COVID-19 Y LAS ESTRATEGIAS PARA REDUCIR EL NIVEL DE ANSIEDAD EN PROFESIONALES DE ENFERMERÍA: REVISIÓN DE ALCANCE Y META-ANÁLISIS

Pereira, Caroline Figueira; Vargas, Divane de; Evangelista, Priscila Araujo; Ito, Victor Daichi; Aguilar, Thiago Faustino

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Brasil

Texto & Contexto - Enfermagem

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Brasil

Español English

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Sumário

Special Section COVID-19 • Texto contexto - enferm. 30 • 2021 • https://doi.org/10.1590/1980-265X-TCE-2021-0015 copiar

COVID-19 Y LAS ESTRATEGIAS PARA REDUCIR EL NIVEL DE ANSIEDAD EN PROFESIONALES DE ENFERMERÍA: REVISIÓN DE ALCANCE Y META-ANÁLISIS

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

mapear la producción de conocimiento sobre las estrategias utilizadas para el manejo de la ansiedad en profesionales de Enfermería durante la lucha contra COVID-19, Sindrome Respiratorio Agudo Grave (SARS) y Sindrome Respiratorio de Oriente Medio (MERS).

Método:

revisión de alcance seguida de meta-análisis, realizada en las siguientes fuentes de información: BVS, EMBASE, PUBMED, CINAHL, PsycINFo, SCOPUS y Web of Science. El protocolo de revisión está registrado en International Prospective Register of Systematic Reviews con número CRD42020192918. Los datos se analizaron y sintetizaron en forma narrativa.

Resultados:

se incluyó un total de 31 estudios en esta revisión; de ellos, 12 fueron incluidos en el meta-análisis. Los profesionales de Enfermería presentaron índices de ansiedad más elevados que los demás profesionales de salud. En las intervenciones para el manejo de la ansiedad, se destacan las siguientes: soporte emocional, apoyo social, campaña educativa, implementación de políticas de seguridad y adopción de un estilo de enfrentamiento positivo.

Conclusión:

las evidencias sugieren que una considerable proporción de profesionales de Enfermería experimentó un nivel de ansiedad elevado, lo que interfirió en la prevención y el control de la epidemia de COVID-19. Por lo tanto, resulta necesario establecer protocolos de intervenciones para reducir la ansiedad, con un lenguaje claro y objetivo, propiciando soporte emocional, técnicas de enfrentamiento positivo y un ambiente de trabajo cálido, además de la implementación de políticas que garanticen medidas de protección contra el COVID-19.

DESCRIPTORES:
Ansiedad; Infecciones por coronavirus; Enfermería; Salud mental; Síndrome respiratorio agudo grave; Personal de salud

