Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers
Abstract
Objective: To assess the immediate and sustained psychological health of health care workers who were at high risk of exposure during the severe acute respiratory syndrome (SARS) outbreak. Methods: At the peak of the 2003 SARS outbreak, we assessed health care workers in 2 acute care Hong Kong general hospitals with the Perceived Stress Scale (PSS-10). One year later, we reassessed these health care workers with the PSS-10, the 21-Item Depression and Anxiety Scale (DASS-21), and the Impact of Events Scale-Revised (IES-R). We recruited high-risk health care workers who practised respiratory medicine and compared them with nonrespiratory medicine workers, who formed the low-risk health care worker control group. Results: In 2003, high-risk health care workers had elevated stress levels (PSS-10 score = 17.0) that were not significantly different from levels in low-risk health care worker control subjects (PSS-10 score = 15.9). More high-risk health care workers reported fatigue, poor sleep, worry about health, and fear of social contact, despite their confidence in infection-control measures. By 2004, however, stress levels in the high-risk group were not only higher (PSS-10 score = 18.6) but also significantly higher than scores among low-risk health care worker control subjects (PSS-10 score = 14.8, P < 0.05). In 2004, the perceived stress levels in the high-risk group were associated with higher depression, anxiety, and posttraumatic stress scores ( P < 0.001). Posttraumatic stress scores were a partial mediator of the relation between the high risk of exposure to SARS and higher perceived stress. Conclusions: Health care workers who were at high risk of contracting SARS appear not only to have chronic stress but also higher levels of depression and anxiety. Front-line staff could benefit from stress management as part of preparation for future outbreaks.
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Previous studies found that higher stress levels, depression, and anxiety symptoms tend to persist over time in health care workers and SARS survivors.
“previous studies had found that associated higher stress levels, depression, and anxiety symptoms tend to persist over time within health care workers [37] and survivors of SARS [16].”
From Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease (2010) · cites this paper as [37]
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- Authors
- McAlonan, G. M., Lee, A. M., Cheung, V., Cheung, C., Tsang, K. W., Sham, P. C., Chua, S. E., & Wong, J. G.
- Affiliations
- Queen Mary Hospital (CN)
- Assistant Professor, Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
- Corresponding author
- Lee, Antoinette M
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2007-04
- Volume
- 52
- Issue
- 4
- Pages
- 241-247
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W1595278784
- Cited by
- 755
- References
- 19
- Citations by year
- 2026: 1 · 2025: 20 · 2024: 21 · 2023: 71 · 2022: 133 · 2021: 241 · 2020: 221 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 3
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- closed
- 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 › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- SARS, healthcare workers, occupational stress, post-traumatic stress, depression, anxiety, psychological impact, infection exposure, stress management, epidemic preparedness
- MeSH terms
- Adult, Disease Outbreaks, Fear, Female, Health Personnel, Hong Kong, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Severity of Illness Index, Stress Disorders, Post-Traumatic, Stress, Psychological, Time Factors, Sickness Impact Profile, Severe Acute Respiratory Syndrome
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