Development of a multidimensional multicomponent self-report measuresurvey of experiences of stress, tragedy and trauma in COVID-19 healthcare professionals (HCPs): A journey into compassion

Paul Gilbert^1,2*Marcela Matos³Jaskaran Kaur Basran^1,2Kelly Morter²Ptarmigan Plowright^1,2Ana Ferreira³Maria do Céu Salvador³William Kirby⁴

• ¹Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
• ²The Compassionate Mind Foundation, Derby, United Kingdom
• ³Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Coimbra, Portugal
• ⁴The Royal London Hospital, London, England, United Kingdom

Background. Life confronts us with many aversive events, including injuries, diseases, losses, decay and death. These life realities often stimulate compassion motives orientated to try to alleviate and prevent suffering. While concepts of ‘stress’ and ‘fear’ have dominated the discourse on responses to ‘traumatic events’, a less common narrative is that of ‘tragedy’. Tragedy narratives focus on the empathic sensitivities to the ‘suffering and traumas of life’ and hence are related to compassion motives. Tragedy has a long history with complex meanings and is focused on sadness and loss, rather than fear. Hence, it invites a different language of experiences requiring grief work rather than (just) exposure work. While the experiences of healthcare professionals (HCPs) working with COVID-19 patients have been studied regarding stresses and fear-based traumas, HCPs were also witness to and experienced these traumas in terms of tragedy. This study developed a multicomponent survey to explore different dimensions and patterns of HCPs’ experiences with a focus on issues of sadness, grief and tragedy. Focusing on the tragic elements of a trauma invites a different narration, language and way of working through trauma. Methods. From informal discussions with colleagues working in high impact COVID-19 environments, such as intensive care units, and with psychologists who supported those staff, we identified a non-exclusive and non-exhaustive set of themes that textured their experience. We were particularly interested in experiences that could be seen as descriptions of tragedy. These were presented as novel self-report surveys to HCPs in British and Portuguese samples. This sought to explore diverse patterns of experiences and responses beyond diagnostic criteria like posttraumatic stress disorder (PTSD). Measures of social safeness, trauma, posttraumatic growth and burnout were also given to explore themes using standard scales. Results. Our survey suggested key compassion themes of: high levels of empathic distress for the suffering of others and being more fearful of passing the virus to friends and close others than being infected oneself. As suggested by a tragedy focus, sadness and tearfulness were as prevalent as fear.