Fo i, Giulia; Bondanini, Gio gia; Fins ad, Geo gia Libe a; Alessio, Fede ico; Gio gi,
Gab iele
A icle
The ela ionship be ween occupa ional s ess, men al
heal h and COVID-19- ela ed s ess: Media ion analysis
esul s
Adminis a i e Sciences
P o ided in Coope a ion wi h:
MDPI – Mul idisciplina y Digi al Publishing Ins i u e, Basel
Sugges ed Ci a ion: Fo i, Giulia; Bondanini, Gio gia; Fins ad, Geo gia Libe a; Alessio, Fede ico; Gio gi,
Gab iele (2023) : The ela ionship be ween occupa ional s ess, men al heal h and COVID-19- ela ed
s ess: Media ion analysis esul s, Adminis a i e Sciences, ISSN 2076-3387, MDPI, Basel, Vol. 13,
Iss. 4, pp. 1-13,
h ps://doi.o g/10.3390/admsci13040116
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Ci a ion: Fo i, Giulia, Gio gia
Bondanini, Geo gia Libe a Fins ad,
Fede ico Alessio, and Gab iele Gio gi.
2023. The Rela ionship be ween
Occupa ional S ess, Men al Heal h
and COVID-19-Rela ed S ess:
Media ion Analysis Resul s.
Adminis a i e Sciences 13: 116.
h ps://doi.o g/10.3390/
admsci13040116
Recei ed: 31 Janua y 2023
Re ised: 15 Ap il 2023
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Published: 21 Ap il 2023
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adminis a i e
sciences
A icle
The Rela ionship be ween Occupa ional S ess, Men al Heal h
and COVID-19-Rela ed S ess: Media ion Analysis Resul s
Giulia Fo i 1,2,* , Gio gia Bondanini 1,2 , Geo gia Libe a Fins ad 1,2 , Fede ico Alessio 1,2
and Gab iele Gio gi 1,2
1Business@Heal h Labo a o y, Eu opean Uni e si y o Rome, 00163 Rome, I aly
2Depa men o Human Sciences, Eu opean Uni e si y o Rome, 00163 Rome, I aly
*Co espondence: [email p o ec ed].i
Abs ac :
The COVID-19 pandemic led o se ious psychological consequences ha nega i ely a ec
wo ke s’ men al heal h, leading o pos - auma ic symp oms. In his scena io, employees may be
exposed o mul iple s esso s ha ul ima ely d ain hei esou ces. D awing on he Conse a ion o
Resou ces Theo y (COR) and he s ess–s ain pe spec i e, we analyzed he ela ionship be ween
di e en dimensions o wo k- ela ed s ess and psychological dis ess in a sample o 294 wo ke s
in he indus ial sec o . Speci ically, we hypo hesized a se ies o media ion models in which he
dimensions o wo k- ela ed s ess a e associa ed wi h a lowe le el o men al heal h di ec ly and
indi ec ly h ough highe le els o COVID-19- ela ed pos - auma ic symp oms. The esul s pa ially
suppo he hypo heses, showing ha COVID-19- ela ed auma plays a media ing ole be ween
he s ess expe ienced and he esul ing dec ease in men al heal h, excep in he case o job con ol
and colleague suppo . These esul s will hope ully o e insigh s in o possible o ganiza ional
in e en ions o he p omo ion o wo ke s’ well-being in he pos pandemic se ing.
Keywo ds: COVID-19; men al heal h; pos - auma ic s ess
1. In oduc ion
1.1. COVID-19 Pandemic and I s Impac on Psychological Dis ess
The COVID-19 pandemic led o se ious psychological consequences ha nega i ely
a ec ed he men al heal h o indi iduals. Indeed, esea ch shows ha COVID-19 is associ-
a ed wi h nega i e ou comes, such as psychological dis ess. Fo example, a su ey ca ied
ou in China on a sample o 600 wo ke s showed ha 6.33% expe ienced anxious s a es
(women had a highe p e alence), while 17.17% expe ienced dep essi e symp oms (Wang
e al. 2020). Se ious men al heal h consequences we e epo ed especially o heal hca e
wo ke s. In ac , an I alian s udy conduc ed on a sample o 1379 wo ke s showed ha
49.38% o he esponden s epo ed pos - auma ic symp oms, 24.73% exhibi ed symp oms
o dep ession, 19.80% epo ed anxie y symp oms, 8.27% exhibi ed p oblems o insomnia,
and inally, 21.90% epo ed high pe cei ed s ess (Rossi e al. 2020). A c oss-sec ional
su ey conduc ed in China also showed ha 40.2% o he sample had signi ican symp oms
ela ed o pos - auma ic s ess diso de . The pe cen ages o dep ession, anxie y, and s ess
s a es we e 13.6, 13.9, and 8.6, espec i ely (Si e al. 2020). While heal hca e wo ke s a e
he popula ion mos a ec ed by he psychosocial consequences o he pandemic, nega i e
ou comes we e also obse ed o o he p o essional g oups. Fo example, a s udy con-
duc ed on a sample o banke s showed ha du ing he pandemic, almos all employees
we e expe iencing anxie y, dep ession, and s ess, and ha 11.1% o he sample anged
om se e ely s essed o ex emely s essed (Yasmin e al. 2022). In addi ion, o he esea ch
highligh ed ha educa ion and social wo k p o essionals, public adminis a i e employees,
bank employees, and employees in o he jobs a high o po en ial isk o COVID-19 in ec-
ion we e ound o be a highe isk o dep essi e and anxie y symp oms. Fu he mo e,
Adm. Sci. 2023,13, 116. h ps://doi.o g/10.3390/admsci13040116 h ps://www.mdpi.com/jou nal/admsci
Adm. Sci. 2023,13, 116 2 o 13
ac o s con ibu ing o men al dis ess may be inadequa e p o ec i e equipmen , educed
ela ionship wi h cowo ke s, and wo k-p i acy con lic s (Casjens e al. 2022).
