Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study

Portillo-Van Diest, Ana; Vilagut Saiz, Gemma, 1975-; Alayo, Itxaso; Ferrer Forés, Maria Montserrat; Amigo, Franco; Amann, Benedikt Lorenz; Rius, Cristina; Sanz, Ferran; Serra, Consol; Pérez Solá, Victor; Alonso Caballero, Jordi; Mortier, Philippe; MINDCOVID Working group

doi:http://dx.doi.org/10.1017/S2045796023000628

Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study

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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, et al. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci. 2023 Aug 9;32:e50. DOI: 10.1017/S2045796023000628

Abstract

Aim: To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. Methods: This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). Results: Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. Conclusions: TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.