{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:17:31Z","timestamp":1781885851089,"version":"3.54.5"},"reference-count":65,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"unspecified","delay-in-days":220,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796023000628_sec1a\">\n\t    <jats:title>Aim<\/jats:title>\n\t    <jats:p>To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796023000628_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>This is a multicenter prospective cohort study. Spanish healthcare workers (<jats:italic>N<\/jats:italic>\u00a0=\u00a04,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796023000628_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4\u201395.6%) and work-related stressful experiences (PARP range 76.8\u201386.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796023000628_sec4d\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796023000628","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T08:03:04Z","timestamp":1691568184000},"source":"Crossref","is-referenced-by-count":10,"title":["Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study"],"prefix":"10.1017","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7199-8339","authenticated-orcid":false,"given":"Ana","family":"Portillo-Van Diest","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Vilagut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itxaso","family":"Alayo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montse","family":"Ferrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Amigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt L.","family":"Amann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Arag\u00f3n-Pe\u00f1a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enric","family":"Aragon\u00e8s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngel","family":"As\u00fansolo Del Barco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Campos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Del Cura-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meritxell","family":"Espuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Gonz\u00e1lez-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep M.","family":"Haro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Larrauri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"L\u00f3pez-Fresne\u00f1a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma","family":"Mart\u00ednez de Sal\u00e1zar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Molina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael M.","family":"Ort\u00ed-Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Parellada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Pelayo-Ter\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"P\u00e9rez-Zapata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 I.","family":"Pijoan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"Plana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Puig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Rodr\u00edguez-Bl\u00e1zquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Sanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Consol","family":"Serra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iratxe","family":"Urreta-Barallobre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4831-2305","authenticated-orcid":false,"given":"Ronald C.","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"Bruffaerts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Vieta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"P\u00e9rez-Sol\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-9636","authenticated-orcid":false,"given":"Jordi","family":"Alonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2113-6241","authenticated-orcid":false,"given":"Philippe","family":"Mortier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"MINDCOVID Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"S2045796023000628_ref34","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12528"},{"key":"S2045796023000628_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2021.01.001"},{"key":"S2045796023000628_ref63","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2022.02.210272"},{"key":"S2045796023000628_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2007.06.007"},{"key":"S2045796023000628_ref60","unstructured":"Weathers, FW , Litz, BT , Keane, TM , Palmieri, PA , Marx, BP and Schnurr, PP (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD . 10.1037\/t02622-000"},{"key":"S2045796023000628_ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2003.12.007"},{"key":"S2045796023000628_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfcle.2021.10.006"},{"key":"S2045796023000628_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104242"},{"key":"S2045796023000628_ref10","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.76.2.272"},{"key":"S2045796023000628_ref52","doi-asserted-by":"publisher","DOI":"10.1002\/art.10993"},{"key":"S2045796023000628_ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-016-0713-6"},{"key":"S2045796023000628_ref57","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-020-00724-0"},{"key":"S2045796023000628_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000661"},{"key":"S2045796023000628_ref42","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-022-01953-7"},{"key":"S2045796023000628_ref54","doi-asserted-by":"publisher","DOI":"10.1177\/0962280210395740"},{"key":"S2045796023000628_ref59","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"S2045796023000628_ref43","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2020.83"},{"key":"S2045796023000628_ref64","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01036-x"},{"key":"S2045796023000628_ref45","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30509-1"},{"key":"S2045796023000628_ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0240146"},{"key":"S2045796023000628_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20656"},{"key":"S2045796023000628_ref22","unstructured":"Fanai, M and Khan, M (2022). Acute stress disorder. 