The impact of the COVID-19 pandemic on seafarers' mental health and chronic fatigue: Beneficial effects of onboard peer support, external support and Internet access

Systematic Review: Measurement Methods and Concept of Resilience Among Seafarers

Shipping is considered a demanding environment that can significantly impact seafarers' well-being and mental health. This review aims to examine existing literature on the resilience of seafarers, with a focus on the measurement methods used. Furthermore, this study intends to gain a comprehensive understanding of the current state of research in the field of seafarers' resilience, examining the variations in defining and conceptualizing resilience across different studies and contexts. The review identified 99 studies published between 2003 and 2023, with ten studies being included in the final analysis. These studies employed various measurement methods and provided definitions of resilience. Five questionnaires were identified, with the Dispositional Resilience Scale-15 (DRS-15) being the most commonly used. Two of the selected studies had a longitudinal follow-up, while eight were cross-sectional. Four studies related to tankers, and an additional four studies focused on naval vessels, while two studies did not specify the vessel type. The publications were distributed in the period between 2003 and 2013 (two papers) and between 2013 and 2023 (eight papers). The identified themes encompassed shipboard stressors (three papers), sleep problems (two papers), occupational groups or attitudes (two papers), experiences in war (two papers), and intervention measures (one paper), highlighting the multidimensional nature of resilience within the maritime field. This review suggests a research gap, as it reveals that the topic of resilience in seafaring has been sparsely represented. Despite an increasing interest in recent years, research remains limited, particularly in the civilian maritime sector. Therefore, this review highlights the importance of understanding and promoting resilience among seafarers. While the variety of questionnaires used was limited, achieving consensus and standardization in resilience measurement is essential for more comparable and consistent research findings. Recognizing resilience as a crucial resource can promote the development of targeted interventions and support systems, enhancing seafarers' well-being and mental health.

Factors Impacting Seafarers' Mental Health and Career Intentions

The main objective of the present study was to investigate factors related to seafarers' mental health. A sample of seafarers from 12 countries participated in the study. A list of stressors was used to assess both perception of exposure to these stressors and their subjective significance. The Symptom Checklist (SCL-90) was used to assess seafarers' mental health on 5 of 9 subscales: Depression, Anxiety, Hostility, Interpersonal Sensitivity, and Somatisation. Three significant findings emerged from the analyses. The first was that 3 types of stressors contribute significantly to mental health problems: (1) environmental factors (eg, vibration), (2) social problems (eg, bullying, homesickness, working alone), and (3) health problems (eg, physical injuries, viruses, and the illnesses). The second finding was that both stress and mental health issues determine seafarers' motivation for their work and their consideration regarding leaving the maritime industry. The third finding was that factors contributing to seafarers' consideration of leaving the industry were mainly related to social stressors such as isolation from family and friends, cultural differences at work, demands from supervisors, and bullying. Factors such as bad weather, working shifts, length of employment contract or a ban on disembarkment in ports were found to be relatively less important for seafarers as factors toward considering leaving the industry. The implications of these findings are discussed.

Suicidal ideation, burnout, and their correlation among health care workers at the end of the fourth wave of the COVID-19 pandemic in Alborz Province, Iran

Background

During the COVID-19 pandemic, Health Care Workers (HCWs) were more vulnerable than ever to Burnout and Suicidal thoughts due to stressful work conditions. This study, investigated the level of Burnout and Suicidal thoughts among HCWs during the fourth wave of the pandemic in Alborz Province in Iran and compared it with the conditions at the beginning of the pandemic.

Methods

A total of 305 HCWs from 3 referral hospitals for COVID-19, including 155 men and 150 women, participated in the study. A cross-sectional study was carried out with a sample of HCWs dealing with COVID-19 patients using the available sampling method. The results of this online survey, which was conducted from June 7 to July 5, 2021 (at the end of the Fourth Wave of the COVID-19 Pandemic in Iran), have been compared with the conditions of the First Wave of the Pandemic (from February 24 to April 27, 2020). The participants were evaluated by the Beck Scale for Suicidal Ideations (BSSI) and Maslach Burnout Inventory (MBI).

Results

The mean age of the participants was 36.34 ± 7.37. The means of Suicide Index (SI), Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) scores were 0.76 ± 1.74, 19.94 ± 4.69, 4.92 ± 1.51, and 31.30 ± 5.88, respectively. SI and PA were significantly higher in workers other than nurses and physicians and EE was higher among workers with night shifts (p value<0.05 in all indices). Age had a significant and negative correlation with EE (p value<0.01) and DP (p value<0.05) and a significant and positive correlation with PA (p value<0.01).

Conclusion

This study showed a high level of SI and Burnout indices among HCWs in the fourth wave of the pandemic in Iran. Paying attention to the factors affecting the development of social capital and creating health policy changes may be effective in reducing Burnout indices and high Suicide index among HCWs.

