Mental health and work-related factors in healthcare workers in a pandemic – meta-analysis

ABSTRACT

Due to the SARS-CoV-2 pandemic, healthcare workers worldwide faced major challenges in the form of psychological stress. The aim of this systematic literature review and meta-analysis is to identify mental health consequences and associated work-related factors in healthcare workers during a pandemic and to quantify the influence of associated work-related factors on mental health consequences. A systematic literature search according to PRISMA was conducted on 5 August 2021 using the databases PubMed Central and APA PsychInfo. The included studies investigated the mental health consequences and associated work-related factors in healthcare workers in a pandemic. In addition, we performed a risk of bias analysis to assess the study quality of the included studies using the JBI checklists. Random-effect models and pooled effect estimators were used for the meta-analysis. The Chi² and I² statistics were used to identify the statistical heterogeneity. Additional sensitivity analysis was performed. From a total of 3,910 publications, 43 studies met the inclusion criteria. These studies provided 15 stress consequences and 20 stress factors. The most frequently reported stress factors were ‘contact with COVID-19 patients’, ‘no education or training in handling infectious diseases’ and ‘insufficient protective equipment’. Anxiety, stress, and depression were the most common outcomes identified. Analyses showed an increase in anxiety scores among HCWs who cared for COVID-19 patients, as well as a rise in depressive symptoms due to inadequate or no personal protective equipment. In this review, various pandemic-associated stress factors and stress consequences of healthcare workers were observed. With the results, criteria for effective measures and interventions can be developed to minimize the risk of stress consequences.

KEYWORDS:

• Mental health
• healthcare workers
• pandemic
• psychological
• stress consequences
• work-related factors
• meta-analysis

Acknowledgments

Statistisches Beratungslabor (StabLab) der Ludwig-Maximilians-Universität München Rayyan.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Contributors

I.M., V.W., S.H., C.H. and M.S. designed the study; I.M., D.M., S.B. and L.S did the literature search; I.M., D.M., S.B. and L.S. have performed the systematic review analysis; I.M. and D.M. created the first draft of the manuscript; I.M., V.W., C.Q., T.W., K.A., D.G., S.H., C.H. and M.S. suggested improvements; I.M., V.W., C.Q., T.W., K.A., D.G., S.H., C.H. and M.S. created the second draft and reviewed the manuscript; I.M. and D.M. created the tables; I.M., V.W., C.Q., T.W., K.A., D.G., S.H., C.H. and M.S. supervised the publication and reviewed the manuscript

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This systematic review and meta-analysis was supported by the Health Promotion and Disease Prevention Program Gesund Leben Bayern of the Bavarian State Ministry of Health and Care.