The DOI matches its Crossref record; 41 of the 44 references it cites were found in a registry or an index.
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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“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]
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“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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BackgroundCharacterization of a Novel Coronavirus Associated with Severe Acute Respiratory Syndrome
Rota, P. A., Oberste, M. S., Monroe, S. S., Nix, W. A., Campagnoli, R. P., Icenogle, J. P., Peñaranda, S., Bankamp, B., Maher, K., Chen, M., et al. (2003) · Science · doi:10.1126/science.1085952 · Cited by 2,477 · cited 1×
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“Significant emotional distress was present in 18%-57% of HCWs (2) (3) (4) (5) (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 disea…”
BackgroundHospital staffing, organization, and quality of care: cross-national findings
Aiken, L. H. (2002) · International Journal for Quality in Health Care · doi:10.1093/intqhc/14.1.5 · Cited by 728
Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution
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“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 attachmen…”
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“Attachment anxiety is a common, relatively enduring, and stable interpersonal style within close relationships (37), which is known to be associated with sensitivity to stress under many conditions (38,39).”
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“Significant emotional distress was present in 18%-57% of HCWs (2) (3) (4) (5) (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 disea…”
BackgroundStress-Response Syndromes: A Review of Posttraumatic and Adjustment Disorders
Horowitz, M. J. (1986) · Psychiatric Services · doi:10.1176/ps.37.3.241 · Cited by 489 · cited 1×
“This survey measured demographic and job data as well as traumatic stress response (15-item Impact of Events Scale [IES] [20,21]), nonspecific psychological distress (Kessler Psychological Distress Scale [K10] [22]), and professional burnout (emotional exhaustion scale of the Maslach Burnout Inventory [MBI-EE] [23–25]…”
MethodWong, T. W., Yau, J. K. Y., Chan, C. L. W., Kwong, R. S. Y., Ho, S. M. Y., Lau, C. C., Lau, F. L., & Lit, C. H. (2005) · European Journal of Emergency Medicine · doi:10.1097/00063110-200502000-00005 · Cited by 486 · cited 2×
“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 attachmen…”
BackgroundResultHospital staffing, organization, and quality of care: Cross-national findings
Aiken, L. H., Clarke, S. P., & Sloane, D. M. (2002) · Nursing Outlook · doi:10.1067/mno.2002.126696 · Cited by 464 · cited 1×
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BackgroundKoh, D., Lim, M. K., Chia, S. E., Ko, S. M., Qian, F., Ng, V., Tan, B. H., Wong, K. S., Chew, W. M., Tang, H. K., et al. (2005) · Medical Care · doi:10.1097/01.mlr.0000167181.36730.cc · Cited by 454 · cited 1×
“Survey B, by using a previously described instrument, measured SARS-related perception of stigma and interpersonal avoidance; adequacy of training, protection, and support; and job stress (6,10,26).”
MethodMaunder, R. (2004) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2004.1483 · Cited by 405
Self-citationMaunder, R. G., Lancee, W. J., Rourke, S., Hunter, J. J., Goldbloom, D., Balderson, K., Petryshen, P., Steinberg, R., Wasylenki, D., Koh, D., et al. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000145673.84698.18 · Cited by 368 · cited 3×
“Survey B, by using a previously described instrument, measured SARS-related perception of stigma and interpersonal avoidance; adequacy of training, protection, and support; and job stress (6,10,26).”
BackgroundMethodResultSelf-citationCoronavirus as a Possible Cause of Severe Acute Respiratory Syndrome
Peiris, J., Lai, S. T., Poon, L. L. M., Yakan, G., Yam, L., & Lim, W. (2003) · The Anatolian Journal of General Medical Research · doi:10.5222/terh.2003.26734 · Cited by 308
Risk and resilience in posttraumatic stress disorder.
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Fear of Severe Acute Respiratory Syndrome (SARS) Among Health Care Workers.
Ho, S. M. Y., Kwong, R. S. Y., Mak, C. W. Y., & Wong, J. S. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.2.344 · Cited by 214 · cited 1×
“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 attachmen…”
BackgroundPsychological Distress of Nurses in Taiwan Who Worked During the Outbreak of SARS
Chen, C., Wu, H.-Y., Yang, P., & Yen, C. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.1.76 · Cited by 205 · cited 2×
“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 attachmen…”
BackgroundResultVerma, S. K., Mythily, S., Chan, Y., Deslypere, J., Teo, E., & Chong, S. A. (2004) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.verma · Cited by 182 · cited 1×
“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 attachmen…”
BackgroundPhua, D. H., Tang, H. K., & Tham, K. Y. (2005) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2005.tb01951.x · Cited by 176 · cited 1×
“Significant emotional distress was present in 18%-57% of HCWs (2) (3) (4) (5) (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 disea…”
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“Attachment anxiety is a common, relatively enduring, and stable interpersonal style within close relationships (37) , which is known to be associated with sensitivity to stress under many conditions (38, 39) .”
Self-citationSARS: Key Factors in Crisis Management
Tseng, H.-C., Chen, T.-F., & Chou, S.-M. (2005) · Journal of Nursing Research · doi:10.1097/01.jnr.0000387526.99770.1e · Cited by 36 · cited 1×
“This observation is consistent with ones made during the SARS outbreak regarding the benefits of responsive communication (29), opportunities for facilitated reflection on normal emotional responses to extraordinary stress, and opportunities for HCWs to contribute to decision-making in the workplace (10,30).”
ResultThe Mental Health Treatment Team as a Work Group: Team Dynamics and the Role of the Leader
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When Orientation Ends ??? Supporting the New Nurse Who is Struggling to Succeed
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“Opportunities for mentorship or “buddying” with more experienced colleagues may be useful (35).”
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Self-citationSARS: Key Factors in Crisis Management
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“int/csr/disease/influenza/inforesources/en) and the potential for bioterrorism (19).”
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Ho, C. S., Chee, C. Y., & Ho, R. C. (2020) · Annals of the Academy of Medicine, Singapore · doi:10.47102/annals-acadmedsg.202043 · Cited by 1,699
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Long-term psychiatric morbidities among SARS survivors
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“[55], long-term occupational effects, including high rate of sick leave and early retirement, were noted among HCWs.”
Background
Metadata
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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