Medical rescuers’ occupational health during COVID-19: Contribution of coping and emotion regulation on burnout, trauma and post-traumatic growth

Sílvia Monteiro Fonseca, Sónia Cunha, Rui Campos, Sara Faria, Márcio Silva, M. Joaquina Ramos, Guilherme Azevedo, António Ruão Barbosa, Cristina Queirós

Abstract


The COVID-19 pandemic places unique challenges to medical rescuers’ occupational health. Thus, it is crucial to assess its direct and indirect impacts on key psychological outcomes and adaptation strategies. This study aims to analyse the impact of this pandemic on medical rescuers’ coping and emotion regulation strategies, and their levels of work-related psychological outcomes, such as burnout, trauma and post-traumatic growth. Additionally, it aims to analyse the contribution of coping and emotion regulation strategies, employed to manage the COVID-19 pandemic, on burnout, trauma and post-traumatic growth. A sample of 111 medical rescuers answered the Brief Cope, Emotion Regulation Questionnaire, Oldenburg Burnout Inventory, Impact of Event Scale-Revised and Post-Traumatic Growth Inventory. Medical rescuers resorted moderately to coping and emotion regulation strategies, since the beginning of COVID-19. They presented moderate burnout and post-traumatic growth and low trauma. Coping presented a higher weight on burnout, trauma and post-traumatic growth, than emotion regulation. Expressive suppression and dysfunctional coping predicted burnout and trauma, and problem and emotion-focused coping predicted post-traumatic growth. Dysfunctional coping mediated and, thus, exacerbated the effect of expressive suppression on burnout and on trauma. Practitioners should pay closer attention to professionals with higher burnout and trauma. Occupational practices should focus on reducing dysfunctional coping and expressive suppression and promoting problem-focused coping.


Keywords


COVID-19, Occupational health, Medical rescuers, Coping strategies, Emotion regulation strategies.

Full Text:

PDF

References


American Psychiatric Association [APA]. (2014). DSM-V: Diagnostic and statistical manual of mental disorders (5th ed.). Climepsi Editores.

Bamonti, P., Conti, E., Cavanagh, C., Gerolimatos, L., Gregg, J., Goulet, C., Pifer, M., & Edelstein, B. (2019). Coping, cognitive emotion regulation, and burnout in long-term care nursing staff: A preliminary study. Journal of Applied Gerontology, 38, 92-111. https://doi.org/10.1177/0733464817716970

Busch, I. M., Moretti, F., Mazzi, M., Wu, A. W., & Rimondini, M. (2021). What we have learned from two decades of epidemics and pandemics: A systematic review and meta-analysis of the psychological burden of frontline healthcare workers. Psychotherapy and Psychosomatics, 11, Article e58954. https://doi.org/10.1159/000513733

Cai, Q., Feng, H., Huang, J., Wang, M., Wang, Q., Lu, X., Xie, Y., Wang, X., Liu, Z., Hou, B., Ouyang, K., Pan, J., Li, Q., Fu, B., Deng, Y., & Liu, Y. (2020). The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study. Journal of Affective Disorders, 275, 210-215. https://doi.org/10.1016/j.jad.2020.06.031

Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267-283. https://doi.org/10.1037/0022-3514.56.2.267

Cui, P. P., Wang, P. P., Wang, K., Ping, Z., Wang, P., & Chen, C. (2020). Post-traumatic growth and influencing factors among frontline nurses fighting against COVID-19. Occupational and Environmental Medicine. Advance online publication. https://doi.org/10.1136/oemed-2020-106540

European Agency for Safety and Health at Work [EU-OSHA]. (2020). COVID-19: Back to the workplace – Adapting workplaces and protecting workers. https://osha.europa.eu/en/publications/covid-19-back-workplace-adapting-workplaces-and-protecting-workers/view

European Agency for Safety and Health at Work [EU-OSHA]. (2021). EU-OSHA – Single programming document 2021-2023. https://osha.europa.eu/en/publications/single-programming-document-2021-2023/view

Field, A. (2009). Discovering statistics using SPSS (2nd ed.). Artmed Editora.

Folkman, S. (2013). Stress: Appraisal and coping. In M. D. Gellman & J. R. Turner (Eds.), Encyclopedia of behavioral medicine (pp. 1913-1915). Springer.

Fonseca, S. M., Cunha, S., Campos, R., Gonçalves, S. P., & Queirós, C. (2019). Saúde ocupacional dos profissionais de emergência pré-hospitalar: Contributo do trauma e coping. International Journal of Working Conditions, 17, 69-88. http://ricot.com.pt/artigos/1/IJWC.17_Fonseca.et.al._p.69.88.pdf

García-Batista, Z. E., Guerra-Peña, K., Kandany, V. N., Marte, M. I., Garrido, L. E., Cantisano-Guzmán, L. M., Moretti, L., & Medrano, L. A. (2021). COVID-19 pandemic and health worker stress: The mediating effect of emotional regulation. MedRxiv. https://doi.org/10.1101/2020.06.19.20135574

Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362. https://doi.org/10.1037/0022-3514.85.2.348

Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 3-24). Guilford Press.

