Prevalence of depression and its impact on quality of life among frontline nurses in emergency departments during the COVID-19 outbreak

An, Ying; Yang, Yuan; Wang, Aiping; Li, Yue; Zhang, Qinge; Cheung, Teris; Ungvári, Gábor S.; Qin, Ming; An, Feng Rong; Xiang, Yu Tao

doi:10.1016/j.jad.2020.06.047

Cited by 234 publications

(271 citation statements)

References 24 publications

(28 reference statements)

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“… Country or region Design Epidemic studied Participants Duration and year Measures An et al. (2020) ( An et al., 2020 ) China Cross-sectional COVID-19 1,103 nurses 6 days, March 2020 PHQ-9 and WHO-QOL-BREF Babore et al. (2020) ( Babore et al., 2020 ) Italy Cross-sectional COVID-19 595 health care workers 6 days, April 2020 PSS and COPE-NVI-25 Bai et al.…”

Section: Resultsmentioning

confidence: 99%

The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review

Cabarkapa

Nadjidai

Murgier

et al. 2020

Brain, Behavior, & Immunity - Health

434

480

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Background As the world is battling the COVID-19 pandemic, frontline health care workers (HCWs) are among the most vulnerable groups at risk of mental health problems. The many risks to the wellbeing of HCWs are not well understood. Of the literature, there is a paucity of information around how to best prevent psychological distress, and what steps are needed to mitigate harm to HCWs’ wellbeing. Methods A systematic review using PRISMA methodology was used to investigate the psychological impact on HCWs facing epidemics or pandemics, using three electronic databases (PubMed, MEDLINE and CINAHL), dating back to 2002 until the 21st of August 2020. The search strategy included terms for HCWs (e.g., nurse and doctor), mental health (e.g., wellbeing and psychological), and viral outbreaks (e.g., epidemic and pandemic). Only studies with greater than 100 frontline HCWs (i.e. doctors or nurses in close proximity to infected patients) were included. Results A total of 55 studies were included, with 53 using quantitative methodology and 2 were qualitative. 50 of the quantitative studies used validated measurement tools while 5 used novel questionnaires. The studies were conducted across various countries and included people with SARS (13 studies), Ebola (1), MERS (3) and COVID-19 (38). Findings suggest that the psychological implications to HCWs are variable with several studies demonstrating an increased risk of acquiring trauma or stress-related disorders, depression and anxiety. Fear of the unknown or becoming infected were at the forefront of the mental challenges faced. Being a nurse and being female appeared to confer greater risk. The perceived stigma from family members and society heightened negative implications; predominantly stress and isolation. Coping strategies varied amongst the contrasting sociocultural settings and appeared to differ amongst doctors, nurses and other HCWs. Implemented changes, and suggestions for prevention in the future consistently highlighted the need for greater psychosocial support and clearer dissemination of disease-related information. Conclusion This review can inform current and future research priorities in the maintenance of wellbeing amongst frontline HCWs. Change needs to start at the level of policy-makers to offer an enhanced variety of supports to HCWs who play a critical role during largescale disease outbreaks. Psychological implications are largely negative and require greater attention to be mitigated, potentially through the involvement of psychologists, raised awareness and better education. The current knowledge of therapeutic interventions suggests they could be beneficial but more long-term follow-up is needed.

