Longitudinal insights in psychosocial stress expressed by health care professionals during the COVID-19 pandemic – a mixed-method approach (Preprint)

BACKGROUND COVID-19 has affected everyday life and working conditions for most European people, particularly health care professionals (HCP). The worsening of mental health, work-related stressors, and helpful coping strategies within HCP have been studied by various quantitative surveys for all waves of infection. Longitudinal comparisons of stressors and coping as well as the themes that are particularly stressful for the HCP on different levels of experience at distinct timepoints of the pandemic are missing. OBJECTIVE Analyzing stressors, coping strategies, and underlying psychosocial stress factors and unmet needs expressed by HCP and non-medical staff at the beginning of the COVID-19 pandemic and the third wave of infections in different European countries. METHODS A cross-sectional survey was conducted in two study periods during COVID-19 pandemic in different European countries. The first study period was between April 1st and June 20th 2020 and the second between the November 25th 2021 and February 28th 2022. Quantitative descriptive analysis was conducted for questionnaires on stressors and coping strategies. Thematic analysis was used to complement the quantitative data with the results of the qualitative data to explore further levels of experience of the individual. RESULTS The most severe stressors identified at both timepoints were the uncertainty about when the pandemic will be under control and the fear of infecting the family. Commonly used coping strategies were the use of protective measures and the collection of information on COVID-19. A thematic analysis revealed 8 first level themes (pandemic situation, government/politics, social climate, measures, working conditions, infection effects, daily life, coping) which can be seen as levels of experience. During the beginning of the pandemic, comments focused on needs regarding protective equipment and handling the social-distancing situation, while unmet psychosocial needs came up only in the second study period. CONCLUSIONS Over the course of three years of the pandemic, there is still a need in the psychosocial pandemic preparedness of health care professionals that deserves further research and coverage. Despite many government and work-related measures, a deterioration of mental health in HCP, could be observed. It is important for future crises to cover the gaps in psychosocial support needs revealed by the COVID-19 pandemic. Thus, an improvement in pandemic preparedness and a mentally healthier population must be ensured in the future.