Risk and Resilience Factors For Psychosocial Impact In Healthcare Workers During COVID-19 Pandemic: A Systematic Review

Aim: During COVID-19 pandemic; unusual workload of healthcare systems and restriction protocols to control the outbreak throughout the world make healthcare workers vulnerable to psychosocial stress. The aim of the present systematic review is to assess the psychosocial impact and related factors in healthcare workers during COVID-19 pandemic. Materials and Methods: A literature search was made for studies assessing psychosocial impact with valid measurement tools till 20th June 2020 in MEDLINE, ULAKBİM and Turk Psikiyatri Dizini databases. Twenty five research articles were included. Results: Seventeen of the studies were conducted in China. Twenty one assessed depression, nineteen assessed anxiety, twelve assessed acute stress disorder symptoms or perceived stress and eight assessed insomnia and/or sleep quality. As protective factors, three studies assessed perceived social support, two assessed psychological resilience, one assessed coping styles and one assessed general self-efficacy. Conclusion: The most common problems in healthcare workers were anxiety, depression and acute stress disorder, respectively. Studies generally reported more psychosocial impact in frontline medical workers and in earlier phases of the outbreak. As protective factors; social support, psychological resilience, ac-tive coping style and general self-efficacy serve as a buffer against negative consequences of stress. To conclude, more studies that assess psychosocial impact in healthcare workers during COVID-19 pandemic in our country and around the world are needed to plan and implement protective and therapeutic mental health programs.

[1]  Zaiquan Dong,et al.  The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study , 2020, European Psychiatry.

[2]  D. Leung,et al.  The Psychological Impacts of a COVID-19 Outbreak on College Students in China: A Longitudinal Study , 2020, International journal of environmental research and public health.

[3]  A. Al-Eyadhy,et al.  The psychological impact of COVID-19 pandemic on health care workers in a MERS-CoV endemic country , 2020, Journal of Infection and Public Health.

[4]  Wenpeng Cai,et al.  Social support and mental health among health care workers during Coronavirus Disease 2019 outbreak: A moderated mediation model , 2020, PloS one.

[5]  Yuan-yuan Li,et al.  The psychological status of people affected by the COVID-19 outbreak in China , 2020, Journal of Psychiatric Research.

[6]  Selim Arpacıoğlu,et al.  Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics , 2020, Psychiatry Research.

[7]  R. Rodríguez-Jiménez,et al.  Mental health impact of COVID-19 pandemic on Spanish healthcare workers , 2020, Psychological Medicine.

[8]  P. Maulik,et al.  Psychological impact of COVID-19 on ophthalmologists-in-training and practising ophthalmologists in India , 2020, Indian journal of ophthalmology.

[9]  Haibo Qu,et al.  Factors Associated with Resilience Among Medical Staff in Radiology Departments During The Outbreak of 2019 Novel Coronavirus Disease (COVID-19): A Cross-Sectional Study , 2020, Medical science monitor : international medical journal of experimental and clinical research.

[10]  Dongliang Yang,et al.  Psychological impact of 2019 novel coronavirus (2019-nCoV) outbreak in health workers in China , 2020, Epidemiology and Infection.

[11]  Xingyue Song,et al.  Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China , 2020, Brain, Behavior, and Immunity.

[12]  Xue-mei Wei,et al.  Analysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the Fight Against COVID-19 in China , 2020, Medical science monitor basic research.

[13]  S. Wang,et al.  Sleep disturbances among medical workers during the outbreak of COVID-2019 , 2020, Occupational medicine.

[14]  P. Katsaounou,et al.  Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis , 2020, Brain, Behavior, and Immunity.

[15]  D. Siskind,et al.  Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis , 2020, BMJ.

[16]  Seoyon Yang,et al.  The Mental Health Burden of the COVID-19 Pandemic on Physical Therapists , 2020, International journal of environmental research and public health.

[17]  C. Iani,et al.  Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia , 2020, International journal of environmental research and public health.

[18]  A. Rossi,et al.  Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy , 2020, JAMA network open.

[19]  S. Xiao,et al.  Prevalence and Influencing Factors of Anxiety and Depression Symptoms in the First-Line Medical Staff Fighting Against COVID-19 in Gansu , 2020, Frontiers in Psychiatry.

[20]  N. Galbraith,et al.  The mental health of doctors during the COVID-19 pandemic , 2020, BJPsych Bulletin.

[21]  N. De Brier,et al.  Factors affecting mental health of health care workers during coronavirus disease outbreaks: a rapid systematic review , 2020 .

