Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic
Abstract
:1. Introduction
1.1. Research Questions and Hypotheses
1.1.1. Question 1. What Is the Association between Post-Traumatic Growth and Sociodemographic and Professional Characteristics?
1.1.2. Question 2. How Do Exposure to, Risk from, and Anxiety about the COVID-19 Affect Post-Traumatic Growth?
1.1.3. Question 3. How Does Connecting with Others Affect Post-Traumatic Growth?
1.1.4. Question 4. How Does Self-Care Affect Post-Traumatic Growth?
1.1.5. Question 5. How Does Professional Development at Work Affect Post-Traumatic Growth?
1.1.6. Question 6. How Does Support at Work Affect Post-Traumatic Growth?
1.1.7. Question 7. How Does Psychological Resilience Affect Post-Traumatic Growth?
1.1.8. Question 8. How Do Depression and Anxiety Affect Post-Traumatic Growth?
2. Materials and Methods
2.1. Design
2.2. Ethics Approval and Consent to Participate
2.3. Setting
2.4. Inclusion Criteria
2.5. Procedure
2.6. Measures
- Demographic and professional characteristics, including gender identity, age, ethnicity, British citizenship, healthcare sector, work location, profession, and NHS Trusts, were collected using a standardised pro forma developed by the research team.
- Personal, environmental and organisational risk/protective factors were derived from available academic literature and were collected using a standardised pro forma developed by the research team. These included the following items rated on a binary yes/no scale: self, family or friends becoming seriously ill or hospitalised with COVID-19; frequent workplace exposure to COVID-19; serious illness of local or wider colleagues from COVID-19; self or family classified as clinically extremely vulnerable. A measure of anxiety about the personal and professional effects of COVID-19 was derived from mean scores on the following items, rated on a Likert scale from Not at all (1), A little bit (2), Somewhat (3) to A lot (4): Worry about yourself or loved ones becoming seriously ill or dying from COVID-19; Worry about colleagues becoming seriously ill or dying from COVID-19; Worry about service-users becoming seriously ill or dying from COVID-19; Worry about your service-users becoming seriously ill or dying from other serious mental or physical health conditions; Feeling less able to deliver adequate and safe mental health care; Feeling less able to deliver adequate and safe physical health care (α = 0.78). These items were based on contemporary academic and professional body publications outlining the specific concerns of healthcare and mental healthcare workers [19,20,21,22,23]. At the time, no validated scale to assess these concerns existed. The following items related to potential protective factors, measured on the same 4-point Likert scale, were also assessed as individual predictors: Time connecting with friends and family; Time connecting with colleagues; Time relaxing or doing hobbies; Time away from work; Time away from thinking about work; Time spent exercising; Time spent on positive self-reflection e.g., mindfulness, meditation, self-help; Adequate and restful sleep; Developed new knowledge or skills in delivering mental health care; Developed new knowledge or skills in delivering physical health care; Access to adequate infection control measures; Access to adequate personal protective equipment; Felt supported by my immediate team; Felt supported by senior management; Felt supported by the United Kingdom government; Felt supported by the people of the UK.
- Psychological resilience was measured using the Connor–Davidson Resilience Scale—10 item Version [55], (α = 0.88).
- Depression was measured using the Patient Health Questionnaire—9 item version (PHQ-9) [56], (α = 0.88).
- Anxiety was measured using the Generalised Anxiety Disorder Assessment—7 item version (GAD-7) [57], (α = 0.92).
- Post-traumatic growth was measured using the 10 item Post-traumatic Growth Inventory—Short Version [58], (α = 0.91).
2.7. Analysis
3. Results
3.1. Response Rates
3.2. Participant Characteristics
3.3. Individual Predictors of Post-Traumatic Growth
3.3.1. Question 1. What Is the Association between Post-Traumatic Growth and Sociodemographic and Professional Characteristics?
