The DOI matches its Crossref record; 190 of the 199 references it cites were found in a registry or an index; none of the 87 sources its claims cite is checked for support yet.
Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis
Open accessPublished version of a preprint
Abstract
Background This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers' (HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact.Method Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception to August 2020). We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems, and used GRADE to ascertain the certainty of evidence.Results We included 117 studies. The pooled prevalence was higher for acute stress disorder (40% (95%CI 39 to 41%)), followed by anxiety (30%, (30 to 31%)), burnout (28% (26 to 31%)), depression (24% (24 to 25%)), and post-traumatic stress disorder (13% (13 to 14%)). We identified factors associated with the likelihood of developing those problems, including sociodemographic (younger age and female gender), social (lack of social support, stigmatization), and occupational (working in a high-risk environment, specific occupational roles, and lower levels of specialised training and job experience) factors. Four studies reported interventions for frontline HCW: two educational interventions increased confidence in pandemic self-efficacy and in interpersonal problems solving (very low certainty), whereas one multifaceted intervention improved anxiety, depression, and sleep quality (very low certainty).Limitations We only searched three databases, and the initial screening was undertaken by a single reviewer.Conclusion Given the very limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified represent important targets for future interventions.
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53 Not checked yet · 21 Own result · 9 Own method · 5 Own interpretation · 3 No basis given
In the paper
“whereas one study (Austria-Corrales et al., 2011) reported that resident pulmonologists were at higher risk of burnout.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Austria-Corrales et al., 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“higher perception of threat and risk was also associated with a higher prevalence of a number of different mental health problems, including depression (Liu et al., 2012)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Liu et al., 2012 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses showed higher prevalence of depression (46%, 95%CI 43 to 48%) and of anxiety (30%, 95% 29 to 30%) after the outbreaks than during the outbreaks (24%, 95%CI 24 to 24%, and 30%, 95%CI 29 to 30%, respectively).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Prevalence of mental health problems in HCWs during and after viral epidemic outbreaks
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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- Rests on an assumption: The classification of studies as during versus after the outbreak, based on each study's own definition, is valid for subgroup comparisons.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“burnout (28%, 95%CI 26 to 31%, 3 studies, 1,168 participants))”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Prevalence of mental health problems in HCWs during and after viral epidemic outbreaks
plainn = 1,168- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Rests on an assumption: The mental health conditions measured by different instruments across the included studies are sufficiently comparable to be combined in meta-analyses.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“post-traumatic stress disorder (13%, 95%CI 13 to 14%, I2 0%; 16 studies, 24,540 participants))”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Prevalence of mental health problems in HCWs during and after viral epidemic outbreaks
plainn = 24,540- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The mental health conditions measured by different instruments across the included studies are sufficiently comparable to be combined in meta-analyses.
None of the sources cited for this claim have been checked yet.
In the paper
“PTSD (Bukhari et al., 2016; Styra et al., 2008; Tang et al., 2017; Wu et al., 2009; Wu et al., 2008; Arpacioglu et al., 2020)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“PTSD (Tang et al., 2017)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Tang et al., 2017
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For clinically significant symptoms of mental health disorders, the pooled prevalence was higher for acute stress (40%, 95%CI 39 to 41%, I2 0%; 9 studies, 6,949 participants)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Prevalence of mental health problems in HCWs during and after viral epidemic outbreaks
plainn = 6,949- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The mental health conditions measured by different instruments across the included studies are sufficiently comparable to be combined in meta-analyses.
None of the sources cited for this claim have been checked yet.
In the paper
“anxiety (Lai et al., 2020; Li et al., 2015; Matsuishi et al., 2012; Verma et al., 2004; Dosil Santamaria et al., 2020; Elbay et al., 2020; Liu et al., 2020; Lu et al., 2020; Ni et al., 2020; Que et al., 2020, Wang et al., 2020b, Zhang et al., 2020)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“and burnout (Tolomiczenko et al., 2005).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Tolomiczenko et al., 2005 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 23
- It may state two separate claims as one. 22
- The quote only partly states this claim. 2
In the paper
“and burnout (Tolomiczenko et al., 2005)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Tolomiczenko et al., 2005 source
plaincorrelational- Asserted: fails — The authors may not put it forward as true.
