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      Primary drivers and psychological manifestations of stress in frontline healthcare workforce during the initial COVID-19 outbreak in the United States

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          Abstract

          Objective

          The purpose of this study was to understand the physical and psychological impact of high stress clinical environments and contributory factors of burnout in multidisciplinary healthcare workforce during the initial outbreak of COVID-19.

          Method

          In-person qualitative interviews informed by an adaptation of Karasek's Job Demand-control model were conducted with a convenience sample of healthcare workforce from March to April 2020.

          Results

          Themes emerging from interviews coalesced around three main areas: fear of uncertainty, physical and psychological manifestations of stress, and resilience building. Shifting information, a lack of PPE, and fear of infecting others prompted worry for those working with Covid-infected patients. Participants reported that stress manifested more psychologically than physically. Individualized stress mitigation efforts, social media and organizational transparency were reported by healthcare workers to be effective against rising stressors.

          Conclusion

          COVID-19 has presented healthcare workforce with unprecedented challenges in their work environment. With attention to understanding stressors and supporting clinicians during healthcare emergencies, more research is necessary in order to effectively promote healthcare workforce well-being.

          Highlights

          • Participants reported that organizations struggled with uniform COVID-19 policies.

          • Infecting others outside hospital setting was among the highest stressors reported.

          • Availability of personal protective equipment emerged as a controversial stressor.

          • Stress manifested more psychologically than physically.

          • Teamwork, transparency, and solidarity across social media alleviated stressors.

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          Most cited references40

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          Job Demands, Job Decision Latitude, and Mental Strain: Implications for Job Redesign

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            Comparison of Convenience Sampling and Purposive Sampling

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              Systematic methodological review: developing a framework for a qualitative semi-structured interview guide.

              To produce a framework for the development of a qualitative semi-structured interview guide.
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                Author and article information

                Journal
                Gen Hosp Psychiatry
                Gen Hosp Psychiatry
                General Hospital Psychiatry
                Elsevier Inc.
                0163-8343
                1873-7714
                10 January 2021
                March-April 2021
                10 January 2021
                : 69
                : 20-26
                Affiliations
                [a ]Columbia University School of Nursing, 630 W. 168th Street, Mail Code 6, New York, NY 10032, United States
                [b ]Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, United States
                [c ]Temple University College of Public Health, Jones Hall 526, 3307 N. Broad Street, Philadelphia, PA 19140, United States
                [d ]New York University Rory Meyers College of Nursing, 433 1st Ave., New York, NY 10010, United States
                [e ]MedStar Washington Hospital Center, 110 Irving St., NW, Washington, DC 20010, United States
                Author notes
                [* ]Corresponding author.
                Article
                S0163-8343(21)00001-3
                10.1016/j.genhosppsych.2021.01.001
                7836752
                33485091
                fe5d9bdd-bf3b-4309-8749-99254166e9e1
                © 2021 Elsevier Inc. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 18 November 2020
                : 3 January 2021
                : 4 January 2021
                Categories
                Article

                burnout,covid-19,stress,healthcare workforce,resilience,qualitative research

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