3.3.2. Question 2. How do Exposure to, Risk from, and Anxiety about the COVID-19 Pandemic Affect Post-Traumatic Growth?
3.3.3. Question 3. How Does Connecting with Others Affect Post-Traumatic Growth?
3.3.4. Question 4. How Does Self-Care Affect Post-Traumatic Growth?
3.3.5. Question 5. How Does Professional Development at Work Affect Post-Traumatic Growth?
3.3.6. Question 6. How Does Support at Work Affect Post-Traumatic Growth?
3.3.7. Question 7. How Does Psychological Resilience Affect Post-Traumatic Growth?
3.3.8. Question 8. How Do Depression and Anxiety Affect Post-Traumatic Growth?
3.4. Combination of Predictors Best Explaining Post-Traumatic Growth
4. Discussion
4.1. Summary of Main Findings
4.2. Interpretation of Findings and Implications for Organisational Management
4.2.1. Positive Self-Reflection
4.2.2. Ethnicity
4.2.3. Professional Development
4.2.4. Social Support
4.2.5. Anxiety about the Personal and Work-Related Consequences of COVID-19
4.2.6. Psychological Resilience and Mental Health
4.2.7. Strengths and Limitations
4.2.8. Implications for Further Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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B | 95% CI | Unadjusted p | Adjusted p | R2 | |
---|---|---|---|---|---|
Age | 0.04 | −0.02 to 0.11 | 0.19 | 1.00 | <0.001 |
Male gender identity | −2.19 | −4.2 to −0.18 | 0.03 | 0.51 | 0.01 |
Ethnicity | 0.09 | ||||
Vs. White: | |||||
Asian | 10.8 | 7.6 to 14.1 | <0.0001 | <0.0001 | |
Black | 12.3 | 8.4 to 16.3 | <0.0001 | <0.0001 | |
Mixed | 2.27 | −1.22 to 5.74 | 0.20 | 1.00 | |
British Citizenship | 0.01 | ||||
Not a British citizen | 2.34 | −3.95 to 5.07 | 0.09 | 1.00 | |
Healthcare sector | 0.01 | ||||
Vs. mental health: | |||||
Community physical health | 1.29 | −1.49 to 4.08 | 0.36 | 1.00 | |
Primary care | 5.76 | 2.06 to 9.46 | <0.001 | <0.0001 | |
Location of work | 0.02 | ||||
Vs. Administration offices | |||||
Community only | −3.59 | −5.25 to −1.74 | <0.0001 | <0.0001 | |
Inpatient (or mixed) | −1.60 | −3.76 to 0.56 | 0.15 | 1.00 | |
Profession | 0.04 | ||||
Vs. non-clinical | |||||
Any clinical | −4.35 | −6.12 to −2.60 | <0.0001 | <0.0001 | |
AHPs & social workers | −4.49 | −6.94 to −2.05 | <0.0001 | <0.0001 | |
HCAs & support workers | −2.48 | −6.21 to 1.25 | 0.19 | 1.00 | |
Medical | −1.49 | −5.05 to 2.07 | 0.41 | 1.00 | |
Nursing & midwifery | −4.04 | −6.12 to −1.96 | <0.0001 | <0.0001 | |
Psychology & psychotherapy | −5.98 | −8.19 to −3.77 | <0.0001 | <0.0001 | |
NHS Trust | 0.02 | ||||
Vs. Trust 1 | |||||
Trust 2 | −3.04 | −4.96 to −1.12 | 0.002 | <0.0001 | |
Trust 3 | −3.47 | −5.55 to −1.38 | 0.001 | <0.001 | |
Trust 4 | −2.53 | −4.86 to −1.20 | 0.033 | 0.51 | |
Self, family or friends becoming seriously ill or hospitalised with COVID-19 | 3.39 | 1.36 to 5.41 | <0.0001 | <0.0001 | 0.01 |
Frequent workplace exposure to COVID-19 or serious illness of local or wider colleagues from COVID-19 | 1.22 | −2.4 to 2.69 | 0.10 | 1.00 | 0.01 |
Self or family CEV | 3.61 | 1.20 to 6.01 | <0.0001 | <0.0001 | 0.01 |
Extent of anxiety about the personal and work-related consequences of COVID-19 | 3.29 | 1.96 to 4.63 | <0.0001 | <0.0001 | 0.03 |
Time spent connecting with colleagues | 2.74 | 1.89 to 3.58 | <0.0001 | <0.0001 | 0.05 |
Time spent connecting with friends and family | 2.98 | 2.00 to 3.77 | <0.0001 | <0.0001 | 0.05 |
Time spent relaxing or doing hobbies | 1.97 | 1.13 to 2.80 | <0.0001 | <0.0001 | 0.03 |
