Open access peer-reviewed chapter
The study samples.
Abstract
Stressful situations are likely to impact health and social care workers’ quality of life negatively. Indeed, mental, physical, and emotional health problems have been reported in relation to the effects of the COVID-19 pandemic on the quality of life of health care workers. Instead of health care workers’ reality, and despite the care sector’s relevance, studies of the effects of COVID-19 on the quality of life of care workers have not been sufficiently explored. Recognizing the effect of COVID on the quality of life of care workers will collaborate with leaders of organizations, social work practitioners, and academics in the design of policies that promote better working conditions. Therefore, during 2021, a study was carried out in Chile where 150 social services and care workers were surveyed in Chile using a version of COV19-QoL in Spanish. The impact of COVID on quality of life is described, and the challenges that this reality implies to social service leaders are presented.
Keywords
- care workers
- quality of life
- COVID-19
- social services
- Chile - COV19-QoL
1. Introduction
Evidence indicates that in the face of catastrophes, natural disasters and conflicts, social services and care workers are exposed to higher levels of demands [1]. Indeed, due to vicarious stress, which is developed from working with vulnerable populations, and from their own experience of the catastrophe, social service workers could develop higher stress levels, affecting their well-being and quality of life [2, 3].
In this way, regarding the coronavirus disease established as a pandemic in March 2020 [4], it is possible to project high levels of stress and affectation on the quality of life of social care workers. Indeed, care workers were strained worldwide as the health and social care systems were quickly overwhelmed by the virus’s rapid spread and the limited availability of effective treatments [5]. At the same time, social care workers, like any citizen, had to face the closure of entire cities, the limitations of displacement and the health crisis, generating an impact on their quality of life [6, 7].
Due to the effects of the pandemic on their lives and jobs, it is necessary to know the effect that the COVID-19 disease has had on the quality of life of care social service workers. While studies are available for similar populations such as health workers, the reality of care workers has not been addressed. On the other hand, although there are studies focusing on well-being and stress in the care workforce in times of COVID-19, there are no studies that research the impact of COVID-19 on the quality of life of these workers.
Studying this question is quite relevant, especially concerning the strategies to be developed to face post-traumatic stress, exhaustion, and vicarious stress that naturally follows situations of catastrophe or disasters [8]. In this sense, the information will allow practitioners to design strategies to cope with stress and promote the well-being and quality of life of those who work in the care industry. Likewise, this study collaborates with the generation of knowledge about the effect of the pandemic on the quality of life.
In this way, this study sought to analyze the effect of the COVID-19 pandemic on the quality of life of social care workers in Chile to guide social and care service managers to face the effect that COVID-19 has had on the well-being of social services workers.
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2. Literature review
2.1 Quality of life and well-being in care workers
Care is a fundamental activity for a society that affects the well-being of all and, in particular, of populations that require greater support. Although caregiving tasks represent a substantial physical and emotional burden for those who perform them, these responsibilities have not been recognized as a social need. They are usually carried out through the donation of time and energy by caregivers [9]. Likewise, people who provide care services have negative working conditions, with low salaries and limited recognition of the social value of such work [10].
Due to the disease generated by the SARS-CoV-2 virus, the precarious conditions associated with care work were even more stressed. The situations of stress, uncertainty, and permanent confinement [11] affected care workers who have faced more demanding confinement and isolation to take care of themselves and those they have to care for [12]. Hence, it is possible to assume that care workers have seen their well-being more affected by the pandemic than other populations for various reasons.
In the first place, the literature confirms that in conditions of regularity, those who care, especially women, have lower levels of well-being compared to different populations analyzed. It has been established that, compared to the general population, caregivers experience lower levels of self-reported health and psychological well-being while reporting a greater number of days with poor physical or mental health [13].
On the other hand, a second factor that allows understanding the decrease in caregivers’ well-being, especially women again, is the situation experienced by formal caregivers who perform domestic work. The evidence shows how there would be a relationship between being a caregiver and playing other social roles with having a lower level of well-being and satisfaction with life, especially when playing the role of head of household [14, 15]. This statement becomes especially relevant when we analyze that domestic task also became tense and increased due to the crisis of care generated due to the pandemic [16].
Thus, it is also possible to estimate higher levels of affectation on quality of life among caregivers based on their living conditions, such as family support, stress, frustration, and economic difficulties, which impact emotional difficulties and high levels of overload [17]. The negative effect of care work would not necessarily be given by care but is configured when other relevant factors appear, such as a high workload and not having the support of another person to perform these functions [18]. All factors have been emphasized during the socio-health crisis [11].
