TOPIC: “Challenges experienced by health care workers during the COVID-19 pandemic”

GROUP 1 members:
Alagar, Mariana Mikaela
Carpio, Karen Nicole
Doloricon, Genesis
Espiritu, Christine Mae O.
Galvez, John Daryll
Janohan, Ma. Patrisha
Padernal, Daniel John Kyle
Sureta, Anne Jeli
CHRISTINE MAE O. ESPIRITU

Title: “Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated
factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study”
Author​: Deying Hu, Yue Kong, Wengang Li, Qiuying Han, Xin Zhang, Li Xia Zhu
Year:​ June 26, 2020
Publisher​: The Lancet
Abstract: ​During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face
enormous mental health challenges. Epidemiological data on the mental health statuses of
frontline nurses are still limited. The aim of this study was to examine mental health (burnout,
anxiety, depression, and fear) and their associated factors among frontline nurses who were
caring for COVID-19 patients in Wuhan, China.
Link in APA Format:
Deying Hu. (2020). Frontliner nurses’ burnout, anxiety, depression and fear statuses and their
associated factors during the COVID-19 outbreak in Wuhan, China - Deying Hu, Yue
Kong, Wengang Li, Li Xia Zhu, 2020. Retrieved June 26, 2020, from
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30168-1/fulltext#%
20

Title: ​“Mental health care for medical staff and affiliated healthcare workers during the
COVID-19 pandemic”
Author: ​Matthew Walton, Esther Murray, Michael D. Christian
Year: ​April 28, 2020
Publisher:​ Sage journals
Abstract: ​The COVID-19 pandemic is an unprecedented challenge for society. Supporting the
mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the
public health response. This paper details the effects on staff and addresses some of the
organisational, team and individual considerations for supporting staff (pragmatically) during
this pandemic. Leaders at all levels of health care organisations will find this a valuable resource.
Link in APA Format:
Matthew Walton, E. (2020). Mental health care for medical staff and affiliated healthcare
workers during the COVID-19 pandemic - Matthew Walton, Esther Murray,
Michael D Christian, 2020. Retrieved September 17, 2020, from
https://journals.sagepub.com/doi/full/10.1177/2048872620922795

Title: ​“Prevalence of Health Care Worker Burnout During the Coronavirus Disease 2019
(COVID-19) Pandemic in Japan”
Author: ​Takahiro Matsuo
Year: ​2020
Publisher: ​JAMA Network
Abstract: ​The coronavirus disease 2019 (COVID-19) pandemic has placed considerable
psychological strain on frontline health care workers (HCWs).​1 Although the problem of
burnout, which overlaps with the symptoms of depression,​2 remains urgent, few studies have
addressed it comprehensively. The objective of this study was to evaluate the prevalence of
burnout among frontline HCWs during the COVID-19 pandemic in Japan based on job
categories and other factors.
Link in APA Format:
Takahiro Matsuo, MD. “Prevalence of Health Care Worker Burnout During the COVID-19
Pandemic in Japan.” ​JAMA Network Open​, American Medical Association, 4 Aug. 2020,
jamanetwork.com/journals/jamanetworkopen/fullarticle/2768947.
CARPIO, KAREN NICOLE C.
Title: “​Exploring the challenges faced by frontline workers in health and social care amid the
COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK”

Author: ​Pfendi, F., Ekpenyong M.

Year: ​June 16, 2020

Publisher:​ Taylor Francis Online
Abstract: ​The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in
December 2019. Globally millions of people have been diagnosed with the virus whilst
thousands have died. As the virus kept spreading health and social care frontline workers
(HSCFW) were faced with difficulties when discharging their duties. This paper was set out to
explore the challenges faced by different frontline workers in health and social care during the
COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty
(N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who
included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social
care workers were drawn from domiciliary care and care homes (with and without nursing
services). All the interviews were done online. The data were thematically analyzed, and the
emergent themes were supported by quotes from the interviews held with participants. Following
data analysis the research study found that lack of pandemic preparedness, shortage of Personal
Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing
social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear
amongst residents and service users, delay in testing, evolving PPE guidance and shortage of
staff were challenges faced by frontline health and social care workers during COVID-19
pandemic. The results of the current study point to a need for adequate pandemic preparedness
within the health and social care sector to protect both frontline workers and the individuals they
look after.

Link in APA Format:Pfendi, F., Ekpenyong M. (May, 2020) ” Exploring the challenges faced by
frontline workers in health and social care amid the COVID-19 pandemic: experiences of
frontline workers in the English Midlands region, UK”
https://www.tandfonline.com/doi/full/10.1080/13561820.2020.1792425

Title: “​Psychological distress, coping behaviors, and preferences for support among New York
healthcare workers during the COVID-19 pandemic”

Author: ​Schecter, A., Diaz, F

​Year: ​June 16,2020

Publisher: ​ScienceDirect

Abstract: ​Objective

The mental health toll of COVID-19 on healthcare workers (HCW) is not yet fully described. We
characterized distress, coping, and preferences for support among NYC HCWs during the
COVID-19 pandemic.

