Post-traumatic stress symptom trajectories following exposure to population-level trauma: findings from the COVID-19 Healthcare Staff Wellbeing Survey

BACKGROUND: The COVID-19 pandemic has been described as a prolonged societal trauma providing new understanding of long-term post-traumatic stress reactions, both generally and in specific at-risk populations. AIMS: The present study examined the longitudinal course of post-traumatic stress disorder (PTSD) symptoms within one of the most high-profile risk groups (i.e. healthcare staff). METHOD: The sample comprised 439 healthcare staff who completed the Northern Ireland longitudinal COVID-19 Staff Wellbeing Survey on a minimum of 3 out of 4 distribution time points. The survey was administered repeatedly over 4 years, spanning both peri- and post-pandemic periods (2020-2023), and contained the Impact of Event Scale-Revised, as well as bespoke items on COVID-19, demographics, occupational issues and support factors. RESULTS: Three distinct classes emerged from a three-class, latent class growth analysis model. A 'resilient' group (74%) displayed symptoms that remained below cut-offs for clinically significant moderate-severe post-traumatic stress throughout the pandemic, whereas a 'recovering' group (23%) exhibited moderate-severe symptoms during the pandemic, which then decreased to subthreshold levels post-pandemic. A key at-risk group was the 'chronic' class (4%), which had moderate-severe post-traumatic stress symptoms peri-pandemic that continued to increase post-pandemic. Significant predictors of the 'recovering' and 'chronic' classes included perception of poor communication within the healthcare organisation; increased exposure to COVID-19 outside their work; and increased personal health risk factors for COVID-19. CONCLUSIONS: Post-pandemic PTSD monitoring and support for healthcare staff may be warranted alongside the development of internal communication strategies within healthcare systems to protect staff and services going forward.