The impact of providing end-of-life care during a pandemic on the mental health and wellbeing of health and social care staff: Systematic review and meta-synthesis
Open accessAbstract
Background Disease outbreaks and disasters can result in excess deaths and severe disruption of usual end-of-life care processes. We aimed to: i) synthesise evidence describing the experiences of health and social care staff providing end-of-life care during a disease outbreak or humanitarian disaster, ii) understand the impact on their mental health and wellbeing and, iii) identify means of support.Methods A systematic review with meta-synthesis was conducted including studies of health and social care staff providing end-of-life care during disease outbreaks (Ebola, COVID-19, SARs, MERs) or humanitarian disasters (2001-2020). MEDLINE (Ovid), Embase, PsycInfo, Web of Science, and grey literature databases were searched systematically, with forward and backward citation searching of included studies. Any research study designs, in any care settings, were included. Study quality was assessed using an appraisal tool relevant to each study design. Qualitative meta-synthesis was used to analyse the findings, which were then reported narratively. PROSPERO registration: CRD42020181444.Results Nineteen studies were included, including 10 Ebola studies and two COVID-19 studies. The analysis generated two superordinate themes: individual experience and organisational responsibilities. Individual experience comprised four themes: dignity in death, positive experiences, negative experience and support for staff. Organisational responsibilities comprised four themes: preparation, adaption, resources, and Personal Protective Equipment (PPE).Discussion No studies quantitively measured the impact of providing end-of-life care on staff mental health and wellbeing, however qualitative studies described experiences in varied settings. Serious disease outbreaks and disasters can expose care staff to abnormally high levels of mortality and suffering. Health and social care systems need to proactively prepare for future events and enable peer support mechanisms that may help mitigate experiences of psychological distress in humanitarian crises.
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Proactively preparing for challenging future situations, both at an individual and organisational level, may help mitigate experiences of psychological distress when a future crisis occurs.
“Proactively preparing for challenging future situations, both at an individual and organisational level, may help mitigate experiences of psychological distress when a future crisis occurs.”
From Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing. (2023) · cites this paper as [47]
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- Authors
- Porter, B., Zile, A., Peryer, G., Farquhar, M., & Sanderson, K.
- Affiliations
- University of East Anglia (GB)
- Corresponding author
- Porter, Bryony
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 287
- Pages
- 114397
- ISSN
- 0277-9536 (ISSN-L)
- PMC
- PMC8445829
- OpenAlex
- W3200170607
- Cited by
- 22
- References
- 66
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 11 · 2022: 4
- FWCI
- 0.63
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Social Science & Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institute for Health Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Keywords
- end-of-life care, health and social care staff, mental health, well-being, outbreak, humanitarian crisis, Ebola, COVID-19 pandemic, SARS, MERS, personal protective equipment, peer support, psychological distress, organizational support
- MeSH terms
- COVID-19, SARS-CoV-2, Humans, Mental Health, Social Support, Terminal Care, Pandemics
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