The first workers to fall ill of COVID-19 at Hôpital Montfort weren’t doctors or nurses. They were members of the cleaning staff.
“This really caught my attention,” said Dr. Marie-Hélène Chomienne, an assistant professor of family medicine at the University of Ottawa and hospitalist at Hôpital Montfort.
“This made me appreciate how much these workers are truly on the front lines. They go unnoticed yet they have such an important role in keeping us safe in this pandemic and fighting the infection. We should be examining how they are coping with the added stress COVID-19 has brought.”
Dr. Chomienne is one of three principal investigators in a six-person multi-disciplinary team that has received a $199,028 grant from the Canadian Institutes of Health Research (CIHR) to study the psychological well-being of Canadian hospital cleaning staff — known as environmental services personnel — during the COVID-19 pandemic. Together, scientists at the University of Ottawa and associated research institutes received six grants totalling over $1 million from the CIHR COVID-19 and Mental Health funding initiative.
Environmental services personnel are a vulnerable group of workers, who toil for relatively low wages at a job that is often under-appreciated, yet who face a high risk of infection, Dr. Chomienne said. She hopes that the study’s findings will result acknowledging their role as essential members of the care team and allow for workplace changes that benefit both them and patients. To that end, the research team will work in close collaboration with the Canadian Union of Public Employees (CUPE) and Hôpital Montfort, as well as the industry association HealthCareCAN and the risk-management organization Healthcare Insurance Reciprocal of Canada.
“Research should provoke transformative change,” said Dr. Chomienne, who is also a researcher at Institut du Savoir Montfort and CT Lamont Primary Health Care Research Centre. “Despite all the knowledge we may generate through research studies, if we cannot promote change I find, as a clinician, there is less meaning to the research I do.”
To conduct the study, the team will send online questionnaires to environmental services personnel at hospitals across Canada. These will be standardized questionnaires that are commonly used in psychological testing to assess feelings of anxiety, depression, distress and insomnia. The tests have been used in similar studies, on different populations, during the early stages of the COVID-19 pandemic. As well, respondents will be asked to answer the Koh questionnaire, rating their sense of risk of contracting the virus and its impact on their work and their personal lives. The questionnaire was developed during the SARS epidemic of 2002-2003, when it was administered in Singapore and Toronto to thousands of healthcare workers. Dr. Chomienne expects that approximately 3,000 workers or more will participate in the survey.
In addition to the online survey, the team plans to conduct more than a dozen in-person, physically distanced or virtual focus groups of four to six participants, in order to truly understand the pressure they felt, how they coped with the increased responsibility, the increased pace of work, the sense of personal risk, how they were supported by their organizations and what could be improved.
Leanne MacMillan, the director of Research, Job Evaluation, and Health and Safety at CUPE, said that the early days of the pandemic — when little was known about the virus and PPE shortages seemed imminent — were especially stressful for cleaning staff. Although the fears have somewhat abated, there is still apprehension about a second wave.
She said she hopes that Dr. Chomienne’s study will result in action that addresses the root causes of workers’ apprehensions, ensuring adequate supplies, staffing, and income security.
“You can’t underestimate the importance of the cleaning function in an acute-care setting, especially during a pandemic,” Ms. MacMillan said. “Cleaners are skilled workers, they’re important, and they know how critical their role is to patient safety and overall health and safety. I’m thrilled that this study is going to allow cleaners to tell their stories.”
In November, Dr. Chomienne was awarded the Chaire de recherche en francophonie internationale et santé de l’immigrant ou du réfugié d’Afrique francophone subsaharienne. The goal of her research is to describe the state of physical and mental health of recent immigrants and refugees from Sub-Saharan Africa now living in Ontario, France, and Francophone Belgium, in order to provide them with appropriate health care.
