ORIGINAL ARTICLE
COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support
Leodoro J. Labrague RN, DM, PhD,
Janet Alexis A. De los Santos RN, MAN, PhD,
Corresponding Author
Leodoro J. Labrague RN, DM, PhD
Lecturer
College of Nursing, Sultan Qaboos University, Muscat, Oman
Correspondence
Leodoro J. Labrague, College of Nursing, Sultan Qaboos University, Muscat, Oman.
Email: [email protected]
Search for more papers by this authorJanet Alexis A. De los Santos RN, MAN, PhD
Assistant Professor
College of Nursing, Visayas State University, Leyte, Philippines
Search for more papers by this authorLeodoro J. Labrague RN, DM, PhD,
Janet Alexis A. De los Santos RN, MAN, PhD,
Corresponding Author
Leodoro J. Labrague RN, DM, PhD
Lecturer
College of Nursing, Sultan Qaboos University, Muscat, Oman
Correspondence
Leodoro J. Labrague, College of Nursing, Sultan Qaboos University, Muscat, Oman.
Email: [email protected]
Search for more papers by this authorJanet Alexis A. De los Santos RN, MAN, PhD
Assistant Professor
College of Nursing, Visayas State University, Leyte, Philippines
Search for more papers by this authorAbstract
Aim
This study examines the relative influence of personal resilience, social support and organisational support in reducing COVID-19 anxiety in front-line nurses.
Background
Anxiety related to the COVID-19 pandemic is prevalent in the nursing workforce, potentially affecting nurses’ well-being and work performance. Identifying factors that could help maintain mental health and reduce coronavirus-related anxiety among front-line nurses is imperative. Currently, no studies have been conducted examining the influence of personal resilience, social support and organisational support in reducing COVID-19 anxiety among nurses.
Methods
This cross-sectional study involved 325 registered nurses from the Philippines using four standardized scales.
Results
Of the 325 nurses in the study, 123 (37.8%) were found to have dysfunctional levels of anxiety. Using multiple linear regression analyses, social support (β = −0.142, p = .011), personal resilience (β = −0.151, p = .008) and organisational support (β = −0.127, p = .023) predicted COVID-19 anxiety. Nurse characteristics were not associated with COVID-19 anxiety.
Conclusions
Resilient nurses and those who perceived higher organisational and social support were more likely to report lower anxiety related to COVID-19.
Implication for Nursing Management
COVID-19 anxiety may be addressed through organisational interventions, including increasing social support, assuring adequate organisational support, providing psychological and mental support services and providing resilience-promoting and stress management interventions.
CONFLICT OF INTEREST
All authors declare no conflict of interest.
REFERENCES
- Alwani, S. S., Majeed, M. M., Hirwani, M. Z., Rauf, S., Saad, S. M., Shah, S. H., & Hamirani, F. M. (2020). Evaluation of knowledge, practices, attitude and anxiety of Pakistans nurses towards COVID-19 during the current outbreak in Pakistan. medRxiv, 1-26. https://doi.org/10.1101/2020.06.05.20123703
- American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders ( 5th ed.).
10.1176/appi.books.9780890425596 Google Scholar
- Baduge, M. S. P., Morphet, J., & Moss, C. (2018). Emergency nurses' and department preparedness for an ebola outbreak: A (narrative) literature review. International Emergency Nursing, 38, 41–49.
- Bautista, J. R., Lauria, P. A. S., Contreras, M. C. S., Maranion, M. M. G., Villanueva, H. H., Sumaguingsing, R. C., & Abeleda, R. D. (2020). Specific stressors relate to nurses' job satisfaction, perceived quality of care, and turnover intention. International Journal of Nursing Practice, 26(1), e12774.
- Bloom, D. E., Black, S., & Rappuoli, R. (2017). Emerging infectious diseases: A proactive approach. Proceedings of the National Academy of Sciences, 114(16), 4055–4059.
- Catton, H. (2020). Global challenges in health and health care for nurses and midwives everywhere. International Nursing Review, 67(1), 4–6.
