Work Stress as a Consequence of the COVID-19 Pandemic: A Systematic Review

Abstract

The purpose of the study was to explore the works and existing scientific information in the databases on work stress during the COVID-19 pandemic. The specific objectives were: to determine the approaches addressed by research on work stress and to analyze the main results achieved. The study was of a documentary type, with a bibliographic design, framed in a systematic review. The articles indexed in the Web of Science and Scopus databases were reviewed, considering the keywords and search limits: work stress, pandemic and COVID-19, published between 2020 and 2022; obtaining 161 articles. The inclusion criteria were applied: original articles, dealing with the subject, in English and with open access; leaving a sample of 22 publications, presented according to a PRISMA diagram. The main approaches addressed were: work stress, working life and remote work; work stress in health workers; work stress in agricultural workers; job stress in restaurant workers; work stress in teaching workers; work stress in prison workers and work stress, depression and anxiety. The results reveal that the workers who experienced the greatest work stress were those in the health sector, considering the latent risk of contagion for being the front-line personnel in care. Consequently, it was determined that the impact of resilience and social support can help minimize this condition.

1. Introduction

The appearance of the COVID-19 virus and its subsequent declaration as a pandemic by the World Health Organization (WHO) [1] resulted in a transformation of the world scenario. This characterization of the virus as a pandemic was based on the spread of the disease across several countries and continents, affecting a large number of people.

According to Galindo et al. [2], the COVID-19 pandemic had an adverse effect on the economic growth of countries, surpassing the effects of the crisis of the past decade, deteriorating economies, decreasing employment and the well-being of society.

From the business level, the emergence of the pandemic represented a process of urgency and complexity, which required the entire world to enter a new normality [3]. However, the risk of contagion was latent, so the workers experienced fear of exposure and uncertainty, altering their safety, health and well-being [4].

Considering that the measures adopted, such as social distancing and mandatory confinement, have transformed the way people live and work. In general, these changes caused stress, to a greater degree to the people who had to continue attending their jobs, while the rest stayed at home [5].

In a general context, according to the WHO, work stress is the response that the worker may have in the face of work demands and pressures that are not equal to their knowledge and skills, which demonstrates their ability to face a situation [6]. Consequently, stress arises when the pressure is disproportionate or difficult to handle [7]. On the other hand, the International Labor Organization (ILO) [8] defines stress as the physical and emotional reaction to damage caused by the mismatch between the perceived demands, as well as the resources and abilities perceived by a person, to meet such demands.

According to Ricciardelli et al. [9], the COVID-19 health crisis produced important changes in the functioning of correctional systems, as well as probation processes. In the case of probation officers, their work was carried out regularly, however, the pandemic caused them stress and instability, since they considered it a new occupational hazard. In this sense, there are three factors that create stress: changes in the workload, routines and the delimitation of working life [10].

Certainly, the COVID-19 pandemic brought a significant increase in the demand for health services, generating additional burdens for workers in this sector [11]. In this sense, it was pointed out by Dabou et al. [12] that in the field of health professionals, the profound mental and emotional stress suffered by nurses during the health crisis altered their well-being and work performance.

Similarly, de Azeredo et al. [13] stated that the COVID-19 pandemic produced innumerable changes in the flow of hospital care and the management of nursing personnel. The adaptation to this new environment was very fast, considering that at the beginning there was not enough information about the disease and the impact it would have on the staff.

For Yıldırım and Yıldız [14], COVID-19 triggered a crisis never seen before that continues today. The nurses took care of aiding high-risk groups, with the possibility of contagion, since they did not have a treatment or vaccine for the disease. In addition, the prolonged use of safety equipment and the risk of infecting family members caused the staff to develop fear, anxiety, uncertainty and stress associated with work.

In the same way, Puto et al. [15] pointed out that it is complex for nurses to see themselves in this new normality, since they, as workers, are highly vulnerable to stress and its consequences. Especially considering the speed with which the COVID-19 virus spread, the short time to adapt to the large number of seriously ill patients, the high mortality rate, the unforeseen events, the loss of control, feelings of helplessness and the fear of carrying out long daily work routines.

Within this framework, Amirmahani et al. [16] considered in his research the work of midwives, in relation to how they were affected by musculoskeletal disorder (MSD) and work stress during the COVID-19 pandemic. In addition, strict sanitary measures, changes in schedules and the reduction in the number of health workers increased the workload of midwives, while their rest time decreased.

In the case of forensic health workers, Bogaerts et al. [17] pointed out that this group assists patients with psychiatric disorders and serious behavioral problems, which places them in a position of greater vulnerability to experience stress and work exhaustion. Therefore, working with these types of patients during the COVID-19 pandemic, with strict sanitary measures, could negatively affect their mental well-being.

The generation of work stress during the pandemic not only occurs depending on the area or sector where the worker works, it also depends on other aspects, such as the country or region of the world where they are located. In this sense, Maqsood et al. [18] indicated that fear of job insecurity, lack of food and social isolation deepened the degree of stress perceived by workers in Pakistan. Being that the health crisis changed the economic conditions in the periods of confinement, as well as the working conditions.

Likewise, Mahgoub et al. [19] pointed out that in the case of Sudan, the health system was directly affected by stress on health professionals, representing an unbearable burden for them. This caused serious negative effects in the country, especially due to loss of concentration, medical errors by doctors and nurses, indiscriminate use of medical supplies, negative atmosphere and considerable loss of life as a consequence of the disease.

Indeed, in a normal situation, working conditions are characterized by high levels of competitiveness and demand, causing a mental overload to the worker that can lead to feelings of stress, tiredness and fatigue, as well as concentration problems. With the appearance of the COVID-19 virus, these effects increased, deteriorating interpersonal relationships with colleagues and family members [20].

