Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Nov 5;11(11):CD013779.
doi: 10.1002/14651858.CD013779.

Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review

Alex Pollock  1 , Pauline Campbell  1 , Joshua Cheyne  2 , Julie Cowie  1 , Bridget Davis  1 , Jacqueline McCallum  3 , Kris McGill  1 , Andrew Elders  1 , Suzanne Hagen  1 , Doreen McClurg  1 , Claire Torrens  4 , Margaret Maxwell  4
Affiliations
Meta-Analysis

Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review

Alex Pollock et al. Cochrane Database Syst Rev. .

Abstract

Background: Evidence from disease epidemics shows that healthcare workers are at risk of developing short- and long-term mental health problems. The World Health Organization (WHO) has warned about the potential negative impact of the COVID-19 crisis on the mental well-being of health and social care professionals. Symptoms of mental health problems commonly include depression, anxiety, stress, and additional cognitive and social problems; these can impact on function in the workplace. The mental health and resilience (ability to cope with the negative effects of stress) of frontline health and social care professionals ('frontline workers' in this review) could be supported during disease epidemics by workplace interventions, interventions to support basic daily needs, psychological support interventions, pharmacological interventions, or a combination of any or all of these.

Objectives: Objective 1: to assess the effects of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. Objective 2: to identify barriers and facilitators that may impact on the implementation of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic.

Search methods: On 28 May 2020 we searched the Cochrane Database of Systematic Reviews, CENTRAL, MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Global Index Medicus databases and WHO Institutional Repository for Information Sharing. We also searched ongoing trials registers and Google Scholar. We ran all searches from the year 2002 onwards, with no language restrictions.

Selection criteria: We included studies in which participants were health and social care professionals working at the front line during infectious disease outbreaks, categorised as epidemics or pandemics by WHO, from 2002 onwards. For objective 1 we included quantitative evidence from randomised trials, non-randomised trials, controlled before-after studies and interrupted time series studies, which investigated the effect of any intervention to support mental health or resilience, compared to no intervention, standard care, placebo or attention control intervention, or other active interventions. For objective 2 we included qualitative evidence from studies that described barriers and facilitators to the implementation of interventions. Outcomes critical to this review were general mental health and resilience. Additional outcomes included psychological symptoms of anxiety, depression or stress; burnout; other mental health disorders; workplace staffing; and adverse events arising from interventions.

Data collection and analysis: Pairs of review authors independently applied selection criteria to abstracts and full papers, with disagreements resolved through discussion. One review author systematically extracted data, cross-checked by a second review author. For objective 1, we assessed risk of bias of studies of effectiveness using the Cochrane 'Risk of bias' tool. For objective 2, we assessed methodological limitations using either the CASP (Critical Appraisal Skills Programme) qualitative study tool, for qualitative studies, or WEIRD (Ways of Evaluating Important and Relevant Data) tool, for descriptive studies. We planned meta-analyses of pairwise comparisons for outcomes if direct evidence were available. Two review authors extracted evidence relating to barriers and facilitators to implementation, organised these around the domains of the Consolidated Framework of Implementation Research, and used the GRADE-CERQual approach to assess confidence in each finding. We planned to produce an overarching synthesis, bringing quantitative and qualitative findings together.

Main results: We included 16 studies that reported implementation of an intervention aimed at supporting the resilience or mental health of frontline workers during disease outbreaks (severe acute respiratory syndrome (SARS): 2; Ebola: 9; Middle East respiratory syndrome (MERS): 1; COVID-19: 4). Interventions studied included workplace interventions, such as training, structure and communication (6 studies); psychological support interventions, such as counselling and psychology services (8 studies); and multifaceted interventions (2 studies). Objective 1: a mixed-methods study that incorporated a cluster-randomised trial, investigating the effect of a work-based intervention, provided very low-certainty evidence about the effect of training frontline healthcare workers to deliver psychological first aid on a measure of burnout. Objective 2: we included all 16 studies in our qualitative evidence synthesis; we classified seven as qualitative and nine as descriptive studies. We identified 17 key findings from multiple barriers and facilitators reported in studies. We did not have high confidence in any of the findings; we had moderate confidence in six findings and low to very low confidence in 11 findings. We are moderately confident that the following two factors were barriers to intervention implementation: frontline workers, or the organisations in which they worked, not being fully aware of what they needed to support their mental well-being; and a lack of equipment, staff time or skills needed for an intervention. We are moderately confident that the following three factors were facilitators of intervention implementation: interventions that could be adapted for local needs; having effective communication, both formally and socially; and having positive, safe and supportive learning environments for frontline workers. We are moderately confident that the knowledge or beliefs, or both, that people have about an intervention can act as either barriers or facilitators to implementation of the intervention.

Authors' conclusions: There is a lack of both quantitative and qualitative evidence from studies carried out during or after disease epidemics and pandemics that can inform the selection of interventions that are beneficial to the resilience and mental health of frontline workers. Alternative sources of evidence (e.g. from other healthcare crises, and general evidence about interventions that support mental well-being) could therefore be used to inform decision making. When selecting interventions aimed at supporting frontline workers' mental health, organisational, social, personal, and psychological factors may all be important. Research to determine the effectiveness of interventions is a high priority. The COVID-19 pandemic provides unique opportunities for robust evaluation of interventions. Future studies must be developed with appropriately rigorous planning, including development, peer review and transparent reporting of research protocols, following guidance and standards for best practice, and with appropriate length of follow-up. Factors that may act as barriers and facilitators to implementation of interventions should be considered during the planning of future research and when selecting interventions to deliver within local settings.

PubMed Disclaimer

Conflict of interest statement

Alex Pollock: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. Employed within a post at the NMAHP Research Unit, which is supported by the Chief Scientist Office, Scottish Government. No other known conflict of interest

Pauline Campbell: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. No other known conflict of interest

Joshua Cheyne: no known conflict of interest

Julie Cowie: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. No other known conflict of interest

Bridget Davis: employed as paid researcher for this grant. No other known conflict of interest.

Jacqueline McCallum: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. No other known conflict of interest

Kris McGill: no known conflict of interest

Andrew Elders: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. Employed within a post at the NMAHP Research Unit, which is supported by the Chief Scientist Office, Scottish Government. No other known conflict of interest

Suzanne Hagen: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. Employed within a post at the NMAHP Research Unit, which is supported by the Chief Scientist Office, Scottish Government. No other known conflict of interest

Doreen McClurg: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. Employed within a post at the NMAHP Research Unit, which is supported by the Chief Scientist Office, Scottish Government. DM was the chair of the Pelvic, Obstetric and Gynaecological Physiotherapy Professional Network of the Chartered Society of Physiotherapists in the UK and was the Chair of the International Continence Society Physiotherapy Committee. No other known conflict of interest

Claire Torrens: employed by the Priory Hospital Group, Glasgow and previously delivered modules within BSc Mental Health Nursing at the University of Stirling. No known conflict of interest

Margaret Maxwell: grant holder on funding from the Chief Scientist Office, Scottish Government to support this review. Employed within a post at the NMAHP Research Unit, which is supported by the Chief Scientist Office, Scottish Government. No other known conflict of interest

