key: cord-0913331-5b4224a8
authors: LOVREGLIO, Piero; LESO, Veruscka; RICCARDI, Elisabetta; STUFANO, Angela; PACELLA, Daniela; CAGNAZZO, Francesco; Luigia ERCOLANO, Maria; IAVICOLI, Ivo
title: Coronavirus disease (COVID-19) pandemic: the psychological well-being in a cohort of workers of a multinational company
date: 2021-10-22
journal: Saf Health Work
DOI: 10.1016/j.shaw.2021.10.006
sha: f7b39cf6cce872a0e99720ea6e90eb89fb5360b2
doc_id: 913331
cord_uid: 5b4224a8

BACKGROUND: The aim of the present study was to evaluate the psychological well-being (PWB) during the coronavirus disease (COVID-19) pandemic in workers of a multinational company. METHODS: Employees (aged ≥ 18 years) were recruited from Latin American, North American, New Zealand and European sites of a multinational company operative during all the pandemic period. The self-reported Psychological General Well Being Index (PGWBI) was employed to assess the global PWB and the effects on 6 sub-domains: anxiety, depressed mood, positive well-being, self-control, general health and vitality. The influencing role of age, gender, geographical location, COVID-19 epidemiology, and restrictive measures adopted to control the pandemic was explored. RESULTS: A total of 1335 workers completed the survey. The aggregate median PWB global score was in a positive range, with significantly better outcomes detected in the Mexican and Colombian Latin American sites compared to the other worldwide countries (p<0.001). Among the European locations, a significantly higher PWB score was determined in Spain compared to the German and French sites (p<0.05). Comparable geographical trends were demonstrated for all the PWB sub-domains. Male workers had a significantly better PWB compared to females (p<0.05), while a negative correlation emerged with aging (p=0.01). COVID-19 epidemiology and pandemic control measures had no clear effects on PWB. CONCLUSIONS: Monitoring PWB and the impact of individual and pandemic-related variables may be helpful to clarify the mental health effects of pandemic, define targeted psychological-supporting measures, also in the workplace, in order to face such a complex situation in a more constructive way.

compared to the Mexican and Colombian ones (p<0.001) support a possible role of local factors in 23 determining the well-being appreciation. The same considerations can explain the significantly lower median

In line with the global PWB perception, also in the analysis of the anxiety and the depression items, the 2 median aggregate scores, 76 and 87, respectively, suggested that the overall investigated population was in a 3 not-distressed condition regarding such domains (Supplementary 3). Moreover, when the median scores for 4 each site were evaluated, significantly higher levels were determined in the Colombian and Mexican sites 5 compared to the other worldwide plants (p<0.05) (Supplementary 4). This suggested significantly lower 6 levels of anxiety and depression in these specific groups of Latin American workers compared to the others, 7 also when an intra-continental analysis was performed in relation to their Chilean colleagues (p<0.001). The 8 highest perception of anxiety was determined in the US workers (64). Concerning the European scenario, the 9 significantly better outcomes were obtained in the Spanish site compared to the German and French ones 10 (p<0.05) and comparable, in the case of the depression score, to those of the Colombian site (p=0.072). In 11 line with anxiety and depression, the general median scores for other domains, such as those exploring the 12 ability to self-control, the perception of being in a general good health, and the appreciation of one's own 13 vitality, resulted in a positive range. More critical situations emerged for the positive well-being item in 14 which all the groups showed lower median scores, with the worst outcome found in the New Zealand site 15 (55). Additionally, the above-mentioned geographical trends recurred in all these items with workers from 16 the Colombia and Mexico having the best psychological outcomes worldwide (p<0.05). In Europe, the 17 Spanish cohort has been confirmed to have the highest scores in all the items investigated (p<0.05), while 18

German workers showed the most critical situations, particularly as concerns the low perception of vitality. 19 20

perception, although with significantly better outcomes in the latter ones (p<0.001). Comparable significant 23 differences were observed within each subscale (p<0.001) ( Table 2) . When the gender impact on PWB was 24 explored in each individual site, no significant sex related differences could be found in all but two plants, 25

the Mexican and New Zealand ones. In fact, significantly higher mean levels±SD were determined in male 26

To assess the possible influencing role of age, workers were stratified in 3 different aged groups: ( Moreover, the significant negative correlation found between age and the subscale scores for depressed 7 mood, positive well-being, general health and the global well-being index supported aging as a predictive 8 factor for worst psychological outcomes (Table 2) . 9 10 11 12

When the impact of the epidemiological situation of positive COVID-19 cases on the PWB was assessed, a 14 significant direct association was found between the rate of positive cases per 100.000 inhabitants in the 15 region and higher scores in the depressed mood (p=0.043) and self-control (p=0.040) dimensions. This was 16 indicative for a decrease in depression and an increase in the self-control according to the growing number of 17 cases (Table 6) . Comparably, the increasing number of suspected cases within the site was positively related 18 to the general health dimension score (p=0.022) (Table 6 ). Interestingly, despite the regions where the 19