Considering the previous evidence, the execution of the present investigation is proposed with the objective of carrying out a systematic review of the investigations carried out on work stress as a consequence of the COVID-19 pandemic. The foregoing will allow the analysis of its causes, consequences and associated factors, in order to resolve the following question: What will be the existing scientific information about work stress as a consequence of the COVID-19 pandemic? On the other hand, the following questions were established that will allow us to delve into this topic:

Q1. What are the main approaches that address the study of work stress as a consequence of the COVID-19 pandemic?

Q2. What are the main results achieved in the study of work stress as a consequence of the COVID-19 pandemic?

In order to answer these questions, the study covered the following aspects: literature review, theoretical framework, materials and methods, results, discussion and conclusions.

2. Literature Review

2.1. Origins of Stress

The study of stress is attributed to Dr. Hans Selye, who is considered the father of stress, since he conceptualized it as the adaptive reaction of the human being to different stressors, calling it general adaptation syndrome [21]. His experiments with rats allowed him to establish the syndrome, which he later called the stress response: where he studied enlarged adrenal glands, lymph nodes and thymic atrophy, and gastric erosions/ulcers [22].

In the same way, Selye is considered the pioneer of stress research, with a study he began more than 50 years ago. In his work The Stress of Life, published in 1956, he defined stress as a non-specific response of the organism to a demand, which today is the best definition of what happens in the human body when it is out of comfortable balance [23].

According to Stora [24], stress is an external agent that the human being perceives at a specific moment, where the individual alerts his mental defense system to face it, through biological mechanisms. This external act and individual reaction, based on the structure of the psychic development of people, are the most advanced concepts on this subject.

Currently, workers worldwide face considerable changes in the performance of their functions, making the pressures to comply with labor demands greater [25]. Consequently, for a long time, one of the biggest challenges for researchers has been the measurement of stress, as well as ensuring that stress is not confused with depression [26].

2.2. Concept of Work Stress

One of the main effects of exposure to psychosocial risks is work stress. Currently, it is considered a common problem and not an individual one that can harm all workers, from all areas and professions. Likewise, job stress has consequences on physical and mental health, but also on the way work is done, that is, it affects the performance and productivity of workers [27].

The general concept of work-related stress can be controversial, since the probability that work causes illness is viewed by many sectors of society with skepticism, disinterest and concern [28]. According to ILO [8], job stress is determined by the form of work, the structure, the labor relations, and it occurs when the demands of the job exceed the capacities, resources or requirements of the worker, or when the knowledge of a worker to meet such demands does not match the expectations of the organization.

On the other hand, ILO [29] defines a healthy job as one where the pressure on the worker coincides with his abilities and resources, the level of control he exercises in his work and the support he receives from the people important to him. Considering that health is a condition of physical, mental and social well-being, and does not only involve the absence of diseases, it also includes a healthy work environment.

For Wontorczyk and Rożnowski [30], work stress is a key term in occupational psychology, which involves distress or eustress. Distress refers to negative events related to job performance, for example, burnout. Eustress is based on positive phenomena inherent to work, for example, commitment and good behavior.

According to Bakker and Demerouti [31], the most important stressors at work are: (1) demands, referring to the amount of work and the work environment; (2) control, related to the management of the way of doing the work; (3) support, constitutes the incentive, support and resources provided by the organization, managers and responsible personnel; (4) the relationship that is represented by the promotion of favorable labor practices to counteract inconveniences and handling of unacceptable attitudes; (5) the role, which corresponds to the knowledge of the functions of workers within the organization; (6) change, which is the way business change is managed and transmitted.

From a general context, all workers at some point feel that they are pressured at work. At the moment in which the individual perceives that these demands exceed his capacities and resources to face them, that is when work stress arises. On the other hand, according to the effort–reward model at work, the risk of experiencing stress and psychosomatic disorders is generated when the effort is not compensated by rewards, for example, in salary, appreciation, professional improvement or security [32,33].

2.3. Causes of Work Stress

The circumstances or factors that generally cause work stress are those that are unforeseen, uncontrollable, uncertain or unknown, generated as a result of a conflict or a decrease in performance. Therefore, stress is usually caused by events determined over time, such as work deadlines or permanent situations, such as family demands or job insecurity [34].

According to ILO [35], the factors in the workplace that have the capacity to produce stress are called psychosocial risks. Psychosocial risks at work are produced by the interactions that the worker has when carrying out his work in a specific context, conditioned by the policies, norms and culture of the organization, as well as by his needs, performance, degree of satisfaction, social and personal well-being.

Currently, there is a consensus in the scientific community about the nature of the psychosocial risk elements of work; however, the appearance of new forms of work and the constant change of work environments allow for the generation of new risk factors [36].

In this sense, Cox et al. [37] defined ten stressful aspects of work or psychosocial risks, divided into two groups, as shown in

Table 1. Psychosocial risk factors at work.

Category	Conditions That Define the Work
work content
Work environment and work equipment	Problems derived from the reliability, availability, maintenance or repair of equipment and facilities.
Activity design	Lack of variety and short work periods, fragmented or meaningless work.
Workload/pace	Overwork, lack of control of work pace, high levels of time-related pressure.
Work schedule	Shift work, inflexible and unforeseen schedules that do not allow you to have a social life.
work contest
Organizational role and culture	Lack of communication, lack of support for problem solving, lack of organizational goals.
Role in the organization	Undefined and conflict of functions.
Professional development	Stalled career development, over or under promotion, low wages, job uncertainty.
Autonomy in decision-making	Little participation in decisions, under work control.
Interpersonal relationships	Social isolation, little interaction with superiors, interpersonal conflicts, little social support.
Home-work relationship	Demands in home-work conflicts, low family support, professional problems.