Figures

1
1
Study flow diagram
See this image and copyright information in PMC

Comment in

References

References to studies included in this review

Belfroid 2018 {published data only}
    1. Belfroid E, Van Steenbergen J, Timen A, Ellerbroek P, Huis A, Hulscher M. Preparedness and the importance of meeting the needs of healthcare workers: a qualitative study on Ebola. Journal of Hospital Infection 2018;98(2):212-18. - PMC - PubMed
Blake 2020 {published data only}
    1. Blake H, Bermingham F, Johnson G, Tabner A. Mitigating the psychological impact of COVID-19 on healthcare workers: a digital learning package. International Journal of Environmental Research and Public Health 2020;17(2997):1-15. - PMC - PubMed
Brown‐Johnson 2020 {published data only}
    1. Brown-Johnson C, Vilendrer S, Heffernan MB, Winter S, Khong T, Reidy J, et al. PPE Portraits-a way to humanize personal protective equipment. Journal of General Internal Medicine 2020;35(7):2240-2. - PMC - PubMed
Cao 2020 {published data only}
    1. Cao J, Wei J, Zhu H, Duan Y, Geng W, Hong X, et al. A study of basic needs and psychological wellbeing of medical workers in the fever clinic of a tertiary general hospital in Beijing during the COVID-19 outbreak. Psychotherapy and Psychosomatics 2020;30:1-3. - PMC - PubMed
    1. Hong X, Cao J, Wei J, Duan Y, Zhao X, Jing J, et al. The stress and psychological impact of the COVID-19 outbreak on medical workers at the fever clinic of a tertiary general hospital in Beijing: a cross-sectional study. SSRN [Preprint] 2020. [DOI: ] - PMC - PubMed
Carvalho 2019 {published data only}
    1. Carvalho E, Castro P, Leon E. Multi‐professional simulation and risk perception of health care workers caring for Ebola‐infected patients. Nursing in Critical Care 2019;24(5):256-62. - PubMed
Chang 2006 {published data only}
    1. Chang K, Gotcher DF, Chan Y. Does social capital matter when medical professionals encounter the SARS crisis in a hospital setting? Health Care Management Review 2006;31(1):26-33. - PubMed
Chen 2020 {published data only}
    1. Chen Q, Lian M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 2020;7(4):E15-16. - PMC - PubMed
Cheung 2015 {published data only}
    1. Cheung EY. An outbreak of fear, rumours and stigma: psychosocial support for the Ebola virus disease outbreak in West Africa. Intervention 2015;13(1):70-6.
Cunningham 2017 {published data only}
    1. Cunningham T, Rosenthal D, Catallozzi M. Narrative medicine practices as a potential therapeutic tool used by expatriate Ebola caregivers. Intervention 2017;15(2):106-19.
    1. Cunningham T. The use and role of narrative practices to mitigate compassion fatigue among expatriate health workers during the Ebola outbreak of 2013-2016. Dissertation Abstracts International: Section B: The Sciences and Engineering 2017;77:11-B(E).
De Jong 2019 {published data only}
    1. De Jong J. Strengthening evidence for the scaling of psychological first aid in humanitarian settings. www.elrha.org/project/strengthening-evidence-scaling-psychological-first... (accessed prior to 8 October 2020).
    1. Horn R, O'May F, Esliker R, Gwaikolo W, Woensdregt L, Ager A. The myth of the 1-day training: the effectiveness of psychosocial support capacity-building during the Ebola outbreak in West Africa. Global Mental Health 2019;6:e5. - PMC - PubMed
    1. Psychological first aid in the Ebola outbreak in West Africa. Research Snapshot, Research for Health in Humanitarian Crises (r2hc), www.elrha.org/wp-content/uploads/2020/03/8.-Elrha-R2HC_Research-Snapshot... (accessed prior to 8 October 2020).
    1. Sijbrandij M, Horn R, Esliker R, O’May F, Reiers R, Ruttenberg L, et al. The effect of psychological first aid training on knowledge and understanding about psychosocial support principles: a cluster-randomized controlled trial. International Journal of Environmental Research and Public Health 2020;17:484. - PMC - PubMed
Ferranti 2016 {published data only}
    1. Ferranti EP, Wands L, Yeager KA, Baker B, Higgins MK, Lupo J, et al. Implementation of an educational program for nursing students amidst the Ebola virus disease epidemic. Nursing Outlook 2016;64(6):597-603. - PMC - PubMed
Klomp 2020 {published data only}
    1. Klomp RW, Jones L, Watanabe E, Thompson WW. CDC's multiple approaches to safeguard the health, safety, and resilience of Ebola responders. Prehospital and Disaster Medicine 2020;35(1):69-75. - PMC - PubMed
Lee 2005 {published data only}
    1. Lee S, Juang Y, Su Y, Lee H, Lin Y, Chao C. Facing SARS: psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital. General Hospital Psychiatry 2005;27(5):352-8. - PMC - PubMed
Schreiber 2019 {published data only}
    1. Schreiber M, Cates DS, Formanski S, King M. Maximizing the resilience of healthcare workers in multi-hazard events: lessons from the 2014–2015 Ebola response in Africa. Military Medicine 2019;184:114-20. - PubMed
Son 2019 {published data only}
    1. Son H, Lee W, Jun K, Hyun S, Lee KS, You M. Examination of hospital workers' emotional responses to an infectious disease outbreak: lessons from the 2015 MERS Co-V outbreak in South Korea. Disaster Medicine and Public Health Preparedness 2019;13(3):504-10. - PubMed
Waterman 2018 {published data only}
    1. Cole CL, Waterman S, Hunter EC, Bell V, Greenberg N, Rubin GJ, et al. Effectiveness of small group cognitive behavioural therapy for anxiety and depression in Ebola treatment centre staff in Sierra Leone. International Review of Psychiatry 2020 Apr 17 [Epub ahead of print]. [DOI: 10.1080/09540261.2020.1750800] - DOI - PubMed
    1. Waterman S, Cole C, Greenberg N, Rubin GJ, Beck A. A qualitative study assessing the feasibility of implementing a group cognitive–behavioural therapy-based intervention in Sierra Leone. British Journal of Psych International 2019;16(2):31-4. - PMC - PubMed
    1. Waterman S, Hunter EC, Cole CL, Evans LJ, Greenberg N, Rubin GJ, et al. Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone. International Journal of Social Psychiatry 2018;64(2):156-65. - PubMed

