Background: Health care workers employed in the COVID‐19 emergency are at a high risk of stress.Aims and objectives: To explore the mediating roles of self‐efficacy and resilience between stress and both physical and mental quality‐of‐life components in intensive care nurses during the COVID‐19 pandemic.Design: Cross‐sectional survey design.Methods: The stress subscale (depression, anxiety, and stress scale in Spanish Scale, DASS‐21), the summary components (physical and mental) of health‐related quality of life (SF‐36), the general self‐efficacy scale (GSES), and the resilience scale (RS‐14) were administered in 308 intensive care nurses. Serial multiple mediator models were used.Results: There was a significant indirect effect of levels of perceived stress on both physical and mental health components through self‐efficacy and resilience. Specifically, greater perception of self‐efficacy was associated with a lower perception of stress and greater resilience, while higher resilience was associated with greater physical and mental health (B = −0.03; SE = 0.02; 95% confidence interval [CI] = [−0.07, −0.01]; B = −0.03, SE = 0.01, 95% CI = [−0.07, −0.01], respectively). It was observed that self‐efficacy alone also mediates the relationship of the perception of stress on the components of physical and mental health (B = −0.07; SE = 0.05; 95% CI = [−0.18, −0.03]; B = −0.09; SE = 0.04; 95% CI = [−0.17, −0.24], respectively). However, resilience alone was not a significant mediator of these associations.Conclusions: It can be concluded that stress is linked to the physical and mental health components related to quality of life through self‐efficacy and resilience.Relevance to clinical practice: These psychological resources would allow the nursing staff to maintain a good quality of life despite high levels of stress. These findings have implications for future research in terms of both model testing and clinical application.

Background: The severe acute respiratory syndrome coronavirus 2 outbreak has been identified as a pandemic and global health emergency. It presents as a severe acute respiratory disease. The rapid dissemination of the disease created challenges for healthcare systems and forced healthcare workers (HCWs) to deal with many clinical and nonclinical stresses. The aim of our research is to describe work conditions, symptoms experienced by HCWs, worries about contagion, and generalized anxiety symptoms and compare those findings across regions in Spain. Methods: This cross-sectional study was conducted using an online survey. Critical care units throughout Spain were included. The sample comprised HCWs working in intensive care units from March to May 2020. We assessed work variables, physical symptoms, worries about contagion, and anxiety (generalized anxiety disorder-7 questionnaire). Results: The final sample comprised 448 surveys. Among the respondents, 86.9% (n=389) were nursing professionals, and 84.8% (n=380) were women. All participants cared for coronavirus disease 2019 (COVID-19) patients during the study period. Workload during the pandemic in Madrid was judged to be higher than in other regions (P<0.01). The availability of personal protective equipment was found to be higher in Cataluña. The most frequently experienced symptom was headaches (78.1%). Worries about self-infection and the possibility of infecting others received mean scores of 3.11 and 3.75, respectively. Mean scores for generalized anxiety levels were 11.02, with 58.7% of the professionals presenting with generalized anxiety syndrome during the assessment. Conclusions: In this study, we found high levels of anxiety among HCWs caring directly for COVID-19 patients, which could produce long-term psychological alterations that still need to be assessed.

Background/Objectives: Previous research points to the prevalence of insomnia during the COVID-19 pandemic among healthcare workers (HCWs). However, longitudinal studies on its evolution, including the post-pandemic stage, are less abundant, with a special lack of research about possible psychosocial risk factors. The aim of the current study is to analyze the evolution of insomnia in Spanish HCWs from the beginning of the pandemic until two years later, examining the influence of sociodemographic, occupational and psychosocial variables. Methods: This was a prospective longitudinal design with three data collection periods in which insomnia was assessed using the Insomnia Severity Index (ISI), in addition to sociodemographic, occupational and psychosocial (i.e., social support, self-efficacy, resilience and cognitive fusion) variables in HCWs (n = 216) who were in direct contact with COVID-19 patients. Results: High scores were observed for insomnia, with a clear decrease throughout the periods studied (F = 30.198, p < 0.001). An association was observed between insomnia and certain sociodemographic and occupational variables (i.e., work category, p = 0.001; availability of Personal Protective Equipment (PPE), p < 0.001; workload, p < 0.001; worry about self or family contagion, p = 0.002, p = 0.003, respectively). Insomnia had negative relationships with social support (p = 0.014), self-efficacy (p < 0.001) and resilience (p < 0.001) and positive relationships with cognitive fusion (p < 0.001). Interaction effects between the evolution of insomnia and social support from friends (p = 0.024, ƞ2 = 0.34) and between the evolution of insomnia and cognitive fusion (p = 0.047; ƞ2 = 0.25) were found. Conclusions: Social support, self-efficacy and resilience act as buffers for insomnia. Cognitive fusion acts as a clear precipitator of insomnia as well as directly influencing its evolution. Social support from friends also affects the evolution of insomnia. Within the specific circumstances of the COVID-19 pandemic, a long-term effect of social support from friends and a short-term effect of cognitive fusion on the evolution of insomnia was observed. The findings emphasize the need to implement specific interventions to promote the mental well-being of HCWs, particularly in crisis contexts that involve an increase in occupational stress, emphasizing the role of certain psychosocial variables as protective factors.

