Hardiness, Stress and Secondary Trauma in Italian Healthcare and Emergency Workers during the COVID-19 Pandemic

The mediation effects of COVID-19-related traumatic stress symptoms and mentalization on the relationship between perceived stress and psychological well-being in healthcare workers transitioning to a post-pandemic world

BACKGROUND

In context of COVID-19 as a collective trauma and the intense involvement of healthcare workers (HCWs) in the pandemic, perceived stress continues to have a tremendous impact on their psychological well-being. However, few studies have attempted to delineate the underlying mechanisms. This study examined whether COVID-19-related traumatic stress symptoms and mentalization act as mediators.

METHODS

A sample of HCWs (N = 2610) from 22 hospitals in Beijing, China participated in this cross-sectional investigation. Data on their perceived stress, psychological well-being, the impact of event, and reflective function during the COVID-19 pandemic were collected using self-report questionnaires. Different mediating models were tested.

RESULTS

COVID-19-related stress symptoms and mentalization independently mediate the association between perceived stress and psychological well-being. These two mediators also compose a serial mediation model. In particular, higher perceived stress inhibits the psychological well-being of HCWs through increased severity of traumatic stress symptoms, which in turn is associated with hypomentalizing.

CONCLUSION

These findings shed light on the mechanisms underlying the relationship between perceived stress and psychological well-being in HCWs. We strongly recommend incorporating a mentalization framework with trauma-informed practice in prevention and intervention work with this population during this and future healthcare crisis.

Predictors of COVID-Related stress in a community sample in Turkey: a cross-sectional study

The distinctive mental health features associated with COVID-19 have gained importance as the psychological effects of the pandemic on the community become more visible. This study aims to assess the COVID-related stress status and associated factors in the community sample of Turkey. The sample of this cross-sectional study is composed of 2.065 people between the ages of 18-90. Data were collected through an online survey prepared by Google.docs between October-December, 2020. Mild to moderate stress was found in the community with the most common symptoms of the fear of contamination and danger. Some variables, such as being female and the severity of COVID-19 illness, were associated with higher COVID-related stress. Vulnerable groups associated with high stress should be monitored during the pandemic. The findings of this study will guide the practices of professionals working in the field of public health, healthcare, or mental health in possible future pandemics.

The influence of meaningful work on the mental health of SME employees in the COVID-19 era: can coping strategies mediate the relationship?

BACKGROUND

Stress, depression, and anxiety are prevalent issues among SME employees during the COVID-19 pandemic. Even while having meaningful work that expressively contributes to individual growth has been related to improving mental health, employees' work may also need to adopt coping strategies to increase outcomes. The purpose of this study was to examine the relationship between meaningful work (positive meaning, meaning-making, and greater good motivations) and mental health, as well as coping strategies (problem-focused and emotion-focused) as a mediator of this relationship.

METHODS

Meaningful work, coping strategies, and mental health were evaluated in empirical research based on a sample of 462 SME employees working in Malaysia. Structured questionnaires were used to collect the data and analyze it through Structural Equation Modelling (SEM) using AMOS 21.0.

RESULTS

The findings of the study show the importance of meaningful work in influencing the mental health of SME employees, particularly during a crisis like the COVID-19 pandemic. This suggests that the more they value and see their work as meaningful, the more capable they are of dealing with limitations and mental health problems associated with crises. The study also discovered a partial mediating role for coping strategies between employees' mental health and meaningful work.

CONCLUSION

This study encourages employees to constantly feel connected and discover continued possibilities to work and learn even during crisis situations. In order to improve human resource efficiency in emerging markets, managers and owners of SMEs must implement the model developed by the researchers.

Coping with Epidemic-Related Job Stressors in Healthcare Workers During the Late Stage of the COVID-19 Pandemic: Effects of Reflective Functioning and Cognitive Emotion Regulation

Background

Healthcare workers encountered novel job stressors during the late stage of the COVID-19 pandemic. These stressors possessed potential deleterious effects on mental health outcomes, yet the underlying mediating and moderating mechanisms remained relatively unexplored.

Objective

The current study aimed to examine the role of cognitive emotion regulation as a mediator in the association between pandemic-related job stressors and the psychological symptoms of healthcare professionals in the late stage of the COVID-19 pandemic, and the role of reflective functioning as a resilience factor moderating both the associations of pandemic-related job stressors and cognitive emotion regulation, as well as psychological symptoms.

Methods

This cross-sectional survey conducted in October 2020 included 2393 healthcare professionals working in departments with a high risk of exposure to COVID-19 from 22 hospitals in Beijing, China. Participants were asked to complete questionnaires measuring pandemic-related job stressors, anxiety, depression, reflective functioning, and cognitive emotion regulation strategies. Path analyses were performed to examine the hypothesized model.

Results

Epidemic-related job stressors had significant direct effects on depression (β=0.31, p<0.001) and anxiety symptoms (β=0.29, p<0.001) and the indirect effects through mediation of maladaptive cognitive regulation were also significant (for depression, indirect effect=0.06, SE=0.01, CI=[0.04, 0.07]; for anxiety, indirect effect=0.06, SE=0.01, CI=[0.04, 0.08]). The dimension of certainty about mental states in the reflective functioning questionnaire (RFQc) moderated the direct effect of pandemic-related job stressors on depression (β=-0.05, p<0.001) and moderated the effect of job stressors on maladaptive cognitive regulation (β=0.06, p<0.001).

Conclusion

The results shed light on the roles of cognitive emotion regulation and reflective functioning in coping with pandemic-related job stressors in frontline healthcare workers in periods of dealing with major infectious diseases. The findings have implications for developing interventions for healthcare workers in need.

Hardiness and Zoom Fatigue on Nursing Students: A Cross-Sectional Study in Indonesia During Online Learning

Introduction

The Covid-19 pandemic caused a change in learning methods to online learning. Zoom fatigue is a problem that many students experience during online learning. Zoom fatigue has an impact on physical and psychological problems so that it disrupts the online learning process. Hardiness is needed by students in order to adapt to online learning.

Aim

The purpose of this study was to determine the relationship between hardiness and zoom fatigue in nursing students at Universitas Padjadjaran.

Methods

This study used a quantitative approach with a cross-sectional study design. The sample technique used total sampling. Respondents were 480 nursing students at Universitas Padjadjaran. The research instrument used the Zoom Exhaustion & Fatigue Scale questionnaire and the Hardiness Instrument for the Online Learning.

Results

This study shows that almost half of the respondents have a medium hardiness level category (45%) and a zoom level of medium fatigue category (46.67%). The results of the analysis show that there is a significant negative relationship between hardiness and zoom fatigue in nursing students at Universitas Padjadjaran. The higher the student's hardiness level, the lower the student's zoom fatigue level. High hardiness can increase focus during the learning process, increase student participation, and reduce stress and fatigue in students during online learning.

Conclusion

Lecturers and students need to collaborate to improve the learning process and repeat mental health problems during online learning. This data forms the basis for university and school nurses in providing interventions for nursing students to reduce the problem of zoom fatigue.

