Factors affecting mental health of health care workers during coronavirus disease outbreaks (SARS, MERS & COVID-19): A rapid systematic review

Abstract

Introduction The novel Coronavirus Disease (COVID-19) outbreak currently puts health care workers at high risk of both physical and mental health problems. This study aimed to identify the risk and protective factors for mental health outcomes in health care workers during coronavirus epidemics. Methods A rapid systematic review was performed in three databases (March 24, 2020) and a current COVID-19 resource (May 28, 2020). Following study selection, study characteristics and effect measures were tabulated, and data were synthesized by using vote counting. Meta-analysis was not possible because of high variation in risk factors, outcomes and effect measures. Risk of bias of each study was assessed and the certainty of evidence was appraised according to the GRADE methodology. Results Out of 2605 references, 33 observational studies were selected and the identified risk and protective factors were categorized in ten thematic categories. Most of these studies (n = 23) were performed during the SARS outbreak, seven during the current COVID-19 pandemic and three during the MERS outbreak. The level of disease exposure and health fear were significantly associated with worse mental health outcomes. There was evidence that clear communication and support from the organization, social support and personal sense of control are protective factors. The evidence was of very low certainty, because of risk of bias and imprecision. Conclusion Safeguarding mental health of health care workers during infectious disease outbreaks should not be treated as a separate mental health intervention strategy, but could benefit from a protective approach. This study suggests that embedding mental health support in a safe and efficient working environment which promotes collegial social support and personal sense of control could help to maximize resilience of health care workers. Low quality cross-sectional studies currently provide the best possible evidence, and further research is warranted to confirm causality.

Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms

“…Higher levels of psychological distress were found in nurses and technicians than in physicians, whereas burnout, defined as a syndrome of emotional exhaustion, cynicism, depersonalization, and perceived inefficacy resulting from long-term job stress that can occur among individuals who work with people in some capacity [ 31 ], was higher in doctors than in nurses and technicians [ 32 , 33 , 34 ]. Conversely, clear communication from the organization, social support, personal sense of control, and emotional regulation were found as protective factors against psychological distress in healthcare professionals [ 35 , 36 , 37 , 38 ]. However, there is still lack of empirical evidence demonstrating the increased risk of mental problems as consequence of the pandemic.…”

Moral Injury and Light Triad traits: anxiety and depression in health-care personnel during the COVID-19 pandemic

“…Given the relevance of these findings, all hospitals and clinics should have mental health screening programs that also provide adequate care to prevent and treat mental well-being, not only during the pandemic but permanently. Specifically, environments that promote social support among colleagues could enhance resilience in health-care personnel (De Brier, Stroobants, Vandekerckhove, & De Buck, 2020). This is of particular importance given the role that lack of trust and betrayal play as key domains of Moral Injury (Greenberg et al, 2020;Zhizhong et al, 2020).…”

We’re Not Gonna Fall: Depressive Complaints, Personal Resilience, Team Social Climate, and Worries about Infections among Hospital Workers during a Pandemic

“…The global COVID-19 pandemic relentlessly confronts hospitals and hospital workers with complex and unprecedented problems [ 1 , 2 , 3 , 4 , 5 ], threatening hospital workers’ psychological health severely [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Hospitals must be resilient in navigating these problems [ 13 , 14 , 15 ] and their personnel–as hospitals’ primary resource [ 16 , 17 , 18 ]–are essential in achieving such resilience [ 19 ].…”

“…Indeed, securing sufficient healthcare workers in terms of both quantity and quality is paramount for public health [ 14 , 20 ]. However, the immense threats to hospital workers’ psychological health that flow from the COVID-19 pandemic complicate the situation [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Depression, anxiety, insomnia, distress, and burnout show vastly increased prevalence among healthcare workers during the pandemic [ 9 , 21 ].…”

“…Relatedly, Rangachari et al [ 14 ] recommend in this special issue that a positive work environment of trust, psychological safety, and empowerment can protect workers and foster organizational resilience. However, how this works exactly and to what extent a team social climate can protect individuals’ psychological health–particularly during the COVID-19 pandemic–still needs to be studied empirically [ 6 , 9 , 10 , 11 ]. Third, studies that do consider the protective and risk factors regarding the individual psychological health of healthcare workers during the pandemic typically only target frontline staff (medical and nursing staff).…”