References to studies excluded from this review

Banerjee 2020 {published data only}
    1. Banerjee D. The COVID-19 outbreak: crucial role the psychiatrists can play. Asian Journal of Psychiatry 2020;50(102014):1-2. - PMC - PubMed
Barrett 2020 {published data only}
    1. Barrett E, Dickson M, Hayes-Brady C, Wheelock H. Storytelling and poetry in the time of coronavirus. Irish Journal of Psychological Medicine 2020 May 14 [Epub ahead of print]. [DOI: 10.1017/ipm.2020.36] - DOI - PMC - PubMed
Barroso 2017 {published data only}
    1. Barroso S. A model for emerging infectious disease/disaster preparedness training for nursing students. Dissertation Abstracts International: Section B: The Sciences and Engineering 2017;78:3-B(E).
Battista 2019 {published data only}
    1. Battista M-C, Loignon C, Benhadj L, Nouvet E, Murthy S, Fowler R, et al. Priorities, barriers, and facilitators towards international guidelines for the delivery of supportive clinical care during an Ebola outbreak: a cross-sectional survey. Viruses 2019;11(194):1-9. - PMC - PubMed
Behan 2020 {published data only}
    1. Behan C. The benefits of meditation and mindfulness practices during times of crisis such as COVID-19. Irish Journal of Psychological Medicine 2020 May 14 [Epub ahead of print]. - PMC - PubMed
Bell 2017 {published data only}
    1. Bell SA, Munro-Kramer ML, Eisenberg MC, Williams G, Amarah P, Lori JR. “Ebola kills generations”: qualitative discussions with Liberian healthcare providers. Midwifery 2017;45:44-9. - PMC - PubMed
Bergeron 2006 {published data only}
    1. Bergeron SM, Cameron S, Armstrong-Stassen M, Pare K. Diverse implications of a national health crisis: a qualitative exploration of community nurses' SARS experiences. Canadian Journal of Nursing Research 2006;38(2):42-54. - PubMed
Bohan 2020 {published data only}
    1. Bohan E, Hannigan L, Walsh M. Mind YOUR mind on the frontline: self-care handbook. Addressing the psychological needs of frontline and healthcare staff in response to the COVID-19 outbreak. www.fedvol.ie/_fileupload/Corona/Self-Care%20Handbook%20-%20Addressing%2... 2020.
Booth 2005 {published data only}
    1. Booth CM, Steward TE. Severe acute respiratory syndrome and critical care medicine: the Toronto experience. Critical Care Medicine 2005;33(1 Suppl):S53-S60. - PubMed
Chalk 2017 {published data only}
    1. Chalk M. The psychological effects of working at an Ebola treatment centre. British Journal of Nursing 2017;26(3):178-9. - PubMed
Chan 2004 {published data only}
    1. Chan AO, Huak CY. Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore. Occupational Medicine 2004;54(3):190-6. - PMC - PubMed
Chan‐Yeung 2004 {published data only}
    1. Chan-Yeung M. Severe acute respiratory syndrome (SARS) and healthcare workers. International Journal of Occupational and Environmental Health 2004;10(4):421-7. - PubMed
Chilton 2016 {published data only}
    1. Chilton JM, McNeill C, Alfred D. Survey of nursing students' self-reported knowledge of Ebola virus disease, willingness to treat, and perceptions of their duty to treat. Journal of Professional Nursing 2016;32(6):487-93. - PubMed
Chou 2010 {published data only}
    1. Chou T-L, Ho L-Y, Wang K-Y, Kao C-W, Yang M-H, Fan P-L. Uniformed service nurses' experiences with the severe acute respiratory syndrome outbreak and response in Taiwan. Nursing Clinics of North America 2010;45(2):179-91. - PMC - PubMed
Chung 2005 {published data only}
    1. Chung BP, Wong TK, Suen ES, Ching JW. SARS: caring for patients in Hong Kong. Journal of Clinical Nursing 2005;14(4):510-7. - PubMed
Corley 2010 {published data only}
    1. Corley A, Hammond NE, Fraser JF. The experiences of health care workers employed in an Australian intensive care unit during the H1N1 influenza pandemic of 2009: a phenomenological study. International Journal of Nursing Studies 47;5:577-85. - PMC - PubMed
Everly 2014 {published data only}
    1. Everly GS, Lee McCabe O, Semon NL, Thompson CB, Links JM. The development of a model of psychological first aid for non-mental health trained public health personnel: the Johns Hopkins RAPID-PFA. Journal of Public Health Management and Practice 2014;5:S24-9. - PubMed
Fukuti 2020 {published data only}
    1. Fukuti P, Uchoa CL, Mazzoco MF, Corchs F, Kamitsuji S, De Rossi L, et al. How institutions can protect the mental health and psychosocial well-being of their healthcare workers in the current COVID-19 pandemic. Clinics 2020;75(e1963):1-3. - PMC - PubMed
Gershon 2016 {published data only}
    1. Gershon R, Dernehl LA, Nwankwo E, Zhi Q, Qureshi K. Experiences and psychosocial impact of West Africa Ebola deployment on US health care volunteers. PLoS Currents 2016;September 21:8. [DOI: 10.1371/currents.outbreaks.c7afaae124e35d2da39ee7e07291b6b5] - DOI - PMC - PubMed
Greenberg 2015 {published data only}
    1. Greenberg N, Wessely S, Wykes T. Potential mental health consequences for workers in the Ebola regions of West Africa - a lesson for all challenging environments. Journal of Mental Health 2015;24(1):1-3. - PubMed
Liu 2020 {published data only}
    1. Liu Y, Wang H, Chen J, Zhang X, Yue X, Ke J, et al. Emergency management of nursing human resources and supplies to respond to coronavirus disease 2019 epidemic. International Journal of Nursing Sciences 2020;7(2):135-8. - PMC - PubMed
Maltzman 2011 {published data only}
    1. Maltzman S. An organizational self-care model: practical suggestions for development and implementation. Counseling Psychologist 2011;39(2):303-19.
Marrs 2020 {published data only}
    1. Marrs R, Horsley TL, Hackbarth D, Landon E. High consequence infectious diseases training using interprofessional simulation and TeamSTEPPS. American Journal of Infection Control 2020;48:615-20. - PubMed
Maunder 2010 {published data only}
    1. Maunder RG, Lancee WJ, Mae R, Vincent L, Peladeau N, Beduz MA, et al. Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training. BMC Health Services Research 2010;10:72. - PMC - PubMed
Meyer 2018 {published data only}
    1. Meyer D, Sell K, Schoch-Spana M, Shearer MP, Chandler H, Thomas E, et al. Lessons from the domestic Ebola response: improving health care system resilience to high consequence infectious diseases. American Journal of Infection Control 2018;46(5):533-7. - PMC - PubMed
NCT04324190 {published data only}
    1. NCT04324190. DIgital online SuPport for COVID-19 StrEss (DISPOSE). ClinicalTrials.gov/show/NCT04324190 (first received 27 March 2020).
Shen 2020b {published data only}
    1. Shen Y, Cui Y, Li N, Tian C, Chen M, Zhang Y-W, et al. Emergency responses to COVID-19 outbreak: experiences and lessons from a general hospital in Nanjing, China. Cardiovascular and Interventional Radiology 2020;43:810-19. - PMC - PubMed
Singh 2020 {published data only}
    1. Singh M, Sharda S, Gautam, M, Hawa R. Optimal sleep health among frontline healthcare workers during the COVID-19 pandemic. Canadian Journal of Anaesthesia 2020;May 18:1-4. - PMC - PubMed
Soma 2020 {published data only}
    1. Soma M, Jacobson I, Brewer J, Blondin A, Davidson G, Singham S. Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2. International Journal of Pediatric Otorhinolaryngology 2020;134(110075):1-9. - PMC - PubMed
Sprang 2015 {published data only}
    1. Sprang G, Silman M. Using professional organizations to prepare the behavioral health workforce to respond to the needs of pediatric populations impacted by health-related disasters: guiding principles and challenges. Disaster Medicine and Public Health Preparedness 2015;9(6):642-9. - PubMed
Tam 2004 {published data only}
    1. Tam CW, Pang EP, Lam LC, Chiu HF. Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers. Psychological Medicine 2004;34(7):1197-204. - PubMed
Taylor 2019 {published data only}
    1. Taylor G. Perspectives of Sierra Leoneans healthcare workers' mental health during the Ebola outbreak. Dissertation Abstracts International: Section B: The Sciences and Engineering 2019;80:11-B(E).
Vymetal 2011 {published data only}
    1. Vymetal S, Deistler A, Bering R, Schedlich C, Rooze M, Orengo F, et al. European Commission project: European guideline for target group-oriented psychosocial aftercare-implementation. Prehospital and Disaster Medicine 2011;26(3):234-6. - PubMed
Wald 2020 {published data only}
    1. Wald HS. Optimizing resilience and wellbeing for healthcare professions trainees and healthcare professionals during public health crises - practical tips for an 'integrative resilience' approach. Medical Teacher 2020;42(7):744-55. - PubMed
WHO 2014b {published data only}
    1. World Health Organization. Psychological first aid during Ebola virus disease outbreaks. www.who.int/mental_health/emergencies/psychological_first_aid_ebola/en/ 2014.
WHO 2015 {published data only}
    1. World Health Organization. Enhanced capacity building training for frontline staff on building trust and communication: facilitator’s guide, July 2015. www.who.int/csr/en/ 2015.
WHO 2020b {published data only}
    1. World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak, 18 March 2020. www.who.int/publications/i/item/mental-health-and-psychosocial-considera... 2020.
WHO 2020d {published data only}
    1. World Health Organization. COVID-19: operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 March 2020. apps.who.int/iris/handle/10665/331561 2020.
WHO 2020e {published data only}
    1. World Health Organization Regional office for the Eastern Mediterranean. WHO interim guidance note: health workforce response to the COVID-19 pandemic: April 2020. apps.who.int/iris/handle/10665/331949?locale-attribute=pt& 2020.
Xi 2019 {published data only}
    1. Xi Y, Chen R, Gillespie AL, He Y, Jia C, Shi K, et al. Mental health workers perceptions of disaster response in China. BMC Public Health 2019;19(1):11. - PMC - PubMed
Yuen‐Tsang 2004 {published data only}
    1. Yuen-Tsang AW, Tsien-Wong TB. Universities and civic responsibility - an actualisation of the university-community partnership model through the Anti-SARS Project in Hong Kong. Asia Pacific Journal of Social Work and Development 2004;14(1):19-32.

