Stress and quality of life of intensive care nurses during the COVID-19 pandemic: Self-efficacy and resilience as resources.

BACKGROUND: Health care workers employed in the COVID-19 emergency are at a high risk of stress. AIMS AND OBJECTIVES: To explore the mediating roles of self-efficacy and resilience between stress and both physical and mental quality-of-life components in intensive care nurses during the COVID-19 pandemic. DESIGN: Cross-sectional survey design. METHODS: The stress subscale (depression, anxiety, and stress scale in Spanish Scale, DASS-21), the summary components (physical and mental) of health-related quality of life (SF-36), the general self-efficacy scale (GSES), and the resilience scale (RS-14) were administered in 308 intensive care nurses. Serial multiple mediator models were used. RESULTS: There was a significant indirect effect of levels of perceived stress on both physical and mental health components through self-efficacy and resilience. Specifically, greater perception of self-efficacy was associated with a lower perception of stress and greater resilience, while higher resilience was associated with greater physical and mental health (B = -0.03; SE = 0.02; 95% confidence interval [CI] = [-0.07, -0.01]; B = -0.03, SE = 0.01, 95% CI = [-0.07, -0.01], respectively). It was observed that self-efficacy alone also mediates the relationship of the perception of stress on the components of physical and mental health (B = -0.07; SE = 0.05; 95% CI = [-0.18, -0.03]; B = -0.09; SE = 0.04; 95% CI = [-0.17, -0.24], respectively). However, resilience alone was not a significant mediator of these associations. CONCLUSIONS: It can be concluded that stress is linked to the physical and mental health components related to quality of life through self-efficacy and resilience. RELEVANCE TO CLINICAL PRACTICE: These psychological resources would allow the nursing staff to maintain a good quality of life despite high levels of stress. These findings have implications for future research in terms of both model testing and clinical application.

Resilience and anxiety among intensive care unit professionals during the COVID-19 pandemic.

BACKGROUND: The situation of the COVID-19 global pandemic has generated an unprecedented state of emergency worldwide that has had a psychological impact on health care workers working in the ICU and this has created the need to implement different psychological strategies. AIM: This study explores (a) the prevalence of symptoms associated with generalized anxiety disorder (GAD), (b) the relationship between GAD symptoms and resilience skills, and (c) which of the resilience skills were associated with a probable GAD among the ICU professionals during the COVID-19 pandemic. STUDY DESIGN: Cross-sectional survey design. METHODS: We explored anxiety and resilience in 448 ICU health care workers using an online survey. RESULTS: The participants showed high resilience levels and more than half of them presented symptoms consistent with a possible diagnosis of GAD. The GAD symptoms were more prevalent among women, nursing assistants, interns, staff who worked on rotation and health care workers who had to attend to more than 20 COVID patients. Significant negative correlations between resilience skills and GAD symptoms were found. The multiple regression analysis showed that resilience skills contribute to 14.4% of the variance for GAD symptoms. The binary logistic regression showed that the only skill that had a significant and negative predictive effect was "I usually take things in my stride" (OR = 0.774, 95% CI 0.67, 0.88; P = .000). This ability was the differentiating skill between professionals who equal or exceed the cut-off point established for the diagnosis of a probable GAD regarding those who do not. CONCLUSION: ICU professionals developed symptoms consistent with a possible diagnosis of GAD due to their exposure to extremely stressful circumstances. However, resilience skills acted as a protective factor. RELEVANCE TO CLINICAL PRACTICE: The importance of incorporating programmes that mitigate these psychological effects and to promote adaptive coping styles during pandemics has become a need after what ICU professionals have gone through.