1.2. COVID-19 as a T auma ic E en : COVID-19-Rela ed S ess
The associa ion be ween COVID-19 and pos - auma ic s ess diso de is becoming
a opic o which esea che s a ound he wo ld a e u ning hei a en ion. Pos - auma ic
s ess diso de can gene ally occu a e exposu e o a auma ic e en . Acco ding o C ame
and colleagues, pos - auma ic s ess eac ion de elops ollowing i e phases: (1) objec i e
exposu e om which subjec i e eac ions a ise; (2) he o ma ion o a memo y ne wo k and
hus he subjec i e p ocessing o he auma ic e en and he in e p e a ion o he s imuli
associa ed wi h i ; (3) in usion, i.e., he memo ies o he auma ic e en which ac i a e
he ea ne wo k, causing hype a ousal and a oidance mechanisms; (4) a oidance, i.e.,
coping s a egies implemen ed in o de o educe he discom o caused by he in usi e
phase; and (5) he ou comes, i.e., he esolu ion o he ne wo k ha mani es s i sel wi h
high symp oma ology (C eame e al. 1992). Then, he e a e h ee nosog aphic c i e ia o
unde s anding auma- ela ed psychopa hology, which will ha e unique cha ac e is ics
wi hin he pandemic amewo k: objec i ely de ined auma, objec i ely de ined exposu e,
and subjec i ely epo ed eac ions (No h e al. 2021). Rega ding he no el co ona i us
and objec i ely de ined auma, we ecognize ha COVID-19 is a disease ha occu s
‘na u ally’, and as such, is no men ioned among he auma ic e en s in he DSM-5,
bu , as we shall see, i p oduces clea ly isible auma ic e ec s and gene a es impo an
seconda y s esso s such as inancial and social losses, educed oppo uni ies o socialize
wi h iends and lo ed ones, and he in e up ion o impo an ac i i ies o daily li e
(No h e al. 2021). Thus, exposu e o he i us is a highly s essogenic ac o o bo h
wo ke s and he gene al popula ion. Finally, wi h ega d o subjec i e emo ional eac ions,
dis essing emo ional s a es could lead o psychopa hological ou comes (No h e al. 2021).
As o he hypo hesis ha COVID-19 can be conside ed a auma ic ac o , he esea ch
by B idgland and colleagues ound ha 13.2% o he pa icipan s p obably had pos -
auma ic symp oms e en i he ypes o exposu e o COVID-19 did no all wi hin he
diagnos ic c i e ia. In addi ion, he emo ional impac o he e en s expe ienced/p edic ed
as wo se was ound o be a p edic o o PTSD (B idgland e al. 2021). Fu he mo e, he
esul s o he s udy by Sanchez-Gomez and colleagues, conduc ed on a gene al sample
o wo ke s, ound a s a is ically signi ican co ela ion be ween ea o COVID-19 and
he h ee dimensions o PTSD: in usion, hype a ousal, and a oidance. In addi ion, he
esul s showed ha hype a ousal plays a media ing ole in he ela ionship be ween
in usi e hough s and indi idual ou comes, such as ea o COVID-19 and men al heal h
(Sanchez-Gomez e al. 2021).
1.3. Wo k-Rela ed S ess: The Fi e Dimensions and Thei Impac on Psychological Dis ess
The Na ional Ins i u e o Occupa ional and Sa e y and Heal h (NIOSH) (Schill and
Chosewood 2013) de ines wo k- ela ed s ess as a se ies o “ha m ul physical and emo-
ional eac ions ha occu when job demands a e no commensu a e wi h he wo ke ’s
capabili ies, esou ces o needs o he wo ke s”. The ype o occupa ion and he o ganiza-
ional condi ions a e impo an ac o s ha can gene a e se ious psychosocial consequences
(Bonde 2008). The e a e se e al ac o s ha con ibu e o occupa ional s ess. The dimension
e med as “job demands (JD)” is linked o he e o equi ed ope a ionalized as wo kload,
bo h physical and psychological; hy hms o wo k; consis ency o eques s (Bakke and
Deme ou i 2007). JD includes high p essu e in he wo kplace, an un a o able wo king
en i onmen , and one ous emo ional e o in in e ac ions wi h cus ome s (Ka asek 1979).
The decision la i ude o job con ol dimension is unde s ood as he eedom pe cei ed
by he wo ke in esponding o wo k asks. I he e o e e e s o mas e y and disc e ion
wi hin he wo k en i onmen . A hi d dimension o be conside ed, which is also included
in he Job Demand Con ol Suppo (JDCS) model, is social suppo , ha is, social suppo
om supe iso s and colleagues. Job con ol can ac as a mode a o , being able o mi iga e
Adm. Sci. 2023,13, 116 3 o 13
he de as a ing e ec s o s ess (Ka asek and Theo ell 1990) and p o ec om job s ain
(Haines e al. 1991).