Author/ Year/Locus	Methodology	Results
Shingler-Nace A, 202021. Shingler-Nace A. COVID-19: When leaderships Calls. Nurse Lead [Internet]. 2020 [cited 2020 Aug 15];18(3):202-3. Available from: https://doi.org/10.1016/j.mnl.2020.03.017 https://doi.org/10.1016/j.mnl.2020.03.01... United States2121. Shingler-Nace A. COVID-19: When leaderships Calls. Nurse Lead [Internet]. 2020 [cited 2020 Aug 15];18(3):202-3. Available from: https://doi.org/10.1016/j.mnl.2020.03.017 https://doi.org/10.1016/j.mnl.2020.03.01...	Opinion article. It described some strategies for Nursing team leaders to reduce anxiety in their teams.	The leader (nurse) needs to: remain calm; establish continuous communication, based on current protocols and information; be collaborative by sending messages regarding the importance of teamwork; coordinate and give support to the team, so as to provide alignment and trust among the team members.
Almutairi AF et al., 201820. Almutairi AF, Adlan AA, Balkhy HH, Abbas OA, Clark AM. “It feels like I'm the dirtiest person in the world”: exploring the experiences of healthcare providers who survived MERS-CoV in Saudi Arabia. J Infect Public Health [Internet]. 2018 [cited 2020 Aug 15];11(2):187-91. Available from: https://doi.org/10.1016/j.jiph.2017.06.011 https://doi.org/10.1016/j.jiph.2017.06.0... . Saudi Arabia2020. Almutairi AF, Adlan AA, Balkhy HH, Abbas OA, Clark AM. “It feels like I'm the dirtiest person in the world”: exploring the experiences of healthcare providers who survived MERS-CoV in Saudi Arabia. J Infect Public Health [Internet]. 2018 [cited 2020 Aug 15];11(2):187-91. Available from: https://doi.org/10.1016/j.jiph.2017.06.011 https://doi.org/10.1016/j.jiph.2017.06.0...	Qualitative study. It explored and described the phenomenon of SARS and MERS by nurses and physicians.	The educational campaign must focus on signs and symptoms, transmissibility, personal hygiene and precaution practices; The hospital must provide emotional support in the form of psychotherapy for infected patients and family members.
Fessell D, Cherniss C, 202022. Fessell D, Cherniss C. Coronavirus disease 2019 (COVID-19) and beyond: micropractices for burnout prevention and emotional wellness. J Am Coll Radiol [Internet]. 2020 [cited 2020 Aug 15];17(6):746-8. Available from: https://doi.org/10.1016/j.jacr.2020.03.013 https://doi.org/10.1016/j.jacr.2020.03.0... United States2222. Fessell D, Cherniss C. Coronavirus disease 2019 (COVID-19) and beyond: micropractices for burnout prevention and emotional wellness. J Am Coll Radiol [Internet]. 2020 [cited 2020 Aug 15];17(6):746-8. Available from: https://doi.org/10.1016/j.jacr.2020.03.013 https://doi.org/10.1016/j.jacr.2020.03.0...	Opinion article. It described the use of micro-practices to reduce anxiety, and to mitigate emotional wear out in the work environment.	Mindfulness; self-management through breathing, focusing on the mind and body; and proper connection to perceive their own physical and psychological needs; Naming emotions; writing three good things for which one is grateful; Gratitude in the team and Diaphragmatic breathing.
Xiang YT et al., 202023. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry [Internet]. 2020 [cited 2020 Aug 15];7(3):228-9. Available from: https://doi.org/10.1016/S2215-0366(20)30046-8 https://doi.org/10.1016/S2215-0366(20)30... . China2323. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry [Internet]. 2020 [cited 2020 Aug 15];7(3):228-9. Available from: https://doi.org/10.1016/S2215-0366(20)30046-8 https://doi.org/10.1016/S2215-0366(20)30...	Opinion article. It described some methods to take care of the professionals' mental health during SARS in 2003.	Creation of multidisciplinary mental health teams to support health professionals; Clear communication and updates to improve the sensation of uncertainty and fear; Regular clinical screenings for depression, anxiety and suicide by mental health professionals.
