Review Article

Reinforcement and Maintenance of Human Resources for Health Systems during Long-Term Crises: A Systematic Review of Systematic Reviews

Table 1

Summaries of the main points of the article.

Name of the first authorYearPeriodObjectivesDatabasesNumber of reviewed articlesMetaFindingsSubset

Muller et al. [12]202001.12.2019–11.05.20201. Investigating the impact of the COVID-19 pandemic on healthcare workers’ mental health, including (a) changes over time, (b) prevalence of mental health problems and risk/resilience factors, (c) strategies and resources used by healthcare providers to protect one’s mental health, (d) perceived need and preferences for interventions, and (e) healthcare workers’ understandings of their mental health during the pandemic
2. Describing the interventions assessed in the literature to prevent or reduce negative impacts on the mental health of healthcare workers working during the COVID-19 pandemic
PubMed, CDC, EMBASE, and NIPH’s59N1. Healthcare staff in different positions are exposed to risks such as depression, anxiety, and sleep problems during the COVID-19 pandemic due to different reasons
2. Preparing appropriate personal protective equipment and shift change programs to allow for rest in long-term crises is important
Motivation-hygiene measures

Cabarkapa et al. [13]20202002–21.08.20201. Investigating psychological disorders in healthcare workers (HCV) during severe epidemics
2. Identifying strategies to solve problems
PubMed, MEDLINE, and CINAHL55N1. Psychological consequences in healthcare staff, such as the risk of problems and anxiety, are different. The fear of unknown cases is one of their challenges
2. The negative mentality created by family and society increases the negative effects of stress
3. Adaptative methods are different among different cultures, physicians, nurses, and other healthcare employees
Motivation-hygiene measures

Willis-Shattuck et al. [14]20081980–09.20071. Identifying factors affecting motivation
2. Investigating the effectiveness of interventions in improving motivation and reducing healthcare workers’ immigration in developing countries
PubMed, ISI Web of Science, EMBASE/Medline, and Google Scholar20NThe following seven motivational factors contribute to maintaining workers:
1. Financial awards
2. Job promotion
3. Pursuing education
4. Hospital infrastructure
5. Availability of resources
6. Hospital management
7. Appreciation
Motivation-hygiene measures
Managers’ soft skills

Barasa [9]2018Till 31.12.20161. Exploring how resilience is conceptualized
2. Identifying factors affecting organizational resilience and how they are nurtured
PubMed, Econlit, EBSCOHOST databases, Google, and Google Scholar23NOrganizational resilience is affected by material resources, preparation, and planning, information management, sideways of increasing revenue, government’s measures, leadership methods, organizational culture, human capital, social media, and cooperationOrganizational resilience

Fernandez et al. [15]2020Till 03.2020Identifying factors affecting the provision of high-quality services by nurses during the epidemicCINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, and ProQuest28NThe nursing team provide high-quality care if the following factors are available:
1. Physical and emotional supports
2. Organization and management’s timely response and reaction
Managers’ soft skills

Anderson et al. [16]20202008–9.12.2019Investigating the effectiveness of organizational peer support and crisis-focused psychological interventions to mitigate posttraumatic stress injuries (PTSIs) among public safety personnel (PSP), frontline healthcare professionals (FHP), and other relevant groups at risk of occupational exposure to potentially psychologically traumatic events (PPTEs)PsycINFO, PubMed, JSTOR, Web of Science, Wiley, Sage, Taylor & Francis, Cambridge and Oxford Journal Online, Google Scholar14NPublic safety personnel (PSP) and frontline healthcare professionals (FHP) are often exposed to potentially psychologically traumatic events (PPTEs), and the increase in the rates of posttraumatic stress injuries (PTSIs) such as frequent absences, labeling, smoking and drugs, and suicide are also noticed among them
Measures such as diverse programming for critical incident stress debriefing, critical incident stress management, peer support, psychological first aid, and trauma risk management result in the reduction of PTSI
Organizational resilience, Managers’ soft skills

Aoyagi et al. [17]201504.2013–20151. Investigating willingness to work in HCWs during the flu pandemic
2. Identifying factors affecting the willingness to work
MEDLINE, EMBASE, Web of Knowledge, SCOPUS, AMED, ASSIA, BioEthicsWeb, CINAHL, Cochrane Library, PsychINFO, Google Scholar, and OpenGrey43YThe following factors were associated with an increase in the willingness to work in healthcare workers, physicians, and nurses:
1. Permanent employment
2. Perceived personal safety
3. Awareness of the pandemic risk and clinical knowledge of epidemics
5. Teaching how to respond to the epidemic
6. Self-confidence in personal skills.
However, childcare was significantly associated with a reduced willingness to work during the flu pandemic.
Motivation-hygiene measures
Managers’ soft skills

