Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.
Humanitarian Services, Belgian Red Cross, Mechelen, Belgium.
PLoS One. 2020 Dec 15;15(12):e0244052. doi: 10.1371/journal.pone.0244052. eCollection 2020.
The novel Coronavirus Disease (COVID-19) outbreak currently puts health care workers at high risk of both physical and mental health problems. This study aimed to identify the risk and protective factors for mental health outcomes in health care workers during coronavirus epidemics.
A rapid systematic review was performed in three databases (March 24, 2020) and a current COVID-19 resource (May 28, 2020). Following study selection, study characteristics and effect measures were tabulated, and data were synthesized by using vote counting. Meta-analysis was not possible because of high variation in risk factors, outcomes and effect measures. Risk of bias of each study was assessed and the certainty of evidence was appraised according to the GRADE methodology.
Out of 2605 references, 33 observational studies were selected and the identified risk and protective factors were categorized in ten thematic categories. Most of these studies (n = 23) were performed during the SARS outbreak, seven during the current COVID-19 pandemic and three during the MERS outbreak. The level of disease exposure and health fear were significantly associated with worse mental health outcomes. There was evidence that clear communication and support from the organization, social support and personal sense of control are protective factors. The evidence was of very low certainty, because of risk of bias and imprecision.
Safeguarding mental health of health care workers during infectious disease outbreaks should not be treated as a separate mental health intervention strategy, but could benefit from a protective approach. This study suggests that embedding mental health support in a safe and efficient working environment which promotes collegial social support and personal sense of control could help to maximize resilience of health care workers. Low quality cross-sectional studies currently provide the best possible evidence, and further research is warranted to confirm causality.
新型冠状病毒病（COVID-19）的爆发目前使医护人员面临身心双重健康问题的高风险。本研究旨在确定在冠状病毒流行期间医护人员心理健康结果的风险和保护因素。
在三个数据库（2020 年 3 月 24 日）和一个当前的 COVID-19 资源（2020 年 5 月 28 日）中进行了快速系统评价。在进行研究选择后，我们对研究特征和效果指标进行了列表，并且通过投票计数对数据进行了综合。由于危险因素、结果和效果指标存在高度差异，因此无法进行荟萃分析。根据 GRADE 方法评估了每个研究的偏倚风险，并评估了证据的确定性。
在 2605 篇参考文献中，选择了 33 项观察性研究，并将确定的风险和保护因素分为十个主题类别。其中大多数研究（n = 23）是在 SARS 爆发期间进行的，7 项是在当前 COVID-19 大流行期间进行的，3 项是在 MERS 爆发期间进行的。疾病暴露水平和健康恐惧与更差的心理健康结果显著相关。有证据表明，来自组织的明确沟通和支持、社会支持和个人控制感是保护因素。由于偏倚和不精确性，证据的确定性为极低。
在传染病爆发期间，医护人员的心理健康不应被视为单独的心理健康干预策略，而可以采用保护方法。本研究表明，在安全高效的工作环境中嵌入心理健康支持，促进同事之间的社会支持和个人控制感，有助于最大限度地增强医护人员的适应力。目前低质量的横断面研究提供了最佳的可能证据，需要进一步研究以确认因果关系。