The e o e, psychological dis ess and ad e se heal h- ela ed consequences a ise when
he e is an imbalance be ween job demands and wo ke s’ esou ces, o example, in e ms o
lack o job con ol and lack o social suppo (Ma chand and Du and 2011). Ano he ac o
o conside is ole ambigui y, de ined by Kahn, Wol e, Quinn, Snoek, and Rosen hal as he
ambigui y expe ienced by wo ke s ega ding he pa s o hei ole which a e no clea ly
de ined in e ms o beha io , asks, p io i ies, and/o c i e ia o be me (Kahn e al. 1964).
In summa y, occupa ional s ess can by analyzed h ough he ollowing dimensions:
supe iso suppo , colleague suppo , job demands, job con ol, and ole ambigui y.
These ac o s a e closely associa ed wi h he employee’s psychological heal h. In ac ,
colleague and supe iso suppo p o ed o be impo an p o ec i e ac o s in he wo k-
place
(Ma chand and Blanc 2010)
. Indeed, bo h low social suppo and lack o supe iso
suppo a e associa ed wi h inc eased psychological dis ess (Inoue e al. 2022) (Denne lein
e al. 2021). This is especially ue o elewo ke s, since insu icien supe iso suppo
is associa ed wi h a high isk o psychological dis ess in his popula ion (Kikunaga e al.
2023). The e o e, ac ions by leade s as supe iso s a e impo an in inc easing posi i e em-
ployee a i udes and beha io s in he o ganiza ion (Cahyadi e al. 2022a,2022b). Mo eo e ,
low job con ol in he wo kplace can gene a e signi ica i e psychological dis ess (Elo ainio
e al. 2007;Ellio e al. 2017) as well as ole ambigui y (Choi e al. 2011). Finally, in line
wi h wha Ka asek supposes (Ka asek 1979), esea ch ca ied ou in a ious o ganiza ional
con ex s has shown ha a high le el o job demands coupled wi h low le els o job con-
ol is associa ed wi h inc eased psychological dis ess (Ka asek and Theo ell 1990;Xie
e al. 2021), while emo ion- ocused coping s a egies ac as a media o in his ela ionship
(Oshio e al. 2021).
1.4. Wo k-Rela ed S ess as a Facili a o o he Onse o COVID-19 S ess Symp oms
The p esence o wo k- ela ed s ess may p omo e he de elopmen o COVID-19-
ela ed pos - auma ic symp oms. Wo k- ela ed s ess has a signi ican impac on he well-
being o he wo ke (Ben-Ez a and Hamama-Raz 2021), as does COVID-19- ela ed s ess
(B idgland e al. 2021), as an icipa ed abo e. The indi idual may pe cei e exposu e o a
gi en s ess ul e en as challenging o h ea ening, as e idenced by Ho boll’s Conse a ion
o Resou ces (COR) heo y. COR heo y, p oposed as mo i a ional heo y, asse s ha
pe sonal and social esou ces mode a e he po en ial nega i e impac o s ess ul si ua ions
in he indi idual’s li e and ocuses on he use o esou ces in hese ci cums ances. The
basic ene o he heo y s a es ha indi iduals a e mo i a ed o acqui e and p o ec hei
esou ces. In his pe spec i e, s ess is he esul o he subjec i e pe cep ion o e en s as
exceeding one’s esou ces and o en i onmen al and objec i e si ua ions ha h ea en o
may induce esou ce deple ion (Laza us and Folkman 1984;Gio gi e al. 2020;Hob oll 1998).
Following he i s co olla y, indi iduals wi h mo e esou ces a e mo e likely o acqui e
new ones and a e less ulne able o esou ce loss, while he opposi e end can be obse ed
in he case o indi iduals wi h a deple ed esou ce pool (Hob oll 1988). Fu he mo e, since
loss is mo e alued han gain and s ess occu s when esou ces a e los , o ganiza ions and
indi iduals can expe ience loss spi als whe e wi h each loss he e is an inc ease in he
magni ude o he e ec (second co olla y) (Hob oll 1998,2001;Halbesleben e al. 2014).
In addi ion, ano he possible explana ion lies in he physiological pe spec i e: exposu e
o high le els o glucoco icoids, a class o ho mones ha a e ac i a ed a e exposu e o
s ess ul si ua ions, could ha e an impac on he onse o psychopa hologies.
In his ega d, we can assume ha an indi idual al eady su e ing om wo k- ela ed
s ess and hus wi h educed pe sonal esou ces may expe ience a u he loss o esou ces
when aced wi h a s ess ul e en such as COVID-19, hus de eloping pos - auma ic
symp oms. Addi ionally, wo ke s in he ea ly s ages o wo k- ela ed s ess coping wi h
a auma ic e en , such as COVID-19, may ha e ele a ed le els o s ess ho mones ha
acili a e he de elopmen o pos - auma ic s ess symp oms (Ma in e al. 2011). In line
Adm. Sci. 2023,13, 116 4 o 13
wi h his pe spec i e, esea ch by Ma in and colleagues (Ma in e al. 2011) demons a ed
ha wo k- ela ed s ess, ac ing on indi idual ulne abili y, igge s he onse o a ious
pa hologies, including pos - auma ic s ess diso de . I is he e o e hypo hesized ha
he ulne abili y induced by he p esence o wo k- ela ed s ess makes he indi idual
mo e ulne able o auma ic expe iences, in his case ela ed o COVID-19. Hence, his
s udy aims o in es iga e how wo k- ela ed s ess dimensions—lack o supe iso suppo ,
lack o colleague suppo , job demands, job con ol, and ole ambigui y—can ha e an
impac on psychological dis ess and how COVID-19- ela ed s ess can ac as a media o in
hese ela ionships.