Linguistic Predictors of Psychological Adjustment in Healthcare Workers during the COVID-19 Pandemic

COVID-19 broke out in China in December 2019 and rapidly became a worldwide pandemic that demanded an extraordinary response from healthcare workers (HCWs). Studies conducted during the pandemic observed severe depression and PTSD in HCWs. Identifying early predictors of mental health disorders in this population is key to informing effective treatment and prevention. The aim of this study was to investigate the power of language-based variables to predict PTSD and depression symptoms in HCWs. One hundred thirty-five HCWs (mean age = 46.34; SD = 10.96) were randomly assigned to one of two writing conditions: expressive writing (EW n = 73) or neutral writing (NW n = 62) and completed three writing sessions. PTSD and depression symptoms were assessed both pre- and post-writing. LIWC was used to analyze linguistic markers of four trauma-related variables (cognitive elaboration, emotional elaboration, perceived threat to life, and self-immersed processing). Changes in PTSD and depression were regressed onto the linguistic markers in hierarchical multiple regression models. The EW group displayed greater changes on the psychological measures and in terms of narrative categories deployed than the NW group. Changes in PTSD symptoms were predicted by cognitive elaboration, emotional elaboration, and perceived threat to life; changes in depression symptoms were predicted by self-immersed processing and cognitive elaboration. Linguistic markers can facilitate the early identification of vulnerability to mental disorders in HCWs involved in public health emergencies. We discuss the clinical implications of these findings.

Religiosity, Theism, Perceived Social Support, Resilience, and Well-Being of University Undergraduate Students in Singapore during the COVID-19 Pandemic

The COVID-19 pandemic infection control measures severely impacted mental well-being, allowing insight into possible protective parameters. With religion playing a role during challenging times, this study investigated theism and religiosity on the mental well-being of university students during the COVID19 pandemic and how social support and resilience can mediate this effect. One hundred eighty-five university students between 17 and 42 years old responded to online surveys on their theism, religious affiliations, religiosity, well-being, perceived support, and resilience. Pearson's correlations and single and sequential mediation analyses showed that theism did not significantly predict well-being (r = 0.049), but religiosity mediated the relationship (r = 0.432, effect size = 0.187). Sequential mediation analysis showed that resilience did not mediate the relationship between religiosity and well-being, but perceived social support significantly positively mediated religiosity and well-being with an effect size of 0.079. The findings reveal that factors, such as religiosity and social support could thus aid in the mental well-being of future challenging times such as the pandemic.

Fear of COVID-19, Coronavirus Anxiety, COVID-19 Burnout, and Resilience: Examining Psychometric Properties of COVID-19 Burnout Scale in Urdu

This research examined the associations between resilience, fear of COVID-19, coronavirus anxiety and COVID-19 burnout. The study also aimed to validate the COVID-19 Burnout Scale (COVID-19-BS) in Urdu. Participants included 812 Pakistani young adults (55.7% males; mean _age 26.4 ± 8.7 years). Results supported a one-factor solution for the COVID-19-BS with high reliability. Mediation analysis showed that resilience mediated the relationships between fear of COVID-19 and coronavirus anxiety with COVID-19 burnout. The study provided preliminary evidence that fear of COVID-19 and coronavirus anxiety might be significant risk factors for burnout among the Pakistani general population, and resilience might mitigate the impacts of these factors.

Perceived stress and coping strategies among emergency department nurses and emergency medical services staff during the fifth wave of COVID-19 in Iran: A cross-sectional correlational study

Background and Purpose

Emergency department (ED) nurses and emergency medical services (EMS) staff as the main parts of care on the front line of treatment during the outbreak of COVID-19 experienced great challenges in their work and life, which caused them a lot of stress. Since limited studies have investigated perceived stress and coping strategies among ED nurses and EMS staff in Iran, this study was conducted to investigate perceived stress and coping strategies among ED nurses and EMS staff during the outbreak of the fifth wave of COVID-19 in Ardabil, Iran.

Materials and methods

This descriptive-analytical cross-sectional study was conducted on 327 ED nurses and EMS staff in 2021. The samples were selected by convenient sampling method, and data were collected by demographic and perceived stressors and coping strategies against the outbreak of COVID-19 questionnaires. Data were analyzed by SPSS (version 22) using descriptive (frequency, percentage, mean, and standard deviation) and analytical (Pearson correlation, t-test, and ANOVA) statistical tests and multiple linear regression analysis.

Results

The most stressful factors were related to the transmission of the disease to the family and seeing the death of COVID-19 patients in front of their eyes. The most commonly used coping strategies were strict personal protective measures for all hospitalized patients and the use of clothes that the hospital prepared separately to reduce the transmission of the virus. The results of multiple linear regression showed employees' emotions (β = 0.429, p < 0.001), gender (β = 0.225, p < 0.001), coping strategies (β = 0.209, p < 0.001), stress-reducing factors (β = 0.124, p = 0.014), worry (β = -0.182, p < 0.001), and workplace (β = -0.149, p = 0.045) were effective predictors of perceived stress.

Conclusion

Coping methods such as following strict personal protective measures, using special clothes, and seeing the recovery status of patients and colleagues were effective factors in reducing the perceived stress of health workers. Therefore, it is necessary to provide health workers with training on coping strategies and psychological support in the current crisis and possible epidemics in the future.

The impact of fear of COVID-19 on the impact of event and indirect trauma

This study investigated the mediating effect of fear of COVID-19 on the relationship between the impact of an event and indirect trauma during the pandemic. The study was conducted online from February 8 to 18, 2021, with 215 participants who had never been diagnosed with COVID-19. The collected data were analyzed using SPSS and PROCESS macro software. It was confirmed that fear of COVID-19 partially mediates the relationship between the impact of an event and indirect trauma. This means that the greater the degree of impact of COVID-19, the higher the level of indirect trauma. Additionally, the greater the fear of COVID-19, the higher the level of indirect trauma. These results indicate that the prolonged spread of COVID-19 may vary depending on the country's quarantine systems. Overall, the findings of this study can assist in understanding the psychological problems of people who have experienced COVID-19 and in preparing relevant countermeasures for emotional problems.

Investigating the relationship between the depression levels of midwives and nurses and their emotional labor and secondary traumatic stress levels in the COVID-19 pandemic period with structural equation modelling

In this study, it was aimed to investigate the relationship between depression levels in midwives and nurses and their emotional labor and secondary traumatic stress levels in the COVID-19 pandemic process structural equation modelling. This cross-sectional study was conducted with 313 midwives and nurses. According to the model formed based on the presence of depression, as the Emotional Labor scores of the participants increased, their Beck Depression scores decreased 0.947-fold, while as their Secondary Traumatic Stress Scale scores increased, their Beck Depression scores increased 1.116-fold. It was determined that the scores of the participants in the Emotional Labor and Secondary Traumatic Stress Scales explained 42.8% of their Beck Depression Inventory scores. It was concluded that the depression statuses of the participants were affected by their emotional labor and secondary traumatic stress statuses.

Personality traits and hardiness as risk- and protective factors for mental distress during the COVID-19 pandemic: a Norwegian two-wave study

BACKGROUND

Several risk factors for anxious-depressive symptomatology during the COVID-19 pandemic have been established. However, few studies have examined the relationship between personality traits, hardiness, and such symptomatology during the pandemic. These constructs might serve as risk- and/or protective factors for such mental distress through the pandemic.

