It has been indicated that the ability to cope with difficulties like coronavirus pandemic may affect mental ill- health indicators (Secer, et al.,2020). Shechter, et al. (2020) found that the most common source of high distress among health care workers is perceiving lack of control. Furthermore, they found that healthcare workers use empirically-supported coping behaviors but they also reported interest in additional wellness resources.
Moreover, literature reviews indicated that research on coping strategies of frontline workers during coronavirus pandemic are still limited (Heath, Sommerfield & Ungern-Sternberg, 2020).
Carmassi et al. (2020) reviewed studies related to other virus diseases outbreak concerning the risk and coping factors for PTSD among healthcare workers. The results show that some factors regarded as risk and coping factors at the same time include; exposure level, working role, years of work experience, social and work support, job organization, age, gender and coping styles. In the same line, Brooks, Amlot, Rubin & Greenberg (2018) found that there are multiple protective factors that play crucial roles in developing mental ill-health indicators those are: training, perceived competence, social support and effective coping strategy.
Coping strategies are classified into three different types; task- oriented, emotion-oriented, and avoidance-oriented strategies and they all aim to decrease stress and manage individuals’ reactions to stressors and difficulties. Task-oriented strategies focus on direct solutions, i.e. action planning, problem solving, positive reappraisal correlate with adaptive psychological wellbeing, sense of control, and self-efficacy. On the other hand, emotion-oriented strategies focus on regulating emotional state (e.g., emotional disclosure, seeking social-emotional support). In the cases of lack of constructive emotional regulation; emotion-oriented strategy can take the form of increased use of negative emotions (e.g., rumination, suppression, self-blame). The third coping strategy is avoidance-oriented which is concerned about the denying or distortion of stressful situations like; self- distractions, substance use, etc. (Smith, Saklofske, Keefer & Tremblay, 2016).
Heath, et al. (2020) the results of their review study explained coping strategies among frontline workers during coronavirus pandemic which insist on individual strategies like self-care strategy and strategies that depend on organizational justice like reducing work-load of them.
Literature reviews revealed that the sense of control over the stressors or unpredictable situations such as coronavirus pandemic and the confidence in one’s coping resources may increase the use of task-oriented strategies. In contrast, low perceived coping resources and feelings of powerlessness would promote greater use of emotion-oriented and avoidance-oriented strategies. But these strategies may help the individual for a short and immediate time not for a long time (Smith, et al., 2016).
1.2 Mental ill-health indicators
Frontline workers, who serve during the COVID-19 pandemic, are at high risk of developing many mental ill- health indicators particularly fear of infection of COVID-19 and posttraumatic stress disorders PTSD (Xiao, et al., 2020). Moreover, in many studies frontline workers reported having neuropsychiatric issues. Hence, there is an urgent need to investigate mental ill- health consequences among them (Kang, et al., 2020; Holmes, et al., 2020; Poudel & Subedi, 2020; Zhang, et al., 2020).
1.1.2 Fear of coronavirus
Frontline workers’ duties are to identify the persons who are infected, respond to their treatment and carry out sever cases to hospitals which in turn may put them at the risk of developing fear of coronavirus in addition to the possibility of getting infected by coronavirus disease at any time (Secer, et al.,2020).
Amin (2020) conducted a study to examine the impacts of COVID-19 on health care professionals’ psychological wellbeing. The results indicated the presence of corona phobia among them which in turn leads to multiple mental ill- health symptoms. Moreover, Huang., Han., Luo & Ren (2020) investigated mental health among clinical first-line medical staff and found that about 23.04% of them suffer severe anxiety in favor to female medical staff.
Fear is a defensive mechanism against dangerous situations which in its minimum degrees help us to survive and protect ourselves against threating situations. But intense degrees of fear can lead to psychopathology. The results of limited studies show that fear of COVID-19 leads to extreme emotional and behavioral consequences like; anxiety disorders, suicide and PTSD (Secer, et al., 2020).
