Author details | Study type | Participants | Measures | Prevalence |
Severe acute respiratory syndrome (SARS) epidemic (2003) | ||||
Nickell et al
(Canada)5 | Survey questionnaire | Doctors, nurses, allied HP | GHQ-12 | 29% of total: probable emotional distress 45%: among nurses |
Su et al
(Taiwan)16 | Interview based, prospective | Nurses (SARS ICU, SARS regular, neurology, CCU) | BDI, STAI, DTS-C PSQI Attitude scale |
Baseline: SARS versus non-SARS units: depression: 38.5% vs 3.1%, insomnia: 37% vs 9.7%, PTSD: no difference. SARS ICU, SARS regular, neurology versus CCU: PTSD: 29.7% vs 11.8%. Follow-up: SARS unit nurse: significant reduction in mood ratings, insomnia rate and perceived negative feelings as well as increasing knowledge and understanding of SARS at the end of the study. |
Maunder (Canada)3 | Survey questionnaire | Hospital workers | IES-R Self-rated attitude scale towards SARS | High distress: 36.0% High IES score related to: being a nurse, contact with patient with SARS and having children at home. Contributory factors: job stress, perceiving stigmatisation, coping by avoiding crowds and colleagues, and feeling scrutinised. |
McAlonan et al (Hong Kong)19 | 1 year longitudinal | Healthcare workers (high vs low risk) | PSS-10 DASS-21 IES-R |
Baseline: high PSS-10 score in both the groups (non-significant difference). Follow-up: higher PSS-10 score in high risk (vs low risk). PSS score correlated with anxiety, depression, PTS scores. |
Poon et al
(Hong Kong)31 | Survey questionnaire | Hospital and administrative staffs | STAI MBI | Higher anxiety: among the hospital workers who had contact with patient with SARS (vs no contact). Higher anxiety: among workmen, healthcare assistants and nurses (vs administrative staff controls or doctors). Anxiety score correlated with the burnout score. |
Wu et al (2009) (Beijing)53 | Self-report questionnaire | Hospital and administrative staffs | IES-R | 10%: high level of PTS symptoms Higher PTS symptoms among those who worked in high-risk areas (quarantined, exposed to SARS, had SARS-positive close friend). |
Bai et al (2009) (Taiwan)54 | Hospital and administrative staffs | IES-R Questionnaire for SARS-related risk perception | 5%: acute stress reaction (ASR) 20%: felt stigmatised 15%: fear of being a contagion Quarantine related to ASR | |
Marjanovic et al (Toronto)22 | Online questionnaire | Nurse | SARS-related stress reactions questionnaire MBI-GS, STAEI Avoidance behaviour questionnaire | Higher levels of vigour, organisational support and trust in equipment/infection control initiative; and lower levels of contact with patients with SARS, and time spent in quarantine—predicted to lower levels of avoidance behaviour, emotional exhaustion and state anger. |
Middle East respiratory syndrome (MERS) (2012) | ||||
Khalid et al (Jeddah)33 | Survey questionnaire | Hospital staff worked in high-risk area | MERS-CoV staff questionnaire | Innate professional and ethical obligation pushed the healthcare workers to continue their jobs. Main concern is about one’s safety. Positive attitude in the workplace: biggest impact in reducing stress. Motivator to work: PPEs, availability of a possible cure for the disease, provision of disability benefits and family support. |
Park et al
(South Korea)28 | Convenient sampling | Nurse | Short Form-36 PSS-10 Dispositional resilience scale, Stigma scale | Stigma directly and indirectly (through stress) caused mental health problems while hardiness directly and indirectly (by decreasing stress) reduced mental health problems. |
Ebola outbreak (2014–2016) | ||||
McMahon et al (Sierra Leone)9 | Qualitative | Front-line HCWs | – | Distrust and hypervigilance prevailed among themselves. Common feelings of loneliness, ostracised, unloved, afraid, saddened and no longer respected. Restriction in behaviour (social distancing) had ill effects on coping. |
Swine flu pandemic (2009) | ||||
Mishra et al
(India)15 | Survey questionnaire | HPs (medical and dental) | Beck’s Anxiety Inventory Knowledge and attitude questionnaire | 98.5% HP score higher than cut-off for anxiety. Medical professionals had higher knowledge about vaccine. Dental professionals were more reluctant to treat the swine flu-positive patients. |
COVID-19 (2020 ongoing) | ||||
Kang et al
(Wuhan)8 | Online survey | Medical and nursing staff | PHQ-9, GAD-7, ISI, IES-R | 34.4% had mild, 22.4% had moderate and 6.2% had severe disturbances. |
Lai et al
(China)35 | Multicentric, cross-sectional, hospital- based survey | HCWs | PHQ-9, GAD-7, ISI, IES-R | 50.4%: symptoms of depression; 44.6%: anxiety; 34%: insomnia, 71.5%: distress Nurses, women, front-line workers and those who worked in Wuhan had more severe symptoms. Compared with tertiary care centre, those who worked in secondary care centre had severe scores on all depression, anxiety and insomnia. |
Zhang et al (China)18 | Online survey | HCWs and non-HCWs | ISI, SCL-90-R, PHQ-4 | Compared with non-HCWs, HCWs had higher depression, anxiety, insomnia and somatisation. |
BDI, Beck’s Depression Inventory; CCU, childcare unit; DASS-21, Depression Anxiety Stress Scale; DTS-C, Davidson Trauma Scale (Chinese version); GAD-7, Generalized Anxiety Disorder Assessment; GHQ-12, General Health Questionnaire; HCW, healthcare worker; HP, health professional; ICU, intensive care unit; IES-R, Impact of Event Scale-Revised; ISI, Insomnia Severity Index; MBI, Maslach Burnout Inventory; MBI-GS, Maslach Burnout Inventory General Survey; PHQ-9/PHQ-4, Physical Health Questionnaire; PPE, personal protective equipment; PSQI, Pittsburgh Sleep Quality Index; PSS-10, Perceived Stress Scale; PTS, Post Tarumatic Stress Symptoms; PTSD, post-traumatic stress disorder; SCL-90-R, Symptom Checklist-90 Revised; STAEI, State-Trait Anger Expression Inventory; STAI, Spielberger State-Trait Anxiety Inventory.