TABLE 1.
Stressors for healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic
| Stressor | Description |
| Physical stress | Care for COVID-19 patients is particularly strenuous, since wearing of protective gear is required and specific interventions, e.g. prone positioning, are physically demanding for HCWs |
| Extra hours | When hospitals become overburdened by the number of patients and at the same time suffer from absenteeism of diseased HCWs, the remaining staff may require to work serious amounts of extra hours |
| Fear of becoming infected or transmitting infections to non-COVID-19 patients, family or friends | Close contact to infectious patients poses a risk for HCWs of getting infected and also a risk for transmission of SARS-CoV-2 to non-COVID-19 patients |
| Restricted visitor policy | Visiting restrictions for relatives and friends of patients causing regrets and sorrow for HCWs |
| No conceivable spatial or temporal boundaries of the pandemic | No outlet to escape the situation because the pandemic as well as the stressors are not confined to the hospital, and not knowing when the pandemic is going to end |
| Social isolation | Family members of older age are at risk and cannot be seen, family celebrations cannot take place |
| Fear of losing family members, friends or colleagues | HCWs may care for many severely ill patients, constantly aware of the danger of a COVID-19 infection |
| Frustration with political leaders | Perceived or real inconsistencies and management failures of political leaders increase the feelings of helplessness and being at the mercy of others |
| Frustration with administration for not having enough equipment/PPE or failure to protect/testing equipment | Perceived or real management failures of administrative staff when equipment for self-protection is not sufficiently available increase the feelings of being sacrificed, thus causing anger |
| Uncertainty because of frequently changing information about COVID-19 | HCWs are frequently asked about their opinion and for advice; they have to deal with a lot of uncertainty themselves and can be overwhelmed when facing individuals who do not understand social distancing and deny the danger of a pandemic spreading rapidly |
| Moral distress | Feelings of being left alone for rationing decisions on own moral standards when there are limited supporting structures and guidelines can lead to considerable moral distress |