Psychological impact of COVID-19 on healthcare workers : Cross-sectional analyses from 14 countries

Journal article

Ghozy, Sherief, Cross, Wendy M., Islam, Shariful, Al-Mawali, Adhra Hilal, AlQurashi, Alaa Ashraf, Hamza, Amr, Joseph, Bindu, Banik, Biswajit, Elsori, Deena H., Sultana, Farhana, Yasmin, Farhana, Mahmud, Ilias, Lam, Louisa, Hammoud, Majeda, Salehin, Masudus, Keblawi, Mohamad Ali, Eltewacy, Nael Kamel, Al Laham, Nahed, El-Khazragy, Nashwa, ... Rahman, Muhammad Aziz. (2022). Psychological impact of COVID-19 on healthcare workers : Cross-sectional analyses from 14 countries. Cambridge Prisms: Global Mental Health. 9, pp. 328-338. https://doi.org/10.1017/gmh.2022.35
AuthorsGhozy, Sherief, Cross, Wendy M., Islam, Shariful, Al-Mawali, Adhra Hilal, AlQurashi, Alaa Ashraf, Hamza, Amr, Joseph, Bindu, Banik, Biswajit, Elsori, Deena H., Sultana, Farhana, Yasmin, Farhana, Mahmud, Ilias, Lam, Louisa, Hammoud, Majeda, Salehin, Masudus, Keblawi, Mohamad Ali, Eltewacy, Nael Kamel, Al Laham, Nahed, El-Khazragy, Nashwa, Oli, Natalia, Tungpunkom, Patraporn, Almustanyir, Sami, Sek Ying, Chair, Alif, Sheikh M., Al-Madhoun, Sondos, Chien, Wai Tong and Rahman, Muhammad Aziz
Abstract

Background
Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs.

Methods
A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively.

Results
A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%).

Conclusion
COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.

Keywordscoronavirus; COVID-19; healthcare workers; mental health; psychological distress
Year2022
JournalCambridge Prisms: Global Mental Health
Journal citation9, pp. 328-338
PublisherCambridge University Press
ISSN2054-4251
Digital Object Identifier (DOI)https://doi.org/10.1017/gmh.2022.35
PubMed ID36606237
Scopus EID2-s2.0-85150350922
PubMed Central IDPMC9300980
Open accessPublished as ‘gold’ (paid) open access
Page range328-338
Publisher's version
License
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Open
Output statusPublished
Publication dates
Online08 Jul 2022
Publication process dates
Accepted24 Jun 2022
Deposited07 May 2025
Additional information

Copyright © The Author(s), 2022. Published by Cambridge University Press.