Ashcroft et al. [18]20201996–19.03.20201. Reviewing disaster training courses for medical students systematically
2. Describing the educational structure and methodology
3. Evaluating both
preparedness for disaster medicine and learning outcomes to inform the development of COVID-19-specific training programs
EMBASE, Medline, and Cochrane23NTo attract medical students aimed at helping dealing with COVID-19, there is a need for a special training program for them. This study indicates that medical students trained by appropriate education systems can play a pivotal role in managing the epidemicManagers’ soft skills
Organizational resilience

Raphael et al. [19]2021Till 30.04.2021Investigating the adaptability of providing mental health services during the outbreak of COVID-19CINAHL, EMBASE, Medline, PsycINFO, and Web of Science19NMental health services need to consider infection control measures and implement service changes to support continuity of care and patient and staff wellbeing. Services also need to ensure they communicate important information in a clear and accessible manner with their staff and patients regarding service delivery, contagion symptoms, government guidelines, and wellbeingManagers’ soft skills

Pappa et al. [20]2020Till 17.04.2020Evaluating the prevalence of depression, anxiety, or insomniaMEDLINE, PubMed, and Google Scholar13YCompared with men and medical staff, women and nurses show more emotional symptoms associated with anxiety and depression.
Special arrangements such as the provision of protective equipment for staff and their family should be made to protect their mental health.
Motivation-hygiene measures

Gross et al. [21]2021Till 26.04.20201. Examining HCV’s physical and mental health status in the COVID-19 situation
2. Detecting corona risk prevention measures
PsycINFO, Web of Science, and PubMed27NBecause of the high exposure of healthcare staff to COVID-19, it is necessary to
1. make the workplace safe
2. increase the healthcare staff information level of how infections outbreak and affect health
Motivation-hygiene measures

Bhaumik et al. [22]20202020Identifying CHWS’ principal roles, issues, obstacles, and activators to respond to the pandemicPubMed, 18 websites of different government ministries (India, Australia, and Singapore), public health agencies (from China, US, South Africa, UK, Hong Kong, and Australia), multinational agencies (WHO, European CDC, and African CDC), COVID-19 resource aggregators available at the time of review (Wiley, Elsevier, Oxford University Press, New England Journal of Medicine, Journal of the American Medical Association), and preprints (medRxiv)36NHealthcare workers play a pivotal role in pandemics. In addition to job satisfaction and workers’ health, it is necessary to ensure role transparency, education, support, and supervisionManagers’ soft skills
Motivation-hygiene measures

Pollock et al. [23]20202002–20201. Evaluating the intervention effects aimed at supporting the frontline healthcare professionals’ resilience and mental health during the outbreak of disease and epidemics
2. Identifying
obstacles and facilitators effective in performing interventions aimed at supporting frontline healthcare professionals’ resilience and mental health during the outbreak of disease and epidemics
CENTRAL, MEDLINE, EMBASE, Web of Science, PsycINFO, CINAHL, Global Index Medicus databases, and WHO16NFrontline healthcare professionals’ mental health and resilience during epidemics can be improved by workplace interventions, supportive interventions to meet basic daily needs, psychopathic interventions, health interventions, or a combination of these.Motivation-hygiene measures Managers’ soft skills

Timbie et al. [24]20131990–2011The analysis of scarce resource allocation management strategiesMedline, Scopus, EMBASE, Cumulative Index to Nursing and Allied health literature, Global Health, Web of Science, Cochrane, New York Academy of Medicine’s Grey literature report, and key websites74NScarce resource allocation management strategies during collective explosion events include
1. reducing demand for healthcare services
2. optimizing the use of available resources
3. increasing existing resources
4. implementing crisis treatment standards and hybrid strategies
Organizational resilience

Allan et al. [25]2020Till 30.03.2020Examining HCWs’ mental health disorders regarding the increasing rate of hospital admissions and mortality due to COVID-19Medline, PsycINFO, CINAHL, PubMed, OVID, and ScienceDirect19YMental health disorders are common among healthcare workers in contact with patients during the epidemic, but the trend of these disorders has not been completely understood. More followup of healthcare workers is necessary.Managers’ soft skills

De Brier et al. [26]2020Till 28.03.2021Identifying risk and protective factors of HCW’s mental health during the corona epidemicMEDLINE, EMBASE, PsycINFO, WHO, and CDC33NThere are some pieces of evidence indicating that clear communication, organizational support, social support, and a sense of personal control are protective factors against mental consequences.Managers’ soft skills