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      Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis

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          Abstract

          Background

          The new coronavirus disease's (COVID-19) high risk of infection can increase the workload of healthcare workers, especially nurses, as they are most of the healthcare workforce. These problems can lead to psychological problems. Therefore, the aim of this systematic review and meta-analysis to ascertain the present impact of the COVID-19 outbreak on the prevalence of stress, anxiety, depression and sleep disturbance among nurses.

          Methods

          A systematic review and meta-analysis were conducted. The following databases were searched: PubMed, CHINAL, MEDLINE, EMBASE, PsycINFO, MedRxiv and Google Scholar, from January 2020 up to 26th October 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I 2) statistics.

          Results

          A total of 93 studies ( n = 93,112), published between January 2020 and September 2020, met the inclusion criteria. The overall prevalence of stress was assessed in 40 studies which accounted for 43% (95% CI 37–49). The pooled prevalence of anxiety was 37% (95% CI 32–41) in 73 studies. Depression was assessed in 62 studies, with a pooled prevalence of 35% (95% CI 31–39). Finally, 18 studies assessed sleep disturbance and the pooled prevalence was 43% (95% CI 36–50).

          Conclusion

          This meta-analysis found that approximately one third of nurses working during the COVID-19 epidemic were suffering from psychological symptoms. This highlights the importance of providing comprehensive support strategies to reduce the psychological impact of the COVID-19 outbreak among nurses under pandemic conditions. Further longitudinal study is needed to distinguish of psychological symptoms during and after the infectious disease outbreaks.

          Highlights

          • •

            Meta-Analysis was conducted included 93 studies of 93,112 nurses.

          • •

            Prevalence of depression and anxiety were 35% and 37% among nurses.

          • •

            Prevalence of stress and sleep disturbance were 43% and 43% among nurses.

          • •

            A strategy to reduce psychological impact of COVID-19 among nurses is required.

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          Most cited references115

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          Measuring inconsistency in meta-analyses.

          Julian P. T. Higgins, Simon Thompson, Jonathan Deeks … (2003)
          Article 0 comments Cited 9705 times – based on 0 reviews     Review now
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Qun Li, Xuhua Guan, Peng Wu … (2020)
            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
            Article 0 comments Cited 7060 times – based on 0 reviews     Review now
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              Bias in meta-analysis detected by a simple, graphical test

              Jos I. M. Egger, G D Smith, M. Schneider … (1997)
              Article 0 comments Cited 6554 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Psychosom Res
                Journal ID (iso-abbrev): J Psychosom Res
                Title: Journal of Psychosomatic Research
                Publisher: Elsevier Inc.
                ISSN (Print): 0022-3999
                ISSN (Electronic): 1879-1360
                Publication date PMC-release: 17 December 2020
                Publication date (Print): February 2021
                Publication date (Electronic): 17 December 2020
                Volume: 141
                Page: 110343
                Affiliations
                [a ]Ministry of Health – Oman, Oman
                [b ]Reproductive and Developmental Biology Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
                [c ]Hamad Medical Corporation, Doha, Qatar
                Author notes
                [* ]Corresponding author at: Al Buraimi Hospital, Ministry of Health Oman, Oman.
                Article
                Publisher Item ID: S0022-3999(20)30905-3 Publisher ID: 110343
                DOI: 10.1016/j.jpsychores.2020.110343
                PMC ID: 7831768
                PubMed ID: 33360329
                SO-VID: d82c1b98-e9cb-4c27-a743-cad109855e3d
                Copyright © © 2020 Elsevier Inc. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 14 September 2020
                Date revision received : 14 December 2020
                Date accepted : 14 December 2020
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: covid-19,nurses, stress,anxiety,depression, sleep disturbance,systematic review,meta-analysis
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: covid-19, nurses, stress, anxiety, depression, sleep disturbance, systematic review, meta-analysis

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