Finally, another way of entering to project the effect of COVID on the well-being of caregivers is by considering the relationship they establish with the people who receive care. This becomes especially relevant in caregivers who exercise their functions toward vulnerable populations, such as people with different types of disease, people with disabilities, and older people. For example, those who care for autistic children experience a deterioration due to the deterioration of daily skills of those who receive care, children’s emotional and behavioral difficulties, the population’s high educational level, and a low-income level of the population median [19]. In the same vein, caregivers who assist people who have suffered strokes present feelings of loss of life that once was, the daily workload, the creation of a new normal, and the interaction with health care providers [20].
In conclusion, evidence suggests that it is possible to project the effect of COVID-19 and the health crisis on carers’ well-being and quality of life. Now, to advance the understanding of the phenomenon, it is relevant to analyze the level of affectation of COVID-19 on the well-being of different populations.
2.2 The effect of COVID-19 on quality of life
Due to the effect of the COVID-19 pandemic on people’s routines globally and, therefore, on people’s quality of life, different studies were quickly carried out that allowed us to know and measure the impact of the disease on people’s lives. Although no measurements have been reported in people who care, different adult populations have been analyzed to understand a problem in full development.
A measure used globally to observe the effect of the pandemic on people’s well-being and quality of life has been the COV19-QoL scale [21], which measures the effect of the pandemic on people’s quality of life and was developed a few months after COVID-19 was declared a pandemic. Hence, the different results it has had in different populations worldwide are presented.
One of the first studies reported describes the application of the measure in Filipino teachers. It was found a significant difference in the impact of COVID-19 on the quality of life according to the degree program of the people, but not according to age, sex, marital status, employment status, monthly salary, presence of a case of COVID-19 near their residence, personal knowledge of someone who was infected or died of COVID-19, presence of a medical condition, and perceived threat [22].
On the other hand, a second study in the Philippines, but this time applied to nursing students, showed that the COVID-19 pandemic had a moderate impact on the quality of life of nursing students and that the effect varied significantly depending on sex and the close presence of COVID-19 cases. The study also revealed a significant moderate inverse relationship between psychological resilience and the impact of COVID-19 on quality of life [23].
The same scale was implemented in a study applied to populations from different parts of the world. In this case, Khodami and his colleagues [24] analyzed changes in quality of life and psychological changes due to the pandemic in 3002 people worldwide. The results showed that quality of life decreases significantly over time, perceived stress increases significantly, and the regulation of emotions is problematic.
To these cases is added the study of the impact on the quality of life in Saudi Arabia. In this country, Islam and Alharthi [25] examined the effects of the pandemic on the quality of life in 506 households in Saudi Arabia. The results show that the quality of life of households was significantly reduced due to the COVID-19. At the same time, negative quality of life was related to low-income households, large households, male-headed households, urban households, households with unemployed or low-educated heads, and households with the elderly.
A group of researchers in Singapore [26] sought to determine the impact of COVID-19 stress syndrome on quality of life and gratitude in Singapore. A sample of 199 people confirmed that fear of foreigners spreading SARS-CoV2 was the most stressful fear among Singaporeans, while traumatic stress from COVID-19 was the least stressful fear. Similarly, COVID-19 stress syndrome was positively correlated with negative quality of life and negatively correlated with gratitude.
The same scale used in the previous studies was used in mental health patients in Serbia. Considering a sample of 251 patients, the research led by Maric et al. [27] confirmed that the effect of the pandemic on quality of life was above the theoretical mean of a 5-point scale. On the other hand, no association was found between the total VOC19-QoL score, demographic characteristics, and patient diagnoses.
Finally, the study by Bolatov et al. [28] aimed to investigate the influence of psychological well-being and different study formats on the academic motivation of medical students during the pandemic. The study concluded that the effect of COVID-19 quality of life on academic motivation was minimal.
In conclusion, based on these various studies, it is possible to establish that the affectation of quality of life does not necessarily depend on some demographic aspect, but eventually on external effects such as the time of experience of pandemic and traumas and stress previously experienced.
2.3 The COVID-19 disease in Chile
Recognizing that the COVID-19 pandemic is a global phenomenon, it is necessary to recognize that the crisis is shaped in a particular way in different social, political, and economic contexts. Specifically, in the Chilean case, the same month in which the WHO declared COVID-19 as a pandemic, in March 2020, Chile reported its first case [29], and like other countries in South America, the cases began to rise rapidly.
