Table 1.
Characteristics of the sample and courses of psychological distress in healthcare workers on the frontlines of the COVID-19 pandemic
| Full sample n = 786 |
No/low distress (1) n = 475 (60.4%) |
Remitted distress (2) n = 150 (19.1%) |
New-Onset distress (3) n = 35 (4.5%) |
Persistent distress (4) n = 126 (16.0%) |
Test of difference | Pairwise contrasts | |
|---|---|---|---|---|---|---|---|
| n (%) or mean (SD) | n (%) or mean (SD) | n (%) or mean (SD) | n (%) or mean (SD) | n (%) or mean (SD) | |||
| Demographic and occupational characteristics | |||||||
| Age | 22.45*** | ||||||
| < 35 | 464 (59.0%) | 254 (53.5%) | 91 (60.7%) | 29 (82.9%) | 90 (71.4%) | 3, 4 > 1, 2 | |
| ≥ 35 | 322 (41.0%) | 221 (46.5%) | 59 (39.3%) | 6 (17.1%) | 36 (28.6%) | ||
| Gender | 18.73*** | ||||||
| Female | 571 (72.6%) | 320 (67.4%) | 117 (78.0%) | 27 (77.1%) | 107 (84.9%) | 4 > 1 | |
| Male | 215 (27.4%) | 155 (32.6%) | 33 (22.0%) | 8 (22.9%) | 19 (15.1%) | ||
| Race/ethnicity | 14.51 | - | |||||
| White, non-hispanic | 416 (52.9%) | 252 (53.1%) | 79 (52.7%) | 21 (60.0%) | 64 (50.8%) | ||
| Black, non-hispanic | 39 (5.0%) | 22 (4.6%) | 8 (5.3%) | 2 (5.7%) | 7 (5.6%) | ||
| Hispanic | 46 (5.9%) | 29 (6.1%) | 11 (7.3%) | 4 (11.4%) | 2 (1.6%) | ||
| Other, mixed race | 30 (3.8%) | 19 (4.0%) | 6 (4.0%) | 2 (5.7%) | 3 (2.4%) | ||
| Prefer not to say | 54 (6.9%) | 34 (7.2%) | 8 (5.3%) | 0 (0%) | 12 (9.5%) | ||
| Relationship Status | 18.36*** | ||||||
| Single/divorced/widowed | 217 (27.6%) | 108 (22.7%) | 46 (30.7%) | 11 (31.4%) | 52 (41.3%) | 4 > 1 | |
| Married/partnered | 569 (72.4%) | 367 (77.3%) | 104 (69.3%) | 24 (68.6%) | 74 (58.7%) | ||
| Living with children | 235 (29.9%) | 169 (35.6%) | 36 (24.0%) | 6 (17.1%) | 24 (19.0%) | 19.60*** | 1 > 4 |
| Profession | 55.99*** | ||||||
| Registered nurse | 267 (34.0%) | 117 (24.6%) | 66 (44.0%) | 19 (54.3%) | 65 (51.6%) | 2, 3, 4 > 1 | |
| Residents/fellows | 184 (23.4%) | 126 (26.5%) | 28 (18.7%) | 8 (22.9%) | 22 (17.5%) | NS | |
| Attending MD/DO | 183 (23.3%) | 134 (28.2%) | 27 (18.0%) | 3 (8.6%) | 19 (15.1%) | 1 > 4 | |
| PA/NP | 114 (14.5%) | 74 (15.6%) | 24 (16.0%) | 4 (11.4%) | 12 (9.5%) | NS | |
| Other | 38 (4.8%) | 24 (5.1%) | 5 (3.3%) | 1 (2.9%) | 8 (6.3%) | NS | |
| Years in practice | 8.3 (8.6) | 9.1 (9.3) | 8.4 (8.8) | 4.8 (5.2) | 6.0 (4.9) | 6.44*** | 1 > 3, 4 |