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

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Guo, Yu-Fang, Plummer, Virginia, Cross, Wendy, Lam, Louisa and Zhang, Jing-Ping. (2020). Impact of WeChat-based 'three good things' on turnover intention and coping style in burnout nurses. Journal of Nursing Management. 28(7), pp. 1570-1577. https://doi.org/10.1111/jonm.13111
Non-pharmacological depression therapies for older Chinese adults : A systematic review & meta-analysis
Gill, Baljit Kaur, Cant, Robyn, Lam, Louisa, Cooper, Simon and Lou, Vivian Wei Qun. (2020). Non-pharmacological depression therapies for older Chinese adults : A systematic review & meta-analysis. Archives of Gerontology and Geriatrics. 88, p. Article 104037. https://doi.org/10.1016/j.archger.2020.104037
Perceptions of shared decision-making in severe mental illness : An integrative review
Huang, Chongmei, Plummer, Virginia, Lam, Louisa and Cross, Wendy. (2020). Perceptions of shared decision-making in severe mental illness : An integrative review. Journal of Psychiatric and Mental Health Nursing. 27(2), pp. 103-127. https://doi.org/10.1111/jpm.12558
Translation and psychometric testing of a decision-making scale
Huang, Chongmei, Plummer, Virginia, Lam, Louisa and Cross, Wendy. (2020). Translation and psychometric testing of a decision-making scale. Journal of Psychiatric and Mental Health Nursing. 27(5), pp. 533-542. https://doi.org/10.1111/jpm.12601
Shared decision-making in serious mental illness : A comparative study
Huang, Chongmei, Plummer, Virginia, Lam, Louisa and Cross, Wendy. (2020). Shared decision-making in serious mental illness : A comparative study. Patient Education and Counseling. 103(8), pp. 1637-1644. https://doi.org/10.1016/j.pec.2020.03.009
A WeChat-based “three good things” positive psychotherapy for the improvement of job performance and self-efficacy in nurses with burnout symptoms : A randomized controlled trial
Guo, Yu-Fang, Lam, Louisa, Plummer, Virginia, Cross, Wendy and Zhang, Jing-Ping. (2020). A WeChat-based “three good things” positive psychotherapy for the improvement of job performance and self-efficacy in nurses with burnout symptoms : A randomized controlled trial. Journal of Nursing Management. 28(3), pp. 480-487. https://doi.org/10.1111/jonm.12927
Hospital nurses' simulation-based education regarding patient safety : A scoping review
Cant, Robyn P., Cooper, Simon J. and Lam, Louisa L.. (2020). Hospital nurses' simulation-based education regarding patient safety : A scoping review. Clinical Simulation in Nursing. 44, pp. 19-34. https://doi.org/10.1016/j.ecns.2019.11.006
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019
Vos, Theo, Lim, Stephen S., Abbafati, Cristiana, Abbas, Kaja M., Abbasi, Mohammad, Abbasifard, Mitra, Abbasi-Kangevari, Mohsen, Abbastabar, Hedayat, Abd-Allah, Foad, Abdelalim, Ahmed, Abdollahi, Mohammad, Abdollahpour, Ibrahim, Abolhassani, Hassan, Aboyans, Victor, Abrams, Elissa M., Abreu, Lucas Guimarães, Abrigo, Michael R. M., Abu-Raddad, Laith Jamal, Abushouk, Abdelrahman I., ... Murray, Christopher J. L.. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 396(10258), pp. 1204-1222. https://doi.org/10.1016/S0140-6736(20)30925-9
Global burden of 87 risk factors in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019
Murray, Christopher J. L., Aravkin, Aleksandr Y., Zheng, Peng, Abbafati, Cristiana, Abbas, Kaja M., Abbasi-Kangevari, Mohsen, Abd-Allah, Foad, Abdelalim, Ahmed, Abdollahi, Mohammad, Abdollahpour, Ibrahim, Abegaz, Kedir Hussein, Abolhassani, Hassan, Aboyans, Victor, Abreu, Lucas Guimarães, Abrigo, Michael R. M., Abualhasan, Ahmed, Abu-Raddad, Laith Jamal, Abushouk, Abdelrahman I., Adabi, Maryam, ... Lim, Stephen S.. (2020). Global burden of 87 risk factors in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 396(10258), pp. 1223-1249. https://doi.org/10.1016/S0140-6736(20)30752-2
A study protocol of mobile phone app-based cognitive behaviour training for the prevention of postpartum depression among high-risk mothers
Sun, Mei, Tang, Siyuan, Chen, Jiarui, Li, Ying, Bai, Wenhui, Plummer, Virginia, Lam, Louisa, Qin, Chunxiang and Cross, Wendy M.. (2019). A study protocol of mobile phone app-based cognitive behaviour training for the prevention of postpartum depression among high-risk mothers. BMC Public Health. 19(1), p. Article 710. https://doi.org/10.1186/s12889-019-6941-8
Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the Global Burden of Disease Study
Fitzmaurice, Christina, Abate, Degu, Abbasi, Naghmeh, Abbastabar, Hedayat, Abd-Allah, Foad, Abdel-Rahman, Omar, Abdelalim, Ahmed, Abdoli, Amir, Abdollahpour, Ibrahim, Abdulle, Abdishakur S. M., Abebe, Nebiyu Dereje, Abraha, Haftom Niguse, Abu-Raddad, Laith Jamal, Abualhasan, Ahmed, Adedeji, Isaac Akinkunmi, Advani, Shailesh M., Afarideh, Mohsen, Afshari, Mahdi, Aghaali, Mohammad, ... Murray, Christopher J. L.. (2019). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the Global Burden of Disease Study. JAMA Oncology. 5(12), pp. 1749-1768. https://doi.org/10.1001/jamaoncol.2019.2996
