Exploration of The Impact of The COVID-19 Pandemic on The Mental Health of Home Health Care Workers in Japan: A Multicenter Cross-Sectional Web-Based Survey

Background: The COVID-19 pandemic has caused home health care workers (home-HCWs) to experience anxiety. Since the mental health of home-HCWs and related factors during the COVID-19 pandemic have not been clarified, we aimed to investigate the status and associated factors of the fear of COVID-19 infection, anxiety, and depression among home-HCWs in Japan. Methods: A multicenter cross-sectional web-based anonymous survey of home-HCWs was conducted in August 2021, during the fifth wave of the pandemic in Japan. We surveyed members of facilities that provide home visit services during the COVID-19 pandemic. We measured the Japanese version of the Fear of COVID-19 scale (FCV-19S-J) and the Hospital Anxiety and Depression scale (HADS) as objective variables, and the Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (J-AITCS-II) as an explanatory variable. Results: A total of 328 members of 37 facilities responded to the survey, and we ultimately analyzed 311 participants. The most frequent occupation was nurse (32.8%), followed by doctor (24.8%) and medical office staff (18.0%). The mean score of the FCV-19S-J was 16.5 ± 5.0 (7.0 – 31.0), and the prevalences of definitive anxiety and depression were 7.4% and 15.7%, respectively. Multivariate regression analysis revealed that the J-AITCS-II teamwork subscale was significantly negatively associated with FCV-19S-J, HADS-anxiety, and HADS-depression (β=-0.171, p= 0.004; β=-0.151, p=0.012; β=-0.225, p<0.001). Medical office staff showed significant positive associations with FCV-19S-J and HADS-depression (β=0.219, p= 0.005; β=0.201, p=0.009), and medical social workers with HADS-anxiety and HADS-depression (β=-0.166, p= 0.011; β=-0.214, p<0.001) compared to doctors. The unmet support need for expert lectures on COVID-19 was significantly positively associated with FCV-19S-J (β=0.131, p= 0.048), and the unmet support need for support systems for psychological stress and emotional exhaustion was significantly positively associated with HADS-anxiety (β=0.141, p= 0.022). Conclusions: Recognizing that different occupations experience different mental health issues, providing learning opportunities about COVID-19 and expert psychological support, and building good teamwork are important for maintaining the mental health of home-HCWs during the COVID-19 pandemic.