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<title>Abstract</title> Purpose Previous research has highlighted the negative impact of the COVID-19 pandemic on healthcare workers' (HCWs) mental health, yet protective factors remain underexplored. Emerging studies emphasize the importance of trust in government and interpersonal relationships in reducing COVID-19 infections and fostering positive attitudes toward vaccines. This study investigates the relationship between HCWs' trust in the workplace and government and depressive symptoms during the COVID-19 pandemic. Methods The COVID-19 HEalth caRe wOrkErS (HEROES) study surveyed 32,410 HCWs from 22 countries, including both clinical and non-clinical staff. Participants completed the Patient Health Questionnaire-9 (PHQ-9) and ad-hoc questions assessing their trust in the workplace and government. Logistic regression and multilevel models were employed to examine the association between trust levels and depressive symptoms. Results High levels of trust in the workplace (OR = 0.72 [0.68, 0.76]) and government (OR = 0.72 [0.69, 0.76]) were associated with lower odds of depressive symptoms, with significant between-country variation in these associations. Conclusions Despite substantial cross-country variation, HCWs with higher trust in the workplace and government had approximately 28% lower odds of experiencing depressive symptoms during the COVID-19 pandemic compared to their counterparts with lower trust levels. Promoting trust in the workplace and government may help mitigate the adverse effects of future crises on HCWs' mental health.
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DOI: 10.21203/rs.3.rs-4776604/v1
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