The cost of care: Cognitive and psychological toll on healthcare professionals

The authors conducted an analytical cross-sectional study between April and August 2023 among staff working in a hospital in Iran.They compared the cognitive function and work resilience of 235 healthcare professionals (HCPs) with 107 randomly selected administrative staff.The administrative staff worked in human resources, information technology, customer service, procurement, management, and medical records departments.The authors collected data on the nature, shift, schedule, and duration of work hours.They assessed cognitive function using the Mini-Mental Status Examination scale (MMSE) across five domains: orientation, registration, attention and calculation, recall, and language.The researchers captured work resilience through the self-administered Arabic version of the Brief Resilience Scale (BRS), which has been reported to have excellent internal consistency (Cronbach's alpha coefficient 0.98) and good convergent and construct validity.They measured psychological distress using the depression, anxiety and stress scale-21 (DASS-21).The authors used the Mann-Whitney U, Chi-square, or Fisher's exact test, and simple and multiple binary logistic regression models for inferential analysis.Compared to the administrative staff, HCPs were younger (mean age 32.2 v. 34.4 years) and more frequently unmarried (29.8%), physically active (21.7%), and living in urban areas (65.5%).They also reported significantly longer working hours (mean 5.93 hours per shift) and a higher prevalence of shift duties (48.9% v. 20.6%).Cognitive performance, measured by the MMSE, was notably lower in HCPs (mean score 26.8) than in administrative staff (29.9), and 14% of HCPs were classified as cognitively impaired compared to 4.7% of administrative staff.Psychological distress was also more common in the HCP group, with depression affecting 37%, anxiety 44.7%, and stress 37.9%, all markedly higher than among administrative staff.Regarding resilience, HCPs had a lower mean BRS score (2.92 v. 3.14), and 54% fell into the low resilience category, compared to 30% of administrative staff.The odds of cognitive impairment in HCPs were 3.33 times higher in crude analysis (p=0.015) and increased to 4.45 after adjusting for confounders (p=0.02).Similarly, the crude odds of low resilience were 2.64, rising to 5.81 after adjustment (p<0.001).Interestingly, no significant association was found between low resilience and cognitive impairment after adjustment (OR 0.55, p=0.185).