title: System factors influencing stress in healthcare workers during the COVID-19 pandemic
title: a case study and scoping review
titleType: Subtitle
Creators: name: Murphy, Brandon
Publisher: name: University of Iowa
Year: 2022
Subjects: COVID-19
Healthcare worker
System Factors
public abstract
Stress

description: With the onset of the COVID-19 pandemic, much of the world was shut down early in the pandemic. However, healthcare workers (HCWs) were still required to care for patients with COVID-19. The pandemic has brought many challenges to HCWs around the world. The literature points to the fact that HCWs are a particularly vulnerable group during the pandemic. This work aims to understand the specific factors of the work system that influence stress in healthcare workers and how healthcare workers cope with this stress.
description: This was a two-part study: a qualitative interview (n=4) with Medical Intensive Care Unit employees in a Midwest teaching hospital as well as a scoping review of the current literature. The interview was structured with the framework of the Systems Engineering Initiative for Patient Safety (SEIPS) model. The interview gathered information about people, tasks, organizational conditions, physical environment, and tools and technologies to understand how these elements of the work system impact stress. The scoping review investigated factors that impact stress in HCWs in the literature. Themes on factors that impact stress emerged from the interviews, as well as from the scoping review.
description: The study discusses these themes from the interviews and scoping review. From the interviews, six themes emerged; (1) People (refers to patients of the pandemic and co-workers/staffing needs) stood out as the most stress-inducing factor in healthcare workers during the pandemic whether that is co-workers or patients (2) Wearing proper PPE and extra tasks leading to more workload in HCWs also contributes to stress (3) HCWs and healthcare organizations have been very supportive for HCWs during the pandemic (4) Perceived risk of the HCWs was very high at the start of the pandemic and decreased as time passed and particularly after the COVID-19 vaccine became available (5) All participants cope, but how they do varies and (6) Tool and technologies and the physical environment are not a stressor reported. In the scoping review six themes emerged: (1) People are contributing to high levels of stress in HCWs with both patients and coworkers (2) Extra tasks are causing HCWs to feel dissatisfied with their heavy workload leading to stress (3) Organizations of which HCWs are a part, are demanding too much while not providing support for HCWs (4) Tools and technologies and the physical environment are not a stressor reported in any of the papers evaluated (5) Uncertainty of the COVID-19 virus causes stress in many HCWs around the world and (6) HCWs cope but this may vary based on individuals. A model was developed based on these results that could be applied to future situations like the COVID-19 pandemic. This thesis addresses the gaps in understanding HCW’s stress during the difficult time of a pandemic. We used the framework of the SEIPS 3.0 model and the addition of the process component to compare different time periods before, during and after the pandemic. The Healthcare Wellbeing Model was developed to help understand the factors that introduce stress in HCWs during the pandemic to help with future-oriented solutions to improve healthcare worker wellbeing outcomes.