Source: Information obtained from [37].

. The first group corresponds to the content of the work, related to its conditions and organization. The second group refers to the factors present in the organization and labor relations.

On the other hand, Selye [38] called stressors the conditions that cause stress. This term conceptualizes the agents that cause the appearance of stress. Since stress is a phenomenon that grows with the addition of each new pressure, a stressor can be minor; however, if added to a high level of stress, it can be counterproductive for the individual.

According to the model of Cooper [39], there are three major sources of stress: environmental factors, organizational factors and individual factors, as shown in Figure 1. Among the environmental factors that have the greatest incidence on workers, there are economic, political and technological uncertainties. Regarding organizational factors, the most relevant are labor demands, interpersonal demands and organizational leadership. The individual factors that most generate stress in workers are family and economic problems.

It is also relevant to note that the intensity and causes of work stress can vary according to the profession or occupation of the worker, also according to age. As Ju et al. [40] pointed out, public workers such as firefighters, health professionals, social workers and government officials have been directly exposed to COVID-19, in harsh work environments, with long working hours, with increases in workload, unclear responsibilities and exposure to human distress.

Similarly, Achdut and Refaeli [41] affirmed that policies should be developed in favor of health initiatives aimed at mitigating the effects of COVID-19 on mental health, as well as promoting changes in the labor market that allow the integration of youth in it.

2.4. Consequences of Work Stress

According to various authors, the level of stress that a person feels occurs as a function of two protective physiological processes: the alarm reaction and adaptation. The alarm reaction occurs when the individual faces a threat that puts his safety at risk, with physiological arousal being the first response reaction. Adaptation is the process that allows stopping responding, when it is accepted that external stimuli no longer constitute a threat to security. When one of these processes does not work properly or when it is difficult to go from one to the other, stress is generated [34,42].

In a general context, stress is evidenced in different ways; however, the consequences or effects on humans can be classified according to three categories: physiology, psychological and behavioral [43]. Physiological effects include changes in metabolism, increased heart rate, headaches and heart attacks. The psychological effects are related to changes in people’s attitudes, such as job dissatisfaction, it can also cause tension, anxiety and boredom. The effects on behavior are associated with changes in productivity, performance, absenteeism and turnover, changes in eating habits, lack of concentration and sleep problems [44].

According to Atalaya [45], when pressure builds up, it causes an adverse effect on emotions, on the cognitive process and on the physical condition of the human being. If stress is excessive, workers experience different symptoms that can impair their job performance and health, and even impair their ability to cope with the environment. Among the most common symptoms are: lack of relaxation, digestive problems, hypertension, restlessness, anxiety, tension, emotional instability and insomnia.

The physical symptoms of stress that an individual generally experiences can cause a temporary distraction, errors of appreciation or failures in daily tasks [46]. Likewise, factors such as the high workload and demands, little decision-making capacity, poor qualification criteria, the absence of organizational support, problems with management and co-workers, as well as monotony at work, are related to a greater possibility of occurrence of stress-related work incidents [47].

3. Theoretical Framework

Different studies indicate that work stress has been presenting an accelerated rate of growth in most countries worldwide. In general, the related statistics place work stress as the second cause of deficiencies in the health of workers, therefore, it is important to delve into such a relevant topic for society. Considering that work stress is a psychological condition, constituted by emotional, cognitive, physiological and behavioral responses, in the face of demanding work circumstances, which exceed the resources that the worker has, and over which he has no control [48].

3.1. Development of the Stress Event

According to Selye [38], a stress episode develops through three phases: alarm, resistance and exhaustion, as shown in Figure 2. In the alarm phase, people face a tensor or element that causes stress. Stress, in other words, is an aspect that increases adrenaline and anguish. The resistance phase constitutes a stage of adaptation to the stressful circumstance, where a series of physiological, cognitive, emotional and behavioral responses are developed, with the aim of negotiating the tensor event in the least harmful way for the person.

If the tensors continue and generate physiological or psychological damage to the person, the exhaustion phase will occur. In this sense, disorders tend to be chronic and even irreversible [38]. Burnout generates a set of effects of a physical, emotional, interpersonal, attitudinal and behavioral nature [49].

3.2. Classic Model of Job Stress

According to the classic model of stress presented in Figure 3, stress experiences are generated by a set of environmental or personal situations that can be defined as sources of stress or stressors. This originates a series of emotional experiences, setting in motion a set of processes to face these situations. Based on the greater or lesser achievement of that coping and stress management, different results can be produced for the individual, and the greater or lesser duration of those results can mean more relevant and prolonged consequences [50].

On the other hand, Karasek [51], in his model, pointed out that stress experiences originate when work demands are high and, in parallel, control ability (due to lack of resources) is low. Consequently, four work situations are distinguished, based on the combination of levels of demands and control. A job with a low level of control and a high level of demands will be stressful. When a job has a high level of demands and a high level of control, it is said to be an active job, since it does not necessarily have to be stressful. On the contrary, a job with a low level of demands and a low level of control is a passive job. Finally, when there is a high level of control and a low level of demands, work is stressful.

For Edwards [52], the element that characterizes a source of stress is the imbalance between the needs, requirements or expectations and the real context, mentioning that this imbalance will end up causing stressful experiences; to the extent that it exceeds the harmony of those variables.

3.3. Alternative Model of Collective Work Stress

The alternative model of the study of stress, as shown in Figure 4, considers that this phenomenon is generated at a collective level, which allows studying shared experiences, as well as the sources of stress that influence a group. In this sense, it is essential to consider social groups and the interactions between them, as the basic element of stress analysis. In addition, it is important to highlight that the subjective experiences of stress cannot be correctly understood by separating the subject from his environment and without considering its influence on him [50].

