Factors associated with the psychological impact of severe acute respiratory syndrome on nurses and other hospital workers in Toronto.
OBJECTIVE
A survey was conducted to measure psychological stress in hospital workers and measure factors that may have mediated acute traumatic responses.


METHODS
A self-report survey was completed by 1557 healthcare workers at three Toronto hospitals in May and June 2003. Psychological stress was measured with the Impact of Event Scale. Scales representing attitudes to the outbreak were derived by factor analysis of 76 items probing attitudes to severe acute respiratory syndrome. The association of Impact of Event Scale scores to job role and contact with severe acute respiratory syndrome patients was tested by analysis of variance. Between-group differences in attitudinal scales were tested by multivariate analysis of variance. Attitudinal scales were tested as factors mediating the association of severe acute respiratory syndrome patient contact and job role with total Impact of Event Scale by linear regression.


RESULTS
Higher Impact of Event Scale scores are found in nurses and healthcare workers having contact with patients with severe acute respiratory syndrome. The relationship of these groups to the Impact of Event Scale score is mediated by three factors: health fear, social isolation, and job stress.


CONCLUSIONS
Although distress in response to the severe acute respiratory syndrome outbreak is greater in nurses and those who care for patients with severe acute respiratory syndrome, these relationships are explained by mediating variables that may be available for interventions to reduce stress in future outbreaks. In particular, the data suggest that the targets of intervention should include job stress, social isolation, and health fear.
Maunder
Robert G
RG
Department of Psychiatry, University of Toronto and Mount Sinai Hospital, Ninth Floor, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada. rmaunder@mtsinai.on.ca
Lancee
William J
WJ
Rourke
Sean
S
Hunter
Jonathan J
JJ
Goldbloom
David
D
Balderson
Ken
K
Petryshen
Patricia
P
Steinberg
Rosalie
R
Wasylenki
Donald
D
Koh
David
D
Fones
Calvin S L
CS
D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003625:Data Collection; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D016014:Linear Models; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009864:Ontario / Q000453:epidemiology; D010564:Personnel, Hospital / Q000523:psychology*; D011594:Psychometrics; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000451:nursing / Q000628:therapy; D012934:Social Isolation / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology