Coping During the COVID-19 Pandemic: A Qualitative Study of Healthcare Workers in Saudi Arabia

Introduction

The COVID-19 pandemic has imposed a considerable worldwide burden due to its widespread prevalence, transmission, and associated morbidity and fatality rates (Maideen et al., 2022; Roca et al., 2021). Healthcare workers (HCWs), in particular, have been dealing with challenging pandemic-related circumstances during and after the COVID-19 pandemic, such as observing a rise in the rate of mortality; increased workloads and job hours, dealing with insufficient equipment, supplies, or resources, and concerns about acquiring and/or transferring COVID-19 to relatives and loved ones (Karram et al., 2023). The COVID-19 outbreak disturbed HCWs daily and weekly routines, forcing them to rapidly adjust to a new work environment. HCWs in a variety of settings around the world have reported experiencing occupational stress due to the global spread of the COVID-19 pandemic. (Zhao et al., 2021). This type of exposure increases the risk of negative psychological outcomes such as acute stress, depression, sleep difficulties, insomnia, moral injury, burnout, post-traumatic stress disorder (PTSD), depression, and anxiety (Karram et al., 2023).

The COVID-19 pandemic has not only highlighted the challenges but also the drivers of resiliency that have evolved as a result of both personal and collective efforts in response to the outbreak (De Leo et al., 2021). The prevalence of mental health disorders among HCWs is linked to a number of contributing variables, including insufficient coping methods, inadequate training, and insufficient amounts of social interaction and emotional support (Roca et al., 2021). Studies have identified a number of predominant coping strategies employed by HCWs during the pandemic, including engaging in physical activity, practicing religion or spirituality, and participating in yoga or meditation (Karram et al., 2023; Zhao et al., 2021). Additionally, HCWs frequently employ coping mechanisms such as accepting the severity of the situation and adopting an optimistic outlook during their job duties; social and peer support; increased self-efficacy; an internal locus of control; and a feeling of coherence to manage stress (Conversano et al., 2020; De Leo et al., 2021; Wong et al., 2005). Khalid et al. (2016) found that a positive attitude in the workplace has the most significant impact on reducing employee stress. Additionally, Gavin et al. (2020) illustrated effective solutions regarded as essential, including clear communication and distribution of duties, flexible work schedules, stigma-free access to psychiatric and psychosocial aid, and extensive training and organizational support for employees. Thus, from an organizational perspective, the two primary components that made it possible for HCWs to continue functioning throughout a pandemic were an appropriate working atmosphere and an assurance of personal safety while performing work (De Leo et al., 2021).

Saudi Arabia implemented a series of proactive measures in the early stages of the COVID-19 pandemic in accordance with international guidelines, with the aim of mitigating the spread of the virus. The implemented measures included the implementation of lockdowns, the enforcement of social distancing measures, the suspension of public transportation services, the closure of educational institutions, the prohibition of large religious gatherings, and the implementation of contact tracing protocols for travelers exhibiting symptoms of COVID-19 infection. In addition, the government implemented measures aimed at improving the capacity for detecting and managing various aspects of COVID-19. Several studies have examined level of stress and anxiety among HCWs during the pandemic. In a comprehensive study conducted by Alenazi et al. (2020), it was observed that a significant majority of HCWs exhibited elevated levels of stress and anxiety, with more than two-thirds of participants falling into the high to moderate range. Other studies have shown similar results (AlJhani et al., 2021; AlAteeq et al., 2020).

The majority of studies evaluating HCWs’ coping mechanisms during and after the COVID-19 epidemic are quantitative in nature, with a particular focus on identifying risk variables. On the other hand, there are a limited number of qualitative research studies that comprehensively investigate beneficial factors for coping with the stress of the pandemic. In addition, the process by which HCWs in Saudi Arabia have selected these coping strategies within the distinct context of the pandemic remains uncertain.

The objective of this research is to obtain a better understanding of the fundamental stress-coping mechanisms or protective factors utilized by HCWs in Saudi Arabia amidst the COVID-19 pandemic. The results will be crucial in generating evidence-based tools targeted at resolving variables impacting coping strategy choices with the goal of improving long-term mental health outcomes for HCWs. Additionally, the findings will provide an established foundation for developing and implementing appropriate mental health intervention policies to successfully address this issue. Since coping strategies are often personal and affected by individual experiences, qualitative research is the best method for investigating the difficulties and methods of coping encountered by HCWs throughout the COVID-19 pandemic (Zhao et al., 2021).

