Well-being at work, productivity, and coping with stress during the COVID-19 pandemic

Abstract This study aims to analyze the mechanisms through which the coronavirus disease (COVID-19) pandemic impacts on well-being at work and on productivity. The secondary objective is to identify stress management strategies for the work environment during the pandemic. This is an integrative review. Phase 1 consisted of searches of open access electronic databases (MEDLINE, SciELO, Bireme, and LILACS) for papers published in 2020 addressing mental health, work, and pandemics. Phase 2 consisted of selecting literature recommended by specialists in occupational psychiatry and positive psychology. These materials were read and critically analyzed. Forty references were included in the literature review. The articles reviewed were classified into the following categories: articles concerning work relationships in Brazil; articles describing the impact of pandemics on mental health and work; articles focusing on the work of health professionals during pandemics; articles about well-being at work; and papers proposing strategies to improve well-being and productivity and to promote mental health. The COVID-19 pandemic can have a significant impact on workers’ mental health and productivity. Most professionals face a need to adapt to changes, which can decrease their feeling of well-being. Consequently, strategies to promote well-being and mental health in the work environment should be a priority. Work routines were modified after the COVID-19 pandemic set in and assessing these changes is essential to maintain workers’ mental health. By so doing, it is possible to promote general well-being and post-traumatic recovery and reduce stress levels.