METHODS

A sample of 5783 Norwegians responded to a survey at two time points within the first year of the pandemic. The first data collection was in April 2020 (T1) and the second in December 2020 (T2). Measures included the Ten-Item Personality-Inventory, the Revised Norwegian Dispositional Resilience Scale, and the Patient Health Questionnaire Anxiety and Depression Scale. Analyses were performed using Pearson's correlations, multiple linear regression, and a moderation analysis.

RESULTS

Anxious-depressive symptomatology in early phases (T1) of the pandemic was the strongest predictor for the presence of such symptomatology 9 months after the outbreak (T2). Personality and hardiness correlated significantly with mental distress at T1 and T2. Personality traits explained 5% variance in symptoms when controlling for age, gender, solitary living, negative economic impact, and mental distress at baseline. Higher neuroticism predicted higher mental distress, whereas higher conscientiousness and extraversion predicted less mental distress. Hardiness did not explain variance in outcome beyond personality traits. Hardiness did not significantly moderate the relationship between neuroticism and mental distress.

CONCLUSION

Individuals with high levels of neuroticism had greater difficulties adapting to the circumstances of the COVID-19 pandemic and were more prone to mental distress. Contrastingly, higher conscientiousness and extraversion may have served as protective factors for mental distress during the pandemic. The current findings might aid identification of vulnerable individuals and groups. Consequently, preventive interventions could be offered to those who need it the most.

Critical Clinical Events and Resilience Among Emergency Nurses in 3 Trauma Hospital-Based Emergency Departments: A Cross-Sectional Study

INTRODUCTION

Emergency nurses experience occupational stressors resulting from exposures to critical clinical events. The purpose of this study was to identify the critical clinical events for emergency nurses serving 3 patient populations (general, adult, pediatric) and whether the resilience of these nurses differed by the patient population served.

METHODS

This study used a cross-sectional survey design. A total of 48 emergency nurses were recruited from 3 trauma hospital-based emergency departments (general, adult, pediatric). Clinical Events Questionnaire, Connor-Davidson Resilience scale, and an investigator-developed demographic questionnaire were used to collect data from respondents.

RESULTS

All respondents were female (n = 48, 100%), and most were White (n = 46, 96%). The average age of participants was 39.6 years, the average number of years as a registered nurse was 12.7 years, and the average number of years as an emergency nurse was 8.8 years. Clinical events considered most critical were providing care to a sexually abused child, experiencing the death of a coworker, and lack of responsiveness by a colleague during a serious situation. The least stress-provoking event was incidents with excessive media coverage. Nurses were less affected by the critical events they experienced more frequently at work. Nurses in the 3 trauma settings had high level of resilience, with no statistically significant differences between groups.

DISCUSSION

The occupational stress from exposure to significant clinical events varied with the patient population served by emergency nurses. It is important that interventions be adopted to alleviate the effect of work-related stressors and promote the psychological health of emergency nurses.

A Bibliometric Analysis of the Association Between Compassion Fatigue and Psychological Resilience From 2008 to 2021

Aims

A negative association between the lower level of psychological resilience (PR) and increased risk of compassion fatigue (CF) and higher Coronavirus disease 2019 (COVID-19) stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic.

Methods

We identified relevant literature from the Web of Science Core Collection® database using "resilience" and "compassion fatigue" on September 30, 2021. All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1.

Results

A total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19.

Conclusion

The results of the present study help us understand the status of the CF and PR field and its recent developments.

Emergency Stress, Hardiness, Coping Strategies and Burnout in Health Care and Emergency Response Workers During the COVID-19 Pandemic

Objective

Stress is a growing problem in the general population, but most especially for workers responding to the COVID-19 crisis. The present study examines stress and Burnout in Health Care workers and Emergency Responders during the third COVID wave in Italy. In addition, we explore the value of psychological Hardiness and positive coping strategies as protective factors against the ill-effects of stress.

Methods

Over a 5-month period in 2021, surveys were administered across all Italian regions to several groups including Health Care workers (N = 220), Emergency Responders (firefighters, civil protection, ambulance personnel; N = 121), volunteer Italian Red Cross workers (N = 328), and a comparison group (N = 400) drawn from the General Population of Italy.

Results

Results showed that among the groups, Health Care workers had the highest levels of Emergency Stress, while the Red Cross volunteers had relatively lower stress levels. Hardiness and positive coping levels were highest among Red Cross workers, and lowest in the General Population sample. The biggest impact on Burnout was seen among health care workers, especially on Emotional Exhaustion and Depersonalization. Multiple regression results showed that Hardiness operates as a moderator of the effects of Emergency Stress on Emotional Exhaustion and Depersonalization aspects of Burnout, while problem focused coping and Stopping Negative Thoughts-Emotions also showed moderating effects.

Conclusion

These results suggest that Health Care workers and Emergency Responders would benefit from additional training in hardiness and positive coping skills.

A virtual reality home-based training for the management of stress and anxiety among healthcare workers during the COVID-19 pandemic: study protocol for a randomized controlled trial

Background

Healthcare workers represent one of the most affected categories by the adverse effects of the COVID-19 pandemic on mental health. Excessive stress and anxiety are critical factors that could compromise work performance. Besides, high levels of stress and anxiety may have long-term physical and psychological consequences. Recent studies investigated virtual reality to reduce stress and anxiety among healthcare workers during the COVID-19 pandemic. However, the proposed virtual reality interventions have important limitations related to their location (i.e., research lab and hospitals) and content (i.e., virtual experiences only for relaxation). Within this context, this randomized controlled trial aims to investigate the efficacy and acceptability of a brief home-based virtual reality training for managing stress and anxiety during the COVID-19 crisis in a sample of Italian healthcare workers.

Methods

The study is a randomized controlled trial. It includes two groups of 30 individuals recruited from healthcare workers: (1) the experimental group and (2) the control group. Participants in the experimental group will receive a training consisting of three home sessions performed in a week. In each session, participants will try through an immersive virtual reality standalone system (i.e., Oculus Quest 2) a virtual psychoeducation experience on stress and anxiety (i.e., MIND-VR). Subsequently, they will try the virtual relaxation content (i.e., The Secret Garden). The control group will receive no training and will be reassessed one week and one month after the initial evaluation.

Discussion

If the proposed brief home-based virtual reality training will result helpful and easy to use, it could become an empirically assessed viable option for protecting healthcare workers’ mental health both during the COVID-19 pandemic and once it will be over. Furthermore, the intervention might be easily adapted for other categories of people who need support in managing stress and anxiety.

Trial registration

ClinicalTrials.gov NCT04611399.

The Fear of COVID-19: Gender Differences among Italian Health Volunteers

Background: During the COVID-19 pandemic, the fear of being infected was a major concern, resulting in both physical and psychological effects. Despite several studies on fear of COVID-19 in the general population, the effects on healthy volunteers who face COVID-19 on the frontlines have not yet been investigated. Methods: An online survey on specific psychological variables related to COVID-19 was administered to 720 healthy volunteers, and gender differences were investigated. Results: The primary finding was that females showed higher scores in all dimensions assessed. A multiple linear regression conducted on both genders exhibited a similar pattern of predictors, highlighting the pivotal role of negative affect in the male group. Conclusions: The findings suggest that COVID-19 had significant effects on healthy volunteers, especially in the female group. Although the previous literature did not report the crucial role played by the negative affect in the male sample, these results highlight the need to deepen how both genders use different emotional strategies to cope with stressful situations. This study may be useful in the development of specific psychological support and ad hoc training for healthy volunteers.

