Psychological impact of COVID-19 pandemic in Western frontline healthcare professionals. A systematic review

Alina Danet Danet, Alina Danet Danet

Abstract

The aim of this study was to assess the psychological impact among healthcare workers who stand in the frontline of the SARS-CoV-2 crisis and to compare it with the rest of healthcare professionals, by means of a systematic review of Western publications. The systematic review was carried out in PubMed, Scopus and Web of Science databases and 12 descriptive studies were reviewed. The European and American quantitative studies reported moderate and high levels of stress, anxiety, depression, sleep disturbance and burnout, with diverse coping strategies and more frequent and intense symptoms among women and nurses, without conclusive results by age. In the first line of assistance the psychological impact was greater than in the rest of the health professionals and in the Asian area. It is necessary to go deeper into the emotional experiences and professional needs for emotional support in order to design effective interventions for protection and help.

Keywords: Coronavirus; Emergency medical services; Emotions; Health personnel; Intensive care units; Mental health; Stress psychological; Systematic review.

© 2020 Elsevier España, S.L.U. All rights reserved.

Figures

Fig. 1
Fig. 1
Flow diagram of the bibliographic selection process. Own elaboration based on the Prisma guidelines.

References

    1. Organización Mundial de la Salud. Alocución de apertura del Director General de la OMS en la rueda de prensa sobre COVID-19 celebrada el 11 de marzo de 2020. [Accessed 21 August 2020]. Available from: ; 2020.
    1. Wang C., Pan R., Wan X., Tan Y., Xu L., Ho C.S., et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17:1729.
    1. Tan B.Y.Q., Chew N.W.S., Lee G.K.H., Jing M., Goh Y., Yeo L.L.L., et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann Intern Med. 2020;173:317–320.
    1. Lai J., Ma S., Wang Y., Cai Z., Hu J., Wei N., et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3
    1. Zhang C., Yang L., Liu S., Ma S., Wang Y., Cai Z., et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel coronavirus disease outbreak. Front Psychiatry. 2020;11:306.
    1. Chew N.W.S., Lee G.K.H., Tan B.Y.Q., Jing M., Goh Y., Ngiam N.J.H., et al. A multinational, multicenter study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak 2020. Brain Behav Immun. 2020;88:559–565.
    1. Kang L., Ma S., Chen M., Yang J., Wang Y., Li R., et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross-sectional study. Brain Behav Immun. 2020;87:11–17.
    1. Lu W., Wang H., Lin Y., Li L. Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatry Res. 2020;288
    1. Wang J., Zhou M., Liu F. Reasons for health care workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect. 2020 doi: 10.1016/j.jhin.2020.03.002.
    1. Liu C.Y., Yang Y.Z., Zhang X.M., Xu X., Dou Q.L., Zhang W.W. The prevalence and influencing factors for anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect. 2020;148:e98.
    1. Huang J.Z., Han M.F., Luo T.D., Ren A.K., Zhou X.P. Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020;38:192–195.
    1. Huang Y., Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288
    1. García-Iglesias J.J., Gómez-Salgado J., Martín-Perreira J., Fagundo-Rivera J., Ayuso-Murillo D., et al. Impacto de SARs-CoV-2 (COVID 19) en la salud mental de profesionales sanitarios: una revisión sistemática. Rev Esp Salud Pública. 2020;94:e1–20.
    1. El-Hage W., Hingray C., Lemogne C., Yrondi A., Brunault P., Bienvenu T., et al. Les professionnels de sant´e face `a la pand´emie de la maladie `a coronavirus (COVID-19): quels risques pour leur sant´e mentale? L’Encéphale. 2020 doi: 10.1016/j.encep.2020.04.008.
    1. Pappa S., Ntella V., Giannakas T., Giannakoulis V.G., Papoutsi E., Katsaounou P. Prevalence of depression, anxiety and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020 doi: 10.1016/j.bbi.2020.05.026.
    1. Shaukat N., Mansoor D., Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: a scoping review. Int J Emerg Med. 2020 doi: 10.1186/s12245-020-00299-5.
