{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:55:35Z","timestamp":1791975335554,"version":"4.4.0"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: The present study aims to assess the level of professional burnout and secondary traumatic stress (STS), and to identify potential risk or protective factors among health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) outbreak.; (2) Methods: This cross-sectional study, based on an online survey, collected demographic data and mental distress outcomes from 184 HCWs from 1 May 2020, to 15 June 2020, from 45 different countries. The degree of STS, perceived stress and burnout was assessed using the Secondary Traumatic Stress Scale (STSS), the Perceived Stress Scale (PSS) and Maslach Burnout Inventory Human Service Survey (MBI-HSS) respectively. Stepwise multiple regression analysis was performed to identify potential risk and protective factors for STS; (3) Results: 184 HCWs (M = 90; Age mean: 46.45; SD: 11.02) completed the survey. A considerable proportion of HCWs had symptoms of STS (41.3%), emotional exhaustion (56.0%), and depersonalization (48.9%). The prevalence of STS was 47.5% in frontline HCWs while in HCWs working in other units it was 30.3% (p &lt; 0.023); 67.1% for the HCWs exposed to patients\u2019 death and 32.9% for those HCWs which were not exposed to the same condition (p &lt; 0.001). In stepwise multiple regression analysis, perceived stress, emotional exhaustion, and exposure to patients\u2019 death remained as significant predictors in the final model for STS (adjusted R2 = 0.537, p &lt; 0.001); (4) Conclusions: During the current COVID-19 pandemic, HCWs facing patients\u2019 physical pain, psychological suffering, and death are more likely to develop STS.<\/jats:p>","DOI":"10.3390\/ijerph18010337","type":"journal-article","created":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T10:35:12Z","timestamp":1609842912000},"page":"337","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":179,"title":["Secondary Traumatic Stress and Burnout in Healthcare Workers during COVID-19 Outbreak"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8769-7693","authenticated-orcid":false,"given":"Graziella","family":"Orr\u00f9","sequence":"first","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-877X","authenticated-orcid":false,"given":"Francesca","family":"Marzetti","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0726-3634","authenticated-orcid":false,"given":"Ciro","family":"Conversano","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6733-2809","authenticated-orcid":false,"given":"Guido","family":"Vagheggini","sequence":"additional","affiliation":[{"name":"Weaning and Cardio-Pulmonary Rehabilitation Unit, Auxilium Vitae Rehabilitation Centre, 56148 Volterra, Italy"},{"name":"Fondazione Volterra Ricerche ONLUS, 56148 Volterra, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Miccoli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4264-6884","authenticated-orcid":false,"given":"Rebecca","family":"Ciacchini","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Panait","sequence":"additional","affiliation":[{"name":"Fondazione Volterra Ricerche ONLUS, 56148 Volterra, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Gemignani","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,5]]},"reference":[{"key":"ref_1","first-page":"112","article-title":"The psychological impact of sars-cov-2 quarantine: Observations through the lens of the polyvagal theory","volume":"17","author":"Poli","year":"2020","journal-title":"Clin. 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