Within this framework, Olmedo [53] pointed out that those personal characteristics have a great impact on the balance and satisfaction of workers regarding their job performance. However, it should not be forgotten that stress in the work context is a social problem, which under no circumstances should be limited to individual reasons.

3.4. Other Perspectives for the Study of Work Stress

For Beehr and Franz [54], work stress is a multidisciplinary issue, which can be described from the medical, clinical, organizational psychology and engineering psychology perspectives. In the case of the medical perspective, it is focused on the contribution that stress has on the health of workers. On the contrary, the clinical perspective focuses on the influence of stressful working conditions on the mental health of the worker. The perspective of organizational psychology refers to the cognitive and perception processes of the worker, that is, what is stressful for him. Finally, the perspective of psychology in engineering is related to the physical or environmental origin of the stressful sources of work.

According to Salanova [55], in the field of psychology, job stress can be defined according to three approaches: stress as a stimulus, stress as a response and stress as a transaction. Additionally, Steiler and Rosnet [56], stated that there is a fourth approach, called job stress as a product of interaction.

In the case of stress as a stimulus, stress is considered to represent an external stimulus originating in the environment. Regarding stress as a physiological, psychological or behavioral response to a stressful event, it is based on Selye’s General Adaptation Syndrome. From the perspective of stress as a transaction, stress constitutes the resulting condition of how transactions (cognitive and emotional processes) between an individual and the environment are perceived [55]. Finally, the perspective of stress as an interaction emphasizes the relationship between the sources of stress and the effects of stress [56].

3.5. Measurement of Job Stress

Different authors have pointed out that to measure work stress, a theoretical approach and a vision must be followed to treat it, however, any way that is selected will have limitations, therefore, occupational health professionals should study such approaches [48]. In this order of ideas, three approaches stand out: personalized, compound and global. The personalized approach involves selecting or designing quantification instruments that best fit the context, population, objectives and existing inputs [56].

Regarding the composite approach, it seeks to quantify at least three dimensions of work stress: stressful aspects; psychological or physiological and organizational consequences; and mediating aspects related to the particularities that affect the interaction between stressors and the effects of stress. The global approach seeks to overcome the restrictions of the two approaches mentioned above [56].

Other approaches for the analysis, measurement and management of psychosocial risks at work, which include work stress, have been developed in certain European countries and their main objective is to analyze their impact on workers. However, most of these models are limited by the lack of clarity about the preventive intervention and the lack of standardization of the instruments for risk analysis. Among the most prominent models are: UK Work Stress Management Standard; START from Germany; Screening, Observation, Analysis, Experience (SOBANE) from Belgium; and the model of the National Institute for Prevention and Safety at Work (INAILISPESL) of Italy [57].

4. Materials and Methods

From the methodological context, the study corresponds to a documentary type, considering that the information for its development was obtained from different sources and documents. According to the design, the study was framed within a bibliographic design, which focused on the systematic and in-depth review of different types of documents, which were studied for a consequent presentation of findings [58].

On the other hand, the study was developed according to the guidelines of a systematic review, which the Ibero-American Cochrane Center [59] defined as the study that is prepared in order to group all the results that meet specific selection criteria having been previously determined, to answer a research question. In the same way, Dempster [60] pointed out that a systematic review is a complete documentation check, which does not correspond to traditional documentation. In other words, it is a review that is carried out methodically, according to a pre-established procedure to reduce bias, in order to summarize the information obtained.

A systematic review of research, whether quantitative, qualitative or a combination of both, has a procedure of steps that must be followed [61]. According to the Cochrane Handbook for Systematic Reviews of Interventions, systematic reviews should have the following characteristics: clearly stated objectives, with predefined selection criteria; explicit and repeatable methodology; methodical search to identify studies that fit the selection criteria; evaluation of the validity of the results of the chosen studies; systematic presentation and synthesis of the particularities and results of the selected studies [62].

The systematic review study was based on the Preferred Reporting Item for Systematic Reviews (PRISMA) statement, a methodology created in 2009 by a group of systematic reviewers, methodologists, clinicians and journal editors, as a guide to support researchers for complete systematic review reports [63]. Likewise, the update that this methodology underwent in 2020 was considered, where a new publication presentation guide was incorporated, considering the progress in the techniques to identify, choose, analyze and synthesize research [64].

In addition, according to Gough et al. [65], the PRISMA diagram is a fundamental element in the development of systematic reviews in research, since it allows the reader to follow the strict procedure of reviewing the evidence and determining the size of the sample.

On the other hand, the PRISMA declaration contemplates four phases, the first corresponds to identification, where there are specified articles related to the subject of study. The second is the selection, through which the titles and abstracts of the articles that may be eligible are reviewed. In this phase, articles are eliminated and those that fully address the topic of study are prioritized. The third phase corresponds to eligibility, where the criteria are established to specify the articles that must be included in the study. In this phase, the research questions are used to design the selection criteria. The last phase is the establishment of the inclusion criteria, where the metrics are specified [66].

In the opinion of Gough et al. [65], another relevant aspect within the PRISMA statement is the self-checking of the quality of the selected literature review. In the present study, a narrative systematic review was carried out; therefore, the analysis of the quality of the articles contemplated the following criteria:

• Update: current studies were incorporated.
• Completeness: the selected studies are the most relevant in the study area.
• Breadth: a sufficient number of studies were considered in the review.
• Rigor: the review and analysis of the results found do not have biases that call into question the credibility of the review.
• Structuring: the review was carried out in an orderly and systematic manner.
• Relevance: the revised approaches are adequate to explore the topic.
• Clarity: the narration of the review is adequate from the grammatical and syntactic point of view; it is also fluid and understandable.
• Precision: the terms used correspond to the lexicon associated with the area of study and the elements that are defined.

