Interpersonal Factors and Resilience Mediate the Association Between Work-Related Stress in Response to a Viral Epidemic and Depression Among Healthcare Workers in the COVID-19 Pandemic

Objective This study aims to explore the association between work-related stress of healthcare workers in response to the coronavirus disease-2019 (COVID-19) pandemic and their depressive symptoms. Additionally, it focuses on the impact of insomnia symptoms, interpersonal factors, and resilience on depressive symptoms. Methods The results of an anonymous survey of 329 healthcare workers were analyzed, including the Stress and Anxiety to Viral Epidemics-3 items, Insomnia Severity Index, Interpersonal Needs Questionnaire, Connor–Davidson Resilience Scale-2 items, and Patient Health Questionnaire-9 items. Mediation analysis assessed whether insomnia symptoms, resilience, and interpersonal factors mediate the association between work-related stress and depressive symptoms. Results Work-related stress directly influenced depressive symptoms (standardized estimator=0.11, p=0.010, 95% confidence interval [CI] 0.03–0.19). The association between the former and latter was positively mediated by insomnia symptoms (standardized estimator=0.10, p<0.001, 95% CI 0.05–0.14), thwarted belongingness (standardized estimator=0.04, p=0.006, 95% CI 0.01–0.07), and perceived burdensomeness (standardized estimator=0.05, p=0.002, 95% CI 0.02–0.08) and was negatively mediated by resilience (standardized estimator=0.02, p=0.041, 95% CI 0.0001–0.04). Conclusion This study highlights the connection between heightened work-related stress experienced by healthcare workers amid the COVID-19 pandemic and the subsequent development of depressive symptoms mediated by insomnia, interpersonal factors, and resilience. Interventions that focus on building resilience could be pivotal in mitigating the detrimental mental health consequences of workplace stress among healthcare workers in a viral epidemic.