Investigating the longitudinal impacts of frontline work on healthcare workers family functioning

BACKGROUND: At a time when many families were sheltering at home, frontline healthcare workers (FHWs) worldwide continued to work in the community, often under significant stress. While it has been well documented that frontline work during the COVID-19 pandemic has had impacts on healthcare workers’ mental and physical health, the impacts on their family functioning remain unclear. This study investigates the longitudinal impact of frontline work on family functioning amongst Australian healthcare workers. METHODS: Semi-structured interviews were conducted with Australian FHWs working in high-risk areas such as Emergency Departments, Intensive Care Units, COVID wards, Hospital in the Home, and Aged Care. Interviews occurred across three timepoints (Dec 2020=39 participants, June 2021=34 participants, Jan 2022=31 participants). Transcripts from each timepoint were analysed separately using reflexive thematic analysis, then whole group comparisons were made between timepoints to identify changes and the nature of the changes. RESULTS: Flexibility and the need for constant adaptation were consistent themes across the three timepoints, as FHWs struggled to balance the demands of workplace changes alongside lockdown and COVID-19 related changes in their personal lives. In the early stages of the pandemic, families with pre-existing vulnerabilities reported significant challenges whereas others reflected on family resilience and growth. Two years on, even those families that articulated resilience and growth have observed declines associated with the persistent demands of their healthcare roles. CONCLUSIONS: While healthcare organisations globally have made efforts to support their staff, these challenges observed by participants highlights the need for more targeted workplace and public health strategies within healthcare systems, particularly with respect to family support. KEY MESSAGES: • Healthcare workers have faced considerable challenges through the course of the COVID-19 pandemic, with declines in mental health and family functioning observed. • Beyond resilience and wellbeing interventions, healthcare workers need workplaces that acknowledge and support their family lives.