Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review

Ignacio Ricci Cabello; Jose F Meneses Echavez; Maria Jesus Serrano-Ripoll; David Fraile-Navarro; Maria Antonia Fiol de Roque; Guadalupe Pastor Moreno; Adoracion Castro; Isabel Ruiz Perez; Rocio Zamanillo Campos; Daniela Goncalves-Bradley

Coping style Coping via problem-solving, seeking support from others and escape-avoidance were measured with subscales of the Ways of Coping Inventory an instrument which yields eight subscales of coping strategies. In this study coping scales were selected that have predictive power with respect to longterm stress-related outcomes of working during the SARS outbreak. Coping scales were calculated as the mean of item scores on a 4 point scale from 0 ("Not used") to 4 ("Used a great deal"). Problem-solving and seeking support were both normally distributed. Cronbach's alpha was 0.76 for problemsolving and 0.77 for seeking support. Escape-avoidance was skewed toward zero. Cronbach's alpha 0.73. Coping with stress using problem-solving, seeking support from others or through escapeavoidance did not change over the course. . After implementation of the SARS prevention program, the mean scores of anxiety level decreased with time. The mean score from the first questionnaire before caring for SARS patients is 60 points (SD= 9.28), indicating moderate anxiety compared to the mean scores of after the implementation of the anti-SARS program, the mean scores of 51, 50, and 46 indicating mild anxiety, mild anxiety, no anxiety, respectively, at the remaining time points. GEE models showed that anxiety levels 2 weeks after the implementation of the prevention program and while caring for SARS patients were significantly lower than anxiety level before caring for SARS patients (p = 0:075). The anxiety level month after caring for SARS patients was also significantly lower than the anxiety levels before care of SARS patients (p<0:0001). After caring for SARS patients for 3 months and 1 month after the hospital returned to normal operations, nursing personnel exhibited anxiety levels significantly lower than that prior to caring for SARS patients (p<0:0001). . After the implementation of the SARS prevention program, mean scores of depression level decreased with time. At the time of the first questionnaire before care of SARS patients began, the mean score was 61 points (SD =12.62), indicating moderate depression. After program initiation, the mean scores of 51, 50, and 48 points indicated mild depression, mild depression, and no depression, respectively. Using GEE, the levels of depression 2 weeks after initiation of the SARS prevention program and while caring for SARS patients were significantly lower than the level before caring for SARS patients (p<0:0001). At 1 month after caring for SARS patients, the level of depression was also significantly lower than the levels of depression levels before the staff began to care for SARS patients (p<0:0001). After the hospital had returned to normal operations, the level of depression was significantly lower than that prior to taking care of SARS patients (p<0:0001).