‘Caring for the helpers’: factors associated with professional quality of life among Hong Kong nurses during the fifth wave of the COVID-19 pandemic

Abstract

Background: Western studies have found that nurses are likely to experience both positive and negative emotions in their job, as a helping profession [professional quality of life (ProQoL)] during the coronavirus disease 2019 (COVID-19) pandemic, and that psychosocial and work-related variables (e.g. pandemic-related stressors, interpersonal and organizational support, coping strategies) are associated with such outcomes. However, relevant studies on nurses in the Asian context are limited. Objective: This study examined the psychosocial correlates of three indicators of ProQoL, i.e. compassion satisfaction, secondary traumatic stress (STS), and burnout, among nurses during the fifth wave of the COVID-19 pandemic in Hong Kong. Method: Nurses in Hong Kong ( N = 220) working in hospitals and community settings during the COVID-19 pandemic were recruited between 24 May and 27 June 2022 through nursing associations to complete an online survey measuring the aforementioned psychosocial variables. Results: Hierarchical regression results found that stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer ProQoL (i.e. lower compassion satisfaction; higher STS and burnout) ( β from 0.16, p > .05, to 0.44, p > .001). In addition, COVID-19-related worries/uncertainties and emotional processing were associated with higher STS ( β from 0.21 to 0.23, p < .01), whereas insufficient organizational support for communication with the healthcare system was associated with higher burnout ( β = 0.12, p < .05). Conclusions: Our findings identified the important psychosocial determinants in ProQoL among nurses in Hong Kong and provide recommendations for services supporting the mental health of these nurses. Providing workshops for nurses to train their skills in coping with COVID-19-related uncertainties, worries, and stressors from the clinical work environment, in using adaptive coping strategies (e.g. positive reframing), and in soliciting emotional support from important others could facilitate their ProQoL. Moreover, the provision of organizational support through timely and transparent communication with the healthcare system could reduce STS in nurses.

Did the Burnout Levels of the Nurses Affect Their Professional Commitment During the Covid -19 Pandemic Process?

“…Our participants had high burnout levels as reported in other studies [4,6,9,11,12,31,35,[48][49][50][51][52]. Research shows that nurses suffer from anxiety, depression, hopelessness, post-traumatic stress disorder, insomnia, fear of COVID-19, and suicidal thoughts [10,[53][54][55][56][57][58][59][60][61][62][63][64].…”

On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021–2023

“…Stressors confronting healthcare workers extend into their personal lives, including fear and guilt regarding the safety of loved ones (Hegarty et al, 2022 ; Laurent et al, 2022 ; Plouffe et al, 2021 ; Qureshi et al, 2022 ; Wilson et al, 2022 ; Yeung et al, 2023 ), isolation in lengthy periods of self-quarantine (Fino et al, 2021 ), and stigma and violence from community members (Assefa et al, 2021 ; McCall et al, 2023 ). Despite preventive recommendations from the World Health Organization as early as March 2020, front-line workers caring for patients infected with the coronavirus experienced multiple potentially traumatic stressors including exposure to the virus without consistent or sufficient access to adequate personal protective equipment and personal viral testing, and feeling entrapped in life threatening conditions by external coercion and a sense of obligation to do whatever was necessary to save the lives or ameliorate the suffering of their patients while not abandoning or betraying the trust of co-workers (D'Alessandro-Lowe et al, 2023 ; McGlinchey et al, 2021 ).…”

“…In addition, as described in a paper in this Special Issue, front-line healthcare workers were faced with the extreme physical and emotional suffering of patients and the distress and grief of patients’ family members when separated from or only able to minimally comfort or protect their dying loved-ones, and traumatic losses and deaths of co-workers (Berkhout et al, 2022 ), in addition to the fear and distress experienced by their families (Tekin et al, 2022 ). As a result, workers were at risk for severe secondary traumatic stress, vicarious trauma, compassion fatigue, and traumatic grief (Adeyemo et al, 2022 ; Hegarty et al, 2022 ; Maftei & Holman, 2021 ; Plouffe et al, 2021 ; Yeung et al, 2023 ; Zerach & Levi-Belz, 2021 ).…”

“…As early as three weeks after the initial pandemic lockdown, almost half of a self-selected sample of physicians working on both COVID-specific and general medical units who were surveyed in Romania reported having experienced potentially morally injurious events (Maftei & Holman, 2021 ). A year later, a survey of Israeli health and social care workers identified sub-groups who reported either very high levels of both personal moral injury and institutional betrayal (one in five of the respondents) or institutional betrayal (one in three of the respondents) – with these workers also reporting high levels of anxiety, guilt, and PTSD symptoms and self-criticism and low levels of self-compassion (Yeung et al, 2023 ; Zerach & Levi-Belz, 2021 )…”

“… 38. Yeung et al ( 2023 ). ‘Caring for the helpers': factors associated with professional quality of life among Hong Kong nurses during the fifth wave of the COVID-19 pandemic A survey of nurses in Hong Kong two years into the COVID-19 pandemic found that stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with lower compassion satisfaction; higher secondary traumatic stress (STS) and burnout.…”