Mental health and lifestyle in mental health nurses: a cross-sectional, nation-wide study from Uganda during COVID-19 times.

Introduction: mental health nurses (MHNs) work in potentially high-stress settings, in particular in low-income countries during the COVID-19 pandemic the risk might be high. This multi-centre, cross-sectional study explored the prevalence of psychological distress and post-traumatic stress disorder (PTSD) symptoms among Ugandan MHNs and investigated associations between these mental health outcomes and lifestyle factors.

Methods: in this cross-sectional study, participants completed the Kessler-6 (K-6), PTSD checklist for DSM-5 (PCL-5), simple physical activity questionnaire (SIMPAQ), physical activity (PA) vital sign (PAVS), Pittsburgh sleep quality index (PSQI, and alcohol use disorder identification test-concise (AUDIT-C). Spearman Rho correlations and Mann Whitney U tests were applied.

Results: of 108 included MHNs (age =34.8±10.0 years; 55.6% female) 92.6% had psychological distress (K-6≥13), 44.4% elevated PTSD symptoms (PCL-%≥41), 74.1% was physically inactive (less than 150min/week on PAVS), 75.9% reported poor sleep quality (PSQI>-5) and 24.4% harmful drinking (AUDIT-C≥3 for women and -≥4 for men). SIMPAQ exercise correlated with K-6 (rho =-0.36, P<0.001) and PCL-5 (rho=-0.24, P=0.013), SIMPAQ walking with PCL-5 (rho =-0.31, P<0.001). Mental health nurses meeting the PA guidelines reported lower PCL-5 scores than those who did not (P<0.005).

Conclusion: in Uganda, the mental health burden is high during the COVID-19 pandemic among MHNs and associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience programs for MHNs focusing on unhealthy lifestyle patterns should be explored.