Implementing PTSD interventions for hospital nurses and physicians during COVID-19: A scoping review

Nurses and physicians in hospitals are particularly affected by the impacts of the COVID-19 pandemic as shown in the high prevalence of post-traumatic stress disorder (PTSD). To handle the urgent and high demand for psychological support, PTSD-related interventions had to be applied rapidly. Thus, interventions that were already evidence-based were adapted to pandemic conditions, or new interventions were developed. To implement these interventions sustainably, and be prepared for future disease outbreaks, we need to identify which strategies are necessary for the successful implementation. From this perspective, four years after the COVID-19 outbreak, we address the following: What are the [1] interventions that address symptoms of post-traumatic stress disorder in hospital-based nurses and physicians during the COVID-19 pandemic? What are the [2] implementation strategies for the identified interventions?

We used a scoping review approach and conducted a literature search from February to April 2023 in PubMed, PsychINFO and CINHAL. Primary studies (protocols) and concept papers focused on PTSD-related interventions for nurses and physicians and their implementation in hospitals during the COVID-19 pandemic, and published between 2020 and 2023 were included. Data extraction and analysis were performed in MaxQDA using deductive content analysis based on the (a) template for intervention description and replication (TIDieR) and the (b) Expert recommendations for implementing change (ERIC) framework.

A total of 16 interventions were adapted or developed world wide during the COVID-19 pandemic between 2020 and 2023. Evidence of effectiveness exist in only six of the 16 interventions. Most of them were designed using digital approaches and were primarly delivered through iterative implementation cycles, whereas the implementation of face-to-face interventions focused on interactions with various stakeholders.

Our findings can be used to support the implementation of PTSD-related interventions for nurses and physicians in hospitals under pandemic conditions. Future research should focus on evaluating the effectiveness of these interventions and identifying strategies for a beneficial and sustainable implementation.