Resilience at Work, Burnout, Secondary Trauma, and Compassion Satisfaction of Social Workers Amidst the COVID-19 Pandemic

Social workers during the COVID-19 pandemic are at risk due to exposure to varied populations in need, which may impact their resilience, burnout, secondary trauma, and compassion satisfaction. The study assessed resilience at work, burnout, secondary trauma, and compassion satisfaction among social workers in Israel during the first wave of the COVID-19 pandemic (May to June 2020). A convenience sample of 332 social workers (291 women (87.6%)) filled out an online, structured questionnaire that included demographics, a professional quality of life scale (ProQOL) (including three subscales), and resilience at work (RAW) (including seven subscales). The overall mean of the RAW was medium (M = 71, SD ± 8.9) compared to standardized scores. The mean scores of two of the subscales of the RAW, maintaining perspective and staying healthy, were low. The mean scores of the sub-scales of ProQOL were: compassion satisfaction was close to the 50th percentile (M = 48.25); burnout (M = 30.18) and secondary trauma (M = 26.27) were below the 25th percentile. Significant low to medium positive associations were found between all the dependent variables, except for staying healthy. A negative association was identified between compassion satisfaction and burnout, as well as between compassion satisfaction and secondary trauma. High levels of compassion satisfaction and contentment, low levels of secondary trauma, and having a managerial position were predicted to be 40% of the RAW. Lower levels of maintaining perspective, secondary trauma, and being younger predicted 27% of burnout. Higher levels of finding your calling, living authentically, maintaining perspective, interacting cooperatively, being older, and not being a manager predicted 58% of compassion satisfaction. Lower levels of burnout, maintaining perspective, and being younger predicted 36% of secondary trauma. As the COVID-19 pandemic still challenges most societies, policymakers should consider ways to integrate mechanisms that will enhance social workers' resilience at work.

Depression, anxiety, and suicidal ideation in nurses with and without symptoms of secondary traumatic stress during the COVID-19 outbreak

BACKGROUND

Nurses tend to experience a lot of Secondary Traumatic Stress (STS) during the outbreak of the COVID-19. This study aimed to evaluate the prevalence of STS and comparing depression, anxiety, and Suicidal Ideation (SI) in nurses with and without STS symptoms during the COVID-19 outbreak.

METHOD

The research method of this study was descriptive-comparative. The statistical sample consisted of 315 nurses working in hospitals of Malayer city, western Iran, selected through census method. Data were collected using the STS Scale, Beck's Depression Inventory (BDI-13), Anxiety Inventory (BAI), and SI scale. Data were analyzed using the independent t-test, multivariate analysis of variance (MANOVA), and multivariate analysis of covariance (MANCOVA).

RESULTS

This study showed that 161 nurses (51.11%) had symptoms of STS. The prevalence of STS symptoms in nurses in emergency, ICU/CCU, medical emergencies, and other wards was 62.27%, 62.02%, 51.61%, and 26.32%, respectively. The results of the MANCOVA showed that the nurses with STS symptoms received higher scores in depression, anxiety, and SI than the ones without STS symptoms (p < 0.01).

CONCLUSION

Hospital authorities and nursing psychiatrists should pay more attention to the STS symptoms in nurses during the COVID-19 outbreak, and its effects on depression, anxiety, and SI.

Mental Health Symptoms among General Practitioners Facing the Acute Phase of the COVID-19 Pandemic: Detecting Different Reaction Groups

During the 2020 first wave of the COVID-19 pandemic, general practitioners (GPs) represented the first line of primary care and were highly exposed to the pandemic risks, with a consequent risk of developing a wide range of mental health symptoms. However, scant data are still available on factors associated with a worse outcome. The aim of the present study was to investigate mental health symptoms in 139 GPs in the aftermath of the first COVID-19 national lockdown in Italy, detecting groups of subjects with different depressive, anxiety, and post-traumatic stress symptom severity. The impact of the mental health symptoms on quality of life and individual functioning were also evaluated. A cluster analysis identified three groups with mild (44.6%), moderate (35.3%), and severe psychopathological burden (20.1%). Higher symptom severity was related to younger age, fewer years in service as GPs, working in a high incidence area for the pandemic, having a relative at risk of medical complications due to COVID-19, besides more severe global functioning impairment, burnout, and secondary traumatic stress. The present findings showed that GPs, forced to perform their professional activity in extremely stressful conditions during the COVID-19 pandemic, were at high risk of developing mental health problems and a worse quality of life.

The Robust Italian Validation of the Coping Humor Scale (RI-CHS) for Adult Health Care Workers

The Coping Humor Scale (CHS) is a seven-item tool widely used to assess the use of humor in coping with stressful situations. The beneficial effect of humor in buffering the impact of negative experiences has been investigated in several contexts and populations; for this reason, the CHS has been used in many languages, but its solid validation in Italian is still missing. Our study aimed at building a robust instrument to measure coping humor strategies among Italian health care workers, a category which has been particularly exposed to stressful situations in the last two years. The CHS translated into Italian was administered to a sample of 735 health care workers during the first wave of the COVID-19 pandemic in Italy. Confirmatory factor analysis and Rasch analysis were performed. As a result, a six-item Robust Italian Coping Humor Scale (RI-CHS) was validated and ready to use for future studies on Italian health care workers’ samples. This study gives evidence that our six-item solution works as a ruler (i.e., an instrument that meets the conditions of fundamental measurement in the context of the human sciences) to measure the degree to which Italian health care workers rely on humor to cope with stress.

Heading for Tomorrow: Resilience Strategies for Post-COVID-19 Grocery Supply Chains

Supply chain resilience is a critical capability needed to compete in the current turbulent and unpredictable business environment, but many companies still tend to underestimate its relevance. In the wake of the COVID-19 pandemic, understanding which supply chain impacts influence the policies and actions undertaken when resilience is concerned is important. This study investigated the relationships between the impacts experienced at the different supply chain tiers during the pandemic, and explored which impacts could drive perceptions towards developing resilience strategies in the future. A survey instrument was developed adopting a mid-range approach, targeting manufacturers active in the Italian grocery supply chain. Data were analysed using partial least square structural equation modelling (PLS-SEM). Results showed that source-related impacts deeply affect make- and delivery-related impacts, and make-related impacts mainly influence the perceptions about future resilience strategies. In fact, manufacturers appear to be primarily interested in those strategies ensuring the continuity of their intrinsic operations. The study could inform theory and practice about companies’ decisions towards the adoption of certain approaches. Also, it highlights promising research avenues related to deepening understanding of how perceptions could predict future intentions to engage in protective actions to adequately cope with potential future disruptions.

