JRSSEM 2023, Vol. 02, No. 7, 1483 – 1499
E-ISSN: 2807 - 6311, P-ISSN: 2807 - 6494
DOI : 10.59141/jrssem.v2i07.421 https://jrssem.publikasiindonesia.id/index.php/jrssem
THE WORKLOAD IMPACT ON HEALTHCARE WORKERS
AT THE HOSPITAL IN COVID-19 ERA: A SYSTEMATIC
REVIEW
Azwar
1
Ilyas Y
2
Alrianti
3
Marlina
4
Ridho
5
1,3,4,5
Hospital Administration Studies Program, Public Health Faculty of Universitas Indonesia
2
Faculty of Public Health Universitas Indonesia
*
e-mail: muhammad.azw[email protected]c.id
*Correspondence: Muhammad Azwar
Submitted
: January 19
th
2023
Revised
: February 09
th
2023
Accepted
: February 25
th
2023
Abstract: COVID-19 has been declared a worldwide pandemic by WHO on 11th March 2020. The
aim of this study was to collect data and investigate across the world in dealing with the load of
healthcare workers on their healthcare systems to get a better understanding of the real
difficulties and challenges they faced. This study is a systematic review, searched some literatur of
PUBMED, PROQUEST, OXFORD JOURNAL, WILEY JOURNAL and SCOPUS journal databases
published in 2020. We used the keywords; “Workload” and “healthcare workers” and “COVID-19”,
and screened by inclusion and exclusion criteria. Nine studies have screened from 673 articles
from database, which investigated factors independent of the workload of the healthcare workers
and explaining the strategy of hospitalis in overcoming the healthcare workers workload in
COVID-19 era. We found several factors related to the workload of health workers in the COVID-
19 era: using the PPE, lack of knowledge about disaster management, the type of professional
group, increasing the number of COVID- 19 patients and the rapidly progress of patient severity.
Changing the flow of patient services is one of pursuing a strategy to reduce the workload by put
the screening at the first step of patient arrival to the hospital.
Keywords: Workload; Healthcare Workers; COVID-19.
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INTRODUCTION
COVID-19 has been declared a
worldwide pandemic by the World Health
Organization (WHO) owing to the rapid
increase in the number of cases, on 11th
March 2020. The WHO recorded
81,159,096 confirmed cases of COVID-19
and 1,791,246 fatalities as of 15:00 on
December 31, 2020, and that figure was
rising(Https://covid19.who.int/, n.d.). The
number of COVID-19 cases is also
escalating rapidly in Indonesia. By 31
December 2020, there were 743.198
confirmed cases in 34 provinces and
22.138 people had lost their lives
(Https://covid19.go.id/peta-sebaran, n.d.).
Indonesia is currently in a serious position,
with the world's twentieth-highest amount
of cases and mortality. Indonesia have not
leave the first wave since the first case on
March 2020 where the other countries on
the world are going to their second wave
of pandemic (Https://covid19.who.int/,
n.d.). Indonesia are struggling to reduce
active cases from 8074 cases daily and
mortality rate which are 3%
(Https://covid19.go.id/peta-sebaran,n.d.).
The absence of a uniform, transparent, and
comprehensive tracking system detecting
COVID-19 infections in Indonesians has
become a major issue in the fight against
thepandemic(Https://kawalcovid19.id/cont
ent/1294/serial-data-virus-korona-2-rasio-
lacak-isolasi-rli-dan-korelasinya-dengan-
kematian-kumulatif#reach-skip-nav, n.d.).
The fast spreading pandemic has put
a lot of stress on the entire Indonesian
healthcare system, especially in
government hospital as referral hospital at
each Provinces. In these early stages of the
outbreak, most ICU isolation units were
overwhelmed by the growing number of
suspected and confirmed cases; general
wards were quickly converted to isolation
wards, and health-care providers without
COVID-19 patients were treated by
infectious disease experts(ICU Jakarta
Menipis, n.d.).
The pandemic places healthcare
workers all across the world in a situation
that has never happened before.
Healthcare workers are on the front lines
of the COVID-19 pandemic response and
are particularly vulnerable to infection.