Based on his amewo k, we hypo hesize:
H1a. Lack o supe iso suppo is associa ed wi h a highe le el o psychological dis ess.
H1b.
COVID-19- ela ed pos - auma ic s ess ac s a media o be ween he lack o supe iso
suppo and psychological dis ess.
H2a. Lack o colleague suppo is associa ed wi h a highe le el o psychological dis ess.
H2b.
COVID-19- ela ed pos - auma ic s ess ac s a media o be ween lack o colleague suppo
and psychological dis ess.
H3a. Job demands a e associa ed wi h a highe le el o psychological dis ess.
H3b.
COVID-19- ela ed pos - auma ic s ess ac s a media o be ween job demands and psycholog-
ical dis ess.
H4a. Lack o job con ol is associa ed wi h a highe le el o psychological dis ess.
H4b.
COVID-19- ela ed pos - auma ic s ess ac s a media o be ween lack o job con ol and
psychological dis ess.
H5a. Role ambigui y is associa ed wi h a highe le el o psychological dis ess.
H5b.
COVID-19- ela ed pos - auma ic s ess ac s a media o be ween ole ambigui y and psycho-
logical dis ess.
2. Ma e ials and Me hods
2.1. Sample and P ocedu e
This s udy was conduc ed as a pa o he wo k- ela ed s ess (WRS) isk assessmen o
a company in he indus ial sec o be ween 2020 and 2021. Employees we e in o med abou
he aim o he esea ch, he da a collec ion me hod, and he olun a y and con iden ial
na u e o hei pa icipa ion. This p elimina y phase ook place oge he wi h he company’s
Sa e y O ice, which p omo ed he ini ia i e and con ac ed he wo ke s ia he company
in ane , wi hou in luencing he p ocess. All pa icipan s ga e hei in o med consen .
The whole p ocess was conduc ed in acco dance wi h he Decla a ion o Helsinki and,
gi en he obse a ional na u e o he s udy, and in he absence o any in ol emen o
he apeu ic medica ion, no o mal app o al o he Ins i u ional Re iew Boa d o he local
E hics Commi ee was equi ed. The sample consis s o 294 wo ke s ( esponse a e = 70%).
The pa icipan s we e classi ied acco ding o 6 g oups. The majo i y (33.5%) pe o med
he ac i i y o G2. The sample is made up o 78.8% males and 21.2% emales. A o al o
39.6% o esponden s had wo ked be ween 4–9 yea s in hei cu en company; 22.5% o
10–19 yea s. Fu he mo e, 76.4% o pa icipan s we e blue-colla .
The pa icipan s we e classi ied acco ding o he ollowing 6 g oups:
•G oup 1: CNC machine ope a o s, panel ope a o s, and ame ope a o s;
•
G oup 2: quali y con ol o ice s and cleaning, epai , deli e y, and assembly pe sonnel;
•G oup 3: employees, supe iso s, and manage s;
•G oup 4: wa ehousing pe sonnel and depo ope a o s;
•G oup 5: p oduc ion line pe sonnel and u ni u e p epa a ion pe sonnel;
•G oup 6: main enance echnician and p o o ype ope a o s.

Adm. Sci. 2023,13, 116 5 o 13
2.2. Measu emen
Wo k- ela ed s ess was measu ed using he scales included in he S ess Ques ionnai e
(Mucci e al. 2015). In his model, i e subscales (wi h a 5-poin Like scale) we e included:
job demands, lack o job con ol, lack o supe iso lack o suppo , colleague suppo ,
and ole. The “job demands” includes 6 i ems (e.g., “I ha e un easonable deadlines”), he
“lack o job con ol” subscale includes 5 i ems (e.g., “ I can decide when o ake a b eak”
e e se coded), he “lack o supe iso suppo ” subscale includes 4 i ems (e.g., “I am
encou aged by my manage /supe iso ” e e se coded), he “lack o colleague suppo ”
subscale includes 5 i ems (e.g., “I ge he help and suppo I need om my colleagues”
e e se coded). C onbach’s alpha alues o he scales we e 0.63, 0.66, 0.78, 0.66, and 0.68,
espec i ely.
Psychological dis ess was measu ed using he Gene al Heal h Ques ionnai e
(GHQ-12)
(F acca oli e al. 1991). This ques ionnai e is used o iden i y nonspeci ic psychia ic
diso de s by e alua ing he cu en s a e o he wo ke and how his di e s om he usual
s a e. I is o med by 12 i ems wi h a 4-poin Like scale. Psychological dis ess can be
calcula ed as a o al sco e o acco ding o h ee subscales: loss o secu i y, (e.g., ‘ hinking o
sel as wo hless’), anxie y (e.g., ‘ eeling unhappy and dep essed’), and social dys unc ion
(e.g., ‘ eeling unable o make decisions’). The in e nal eliabili y showed a sa is ac o y
alue o 0.75.
