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Which healthcare workers are most at risk of psychological distress during COVID-19?

Nurses and female healthcare workers (HCWs) are most at risk of experiencing psychological distress during the COVID-19 pandemic, a new rapid systematic review published in Frontiers in Psychiatry has found.

The new study by University of Sheffield researchers is the largest global review of factors associated with distress amongst HCWs during an infectious disease outbreak, including COVID-19, SARS, Bird Flu, Swine Flu and Ebola.

The researcherssystematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCWs during an outbreak of the aforementioned infectious diseases. Four electronic databases were searched (2000 to 15 November 2020) for relevant peer-reviewed research according to a pre-registered protocol.

From the 4,621 records identified, 138 with data from 143,246 HCWs in 139 studies were included. All but two studies were cross-sectional. The majority of the studies were conducted during COVID-19 (k=107, n=34,334) and SARS (k=21, n=18,096).

Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk of contact with infected patients, and experiencing quarantine, were risk factors for psychological distress among HCWs.

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.

The study authors recommended that HCWs at risk for increased distress receive early interventions and ongoing monitoring because there is evidence that HCW distress can persist for up to three years after an outbreak.

The study findings have informed a new framework which healthcare providers can use to identify those most at risk of increased distress, as well as areas to target to help build resilience.

The research team is now conducting a further study with NHS workers using this new framework in order to help identify factors which could help to reduce distress during COVID-19.


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