Cai W et al., 202034. Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, et al. Psychological impact and coping strategies of frontline medical staff in hunan between January and March 2020 during the outbreak of Coronavirus disease 2019 (COVID19) in Hubei, China. Med Sci Monit [Internet]. 2020 [cited 2020 Aug 16];26:e924171. Available from: https://doi.org/10.12659/msm.924171 https://doi.org/10.12659/msm.924171... . China2424. Cai W, Lian B, Song X, Hou T, Deng G, Li H. A cross-sectional study on mental health among health care workers during the outbreak of Coronavirus disease 2019. Asian J Psychiatr [Internet]. 2020 Apr 24 [cited 2020 Aug 15];51:102-11. Available from: https://doi.org/10.1016/j.ajp.2020.102111 https://doi.org/10.1016/j.ajp.2020.10211...	Cross-sectional study. It investigated psychological changes in the professionals: social support, resilience and mental health.	Peer support: exchange between the experienced professionals (who acted against SARS and H1N1) and their inexperienced peers; Online mental health service; Early screening and interventions.
Bohlken J et al., 202042. Bohlken J, Schömig F, Lemke MR, Pumberger M, Riedel-Heller SG. COVID-19-Pandemie: belastungen des medizinischen Personals [COVID-19 Pandemic: stress experience of healthcare workers - a short current review]. Psychiatr Prax [Internet]. 2020 [cited 2020 Aug 16];47(4):190-7. Available from: https://doi.org/10.1055/a-1159-5551 https://doi.org/10.1055/a-1159-5551... . Germany4242. Bohlken J, Schömig F, Lemke MR, Pumberger M, Riedel-Heller SG. COVID-19-Pandemie: belastungen des medizinischen Personals [COVID-19 Pandemic: stress experience of healthcare workers - a short current review]. Psychiatr Prax [Internet]. 2020 [cited 2020 Aug 16];47(4):190-7. Available from: https://doi.org/10.1055/a-1159-5551 https://doi.org/10.1055/a-1159-5551...	Review article. It analyzed the psychological stress of care, due to the pandemic.	Preventive interventions that assist the professionals in dealing with anxiety and stress; Social support plays an important role in the reduction of anxiety and psychological stress.
Huang JZ et al., 202026. Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. [Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19 ]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi CMA J Cn [Internet]. 2020 [cited 2020 Aug 16];38(3):192-5. Available from: https://doi.org/10.3760/cma.j.cn121094-20200219-00063 https://doi.org/10.3760/cma.j.cn121094-2... . China2626. Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. [Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19 ]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi CMA J Cn [Internet]. 2020 [cited 2020 Aug 16];38(3):192-5. Available from: https://doi.org/10.3760/cma.j.cn121094-20200219-00063 https://doi.org/10.3760/cma.j.cn121094-2...	Cross-sectional study. It investigated the health professionals' mental health.	Training of psychological skills in the health team; Increase of social support; and Psychological counseling.
Wu J et al., 202046. Wu PE, Styra R, Gold WL. Mitigating the psychological effects of COVID-19 on health care workers. CMAJ [Internet]. 2020 [cited 2020 Aug 16];192(17):459-60. Available from: https://doi.org/10.1503/cmaj.200519 https://doi.org/10.1503/cmaj.200519... . China2727. Wu J, Rong X, Chen F. Investigation on sleep quality of first-line nurses in fighting against corona virus disease 2019 and its influencing factors. Chin Nurs Res [Internet]. 2020 [cited 2020 Aug 15];34(4):558-62. Available from: https://kns.cnki.net/kcms/detail/detail.aspx?FileName=ZXWS2020081000C&DbName=CAPJ2020 https://kns.cnki.net/kcms/detail/detail....	Cross-sectional study. It analyzed the factors that exerted an influence on the sleep quality of clinical nurses in the front line against COVID-19;	Improvement of the mechanism for the management of public health emergencies; Guaranteeing adequate human resources; Comprehensive infectious disease prevention system; Strengthening psychological guidance and humanistic care.
Shen X et al., 202028. Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of COVID-19. Crit Care. 2020 [cited 2020 Aug 16];24(1):200. Available from: https://doi.org/10.1186/s13054-020-02926-2 https://doi.org/10.1186/s13054-020-02926... . China2828. Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of COVID-19. Crit Care. 2020 [cited 2020 Aug 16];24(1):200. Available from: https://doi.org/10.1186/s13054-020-02926-2 https://doi.org/10.1186/s13054-020-02926...	Opinion article. It described psychological problems, such as anxiety, among the nurses working in ICUs during the COVID-19 pandemic, as well as interventions conducted to promote mental health care.	Inclusion of a psychologist in the health team, in addition to a multi-professional support team; Expressing emotions through conversations, drawings, singing and exercise; Encouraging deep breathing and relaxation techniques during working hours; Sharing experiences and communication among the colleagues; Not making oneself forget about unpleasant experiences and Social Support System.