Methods

This was a cross-sectional web survey of physicians, advanced practice providers,

residents/fellows, and nurses, conducted during a peak of inpatient admissions for COVID-19 in
NYC (April 9th–April 24th 2020) at a large medical center in NYC (​n​ = 657).

Results

Positive screens for psychological symptoms were common; 57% for acute stress, 48% for
depressive, and 33% for anxiety symptoms. For each, a higher percent of nurses/advanced
practice providers screened positive vs. attending physicians, though housestaff's rates for acute
stress and depression did not differ from either. Sixty-one percent of participants reported
increased sense of meaning/purpose since the COVID-19 outbreak. Physical activity/exercise
was the most common coping behavior (59%), and access to an individual therapist with online
self-guided counseling (33%) garnered the most interest.
Conclusions

NYC HCWs, especially nurses and advanced practice providers, are experiencing
COVID-19-related psychological distress. Participants reported using empirically-supported
coping behaviors, and endorsed indicators of resilience, but they also reported interest in
additional wellness resources. Programs developed to mitigate stress among HCWs during the
COVID-19 pandemic should integrate HCW preferences.

Link in APA Format:

Schecter, A., Diaz, F. (June, 2020) “Psychological distress, coping behaviors, and preferences for
support among New York healthcare workers during the COVID-19 pandemic.”
https://www.sciencedirect.com/science/article/pii/S0163834320300839

Title: ​“Mental Health in Healthcare Workers and the Covid-19 Pandemic Era: Novel Challenge
for Critical Care”

Author: ​Jansson, M.

Year: ​June 10, 2020

Publisher: ​iMed Pub Journals

Abstract: During the COVID-19 outbreak, the front-line Health Care Workers have experienced
varying levels of stress, anxiety, and insomnia. Targeted interventions are needed to enhance
psychological wellbeing of Health Care Workers and strengthen the healthcare systems’ capacity
during pandemic. Clear communication, limitation of shift hours, provision of rest areas as well
as broad access and detailed rules on the use and management of protective personal equipment
and specialized training on handling COVID-19 patients could reduce anxiety coming from the
perceived unfamiliarity and uncontrollability of the hazards involved.

Link in APA Format: ​Jansson, M. (June, 2020) “Mental Health in Healthcare Workers and the
Covid-19 Pandemic Era: Novel Challenge for Critical Care.”
https://criticalcare.imedpub.com/mental-health-in-healthcare-workers-and-the-covid19-pandemic
-era-novel-challenge-for-critical-care.pdf
MA. PATRISHA A. JANOHAN
Title: ​“Burnout Among Healthcare Providers During COVID 19 Pandemic: Challenges and
Evidence based Interventions”
Author​: Abida Sultana ,Rachit Sharma, Md Mahbub Hossain ,Sudip Bhattacharya and Neetu
Purohit PhD
Year: ​April 15, 2020
​Publisher:​ SocArXiv Papers
Abstract: ​Burnout is a major occupational problem among healthcare providers. During
coronavirus disease (COVID-19) pandemic,the frontline health workforce is experiencing a
high workload and multiple psychosocial stressors, which may affect their mental and
emotional health,leading to burnout symptoms. Moreover, sleep deprivation and a critical lack of
psychosocial support may aggravate such symptoms amidst COVID-19. From an ethical
viewpoint, healthcare providers may experience moral distress while safeguarding patient
welfare and autonomy. Moreover, social injustice and structural inequities may affect their
emotional health while witnessing high volume of new cases and mortality during this pandemic.
Global evidence informs the need for adopting multipronged evidence-based approaches
addressing burnout during this pandemic. Such interventions may include increasing the
awareness of work-related stress and burnout, promoting mindfulness and self-care practices
for promoting mental wellbeing, ensuring optimal mental health services, using digital
technologies to address workplace stress and deliver mental health interventions, and improving
organizational policies and practices emphasizing on addressing burnout among healthcare
providers. As COVID-19 may impose unique workplace stress in addition to preexisting
psychosocial burden among individuals, it is essential to acknowledge the ethical implications of
those challenges and prevent burnout through effective measures ensuring the mental and
emotional wellbeing of healthcare providers amid this pandemic.
Link of rrl : ​Sultana,A.,Sharma,R,. et al (2020). “Burnout Among Healthcare Providers During
COVID 19 Pandemic: Challenges and Evidence based Interventions”. ​SocArXiv. Retrieved
September 17, 2020 from ​https://osf.io/preprints/socarxiv/4hxga/