Introduction
Coronavirus disease (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020 and since then it has caused widespread changes around the world. 1 Besides the direct harmful effects of the new coronavirus, some groups seem to be more vulnerable to psychiatric symptomatology, stress, and burnout, which are factors that usually lead to a diminished quality of life. 2 Another concern already expressed by some affected countries relates to the economic impact of the pandemic, since many sectors have been undermined at varying degrees of intensity. 3 In this context, people need to adapt to new and different routines of life and professional activities, while society keeps demanding high productivity. As stated previously, the COVID-19 pandemic poses new occupational health challenges involving, for example, risk of contamination during work activities of people whose activities are performed in proximity to other people. In these cases, occupational demands impose additional distress by preventing workers from following recommendations concerning social distancing and increasing their risk of contagion. In other cases, there is the great challenge of having to adapt to a new framework of activities including changes in work routines and environment. 4 In Brazil, different types of work are classified according to their contracts, legality, and formality.
Each type is impacted in a different way. Therefore, the application of the concept of well-being at work also has many differences, as do impacts on workers' mental health. 5 Formal can become blurred, with negative consequences for workers' well-being. 6 In turn, adaptation to the remote working model is not always possible for operational services. As a result, workers whose functions constitute essential activities must keep performing their roles on site and thus need to follow all the biosafety rules. This situation can increase their levels of stress and trigger internal conflicts within teams because in many scenarios only part of the team is authorized to work remotely. 7 An observational study conducted recently in Chinese provinces affected by COVID-19 suggests that, despite the risks, those who keep their work routine unchanged have better levels of mental health than those allocated to remote work (home office). 8 This highlights the importance of work both for the mental health of the population and for the economic recovery of a country or region.
In this context, with such diverse measures affecting the work teams, it can be challenging to maintain a healthy work organization. The problem is exacerbated for formal workers who perform nonessential services, because the operational workers in these areas are usually affected by unemployment due to closure of some companies for indefinite periods.
The literature shows that the current crisis had already caused a significant reduction in economic activity and hours worked in the first six months of 2020. 9 This leads to aggravation of existing mental pathologies and development of others, including a possible increase in suicide rates. 10 Informal work is in an opposite situation. Informal employees are not registered with social security or tax authorities via the Brazilian "carteira de trabalho" system, do not therefore receive benefits, and are subject to more flexible work schedules. 9 Informal workers also remain in the labor market because they do not have any legal guarantees to maintain them financially if they cease work activities. It is possible that informal workers endure increased levels of stress and work for more hours than recommended to meet the increased demands for some essential services during the pandemic. 11 Many informal workers also have difficulty in complying with social distancing measures because they do not have appropriate social security protection to cover periods of crisis, meaning they must keep working to maintain an income. Moreover, the economic recession caused by the pandemic can increase rates of unemployment in this sector, posing an additional threat to well-being, since these people do not have the guaranteed benefits of formal work.
The COVID-19 pandemic can therefore negatively impact workers in the informal sector and aggravate inequalities in all these ways. 12 Another category, autonomous workers and independent professionals, are defined as people who provide services on their own and guarantee their income without any kind of employment relationship (whether formal or informal). Medical workers in particular faced urgent implementation of telemedicine to minimize exposure of the population without severe diseases to health services, while maintaining clinical care in different specialties. This new situation for many doctors is considered a stress factor because it demands a minimum level of mastery of technology and personal readiness to accept new forms of working. In addition, telemedicine also involves other barriers, such as difficulties for patients to access technology, which can limit the medical care provided by independent professionals. Issues like these affect professionals' well-being and they may question the quality of the service they are providing to their patients. 13 Another specific way of providing services, volunteer work, is characterized by working without any kind of remuneration. This type of work has been of great relevance in the pandemic. The feeling of well-being afforded by these activities is significant and is linked to the affective component of this type of work. Performing volunteer work protects mental health, even when social distancing is not observed and it involves increased exposure to pathogenic risks. Workers report positive experiences with volunteer work, like strengthening of the notion of purpose and well-being derived from the impact of these activities in the community. Although the pandemic has imposed changes to work models, the current situation can be favorable to the practice of volunteerism in several sectors. 14 The last type of work is that performed by entrepreneurs who provide services to their own companies and obtain their income from this source.
The current situation of the country in recent months forced many businessmen to cease their activities and compelled them to dismiss their employees.
Consequently, it is possible that, with no concrete prospect of improvement in the economic scenario, they lose the sensation of well-being at work and part of their meaning of life, giving rise to hopelessness and helplessness. 10 The exact impacts of COVID-19 on mental health are still unknown, but undoubtedly tend to be significant in at least part of the population. There are many factors involved, like social distancing, generalized fear, and grieving without the possibility of a final farewell. In periods of crisis, insecurity about employment stability and financial concerns usually become evident. 11 Along the same lines, the need for social distancing because of the pandemic isolates workers from the social support found in work relations, which is a significant protective factor against stress. 15 The support derived from the work environment includes interaction with colleagues and leaders and can be imparted through practical assistance, encouragement, emotional support, and other ways, which are associated with greater satisfaction at work. 16 Workers with special needs and those deprived of this support network for prolonged periods report greater harm to their well-being at work and their productivity. 17 It is plausible that drastic changes to routines, compounded by the impact on mental health and economic instability, affect workers' ability to cope with the demands of work and, in the long term, hamper economic recovery of organizations and the country as a whole. 4 It is important to understand the relation between individuals and their work environment. Well-being at work positively influences workers' motivation, their performance, and their effort. It also improves organizational behavior and interpersonal relationships.
On the other hand, low levels of well-being at work can negatively impact organizations. 18

Results
The  Table 1.  consequences. 22 The trend is that these findings may be replicated in the current pandemic, since health professionals on the front line are already reporting higher levels of anxiety and lower rates of well-being. 23 Some healthcare professionals at higher risk of contagion by coronavirus were advised to keep social distance even from their families, which can intensify the perception of stress and aggravate emotional difficulties. This group requires special attention and care, so development of concepts of well-being at work is essential to minimize the negative impacts caused by the current scenario. In addition to these professionals on the front line, other sectors may also be suffering from issues associated with work or the lack of it, since boredom is also related to burnout. 24

Well-being at work
Well-being at work has traditionally been conceptualized according to two different approaches.

