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

Tiziana Maiorano,Monia Vagni,Daniela Pajardi,Valeria Giostra

doi:10.3390/su12219004

Abstract

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.

Highlights

The emergency situation linked to the COVID-19 pandemic required many health and emergency workers to guarantee protection, treatment, and safety measures for people who had contracted the virus and to limit the spread of the infection
As described by many studies, the direct victims of traumatic events of different nature develop post-traumatic disorder, and the medical staff and emergency workers who care for these victims may develop severe post-traumatic symptoms, as we showed in our study about this health emergency
The results of this study highlighted how emergency workers, and especially healthcare workers who worked with COVID patients, were exposed to sources of high stress and to the risk of developing secondary trauma

Summary

Introduction

The emergency situation linked to the COVID-19 pandemic required many health and emergency workers to guarantee protection, treatment, and safety measures for people who had contracted the virus and to limit the spread of the infection. During the first weeks of the pandemic, clear intervention protocols, adequate instruments, and the necessary personal protective equipment (PPE) were lacking. These objective difficulties were coupled with psychological difficulties linked to the fear of contracting the virus, infecting one’s family members, and, above all, to one’s sense of helplessness in the face of patient losses. The high stress associated with post-traumatic symptoms tends to impact the sense of gratification in one’s work and the loss of the ability to cope with difficulties and resistance

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Results

Discussion

Conclusion