The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis

Int J Ment Health Nurs. 2024 Jun;33(3):523-545. doi: 10.1111/inm.13257. Epub 2023 Dec 7.

Abstract

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

Keywords: COVID‐19; mental health; nursing; occupational health; post‐traumatic stress disorder (PTSD).

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Humans
  • Nurses / psychology
  • Nurses / statistics & numerical data
  • Prevalence
  • Risk Factors
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Stress Disorders, Post-Traumatic* / psychology