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Meta-Analysis
. 2020 Dec 1:277:347-357.
doi: 10.1016/j.jad.2020.08.034. Epub 2020 Aug 23.

Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis

Maria J Serrano-Ripoll  1 , Jose F Meneses-Echavez  2 , Ignacio Ricci-Cabello  3 , David Fraile-Navarro  4 , Maria A Fiol-deRoque  5 , Guadalupe Pastor-Moreno  6 , Adoración Castro  7 , Isabel Ruiz-Pérez  8 , Rocío Zamanillo Campos  9 , Daniela C Gonçalves-Bradley  10
Affiliations
Meta-Analysis

Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis

Maria J Serrano-Ripoll et al. J Affect Disord. .

Abstract

Background: This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers' (HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact.

Method: Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception to August 2020). We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems, and used GRADE to ascertain the certainty of evidence.

Results: We included 117 studies. The pooled prevalence was higher for acute stress disorder (40% (95%CI 39 to 41%)), followed by anxiety (30%, (30 to 31%)), burnout (28% (26 to 31%)), depression (24% (24 to 25%)), and post-traumatic stress disorder (13% (13 to 14%)). We identified factors associated with the likelihood of developing those problems, including sociodemographic (younger age and female gender), social (lack of social support, stigmatization), and occupational (working in a high-risk environment, specific occupational roles, and lower levels of specialised training and job experience) factors. Four studies reported interventions for frontline HCW: two educational interventions increased confidence in pandemic self-efficacy and in interpersonal problems solving (very low certainty), whereas one multifaceted intervention improved anxiety, depression, and sleep quality (very low certainty).

Limitations: We only searched three databases, and the initial screening was undertaken by a single reviewer.

Conclusion: Given the very limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified represent important targets for future interventions.

Keywords: COVID-19; Healthcare workers; Mental health; Meta-analysis; Systematic review; Viral pandemic.

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Conflict of interest statement

None.

Figures

Fig 1
Fig. 1
PRISMA Flowchart.
Fig 2
Fig. 2
Forest plot - prevalence of depression. Legend: ES, effect size; CI, confidence interval; I2, heterogeneity level.
Fig 3
Fig. 3
Forest plot - prevalence of anxiety. Legend: ES, effect size; CI, confidence interval; I2, heterogeneity level
Fig 4
Fig. 4
Forest plot - prevalence of posttraumatic stress. Legend: ES, effect size; CI, confidence interval; I2, heterogeneity level.
Fig 5
Fig. 5
Forest plot - prevalence of acute disorders. Legend: ES, effect size; CI, confidence interval; I2, heterogeneity level.
Fig 6
Fig. 6
Forest plot - prevalence of burnout. Legend: ES, effect size; CI, confidence interval; I2, heterogeneity level.
See this image and copyright information in PMC

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