Background and Objectives: Evidence shows that throughout the COVID-19 pandemic, nurses suffered from emotional symptoms, yet in spite of this, few studies within “positive psychology” have analyzed the emergence/promotion of positive traits, such as hardiness. In this context, the present study aimed to test a model regarding the mediating role of self-efficacy between anxiety experienced at the beginning of the COVID-19 pandemic and hardiness assessed six months later among nurses in critical care units (CCU) in Spain. Materials and Methods: An observational, descriptive, prospective longitudinal study with two data collection periods: (1) from the 1 to the 21 June 2020 (final phase of the state of alarm declared in Spain on 14 March) in which socio-demographic and occupational variables, anxiety (Depression, Anxiety and Stress Scale, DASS-21), self-efficacy (General Self-Efficacy Scale, GSES) and basal resilience (Resilience Scale-14, RS-14) were assessed, and (2) a follow-up 6 months later (January–March 2021) in which hardiness (Occupational Hardiness Questionnaire, OHQ) was evaluated. To analyze the data, multivariate regressions were performed using the PROCESS macro (simple mediation, model 4). Results: A total of 131 Spanish nurses from CCUs, with a mean age of 40.54 years (88.5% women) participated in the study. Moderate and severe levels of anxiety were observed in 19.1% of the sample. Significant and positive correlations were observed between self-efficacy, hardiness and resilience (all p < 0.001). Significant negative correlations were observed between anxiety and self-efficacy (p < 0.001), hardiness (p = 0.027) and resilience (p = 0.005). The indirect effect of anxiety on hardiness through self-efficacy was significant (Effect (SE) = −0.275 (0.100); LLCI = −0.487, ULCI = −0.097), contributing to 28% of the variance, including resilience (p = 0.015), age (p = 0.784), gender (p = 0.294) and years of experience (p = 0.652) as covariates. A total mediation was observed (non-significant anxiety-hardiness direct effect; Effect (SE) = −0.053 (0.215), t = 0.248, p = 0.804, LLCI = −0.372, ULCI = 0.479). Conclusions: The results suggest that in Spanish CCU nurses, anxiety experienced at the beginning of the COVID-19 pandemic may contribute to the development of hardiness through positive resources such as self-efficacy.

Background: Intensive care unit (ICU) nurses have experienced a high degree of stress during the COVID‐19 pandemic. While the literature on the consequences on emotional symptomatology is abundant, studies on the protective psychosocial variables that have contributed to buffering these consequences are scarcer. Aim: This study analyses the role of self‐efficacy as a protective personality trait in ICU nurses during the COVID‐19 pandemic, using a moderated mediation model that begins with the stress and anxiety experienced at the onset of the pandemic and concludes with the emotional exhaustion experienced 6 months later. Study Design: Prospective longitudinal study with two data collection periods during the COVID‐19 pandemic: (1) from 5 May to 21 June 2020 and (2) a follow‐up 6 months after the state of alarm finalized (January–April 2021). These were both very stressful periods for ICU staff because of the COVID‐19 pandemic. This study was conducted with 129 ICU nurses (a non‐probabilistic convenience sample in the Spanish health care system). Socio‐demographic, occupational and psychosocial variables (i.e. stress, anxiety, self‐efficacy and emotional exhaustion) were assessed. Descriptive analyses, Pearson correlations, covariate analyses (i.e. Student's t ‐test, one‐factor ANOVA) and moderated mediation analyses were carried out (SPSS PROCESS macro, model 7). STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) reporting guidelines were followed. Results: It shows that the higher the self‐efficacy score, the lower the effect of stress on anxiety ( p < .001); likewise, the moderating role of self‐efficacy was equally valid for the whole final model ( F = 8.790, p < .001), showing self‐efficacy to be a good buffer for emotional exhaustion derived from the stress suffered in the ICU. Conclusions: Self‐efficacy (i.e. the belief of being able to do certain tasks successfully) is shown to be a highly relevant trait to enhance among ICU nurses during the COVID‐19 pandemic, allowing them to manage work stress effectively and thus buffering the development of anxiety in the short term and emotional exhaustion in the long term. Relevance to Clinical Practice: Our results point to the need to assess and take action on self‐efficacy in ICU nurses in highly stressful situations such as the COVID‐19 pandemic. As a psychological variable, self‐efficacy refers to beliefs and therefore has to be trained by evidence‐based psychological techniques, such as cognitive behavioural therapy. In addition, previous literature has pointed out that previous experience or specific training is an influential (although not a determining) factor in self‐efficacy, so specialization for ICU nurses could also be considered.

This study analyzes, in nurses, the influence of openness to experience and hardiness (assessed at baseline and one year after the COVID-19 pandemic respectively) on the development of optimism (assessed two years after the COVID-19 pandemic). Concerns about self-contagion were included as a moderating variable, given their relevance as a risk factor. Nurses have been among the healthcare professionals most affected by the COVID-19 pandemic. Most previous studies have focused on the variables contributing to psychological symptoms, whilst the attention given to the variables adding to the well-being of these professionals has been much scarcer. A prospective study was carried out. This study was carried out using three data collection periods: Period 1 (From May to June 2020), Period 2 (From January 2021 to April 2021), and Period 3 (From April 2022 to July 2022), with the participation of 151 Spanish nurses, using online self-reporting questionnaires. The study followed the STROBE statement. The results showed that the proposed model was statistically significant. There was a positive effect of openness to experience (year 2020) on hardiness assessed one year later (year 2021). Similarly, hardiness had a positive effect on optimism assessed another year on (year 2022). Concerns about self-contagion behaved as a moderator in the relationship between openness to experience and hardiness (the relationship between openness and hardiness was statistically significant when contagion concern was higher). Relevance to clinical practice: In-depth understanding of the psychological processes that trigger psychological strengths (i.e. optimism) as a result of adverse situations (i.e. COVID-19 pandemic) is essential in promoting the mental health of healthcare professionals. Interventions targeting resilient personality traits and cognitive flexibility are key to this goal. No Patient or Public Contribution: The participants contributed exclusively to the collection of the sample.