COVID-19- ela ed pos - auma ic s ess was measu ed using he Impac o E en Scale
in i s sho e e sion (IES-6) (Gio gi e al. 2015). The scale used COVID-19 as he speci ic
auma ic e en . The i ems e e o eelings o dis ess expe ienced o e he p e ious 7 days
ollowing a speci ic auma ic si ua ion. Speci ically, he IES-6 includes 2 i ems o each o
he pos - auma ic s ess dimension: in usion (e.g., “Since he beginning o he COVID-19
eme gency, I hough abou i when I didn’ mean o”), a oidance (e.g., “Since he beginning
o he COVID-19 eme gency, I was awa e ha I s ill had a lo o eelings abou i , bu I
didn’ deal wi h hem”), and hype a ousal (e.g., “Since he beginning o he COVID-19
eme gency, I had ouble concen a ing”). C onbach’s alpha had a alue o 0.80.
2.3. S a is ical Analyses
The s a is ics so wa e IBM SPSS
®
( . 25, package o Windows, SPSS Inc., Chicago, IL,
USA) was used o analyze he da a. Fi s , we pe o med desc ip i e s a is ics and eliabili y
analyses. A e analyzing Pea son’s co ela ions, we conduc ed a media ion analysis o
es he hypo heses. Fo his pu pose, he mac o PROCESS 3.3 was applied (model 4).
Following a boo s ap me hod wi h 10,000 da a samples ha gene a ed 95% bias-co ec ed
con idence in e als, i was possible o examine condi ional models o p edic di ec and
indi ec e ec s be ween he a iables. A pa h is s a is ically signi ican i he associa ed 95%
con idence in e al (CI; bias co ec ed) does no include ze o (Hayes 2002).
3. Resul s
3.1. Desc ip i e Analyses
As shown in Table 1, he e is a s a is ically signi ican co ela ion be ween COVID-19-
ela ed pos - auma ic s ess and psychological dis ess ( = 0.37, p< 0.001) and be ween
job demands and COVID-19- ela ed pos - auma ic s ess ( = 0.19, p< 0.01), as expec ed.
Simila ly, he e is a s a is ically signi ican co ela ion be ween psychological dis ess and
ole ambigui y ( = 0.34, p< 0.001) and lack o supe iso suppo ( = 0.33, p< 0.01). The
same esul s we e ound o he co ela ions be ween he i e subdimensions o WRS (i.e.,
lack o supe iso suppo , lack o colleague suppo , job demands, lack o job con ol,
and ole ambigui y), as expec ed. Finally, he esul s show a good le el o eliabili y, wi h
C onbach’s alpha coe icien s be ween 0.63 and 0.85.
Adm. Sci. 2023,13, 116 6 o 13
Table 1. Desc ip i e s a is ics, C onbach’s alphas, and co ela ions be ween he s udy a iables.
Va iables 1 2 3 4 5 6 7
1. Lack o supe iso suppo -
2. Lack o colleague suppo 0.40 ** -
3. Job demands 0.36 ** 0.26 *** -
4. Lack o job con ol 0.33 ** 0.40 *** 0.25 ** -
5. Role ambigui y 0.41 ** 0.37 *** 0.13 * 0.38 *** -
6. Co id-19 s ess 0.15 * 0.02 0.19 ** 0.11 0.15 * -
7. Men al heal h 0.33 ** 0.28 *** 0.30 *** 0.26 *** 0.34 *** 0.37 *** -
Mean 2.72 2.49 2.85 2.62 2.10 2.42 1.98
S anda d De ia ion 0.98 0.74 0.74 0.76 0.71 0.79 0.45
α0.78 0.66 0.63 0.66 0.68 0.80 0.85
No e: N= 275, *** p< 0.001, ** p< 0.01, * p< 0.05.
3.2. Media ion Analyses
Rega ding he indi ec e ec , lack o supe iso suppo has a signi ican e ec on
COVID-19 ela ed-pos - auma ic s ess (
β
= 0.12; p< 0.01; 95% CI = 0.02, 0.21) [Figu e 1],
which, in u n, shows a signi ican e ec on psychological dis ess (
β
= 2.44; p< 0.001;
95% CI = 1.64, 3.23). As can be seen in Figu e 2, he e is a signi ican di ec e ec o
lack o supe iso suppo on psychological dis ess (
β
= 1.70; p< 0.001: 95% CI = 1.06,
2.33). The boo s ap con idence in e al o he indi ec e ec (ab) using 5000 boo s ap
samples was en i ely below ze o (
β
= 0.29, SE = 0.14, CI 95% [0.02, 0.61]). The e o e, he
esul s show a pa ial media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween
lack o supe iso suppo and psychological dis ess. Lack o supe iso suppo and
COVID-19- ela ed pos - auma ic s ess can explain 21.67% o he a iance (R
2
= 0. 2167;
p< 001).