Title: “​The structural vulnerability of healthcare workers during COVID-19: Observations on

the social context of risk and the equitable distribution of resources”
Author: ​Catherine Smith
Year: ​August 1, 2020
Publisher: ​National Center for Biotechnology Information
Abstract​: Healthcare workers have emerged as a vulnerable population group during
COVID-19, and securing supply chains of personal protective equipment (PPE) has been
identified as a critical issue to protect healthcare workers and to prevent health system
overwhelm. While securing PPE is a complex logistical challenge facing many countries, it is
vital to recognise the social and health systems issues that structure the differential degrees of
risk faced by various subgroups of healthcare workers. As an illustrative case study, the author
identifies two key social factors that are likely to face the degrees of risk faced by midwives in
the Special Region of Yogyakarta, Indonesia, if and when COVID-19 takes hold in Indonesia.
Healthcare workers in both high and low resource-settings globally are likely to face particular
risks and vulnerabilities that are shaped by localized social and health systems factors.
Qualitative social and health systems research can and should be utilized proactively in order to
protect healthcare workers, to inform more equitable program design, and to create a foundation
for health equity within the future of global health that emerges from the pandemic.
Link of rrl : Catherine Smith (2020)​“​The structural vulnerability of healthcare workers during
COVID-19: Observations on the social context of risk and the equitable distribution of
resources”. ​The National Center for Biotechnology Information.​ Retrieved September 17, 2020
from ​https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280115/
Title: “​Impact of COVID-19 Outbreak on Healthcare Workers in Italy: Results from a National
E-Survey “
Author:​ Carla Felice, Gian Luca Di Tanna, Giacomo Zanus & Ugo Grossi
Year: ​May 22, 2020
Publisher: ​Springer Nature

Abstract​: ​Italy has been the first-hit European country to face the outbreak of coronavirus
disease 2019 (COVID-19). Aim of this survey was to assess in depth the impact of the outbreak
on healthcare workers (HCW). A 40-item online survey was disseminated via social media
inviting Italian HCW, with questions exploring demographics, health status and work
environment of respondents. A total of 527 were invited to take part in March 2020, of whom
74% (n = 388) responded to the survey. Of these, 235 (61%) were women. HCW were mostly
physicians (74%), from high-prevalence regions (52%). 25% experienced typical symptoms
during the last 14 days prior to survey completion, with only 45% of them being tested for
COVID-19. Among the tested population, 18 (18%) resulted positive for COVID-19, with 33%
being asymptomatic. Only 22% of HCW considered personal protective equipment adequate for
quality and quantity. Females and respondents working in high-risk sectors were more likely to
rate psychological support as useful (OR, 1.78 [CI 95% 1.14–2.78] P = 0.012, and 2.02
[1.12–3.65] P = 0.020, respectively) and workload as increased (mean increase, 0.38
[0.06–0.69] P = 0.018; and 0.54 [0.16–0.92] P = 0.005, respectively). The insights from this
survey may help authorities in countries where COVID-19 epidemic has not yet broken out.
Management strategies should be promptly undertaken in order to enhance safety and optimise
resource allocation.

Link of rrl: ​Felice,C,.Tanna,G,.et al (2020) “Impact of COVID-19 Outbreak on Healthcare

Workers in Italy: Results from a National E-Survey “​. S​ pringer Nature. ​Retrieved September 17,
2020 from ​https://link.springer.com/article/10.1007/s10900-020-00845-5
JOHN DARYLL B. GALVEZ
Title: ​“Symptoms of Posttraumatic Stress, Anxiety, Depression, Levels of Resilience and
Burnout in Spanish Health Personnel during the COVID-19 Pandemic”
Author: ​Lourdes Luceño-Moreno, Beatriz Talavera-Velasco, Yolanda Garcia-Albuerne, and
Jesus Martin-Garcia
Year: ​30 July 2020
Publisher: ​MDPI
Abstract: ​The number of health workers infected with COVID-19 in Spain is one of the highest
in the world. The aim of this study is to analyse posttraumatic stress, anxiety and depression
during the COVID-19 pandemic. Association between burnout, resilience, demographic work
and COVID-19 variables are analysed. Cross-sectional data on 1422 health workers were
analysed. A total of 56.6% of health workers present symptoms of posttraumatic stress disorder,
58.6% anxiety disorder, 46% depressive disorder and 41.1% feel emotionally drained. The
profile of a health worker with greater posttraumatic stress symptoms would be a person who
works in the Autonomous Community of Madrid, in a hospital, is a woman, is concerned that a
person he/she lives may be infected, and thinks that he/she is very likely to be infected. The risk
variable for anxiety and depression would be a person that is a woman, working on 12- or 24-h
shifts, and being worried that a family member could be infected. High scores on emotional
exhaustion and depersonalization are risk factors for mental health, with resilience and personal
fulfilment being protective variables
Link of RRL: ​Luceño-Moreno, L., Talavera-Velasco, B., García-Albuerne, Y., &
Martín-García, J. (2020, July 30). Symptoms of Posttraumatic Stress, Anxiety, Depression,
Levels of Resilience and Burnout in Spanish Health Personnel during the COVID-19 Pandemic.
​ etrieved September 18,
International Journal of Environmental Research and Public Health. R
2020, from
https://www.mdpi.com/1660-4601/17/15/5514/htm?fbclid=IwAR1h-seSE6wBoDqDPvr09XFJjy
WXndpFHF9VJt8yG1CAYQVMPIGHsXExgOw
Title: ​“Burnout and Posttrraumatic Stress Disorder in the Coronavirus Disease 2019
(COVID-19) Pandemic: Intersection, Impact and Intervention”
Author: ​Nicole Restauri, MD, Alison D, Sheridan, MD
Year: ​July 2020
Publisher: ​ScienceDirect
Abstract: ​The coronavirus disease 2019 (COVID 2019) pandemic has presented myriad
challenges to an underprepared health care system. Health care providers are facing
unprecedented acute workplace stress compounded by a high baseline rate of physician burnout.
This article discusses the relationship between acute stress disorder, posttraumatic stress
disorder, and burnout through a literature review focusing on the mental health impact on health
care providers after prior epidemics and natural disasters. We offer both a framework for
understanding the mental health impact of the COVID-19 epidemic on physicians while
proposing a systems based model to respond to these challenges.
Link of RRL: ​Restauri, N., & Sheridan, A. (2020, May 27). Burnout and Posttraumatic Stress
Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and
Interventions​. Journal of American College of Radiology. Retrieved September 18, 2020, from
https://www.sciencedirect.com/science/article/pii/S1546144020305469?fbclid=IwAR3i8xkY57-
KqI6wR1qKvLYFgkT4ZFzOvmaLNSpSwlgy_teczNQGmRZA5Oo