- Choi, B. S. (2018). Influence of social support and resilience on the nurse job performance. Indian Journal of Public Health Research & Development, 9(3), 788–792.
10.5958/0976-5506.2018.00385.6 Google Scholar
- Cooper, A. L., Brown, J. A., Rees, C. S., & Leslie, G. D. (2020). Nurse resilience: A concept analysis. International Journal of Mental Health Nursing, 29(4): 553-575.
- Dayrit, M. M., Lp, L., Of, P., Mc, P., & Mc, V. (2018). The Philippines health system review [Internet]. World Health Organization. In: Regional Office for South-East Asia; 2018. [cited 2018 Sep 27]. Retrieved from http://apps.who.int/iris/handle/10665/274579
- De Brier, N., Stroobants, S., Vandekerckhove, P., & De Buck, E. (2020). Factors affecting mental health of health care workers during coronavirus disease outbreaks: A rapid systematic review. Psyarxiv. https://doi.org/10.31234/osf.io/w9uxs
- Department of Health. (2020). Updates on novel coronavirus disease (COVID-19). Retrieved from https://www.doh.gov.ph/2019-nCoV
- Duan, X., Ni, X., Shi, L., Zhang, L., Ye, Y., Mu, H., … & Wang, Y. (2019). The impact of workplace violence on job satisfaction, job burnout, and turnover intention: the mediating role of social support. Health and quality of life outcomes, 17(1), 93.
- Duncan, D. L. (2020). What the COVID-19 pandemic tells us about the need to develop resilience in the nursing workforce. Nursing Management, 27(3), 22–27. https://doi.org/10.7748/nm.2020.e1933
10.7748/nm.2020.e1933 Google Scholar
- Eisenberger, R., Huntington, R., Hutchison, S., & Sowa, D. (1987). Perceived organizational support. Journal of Applied Psychology, 71, 500–507.
- Eisenberger, R., Stinglhamber, F., Vandenberghe, C., Sucharski, I. L., & Rhoades, L. (2002). Perceived supervisor support: contributions to perceived organizational support and employee retention. Journal of applied psychology, 87(3), 565.
- Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
- Foster, K., Roche, M., Giandinoto, J., & Furness, T. (2020). Workplace stressors, psychological well-being, resilience, and caring behaviours of mental health nurses: A descriptive correlational study. International Journal of Mental Health Nursing, 29(1), 56–68.
- Gao, T., Ding, X., Chai, J., Zhang, Z., Zhang, H., Kong, Y., & Mei, S. (2017). The influence of resilience on mental health: The role of general well-being. International Journal of Nursing Practice, 23(3), e12535.
- Guo, Y. F., Cross, W., Plummer, V., Lam, L., Luo, Y. H., & Zhang, J. P. (2017). Exploring resilience in Chinese nurses: A cross-sectional study. Journal of Nursing Management, 25(3), 223–230.
- Hart, P. L., Brannan, J. D., & De Chesnay, M. (2014). Resilience in nurses: An integrative review. Journal of Nursing Management, 22(6), 720–734.
- Higazee, M. Z. A., Rayan, A., & Khalil, M. (2016). Relationship between job stressors and organizational support among Jordanian nurses. American Journal of Nursing Research, 4(3), 51–55.
- Hou, T., Zhang, T., Cai, W., Song, X., Chen, A., Deng, G., & Ni, C. (2020). Social support and mental health among health care workers during Coronavirus Disease 2019 outbreak: A moderated mediation model. Plos one, 15(5), 1–14.
- Hu, S. H., Yu, Y. M., Chang, W. Y., & Lin, Y. K. (2018). Social support and factors associated with self-efficacy among acute-care nurse practitioners. Journal of Clinical Nursing, 27(3–4), 876–882.