Methods

Results

Participants

Table 1 presents an overview of the demographic characteristics of the study participants. The sample consisted of 25 participants, with an average experience of 8 years, and an almost equal sex distribution of 48% male and 52% female.

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Table 1.

Characteristics of Study Participants (n = 25).

Variable	N	(%)
Sex
Female	13	52
Male	12	48
Age group (years)
21–30	15	60
31–40	6	24
≥40	4	16
Social status
Married	16	64
Single	9	36
Education level
Ungraduate	24	96
Graduate	1	4
Occupation
Hospital physician	8	32
Nurse	12	48
Other (e.g., audiologist, respiratory therapist, dietician, radiographer, paramedic/Emergency Medical Technician)	5	20
Years in job
<5	5	20
5–10	17	68
> 10	3	12
Monthly income
<5,000 SAR	3	12
5,001–10,000 SAR	13	52
>10,000 SAR	9	36

Qualitative Thematic Analysis

Despite the challenges identified for HCWs in managing stress through the pandemic, a considerable number of HCWs were able to employ coping mechanisms. Following the qualitative thematic analysis, it was determined that two major themes emerged, each consisting of three subthemes. The themes identified in the study are not considered to be mutually exclusive. However, their collective analysis has contributed to a broader and more encompassing comprehension of the coping mechanisms employed by HCWs in Saudi Arabia during the COVID-19 pandemic. The data from the interviews were analyzed, and a description of the themes and subthemes is shown in Figure 1. Three subthemes emerged in the “Internal resources for coping” theme: (1) self-care, (2) self-control, and (3) intrinsic motivation. Three subthemes emerged in the “External resources for coping” theme related to the place where they were developed: (1) social support, (2) social media, and (3) organizational climate.

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Figure 1.

Thematic map.

Theme 1: Internal Resources for Coping

Internal resources for coping refer to the psychological and behavioral strategies an individual employs to alleviate perceived stress. The theme comprises three primary methods that most HCWs utilized to cope with stress during the pandemic.

Subthemes 1: Self-Care

Self-care is the process of forming behaviors that maintain an individual's overall wellbeing, improve health, and effectively control health issues as they arise. A significant number of HCWs reported engaging in self-care practices as a means of managing the stress associated with the pandemic and enhancing their psychological wellbeing. Some HCWs started utilizing coping mechanisms such as religious practices, a healthy diet, and physical exercise, while others chose activities such as keeping a diary and watching movies. The majority of HCWs reported positive impacts resulting from such activities. However, certain activities, such as physical exercise, were initially constrained during the pandemic. Nevertheless, some HCWs were able to overcome these limitations:

“One of the things that help me take my mind off all the stressors is walking or jogging around the neighborhood, this was not allowed at the beginning of the pandemic, so I used to walk around in my apartment and exercise at home. I felt good after an hour of training, and I use to tell my friends and family to do so.” (P8)

Nevertheless, some HCWs encountered challenges in sustaining such behavior and had to depend on support from their loved ones to establish a consistent routine:

“I feel that writing what is in my mind has kept me positive and hopeful about the future. I was not into writing a journal before in my life, but I tried during the pandemic to help focus on the good things in life and positively interpret what goes around me. I had to make it a routine though. So, there were a lot of days when I just forgot or hadn’t had the motivation to do so. I had to make it a habit because it was one of the things that gave me perspective about the situation and made me feel better.” (P22)

All HCWs reported engaging in spiritual practices, specifically, prayer proved to be the most efficacious daily routine in mitigating the stress caused by the worldwide crisis. Amidst the pandemic, prayer served as a mechanism for establishing a connection with a divine entity and provided a ray of optimism considering the mounting toll on their stressful daily job:

“Praying and reading Quran was an everyday practice and I had done it five times a day and sometimes more than 5 times a day. It was a way of venting the emotions I have and asking for an end to such days. I felt that no one but God can help me and all of us to surpass these bad days and every time I felt so anxious or afraid, I used to go to my room and pray.” (P14)

Subthemes 2: Self-Control

Self-control can be defined as the capacity to control one's emotions and behavior in the face of temptation or difficult circumstances. HCWs expressed that they have dealt with a broad range of thoughts and feelings. Most of them experience negative emotions in relation to the COVID-19 pandemic, including apprehension regarding contracting the virus and subsequently transmitting it to their loved ones:

“My mind was racing with thoughts about how the disease was deadly and the consequences of the disease. I live with my parents, and I was always afraid that I might have them infected.” (P25)

In order to mitigate the adverse effects of such detrimental thought patterns, the majority of HCWs attempt to regulate such thinking and resist the urge to adopt a negative outlook toward the circumstances:

“I deliberately stopped myself from the thing about negative things that might happen and instead I started reminding myself to adhere to the protocols and protective procedures.” (P20)

Other HCWs participated in education and training sessions in order to better their skills and boost their confidence in order to combat negative thoughts about the negative consequences of the pandemic:

“I had to ensure myself that I have the ability to protect myself so I started reading more about the disease. I also got into a course we have in our hospital to learn about the best ways to minimize the chance of me being infected.” (P12)

Subthemes 3: Intrinsic Motivation

The term “intrinsic motivation” pertains to behaviors that are motivated by deep incentives. The intrinsic drive to participate in behavior stems from the inherent gratification of the task, instead of the pursuit of a reward or particular consequence. Stated differently, an individual's drive to engage in an activity originates from intrinsic factors such as enjoyment, difficulty, or personal fulfillment, rather than extrinsic factors such as external incentives, coercion, or recognition.

Several HCWs have reported that the concept of professional obligations, coupled with social and moral responsibilities, has aided in diminishing the surmounting fear and pressure caused by high demand during the pandemic's most critical and stressful periods:

“Sometimes when I am really stressed about dealing with patients who were infected, I remind myself of the oath I made to help others and the care that I must provide to patients and making sure to pull through safely and go back to their families. It feels good at the end of the day to see the lives you touched and help their situation get better. This feeling made me overcome all the stress and challenge I had during the pandemic and make my job easier.” (P12)

Other HCWs indicated that the experience of handling challenging cases and operating under stressful circumstances has motivated them to enhance their skills and competence, instilling a sense of enthusiasm and a goal to strive toward:

“every patient we come across had a different need and brings a new insight into the nature of the disease. I had the opportunity to witness firsthand how the disease presents itself and how to alleviate its symptoms. My skills and knowledge have developed tremendously in dealing with an outbreak.” (P2)

Theme 2: External Resources for Coping

External resources refer to any factors or entities that exist outside of an individual and contribute to their feelings of tranquility, support, resilience, and competence. The theme encompasses three principal strategies that the majority of HCWs employed to manage stress throughout the pandemic.

Subthemes 1: Social Support

The concept of social support has been identified as the provision of information by individuals within a person's social circle, which conveys feelings of affection, concern, admiration, and recognition, as well as a sense of belonging to a community characterized by reciprocal interaction and responsibilities (Kim et al., 2008).

A significant number of HCWs in Saudi Arabia encountered challenges in sustaining social support during the course of the pandemic. Difficulties associated with upholding social communication can arise from various factors, including but not limited to elevated home obligations, heightened occupational demand, or restrictions imposed during periods of lockdown:

“my work schedule was always changing and my daily hours were increasing because of the load of hours we have to be in the hospital. I did not have time to have a normal conversation with anybody as I used to before.” (P7)

“The major thing that affected my life is the lockdown. I could not see anyone of my family and friends for months. It was a weird situation at the beginning but later it affected me a lot mentally.” (P16)

Some HCWs reported that utilizing phone calls and online meetings with loved ones aided in alleviating stress and mitigating feelings of isolation:

“I could not go to my parents because I was afraid, I will get them infected but at least, I can call them and use the internet to see them virtually. This assured me they are ok and in good health.” (P18)

The provision of emotional support by colleagues and patients proved instrumental in mitigating the sense of isolation experienced by HCWs:

“Seeing and talking with patients and their relatives and the compassion I received from them was nice. I saw the acknowledgment and appreciation for the work I do in the words of patients. Also, patients tell you about the difficulty they have and that takes some of the pressure off your back.” (P21)

Subthemes 2: Social media

The increased utilization of social media platforms amidst the pandemic may potentially signify a mechanism for managing and coping with the stress induced by the pandemic.

HCWs indicated they initially resorted to social media as a coping mechanism to alleviate their stress and divert their attention away from the challenges they were facing:

“…I don't have much to do in my free time, so I check my cell phone to see what's going on in other places. I did this to pass the time and take my mind off things for a while.” (P3)

As a result of the excessive amount of pandemic-related information spread through such channels, some HCWs transitioned to refraining from using social media platforms as a coping mechanism.

“At first, it was fun and relaxing, but as time went on, I became bored and even more stressed than before, especially after hearing all the news and information about the pandemic. so I tried to turn my mind to something else.” (P7)

Subthemes 3: Organizational Climate

Establishing a robust organizational culture can be achieved by actively prioritizing communication, fostering positive relationships, cultivating self-awareness, and recognizing the symbolic implications of policies and behaviors. HCWs experienced a deficiency in clear intervention protocols and guidelines:

“We had so much confusion about the disease and how to deal with it at the beginning. The protocol was constantly changing as more information is gathered about the virus. This created unease to me as I struggled to understand the severity of the disease and how to deal with it.” (P18)

In certain instances, the organizational aspect served as a means of assistance, was regarded as helpful, and supported the effort to rescue HCW's stress:

“It was incredible to see all levels of staff helping and encouraging one another. The hospital's culture shifted as if we were fighting a disease. Like nothing else, higher-level administration provided all necessary assistance.” (P22)

Discussion

The purpose of this research is to gain insight into the coping mechanisms employed by HCWs in Saudi Arabia amidst the COVID-19 pandemic. To the best of our knowledge, little research has been done on the COVID-19 pandemic coping mechanisms of Saudi Arabian HCWs. Additionally, due to the pandemic's magnitude, most studies emphasized the adverse ramifications of the pandemic. Thus, this study provides an approach for investigating the protective factors that contribute to the maintenance of mental health among HCWs in the context of the pandemic.

The results of the thematic analysis indicated that a majority of the participants demonstrated the ability to determine and employ diverse coping mechanisms in response to the stress and anxiety arising from the COVID-19 pandemic. In our study, HCWs identified numerous coping strategies that resembled those previously described in the literature. These strategies included religion, teamwork, recreational activities, socializing with friends and family mostly via social media, peer support, self-reliance, and psychological support provided by the hospital (Roca et al., 2021; Savitsky et al., 2020; Shechter et al., 2020; Smallwood et al., 2021; Smeltzer et al., 2022; Zandi et al., 2023).

The existence of social support is a protective element against the emergence of mental health issues such as anxiety, depression, trauma-related illnesses, and PTSD in the wake of trauma and stress (Smith et al., 2022). Our findings corroborate those of Smallwood et al. (2021), who found that most Australian HCWs struggled to maintain social support. The pandemic has presented HCWs with a number of challenges that may have hampered their access to various forms of social support. These obstacles include, but are not limited to, increased job expectations, lockdown restrictions, and significant at-home responsibilities (Karram et al., 2023).

As per the stress and coping theory, the provision of social support has the potential to alleviate negative emotional experiences associated with stress (Mark & Smith, 2012). Research findings have shown that social support is the primary coping mechanism used to manage stress and that the availability of social support in the workplace has a significant impact on job-related stress and satisfaction (Labrague et al., 2018). In addition, the provision of social support has been found to have both direct and buffering effects (Lin et al., 2010). During periods of heightened stress, nurses who rely more heavily on social support, specifically familial support, exhibit superior coping mechanisms compared to their counterparts who lack such support (Zhao et al., 2021). The received social support increases intimacy and social solidarity (Mishra & Rath, 2020) Interpersonal relationships with colleagues are also an important source of support and a significant resource component (Labrague et al., 2018). The provision of emotional support by colleagues proved beneficial in reducing feelings of isolation among healthcare professionals. Collaborative efforts and information sharing were found to increase workplace productivity, promoting a sense of self-control. This, in turn, acted as a buffer against feelings of dysfunction and powerlessness (Khalid et al., 2016). Simultaneously, the relationship with patients serves as a significant source of motivation for HCWs to continue working through difficult times. HCWs who showed a significant investment in those relationships appeared to be more content and motivated to continue their work (Ardebili et al., 2021).

Anxiety exists about the possibility of HCWs spreading the virus to their loved ones, but it is important to note that HCWs close relationships with their families, as well as their other interpersonal connections outside of work, serve as crucial protective factors. Most HCWs sought comfort in their personal networks of family and friends during moments of emotional distress, as they were confident that these individuals would provide unwavering support and empathize with their experiences. The observations made by HCWs indicated that the family members possess a comprehension of their struggles and are capable of providing valuable assistance through the provision of timely and meaningful care. This is consistent with the existing scientific literature, which claims that the perception of having a meaningful existence is associated with lower stress levels, increased engagement in health-promoting behaviors, and increased use of active and adaptive coping strategies (Ardebili et al., 2021).