Europe had the largest number of COVID-
19 infections among health-care workers
(119.628 cases, or 78.2%), whereas Africa
had the lowest number (1472 cases, 1.0%).
In terms of mortality, the same
geographical trend emerged: Europe had
the largest number of deaths (712, or 50.4
percent), while Africa had the lowest (17
death, 1.2 percent). Despite having the
highest number of fatalities, Europe also
had the highest number of illnesses,
resulting in the lowest Case Fatality Rate.
The greatest Case Fatality Rate (5.7
fatalities per 100 infections) is found in the
Eastern Mediterranean, followed by South
East Asia (3.1 deaths per 100
infections)(Bandyopadhyay S, Baticulon RE,
Kadhum M, Alser M, Ojuka DK, Badereddin
Y, n.d.). As 21 of December 2020 Indonesia
has lose 518 their healthcare workers
(2,3%) (Https://nakes.laporcovid19.org/,
n.d.).
During the COVID-19 pandemic, all
provinces reported an increase in
healthcare worker workload, placing them
at a higher risk of infection and disease
transfer to their families and
1485 | The Workload Impact on Healthcare Workers At The Hospital In Covid-19 Era: A Systematic
Review
coworkers(NEWS - dob CI. Ini Alasan
24.400 Pasien Positif Covid di Klaster
Rumah Sakit. NEWS - dob, n.d.). One of
the most common ways for the corona
virus to spread throughout the world is
through hospital-associated transmission
(Yuki Furuse, Eiichiro Sando, Naho
Tsuchiya, Reiko Miyahara, Ikkoh Yasuda,
Yura K. Ko, et al. Cluster of Coronavirus
Disease in Communities, Japan, n.d.).
As a result, we decided to undertake a
research to learn from other nations'
experiences in overcoming the burden of
healthcare workers on their healthcare
systems in order to gain a better
knowledge of the genuine issues and
obstacles they faced. Our findings will be a
useful resource for establishing safer
healthcare providers who can respond
more quickly and methodically to future
outbreaks.
MATERIALS AND METHODS
This review used the protocol of the
reporting items for Systematic review and
Meta-analysis (PRISMA) guidline.
Eligibility
The articles were screened by
inclusion and exclusion criteria. The
inclusion criterias were a article just in
English languange, published in 2020,
articles about COVID-19 focusing in the
workload impact on healthcare workers at
the hospital in some countries. The
exclusion criterias were lack of information
on target outcome, unable to download
and there was no method on research.
Information Sources and Search
A number of 673 articles were
collected from PubMed, PROQUEST,
Oxford Journal, Wiley Journal, and Scopus
databases using Excel 2013 version 2020.
We collected the relevant article which the
topic and then we screened them by
inclusion and exclusion criteria. The
detailed screening process is described in
FIGURE 1.
Study Selection
We filtered the total list of identified
record articles to determine standardized
and eligibility. Initially, we screened the
articles via title and abstract. Afterward,
eliminated the irrelevant articles from the
study. And next we reviewed the full-text
of articles and include them to the list. We
discussed about incompatibility and
compare the articles.
Data Collection Process
Two authors finished an outcome data
base to review. And one authors extracted
the next articles from the included studies.
The last one authors corrected the
extracted data and any disagreements
were reviewed by him.
Data Item
The following information will be
extracted from each the articles : Journal
title, author, publication year, study design,
Variable (the healthcare workers working
in the front line of the COVID-19
pandemic, the healthcare workers
experience negative and positive mental
symptom before and during the COVID-19
crisis).
Risk Of Bias In Individual Studies
The checklist of Joanna Briggs Institute
(JBI) critical appraisal was used to assess
the methodological quality. We have seven
articles using cross-sectional study and
two articles using qualitative analysis.
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RESULTS AND DISCUSSION
This systematic review demonstrates
factors that influence the workload of
healthcare workers in COVID-19 era,
incorporating two studies across six
countries. A number of nine articles have
screened from 673 articles from database
( PubMed, PROQUEST, Wiley Journal,
Oxford Journal, and SCOPUS) . Ten articles
excluded because duplication. 663 articles
will be screened by title and abstract and
we got 179 articles that relevant. 25 full-
text articles assessed for eligibility. And
the nine articles were study primer. The
detailed screening process is described in
FIGURE 1.
