Tekin, Sahra; (2024) The Impact of Occupational Trauma on Family Members and Close Friends of High-Risk Occupational Group Workers: A mixed-method thesis. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Background: The American Psychological Association (APA) has described high-risk occupational groups as those working in hazardous work environments and worker populations that may be exposed to such precarious environments. Due to long working hours, shift work, poor working conditions, and the risk of exposure the potentially traumatic incidents, high-risk occupational group workers are at risk of developing mental health and well-being issues. Social support is one of the key protective factors against mental health issues for high-risk workers, and family members and close friends of high-risk workers are frequently the primary source of support for such workers. However, while they are supporting their high-risk worker loved ones, they are also at risk of developing mental health and wellbeing issues. Aims: During my PhD programme of research, I aimed to understand the experiences, views, needs, and mental health and wellbeing issues of family members and close friends of high-risk workers. Methods: In my qualitative study, I conducted in-depth interviews with family members and close friends of healthcare workers (HCWs) who worked during the COVID-19 pandemic in the UK and analysed the data via thematic analysis. In my first systematic review, I used best evidence synthesis to understand the experiences of high-risk workers across a range of occupational groups. In my second systematic review, I used narrative synthesis to explore the experiences of the HCWs’ family members and close friends before and during the COVID-19 pandemic. Finally, in my mixed-method survey study, I quantitatively examined the degree of secondary traumatic stress (STS) and associated factors amongst household members of HCWs, and I used content analysis to explore their experiences in detail. Results: In my qualitative study, family members and close friends of HCWs reported that due to the long working hours and shifts, they had to take more domestic responsibilities such as cleaning, shopping, and childcare and that they experienced emotional burden due to anxiety about the HCW’s work. They reported that the sacrifices made by family members and close friends were not recognised by society and that the needs of HCWs and their families were not met by healthcare organisations, which impacted their mental health and wellbeing. According to the findings of my two systematic reviews, family members and close friends of high-risk workers are at risk of developing mental health and well-being issues in addition to relationship problems within the family. Social support was one of the most important coping strategies for family members and friends of high-risk workers. While there were similar experiences before and during the COVID-19 pandemic amongst the family members and friends of the HCWs (i.e. experiencing anxiety and worry due to the healthcare work and taking more domestic responsibilities at home due to the demanding nature of the healthcare work), there were also different experiences. For example, due to the COVID-19 pandemic, HCWs’ working hours and shifts were increased and this impacted their family lives negatively. Additionally, due to the risk of transmission of COVID-19, family members were not only worried about the health of HCW loved ones, but also the rest of the household’s health. In my mixed method survey study, 33.8% of household members reported STS within the severe range. Female spouses and partners of HCWs with clinical roles showed higher STS compared to male and other household members of the HCWs with non-clinical roles. Being a spouse/partner of a HCW and having a HCW with a clinical role were significant predictors for high STS. Additionally, based on the findings of the content analysis, household members reported that HCWs tended to be irritated, quieter/distant, anxious/stressed, in low moods, and exhausted after having a difficult day at work. These feelings and behaviours impacted the rest of the household members negatively. Conclusion: High-risk workers are at risk of developing mental health and wellbeing issues due to the nature of their jobs, and it can be challenging being a family member and close friend of a high-risk worker. Due to the potentially traumatic nature of high-risk work, workers’ family members and close friends may experience negative impacts on their own mental health by hearing about traumatic incidents, or they could be affected by the long hours, shift work, and compassion fatigue of their high-risk worker. Organisations have legal and moral responsibilities to protect workers and their loved ones. In order to provide better support, it is important to conduct further research to expand and address gaps identified in the literature. Additionally, it is necessary to increase awareness amongst organisations of the potential impact of occupational stress on family members of HCWs.

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