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Psychological Effects of the SARS Outbreak in Hong Kong on High-Risk Health Care Workers
Open accessAbstract
Objective: To quantify stress and the psychological impact of severe acute respiratory syndrome (SARS) on high-risk health care workers (HCWs). Method: We evaluated 271 HCWs from SARS units and 342 healthy control subjects, using the Perceived Stress Scale (PSS) to assess stress levels and a structured list of putative psychological effects of SARS to assess its psychological effects. Healthy control subjects were balanced for age, sex, education, parenthood, living circumstances, and lack of health care experience. Results: Stress levels were raised in both groups (PSS = 18) but were not relatively increased in the HCWs. HCWs reported significantly more positive (94%, n = 256) and more negative psychological effects (89%, n = 241) from SARS than did control subjects. HCWs declared confidence in infection-control measures. Conclusions: In HCWs, adaptive responses to stress and the positive effects of infection control training may be protective in future outbreaks. Elevated stress in the population may be an important indicator of future psychiatric morbidity.
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“The panic and anxiety caused by the stress response, separate from the emergency, are also common among medical staff (Maunder et al., 2003, Bai et al., 2004, Chua et al., 2004).”
From Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China (2020) · cites this paper as Chua et al., 2004
In the citing paper
“One study (Chua et al., 2004) compared HCWs with healthy controls and found that HCWs were not more stressed than controls (342) but 89% (241 of 271) of HCWs experienced negative psychological symptoms.”
From The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review (2020) · cites this paper as Chua et al., 2004
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Nicolaou, C., Menikou, J., Lamnisos, D., Ļubenko, J., Presti, G., Squatrito, V., Constantinou, M., Papacostas, S., Aydın, G., Chong, Y. Y., et al. (2021) · European Journal of Psychology Open · doi:10.1024/2673-8627/a000010 · Cited by 13
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MENTAL HEALTH IN THE PANDEMIC TIMES
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BackgroundDepression and Anxiety in Health Care Workers during COVID-19
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“…diseases, such as severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and H1N1 influenza, serious psychological crises could invade medical staff and lead to psychiatric morbidities (Chong et al., 2004; Chua et al., 2004; Lee et al., 2018; Matsuishi et al., 2012).”
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Gjerstad, C. L., Bøe, H. J., Falkum, E., Nordstrand, A. E., Tønnesen, A., Reichelt, J. G., & Lystad, J. U. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.566199 · Cited by 7
“Research following previous pandemics like the 2003 severe acute respiratory syndrome (SARS) outbreak has shown that stressors experienced by HCWs may pose an imminent risk of stress reactions and development of adverse mental health consequences (Bai et al., 2004; Chua et al., 2004; Lee et al., 2007).”
BackgroundInfluentialPandemic proofing dental education
Chopra, S. S., & Sahoo, N. K. (2021) · Medical Journal Armed Forces India · doi:10.1016/j.mjafi.2020.11.025 · Cited by 7
“Dental students are likely to suffer from anxiety attributed to high viral exposure and will benefit from psychological support and mental health counselling services.(6) Patients are likely to postpone elective dental treatment due to reduced availability of funds for discretionary spending resulting from the economi…”
BackgroundVoorspoels, W., Jansen, L., Mortier, P., Vilagut, G., Vocht, J. D., Kessler, R. C., Alonso, J., & Bruffaerts, R. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.05.024 · Cited by 7
Robba, H. C. S., Costa, A. A., Kozu, K. T., Silva, C. A., Farhat, S. C. L., & Ferreira, J. C. D. O. A. (2022) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.5750.3530 · Cited by 10
“These findings were similar to other studies that evaluated health professionals during COVID-19 pandemic(9,18-20), especially female nurses(7,21).”
ResultEl-Gamal, F., Ghandoura, A. N., Alammari, A., Alghamdi, B., Babhair, L., & Alsabhani, S. (2021) · World Family Medicine Journal/Middle East Journal of Family Medicine · doi:10.5742/mewfm.2021.94120 · Cited by 7
Brucki, B. M., Bagade, T., & Majeed, T. (2023) · BMC Public Health · doi:10.1186/s12889-022-14356-6 · Cited by 9
Saruç, S. (2021) · Journal of Psychiatric Nursing · doi:10.14744/phd.2021.04378 · Cited by 7
“[12,14,16] Fiziksel bitkinlik ve uzun süreli yorgunluğun da diğer bazı etkenler gibi hemşireler üzerinde tükenmişliğe yol açabildiği üzerinde durulmaktadır.[46] Benzer bir etkinin diğer sağlık çalışanları için de geçerli olabileceği düşünülmektedir.”