[22]  Vijay K. Sharma,et al.  A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak , 2020, Brain, Behavior, and Immunity.

[23]  M. Agha,et al.  The socio-economic implications of the coronavirus pandemic (COVID-19): A review , 2020, International Journal of Surgery.

[24]  M. Mckenney,et al.  Preserving mental health and resilience in frontline healthcare workers during COVID-19 , 2020, The American Journal of Emergency Medicine.

[25]  Lijun Kang,et al.  Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak , 2020, Frontiers in Psychiatry.

[26]  Bach Tran,et al.  A longitudinal study on the mental health of general population during the COVID-19 epidemic in China , 2020, Brain, Behavior, and Immunity.

[27]  Kun Wang,et al.  Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China , 2020, Psychotherapy and Psychosomatics.

[28]  M. De Domenico,et al.  Assessing the risks of ‘infodemics’ in response to COVID-19 epidemics , 2020, Nature Human Behaviour.

[29]  S. Singh,et al.  Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients , 2020, Asian Journal of Psychiatry.

[30]  Han-i Wang,et al.  Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study , 2020, Psychiatry Research.

[31]  Ying-jian Liang,et al.  Screening for Chinese medical staff mental health by SDS and SAS during the outbreak of COVID-19 , 2020, Journal of Psychosomatic Research.

[32]  Ling Zhang,et al.  Tribute to health workers in China: A group of respectable population during the outbreak of the COVID-19 , 2020, International journal of biological sciences.

[33]  Jun Xu,et al.  Study of the mental health status of medical personnel dealing with new coronavirus pneumonia , 2020, medRxiv.

[34]  Ningxi Yang,et al.  The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China , 2020, Medical science monitor : international medical journal of experimental and clinical research.

[35]  K. Hashimoto,et al.  Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control , 2020, Brain, Behavior, and Immunity.

[36]  J. Lee,et al.  Posttraumatic stress disorder and depression of survivors 12 months after the outbreak of Middle East respiratory syndrome in South Korea , 2020, BMC Public Health.

[37]  Shao-hua Hu,et al.  Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 , 2020, JAMA network open.

[38]  R. Ho,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 , 2020, International journal of environmental research and public health.

[39]  Mary A Lake,et al.  What we know so far: COVID-19 current clinical knowledge and research. , 2020, Clinical medicine.

[40]  Andy S. K. Cheng,et al.  The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey , 2020, Epidemiology and Infection.

[41]  Shi-Yan Ren,et al.  Fear can be more harmful than the severe acute respiratory syndrome coronavirus 2 in controlling the corona virus disease 2019 epidemic , 2020, World journal of clinical cases.

[42]  H. Fu,et al.  Mental health problems and social media exposure during COVID-19 outbreak , 2020, PloS one.

[43]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[44]  J. Bierens,et al.  A Systematic Review of the Impact of Disaster on the Mental Health of Medical Responders , 2019, Prehospital and Disaster Medicine.

[45]  Chaojie Liu,et al.  Work-Related Accumulated Fatigue among Doctors in Tertiary Hospitals: A Cross-Sectional Survey in Six Provinces of China , 2019, International journal of environmental research and public health.

[46]  C. Brewin,et al.  Responding to mental health needs after terror attacks , 2019, BMJ.

[47]  Sang Min Lee,et al.  Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients , 2018, Comprehensive Psychiatry.

[48]  S. Lydon,et al.  Stress, coping, and psychological resilience among physicians , 2018, BMC Health Services Research.

[49]  S. Thompson,et al.  Systematic review of resilience-enhancing, universal, primary school-based mental health promotion programs , 2018, BMC Psychology.

[50]  Alyson K. Myers,et al.  Shift Work and Sleep: Medical Implications and Management. , 2017, Sleep medicine and disorders : international journal.

[51]  J. Bower,et al.  Relationship of Psychosocial Resources With Allostatic Load: A Systematic Review , 2017, Psychosomatic medicine.

[52]  Gemma-Claire Ali,et al.  Validated Screening Tools for Common Mental Disorders in Low and Middle Income Countries: A Systematic Review , 2016, PloS one.

[53]  Martin H. Schmidt,et al.  Positive coping styles and perigenual ACC volume: two related mechanisms for conferring resilience? , 2016, Social cognitive and affective neuroscience.

[54]  I. Khalid,et al.  Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak , 2016, Clinical Medicine & Research.