Halbesleben, J. R. B., & Demerouti, E. (2005). The construct validity of an alternative measure of burnout: Investigating the English translation of the Oldenburg Burnout Inventory. Work & Stress, 19, 208-220. https://doi.org/10.1080/02678370500340728

Hayes, A. F. (2018). Introduction to mediation, moderation and conditional process analysis: A regression-based approach (2nd ed.). Guilford Press.

Hobfoll, S. E., Hall, B. J., Canetti-Nisim, D., Galea, S., Johnson, R. L., & Palmieri, P. A. (2007). Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology: An International Review, 56, 345-366. https://doi.org/10.1111/j.1464-

2007.00292.x

Huang, Q., Zhang, Q., An, Y., & Xu, W. (2019). The relationship between dispositional mindfulness and PTSD/PTG among firefighters: The mediating role of emotion regulation. Personality and Individual Differences, 151, Article e109492. https://doi.org/10.1016/j.paid.2019.07.002

Jarego, M., Pimenta, F., Pais-Ribeiro, J., Costa, R. M., Patrão, I., Coelho, L., & Ferreira-Valente, A. (2021). Do coping responses predict better/poorer mental health in Portuguese adults during Portugal’s national lockdown associated with the COVID-19?. Personality and Individual Differences, 175, Article e110698. https://doi.org/10.1016/j.paid.2021.110698

Kalaitzaki, A., & Rovithis, M. (2021). Secondary traumatic stress and vicarious posttraumatic growth in healthcare workers during the first COVID-19 lockdown in Greece: The role of resilience and coping strategies. Psychiatriki, 32, 19-25. https://doi.org/10.22365/jpsych.2021.001

Kline, B. (2011). Principles and practice of structural equation modeling (2nd ed.). Guilford Press.

Martín-Brufau, R., Martin-Gorgojo, A., Suso-Ribera, C., Estrada, E., Capriles-Ovalles, M. E., & Romero-Brufau, S. (2020). Emotion regulation strategies, workload conditions, and burnout in healthcare residents. International Journal of Environmental Research and Public Health, 17(21), Article e7816. https://doi.org/

3390/ijerph17217816

Maslach, C., Schaufeli, W., & Leiter, M. (2001). Job burnout. Annual Review of Psychology, 52, 397-422. https://doi.org/10.1146/annurev.psych.52.1.397

Matos, M., Pinto-Gouveia, J., & Martins, S. (2011). O impacto traumático de experiências de vergonha: Estudo das propriedades psicométricas da versão portuguesa da Impact of Event Scale – Revised. Psychologica, 54, 413-438. https://doi.org/10.14195/1647-8606_54_16

McCabe, D. (2019). The impact of event scale – Revised (Try this: General assessment series). The Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing. https://consultgeri.org/try-this/general-assessment/issue-19

Ogińska-Bulik, N., & Kobylarczyk, M. (2015). Relation between resiliency and post-traumatic growth in a group of paramedics: The mediating role of coping strategies. International Journal of Occupational Medicine and Environmental Health, 28(4), 707-719. https://doi.org/10.13075/ijomeh.1896.00323

Pais-Ribeiro, J. L., & Rodrigues, A. P. (2004). Questões acerca do coping: A propósito do estudo de adaptação do Brief COPE. Psicologia, Saúde & Doenças, 5, 3-15.

Petrie, K., Milligan-Saville, J., Gayed, A., Deady, M., Phelps, A., Dell, L., Forbes, D., Bryant, R. A., Calvo, R. A., Glozier, N., & Harvey, S. B. (2018). Prevalence of PTSD and common mental disorders amongst ambulance personnel: A systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 53, 897-909. https://doi.org/10.1007/s00127-018-1539-5

Portero de la Cruz, S., Cebrino, J., Herruzo, J., & Vaquero-Abellán, M. (2020). A multicenter study into burnout, perceived stress, job satisfaction, coping strategies, and general health among emergency department nursing staff. Journal of Clinical Medicine, 9(4), Article e1007. https://doi.org/10.3390/jcm9041007

Roslan, N. S., Yusoff, M. S. B., Asrenee, A. R., & Morgan, K. (2021). Burnout prevalence and its associated factors among Malaysian healthcare workers during COVID-19 pandemic: An embedded mixed-method study. Healthcare, 9(1), Article e90. https://doi.org/10.3390/healthcare9010090

Ross, R. R., & Altmaier, E. M. (1994). Intervention in occupational stress: A handbook of counselling for stress at work. Sage Publications, Inc.