- Jung, H., Jung, S. Y., Lee, M. H., & Kim, M. S. (2020). Assessing the presence of post-traumatic stress and turnover intention among nurses post-middle east respiratory syndrome outbreak: The importance of supervisor support. Workplace Health & Safety, 68(7): 337-345. https://doi.org/10.1177/2165079919897693
- Kim, H. J., & Park, H. R. (2017). Factors affecting post-traumatic stress of general hospital nurses after the epidemic of Middle East respiratory syndrome infection. Journal of Korean Clinical Nursing Research, 23(2), 179–188.
- Kutluturkan, S., Sozeri, E., Uysal, N., & Bay, F. (2016). Resilience and burnout status among nurses working in oncology. Annals of General Psychiatry, 15(1), 33.
- Labrague, L. J., & De los Santos, J. A. A., Falguera, C. C., Nwafor, C. E., Galabay, J. R., Rosales, R. A., & Firmo, C. N. (2020). Predictors of nurses’ turnover intention at one and five years’ time. International Nursing Review., 67(2), 191–198.
- Labrague, L. J., Hammad, K., Gloe, D. S., McEnroe-Petitte, D. M., Fronda, D. C., Obeidat, A. A., … Mirafuentes, E. C. (2018). Disaster preparedness among nurses: A systematic review of literature. International Nursing Review, 65(1), 41–53.
- Labrague, L. J., McEnroe Petitte, D. M., Leocadio, M. C., Van Bogaert, P., & Tsaras, K. (2018). Perceptions of organizational support and its impact on nurses’ job outcomes. Nursing Forum, 53(3), 339–347.
- Labrague, L. J., & McEnroe-Petitte, D. M. (2018). Job stress in new nurses during the transition period: An integrative review. International Nursing Review, 65(4), 491–504.
- Labrague, L. J., Yboa, B. C., McEnroe–Petitte, D. M., Lobrino, L. R., & Brennan, M. G. B.(2016). Disaster preparedness in Philippine nurses. Journal of Nursing Scholarship, 48(1), 98–105.
- Langford, C. P. H., Bowsher, J., Maloney, J. P., & Lillis, P. P. (1997). Social support: A conceptual analysis. Journal of Advanced Nursing, 25(1), 95–100.
- Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Studies, 44(7), 393–401.
- Lee, S. A., Jobe, M. C., Mathis, A. A., & Gibbons, J. A. (2020). Incremental validity of coronaphobia: Coronavirus anxiety explains depression, generalized anxiety, and death anxiety. Journal of anxiety disorders, 74, 102268.
- Lin, M., Hirschfeld, G., & Margraf, J. (2019). Brief form of the Perceived Social Support Questionnaire (F-SozU K-6): Validation, norms, and cross-cultural measurement invariance in the USA, Germany, Russia, and China. Psychological Assessment, 31(5), 609–621.
- Liu, Y., & Aungsuroch, Y. (2019). Work stress, perceived social support, self-efficacy and burnout among Chinese registered nurses. Journal of Nursing Management, 27(7), 1445–1453.
- Liu, Y., Gayle, A. A., Wilder-Smith, A., & Rocklöv, J. (2020). The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of Travel Medicine, 27(2), 1–4.
- Luo, M., Guo, L., Yu, M., & Wang, H. (2020). The Psychological and Mental Impact of Coronavirus Disease 2019 (COVID-19) on medical staff and general public–A systematic review and meta-analysis. Psychiatry Research, 291, 113190.
- Lv, Y., Yao, H., Xi, Y., Zhang, Z., Zhang, Y., Chen, J., … Luo, G. Q. (2020). Social support protects chinese medical staff from suffering psychological symptoms in COVID-19 Defense. SSRN, 1-23. https://doi.org/10.2139/ssrn.3559617
- Maben, J., & Bridges, J. (2020). Covid-19: Supporting nurses' psychological and mental health. Journal of Clinical Nursing, 29(15-16): 2742-2750. https://doi.org/10.1111/jocn.15307
- McMullan, C., Brown, G. D., & O'Sullivan, D. (2016). Preparing to respond: Irish nurses' perceptions of preparedness for an influenza pandemic. International Emergency Nursing, 26, 3–7.