The effects of resilience and turnover intention on nurses’ burnout : Findings from a comparative cross-sectional study
Guo, Yu-fang, Plummer, Virginia, Lam, Louisa, Wang, Yan, Cross, Wendy and Zhang, Jing-ping. (2019). The effects of resilience and turnover intention on nurses’ burnout : Findings from a comparative cross-sectional study. Journal of Clinical Nursing. 28(3-4), pp. 499-508. https://doi.org/10.1111/jocn.14637
The risk factors of antenatal depression : A cross-sectional survey
Chen, Jiarui, Cross, Wendy M., Plummer, Virginia, Lam, Louisa, Sun, Mei, Qin, Chunxiang and Tang, Siyuan. (2019). The risk factors of antenatal depression : A cross-sectional survey. Journal of Clinical Nursing. 28(19-20), pp. 3599-3609. https://doi.org/10.1111/jocn.14955
Using the theory of planned behaviour to predict nurse's intention to undertake dual practice in China : A multicentre survey
Bai, Xiaoling, Wang, Anni, Plummer, Virginia, Lam, Louisa, Cross, Wendy, Guan, Ziyao, Hu, Xin, Sun, Mei and Tang, Siyuan. (2019). Using the theory of planned behaviour to predict nurse's intention to undertake dual practice in China : A multicentre survey. Journal of Clinical Nursing. 28(11-12), pp. 2101-2110. https://doi.org/10.1111/jocn.14791
An evaluation of a positive psychological intervention to reduce burnout among nurses
Luo, Yuan-hui, Li, Hui, Plummer, Virginia, Cross, Wendy M., Lam, Louisa, Guo, Yu-fang, Yin, Yi-zhen and Zhang, Jing-ping. (2019). An evaluation of a positive psychological intervention to reduce burnout among nurses. Archives of Psychiatric Nursing. 33(6), pp. 186-191. https://doi.org/10.1016/j.apnu.2019.08.004
A systematic review of prevalence and risk factors of postpartum depression in Chinese immigrant women
Chen, Jiarui, Cross, Wendy M., Plummer, Virginia, Lam, Louisa and Tang, Siyuan. (2019). A systematic review of prevalence and risk factors of postpartum depression in Chinese immigrant women. Women and Birth. 32(6), pp. 487-492. https://doi.org/10.1016/j.wombi.2018.11.019
Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings
Mammen, Bindu, Hills, Danny J. and Lam, Louisa. (2018). Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings. Collegian. 25(6), pp. 591-599. https://doi.org/10.1016/j.colegn.2018.08.003
Burnout and its association with resilience in nurses : A cross-sectional study
Guo, Yu-fang, Luo, Yuan-hui, Lam, Louisa, Cross, Wendy, Plummer, Virginia and Zhang, Jing-ping. (2018). Burnout and its association with resilience in nurses : A cross-sectional study. Journal of Clinical Nursing. 27(1-2), pp. 441-449. https://doi.org/10.1111/jocn.13952
Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel
Hills, Danny, Lam, Louisa and Hills, Sharon. (2018). Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel. Collegian. 25(6), pp. 575-582. https://doi.org/10.1016/j.colegn.2018.09.003
The efficacy of different modes of analgesia in postoperative pain management and early mobilization in postoperative cardiac surgical patients : A systematic review
Nachiyunde, Brenda and Lam, Louisa. (2018). The efficacy of different modes of analgesia in postoperative pain management and early mobilization in postoperative cardiac surgical patients : A systematic review. Annals of Cardiac Anaesthesia. 21(4), pp. 363-370. https://doi.org/10.4103/aca.ACA_186_17
Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017 : A systematic analysis for the Global Burden of Disease Study 2017
James, Spencer L., Abate, Degu, Abate, Kalkidan Hassen, Abay, Solomon M., Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Zegeye, Abera, Semaw F., Abil, Olifan Zewdie, Abraha, Haftom Niguse, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen M. E., Accrombessi, Manfred Mario Kokou, ... Murray, Christopher J. L.. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017 : A systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392(10159), pp. 1789-1858. https://doi.org/10.1016/S0140-6736(18)32279-7
Positive psychotherapy for depression and self-efficacy in undergraduate nursing students : A randomized, controlled trial
Guo, Yu-Fang, Zhang, Xia, Plummer, Virginia, Lam, Louisa, Cross, Wendy and Zhang, Jing-Ping. (2017). Positive psychotherapy for depression and self-efficacy in undergraduate nursing students : A randomized, controlled trial. International Journal of Mental Health Nursing. 26(4), pp. 375-383. https://doi.org/10.1111/inm.12255
Female nurses’ burnout symptoms : No association with the Hypothalamic-Pituitary-Thyroid (HPT) axis
Guo, Yufang, Lam, Louisa, Luo, Yuanhui, Plummer, Virginia, Cross, Wendy, Li, Hui, Yin, Yizhen and Zhang, Jingping. (2017). Female nurses’ burnout symptoms : No association with the Hypothalamic-Pituitary-Thyroid (HPT) axis. Psychoneuroendocrinology. 77, pp. 47-50. https://doi.org/10.1016/j.psyneuen.2016.11.020
Exploring resilience in Chinese nurses : A cross-sectional study
Guo, Yu-Fang, Cross, Wendy, Plummer, Virginia, Lam, Louisa, Luo, Yuan-Hui and Zhang, Jing-Ping. (2017). Exploring resilience in Chinese nurses : A cross-sectional study. Journal of Nursing Management. 25(3), pp. 223-230. https://doi.org/10.1111/jonm.12457