Key result
Higher New York City COVID-19 case counts were associated with increased longitudinal stress (P=0.008), while high baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<0.001) in health care workers.
Why the study?
There is a need to identify which health care workers are at increased risk of psychological effects during the COVID-19 pandemic and to evaluate both perceived and physiological stress markers such as heart rate variability.
Observational (n=361)
Yes
p-value: p=<0.001
High resilience, emotional support, and quality of life are associated with reduced longitudinal perceived stress and distinct physiological stress profiles (HRV) in healthcare workers during the COVID-19 pandemic.
BACKGROUND: The COVID-19 pandemic has resulted in a high degree of psychological distress among health care workers (HCWs). There is a need to characterize which HCWs are at an increased risk of developing psychological effects from the pandemic. Given the differences in the response of individuals to stress, an analysis of both the perceived and physiological consequences of stressors can provide a comprehensive evaluation of its impact. OBJECTIVE: This study aimed to determine characteristics associated with longitudinal perceived stress in HCWs and to assess whether changes in heart rate variability (HRV), a marker of autonomic nervous system function, are associated with features protective against longitudinal stress. METHODS: HCWs across 7 hospitals in New York City, NY, were prospectively followed in an ongoing observational digital study using the custom Warrior Watch Study app. Participants wore an Apple Watch for the duration of the study to measure HRV throughout the follow-up period. Surveys measuring perceived stress, resilience, emotional support, quality of life, and optimism were collected at baseline and longitudinally. RESULTS: A total of 361 participants (mean age 36.8, SD 10.1 years; female: n=246, 69.3%) were enrolled. Multivariate analysis found New York City's COVID-19 case count to be associated with increased longitudinal stress (P=.008). Baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<.001). A significant reduction in stress during the 4-week period after COVID-19 diagnosis was observed in the highest tertial of emotional support (P=.03) and resilience (P=.006). Participants in the highest tertial of baseline emotional support and resilience had a significantly different circadian pattern of longitudinally collected HRV compared to subjects in the low or medium tertial. CONCLUSIONS: High resilience, emotional support, and quality of life place HCWs at reduced risk of longitudinal perceived stress and have a distinct physiological stress profile. Our findings support the use of these characteristics to identify HCWs at risk of the psychological and physiological stress effects of the pandemic.
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Hirten et al. (2021) conducted an observational in Psychological and physiological stress during the COVID-19 pandemic (n=361). Environmental and psychological factors (COVID-19 case count, emotional support, resilience, quality of life) vs. Low or medium levels of protective psychological factors was evaluated on Longitudinal perceived stress (p=<0.001). Higher New York City COVID-19 case counts were associated with increased longitudinal stress (P=0.008), while high baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<0.001) in health care workers.
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