Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis

Abstract Background Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress. Conclusions The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

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Healthcare Workers’ Experiences of Working on the Frontline and Views About Support During COVID-19 and Previous Pandemics: A Systematic Review and Qualitative Meta-Synthesis

10.21203/rs.3.rs-322448/v1 ◽

2021 ◽

Author(s):

Jo Billings ◽

Brian Chi Fung Ching ◽

Vasiliki Gkofa ◽

Talya Greene ◽

Michael Bloomfield

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Psychosocial Support ◽

Grey Literature ◽

Opportunity To Learn ◽

Health Impact ◽

Frontline Workers ◽

Health And Wellbeing ◽

Frontline Healthcare Workers ◽

The Impact

Abstract Background: Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods: We searched key healthcare databases (Medline, PsychINFO and PubMed), reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. Final searches took place on September 28, 2020. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results: This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate PPE, insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and nuanced and could be experienced concomitantly as sources of support but also sources of stress. Conclusions: The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

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Healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and comparable pandemics: A rapid review and meta-synthesis

10.1101/2020.06.21.20136705 ◽

2020 ◽

Cited By ~ 2

Author(s):

Jo Billings ◽

Brian Chi Fung Ching ◽

Vasiliki Gkofa ◽

Talya Greene ◽

Michael Bloomfield

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Psychosocial Support ◽

Opportunity To Learn ◽

Health Impact ◽

Rapid Review ◽

Health And Wellbeing ◽

Healthcare Workforce ◽

Frontline Healthcare Workers ◽

The Impact

AbstractHealthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline healthcare workers and growing calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. This rapid review identified 40 qualitative studies which have explored healthcare workers’ experiences and views from previous pandemics, including and comparable to COVID-19. Meta-synthesis of this qualitative data using thematic analysis derived eight key themes which transcended pandemics, time, and geographical boundaries. This pandemic is not unprecedented; the themes that arose from previous pandemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous pandemics, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

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Mental Health Impact of COVID-19 Pandemic on Health Care Workers in Ebonyi State, Southeast, Nigeria

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i09/955 ◽

2020 ◽

Vol 5 (09) ◽

pp. 400-406

Author(s):

Okechukwu B. Anozie ◽

Johnbosco I. Nwafor ◽

Ephraim I. Nwokporo ◽

Chidi U. Esike ◽

Richard L. Ewah ◽

...

Keyword(s):

Mental Health ◽

Health Outcome ◽

Psychological Distress ◽

Healthcare Workers ◽

Short Form ◽

Health Impact ◽

Mental Health Outcome ◽

Mental Wellbeing ◽

Frontline Healthcare Workers ◽

The Impact

Background: Globally, mental health issues have become one of the predominant public health concerns as a result of the COVID-19 outbreak. The impact of COVID-19 pandemic on the mental health of frontline healthcare workers has not been fully described in Nigeria. Aim: To determine the mental health impact of COVID-19 pandemic and its associated factors among frontline healthcare workers in Ebonyi State, Nigeria. Materials and methods: This was an online cross-sectional study conducted among 315 frontline healthcare workers treating COVID-19 patients at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. The mental health outcome of the participants was assessed using the short form of the Mental Health Continuum (MHC-SF). Results: The prevalence of mental health outcome for different categories was 47% (n = 148) for flourishing, 28.3% (n = 89) for moderate and 24.7% (n = 78) for languishing mental health. The predictors of languishing mental health outcome were being married (OR = 3.12, 95%CI 1.67 - 4.09, p = 0.035), a physician (OR = 4.09, 95%CI 1.98 - 5.61, p = 0.002), a nurse (OR = 2.21, 95%CI 0.05 - 0.24, p < 0.001), limited access to personal protective equipment (OR = 3.25, 95%CI 1.62 - 6.22, p = 0.043) and self-isolation and quarantine due to SARS-CoV-2 infection (OR = 3.03, 95%CI 0.02 - 0.95, p < 0.001). Conclusion: Nigeria’s frontline healthcare workers, especially physicians and nurses, are experiencing COVID-19 related psychological distress. There is need to develop and implement interventions to reduce the impact of prolonged psychological distress on long-term mental wellbeing in healthcare workers treating COVID-19 patients.