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Section: Resultsmentioning

confidence: 99%

The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review

Cabarkapa

Nadjidai

Murgier

et al. 2020

Brain, Behavior, & Immunity - Health

434

480

View full text Add to dashboard Cite

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“…The main occupational factors were working in a high-risk environment, higher perception of threat and risk, specialised training received, and specific occupational role. Working in a high risk environment was associated with different mental health problems, namely depression ( Lai et al 2020 , An et al 2020 , Chatterjee et al 2020 , Elbay et al 2020 , Lu et al 2020 , Ni et al 2020 , Huajun Wang et al 2020, Wu et al 2008 ), anxiety ( Lai et al 2020 , Li et al 2015 , Matsuishi et al 2012 , Verma et al 2004 , Dosil Santamaria et al 2020 , Elbay et al 2020 , Liu et al 2020 , Lu et al 2020 , Ni et al 2020 , Que et al 2020 , Huajun Wang et al 2020, Zhang et al 2020 ), PTSD ( Bukhari et al 2016 , Styra et al 2008 , Tang et al 2017 , Wu et al 2009 , Wu et al 2008 , Arpacioglu et al 2020 ), and burnout ( Tolomiczenko et al 2005 ). The definition of high risk environment varied across studies, but usually included being in direct contact with infected patients, either providing care ( Bukhari et al 2016 , Verma et al 2004 ) or being responsible for cleaning and disinfection ( Li et al 2015 ).…”

Section: Resultsmentioning

confidence: 99%

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

Serrano-Ripoll

Meneses-Echávez

Ricci‐Cabello

et al. 2020

Journal of Affective Disorders

401

358

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Highlights Healthcare workers are at high risk of mental health problems during viral epidemic outbreaks This review of 117 studies offers pooled estimations of prevalence of acute stress disorder (40%), followed by anxiety (30%), burnout (28%), depression (24%), and post-traumatic stress disorder (13%). It identifies a number of factors (sociodemographic, occupational and social) associated with mental health problems. Interventional high-quality research is urgently needed to inform evidence-based policies for viral pandemics.

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“…In our survey, 86.57% of HCWs in Wuhan, 89.37% of HCWs in other cities in Hubei except Wuhan, and 71.22% of HCWs in other provinces in China except Hubei were worried about their family's cross-infection because of them. Given the high infectivity of the virus and its transmission through respiratory droplets and close contact, fear of inadvertently endangering members of family and loved ones was a widespread concern among HCWs (8). The HCWs were torn between their own responsibilities and this concern.…”

Section: Discussionmentioning

confidence: 99%

“…As of February 17, 2020, Chinese officials reported that more than 3,000 HCWs had been infected with COVID-19. Another important reason for the psychological burden on HCWs is the greater fear of their family members being at a higher risk of infection (8)(9)(10)(11). Therefore, when new epidemics break out, HCWs often suffer from huge psychological health problem, such as anxiety and depression (12,13).…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Study of Psychological Status in Different Epidemic Areas in China After the COVID-19 Outbreak

Cao

Zuo

et al. 2020

Front. Psychiatry

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Background: The outbreak of coronavirus disease 2019 in Wuhan, Hubei Province, China has seriously affected people's mental health. We aimed to assess the psychological impact of the coronavirus disease 2019 on health care workers and non-health care workers in three different epidemic areas in China and to identify independent risk factors. Methods: We surveyed 1,020 non-health care workers and 480 health care workers in Wuhan, other cities in Hubei except Wuhan and other provinces in China except Hubei. Results: Health care workers in Hubei had higher levels of anxiety and depression than non-health care workers (p < 0.05), but there was no such difference in other provinces in China except Hubei (p > 0.05). Compared with other regions, health care workers in Wuhan was more anxious (p < 0.05), and this anxiety may be caused by concerns about occupational exposure and wearing protective clothing for a long time daily; health care workers in Hubei had more obvious depression (p < 0.05), which may be associated with long days participating in epidemic work and wearing protective clothing for a long time daily. Meanwhile, 62.5% of health care workers were proud of their work. The anxiety and depression of non-health care workers in Wuhan were also the most serious. Conclusions: In Wuhan, where the epidemic is most severe, levels of anxiety and depression seem to be higher, especially among health care workers. This information may help to better prepare for future events.

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Prevalence of depression and its impact on quality of life among frontline nurses in emergency departments during the COVID-19 outbreak

Abstract: Highlights ED nurses exposed to COVID-19 could be psychologically and mentally exhausted. Prevalence of depression among 1,103 ED nurses was 43.61% (95% CI=40.68%–46.54%). A heightened awareness of and timely treatment for depression for frontline ED nurses should be provided.

Cited by 234 publications

References 24 publications

The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review

The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review

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

A Cross-Sectional Study of Psychological Status in Different Epidemic Areas in China After the COVID-19 Outbreak

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