HCWs resorted to social media as a coping mechanism to alleviate stress and distract themselves after extended work shifts. However, they eventually abandoned this practice and adopted alternative coping strategies to manage the heightened stress levels associated with the overflow of pandemic-related information. Reilly et al. (2021) conducted a survey of 888 healthcare workers during the COVID-19 pandemic in the United States that revealed a significant number of respondents employed the strategy of reducing their social media usage as a means of coping. The authors postulated that such behavior was adopted as a preventive measure against adverse mental health consequences and to circumvent potential exposure to distressing events portrayed in the media. Franck et al. (2021) initially perceived social media platforms as a beneficial coping mechanism for HCWs to manage stress. However, their subsequent research revealed a correlation between social media use and increased distress among HCWs during the COVID-19 pandemic. According to Kalaitzaki et al. (2022), COVID-19 was considered an excessive and untamed threat, leading individuals to experience uncertainty and difficulty adapting. Consequently, individuals resorted to a variety of coping strategies, both adaptive and maladaptive. Maladaptive strategies were employed as a means of quickly, directly, and temporarily relieving stress. This theory is consistent with the findings of the current study and could potentially elucidate the reasons why HCWs persisted in utilizing coping mechanisms such as substance consumption or social media, despite harboring unfavorable attitudes towards these methods (Okediran et al., 2020). Participants generally identified social media as a major cause of increased stress and anxiety in modern society. Potentially due to the dissemination of false information, hoaxes through social media platforms, and the phenomenon of denying the existence or severity of viruses (Powell et al., 2021). Previous studies have shown that social media can exacerbate mental health problems (Post et al., 2021; Salopek-Žiha et al., 2020).

The most commonly employed approach for managing self-care was found to be the integration of spiritual coping and physical exercise. In the study conducted by Deliktas Demirci et al. (2021), it was found that nurses employed comparable coping mechanisms to manage their anxiety and stress levels. These coping strategies included engaging in physical activity and exercise, adopting a positive mindset upon waking up each day, and utilizing religion-based practices such as spirituality, yoga, and meditation. The practice of self-care is of utmost importance for HCWs, as its absence during periods of heightened stress can significantly hinder their capacity to deliver care and exhibit empathy toward their patients (Mills et al., 2020). Religious coping and a strong sense of duty to serve both humanity and the country were commonly utilized coping mechanisms. The present findings align with prior studies on healthcare personnel, which suggest that their dedication to their career serves as a key impetus for their sustained employment (Shirey et al., 2010; Yu et al., 2019). Furthermore, the failure to prioritize self-care during periods of stress heightens the likelihood of resorting to ineffective methods of coping (Lloyd & Campion, 2017). HCWs are known for prioritizing the wellbeing of others over their own. As a result, they may require external encouragement from colleagues, acquaintances, and supervisors to prioritize their own self-care (Maben & Bridges, 2020). This phenomenon was also observable in other contexts (Greenberg et al. 2020). It is important to acknowledge that self-care can encompass social dimensions, as explained by Michel Foucault's novel conceptualization of self-care from a social standpoint, and the influential role of knowledge in shaping self-care practices (Powell & Biggs, 2003).

Recognizing an HCWs ability to self-regulate can be a preventative measure that enables nurses to recognize and circumvent potential problems, thereby increasing the likelihood of positive outcomes and, ultimately, facilitating both personal and professional growth. Studies that have been conducted on the effects of occupational stress on nurses have shown that one of the strategies that are frequently used by nurses to deal with occupational stress is exercising self-control (Akbar et al., 2016; Yu et al., 2019). Additionally, previous research has demonstrated a positive correlation between the capacity to exert self-regulation and various desirable outcomes, such as occupational proficiency, a positive outlook, and aspirational thinking (Mark & Smith, 2012; Zhou et al., 2017).

HCWs were motivated by intrinsic and ethical factors, which included moral and social commitments, as well as their job duties. These factors proved crucial during the most serious stage of the outbreak, when HCWs lacked the necessary protective equipment and had limited information regarding the virus. Despite the risks posed to their personal lives and families, these motivations inspired HCWs to continue their work. In instances where the position was perceived as a matter of personal choice, the exhaustion linked with managing crises was countered by directing one's efforts towards the principal objective of “guaranteeing the interest of the patients” (Barnett et al., 2012).

