Psychological and Coping Responses of Health Care Workers Toward Emerging Infectious Disease Outbreaks

Introduction: The novel Coronavirus Disease (COVID-19) outbreak currently puts health care workers at high risk of both infection and mental health problems. Considering their pivotal role in tackling this pandemic crisis, providing adequate mental health care for health care workers is imperative. This study aimed to identify the risk and protective factors for mental health outcomes in health care workers during coronavirus epidemics.Methods: A rapid systematic review was performed in three databases and current COVID-19 resources (search date March 24, 2020). Following study selection, study characteristics and effect measures were tabulated, and data were synthesized by using vote counting based on direction of effect. Risk of bias of each study was assessed and the certainty of evidence was appraised according to the GRADE methodology.Results: Out of 2605 references, 28 observational studies were selected and the identified risk and protective factors were categorized in ten thematic categories. The level of disease exposure, being quarantined as health care worker, and health fear were significantly associated with worse mental health outcomes. There was evidence that clear communication and support from the organization, social support and personal sense of control and coping ability are effective protective factors. No specific mental health interventions for assisting health care workers in mental distress during infectious disease outbreaks were identified. The evidence was of very low certainty, because of risk of bias and imprecise results.Conclusion: Safeguarding mental health of health care workers during infectious disease outbreaks should not be treated as a separate mental health intervention strategy, but requires a protective approach. This study therefore suggests that embedding mental health support in a safe and efficient working environment which promotes collegial social support and personal sense of control can help to maximize resilience of health care workers during the COVID-19 global health crisis.

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Health Care Student Knowledge and Willingness to Work in Infectious Disease Outbreaks

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2017.18 ◽

2017 ◽

Vol 11 (6) ◽

pp. 694-700 ◽

Cited By ~ 11

Author(s):

Rima Patel ◽

Kapil Wattamwar ◽

Jaya Kanduri ◽

Meghan Nahass ◽

Jennifer Yoon ◽

...

Keyword(s):

Infectious Disease ◽

Health Care ◽

Medical Students ◽

Health Care Workers ◽

Disease Outbreaks ◽

Pharmacy Students ◽

Health Care Students ◽

Infectious Disease Outbreaks ◽

Care Workers ◽

Disaster Training

AbstractObjectiveHealth care workers are critical first responders. Understanding which factors motivate their willingness to work (WTW) during infectious disease outbreaks may guide improvements in preparedness. The perspective of health care students, the future workforce, remains largely unexplored. This study compared factors influencing WTW among medical, nursing, and pharmacy students.MethodsA printed survey was administered to 631 medical, nursing, and pharmacy students. The questionnaire elicited information regarding prior disaster training, disease-related knowledge, and WTW in the setting of infectious diseases with contact or respiratory transmission.ResultsAnalyses of the 579 respondents (92% response rate) demonstrated that students were less fearful for their health and more willing to work during outbreaks with contact transmission than during those with respiratory transmission. Medical students were the most fearful for their health, but they demonstrated the greatest WTW, followed by nursing students, and then pharmacy students. Medical students were also the most knowledgeable about infectious diseases. Prior disaster training was associated with greater WTW.ConclusionsExtent of disease-related knowledge and prior disaster training appear to influence WTW. Our findings, taken in the context of a remarkable underemphasis on disaster preparedness in health care curricula, call for a broader incorporation of disaster training to improve the WTW of health care students, and, ultimately, health care workers. (Disaster Med Public Health Preparedness. 2017;11:694–700)

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Factors Influencing Health Care Workers’ Willingness to Respond to Duty during Infectious Disease Outbreaks and Bioterrorist Events: An Integrative Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000248 ◽

2021 ◽

pp. 1-35

Author(s):

Eleanor J. Murray ◽

Matt Mason ◽

Vanessa Sparke ◽

Peta-Anne P. Zimmerman

Keyword(s):

Infectious Disease ◽

Health Care ◽

Health Care Workers ◽

Perceived Risk ◽

Assessment Tool ◽

Care Delivery ◽

Disease Outbreaks ◽

Factors Affecting ◽

Infectious Disease Outbreaks ◽

Care Workers

Abstract Background: Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond. Aim: The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events. Methods: An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool. Results: A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics. Conclusions: By comprehensively identifying the facilitators and barriers to HCWs’ WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety.