Sanghera, J., Pattani, N., Hashmi, Y., Varley, K. F., Cheruvu, M. S., Bradley, A., & Burke, J. R. (2020). The impact of SARS‐CoV‐2 on the mental health of healthcare workers in a hospital setting – A systematic review. Journal of Occupational Health, 62(1), Article e12175. https://doi.org/10.1002/1348-9585.12175

Sattler, D. N., Boyd, B., & Kirsch, J. (2014). Trauma-exposed firefighters: Relationships among post-traumatic growth, post-traumatic stress, resource availability, coping and critical incident stress debriefing experience. Stress and Health, 30(5), 356-365. https://doi.org/10.1002/smi.2608

Serrão, C., Duarte, I., Castro, L., & Teixeira, A. (2021). Burnout and depression in Portuguese healthcare workers during the COVID-19 pandemic – The mediating role of psychological resilience. International Journal of Environmental Research and Public Health, 18(2), Article e636. https://doi.org/10.3390/ijerph18020636

Silva, S., Moreira, H., Pinto, S., & Canavarro, M. (2009). Cancro do mama e desenvolvimento pessoal e relacional: Estudo das características psicométricas do Inventário de Desenvolvimento Pós-Traumático (Post-Traumatic Growth Inventory) numa amostra de mulheres da população portuguesa. Revista Iberoamericana de Diagnostico y Evaluacion Psicologica, 28, 105-133. https://www.redalyc.org/articulo.oa?id=459645444007

Sinclair, R. R., Allen, T., Barber, L., Bergman, M., Britt, T., Butler, A., Ford, M., Hammer, L., Kath, L., Probst, T., & Yuan, Z. (2020). Occupational health science in the time of COVID-19: Now more than ever [Editorial]. Occupational Health Science, 4(1-2), 1-22. https://doi.org/10.1007/s41542-020-00064-3

Sinval, J., Queirós, C., Pasian, S., & Marôco, J. (2019). Transcultural adaptation of the Oldenburg Burnout Inventory (OLBI) for Brazil and Portugal. Frontiers in Psychology, 10, Article e338. https://doi.org/10.3389/fpsyg.2019.00338

Sirois, F. M., & Owens, J. (2021). Factors associated with psychological distress in health-care workers during an infectious disease outbreak: A rapid systematic review of the evidence. Frontiers in Psychiatry, 11, Article e589545. https://doi.org/10.3389/fpsyt.2020.589545

Soravia, L. M., Schwab, S., Walther, S., & Müller, T. (2021). Rescuers at risk: Posttraumatic stress symptoms among police officers, firefighters, ambulance personnel, and emergency and psychiatric nurses. Frontiers in Psychiatry, 11, Article e602064. https://doi.org/10.3389/fpsyt.2020.602064

Sun, J. W., Lin, P. Z., Zhang, H. H., Li, J. H., & Cao, F. L. (2017). A non-linear relationship between the cumulative exposure to occupational stressors and nurses’ burnout and the potentially emotion regulation factors. Journal of Mental Health, 27(5), 409-415. https://doi.org/10.1080/09638237.2017.1385740

Sun, X., Li, X., Huang, J., & An, Y. (2020). Prevalence and predictors of PTSD, depression and posttraumatic growth among Chinese firefighters. Archives of Psychiatric Nursing, 34(1), 14-18. https://doi.org/10.1016/j.apnu.2019.12.007

Tedeschi, R. G., & Calhoun, L. G. (1996). The post-traumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455-471. https://doi.org/10.1002/jts.2490090305

Vaz, F. M., Martins, C., & Martins, E. C. (2014). Diferenciação emocional e regulação emocional em adultos portugueses. Psicologia, 22(2), 123-135. https://doi.org/10.17575/rpsicol.v22i2.350

Weiss, D. S., & Marmar, C. R. (1997). The impact of event scale – Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). Guilford Press.

World Health Organization [WHO]. (2019, May 19). Burn-out an “occupational phenomenon”: International Classification of Diseases. https://www.who.int/mental_health/evidence/burn-out/en

World Health Organization [WHO]. (2020, March 11). WHO director-general’s opening remarks at the media briefing on COVID-19 – 11 march 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—-11-march-2020




DOI: https://doi.org/10.14417/ap.1868

Refbacks

  • There are currently no refbacks.


Nº ERC: 107494 | ISSN (in print): 0870-8231 | ISSN (online): 1646-6020 | Copyright © ISPA - CRL, 2012 | Rua Jardim do Tabaco, 34, 1149-041 Lisboa | NIF: 501313672 | The portal and metadata are licensed under the license Creative Commons CC BY-NC