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Stress, Anxiety, and Depression among Healthcare Workers

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A special issue of Behavioral Sciences (ISSN 2076-328X). This special issue belongs to the section "Social Psychology".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 27250

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Dr. Eduardo Fernández-Jiménez

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Guest Editor

1. Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
2. Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, 28046 Madrid, Spain
Interests: clinical and health psychology; mental health

Dr. Clara González-Sanguino

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Guest Editor

Department of Psychology, University of Valladolid, 47011 Valladolid, Spain
Interests: clinical and health psychology; mental health

Special Issue Information

Dear Colleagues,

Healthcare workers are exposed to high levels of workload (before, during and after the COVID-19 pandemic). This leads to affective reactions such as stress, anxiety, and depression, most of the time as adaptative and transient responses. However, relevant proportions of healthcare workers suffer clinically significant mental health problems and especially relevant work-related syndromes such as burnout. Therefore, this Special Issue will cover a wide range of study designs to further the affective impact of professional activity among healthcare workers. In particular, we welcome sound theoretical (systematic reviews or meta-analysis) and/or empirical contributions, from qualitative, quantitative or mixed-methods designs, including observational, interventional (RCT or nonrandomized trials) and assessment studies (e.g., validation of new instruments) that focus on this population.

Dr. Eduardo Fernández-Jiménez
Dr. Clara González-Sanguino
Guest Editors

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Keywords

stress
anxiety
depression
healthcare workers
burnout

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Published Papers (10 papers)

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Research

20 pages, 647 KiB

Open AccessArticle

Occupational Burnout and Insomnia in Relation to Psychological Resilience Among Greek Nurses in the Post-Pandemic Era

by Christos Sikaras, Argyro Pachi, Sofia Alikanioti, Ioannis Ilias, Eleni Paraskevi Sideri, Athanasios Tselebis and Aspasia Panagiotou

Behav. Sci. 2025, 15(2), 126; https://doi.org/10.3390/bs15020126 - 24 Jan 2025

Cited by 2 | Viewed by 2272

Abstract

Recent studies indicate that nurses experienced high levels of occupational burnout and insomnia during and after the pandemic and highlight resilience as a crucial competence for overcoming adversity. The aim of this study was to assess occupational burnout, insomnia, and psychological resilience and to explore their interrelations among Greek nurses 14 months after the official ending of the pandemic which was declared in May 2023. The study was conducted online in July 2024 and included 380 nurses currently working in Greek hospitals, who completed the Copenhagen Burnout Inventory (CBI), the Athens Insomnia Scale (AIS), and the Brief Resilience Scale (BRS). Overall, 56.1% of the nurses exhibited insomnia symptoms and 46.8% displayed signs of occupational burnout. Low resilience scores were observed in 26.3%. Multiple regression analysis indicated that CBI explained 34.4% of the variance in the AIS scores, while an additional 3% was explained by the BRS. Mediation analysis revealed that resilience operates protectively as a negative mediator in the relationship between burnout and insomnia. In conclusion, one year after the end of the pandemic the levels of occupational burnout and insomnia among nurses remain high, whereas psychological resilience seems to be retained at moderate levels. Consequently, there is an urgent need to regularly monitor for risk of burnout and insomnia and to implement resilience-building strategies for nurses to combat burnout and improve insomnia symptoms. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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20 pages, 327 KiB

Open AccessArticle

“Direct Me or Leave Me”: The Effect of Leadership Style on Stress and Self-Efficacy of Healthcare Professionals

by Stefan Milojević, Vesna Stojanović Aleksić and Marko Slavković

Behav. Sci. 2025, 15(1), 25; https://doi.org/10.3390/bs15010025 - 30 Dec 2024

Viewed by 2053

Abstract

This study aims to investigate the influence of leadership on the self-efficacy of healthcare professionals. Additionally, it seeks to explore whether stress mediates the relationship between leadership and self-efficacy. Specifically, our study is focused on both transactional leadership and laissez-faire leadership, which are commonly practiced by healthcare professionals due to the settings of healthcare environments. This study utilized a structured questionnaire for measuring the leadership, stress, and self-efficacy of healthcare professionals. Data collection involved respondents rating these statements on a Likert scale. The sample consisted of 395 participants employed in healthcare organizations in Serbia. The analysis employed partial least squares structural equation modeling (PLS-SEM). The research findings indicate that laissez-faire leadership is positively associated with stress, while no significant negative impact on self-efficacy was observed. Transactional leadership did not demonstrate a significant relationship with reduced stress but was found to positively influence self-efficacy. Moreover, stress was identified as negatively impacting self-efficacy and mediated the association between laissez-faire leadership and self-efficacy, although no mediating effect was found for transactional leadership. This study underscores the critical role of leadership style in shaping the well-being and self-efficacy of healthcare professionals. By understanding how different leadership approaches impact employee stress and job satisfaction, healthcare organizations can tailor their management practices to foster a supportive work environment and enhance overall performance. The results emphasize the need for leaders to balance organizational objectives with employee needs, demonstrating effective communication and adaptability to promote a positive workplace culture. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

