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E.P. Arble1, S. Shankar1, S.W. Steinert1, A.M. Daugherty2


1. Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA; 2. Department of Psychology, Department of Psychiatry and Behavioral Neurosciences, Institute of Gerontology, Wayne State University, Detroit, MI, USA. Corresponding author: Eamonn P. Arble, Department of Psychology, Eastern Michigan University, Ypsilanti, 341 Science Complex, Ypsilanti, MI 48197. Email: earble2@emich.edu

Jour Nursing Home Res 2020;6:89
Published online October 7, 2020, http://dx.doi.org/10.14283/jnhrs.2020.23


Dear Editor,

The COVID-19 pandemic has created a crisis in nursing home facilities across the United States (1). Workers in these facilities are carrying a tremendous burden, facing the anxiety of possible infection, grief from the loss of those in their care, and increased workloads (2). As a result, nursing home workers are experiencing a variety of emotional consequences, including symptoms of mood disorders and posttraumatic stress disorder (PTSD) (3). Given these challenges, the role of psychosocial support among nursing home workers should be carefully considered, as it may predict overall emotional functioning.
We examined this among nursing home employees (N = 103, age 24-79 years; 90% female; 72.8% Caucasian) in the Metro Detroit region who were surveyed anonymously, online April 29 to May 14, 2020. A wide range of PTSD (range = 0-62; M = 20.56, SD = 16.76), depression (range = 0-20; M = 4.27, SD = 4.79), anxiety (range = 0-18; M = 3.29, SD = 3.84), and stress symptoms (range = 0-18; M = 6.14, SD = 5.02) were reported, with some workers demonstrating clinical elevations. Across all measures, poorer relationship quality was associated with greater symptom severity (all p < 0.001) of PTSD (ρ = 0.62), depression (ρ = 0.58), anxiety (ρ = 0.50) and perceived stress (ρ = 0.63).
In our sample, those reporting poorer relationship quality also reported greater symptoms of affective disturbance. This is a clear indication that nursing home workers experiencing relational deficits may be at increased risk for emotional disruption. This finding aligns with previous research (4). Greater emotional strain calls for increased social support, but the ability to receive such support can be diminished in the face of quarantines and fears of infection. Unfortunately, workers in nursing homes may find themselves becoming increasingly isolated at precisely the time when they could most benefit from their interpersonal connections. Nursing home workers, administrators, and researchers should thus investigate mechanisms to obtain psychosocial support in the midst of quarantine, particularly when workplace strain has increased. Developing a workplace culture within nursing homes that facilitates and encourages workers to identify and connect with sources of emotional support may be critical as we continue to navigate the COVID-19 pandemic.


Acknowledgments: This work was not externally funded. All authors declare to have no conflict of interests in regard to this work.

Conflicts of interest: The authors have no conflicts of interest to disclose.

Ethical standard: The study was approved by the institutional review boards at Eastern Michigan University and Wayne State University.



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3. Rossi R, Socci V, Pacitti F et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open 2020; 3: e2010185.
4. Williams KL, Galliher RV. Predicting depression and self-esteem from social connectedness, support, and competence. Journal of Social and Clinical Psychology 2006; 25: 855–874.