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

• Published in: PloS one 2024-09, Vol.19 (9), p.e0309561
• Main Authors: Wang, Qian, Zhou, You, Wang, Gang, Pan, Xinyu, Sha, Sha, Wang, Zhe, Liu, Yinqi, Tian, Tengfei, Liang, Sixiang
• Format: Article
• Language: English
• Subjects: Adult; Biology and Life Sciences; Burnout; Care and treatment; China; China - epidemiology; Coping; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - psychology; Cross-Sectional Studies; Diagnosis; Emotions; Epidemics; Female; Health aspects; Health care; Health Personnel - psychology; Humans; Male; Medical personnel; Medical supplies; Medicine and Health Sciences; Mental Health; Middle Aged; Occupational stress; Pandemics; Personality disorders; Post traumatic stress disorder; Psychological aspects; Psychological factors; Psychological Well-Being; Psychopathology; SARS-CoV-2; Social Sciences; Stress; Stress (Psychology); Stress, Psychological - psychology; Surveys and Questionnaires; Trauma; Well being; Work environment
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0309561

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. 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. 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. 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.