19 pages, 627 KiB

Open AccessArticle

Consequences of the Pandemic on Mental Health of Healthcare Workers in the NHS

by Arjun Vyas, Nantapong Butakhieo and Lina Vyas

Behav. Sci. 2024, 14(12), 1208; https://doi.org/10.3390/bs14121208 - 17 Dec 2024

Viewed by 1264

Abstract

In recent years, the public health system of the United Kingdom, the National Healthcare System (NHS), has encountered difficulties that have been acknowledged in research studies and public policy discussions, such as resignations and staff shortages. During the COVID-19 pandemic, NHS healthcare workers were confronted with demanding circumstances, exacerbating the constraints of an already struggling system. With this, the authors of this paper aim to better understand the relationships between frustration at work, fear of infection, working hours, and the turnover intention of healthcare workers during the pandemic. This study employed a mixed-methods research approach, as a questionnaire survey was conducted along with an online self-administered interview questionnaire. Using mediation and moderated mediation analyses, it was found that the indirect effect of frustration at work through fear of infection on turnover intention was positively significant. Working hours moderated the mediation effect of fear of infection on the relationship between frustration at work and turnover intention. Surprisingly, the conditional indirect effect of frustration at work on turnover intention through fear of infection was the strongest among those with short working hours. This evidence was supplemented with qualitative results that enhance the understanding of why healthcare workers want to leave the system and the actions that can be taken on the organisational and policy fronts to address this issue. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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12 pages, 597 KiB

Open AccessArticle

Burnout and Personality Profiles Among Chinese Nurses

by Sijun Zhang, Ke Xiao and Zhen Tian

Behav. Sci. 2024, 14(12), 1117; https://doi.org/10.3390/bs14121117 - 21 Nov 2024

Cited by 1 | Viewed by 835

Abstract

Although many studies have examined the relationship between the five dimensions of personality and nurse burnout, few studies have examined the relationship between nurse burnout and the overall personality profile. In addition, nurses’ demographic characteristics have been found to be related to nurses’ burnout level, but the results have been inconsistent. This study aimed to determine personality profiles based on the Big Five personality model in a sample of Chinese nurses then analyze the relationship between burnout and personality profiles and demographics. A total of 1423 nurses were sampled and assessed using the Big Five Inventory and the Oldenburg Burnout Inventory. A k-means cluster analysis was used to divide participants into different personality profiles. Multivariate analysis of variance and binomial logistic regression were used to examine the relationship of burnout with personality profiles and demographics. Cluster analysis identified three personality profiles among nurses: resilient, ordinary, and distressed. For each dimension of the Big Five Inventory and Oldenburg Burnout Inventory, there was a significant difference between different personality profiles, with effect sizes being from 0.37 to 0.57. Nurses with a distressed personality profile were 4.52 times more likely to be diagnosed with burnout than nurses with an ordinary profile, while nurses with a resilient personality profile had a 55% reduction in burnout compared to nurses with an ordinary profile. The results suggested that hospital administrators should focus on nurses with a distressed personality profile to identify potential burnout nurses as early as possible. The findings also enabled hospital administrators to consider the different personality profiles of nurses and the specific requirements of the job to select suitable candidates. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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15 pages, 313 KiB

Open AccessArticle

A Burnt-Out Health: Stigma towards Mental Health Problems as a Predictor of Burnout in a Sample of Community Social Healthcare Professionals

by Sara Zamorano, Clara González-Sanguino, Eduardo Fernández-Jiménez and Manuel Muñoz

Behav. Sci. 2024, 14(9), 812; https://doi.org/10.3390/bs14090812 - 13 Sep 2024

Viewed by 3219

Abstract

Burnout is a primary psychosocial risk factor in the workplace. Mental health stigma, which includes negative cognitions, emotions, and behaviors, also undermines the performance of social healthcare professionals. This study aimed to explore the levels of burnout in a sample of community social healthcare workers as well as its relationships with variables such as stigma towards mental health problems, professional skills, and job characteristics. An online assessment was conducted with 184 social healthcare professionals (75.5% female, mean age = 40.82 years, SD = 9.9). Medium levels of burnout and stigma and high levels of professional skills were observed. Multiple linear regression analyses revealed that stigma towards mental health problems and professional skills predicted emotional exhaustion (R² = 0.153, F(4, 179) = 9.245, p < 0.001), depersonalization (R² = 0.213, F(3, 180) = 17.540, p < 0.001), and personal accomplishment (R² = 0.289, F(5, 178) = 15.87, p < 0.001). These findings suggest that social healthcare systems could benefit from taking care of the mental health of their workers by addressing burnout, tackling negative attitudes towards mental health problems, and providing professional skills training. This would help to make social healthcare systems more inclusive and of higher quality, thereby reducing health costs. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

