Trauma exposure and depression among frontline health professionals during COVID-19 outbreak in China: the role of intrusive rumination and organizational silence.

BACKGROUND: Healthcare professionals bared particularly high risk and stress during the COVID-19 outbreak. Previous studies have demonstrated that healthcare professionals exposed to COVID-19 incurred various affective disorders including depressive symptoms, anxiety, insomnia, and distress. However, the mechanism underlying the relationship between trauma exposure and depressive symptom among frontline hospital staff has yet to be investigated. This study aims to assess the prevalence of depressive symptoms among frontline healthcare professionals in Shenzhen, China, and elucidate the complex relationship among trauma exposure, intrusive rumination, and organizational silence. METHODS: The data of this study were collected through a time-lagged panel questionnaire survey with three rounds of measurements from February 2020 to May 2020 at an infectious disease hospital in Shenzhen, in which all the confirmed cases of COVID-19 patients were accommodated. Based on cluster sampling design, a total of 134 frontline healthcare professionals directly involved in providing diagnosis, treatment, and nursing services for COVID-19 patients completed three times of web survey. The depressive symptom and trauma exposure were measured via the 12-items General Health Questionnaire and the Explosion Exposure Questionnaire respectively. A moderated mediation model examined the complex interplay among the major study variables. Gender and working year were included as control variables. RESULTS: Trauma exposure was significantly associated with depression in frontline healthcare professionals. Intrusive rumination mediated the effect of trauma exposure on the depressive symptom, which was moderated by organizational silence. Intrusive rumination presented a more substantial impact on depression while organization silence was lower. CONCLUSIONS: This research demonstrates that intrusive rumination and organizational silence are imperative for predicting the depressive symptoms among the frontline healthcare professionals during the COVID-19 pandemic.

Positive functioning at work during COVID-19: Posttraumatic growth, resilience, and emotional exhaustion in Chinese frontline healthcare workers.

Research on traumatic events often emphasizes the importance of posttraumatic growth (PTG) and resilience, yet few studies have explored their trends and their relationship throughout the progression of traumatic events. This paper explores the longitudinal relationship between resilience and PTG, as well as the role of job burnout in this relationship, among frontline healthcare workers during the COVID-19 pandemic, who have been exposed to high-risk work environments over extraordinarily long workdays. In Study 1, 134 Chinese frontline healthcare workers completed a three-wave survey (Time 1, Time 2, and Time 3) in February-May 2020. In Study 2, 401 frontline healthcare workers completed a cross-sectional survey. The cross-lagged analysis suggested that resilience at Time 1 positively predicted PTG at Time 2, which in turn positively predicted resilience at Time 3. PTG at Time 1 also positively predicted resilience at Time 2 (Study 1). However, job burnout was negatively related to both resilience and PTG; in particular, emotional exhaustion moderated the link between PTG and resilience (Study 2). Our findings support a cycle of reinforcement between resilience and PTG over time. The positive effect of PTG on resilience, however, is undermined by emotional exhaustion. Implications for future intervention research and workplace support are discussed.