Safety Responsiveness and Psychological Distress Among Health Care Workers During COVID-19 (2020–2022) in the Pacific Northwest

Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n 5 3468). Psychological distress was measured with the Well-being Index (range: 22 to 7 points). Safety response was scored on the basis of participants’ ratings (on a 1–5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b 5 20.54; 95% confidence interval [CI] 5 20.67, 20.41) and the unit level (b 5 20.73; 95% CI 5 21.46, 20.01). The cross-level interaction was also statistically significant (b 5 20.46; 95% CI 5 20.87, 20.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. (Am J Public Health. 2024;114(S2):S204–S212. https://doi.org/10.2105/AJPH.2024.307582)