1\u201321. https:\/\/pubmed.ncbi.nlm.nih.gov\/32809650\/ (accessed 21 July 2023 )."},{"key":"S2045796023000628_ref30","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.168"},{"key":"S2045796023000628_ref36","article-title":"Prevalence of depression, anxiety and posttraumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-Analysis","volume":"16","author":"Li","year":"2021b","journal-title":"PLoS One"},{"key":"S2045796023000628_ref56","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.08.034"},{"key":"S2045796023000628_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.01.021"},{"key":"S2045796023000628_ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.03.014"},{"key":"S2045796023000628_ref61","unstructured":"World Health Organization (2018) International classification of diseases for mortality and morbidity statistics (11th Revision). https:\/\/icd.who.int\/browse11\/l-m\/en (accessed 21 July 2023 )."},{"key":"S2045796023000628_ref47","unstructured":"R Core Team (2021) R. https:\/\/www.R-project.org\/ (accessed 07 July 2023 )."},{"key":"S2045796023000628_ref17","unstructured":"Centers for Disease Control and Prevention (2012) Principles of epidemiology in public health practice. https:\/\/www.cdc.gov\/csels\/dsepd\/ss1978\/ss1978.pdf (accessed 21 July 2023 )."},{"key":"S2045796023000628_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-200107000-00021"},{"key":"S2045796023000628_ref20","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18020601"},{"key":"S2045796023000628_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-8-8"},{"key":"S2045796023000628_ref35","first-page":"1065","article-title":"Large-sample significance levels from multiply imputed data using moment-based statistics and an F reference distribution","volume":"86","author":"Li","year":"1991","journal-title":"Journal of the American Statistical Association"},{"key":"S2045796023000628_ref3","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"S2045796023000628_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.06.026"},{"key":"S2045796023000628_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.04.005"},{"key":"S2045796023000628_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.09.007"},{"key":"S2045796023000628_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-018-0976-x"},{"key":"S2045796023000628_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpsm.2020.12.001"},{"key":"S2045796023000628_ref4","first-page":"1","article-title":"Burnout and post-traumatic stress disorder in frontline nurses during the COVID-19 pandemic: A systematic literature review and meta-analysis of studies published in 2020","volume":"92","author":"Annaloro","year":"2021","journal-title":"Acta Biomedica"},{"key":"S2045796023000628_ref58","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqt003"},{"key":"S2045796023000628_ref65","doi-asserted-by":"publisher","DOI":"10.1002\/da.22942"},{"key":"S2045796023000628_ref29","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2021.988"},{"key":"S2045796023000628_ref38","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2022.2129082"},{"key":"S2045796023000628_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.12.188"},{"key":"S2045796023000628_ref62","unstructured":"World Health Organization, & International Labour Organization (2022) Caring for those who care: Guide for the development and implementation of occupational health and safety programmes for health workers. https:\/\/www.who.int\/publications\/i\/item\/9789240040779 (accessed 21 July 2023 )."},{"key":"S2045796023000628_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06917-z"},{"key":"S2045796023000628_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrp.2006.05.002"},{"key":"S2045796023000628_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"S2045796023000628_ref53","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181a819a1"},{"key":"S2045796023000628_ref48","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20050"},{"key":"S2045796023000628_ref31","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717000708"},{"key":"S2045796023000628_ref55","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2011.01666.x"},{"key":"S2045796023000628_ref39","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17155514"},{"key":"S2045796023000628_ref27","doi-asserted-by":"publisher","DOI":"10.1177\/24705470211051327"},{"key":"S2045796023000628_ref37","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13146"},{"key":"S2045796023000628_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.06.022"},{"key":"S2045796023000628_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113312"},{"key":"S2045796023000628_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2020.05.040"},{"key":"S2045796023000628_ref1","article-title":"Prevalence and determinants of immediate and long-term PTSD consequences of coronavirus-related (CoV-1 and CoV-2) pandemics among healthcare professionals: A Systematic review and meta-analysis","volume":"18","author":"Al Falasi","year":"2021","journal-title":"Public Health"},{"key":"S2045796023000628_ref28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241032"},{"key":"S2045796023000628_ref18","doi-asserted-by":"publisher","DOI":"10.1177\/0163278713496425"},{"key":"S2045796023000628_ref26","article-title":"Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19","volume":"12","author":"Greene","year":"2020","journal-title":"Journal of Psychotraumatology"},{"key":"S2045796023000628_ref44","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-021-03589-1"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2045796023000628","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T08:03:26Z","timestamp":1691568206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2045796023000628\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":65,"alternative-id":["S2045796023000628"],"URL":"https:\/\/doi.org\/10.1017\/s2045796023000628","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023]]},"article-number":"e50"}}