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.