Comments on “Factors Affecting the Psychological Well-being of Health Care Workers During an Epidemic: A Thematic Review”

Philip and Cherian’s work (2020) ¹ has an important and relevant contribution to the field of health care, especially during the ongoing COVID crisis. It has significant implications in policy development for the health care workers (HCWs) from mental health’s perspective. The authors aimed to thematically analyze the factors affecting the mental states of HCWs amid the epidemic. The authors selected COVID-19, Ebola, Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), and Severe Acute Respiratory Syndrome (SARS) breakouts. However, according to the World health organization (WHO), COVID-19 is a pandemic. ² This was declared by WHO chief Dr Tedros Adhanom Ghebreyesus in March 2020. Moreover, SARS has also been termed as the “first pandemic of the 21st Century.” ³ To remove this ambiguity, the authors could have included the word “pandemic” in their study. A pandemic is an epidemic that occurs worldwide and spreads beyond international boundaries, ⁴ while an epidemic refers to a sudden increase in the number of cases in a geographic location. ⁴ This difference could have been used to compare their individual effects on HCW’s mental health states. Also, the authors could have provided the readers with a rationale behind selecting these four pandemics/epidemics from a list of 20 similar breakouts, to justify the study’s significance and novelty. ⁵

The WHO’s definition of HCWs includes all people intending to improve health. ⁶ By this definition, a caring mother also comes under the umbrella of HCW. ⁶ The authors could have explicitly stated what they meant by HCWs for their research context and the rationale behind selecting a particular group of HCWs. Also, the nature of an HCW’s job can have a moderating role in determining the impact of a pandemic/epidemic on mental states. For example, I think that a psychologist will have a better coping mechanism as compared to any other health care professional as they study and practice coping strategies and well-being with their clients, in their field of work. Hence, the nature of work could have been included as one of the factors in the thematic analysis section.

Moreover, the authors could have highlighted the specific factors related to the recent COVID-19 pandemic that are affecting the HCWs globally. For instance, media coverage, uncertainties in treatment protocols, and the rapid spread of infection ⁷ could have been highlighted in the study, to spread awareness regarding the current situation.

Other errors could have been avoided in this study. For example, the inclusion criteria do not consist of the time frame for including the selected studies. Also, in Table 1, under the “participant” column against the COVID-19 study in Pondicherry (India), the authors have written “four articles finally included” without justifying its position in the table.

Even though the study majorly highlights the factors that affect a vulnerable population’s mental states, that is, HCWs, it lacks the appropriate justification of the current study’s rationale. The study’s title mentioning epidemic is also misleading to its readers as the authors talk about both pandemics (COVID-19 and SARS) and epidemics (Ebola and MERS-CoV) in their study content. Future research on comparing the effects of a pandemic versus an epidemic on the mental health states of people could have been implicated. Thematic analysis of literature selected within a time frame with strict exclusion criteria could have yielded more relevant factors affecting the mental health states of HCWs.