The mediation effects of COVID-19-related traumatic stress symptoms and mentalization on the relationship between perceived stress and psychological well-being in healthcare workers transitioning to a post-pandemic world

Abstract

Background In context of COVID-19 as a collective trauma and the intense involvement of healthcare workers (HCWs) in the pandemic, perceived stress continues to have a tremendous impact on their psychological well-being. However, few studies have attempted to delineate the underlying mechanisms. This study examined whether COVID-19-related traumatic stress symptoms and mentalization act as mediators. Methods A sample of HCWs (N = 2610) from 22 hospitals in Beijing, China participated in this cross-sectional investigation. Data on their perceived stress, psychological well-being, the impact of event, and reflective function during the COVID-19 pandemic were collected using self-report questionnaires. Different mediating models were tested. Results COVID-19-related stress symptoms and mentalization independently mediate the association between perceived stress and psychological well-being. These two mediators also compose a serial mediation model. In particular, higher perceived stress inhibits the psychological well-being of HCWs through increased severity of traumatic stress symptoms, which in turn is associated with hypomentalizing. Conclusion These findings shed light on the mechanisms underlying the relationship between perceived stress and psychological well-being in HCWs. We strongly recommend incorporating a mentalization framework with trauma-informed practice in prevention and intervention work with this population during this and future healthcare crisis.