The impact of COVID-19 on maritime pilots: Evidence and lessons

The COVID-19 pandemic led to port congestion and disruption to global logistics and supply chains. While previous research has examined the impact on port performance and economics, social issues, such as the impact on port personnel (including pilots), have been overlooked. In this context, this paper examines the challenges experienced by Chinese pilots during the pandemic through in-depth interviews with 28 pilots. It shows that the draconian pandemic control measures adopted in China, rather than the pandemic itself, impaired pilots' physical and mental health, reduced their availability, and introduced new safety hazards, which curtailed both the port's capacity and ability to provide efficient and safe pilotage and resulted in sub-standard services. The findings suggest that there is a serious issue regarding the absence of effective mechanisms for pilots to raise their health and safety concerns and how these might be addressed by port administrators and/or local authorities. Worker participation and involvement in occupational health and safety management was problematic. These findings have implications for pilot station management at both company and government administrative and legislative levels.

Fatigue during the COVID-19 pandemic: The experiences of Chinese seafarers

Though the COVID-19 pandemic is drawing to a close, very little is known about the impact of China's zero-COVID policy on Chinese seafarers. This paper examines Chinese seafarers' experiences of fatigue during the pandemic. It adopted a mix-method research design involving two quantitative surveys conducted with seafarers before and during the pandemic and 35 in-depth interviews with both seafarers and managers. All the participants were from two Chinese shipping companies. The comparisons between the two surveys show that Chinese seafarers experienced significantly higher levels of fatigue during the pandemic. The interview data suggest a range of factors underpinning the higher levels of fatigue including fear of being infected, increased workload, wearing of four-piece personal protection equipment (PPE), the deprivation of shore leaves, and the prolonged service time. More importantly, the data indicate that the draconian zero-COVID policy in China and the related policy guidelines for Chinese shipping companies and seafarers reinforce these factors. This research extends previous research by providing an exclusive and comprehensive examination of seafarer fatigue during the pandemic and revealing that the policies adopted by seafarers' home countries can have profound implications for seafarers' experiences of fatigue. Suggestions are provided at the end of the paper.

The impacts of COVID-19 on the cruise industry based on an empirical study in China

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on the entire cruise industry. This research aims to provide an understanding of the impacts of COVID-19 on the cruise industry from various stakeholders and recommend corresponding post-COVID recovery strategies for building a sustainable cruise industry. By conducting 22 semi-structured interviews in Shanghai, China and analysing the interview data using content analysis, this research finds five aspects of the impacts that are worth discussing, namely social, health and well-being, regulatory, operational, and financial aspects. Key findings include the impacts of different stakeholders' opinions, the problems existing in the current cruise industry, and the potential for future improvement. Recommendations and recovery strategies are proposed to mitigate the negative impacts. This research not only explores the impact of COVID-19 on cruise tourism and fosters recommendations in the most fast-developing region (China) but also facilitates researchers and policymakers to understand the effects of the pandemic and proposes future risk mitigation strategies.

Fatigue at sea during and after the COVID-19 pandemic: A comparative study of two matched samples of seafarers

This paper examines seafarers' experience of fatigue during and after the pandemic. A multi-phase mixed methods research design was used, including two quantitative surveys (N_{during-pandemic=501} and N_{after-pandemic=412}) and 36 in-depth interviews. Applying propensity score matching the two samples to approximate the conditions of a randomized controlled experiment, the study shows that surprisingly seafarers reported higher levels of fatigue after the pandemic. Qualitative interviews with seafarers and ship managers reveal the underlying reason - the intensified ship inspection regime together with policy and regulatory updates/revisions in the immediate aftermath of the pandemic increased seafarers' workload and made seafarers more fatigued. The results of the two surveys also show that while fatigue risk factors differed between the two periods, fatigue risk can be managed and mitigated in both periods by implementing fatigue risk management policies and practices. Policy and management implications for improving seafarers' occupational health and safety are discussed at the end of the paper.

A Systematic Review of Assessment Methods for Seafarers' Mental Health and Well-Being During the COVID-19 Pandemic

Seafarers spend more time at sea than on land, which makes them a hard-to-reach community. Since their mental health and well-being is usually addressed from a land-based perspective, dedicated and validated methods incorporating maritime specificities are lacking. During the COVID-19 pandemic, research into seafarers' mental health and well-being flourished. However, a systematic review of the literature to assess the type and appropriateness of assessment methods pertaining to the mental health and well-being of seafarers has yet to be undertaken. This study reviews 5 databases (ERIC, Scopus, PubMed, Google Scholar and EBSCO) to assess the methods used to examine seafarers' mental health and well-being during the pandemic. Peer-reviewed literature alongside grey literature that applied quantitative or qualitative instruments to measure seafarers' mental health and/or well-being, published in English between March 2020 and February 2023, was eligible for the review. Studies from all geographic regions and regardless of nationality, rank and ship type of the subjects were explored. Database searches produced 272 records. Five additional records were identified via other methods. We identified 27 studies suitable for review, including 24 published in peer-reviewed scientific journals and 3 reports and surveys produced by the industry or welfare organizations. Assessment methods used to measure seafarers' mental health and well-being vary significantly in the literature. The frequent use of ad hoc questionnaires limits the possibility to replicate and compare the studies due to various inconsistencies. Furthermore, several validation and reliability measures needed more solidity when applied to the seafaring population. Such inadequate measuring and a mix of assessment methods impacted the comparison of results and might inflate the risks of underreporting or overstating mental complaints.