Time spent away from work | 0.96 | 0.05 to 1.87 | 0.04 | 0.64 | 0.01 |
Time spent not thinking about work | 0.01 | −0.85 to 0.87 | 0.99 | 1.00 | 0.00 |
Time spent exercising | 2.06 | 1.24 to 2.87 | <0.0001 | <0.0001 | 0.03 |
Time spent on positive self-reflection | 3.61 | 2.86 to 4.37 | <0.0001 | <0.0001 | 0.09 |
Adequate and restful sleep | 0.57 | −0.29 to 1.43 | 0.19 | 1.00 | 0.00 |
Developed new knowledge or skills in delivering mental health care | 2.53 | 1.80 to 3.26 | <0.0001 | <0.0001 | 0.05 |
Developed new knowledge or skills in delivering physical health care | 3.70 | 2.90 to 4.49 | <0.0001 | <0.0001 | 0.09 |
Support at work | |||||
Had access to adequate infection control measures | 0.27 | −0.51 to 1.04 | 0.50 | 1.00 | 0.00 |
Had access to adequate personal protective equipment | 0.00 | −0.73 to 0.73 | 0.99 | 1.00 | 0.00 |
Felt supported by my immediate team | 1.72 | 0.83 to 2.62 | <0.0001 | <0.0001 | 0.02 |
Felt supported by senior management | 1.76 | 1.02 to 2.52 | <0.0001 | <0.0001 | 0.03 |
Felt supported by the UK government | 2.23 | 1.37 to 3.08 | <0.0001 | <0.0001 | 0.03 |
Felt supported by the people of the UK | 2.13 | 1.26 to 3.00 | <0.0001 | <0.0001 | 0.03 |
Psychological resilience (CDRS-10) | 0.23 | −0.79 to 1.25 | 0.66 | 1.00 | 0.00 |
Depression (PHQ-9) | −0.87 | −0.24 to 0.06 | 0.25 | 1.00 | 0.00 |
Anxiety (GAD-7) | 0.09 | −0.07 to 0.24 | 0.27 | 1.00 | 0.00 |
Model: Total Adjusted R2 = 0.32 | B | 95% CI | p |
---|---|---|---|
Time spent on positiveself-reflection | 2.17 | 1.40 to 2.94 | <0.0001 |
Ethnicity | |||
Vs. White: | |||
Asian | 7.03 | 3.78 to 10.27 | <0.0001 |
Black | 11.21 | 7.82 to 14.60 | <0.0001 |
Mixed | 2.85 | −0.65 to 6.34 | 0.11 |
Developed new skills in physical healthcare | 2.13 | 1.23 to 3.04 | <0.0001 |
Developed new skills in mental healthcare | 1.05 | 0.22 to 1.88 | 0.013 |
Time spent connecting with friends and family | 1.89 | 1.10 to 2.67 | <0.0001 |
Felt supported by senior management | 0.89 | 0.20 to 1.58 | 0.012 |
Felt supported by the people of the UK | 1.46 | 0.70 to 2.21 | <0.0001 |
Profession | |||
Vs. non-clinical | |||
AHPs & social workers | −5.60 | −7.77 to −3.42 | <0.0001 |
HCAs & support workers | −3.56 | −6.69 to −0.44 | 0.026 |
Medical | −4.92 | −8.40 to −1.44 | 0.006 |
Nursing & midwifery | −5.24 | −7.22 to −3.26 | 0.0001 |
Psychology & psychotherapy | −6.52 | −8.67 to −4.83 | <0.0001 |
Healthcare sector | |||
Vs. primary care: | |||
Community physical health | −4.16 | −8.21 to −0.11 | 0.044 |
Mental health | −3.68 | −7.06 to −0.31 | 0.032 |
Extent of anxiety about the personal and work-related consequences of COVID-19 | 2.10 | 0.88 to 3.32 | 0.001 |
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Barnicot, K.; McCabe, R.; Bogosian, A.; Papadopoulos, R.; Crawford, M.; Aitken, P.; Christensen, T.; Wilson, J.; Teague, B.; Rana, R.; et al. Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2023, 20, 3539. https://doi.org/10.3390/ijerph20043539
Barnicot K, McCabe R, Bogosian A, Papadopoulos R, Crawford M, Aitken P, Christensen T, Wilson J, Teague B, Rana R, et al. Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2023; 20(4):3539. https://doi.org/10.3390/ijerph20043539
Chicago/Turabian StyleBarnicot, Kirsten, Rose McCabe, Angeliki Bogosian, Renos Papadopoulos, Mike Crawford, Peter Aitken, Tanja Christensen, Jonathan Wilson, Bonnie Teague, Ravi Rana, and et al. 2023. "Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 20, no. 4: 3539. https://doi.org/10.3390/ijerph20043539