Research Department, Institute of Mental Health, Republic of Singapore.
West Region, Institute of Mental Health, Republic of Singapore.
J Clin Psychiatry. 2020 Oct 20;81(6):20r13450. doi: 10.4088/JCP.20r13450.
In light of the current evolving coronavirus disease 2019 (COVID-19) pandemic, and the need to learn from past infectious disease outbreaks to provide better psychological support for our frontline health care workers (HCW), we conducted a rapid review of extant studies that have reported on both psychological and coping responses in HCW during recent outbreaks.
We performed a systematic search of the available literature using PubMed, MEDLINE (Ovid), and Web of Science, combining key terms regarding recent infectious disease outbreaks and psychological and coping responses. Papers published from database inception to April 20, 2020, were considered for inclusion. Only studies in the English language and papers from peer-reviewed journals were included.
We identified 95 (PubMed) and 49 papers (Web of Science) from the database search, of which 23 papers were eventually included in the review.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for data extraction. The McMaster University critical appraisal tool was used to appraise quantitative studies. Guidelines by Higginbotham and colleagues were used to appraise qualitative studies. Only studies exploring the combined psychological and coping responses of HCW amid infectious diseases were included.
Salient psychological responses that can persist beyond the outbreaks included anxiety/fears, stigmatization, depression, posttraumatic stress, anger/frustration, grief, and burnout, but also positive growth and transformation. Personal coping methods (such as problem solving, seeking social support, and positive thinking) alongside workplace measures (including infection control and safety, staff support and recognition, and clear communication) were reported to be helpful.
Psychological support for HCW in the current COVID-19 pandemic and future outbreaks should focus on both individual (eg, psychoeducation on possible psychological responses, self-care) and institutional (eg, clear communication, providing access to resources for help, recognition of efforts of HCW) measures.
鉴于当前不断演变的 2019 年冠状病毒病(COVID-19)大流行,并且需要从过去的传染病暴发中吸取经验教训,为我们的一线医护人员(HCW)提供更好的心理支持,我们对报告近期暴发期间 HCW 的心理和应对反应的现有研究进行了快速审查。
我们使用 PubMed、MEDLINE(Ovid)和 Web of Science 对现有文献进行了系统搜索,结合了有关近期传染病暴发以及心理和应对反应的关键词。考虑纳入从数据库创建到 2020 年 4 月 20 日发表的论文。仅包括英语语言的研究和同行评议期刊的论文。
我们从数据库搜索中确定了 95 篇(PubMed)和 49 篇(Web of Science)论文,其中 23 篇最终纳入综述。
使用系统评价和荟萃分析的首选报告项目指南进行数据提取。使用麦克马斯特大学批判性评估工具评估定量研究。使用 Higginbotham 及其同事的指南评估定性研究。仅包括探索传染病期间 HCW 综合心理和应对反应的研究。
持续存在的明显心理反应包括焦虑/恐惧、污名化、抑郁、创伤后应激、愤怒/挫败感、悲伤和倦怠,但也有积极的成长和转变。个人应对方法(如解决问题、寻求社会支持和积极思考)以及工作场所措施(包括感染控制和安全、员工支持和认可以及清晰的沟通)被报告为有帮助。
当前 COVID-19 大流行和未来暴发期间对 HCW 的心理支持应侧重于个人(例如,可能的心理反应的心理教育、自我保健)和机构(例如,清晰的沟通、提供获取帮助的资源、认可 HCW 的努力)措施。