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      How can we build and maintain the resilience of our health care professionals during COVID-19? Recommendations based on a scoping review

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          Abstract

          Objective

          To explore how to build and maintain the resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions.

          Design

          Scoping review supplemented with expert interviews to validate the findings.

          Setting

          Hospitals.

          Methods

          We searched PubMed, Embase, PsycINFO, CINAHL, bioRxiv and medRxiv systematically and grey literature for articles focusing on the impact of COVID-19-like working conditions on the physical and/or mental health of healthcare professionals in a hospital setting. Articles using an empirical design about determinants or causes of physical and/or mental health and about interventions, measures and policies to preserve physical and/or mental health were included. Four experts were interviewed to reflect on the results from the scoping review.

          Results

          In total, 4471 records were screened leading to an inclusion of 73 articles. Recommendations prior to the outbreak fostering resilience included optimal provision of education and training, resilience training and interventions to create a feeling of being prepared. Recommendations during the outbreak consisted of (1) enhancing resilience by proper provision of information, psychosocial support and treatment (eg, create enabling conditions such as forming a psychosocial support team), monitoring the health status of professionals and using various forms and content of psychosocial support (eg, encouraging peer support, sharing and celebrating successes), (2) tasks and responsibilities, in which attention should be paid to kind of tasks, task mix and responsibilities as well as the intensity and weight of these tasks and (3) work patterns and working conditions. Findings of the review were validated by experts.

          Conclusions

          Recommendations were developed on how to build and maintain resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions. These practical and easy to implement recommendations can be used by hospitals and other healthcare organisations to foster and preserve short-term and long-term physical and mental health and employability of their professionals.

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          Most cited references111

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          PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

          Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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            Scoping studies: towards a methodological framework

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              Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

              Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2021
                6 January 2021
                : 11
                : 1
                : e043718
                Affiliations
                [1 ]departmentNursing Science, Julius Center for Health Sciences and Primary Care , University Medical Center Utrecht, Utrecht University , Utrecht, The Netherlands
                [2 ]departmentResearch Group Chronically Ill, Research Centre for Healthy and Sustainable Living , University of Applied Sciences Utrecht , Utrecht, The Netherlands
                [3 ]departmentJulius Center for Health Sciences and Primary Care , University Medical Center Utrecht, Utrecht University , Utrecht, The Netherlands
                [4 ]departmentCochrane Netherlands , University Medical Center Utrecht, Utrecht University , Utrecht, Netherlands
                [5 ]Dutch Hospital Association , Utrecht, Netherlands
                [6 ]departmentSchool of Health Sciences, Faculty of Environmental and Life Sciences , University of Southampton , Southampton, UK
                Author notes
                [Correspondence to ] Dr Anja Rieckert; a.rieckert@ 123456umcutrecht.nl
                Author information
                http://orcid.org/0000-0002-9735-378X
                http://orcid.org/0000-0001-5488-2967
                http://orcid.org/0000-0002-7761-5690
                Article
                bmjopen-2020-043718
                10.1136/bmjopen-2020-043718
                7789206
                33408212
                33d277d9-669c-4125-adf5-0dc524766c3e
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 15 August 2020
                : 19 November 2020
                : 27 November 2020
                Categories
                Evidence Based Practice
                1506
                2474
                1694
                Original research
                Custom metadata
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                Medicine
                covid-19,mental health,organisation of health services,occupational & industrial medicine

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