IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i10p5258-d555061.html
   My bibliography  Save this article

Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms

Author

Listed:
  • Mariagrazia Di Giuseppe

    (Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy)

  • Gianni Nepa

    (Hospital “G. Mazzini”, ASL 4, 64100 Teramo, Italy)

  • Tracy A. Prout

    (Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, NY 10461, USA)

  • Fabrizio Albertini

    (Hospital “G. Mazzoni”, Asur Marche Area Vasta 5 Ascoli Piceno, 63100 Ascoli Piceno, Italy)

  • Stefano Marcelli

    (Hospital “G. Mazzoni”, Asur Marche Area Vasta 5 Ascoli Piceno, 63100 Ascoli Piceno, Italy
    Faculty of Medicine and Surgery, Marche Polytechnic University, 60131 Ancona, Italy)

  • Graziella Orrù

    (Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy)

  • Ciro Conversano

    (Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy)

Abstract

The experience of working on the frontlines of the COVID-19 healthcare crisis has presented a cumulative traumatic experience that affects healthcare professionals’ well-being. Psychological resources such as resilience and adaptive defense mechanisms are essential in protecting individuals from severe stress and burnout. During September 2020, 233 healthcare workers responded to an online survey to test the impact of demographic variables, COVID-19 exposure, and psychological resources in determining stress and burnout during the COVID-19 emergency. Frontline workers reported higher scores for stress, emotional exhaustion, and depersonalization ( p < 0.001) as compared to colleagues working in units not directly serving patients with COVID-19. Mature defensive functioning was associated with resilience and personal accomplishment ( r = 0.320; p < 0.001), while neurotic and immature defenses were related to perceived stress and burnout. Stress and burnout were predicted by lower age, female gender, greater exposure to COVID-19, lower resilience, and immature defensive functioning among healthcare professionals (R 2 = 463; p < 0.001). Working on the frontlines of the COVID-19 pandemic appears to provoke greater stress and burnout. On the other hand, resilience and adaptive defense mechanisms predicted better adjustment. Future reaction plans should promote effective programs offering support for healthcare workers who provide direct care to patients with COVID-19.

