Multilevel Factors Affecting Healthcare Workers’ Perceived Stress and Risk of Infection During COVID-19 Pandemic

Objectives: Healthcare workers (HCWs) worldwide on the frontline of the coronavirus disease 2019 (COVID-19) pandemic are reporting significant stress and concerns about health and wellbeing of themselves and their family members. This study aimed to identify key factors affecting HCWs’ perceived stress and risk of contracting COVID-19 among themselves and their family members during the pandemic. Methods: A cross-sectional questionnaire study was conducted between 19 March and 5 April 2020. HCWs from public hospitals and private dentists were asked to complete an online questionnaire on their demographics, perceived stress, risk of themselves and their family members contracting COVID-19, changes in family relationships and family cohesion. Their family member was asked to report their perceived level of stress and family cohesion. Results: A total of 747 HCWs and 245 family members participated in this study. Higher perceived stress in HCWs was associated with more negative changes in family relationship (p=0.025). The HCWs’ perceived stress, however, was positively associated with family cohesion (p=0.033) and stress levels of family members (p<0.001). The level of HCWs’ satisfaction towards the hospital policies in response to the COVID-19 outbreak was associated with lower levels of perceived stress and risk of themselves or their family members contracting COVID-19. HCWs’ previous frontline experience of SARS was significantly associated with less perceived risk of themselves or their family members contracting COVID-19. Conclusions: Hospital policies addressing HCWs’ needs, frontline experience of SARS, and family relationship influenced psychological wellbeing of HCWs during the COVID-19 outbreak.