F; 26M; mean 43.63 years). The HCWs were selected from a larger group of health workers (n. 57/124: 45.97%) in psychiatric rehabilitation centers.

An inclusion criterion for HCWs was the care to patients ≥ 65 ys with primary psychosis. All selected patients had a total score on the B.P.R.S. ≥ 35. The HCWs were scheduled in two times (T0 and T1). T0 (September – October 2020) vs T1 (July – September 2021).

All caregivers (HCWs) (Clinicians / Psychiatrists; HealthCare Assistant; HealthCare Workers, Health Educator; Nurses; Psychiatric Rehabilitation Technicians; Psychologists; Social Care Worker) were administered the following diagnostic assessment scales in times T0 and T1:

– ProQoL (Professional Quality of Life)

– CBI (Caregiver Burden Inventory)

– SAVE (SAVE-9 scale – Stress and Anxiety to Viral Epidemics- 9 items)

– BHS (Beck Hopelessness Scale)

The data obtained were analyzed using the EZAnalyze 3.1 statistical analysis program, Microsoft Excel platform and p ≤ 0.05 was considered statistically significant.

Results: The results obtained during a one-year evaluation period, in Covid-19 pandemic, showed a significant increase in stress, burnout, and anxiety in all of the examined HCWs [ProQoL (ST: T-test P: .012); CBI (Time: p> .000, S dimension: p< .000)]. Instead, it was observed a decrease in work-related satisfaction (ProQoL: CS: P: .01). The analysis of the subgroup showed an increase in BO subscale (Burnout) in moderate-to-high values, especially in the nurses’ group (T0 vs t1: 50% vs 68.75%). After one year, it was observed a overall reduction of hope (Total p= .0001, Eta Squared= .252; T-Score = 4.381; mean: 6.236 vs 8.614).

Conclusions: Our small observational study confirmed the results observed in our previous studies [2, 3, 4], with high levels of anxiety and stress in all HCWs. Some HCWs are more affected by the workload, such as nurses and Healthcare assistants. HCWs with a higher number of years of education were more protected from the managerial burden. However, they had an increase in hopelessness in T1. Management of elderly psychiatric patients is complex. The ability to intercept the elements of stress and the first signs of psychological distress makes it possible to implement early targeted psychological interventions. However, the limit of our study suggests a more in-depth evaluation.


  • Franza, F., Solomita, B., Tavormina, G., 2021. Loneliness and Hopelesness: Their Role in the Depressive Cases during the COVID Pandemia. Psychiatr Danub 33(Suppl 9),14-17.
  • Fountoulakis, K.N., Karakatsoulis, G., Abraham, S, et al., Smirnova, D., 2022. Results of the COVID-19 mental health international for the general population (COMET-G) study. Eur Neuropsychopharmacol 54(1),21-40.
  • Vacca, A., Minò, M.V., Colizzi, I., Solomita, B., Longo, R., Franza, F., Tavormina, G., 2021. The Emotional Impact of the Operator in te Care of Patients With Mental Disorders during the Pandemic: Measure of Interventions on Compassion Fatigue and Burn-Out. Psychiatr Danub 33(Suppl 9),108-113.
  • Minò, M.V., Vacca, A., Colizzi, I., Solomita, B., Franza, F., Tavormina, G., 2021. The Effect of the Pandemic on the Care of Patients with Mental Disorders: Measure of “Compassion Fatigue” and “Burn-Out” in the Operator. Psychiatr Danub 2021;33(Suppl 9):114-118. PMID: 34559789.

No conflict of interest

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