Workplace Determinants of Depression, Anxiety, and Stress in U.S. Mariners during the COVID-19 Pandemic

United States (U.S.) mariners continued sailing throughout COVID-19. Many aspects of their work could make them prone to adverse mental health outcomes but research on workplace determinants of their mental health during COVID-19 is limited. Between January and July 2021 an online survey assessed the outcomes of increased depressive symptoms, increased anxiety symptoms, and increased perceived stress in addition to concerns, worries, and experiences when sailing during COVID-19, job satisfaction, and safety climate in n = 1384 U.S. mariners. Demographic measures were also collected. Logistic regression models (for depression and anxiety) and a linear regression model (for stress) were developed. We found that increased COVID-19 concerns and poor self-reported mental health were related to increased odds of likely depression and anxiety and higher stress. Mariners who experienced more adverse experiences aboard a vessel had increased stress and increased odds of depression. Poor sleep quality was also related to increased odds of depression, and poor vessel support/safety culture was related to higher stress. Differences in outcomes were seen by vessel type, age, and credential in regression analyses. Results from this study will help to prioritize interventions to minimize the mental health impacts of COVID-19, and influence evidence-based recommendations to improve the mental health of mariners going forward.

Seafarers' mental health during the COVID-19 pandemic: An examination of current supportive measures and their perceived effectiveness

As the current COVID-19 pandemic and the resulting crew change crisis exacerbates the mental health problem faced by seafarers, various maritime stakeholders have mobilised their resources and strengths to provide a variety of supportive measures to address the issue. This paper aims to find out what measures have been adopted in the industry and how widely they have been experienced/received by seafarers and evaluate their effectiveness. To achieve this aim, this research employed a mixed methods design involving qualitative interviews with 26 stakeholders and a quantitative questionnaire survey of 817 seafarers. The research identified a total number of 22 mental health support measures, all of which were perceived to have contributed positively to seafarers' mental health. However, not all of them were widely available to or utilised by seafarers. The findings also highlighted the importance of family, colleagues, shipping companies, and government agencies, as they are associated with the most effective support measures, namely communication with family, timely crew changes, being prioritised for vaccination, being vaccinated, and a positive and collegial atmosphere on-board. Based on the findings, recommendations are provided.

Building social support: The impact of workgroup characteristics, the COVID-19 pandemic and informal interactions

BACKGROUND:

Social support from colleagues is a key resource for employees and organizations, with beneficial effects on performance, employee well-being and resilience. Although the importance of social support is well-known, the factors that help to build and maintain social support are not equally well understood.

OBJECTIVE:

This study analyzes the impact of workgroup characteristics (i.e., workgroup composition regarding national diversity and tenure; workload) and the COVID-19 pandemic on employees’ perceptions of instrumental and emotional support, and examines the mediating role of informal interactions.

METHODS:

The study is based on responses from 382 seafarers to a cross-sectional online survey. Hypotheses were tested using OLS regression and mediation analysis using PROCESS.

RESULTS:

Workgroup composition regarding national diversity had indirect effects on social support through informal interactions around social foci (here: joint leisure activities). High workload and pressure from the COVID-19 pandemic reduced interactions around social foci, thus contributing to the erosion of perceived social support.

CONCLUSION:

The findings provide insights on the development of social support, suggesting that informal interactions provide an important mechanism for the development of social support at work. From a theoretical perspective, this highlights the value of a relational perspective on the development of social support, a perspective that is based on the insight that social support is embedded in social relationships. From a practical point of view, this indicates that organizations can proactively foster the development of social support through practices that shape workgroup characteristics and social foci.

Mental health and wellbeing of seafaring personnel during COVID-19: Scoping review

OBJECTIVES

We aimed to synthesize published literature on seafarers' mental health and wellbeing during the COVID-19 pandemic.

METHODS

This scoping review searched four electronic databases for literature on the mental health and wellbeing of seafarers during the COVID-19 pandemic.

RESULTS

Fourteen studies were included in the review. Few reported on the prevalence of mental health conditions. Only one compared mental health data gathered during the pandemic to pre-pandemic matched samples, suggesting symptoms of depression and anxiety were greater during the pandemic. There was some evidence that mental health worsened with longer stays on board during the pandemic and being on board longer than expected. Crew exchange difficulties forced many participants to extend their contracts or delay repatriation, often with little information as to when they might get to go home, leading them to feel they had no control over their lives and causing concern about fatigue and the potential for accidents and injuries. Participants described other challenges such as denial of shore leave; concerns about finances and future employment; loneliness and isolation; fears of COVID-19 infection; limited access to essential supplies; and feeling unsupported by management.

CONCLUSIONS

Maritime organizations must understand how best to support their staff in the aftermath of the COVID-19 pandemic and in any other prolonged crises that may arise in the future. Recommendations include ensuring that staff feel valued by their organization; enhancing work-related autonomy; ensuring that communication is accurate, consistent, and timely; and using lessons learned from the COVID-19 pandemic to inform emergency preparedness policies.