Study Characteristic
Of the 9 identified studies, one study
included non-medical participants, 8
studies conducted a survey of the
healthcare workers. 4 studies were
conducted in China, the remaining were
conducted in south Sudan, Iran, Saudi
Arabia, Brazil, and Belgium. The
demographics of study participants varied.
The Cross-sectional design was used in 7
studies and Qualitative analysis was used
in 2 studies. All the studies rely on
questionnaires and survey. In table 1, we
summarize the characteristics of this study.
These 9 studies investigated factors
independent of the workload of the
healthcare workers. Several studies
explaining the strategy of hospitalis in
overcoming the healthcare workers
workload in COVID-19 era.
Figure 1. Prisma Flow Diagram
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DOI : 10.59141/jrssem.v2i07.421 https://jrssem.publikasiindonesia.id/index.php/jrssem
Table 1. Study Characteristic
No.
Title
Date of
Study
Authors
Method
Variable
(Participants)
Result
Others
Information
1.
Coping
with
COVID-19
in United
Nations
peacekeep
ing field
hospitals:
increased
workload
and
mental
stress for
military
healthcare
providers
April
2020 -
August
2020
Yongxue
Zhang,D
Xiang, N
Alejok
Cross-
sectional
study
62 personnel at the
UN level II Hospital
(april 2020 –
august 2020)
1.Healthcare
workers = 47
medical staf (22
doctors, 17 nurses,
8
technicians/pharma
cist)
2. Non-medical
duties = 16
personnel
The hospital :
there has been a change in
the triage system in
hospital since the Covid-
19 case.
the workload healthcare
workers:
“an increase in workload
due to : increased working
hours, increased mental
stress, limited health
facilities and human
resources, especially
healthcare workers.
During the
COVID-19
era, the
workload of
hospital
cleaners
increased.
The change
of hospital
triage and
protocols
service are
one of the
factors in
increasing
the workload
for cleaning
workers.
2.
Covid-19
effects on
(2020)
Esmail
Shoja,
cross-
sectional
The healthcare
workers worked in
The workload increases at :
the healthcare workers
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the
workload
of Iranian
healthcare
workers
Vahideh
Aghamoha
mmadi,
Hadi Bazyar,
Hamed
Rezakhani
Moghadda
m, Khadijeh
Nasiri,
Mohammad
Dashti, Ali
Choupani,
Masoumeh
Garaee,
Shafagh
Aliasgharza
deh and
Amin Asgari
study
Iran ministry of
health and medical
education (495
participants).
The subjects of
sociodemographi
informasion :
“sex, age, shift
working, job title,
duration of
employement,
interacting with
Covid-19 patients
at work, Due to the
extreme incidence
of Covid-19,
working hours have
risen, ward of labor
who are in direct contact
with Covid-19 patients
the use standard PPE
also increases the
workload
Long shift time (12
hours) increases fatigue
and workload compared to
8 hours shift
the type of job also
affects the workload.
Nurses have a higher level
of workload than doctors,
because nurses have more
duties according to this
study.
3.
Experience
s of front-
line nurses
combating
26
January
2020 –
5
Yu-E Liu,
Zhong-
Chang Zhai
BD, Yan-
Descriptiv
e
qualitative
analysis
15 nurses (5 males,
10 females) from 2
hospitals and
working history
the workload healthcare
workers:
Their lack of knowledge
support from
the society
for the nurses
during
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coronaviru
s disease-
2019 in
China: A
qualitative
analysis
Februar
y 2020
Hong Han,
Yi-Lan Liu,
Feng-Ping
Liu, De-Ying
Hu
with the
interviewe
d semi-
structured
was 5-7 years.
7 nurses worked in
ICU, 2 nurses work
on infectious
disease wards, 6
nurses worked on
general wards
and abilities in emergency
catastrophe rescue are
variables that impact it, as
well as psychological
pressure.
COVID-19
pandemic
make them
more excited
doing their
job.
4.
Healthcare
workers
experience
in dealing
with
Coronavir
us
(COVID-
19)
pandemic
Marc
2020
and
April
2020;
Rana H.