However, in the case of Chile, the health crisis that has had political, social, and economic repercussions has occurred in parallel with a social, economic, and political crisis that became evident months before the appearance of the disease caused by the SARS CoV-2 virus.
On October 18, 2019, Chile witnessed a “social explosion.” This was characterized by massive marches in the country’s main cities that had as their center the historical, social demands associated with an unacceptable level of inequality in a context of neoliberal policies that marked individualism and the lack of social cohesion [30]. This search for social transformations was not without its difficulties. The large mobilizations were accompanied by the use of violence by demonstrators and the police [31], causing looting, fires, and the vandalization of emblematic sites and spaces [32], which in turn had an impact on the mental health of the population [31].
Thus, in October 2019, the country was immersed in the most relevant social and political crisis of the last 40 years, and months later, the Chile faced one of the most significant health crises in its history, which severely exacerbated the above in economic terms.
In this scenario, the demand for assistance for workers in the so-called psychosocial area had to face new scenarios and challenges in a context of precarious work [33]. Thus, these workers, not only in Chile, had consequences and implications for their mental health [34]. On the other hand, the neoliberal policies on social welfare implemented in Chile during the Pinochet dictatorship [35] have exposed the necessary coordination between chiefs and frontline workers, stressing the work with budget cuts, demands for results, and other matters in terms of efficiency [36]. In addition, the institutional support to have sufficient resources—internet for the home, adequate mobile phones, computers—for a quality social intervention were not present [33].
Demands in Chile for greater social care were characterized by increased poverty, overcrowding, and precarious settlements, leading to an increase in infections [33]. Individuals and families experienced fragility and uncertainty, and professionals in care industries inhabit the same contradictions: social distancing policies include mandatory quarantines, periods of isolation and fear of getting sick, suspension of productive activity or radical changes, loss of income, and fear of the future [37].
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3. Methodology
A quantitative observational study was developed for exploratory purposes to analyze the effect of COVID-19 on caregiver quality of life. Thus, a before-after research design was carried out. First, demographic and occupational characteristics were asked, and between 2 and 4 weeks later, the impact of COVID-19 on quality of life was collected.
3.1 Sample
The sample of this research corresponds to workers dependent on organizations that provide care services in Chile and pursue social purposes such as overcoming poverty, the inclusion of people with disabilities, and caring for vulnerable and excluded people. The detail of the sample and its participation rate is described in Table 1.
| Organization | Number of workers contacted | Number of workers who finished the study | % |
|---|---|---|---|
| 1 (NGO aimed at overcoming poverty in Chile) | 119 | 57 | 47.9% |
| 2 (NGO that provides free care to children and young people with Down syndrome) | 41 | 20 | 48.78% |
| 3 (NGO that seeks to expand opportunities for a better life for Chile’s poorest and most excluded) | 150 | 73 | 48.67% |
Table 1.
The sample considered 310 people who were accessed through the organization in which they worked, communicating in detail the study’s objective, its stages, the treatment of the information, its anonymity, and its confidentiality. The number of people who answered the two surveys was 150, equivalent to 48.39% of the sample.
3.2 Measures
3.2.1 Demographics
The demographic and identity characteristics were collected in the first questionnaire sent to the sample. Information on gender, age, nationality, experience, school level, socioeconomic level, occupation, place of work, and modality of work during the last 6 months was requested.
3.2.2 COVID-19 pandemic affectation
To observe the effect of the pandemic on quality of life, the scale “Impact on Quality of Life” (COV19-QoL) developed by Repišti et al. [21] was used, which aims to capture the effect of COVID-19 on people’s quality of life and has been applied in different populations.
For application in a Spanish-speaking population, the questionnaire, composed of six statements, was translated into Spanish and then tested by three expert judges. The questionnaire in English and Spanish is in Table 2.
| Due to the spread of the coronavirus | Debido al CORONAVIRUS, usted: |
|---|---|
| I think my quality of life is lower than before | Creo que mi calidad de vida es peor/baja que antes |
| I think my mental health has deteriorated | Creo que mi salud mental se ha deteriorado |
| I think my physical health may deteriorate | Creo que mi salud física se ha deteriorado |
| I feel more tense than before | Me siento más tensa(o) que antes |
| I feel more depressed than before | Me siento más deprimida(o) que antes |
| I feel that my personal safety is at risk | Siento que mi seguridad personal está en riesgo |
Table 2.
English version and Spanish translation of the COV19-QoL scale.