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Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“While most participants did not feel prepared to deal confidently with the pandemic before the session (35%), there was a higher proportion of participants who felt better able to cope after the session (76%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Interventions to reduce the mental health impact of viral epidemic outbreaks in HCWs
What the sources say
- Not checked yetcites Aiello et al., 2011 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“and anxiety (Que et al., 2020).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Que et al., 2020
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“stress (Zhu et al., 2020)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Zhu et al., 2020
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Feelings of social rejection or isolation and higher impact of the outbreak on daily life (Styra et al., 2008) increased the likelihood of developing PTSD”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Styra et al., 2008 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“depression (Chatterjee et al., 2020)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Chatterjee et al., 2020 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The intervention improved confidence in support and training, pandemic self-efficacy and interpersonal problems (p<0.05).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Interventions to reduce the mental health impact of viral epidemic outbreaks in HCWs
What the sources say
- Not checked yetcites Maunder et al., 2010 source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one. The quote only partly states this claim.
In the paper
“and burnout (Tolomiczenko et al., 2005)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
- Not checked yetcites Tolomiczenko et al., 2005 source
plaincorrelational- Asserted: fails — The authors may not put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, stigmatisation (Koh et al., 2005), social rejection (Park et al., 2018), and lower levels of social support were identified as risk factors for stress (Xiao et al., 2020).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk factors for mental health problems in HCWs during and after viral epidemic outbreaks
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Four studies (Aiello et al., 2011; Maunder et al., 2010; Chen et al., 2006; Wu and Wei, 2020) described four different interventions to reduce the mental health impact of viral epidemic outbreaks in HCWs (Online Appendix 6). None of them used an experimental design.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Interventions to reduce the mental health impact of viral epidemic outbreaks in HCWs
What the sources say
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In comparison with the control group, participants in the intervention group experienced higher levels of anxiety (45.89±1.12 vs 41.02±1.15; p=0.056), depression (50.13±1.81 vs 36.11±2.06; p=0.04), and PTSD (50.13±1.813 vs 29.89 ±1.97; p=0.03).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Interventions to reduce the mental health impact of viral epidemic outbreaks in HCWs
What the sources say
- Not checked yetcites Wu and Wei, 2020
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In general, main risks of bias in the 106 cross-sectional studies were low response rate (high risk of bias in 10% of the studies) and selection bias (10%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Risk of bias assessment
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The majority followed a cross-sectional design (91%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Around half of the studies (52%) examined the impact of COVID-19, followed by Severe Acute Respiratory Syndrome (SARS epidemic) (35%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“84% did use validated instruments to evaluate mental health.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most of the studies (65%) were conducted in Asian countries (excluding Middle East countries), including China (43%), Taiwan (8%), and Singapore (7%), among others.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most studies were conducted during the viral epidemic outbreaks (74%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Anxiety (62%) and depression (54%) were the mental health conditions most frequently examined, followed by acute stress disorder (33%) and PTSD (31%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, we could not conduct subgroups analyses to explore differences according to HCWs' age due to the lack of available data reported in a homogeneous format (e.g. age quartiles).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Prevalence of mental health problems in HCWs during and after viral epidemic outbreaks
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results showed that HCWs commonly present high levels of anxiety, depression, and PTSD, both during and after the outbreaks.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Summary of findings
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“We assessed the risk of bias of observational studies (i.e., cross-sectional, case-control, and cohort studies) by using the set of tools developed by Evidence Partners (McMaster University) (Partners, 2020); whereas ROBINS I (Sterne et al., 2016) was applied to uncontrolled trials.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > Data extraction and quality assessment
What the sources say
- Not checked yetcites Partners, 2020
- Not checked yetcites Sterne et al., 2016 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two reviewers (of those aforementioned) independently and blinded against the others’ judgements assessed full-text eligibility.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > Study selection
