Disaster Mental Health
Bre'Anna L. Free, M.S.
Graduate Student
University of Memphis
Memphis, Tennessee
Allyssa S. Martin, None
Research Assistant
University of Memphis
Memphis, Tennessee
Mya E. Bowen, M.S.
Graduate Student
University of Memphis
MEMPHIS, Tennessee
Rimsha Majeed, M.S.
Graduate Research Assistant
University of Memphis
Cordova, Tennessee
Audrey B. Garrett, B.A.
Student
The University of Memphis
Memphis, Tennessee
Timothy A. Brown, None
Professor
Boston University
Boston, Massachusetts
Todd J. Farchione, Ph.D.
Research Associate Professor
Boston University
Boston, Massachusetts
Bonnie Brown, B.S., RN
Nurse Administrator and Health Communications Specialist
Boston University
Boston, Massachusetts
J Gayle Beck, Ph.D.
Chair of Excellence Emerita
University of Memphis
Memphis, Tennessee
The COVID-19 pandemic has been linked to negative psychological outcomes in healthcare providers. In nurses specifically, increased depression and anxiety symptoms have been noted. In this context, the concept of institutional betrayal (harmful acts by a trusted institution) has garnered interest given the medical systems’ varied responses to the pandemic and perceived failure to support staff. Institutional betrayal has been noted to exacerbate the impact of stressors and has been linked to negative psychological sequalae. Research suggests that factors such as social support may buffer against depression and anxiety symptoms, yet this hypothesis has not been directly examined. As such, the current study aimed to examine the moderating impact of social support on the relationship between institutional betrayal and simultaneous outcomes of depression and anxiety symptoms in a sample of nurses.
The final sample included 324 nurses in Massachusetts, ranging in age from 23 to 69 (Mage = 43.23; SDage = 12.65). The sample was predominantly white (94.5%) and used she/her pronouns (93.2%). Perceived institutional betrayal was measured via modified version of the Institutional Betrayal Questionnaire and perceived social support was measured via the Multidimensional Scale of Perceived Social Support. Depression and generalized anxiety symptoms were measured via the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Assessment, respectively.
Moderation analysis was conducted via Mplus. First, main effects were examined; this model explained 12.6% and 16.7% of the variance in depression (p < .001) and generalized anxiety symptoms (p < .001). Next, the model was re-examined including the interaction between perceived social support and perceived institutional betrayal. Significant interactions were noted on depression (B = -0.10, p = .03) and anxiety symptoms (B = -0.11, p = .02). Specifically, for every unstandardized unit increase in perceived social support, the direct effect of institutional betrayal on depression and anxiety decreased by .10 and .11 units, respectively.
Results from the current study underscore the importance of social support among nurses in the face of COVID-related stressors. When perceptions of social support increased, the strength of the association between perceived institutional betrayal and both depression and anxiety symptoms decreased. These findings highlight the buffering effect of social support, which supports and extends findings in the broader literature. Continued exploration of other factors is warranted to increase understanding the impact of COVID-19 on nurses. Policy and clinical implications will be explored at the systemic and individual level, respectively.