Evaluation of the sickness period and return-to-work experiences of employees who contracted COVID-19 in Ankara Metropolitan Municipality

Aim: The aim of the study is to evaluate the difficulties experienced by Ankara Metropolitan Municipality employees after recovering from COVID-19 in returning to work, the perception of blame from their surroundings after the isolation period, and the need for psychological help after contracting COVID-19, as well as the associated factors. Materials and Methods: This study was conducted as a cross-sectional research between September 2021 and February 2022. The study population consisted of 4400 Ankara Metropolitan Municipality employees who had contracted COVID-19 in various districts of Ankara, according to the information provided by the municipality. The study group was formed by 222 individuals who agreed to participate in the study from this population. The data collection form, consisting of a section related to personal and social characteristics (10 questions) and a section related to the illness and return-to-work experiences of the individuals (47 questions), totaling 57 questions, was sent online to the municipality employees who had contracted COVID-19. No scale was used in the preparation of the questions, and various studies conducted on individuals who had contracted COVID-19 and scales that address COVID-19 from a psychosocial perspective were used to form the questions. Necessary permissions were obtained from the Ministry of Health Scientific Research Platform, Ankara University Rectorate Ethics Committee, and Ankara Metropolitan Municipality Health Affairs Department for the research. The SPSS 21.0 package program was used for data analysis. Descriptive statistics of numerical and categorical data obtained in the study were analyzed, and numerical parameters were expressed as median or mean±standard deviation, while categorical variables were expressed as frequency and percentage. The Kolmogorov-Smirnov test, histogram analyses, and skewness/kurtosis values were used to evaluate the normal distribution of numerical variables. Levene's test was used to analyze the homogeneity properties of numerical parameters between groups. The independent t-test was used to compare two independent groups for numerical parameters showing normal distribution, while the Mann-Whitney U test was used for parameters that did not show normal distribution. Binary logistic regression analysis was applied for variables showing significant differences. The accuracy of the binary relationships and analyses in the modeling was verified with the Hosmer-Lemeshow test. The chi-square or Fisher's exact tests were used to analyze the relationship between binary categorical groups. A type-I error rate of 5% was assumed throughout the study, and a p-value of less than 0.05 was considered significant. Results: The average age of the participants in the study was 37.7±7.2, with 78.4% male and 65.1% unmarried. 49.6% of the participants were undergraduate/graduate degree holders, and the largest group worked for EGO General Directorate (16.7%). 22.1% of the participants reported having a chronic illness, while this rate was 5% for psychiatric illnesses. 38.5% of the participants identified the workplace as the source of transmission, and 12.2% were hospitalized for COVID-19 treatment during their illness. Additionally, 55% of the participants reported experiencing difficulties or challenges during home isolation, and 59.9% reported having difficulty accessing accurate and comprehensive information during the COVID-19 period. 47.4% of the participants reported that they had difficulty returning to work after COVID-19 infection.The study also found that women were 1.96 times more likely to experience difficulties in returning to work compared to men (B=0.677, OR=1.96, p=0.04), individuals who received inpatient treatment were 3.69 times more likely to experience difficulties in returning to work compared to those who did not receive inpatient treatment (Exp(B)=3.69, p=0.005), and individuals who experienced income loss during the pandemic were 1.78 times more likely to experience difficulties in returning to work (B=0.580, OR=1.78, p=0.03). 18.5% of the participants reported feeling a blaming attitude from at least one group (family, relative, neighbor, friends) in their environment after the isolation period. Participants who did not perform desk jobs were found to have 3.51 times more likelihood of being exposed to blaming attitudes compared to those who performed desk jobs (B=1.25, OR=3.51, p=0.004). The group who experienced isolation during the pandemic was found to have 2.33 times more likelihood of being exposed to blaming attitudes compared to the group who did not experience isolation (B=0.849, OR=2.33, p=0.02). The group whose colleagues exhibited indifferent, exclusionary, blaming, and/or fearful attitudes after recovering from COVID-19 was found to have 5.33 times more likelihood of feeling blaming attitudes from their surroundings (B=-1.673, OR=5.33, p<0.001). The group who did not receive supportive attitudes from their workplace during illness was found to have 5.28 times more likelihood of being exposed to blaming attitudes compared to the group who received supportive attitudes (B=1.665, OR=5.28, p<0.001). The group who felt blaming attitudes from their surroundings during illness and/or isolation was found to have 49.7 times more likelihood of being exposed to blaming attitudes (B=3.90, OR=49.7, p<0.001). The group who required psychological assistance after COVID-19 infection was found to have 7.08 times more likelihood of being exposed to blaming attitudes (B=1.958, OR=7.08, p<0.001). The group who experienced income loss due to COVID-19 was found to have 2.27 times more likelihood of being exposed to blaming attitudes (B=0.82, OR=2.27, p=0.02). 16.2% of the participants in the study stated that they needed psychological help after COVID-19 disease. The group of participants who had difficulties during isolation had 2.49 times higher likelihood of needing psychological assistance after the isolation period compared to those who did not have difficulties (B=0.912, OR=2.49, p=0.02). The group whose coworkers had unsupportive attitudes had 4.21 times higher likelihood of needing psychological assistance after the isolation period compared to those whose coworkers were supportive (B=1.438, OR=4.21, p<0.001). The group who felt a blaming attitude from their surroundings had 6.49 times higher likelihood of needing psychological assistance after the isolation period compared to those who did not feel this attitude (B=1.870, OR=6.49, p<0.001). It was observed that the group who experienced loss of income had 2.32 times higher likelihood of needing psychological assistance after the isolation period compared to those who did not experience loss of income (B=0.844, OR=2.32, p=0.02). Conclusions: The psychological problems caused by existing problems in the workplace such as inequality, sexism, discrimination, stigmatization, and financial and moral responsibilities have been exacerbated by the pandemic. Public health measures should be taken to protect and support the mental health and social relationships of employees returning to work after COVID-19 infection. These measures should aim to reduce stigmatization and discrimination in the workplace, strengthen employees' social support systems, and provide access to accurate information. In the post-pandemic period, it is recommended that public health and occupational health policies be strengthened and effectively implemented to enable employees to manage their return to work in a much healthier way. Keywords: COVID-19, return to work, stigmatization, employee health