Mohapatra, S., Kumar, P. A., Farooq, U., Jain, P., Khan, R., Hassan, N., Shamim, A., Ansari, M. J., Alalaiwe, A. S., Aldawsari, M. F., et al. (2022) · Saudi Pharmaceutical Journal · doi:10.1016/j.jsps.2022.05.004 · Cited by 7
Zebley, B., Wolk, D., McAllister, M. A., Lynch, C. J., Mikofsky, R. M., & Liston, C. M. (2021) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2021.08.008 · Cited by 7
Preventing Absenteeism and Promoting Resilience Among Health Care Workers In Biological Emergencies
Lesperance, A. M., & Miller, J. S. (2009) · doi:10.2172/974987 · Cited by 7
“"Psychological Effects of the SARS Outbreak in Hong Kong on High-Risk Health Care Workers."”
BackgroundThe mental burden of stay-at-home order extensions during COVID-19
Segovia, M. S., Huseynov, S., Palma, M. A., & Nayga, R. M. (2024) · Scientific Reports · doi:10.1038/s41598-024-54059-z · Cited by 6
Yao, D., Lyu, J., Ma, Z., Champ, M., Xiong, Q., Li, M., Li, W., Mu, H., Hu, Y., Gao, W., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.591026 · Cited by 7
“Positive coping strategies helped reduce anxiety and depression levels of hospital staff during the SARS outbreak (45, 46).”
BackgroundMoayed, M. S., Vahedian‐Azimi, A., Mirmomeni, G., Rahimi‐Bashar, F., Gohari-Moghadam, K., Pourhoseingholi, M. A., Abbasi-Farajzadeh, M., Babaei, M., Sathyapalan, T., Guest, P. C., et al. (2021) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-59261-5_22 · Cited by 6
Asad, M., Alenezi, A., Alsalowly, M. N., Asdaq, S. M. B., Alamri, A. S., Alsanie, W. F., Alhomrani, M., Mohzari, Y. A., Alrashed, A. A., Shammakhi, I. N., et al. (2021) · Indian Journal of Pharmaceutical Education and Research · doi:10.5530/ijper.55.3s.170 · Cited by 6
Bandyopadhyay, S. K., & Dutta, S. (2020) · Preprints.org · doi:10.20944/preprints202008.0542.v1 · Cited by 6
“Manufacturing of the products are slowed down by many countries [14-15].”
BackgroundPiccolo, L. D., Raffaelli, R., Garzon, S., Bosco, M., Casarin, J., Ciccarone, F., Dionisi, V., Ginami, M., Laganà, A. S., Mazzoni, G., et al. (2020) · Italian Journal of Gynaecology and Obstetrics · doi:10.36129/jog.32.04.07 · Cited by 5
A study on psychological implications of COVID-19 on nursing professionals
Wang, S., Xu, H., Kotian, R. P., D’Souza, B., & Rao, S. S. (2021) · International Journal of Healthcare Management · doi:10.1080/20479700.2020.1870357 · Cited by 5
“Overall mean DASS-21 scores among NPs were higher than those in the published literature from previous disease outbreaks, such as the severe acute respiratory syndrome (SARS) [14].”
BackgroundInfluentialNeuropsychological and Psychosocial Consequences of the COVID-19 Pandemic
Namdar, P., Mojabi, N. A., & Mojabi, B. (2020) · Neurophysiology · doi:10.1007/s11062-021-09903-7 · Cited by 6
Scarpis, E., Bravo, G., Cocconi, R., & Brunelli, L. (2022) · BMJ Leader · doi:10.1136/leader-2021-000534 · Cited by 5
Gad, B. K., Arafa, M. A., Attia, A. F., Farahat, A. H., & Abdou, M. S. M. (2023) · Scientific Reports · doi:10.1038/s41598-023-45775-z · Cited by 5
“Thus, viruses similar to COVID-19 can be linked to the presence of mental health symptoms among patients and their caregivers 23 .”