Mental Health of Nurses during the Fourth Wave of the COVID-19 Pandemic in Poland

In the face of the current COVID-19 pandemic crisis, healthcare professionals, including nurses who provide direct care for patients, are at particular risk of mental health problems. The aim of the study was to evaluate the prevalence of symptoms of depression, anxiety, and stress among nurses working in healthcare facilities during the COVID-19 pandemic.

MATERIALS AND METHODS

This was a cross-sectional observational study. A total of 333 professionally active nurses participated in the study. Data was collected in the period from 10 November to 20 November 2021. We collected sociodemographic data and used the short form of Depression Anxiety Stress Scale (DASS-21) to assess the mental health among nurses.

RESULTS

Severe and very severe symptoms of depression were found in 23.1% of nurses, whereas moderate symptoms were detected in 30.3%. High to very high levels of anxiety were observed in 46.5% of respondents, while 25.8% of nurses showed a moderate level of anxiety. Moderate and high levels of stress were found in 35.4% and 14.1% of the respondents, respectively. Contact with a patient suspected of having SARS-CoV-2 infection was a significant predictor of depressive symptoms. Gender, workplace, and contact with patients suspected of SARS-CoV-2 infection and patients with COVID-19 were significant predictors of anxiety, whereas contact with patients suspected of being infected with SARS-CoV-2 and COVID-19 patients was a significant predictor of stress.

CONCLUSIONS

High scores for depressive symptoms, anxiety, and stress among Polish nurses during the fourth wave of the COVID-19 pandemic are indicative of a direct threat to the mental health of nurses. Targeted support strategies need to be developed and implemented to prevent the deterioration of mental health in this group.

Work-based concerns of Australian frontline healthcare workers during the first wave of the COVID-19 pandemic

OBJECTIVE

This research sought to gauge the extent to which doctors, nurses and paramedics in Australia were concerned about contracting SARS-CoV-2 during the country's first wave of the virus in April 2020.

METHODS

Australian registered doctors, nurses and paramedics (n=580) completed an online questionnaire during April 16-30, 2020 (period immediately following the highest four-week period (first wave) of SARS-CoV-2 confirmed cases in Australia).

RESULTS

During April 2020, two-thirds of participants felt it was likely they would contract SARS-CoV-2 at work. Half the participants suggested Personal Protective Equipment (PPE) supplies were inadequate for them to safely perform their job, with two-thirds suggesting management advised them to alter normal PPE use. One-third of participants suggested they were dissatisfied with their employer's communication of COVID-19 related information. Conclusions and implications for public health: After reports of PPE shortages during Australia's first SARS-CoV-2 wave, and suggestions access to PPE was still limited during Australia's second wave five months later, we must forecast for this and future pandemics ensuring adequate access to PPE for frontline healthcare workers. Further, ensuring consistent and standardised pathways for communication to staff (acknowledging the reality that information may rapidly change) will help alleviate frustration and anxiety.

Promoting and Risk Factors of Nurses' Hardiness Levels during the COVID-19 Pandemic: Results from an Italian Cohort

Aim: Few studies in the literature specifically address the hardiness of nurses during the COVID-19 pandemic. Thus, the primary aim of this study was to assess the impact of COVID-19 on the hardiness levels in an Italian cohort of nurses. The secondary aims were to assess the level of hardiness in nurses directly caring for patients with COVID-19 and to verify the presence of related risk and promoting factors. Methods: A descriptive and explorative study was performed through an online survey from March to July 2020. The survey was composed of a multiple answer questionnaire with open, closed, and semi-closed-ended questions. Hardiness and anxiety were assessed using two psychometric instruments: the Dispositional Resilience Scale (DRS-15) and State-Trait Anxiety Inventory (STAI-Y). Results: A total of 1250 nurses completed the questionnaire entirely (92.3% of respondents). The average length of service was 17.8 ± 11.5 years. A decrease in the hardiness was recorded after the first wave of COVID-19 if compared to the baseline (mean Δ DRS-15 total = 1.3 ± 5.0), whereas in the subsample of nurses caring for COVID-19 patients, the total hardiness level decreased more consistently (mean Δ DRS Total = 1.9 + 5.3). Multivariate analysis showed that high levels of anxiety were risk factors for reducing hardiness. In contrast, anxiety, when associated with a greater length of service, was a promoting factor for the increase in hardiness. Conclusions: The correlation between anxiety and years of length of service appears to be pivotal. Future research should focus on the role of anxiety to establish its actual role as a predictor of hardiness.

Psychological Impact of the COVID-19 Pandemic on Out-of-Hospital Health Professionals: A Living Systematic Review

Health professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs.

Individual and organisational strategies to develop resilience in the nursing workforce

Nurses are likely to encounter a wide range of distressing, challenging and sometimes traumatic situations. However, the coronavirus disease 2019 (COVID-19) pandemic has created unprecedented levels of stress, risk, uncertainty and anxiety for nurses. Nurses have been working in highly challenging conditions, particularly on the front line of patient care, which has had adverse effects on their mental health and well-being. The challenges generated by the COVID-19 pandemic have called into question the notion of nursing being an innately resilient profession. Consequently, the pandemic has reinforced the need for individuals, teams and healthcare organisations to foster resilience in nurses. This article discusses the theoretical underpinnings of resilience, explains what resilience in nurses means, and describes the adverse effects of the pandemic on nurses' mental health and resilience. The article also explores how nurses' resilience can be developed and enhanced from an individual and organisational perspective.

Perceived organizational support and PTSD symptoms of frontline healthcare workers in the outbreak of COVID-19 in Wuhan: The mediating effects of self-efficacy and coping strategies

The present study aimed to examine the effect of perceived organizational support on the PTSD symptoms of frontline healthcare workers, and to examine the mediating effects of coping self-efficacy and coping strategies in this relationship. A short-term longitudinal study design was used to conduct two waves of online surveys in March and April 2020. Participants comprised 107 medical staff in both waves of investigation. Self-efficacy, coping strategies, and perceived organizational support were reported at Wave 1, and PTSD symptoms were reported at Wave 2. Results indicated that (1) The prevalence of probable PTSD was 9.3% and 4.7% on the Chinese version of the Impact of Events Scale-Revised of 33 and 35, respectively. Local healthcare workers had greater risks of PTSD than the members of medical rescue teams. Doctors reported higher PTSD symptoms than nurses. (2) Perceived organizational support had a significant indirect effect on PTSD symptoms through the mediation of problem-focused coping strategies and the sequential mediating effect of coping self-efficacy and problem-focused coping strategies. The findings highlight the importance of providing adequate organizational support to reduce PTSD symptoms in frontline medical staff during the COVID-19 pandemic.

