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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 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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Metadata
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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