Evolution of Posttraumatic Symptoms and Related Factors in Healthcare Workers During the COVID-19 Pandemic: A Longitudinal Study

Predictors of mental health in healthcare workers during the COVID-19 pandemic: The role of experiential avoidance, emotion regulation and resilience

AIMS

This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID-19 pandemic. Additionally, we explored the association of such levels with personal and professional variables.

DESIGN

Cross-sectional study.

METHODS

Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work-related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested.

RESULTS

In total, 18.8% of the sample scored above the cut-off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%-53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work-related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre-pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID-19.

CONCLUSION

Healthcare workers showed high levels of psychological impact during the COVID-19 pandemic. Such impact was predicted from some work-stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression.

IMPACT

Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Sense of coherence on the relationship between COVID-19-related stress and sleep quality among nurses

AIM

We aimed to examine the mediating effects of the Sense of Coherence (SOC) on the relationship between stress and sleep in nurses during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A cross-sectional survey targeting nurses in Chiba and Tokyo during the summer of 2021 was conducted using Google Forms. Responses were obtained using the Pittsburgh Sleep Quality Index (PSQI), the 13-item version of the SOC scale (SOC-13), and questions regarding COVID-19-related stress. Structural equation modeling (SEM) was performed to investigate relevant relationships.

RESULTS

A total of 181 valid responses were obtained from 400 surveyed nurses. SEM analysis showed that COVID-19 stress was indirectly related to PSQI via its effect on SOC-13, with higher SOC-13 negatively correlated with PSQI.

CONCLUSIONS

Our findings suggest the need for interventions designed to promote SOC for nurses working under stressful conditions.

Association between burnout and post-traumatic stress disorder among frontline nurse during COVID-19 pandemic: A moderated mediation analysis

AIMS AND OBJECTIVES

The aim of this study was to investigate the relationship between burnout and post-traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship.

BACKGROUND

The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID-19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies.

DESIGN

An online cross-sectional survey of targeted local 327 nurses who went to assist the COVID-19 epidemic situation in Wuhan during the initial outbreak.

METHODS

This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses.

RESULTS

Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD.

CONCLUSIONS

Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD.

RELEVANCE TO CLINICAL PRACTICE

PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups.

PATIENT OR PUBLIC CONTRIBUTION

Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study.

Coping profiles and their association with vicarious post-traumatic growth among nurses during the three waves of the COVID-19 pandemic

AIMS

This study aimed to examine (a) changes in coping strategies and vicarious post-traumatic growth (VPTG) across three timepoints of the COVID-19 pandemic among nurses; (b) discrete groups of nurses with unique coping profiles and (c) the association of these coping profiles with VPTG across the timepoints.

BACKGROUND

Although literature abounds with the negative mental health consequences of the pandemic among healthcare professionals, much less is known about the positive consequences on nurses, the coping strategies that they use, and how these change over time.

DESIGN

This was a cross-sectional web-based survey at three timepoints during the pandemic.

METHODS

A sample of 429 nurses completed online the Post-Traumatic Growth Inventory (PTGI) and the Brief Coping Orientation to Problems Experienced Inventory (COPE) to measure vicarious post-traumatic growth (VPTG) and coping strategies, respectively. The STROBE checklist was used to report the present study.

RESULTS

Significantly higher VPTG scores were observed during the third timepoint. Different coping strategies were employed across the three timepoints. Nurses responded to the pandemic either with an active, an avoidant or a passive coping profile. Significantly higher VPTG levels were reported by the nurses of the active profile compared to those of the passive profile, whereas the difference between active and avoidant profiles was not significant.

CONCLUSIONS

Notwithstanding the preponderance of the nurses with the active coping profile in achieving high VPTG, the avoidant copers had more gains (VPTG) than the passive copers, suggesting that doing something to cope with the stressor-let it be trying to avoid it-was better than doing nothing.

RELEVANCE TO CLINICAL PRACTICE

The identification of distinct coping profiles among nurses and their association with VPTG is of particular use to policymakers and practitioners in developing tailored prevention and intervention efforts to help the nurses effectively manage the demands of the pandemic.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution since the study was exclusively conducted by the authors.

Occupational pressures of frontline workers enforcing COVID-19 pandemic measures in Ontario and Quebec, Canada

BACKGROUND

During the COVID-19 pandemic, low-wage public-facing frontline workers (FLWs), such as grocery store clerks, were required to monitor retail customers and enforce COVID-19 protocols.

OBJECTIVE

This analysis aimed to examine FLWs experiences of enforcing COVID-19 pandemic measures.

METHODS

Between September 2020 and March 2021, in Ontario and Quebec (Canada), we conducted in-depth interviews about customer-related work and health risks with FLWs who interacted with the public (n = 40) and their supervisors (n = 16). Using a lens of situational analysis, verbatim transcripts were coded according to recurring topics.

RESULTS

We found that enforcing public health measures placed already-precarious workers in difficult occupational health circumstances. Enforcement of measures created additional workplace responsibilities, stress, and exposed them to potentially negative reactions from customers.

CONCLUSIONS

Interventions to better support these workers and improved methods of protection are discussed.