Health Care Professional Stress and Resilience:


The impact of COVID-19 has been particularly felt by cancer healthcare professionals. Health care providers (HCP) have been faced with a number of unprecedented challenges during the COVID-19 pandemic. Although high levels of
HCP stress have been described in settings where COVID-19 caseloads exceed capacities, we sought to quantify perceived stress and resilience in a Canadian academic hospital where COVID-19 caseload was manageable, in order to inform institutional HCP support strategies. Led by Prof Chris Booth, the Canadian team have conducted a cross-sectional survey to quantify self-reported perceived stress (and its sources), resilience, and moral distress across a spectrum of HCP, using three validated tools (Perceived Stress Scale, Connor-Davidson Resilience Scale and Moral Distress Thermometer). Participation was invited through multiple streams (intranet postings, staff communications, and information updates). In total, 339 HCP responded in Canada, categorized into eight professional groups each with 15 or more respondents. The age and sex distributions were reflective of the staffing profiles. For perceived stress, the mean score among all respondents was 21.1 (SD ± 3.6), indicating “moderate” average stress. The mean resilience score for all respondents was 27.7 (SD ± 6.0) and mean Moral Distress score was 3.37 (SD ± 6.12). For all three outcomes, the distribution of scores varied widely (full range) in each of the eight HCP groups. Numerous sources of stress were endorsed, with considerable variation observed among respondents. Qualitative analysis of free-text comments further informed the description of HCP experiences. Multiple dimensions of stress are evident and vary more between individual HCP than between groups. The findings inform organizational strategies for supporting the mental health of HCP in the workplace.

This approach to understanding healthcare professional stress and resilience is now being rolled out to a number of countries and major centres across the global taskforce including Pakistan, Jordan, Zambia and others.

Taskforce colleagues in Japan led by Dr Tomohiro Matsuda, with Drs. Narikazu Boku, Rika Nakahara, Masaru Konishi, Asao Ogawa, Tatsuya Suzuki, Yosuke Uchitomi, Maiko Fujimori, Masako Okamura, and Shinichi Goto have nearly completed a major national study. They conducted surveys on stress, resilience and moral distress among cancer health care providers (n=3,764) working in National Cancer Center in Japan. This study was approved by the Institutional Review Board and Ethics Committee of NCC, Japan, and was conducted in accordance with the principles laid down in the Helsinki Declaration. The surveys were done by an electronic questionnaire. Participation was encouraged through an email within the center. The 1 st survey was conducted from Jul. 7 to Jul. 27 2020, by asking theiremotion during the 1 st wave of the epidemic period (April-May) and the 2 nd E-mail based survey was conducted from Oct. 19 to Nov. 6 2020, by asking their current emotion. They compared the Connor-Davidson resilience scale scores, the perceived stress scale scores, and the moral distress thermometer scores between 1st survey (n=566) and 2nd survey (n=336). Statistically significant differences between the two surveys, and by sex and by occupation were found.

Work from these national groups will be published and the aim is to then conduct a meta-analysis once national research has been completed.