4.1. Search Procedure

The search for the articles was carried out in the Web of Science and Scopus databases, which are among the most complete for peer-reviewed literature. The period selected for the search for publications was from 1 January 2020 to 30 November 2022. The selection procedure in the selected databases was carried out using the keywords “work stress”, “pandemic” and “COVID-19”. Within this framework, it was established that the title of the articles must contain both keywords in a mandatory manner, through the use of the “And” connector.

In the same way, search limits were used that reduced the results, allowing the most relevant and specific articles to be obtained to answer the research question. Within these search limits were included: type of article, date of publication and subject.

4.2. Inclusion Criteria

The inclusion criteria established for the collection of the articles that were part of the investigation were the following: (1) original articles, (2) articles on work stress during the COVID-19 pandemic, (3) articles published between 2020 and 2022, (4) articles published in English, (5) open access articles. On the other hand, systematic review articles, expert opinions published in editorials and letters to the editor were excluded. In the same way, articles repeated in the databases were excluded.

4.3. Research Selection

In the search process, 161 publications were obtained, of which 83 were taken from the Web of Science database and 78 from Scopus. Of these 161 articles, 48 were excluded because they were repeated in the databases, leaving a total of 113. The title and abstract were reviewed for these 113 articles in order to verify compliance with the inclusion criteria.

Subsequently, 79 articles that did not describe the subject of study specifically, as established in the research question, one from a systematic review and eight with a language other than English, were excluded. Finally, 25 eligible publications remained, of which three that could not be analyzed due to their closed access were excluded. Therefore, the sample was made up of 22 articles. To illustrate this process of identification, selection and determination of the final sample of the systematic review study, Figure 5 shows the PRISMA diagram.

4.4. Analysis of the Information

The selected articles were tabulated considering different dimensions, such as author, year of publication, title, name of the journal and methodology used, as shown in

Table 2. Selected articles.

Authors	Title	Reference	Source Title	Methodology
Sandoval et al. (2021)	Remote Work, Work Stress, and Work-Life during Pandemic Times: A Latin America Situation Remote Work, Work Stress, and Work-Life during Pandemic Times: A Latin America Situation	[67]	INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH	Quantitative
Chang et al. (2022)	Work Stress and Willingness of Nursing Aides during the COVID-19 Pandemic	[68]	HEALTHCARE	Quantitative
Irawanto et al. (2021)	Work from Home: Measuring Satisfaction between Work-Life Balance and Work Stress during the COVID-19 Pandemic in Indonesia	[69]	ECONOMIES	Quantitative
Keeney et al. (2022)	Work-Life Stress during the Coronavirus Pandemic among Latina Farmworkers in a Rural California Region	[70]	INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH	Quantitative
Sadiq (2020)	Policing in pandemic: Is perception of workload causing work-family conflict, job dissatisfaction and job stress?	[71]	JOURNAL OF PUBLIC AFFAIRS	Quantitative
Lippert et al. (2021)	The Impact of the COVID-19 Pandemic on Occupational Stress in Restaurant Work: A Qualitative Study	[72]	INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH	Qualitative
Kuo et al. (2020)	Survey on perceived work stress and its influencing factors among hospital staff during the COVID-19 pandemic in Taiwan	[73]	KAOHSIUNG JOURNAL OF MEDICAL SCIENCES	Quantitative
Karadas and Duran (2021)	The effect of social support on work stress in health workers during the pandemic: The mediation role of resilience	[74]	JOURNAL OF COMMUNITY PSYCHOLOGY	Quantitative
Jia et al. (2022)	Work Stress, Health Status and Presenteeism in Relation to Task Performance Among Chinese Medical Staff During COVID-19 Pandemic	[75]	FRONTIERS IN PUBLIC HEALTH	Quantitative
Said and El-Shafei (2021)	Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt	[76]	ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH	Quantitative
Kostorz et al. (2022)	Coping Strategies for Stress Used by People Working in Managerial Positions in Schools and Educational Establishments during the COVID-19 Pandemic	[77]	SUSTAINABILITY	Quantitative
Rafique et al. (2022)	Investigating the impact of pandemic job stress and transformational leadership on innovative work behavior: The mediating and moderating role of knowledge sharing	[78]	JOURNAL OF INNOVATION & KNOWLEDGE	Quantitative
Košir et al. (2020)	Predictors of perceived teachers’ and school counsellors’ work stress in the transition period of online education in schools during the COVID-19 pandemic	[79]	EDUCATIONAL STUDIES	Quantitative
Langdon et al. (2022)	Occupational stress, coping and wellbeing among registered psychologists working with people with intellectual disabilities during the COVID-19 pandemic in the United	[80]	JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY	Quantitative
Ricciardelli et al. (2021)	In this line of work, boundaries are important: occupational stress and the well-being of community parole officers during the COVID-19 pandemic	[9]	CANADIAN JOURNAL OF SOCIOLOGY-CAHIERS CANADIENS DE SOCIOLOGIE	Qualitative
Deguchi et al. (2022)	Relationships between Occupational Stress, Change in Work Environment during the COVID-19 Pandemic, and Depressive and Anxiety Symptoms among Non-Healthcare	[81]	INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH	Quantitative
Mao et al. (2022)	Understanding the condition of disease prevention and control workforce by disciplines, duties, and work stress during the COVID-19 pandemic: A case from Beijing disease	[82]	FRONTIERS IN PUBLIC HEALTH	Quantitative
Modjo et al. (2022)	Analysis Factors Related to Work Stress among Public High School Teachers in Jakarta during COVID-19 Pandemic	[83]	MALAYSIAN JOURNAL OF MEDICINE AND HEALTH SCIENCES	Quantitative
Li et al. (2022)	Psychological Behavior, Work Stress, and Social Support of Frontline Nurses During the COVID-19 Pandemic	[84]	JOURNAL OF PSYCHOSOCIAL NURSING AND MENTAL HEALTH SERVICES	Quantitative
Coelho et al. (2022)	Association Between Occupational Stress, Work Shift and Health Outcomes in Hospital Workers of the Recôncavo of Bahia, Brazil: The Impact of COVID-19 Pandemic	[85]	BRITISH JOURNAL OF NUTRITION	Quantitative
Prasad and Vaidya (2021)	Occupational Stress and its Impact on Work-Life Balance and Psychological Well-being of Remote Working Women Employees in Information Technology Enabled Sector during COVID-19 Pandemic: An Empirical Study in Hyderabad Metro	[86]	REVIEW OF INTERNATIONAL GEOGRAPHICAL EDUCATION ONLINE	Quantitative
Israel et al. (2020)	Extension professionals’ information use, protective behaviors, and work-life stress during the COVID-19 pandemic	[87]	JOURNAL OF EXTENSION	Quantitative