13 pages, 462 KiB

Open AccessArticle

The Impact of Intensive Care Unit Nurses’ Burnout Levels on Turnover Intention and the Mediating Role of Psychological Resilience

by Ömer Turunç, Abdullah Çalışkan, İrfan Akkoç, Özlem Köroğlu, Güney Gürsel, Ayhan Demirci, Köksal Hazır and Neslihan Özcanarslan

Behav. Sci. 2024, 14(9), 782; https://doi.org/10.3390/bs14090782 - 6 Sep 2024

Cited by 3 | Viewed by 3755

Abstract

Background: This study aims to investigate the relationship between burnout levels among intensive care unit (ICU) nurses, turnover intention, and the mediating role of psychological resilience. Methods: This survey design was used to collect data from 228 ICU nurses from hospitals in Turkey. The study utilized self-report questionnaires to measure burnout levels, turnover intention, and psychological resilience. The data were analyzed through structural equation modeling. Results: In the study, a positive relationship between burnout and turnover intention and burnout and psychological resilience is significant (p ≤ 0.001). However, psychological resilience was not found to have a mediating role, indicating that other factors or variables may play a more substantial role in the relation found between burnout and turnover intention. Also, the research model’s Standardized Root Mean Square Residual is expected to be less than 0.10 for the model to have an acceptable fit. Conclusion: The findings suggest that levels of burnout among ICU nurses may have significant consequences on turnover intention. However, promoting resilience cannot help diminish the negative effects of burnout on turnover intention. The findings highlight the importance of burnout levels in nursing by synthesizing findings from the previous literature. Then, focusing on the concepts of turnover intention and psychological resilience, it explains the importance of these concepts in the Intensive Care Unit nurses and their relationships with each other. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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23 pages, 791 KiB

Open AccessArticle

Exploring the Relationship between Surface Acting, Job Stress, and Emotional Exhaustion in Health Professionals: The Moderating Role of LMX

by Ibrahim Yikilmaz, Lutfi Surucu, Ahmet Maslakci, Alper Bahadir Dalmis and Emete Toros

Behav. Sci. 2024, 14(8), 637; https://doi.org/10.3390/bs14080637 - 25 Jul 2024

Cited by 4 | Viewed by 4819

Abstract

Rapid organizational changes due to technological advancements, high-efficiency expectations, and uncertainties, particularly in healthcare, have led to a global stress epidemic among em-ployees. This has been exacerbated by the COVID-19 pandemic and evolving workplace practices. Surface acting, or the suppression and faking of emotions, significantly contributes to this stress and burnout, impacting not only individual healthcare professionals but also healthcare systems’ overall effectiveness and sustainability. Providing adequate resources in high-demand work environments is, thus, essential to mitigate these negative experiences. Leader–member exchange (LMX) can play a pivotal role in understanding and addressing the needs and expectations of healthcare professionals. Drawing on Conservation of Resources (COR), Job Demands-Resources (JD-R), Social Exchange theories, and Grandey’s Emotional Regulation Model, this study analyzed data from a convenience sample of 350 healthcare professionals. The results reveal that surface acting intensifies healthcare professionals’ experiences of job stress and emotional exhaustion. Notably, the study empirically demonstrated that high levels of LMX in healthcare professionals’ relationships with their leaders can mitigate the impact of surface acting on job stress and emotional exhaustion. These findings offer valuable insights for managers and policymakers, highlighting the importance of LMX in maintaining sustainable management practices in complex and stressful healthcare organizations. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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24 pages, 1202 KiB

Open AccessArticle

Mitigating Job Burnout in Jordanian Public Healthcare: The Interplay between Ethical Leadership, Organizational Climate, and Role Overload