Suggested Citation

  • Mariagrazia Di Giuseppe & Gianni Nepa & Tracy A. Prout & Fabrizio Albertini & Stefano Marcelli & Graziella Orrù & Ciro Conversano, 2021. "Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms," IJERPH, MDPI, vol. 18(10), pages 1-12, May.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:10:p:5258-:d:555061
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/10/5258/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/10/5258/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Vittorio Lenzo & Valentina Bordino & George A Bonanno & Maria C Quattropani, 2020. "Understanding the role of regulatory flexibility and context sensitivity in preventing burnout in a palliative home care team," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-13, May.
    2. Qin Xiang Ng & Kuan Tsee Chee & Michelle Lee Zhi Qing De Deyn & Zenn Chua, 2020. "Staying connected during the COVID-19 pandemic," International Journal of Social Psychiatry, , vol. 66(5), pages 519-520, August.
    3. Kritika Poudel & Pramod Subedi, 2020. "Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal," International Journal of Social Psychiatry, , vol. 66(8), pages 748-755, December.
    4. Graziella Orrù & Francesca Marzetti & Ciro Conversano & Guido Vagheggini & Mario Miccoli & Rebecca Ciacchini & Eugenia Panait & Angelo Gemignani, 2021. "Secondary Traumatic Stress and Burnout in Healthcare Workers during COVID-19 Outbreak," IJERPH, MDPI, vol. 18(1), pages 1-13, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Margaret E. Beier & Mona Cockerham & Sandy Branson & Lisa Boss, 2023. "Aging and Burnout for Nurses in an Acute Care Setting: The First Wave of COVID-19," IJERPH, MDPI, vol. 20(8), pages 1-20, April.
    2. Georgia Libera Finstad & Gabriele Giorgi & Lucrezia Ginevra Lulli & Caterina Pandolfi & Giulia Foti & José M. León-Perez & Francisco J. Cantero-Sánchez & Nicola Mucci, 2021. "Resilience, Coping Strategies and Posttraumatic Growth in the Workplace Following COVID-19: A Narrative Review on the Positive Aspects of Trauma," IJERPH, MDPI, vol. 18(18), pages 1-25, September.
    3. Mariagrazia Di Giuseppe & Graziella Orrù & Angelo Gemignani & Rebecca Ciacchini & Mario Miniati & Ciro Conversano, 2022. "Mindfulness and Defense Mechanisms as Explicit and Implicit Emotion Regulation Strategies against Psychological Distress during Massive Catastrophic Events," IJERPH, MDPI, vol. 19(19), pages 1-10, October.
    4. Marcella Paterlini & Erica Neri & Alessia Nicoli & Federica Genova & Maria Teresa Villani & Sara Santi & Francesca Agostini, 2022. "Emotions, Stress and Coping among Healthcare Workers in a Reproductive Medicine Unit during the First and Second COVID-19 Lockdowns," IJERPH, MDPI, vol. 19(10), pages 1-16, May.
    5. Ladislav Štěpánek & Marie Nakládalová & Magdaléna Janošíková & Romana Ulbrichtová & Viera Švihrová & Henrieta Hudečková & Eliška Sovová & Milan Sova & Jiří Vévoda, 2023. "Prevalence of Burnout in Healthcare Workers of Tertiary-Care Hospitals during the COVID-19 Pandemic: A Cross-Sectional Survey from Two Central European Countries," IJERPH, MDPI, vol. 20(4), pages 1-13, February.
    6. Teodora Safiye & Branimir Vukčević & Medo Gutić & Ardea Milidrag & Draško Dubljanin & Jakša Dubljanin & Branimir Radmanović, 2022. "Resilience, Mentalizing and Burnout Syndrome among Healthcare Workers during the COVID-19 Pandemic in Serbia," IJERPH, MDPI, vol. 19(11), pages 1-13, May.
    7. Davis Cooper-Bribiesca & Dulce María Rascón-Martínez & José Adan Miguel-Puga & María Karen Juárez-Carreón & Luis Alejandro Sánchez-Hurtado & Tania Colin-Martinez & Juan Carlos Anda-Garay & Eliseo Espi, 2023. "Physicians’ Distress Related to Moral Issues and Mental Health In-Between Two Late Waves of COVID-19 Contagions," IJERPH, MDPI, vol. 20(5), pages 1-19, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Juan Sandoval-Reyes & Sandra Idrovo-Carlier & Edison Jair Duque-Oliva, 2021. "Remote Work, Work Stress, and Work–Life during Pandemic Times: A Latin America Situation," IJERPH, MDPI, vol. 18(13), pages 1-12, July.
    2. Carla Miguel & Luísa Castro & José Paulo Marques dos Santos & Carla Serrão & Ivone Duarte, 2021. "Impact of COVID-19 on Medicine Lecturers’ Mental Health and Emergency Remote Teaching Challenges," IJERPH, MDPI, vol. 18(13), pages 1-18, June.
    3. Asma Akter Akhy & Mallika Roy, 2024. "Navigating Livelihood Challenges: A Comprehensive Analysis of the Socioeconomic Landscape in Rural Bangladesh during COVID-19 and post-COVID Era," International Journal of Management Science and Business Administration, Inovatus Services Ltd., vol. 10(2), pages 15-27, January.
    4. Jennifer E. Moreno-Jiménez & Luis Manuel Blanco-Donoso & Evangelia Demerouti & Sylvia Belda Hofheinz & Mario Chico-Fernández & Bernardo Moreno-Jiménez & Eva Garrosa, 2021. "The Role of Healthcare Professionals’ Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach," IJERPH, MDPI, vol. 18(9), pages 1-16, April.
