Stress and Factors Associated with Stress in Frontline Healthcare Workers During the COVID-19 Pandemic in Thailand

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Surasak Mulsrisuk
Pongsak Dharmakulsakti
Chantana Keha
Nattha Saisavoey
Worapat Ratta-apha
Juthawadee Lortrakul


Frontline healthcare workers (HCWs) who tirelessly served during the COVID-19 pandemic face a significant risk of stress because of increased workload and ineffective management. This study examined the various factors affecting HCWs' stress levels, employing a cross-sectional study, descriptive statistics, and multiple logistic regression analysis to identify the key stress-associated factors. Data collection involved the administration of online questionnaires to 558 HCWs at Siriraj Hospital. The questionnaires encompassed various aspects, including demographic information, health status, essential working requirements, and the Thai version of the mental status evaluation form (DASS-21).The results revealed that 23.3% of HCWs experienced stress, with several stress-associated factors identified. These factors include the profession of the HCWs, such as nurse (OR = 4.62; 95% CI: 8.90–28.10), general officer (OR = 13.72; 95% CI: 2.48–76.03), and porter (OR = 2.75; 95% CI: 0.17–45.57). Additionally, inadequate personal protective equipment (PPE) (OR = 1.75; 95% CI: 1.06–2.88), inappropriate assignment (OR = 2.45; 95% CI: 1.44–4.15),pre-existing health conditions (OR = 2.82; 95% CI: 1.62–4.92), and poor sleep quality (OR = 0.38; 95% CI: 0.24–0.60) were identified as contributing factors. The statistical analysis, representing 36.2% of the association between these factors and stress (Nagelkerke R2= 0.362), highlights the significance of these findings. The study's outcomes provide valuable data for effectively implementing protective management of stress for HCWs in both public and private sectors.


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Mulsrisuk, S., Dharmakulsakti, P., Keha, C., Saisavoey, N., Ratta-apha, W., & Lortrakul, J. (2023). Stress and Factors Associated with Stress in Frontline Healthcare Workers During the COVID-19 Pandemic in Thailand. Vajira Nursing Journal, 25(1), 15–25. Retrieved from
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