BackgroundBarrett, J. W., Bennett, K., Herbland, A., Owen, P., Naeem, S., Mortimer, C., KING, J. F., Foster, T., Rees, N., Rosser, A., et al. (2024) · British Paramedic Journal · doi:10.29045/14784726.2024.3.8.4.10 · Cited by 5
“…studies from previous pandemics found that psychological effects experienced by healthcare professionals did not differ from the general population, likely due to training, experience and confidence in infection and prevention control procedures (Chua et al., 2004; Lancee et al., 2008).”
Practitioner experiences in epidemics and pandemics in relation to COVID-19
Hogan, C., Williams, J., & Rees, N. (2020) · International Paramedic Practice · doi:10.12968/ippr.2020.10.4.79 · Cited by 5
Hemşirelerin Koronavirüs Korku Düzeylerini Etkileyen Faktörler
Durmuş, M., Yıldız, O. F., & KÖSE, H. (2021) · Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi · doi:10.38108/ouhcd.838675 · Cited by 5
Elmahdy, M. A., & Shebl, E. M. (2021) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2021.178615 · Cited by 4
“Total score 14 (1-28) 15 (0-27) 12 (0-21) Median (Range)”
Estresse da equipe de enfermagem em cuidados paliativos no enfrentamento da COVID-19
da Cunha, D. A. D. O., Fuly, P. D. S. C., Siqueira, A. S. D. A., Santiago, F. B., Kirby, E. E. F., Beserra, V. D. S., & Neves, L. M. L. (2021) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2021ao001915 · Cited by 6
Jin, M., Zhang, X., He, H., Zeng, L., Yuan, Z., Xie, W., Tang, P., & Wang, J. (2021) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20211118-03 · Cited by 5
Mental Health Issues of the Medical Workforce during COVID-19: A Review
Domenicano, I. (2020) · Journal of Psychological Research · doi:10.30564/jpr.v2i3.2073 · Cited by 5
“Moreover, given the data from the previous studies about SARS and MERS, it is most likely that similar reactions to those observed during the previous outbreaks will be seen in the current crisis as well.”
BackgroundResultInfluentialAssessment of Anxiety among Healthcare Professionals Working on Frontline against COVID-19
Farrukh, S., Hussain, W., & Siddiqui, Z. S. (2020) · BIOMEDICA · doi:10.51441/biomedica//biomedica/5-424 · Cited by 5
A study on mental health status among the staff in a designated hospital for COVID- 19Preprint
Wang, B., Sun, J., Gao, F., Chen, J., Shi, L., Li, L., Tang, Y., Wang, K., & Lu, H. (2020) · doi:10.21203/rs.3.rs-23224/v1 · Cited by 5
“During the period of SARS in 2003, the mental health of many medical workers who participated in the control of coronavirus infection was affected[9-11].”
BackgroundChallenges of Mental Health in Medical Staffs during COVID-19 Outbreak: A Systematic Review
Rakhshan, M., Hakimi, H., Mousazadeh, N., & Dorri, S. (2023) · Medicina Clínica Práctica · doi:10.1016/j.mcpsp.2022.100361 · Cited by 4
Bendjelloul, G., Gerard, S., Birgand, G., Lenne, F., Rioux, C., Lescure, F.-X., Yazdanpanah, Y., & Lucet, J. C. (2020) · Infectious Diseases Now · doi:10.1016/j.medmal.2020.10.020 · Cited by 4
Metadata
- Authors
- Chua, S. E., Cheung, V., Cheung, C., McAlonan, G. M., Wong, J. W., Cheung, E. P., Chan, M. T., Wong, M. M., Tang, S. W., Choy, K. M., Wong, M. K., Chu, C. M., & Tsang, K. W.
- Affiliations
- Queen Mary Hospital (CN)
- Hospital Authority (HK)
- United Christian Hospital (CN)
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2004-06
- Volume
- 49
- Issue
- 6
- Pages
- 391-393
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W2131841402
- Cited by
- 462
- References
- 10
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 13 · 2023: 36 · 2022: 74 · 2021: 164 · 2020: 132 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 1 · 2013: 1 · 2012: 1
- FWCI
- 7.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Queen Mary University of London
- 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
- SARS, healthcare workers, psychological stress, psychological impact, infection control, infection control training, psychiatric morbidity, outbreak response, Hong Kong
- MeSH terms
- Adult, Disease Outbreaks, Fatigue, Female, Health Personnel, Hong Kong, Humans, Male, Occupational Diseases, Prospective Studies, Surveys and Questionnaires, Risk Factors, Health Behavior, Occupational Exposure, Severe Acute Respiratory Syndrome
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