Stressors, overall health and workplace wellbeing of Swiss nurses during the COVID-19 pandemic and potential health protective factors: A longitudinal mixed-method study

The COVID-19 pandemic had a heavy impact on healthcare systems in the spring of 2020 in Europe and most predictive models for the pandemic concur that a second wave is in the offing. Pandemics of the sort expose nurses to different types of stressor, such as having to perform unusual tasks in unusual settings, which may be associated with high levels of psychological distress. The majority of studies undertaken have taken a pathogenic approach to the subject. However, according to the WHO, health is 'a state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity.' The few studies that have taken a salutogenic approach to the subject have shown that nurses can retain their health despite a pandemic by mobilizing what is referred to as generalized resistance resources. It is extremely important to gain a better understanding of how nurses retain their health in the face of this type of epidemic situation. This information could then suggest leads for developing interventions aimed at maintaining their health and workplace wellbeing in the context of a pandemic. Against this background, we intend to undertake a study to understand how nurses working in Swiss hospitals retain their health and workplace wellbeing over the course of the COVID-19 pandemic by investigating the moderating effects of resources mobilized against stressors inherent to the pandemic situation. To this end, we will use a concurrent mixed-method panel design with qualitative interviews ancillary to quantitative analyses. Data will be collected at four time points: T0, to set baseline levels; T1, six months after T0; T2, 12 months after T0; and T3, 18 months after T0. Qualitative data (T1 and T3) will be collected through focus groups (FGs). The target population will consist of all nurses working in care establishments who have had direct, indirect or no contact with COVID-19 patients in several hospitals in the three linguistic regions of Switzerland. Results will serve to a) analyze change in nurses two years after exposure during the COVID-19 pandemic, b) analyze change in the effects of potential health protective factors and in nurse workplace wellbeing, c) develop new knowledge in an unusual context using a theoretical framework to guide analysis of how the concepts under study relate to one another, and d) develop solid new knowledge to be used to develop new preventive interventions to support nurses during a pandemic. These results could also be integrated in quality improvement processes at the participating care establishments and will help steer the development of healthcare worker support programs for disease prevention and health promotion.