Abstract
Prior to the 2019 novel coronavirus (COVID-19) outbreak, the South African healthcare system was already under severe strain due to amongst others, a lack of human resources, poor governance and management, and an unequal distribution of resources among provinces and between the public and private healthcare sectors. At the center of these challenges are nurses, the backbone of the healthcare system, and the first point of call for most patients in the country. This research investigated post-traumatic stress and coping strategies of nurses during the second wave of COVID-19 in the country. A structured self-administered questionnaire captured the biographic characteristics, perceived risk factors for COVID-19, and views on infection control of 286 nurses Data were subjected to descriptive and binomial logistic regression analyses. More than four in every 10 nurses screened positive for higher levels of post-traumatic disorder (PTSD). Self-reported risk for contracting COVID-19 mainly centered on being a health worker and patients’ non-adherence to infection prevention guidelines. Unpreparedness to manage COVID-19 patients, poorer health, and avoidant coping were associated with PTSD. Nurses voiced a need for emotional support and empathy from managers. Emotional, psychological, and debriefing intervention sessions that focus on positive coping strategies to actively address stress are recommended.
Highlights
Pandemics are a unique form of disaster, resulting in adverse psychological symptoms and behavioral reactions [1]
The objectives of the study are to (1) identify perceptions of risk for COVID-19 infection; (2) determine levels of post-traumatic stress experienced by nurses; (3) identify coping mechanisms used during COVID-19; (4) investigate associations between different coping strategies and post-traumatic stress; (5) describe the support needs of nurses
We found that 44% of nurses screened positive for post-traumatic stress disorder (PTSD), which was higher than recorded in a study conducted earlier in the year where only approximately 20% of Healthcare workers (HCWs) were reported to be severely distressed [28]
Summary
Pandemics are a unique form of disaster, resulting in adverse psychological symptoms and behavioral reactions [1]. Healthcare workers (HCWs) are at the frontline of responses to pandemics, increasing their risk of infection as well as psychological distress [2]. This was evidenced in earlier disease outbreaks like Ebola and Severe Acute Respiratory Syndrome (SARS). During the 2003 SARS epidemic, one index patient was found to infect up to 50 HCWs [4]. A Canadian study found that, one to two years after SARS, HCWs still experienced higher levels of burnout, psychological distress and post-traumatic stress disorder (PTSD) compared to HCWs who did not care for SARS patients [5]
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