Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak

Robert G Maunder ,Jonathan Hunter,Nancy Read,Susan Vandevelde-Coke,Donald Wasylenki,Bjug Borgundvaag,Clare Pain,Glenna Raymond,Rosalie Steinberg,Georgina Veldhorst,David S Goldbloom ,Joanna Bennett ,Sean B Rourke ,Christopher M.b Fernandes ,Slayton A Evans ,William J Lancee ,Kenneth E Balderson ,Sonia S Peczeniuk ,Linda Mc Gillis Hall ,Thomas E Stewart ,Lynn M Nagle ,Mona Somani Gupta

doi:10.3201/eid1212.060584

Robert G Maunder , Jonathan Hunter + Show 20 more

Open Access

https://doi.org/10.3201/eid1212.060584

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Abstract

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.

Highlights

Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known
To determine how representative participants were of all eligible hospital staff, after the Impact of SARS Study a representativeness study was presented to 258 Toronto HCWs who had been eligible; it was completed by 255 (99%) of these HCWs
Exposure to SARS patients was more common in HCWs who participated in the Impact of SARS Study than those who did not

Summary

Introduction

Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known. The SARS outbreak was acutely stressful, the longer term impact of SARS on HCWs is unknown. Long-term Effects of Providing Healthcare for SARS during the SARS outbreak and during an influenza pandemic will differ in key respects, SARS experience provides the most extensive information available about the effects on HCWs of a large-scale infectious outbreak. The objective of the Impact of SARS Study was to assess the long-term psychological and occupational impact of SARS outbreak on HCWs and to identify personal and systemic factors that increase vulnerability

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