“We All Held Our Own”: Job Demands and Resources at Individual, Leader, Group, and Organizational Levels During COVID-19 Outbreak in Health Care. A Multi-Source Qualitative Study

BACKGROUND: Interventions tackling COVID-19 impact on health care workers’ mental health would benefit from being informed by validated and integrated assessment frameworks. This study aimed to explore the fitness of integrating the Job Demands-Resources (JD-R) model and the Individual-Group-Leader-Organization (IGLO) framework to investigate the pandemic’s impact on health care workers’ mental health. METHODS: Qualitative data were collected via 21 semi-structured interviews with senior and middle managers and four focus groups with employees (doctors, nurses, health care assistants) from three areas (Department of Emergency, Department of Medicine, Research Institute of Neuroscience) of a large health care institution facing the first wave of COVID-19. NVivo deductive content analysis of text data was performed. FINDINGS: Several COVID-19-related job demands and resources were found at IGLO levels. Individual-level demands included emotional load, while resources included resilience and motivation. Group-level demands included social distancing, while resources included team support and cohesion. Leader-level demands included managers’ workload, while resources included leader support. Organizational-level demands included work reorganization, while resources included mental health initiatives. CONCLUSIONS/APPLICATION TO PRACTICE: Integrating JD-R and IGLO proved feasible, as job demands and resources could be categorized according to the individual, group, leader, and organization framework. The findings expand previous studies by filling the lack of knowledge on how job demands and resources might unfold at different workplace levels during a pandemic. Results provide unit-level evidence for designing and implementing multilevel interventions to manage health care workers’ mental health during COVID-19 and future pandemics. Our findings offer occupational health practitioners a suitable approach to perform workplace mental health assessment activities.