• José Joaquín Mira, Irene Carrillo, Mercedes Guilabert, Aurora Mula, Jimmy Martin-Delgado, Maria Virtudes Pérez-Jover, Maria Asunción Vicente, César Fernández, and SARS-CoV-2 Second Victim Study Group.
• Health Psychology, Miguel Hernandez University of Elche, Elche, Valenciana, Spain jose.mira@umh.es.
• BMJ Open. 2020 Nov 6; 10 (11): e042555.

ObjectivesTo determine the volume of health professionals who suffered distress due to their care of patients with COVID-19 and to analyse the direction in which the response capacity of the professionals to face future waves of COVID-19 is evolving.DesignA cross-sectional study.SettingPrimary care and hospitals in Spain.ParticipantsA non-randomised sample of 685 professionals (physicians, nurses and other health staff).Primary And Secondary Outcome MeasuresFrequency and intensity of stress responses measured by the Acute Stress of Health Professionals Caring COVID-19 Scale (EASE). Variation of stress responses according to the number of deaths per day per territory and the evolutionary stage of the COVID-19 outbreak measured by the Kruskal-Wallis and the Mann-Whitney U tests.ResultsThe average score on the EASE Scale was 11.1 (SD 6.7) out of 30. Among the participants, 44.2% presented a good emotional adjustment, 27.4% a tolerable level of distress, 23.9% medium-high emotional load and 4.5% extreme acute stress. The stress responses were more intense in the most affected territories (12.1 vs 9.3, p=0.003) and during the disillusionment phase (12.7 vs 8.5 impact, 10.2 heroic and 9.8 honeymoon, p=0.000).ConclusionsThe pandemic has affected the mental health of a significant proportion of health professionals which may reduce their resilience in the face of future waves of COVID-19. The institutional approaches to support the psychological needs of health professionals are essential to ensure optimal care considering these results.© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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