    1. Pan R., Zhamg L., Pan J. The anxiety status of Chinese medical workers during the epidemic of COVID-19: a meta-analysis. Psychiatry Investig. 2020;17:475–480.
    1. Tran B.X., Ha G.H., Nguyen L.H., Vu G.T., Hoang M.T., Le H.T., et al. Studies of Novel Coronavirus Disease 19 (COVID-19) pandemic: a global analysis of literature. Int J Environ Res Public Health. 2020;17:4095.
    1. Maunder R.G., Lancee W.J., Rourke S., Hunter J.J., Goldbloom D., Balderson K., et al. Factors associated with the psychological impact of severe acute respiratory syndrome on nurses and other hospital workers in Toronto. Psychosom Med. 2004;66:938–942.
    1. Chong M.Y., Wang W.C., Hsieh W.C., Lee C.Y., Chiu N.M., Yeh W.C., et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry. 2004;185:127–133.
    1. Lung F.W., Lu Y.C., Chang Y.Y., Shu B.C. Mental symptoms in different health professionals during the SARS attack: a Follow-up study. Psychiatr Q. 2009;80:107–116.
    1. Wu P., Fang Y., Guan Z., Fan B., Kong J., Yao Z., et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54:302–311.
    1. Nickell L.A., Crighton E.J., Tracy C.S., Al-Enazy H., Bolaji Y., Hanjrah S., et al. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. Can Med Assoc J. 2004;170:793–798.
    1. Goulia P., Mantas C., Dimitroula D., Mantis D., Hyphantis T. General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic. BMC Infect Dis. 2010;10:322.
    1. Liao Q., Cowling B.J., Lam W.W., Ng D.M., Fielding R. Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys. BMC Infect Dis. 2014;14:169.
    1. Khalid I., Khalid T.J., Qabajah M.R., Barnard A.G., Qushmaq I.A. Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clin Med Res. 2016;14:7–14.
    1. Lee S.M., Kang W.S., Cho A.R., Kim T., Park J.K. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018;87:123–127.
    1. Stawicki S.P., Paladino L., Sharpe R.P., Galwankar S.C., Sholevar F., Marchionni C., et al. Reflections on the Ebola public health emergency of international concern, part 2: the unseen epidemic of posttraumatic stress among health-care personnel and survivors of the 2014–2016 Ebola outbreak. J Glob Infect Dis. 2017;9:45–50.
    1. Shultz J.M., Cooper J.L., Baingana F., Oquendo M.A., Espinel Z., Althouse B.M., et al. The role of fear-related behaviors in the 2013-2016 West Africa Ebola virus disease outbreak. Curr Psychiatry Rep. 2016;18:104.
    1. Ho S.M.Y., Kwong-Lo R.S.Y., Mak C.W.Y., Wong J.S. Fear of severe acute respiratory syndrome (SARS) among health care workers. J Consult Clin Psychol. 2005;73:344.
    1. Liu X., Kakade M., Fuller C.J., Fan B., Fang Y., Kong J., et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatry. 2012;53:15–23.
    1. Xiang Y.T., Yang Y., Li W., Zhang L., Zhang Q., Cheung T., et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228–229.
    1. Kröger C. Shattered social identity and moral injuries: work-related conditions in health care professionals during the COVID-19 pandemic. Psychol Trauma. 2020;12:S156–8.
    1. Kobasa S.C. Stressful life events, personality, and health: an inquiry into hardiness. J Pers Soc Psychol. 1979;37:1–11.
    1. Bao Y., Sun Y., Meng S., Shi J., Lu L. 2019-CoV epidemic: address mental health care to empower society. Lancet. 2020;395:e37–8.
    1. Jizheng H., Mingfeng H., Tengda L., Ake R., Xiaoping Z. Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19. Chin J Indust Hygiene Occup Dis. 2020;38:E001.
    1. Junhua M., Qi Z., Xue G., Lijuan L., Zhongwen Z., Jing W., et al. Analysis of psychological and sleep state of medical stuff with novel coronavirus pneumonia. Herald Med. 2020;39:345–349.
    1. Jijun W., Xian S., Fei C., Yuanjie D., Dechun C., Xingcao J., et al. Investigation on sleep quality of first line nurses in fighting against novel coronavirus pneumonia and its influencing factors. Nurs Res China. 2020;34:558–562.
    1. Wenhui Z., Er L., Yi Z. Investigation and countermeasures of anxiety of nurses in a designated hospital of novel coronavirus pneumonia in Hangzhou. Health Res. 2020;40:130–133.
    1. Moher D., Liberati A., Tetzlaff J., Altman D.G. Preferred reporting items for systematic review and meta-analysis: the PRISMA Statement. PLoS Med. 2009;6:1–6.
