Associations of Social Support and Resilience with Psychological Distress Among Nurses During The Covid-19 Pandemic in Indonesia

SAFA TIARA KIANI, Khudazi Aulawi, S.Kp., M.Kes., MN.Sc., Ph.D.; Pei-Shan Tsai, Ph.D, RN, BCIA

2023 | Tesis | MAGISTER KEPERAWATAN

Background The psychological health of nurses is an essential concern because nurses provide around the clock nursing care with direct contact to the COVID-19 patients. Despite existing evidence of nurses experiencing psychological distress during the pandemic, factors associated with the increased vulnerability to psychological distress among nurses in Indonesia during the COVID-19 pandemic are not well known. Mounting evidence suggests that social support and resilience both play a protective role in an individual�¢ï¿½ï¿½s mental health. Resilience and social support can potentially decrease the vulnerability to psychological distress among nurses who provide care to the COVID-19 patients. However, few studies have determined the role of resilience as a mediator in the association between social support and psychological distress among nurses in Indonesia. Objective The specific aims of this study were to determine: 1) whether social support independently predict psychological distress among nurses during the COVID-19 pandemic in Indonesia after adjusting for confounders; 2) whether resilience independently predict psychological distress among nurses during the COVID-19 pandemic in Indonesia after adjusting for confounders; and 3) the mediator role of resilience in the association between social support and psychological distress among nurses during the COVID-19 pandemic in Indonesia. Methods A cross-sectional study involving 150 nurses who had experience with taking care of COVID-19 infected patients was conducted. Social support, resilience, and psychological distress were assessed using the Social Provision Scale (SPS), Resilience Scale (RS-14), and Kessler Psychological Distress Scale (K10), respectively. The data were analyzed using SPSS statistical software package (version 26; IBM, Armonk, NY, USA). Multivariable logistic regression was performed to determine whether social support and resilience predict psychological distress independently after adjustment for confounders. The mediating statistical analysis was performed to determine the mediator role of resilience in the relationship between social support and psychological distress using the Mplus statistical software package (Mplus for Macintosh, version 26.0, SPSS, Chicago, IL, USA). Result Of the 150 participants, 25 (16.7%) were classified as having a high level of psychological stress. The likelihood of having high resilience increased 1.061 times when the score of social support increased by 1 unit [odds ratio (OR) = 1.061., confidence interval (CI): 1.013 �¢ï¿½ï¿½ 1.110: p value = .011]. The results of the multivariable logistic regression analysis with psychological distress as the dependent variable revealed that higher social support total scores were significantly associated with decreased odds of experiencing high psychological distress (OR = 0.927, CI: 0.882-0.975; p value = .003) after adjustment of confounders. However, resilience was not a significant determinant of psychological distress after adjusting for confounders (p = .310). Furthermore, a mediation effect of resilience was not found in the association between social support and psychological distress (���² = -.003; SE = .006; p = .633). Conclusion Social support but not resilience was found to be an independent predictor of psychological distress among nurses during the COVID-19 pandemic. Furthermore, our results did not support a mediation role of resilience in the association between social support and psychological distress.

Background The psychological health of nurses is an essential concern because nurses provide around the clock nursing care with direct contact to the COVID-19 patients. Despite existing evidence of nurses experiencing psychological distress during the pandemic, factors associated with the increased vulnerability to psychological distress among nurses in Indonesia during the COVID-19 pandemic are not well known. Mounting evidence suggests that social support and resilience both play a protective role in an individual�¢ï¿½ï¿½s mental health. Resilience and social support can potentially decrease the vulnerability to psychological distress among nurses who provide care to the COVID-19 patients. However, few studies have determined the role of resilience as a mediator in the association between social support and psychological distress among nurses in Indonesia. Objective The specific aims of this study were to determine: 1) whether social support independently predict psychological distress among nurses during the COVID-19 pandemic in Indonesia after adjusting for confounders; 2) whether resilience independently predict psychological distress among nurses during the COVID-19 pandemic in Indonesia after adjusting for confounders; and 3) the mediator role of resilience in the association between social support and psychological distress among nurses during the COVID-19 pandemic in Indonesia. Methods A cross-sectional study involving 150 nurses who had experience with taking care of COVID-19 infected patients was conducted. Social support, resilience, and psychological distress were assessed using the Social Provision Scale (SPS), Resilience Scale (RS-14), and Kessler Psychological Distress Scale (K10), respectively. The data were analyzed using SPSS statistical software package (version 26; IBM, Armonk, NY, USA). Multivariable logistic regression was performed to determine whether social support and resilience predict psychological distress independently after adjustment for confounders. The mediating statistical analysis was performed to determine the mediator role of resilience in the relationship between social support and psychological distress using the Mplus statistical software package (Mplus for Macintosh, version 26.0, SPSS, Chicago, IL, USA). Result Of the 150 participants, 25 (16.7%) were classified as having a high level of psychological stress. The likelihood of having high resilience increased 1.061 times when the score of social support increased by 1 unit [odds ratio (OR) = 1.061., confidence interval (CI): 1.013 �¢ï¿½ï¿½ 1.110: p value = .011]. The results of the multivariable logistic regression analysis with psychological distress as the dependent variable revealed that higher social support total scores were significantly associated with decreased odds of experiencing high psychological distress (OR = 0.927, CI: 0.882-0.975; p value = .003) after adjustment of confounders. However, resilience was not a significant determinant of psychological distress after adjusting for confounders (p = .310). Furthermore, a mediation effect of resilience was not found in the association between social support and psychological distress (���² = -.003; SE = .006; p = .633). Conclusion Social support but not resilience was found to be an independent predictor of psychological distress among nurses during the COVID-19 pandemic. Furthermore, our results did not support a mediation role of resilience in the association between social support and psychological distress.

Kata Kunci : Social support, resilience, psychological distress, COVID-19, nurses, cross-sectional study