Mo Y et al., 202029. Mo Y, Deng L, Zhang L, Lang Q, Liao C, Wang N, et al. Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic. J Nurs Manag [Internet]. 2020 [cited 2020 Aug 16];28(5):1002-9. Available from: https://doi.org/10.1111/jonm.13014 https://doi.org/10.1111/jonm.13014... . China2929. Mo Y, Deng L, Zhang L, Lang Q, Liao C, Wang N, et al. Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic. J Nurs Manag [Internet]. 2020 [cited 2020 Aug 16];28(5):1002-9. Available from: https://doi.org/10.1111/jonm.13014 https://doi.org/10.1111/jonm.13014...	Cross-sectional study. It identified stress among the nurses and the factors that influence it during the fight against COVID-19.	Offering assistance: it relieves the team's psychological stress; Training and qualification for the fight against COVID-19 and Social support; Mutual care measures; support and encouragement among the nurses, with exchange of experiences; Creation of online platforms: with counseling on how to reduce transmission risk; Training on leisure to reduce anxiety.
Alsubaie S et al., 201941. Alsubaie S, Temsah MH, Al-Eyadhy AA, Gossady I, Hasan GM, Al-Rabiaah A, et al. Middle east respiratory syndrome Coronavirus epidemic impact on healthcare workers' risk perceptions, work and personal lives. J Infect Dev Countr [Internet]. 2019 [cited 2020 Aug 16];13(10):920-6. Available from: https://doi.org/10.3855/jidc.11753 https://doi.org/10.3855/jidc.11753... . Saudi Arabia4141. Alsubaie S, Temsah MH, Al-Eyadhy AA, Gossady I, Hasan GM, Al-Rabiaah A, et al. Middle east respiratory syndrome Coronavirus epidemic impact on healthcare workers' risk perceptions, work and personal lives. J Infect Dev Countr [Internet]. 2019 [cited 2020 Aug 16];13(10):920-6. Available from: https://doi.org/10.3855/jidc.11753 https://doi.org/10.3855/jidc.11753...	Cross-sectional research. It identified knowledge, anxiety level, and change in the preventive practices during MERS-CoV.	Approaches to reduce the concerns referring to virus transmission to family members; Creation of educational campaigns with infection control protocols and guidelines on the use of equipment; Psychological support; Providing counseling and consultations; Ensuring adequate protective measures.
Chew NWS et al., 202043. Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun [Internet]. 2020 [cited 2020 Aug 16];88:559-65. Available from: https://doi.org/10.1016/j.bbi.2020.04.049 https://doi.org/10.1016/j.bbi.2020.04.04... . Singapur4343. Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun [Internet]. 2020 [cited 2020 Aug 16];88:559-65. Available from: https://doi.org/10.1016/j.bbi.2020.04.049 https://doi.org/10.1016/j.bbi.2020.04.04...	Cross-sectional study. It assessed the prevalence of physical and psychological symptoms in the professionals.	Advice can be provided to mitigate the fear of transmitting the virus to family members; Multidisciplinary interventions to offer support; Psychological support to the professionals who present physical symptoms after discarding coronavirus infection.
Sun N et al., 202025. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control [Internet]. 2020 [cited 2020 Aug 15];48(6):592-8. Available from: https://doi.org/10.1016/j.ajic.2020.03.018 https://doi.org/10.1016/j.ajic.2020.03.0... . China2525. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control [Internet]. 2020 [cited 2020 Aug 15];48(6):592-8. Available from: https://doi.org/10.1016/j.ajic.2020.03.018 https://doi.org/10.1016/j.ajic.2020.03.0...	Qualitative study. It identified the nurses' experiences in the care of COVID-19 patients.	Early psychological intervention; Stress assessment and screening; Provision of material and human resources; Adequate training; Offering assistance to the nurses' family members; Practices of psychological protective measures: breathing to relax, music, meditation, mindfulness exercises; Social support.