. Making a general analysis, the following was found: 11 articles were published in the 2022, seven in 2021 and four in 2020. On the other hand, the articles were published by 19 different journals, that is, the same journal published four investigations. Finally, 20 studies were developed with a quantitative methodology and two were qualitative. Subsequently, an analysis of the content of each publication was carried out, in order to extract the information required to answer the research questions and finally establish the conclusions.

5. Results

5.1. Approaches That Address the Study of Work Stress as a Consequence of the COVID-19 Pandemic

An analysis of the different approaches or areas of study that addressed research on work stress during the COVID-19 pandemic was carried out, identifying the following: (1) work stress, working life and remote work, (2) work stress in workers of the health, (3) job stress in farmworkers, (4) job stress in restaurant workers, (5) job stress in educational workers, (6) job stress in prison workers and (7) job stress, depression and anxiety.

In the case of publications that focused on remote work, work stress and working life, four were counted. It should be noted that most of the articles focused on work stress in health workers, in total there were nine, considering that they were the front-line personnel during the COVID-19 pandemic. Additionally, two publications referring to job stress in agricultural workers and one on job stress in restaurant workers were recorded.

In the same way, four publications related to work stress in teaching workers were analyzed. Finally, the existence of one article on work stress in prison workers and one on work stress, depression and anxiety was verified within the sample; as presented in

Table 3. Approaches addressed in the selected articles.

Authors	Main Approaches	Reference
Sandoval et al. (2021)	Work stress, work life and remote work	[67]
Irawanto et al. (2021)		[69]
Sadiq (2020)		[71]
Prasad and Vaidya (2021)		[86]
Chang et al. (2022)	Occupational stress in health workers	[68]
Kuo et al. (2020)		[73]
Karadas and Duran (2021)		[74]
Jia et al. (2022)		[75]
Said and El-Shafei (2021)		[76]
Langdon et al. (2022)		[80]
Mao et al. (2022)		[82]
Li et al. (2022)		[84]
Coelho et al. (2022)		[85]
Keeney et al. (2022)	Work stress in agricultural workers	[70]
Israel et al. (2020)		[87]
Lippert et al. (2021)	Job stress in restaurant workers	[72]
Kostorz et al. (2022)	Work stress in teaching workers	[77]
Rafique et al. (2022)		[78]
Košir et al. (2020)		[79]
Modjo et al. (2022)		[83]
Ricciardelli et al. (2021)	Work stress in prison workers	[9]
Deguchi et al. (2022)	Work stress, depression and anxiety	[81]

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5.2. Results Achieved in the Study of Work Stress as a Consequence of the COVID-19 Pandemic

To determine the most outstanding results of the selected publications, the seven most outstanding approaches defined above were used, analyzing each article separately and selecting the most relevant, as shown in

Table 4. Main results obtained in the selected articles.

