Factors Associated With Post-traumatic Growth Among Healthcare Workers Who Experienced the Outbreak of MERS Virus in South Korea: A Mixed-Method Study

Abstract

Background: Infectious disease outbreaks such as COVID-19 and MERS pose a major threat to healthcare workers' (HCWs) physical and mental health. Studies exploring the positive changes gained from adapting to traumatic events, known as post-traumatic growth (PTG), have attracted much attention. However, it is unclear which factors or experiences lead to PTG among HCWs. The purpose of this mixed-method study was to investigate factors associated with PTG among HCWs who experienced the MERS outbreak in South Korea, and fully describe their experience of developing PTG.Methods: Quantitative data from 78 participants were collected using psychometric tools for Psychological distress, Resilience, and Support for coping, and Post-traumatic growth. Qualitative interviews were conducted with seven nurses. Data were analyzed using the qualitative content analysis method according to the sub-themes of resilience, which was the main factor associated with PTG.Results: We found resilience to have a significant impact on PTG (ß =0.486, p = 0.001). Thus the qualitative interviews were analyzed using the core concepts of resilience. Qualitative interviews with nurses illustrated how participants experienced the development of resilience in terms of its sub-factors: hardiness, persistence, optimism, and support.Conclusion: HCWs who endured the MERS outbreak showed high levels of PTG, and the analysis of the interview data provided a fuller understanding on the experience of remaining resilient and developing PTG. These results provide practical and pragmatic information helpful for developing intervention strategies and protocols that can help HCWs transform adversity into growth and development.

The Impact of Coping Skills in Post-traumatic Growth of Healthcare Providers: When Mental Health Is Deteriorating Due to COVID-19 Pandemic

“…Nevertheless, the results showed statistical differences across all PTG subscales except relation to others when comparing participants who experienced COVID-19 infection as opposed to those who did not, as shown in Table 2. In line with other studies (Lau et al, 2006;Bridgland et al, 2021;Huecker et al, 2021;Hyun et al, 2021); COVID-19 as severe acute respiratory syndrome appears to have been experienced as a harmful and traumatic stressful event by healthcare providers, eliciting post-traumatic stress responses. However, overcoming the trauma seems to lead them to constructive outcomes, underlining that PTG can occur after infectious diseases.…”

Resilience, Coping Strategies and Posttraumatic Growth in the Workplace Following COVID-19: A Narrative Review on the Positive Aspects of Trauma

“…Most of the retrieved articles considered healthcare professionals as a sample, as the literature has extensively analyzed the impact of the sanitary emergency on these workers. Despite the negative mental effects, dealing with the COVID-19 pandemic has forced workers to develop resilience strategies, as during other outbreaks [ 17 ]. As already mentioned, resilience is generally defined as the ability to adapt and maintain adequate functioning despite adverse events and can be conceptualized as a trait, outcome or process [ 20 , 21 , 22 ].…”

“…The post-disaster mental health literature and trauma research have actually shown that adverse effects on psychological health do not always occur and that traumatic experiences can even lead to positive emotional states and growth [ 11 , 12 , 13 , 14 , 15 , 16 ]. Even after experiencing terrible events, the evidence suggests that people may experience some positive aspects, such as in the case of bereavement, rape, cancer, terrorism, natural disasters and even epidemics, as in the case of the MERS outbreak [ 14 , 15 , 16 , 17 ]. The ability to adapt to unpleasant situations and to recover quickly from trauma has been studied through the constructs of resilience, posttraumatic growth (PTG) and coping strategies [ 11 , 12 , 14 , 18 , 19 ].…”

“…For example, according to Tedeschi and Calhoun [ 14 ] the adversity experienced is greater in the case of PTG, which involves a qualitative transformation in functioning that exceeds the ability to resist traumatic circumstances. Nevertheless, some studies show a significant relationship between resilience and PTG [ 17 , 23 ]. Eventually, another factor that strongly affects the psychological outcomes of disaster-exposed employees refers to coping, which can be defined as the set of adaptive or maladaptive cognitive/behavioral strategies used to deal with adverse and stressful events [ 11 , 24 ].…”

“…In addition, growth also occurs in cases of vicarious or secondary trauma as for professionals who work closely with victims of adverse events (e.g., health personnel, social workers) [ 29 ]. Regarding the specific context of bio-disasters, a recent study analyzed PTG in a sample of healthcare workers (HCWs) involved in the 2015 MERS epidemic in South Korea [ 17 ]. The results showed that resilience was the only significant predictor of PTG while the interviews showed that resilience was experienced in terms of the hardiness, persistence, optimism and support sub factors.…”