Fear of COVID-19 and Life Satisfaction: The Role of the Health-Related Hardiness and Sense of Coherence

Introduction: The COVID-19 pandemic is contributing to increased fear and anxiety throughout society, which may affect life satisfaction. Health-related hardiness and sense of coherence (SOC) are personal resources that help people adapt to difficult circumstances. The purpose of this study was to investigate the relationship between fear of COVID-19, SOC, health-related hardiness, and life satisfaction. Methods: A total of 907 Polish people (522 women and 385 men) participated in this study. The Fear of COVID-19 Scale (FOC-6), the Health-Related Hardiness Scale, the Sense of Coherence Scale (SOC-29), and the Satisfaction with Life Scale were used. Results: Correlation showed that fear of COVID-19 was negatively related to health-related hardiness, SOC, and life satisfaction. Health-related hardiness and SOC were positively related to life satisfaction. Both SOC and hardiness were mediators between fear of COVID-19 and life satisfaction during the current pandemic. Conclusion: SOC and health-related hardiness are personal resources that are important for dealing with the effects of the COVID-19 pandemic. According to our study, SOC and hardiness can mediate between fear of COVID-19 and life satisfaction. Presented cross-sectional results have to be verified in future longitudinal studies in order to strengthen the conclusions presented in this manuscript. This study verified the role of only two personal resources, so more research is needed on the role of other personal resources during COVID-19 pandemic.

Resilience and stress in frontline social workers during the COVID-19 pandemic in Singapore

As social work under normal circumstances is already a stress-laden helping profession, this study intended to examine the level of psychological distress among the frontline social workers during the COVID-19 pandemic and whether resilience and organizational support played a part in mitigating their psychological distress. Frontline social workers from various social service sectors across Singapore were surveyed using two standardized measurements to assess resilience (Connor-Davidson Resilience Scale 25) and psychological distress (Depression Anxiety and Stress Scale 21). A self-designed questionnaire comprising 10 items measured "personal" and "work-related" support at the organization. Sociodemographic data were captured using a structured questionnaire. The results showed that the frontline social workers, although resilient, were psychologically distressed in all the three areas of depression, anxiety and stress. The results indicated that those working in the Family Service Centers (FSC) were the most affected. Significant correlations were observed between psychological distress, resilience, and organizational support. Organizations must be mindful that support can help frontline staff who are usually younger and less experienced during challenging times such as the pandemic. Building the resilience of social workers will prepare them for their daily challenges and those that accompany unexpected situations.

Secondary traumatic stress in nurses working with patients with suspected/confirmed COVID-19 in Turkey

PURPOSE

This study aimed to determine the level of secondary traumatic stress in nurses (n = 205) working with patients with suspected or confirmed COVID-19 in Turkey.

DESIGN AND METHODS

Data were collected using the personal information form and Secondary Traumatic Stress Scale.

FINDINGS

Of the total sample, 62% were female and 52% of nurses were in the 20- to 30-years age range. 67.8% of the nurses experienced high and severe secondary traumatic stress symptoms, the mean score was 49.66 ± 0.86. At the level of secondary traumatic stress subscales, the highest average score was avoidance symptom (20.09 ± 5.06).

PRACTICE IMPLICATIONS

More than half of the nurses experienced high and severe secondary traumatic stress where the highest symptom "avoidance." The nurses may need psychosocial support during and after the pandemic.

Trauma-informed career counselling to address work traumas resulting from the COVID-19 pandemic

Background

Sudden work traumas as a result of the coronavirus disease 2019 (COVID-19) pandemic have left thousands displaced from their current jobs and occupations. Traditional career counselling approaches that overlook the role of emotion are not adequate to address the numerous emotional difficulties that arise after a sudden unexpected job loss.

Objectives

The objective of this research is to examine to what extent career counselling theories and interventions incorporate a trauma-informed career counselling approach and are prepared to address the emotional, psychological, and career counselling concerns that arise from work traumas as a result of the COVID-19 pandemic.

Methods

A qualitative systematic literature review of all career-related journals that have trauma-informed career counselling in the title or body of the manuscript was conducted. Additionally, career related articles, books, and book chapters specifically mentioning work traumas and interventions to address these issues were also examined.

Results

Only one article on trauma-informed career counselling was found given the parameters of the literature review. Currently, no articles outline how to integrate career counselling and emotion-focused therapy for trauma in order to address work traumas related to COVID-19.

Conclusion

A trauma-informed career counselling approach that integrates career construction counselling and emotion-focused trauma therapy is needed to address the emotional, psychological, and career counselling concerns that arise from a work trauma as a result of the COVID-19 pandemic. An integrated approach to provide trauma-informed career counselling has been provided.

Willingness to Work amongst Australian Frontline Healthcare Workers during Australia's First Wave of Covid-19 Community Transmission: Results of an Online Survey

OBJECTIVES

The majority of research investigating healthcare workers' (HCWs) willingness to work during public health emergencies, asks participants to forecast their perceptions based on hypothetical emergencies, rather than in response to the actual public health emergencies they have experienced. This research explored frontline HCWs willingness to work during Australia's first wave of the COVID-19 pandemic among frontline HCWs.

METHODS

Participants (n = 580) completed an online questionnaire regarding their willingness to work during the pandemic.

RESULTS

A total of 42% of participants reported being less willing to work during the pandemic compared to before. Availability of personal protective equipment (PPE), concern expressed by family members, and viral exposure were significant barriers. A third of participants disagreed that some level of occupational risk for exposure to infectious disease was acceptable while a quarter of participants had received communications from their workplace concerning obligations to work during COVID-19.

CONCLUSIONS

The COVID-19 pandemic has impacted Australian frontline HCWs' willingness to work. Scarcity of PPE and exposure to the virus were the most cited reasons impacting on willingness to work. Appropriate policies and practices should be implemented and communicated efficiently to frontline HCW's. This research provides insight into the lived experiences of Australian healthcare professionals' willingness to work during a pandemic.

Resilience, Coping Strategies and Posttraumatic Growth in the Workplace Following COVID-19: A Narrative Review on the Positive Aspects of Trauma

The COVID-19 pandemic represents a traumatic event that has profoundly changed working conditions with detrimental consequences for workers' health, in particular for the healthcare population directly involved in addressing the emergency. Nevertheless, previous research has demonstrated that traumatic experiences can also lead to positive reactions, stimulating resilience and feelings of growth. The aim of this narrative review is to investigate the positive aspects associated with the COVID-19 pandemic and the possible health prevention and promotion strategies by analyzing the available scientific evidence. In particular, we focus on the constructs of resilience, coping strategies and posttraumatic growth (PTG). A literature search was performed on the PubMed, EMBASE, Scopus, Web of Science, Google Scholar and Psycinfo databases. Forty-six articles were included in the literature synthesis. Psychological resilience is a fundamental variable for reducing and preventing the negative psychological effects of the pandemic and is associated with lower levels of depression, anxiety and burnout. At the individual and organizational level, resilience plays a crucial role in enhancing wellbeing in healthcare and non-healthcare workers. Connected to resilience, adaptive coping strategies are essential for managing the emergency and work-related stress. Several positive factors influencing resilience have been highlighted in the development of PTG. At the same time, high levels of resilience and positive coping strategies can enhance personal growth. Considering the possible long-term coexistence and consequences of COVID-19, organizational interventions should aim to improve workers' adaptive coping skills, resilience and PTG in order to promote wellbeing.

Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic-A Multi-Group Path-Analysis

The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs' interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks.