| History of psychiatric disorder | 160 (20.4%) | 86 (18.1%) | 23 (15.3%) | 10 (28.6%) | 41 (32.5%) | 16.81** | 4 > 1, 2 |
| Past-year burnout | 303 (38.6%) | 118 (24.9%) | 78 (52.0%) | 20 (57.1%) | 87 (69.0%) | 103.30*** | 4 > 2 > 1 |
| COVID-19 pandemic-related factors | |||||||
| Perceived preparedness | 2.8 (1.1) | 3.0 (1.0) | 2.6 (1.2) | 2.5 (1.1) | 2.5 (1.2) | 9.52*** | 1 > 2,4 |
| Acute surge stressors | 0.0 (1.0) | − 0.2 (0.9) | 0.2 (0.9) | 0.2 (1.2) | 0.6 (1.0) | 29.68*** | 4, 3 > 2 > 1 |
| Infection-related concerns | 0.0 (1.0) | − 0.2 (1.0) | 0.0 (1.0) | 0.1 (1.0) | 0.2 (1.0) | 6.22*** | 4 > 1 |
| Family-related concerns | 0.0 (1.0) | − 0.3 (1.0) | 0.3 (1.0) | − 0.1 (1.2) | 0.2 (1.1) | 16.94*** | 2,4 > 1 |
| Work-related concerns | 0.0 (1.0) | − 0.2 (0.9) | 0.3 (1.0) | 0.0 (1.0) | 0.4 (1.0) | 20.01*** | 2,4 > 1 |
| Post-acute surge stressors | 0.0 (1.0) | − 0.2 (0.9) | − 0.1 (0.8) | 0.8 (1.1) | 0.6 (1.2) | 28.12*** | 4, 3 > 1,2 |
| Psychosocial characteristics | |||||||
| Coping self-efficacy (resilience) | 6.5 (1.3) | 6.7 (1.3) | 6.2 (1.3) | 6.6 (1.3) | 6.1 (1.3) | 12.40*** | 1 > 2, 4 |
| Positive characteristics | 0 (1.0) | 0.2 (0.9) | − 0.1 (1.0) | − 0.2 (1.1) | − 0.4 (1.1) | 13.77*** | 1 > 2, 4 |
| Work-related inspiration | 0 (1.0) | 0.1 (1.0) | − 0.1 (1.0) | − 0.1 (1.0) | − 0.1 (1.1) | 1.63 | – |
| Feeling valued/supported at work | 0 (1.0) | 0.2 (0.9) | − 0.3 (1.0) | − 0.4 (1.0) | − 0.5 (1.0) | 26.72*** | 1 > 2, 3, 4 |
| Perceived social support | 12.3 (2.9) | 12.8 (2.6) | 12.2 (2.7) | 11.4 (3.5) | 11.1 (3.3) | 13.37*** | 1 > 3, 4 |
| Restorative behaviors | |||||||
| Sleep hours | 6.4 (1.1) | 6.6 (1.0) | 6.3 (1.3) | 6.6 (1.1) | 6.0 (1.1) | 10.79*** | 1 > 2,4 |
| Physical exercise | 2.2 (1.9) | 2.4 (2.0) | 2.0 (1.8) | 2.2 (1.9) | 1.9 (1.8) | 2.69* | NS |
| Coping strategies | |||||||
| Self-sufficient coping | 1.4 (1.1) | 1.6 (1.0) | 1.1 (1.0) | 1.2 (1.3) | 1.1 (1.0) | 12.33*** | 1 > 2, 4 |
| Socially supported coping | 1.0 (0.7) | 0.9 (0.7) | 1.2 (0.7) | 0.9 (0.7) | 1.0 (0.7) | 6.62*** | 2 > 1 |
| Avoidant coping | 0.8 (0.6) | 0.7 (0.6) | 0.8 (0.6) | 1.0 (0.7) | 1.0 (0.7) | 9.48*** | 4 > 1 |
Distress = psychological distress (positive screen for MDD, GAD, and PTSD symptoms)
Statistically significant association: *p < 0.05, **p < 0.01, ***p < 0.001