The psychological impact of the Coronavirus emergency on physicians and nurses: an Italian observational study

Main Article Content

Maria Chiara Carriero
Luana Conte
Marica Calignano
Roberto Lupo
Antonino Calabrò
Pietro Santoro
Giovanna Artioli
Cosimo Caldararo
Maurizio Ercolani
Maicol Carvello
Antonio Leo


psychological intervention, COVID-19, stress, anxiety, depression, psychological impact, Health workers, Mental health, Pandemic, Post-traumatic stress disorder.


Background. The Coronavirus has put a strain on the response capacity of health systems and there are various psychological effects on health workers.

Aim of the study. To investigate the psychological impact of the coronavirus emergency on physicians and nurses.

Materials and methods. A study was conducted on a sample of nurses and physicians (n=770), who were asked to fill in a questionnaire investigating physical and psychological problems. It also included the IES (Impact Event Scale), STAI (State Trait Anxiety Inventory) scale and BDI (Beck Depression Inventory).

Results. 87.7% of the sample was represented by nurses (n=675), 12.3% (n=95) by physicians. 52.3% (n=403) of the participants believed that they had not received good training on the correct use of Personal Protective Equipment. 18.2% (n=140) declared that they had experienced a moment in which they had had to choose among the patients whom to treat for an essential therapy. Among the psychological symptoms, stress (76.2%; n=587), anxiety (59.4%; n=457) and depression (11.8%) prevailed and only 3.9% of the healthcare personnel sought help from a psychologist. The total score of the IES-R scale was 3.47. A significant association emerged between exposure and the risk of contagion (p-value = 0.003), stress was more present among nurses than among physicians (77.5% vs. 67.4%; p = 0.003). Among physical symptoms, headache (52.2%; n=402) and pressure injuries (24.8% n= 191) prevailed.

Conclusions. The results of the study show that mental health monitoring of health workers, who are at risk of developing major psychological disorders, is a priority.


Download data is not yet available.
Abstract 238 | PDF Downloads 186


1. Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychol. maggio 2020;39(5):355–7.
2. Coronavirus Disease (COVID-19) Situation Reports [Internet]. [citato 21 gennaio 2021]. Disponibile su:
3. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. 14 marzo 2020;395(10227):912–20.
4. Banerjee D. The COVID-19 outbreak: Crucial role the psychiatrists can play. Asian Journal of Psychiatry. 1 marzo 2020;50:102014.
5. Lima CKT, Carvalho PM de M, Lima I de AAS, Nunes JVA de O, Saraiva JS, de Souza RI, et al. The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatry Res. maggio 2020;287:112915.
6. Hahad O, Gilan DA, Daiber A, Münzel T. [Public Mental Health as One of the Key Factors in Dealing with COVID-19]. Gesundheitswesen. maggio 2020;82(5):389–91.
7. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2 marzo 2020;3(3):e203976.
8. Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep. 10 luglio 2020;22(8):43.
9. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. maggio 2020;287:112934.
10. Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Res. settembre 2020;291:113190.
11. Rafforzamento dell’Organizzazione mondiale della sanità: l’UE è pronta ad assumere un ruolo di primo piano [Internet]. [citato 23 gennaio 2021]. Disponibile su:
12. Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. maggio 1979;41(3):209–18.
13. STAI : state-trait anxiety inventory : forma Y : manuale / Charles D. Spielberger ; adattamento italiano a cura di Luigi Pedrabissi e Massimo Santinello [Internet]. [citato 21 gennaio 2021]. Disponibile su:
14. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. giugno 1961;4:561–71.
15. Kang HS, Son YD, Chae S-M, Corte C. Working experiences of nurses during the Middle East respiratory syndrome outbreak. International Journal of Nursing Practice. 2018;24(5):e12664.
16. Chung BPM, Wong TKS, Suen ESB, Chung JWY. SARS: caring for patients in Hong Kong. Journal of Clinical Nursing. 2005;14(4):510–7.
17. Holroyd E, McNaught C. The SARS crisis: reflections of Hong Kong nurses. International Nursing Review. 2008;55(1):27–33.
18. Lam KK, Hung SYM. Perceptions of emergency nurses during the human swine influenza outbreak: a qualitative study. Int Emerg Nurs. ottobre 2013;21(4):240–6.
19. Lam SKK, Kwong EWY, Hung MSY, Chien WT. Emergency nurses’ perceptions regarding the risks appraisal of the threat of the emerging infectious disease situation in emergency departments. International Journal of Qualitative Studies on Health and Well-being. 1 gennaio 2020;15(1):1718468.
20. Liu H, Liehr P. Instructive messages from Chinese nurses’ stories of caring for SARS patients. Journal of Clinical Nursing. 2009;18(20):2880–7.
21. Corley A, Hammond NE, Fraser JF. The experiences of health care workers employed in an Australian intensive care unit during the H1N1 Influenza pandemic of 2009: A phenomenological study. International Journal of Nursing Studies. 1 maggio 2010;47(5):577–85.
22. Hope D, Bates T, Penke L, Gow AJ, Starr JM, Deary IJ. Fluctuating Asymmetry and personality. Personality and Individual Differences. 1 gennaio 2011;50(1):49–52.
23. MacIntyre CR, Cauchemez S, Dwyer DE, Seale H, Cheung P, Browne G, et al. Face mask use and control of respiratory virus transmission in households. Emerg Infect Dis. febbraio 2009;15(2):233–41.
24. Chiang H-H, Chen M-B, Sue I-L. Self-state of nurses in caring for SARS survivors. Nurs Ethics. gennaio 2007;14(1):18–26.
25. Hope K, Massey P, Osbourn M, Durrheim D, Kewley C, Turner C. Senior clinical nurses effectively contribute to the pandemic public health response. Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation, The. 1 luglio 2011;28.
26. Koh D, Lim MK, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn? Med Care. luglio 2005;43(7):676–82.
27. Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, et al. Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies. 1 novembre 2020;111:103637.
28. Liu M, Cheng S-Z, Xu K-W, Yang Y, Zhu Q-T, Zhang H, et al. Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study. BMJ. 10 giugno 2020;369:m2195.
29. Coia J, Ritchie L, Adisesh A, Booth C, Bradley C, Bunyan D, et al. Guidance on the use of respiratory and facial protection equipment. Journal of Hospital Infection. 17 settembre 2013;85.
30. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. agosto 2020;88:901–7.
31. Simonetti V, Durante A, Ambrosca R, Arcadi P, Graziano G, Pucciarelli G, Simeone S, Vellone E, Alvaro R, Cicolini G. Anxiety, sleep disorders and self-efficacy among nurses during COVID-19 pandemic: A cross-sectional study. J Clin Nurs. 2021 Feb 3. doi: 10.1111/jocn.15685.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 > >>