Main factors
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High service demand;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
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• Prolonged exposure in critical environments;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2121 Jung SJ, Jun JY. Mental health and psychological intervention amid COVID-19 Outbreak: perspectives from South Korea. Yonsei Med J. 2020;61(4):271-2. http://dx.doi.org/10.3349/ymj.2020.61.4.271. PMid:32233168. http://dx.doi.org/10.3349/ymj.2020.61.4....
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• Continuous risk of infection;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
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• Personal protective equipment (e.g., discomfort, limited mobility and communication, effectiveness, and restricted availability);1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2121 Jung SJ, Jun JY. Mental health and psychological intervention amid COVID-19 Outbreak: perspectives from South Korea. Yonsei Med J. 2020;61(4):271-2. http://dx.doi.org/10.3349/ymj.2020.61.4.271. PMid:32233168. http://dx.doi.org/10.3349/ymj.2020.61.4....
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• Management of distress experienced by patients and family members;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
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• Lack of contact with family;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
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• Interpersonal conflict;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
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• Recurrent thoughts about the epidemic; and also related to death and dying;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
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• Stigma for working with COVID-19 patients;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2121 Jung SJ, Jun JY. Mental health and psychological intervention amid COVID-19 Outbreak: perspectives from South Korea. Yonsei Med J. 2020;61(4):271-2. http://dx.doi.org/10.3349/ymj.2020.61.4.271. PMid:32233168. http://dx.doi.org/10.3349/ymj.2020.61.4....
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• The need to continually demystify misleading information.1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2121 Jung SJ, Jun JY. Mental health and psychological intervention amid COVID-19 Outbreak: perspectives from South Korea. Yonsei Med J. 2020;61(4):271-2. http://dx.doi.org/10.3349/ymj.2020.61.4.271. PMid:32233168. http://dx.doi.org/10.3349/ymj.2020.61.4....
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Emotional Response
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• Fear, regret, frustration, guilt, anger, exhaustion, uncertainty, moral distress, burnout, stress, anxiety, depressive symptoms, denial, helplessness, feelings of vulnerability, and irritability;1717 Choi KR, Heilemann MV, Fauer A, Mead M. A second pandemic: mental health spillover from the novel Coronavirus (COVID-19). J Am Psychiatr Nurses Assoc. 2020;26(4):340-3. http://dx.doi.org/10.1177/1078390320919803. PMid:32340586. http://dx.doi.org/10.1177/10783903209198...
,2020 Sullivan AB, Kane A, Roth AJ, Davis BE, Drerup ML, Heinberg LJ. The COVID-19 crisis: a mental health perspective and response using telemedicine. J Patient Exp. 2020;7(3):295-301. http://dx.doi.org/10.1177/2374373520922747. PMid:32821785. http://dx.doi.org/10.1177/23743735209227...
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• Appetite changes or disorders (lack of appetite or excessive appetite);1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2020 Sullivan AB, Kane A, Roth AJ, Davis BE, Drerup ML, Heinberg LJ. The COVID-19 crisis: a mental health perspective and response using telemedicine. J Patient Exp. 2020;7(3):295-301. http://dx.doi.org/10.1177/2374373520922747. PMid:32821785. http://dx.doi.org/10.1177/23743735209227...
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• Sleep changes or disorders (insomnia, difficult sleeping or excessive sleepiness, recurrent nightmares);1212 Smith MW, Smith PW, Kratochvil CJ, Schwedhelm S. The psychosocial challenges of caring for patients with Ebola virus disease. Health Secur. 2017;15(1):104-9. http://dx.doi.org/10.1089/hs.2016.0068. PMid:28192056. http://dx.doi.org/10.1089/hs.2016.0068...
,2020 Sullivan AB, Kane A, Roth AJ, Davis BE, Drerup ML, Heinberg LJ. The COVID-19 crisis: a mental health perspective and response using telemedicine. J Patient Exp. 2020;7(3):295-301. http://dx.doi.org/10.1177/2374373520922747. PMid:32821785. http://dx.doi.org/10.1177/23743735209227...
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• Use of legal and illegal drugs.2020 Sullivan AB, Kane A, Roth AJ, Davis BE, Drerup ML, Heinberg LJ. The COVID-19 crisis: a mental health perspective and response using telemedicine. J Patient Exp. 2020;7(3):295-301. http://dx.doi.org/10.1177/2374373520922747. PMid:32821785. http://dx.doi.org/10.1177/23743735209227...
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Coping strategies/support resources
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✓ Meet your basic needs: implement regular intervals to eat, hydrate and sleep to optimize your ability to self-care and care for others;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Avoid harmful habits – Watch for the abusive use of tobacco, alcohol, and other drugs to escape from anguish;1212 Smith MW, Smith PW, Kratochvil CJ, Schwedhelm S. The psychosocial challenges of caring for patients with Ebola virus disease. Health Secur. 2017;15(1):104-9. http://dx.doi.org/10.1089/hs.2016.0068. PMid:28192056. http://dx.doi.org/10.1089/hs.2016.0068...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Respect your time: take breaks, allow yourself to do something unrelated to your work, and which you find comforting, fun, or relaxing. Resting activities, exercises, and relaxing practices are important allies against stress and anxiety;1212 Smith MW, Smith PW, Kratochvil CJ, Schwedhelm S. The psychosocial challenges of caring for patients with Ebola virus disease. Health Secur. 2017;15(1):104-9. http://dx.doi.org/10.1089/hs.2016.0068. PMid:28192056. http://dx.doi.org/10.1089/hs.2016.0068...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Establish a work and self-care routine: try to perform pleasant and meaningful activities. These will help your day to be more organized and calm;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Remain connected to your socio-affective network: connect with your family, friends, and acquaintances (they represent your support out of the health system), give and receive support, reduce the feeling of isolation;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Keep yourself updated: trust on reliable sources of information and beware for excesses. Take part in work meetings where relevant information is shared;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Auto check-ins: monitor yourself from time to time for symptoms of depression or stress disorder; prolonged sadness, difficulty sleeping, intrusive memories, hopelessness. Talk to a colleague, supervisor or seek professional help if needed;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Practice resilience – Reflect upon the challenges faced and what you can learn from them, reframe your experience. Resume the coping strategies already used in previous crises;1212 Smith MW, Smith PW, Kratochvil CJ, Schwedhelm S. The psychosocial challenges of caring for patients with Ebola virus disease. Health Secur. 2017;15(1):104-9. http://dx.doi.org/10.1089/hs.2016.0068. PMid:28192056. http://dx.doi.org/10.1089/hs.2016.0068...
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✓ Keep your faith and religious and/or spiritual activities, if they are part of your routine;1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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✓ Seek a health worker when the strategies used are not sufficient for you to achieve emotional stability: Find out about the availability of health services for you.1515 Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID19 scale: development and initial validation. Int J Ment Health Addict. 2020;27:1-9. http://dx.doi.org/10.1007/s11469-020-00270-8. PMid:32226353. http://dx.doi.org/10.1007/s11469-020-002...
,2424 Fundação Oswaldo Cruz. Saúde mental e atenção psicossocial na pandemia COVID-19: recomendações para gestores [Internet]. Brasília: FIOCRUZ; 2020. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/Sa%c3%bade-Mental-e-Aten%c3%a7%c3%a3o-Psicossocial-na-Pandemia-Covid-19-recomenda%c3%a7%c3%b5es-gerais.pdf https://www.fiocruzbrasilia.fiocruz.br/w...
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