References to studies awaiting assessment

Albott 2020 {published data only}
    1. Albott CS, Wozniak JR, McGlinch BP, Wall MH, Gold BS, Vinogradov S. Battle Buddies: rapid deployment of a psychological resilience intervention for healthcare workers during the COVID-19 pandemic. Anesthesia and Analgesia 2020;131(1):43-54. - PMC - PubMed
Banerjee 2020a {published data only}
    1. Banerjee D, Nair VS. Handling the COVID-19 pandemic: proposing a community based toolkit for psycho-social management and preparedness. Asian Journal of Psychiatry 2020;51(102152):1-4. - PMC - PubMed
Benzarti 2020 {published data only}
    1. Benzarti S, Achouri MY, Nouira S, Mlouki I, Yahia F, Ben Abdelaziz A, et al. Counter-COVID- 19 pandemic strategy in the Maghreb Central. Qualitative study of the perceptions of health professionals. Tunisie Medicale 2020;98(4):266-82. - PubMed
Brusin 2003 {published data only}
    1. Brusin LK. Addressing stress reactions in disaster mental health clinicians: a post-disaster assignment recovery manual. Dissertation Abstracts International: Section B: The Sciences and Engineering 2003.
Casado‐Mejia 2016 {published data only}
    1. Casado-Mejia R, Brea-Ruiz MT, Torres-Enamorado D, Albar-Marin MJ, Botello-Hermosa A, Santos-Casado M, et al. Motivations and emotional experiences of the first hospital multidisciplinary team trained to care for people with Ebola in Andalusia, Spain (2014-2016) [Motivaciones y experiencias emocionales del primer equipo multidisciplinario hospitalario entrenado para atender casos de Ebola en Andalucia (2014-2016)]. Gaceta Sanitaria 2016;30(4):242-9. - PubMed
Cheng 2020 {published data only}
    1. Cheng P, Xia G, Pang P, Wu B, Jiang W, Li Y-T, et al. COVID-19 epidemic peer support and crisis intervention via social media. Community Mental Health Journal 2020;56:786-92. - PMC - PubMed
ChiCTR‐TRC‐11001268 {published data only}
    1. ChiCTR-TRC-11001268. Effectiveness of psychological first aid training in improving self-efficacy and mental health outcomes for Chinese emergency responders: a randomized controlled trial. apps.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-TRC-11001268 (first received 24 March 2011).
Chung 2020 {published data only}
    1. Chung JP, Yeung W-S. Staff mental health self-assessment during the COVID-19 outbreak. East Asian Archives of Psychiatry 2020;30:34. - PubMed
Cole 2020 {published data only}
    1. Cole EL, Waterman S, Stott J, Saunders R, Buckman JE, Pilling S, et al. Adapting IAPT services to support frontline NHS staff during the COVID-19 pandemic: the Homerton Covid Psychological Support (HCPS) pathway. discovery.ucl.ac.uk/id/eprint/10096883/1/adapting_iapt_services_to_suppo... 2020. [DOI: 10.1017/S1754470X20000148] - DOI - PMC - PubMed
Fu 2004 {published data only}
    1. Fu XL, Wang ZQ, Zhu ZH, Zhu HW. A randomed controlled study on the effect of psychological behavior training on mental health of the healthcare workers in SARS ward. International Journal of Psychology 39;5-6:191.
Goh 2020 {published data only}
    1. Goh SS, Chia MY. Anxiety and morale in front-line healthcare workers during the coronavirus disease 2019 (COVID-19) outbreak at the National Screening Centre in Singapore. Annals of the Academy of Medicine 2020;49(4):259-62. - PubMed
James 2020 {published data only}
    1. James PB, Wardle J, Steel A, Adams J, Bah AJ, Sevalie S. Providing healthcare to Ebola survivors: a qualitative exploratory investigation of healthcare providers' views and experiences in Sierra Leone. Global Public Health 2020;15(9):1380-95. - PubMed
Jiang 2020 {published data only}
    1. Jiang X, Deng L, Zhu Y, Ji H, Tao L, Yang D, et al. Psychological crisis intervention during the outbreak period of new coronavirus pneumonia from experience in Shanghai. Psychiatry Research 2020;286:112903. - PMC - PubMed
Keita 2017 {published data only}
    1. Keita MM, Doukoure M, Chantereau I, Sako FB, Traore FA, Soumaoro K, et al. Survivors of epidemic recent disease Ebola virus in psychiatric hospital service national Donka in Guinea: psychopathological and psychotherapeutic study. Evolution Psychiatrique 2017;82(1):127-42.
Khee 2004 {published data only}
    1. Khee KS, Lee LB, Chai OT, Loong CK, Ming CW, Kheng TH. The psychological impact of SARS on healthcare providers. Critical Care and Shock 2004;7(2):99-106.
Li 2020 {published data only}
    1. Li YF, Zhang YG, Niu JT, Si XL, Yan XK. Analysis of TCM in prevention and treatment of post-traumatic stress disorder induced by COVID-19. Chinese Traditional and Herbal Drugs 2020;51(5):1130-8.
Liu 2015 {published data only}
    1. Liu B, Zhu Y, Huang S. Influence of TCM baduanjing exercise on physical and mental condition of international medical team members fighting against Ebola virus. Chinese Nursing Research 2015;29(7C):2629-30.
Masumbuko 2020 {published data only}
    1. Masumbuko CK, Hawkes MT. Ebola crisis in Eastern Democratic Republic of Congo: student-led community engagement. Pathogens and Global Health 2020;114(4):218-23. - PMC - PubMed
Mehtar 2016 {published data only}
    1. Mehtar S. The impact of education on reducing Ebola virus disease transmission in healthcare facilities. International Journal of Infectious Diseases 2016;45 Suppl 1:66-7.
NCT04363671 {published and unpublished data}
    1. NCT04363671. Adolescents and health professionals faced with the necessity for changing to remote care during the COVID-19 outbreak quarantine (AdoPro-Cov19). clinicaltrials.gov/ct2/show/NCT04363671 (first received 27 April 2020).
NCT04367857 {published and unpublished data}
    1. NCT04367857. ARMOR Study: COVID-19 seroprevalence among healthcare workers. clinicaltrials.gov/ct2/show/NCT04367857 (first received 29 April 2020).
NCT04377165 {published and unpublished data}
    1. NCT04377165. Innovative tool to limit spread of SARS-CoV-2 in residential aged care facilities. ClinicalTrials.gov/show/NCT04377165 (first received 6 May 2020).
NCT04379063 {published and unpublished data}
    1. NCT04379063. COVID-19 pandemic short interval national survey gauging psychological distress (COPING). www.clinicaltrials.gov/ct2/show/NCT04379063 (first received 7 May 2020).
NCT04379336 {published data only}
    1. NCT04379336. BCG vaccination for healthcare workers in COVID-19 pandemic. clinicaltrials.gov/ct2/show/NCT04379336 (first received 7 May 2020).
NCT04389476 {published data only}
    1. NCT04389476. The impact and coping strategy of COVID-19 among Taiwan society and medical and nursing institutes. clinicaltrials.gov/ct2/show/record/NCT04389476?view=record (first received 15 May 2020).
Saul 2016 {published data only}
    1. Saul J, Simon W. Building resilience in families, communities, and organizations: a training program in global mental health and psychosocial support. Family Process 55;4:689-99. - PubMed
Schulte 2020 {published data only}
    1. Schulte EE, Bernstein CA, Cabana MD. Addressing faculty emotional responses during the coronavirus 2019 pandemic. Journal of Pediatrics 2020;222:13-14. - PMC - PubMed
Shen 2020a {published data only}
    1. Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of COVID-19. Critical Care 2020;24(1):200. - PMC - PubMed
Siddle 2016 {published data only}
    1. Siddle J, Tolleson-Rinehart S, Brice J. Survey of emergency department staff on disaster preparedness and training for Ebola virus disease. American Journal of Disaster Medicine 2016;11(1):5-18. - PubMed
Xiao 2020 {published data only}
    1. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical Science Monitor: International Journal of Experimental and Clinical Research 2020;26(e923549):1-8. - PMC - PubMed
Yau 2020 {published data only}
    1. Yau EK, Ping NP, Shoesmith WD, James S, Hadi NM, Loo JL. The behaviour changes in response to COVID-19 Pandemic within Malaysia. Malaysian Journal of Medical Sciences 2020;27(2):45-50. - PMC - PubMed
Zhang 2020 {published data only}
    1. Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, et al. Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: a model of West China Hospital. Precision Clinical Medicine 2020;3(1):3-8. - PMC - PubMed