The scale was applied through an online form. Thus, using a Likert scale, the statements were presented to the individuals, and they were asked to identify the level according to each sentence between 1 (strongly disagree) and 5 (strongly agree). The total score is the mean of the item scores, and the higher scores indicate a more severe impact of COVID-19 on QoL.
Reliability tests were applied through Cronbach’s alpha statistic, evidencing good reliability equivalent to 0.88.
Regarding the validity of the construct, a study was carried out considering a study of different populations of social organizations, among which was that of this sample, and a factor analysis test was applied considering the six items and 217 responses. The results are shown in Table 3 and allow to establish an adequate adjustment of the scale model.
| Estimator | Result |
|---|---|
| RMSEA (Root Mean Square Error Of Approximation) | 0.083 |
| CFI | 0.975 |
| TLI | 0.959 |
| SRMR | 0.09 |
Table 3.
COV19-QoL scale confirmatory factor analysis estimators.
3.3 Data collection procedure
The study contemplated the application of two online questionnaires. The first one collected demographic information, while the second one observed the impact of COVID-19 on quality of life 2 to 4 weeks later. Both were emailed to the participants. Compensation draws were committed to those who completed the study to ensure adherence to the study. Access to the sample was coordinated with the human resources office of each organization, ensuring that it did not intervene in the performance of its tasks.
The participants were informed about the study purpose, the content of the questionnaires, confidentiality, and their anonymous and voluntary participation. The form application began in June and ended in October 2021. Once the survey was closed, the database was created in the statistical software (SPSS), where the information was processed.
3.4 Data analysis
To meet the study’s objective, a descriptive statistical analysis was carried out to measure and characterize the level of affectation of COVID-19 on the sample. The responsible researchers carried out the analysis of the information. Additionally, the impact of COVID-19 on quality of life was explored about demographic variables identified by the specialized literature and that were self-reported by the participants, such as occupation, age, socioeconomic level, and race.
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4. Results
The first analysis sought to describe the sample based on demographic characteristics based on frequencies and summary statistics such as mean, median, and standard deviation.
Thus, Table 4 describes the sample as a feminized population, while women represent 72%. Regarding ethnicity, most people identify as mestizos. Only 30% define themselves as white people. The percentage of black people or mulattos is less than 1%. This is different about other studies focused on social services, where the distribution of people according to their race presents greater dispersion than the case presented [38].
| Variables | n | % | Average (years) | Median (years) | Standard deviation (years) |
|---|---|---|---|---|---|
| Organización | |||||
| 1 | 57 | 38.0 | |||
| 2 | 20 | 13.3 | |||
| 3 | 73 | 48.7 | |||
| Gender Women Men | 108 42 | 72 28 | |||
| Ethnicity White Mestiza Indigenous Mulata Afro-American Other | 45 86 9 1 0 9 | 30 57.3 6 0.7 0 6 | |||
| School Level Primary High School Technical Ed. Undergraduate Postgraduate | 0 8 16 68 58 | 0 5.3 10.7 45.3 38.7 | |||
| Socioeconomic Level Low Middle High ND | 21 55 72 2 | 14 36.7 48 1.3 | |||
| Age | 40.23 | 38 | 9.799 | ||
| Tenure | 7.77 | 6 | 5.95 | ||
| COV19-QoL | 2.94 | 3 | 0.95 |
Table 4.
Characteristics of the study sample.
Other relevant information regarding the sample is its high level of education, while 94.7% have higher education courses. Moreover, 38.5% have postgraduate studies that far exceed the national reality. 1
On the other hand, it is relevant to note that the people in the sample have a mean of 40.23 years old and 7.7 years of tenure, thus constituting a young population with average seniority higher than other studies in the same area. Finally, it is important to highlight the composition of the socioeconomic level of the sample since a large part of the people who participated in the study belongs to the middle and upper sections. Although this composition is different from that observed in the national population, it makes sense that people with a high level of schooling have a high average socioeconomic situation.
Finally, it should be noted that the sample presents a mean index of affectation of quality of life above the arithmetic mean of the scale. In addition, 50% of the sample has an index higher than 3, which can mean a high affectation.
After a description of the sample, bivariate analyses were performed to observe the relationship between demographic aspects that could be configured as antecedents of people’s quality of life.
Thus, we analyzed the average affectation of quality of life by COVID-19 according to organization, gender, ethnicity, work modality, school level, and socioeconomic level, identifying a relationship between affectation of quality of life according to the organization of those who responded, their age, level of schooling and socioeconomic level.
Based on these first results and regarding the objective of the study, we made contingency tables to evaluate the factors that show a relationship with the COV19-QoL index.
