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Cited by 24COVID-19 and Mental HealthHealthcare professionals’ stress and burnoutOccupational Health and Burnout

Psychological Distress in South African Healthcare Workers Early in the COVID-19 Pandemic: An Analysis of Associations and Mitigating Factors

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Lee, Hsin-Ling, Wilson, Kerry S., Bernstein, Colleen, Naicker, Nisha, Yassi, Annalee, Spiegel, Jerry M.·2022·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph19159722PMC PMC9368661

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Abstract

While the global COVID-19 pandemic has been widely acknowledged to affect the mental health of health care workers (HCWs), attention to measures that protect those on the front lines of health outbreak response has been limited. In this cross-sectional study, we examine workplace contextual factors associated with how psychological distress was experienced in a South African setting where a severe first wave was being experienced with the objective of identifying factors that can protect against HCWs experiencing negative impacts. Consistent with mounting literature on mental health effects, we found a high degree of psychological distress (57.4% above the General Health Questionnaire cut-off value) and a strong association between perceived risks associated with the presence of COVID-19 in the healthcare workplace and psychological distress (adjusted OR = 2.35, p < 0.01). Our research indicates that both training (adjusted OR 0.41, 95% CI 0.21–0.81) and the reported presence of supportive workplace relationships (adjusted OR 0.52, 95% CI 0.27–0.97) were associated with positive outcomes. This evidence that workplace resilience can be reinforced to better prepare for the onset of similar outbreaks in the future suggests that pursuit of further research into specific interventions to improve resilience is well merited.

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  • In South Africa during the COVID-19 pandemic, team cohesion and supportive leadership emerged as particularly effective resilience mechanisms.

    “In South Africa during the COVID-19 pandemic, team cohesion and supportive leadership emerged as particularly effective resilience mechanisms (27).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [27]

    The Results (§3.6; page unavailable) report that support from an immediate supervisor was associated with less psychological distress. They say only supervisor support—not support from other sources—showed this association, so the finding does not establish team cohesion as a protective mechanism. Because the study was cross-sectional, it also does not demonstrate that either factor was an effective intervention. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Studies during COVID-19 demonstrated that weak infrastructure and insufficient institutional support intensified distress.

    “Studies during COVID-19 similarly demonstrated that weak infrastructure and insufficient institutional support intensified distress (27, 28, 34).”

    From Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review (2026) · cites this paper as [27]

    The Discussion (page not available) identifies perceived barriers to infection control—including space and manager support—as predictors of psychological distress. The Results (section 3.6, page not available) associate better supervisor support with less distress. But the Limitations (section 4.2) say the cross-sectional study cannot establish cause and effect, so it does not demonstrate that weak infrastructure and insufficient support intensified distress. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Lee, H.-L., Wilson, K. S., Bernstein, C., Naicker, N., Yassi, A., & Spiegel, J. M.
Affiliations
  • University of British Columbia (CA)
  • National Health Laboratory Service (ZA)
  • University of the Witwatersrand (ZA)
Corresponding author
Yassi, Annalee
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2022-08-07
Volume
19
Issue
15
Pages
9722
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph19159722
PMC
PMC9368661
OpenAlex
W4290515206
Cited by
24
References
9
Citations by year
2026: 2 · 2025: 2 · 2024: 7 · 2023: 12 · 2022: 1
FWCI
5.02
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • cIRcle (University of British Columbia) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • The International Development Research Centre (IDRC) (M20-00559, VS1-175519)
  • the Canadian Institutes of Health Research (CIHR) (M20-00559, VS1-175519)
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
psychological distress, healthcare workers, COVID-19 pandemic, workplace mental health, risk perception, workplace relationships, resilience, training, South Africa
MeSH terms
Psychological Distress, COVID-19, Cross-Sectional Studies, Health Personnel, Humans, South Africa, Pandemics

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