Assessment of healthcare worker resilience at the epicenter of the 2022 Sudan virus disease outbreak in Uganda: implications for future preparedness

Abstract

Abstract Background: Healthcare workers (HCWs) mental resilience can be challenged during times of adversity, including outbreaks. On September 20, 2022, the Uganda Ministry of Health declared an Ebola outbreak of the Sudan virus disease (SVD) subtype. We assessed the level and determinants of resilience at the workplace among HCWs working at the epicenter of the SVD outbreak (Mubende and Kassanda districts) in Uganda. Methods: During March 2023, we conducted a cross-sectional survey among all HCWs (clinical and non-clinical) working from September 20, 2022─January 23, 2023 (the outbreak period) in the three health facilities that were directly involved in the SVD response in Mubende and Kassanda districts. Risk perception was assessed using 12 statements with a 4-point Likert-type scale. We assessed resilience using the Connor-Davidson Resilience Scale (CD-RISC-10). Resilience was dichotomized into ‘not resilient’ (score 1-29) and ‘resilient’ (score 30-40). Logistic regression was used to identify factors associated with resilience. Results: Of 429 eligible HCWs, 400 (93%) were interviewed. Mean age was 35 (range: 20-58) years; 222 (56%) were male and median work experience was 8 years (range:1-38). One hundred and ten (28%) were support staff and 72 (18%) were nurses; 344 (86%) worked >40 hours per week. Overall, 93 (23%; 95%CI: 19-25%) were resilient. Three hundred and fifty-six (89%) expressed fear of contracting SVD and 356 (89%) expressed concern about stigma at their workplace if they became infected. Resilience was associated with age >40 years (adjusted odds ratio [AOR]=2.1; CI=1.3-3.5), work experience >10 years (AOR=2.2; CI=1.1-4.7), working >40 hours per week (AOR=6.8; CI=2.1-23), and receiving Ebolavirus-specific counseling (AOR=3.3; CI=1.7-6.5). Conclusion: Most HCWs at the SVD outbreak epicentre in Uganda faced resiliency challenges during the outbreak, related to their infection risk and treatment by others if they became infected. Psychological counselling and mental health support to HCWs and addressing concerns that bring them a high risk of infection could improve on their resilience during future outbreaks.