Psychological Distress in Healthcare Workers During the Covid-19 Pandemic: Development and Validation of the Italian Version of the Healthcare Workers Emergency Distress Questionnaire (HEDQ).

Objective: The COVID-19 pandemic has presented unprecedented challenges for health systems as it has proven to be an extraordinary emergency. Exposure to such chronic stress can have detrimental effects on the psychophysical well-being of healthcare workers, with possible manifestation of stress-related symptoms. The present study aimed to develop and validate the Healthcare Workers Emergency Distress Questionnaire (HEDQ), a self-report screening questionnaire with the purpose of identifying the healthcare workers at risk for psychological and moral distress, and PTSD-related symptoms during emergencies. Method: The HEDQ was administered to 250 healthcare workers of the AULSS 3 Serenissima and 47 citizens from the general population in Venice (Italy) during the health emergency period (from April to June 2020). In the second administration (from August to September 2020), data were collected from 101 of the 250 healthcare workers who had participated in the first administration. To test for the convergent validity, the Depression Anxiety Stress Scale (DASS-21) was also administered. Results: Exploratory and hierarchical confirmatory factor analyses validated the 21-item structure of the questionnaire. Internal consistency, and factorial and convergent validity were good. Moreover, the HEDQ discriminated between those who worked in COVID-19 hospital units and those who did not (including the general population), showing good known-group validity. The two-month temporal stability of the questionnaire was excellent. The HEDQ scale scores significantly decreased from the first to the second administration, thus supporting that the tool is a measure of acute stress in healthcare workers. Conclusions: Our results provide support for the use of the HEDQ as a brief, multidimensional measure of emergency-related stress reactions in healthcare workers. Consequently, the HEDQ can be considered a useful instrument supporting clinical activity to identify those who may be more easily affected by stress reactions in the event of atypically high levels of risk exposure during crises.