Black JRM et al., 202044. Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet. 2020 [cited 2020 Aug 16];395(10234):1418-20. Available from: https://doi.org/10.1016/s0140-6736(20)30917-x https://doi.org/10.1016/s0140-6736(20)30... United Kingdom4444. Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet. 2020 [cited 2020 Aug 16];395(10234):1418-20. Available from: https://doi.org/10.1016/s0140-6736(20)30917-x https://doi.org/10.1016/s0140-6736(20)30...	Opinion article. It focused on the importance of performing diagnostic tests for coronavirus.	Mass testing in health professionals (both symptomatic and asymptomatic) was identified as a means of relieving anxiety.
Al Knawy BA et al., 2015. Saudi Arabia1919. Al Knawy BA, Al-Kadri HMF, Elbarbary M, Arabi Y, Balkhy H, Clark A. Perceptions of post outbreak management by management and healthcare workers of a Middle East respiratory syndrome outbreak in a tertiary care hospital: a qualitative study. BMJ Open [Internet]. 2019 [cited 2020 Aug 15];9(5):e017476. Available from: https://doi.org/10.1136/bmjopen-2017-017476 https://doi.org/10.1136/bmjopen-2017-017...	Qualitative study. It identified the perceptions of the health professionals during MERS.	Mental health counseling and support, since the high anxiety levels were related to lack of mental health support; Management of national crises, to reduce anxiety in health professionals.
Wu PE et al., 202046. Wu PE, Styra R, Gold WL. Mitigating the psychological effects of COVID-19 on health care workers. CMAJ [Internet]. 2020 [cited 2020 Aug 16];192(17):459-60. Available from: https://doi.org/10.1503/cmaj.200519 https://doi.org/10.1503/cmaj.200519... . Canada4646. Wu PE, Styra R, Gold WL. Mitigating the psychological effects of COVID-19 on health care workers. CMAJ [Internet]. 2020 [cited 2020 Aug 16];192(17):459-60. Available from: https://doi.org/10.1503/cmaj.200519 https://doi.org/10.1503/cmaj.200519...	Opinion article. It assessed the psychological effects of the pandemic on the health professionals.	Relief strategies in all the scenarios are vital to ensure psychological well-being; Frequent, fast and clear hospital communication; Strong social support network; Mental health support.
Zhang C. et al., 202040. Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel Coronavirus disease outbreak. Front Psychiat [Internet]. 2020 [cited 2020 Aug 16];11:306. Available from: https://doi.org/10.3389/fpsyt.2020.00306 https://doi.org/10.3389/fpsyt.2020.00306... . China4040. Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel Coronavirus disease outbreak. Front Psychiat [Internet]. 2020 [cited 2020 Aug 16];11:306. Available from: https://doi.org/10.3389/fpsyt.2020.00306 https://doi.org/10.3389/fpsyt.2020.00306...	Cross-sectional study. It analyzed insomnia and the health professionals' psychological and social factors.	Clarity in the plans, policies and procedures; Understanding what is happening and how the team is adapting to the general operations; their roles and expectations can help to stay focused, avoiding the uncertainties that generate anxiety; Behavioral cognitive therapy for insomnia, including relaxation therapy, among others.
Kang J et al., 201818. Kang J, Kim EJ, Choi JH, Hong HK, Han S, Choi IS, et al. Difficulties in using personal protective equipment: training experiences with the 2015 outbreak of Middle East respiratory syndrome in Korea. Am J Infect Control [Internet]. 2018 [cited 2020 Aug 15];46(2):235-37. Available from: https://doi.org/10.1016/j.ajic.2017.08.041 https://doi.org/10.1016/j.ajic.2017.08.0... . South Korea1818. Kang J, Kim EJ, Choi JH, Hong HK, Han S, Choi IS, et al. Difficulties in using personal protective equipment: training experiences with the 2015 outbreak of Middle East respiratory syndrome in Korea. Am J Infect Control [Internet]. 2018 [cited 2020 Aug 15];46(2):235-37. Available from: https://doi.org/10.1016/j.ajic.2017.08.041 https://doi.org/10.1016/j.ajic.2017.08.0...	Qualitative study. It assessed the barriers to the use of PPE during and after the MERS outbreak.	The CCIH leaders must allow health professionals to use their own methods for relieving anxiety.
