Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak
Open accessAbstract
Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known.From 13 to 26 months after the SARS outbreak, 769 HCWs at 9 Toronto hospitals that treated SARS patients and 4 Hamilton hospitals that did not treat SARS patients completed a survey of several adverse outcomes.Toronto HCWs reported significantly higher levels of burnout (p = 0.019), psychological distress (p<0.001), and posttraumatic stress (p<0.001).Toronto workers were more likely to have reduced patient contact and work hours and to report behavioral consequences of stress.Variance in adverse outcomes was explained by a protective effect of the perceived adequacy of training and support and by a provocative effect of maladaptive coping style and other individual factors.The results reinforce the value of effective staff support and training in preparation for future outbreaks.S evere acute respiratory syndrome (SARS) emerged from Guangdong Province, People's Republic of China, in November 2002 and spread rapidly; transmission occurred primarily in hospitals, often to healthcare workers (HCWs).Although initially virtually no literature was available to guide expectations of how an emerging infection would affect the psychological well-being of hospital staff (1), by the summer of 2003 the acute psychological impact of SARS had been widely studied.Significant emotional distress was present in 18%-57% of HCWs (2-6) and was associated with quarantine (7), fear of contagion (6,8,9), concern for family (5,9,10), job stress (6,9), interpersonal isolation (6,9), perceived stigma (6,7,11), conscription of nonspecialists into infectious disease work (12), and attachment insecurity (10).Working in SARS-affected hospitals could have been traumatic for some HCWs (i.e., an event that "threatens an individual's life or physical integrity and involves a subjective response of fear, helplessness, or horror" [13]).Before the SARS coronavirus was identified (14-17), SARS was an infection of unknown cause, unknown mode of transmission, global spread, and high mortality, characteristics that generally increase perceived risk (18).However, although the SARS outbreak was acutely stressful, the longer term impact of SARS on HCWs is unknown.Understanding the enduring occupational and psychological effects of working during this SARS outbreak is important because it involves the well-being of large numbers of HCWs.Additionally, this information has wider relevance to health systems in planning for emerging infections, including pandemic influenza (http://www.who.int/csr/disease/influenza/inforesources/en) and the potential for bioterrorism (19).
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After the 2003 SARS outbreak, health-care workers reported chronic stress effects lasting months to years.
“Following the outbreak of severe acute respiratory syndrome in 2003, health-care workers reported chronic stress effects for months to years.4”
From COVID-19: a heavy toll on health-care workers (2021) · cites this paper as [4]
Previous studies of epidemics and quarantine indicate that an extraordinary event such as COVID-19 will have long-term effects on mental health.
“Such an extraordinary event will have long-term effects on mental health according to previous studies of epidemics and quarantine (Maunder et al., 2006; Brooks S. K. et al., 2020; Kisely et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Maunder et al., 2006
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- Authors
- Maunder, R., Lancee, W., Balderson, K., Bennett, J., Borgundvaag, B., Evans, S., Fernandes, C., Goldbloom, D., Gupta, M., Hunter, J., McGillis Hall, L., Nagle, L., Pain, C., Peczeniuk, S., Raymond, G., Read, N., Rourke, S., Steinberg, R., Stewart, T., VanDeVelde-Coke, S., Veldhorst, G., & Wasylenki, D.
- Affiliations
- Mount Sinai Hospital (CA)
- Scarborough Health Network (CA)
- Sunnybrook Health Science Centre (CA)
- University of Toronto (CA)
- St. Michael's Hospital (CA)
- Corresponding author
- Maunder, Robert
- Lancee, William
- Bennett, Jocelyn
- Borgundvaag, Bjug
- Goldbloom, David
- Hunter, Jonathan
- Pain, Clare
- Steinberg, Rosalie
- Stewart, Thomas
- ORCID
- Venue
- Emerging Infectious Diseases
- Published
- 2006
- Volume
- 12
- Issue
- 12
- Pages
- 1924-1932
- ISSN
- 1080-6040 (ISSN-L)
- PMC
- PMC3291360
- OpenAlex
- W1985834457
- Cited by
- 1,109
- References
- 44
- Citations by year
- 2026: 16 · 2025: 33 · 2024: 47 · 2023: 121 · 2022: 223 · 2021: 335 · 2020: 259 · 2019: 12 · 2018: 8 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 1 · 2013: 5
- FWCI
- 6.15
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Canadian Institutes of Health Research (67807)
- 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, burnout, psychological distress, post-traumatic stress, occupational stress, coping styles, staff training and support, hospital staff well-being, stigma, working time reduction, insecure attachment, risk perception, 2003 SARS outbreak
- MeSH terms
- Adult, Data Collection, Disease Outbreaks, Female, Humans, Male, Ontario, Personnel, Hospital, Regression Analysis, Severe Acute Respiratory Syndrome, Severe acute respiratory syndrome-related coronavirus
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