    5. Kumar, Pavan & Singh, S.S. & Pandey, A.K. & Singh, Ram Kumar & Srivastava, Prashant Kumar & Kumar, Manoj & Dubey, Shantanu Kumar & Sah, Uma & Nandan, Rajiv & Singh, Susheel Kumar & Agrawal, Priyanshi , 2021. "Multi-level impacts of the COVID-19 lockdown on agricultural systems in India: The case of Uttar Pradesh," Agricultural Systems, Elsevier, vol. 187(C).
    6. Ward van Zoonen & Anu Sivunen & Kirsimarja Blomqvist & Thomas Olsson & Annina Ropponen & Kaisa Henttonen & Matti Vartiainen, 2021. "Factors Influencing Adjustment to Remote Work: Employees’ Initial Responses to the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(13), pages 1-19, June.
    7. Natalia Sauer & Agnieszka Sałek & Wojciech Szlasa & Tomasz Ciecieląg & Jakub Obara & Sara Gaweł & Dominik Marciniak & Katarzyna Karłowicz-Bodalska, 2022. "The Impact of COVID-19 on the Mental Well-Being of College Students," IJERPH, MDPI, vol. 19(9), pages 1-14, April.
    8. Ieva Norkiene & Lina Jovarauskaite & Monika Kvedaraite & Encarl Uppal & Mandeep Kaur Phull & Heidi Chander & Kathryn Halford & Evaldas Kazlauskas, 2021. "‘Should I Stay, or Should I Go?’ Psychological Distress Predicts Career Change Ideation among Intensive Care Staff in Lithuania and the UK Amid COVID-19 Pandemic," IJERPH, MDPI, vol. 18(5), pages 1-9, March.
    9. Jessica Lee Oliva & Kim Louise Johnston, 2021. "Puppy love in the time of Corona: Dog ownership protects against loneliness for those living alone during the COVID-19 lockdown," International Journal of Social Psychiatry, , vol. 67(3), pages 232-242, May.
    10. Eleonora Gambaro & Carla Gramaglia & Debora Marangon & Manuela Probo & Marco Rudoni & Patrizia Zeppegno, 2023. "Health Workers’ Burnout and COVID-19 Pandemic: 1-Year after—Results from a Repeated Cross-Sectional Survey," IJERPH, MDPI, vol. 20(12), pages 1-22, June.
    11. Shimaa A. Elghazally & Atef F. Alkarn & Hussein Elkhayat & Ahmed K. Ibrahim & Mariam Roshdy Elkhayat, 2021. "Burnout Impact of COVID-19 Pandemic on Health-Care Professionals at Assiut University Hospitals, 2020," IJERPH, MDPI, vol. 18(10), pages 1-12, May.
    12. Lena Serafin & Aleksandra Kusiak & Bożena Czarkowska-Pączek, 2022. "The COVID-19 Pandemic Increased Burnout and Bullying among Newly Graduated Nurses but Did Not Impact the Relationship between Burnout and Bullying and Self-Labelled Subjective Feeling of Being Bullied," IJERPH, MDPI, vol. 19(3), pages 1-12, February.
    13. Adhikari, Jagannath & Timsina, Jagadish & Khadka, Sarba Raj & Ghale, Yamuna & Ojha, Hemant, 2021. "COVID-19 impacts on agriculture and food systems in Nepal: Implications for SDGs," Agricultural Systems, Elsevier, vol. 186(C).
    14. S Vivek Anand & Yao Kang Shuy & Poay Sian Sabrina Lee & Eng Sing Lee, 2021. "One Year on: An Overview of Singapore’s Response to COVID-19—What We Did, How We Fared, How We Can Move Forward," IJERPH, MDPI, vol. 18(17), pages 1-33, August.
    15. Dillon, Mary & Vauhkonen, Ilmari & Arvas, Mikko & Ihalainen, Jarkko & Vilkkumaa, Eeva & Oliveira, Fabricio, 2023. "Supporting platelet inventory management decisions: What is the effect of extending platelets’ shelf life?," European Journal of Operational Research, Elsevier, vol. 310(2), pages 640-654.
    16. Romana Ulbrichtova & Viera Svihrova & Maria Tatarkova & Jan Svihra & Martin Novak & Henrieta Hudeckova, 2022. "Prevalence of Burnout Syndrome in COVID-19 and Non-COVID-19 Units in University Hospital: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(19), pages 1-9, October.
    17. Chenyu Shangguan & Lihui Zhang & Yali Wang & Wei Wang & Meixian Shan & Feng Liu, 2022. "Expressive Flexibility and Mental Health: The Mediating Role of Social Support and Gender Differences," IJERPH, MDPI, vol. 19(1), pages 1-14, January.
    18. Ilaria Buonomo & Paolo Emilio Santoro & Paula Benevene & Ivan Borrelli & Giacomo Angelini & Caterina Fiorilli & Maria Rosaria Gualano & Umberto Moscato, 2022. "Buffering the Effects of Burnout on Healthcare Professionals’ Health—The Mediating Role of Compassionate Relationships at Work in the COVID Era," IJERPH, MDPI, vol. 19(15), pages 1-15, July.
    19. Souad Hassanie & Olusegun A. Olugbade & Georgiana Karadas & Özlem Altun, 2022. "The Impact of Workload on Workers’ Traumatic Stress and Mental Health Mediated by Career Adaptability during COVID-19," Sustainability, MDPI, vol. 14(19), pages 1-18, September.
    20. Lorenza Lia & Eleonora Ricci & Corrado Colaprico & Eleonora Di Legge & Augusto Faticoni & Lorenzo Maria Donini & Giuseppe La Torre, 2022. "Assessment of the Impact of COVID-19 Lockdown on the Nutritional Status and Lipid Profile of Employees in a Teaching Hospital in Rome: A Retrospective Cohort Study," IJERPH, MDPI, vol. 19(8), pages 1-12, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:10:p:5258-:d:555061. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.