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some of the risk factors associated with mental health problems while providing frontline care during viral epidemic outbreaks cannot be modified. In this way, working in a high risk environment increases the risk of developing clinically significant symptoms, namely depression”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Discussion of the main findings
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“We conducted a rapid systematic review following WHO guidelines (Tricco et al., 2017) and Cochrane's recommendations for Rapid Reviews in response to COVID-19 (Cochrane, 2020).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods
What the sources say
- Not checked yetcites Cochrane, 2020
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“We conducted a rapid systematic review following WHO guidelines (Tricco et al., 2017) and Cochrane's recommendations for Rapid Reviews in response to COVID-19 (Cochrane, 2020).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods
What the sources say
- Not checked yetcites Tricco et al., 2017
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Likewise, it seems like specific cadres are more likely to report mental health problems, namely PTSD (Tang et al., 2017), and burnout (Austria-Corrales et al., 2011; Tolomiczenko et al., 2005).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Discussion of the main findings
What the sources say
- Not checked yetcites Tang et al., 2017
- Not checked yetcites Austria-Corrales et al., 2011
- Not checked yetcites Tolomiczenko et al., 2005 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For all studies one reviewer (of MJSR, MAFR, AC, DF, JM, GP, RZC) extracted all the data and assessed the risk of bias, while a second reviewer cross-checked the information for accuracy and completeness.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > Data extraction and quality assessment
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In contrast with the high number of studies examining impact on mental health, there is limited evidence regarding the impact of interventions to reduce mental health problems in this particularly vulnerable population, and overall its certainty is very low, mainly due to study design and serious risk of bias.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Summary of findings
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for planning, conducting and reporting this study (Moher et al., 2009).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods
What the sources say
- Not checked yetcites Moher et al., 2009 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“However, this review also identified specific modifiable factors that can be addressed in advance and mitigate the risk brought by the aforementioned factors. Lack of specialized training was associated with anxiety, PTSD (Tang et al., 2017), and burnout (Maunder et al., 2004), and higher perception of threat and risk was associated with depression (Liu et al., 2012), anxiety (Alsubaie et al., 201”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Discussion of the main findings
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Publication bias was examined with funnel plots and presence of asymmetry tested with Begg (Begg and Mazumdar, 1994) and Egger tests (Egger et al., 1997).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > Data synthesis and analysis
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“we used the GRADE approach to evaluate the certainty of the evidence, in order to facilitate evidence-informed decision making processes.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Strengths and limitations of the review
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite searching three major databases and manually searching references of previously published systematic reviews, we did not examine grey literature.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Strengths and limitations of the review
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“and stigmatization (Koh et al., 2005), especially among those HCWs who have to be quarantined.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Discussion of the main findings
What the sources say
- Not checked yetcites Koh et al., 2005 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As observed in our review, the mental health burden for HCWs during pandemics is especially high both during and after the outbreak.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, the initial screening was undertaken by a single reviewer.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Strengths and limitations of the review
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and can also be used for informal contacts between HCWs who are quarantined.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Discussion of the main findings
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Heterogeneity was quantified by the I 2 statistic, where I 2>50% was deemed as substantial heterogeneity (Deeks et al., 2019).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > Data synthesis and analysis
What the sources say
- Not checked yetcites Deeks et al., 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The proliferation of online mobile-based technologies could play an essential role in promoting connectedness and decrease the feelings of isolation and stigmatization (Gonçalves‐Bradley et al., 2018)”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Discussion > Discussion of the main findings
What the sources say
- Not checked yetcites Gonçalves‐Bradley et al., 2018
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“We used the GRADE approach (Schünemann et al., 2019) to assess the quality of evidence related to the outcomes included in this rapid review.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > GRADE and 'summary of findings' tables
What the sources say
- Not checked yetcites Schünemann et al., 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The mental health conditions measured by different instruments across the included studies are sufficiently comparable to be combined in meta-analyses.
