COVID-19 Mental Health Stressors of Health Care Providers in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) Intervention (Preprint)

Abstract

Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing high level of stressors are health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs are negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and post-traumatic stress symptoms.

The aim of this study is to explore the pandemic stressors experienced by HCPs at work, at home and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention.

Informed by a social ecological approach, we use a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first two waves of the COVID-19 pandemic (June 2020 to February 2021) in Canada.

Informed by a social ecological framework, five overarching themes were identified in our thematic analysis: 1) personal level stressors that highlight HCPs identities and responsibilities beyond the workplace; 2) interpersonal level stressors from disrupted social relationships; 3) organizational stressors that contributed to unsettled workplaces and moral distress; 4) community and societal stressors attributed to vicarious trauma and emotional labour; and 5) the multilevel and cumulative impacts of COVID-19 stressors on HCPs’ health.

COVID-19 is not merely a communicable disease but a social and political phenomenon that intensifies the effects of social inequities. Current understanding of pandemic stressors affecting HCPs is largely partial in nature. While workplace stressors of HCPs are real and intense, they need to be explored and understood in the context of stressors that exist in other domains of HCPs’ lives such as family and community to ensure these experiences are not being silenced by the ‘hero’ discourses or overshadowed by professional demands.