Developing a healthcare worker psychological preparedness support programme for the COVID-19 outbreak

Background: The coronavirus disease 2019 (COVID-19) outbreak caused worldwide disruptions to healthcare systems. The emerging evidence indicates that mental health problems have consequently become an occupational hazard in frontline healthcare workers. Aim: We aimed to develop a psychological preparedness training (PPT) programme to support frontline health workers in three resource-limited hospitals in South Africa dealing with the COVID-19 outbreak and to evaluate its effectiveness using an audit tool. We established a theoretical framework and goals for a psychological preparedness programme to support healthcare workers at the study sites. Setting: Data were collected at the Dora Nginza Hospital, Nelson Mandela Academic Hospital and Elizabeth Donkin Hospital. Methods: We employed an observational, descriptive, and cross-sectional design. A group psychological intervention was developed and implemented at the three sites in South Africa, from mid-April 2020 over 20 weeks. We collected data using an audit tool to measure healthcare workers' perceptions of the outbreak before and after the intervention. We analysed the data to test for a statistically significant difference between the pre-intervention and post-intervention audit tools. Results: We supported 761 healthcare workers during the 20 weeks of the programme. Statistical analysis showed a significant positive change from pre- to post-intervention measures in perceptions of health worker about the outbreak, their anxiety associated with the outbreak, their ability to control reactions to stress and the perception of their ability to support others. Feedback comments indicated that the programme was beneficial for the majority of those who attended. Conclusion: Health workers who attended the programme reported improvement in stress levels and in perceptions about their ability to cope with the outbreak, as well as in their perceptions of being able to support others.