Title: “​Burnout and somatic symptoms among frontline healthcare professionals at the peak of
the Italian COVID-19 pandemic.”
Author: ​Serena Barello, Lorenzo Palamenghi, Guendalina Graffigna
Publisher: ​ScienceDirect
Abstract: ​Italy is among the most severely hit nations in terms of hospital patients’ overload,
and its healthcare workforce is struggling to cope with challenges that could threaten their own
wellbeing. In this scenario, understanding the health-related consequences of COVID-19
outbreak on Italian frontline healthcare professionals is urgent. Our study provides a first account
of the huge psycho-physical impact of COVID-19 outbreak for healthcare workers in Italy.
Italian healthcare professionals reported relevant work-related psychological pressure, emotional
burnout and somatic symptoms. This result requires attention as previous studies showed that
emotional distress is associated with long-lasting effect on professionals’ health, including risk
of post-traumatic stress disorder.
Link of RRL: ​Barello, S., Palamenghi, L., & Graffigna, G. (2020, May 27). Burnout and
somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19
pandemic. ​Psychiatry Research​. Retrieved September 18, 2020, from
https://www.sciencedirect.com/science/article/pii/S0165178120311975?fbclid=IwAR3P0z0JkIA
y07jUCtCh1iG42-9lt1lAV8WtAf5qxIP3XgXLXlFmBrZYbm8
ANNE JELI SURETA
Title: ​COVID-19 and telemedicine: Immediate action required for maintaining healthcare
providers well-being
Author: Bobak Moazzami, Niloofar Razavi-Khorasani, Arash Dooghaie Moghadam, Ermia
Farokhi, and Nima Rezaeia
Publisher: ​The National Center for Biotechnology Information
Abstract: ​The well-being of the health care workforce is the cornerstone of every
well-functioning health system. As a result of the pandemic, medical healthcare providers are
under an enormous amount of workload pressure along with increased total health expenditures.
The overwhelming burden of COVID-19 illness could lead to caregiver burnout.
Direct-to-consumer telemedicine can enable patients to connect with their healthcare provider at
a distance. This virtual platform could be used by smartphones or webcam-enabled computers
and allows physicians to effectively screen patients with early signs of COVID-19 before they
reach to hospital.
Link of RRL: ​Moazzami, B., Razavi-Khorasani, N., Moghadam, A., Farokhi, E., & Rezaeia, N.
(2020) COVID-19 and telemedicine: Immediate action required for maintaining healthcare
providers well-being. ​The National Center for Biotechnology Information. ​Retrieved September
17, 2020 from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129277/?fbclid=IwAR0Fs6DmQbXpoNP4MH
8ttM5iuYAsTmRWiEcHA2xq_vEkasXwY3Q0vwKjOJ4
Title: ​Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential
Stress Mitigation Measures During the Acceleration Phase of the COVID-19 Pandemic
Author: ​Robert M. Rodriguez MD, Anthony J. Medak MD, Brigitte M. Baumann MD,
Stephen Lim MD, Brian Chinnock MD, Remi Frazier MD, and Richelle J. Cooper MD
Publisher: ​ Wiley Online Library
Abstract:
Objective
The objective was to assess anxiety and burnout levels, home life changes, and measures
to relieve stress of U.S. academic emergency medicine (EM) physicians during the COVID-19
pandemic acceleration phase.
Methods
We sent a cross-sectional e-mail survey to all EM physicians at seven academic
emergency departments. The survey incorporated items from validated stress scales and assessed
perceptions and key elements in the following domains: numbers of suspected COVID-19
patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of
work burnout, identification of stressors, changes in home behaviors, and measures to decrease
provider anxiety.
Results
A total of 426 (56.7%) EM physicians responded. On a scale of 1 to 7 (1 = not at all, 4 =
somewhat, and 7 = extremely), the median (interquartile range) reported effect of the pandemic
on both work and home stress levels was 5 (4–6). Reported levels of emotional
exhaustion/burnout increased from a prepandemic median (IQR) of 3 (2–4) to since the
pandemic started a median of 4 (3–6), with a difference in medians of 1.8 (95% confidence
interval = 1.7 to 1.9). Most physicians (90.8%) reported changing their behavior toward family
and friends, especially by decreasing signs of affection (76.8%). The most commonly cited
measures cited to alleviate stress/anxiety were increasing personal protective equipment (PPE)
availability, offering rapid COVID-19 testing at physician discretion, providing clearer
communication about COVID-19 protocol changes, and assuring that physicians can take leave
for care of family and self.
Conclusions
During the acceleration phase, the COVID-19 pandemic has induced substantial
workplace and home anxiety in academic EM physicians, and their exposure during work has
had a major impact on their home lives. Measures cited to decrease stress include enhanced
availability of PPE, rapid turnaround testing at provider discretion, and clear communication
about COVID-19 protocol changes.