Unpacking the Mental Health of Nurses during COVID-19: Evidence from Pakistan

The prime objective of the present study is to test the effect of COVID-19 fear on the mental condition of nurses in the public health sector of Pakistan. This study seeks to measure the psychological distress, anxiety, and psychological well-being of nurses due to fear of COVID-19 and exposure to COVID-19. This research further reveals the moderating role of “social support” in the link between COVID-19 fear, exposure and mental health. Through a convenient sampling technique, 250 sample contributors were chosen from 12 public hospitals. The results were obtained by applying multiple regression and moderation analysis by SPSS and the Hayes process. The outcomes indicated that fear of exposure to COVID-19 affects the mental health of nurses. The findings also discovered that social support is not very constructive in the pandemic. However, we suggested that social support is the best weapon to encourage nurses to relieve their fear and minimize negative emotions.

Beyond workplace violence: Direct and vicarious trauma among psychiatric hospital workers. A qualitative study

AIM

We aimed to explore psychiatric nurses' and other psychiatric workers' understanding of trauma in the context of their relationships with the people they care for and the effects on their mental health.

BACKGROUND

Workplace violence in psychiatric hospitals can lead to mental health problems, including posttraumatic stress disorder. Professional relationships with the people they care for may complicate psychiatric workers' experiences of trauma.

METHODS

We qualitatively analysed responses of 30 psychiatric workers who answered relevant open-ended questions in a survey of workplace violence and posttraumatic stress disorder symptoms.

RESULTS

We found that respondents were profoundly affected by violence and vicarious trauma through the current and previous suffering of people in their care. The effects of vicarious exposure and other potentially psychologically traumatic events were often made worse by lack of organizational support.

CONCLUSION

Not only direct exposure to violent events but also indirect exposure, vicarious traumatic stress and perceived lack of organizational support affect staff's well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

Management should ensure that mental health supports are not limited to workers directly affected by workplace violence but should extend to those who witnessed the event and to those regularly exposed to vicarious trauma.

How have journalists been affected psychologically by their coverage of the COVID-19 pandemic? A descriptive study of two international news organisations

OBJECTIVES

The COVID-19 pandemic has presented unprecedented healthcare challenges. Journalists covering the pandemic at close quarters are working in ways akin to first responders, but nothing to date is known of the psychological distress this is potentially causing them. This study aims to determine whether journalists reporting on the COVID-19 crisis have been affected emotionally, and if so to assess the severity of their distress. It also investigates potential demographic and work-related predictors and whether news organisations had provided counselling to their journalists.

PARTICIPANTS

A total of 111 journalists working for two international news organisations were approached of which 73 (66%) participated in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Symptoms of anxiety (Generalised Anxiety Disorder Scale-7 (GAD-7)), depression (Patient Health Questionnaire (PHQ-9)), posttraumatic stress disorder (PTSD; PTSD Checklist for DSM-5 (PCL-5)), overall psychological distress (12-item General Health Questionnaire (GHQ-12)), and treatment.

RESULTS

The percentages of journalists exceeding threshold scores for clinically significant anxiety, depression, PTSD and psychological distress were: GAD-7, 26%; PHQ-9, 20.5%; PCL-5, 9.6%; GHQ-12, 82.2%. Journalists assigned to cover the pandemic (n=54 (74%)) were significantly more anxious (p<0.05). Journalists who received counselling (n=38 (52%)) following the onset of the pandemic reported significantly fewer symptoms of anxiety (p<0.01), depression (p<0.01) and overall psychological distress (p<0.01).

CONCLUSIONS

Journalists covering the COVID-19 pandemic are experiencing levels of anxiety and depression similar to those seen in first responders. Psychological therapy provided in a timely manner can significantly alleviate emotional distress.

Job Demands and Negative Outcomes after the Lockdown: The Moderating Role of Stigma towards Italian Supermarket Workers

The Job Demands-Resources model hypothesises that some variables (especially personal and social resources/threats) moderate the relationship between job demands and work outcomes. Based on this model, in this study we examine the role of stigma towards customers as a moderator of the relationship between job demands and a series of work outcomes: that is, fatigue, burnout, and satisfaction. We advance that the relationships between work demands and outcomes should be influenced by the employee’s perceptions regarding resources and constraint. In particular, we hypothesised that social stigma towards customers can represent a reliable moderating variable. Hypotheses were tested among 308 Italian supermarket workers in five supermarkets in the same chain, just after the end of the Italian lockdown caused by COVID-19. Results showed that stigma towards customers moderates the relationship between job demands and the consequences on the professional quality of life. The implications of these findings for the JD-R model are discussed.

Fear, Stress, Resilience and Coping Strategies during COVID-19 in Spanish University Students

COVID-19 (2019 coronavirus pandemic) and the resulting confinement has had an impact on mental health and the educational environment, affecting the stress, concerns, fear, and life quality of the university population. This study aimed to examine the correlation between fear of COVID-19, stress with COVID-19, and technological stress in university students, and their resilience, self-esteem, and coping strategies. The final sample comprised 180 Spanish university students, with an average age of 20.76 years (SD = 4.59). The above-mentioned effects were administered a series of self-report scales. We found statistically significant associations between fear of COVID-19 and stress with COVID-19, technological stress (total score), overload, and complexity (subdimensions of technological stress). Likewise, we found inverse relationships between the students’ fear of COVID-19 and the use of the coping strategy, cognitive restructuring. Ascertaining the factors that influence the coping strategies of undergraduate university students and their fears, psychological stress, and resilience provides valuable information for the development of educational interventions. This research has relevant implications for the diagnosis, orientation, and design of psycho-educational and clinical interventions that can improve students’ well-being and training for effective coping strategies for daily stress and this pandemic situation.

Protective Factors against Emergency Stress and Burnout in Healthcare and Emergency Workers during Second Wave of COVID-19

Working as healthcare workers (HCWs) and emergency workers (EWs) during the first wave of COVID-19 has been associated with high levels of stress and burnout, while hardiness, coping strategies and resilience have emerged as protective factors. No studies have so far investigated these psychological factors during the second wave. We aimed to verify the trend of stress levels, burnout, coping strategies and resilience during the pandemic in Italian healthcare and emergency workers by comparing a first sample recruited from the first COVID-19 wave (N = 240) with a second sample relating to the second wave (N = 260). Through an online platform we administered questionnaires to measure stress, burnout, resilience, hardiness and coping strategies. The results showed that in the two waves the total stress levels of HCWs and EWs did not differ, while the physical stress and hardiness scores in the second wave were greater. No differences were found in the coping strategies used. An analysis of burnout levels in the second wave sample found that stress showed a high predictive power in the emotional exhaustion and depersonalization scales. Hardiness and resilience emerged as protective factors in reducing stress. The implications for the need to provide support and to improve hardiness for HCWs and EWs are discussed.

Mental health of Health Care Workers (HCWs): a review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19

The COVID-19 outbreak has been associated with significant occupational stressors and challenges for healthcare workers (HCWs) including the risk of exposure to SARS-CoV-2. Many reports from all over the world have already found that HCWs have significant levels of self-reported anxiety, depression and even symptoms of post-traumatic stress disorder. Therefore, supporting mental health of HCWs is a crucial part of the public health response to the COVID-19 pandemic. The aim of the present review is to ascertain the interventions put in place worldwide in reducing stress in HCWs during the COVID-19 outbreak. We evidenced how only few countries have published specific psychological support intervention protocols for HCWs. All programs were developed in university associated hospitals and highlighted the importance of multidisciplinary collaboration. All of them had as their purpose to manage the psychosocial challenges to HCW's during the pandemic in order to prevent mental health problems.Whether one program offers distinct benefit compared to the others cannot be known given the heterogeneity of the protocols and the lack of a rigorous protocol and clinical outcomes. Further research is crucial to find out the best ways to support the resilience and mental well-being of HCWs.