Some HCWs indicated that the pandemic experience enhanced their professional skills and viewed this period as a constructive personal opportunity. The concept of “hardiness” appears to be linked to the overall dispositions of commitment, control, and challenge. The concept of hardiness pertains to an individual's personal attribute that is linked to resilience. This attribute is typically associated with favorable internal states, which prompts individuals to view external events as a challenge and a chance for self-enhancement (Gee & Skovdal, 2017). Someone exhibiting a greater degree of hardiness tends to exhibit reduced levels of stress and secondary trauma (Devnani, 2012).

The findings of the data analysis indicate that while HCWs commonly experienced a deficiency in welldefined and precise intervention protocols and guidelines, certain instances revealed organizational aspects that served as a means of assistance and were viewed favorably. The presence of an encouraging work environment and a perceived productive and collective sense of work can foster teamwork and promote cooperation among diverse professionals. These results enhance the limited number of studies that utilize an organizational viewpoint. Researchers have emphasized the value of healthcare organizations acknowledging the potential negative impacts of internal factors, including leadership, management styles, and administrative policies. They further suggested that cultivating a positive work environment could be accomplished by a deliberate focus on interaction, relationships, empathy, and the cultural implications of regulations and behaviors (Galehdar et al., 2020). Other research indicated that despite the presence of emotional assistance resources in most healthcare facilities in which they worked, the dissemination of details regarding such initiatives and support groups was inadequate (Liberati et al., 2021).

Conclusion

The present study provides a comprehensive and detailed examination of the methods employed by HCWs in Saudi Arabia to manage the stress induced by the COVID-19 pandemic. Using thematic analysis, this research explores the stress-coping mechanisms, risk factors, and difficulties encountered by HCWs when attending to COVID-19 patients. The findings suggest that healthcare workers encountered obstacles in implementing their typical coping mechanisms amidst the pandemic due to a range of obstacles. However, HCWs continued to utilize coping mechanisms, alternating between various methods. HCWs employed a variety of coping strategies, both internal and external, which were influenced by contextual variables. The study revealed that amidst the pandemic, individuals reported relying on various factors such as self-care, self-control, internal motivation, social support, social media, and organizational climate to enhance their resilience and coping strategies. The previously mentioned findings can provide insight into the types of assistance and provisions that can be implemented at both the personal and institutional levels to prepare healthcare workers to manage heightened levels of stress, with the ultimate objective of enhancing their psychological health and overall wellness. Subsequent research endeavors ought to further investigate the determinants that influence the selection of coping mechanisms while also pinpointing coping techniques that have been substantiated to mitigate stress and unfavorable mental health indicators among healthcare workers. Moreover, the results indicate that it would be beneficial to implement extensive and sustained public education initiatives aimed at enhancing the knowledge of the general populace regarding the modes of transmission and context-specific preventative measures while also addressing issues related to distrust, fallacies, and misunderstandings. Promoting healthcare system strengthening can be achieved by equipping HCWs with important knowledge regarding mental health resources offered to them. This approach can enhance the self-confidence, adaptability, and overall capacity of HCWs to react appropriately to the ongoing pandemic. Furthermore, the results of this study can be utilized as a point of comparison and a source of motivation for forthcoming research endeavors in the field of mental wellness, specifically in relation to resiliency and the necessity for interventions, education, and support for emergency healthcare workers in Pakistan and the surrounding region. The implementation of this approach has the potential to aid governmental entities and healthcare practitioners in safeguarding the emotional wellness of healthcare workers amidst the COVID-19 pandemic in Saudi Arabia and other regions across the globe.

Limitations

This research has certain limitations. First, given that most of our sample consisted of healthcare HCWs who resided in Riyadh, it is important to note that our findings cannot be extrapolated to the entire HCWs in Saudi Arabia. This includes individuals who may have different occupations, genders, and provinces of residency. Subsequent studies may attempt to obtain a representative sample of HCWs in Saudi Arabia. Second, it is noteworthy that the study employed a qualitative research design, which precluded the possibility of quantifying the impact of the experience on HCWs. The research solely facilitated the depiction of affective states or emotions. The constraint could be surmounted through the implementation of a mixed-methods research design. Third, the research employed a thematic analysis methodology, which may have limited its ability to conduct a comprehensive analysis and solely presented the themes that were examined for both semantic and latent interpretations. Subsequent research endeavors could adopt a more comprehensive methodology, such as phenomenology or grounded theory, to conduct supplementary linguistic scrutiny of the data.