Authors	Main Approaches	Results	Reference
Sandoval et al. (2021)	Work stress, work life and remote work	The research had a sample of 1285 reactions collected during April and May 2020, through a PLS-SEM model, where it was verified that working remotely had a significant and positive impact on job satisfaction (β = 0.424, t = 8.496 > 1.96, p < 0.05). Likewise, remote work had a significant and negative effect on the work–life mix (β = −0.442, t = 10.456 > 1.96, p < 0.05). Similarly, working from home had a significant and negative impact on work stress (β = −0.452, t = 9.642 > 1.96, p < 0.05). On the other hand, the balance of work and family life had a positive and significant effect on job satisfaction (β = 0.171, t = 2.861 > 1.96, p < 0.05). In addition, job stress had a significant and negative effect on job satisfaction (β = −0.323, t = 4.721 > 1.96, p < 0.05).	[69]
Karadas and Duran (2022)	Occupational stress in health workers	The study had a sample of 402 health workers. The “General Work Stress Scale”, the “Brief Resilience Scale” and the “Multidimensional Scale of Perceived Social Support” were used as instruments. The existence of a significant negative correlation was found between job stress and social support (r = −0.223, p = 0.00) and resilience (r = −0.432, p = 0.00), and a significant positive correlation between social support and resilience (r = 0.226, p = 0.00). Resilience made it possible to measure the association between the perception of social support and work stress.	[74]
Keeney et al. (2022)	Work stress in agricultural workers	The study was developed through the implementation of the Migrant Farmworker Stress Inventory instrument, which was applied to 77 Latina farmworkers who worked in a border region of the US and Mexico. A subsample of five women participated in an interview with key informants. The data collection was carried out in the summer of 2021, where it was obtained that almost 40% of the respondents reported high levels of stress, indicative of psychosocial risks for mental health. Health and safety conditions, as well as stressors experienced, such as drug abuse and poor bathroom conditions in the workplace, language gaps and balancing the demands of work and family life.	[70]
Lippert et al. (2021)	Job stress in restaurant workers	The work had a sample of 16 people, all restaurant workers located in the city of Chicago, in this sense they were allowed to serve limited meals inside and unlimited outside (outdoors). Most of the participants were fired (n = 7) and the rest of the participants were placed in a different job (n = 3) or were employed at the same job (n = 6). Most of the participants had less income (n = 9) regardless of their employment status and others received unemployment insurance benefits (n = 10). Three participants had no health insurance, five had employer-paid health insurance, three paid out-of-pocket and five had public insurance. In addition, 88% of the participants reported having had more stress during the pandemic, but only 50% said they had difficulty managing stress. All respondents stated that their mental health had deteriorated as a result of the pandemic, however, when asked to report their mental health, few respondents (n = 4) reported “poor” mental health and most reported that their mental health was “bad”, “OK” or “Fine”.	[72]
Modjo et al. (2022)	Work stress in teaching workers	The research was carried out considering a sample of 113 teachers from public secondary schools during the year 2021, in the second wave of COVID-19. The instrument used was the NIOSH Generic Job Stress Questionnaire (GJSQ). The results showed that 47.8% of teacher’s experience job stress. It was found that role conflict (p 0.127), workload (p 0.134) and support (p 0.056) were not significantly related to work stress. However, role ambiguity (p < 0.015) is significantly related to work stress	[83]
Ricciardelli et al. (2021)	Work stress in prison workers	The work included a sample of 54 community probation officers in Canada, who were interviewed to identify stressful factors in the performance of their duties. Three occupational stressors related to COVID-19 were identified that stand out from the responses of the interviewees: (1) changes in the workload, routines and limits of work life; (2) effects of release policies; and (3) receive support and supervision in the face of additional health risks and reduced ability to interact with parolees.	[9]
Deguchi et al. (2022)	Work stress, depression and anxiety	The research was carried out with a sample of 807 health workers. Data were collected from 16 to 17 December 2020. Job stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Symptoms of depression and anxiety were studied using the Japanese version of the Patient Health Questionnaire-9 and the 7-item Generalized Anxiety Disorder scale, respectively. Likewise, demographic data, variables associated with work and variables associated with COVID-19 were collected. Adjusted odds ratios for the depression and anxiety groups were estimated via multivariate logistic regression analysis, for all demographic data, work-related variables, COVID-19-related variables and the six subdivided GJSQ subscales. The findings reflect the existence of a relationship between the variation in the workload, the ambiguity in the future work, the social support of co-workers, the contact with patients with COVID-19 and the depressive and anxiety symptoms.	[81]

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Consequently, within the works that addressed work stress, work life and remote work, that of Silva [67] stood out, since it states that the demands of remote work in conditions of confinement affected workers, generating a sensation of uncertainty related to employment, well-being and the economy. This research focused on how remote work during the COVID-19 pandemic generated work stress, affected the productivity, satisfaction, commitment and personal lives of workers.

On the other hand, the work of Karadas and Duran [74] that addressed work stress in health workers was selected, which analyzes the actions of resilience and the influence of social support in health workers; to minimize work stress during the pandemic. In the case of the articles that addressed the issue of job stress in farmworkers, only the one by Keeney et al. [70] was included in the sample, whose results reflect the different stressors that Latina farmworkers face in California. In this sample, the following factors stand out: substance abuse, the precarious conditions of the bathrooms, the language and the imbalance in the work and family life of these workers.

Similarly, Lippert et al. [72] was framed within the approach of managing work stress in restaurant workers. In this sense, the author determined various aspects that increased work stress in workers: fear of contagion due to inadequate safety conditions, public policies, job uncertainty, inconsistent wages and hours, absence of health benefits and paid time off.

One of the sectors hardest hit by the pandemic was education, which is reflected in the article by Modjo et al. [83], who pointed out that during the pandemic, teachers experienced an accelerated imbalance between work and their ability to handle it. Therefore, it was verified that the teachers faced the following aspects: role conflict, workload, lack of support and role ambiguity.

Within this perspective, the work of Ricciardelli et al. [9] referring to work stress in prison workers was considered, given that as essential workers, they continued their work during the pandemic. In this sense, the author determined the following main causes of work stress in this area: (1) changes in the workload, routines and limits of working life; (2) effects of release policies; and (3) receive support and supervision in the face of new health risks and reduced ability to interact with parolees.

Finally, within the articles that addressed work stress, depression and anxiety, the one by Deguchi et al. [81] was selected since it stated that the work stress generated by the pandemic and the variations in the work environment had a considerable impact on the mental health of workers who work in the health area. In this order of ideas, the results verified the existence of an association between the change in the workload, job uncertainty, social support, depression and anxiety.

6. Discussion

The objective of the study was to carry out a systematic review of work stress as a consequence of the COVID-19 pandemic, which made it possible to determine the existing scientific information in the selected databases. Within this framework, it was confirmed that most of the studies were published in the year 2022. In the same way, it was determined that the works were published by 19 different journals. Additionally, that most of the works were developed under a quantitative methodology.

In general, the selected papers addressed the issue of job stress experienced by workers during the COVID-19 pandemic, from different perspectives. Considering that the risk of contagion was the main fear of people, due to the large number of deaths caused by the disease. In addition to this, the workers’ safety, health and well-being were affected as a result of the spread of the virus.