Link of RRL: ​Rodriguez, R., Medak, A., Baumann, B., Lim, S., Chinnock, B., Frazier, R., &
Cooper, R. (2020) Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and
Potential Stress Mitigation Measures During the Acceleration Phase of the COVID-19
Pandemic. ​Wiley Online Library. ​Retrieved September 17, 2020 from
https://onlinelibrary.wiley.com/doi/full/10.1111/acem.14065?fbclid=IwAR0yaOG-jQIm42Y2pY
pov-DOwwchqn0_M-UTyDqn0ZLNLM_XQroQcPUDkVE

Title: ​High Work-related Stress and Anxiety Response to COVID-19 among Healthcare
Workers in South Korea: SAVE study
Author: Myung Hee Ahn, Yong-Wook Shin, Jeong Hye Kim, Hwa Jung Kim, Kyoung-Uk Lee,
and Seockhoon Chung
Publisher: ​PsyArXiv
Abstract:
We investigated the risk factors associated with the psychological impact of each healthcare
worker group, to help optimize psychological interventions for health care workers in countries
affected by COVID-19.
Methods:
Participants for this study comprised 1,783healthcare workers drawn from two hospitals
in Korea. We adopted a cross-sectional online survey design and used an anonymous
questionnaire from 20-30April 2020, with information on demographics, psychiatric history,
Stress and Anxiety to Viral Epidemics-9 (SAVE-9), Patient Health Questionnaire -9 (PHQ-9),
and Generalized Anxiety Disorder -7 (GAD-7) scale.
Results:
Among the 1,783 healthcare workers, compared to other healthcare workers, nursing
professionals had significantly higher levels of depression, general anxiety, and virus-related
anxiety symptoms (p < 0.01). In the nursing professionals group, single workers reported more
severe depressive symptoms (PHQ-9 ≥ 10) than married workers (20.3% vs 14.1%; p < 0.01),and
junior (< 40 years old) workers reported more anxiety about the viral epidemic (p < 0.01).
Logistic regression analysis adjusted with age, sex, and work duration identified threefactors as
significantly associated with healthcare worker's depression (PHQ-9 ≥ 10): being a nursing
professional (adjusted odds ratio [OR] 1.44, 95% confidence interval[CI] 1.05–1.98), single
(adjusted OR 1.36, 95% CI 1.01–1.83), and higher stress and anxiety to the viral infection (high
SAVE-9 score, adjusted OR 1.19, 95% CI 1.15 –1.22).
Conclusions:
Psychological support and interventions for healthcare workers,especially nursing
professionals, single,and high SAVE-9 level should be considered.
Link of RRL:
Ahn, M., Shin, Y., Kim, J., Kim, H., Lee, K., & Chung, S. (2020) High Work-related Stress and
Anxiety Response to COVID-19 among Healthcare Workers in South Korea: SAVE study.
PsyArXiv. ​ etrieved
R September 17, 2020 from
https://psyarxiv.com/9nxth/?fbclid=IwAR1uZwmP8kOuLP6zdEw3Un9Um083bJwckI4AmPKlb
nXoQY3tn4PagqezKxs
GENESIS C. DOLORICON
TITLE​: COVID-19 pandemic as a watershed moment: A call for systematic psychological
health care for frontline medical staff
AUTHOR​: Agustina Zaka, Soraya E Shamloo, Pasquale Fiorente, Alessandro Tafuri
YEAR​: May 5, 2020
PUBLISHER​: Sage Journal
ABSTRACT​: The COVID-19 pandemic is producing a huge health care burden with millions of
cases and thousands of deaths. The coronavirus’ high virulence and contagiousness and the
frequent sudden onset of illness is overwhelming critical care and frontline healthcare staff.
Frontline professionals are exposed to unprecedented levels of intensive existential threat
requiring systematic, specialized psychological intervention and support. New psychological
services need to be urgently implemented to manage the mental healthcare needs of frontline
medical staff working with patients with COVID-19. The COVID-19 pandemic is a watershed
moment: health care systems universally require a step-change to improve our preparedness for
future pandemics.
LINK IN APA FORMAT​:
Agustina Zaka. (2020). : COVID-19 pandemic as a watershed moment: A call for systematic
psychological health care for frontline medical staff - Agustina Zaka, Soraya E Shamloo,
Pasquale Fiorente, Alessandro Tafuri, 2020. Retrieved from
https://journals.sagepub.com/doi/full/10.1177/1359105320925148

