Fluctuations of stress and resilience in healthcare workers during the COVID-19 pandemic: Insights and recommendations

Background

Healthcare workers (HCW) have faced unprecedented challenges during the COVID-19, with significant impact on their well-being. We aimed to monitor stress-related symptoms and resilience in HCW over time in relation to various factors during the COVID-19 pandemic.

Methods

Between June 2020 and May 2022, data was collected among HCW of Leiden University Medical Centre (LUMC) through a digital self-monitoring application. The application included a 14-items self-monitoring tool (i.e., 7-items on Supporting factors, 7-items on Stressful burden), and a set of validated questionnaires (i.e., the Copenhagen Burnout Inventory (CBI), Impact of Event Scale – Revised (IES-R), Resilience Evaluation Scale (RES), and Depression Anxiety and Stress Scale (DASS-21).

Results

The self-monitoring tool and validated questionnaires were completed by 1070 and 413 participants respectively. Mean stress-related symptom scores (as measured by the self-monitoring, CBI, IES-R, and DASS-21) exhibited significant changes over time (all p’s < 0.001), which correlated with the waves of COVID-19 patients admitted and the national COVID-19 mortality rate (all p’s < 0.005). Resilience, as measured by the RES, showed a significant decrease from the start of data collection onwards (p = 0.001), whereas supporting factors showed significant decreases the first few months, followed by fluctuations after January 2021 (p = 0.02).

Limitations

Selection bias may have arisen as those participating may have been more concerned with the burden on mental wellbeing.

Conclusions

The current study underscores the need for active psychosocial support for all HCW particularly during periods of increased admissions due to pandemics.