Zhu J et al., 202031. Zhu J, Sun L, Zhang L, Wang H, Fan A, Yang B, et. al. Prevalence and Influencing Factors of Anxiety and Depression Symptoms in the First-Line Medical Staff Fighting Against COVID-19 in Gansu. Front Psychiatry [Internet]. 2020 2020 [cited 2020 Aug 16];11:386. Available from: https://doi.org/10.3389/fpsyt.2020.00386 https://doi.org/10.3389/fpsyt.2020.00386... . China3131. Zhu J, Sun L, Zhang L, Wang H, Fan A, Yang B, et. al. Prevalence and Influencing Factors of Anxiety and Depression Symptoms in the First-Line Medical Staff Fighting Against COVID-19 in Gansu. Front Psychiatry [Internet]. 2020 2020 [cited 2020 Aug 16];11:386. Available from: https://doi.org/10.3389/fpsyt.2020.00386 https://doi.org/10.3389/fpsyt.2020.00386...	A cross-sectional study. It identified prevalence and factors that exert an influence on anxiety and depression symptoms.	Reduction of inadequate coping behaviors; Better perception of the factors that trigger stress; Adoption of a positive coping style in the crisis, improving negative emotions.
Lai J et al., 202032. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health Outcomes among health care workers exposed to Coronavirus disease 2019. JAMA Netw Open [Internet]. 2020 [cited 2020 Aug 16];3(3):e203976. Available from: https://doi.org/10.1001/jamanetworkopen.2020.3976 https://doi.org/10.1001/jamanetworkopen.... China3232. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health Outcomes among health care workers exposed to Coronavirus disease 2019. JAMA Netw Open [Internet]. 2020 [cited 2020 Aug 16];3(3):e203976. Available from: https://doi.org/10.1001/jamanetworkopen.2020.3976 https://doi.org/10.1001/jamanetworkopen....	A cross-sectional study. It assessed the factors associated with mental health: professionals who were in charge of the care of COVID-19 patients.	Paying special attention to the mental health of the female nurses who cared for COVID-19 patients, as the results showed that being a woman was a risk factor for developing more severe anxiety levels.
Lee SM et al., 201817. Lee SM, Kang WS, Cho AR, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital 1workers and quarantined hemodialysis patients. Compr Psychiatry [Internet]. 2018 [cited 2020 Aug 15];87:123-27. Available from: https://doi.org/10.1016/j.comppsych.2018.10.003 https://doi.org/10.1016/j.comppsych.2018... . South Korea1717. Lee SM, Kang WS, Cho AR, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital 1workers and quarantined hemodialysis patients. Compr Psychiatry [Internet]. 2018 [cited 2020 Aug 15];87:123-27. Available from: https://doi.org/10.1016/j.comppsych.2018.10.003 https://doi.org/10.1016/j.comppsych.2018...	Cross-sectional study. It assessed the understanding of the psychological impact experienced by the workers during and after MERS.	Increased awareness about the mental health issues; Development of psychological protocols during the isolation quarantine period; Psychiatric interventions.
Li W et al., 202030. Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci [Internet]. 2020 [cited 2020 Aug 16];16(10):1732-8. Available from: http://www.ijbs.com/v16p1732.htm http://www.ijbs.com/v16p1732.htm... . China3030. Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci [Internet]. 2020 [cited 2020 Aug 16];16(10):1732-8. Available from: http://www.ijbs.com/v16p1732.htm http://www.ijbs.com/v16p1732.htm...	Literature review. It analyzed the mental health services during the COVID-19 pandemic.	Integration of the intervention in psychological crises to the disease prevention general department; Development and implementation of the intervention protocol in psychological emergencies; The specialists in mental health must take the lead in the interventions in psychological crises and related activities; Publication of guidelines and instructions for the mental health service by the mental health and academic associations; National Manual of Mental Health for the New Coronavirus Outbreak; Psychological interventions during the pandemic; It launched the ‘Psychological Adjustment Guideline’ to address the new coronavirus for specific populations; Online consulting, crisis response services and teams to provide education in health; Implementation of the Support System to strengthen lung and mental health.