Rega ding he indi ec e ec , lack o colleague suppo has a nonsigni ican e ec
on COVID-19- ela ed pos - auma ic s ess (
β
= 0.02; p> 0.05; 95% CI =
−
0.10, 0.15),
which, in u n, shows a signi ican e ec on psychological dis ess (
β
= 2.71; p< 0.001;
95% CI = 1.92, 3.50). As can be seen in Figu e 1 he e is a signi ican di ec e ec o lack
o colleague suppo on psychological dis ess (
β
= 2.09; p< 0.001: 95% CI = 1.25, 2.92)
[Figu e 2]. The boo s ap con idence in e al o he indi ec e ec (ab) using 5000 boo s ap
samples was en i ely below ze o (
β
= 0.06, SE = 0.20, CI 95% [
−
0.33, 0.46]). The e o e,
he esul s show no signi ican media ing e ec o COVID-19- ela ed pos - auma ic s ess
be ween lack o colleague suppo and psychological dis ess. Lack o colleague suppo
and COVID-19- ela ed pos - auma ic s ess can explain 20.69% o he a iance (R
2
= 0.2069;
p< 0.001).
Adm. Sci. 2023, 13, x FOR PEER REVIEW 7 o 14
Figu e 1. COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o supe iso suppo
and psychological dis ess. No e: N = 275, ** p < 0.01, * p < 0.05.
Figu e 2. COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o colleague suppo
and psychological dis ess. No e: N = 275, ** p < 0.01.
Rega ding he indi ec e ec , job demands has a signi ican e ec on COVID-19-
ela ed pos - auma ic s ess (β = 0.20; p < 0.01; 95% CI = 0.08, 0.33) [Figu e 3], which, in
u n, shows a signi ican e ec on psychological dis ess (β = 2.43; p < 0.001; 95% CI = 1.61,
3.24). As can be seen in Figu e 1, he e is no a signi ican di ec e ec o job demands on
psychological dis ess (β = 1.84; p < 0.001: 95% CI = 0.97, 2.70). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(β = 0.48, SE = 0.18, CI 95% [0.17, 0.91]). The e o e, he esul s show a media ion e ec o
COVID-19- ela ed pos - auma ic s ess be ween job demands and men al heal h. Job
demands and COVID-19- ela ed pos - auma ic s ess can explain 18.90% o he a iance
(R
2
= 0.1890; p < 0.001).
Figu e 1.
COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o supe iso suppo
and psychological dis ess. No e: N= 275, ** p< 0.01, * p< 0.05.
Adm. Sci. 2023,13, 116 7 o 13
Adm. Sci. 2023, 13, x FOR PEER REVIEW 7 o 14
Figu e 1. COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o supe iso suppo
and psychological dis ess. No e: N = 275, ** p < 0.01, * p < 0.05.
Figu e 2. COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o colleague suppo
and psychological dis ess. No e: N = 275, ** p < 0.01.
Rega ding he indi ec e ec , job demands has a signi ican e ec on COVID-19-
ela ed pos - auma ic s ess (β = 0.20; p < 0.01; 95% CI = 0.08, 0.33) [Figu e 3], which, in
u n, shows a signi ican e ec on psychological dis ess (β = 2.43; p < 0.001; 95% CI = 1.61,
3.24). As can be seen in Figu e 1, he e is no a signi ican di ec e ec o job demands on
psychological dis ess (β = 1.84; p < 0.001: 95% CI = 0.97, 2.70). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(β = 0.48, SE = 0.18, CI 95% [0.17, 0.91]). The e o e, he esul s show a media ion e ec o
COVID-19- ela ed pos - auma ic s ess be ween job demands and men al heal h. Job
demands and COVID-19- ela ed pos - auma ic s ess can explain 18.90% o he a iance
(R
2
= 0.1890; p < 0.001).
Figu e 2.
COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o colleague suppo
and psychological dis ess. No e: N= 275, ** p< 0.01.
Rega ding he indi ec e ec , job demands has a signi ican e ec on COVID-19- ela ed
pos - auma ic s ess (
β
= 0.20; p< 0.01; 95% CI = 0.08, 0.33) [Figu e 3], which, in u n,
shows a signi ican e ec on psychological dis ess (
β
= 2.43; p< 0.001; 95% CI = 1.61,
3.24). As can be seen in Figu e 1, he e is no a signi ican di ec e ec o job demands on
psychological dis ess (
β
= 1.84; p< 0.001: 95% CI = 0.97, 2.70). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(
β
= 0.48, SE = 0.18, CI 95% [0.17, 0.91]). The e o e, he esul s show a media ion e ec
o COVID-19- ela ed pos - auma ic s ess be ween job demands and men al heal h. Job
demands and COVID-19- ela ed pos - auma ic s ess can explain 18.90% o he a iance
(R2= 0.1890; p< 0.001).
Adm. Sci. 2023, 13, x FOR PEER REVIEW 8 o 14
Figu e 3. COVID-19- ela ed pos - auma ic s ess as a media o be ween job demands and
psychological dis ess. No e: N = 275, ** p < 0.01.
Rega ding he indi ec e ec , lack o job con ol has a signi ican e ec on COVID-
19- ela ed pos - auma ic s ess (β = 0.12; p > 0.05; 95% CI = −0.00, 0.24) [Figu e 4], which,
in u n, shows a signi ican e ec on psychological dis ess (β = 2.56; p < 0.001; 95% CI =
1.75, 3.37). As can be seen in Figu e 1, he e is no a signi ican di ec e ec o lack o job
con ol on psychological dis ess (β = 1.68; p < 0.001: 95% CI = 0.90, 2.50). The boo s ap
con idence in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely
below ze o (β = 0.30, SE = 0.18, CI 95% [−0.00, 0.69]). The e o e, he esul s do no show a
signi ican media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween lack o job
con ol and psychological dis ess. Lack o job con ol and COVID-19- ela ed pos -
auma ic s ess can explain 18.59% o he a iance (R
2
= 0.1859; p < 0.001).
