The Serial Mediation Effect of COVID-19 Anxiety and COVID-19 Burnout on the Relationship Between the Fear of COVID-19 and COVID-19 Quality of Life in Nurses

There is growing interest in the association between COVID-19-related stressors and quality of life. This study aimed to extend current knowledge by investigating the potential mediating roles of COVID-19 anxiety and COVID-19 burnout in the association between fear of COVID-19 and COVID-19 quality of life in nurses. A total of 300 nurses were selected by convenience sampling approach from a training and research hospital serving as a pandemic hospital in Turkey. COVID-19 anxiety, COVID-19 burnout, and COVID-19 quality of life data were collected using the self-reported questionnaires using both online and paper-and-pencil versions of the questionnaires. Structural equation modeling was used to conduct serial multiple mediation analysis. We found statistically significant associations among fear of COVID-19, COVID-19 anxiety, COVID-19 burnout, and COVID-19 quality of life. Serial multiple mediation analysis revealed that the association of fear of COVID-19 with COVID-19 quality of life was partially mediated by COVID-19 anxiety and COVID-19 burnout. These results indicate that the association of fear of COVID-19 with COVID-19 quality of life in nurses may be changed through COVID-19 anxiety and COVID-19 burnout, which appear to play serial multiple mediating roles in this association. These findings enrich our understanding of the associations among these psychological factors and suggest that focusing solely on fear of COVID-19 without considering the mediating effects of COVID-19 anxiety and COVID-19 burnout might not be adequate for reducing the COVID-19-impact on the quality of life among nurses.