TITLE​: Implementing an Emotional Support and Mental Health Response Plan for Healthcare
Workers During the COVID-19 Pandemic
AUTHOR​: Karen Miotto, Jesse Sanford, Melissa J. Brymer, Brenda Bursch, Robert S. Pynoos
YEAR​: June 11, 2020
PUBLISHER​: APA PsycNet
ABSTRACT​: Institutions across the world are working to develop initiatives aimed at
supporting the well-being of healthcare workers (HCWs) facing the psychological impacts of the
novel coronavirus (COVID-19) pandemic. This Commentary identifies risks that HCWs are
experiencing, reviews sources of fear and stress, and describes the implementation of a
three-tiered model for the provision of emotional support and mental health services for clinical
and nonclinical HCWs. The model recognizes the fluid, ever-evolving nature of the COVID-19
pandemic and includes proactive, visible, and easy-to-access supportive psychological services
that expand the safety net and help address immediate and future mental health challenges of
HCWs.
LINK IN APA FORMAT​:
Miotto, K., Sanford, J., Brymer, M. J., Bursch, B., & Pynoos, R. S. (2020). Implementing an
emotional support and mental health response plan for healthcare workers during the COVID-19
pandemic. Retrieved from ​https://psycnet.apa.org/fulltext/2020-41742-001.html

TITLE​: Managing mental health challenges faced by healthcare workers during covid-19
pandemic
AUTHOR​: Neil Greenberg
YEAR​: March, 2020
PUBLISHER​: Veterans and Families Research Hub
ABSTRACT​: The covid-19 pandemic is likely to put healthcare professionals across the world
in an unprecedented situation, having to make impossible decisions and work under extreme
pressures. These decisions may include how to allocate scant resources to equally needy patients,
how to balance their own physical and mental healthcare needs with those of patients, how to
align their desire and duty to patients with those to family and friends, and how to provide care
for all severely unwell patients with constrained or inadequate resources. This may cause some
to experience moral injury or mental health problems.
LINK IN APA FORMAT:
Greenberg, N., 2020. Managing mental health challenges faced by healthcare workers during
covid-19 pandemic. BMJ, 368. doi: https://doi.org/10.1136/bmj.m1211. Retrieved from
https://www.vfrhub.com/article/managing-mental-health-challenges-faced-by-healthcare-worker
s-during-covid-19-pandemic/#
PADERNAL, DANIEL JOHN KYLE W
Title: “Physical and mental health impacts of COVID-19 on healthcare workers: a scoping
review”
Author​: Natasha Shaukat, Daniyal Mansoor Ali & Junaid Razzak
Year:​ July 20, 2020
Publisher​: International Journal of Emergency Medicine
Abstract:
Coronavirus disease (COVID-19) pandemic has spread to 198 countries, with approximately 2.4
million confirmed cases and 150,000 deaths globally as of April 18. Frontline healthcare workers
(HCWs) face a substantially higher risk of infection and death due to excessive COVID-19
exposure. This review aimed at summarizing the evidence of the physical and mental health
impacts of COVID-19 pandemic on health-care workers (HCWs).
Methods
We used the Arksey O’Malley framework to conduct a scoping review. A systematic literature
search was conducted using two databases: PubMed and Google Scholar. We found 154 studies,
and out of which 10 met our criteria. We collected information on the date of publication, first
author’s country, the title of the article, study design, study population, intervention and
outcome, and key findings, and divided all research articles into two domains: physical and
mental health impact.
Results
We reviewed a total of 154 articles from PubMed (126) and Google Scholar (28), of which 58
were found to be duplicate articles and were excluded. Of the remaining 96 articles, 82 were
excluded after screening for eligibility, and 4 articles did not have available full texts. Ten
full-text articles were reviewed and included in this study. Our findings identified the following
risk factors for COVID-19-related health impact: working in a high-risk department, diagnosed
family member, inadequate hand hygiene, suboptimal hand hygiene before and after contact with
patients, improper PPE use, close contact with patients (≥ 12 times/day), long daily contact hours
(≥ 15 h), and unprotected exposure. The most common symptoms identified amongst HCWs
were fever (85%), cough (70%), and weakness (70%). Prolonged PPE usage led to cutaneous
manifestations and skin damage (97%), with the nasal bridge (83%) most commonly affected
site. HCWs experienced high levels of depression, anxiety, insomnia, and distress. Female
HCWs and nurses were disproportionately affected.
Conclusion
The frontline healthcare workers are at risk of physical and mental consequences directly as the
result of providing care to patients with COVID-19. Even though there are few intervention
studies, early data suggest implementation strategies to reduce the chances of infections, shorter
shift lengths, and mechanisms for mental health support could reduce the morbidity and
mortality amongst HCWs.

