Developmental trajectories, heterogeneous subgroups, and predictors of subgroup membership of PTSD among healthcare workers: An 18-month longitudinal study.

INTRODUCTION

Healthcare workers are at high risk of developing posttraumatic stress disorder (PTSD) when exposed to public health emergencies. The latent developmental trajectories of PTSD differ among individuals, even if they are exposed to similar environment. This study aimed to explore the longitudinal trajectories of PTSD among healthcare workers and to identify factors associated with different trajectory subgroups.

METHODS

This study conducted four surveys over an 18-month. In total, 2867 healthcare workers were included at baseline, and ultimately, 2422 individuals who participated in all four surveys were included in analysis, with a follow-up response rate of 84.48%. The developmental trajectory of PTSD and the heterogeneity of trajectory were identified using latent growth curve model and latent growth mixture model, respectively. Risk factors for the trajectories were analysed using multinomial logistic regression.

RESULTS

PTSD symptoms among healthcare workers decreased gradually from T1 to T3 yet increased slightly at T4. In addition, three PTSD symptom severity trajectories were identified: 'low symptom' (66.80%), 'moderate symptom' (27.25%), and 'high symptom' (5.95%). Compared with the low symptom trajectory, the main risk factors for the moderate symptom and high symptom trajectories were longer work seniority (OR = 1.897∼3.776), insufficient sleep duration (OR = 1.915∼2.522), exposure to traumatic life events (OR = 1.489∼1.882), and negative coping strategies (OR = 2.933∼7.543).

CONCLUSION

A considerable proportion of healthcare workers continued to experience moderate or high levels of PTSD symptoms during the mid-to-late stage of the public health emergency, which requires sustained attention from managers. Identified risk factors can inform references for prevention, early detection and intervention in individuals at risk of developing adverse PTSD.