OBJECTIVE To examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress. DESIGN Rapid review and meta-analysis. DATA SOURCES Cochrane Central Register of Controlled Trials, PubMed/Medline, PsycInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to late March 2020. ELIGIBILITY CRITERIA FOR STUDY SELECTION Any study that described the psychological reactions of healthcare staff working with patients in an outbreak of any emerging virus in any clinical setting, irrespective of any comparison with other clinicians or the general population. RESULTS 59 papers met the inclusion criteria: 37 were of severe acute respiratory syndrome (SARS), eight of coronavirus disease 2019 (covid-19), seven of Middle East respiratory syndrome (MERS), three each of Ebola virus disease and influenza A virus subtype H1N1, and one of influenza A virus subtype H7N9. Of the 38 studies that compared psychological outcomes of healthcare workers in direct contact with affected patients, 25 contained data that could be combined in a pairwise meta-analysis comparing healthcare workers at high and low risk of exposure. Compared with lower risk controls, staff in contact with affected patients had greater levels of both acute or post-traumatic stress (odds ratio 1.71, 95% confidence interval 1.28 to 2.29) and psychological distress (1.74, 1.50 to 2.03), with similar results for continuous outcomes. These findings were the same as in the other studies not included in the meta-analysis. Risk factors for psychological distress included being younger, being more junior, being the parents of dependent children, or having an infected family member. Longer quarantine, lack of practical support, and stigma also contributed. Clear communication, access to adequate personal protection, adequate rest, and both practical and psychological support were associated with reduced morbidity. CONCLUSIONS Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak. These interventions were similar despite the wide range of settings and types of outbreaks covered in this review, and thus could be applicable to the current covid-19 outbreak.

中文翻译：

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新出现的病毒爆发对医护人员心理影响的发生、预防和管理：快速回顾和荟萃分析。


目的 研究应对新型病毒爆发对临床医生的心理影响，以及应对压力和心理困扰的成功措施。设计 快速审查和荟萃分析。数据来源 Cochrane 对照试验中央注册库、PubMed/Medline、PsycInfo、Scopus、Web of Science、Embase 和 Google Scholar，检索截至 2020 年 3 月下旬。 研究选择的资格标准 任何描述医护人员工作心理反应的研究与任何临床环境中任何新出现的病毒爆发的患者进行比较，无论与其他临床医生或一般人群进行比较。结果 59 篇论文符合纳入标准：严重急性呼吸综合征 (SARS) 论文 37 篇，2019 年冠状病毒病 (covid-19) 论文 8 篇，中东呼吸综合征 (MERS) 论文 7 篇，埃博拉病毒病和甲型流感病毒各 3 篇H1N1 亚型和甲型流感病毒 H7N9 亚型之一。在比较与受影响患者直接接触的医护人员的心理结果的 38 项研究中，有 25 项包含的数据可以合并到成对荟萃分析中，比较高暴露风险和低暴露风险的医护人员。与较低风险控制相比，与受影响患者接触的工作人员的急性或创伤后压力（比值比 1.71，95% 置信区间 1.28 至 2.29）和心理困扰（1.74、1.50 至 2.03）水平更高，结果相似以获得持续的结果。这些发现与未纳入荟萃分析的其他研究相同。心理困扰的危险因素包括年龄较小、资历较浅、是受抚养子女的父母或有受感染的家庭成员。 隔离时间更长、缺乏实际支持以及耻辱也是原因之一。清晰的沟通、获得充分的个人保护、充分的休息以及实际和心理支持与发病率降低有关。结论 有效的干预措施可以帮助减轻在新发疾病暴发中照顾患者的工作人员所经历的心理困扰。尽管本次审查涵盖了广泛的环境和疫情类型，但这些干预措施是相似的，因此可能适用于当前的 covid-19 疫情。