Table 4.

Main results of the reviewed studies.

Reference	Study Period	Participants	Measures	Main Results
Bergman et al., 2021 [36]	May 2020	151 ICU nurses (131 moved to the ICU due to pandemic)	Thirteen multiple-choice questions, including questions about participants’ specialist training, years of clinicalexperience, workplace, number of patients per shift, and introductionand training regarding COVID-19 patients.	The situation of not being able to provide nursing care resulted in ethical stress and led to an increased workload and worsened work environment, which affected nurses’ health and well-being.
Bruyneel et al., 2021 [37]	April–May 2020	1135 ICU nurses	Maslach Burnout Inventory (MBI)	Overall, 68% of ICU nurses were at risk of BOS. A total of 29% were at risk for depersonalization (DP), 31% for reduced personal accomplishment (PA), and 38% for emotional exhaustion (EE). A nurse–patient ratio of 1:3 increased the risk of EE and DP. High workload was associated with a higher risk for BOS. A lack of protective equipment increased the risk of EE. The presence of COVID-19-like symptoms without being tested increased the risk of EE.
Cadge et al., 2021 [45]	June–August 2020	16 ICU nurses (8 already in ICU, 8 moved to ICU due to pandemic)	Semi-structured interviews with questions about working under unfamiliar circumstances, caring for patients with a new infectious disease, risks to themselves and their family, ideas on additional support they would find helpful.	Participants emphasized the importance of nurse leadership support during this experience. Leadership practices that maximize visibility and support facilitated individual and group well-being and minimized BOS risk.
Çelik and Kiliç, 2022 [46]	May–June 2020	18 ICU nurses	Individual in-depth interview: two questions were asked by the authors, namely: (1) Can you explain the effects of the COVID-19 pandemic on your relations with your family? (2) How does the COVID-19 pandemic affect you?	The study investigated three themes: breakdown in continuity of intrafamilial relationship, ineffectiveness in role performance, and ineffective individual coping. Nurses suffered from family relationship breakdown and insufficiency in intrafamilial coping; they reported to live a tiring life with great responsibility and face mental problems such as burnout syndrome and depression.
Christianson et al., 2022 [47]	November 2020–January 2021	13 ICU Nurses	One-on-one semi-structured interviews conducted by nurses following broad questions about the lived experience of nurses about the pandemic, e.g., can you tell me about what it has been like towork in the ICU during the COVID-19 pandemic?	Nurses reported betrayal at perceived breeches in their duty-of-care agreement by their employers, the society, and national health authorities. Alterations to previous standards of care such as significantly increased workloads, worsening understaffing, and changes to patient-care expectations that were implemented for reasons other than the betterment of patient care. Nurses reported to feel a moral obligation to provide care while experiencing disempowerment and burnout that affected them both in and out of the workplace.
Crowe et al., 2022 [38]	May–June 2021	425 ICU Nurses	Quantitative measures: the Impact of Event Scale—Revised (IES–R), the Depression, Anxiety, Stress Scale (DASS–21), the Professional Quality of Life scale (ProQoL), and the Intent to Turnover scale; Qualitative questions: optional open-ended question asking participants if there was anything else they wanted to share.	Nurses had symptoms of post-traumatic stress disorder (74%), depression (70%), anxiety (57%), and stress (61%). All (100%) nurses showed moderate-to-high burnout, 87% suffering from signs of secondary traumatic stress, and 22% intended to quit their current employment. Qualitative analysis of written comments submitted by 147 (34.5%) of the respondents depicted an immense mental health toll on the ICU that stemmed from (1) failed leadership and (2) the traumatic nature of the work environment, which led to (3) a sense of disillusionment, defeat, and an intent to leave.
Guttormson et al., 2022 [39]	October 2020–January 2021	285 ICU nurses	Closed questions on respondents’ characteristics, work setting, and challenges during the pandemic. Three open questions: (1) What do you want people to know about your experience during the COVID-19 pandemic? (2) Please, describe the greatest challenges you faced caring for COVID-19 patients. (3) Please, describe any positive things you observed or experienced during COVID-19.	Nurses reported stress due to a lack of evidence-based treatment, poor patient prognosis, and lack of family presence in the ICU. They perceived inadequate leadership support and inequity within working teams. They felt isolated due to a lack of consistent community efforts to slow the virus spread. Nurses reported exhaustion, anxiety, sleeplessness, moral distress, and fear of contracting COVID-19 or infecting family and friends.
Kagan et al., 2022 [40]	February–May 2021	115 ICU nurses (15 for the focus group and 100 for the cross-sectional study)	Quantitative measures: professional functioning, emotional stress at work, State Hope Scale, Nurses’ uncertainty, and Shirom–Melamed Burnout Measure; Qualitative measure: 15 focus groups.	Qualitative data analysis revealed challenges of the COVID-19 pandemic and positive aspects of the COVID-19 pandemic. Nurses reported high levels of burnout, emotional stress, and uncertainty, but moderate State Hope Scale scores, and moderate levels of professional functioning. State Hope Scale levels, uncertainty, and burnout variables contributed significantly and explained 46% of the variance of the professional functioning.
Kurt Alkan et al., 2022 [41]	February–April 2021	116 ICU nurses	Descriptive Information Form, COVID-19 Fear Scale, Depression, Anxiety and Stress Scale Short Form and Burnout Short Version, COVID-19 Fear Scale.	Strong associations among the presence of moderate-to-high symptoms of depression, anxiety, stress, and burnout levels among ICU nurses.
Ndlovu et al., 2022 [42]	January–May 2020	154 ICU nurses	Professional Quality of Life comprising dimensions of compassion satisfaction, burnout, and secondary traumatic stress disorder.	The high workload, which may have been associated with the COVID-19 pandemic, influenced nurses’ professional quality of life.
Omidi et al., 2022 [43]	July 2020–January 2021	140 ICU nurses	Maslach Burnout Inventory (MBI) and the WHO Quality of Life-BREF.	Positive associations between personal accomplishment and all dimensions of QoL and a negative association between emotional exhaustion, depersonalization of burnout and QOL dimensions.
Vitale et al., 2020 [44]	March–April 2020	291 ICU nurses (132 moved to ICU due to pandemic)	Maslach Burnout Inventory (MBI).	A total of 90.4% of the nurses reported above-threshold values for EE, 8.2% for DP, and 24.4% for reduced PA. Female nurses reported higher negative values than men for the only EE dimension.