Clinicians caring for Covid-19 patients have shown multiple signs of stress including anxiety, depression and sleep disturbance.¹ Predictors of these adverse effects include young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support.²

Issues in COVID-19 care that may provoke these problems include “limited information about COVID-19, unpredictable tasks and challenging practices, insufficient support, concerns about family, and emotional and psychological stress”³, as well as “working in an isolated environment, concerns about personal protective equipment shortage and usage, physical and emotional exhaustion, intensive workload, fear of being infected, and insufficient work experiences with COVID-19.”⁴

One study showed that distressed professionals showed significantly lower levels of work engagement⁵ and another that “studies of previous pandemics demonstrate heightened distress in health care workers years after the event”.⁶

Factors that may protect clinicians from stressors include years of “work experience, …. age, gender, marital status, and coping styles.”⁷ Systemic support, adequate knowledge and resilience were also identified as factors protecting against adverse mental health outcomes.⁸

Recommendations for healthcare and hospital-support systems include the “assessment and promotion of coping strategies and resilience, special attention to frontline HCWs, provision of adequate protective supplies, and organization of online support services”.⁹

Additional research is suggested to improve frontline nursing and to “better support the nursing workforce in the current or a future pandemic”.³

References:

1. Al Maqbali M, Al Sinani M, Al-Lenjawi B. Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis. J Psychosom Res. 2020 Dec 17;141:110343. doi: 10.1016/j.jpsychores.2020.110343. Epub ahead of print. PMID: 33360329.  For Emory Users.

2. d’Ettorre G, Ceccarelli G, Santinelli L, et al. Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review. Int J Environ Res Public Health. 2021 Jan 12;18(2):E601. doi: 10.3390/ijerph18020601. PMID: 33445712; PMCID: PMC7828167.

3. Joo JY, Liu MF. Nurses’ barriers to caring for patients with COVID-19: a qualitative systematic review. Int Nurs Rev. 2021 Jan 8. doi: 10.1111/inr.12648. Epub ahead of print. PMID: 33420749. For Emory Users.

4. Leng M, Wei L, Shi X, Cao G, et al. Mental distress and influencing factors in nurses caring for patients with COVID-19. Nurs Crit Care. 2020 Jul 27. doi: 10.1111/nicc.12528. Epub ahead of print. PMID: 33448567. For Emory Users.

5. Gómez-Salgado J, Domínguez-Salas S, Romero-Martín M, et al. Work engagement and psychological distress of health professionals during the COVID-19 pandemic. J Nurs Manag. 2021 Jan 5. doi: 10.1111/jonm.13239. Epub ahead of print. PMID: 33400325. For Emory Users.

6. Schwartz R, Sinskey JL, Anand U, Margolis RD. Addressing Postpandemic Clinician Mental Health : A Narrative Review and Conceptual Framework. Ann Intern Med. 2020 Dec 11/15;173(12):981-988. doi: 10.7326/M20-4199. Epub 2020 Aug 21. PMID: 32822206; PMCID: PMC7450528.

7. Carmassi C, Foghi C, Dell’Oste V, et al. PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic. Psychiatry Res. 2020 Oct;292:113312. doi: 10.1016/j.psychres.2020.113312. Epub 2020 Jul 20. PMID: 32717711; PMCID: PMC7370915.  

8. De Kock JH, Latham HA, Leslie SJ, Grindle M, Munoz SA, Ellis L, Polson R, O’Malley CM. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health. 2021 Jan 9;21(1):104. doi: 10.1186/s12889-020-10070-3. PMID: 33422039; PMCID: PMC7794640.

9. Preti E, Di Mattei V, Perego G, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep. 2020 Jul 10;22(8):43. doi: 10.1007/s11920-020-01166-z. PMID: 32651717; PMCID: PMC7350408.

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