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Multicenter Study
. 2025 Jun 16;20(6):e0323777.
doi: 10.1371/journal.pone.0323777. eCollection 2025.

Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study

Beatriz Arregui-Gallego  1 , María Isabel Orts-Cortés  2   3   4 , María Teresa Moreno-Casbas  2   3 , Eva Abad-Corpa  2   3   5 , Rafaela Camacho-Bejarano  2   6   7 , Mª Ángeles Cidoncha-Moreno  2   8   9   10 , Isabel Feria-Raposo  2   11   12   13 , Javier Iruzubieta-Barragán  2   14 , Montserrat Carmona  7   15 , Estíbaliz Cristóbal-Domínguez  16   17 , Leticia Bernués-Caudillo  2 , Elvira Casado-Ramírez  2   3 , Alda Recas-Martin  18 , Dolores Sánchez-López  19 , M Consuelo Company-Sancho  2   20 , Noelia López Rascón  21 , Silvia Esteban-Sepúlveda  22 , María Clara Vidal-Thomàs  2   23 , Isabel Alonso  17 , Daniel Muñoz-Jiménez  2   7   24 , José Vicente Segura-Heras  25 , Joaquín Moncho  26 , Manuel Rich-Ruiz  2   3   27
Affiliations
Multicenter Study

Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study

Beatriz Arregui-Gallego et al. PLoS One. .

Abstract

Introduction: The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS).

Aim: Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors.

Method: A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models.

Results: Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p < 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics.

Conclusions: This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Evolution of mean values of posttraumatic stress symptomatology according to sociodemographic and occupational variables from baseline to 12-month.
X-axis: Time (Baseline and 12 month). Y-axis: PTSS Score (EGS-R). HCA: Healthcare Assistant. E. Service/ICU: Emergency Service/ Intensive Care Unit.
See this image and copyright information in PMC

References

    1. Finstad GL, Giorgi G, Lulli LG, Pandolfi C, Foti G, León-Perez JM, et al. Resilience, coping strategies and posttraumatic growth in the workplace following COVID-19: a narrative review on the positive aspects of trauma. Int J Environ Res Public Health. 2021;18(18):9453. doi: 10.3390/ijerph18189453 - DOI - PMC - PubMed
    1. Dzau VJ, Kirch D, Nasca T. Preventing a parallel pandemic - a national strategy to protect clinicians’ well-being. N Engl J Med. 2020;383(6):513–5. doi: 10.1056/NEJMp2011027 - DOI - PubMed
    1. Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland SØ, et al. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: a rapid systematic review. Psychiatry Res. 2020;293:113441. doi: 10.1016/j.psychres.2020.113441 - DOI - PMC - PubMed
    1. Sánchez-Sánchez E, García-Álvarez JÁ, García-Marín E, Gutierrez-Serrano M, Alférez MJM, Ramirez-Vargas G. Impact of the COVID-19 pandemic on the mental health of nurses and auxiliary nursing care technicians – a voluntary online survey. Int J Environ Res Public Health. 2021;18(16):8310. doi: 10.3390/ijerph18168310 - DOI - PMC - PubMed
    1. Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological impact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep. 2020;22(8):43. doi: 10.1007/s11920-020-01166-z - DOI - PMC - PubMed

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