- Mealer, M., Jones, J., & Meek, P. (2017). Factors affecting resilience and development of posttraumatic stress disorder in critical care nurses. American Journal of Critical Care, 26(3), 184–192.
- Mo, Y., Deng, L., Zhang, L., Lang, Q., Liao, C., Wang, N., … Huang, H. (2020). Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic. Journal of Nursing Management, 28(5), 1002-1009. https://doi.org/10.1111/jonm.13014
- Möller, A., Söndergaard, H. P., & Helström, L. (2017). Tonic immobility during sexual assault–A common reaction predicting post-traumatic stress disorder and severe depression. Acta Obstetricia Et Gynecologica Scandinavica, 96(8), 932–938.
- Pahlevan Sharif, S., Ahadzadeh, A. S., & Sharif Nia, H. (2018). Mediating role of psychological well-being in the relationship between organizational support and nurses’ outcomes: A cross-sectional study. Journal of Advanced Nursing, 74(4), 887–899.
- Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901-907. https://doi.org/10.1016/j.bbi.2020.05.026
- Philippine Statistics Authority. (2018). Philippines in figures. Retrieved from https://psa.gov.ph/sites/default/files/PIF%202018.pdf
- Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA, 323(21), 2133–2134.
- Shevlin, M., Nolan, E., Owczarek, M., McBride, O., Murphy, J., Gibson Miller, J., … McKay, R. (2020). COVID-19-related anxiety predicts somatic symptoms in the UK population. British Journal of Health Psychology, https://doi.org/10.1111/bjhp.12430
- Shiao, J. S. C., Koh, D., Lo, L. H., Lim, M. K., & Guo, Y. L. (2007). Factors predicting nurses' consideration of leaving their job during the SARS outbreak. Nursing Ethics, 14(1), 5–17.
- Skalski, S., Uram, P., Dobrakowski, P., & Kwiatkowska, A. (2020). The link between ego-resiliency, social support, SARS-CoV-2 anxiety and trauma effects. Polish Adaptation of the Coronavirus Anxiety Scale.
- Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15(3), 194–200.
- Soper, D. S. (2020). A-priori sample size calculator for multiple regression. Retrieved from http://www.danielsoper.com/statcalc/calculator.aspx?id=1
- Spielberger, C. D. (2010). State-Trait anxiety inventory. The Corsini Encyclopedia of Psychology. Hoboken, NJ: John Wiley & Sons, Inc.
- Teles, M. A. B., Barbosa, M. R., Vargas, A. M. D., Gomes, V. E., de Ferreira, E. F., de Barros Lima, A. M. E., & Ferreira, R. C.(2014). Psychosocial work conditions and quality of life among primary health care employees: A cross sectional study. Health and Quality of Life Outcomes, 12(1), 72.
- Turner, S. B. (2015). Resilience of nurses in the face of disaster. Disaster Medicine and Public Health Preparedness, 9(6), 601–604.
- Tzeng, W. C., Feng, H. P., Cheng, W. T., Lin, C. H., Chiang, L. C., Pai, L., & Lee, C. L. (2016). Readiness of hospital nurses for disaster responses in Taiwan: a cross-sectional study. Nurse education today, 47, 37–42.
- Veenema, T. G., Deruggiero, K., Losinski, S., & Barnett, D. (2017). Hospital administration and nursing leadership in disasters. Nursing Administration Quarterly, 41(2), 151–163.
- World Health Organization. (2020). Coronavirus disease 2019 (COVID-19) situation report-60[EB/OL]. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
- Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020). The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e923549–e923551.
- Yu, H., Li, M., Li, Z., Xiang, W., Yuan, Y., Liu, Y., Xiong, Z. (2020). Coping style, social support and psychological distress in the general Chinese population in the early stages of the COVID-2019 epidemic. Social Support and Psychological Distress in the General Chinese Population in the Early Stages of the COVID-2019 Epidemic. SSRN, 1-34. https://doi.org/10.2139/ssrn.3556633