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Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers

The Canadian Journal of Psychiatry ◽

10.1177/070674370705200406 ◽

2007 ◽

Vol 52 (4) ◽

pp. 241-247 ◽

Cited By ~ 189

Author(s):

Grainne M McAlonan ◽

Antoinette M Lee ◽

Vinci Cheung ◽

Charlton Cheung ◽

Kenneth WT Tsang ◽

...

Keyword(s):

Infectious Disease ◽

Health Care ◽

Health Care Workers ◽

Psychological Impact ◽

Disease Outbreak ◽

Emerging Infectious Disease ◽

Infectious Disease Outbreak ◽

Care Workers

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Use of a Real-Time Locating System for Contact Tracing of Health Care Workers During the COVID-19 Pandemic at an Infectious Disease Center in Singapore: Validation Study (Preprint)

10.2196/preprints.19437 ◽

2020 ◽

Author(s):

Hanley J Ho ◽

Zoe Xiaozhu Zhang ◽

Zhilian Huang ◽

Aung Hein Aung ◽

Wei-Yen Lim ◽

...

Keyword(s):

Infectious Disease ◽

Health Care ◽

Real Time ◽

Sensitivity And Specificity ◽

Health Care Workers ◽

Disease Outbreaks ◽

Contact Tracing ◽

Staff Members ◽

Care Workers ◽

Locating System

BACKGROUND In early 2020, coronavirus disease (COVID-19) emerged and spread by community and nosocomial transmission. Effective contact tracing of potentially exposed health care workers is crucial for the prevention and control of infectious disease outbreaks in the health care setting. OBJECTIVE This study aimed to evaluate the comparative effectiveness of contact tracing during the COVID-19 pandemic through the real-time locating system (RTLS) and review of the electronic medical record (EMR) at the designated hospital for COVID-19 response in Singapore. METHODS Over a 2-day study period, all admitted patients with COVID-19, their ward locations, and the health care workers rostered to each ward were identified to determine the total number of potential contacts between patients with COVID-19 and health care workers. The numbers of staff-patient contacts determined by EMR reviews, RTLS-based contact tracing, and a combination of both methods were evaluated. The use of EMR-based and RTLS-based contact tracing methods was further validated by comparing their sensitivity and specificity against self-reported staff-patient contacts by health care workers. RESULTS Of 796 potential staff-patient contacts (between 17 patients and 162 staff members), 104 (13.1%) were identified by both the RTLS and EMR, 54 (6.8%) by the RTLS alone, and 99 (12.4%) by the EMR alone; 539 (67.7%) were not identified through either method. Compared to self-reported contacts, EMR reviews had a sensitivity of 47.2% and a specificity of 77.9%, while the RTLS had a sensitivity of 72.2% and a specificity of 87.7%. The highest sensitivity was obtained by including all contacts identified by either the RTLS or the EMR (sensitivity 77.8%, specificity 73.4%). CONCLUSIONS RTLS-based contact tracing showed higher sensitivity and specificity than EMR review. Integration of both methods provided the best performance for rapid contact tracing, although technical adjustments to the RTLS and increasing user compliance with wearing of RTLS tags remain necessary.

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Use of a Real-Time Locating System for Contact Tracing of Health Care Workers During the COVID-19 Pandemic at an Infectious Disease Center in Singapore: Validation Study

Journal of Medical Internet Research ◽

10.2196/19437 ◽

2020 ◽

Vol 22 (5) ◽

pp. e19437 ◽

Cited By ~ 11

Author(s):

Hanley J Ho ◽

Zoe Xiaozhu Zhang ◽

Zhilian Huang ◽

Aung Hein Aung ◽

Wei-Yen Lim ◽

...