by Kayed Al’Ararah, Dilber Çağlar and Hasan Yousef Aljuhmani

Behav. Sci. 2024, 14(6), 490; https://doi.org/10.3390/bs14060490 - 11 Jun 2024

Cited by 9 | Viewed by 2719

Abstract

In today’s dynamic organizational landscape, characterized by rapid technological advancements and evolving workplace dynamics, understanding the factors influencing employee well-being is paramount. This study investigates the interplay between ethical leadership, organizational climate, role overload, and job burnout in public healthcare organizations across northern Jordan. By focusing on ethical leadership, organizational climate, and role overload as determinants of job burnout, this research provides insights into strategies for enhancing employee well-being. Drawing on ethical leadership theory, social exchange theory, and the job demands–resources model, this study employs PLS-SEM to analyze data collected from 260 employees working in Jordanian government hospitals. The findings reveal negative associations between ethical leadership and job burnout, highlighting the importance of ethical leadership behaviors in mitigating employee burnout. Additionally, a positive organizational climate is associated with lower levels of burnout, underscoring the impact of the broader organizational context on employee well-being. The study also explores the mediating role of organizational climate and the moderating effect of role overload in the relationship between ethical leadership and job burnout, providing insights into the complex dynamics at play in healthcare organizations. These findings enrich our understanding of the factors influencing employee well-being in healthcare contexts and underscore the importance of fostering ethical leadership and supportive organizational climates to mitigate job burnout. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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17 pages, 1694 KiB

Open AccessArticle

Burnout and Quality of Work Life among Physicians during Internships in Public Hospitals in Thailand

by Vithawat Surawattanasakul, Wuttipat Kiratipaisarl and Penprapa Siviroj

Behav. Sci. 2024, 14(5), 361; https://doi.org/10.3390/bs14050361 - 25 Apr 2024

Cited by 3 | Viewed by 2603

Abstract

Physicians are exposed to occupational stress and burnout, which have been identified as contributing to a decrease in the quality of work life (QWL). Thailand’s medical education program, consisting of a six-year curriculum with government tuition support followed by three years of internships, provides the context for this investigation. This study aimed to assess the QWL among intern physicians (IPs) in public hospitals and investigated the association between burnout and QWL. A cross-sectional study was conducted among 241 IPs in public hospitals in Thailand utilizing an online self-administered questionnaire. The questionnaire included a Thai version of a 25-item QWL scale and the Maslach Burnout Inventory—Human Services Survey for Medical Personnel. Data analysis was performed using multivariable logistic regression. A significant proportion of IPs experienced low to moderate QWL (72.6%), with low levels of home–work interface (39.4%) and employee engagement (38.6%). In the exploratory model, after adjusting for sex and age, IPs with high depersonalization and low personal accomplishment demonstrated an association with low QWL (adjusted OR, aOR 2.08, 95% CI 1.01 to 4.31; aOR 2.74, 95% CI 1.40 to 5.39). Healthcare organizations should regularly assess intern physicians’ QWL and burnout, prioritizing interventions; ensure reasonable work hours, schedule adjustments, and open communication; and develop support systems for cost-effective interventions. Further research on the dynamic relationship between burnout and QWL is crucial for targeted and culturally sensitive interventions. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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15 pages, 796 KiB

Open AccessArticle

Social Network Characteristics and Depressive Symptoms of Italian Public Health Medical Residents: The Public Health Residents’ Anonymous Survey in Italy (PHRASI)

by Lorenzo Stacchini, Alessandro Catalini, Valentina De Nicolò, Claudia Cosma, Veronica Gallinoro, Angela Ancona, Nausicaa Berselli, Marta Caminiti, Clara Mazza, Giuseppa Minutolo, Fabrizio Cedrone, Vincenza Gianfredi and on Behalf of the Working Group on Public Mental Health 2021/2022 of the Medical Residents’ Assembly of the Italian Society of Hygiene and Preventive Medicine

Behav. Sci. 2023, 13(11), 881; https://doi.org/10.3390/bs13110881 - 25 Oct 2023

Cited by 5 | Viewed by 2233

Abstract

Despite the high impact of the COVID-19 pandemic on social interactions and healthcare workers’ (HWs’) mental health, few studies have investigated the association between social network characteristics and HWs’ mental health, particularly during the pandemic. Therefore, we aimed to assess the associations between public health residents’ (PHRs’) social network characteristics and depression. We used data from the Public Health Residents’ Anonymous Survey in Italy (PHRASI), a nationwide cross-sectional study. Social network characteristics were self-reported. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. Linear and logistic models adjusted for age, sex, physical activity, and alcohol were used. A moderation analysis by sex was also performed. A total of 379 PHRs participated in the survey (58% females, median age of 30 years). More peer-to-peer (odds ratio OR = 0.62 (0.47–0.83)) and supervisor support (OR = 0.49 (0.36–0.68)), more social participation ((OR) = 0.36 95% CI (0.25–0.50)), and having a partner (OR = 0.49 (0.25–0.96)) were significantly associated with a lower risk of clinically relevant depressive symptoms. Work-to-private-life interference was significantly associated with a higher risk of clinically relevant depressive symptoms (OR = 1.77 (1.28–2.45)). Promoting a supportive work environment and social participation as well as reducing work-to-private life interference can contribute to reducing the high burden among PHRs. Full article

(This article belongs to the Special Issue Stress, Anxiety, and Depression among Healthcare Workers)

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