Well-being at work during the pandemic
When we think about well-being at work constructs and the situations that workers in general are subjected to in this pandemic scenario, it is evident that there is great loss in achievement of general well-being and especially of well-being at work. Most professionals currently face a need to adapt to change, which can constitute a risk factor and decrease subjective wellbeing. 28 For some workers, the negative aspects of work may, for some time, supplant the positive ones, and we need to pay attention to this matter. With the possibility of workers presenting depressive and anxious symptoms, possibly triggered by the pandemic, adaptation to a new work system is likely to be necessary, especially with regard to the style of leaders, who are known to have an impact on workers' well-being when they adopt a positive style, focused on the employee's potential. 29 The COVID-19 pandemic is impacting society as a whole and will have particular effects on individuals' mental health. Consequently, work behavior and work relationships can change. Companies must pay attention to this dynamic scenario and seek to promote a healthy work environment, whether physical or virtual. 30 To achieve this, it is worth remembering that some psychosocial factors can be targeted as potential protectors to promote workers' health and well-being, leading to happiness and flourishing. 31 A positive movement can be initiated by directing interventions towards aspects that boost motivation, productive behavior, and adequate performance, not only for productivity, but also for workers' health. 32 As part of the well-being at work construct, the specialized literature cites items such as demographic variables, social climate, personality traits, and coping strategies (coping, emotional regulation, mastery of the work environment, and autonomy). It is necessary to intervene in each item to minimize the negative impact and amplify the positive impact, seeking to increase well-being at work during the pandemic, as well as to develop other strategies that aim to reduce perceived stress. 33 Demographic variables have a weak correlation with well-being at work, but it is important that companies pay attention to the conditions under which the worker will perform remote work. Assessment of a professional's psychosocial reality must be carried out individually, proposing adjustments when necessary. 34 In some situations, it may even be necessary to assist with the physical organization of the workplace, including provision of furniture, equipment, and platforms for performing work in an appropriate manner.
Social climate is the strongest predictor of wellbeing at work and is perhaps the element most affected at this time, since feelings of insecurity and helplessness in the face of the pandemic and quarantine are prevalent. 35 The overload of negative and fake news contributes to worsen this situation. With social distancing, the individual's relational field can be impaired. 36 It is therefore important to avoid emotional distance, including between members of work teams, holding meetings virtually or by telephone. 37 Still, in relation to the social climate, leaders have great significance, since they influence the environments and structures of work relationships. The  41 In addition to the effect of identifying meaning in the professional task, acknowledgement from managers and, in the current context, from society, of the professionals who are maintaining the country's economy and of professionals who are intensely exposed to the coronavirus, is of paramount importance. 42 It is essential that individuals from all work areas are able to recognize how much their jobs are contributing to society, so that even workers who previously did not feel a purpose in life at work can start to develop one. 43 Dealing with negative emotions is a crucial job demand, especially for healthcare workers. Resources present in employment, such as autonomy, social support, or reward, but also personal resources, such as emotional regulation strategies, can reduce stress at work and increase well-being at work. 44 Coping or coping strategies, which are also an item within the well-being showed that participants with low scores on the scales that measured positive emotions, self-efficacy, and engagement before the intervention benefited more than those who already had higher scores. These data reinforce the need to be attentive to employees with lower levels of engagement and well-being, who may be those that most benefit from these interventions. 55 Although the topic of productivity in the organizational context and its relationship with affective aspects is still scarcely covered in the literature, some  Table   2 lists some coping strategies for promoting mental health, increasing well-being at work, and increasing productivity.

Conclusion
It is well known that work routines were modified after the COVID-19 pandemic set in. Consequently, employees working in a variety of sectors may be subjected to work overload, stress, and psychological symptoms. The faster the process of assessing these changes in routines, the more likely it is that the workers will be able to exercise control over the environments in which they find themselves. Also, as adaptations are implemented, the feeling of well-being and the possibility for professionals to exercise their autonomy in the work environment will increase. Since research on this topic has yet to be published, an integrative review including all types of publications can provide a source of answers for very pressing questions.

Disclosure
No conflicts of interest declared concerning the publication of this article.