Resilience changes and occupational resilience factors among healthcare workers during and after the COVID-19 pandemic: A 2-year prospective cohort study
Healthcare workers (HCWs) in COVID-19 pandemic hotspots were exposed to heightened workplace stressor load. Structural occupational resilience factors could prevent work-related stressor exposure from translating into mental health problems but remain poorly understood. This study identifies resilience factors actionable at the workplace and examines the impact of prior stressor exposure early in the pandemic on the later development of depressive and general distress symptoms. We prospectively followed a convenience sample of HCWs working in Spain during the pandemic using a 3-wave online survey conducted in 2020 (wave 1, n = 2,422), 2021 (wave 2, n = 1,827), and 2022 (wave 3, n = 538). We operationalised resilience as low stressor reactivity (SR), quantified as individual deviations from the normative relation between stressors exposure and either depressive or distress symptoms. Mental health problems and stressor exposure both decreased over time, whereas stressor reactivity remained stable. Stressor exposure at baseline was inversely associated with resilience at follow-up. The structural occupational factors support from colleagues, trust in the workplace, and perceived ability to recover from stress were prospectively associated with resilience and thus identified as resilience factors. These results show that resilient responses of HCWs in times of crisis could be supported by promoting structural occupational resilience factors and mitigating cumulative stressor exposure. Future research should test this association in studies that allow causal inferences.
Authors
- Irwin Hecker (ORCID: https://orcid.org/0000-0002-5707-2799)
- Marit Sijbrandij (ORCID: https://orcid.org/0000-0001-5430-9810)
- Gonzalo Martínez‐Alés (ORCID: https://orcid.org/0000-0002-1902-4067)
- Berta Moreno‐Küstner (ORCID: https://orcid.org/0000-0002-9541-215X)
- María Fe Bravo‐Ortiz (ORCID: https://orcid.org/0000-0001-7969-9245)
- Irene Martinez‐Morata (ORCID: https://orcid.org/0000-0003-3165-4931)
- Papoula Petri‐Romão (ORCID: https://orcid.org/0000-0003-4675-170X)
- Roberto Mediavilla (ORCID: https://orcid.org/0000-0001-6411-9439)
- Ellenor Mittendorfer‐Rutz (ORCID: https://orcid.org/0000-0001-5227-0721)
- Henrik Walter (ORCID: https://orcid.org/0000-0002-9403-6121)
- Lara Puhlmann (ORCID: https://orcid.org/0000-0002-0870-8770)
- Eduardo Fernández-Jiménez (ORCID: https://orcid.org/0000-0003-1238-8906)
- José Luís Ayuso‐Mateos (ORCID: https://orcid.org/0000-0002-7544-826X)
- Maria Melchior (ORCID: https://orcid.org/0000-0002-2377-619X)
- Raffaël Kalisch (ORCID: https://orcid.org/0000-0002-9503-7601)
- Anke B. Witteveen (ORCID: https://orcid.org/0000-0002-9636-7522)
Institutions
- Harvard University (US)
- Inserm (FR)
- Johannes Gutenberg University Mainz (DE)
- Instituto de Salud Carlos III (ES)
- Karolinska Institutet (SE)
- Humboldt-Universität zu Berlin (DE)
- Sorbonne Université (FR)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Leibniz Institute for Resilience Research (DE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Hospital La Paz Institute for Health Research (ES)
- Hospital Universitario de La Princesa (ES)
- Institut Pierre Louis d‘Épidémiologie et de Santé Publique (FR)
- Instituto de Investigación Biomédica de Málaga (ES)
- Universidad Autónoma de Madrid (ES)
- Columbia University (US)
- Technische Universität Dresden (DE)
- Universidad de Málaga (ES)
- Vrije Universiteit Amsterdam (NL)
- Universidad Europea de Madrid (ES)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- Scientific Reports
- Published
- 2025-08-10
- DOI
- https://doi.org/10.1038/s41598-025-09829-8
- Primary Topic
- Resilience and Mental Health
- Type
- article
- Field-Weighted Citation Impact
- 0.00