References to ongoing studies

NCT04362358 {published and unpublished data}
    1. NCT04362358. Online cognitive behavioral therapy (CBT) for stress disorders in health workers involved in the care of patients during the COVID-19 epidemic (REST). clinicaltrials.gov/ct2/show/NCT04362358 (first received 24 April 2020).
NCT04373382 {published and unpublished data}
    1. NCT04373382. Peer champion support for hospital staff during and after the COVID-19 pandemic. clinicaltrials.gov/ct2/show/NCT04373382 (first received 4 May 2020).
NCT04387643 {published and unpublished data}
    1. NCT04387643. Protecting health care workers during the COVID-19 outbreak. clinicaltrials.gov/ct2/show/NCT04387643 (first received 14 May 2020).

Additional references

Allan 2020
    1. Allan SM, Bealey R, Birch J, Cushing T, Parke S, Sergi G, et al. The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis. European Journal of Psychotraumatology 2020;11(1):1-12. - PMC - PubMed
Ames 2017
    1. Ames HM, Glenton C, Lewin S. Parents' and informal caregivers' views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No: CD011787. [DOI: 10.1002/14651858.CD011787.pub2] - DOI - PMC - PubMed
Aoyagi 2015
    1. Aoyagi Y, Beck CR, Dingwall R, Nguyen-Van-Tam JS. Healthcare workers' willingness to work during an influenza pandemic: a systematic review and meta-analysis. Influenza and Other Respiratory Viruses 2015;9(3):120-30. - PMC - PubMed
Ayanore 2019
    1. Ayanore MA, Amuna N, Aviisah M, Awolu A, Kipo-Sunyehzi DD, Mogre V, et al. Towards resilient health systems in Sub-Saharan Africa: a systematic review of the English language literature on health workforce, surveillance, and health governance issues for health systems strengthening. Annals of Global Health 2019;85(1):113, 1-15. - PMC - PubMed
Bach‐Mortensen 2018
    1. Bach-Mortensen AM, Lange BC, Montgomery P. Barriers and facilitators to implementing evidence-based interventions among third sector organisations: a systematic review. Implementation Science 2018;13(1):103. - PMC - PubMed
Baduge 2018
    1. Baduge M, Morphet J, Moss C. Emergency nurses' and department preparedness for an ebola outbreak: a (narrative) literature review. International Emergency Nursing 2018;38:41-9. - PubMed
Balasubramanian 2020
    1. Balasubramanian A, Paleri V, Bennett R, Paleri V. Impact of COVID‐19 on the mental health of surgeons and coping strategies. Head and Neck 2020;42(7):1-7. - PMC - PubMed
Bansal 2020
    1. Bansal P, BingemannTA, Greenhawt M, Mosnaim G, Nanda A, Oppenheimer J, et al. Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist. Journal of Allergy and Clinical Immunology 2020;8(6):1781-90. e3. - PMC - PubMed
Bell 2020
    1. Bell V, Wade D. Mental health of clinical staff working in high-risk epidemic and pandemic health emergencies: a rapid review of the evidence and meta-analysis. medRxiv [Preprint] 2020. [DOI: ] - PMC - PubMed
Benedek 2007
    1. Benedek DM, Fullerton C, Ursano RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annual Review of Public Health 2007;28:55-68. - PubMed
British Psychological Society 2020
    1. British Psychological Society Covid 19 Staff Wellbeing Group. The psychological needs of healthcare staff as a result of the coronavirus pandemic: guidance. www.bps.org.uk/sites/www.bps.org.uk/files/News/News%20-%20Files/Psycholo... 2020.
Brooks 2016
    1. Brooks SK, Dunn R, Amlot R, Greenberg N, Rubin GJ. Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review. BMC Psychology 2016;4:18. - PMC - PubMed
Brooks 2018
    1. Brooks SK, Dunn R, Amlot R, Rubin GJ, Greenberg N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. Journal of Occupational and Environmental Medicine 2018;60(3):248-57. - PubMed
Cabello 2020
    1. Cabello IR, Echavez JF, Serrano-Ripoll MJ, Fraile-Navarro D, Roque MA, Moreno GP, et al. Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review. medRxiv [Preprint] 2020. [DOI: ] - PMC - PubMed
Campbell 2020
    1. Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ 2020;368:l6890. - PMC - PubMed
Carroll 2011
    1. Carroll C, Booth A, Cooper K. A worked example of "best fit" framework synthesis: a systematic review of views concerning the taking of some potential chemopreventive agents. BMC Medical Research Methodology 2011;11(1):29. - PMC - PubMed
CASP 2018
    1. Critical Appraisal Skills Programme (CASP). Critical Appraisal Skills Programme Checklists. casp-uk.net/#!casp-tools- checklists/c18f82018) 2018.
CDC 2011
    1. Centre for Disease Control and Prevention. Section 11: Epidemic disease occurrence. In: Principles of Epidemiology in Public Health Practice. 3rd edition. CDC Division of scientific education and professional development, 2011:www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html.
CDC 2020a
    1. Centers for Diseases Control and Prevention. Employees: how to cope with job stress and build resilience during the COVID-19 pandemic. www.cdc.gov/coronavirus/2019-ncov/community/mental-health-non- healthcare.html 2020.
CDC 2020b
    1. Centers for Disease Control and Prevention. Coping with stress. www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxi... 2020.
Cenat 2020
    1. Cenat JM, Mukunzi JN, Noorishad P-G, Rousseau C, Derivois D, Bukaka J. A systematic review of mental health programs among populations affected by the Ebola virus disease. Journal of Psychosomatic Research 2020;131(109966):1-11. - PubMed
CFIR 2020
    1. Consolidated Framework for Implementation Research. Consolidated Framework for Implementation Research (CFIR) guide. cfirguide.org 2020.
Chakraborty 2020
    1. Chakraborty N. The COVID‐19 pandemic and its impact on mental health. Progress in Neurology & Psychiatry 2020;24(2):21-4.
Chen 2006
    1. Chen R, Chou KR, Huang YJ, Wang TS, Liu SY, Ho LY. Effects of a SARS prevention programme in Taiwan on nursing staff's anxiety, depression and sleep quality: a longitudinal survey. International Journal of Nursing Studies 2006;43(2):215-25. - PMC - PubMed
Chersich 2020
    1. Chersich MF, Gray G, Fairlie L, Eichbaum Q, Mayhew S, Allwood B, et al. COVID-19 in Africa: care and protection for frontline healthcare workers. Globalization and Health 2020;16(1):46. - PMC - PubMed
Connor 2014