    1. Kelley K., Clark B., Brown V., Sitzia J. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003;15:261–266.
    1. Shea B.J., Reeves B.C., Wells G.A., Thuku M., Hamel C., Moran J., et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomized and non-randomised studies of healthcare interventions or both. BMC. 2017;358:j4008.
    1. Arpacioglu S., Gurler M., Cakiroglu S. Secondary traumatization outcomes and associated factors among the health care workers exposed to the COVID-19. Int J Soc Psychiatry. 2020
    1. Barello S., Palamenghi L., Graffigna G. Burnout and somatic symptoms among frontline professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res. 2020 doi: 10.1016/j.psychres.2020.113129.
    1. Cipolotti L., Chan E., Murphy P., van Harskamp N., Foley J.A. Factors contributing to the distress, concerns, and needs of UK Neuroscience health care workers during the COVID-19 pandemic. Psychol Psycother. 2020 doi: 10.1111/papt.12298.
    1. DiTella M., Romeo A., Benfante A., Castelli L. Mental health of healthcare workers during the COVID-19 pandemic in Italy. J Eval Clin Pract. 2020 doi: 10.1111/jep.13444.
    1. Dosil Santamaría M., Ozamiz-Etxebarria N., Redondo Rodríguez I., Jaureguizar Alboniga-Mayor J., Picaza Gorrotxategi M. Impacto psicológico de la COVID-19 en una muestra de profesionales sanitarios españoles. Rev Psiquiatr Salud Ment (Barc) 2020 doi: 10.1016/j.rpsm.2020.05.004.
    1. Elbay R.Y., Kurtulmus A., Arpacioglu S., Karandere E. Depression, anxiety, stress levels of physicians and associated factors inCOVID-19 pandemics. Psychiatry Res. 2020 doi: 10.1016/j.psychres.2020.113130.
    1. Giusti E.M., Pedroli E., D’Aniello G.E., Stramba Badiale C., Pietrabissa G., Manna C., et al. The psychological impact of the COVID-19 outbreak on health professionals: a cross-sectional study. Front Psychol. 2020;11:1684.
    1. Man A.M., Toma C., Motoc N.S., Necrelescu O.L., Bondor C.I., Chis A.F., et al. Disease perception and coping with emotional distress during COVID-19 pandemic: a survey among medical staff. Int J Environ Res Public Health. 2020 doi: 10.3390/ijerph17134899.
    1. Romero C.S., Catalá J., Delgado C., Ferrer C., Errando C., Iftimi A., et al. COVID-19 psychological impact in 1309 healthcare workers in Spain: the PSIMCOV group. Psychol Med. 2020 doi: 10.1017/S0033291720001671.
    1. Rossi R., Socci V., Pacitti F., Di Lorenzo G., Di Marco A., Siracusano A., et al. Mental health outcomes among frontline and second-line health workers during the Coronavirus Disease 2019 (COVID-19) pandemic in Italy. JAMA Network Open. 2020 doi: 10.1001/jamanetworkopen.2020.10185.
    1. Shechter A., Diaz F., Moise N., Anstey D.E., Ye S., Agarwal S., Birk J.L., et al. Psychological distress, coping behaviors and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020 doi: 10.1016/j.genhosppsych.2020.06.007.
    1. Stojanov J., Malobabic M., Stanojevic G. Quality of sleep and health-related quality of life among health care professionals treating patients with coronavirus disease-19. Int J Soc Psychiatry. 2020 doi: 10.1177/0020764020942800.
    1. Maunder R.G., Lancee W.J., Balderson K.E., Bennett J.P., Borgundvaag B., Evans S., et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12:1924–1932.
    1. Brooks S.K., Webster R.K., Smith L.E., Woodland L., Wessely S., Greenberg N., et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. 2020;395:912–920.
    1. Boniol M., McIsaac M., Xu L., Wuliji T., Diallo K., Campbell J. Gender equity in the health workforce: Analysis of 104 countries (Health Workforce Working Paper No. 1) 2019. [Accessed 21 August 2020]
    1. Soklaridis S., Lin E., Lalani Y., Rodak T., Sockalingam S. Mental health interventions and supports during COVID-19 and other pandemics: a rapid review of the evidence. Gen Hosp Psychiatry. 2020;66:133–146.
    1. López-Atanes M., Recio-Barbero M., Sáenz-Herrero M. Are women still “the other”? Gendered mental health interventions for health care workers in Spain during COVID-19. Psychol Trauma. 2020;12:S243–4.
    1. Holmes E.A., O’Connor R.C., Perry V.H., Tracey I., Wessely S., Arseneault L., Ford T. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry. 2020;7:547–560.

Source: PubMed

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