Key salutogenic factors associated with wellbeing among a cohort of regional and rural healthcare workers during the COVID-19 pandemic: an exposure-wide cross-sectional study

Background Growing evidence shows that an understanding of factors which protect a person’s wellbeing is integral to improving overall mental health. As advocated by the salutogenic approach, health resources (assets) available to an individual (e.g. social support, clinical training, psychological resilience) can enable movement towards the healthier end of a health continuum. However, little is known about protective factors associated with healthcare worker (HCW) wellbeing in regional/rural settings. The current study aimed to conduct a salutogenic exploration of factors associated with HCW wellbeing among an Australian regional/rural cohort during the COVID-19 pandemic. Methods This exposure-wide, cross-sectional study was conducted using participant data from 1313 healthcare workers in the Loddon Mallee Healthcare Worker COVID-19 Study. Thirty-three candidate exposure (i.e. independent) variables spanning sociodemographic, occupational, COVID-19 related, emotional health and wellbeing, physical health/medical and health behaviours, were evaluated for their independent association with HCW life satisfaction as the wellbeing measure. Specifically, multiple linear regression was used for each model after adjustment for a comprehensive set of confounding variables. Results After adjusting for a large set of confounding variables, sociodemographic factors (e.g. income, income concern, marital status), occupational factors (e.g. job satisfaction, job stress, work engagement, redeployment, perceived workplace preparedness, working arrangements) and emotional health/wellbeing factors (e.g. psychological resilience, purpose, social support, depressive and anxiety symptoms) and health states (e.g. self-reported health status) were associated with HCW life satisfaction. Conclusions These findings align with previous wellbeing studies and highlight the importance of social capital, income, purpose, resilience and occupational factors in regional/rural areas, which may be important targets for interventions aiming to promote regional/rural HCW wellbeing during future pandemics. However, longitudinal research first needs to confirm the temporal order of the association to gain better evidence of potential cause and effect for this underserved workforce.