Resilience and mindfulness as factors of posttraumatic stress and growth among Chinese healthcare workers during the COVID-19 pandemic : mediation via adaptive coping and stigmatisation

Abstract

Experiences during the COVID-19 pandemic may be traumatic to healthcare workers (HCWs). This study investigated the associations of resilience and mindfulness with posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG), and the mediation role of adaptive coping and stigmatisation related to HCWs' role in these associations from the perspective of trauma and positive psychology research. An anonymous online survey was conducted among 1449 doctors and nurses (85.4% females; mean age 34.1 years) from five hospitals in different regions of China between October and November 2020, which was about six months after the COVID-19 outbreak was almost ‘put under control’ in China. PTSS and PTG were assessed using the 17-item PTSS Scale-Self-Report and Posttraumatic Growth Inventory, respectively. The prevalence of PTSS and PTG was 42% and 65%, respectively. Results of structural equation modelling suggested that the association between resilience and PTSS was partially mediated by adaptive coping, self-stigma, and the serial path via adaptive coping and self-stigma, which accounted for 66% of the total association. The association between mindfulness and PTSS was partially mediated by adaptive coping and serially mediated by adaptive coping and self-stigma. In contrast, only adaptive coping was a significant mediator in the associations between resilience/mindfulness and PTG. The findings first unravelled the mechanisms between resilience, mindfulness, and posttraumatic outcomes of COVID-19 among a large sample of HCWs. Health promotion may consider alleviating PTSS and promoting PTG for HCWs experiencing traumatic stressful events via strengthening resilience and mindfulness, fostering adaptive coping, and reducing stigmatisation.