Link in APA Format:

Shaukat,. N. (2020). Physical and mental health impacts of COVID-19 on healthcare workers: a
scoping review - Daniyal Mansoor Ali & Junaid Razzak 2020. Retrieved July 20, 2020, from
https://intjem.biomedcentral.com/articles/10.1186/s12245-020-00299-5

TITLE​: Healthcare Workers Struggle to Balance Commitment to Work With Safety of Family
During COVID-19
AUTHOR​: Emily Pond
YEAR​: April 16 2020
PUBLISHER​: Infectious Disease Advisor
ABSTRACT​: The position of doctors during a pandemic is a challenging one. Because they
comprise the core of outbreak response programs, healthcare workers are at a substantially
elevated risk for developing COVID-19—and for spreading it. Work-related stress is believed to
weaken immune response and increase the risk of developing infection in healthcare providers,
who may then take the infection, with potentially higher viral loads, home to their close contacts.
In the time of COVID-19, as has been the case with past outbreaks, many healthcare workers
report stigma from the public and from family members.
LINK IN APA FORMAT:
Pond,. E. 2020. Healthcare Workers Struggle to Balance Commitment to Work With
Safety of Family During COVID-19 Retrieved from
https://www.infectiousdiseaseadvisor.com/home/topics/covid19/ed-doctor-writes-about-his-expe
rience-in-working-during-the-covid-19-pandemic/

TITLE​: The structural vulnerability of healthcare workers during COVID-19: Observations on

the social context of risk and the equitable distribution of resources
AUTHOR​: Catherine Smith
YEAR​:June 9, 2020
PUBLISHER​: Elsevier Public Health Emergency Collection
ABSTRACT​: Healthcare workers have emerged as a vulnerable population group during
COVID-19, and securing supply chains of personal protective equipment (PPE) has been
identified as a critical issue to protect healthcare workers and to prevent health system
overwhelm. While securing PPE is a complex logistical challenge facing many countries, it is
vital to recognise the social and health systems issues that structure the differential degrees of
risk faced by various subgroups of healthcare workers. As an illustrative case study, the author
identifies two key social factors that are likely to face the degrees of risk faced by midwives in
the Special Region of Yogyakarta, Indonesia, if and when COVID-19 takes hold in Indonesia.
Healthcare workers in both high and low resource-settings globally are likely to face particular
risks and vulnerabilities that are shaped by localized social and health systems factors.
Qualitative social and health systems research can and should be utilized proactively in order to
protect healthcare workers, to inform more equitable program design, and to create a foundation
for health equity within the future of global health that emerges from the pandemic.
LINK IN APA FORMAT:
Smith,. C 2020.The structural vulnerability of healthcare workers during COVID-19:
Observations on the social context of risk and the equitable distribution of resources Retrieved
from ​https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280115/
ALAGAR, MARIANA MIKAELA DANIELLE C.
TITLE​: Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A
review
AUTHOR​: Mamidipalli Sai Spoorthy, Sree Karthik Pratapa, and Supriya Mahantc
YEAR​: 2020 Apr 22
PUBLISHER​: NCBI
ABSTRACT​:
Introduction
The spread of novel coronavirus (COVID-19) across the globe and the associated morbidity and
mortality challenged the nations by several means. One such underrecognized and unaddressed
area is the mental health issues medical staff develop during the pandemic.

Materials and methods

This review aimed to review the literature about mental health problems faced by health care
workers (HCW) during the COVID-19 pandemic. Literature search was conducted in the
following databases: PubMed, Google Scholar, Cochrane Library, Embase. All types of articles
published in the last 4 months (January 2020-April 2020) which were relevant to the subject of
the review were searched. A total of 23 articles were selected by initial screening and 6 articles
were included in the final review.

Results
Review of all the 6 articles showed that current research focused on assessing several aspects of
mental health affected in HCW due to COVID-19. Several sociodemographic variables like
gender, profession, age, place of work, department of work and psychological variables like poor
social support, self-efficacy were associated with increased stress, anxiety, depressive symptoms,
insomnia in HCW. There is increasing evidence that suggests that COVID-19 can be an
independent risk factor for stress in HCW.
Conclusion
Regular screening of medical personnel involved in treating, diagnosing patients with COVID-19
should be done for evaluating stress, depression and anxiety by using multidisciplinary
Psychiatry teams.