    1. Connor B. When and why health care personnel respond to a disaster: the state of the science. Prehospital & Disaster Medicine 2014;29(3):270-4. - PubMed
Covidence [Computer program]
    1. Covidence. Version accessed 28 May 2020. Melbourne, Australia: Veritas Health Innovation. Available at covidence.org.
Devnani 2012
    1. Devnani M. Factors associated with the willingness of health care personnel to work during an influenza public health emergency: An integrative review. Prehospital and Disaster Medicine 2012;27(6):551-66. - PubMed
Downe 2019
    1. Downe S, Finlayson KW, Lawrie TA, Lewin SA, Rosenbaum S, Barreix M, et al. Qualitative evidence synthesis (QES) for guidelines: paper 1 – using qualitative evidence synthesis to inform guideline scope and develop qualitative findings statements. Health Research Policy and Systems 2019;17:Article number: 76. - PMC - PubMed
Duan 2020
    1. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry 2020;7(4):300-2. - PMC - PubMed
Duncan 2020
    1. Duncan DL. What the COVID-19 pandemic tells us about the need to develop resilience in the nursing workforce. Nursing Management 2020;27(3):22-7. - PubMed
Ejeta 2015
    1. Ejeta LT, Ardalan A, Paton D. Application of behavioral theories to disaster and emergency health preparedness: a systematic review. PLoS Currents 2015;1:7. - PMC - PubMed
EPOC 2017a
    1. Cochrane Effective Practice and Organisation of Care (EPOC). EPOC Resources for review authors. What study designs can be considered for inclusion in an EPOC review and what should they be called? epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/Resources... (accessed 5 May 2020).
EPOC 2017b
    1. Cochrane Effective Practice and Organisation of Care (EPOC). EPOC resources for review authors. EPOC qualitative evidence syntheses guidance on when to sample and how to develop a purposive sampling frame. epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/Resources... (accessed 4 June 2020).
EPOC 2019
    1. Glenton C, Bohren MA, Downe S, Paulsen EJ, Lewin S, Cochrane Effective Practice and Organisation of Care (EPOC). EPOC qualitative evidence synthesis: protocol and review template. epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/Resources... (accessed 29 June 2020).
Erren 2013
    1. Erren TC, Herbst C, Koch MS, Fritschi L, Foster RG, Driscoll TR, et al. Adaptation of shift work schedules for preventing and treating sleepiness and sleep disturbances caused by shift work. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No: CD010639. [DOI: 10.1002/14651858.CD010639] - DOI
Etkind 2020
    1. Etkind SN, Bone AE, Lovell N, Cripps RL, Harding R, Higginson IJ, et al. The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic. Journal of Pain and Symptom Management 2020;60(1):e31-40. - PMC - PubMed
Galbraith 2020
    1. Galbraith N, Boyda D, McFeeters D, Hassan T. The mental health of doctors during the COVID-19 pandemic. BJPsych Bulletin 2020 Apr 28 [Epub ahead of print]. [DOI: 10.1192/bjb.2020.44] - DOI - PMC - PubMed
Gardner 2015
    1. Gardner PJ, Moallef P. Psychological impact on SARS survivors: critical review of the English language literature. Canadian Psychology 2015;56(1):123-35.
Giga 2018
    1. Giga SI, Fletcher IJ, Sgourakis G, Mulvaney CA, Vrkljan BH. Organisational level interventions for reducing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No: CD013014. [DOI: 10.1002/14651858.CD013014] - DOI
Gowing 2017
    1. Gowing JR, Walker KN, Elmer SL, Cummings EA. Disaster preparedness among health professionals and support staff: what is effective? an integrative literature review. Prehospital and Disaster Medicine 2017;32(3):321-8. - PubMed
Harmer 2017
    1. Harmer CJ, Duman RS, Cowen PJ. How do antidepressants work? New perspectives for refining future treatment approaches. Lancet Psychiatry 2017;4(5):409-18. - PMC - PubMed
HCPC 2016
    1. Health and Care Professions Council. Returning to practice. www.hcpc-uk.org/resources/guidance/returning-to-practice/ 2016.
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-60. - PMC - PubMed
Higgins 2017
    1. Higgins JP, Altman DG, Sterne JA, editor(s). Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Churchill R, Chandler J, Cumpston MS, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). Cochrane, 2017. Available from www.training.cochrane.org/handbook.
Higgins 2020a
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Higgins 2020b
    1. Higgins JP, Eldridge S, Li T, editor(s). Chapter 23: Including variants on randomized trials. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Hoffmann 2014
    1. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. - PubMed
Houghton 2020
    1. Houghton C, Meskell P, Delaney H, Smalle M, Glenton C, Booth A, et al. Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No: CD013582. [DOI: 10.1002/14651858.CD013582] - DOI - PMC - PubMed
Jackson 2007
    1. Jackson D, Firtko A, Edenborough M. Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review. Journal of Advanced Nursing 2007;60(1):1-9. - PubMed
Kang 2020
    1. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3):e14. - PMC - PubMed
Kausto 2019
    1. Kausto J, Verbeek JH, Ruotsalainen JH, Halonen JI, Virta LJ, Kankaanpää E. Self-certification versus physician certification of sick leave for reducing sickness absence and associated costs. Cochrane Database of Systematic Reviews 2019, Issue 5. Art. No: CD013098. [DOI: 10.1002/14651858.CD013098.pub2] - DOI - PMC - PubMed
Kisely 2020
    1. Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ 2020;369(m1642):1-11. - PMC - PubMed
Koh 2010
    1. Koh Y, Hegney D, Drury V. A comprehensive systematic review of healthcare workers' perceptions of risk from exposure to emerging acute respiratory infectious diseases and the perceived effectiveness of strategies used to facilitate healthy coping in acute hospital and community healthcare settings. JBI Library of Systematic Reviews 2010;8(23):917-71. - PubMed
Kuehnl 2019
    1. Kuehnl A, Seubert C, Rehfuess E, Elm E, Nowak D, Glaser J. Human resource management training of supervisors for improving health and well-being of employees. Cochrane Database of Systematic Reviews 2019, Issue 9. Art. No: CD010905. [DOI: 10.1002/14651858.CD010905.pub2] - DOI - PMC - PubMed
Kunzler 2020
