Psychological Impact of Deploying in Support of the U.S. Response to Ebola: A Systematic Review and Meta-Analysis of Past Outbreaks

Vyas, Kartavya J.; Delaney, Eileen; Webb-Murphy, Jennifer; Johnston, Scott L.

doi:10.7205/milmed-d-15-00473

Cited by 77 publications

(100 citation statements)

References 49 publications

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“…Caring for patients during an epidemic/pandemic may impact negatively on the mental health of HCPs [5,6]. While studies on this impact exist, this literature has yet to be updated and fully synthesized alongside a review of potential risk and protective factors.…”

Section: Why Is This Review Needed?mentioning

confidence: 99%

Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

et al. 2020

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Background: Epidemics or pandemics, such as the current Coronavirus Disease 2019 (COVID-19) crisis, pose unique challenges to healthcare professionals (HCPs). Caring for patients during an epidemic/pandemic may impact negatively on the mental health of HCPs. There is a lack of evidence-based advice on what would be effective in mitigating this impact. Objectives: This rapid review synthesizes the evidence on the psychological impact of pandemics/epidemics on the mental health of HCPs, what factors predict this impact, and the evidence of prevention/intervention strategies to reduce this impact. Method: According to rapid review guidelines, systematic searches were carried out in Embase.com, PubMed, APA PsycINFO-Ovid SP, and Web of Science (core collection). Searches were restricted to the years 2003 or later to ensure inclusion of the most recent epidemic/pandemics, such as Severe Acute Respiratory Syndrome (SARS). Papers written in French or English, published in peer-reviewed journals, and of quantitative design using validated measures of mental health outcomes were included. Of 1308 papers found, 50 were included. The full protocol for this rapid review was registered with Prospero (reg.no. CRD42020175985). Results: Results show that exposed HCPs working with patients during an epidemic/pandemic are at heightened risk of mental health problems in the short and longer term, particularly: psychological distress, insomnia, alcohol/ drug misuse, and symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, burnout, anger, and higher perceived stress. These mental health problems are predicted by organizational, social, personal, and psychological factors and may interfere with the quality of patient care. Few evidence-based early interventions exist so far. Discussion: HCPs need to be provided with psychosocial support to protect their mental wellbeing if they are to continue to provide high quality patient care. Several recommendations relevant during and after an epidemic/ pandemic, such as COVID-19, and in preparation for a future outbreak, are proposed.

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Section: Why Is This Review Needed?mentioning

confidence: 99%

Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

et al. 2020

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“…Research during the H1N1 outbreak in 2009 (24) , found out that the average rate of psychological distress among exposed health professionals was nearly 40%. According to a systematic review (25) , risk factors for psychological distress during an epidemic included the duration of exposure (26) , little professional experience (26) , being single (27) , nurse (28) , a part-time job (28) , female (29) , physical health problem (29) , difficulty in carrying out activities due to precaution measures (28) and absence of psychological support at work (29) .…”

Section: The Emotions Of Health Professionals In the Battle Against Cmentioning

confidence: 99%

“…Health professionals who experienced working directly with infected patients had relatively high levels of depressive symptoms one year after the outbreak. Insomnia, alcohol and other drug abuse, PTSD symptoms, depression and anxiety have also been reported (25) . All these factors require caution in evaluation, because of the effects on the quality of life of professionals.…”

Section: The Post-epidemic Consequences For the Mental Health Of Healmentioning

confidence: 99%

Mental health of healthcare professionals in China during the new coronavirus pandemic: an integrative review

et al. 2020

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Objective: to identify publishing related to the mental health of health professionals working in the front line of the COVID-19 pandemic. Methods: an integrative review that included primary articles indexed in the Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Science Direct databases and US National Library of Medicine databases. The result analysis was performed descriptively, in four analytical categories. Results: The publishing involved aspects related to insufficient personal protective equipment, feelings of fear and stigma, the need for psychological and psychiatric support and the possibility of post-outbreak mental disorders. Conclusion: All mentioned aspects have a direct impact on the mental health of professionals, demanding the creation of strategies that minimize the emotional burnout of workers, considering that each country and culture reacts differently to the disease.

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“…The seven items were summed, resulting in a composite score ranging from 0 to 28. The summed scores were categorized to include no sleep problems (0-7), subthreshold insomnia (8)(9)(10)(11)(12)(13)(14), moderate insomnia (15)(16)(17)(18)(19)(20)(21), and severe insomnia (22-28) based on validated literature guidelines (54). The scale was further dichotomized to no sleep problems (0-14) and sleep problems (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Behavioral Health and Wellbeingmentioning

confidence: 99%

“…Several previous studies have focused on stressors and behavioral health consequences experienced by medical staff responding to outbreaks of infectious disease, such as Middle East Respiratory Syndrome(1), Severe Acute Respiratory Syndrome (2), Ebola (3,4) and . Medical professionals like physicians and nurses managing these outbreaks report elevated psychological distress (5,(8)(9)(10), posttraumatic stress symptoms (2,(8)(9)(10)(11), depression and anxiety (4)(5)(6)9), sleep problems (5,6,9), and burnout (7,8). Studies have also documented that working in the context of an outbreak can place a strain on the team as a whole (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Health-Promoting Leadership during an Infectious Disease Outbreak: A Cross-sectional Study of US Soldiers Deployed to Liberia

Booth

Schwalb

Kim

et al. 2020

Preprint

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Background Infectious disease outbreaks are uniquely stressful for non-medical essential employees. Promoting the health of these workers is vital to minimize their distress and to ensure they are able to continue in their professional capacity. One way to support worker health is for supervisors to engage in behaviors that promote their employees’ behavioral health, wellbeing, and attitudes towards preventive medicine practices. Methods The present study examined if health-promoting leadership contributes to these outcomes in employees operating in an epidemic. Active-duty soldiers (N = 173) deployed to provide non-medical support in Liberia during the 2014 Ebola crisis completed surveys assessing posttraumatic stress disorder (PTSD), depression, anxiety, sleep problems, burnout, morale and attitudes, and rating their leaders on health-promoting behaviors. An exploratory factor analysis identified two leadership factors, one focused on psychological health and one on preventive medicine behaviors. Results Using mixed effects logistic regression, after adjusting for general leadership and soldier rank, health-promoting leadership focused on psychological health was associated with decreased odds of PTSD, depression, anxiety, and burnout, and increased odds of high morale and avoiding unnecessary risk. Health-promoting leadership behaviors focused on preventive medicine were associated with decreased odds of depression and anxiety, and increased odds of high morale, understanding the level of risk from disease, positive attitudes towards the deployment and preventive practices, and avoiding unnecessary risk. Conclusions Findings suggest health-promoting leadership behaviors could be valuable for employees responding to infectious disease outbreaks. Future research should examine whether training leaders in these skills can improve outcomes for non-medical employees in both military and civilian settings.

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Psychological Impact of Deploying in Support of the U.S. Response to Ebola: A Systematic Review and Meta-Analysis of Past Outbreaks

Abstract: Deployed service members may return with clinically significant problems, the most notable of which is depression. Delivering resilience training and fostering altruistic acceptance may protect service members from developing mental health disorders.

Cited by 77 publications

References 49 publications

Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

Mental health of healthcare professionals in China during the new coronavirus pandemic: an integrative review

Health-Promoting Leadership during an Infectious Disease Outbreak: A Cross-sectional Study of US Soldiers Deployed to Liberia

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