Lit Review regarding Burnout, Pandemic, Epidemic, and COVID-19 on healthcare practitioners
According to Zaka, Shamloo, Fiorente, et al. (2020), the epidemics and pandemics have both been associated with adverse psychosocial effects worse effects than the burden caused by the epidemic or pandemics, as a direct effect. The study further postulates that in the post epidemic period, the populations are more predisposed to anxiety with soaring depression levels. The Severe Acute Respiratory Syndrome of Coronavirus II (SARS-COV2), previously the 2019 novel coronavirus (COVID-19), since it has conferred created an international public health emergency, has, in conformity to the findings of Zaka et al. (2020), afforded stress, depression, and anxiety among the general population calling for further, swift consideration of the mental health psychological impacts COVID-19 has caused, insofar. The groups with high predisposition risks to COVID-19 such as the healthcare workers including the nurses, the medical doctors, nurses, and nurse technicians as well as the other cadres in primary healthcare who are in constant exposure and contact with the infected patients, their fluids, needs, if not therapeutic evaluation, prophylactic mental healthcare as they deliver their services to the COVID-19 patients, (Galbraith & Boyda et al., 2020). In conformity to the findings of the two studies analyzed, insofar, Ornell, Halpern, Kessler et al. (2020), asperses that the primary healthcare workers have an additional psychosocial disturbance following the thought that they are compelled to move in the opposite direction with the general public who are being told to keep social distancing and self-isolate themselves, and instead, walk in the different paths and have to deal with the patients of a virus for which inconclusive clinical studies and research exist.
In its findings, Wind, Rijkeboer, Andersson, et al. (2020), reported that healthcare workers are further subjected to high mental health torture emanating from being compelled to wear Personal Protective Equipment (PPE) including masks that hamper their breathing, having to deal with long workings shifts and the fear of the possibility of transferring the virus back to their families, to their friends or, the chance of infecting their colleagues in the healthcare system. Wind et al. (2020) further posits that COVID-19 has conferred, upon healthcare workers, mental health impacts as the feeling of weariness, mental fatigue, physical fatigue, and irritability, among other psychosocial stressors, increased chances of developing psychiatric disorders. In the analysis of the previous COVID-19-like epidemics and pandemics, Hamza Shuja, Aqeel, Jaffar et al. (2020), established that the severe acute respiratory syndrome (SARS COV1) outbreak in 2003 resulted into between 18 to 57%of healthcare workers experiencing severe symptoms of psychiatric illnesses as well as emotional problems both during and after the outbreak.
Similarly, Tsamakis, Rizos, Manolis et al. (2020) found out that even during the 2015 outbreak of the Middle East Respiratory Syndrome (MERS), the healthcare professionals experienced dysphoric symptoms marked with high-stress levels that, consequently, resulted into absenteeism of healthcare professionals, a breach in communications resulting into delays in the administration of treatment, and effects of both omission and commission errors. These findings were similar to the findings of Roy, Tripathy, Kar et al. (2020) postulating that the healthcare professionals at the frontline were at higher risk of developing post-traumatic stress disorder (PTSD) with effects lasting among healthcare workers even when they were absent from work. According to Roy et al. (2020), PTSD exists among healthcare workers, some of whom the loss of appetite, onset of fatigue, feeling of despair, irritability. Sleep attention disorders have been established, a trend that could hinder the delivery of healthcare services with the resultant collapse of the healthcare systems as it interferes with decision-making processes. This study also pointed out fear, lack of knowledge, and the fears of uncertainties regarding facing the suffering, as the key contributors to poor decision making during healthcare catastrophes. Further findings of the study also established that of the two genders, PTSD, anxiety, depression, and stress were more pronounced among the female nurses with justification pointing towards closer relationships that exist between the female nurses and their patients which, together with long working shifts, results into tension and fatigue levels.
