Coping strategies at the frontline of care: Comparisons between Covid‐19 and non‐Covid‐19 units' nurses and the role of moderator variables

Abstract

Introduction Relatively few studies focused on the coping strategies adopted by the healthcare workers during the second phase of the pandemic. The present study compared the coping strategies between Italian nurses working in Covid‐19 and in other units and it explored whether socio‐demographic and work‐related variables moderate the relation between the type of unit and coping strategies. Methods A web‐based questionnaire that included sociodemographic and work‐related questions and the Coping Orientation to Problem Experienced—New Italian Version‐25 item was administered. Moderation effects between variables and coping strategies were analyzed using generalized linear models. Results 253 nurses participated. Nurses who worked in a Covid‐19 unit had significantly lower scores on Avoidance Strategies subscale and higher scores on Positive Attitude and Social Support subscales than nurses working in other units. Discussion Gender differences emerged only on the social support coping dimension, with women being more likely to adopt social support than men. No association between the type of unit and the other coping strategies was found. Conclusion Nurses working in Covid‐19 units showed better coping strategies than their colleagues: this suggests that support interventions aimed to promote coping strategies should be offered also to Covid‐19‐free units' nurses.

Occupational Stress and Burnout among Intensive Care Unit Nurses during the Pandemic: A Prospective Longitudinal Study of Nurses in COVID and non-COVID Units

“…A combination of increased emotional exhaustion, perceived stress, anxiety, chronic fatigue, and reduced personal achievement and inter-shift recovery suggest higher level of occupational stress and burnout among nurses working in COVID units than nurses in non-COVID units. This is in line with prior work which demonstrated that the uncertain treatment outcomes of COVID patients and the fear of getting infected induce stress and burnout among nurses working with COVID patients [19].…”

“…For example, Yoon et al [16] documented the increased stress among healthcare providers due to the 'spillover' or the indirect effects of COVID-19 on the vulnerable non-COVID patients resulting in treatment disparities towards chronically ill and mental health patients. Furthermore, studies have supported that nurses who cared for non-COVID patients experienced higher levels of anxiety, PTSD symptoms, neuroticism and poor coping strategies compared to the COVID unit nurses [17][18][19]. Similarly, Doo et al [20] found that the nurses in COVID units working with COVID-suspected patients suffered significantly higher anxiety, depression, and low resilience than nurses working with COVID-positive and non-COVID patients due to the increased uncertainty of infection risk and insufficiently protective equipment and environment.…”

“…Despite this evidence suggesting the globally negative impact of the pandemic on nurses, more rigorous unit-level comparison is warranted. Most of these studies employed online surveys or questionnaires [17][18][19][20]. While self-reported measures allow timely and remote data collection to document the psychological impact of the pandemic on the nursing profession [23], such methods are inherently prone to selection biases (nonresponse bias and self-selection bias) [24] and recall bias [25].…”

“…To our knowledge, differences in occupational stress between nurses working in COVID and non-COVID ICUs has not been investigated using objective methods such as those using physiological data. Furthermore, most of these studies are not ICU-specific [16][17][18][19]. In addition, recent reviews of the literature on the impact of the pandemic on nurses' occupational stress and related factors [14,26] show that most studies were conducted in the southern parts of Asia and Europe, and hence some variance may exist across settings and the results may not be generalizable.…”

Moral distress, emotional impact and coping in intensive care unit staff during the outbreak of COVID-19

“… Romero-García et al (2022) found that avoidance-oriented coping styles, such as self-distraction, substance use, and self-blame, predicted anxiety and depression, but the choice of coping style has been associated with demographic characteristics. Some studies examining the coping styles of healthcare workers during the COVID-19 pandemic have found that the choice of an avoidance-oriented coping style is associated with age, education, marital status, and years of service as a nurse ( Kowalczuk et al, 2022 , Righi et al, 2022 ). In other words, coping style might mediate the effect of demographic characteristics on anxiety and depression.…”