LINK IN APA FORMAT:

Spoorthy, M. et al (2020, April 22) Mental health problems faced by healthcare workers due to
the COVID-19 pandemic–A review Retrieved June 2020 from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175897/

TITLE​: ​ I​ nfecting the mind: Burnout in health care workers during COVID-19

AUTHOR​: Farzan Sasangohar, Stephen L. Jones, Faisal N. Masud, Farhaan S. Vahidy, Bita A.
Kash
YEAR​: 2020 May 13
PUBLISHER​: Science Daily
ABSTRACT​:
Doctors and nurses across the country are experiencing occupational burnout and fatigue from
the increased stress caused by the COVID-19 pandemic. A team of researchers and medical
professionals at Texas A&M University and Houston Methodist Hospital are working together to
fight two afflictions: COVID-19 and the mental strain experienced by medical professionals.

In an article recently published in the journal Anesthesia & Analgesia, Dr. Farzan Sasangohar,
assistant professor in the Department of Industrial and Systems Engineering and colleagues at
Houston Methodist Hospital, outline the effects of fatigue and burnout on intensive care unit
(ICU) workers, and the steps that can be taken to mitigate these symptoms.

"The COVID-19 pandemic exacerbated an already existing problem within our health care
systems and is exposing the pernicious implications of provider burnout," Sasangohar said.
Health care workers are experiencing added stress from multiple areas. Many of them are
working longer shifts and experiencing more loss of life. The lack of personal protective
equipment (PPE) and training on how to use new equipment causes many professionals to
question if they have been exposed. This leads to fear that they could infect their family and
loved ones. In addition to those fears, there is anxiety surrounding job security. To reduce the
spread of infection, many states have stopped elective procedures and consequently, many health
care professionals have been laid off or had their hours reduced.

Sasangohar and the research team documented four major areas of stress with the goal of
identifying mitigation strategies to reduce burnout among these life-saving workers. The four
areas identified by the researchers include occupational hazards, national versus locally scaled
responses, process inefficiencies and financial instability.

LINK IN APA FORMAT:

Texas A&M University. (2020, May 13). Infecting the mind: Burnout in health care workers
during COVID-19. ScienceDaily. Retrieved September 18, 2020 from
www.sciencedaily.com/releases/2020/05/200513143749.htm

TITLE​: The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A

Cross-Sectional Study
AUTHOR​: Emanuele Maria Giusti, Elisa Pedroli, Guido E. D'Aniello, Chiara Stramba Badiale,
Giada Pietrabissa, Chiara Manna, Marco Stramba Badiale, Giuseppe Riva, Gianluca
Castelnuovo, and Enrico Molinari
YEAR​: 2020 July 10
PUBLISHER​: Frontiers in Psychology
ABSTRACT​:
Background: The COVID-19 pandemic had a massive impact on health care systems, increasing
the risks of psychological distress in health professionals. This study aims at assessing the
prevalence of burnout and psychopathological conditions in health professionals working in a
health institution in the Northern Italy, and to identify socio-demographic, work-related and
psychological predictors of burnout.

Methods: Health professionals working in the hospitals of the Istituto Auxologico Italiano were
asked to participate to an online anonymous survey investigating socio-demographic data,
COVID-19 emergency-related work and psychological factors, state anxiety, psychological
distress, post-traumatic symptoms and burnout. Predictors of the three components of burnout
were assessed using elastic net regression models.

Results: Three hundred and thirty health professionals participated to the online survey. Two
hundred and thirty-five health professionals (71.2%) had scores of state anxiety above the
clinical cutoff, 88 (26.8%) had clinical levels of depression, 103 (31.3%) of anxiety, 113 (34.3%)
of stress, 121 (36.7%) of post-traumatic stress. Regarding burnout, 107 (35.7%) had moderate
and 105 (31.9%) severe levels of emotional exhaustion; 46 (14.0%) had moderate and 40
(12.1%) severe levels of depersonalization; 132 (40.1%) had moderate and 113 (34.3%) severe
levels of reduced personal accomplishment. Predictors of all the three components of burnout
were work hours, psychological comorbidities, fear of infection and perceived support by
friends. Predictors of both emotional exhaustion and depersonalization were female gender,
being a nurse, working in the hospital, being in contact with COVID-19 patients. Reduced
personal accomplishment was also predicted by age.

Conclusions: Health professionals had high levels of burnout and psychological symptoms
during the COVID-19 emergency. Monitoring and timely treatment of these conditions is
needed.

LINK IN APA FORMAT:

Giusti EM, Pedroli E, D'Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, Stramba
Badiale M, Riva G, Castelnuovo G and Molinari E (2020, July 10) The Psychological Impact of
the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. From
https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01684/full