Stress among healthcare workers during the COVID-19 pandemic and the determinant factors: a cross-sectional study
BACKGROUND During the COVID-19 pandemic, there has been an increase in workload, as well as greater vigilance and compliance at work. Healthcare workers must perform their duties while facing the fear of COVID-19, which can trigger and/or aggravate stress. This study aimed to obtain the determinant factors of stress among healthcare workers during the pandemic by emphasizing the change in the psychosocial situation at the hospital.
METHODS This cross-sectional study was conducted from January to March 2021 using an online questionnaire consisting of personal and occupational questionnaires, as well as the validated stressor and stress questionnaires using validity and reliability tests (Cronbach’s alpha 0.8 and 0.9). For the multivariate analysis, multiple logistic regression was used to identify the determinant factors (p<0.05). Data were analyzed using SPSS software version 20 (IBM Corp., USA).
RESULTS Determinant factors of the occurrence of moderate–severe stress were the alteration of stressors including age (aOR = 1.9), working hours (aOR = 1.9), work zone (aOR = 2.7), limited facilities and resources (aOR = 6.2), risk of disease transmission (aOR = 0.3), and personal work demands (aOR = 2.1).
CONCLUSIONS In addition to the younger age, the determinant factors of the incidence of moderate–severe stress in healthcare workers during the COVID-19 pandemic at the hospitals were work-related conditions. However, they remained controllable to prevent stress among healthcare workers in the peak load work situations such as a pandemic.
Ruotsalainen JH, Verbeek JH, Mariné A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2015;2015(4):CD002892. https://doi.org/10.1002/14651858.CD002892.pub5
National Center for PTSD. Managing healthcare workers' stress associated with the COVID-19 virus outbreak [Internet]. U.S. Department of Veterans Affairs; 2020 [cited 2020 Jun 20]. Available from: https://www.ptsd.va.gov/covid/COVID19ManagingStressHCW032020.pdf.
Shacham M, Hamama-Raz Y, Kolerman R, Mijiritsky O, Ben-Ezra M, Mijiritsky E. COVID-19 factors and psychological factors associated with elevated psychological distress among dentists and dental hygienists in Israel. Int J Environ Res Public Health. 2020;17(8):2900. https://doi.org/10.3390/ijerph17082900
Walton M, Murray E, Christian MD. Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. Eur Heart J Acute Cardiovasc Care. 2020;9(3):241-7. https://doi.org/10.1177/2048872620922795
Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth Analg. 2020;131(1):106-11. https://doi.org/10.1213/ANE.0000000000004866
Nasrullah D, Natsir M, Twistiandayani R, Rohayani L, Siswanto, Sumartyawati NM, et al. Psychological impact among health workers in effort to facing the COVID-19 in Indonesia. Int J Publ Health Sci. 2021;10(1):181-8. https://doi.org/10.11591/ijphs.v10i1.20524
Alnazly E, Khraisat OM, Al-Bashaireh AM, Bryant CL. Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers. PLoS One. 2021;16(3):e0247679. https://doi.org/10.1371/journal.pone.0247679
International Labour Organization (ILO). Workplace stress: a collective challenge [Internet]. Turin: International Labour Organization (ILO); 2016. 57 p. [cited 2020 Sep 7]. Available from: https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_466547.pdf.
Berland A, Natvig GK, Gundersen D. Patient safety and job-related stress: a focus group study. Intensive Crit Care Nurs. 2008;24(2):90-7. https://doi.org/10.1016/j.iccn.2007.11.001
Sastroasmoro S, Ismael S. [Fundamentals of research methodology]. 4th ed. Jakarta: Sagung Seto; 2011. 359 p. Indonesian.
The Abdul Latif Jameel Poverty Action Lab (J-PAL). Six rules of thumb for determining sample size and statistical power [Internet]. Cambridge: The Abdul Latif Jameel Poverty Action Lab (J-PAL); 2017 [cited 2020 Dec 15]. Available from: https://www.povertyactionlab.org/blog/5-21-18/six-rules-thumb-understanding-statistical-power.
Ministry of Health of the Republic of Indonesia. Decree of the Minister of Health of the Republic of Indonesia number HK.01.07/MENKES/230/2021 concerning guidelines for operation of field hospitals/emergency hospitals during the Corona Virus Disease 2019 (COVID-19) Pandemic. Jakarta: Ministry of Health of the Republic of Indonesia; 2021. p. 13.
Afulani PA, Gyamerah AO, Nutor JJ, Laar A, Aborigo RA, Malechi H, et al. Inadequate preparedness for response to COVID-19 is associated with stress and burnout among healthcare workers in Ghana. PLoS One. 2021;16(4):e0250294. https://doi.org/10.1371/journal.pone.0250294
Roslan NS, Yusoff MSB, Razak AA, Morgan K. Burnout prevalence and its associated factors among Malaysian healthcare workers during COVID-19 pandemic: an embedded mixed-method study. Healthcare (Basel). 2021;9(1):90. https://doi.org/10.3390/healthcare9010090
Wang H, Liu Y, Hu K, Zhang M, Du M, Huang H, et al. Healthcare workers' stress when caring for COVID-19 patients: an altruistic perspective. Nurs Ethics. 2020;27(7):1490-500. https://doi.org/10.1177/0969733020934146
Hoedl M, Eglseer D, Bauer S. Associations between personal protective equipment and nursing staff stress during the COVID-19 pandemic. J Nurs Manag. 2021;29(8):2374-82. https://doi.org/10.1111/jonm.13400
Kittiteerasack P, Steffen A, Matthews A. The influence of minority stress on level of depression among Thai LGBT adults. J Keperawatan Indones. 2020;23(1):74-84. https://doi.org/10.7454/jki.v23i1.1073
Carstensen LL, Turan B, Scheibe S, Ram N, Ersner-Hershfield H, Samanez-Larkin G, et al. Emotional experience improves with age: evidence based on over 10 years of experience sampling. Psychol Aging. 2011;26(1):21-33. https://doi.org/10.1037/a0021285
Nieto M, Romero D, Ros L, Zabala C, Martínez M, Ricarte JJ, et al. Differences in coping strategies between young and older adults: the role of executive functions. Int J Aging Hum Dev. 2020;90(1):28-49. https://doi.org/10.1177/0091415018822040
Teo I, Chay J, Cheung YB, Sung SC, Tewani KG, Yeo LF, et al. Healthcare worker stress, anxiety and burnout during the COVID-19 pandemic in Singapore: a 6-month multi-centre prospective study. PLoS One. 2021 Oct 22;16(10):e0258866. https://doi.org/10.1371/journal.pone.0258866
World Health Organization (WHO). COVID-19 Indonesia situation update [Internet]. World Health Organization (WHO); 2020 [cited 2022 Feb 4]. Available from: https://covid19.who.int/region/searo/country/id.
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