“We used the STATA command “metaprop” (Nyaga et al., 2014) to pool estimates of proportions with corresponding 95% confidence intervals.”
“84% did use validated instruments to evaluate mental health.”
The paper relies on this without support.
The classification of studies as during versus after the outbreak, based on each study's own definition, is valid for subgroup comparisons.
“timing of data collection (i.e., before, during, or after the outbreak – based on the studies´ own definition)”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In Spain, data revealed a high percentage of healthcare professionals experiencing symptoms of anxiety, stress, depression, and sleep disorders. The prevalence of anxiety, depression, and stress was higher than that reported in previous studies on COVID-19 [19,22].”
From Mental Health in Healthcare Workers Post-COVID-19: A Latin American Review and Insights into Personalized Management Strategies (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“At the primary care level, morbidity and mortality have a significant impact. Illnesses, absenteeism, shift changes, and excessive workloads directly affect the emotional state and mental health of professionals, with healthcare workers being the most affected [22].”
From Mental Health in Healthcare Workers Post-COVID-19: A Latin American Review and Insights into Personalized Management Strategies (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“From the perspective of grief and trauma theory, it is crucial to recognize that the effects of a stressor or trauma vary not only according to its intensity, duration, and characteristics but also according to the psychosocial context in which it occurs. Moreover, these effects are influenced by gender and psychological characteristics of the individual or group affected by trauma or stress.”
From Mental Health in Healthcare Workers Post-COVID-19: A Latin American Review and Insights into Personalized Management Strategies (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredIn the citing paper
“Consistently with the results of many studies on the psychological impact of past pandemics on health professionals [14,15,16], the literature published until now about COVID-19 revealed that HCWs are at particular risk of adverse psychological outcomes, i.e., of developing more severe mental symptoms, including stress, anxiety, depression, distress, insomnia, emotional exhaustion, burnout, as wel”
In the citing paper
“Very few studies have highlighted effective interventions that can improve the mental health of health care workers during infectious disease epidemics such as SARS, Ebola, and Middle East respiratory syndrome [3].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
“Anxiety (62%) and depression (54%) were the mental health conditions most frequently examined, followed by acute stress disorder (33%) and PTSD (31%).”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
“| Anxiety | 62 | 53 | | Depression | 54 | 46 | | Acute stress disorder | 33 | 28 | | Post-traumatic stress disorder | 31 | 26 |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Primary Care centre | 3 | 5 |”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Characteristics of the studies
Reported 5 · recomputed 2.564103
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Results > Interventions to reduce the mental health impact of viral epidemic outbreaks in HCWs
“None of them used an experimental design.”
§ Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis > Methods > Selection criteria
“experimental studies (non-controlled before-after studies, controlled before-after studies, non-randomised controlled trials, and randomised controlled trials).”
Citations
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Metadata
- Authors
- Serrano-Ripoll, M. J., Meneses-Echavez, J. F., Ricci-Cabello, I., Fraile-Navarro, D., Fiol-deRoque, M. A., Pastor-Moreno, G., Castro, A., Ruiz-Pérez, I., Zamanillo Campos, R., & Gonçalves-Bradley, D. C.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Health Research Institute of the Balearic Islands (ES)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 277
- Pages
- 347-357
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7443314
- OpenAlex
- W3081088380
- Semantic Scholar
- 45e353eacba1f376e269df9998854b053e8fe1c1
- Cited by
- 592
- References
- 199
- Citations by year
- 2026: 26 · 2025: 28 · 2024: 83 · 2023: 113 · 2022: 153 · 2021: 150 · 2020: 39
- FWCI
- 9.01
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Keywords
- healthcare workers, mental health, acute stress disorder, anxiety, burnout, depression, post-traumatic stress disorder, risk factors, social support, stigma, occupational stress, self-efficacy, sleep quality, mental health interventions
- MeSH terms
- COVID-19, Health Personnel, Humans, Mental Health, Pneumonia, Viral, Stress Disorders, Post-Traumatic, Prevalence, Coronavirus Infections, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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