    1. Kunzler AM, Helmreich I, Chmitorz A, König J, Binder H, Wessa M, et al. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No: CD012527. [DOI: 10.1002/14651858.CD012527.pub2] - DOI - PMC - PubMed
Kuster 2017
    1. Kuster AT, Dalsbø TK, Luong Thanh BY, Agarwal A, Durand‐Moreau QV, Kirkehei I. Computer-based versus in-person interventions for preventing and reducing stress in workers. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No: CD011899. [DOI: 10.1002/14651858.CD011899.pub2] - DOI - PMC - PubMed
Lewin 2018
    1. Lewin S, Booth A, Glenton C, Munthe-Kaas H, Rashidian A, Wainwright M, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series. Implementation Science 2018;13 Suppl 1:2. - PMC - PubMed
Lewin 2019
    1. Lewin S, Langlois E, Tuncalp Ö, Portela A, the COMMVAC Project Team. WEIRD (Ways of Evaluating Important and Relevant Data) tool: questions to guide assessment / critical appraisal of programme descriptions, implementation descriptions and other mainly descriptive types of evidence. Norwegian Institute of Public Health; epoc.cochrane.org/resources/epocresources-review-authors 2019;1.1.
Liira 2014
    1. Liira J, Verbeek JH, Costa G, Driscoll TR, Sallinen M, Isotalo LK, et al. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work. Cochrane Database of Systematic Reviews 2014, Issue 8. Art. No: CD009776. [DOI: 10.1002/14651858.CD009776.pub2] - DOI - PMC - PubMed
Liira 2016
    1. Liira H, Knight AP, Sim MG, Wilcox HM, Cheetham S, Aalto MT. Workplace interventions for preventing job loss and other work related outcomes in workers with alcohol misuse. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No: CD012344. [DOI: 10.1002/14651858.CD012344] - DOI
Lubans 2016
    1. Lubans D, Richards J, Hillman C, Faulkner G, Beauchamp M, Nilsson M, et al. Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics 2016;138(3):e20161642. - PubMed
Lynch 2020
    1. Lynch P. New resources to help health care workers cope with COVID-19-related stress. www.univadis.co.uk/viewarticle/new-resources-to-help-health-care-workers... with-covid-19-related-stress-717806?topic=covid-19 2020.
Maunder 2006
    1. Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases 2006;12(12):1924-32. - PMC - PubMed
McGowan 2016
    1. McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. Journal of Clinical Epidemiology 2016;75:40-6. - PubMed
MHF 2016
    1. Mental Health Foundation. Fundamental facts about mental health. www.mentalhealth.org.uk/publications/fundamental-facts-about-mental-heal... (accessed 29 June 2020).
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine 2009;6(7):e1000100. - PMC - PubMed
Muller 2020
    1. Muller AE, Hafstad EV, Himmels JP, Smedslund G, Flottorp S, Stensland S, et al. The mental health impact of the COVID-19 pandemic on healthcare workers, and interventions to help them: a rapid systematic review. Psychiatry Research 2020;293:1-11. - PMC - PubMed
Naghieh 2015
    1. Naghieh A, Montgomery P, Bonell CP, Thompson M, Aber JL. Organisational interventions for improving wellbeing and reducing work-related stress in teachers. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No: CD010306. [DOI: 10.1002/14651858.CD010306.pub2] - DOI - PMC - PubMed
Nair 2020
    1. Nair V, Sekar K, Thomas P. Knowledge among nursing students on Zika preparedness. Acta Scientific Neurology 2020;3(3):17-21.
NHS England 2020
    1. NHS Health Education England. Roles in the wider healthcare team UK. www.healthcareers.nhs.uk/explore-roles/wider-healthcare-team/roles-wider... (accessed July 2020).
Nieuwenhuijsen 2014
    1. Nieuwenhuijsen K, Faber B, Verbeek JH, Neumeyer‐Gromen A, Hees HL, Verhoeven AC, et al. Interventions to improve return to work in depressed people. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No: CD006237. [DOI: 10.1002/14651858.CD006237.pub3] - DOI - PMC - PubMed
Noyes 2018
    1. Noyes J, Booth A, Cargo M, Flemming K, Garside R, Hannes K, et al. Cochrane Qualitative and Implementation Methods Group guidance series-paper 1: introduction. Journal of Clinical Epidemiology 2018;97:35-8. - PubMed
Noyes 2020
    1. Noyes J, Booth A, Cargo M, Flemming K, Harden A, Harris J, et al. Chapter 21: Qualitative evidence. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Pachito 2018
    1. Pachito DV, Eckeli AL, Desouky AS, Corbett MA, Partonen T, Rajaratnam SM, et al. Workplace lighting for improving alertness and mood in daytime workers. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No: CD012243. [DOI: 10.1002/14651858.CD012243.pub2] - DOI - PMC - PubMed
Pluye 2009
    1. Pluye P, Gagnon MP, Griffiths F, Johnson-Lafleur J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed studies reviews. International Journal of Nursing Studies 2009;46(4):529-46. - PubMed
ProQOL‐5
    1. Stamm BH. The Concise ProQOL Manual. 2nd edition. Pocatello, USA: ProQOL.org, 2010.
Reeves 2020
    1. Reeves BC, Deeks JJ, Higgins JP, Shea B, Tugwell P, Wells GA. Chapter 24: Including non-randomized studies on intervention effects. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: The Cochrane Collaboration, 2020.
Robertson 2016
    1. Robertson HD, Elliot AM, Burton C, Iversen P, Murchie P, Porteuous T, et al. Resilience of primary healthcare professionals: a systematic review. British Journal of General Practice 2016;66(647):e423-e33. - PMC - PubMed
Robertson 2020
    1. Robertson LJ, Maposa I, Somaroo H, Johnson O. Mental health of healthcare workers during the COVID-19 outbreak; a rapid scoping review to inform provincial guidelines in South Africa. South African Medical Journal 2020;110(10):1010-19. [DOI: 10.7196/SAMJ.2020.v110i10.15022] - DOI - PubMed
Ruotsalainen 2015
    1. Ruotsalainen JH, Verbeek JH, Mariné A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No: CD002892. [DOI: 10.1002/14651858.CD002892.pub5] - DOI - PMC - PubMed
Sandelowski 2007
    1. Sandelowski M, Barraso J. Handbook for Synthesizing Qualitative Research. New York: Springer Publishing, 2007.
Schünemann 2020
    1. Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Scior 2020
    1. Scior K, Clements H. Proposed Pilot and Formative Evaluation of 20minCareSpace. Unpublished manuscript 2020.
Shah 2020
    1. Shah K, Kamrai D, Mekala H, Mann B, Desai K, Patel RS. Focus on mental health during the coronavirus (COVID-19) pandemic: applying learnings from the past outbreaks. Cureus 2020;12(3):e7405. - PMC - PubMed
