ArticleBMC health services research2021
Holding the frontline: a cross-sectional survey of emergency department staff well-being and psychological distress in the course of the COVID-19 outbreak.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Secondary traumatic stress and burnout in healthcare professional: systematic review and a meta-analysis based on correlation coefficient.Scientific reports · 2025Pooled it
- Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations.Human resources for health · 2024Pooled it
- Prevalence and associated factors of secondary traumatic stress in emergency nurses: a systematic review and meta-analysis.European journal of psychotraumatology · 2024Pooled it
- Compassionate self-talk enhances autonomic flexibility during cognitive stress in generalized anxiety disorder: a randomized controlled trial with HRV evidence.Frontiers in psychiatry · 2026Trial
- Self-compassion modulates autonomic and psychological responses to stress among adults with generalized anxiety disorders.Frontiers in psychiatry · 2025Article
- Experience of moral distress among doctors at emergency departments in Stockholm during the Covid-19 pandemic: a qualitative interview study.International journal of qualitative studies on health and well-being · 2024Article
- Gender sensitivity of the COVID-19 mental health research in Europe: a scoping review.International journal for equity in health · 2024Article
- Emergency department workforces' experiences and perceptions of well-being from an international perspective: a scoping review.BMJ open · 2024Article
- A pre-post study of stressors and burnout affecting breast radiologists before and during the COVID-19 pandemic.European journal of radiology open · 2023Article
- Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism.Social psychiatry and psychiatric epidemiology · 2023Article
- The relationship between moral distress, burnout, and considering leaving a hospital job during the COVID-19 pandemic: a longitudinal survey.BMC nursing · 2023Article
- Correlation between moral distress and clinical competence in COVID-19 ICU nurses.BMC nursing · 2023Article
- Tackling the First COVID-19 Wave at the Cape Town Hospital of Hope: Why Was It Such a Positive Experience for Staff?Healthcare (Basel, Switzerland) · 2023Article
- Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review.Frontiers in medicine · 2023Article
- Validation of the World Health Organization Well-Being Index (WHO-5) among medical educators in Hong Kong: a confirmatory factor analysis.Medical education online · 2022Article
- In their own words: Experiences of emergency health care workers during the COVID-19 pandemic.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Article
- Moral and exhausting distress working in the frontline of COVID-19: a Swedish survey during the first wave in four healthcare settings.BMJ open · 2022Article
- Chronicling moral distress among healthcare providers during the COVID-19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours.International journal of mental health nursing · 2022Article
- Tweeting about alcohol: Exploring differences in Twitter sentiment during the onset of the COVID-19 pandemic.PloS one · 2022Article
- A national study of moral distress among U.S. internal medicine physicians during the COVID-19 pandemic.PloS one · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe coronavirus disease 2019 (COVID-19) outbreak has been associated with stress and challenges for healthcare professionals, especially for those working in the front-line of treating COVID-19 patients. This study aimed to: 1) assess changes in well-being and perceived stress symptoms of Dutch emergency department (ED) staff in the course of the first COVID-19 wave, and 2) assess and explore stressors experienced by ED staff since the COVID-19 outbreak.
methodsWe conducted a cross-sectional study. An online questionnaire was administered during June-July 2020 to physicians, nurses and non-clinical staff of four EDs in the Netherlands. Well-being and stress symptoms (i.e., cognitive, emotional and physical) were scored for the periods pre, during and after the first COVID-19 wave using the World Health Organization Well-Being Index (WHO-5) and a 10-point Likert scale. Stressors were assessed and explored by rating experiences with specific situations (i.e., frequency and intensity of distress) and in free-text narratives. Quantitative data were analyzed with descriptive statistics and generalized estimating equations (GEE). Narratives were analyzed thematically.
resultsIn total, 192 questionnaires were returned (39% response). Compared to pre-COVID-19, the mean WHO-5 index score (range: 0-100) decreased significantly with 14.1 points (p < 0.001) during the peak of the first wave and 3.7 points (< 0.001) after the first wave. Mean self-perceived stress symptom levels almost doubled during the peak of the first wave (≤0.005). Half of the respondents reported experiencing more moral distress in the ED since the COVID-19 outbreak. High levels of distress were primarily found in situations where the staff was unable to provide or facilitate necessary emotional support to a patient or family. Analysis of 51 free-texts revealed witnessing suffering, high work pressure, fear of contamination, inability to provide comfort and support, rapidly changing protocols regarding COVID-19 care and personal protection, and shortage of protection equipment as important stressors.
conclusionsThe first COVID-19 wave took its toll on ED staff. Actions to limit drop-out and illness among staff resulting from psychological distress are vital to secure acute care for (non-)COVID-19 patients during future infection waves.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.