Further studies such as the findings of Sher (2020) espousing that the levels of social support accorded to the patients by their physicians were directly related to the efficacy and the quality of sleep the physicians had, with negative correlation with stress and the state of anxiousness. Sher (2020) further established that COVID-19, just like other previous outbreaks like SARS COVI, H1N1 influenza of 2009 among other past healthcare pandemics, have resulted in a surge in the reported mental health cases. From the study, the community has suffered a considerable amount of psychological impacts. From the data, a third of the sample size has, since the outbreak of COVID-19, reported moderate-to-severe anxiety. The relatives of more than half of the participants had reported increased anxiety levels with an expression of distress and fear for COVID-19, primarily emanating from the uncertainty surrounding the virus. The burden of COVID-19, as reported by the study, has been more marked among the patients and the healthcare workers with a previous history of mental health illnesses. In these populations, relapses in mental state illnesses have been reported, with most cases being depression and anxiety. The study also established a causal association with panic attacks triggered by fear and the resurfacing of psychosomatic symptoms. Similarly, in its investigations, Sher (2020), in conjunction with the findings of Ornell et al. 2020 established that healthcare practitioners with comorbidities are even worse affected. The results pointed out that among these populations, the fear of destabilized healthcare services amidst the COVID-19 pandemic has further inferred anxiety and depression, which would, in turn, result in poor compliance with medications, thus increases the prevalence of morbidities and mortalities.
Further studies, as reported by Shalev and Shapiro (2020), state that the significance and urgency in rolling out supportive psychological strategies and psychological interventions are imperative. This is so as psychological interventions and psychological support policies would curb, at their earliest stages, intrusive thoughts and anxiety that is situational and suppressing anticipatory anxiety. Through these interventions, and according to the study, intra-team support, the sense of compassion, as well as empathy, would be nurtured through availing adequate support facilities and the necessary information, presenting informative folders that promote mental health, availing psychological psychotherapy as well as psychological counseling to the high risks personnel. These are significant as the predisposed healthcare workers will be able to disseminate the information to identify the sentinel symptoms of COVID-19. The study also, in concurrence with the findings of Seidi, Ardebil, and Jaff (2020), established that the escalating data as reported in the US, Brazil, Italy and Spain points towards the need to prioritize the healthcare workers as burnout, and emotional breakdown could, synergistically, lead to failure in healthcare services. In this regard, the study recommended creating a healthcare system that condones expression of emotional outbursts and burnout to enhance reciprocity and cooperation geared towards expression of empathy and support in such cases.
References
Galbraith, N., Boyda, D., McFeeters, D., & Hassan, T. (2020). The mental health of doctors during the Covid-19 pandemic. BJPsych Bulletin, 1-4.
Hamza Shuja, K., Aqeel, M., Jaffar, A., & Ahmed, A. (2020). COVID-19 pandemic and impending global mental health implications. Psychiatry Danubina, 32(1), 32-35.
Ornell, F., Halpern, S. C., Kessler, F. H. P., & Narvaez, J. C. D. M. (2020). The impact of COVID-19 pandemic on the mental health of healthcare professionals. Cadernos de Saude Publica, 36, e00063520.
https://www.scielosp.org/article/csp/2020.v36n4/e00063520/
Roy, D., Tripathy, S., Kar, S. K., Sharma, N., Verma, S. K., & Kaushal, V. (2020). Study of knowledge, attitude, anxiety &perceived mental healthcare need in the Indian population during COVID-19 pandemic. Asian Journal of Psychiatry, 102083.
https://www.sciencedirect.com/science/article/pii/S1876201820301945
Seidi, P. A., Ardebil, M. D., & Jaff, D. (2020). COVID-19 pandemic; New challenges to securing mental well-being in conflict settings. Asian Journal of Psychiatry, 51, 102151.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198392/
Shah, K., Kamrai, D., Mekala, H., Mann, D., Desai, K., &Patel, R. S. (2020). Focus on mental health during the coronavirus (COVID-19) pandemic, applying learnings from past outbreaks. Cereus, 12(3).
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7182052/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194518/
Sher, L. (2020). The impact of the COVID-19 pandemic on suicide rates. QJM; An International Journal of Medicine.
. https://academic.oup.com/qjmed/article abstract/doi/10.1093/qjmed/hcaa202/5857612
Tsamakis, K., Rizos, E., Manolis, A. J., Chaidou, S., Kymporopoulos, S., Spartalis, E., …& Trianafyllis, A. S. (2020). COVID-19 pandemic and its impact on mental health of healthcare professionals. Experimental and Therapeutic Medicine, 19(6), 3451-3453.
https://www.spandidos-publications.com/10.3892/etm.2020.8646
Wind, T. R., Rijkeboer, M., Andersson, G., &Riper, H. (2020). The COVID-19 pandemic; The black swan for mental healthcare and turning point for e-health. Internet interventions, 20.
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7104190/
Zaka, A., Shamloo, S. E., Fiorente, P., & Tafuri, A. (2020). COVID-19 pandemic as a watershed moment; a call for systematic psychological healthcare for frontline medical staff.
https://journals.sagepub.com/doi/abs/10.1177/1359105320925148