A rapid review of the impact of COVID-19 on the mental health of health and social care workers: implications for psychological interventions

Abstract

BackgroundHealth and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and in the challenge to control the virus have directly faced its consequences. Supporting their psychological wellbeing continues therefore to be a priority. This rapid review was carried out to identify whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis. The review also sought to identify a participant population for the trial of a digital intervention to support HSCW’s psychological wellbeing during the pandemic. MethodsWe undertook a rapid review of the literature following guidelines by the WHO and the COVID-19 Cochrane Collaboration’s recommendations. We searched across 14 databases, executing the search at two different time points. We included published observational and experimental studies that reported the psychological effects on health and care workers during the COVID-19 pandemic. ResultsThe 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the social care or primary care workforce. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Resilience was identified as a factor protecting against adverse mental health outcomes. ConclusionsThe evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from psychological interventions. However, inconsistencies in findings and a lack of data outside of hospital settings, suggest that we should not exclude any groups when addressing psychological wellbeing in health and social care workers. Psychological interventions aimed at enhancing psychological resilience and utilising innovative methods to personalise treatments without excluding groups may be of benefit.

COVID-19: Risk Factors and Protective Role of Resilience and Coping Strategies for Emergency Stress and Secondary Trauma in Medical Staff and Emergency Workers—An Online-Based Inquiry

“…As found by other authors [10,13,14,[16][17][18][19], in this study, women also seemed to show higher stress levels than men (Table 1).…”

“…The comparisons made between the three categories of operators showed a difference in total stress, albeit small, indicating that physicians, nurses, and rescuers were exposed to similar levels of organizational, cognitive, social, and emotional stress. Nurses and physicians had the highest total stress scores, similar to the findings in other studies [16,18]. This is linked to the fact that, despite being the persons who dealt with the physical and material needs of patients throughout their hospital stay, they were most directly exposed to the patients' suffering and, in many cases, to their death.…”

“…Among the risk factors of developing psychopathological symptoms during the COVID-19 emergency, the literature highlights some sociodemographic variables, such as female sex [10,13,[16][17][18][19]. Women tend to have higher fear and perception of the risk of infection, and this increases their risk of developing anxiety and distress [14].…”

“…Some studies found that frontline healthcare workers had higher secondary traumatization scores than non-frontline health workers [10,13,20,21]. According to a review on the subject [18], the evidence suggests that female nurses with direct and close contact with COVID-19 patients may be at higher risk of adverse mental health outcomes during this pandemic.…”

“…Several studies have revealed that insufficient instruction and lack of personal protective equipment (PPE) are important predictors of stress for healthcare and emergency workers dealing with the COVID-19 emergency [8,18,[22][23][24]. Some studies found that longer working hours [25], increased work intensity or patient load per hour [26], and heavy workload [27] can be considered risk factors.…”