Sources and symptoms of stress among nurses in the first Chinese anti-Ebola medical team during the Sierra Leone aid mission: A qualitative study

Liu, Chunzi; Wang, Huaming; Zhou, Lin; Xie, Hui; Yang, Huiyin; Yu, Yanbo; Sha, Huayan; Yang, Ying; Zhang, Xin

Severe infection among medical staff characterized the March 2014 outbreak. Medical personnel were easily infected if they did not strictly follow the preventive protocol for infection control, and then came into close contact with suspected or confirmed EVD patients during diagnosis and treatment [5] . According to the World Health Organization, 605 medical personnel were infected in Guinea, Liberia, and Sierra Leone. Among these, 339 died, resulting in a mortality rate of 56% [11] . Koh et al. [12] found that Singaporean Chinese nurses felt themselves at high risk when handling cases of severe acute respiratory syndrome (SARS) and influenza A H1N1. The nurses even believed that infections were unavoidable; however, they remained loyal to their duties. Bonnie and Barry retrospectively studied first-line central African nurses during the EVD outbreaks in 1995, 2000e2001, and 2003. The nurses' stress was found to be mainly due to the lack of protective gear and basic equipment, especially during the early phases of the outbreaks. The nurses were likewise stigmatized by their community, coworkers, and family [13] . A qualitative research reported that nurses caring for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) were considered to be "going into a dangerous field," or as "strong pressure because of MERS-CoV" [14] . Another study found that a significant percentage of workers encountered stressors due to isolation, alterations in home life, and discrimination. Physicians and nurses exhibited stressors that were primarily related to patient care [15] .