Almaghrabi,
MD, MBBS,
Huda
Alfaradi,
MD,Wejdan
A. Al
Hebshi, BSc,
DipIC
Mohammed
M.
Albaadani,
BSN, RN
Cross-
sectional
study with
questionn
aire-based
online
survey
1036 Healthcare
workers.
> respondent’s
age were 26-34
years.
Healthcare workers have a
strong commitment in
carrying out the
responsibility of treating
COVID-19 patients. They
need support especially in
crisis management
program to deal with
disasters. Problems that
often arise related to their
workload are the
additional shift, use PPE,
and mental burdens for
fear of contracting and
having to be far from their
family
The positive
role of social
media in
making
awareness for
society.
5.
Healthcare
2020
Paula
Cross-
536 the
at the start of the
the setting
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Workers in
Brazil
during the
COVID-19
Pandemic:
A Cross-
Sectional
Online
Survey
Cotrin,
Wilana
Moura,
Caroline
Martins
Gambardela
-Tkacz,
Fernando
Castilho
Pelloso,
Lander dos
Santos,
Maria Dalva
de Barros
Carvalho,
Sandra
Marisa
Pelloso, and
Karina
Maria
Salvatore
Freitas
Sectional
Study
the
observer's
assessmen
t
A Google
Forms
(Google
Inc.,
Mountain
View, CA,
USA)
questionn
aire was
created
and sent
through
email and
WhatsApp
(WhatsAp
p Inc,
Mountain
View,
healthcare workers
in Brazil (doctors,
nurses, dentists)
above the age of
22
battling the
COVID-19
epidemic on the
front lines
pandemic many dentists
and nurses wanted to give
up their jobs.
The fear of contracting
COVID-19 was expressed
by 90% of respondents
The majority of
healthcare personnel were
not trained to treat
individuals who were
suspected of being
infected with the
coronavirus.
almost all the healthcare
workers complain of
difficulty sleeping
of work lack
study are
variety from
private
clinical
practice to
public health
sector.
Causing of
the workload
on physician
and dentist
lower than
nurses
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CA,USA)
6.
Hospice
care self-
efficacy
among
clinical
medical
staff
working in
the
coronaviru
s
disease
2019
(COVID-
19)
isolation
wards of
designate
d
hospitals:
a cross–
sectional
study
from
Februar
y to
April)
Ze-hong
Zheng,
Zhong-chen
Luo, You
Zhang,
Wallace Chi
Ho Chan,
Jian-qiong
Li, Jin Pang,
Yu-ling Jia
and Jiao
Tang
cross-
sectional
study
with
questionn
aire survey
A large number of
the healthcare
workers who
handle COVID-19
patients.
The mean age
was 32.96 ± 5.96
years
Healthcare workers who
have the competence,
knowledge, skills for
pandemic problems will be
better prepared to carry
out their duties and can
reduce their mental
burden due to being faced
with death.
-
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7.
COVID-19
is having a
destructiv
e impact
on
health-
care
workers’
mental
well-being
2 April
2020
and 4
May
2020
Kris
Vanhaecht,
Deborah
Seys, Luk
Bruyneel,
Bianca Cox,
Gorik
Kaesemans,
Margot
Cloet, Kris
Van Den
Broeck,
Olivia Cools,
Andy De
Witte, Koen
Lowet,
Johan
Hellings,
Johan
Bilsen,
Gilbert
Lemmens
and
Stephan
Claes
cross-
sectional
Study
Workers in
the
healthcare
industry
were
invited to
take part
in a two-
wave
online
survey
the healthcare
workers in Belgium
survey online
about : before and
during the COVID-
19 crisis, people
had negative and
positive mental
symptoms.
there was an increase in
negative mental health
symptoms during the
COVID-19 era.
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8.
Frontline
nurses’
burnout,
anxiety,
depression
, and fear
statuses
and their
associated
factors
during the
COVID-19
outbreak
in Wuhan,
China: A
large-scale
cross-
sectional
study
from
13-24
februar
y 2020
Deying Hu,
Yue Kong,
Wengang Li,
Qiuying
Han, Xin
Zhange, Li
Xia Zhu, Su
Wei Wan,
Zuofeng
Liu, Qu
Shen,
Jingqiu
Yang, Hong-
Gu He,
Jiemin Zhu
This was a
large-scale
cross-
sectional,
descriptive
,
correlation
al study.