In the first place, we observed the age, as it presents a negative relationship with COV19-QoL, which in the framework of the sector and sample analyzed could be related to the care work that people could have, particularly women, younger, for this we categorize people in age ranges and gender. This analysis is presented in Table 5.
| Age | |||||
|---|---|---|---|---|---|
| Gender | 18–24 years | 25–35 years | 36–45 years | 46–55 years | 55 < years |
| Women | — | 3.20 | 2.82 | 2.70 | 2.55 |
| Men | 2.67 | 3.44 | 2.94 | 2.58 | 2.58 |
Table 5.
COV19-QoL mean and age.
In fact, the group between 25 and 35 years old presents the highest levels of affectation, both in men and women, exceeding the average of the sample. Because one of the organizations has a higher percentage of men, we observe the same relationship according to the organization, and the trend is maintained, that is, considering the gender and organization of people, people between 25 and 35 years old are the most affected.
On the other hand, we were particularly struck by the relationship observed between the organization and COVID-19 affectation, which is detailed in Table 6, despite the differences in mission, they are similar in relation to the type of services they offer and the work they do. Because of the above, we reviewed the timing of the data collection, because the study was conducted at a time when the pandemic was active, therefore, the specific COVID-19 situation could affect the average affectation. In fact, the organization that had an average affectation of 3.34, the highest, participated in the study when the infection positivity rate was 12%, while the organization that had the lowest affectation value participated in the study when the positivity rate was also the lowest (1%).
| Variables | n | Mean COV19-QoL | Standard deviation |
|---|---|---|---|
| Organización 1 2 3 | 57 20 73 | 3.34 3.04 2.6 | 0.12 0.21 0.1 |
| Gender Women Men | 108 42 | 2.89 3.05 | 0.09 0.15 |
| Ethnicity White Mestiza Indigenous Mulata Afro-American Other | 45 86 9 1 0 9 | 2.72 3.12 3.03 - - 2.05 | 0.11 0.10 0.36 - - 0.27 |
| School Level Primary High School Technical Ed. Undergraduate Postgraduate | 0 8 16 68 58 | - 2.95 2.32 3 3.04 | - 0.31 0.12 0.12 0.12 |
| Socioeconomic Level Low Middle High ND | 21 55 72 2 | - 2.5 3.01 3.03 | - 0.15 0.13 0.11 |
Table 6.
COV19-QoL and demographics variables.
Finally, we analyze the results associated with the socioeconomic level and the negative relationship to COV19-Qol. Given the low representation of the endpoint levels in the sample, we categorized the variable into three: low, medium, and high. According to this classification, it became clearer that the most affected were middle-class people, regardless of organization and gender, as presented in Table 7.
| Socioeconomic level | ||||
|---|---|---|---|---|
| Organization | Gender | Low | Middle | High |
| 1 | Women | 2.63 | 3.23 | 3.38 |
| Men | 4.00 | 3.38 | ||
| 2 | Women | 2.58 | 3.12 | 2.97 |
| Men | 3.17 | 4.17 | 2.25 | |
| 3 | Women | 2.32 | 2.78 | 2.66 |
| Men | 2.63 | 2.70 | 2.06 | |
Table 7.
Cov19-QoL mean by organization, gender, and socioeconomic level.
However, considering this information and the results of the bivariate analyses, a bivariate correlation test was applied, obtaining the Pearson coefficient. The results are described in Table 8.
| 1 | 2 | 3 | 4 | |
|---|---|---|---|---|
| COV19- QoL | 1 | .174* | .340** | −.266** |
| Socioeconomic Leve | 1 | 304** | -,175* | |
| % COVID-19 Test Positive | 1 | −0.102 | ||
| Age | 1 |
Table 8.
Correlations Cov19-QoL mean by organization, gender, and socioeconomic level.
According to the results of the correlations, it is possible to confirm a positive relationship between socioeconomic status and the affectation of quality of life. Therefore, people from the lower ranges of socioeconomic levels have lower average scores that show a lower affectation of COVID on quality of life. There is also a negative relationship between age and affectation, which means that older people have a lower level of affectation on quality of life. Finally, the direct relationship between test positivity and deterioration of quality of life was confirmed.
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5. Discussion
The quality of life of people who worked in care social services in Chile during the COVID-19 pandemic was affected by the pandemic. Our study confirmed that the sample obtained a COV19-QoL score higher than the arithmetic means, and almost half of them obtained high scores (>3). More specifically, our study confirmed that it was young people from middle socioeconomic levels were most affected by the pandemic in Chile.