Keyword(s):

Infectious Disease ◽

Health Care ◽

Real Time ◽

Sensitivity And Specificity ◽

Health Care Workers ◽

Disease Outbreaks ◽

Contact Tracing ◽

Staff Members ◽

Care Workers ◽

Locating System

Background In early 2020, coronavirus disease (COVID-19) emerged and spread by community and nosocomial transmission. Effective contact tracing of potentially exposed health care workers is crucial for the prevention and control of infectious disease outbreaks in the health care setting. Objective This study aimed to evaluate the comparative effectiveness of contact tracing during the COVID-19 pandemic through the real-time locating system (RTLS) and review of the electronic medical record (EMR) at the designated hospital for COVID-19 response in Singapore. Methods Over a 2-day study period, all admitted patients with COVID-19, their ward locations, and the health care workers rostered to each ward were identified to determine the total number of potential contacts between patients with COVID-19 and health care workers. The numbers of staff-patient contacts determined by EMR reviews, RTLS-based contact tracing, and a combination of both methods were evaluated. The use of EMR-based and RTLS-based contact tracing methods was further validated by comparing their sensitivity and specificity against self-reported staff-patient contacts by health care workers. Results Of 796 potential staff-patient contacts (between 17 patients and 162 staff members), 104 (13.1%) were identified by both the RTLS and EMR, 54 (6.8%) by the RTLS alone, and 99 (12.4%) by the EMR alone; 539 (67.7%) were not identified through either method. Compared to self-reported contacts, EMR reviews had a sensitivity of 47.2% and a specificity of 77.9%, while the RTLS had a sensitivity of 72.2% and a specificity of 87.7%. The highest sensitivity was obtained by including all contacts identified by either the RTLS or the EMR (sensitivity 77.8%, specificity 73.4%). Conclusions RTLS-based contact tracing showed higher sensitivity and specificity than EMR review. Integration of both methods provided the best performance for rapid contact tracing, although technical adjustments to the RTLS and increasing user compliance with wearing of RTLS tags remain necessary.

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Stressors and Coping Strategies During the Outbreak of Coronavirus Disease 2019 Among Hospital Staff: A Case Study in Iran

Quarterly of Horizon of Medical Sciences ◽

10.32598/hms.27.2.3289.1 ◽

2021 ◽

Vol 27 (2) ◽

pp. 148-163

Author(s):

Fatemeh Mohammadzadeh ◽

◽

Ali Delshad Noghabi ◽

Javad Bazeli ◽

Hamidreza Karimi ◽

...

Keyword(s):

Health Care ◽

Stress Intensity ◽

Health Care Workers ◽

Coping Styles ◽

Hospital Staff ◽

Maladaptive Coping ◽

Care Workers ◽

High Level ◽

And Coping ◽

Sports Activities

Aims: The emergence of COVID-19 disease has created significant stress and anxiety for health care workers. This study aimed to investigate the stressors and coping strategies in the staff of Allameh Bohlool Hospital in Gonabad City, Iran, during the outbreak of the COVID-19 disease. Methods & Materials: This cross-sectional study was performed on 252 employees of Allameh Bohlool Hospital in Gonabad from March 2020 to April 2020. Study tools included a brief form of coping styles (Brief-COPE) and a researcher-made questionnaire of stressors due to the emergence of COVID-19 among health care workers. The obtained data were analyzed using linear regression and ordinal regression models at the significance level of 0.05. Findings: About 74.2%, 69.4%, 52.7%, 52.7%, and 99.2% of the hospital staff had moderate to high stress in the domains of internal, family-social, workplace-related, infection control, and government measures, respectively. The degree of using adaptive and maladaptive coping styles used by staff were 52.0% and 23.8% at the moderate to the high level, respectively. Maladaptive coping styles had a positive and significant relationship with stress intensity so that for each unit increase in maladaptive coping score, the odds of experiencing higher levels of stress increased 1.24 to 1.45 times (P<0.001). Also, the odds of experiencing higher levels of stress in those who had sports activities was 24% to 76% lower (P=0.003). Conclusion: The findings of the present study indicated a high level of stress among hospital staff. Also, the use of maladaptive coping styles and sports activities had a significant positive and negative relationship with stress intensity, respectively. Therefore, designing effective interventions focusing on reducing maladaptive coping patterns among hospital staff and encouraging people to engage in sports activities can help manage stress as much as possible due to the outbreak of COVID-19 disease.

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