All the nurses who
are in charge of
dealing directly
with COVID-19 but
have never
experienced mental
disorder.
the use of PPE which
causes the lesion on the
face of the nurse is one of
the factors that increases
the mental burden and
stress of the nurses
the nurses complained
of anxiety, fatigue, fear,
and depression on duty
during COVID-19 era.
9.
The
experience
s of
health-
care
providers
10-15
februar
y 2020
Qian Liu,
Dan Luo,
Joan E
Haase,
Qiaohong
Guo, Xiao
a
qualitative
study
with Semi-
structured,
telephone
--> In February
2020, nine nurses
and four physicians
were recruited from
five COVID-19-
designated
Three theme categories
emerged from data
analysis:
being totally
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during the
COVID-19
crisis in
China: a
qualitative
study
Qin Wang,
Shuo Liu,
Lin Xia,
Zhongchun
Liu, Jiong
Yang, Bing
Xiang Yang
interviews
in-depth
institutions in
Hubei province.
they were in
charge of directly
dealing with
COVID-19 patients.
responsible for the health
and well-being of patients
The obstacles of
working on COVID-19
wards are numerous.
The healthcare workers
experience fatigue due to
heavy workloads, fear of
transmitting and being
infected of COVID-19
The third category was
resiliency in the face of
adversity
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Question 1 : The factors Associated
workload of Healthcare Workers in
COVID-19 era
According to our findings from nine
studies that there were some factors
associated workload of healthcare workers
in COVID-19 era. There were some factors
that increasing workload on healthcare
workers in COVID-19 era. Using personal
protective equipment (PPE) was the first
factor (Shoja et al., 2020)
,
(Almaghrabi et al.,
2020)
,
(Hu et al., 2020). The healthcare
workers must use personal protective
equipment (PPE) while on duty, so that
they are protected from the transmission
of COVID-19 but they felt uncomfortable.
Because the rules of using PPE was difficult
(Shoja et al., 2020). Beside that using of
special personal protective equipment
(PPE) caused some of them complain
about problems with their face skin (Hu et
al., 2020). Secound of factor was lack of
knowledge about disaster management,
such as how to use PPE correctly, how to
managed critical ill patients and increasing
knowledge of hospice care self-efficacy,
knowledge of healthcare workers self care
(Almaghrabi et al., 2020)
,
(Liu et al.,
2020)
,
(Zheng et al., 2020). Third, the type of
professional group where the nurses have
more workload than others professional
group (Shoja et al., 2020). Fourth,
Increasing the number of COVID-19
patients and the rapidly progress of
patients severity (Zhang et al., 2020).
The increasing workload of healthcare
workers also affected to their physical and
mental health, Because during the COVID-
19 era, healthcare personnel were under
duress. Such as anxiety, depression, sleep
disorder, burn out, fear, and exhausted
factor (Cotrin et al., 2020)
,
(Vanhaecht et al.,
2020)
,
(Ramanathan et al., 2020).
Question 2 : The Hospital Strategic to
solve the workload of healthcare workers
during COVID-19 era
Changing the flow of patient services is
one of pursuing a strategy to reduce the
workload due to the Covid-19 pandemic
by put the screening at the first step of
patient arrival to the hospital and the
patient must have appointment with the
hospital management except patient with
emergency condition. The management of
hospital devided the area depend on risk
of infection. The high risk of infection area
was desinfected two times a day with
sodium hypoclorite, whereas the non-
infection area was desinfected once a day
during COVID-19 era (Zhang et al., 2020).
Some studies gave advice for the
management of hospital strategic during
COVID-19 era. The first was providing
disaster management and critical ill course
for HCW. The secound was recruitment of
HCW by criteria having compotents about
COIVID-19 and exhause PPE knowledge.
The third was proper insentive with risk of
job and workload in pandemic situation.
