Table 1.
Summary of results of the pragmatic literature review of studies on stress and affective reactions of professionals who attended patients with COVID-19 compared to previous outbreaks.
| COVID-19 Pandemic [1,2,23,24,25,26,27]. | Other Previous Outbreaks [28,29,30] |
|---|---|
| Healthcare professionals were reluctant to seek psychological help or to participate in group or individual sessions provided to them to cope with acute stress, despite clear signs of acute stress or panic reactions. | Frontline workers felt helplessness, extreme vulnerability, uncertainty, life-threatening, and increased job stress during the initial phase of disease outbreaks. |
| For a large number of the professionals, the main concern was the fear of infecting their families upon returning home. | Avian influenza outbreak studies: The majority of the primary care physicians expressed concerns about their family members being at risk of infection with avian influenza because of their jobs. Frontline workers experienced more prejudice from others, perceived a higher risk that they or their family members would contract or die from the infection, and felt stigmatized and rejected by their neighbors. |
| The lack of means to prevent contamination between professionals was one of the leading causes of acute stress. | Lack of adequate training, peer support, and social support were risk factors for all adverse outcomes following public health disasters. |
| Many were dismayed at not knowing how to treat patients when they, or their families, did not accept being isolated in the hospital or following the instructions given to them. | Quarantine was the factor most strongly associated with acute stress disorder, feeling stigmatized, considering quitting work, and impaired job performance. Job stressors included a commitment to the ability to do one’s job and a lack of work-related control, including involuntary conscription. |
| Professionals called for more frequent breaks, guidance on dealing with the emotional problems of COVID-19 patients and their families, and referral to mental health resources. | Inadequate psychological support from employers, inadequate insurance/compensation, frontline staff feedback not reaching managers, and poor sense of team were reported as risk factors for poor mental health. |
| The following helped to reduce stress: providing food and other products to make daily life easier, encouraging them to talk to their families during the workday, relieving their tension, their families’ concerns and the pressure of professionals among them, providing hotels to stay in and training courses on how to deal with acute stress. | Factors that were positively correlated with HCWs’ willingness to care for patients with SARS: having a positive attitude toward caring for their patients, feeling professional obligation as HCWs to care for their patients, perceived subjective standards (i.e., from superiors), had more significant contact with SARS patients, having self-efficacy, thinking they had resources to care for SARS patients, knowing SARS, perceived institutional measures (i.e., protective facilities or equipment such as those used in university hospitals) to be adequate. Other measures identified in the studies included the use of PPE (i.e., masks, gowns, gloves, and goggles) in accordance with infection control protocols, self-monitoring for signs and symptoms of SARS, temperature control of all staff and visitors, restrictions on visitors, and cancellation of outpatient visits. The precautions were considered effective in limiting the spread of SARS and adequate to prevent it. |
Other two preprint manuscripts were reviewed: Jiang N, Jia X, Qiu Z, Hu Y, Yang F, Wang H, et al. The influence of health beliefs on interpersonal loneliness among frontline healthcare workers during the 2019 novel coronavirus outbreak in China: a cross-sectional study. SSRN. 2020. doi: 10.2139/ssrn.3552645; and Dai Y, Hu G, Xiong H, Qiu H, Yuan X. Psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on healthcare workers in China. medRxiv Posted 6 March 2020 [Preprint]. DOI: 10.1101/2020.03.03.20030874.