How healthcare workers respond to COVID-19: The role of vulnerability and social support in a close relationships defense mechanism

Yunjiao Chen,Xuyun Tan,Cai Xing,Jiaren Zheng

doi:10.1016/j.actpsy.2021.103442

Abstract

Healthcare workers play a vital role in the fight against COVID-19. Based on Terror Management Theory (TMT), the present research examined whether a close relationships defense mechanism reduces anxiety among healthcare workers (N = 729) in China. Our results suggest that this defense mechanism, as indexed by relationship satisfaction, serves as an effective terror management source after exposure to reminders of death (MS; mortality salience). These findings extend TMT by identifying two moderating variables: vulnerability and social support. In a low objective vulnerability group, healthcare workers who subjectively believed themselves as less vulnerable to COVID-19 showed a stronger defense mechanism after a MS manipulation as compared to those who felt more vulnerable. Further, healthcare workers with higher levels of social support reported more relationship satisfaction. These findings have practical implications for guiding healthcare workers on how to buffer death-related anxiety and maintain their mental health in the fight against COVID-19.

Highlights

The COVID-19 pandemic quickly swept across the world in 2020, infecting more than 200 million people and was associated with more than 4 million deaths by August 2021 (World Health Organization, 2021)
We focused on the impact of COVID-19 on healthcare workers, so we added the context of COVID-19 to the the Death Anxiety Scale (T-DAS) items (e.g., “I am very much afraid to die from COVID-19”)
Close rela tionship satisfaction measured by the two relationship scales before and after mortality salience (MS) manipulation served as the outcome variables

Summary

Introduction

The COVID-19 pandemic quickly swept across the world in 2020, infecting more than 200 million people and was associated with more than 4 million deaths by August 2021 (World Health Organization, 2021). We applied Terror Management Theory (TMT, Greenberg et al, 1986) to investigate the anxietybuffering effect of close relationships on healthcare workers' fear of death during the pandemic. According to the anxiety-buffer hypothesis in TMT, self-esteem and cultural worldview defenses (Solomon et al, 1991) are distal defense mechanisms that individuals may use to buffer deathrelated anxiety. A worldview defense refers to constructing and maintaining something immortal to continue one's own values, such as those relating to religions, customs, or laws Any threats to these anxiety-buffering defense mechanisms heightens the accessibility of death-related thoughts (DTA, deaththought accessibility hypothesis, Pyszczynski et al, 2015). To deal with such unwanted death-related thoughts, individuals are thought to employ (or enhance) their self-esteem and worldview defenses when thoughts of mortality are salient (i.e., the mortality salience hypothesis)

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