Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis
Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis
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DOI：
10.1016/j.jad.2020.08.034
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发表时间：
2020-12-01
影响因子：
6.6
通讯作者：
Goncalves-Bradley, Daniela C.
中科院分区：
文献类型：
--
作者：
Serrano-Ripoll, Maria J.;Meneses-Echavez, Jose F.;Goncalves-Bradley, Daniela C.
背景资料：本研究旨在探讨在病毒性流行病爆发引起的卫生紧急情况下提供医疗保健对医护人员（HCWs）心理健康的影响;确定与更坏的影响相关的因素，并评估现有的证据基础，干预措施，以减少这种影响。我们检索了MEDLINE、Embase和PsycINFO（开始至2020年8月）。我们使用随机效应荟萃分析汇总数据，以估计特定精神健康问题的患病率，并使用GRADE确定证据的确定性。急性应激障碍的合并患病率较高（40%（95%CI 39 - 41%）），其次是焦虑（30%（30 - 31%））、倦怠（28%（26 - 31%））、抑郁（24%（24 - 25%））和创伤后应激障碍（13%（13 - 14%））。我们确定了与发展这些问题的可能性相关的因素，包括社会人口（年轻和女性），社会（缺乏社会支持，污名化）和职业（在高风险环境中工作，特定的职业角色，以及较低水平的专业培训和工作经验）因素。四项研究报告了对一线医务工作者的干预措施：两项教育干预措施增加了对大流行自我效能和解决人际关系问题的信心（非常低的确定性），而一个多方面的干预改善了焦虑，抑郁和睡眠质量局限性：我们只检索了三个数据库，并且最初的筛选是由一位评审员进行的。结论：鉴于非常有限的证据干预措施的影响，以解决心理健康问题的HCWs，确定的风险因素是未来的干预措施的重要目标。
Background: This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers' (HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact.Method: Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception to August 2020). We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems, and used GRADE to ascertain the certainty of evidence.Results: We included 117 studies. The pooled prevalence was higher for acute stress disorder (40% (95%CI 39 to 41%)), followed by anxiety (30%, (30 to 31%)), burnout (28% (26 to 31%)), depression (24% (24 to 25%)), and post-traumatic stress disorder (13% (13 to 14%)). We identified factors associated with the likelihood of developing those problems, including sociodemographic (younger age and female gender), social (lack of social support, stigmatization), and occupational (working in a high-risk environment, specific occupational roles, and lower levels of specialised training and job experience) factors. Four studies reported interventions for frontline HCW: two educational interventions increased confidence in pandemic self-efficacy and in interpersonal problems solving (very low certainty), whereas one multifaceted intervention improved anxiety, depression, and sleep quality (very low certainty).Limitations: We only searched three databases, and the initial screening was undertaken by a single reviewer.Conclusion: Given the very limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified represent important targets for future interventions.