Similarly, Conti et al. [11] pointed out that the health crisis caused by the COVID-19 virus represented an example of an abrupt stressor for workers, which can go from chronic to acute, depending on the duration of the pandemic. In this sense, health professionals, specifically nurses, experienced this change immediately, as pointed out Yıldırım and Yıldız [14], regarding the risk of nurses in their usual work, where they are exposed to the physical and social consequences of different diseases. Therefore, in his case, the appearance of COVID-19 increased the generation of stress.

One of the goals of the research was to analyze the various approaches that the selected investigations addressed. In this sense, one of the most studied areas was the work stress generated by the pandemic in health workers. In this regard, it was stated by Dabou et al. [12] that the profound psychological and emotional stress suffered by nurses during the pandemic affected their well-being and work efficiency. Therefore, it is necessary to evaluate behavior and stress management, with the aim of improving their well-being.

Within this perspective, Mahgoub et al. [19] stated that the pandemic accelerated the generation of groups of people with or without risks of deteriorating their mental health, with conditions such as depression, anxiety and stress. Considering that health professionals are the sector most vulnerable to psychological consequences, special attention must be paid, since high levels of stress can impact work environments and productivity.

Another of the objectives of the study was to evaluate the most relevant results of the selected articles. In this framework, the investigations of Ricciardelli et al., Irawanto et al., Keeney et al., Lippert et al., Karadas and Duran, Deguchi et al. and Modjo et al. [9,69,70,72,74,81,83] turned out to be the most relevant within their approach. The results achieved by the authors reflect the causes, consequences and effects of work stress in workers, from different approaches, where it was found that the most studied (greatest number of publications) was that of health workers.

This coincides with Aguero et al. [20], who stated that the negative interaction between the work environment and human factors can cause physical and emotional responses, which generate deterioration in the quality of life and lead to the emergence of diseases. All these elements make healthcare personnel more prone, in relation to the general population, to experience inconveniences related to work stress as a consequence of the battle against COVID-19.

Regarding the analysis of the findings of Sandoval et al. [67], it is confirmed that perceived stress has a competitive and mediating impact that minimizes the positive impact of remote work on worker productivity and commitment. In addition, people who were able to migrate to remote work during the pandemic experienced increased demands that increased perceived stress and decreased the balance between work and personal life.

In a similar study, Maqsood et al. [18] evaluated remote work and salary decreases as the main causes of the increase in perceived stress in workers during the pandemic. They found that salary reductions are a stress factor, causing financial insecurity and inability to face economic burdens during the health crisis.

Regarding the study by Karadas and Duran [74], the results showed that work stress can be mitigated by increasing social support and resilience. Considering that resilience can mediate the effect of social support on work stress in health workers. In this sense, effective guidance programs must be developed to reduce the factors that increase work stress.

In the same way, in his research, Bogaerts et al. [17], stated that resilience can reduce work stress and make positive contributions to the psychological well-being of the worker. Consequently, the authors determined that stress and fear of contagion from COVID-19 may be detrimental to the mental health of workers, while resilience may constitute a protective factor.

In relation to the study by Keeney et al. [70], it was based on the effects of work stress in agricultural workers, in an area where female labor is essential; therefore, the causes and effects of work stress directly affect the workers’ own well-being.

These findings are similar to those of Dabou et al. [12], who carried out a gender study, evaluating the impact of work stress on nurses. In this regard, the author determined that nurses perceive the delegation of tasks and the development of resilience as useful factors for managing work stress during the pandemic.

With reference to the work of Lippert et al. [72], stressors related to restaurant workers were analyzed. Such factors have represented a challenge during the times of closure and subsequent reopening, especially due to financial and labor uncertainty, as well as health concerns.

Within this order of ideas, the findings of Modjo et al. [83] indicate that the uncertainty of the role of secondary school teachers in Yakarta during the health crisis was the main cause of work stress. In this sense, the author proposed recommendations for the prevention and control of work stress in order to minimize the risks of its occurrence.

On the other hand, in his study on the effects of the health crisis on prison workers, Ricciardelli et al. [9] determined that correctional services must take into account the diverse experiences of frontline workers in the constitution of a system of probation (in post-pandemic) that is robust, supportive and inclusive, according to the realities of prison staff.

Another important approach to work stress is that developed by Deguchi et al. [81] who, in his study on work stress, depression and anxiety symptoms in Japanese non-health workers, identified two important relationships: one related to the level of workload, uncertainty, social support from colleagues, contact with people infected with the virus and anxiety symptoms; and another related to socioeconomic status and symptoms of depression.

These findings differ from those of Dennerlein et al. [5], whose approach was to develop an integrative framework for the total health of workers, incorporating health, safety and well-being. This framework should include several important aspects: be based on the conditions of work, use participatory and collaborative strategies; have the help of the commitment of the leaders, comply with the rules and laws.

7. Conclusions

Occupational stress in workers as a consequence of the COVID-19 pandemic is an issue that has been sufficiently addressed by various authors. However, it represents a great cause for concern for society, since it is directly related to anxiety, depression, productivity, efficiency and people’s quality of life. In addition, work stress is a global problem, which is increasing due to constant changes in the forms of work, economic growth and development of countries, added to this if a health crisis is added, the consequences can be unfavorable.

The experiences lived in the pandemic with respect to work stress, can be used to generate strategies and mechanisms that allow it to be measured and managed, since changes definitely generate stress, it would be possible to combat it so that its effect on the lives of workers is minimal. Considering that many things can happen that affect the performance of workers.

The findings of this work reflect that most of the selected studies focused on workers in the health area, being those who experienced the greatest stress during the COVID-19 pandemic, since they were caring for infected people, therefore they suffered the risk of contagion and even death.

It is noted that the study has certain limitations. It is a short investigation, which only considered two databases. Likewise, a weak point of the study is that it was only possible to analyze the approaches and results of the investigations, while other relevant aspects could not be analyzed, such as the methods used and the conclusions.