DISCUSSION
In this systematic review of nine
studies, we identified the factors
influenced healthcare workers workload
during COVID-19 era and the hospital
strategic to solve that problem. Because
health-care professionals aren't aware of
the situation, treatment may be delayed,
resulting in infection transmission. As the
worldwide danger of COVID-19 grows, it's
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more important than ever to enhance
health-care professionals' understanding
and attitudes. Educational initiatives are
desperately needed to reach health-care
personnel all around the world, and more
research is needed (Bhagavathula AS,
Aldhaleei WA, Rahmani J, Mahabadi MA,
n.d.). Most of the study were observed
situation of health care workers
knowledge at the beginning of the covid-
19 pandemic. Lack of knowledge about
covid-19 because of not yet many things
about its aspect were known. Along with
the pandemic travel access to get
information about various aspects of
transmission and management of covid-19
has been very developed and the
globalization cause this information is very
easy to be accessed by anyone.
The health care workers capacity of
critical ill skill contributed on reducing
case fatality rate. The average case fatality
rate of covid-19 was about 1%. Meanwhile
the fact today Covid-19 has caused a
rampage around the world. The key areas
feeling the brunt of this pandemic have
been ICUs in variable healthcare settings,
which have experienced a substantial
increase in critical care beds and shortages
of supplies and health care workers.
Causes of deaths in previous pandemics
were a result of respiratory failure
(Https://www.medscape.org/viewarticle/931
961, n.d.). several health services address
the shortage of ICU health care workers by
moving health care workers from other
non-ICU wards or by recruiting new,
younger health workers. This condition
makes the Health service have to prepare
critical ill training to them.
Long labor hours, exhaustion,
occupational burnout, stigma, physical and
psychological aggression, and back
injuries from patient handling are all
frequent among COVID-19 patients'
caregivers. It is important that efforts be
made to preserve health care
professionals' physical and emotional
health, as well as the quality of treatment
they provide. WHO recommends that IPC
measures be supplemented by
occupational safety and health measures,
psychosocial support, adequate staffing
levels, and clinical rotation to reduce the
risk of burnout, for safe and healthy
working environments, and to respect the
rights of health workers to decent working
conditions
(Http://weekly.chinacdc.cn/en/article/id/e53
946e2-c6c4-41e9-9a9b-fea8db1a8f51, n.d.).
The pandemic of COVID-19 has a
major impact on the health sector, causing
of hospitals as part of health service
facilities to experience various problems.
Several studies that we identified
explained various problems experienced
by the hospital, including; limited personal
protective equipment for healthcare
workers and lack of knowledge about
disaster management. These things were
factors that affected the workload of
healthcare workers. The problems arise
indicating the lack of hospital preparation
in the face of a natural disaster or a
pandemic (World Health Organisation,
2014). The hospital should have formed a
risk management team to prepared special
plan during pandemic, such as
implementation and identification of steps
to reduced emergency risk, identified
resources as medical equipment supplies,
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health personal staff supplies,
infrastructure and utilities, make policies,
identified deficiencies and weaknesses in
hospital emergency preparedness,
implement mechanisms to immediately
correct these deficiencies such as
immediately holding staff training about
disaster management (World Health
Organisation, 2014) .
In addition, the hospitals as the most
important part of managing of pandemic
as COVID-19 must prepared standard
operating procedures that apply to
emergency situation, such as infection
prevention and control procedures in
hospital, division of infection and non-
infection areas, patient triage protocols,
the flow of patient traffic in and around
the hospital, paying attention to the
actions that must be taken to ensure the
safety of hospital staff, (especially the
healthcare workers), communication and
information activities, logistics service and
human resource issue (World Health
Organisation, 2014).
CONCLUSIONS
Other Information
We identified from several studies
regarding others information such as an
increase in the workload of cleaning
workers in hospitals because they had to
disinfect according to protocols. Then
there's information on how social media
may help people learn about COVID-19.
Limitation
This systematic review has several
limitations, the number of studies that we
obtained was very small, only nine studies.
So, the information that we wanted to
achieve was also not in depth. The type of
methodology is cross-sectional, as a result,
we're still stumped as to what's causing
the rise in healthcare professionals'
workload in the COVID-19 era. So, in our
opinion, further study is needed related to
this theme so that the information
obtained is protected from bias.
REFERENCES
Almaghrabi, R. H., Alfaradi, H., Hebshi, W.
