Abstract
Background Health-care workers (HCW) are at risk for psychological distress during an infectious disease outbreak due to the demands of dealing with a public health emergency.
Aims To examine the factors associated with psychological distress among HCW during an outbreak.
Method We systematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCW during an outbreak (COVID-19, SARS, MERS, H1N1, H7N9, Ebola). Four electronic databases were searched (2000 to 10 July 2020) for relevant peer-reviewed research according to a pre-registered protocol. A narrative synthesis was conducted to identify fixed, modifiable, and infection-related factors.
Results From the 3335 records identified, 52 with data from 54,800 HCW were included. All but two studies were cross-sectional. Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk for contact with infected patients, and being quarantined, were risk factors for psychological distress among HCW. Personal and organisational social support, perceiving control, positive work attitudes, sufficient information about the outbreak and proper protection, training and resources, were associated with less psychological distress.
Conclusions HCW who may be most at risk for psychological distress during an outbreak require early intervention and ongoing monitoring as there is some evidence that HCW distress can persist for years after an outbreak. Further research is needed to track the associations of risk factors with distress over time and the extent to which certain factors are inter-related and linked to sustained or transient distress.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
Funding Statement: This research received no specific grant from any funding agency, commercial or not-for-profit sectors.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
No ethical approval was required as this is a systematic review.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
Footnotes
Funding Statement: This research received no specific grant from any funding agency, commercial or not-for-profit sectors.
Conflicts of Interest: None
Data Availability
Protocol for the systematic review is available on PROSPERO: https://www.crd.york.ac.uk/PROSPERO/; registration ID: CRD42020178185