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Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽

10.1136/bmjopen-2020-046547 ◽

2021 ◽

Vol 11 (5) ◽

pp. e046547

Author(s):

Luke Johnson ◽

Kerry Gutridge ◽

Julie Parkes ◽

Anjana Roy ◽

Emma Plugge

Keyword(s):

Mental Health ◽

Scoping Review ◽

Grey Literature ◽

Well Being ◽

Health Impact ◽

Poor Quality ◽

Eligibility Criteria ◽

Prison Staff ◽

The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

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Impact of COVID-19 on the mental health of healthcare workers in different regions of the world

BJPsych Open ◽

10.1192/bjo.2021.689 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S258-S258

Author(s):

Mahfuja Islam ◽

Philip George ◽

Sindhu Sankaran ◽

Janet Leu Su Hui ◽

Tzun Kit

Keyword(s):

Mental Health ◽

Health Care ◽

Psychological Distress ◽

Healthcare Workers ◽

Well Being ◽

Subjective Assessment ◽

Survey Tool ◽

Frontline Workers ◽

The World ◽

The Impact

AimsThe global health system is facing a serious challenge after the recent outbreak of COVID-19 coronavirus infection which was first identified in Wuhan, China in November 2019 and declared as a pandemic in March 2020 by WHO. There is a wide consensus that this pandemic has negative psychosocial consequences as well as unforeseeable provision of mental health care services and just not on physical health alone. The aim of this research study is to determine the prevalence of psychological distress and to identify the sociodemographic variables with the main attributable factors associated with the psychological distress among healthcare workers and suggestions on how to reduce the impact on the mental health of healthcare workers during the COVID-19 pandemic in different regions of the world.MethodWe performed a cross-sectional study from September-November 2020. We used a self-administered survey tool which was distributed electronically to healthcare workers across the globe. The data were stored on an online database with password protected devices where survey responses were restricted to investigators exclusively.Data collected were: 1) Socio-demographic data (age, gender, marital status, ethnicity, religion, role in the healthcare, region of practice); 2) Psychological General Well-Being Index (PGWBI) questionnaire which contains 22 standardized items. This is a subjective assessment to score the degree of psychological well-being by focusing on 6 domains: depression; anxiety; positive-well-being; self-control; vitality and general health; 3) Subjective assessment from respondents of the main attributable factors causing psychological distress and suggested methods to help reduce the impact on mental health on health care workers.ResultMajority out of the 217 respondents were from a younger age group; females and married/domestic partnership, mainly from Western Pacific Region, South East Asian and the African Region. More than half the respondents were moderate-severely psychologically distressed and the three main attributable factors causing psychological distress were: fear of family/friends contracting COVID-19 followed by lack of PPE and discomfort caused by wearing PPE for long hours. Respondents suggested that the distress would be reduced if: more resources were provided in hospital; protocols and guidelines were implemented and counselling facilities with recreational activities were available to frontline workers.ConclusionThis study showed that the COVID-19 pandemic has affected the mental health of healthcare workers and more support or strategies need to come in place to protect frontline workers at the time of crises.

