Symposia
Dissemination & Implementation Science
Simone Schriger, M.A. (she/her/hers)
Doctoral Candidate
University of Pennsylvania
Los Angeles, California
Pamela Baez, MD, MSc (she/her/hers)
Research Director
Clínica de Familia La Romana
La Romana, La Romana, Dominican Republic
Jessica Escober, B.A. (she/her/hers)
Research Assistant
University of Michigan
NA, Michigan
Ana Acevedo, B.A. (she/her/hers)
Research Assistant
University of Pennsylvania
Philadelphia, Pennsylvania
Celestino Garcia, - (he/him/his)
Research Assistant
Clínica de Familia La Romana
La Romana, La Romana, Dominican Republic
Mina Halpern, MPH (she/her/hers)
Executive Director
Clínica de Familia La Romana
La Romana, La Romana, Dominican Republic
Elizabeth Lowenthal, MD, MSCE (she/her/hers)
Associate Professor of Pediatrics and Epidemiology
University of Pennsylvania Perelman School of Medicine
Philadelphia, Pennsylvania
A broad literature across contexts and continents has documented the deleterious effects of the COVID-19 pandemic on mental health globally, particularly among health care workers (HCWs). There has been very limited research on mental health symptomatology within the Dominican Republic (DR), and to our knowledge, no studies focused on Dominican HCWs specifically. Given the importance of HCWs in deploying evidence-based medical and psychological interventions to the public, it is important to understand their psychological wellbeing. In this study, we sought to identify the burden of stress, burnout, and anxiety and depression symptomatology within Dominican HCWs. Additionally, we sought to capture their perceptions of these symptoms within the context of contextual factors such as workplace resource limitations and the impact of COVID-19. Through convenience sampling, we surveyed 200 HCWs (doctors, nurses, psychologists, and community health workers) from four health centers in the eastern DR between April and August 2021. Participants completed a one-time survey to measure symptoms of, stress, burnout, anxiety, and depression. We then purposively sampled a subset of participants across all four HCW groups (n=28) to participate in semi-structured interviews to gain deeper understanding of survey results. Quantitative results indicated a high burden of mental health symptomatology among Dominican HCWs; 7% reported moderate to severe stress, 93% reported at least mild burnout, over a third reported moderate (28.5%) or severe (7.5%) anxiety, and 10% reported at least mild symptoms of depression. Using a phenomenological qualitative analytic approach, we identified four main themes from those interviewed: 1) the major impact of the pandemic on straining an already-taxed system in which work burdens became higher and resources became scarcer; 2) the pronounced psychological impact of COVID-19-related changes (e.g., social distancing) on HCWs' levels of stress, anxiety, and burnout; 3) the gradual shift towards “Covidianidad” (a quotidian experience of COVID) that allowed many HCWs to build resilience and motivation, and; 4) the impact of the stigma of mental health service utilization on seeking mental health support. These findings point to a need for greater mental health support for Dominican HCWs. Further, they point to the importance of addressing the impact of structural, social, and workforce burdens faced by HCWs that may impact their ability to deliver evidence-based care.