With respect to age, the findings present that there is a greater impact of COVID on social service workers at a younger age. This makes sense given that younger people generally have less professional experience in dealing with complex situations in their work environment. In addition, it is expected that younger people have lower levels of training in the area, so they have fewer professional tools to cope with these situations, an issue that has been considered by the literature previously [39, 40]. It is also important to consider that young workers are more likely to be employed in occupations more affected by the pandemic, with a higher risk of losing their jobs or reducing their working hours [41]. The negative relationship between age and COV19-QoL could also be explained due to other care roles held by people between 25 and 35 years old, the age range most affected in the study. In this sense, age could be related to care functions within their home, assuming that workers in care industries, men and women, must face the difficulties of care in the organizations where they work and their homes.
Moreover, a positive and significant relationship is reported between the socioeconomic level of social service workers and a COVID affectation on quality of life. It could be considered that this socioeconomic level is related to professional profile and positions of high responsibility in care centers. Therefore, modifications in work routines, protocols, and other activities have gone through these workers, who have been called to lead the transformations in the workspaces [42], which could mean a higher level of stress and exhaustion.
In this way, it is expected that COVID represents an especially complex challenge for women, considering situations such as quarantine, and telematic classes, to point out some examples have generated that the boundaries between the workspace and the domestic space become blurred. This could be reflected in women between 25 and 35 years old cases, where a higher level of impact of the pandemic is observed. The results allow understanding the connection between two of the groups most exposed to experiencing complex situations at work; women with a high workload for care work outside the workplace and young people with a less academic or professional specialization.
The results of our study are consistent with previous results in other parts of the world since the effect of demographic factors on the impact of quality of life (gender, age, socioeconomic status, ethnicity, among others) is unclear. It seems that other demanding and stressful experiences are antecedents of the greater impact of the pandemic on the quality of life. In the case of the population analyzed, it seems that the demands of other roles or identities would affect how people live the pandemic.
Thus, these results are added to the fact that social services were affected by the absence of face-to-face, the incorporation of digital technologies, and the adaptation, on the fly, of work processes, in an environment of great uncertainty. Telematic work developed a favorable area to withdraw the labor rights achieved in salaried work, in terms of privacy, control of leisure and rest, conciliation of work and family life, and rights with a gender focus, among others [43]. Given the above, it is necessary to intervene in the working conditions in these organizations, recognizing the double experience of stress in their workplaces.
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6. Conclusions
COVID-19 has transformed the lives of people around the world, and care social service workers are no exception. The pandemic changed their practices and routines at work, having to face a double challenge, that of the pandemic and that of caring for others during the pandemic.
Through our study, we were able to know that the levels of affectation in this population are high and that those who are most affected are the youngest people, who could be developing other care and parenting tasks in their own homes. Also, as noted in other studies, women are affected.
In addition to providing key information, our study allows us to have a tool in Spanish to evaluate the impact of COVID-19 on people’s lives and thus monitor the welfare status of people in a Spanish-speaking context.
While this research highlights the deterioration of the quality of life to which health care workers are exposed, its results should be observed with caution. First, the COVID-19 pandemic continues to be a developing phenomenon that continues to be researched and about which new things are constantly known.
Likewise, the study sample is limited to the unique context of social services in Chile, and they are not generalizable because of the context and because some attributes of caregivers in this type of service may have cultural roots [44]. In fact, the results may not be generalizable to other countries, as cultural norms are one of the key factors that can shape individual behavior [45]. Therefore, studies that test a similar model in an intercultural setting should be encouraged.
However, the scenario described is an urgent call to social work managers and leaders to promote the well-being and performance of care workers and to address post-traumatic stress and vicarious stress while populations served by the care workforce present significant mental health issues.
Therefore, it is proposed that those in leadership positions implement practices that address the problem described. In this way, the first step for managers should be to recognize the problem, while many times, the symptoms of stress are overlooked by teams, naturalizing the impact on quality of life. Once the different actors have recognized the problem, the provision of permanent personal and collective protective equipment must be guaranteed, and effective use must be ensured. In the same way, health in all its dimensions of caregivers should be monitored, breaks in their working day should be encouraged, and periodic instances of self-care and progress in individual or collective supervision should be provided.
By following some of these guidelines, we believe that social service will be a little stronger than what has happened in the last 2 years.
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Notes
- In Chile, the academic undergraduate degree (between 4 and 6 years) is sufficient to practice professionally.