[55]  S. Tokuno,et al.  Rumor-Related and Exclusive Behavior Coverage in Internet News Reports Following the 2009 H1N1 Influenza Outbreak in Japan , 2015, Disaster Medicine and Public Health Preparedness.

[56]  P. Albert,et al.  Why is depression more prevalent in women? , 2015, Journal of psychiatry & neuroscience : JPN.

[57]  P. Gehrman,et al.  Sleep disturbance is associated with cardiovascular and metabolic disorders , 2012, Journal of sleep research.

[58]  K. Miyake,et al.  Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe , 2012, Psychiatry and clinical neurosciences.

[59]  S. Wong,et al.  Healthcare workers' duty concerns of working in the isolation ward during the novel H1N1 pandemic. , 2012, Journal of clinical nursing.

[60]  Catherine E. Goodall,et al.  Threat, Efficacy, and Uncertainty in the First 5 Months of National Print and Electronic News Coverage of the H1N1 Virus , 2012, Journal of health communication.

[61]  Xinhua Liu,et al.  Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic , 2011, Comprehensive Psychiatry.

[62]  T. Hyphantis,et al.  General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic , 2010, BMC infectious diseases.

[63]  A. Kong,et al.  Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. , 2009, Archives of internal medicine.

[64]  E. Susser,et al.  The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk , 2009, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[65]  C. Chu,et al.  Long-term psychiatric morbidities among SARS survivors , 2009, General Hospital Psychiatry.

[66]  J. Siu.  The SARS-Associated Stigma of SARS Victims in the Post-SARS Era of Hong Kong , 2008, Qualitative health research.

[67]  Charlton Cheung,et al.  Stress and Psychological Distress among SARS Survivors 1 Year after the Outbreak , 2007, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[68]  Charlton Cheung,et al.  Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers , 2007, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[69]  C.-Y. Lin,et al.  The psychological effect of severe acute respiratory syndrome on emergency department staff , 2006, Emergency Medicine Journal.

[70]  Robert G. Maunder,et al.  Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak , 2006, Emerging infectious diseases.

[71]  Torbjörn Akerstedt,et al.  Psychosocial stress and impaired sleep. , 2006, Scandinavian journal of work, environment & health.

[72]  T. Winzenberg,et al.  The GP's response to pandemic influenza: a qualitative study. , 2006, Family practice.

[73]  T. Su,et al.  Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: A prospective and periodic assessment study in Taiwan , 2006, Journal of Psychiatric Research.

[74]  Jennifer L Martin,et al.  Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home. , 2006, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[75]  A. Hedley,et al.  Longitudinal assessment of community psychobehavioral responses during and after the 2003 outbreak of severe acute respiratory syndrome in Hong Kong. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[76]  Sing Lee,et al.  The experience of SARS-related stigma at Amoy Gardens , 2005, Social Science & Medicine.

[77]  S. Ho,et al.  The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope , 2005, European journal of emergency medicine : official journal of the European Society for Emergency Medicine.

[78]  R. Maunder,et al.  Factors Associated With the Psychological Impact of Severe Acute Respiratory Syndrome on Nurses and Other Hospital Workers in Toronto , 2004, Psychosomatic medicine.

[79]  C. W. Tam,et al.  Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers , 2004, Psychological Medicine.

[80]  Y. Chan,et al.  Severe acute respiratory syndrome-related psychiatric and posttraumatic morbidities and coping responses in medical staff within a primary health care setting in Singapore. , 2004, The Journal of clinical psychiatry.

[81]  M. Chong,et al.  Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital , 2004, British Journal of Psychiatry.

[82]  D. Stewart,et al.  The Psychosocial Effects of Being Quarantined following Exposure to SARS: A Qualitative Study of Toronto Health Care Workers , 2004, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[83]  Ross Upshur,et al.  Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution , 2004, Canadian Medical Association Journal.

[84]  R. Maunder,et al.  The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. , 2003, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[85]  L. Aiken,et al.  Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. , 2002, JAMA.

[86]  T. Wills,et al.  Stress, social support, and the buffering hypothesis. , 1985, Psychological bulletin.

[87]  M. You,et al.  Hospital workers’ psychological resilience after the 2015 Middle East respiratory syndrome outbreak , 2019, Social Behavior and Personality: an international journal.

[88]  Jorge M Serrador,et al.  Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. , 2009, Progress in cardiovascular diseases.

[89]  Mary Ellen O'Connell,et al.  Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions , 2009 .

[90]  R. Maunder,et al.  Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. , 2008, Psychiatric services.