Liang Y et al., 202039. Liang Y, Chen M, Zheng X, Liu J. Screening for Chinese medical staff mental health by SDS and SAS during the outbreak of COVID-19. J Psychosom Res [Internet]. 2020 [cited 2020 Aug 16];133:110102. Available from: https://doi.org/10.1016/j.jpsychores.2020.110102 https://doi.org/10.1016/j.jpsychores.202... . China3939. Liang Y, Chen M, Zheng X, Liu J. Screening for Chinese medical staff mental health by SDS and SAS during the outbreak of COVID-19. J Psychosom Res [Internet]. 2020 [cited 2020 Aug 16];133:110102. Available from: https://doi.org/10.1016/j.jpsychores.2020.110102 https://doi.org/10.1016/j.jpsychores.202...	Opinion article. It assessed the mental health of the professionals during the COVID-19 outbreak.	Reasonable rest for the team; Leisure activities; Pre-employment training and psychological counseling using anxiety assessment scales as monitoring tools.
Gan X et al., 202033. Gan X, Shi Z, Chair SY, Cao X, Wang Q. Willingness of Chinese nurses to practice in Hubei combating the coronavirus disease 2019 epidemic: a cross-sectional study. J Adv Nurs [Internet]. 2020 [cited 2020 Aug 16];76:2137-50. Available from: https://doi.org/10.1111/jan.14434 https://doi.org/10.1111/jan.14434... . China3333. Gan X, Shi Z, Chair SY, Cao X, Wang Q. Willingness of Chinese nurses to practice in Hubei combating the coronavirus disease 2019 epidemic: a cross-sectional study. J Adv Nurs [Internet]. 2020 [cited 2020 Aug 16];76:2137-50. Available from: https://doi.org/10.1111/jan.14434 https://doi.org/10.1111/jan.14434...	Cross-sectional study. It analyzed the relation between nurses and work-associated factors during the pandemic.	Professional support must be provided to promote the nurses' psychological health, not only during an infectious disease outbreak, but also as routine practice.
Cai H et al., 202034. Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, et al. Psychological impact and coping strategies of frontline medical staff in hunan between January and March 2020 during the outbreak of Coronavirus disease 2019 (COVID19) in Hubei, China. Med Sci Monit [Internet]. 2020 [cited 2020 Aug 16];26:e924171. Available from: https://doi.org/10.12659/msm.924171 https://doi.org/10.12659/msm.924171... . China3434. Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, et al. Psychological impact and coping strategies of frontline medical staff in hunan between January and March 2020 during the outbreak of Coronavirus disease 2019 (COVID19) in Hubei, China. Med Sci Monit [Internet]. 2020 [cited 2020 Aug 16];26:e924171. Available from: https://doi.org/10.12659/msm.924171 https://doi.org/10.12659/msm.924171...	Cross-sectional study. It assessed the psychological impact and the coping strategies of the “front line” team during COVID-19.	Effective control of infections, personal protection measures, clear institutional policies and protocols; Recognition and appreciation of the professionals' work and efforts; Family safety was the biggest impact in reducing the team’s anxiety; Positive attitudes of the work colleagues.
Pappa S et al., 202045. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun [Internet]. 2020 [cited 2020 Aug 16];88:901-7. Available from: https://doi.org/10.1016/j.bbi.2020.05.026 https://doi.org/10.1016/j.bbi.2020.05.02... . United Kingdom4545. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun [Internet]. 2020 [cited 2020 Aug 16];88:901-7. Available from: https://doi.org/10.1016/j.bbi.2020.05.026 https://doi.org/10.1016/j.bbi.2020.05.02...	Systematic review and meta-analysis. It synthesized and analyzed existing evidence of the prevalence of depression, anxiety and insomnia among the health professionals during COVID-19.	Clear communication; Provision of rest areas; Provision of mental health support through a hotline of teams, media or multidisciplinary teams; Early detection and importance of noticing and treating the clinical and psychiatric symptoms; Mental health support is necessary even for mild psychological reactions.
Lancee, WJ et al., 2010. Canada1616. Lancee WJ, Maunder RG, Goldbloom DS. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv [Internet]. 2008 [cited 2020 Aug 15];59(1):91-5. Available from: https://doi.org/10.1176/ps.2008.59.1.91 https://doi.org/10.1176/ps.2008.59.1.91...	Cohort study. It identified the incidence of psychiatric disorders (among the professionals) after the SARS outbreak, as well as the risk factors.	The professionals' attention to their own personal risk allows for a quick response to emergent symptoms related to anxiety; Effective practical and emotional support; Training sessions and personal protection.