2.1.2 Posttraumatic stress disorders (PTSD)
Posttraumatic stress disorders PTSD is the most common mental ill- health indicator studied after the crises like coronavirus pandemic. Moreover, Shechter, et al. (2020) found that PTSD is normal and expected during traumatic events. The results of most studies that were conducted to investigate its ratio among frontline workers during coronavirus pandemic revealed that it has occurred in high rates among them (Albott, et al.,2020; Boyraz & Legros, 2020; Shah, et al., 2020; Xiao, et al.,2020; Zandifar et al., 2020).
PTSD is a common mental ill-health indicator caused by major psychological trauma like witnessing physical suffering and death related to COVID-19 pandemic and it can create a sense of threat to ones’ safety manifested in sleep disturbance, intrusive memories, grief (Albott, et al., 2020; Boyraz & Legros, 2020).
The main symptoms of PTSD, as defined by the Diagnostic and Statistics of Mental Disorders, the fifth edition (DSM-5) of the American Psychiatric Association, include persistent intrusion symptoms, persistent avoidance of stimuli, negative alterations in cognition or mood, and marked alterations in arousal and reactivity, all of the above are associated with experienced traumatic event (Albott, et al.,2020).
There are many features that have the ability to influence the risk for PTSD among frontline worker such as confronting relatively large numbers of critically ill patients, high mortality rates and lack of effective treatment. Second, they work in highly stressful situations and frequently witness death and trauma (Albott, et al., 2020; Carmassi, et al., 2020).
1.3 Coping strategies and mental ill-health indicators (fear of coronavirus, PTSD)
Some studies are conducted to investigate the relationships between coping strategies and mental ill-health during coronavirus pandemic; Secer, et al., (2020) conducted a study to investigate the impact of COVID-19 on 370 healthcare professionals in Turkey on psychological adjustments skills. Results showed that the fear of COVID-19 has a negative effect on the psychological adjustment. And it is found that psychological resilience has a protective function that limits this effect. Moreover, Lotzin, et al. (2020) in their study which was conducted in Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden to investigate the relationship between mental ill- health indicators and coping strategy. It was found that mental ill- health indicators; fear and PTSD correlate to coping strategy. Furthermore, Chew, et al. (2020) conducted a study aimed at exploring the changes in psychological responses (perceived stress, coping, PTSD) among healthcare workers. The results showed that using avoidance coping is associated with both perceived stress and PTSD. And Shechter, et al. (2020) found that healthcare workers used empirically-supported coping behaviors but they reported an interest in additional wellness resources. Also, Callus, et al. (2020) conducted a review of studies to identify the most effective stress reduction techniques for health care providers who treat patients infected with severe coronavirus (SARS, MERS COVID-19). The result showed that relaxation techniques were implemented on health care workers who take care of patients during severe coronavirus pandemics. Also, Bhat, Mir, Hussain & Shah (2020) in their study revealed that younger people, females living in urban conditions and those using maladaptive coping skills are likely to have anxiety symptoms. And, liao, Cowling, Lam, Ng & Fielding (2014) found in their study that anxiety and worry were strongly associated with coping in proactive behaviors. Moreover, Zhu, Wei, Meng & Li (2020) found that medical staff have high level of anxiety during COVID-19 and coping styles mediate the association between social support and anxiety.
1.4 Questions of the study
The current study aims at examining the prediction ability of coping strategies and mental ill-health indicators (fear of coronavirus, PTSD) among frontline workers. The study attempts to answer the following questions:
- What are the prominent coping strategies in light of some variables (gender, work place, age and major) among frontline workers?
- What are the levels of mental ill- health indicators (fear of coronavirus, PTSD) in light of some variables (gender, work place, age and major) among frontline workers?
- What is the prediction ability of coping strategies on mental ill- health indicators (fear of coronavirus, PTSD) among frontline workers?