Symptoms of Psychological Stress and Sickness Absence Among Healthcare Workers During a Persistent Crisis

Elevated psychological stress reactions among healthcare workers during the COVID-19 pandemic necessitated a need to better understand their possible impact on sickness absence (SA). The study aimed to describe the relation between SA related to mental health problems and symptoms of psychological stress among healthcare workers during the COVID-19 pandemic. We further aimed to identify whether latent profiles of psychological stress reactions exist within the same population. In this observational registry-based study, survey data between May 2020 and March 2021 and SA register data between May 2019 and February 2023 were collected from 1245 Swedish healthcare workers. Differences between symptoms of burnout, depression, anxiety, PTSD, sleep disturbance, lack of detachment, and lack of recovery among groups with no, few (< 90), or many (>= 90) SA days were analyzed with Kruskal-Wallis tests. Interrelations between symptoms of psychological stress were identified using latent profile analysis. Compared to healthy participants, participants with SA days (in total 6.3%) reported more severe symptoms of psychological stress, were younger, and more likely to work as assistant nurses. Furthermore, they displayed a higher degree of previous SA (prior to the pandemic). No statistically significant differences between groups with few (< 90) and many (>= 90) days of SA in symptoms were noted. Four latent profiles of psychological stress were identified, but they differed only in the level of experienced symptoms. We conclude that different symptoms of psychological stress are highly interrelated among healthcare workers during a crisis. Although many healthcare workers may experience elevated symptoms in relation to the crisis, it will not necessarily lead to serious mental health problems requiring SA.