Background

Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problems with comprehensive analysis among hospital staff during the COVID-19 pandemic.

Objectives

To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic.

Design

A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic.

Review methods

Systematic searches were conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The random effects model was used for the meta-analysis, and the I² index was employed to assess between-study heterogeneity. Publication bias using Egger test and LFK index was examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence.

Results

Forty-four meta-analyses from 1298 individual studies were included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence: 28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff.

Conclusions

The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed.

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Tweetable abstract

The COVID-19 pandemic is having a major impact on the mental health of hospital staff. The need for support must be different for nurses and doctors @eldi12345.

中文翻译：

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COVID-19 大流行对医院工作人员心理健康的影响：对 44 项荟萃分析的综合回顾

背景

在冠状病毒 (COVID-19) 大流行期间，医院工作人员极有可能出现心理健康问题。然而，文献缺乏对 COVID-19 大流行期间医院工作人员心理健康问题的全面和包容性分析。

目标

确定在 COVID-19 大流行期间医院工作人员中原始文章中报告的焦虑、抑郁和其他心理健康结果的患病率。

设计

一项符合 PRISMA 2020 和 MOOSE 2000 标准的综合审查，对已发表的观察性研究的荟萃分析进行了评估，这些研究评估了大流行期间医院工作人员心理健康问题的普遍性。

审核方法

从2019年12月1日至2021年8月13日在PubMed/Medline、CINAHL、EMBASE和PsycINFO中进行系统检索。采用随机效应模型进行meta分析，采用I ²指数评估研究间异质性。使用 Egger 检验和 LFK 指数检查发表偏倚。使用 STATA 17.0 软件分析数据。AMSTAR-2 用于系统评价的质量评估，而我们使用 GRADE 对证据质量进行评级。

结果

来自 1298 项独立研究的 44 项荟萃分析被纳入最终分析，涵盖 16 种心理健康症状的普遍性。三分之一的医院工作人员报告了焦虑（患病率：29.9%，95% CI：27.1% 至 32.7%）和抑郁症（患病率：28.4%，95% CI：25.5% 至 31.3%）症状，而约 40%（95 % CI：36.9% 至 42.0%）患有睡眠障碍。与恐惧相关的症状、幸福感下降、生活质量差和急性应激症状在医院工作人员中的患病率最高。然而，这些领域的证据质量从低到极低不等。与医生相比，护士更容易出现睡眠问题以及焦虑和抑郁症状，而医生报告的急性压力和创伤后疾病的患病率更高。焦虑、抑郁的负担，女性员工的睡眠障碍高于男性员工。值得注意的是，急性压力和失眠影响了一半以上的一线医务人员。

结论

在 COVID-19 大流行期间，医院工作人员心理健康问题的患病率普遍很高，焦虑、抑郁和失眠症状代表了基于患病率荟萃分析的大型数据集的最有力证据。但是，对于评估的每个结果，证据主体都没有很强的信心。

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推文摘要

COVID-19 大流行对医院工作人员的心理健康产生了重大影响。护士和医生@eldi12345 对支持的需求肯定不同。