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Impact of COVID-19 on the mental health of healthcare workers in different regions of the world

BJPsych Open ◽

10.1192/bjo.2021.690 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S258-S259

Author(s):

Mahfuja Islam ◽

Philip George ◽

Sindhu Sankaran ◽

Janet Leu Su Hui ◽

Tzun Kit

Keyword(s):

Mental Health ◽

Health Care ◽

Psychological Distress ◽

Healthcare Workers ◽

Well Being ◽

Subjective Assessment ◽

Survey Tool ◽

Frontline Workers ◽

The World ◽

The Impact

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The Effect of COVID-19 on the Mental Health of Healthcare Workers: A Systematic Review

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2131147 ◽

2021 ◽

pp. 183-194

Author(s):

Consolata Uzzi ◽

Bolaji Yoade ◽

Victoria Iyanu Olateju ◽

Mary Olowere ◽

Gibson Anugwom ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Sleep Problems ◽

Psychosocial Support ◽

Psychological Impact ◽

Ptsd Symptoms ◽

Eligibility Criteria ◽

Self Harm ◽

Study Participants ◽

The Impact

Background: As COVID-19 pandemic continues to affect every nation, Healthcare Workers (HCW) who care for the patients are psychologically impacted. This study aims to assess the psychological impact experienced by HCW and the psychosocial support they received. Methods: Using PubMed, google scholar and Embase from December 2019 through June 2021, we found 376 studies on the impact of the COVID-19 pandemic on the mental health of HCW. Using our inclusion criteria, 325 studies were excluded. 51 full-text articles were assessed for eligibility. 9 articles which met our criteria and eligibility criteria reported on 19,232 HCW, and 75.2% of the study participants were women. Results: The study participants reported high levels of stress, hypervigilance, fatigue, sleep problems, PTSD symptoms, poor concentration, depression, anxiety, burnout, emotional exhaustion, depersonalization, suicide and self-harm ideations and somatic symptoms due to the COVID-19 pandemic. The psychosocial support provided to HCW includes counseling and psychotherapy-based sessions on stress adaptation, onsite mindfulness-based crisis intervention, online form of emotional freedom technique, and Effort-reward system. Conclusion: Multiple interventions found in our review were effective in mitigating psychological stress among HCWs. These interventions should be considered as part of support provided to HCW with psychosocial challenges.

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The impact of emergency call taking on the mental health and wellbeing of ambulance call-takers: A systematic thematic narrative of qualitative research

Australasian Journal of Paramedicine ◽

10.33151/ajp.17.801 ◽

2020 ◽

Vol 17 ◽

Cited By ~ 1

Author(s):

Eileen Willis ◽

Sharon Lawn ◽

Louise Roberts ◽

Leah Couzner ◽

Leila Mohammadi Mohammadi ◽

...

Keyword(s):

Mental Health ◽

Peer Review ◽

Vicarious Trauma ◽

Emergency Service ◽

Grey Literature ◽

Workplace Culture ◽

Service Workers ◽

Health And Wellbeing ◽

Emergency Service Workers ◽

The Impact

BackgroundOver the past decade there has been significant focus on the mental health and wellbeing of emergency service workers in Australia, evidenced by the 2018 Senate Inquiry into the role of Commonwealth, state and territory Governments in addressing the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers. Call-takers as an occupational group within this domain are at risk of cumulative and vicarious trauma, yet there is little research on their work-related mental illness. This systematic thematic narative literature review of qualitative articles reports on the mental health and wellbeing of emergency call-takers. MethodsBoth published peer review (2000–2018) and grey literature (2009–2018) that examined the impact of emergency work on call-takers was retrieved. Papers that focussed on call-takers’ psychological and psychosocial health were selected. Databases included Ovid Medline, CINAHL, Ovid EMcare, PsychInfo, Scopus as well as Google Scholar. ResultsFourteen articles met the eligibility criteria; five peer review and nine grey literature studies. Thematic analysis identified issues around surveillance versus lack of supervision; role denial versus advocacy; and failure to acknowledge vicarious trauma. Suggestions for improvement required recognition of the stressful nature of the work, improvements in workplace culture and the provision of support and counselling services. ConclusionWorkplace stressors for call-takers arise from their work in dealing with trauma related communication with the public as well workplace culture, particularly the response of management to issues such as shift work, poorly managed rosters and long hours of work with little time for recovery. Compounding these issues is the invisibility of call-taker work.

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