Ni MY et al., 202035. Ni MY, Yang L, Leung CMC, Li N, Yao XI, Wang Y, et al. Mental health, risk factors, and social media use during the COVID-19 epidemic and cordon sanitaire among the community and health professionals in Wuhan, China: cross-sectional survey. JMIR Ment Health [Internet]. 2020 [cited 2020 Aug 16];7(5):e19009. Available from: https://doi.org/10.2196/19009 https://doi.org/10.2196/19009... . China3535. Ni MY, Yang L, Leung CMC, Li N, Yao XI, Wang Y, et al. Mental health, risk factors, and social media use during the COVID-19 epidemic and cordon sanitaire among the community and health professionals in Wuhan, China: cross-sectional survey. JMIR Ment Health [Internet]. 2020 [cited 2020 Aug 16];7(5):e19009. Available from: https://doi.org/10.2196/19009 https://doi.org/10.2196/19009...	Cross-sectional study. It assessed the risk factors for anxiety in the community and among the health professionals.	Social support must be maintained as the key to emotional support; Use of online platforms to conduct psychological counseling; Psychosocial support; Provision of protective equipment.
Sheng X et al., 202036. Sheng X, Liu F, Zhou J, Liao R. Nan Fang Yi Ke Da Xue Xue Bao [Psychological status and sleep quality of nursing interns during the outbreak of COVID-19]. J South Med Univ [Internet]. 2020 [cited 2020 Aug 16];40(3):346-50. Available from: https://doi.org/10.12122/j.issn.1673-4254.2020.03.09 https://doi.org/10.12122/j.issn.1673-425... . China3636. Sheng X, Liu F, Zhou J, Liao R. Nan Fang Yi Ke Da Xue Xue Bao [Psychological status and sleep quality of nursing interns during the outbreak of COVID-19]. J South Med Univ [Internet]. 2020 [cited 2020 Aug 16];40(3):346-50. Available from: https://doi.org/10.12122/j.issn.1673-4254.2020.03.09 https://doi.org/10.12122/j.issn.1673-425...	Cross-sectional study. It investigated the psychological status and sleep quality of ,the nurses in collective isolation.	Focusing on the nurses' psychological needs in the formulation of the psychological intervention program; Timely reporting on the progress of the epidemic prevention and control measures.
Chen Q et al., 202037. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiat [Internet]. 2020 [cited 2020 Aug 16];7(4):15-6. Available from: https://doi.org/10.1016/s2215-0366(20)30078-x https://doi.org/10.1016/s2215-0366(20)30... . China3737. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiat [Internet]. 2020 [cited 2020 Aug 16];7(4):15-6. Available from: https://doi.org/10.1016/s2215-0366(20)30078-x https://doi.org/10.1016/s2215-0366(20)30...	This is an experience report from a University Hospital in Hunan, which initiated actions and modified sectors to give priority to COVID-19.	Development of a psychological intervention plan: medical team for psychological intervention; psychological assistance team by telephone calls; psychological interventions with group activities to relieve stress; Skills training for the management of anxiety, panic and other emotional problems; Moments of leisure and training on relaxation.
Liu CY et al., 202048. Liu Z, Han B, Jiang R, Huang Y, Ma Chao, Wen J, et al. Mental Health Status of Doctors and Nurses During COVID-19 Epidemic in China. SSRN Electron J [Internet]. 2020 [cited 2020 Aug 16];Preprint. Available from: https://doi.org/10.2139/ssrn.3551329 https://doi.org/10.2139/ssrn.3551329... . China3838. Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang WW, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect [Internet]. 2020 [cited 2020 Aug 16];148:e98. Available from: https://doi.org/10.1017/s0950268820001107 https://doi.org/10.1017/s095026882000110...	Cross-sectional study. It estimated the prevalence of anxiety in the health team.	Early initiatives for the implementation of actions that mitigate mental symptoms; Governmental support; Identification of the need to implement measures that protect the workers' mental health; Psychological counseling to the professionals.

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Caroline Figueira Pereira pereiracf@usp.br