Figu e 4. COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o job con ol and
psychological dis ess. No e: N = 275, ** p < 0.01, * p < 0.05.
Rega ding he indi ec e ec , ole ambigui y has a signi ican e ec on COVID-19-
ela ed pos - auma ic s ess (β = 0.17; p < 0.01; 95% CI = 0.04, 0.30) [Figu e 5], which, in
u n, shows a signi ican e ec on psychological dis ess (β = 2.43; p < 0.001; 95% CI = 1.63,
3.22). As can be seen in Figu e 1, he e is also a signi ican di ec e ec o ole ambigui y
on psychological dis ess (β = 2.45; p < 0.001: 95% CI = 1.56, 3.34). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(β = 0.40, SE = 0.19, CI 95% [0.04, 0.81]). The e o e, he esul s show signi ican pa ial
media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween ole ambigui y and
psychological dis ess. Role ambigui y and COVID-19- ela ed pos - auma ic s ess can
explain 22.14% o he a iance (R
2
= 0.2214; p < 0.001).
Figu e 3.
COVID-19- ela ed pos - auma ic s ess as a media o be ween job demands and psycho-
logical dis ess. No e: N= 275, ** p< 0.01.
Rega ding he indi ec e ec , lack o job con ol has a signi ican e ec on COVID-19-
ela ed pos - auma ic s ess (
β
= 0.12; p> 0.05; 95% CI =
−
0.00, 0.24) [Figu e 4], which, in
u n, shows a signi ican e ec on psychological dis ess (
β
= 2.56; p< 0.001; 95% CI = 1.75,
3.37). As can be seen in Figu e 1, he e is no a signi ican di ec e ec o lack o job con ol
on psychological dis ess (
β
= 1.68; p< 0.001: 95% CI = 0.90, 2.50). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(
β
= 0.30, SE = 0.18, CI 95% [
−
0.00, 0.69]). The e o e, he esul s do no show a signi ican
media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween lack o job con ol and
psychological dis ess. Lack o job con ol and COVID-19- ela ed pos - auma ic s ess can
explain 18.59% o he a iance (R2= 0.1859; p< 0.001).
Adm. Sci. 2023,13, 116 8 o 13
Adm. Sci. 2023, 13, x FOR PEER REVIEW 8 o 14
Figu e 3. COVID-19- ela ed pos - auma ic s ess as a media o be ween job demands and
psychological dis ess. No e: N = 275, ** p < 0.01.
Rega ding he indi ec e ec , lack o job con ol has a signi ican e ec on COVID-
19- ela ed pos - auma ic s ess (β = 0.12; p > 0.05; 95% CI = −0.00, 0.24) [Figu e 4], which,
in u n, shows a signi ican e ec on psychological dis ess (β = 2.56; p < 0.001; 95% CI =
1.75, 3.37). As can be seen in Figu e 1, he e is no a signi ican di ec e ec o lack o job
con ol on psychological dis ess (β = 1.68; p < 0.001: 95% CI = 0.90, 2.50). The boo s ap
con idence in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely
below ze o (β = 0.30, SE = 0.18, CI 95% [−0.00, 0.69]). The e o e, he esul s do no show a
signi ican media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween lack o job
con ol and psychological dis ess. Lack o job con ol and COVID-19- ela ed pos -
auma ic s ess can explain 18.59% o he a iance (R
2
= 0.1859; p < 0.001).
Figu e 4. COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o job con ol and
psychological dis ess. No e: N = 275, ** p < 0.01, * p < 0.05.
Rega ding he indi ec e ec , ole ambigui y has a signi ican e ec on COVID-19-
ela ed pos - auma ic s ess (β = 0.17; p < 0.01; 95% CI = 0.04, 0.30) [Figu e 5], which, in
u n, shows a signi ican e ec on psychological dis ess (β = 2.43; p < 0.001; 95% CI = 1.63,
3.22). As can be seen in Figu e 1, he e is also a signi ican di ec e ec o ole ambigui y
on psychological dis ess (β = 2.45; p < 0.001: 95% CI = 1.56, 3.34). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(β = 0.40, SE = 0.19, CI 95% [0.04, 0.81]). The e o e, he esul s show signi ican pa ial
media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween ole ambigui y and
psychological dis ess. Role ambigui y and COVID-19- ela ed pos - auma ic s ess can
explain 22.14% o he a iance (R
2
= 0.2214; p < 0.001).
Figu e 4.
COVID-19- ela ed pos - auma ic s ess as a media o be ween lack o job con ol and
psychological dis ess. No e: N= 275, ** p< 0.01, * p< 0.05.