Shanafelt 2020
    1. Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA 2020;323(21):2133-4. [DOI: 10.1001/jama.2020.5893] - DOI - PubMed
Shokraneh 2020
    1. Shokraneh F. Keeping up with studies on COVID-19: systematic search strategies and resources. BMJ 2020;369:m1601. - PubMed
Shultz 2016
    1. Shultz JM, Cooper JL, Baingana F, Oquendo MA, Espinel Z, Althouse BM, et al. The role of fear-related behaviors in the 2013–2016 West Africa Ebola virus disease outbreak. Current Psychiatry Reports 2016;18(104):1-14. - PMC - PubMed
Slanger 2016
    1. Slanger TE, Gross JV, Pinger A, Morfeld P, Bellinger M, Duhme AL, et al. Person-directed, non-pharmacological interventions for sleepiness at work and sleep disturbances caused by shift work. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No: CD010641. [DOI: 10.1002/14651858.CD010641.pub2] - DOI - PMC - PubMed
Spokane 2011
    1. Spokane AR, Inman AG, Weatherford RD, Davidson AK, Straw R. Ecologically based, culturally concordant responding following disasters: the counseling psychologist’s role. Counseling Psychologist 2011;39(8):1128–59.
Spoorthy 2020
    1. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-a review. Asian Journal of Psychiatry 2020;51(102119):1-4. - PMC - PubMed
SQUIRE 2018
    1. Standards for Quality Improvment Reporting Excellence. www.squire-statement.org/ 2018.
Stanley 2012
    1. Stanley SA, Bulecza S, Gopalani SV. Psychological impact of disasters on communities. Annual Review of Nursing Research 2012;30:89-123. - PubMed
Sterne 2016
    1. Sterne JA, Hernan MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non- randomised studies of interventions. BMJ 2016;355:i4919. - PMC - PubMed
Sterne 2020
    1. Sterne JA, Hernán MA, McAleenan A, Reeves BC, Higgins JP. Chapter 25: Assessing risk of bias in a non-randomized study. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Strathdee 2015
    1. Strathdee G. A defining moment in mental health care. www.england.nhs.uk/blog/geraldine-strathdee-8/ 2015.
Stuijfzand 2020
    1. Stuijfzand S, Deforges C, Sandoz V, Sajin C-T, Jaques C, Elmers J, et al. Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review. BMC Public Health 2020;20:1-18. - PMC - PubMed
Suijkerbuijk 2017
    1. Suijkerbuijk YB, Schaafsma FG, Van Mechelen JC, Ojajärvi A, Corbière M, Anema JR. Interventions for obtaining and maintaining employment in adults with severe mental illness, a network meta-analysis. Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No: CD011867. [DOI: 10.1002/14651858.CD011867.pub2] - DOI - PMC - PubMed
Tsamakis 2020
    1. Tsamakis K, Triantafyllis AS, Tsiptosios D, Spartalis E, Mueller C, Tsamakis C, et al. COVID-19 related stress exacerbates common physical and mental pathologies and affects treatment (Review). Experimental and Therapeutic Medicine 2020;20:159-62. - PMC - PubMed
Verbeek 2018
    1. Verbeek L, Ruotsalainen J, Laitinen J, Korkiakangas E, Lusa S, Mänttäri S, et al. Interventions to enhance recovery in healthy workers; a scoping review. Occupational Medicine 2019;69(1):54-63. - PubMed
Vogel 2017
    1. Vogel N, Schandelmaier S, Zumbrunn T, Ebrahim S, De Boer WE, Busse JW, et al. Return-to-work coordination programmes for improving return to work in workers on sick leave. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No: CD011618. [DOI: 10.1002/14651858.CD011618.pub2] - DOI - PMC - PubMed
Vyas 2016
    1. Vyas KJ, Delaney EM, Webb-Murphy JA, Johnston SL. Psychological Impact of deploying in support of the US response to Ebola: a systematic review and meta-analysis of past outbreaks. Military Medicine 2016;181(11/12):e1515-e31. - PubMed
Walton 2020
    1. Walton M, Murray E, Christian MD. Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. European Heart Journal: Acute Cardiovascular Care 2020;9(3):241-7. - PMC - PubMed
Weiss 2020
    1. Weiss PG, Li S-TT. Leading change to address the needs and well-being of trainees during the COVID-19 pandemic. Academic Pediatrics 2020;20(6):735-41. - PMC - PubMed
WHO 2002
    1. Department of Mental Health and Substance Dependence, World Health Organization. Prevention and promotion in mental health. Available from who.int/mental_health/media/en/545.pdf (accessed 4 June 2020).
WHO 2004
    1. World Health Organization. Promoting mental health. Concepts, emerging evidence, practice. Summary report. who.int/mental_health/evidence/en/promoting_mhh.pdf (accessed 4 June 2020).
WHO 2014a
    1. World Health Organization and Calouste Gulbenkian Foundation. Social determinants of mental health. who.int/social_determinants/sdh_definition/en/ (accessed 29 June 2020).
WHO 2018
    1. World Health Organization and United Nations High Commissioner for Refugees. WHO Mental Health Gap Action Programme (mhGAP). who.int/mental_health/mhgap/en/ 2018.
WHO 2019a
    1. World Health Organization. Mental health in the workplace. Information sheet. who.int/mental_health/in_the_workplace/en/ (accessed 5 June 2020).
WHO 2019b
    1. World Health Organization. Burn-out an “occupational phenomenon”: International Classification of Diseases. www.who.int/mental_health/evidence/burn-out/en/ 2019.
WHO 2020a
    1. World Health Organization. Emergencies. www.who.int/emergencies/diseases/en/ 2020.
WHO 2020c
    1. Kluge HH. WHO announces COVID-19 outbreak a pandemic. euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/ne... 2020.
Zuercher 2020
    1. Zürcher SJ, Kerksieck P, Adamus C, Burr C, Lehmann AI, Huber FK, et al. Prevalence of mental health problems during virus epidemics in the general public, health care workers and survivors: a rapid review of the evidence. medRxiv [Preprint] 2020. [DOI: ] - PMC - PubMed

References to other published versions of this review

Pollock 2020
    1. Pollock A, Campbell P, Cowie J, Davis B, Elders A, Hagen S, et al. Effective interventions to support the resilience and mental health of frontline health and social care staff during a global health crisis and following de-escalation. (RECOVER: REsilience and mental wellbeing of frontline COVid-19 workers a series of Evidence Reviews). PROSPERO 2020 CRD42020187884. Available from: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020187884 2020.

Publication types

MeSH terms