Psychological and Coping Responses of Health Care Workers Toward Emerging Infectious Disease Outbreaks: A Rapid Review and Practical Implications for the COVID-19 Pandemic.

OBJECTIVE: 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. DATA SOURCES: 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. STUDY SELECTION: We identified 95 (PubMed) and 49 papers (Web of Science) from the database search, of which 23 papers were eventually included in the review. DATA EXTRACTION: 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. RESULTS: 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. CONCLUSIONS: 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.

Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic.

INTRODUCTION: Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks. METHODS: We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks. RESULTS: A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation. CONCLUSION: Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self-care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.