Rega ding he indi ec e ec , ole ambigui y has a signi ican e ec on COVID-19-
ela ed pos - auma ic s ess (
β
= 0.17; p< 0.01; 95% CI = 0.04, 0.30) [Figu e 5], which, in
u n, shows a signi ican e ec on psychological dis ess (
β
= 2.43; p< 0.001; 95% CI = 1.63,
3.22). As can be seen in Figu e 1, he e is also a signi ican di ec e ec o ole ambigui y on
psychological dis ess (
β
= 2.45; p< 0.001: 95% CI = 1.56, 3.34). The boo s ap con idence
in e al o he indi ec e ec (ab) using 5000 boo s ap samples was en i ely below ze o
(
β
= 0.40, SE = 0.19, CI 95% [0.04, 0.81]). The e o e, he esul s show signi ican pa ial
media ion e ec o COVID-19- ela ed pos - auma ic s ess be ween ole ambigui y and
psychological dis ess. Role ambigui y and COVID-19- ela ed pos - auma ic s ess can
explain 22.14% o he a iance (R2= 0.2214; p< 0.001).
Adm. Sci. 2023, 13, x FOR PEER REVIEW 9 o 14
Figu e 5. COVID-19- ela ed pos - auma ic s ess as a media o be ween ole ambigui y and
psychological dis ess. No e: N = 275, ** p < 0.01.
4. Discussion
The aim o his esea ch was o in es iga e heo e ically, h ough he suppo o
p e ious li e a u e, and empi ically, h ough he de elopmen o s a is ical models, he
in luence o WRS on psychological dis ess and he media ing ole o COVID-19- ela ed
pos - auma ic s ess. The ocus o his esea ch was o in es iga e he link be ween he
subdimensions o wo k- ela ed s ess (i.e., job demands, job con ol, suppo om
colleagues and supe io s, and ambigui y) and psychological dis ess and o assess how
COVID-19- ela ed pos - auma ic s ess could be a media o in his ela ionship. As
p e iously men ioned, he SARS-Co -2 pandemic had signi ican nega i e e ec s on he
psychological heal h o indi iduals (Wang e al. 2020; Rahman e al. 2020). The e o e, in
line wi h Ka asek’s model, s udies showed ha a high le el o job demands is associa ed
wi h inc eased psychological dis ess (Inoue e al. 2022; Denne lein e al. 2021).
Fu he mo e, COVID-19, in e p e ed as an indi ec auma ic e en , can p o oundly a ec
he men al heal h o wo ke s who al eady su e om wo k- ela ed s ess (Laza us and
Folkman 1984; Gio gi e al. 2020; Hob oll 1998). In his ega d, ou amewo k is based on
COR heo y. Acco ding o his concep ualiza ion, bo h pe sonal and social esou ces can
mode a e he nega i e impac o s ess ul e en s, while wo ke s wi h low esou ce le els
can deple e hei ese oi in he ace o ano he s ess ul e en , he e o e leading o
g ea e psychological dis ess (Laza us and Folkman 1984; Gio gi e al. 2020; Hob oll
1998). The e o e, he p oposed models sugges ha COVID-19- ela ed s ess can ac as a
media o be ween occupa ional s ess and men al heal h. Adop ing a di e en ial
app oach, we conside ed di e en wo k- ela ed s ess subdimensions: lack o supe iso
suppo , lack o colleague suppo , job demands, lack o job con ol, and ole ambigui y.
The mos ele an media ing e ec o COVID-19- ela ed pos - auma ic s ess eme ges
be ween wo k demands, lack o job con ol, and men al heal h. I is in ac possible o
highligh a ela ionship o o al media ion be ween he a iables con i med by he
nonsigni icance o he di ec e ec o he job demands and lack o job con ol on men al
heal h (Vol me e al. 2021).
The indings o his s udy highligh he pi o al ole o COVID-19- ela ed pos -
auma ic s ess as an unde lying mechanism in he ela ionship be ween job demand,
lack o job con ol, and psychological dis ess. This is also in line wi h s udies p oposed
by d’E o e e al. (2021) and Giannopoulou e al. (2021), and he esea ch o (B i e al.
2021; d’E o e e al. 2021; Giannopoulou e al. 2021).
The media ing ole o COVID-19 in he ela ionship be ween job demands and
psychological dis ess could also be explained by he ac ha psychological dis ess and
nega i e heal h consequences appea when he e is an imbalance be ween demands and
esou ces (Ma chand and Du and 2011), as in he case o an e en such as COVID-19
Figu e 5.
COVID-19- ela ed pos - auma ic s ess as a media o be ween ole ambigui y and psycho-
logical dis ess. No e: N= 275, ** p< 0.01.
4. Discussion
The aim o his esea ch was o in es iga e heo e ically, h ough he suppo o
p e ious li e a u e, and empi ically, h ough he de elopmen o s a is ical models, he
in luence o WRS on psychological dis ess and he media ing ole o COVID-19- ela ed
pos - auma ic s ess. The ocus o his esea ch was o in es iga e he link be ween he sub-
dimensions o wo k- ela ed s ess (i.e., job demands, job con ol, suppo om colleagues
and supe io s, and ambigui y) and psychological dis ess and o assess how COVID-
19- ela ed pos - auma ic s ess could be a media o in his ela ionship. As p e iously
men ioned, he SARS-Co -2 pandemic had signi ican nega i e e ec s on he psycholog-
ical heal h o indi iduals (Wang e al. 2020;Rahman e al. 2020). The e o e, in line wi h
Ka asek’s model, s udies showed ha a high le el o job demands is associa ed wi h in-