A Model of Stress Change under the First COVID-19 Pandemic among the General Public in Japanese Major Cities and Rural Areas

Research on stress related to the COVID-19 pandemic has been dominated by the cases of healthcare workers, students, patients, and their stress during the COVID-19 pandemic. This study examined the relationship between the amount of stress change under the COVID-19 pandemic and demographic factors (age, sex, occupation, etc.) in residents of a large city and a rural area of Japan. A total of 1331 valid responses were received in June 2020 from residents of Tokyo, Osaka, and Nagano registered with a private research firm. We were able to identify 15 statistically significant variables out of 36 explanatory variables, which explained the significant increase in stress compared to the pre-pandemic period. Multiple-factor analysis showed that the relationship with people is a more significant explanatory variable for the level of increase in stress than the difference in environment between big cities (Tokyo, Osaka) and rural areas (Nagano), the type of housing, and the decrease in income compared to the pre-pandemic period.

Major Stressors and Coping Strategies of Frontline Nursing Staff During the Outbreak of Coronavirus Disease 2020 (COVID-19) in Alabama

BACKGROUND

Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-19 exhibit higher than usual stress levels due to an increasingly overburdened healthcare system and increasing infection rates. This study aims to investigate the major stressors and coping strategies reported by nurses working directly with potentially infectious patients in Alabama, United States, during the COVID-19 pandemic.

MATERIALS AND METHODS

A cross-sectional questionnaire study was conducted with nursing staff working in hospital settings in the state. The questionnaire was completed by 109 nurses working in hospitals that treated COVID-19 patients.

RESULTS

Around 71% of the nursing staff were concerned about receiving more COVID-19 patients and exhibited heightened workload-related stress resulting from taking care of infected patients. The study found that most nurses (82%) are stressed about getting their friends and family infected. Overall, younger, less experienced nurses reported more stress levels compared to older, senior-level nurses. Findings suggest that many nurses fail to perceive protective measures as an effective coping strategy, with only 75% reporting problem-solving strategies such as hand washing and wearing a face mask, and only 60% avoiding public transportation and crowded spaces. Findings also suggest a lack of organizational support including psychiatric assistance, with no nurses reportedly seeking psychological therapy.

CONCLUSION

The COVID-19 pandemic increased the stress level of the nursing staff in Alabama. The study finds that the cases in the state of AL are still increasing dramatically, which can overwhelme the healthcare system and escalate nurse stress levels.

Facing the COVID-19 Pandemic: The Role of Sense of Coherence

The worldwide outbreak of COVID-19, the ensuing pandemic, and the related containment measures pose considerable challenges to psychological resilience and well-being. Researchers are now forced to look for resources to cope with negative experiences linked to this health emergency. According to the salutogenic approach proposed by Antonovsky, the sense of coherence (SOC) is a major source of resilience. Thus, this study aimed at assessing the role of SOC in moderating the link between illness experiences (in terms of knowing persons diagnosed with COVID-19 and fear of contracting COVID-19) and psychological well-being. 2,784 participants, taken from a large sample of the Italian population (65.4% females) and aged between 18 and 85 years, filled in an anonymous online survey during the 3rd week of the lockdown. Findings supported the moderating role of SOC in shaping the link between illness experiences and psychological well-being. Specifically, participants who knew at least one person diagnosed with COVID-19 showed lower levels of psychological well-being at low levels of SOC. The negative relation between participants' fear of contracting COVID-19 and psychological well-being was stronger for those who showed higher levels of SOC. This study discusses the implications of these results for interventions aimed at reducing the pandemic's detrimental effects and promoting resilience.

Personal Accomplishment and Hardiness in Reducing Emergency Stress and Burnout among COVID-19 Emergency Workers

During the severe phase of the pandemic, COVID-19 emergency workers were engaged in long and numerous shifts of duty, resulting in exposure to various stress factors. A high stress level is associated with risk of burnout. Resilience and personal accomplishment can effectively help mitigate and reduce emergency stress levels and emotional exhaustion. The main aim of this study was to analyze the relationship of emergency stress and hardiness with burnout among emergency workers. The participants included 494 emergency volunteers from the Red Cross Committee in Veneto, Italy, engaged in various health, emergency, and social activities aimed at COVID-19 patients and people at risk of contracting the virus. Questionnaires used to measure emergency stress, hardiness and burnout were administered on an online platform. We analyzed the influence of age, sex, weekly hours of service, stress risk factors, and use of personal protective equipment. To verify the predictive effects of risk and protective factors on burnout, correlational and multivariate analyses, and regressions were conducted. Hardiness showed an effect in reducing emergency stress levels, emotional exhaustion, and depersonalization and simultaneously increased personal accomplishment.

COVID-19: Risk Factors and Protective Role of Resilience and Coping Strategies for Emergency Stress and Secondary Trauma in Medical Staff and Emergency Workers—An Online-Based Inquiry

The COVID-19 crisis has placed a heavy burden on medical staff and emergency workers, who may be at risk of developing psychological distress and secondary trauma. Coping and resilience to stress during a pandemic are protective factors that can mitigate the potential adverse psychological effects. Here, we investigated the direct and mediated effects of coping strategies and hardiness on secondary trauma among Italian medical staff (physicians and nurses, n = 140) and emergency workers (firefighters, civil protection, and ambulance personnel, n = 100) involved in the first phase of the pandemic. For this purpose, we collected data from participants through online questionnaires to measure emergency stress, coping strategies, hardiness, and secondary trauma. Other variables analyzed were age, sex, direct contact with COVID-19 patients, and use of personal protective equipment (PPE). We performed a correlational analysis, regressions, and a mediation analysis. The results show that nurses and physicians experienced higher levels of emergency stress than emergency workers. Direct contact with COVID-19 patients, female sex, unexpected events, and lack of PPE were risk factors for emergency stress, while resilience and coping strategies played a protective role. Mediation analysis shows that coping strategies and hardiness are protective factors and reduce the effect of stress on secondary trauma.

New Ways of Working and Public Healthcare Professionals’ Well-Being: The Response to Face the COVID-19 Pandemic

This research proposes analyzing the influence of new ways of working (NWW) on healthcare professional’s well-being and how these may affect work performance and public service motivation. These variables and relationships were important before COVID-19 pandemic, and everything points to the fact that during and after the pandemic their importance will be higher. To buffer the potential negative effects of implementing the NWW, both organizations and employees must identify personal (psychological capital) and job resources (inter-role conflict, psychological empowerment, meaning of work) capable of acting as effective moderators to promote employee well-being and avoid negative experiences at work. This paper aims to shed light on new ways of coping and adapting to uncertain job requirements such as those that have arisen during COVID-19. Moreover, it highlights the great changes that public healthcare needs to face to improve the quality of the service offered to society. It is urgent that public administrators and human resources managers design effective strategies and make effective decisions in which employee well-being and service quality are main priorities.