Factors associated with psychological distress in health-care workers during an infectious disease outbreak: A rapid living systematic review

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Abstract

Background

Health-care workers (HCW) are at risk for psychological distress during an infectious disease outbreak due to the demands of dealing with a public health emergency.

Aims

To examine the factors associated with psychological distress among HCW during an outbreak.

Method

We systematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCW during an outbreak (COVID-19, SARS, MERS, H1N1, H7N9, Ebola). Four electronic databases were searched (2000 to 10 July 2020) for relevant peer-reviewed research according to a pre-registered protocol. A narrative synthesis was conducted to identify fixed, modifiable, and infection-related factors.

Results

From the 3335 records identified, 52 with data from 54,800 HCW were included. All but two studies were cross-sectional. Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk for contact with infected patients, and being quarantined, were risk factors for psychological distress among HCW. Personal and organisational social support, perceiving control, positive work attitudes, sufficient information about the outbreak and proper protection, training and resources, were associated with less psychological distress.

Conclusions

HCW who may be most at risk for psychological distress during an outbreak require early intervention and ongoing monitoring as there is some evidence that HCW distress can persist for years after an outbreak. Further research is needed to track the associations of risk factors with distress over time and the extent to which certain factors are inter-related and linked to sustained or transient distress.

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