This study represents the first attempt to provide a cross-national comparison of PWB perception of non-2 healthcare workers, employed in different worldwide plants of the same multinational company with the aim 3 to point out the influencing role of individual and epidemiological-related risk factors. Despite the critical 4 period experienced, the general levels of PWB were in a positive range both when the analysis was 5 performed on all the workforce, as well as when different sites were individually considered. These results 6 can be partly explained by the psychological benefits to retain a job during such pandemic, against the 7 negative impact induced by the employment uncertainty, income loss or experience of wage reduction due to 8

short-time working [10] . Working during the pandemic may support the individual perception to be able to 9 cope with stress-full situations, thus preventing psychological disorders [11] . Additionally, to work outside 10 the healthcare sector, thus not experiencing the fear to be infected while caring for COVID-19 patients and 11 not facing suffering and deaths every-day, as well as to be not engaged in home working, avoiding the stress-12 full balance between work and home needs and social loneliness, could result in a lower level of 13 psychological distress [10,12]. 14 The general positive results obtained in our cohort of manual workers, seem in contrast with the idea that a 15 lower job level could predict a lower subjective well-being [13] . However, the lack of detailed information 16 on the specific tasks performed by the enrolled workers (necessary to ensure the anonymity of the 17 participants) and the absence of a comparison with groups engaged in more skilled and managerial positions, 18

prevented an adequate interpretation of our findings. The mediating role of different educational levels, 19 socioeconomic status and company responsibilities in forward the production, while ensuring the health and 20

safety of the employees, should be deeply elucidated. 21

With regard to the geographical differences, our results demonstrated better outcomes in Latin American and 22

Southern European workers. This can suggest that PWB can be influenced by cultural variations. The 23 collectivistic culture of Hispanics, compared to the individualistic one of Western Europe and North 24

American, which emphasizes needs and goals of the group over those of the individual, would characterize a 25 stronger support in alleviating the negative psychological consequences of the pandemic [14] . Additionally, 26 also the geographical differences in personality traits, which may be affected by social, genetic and 27 ecological influences, may encourage more resilient traits [15, 16] . Geographical distribution of personality showed that Asian countries scored lower on extraversion, higher levels for openness were reported for the 1 Central and South American nations, while neuroticism was higher in the Southern and Eastern European 2 nations compared to the Western ones [16] . These personality traits correlate with well-being: 3 conscientiousness with life satisfaction; extraversion and neuroticism with positive and negative affect, 4 respectively [1, 17] . However, further research, aimed to address inter-and intra-continental differences, 5 appears necessary to understand whether personality traits could explain PWB geographical variability. 6

Moreover, our data do not allow to understand the impact that cultural variations may have on PWB with 7 respect to geographical related social security level and the social position held by enrolled workers. 8

Additional studies are necessary to clarify these aspects and provide a better interpretation of our findings. 9

However, it cannot be excluded that a possible "healthy worker effect" or a selection bias could have 10 affected our results. In some cases, the participation rate was slightly higher than the half of the total working 11 populations and could be responsible for the inclusion of most motivated workers, with a better PWB 12 perception, or conversely, of those more willing to claim critical issues in their condition. This may provide a 13 can suggest that other factors, including those mentioned before, could play a more impacting role. However, the impact of such gender-related differences on the various aspects and dynamics of the PWB need deeper 1

In relation to the age-related effects, no clear trends could be pointed out, as only one site showed a 3 significant decrease in PWB with respect to aging. Although mixed evidence is available concerning the 4 PWB in different aged groups, lower levels in elderly may be related to the physical health and cognitive 5 decline in later life, as well as to the fear, perceived threat, and distress due to the higher risk for a severe 6 COVID-19 [5, 20] . However, although inconclusive, our results support the relevance to not neglect age as a 7 possible influencing factor in affecting PWB during the COVID-19 outbreak. 8

The potentially threatening COVID-19 experiences resulted more distal predictors for a decrease in PWB, as 9 a no clear relationship emerged between pandemic parameters, at the national, regional or occupational site 10 level and worst outcomes in all the investigated domains. Conversely, the number of positive cases within 11 the region or suspected cases within the workplace were significantly related to higher self-control and lower 12 depression levels, as well as to a better perception of the general health, respectively. This may be argued to 13 be related to a better perception of the one's health in comparison to other worst conditions "outside". 14 However, it cannot be excluded that some aspects of the COVID-19 pandemic, i.e. the stigma and social 15 avoidance for being infected, or the positive influence of having tests negative for COVID-19, could have 16 been somewhat undervalued. Also, the role of the measures adopted to control the pandemic outbreak, 17 remains to be fully clarified. Among different restrictions analyzed, only the school closure had a positive 18 impact on PWB, in terms of better outcomes in depression, positive well-being, self-control and global well-19 being perception. Overall, although still preliminary and in a general positive range, the findings derived 20 from this pilot analysis point out a specific psychological profile for different occupational populations. 21

These issues may be important to plan targeted supportive interventions, including psychological education 22 or cognitive behavioral techniques, that may be specifically tailored to the identified predictive factors for 23 worst outcomes. 24

Strengths of the study include its large size and worldwide perspective, the examination of employees who 25

are not in the healthcare, and the evaluation of both personal and epidemiological factors that may affect 26 PWB. Some limitations include the collection of data through a self-administered survey that may be 27 affected by recall bias and inaccurate self-reporting and the cross-sectional nature of our investigation that 28 prevents to understand possible PWB changes due to the COVID-19 pandemic with respect to the previous 1 periods. Additionally, the lack of PWB data from other groups of healthy residents/workers in the 2 investigated countries, and of "reference PWB values" for the general population in these countries prevent 3 to understand the impact that an intrinsically higher/lower PWB perception, due to economical rewards and 4 welfare during employment, may have on the interpretation of the retrieved results. In this view, longitudinal 5 studies under different pandemic waves, as well as when all the restrictions will definitively end, should be 6 planned to define the direction of the above-mentioned effects, and the possible long-term impact of 7 COVID-19. Data are presented as frequency (percentage) for the categorical variables number of participants and sex. Mean (SD) have been used for the continuous variable age. Frequency of missing data is also reported. J o u r n a l P r e -p r o o f Ref.

Effect of the COVID-19 Pandemic and Big Five Personality on Subjective 3 and Psychological Well-Being

Mental Health and the Covid-19 Pandemic

COVID-19 pandemic and mental health consequences: Systematic

Subjective wellbeing, health, and ageing

Hispanic Culture and Relational Cultural Theory