TY  - EJOU
AU  - Aviles, Lissette 
AU  - Sun, Shao-Jun 
AU  - Clarissa, Catherine 
AU  - Shih, Yun-Hsuan 
AU  - Gau, Bih-Shya 
AU  - Chen, Lu-Yen Anny 

TI  - From Workplace Uncertainty to Social Burden: Nurses’ Psychological Distress during COVID-19 in Taiwan
T2  - International Journal of Mental Health Promotion

PY  - 
VL  - 
IS  - 
SN  - 2049-8543

AB  - <b>Background:</b> Less is known about how the pattern of distress and related stressors differed across pandemic policy phases. <b>Study’s purpose:</b> This study examines whether nurses’ psychological burden differed across two independent survey waves. <b>Methods:</b> A repeated cross-sectional online survey recruited registered nurses through professional networks using snowball sampling. Wave 1 was conducted from January to June 2021, with 92.0% responding on or after 15 May; Wave 2 was conducted from September 2022 to May 2023. The questionnaire assessed preparedness, workplace and social experiences, and distress using the Impact of Event Scale-Revised (IES-R). Verified “Do not know” responses were treated as missing. Group comparisons, correlations, and multivariable linear regression with HC3 standard errors were performed. <b>Results:</b> The sample included 2500 nurses (2021: n = 2227; 2022–2023: n = 273). The later sample reported greater preparedness and personal protective equipment (PPE) confidence, less infection-related worry, and lower total and subscale IES-R scores (mean total-score difference = −9.82; Cohen’s d = −0.66). In 2021 bivariate analyses, workplace transfer and treatment of suspected cases and direct COVID-19 care, but not workplace screening, were associated with higher overall IES-R scores. No workplace-exposure variable was associated with overall IES-R score in 2022–2023. In the fully adjusted complete-case model (N = 2379), the later wave remained associated with lower total IES-R scores (<i>B</i> = −3.88, 95% CI [−5.83, −1.94], <i>p</i> &lt; 0.001). Infection-related worry, concealment of COVID-19 care work, family or friend avoidance, and discrimination were associated with higher distress, whereas PPE confidence was associated with lower distress. Direct COVID-19 care was not independently associated with distress. <b>Conclusions:</b> Distress was lower in the later sample, but infection-related worry and social stressors remained important. Support should combine early preparedness and safety measures with longer-term interventions addressing infection-related worry, stigma, and relational consequences.
KW  - COVID-19; distress; nurse; workplace preparedness; social stressors

DO  - 10.32604/ijmhp.2026.086458