A. A., & Albaadani, M. M. (2020).
Healthcare workers experience in
dealing with Coronavirus (COVID-19)
pandemic.
Saudi Medical Journal
,
41
(6), 657–660.
https://doi.org/10.15537/SMJ.2020.6.
25101
Bandyopadhyay S, Baticulon RE, Kadhum
M, Alser M, Ojuka DK, Badereddin Y,
et al. I. and mortality of healthcare
workers worldwide from C.-19: a
systematic review. B. G. H. [Internet].
2020 D. 4;5(12):e003097. A. from:
https://gh. bmj. com/lookup/doi/10.
1136/bmjgh-2020-003097. (n.d.).
No
Title
.
Bhagavathula AS, Aldhaleei WA, Rahmani
J, Mahabadi MA, B. DK. K. and
perceptions of C.-19 among health
care workers: C. study. J. P. H. S.
[Internet]. 2020 A. 1 [cited 2021 J.
13];6(2). A. from: https://pubmed.
ncbi. nlm. nih. gov/32320381. (n.d.).
No Title
.
Cotrin, P., Moura, W., Gambardela-Tkacz, C.
M., Pelloso, F. C., Santos, L. dos,
Carvalho, M. D. de B., Pelloso, S. M., &
Azwar
1
Ilyas Y
2
Alrianti
3
Marlina
4
Ridho
5
|1498
Freitas, K. M. S. (2020). Healthcare
Workers in Brazil during the COVID-
19 Pandemic: A Cross-Sectional
Online Survey.
Inquiry (United States)
,
57
.
https://doi.org/10.1177/00469580209
63711
Https://covid19.go.id/peta-sebaran, P. S. |
S. P. C.-19 [Internet]. [cited 2020 D.
31]. A. from: (n.d.).
No Title
.
Https://covid19.who.int/, W. C. D. (COVID-
19) D. | W. C. D. (COVID-19) D.
[Internet]. [cited 2020 D. 31]. A. from:
(n.d.).
No Title
.
Https://kawalcovid19.id/content/1294/seri
al-data-virus-korona-2-rasio-lacak-
isolasi-rli-dan-korelasinya-dengan-
kematian-kumulatif#reach-skip-nav,
S. D. V. K. 2: R. L. – I. (RLI) dan K.
dengan K. K. | K. [Internet]. [cited
2020 D. 31]. A. from: (n.d.).
No Title
.
Https://nakes.laporcovid19.org/, T. K. P. K. I.
[Internet]. [cited 2020 D. 31]. A. from:
(n.d.).
No Title
.
Https://www.medscape.org/viewarticle/93
1961, C.-19: S. in C. for C. I. P.
[Internet]. [cited 2021 J. 13]. A. from:
(n.d.).
No Title
.
Http://weekly.chinacdc.cn/en/article/id/e5
3946e2-c6c4-41e9-9a9b-
fea8db1a8f51, S. R.-82 HIGHLIGHTS.
[cited 2021 J. 13]; A. from: (n.d.).
No
Title
.
Hu, D., Kong, Y., Li, W., Han, Q., Zhang, X.,
Zhu, L. X., Wan, S. W., Liu, Z., Shen, Q.,
Yang, J., He, H. G., & Zhu, J. (2020).
Frontline nurses’ burnout, anxiety,
depression, and fear statuses and
their associated factors during the
COVID-19 outbreak in Wuhan, China:
A large-scale cross-sectional study.
EClinicalMedicine
,
24
.
https://doi.org/10.1016/j.eclinm.2020.
100424
ICU Jakarta Menipis, A. I. R. S. di I. P. W.
[Internet]. [cited 2020 D. 31]. A. from:
https://www. kompas.
com/sains/read/2020/09/10/1302009
23/icu-jakarta-menipis-ahli-ingatkan-
rumah-sakit-di-indonesia-perlu-
waspada. (n.d.).
No Title
.
Liu, Y. E., Zhai, Z. C., Han, Y. H., Liu, Y. L., Liu,
F. P., & Hu, D. Y. (2020). Experiences of
front-line nurses combating
coronavirus disease-2019 in China: A
qualitative analysis.
Public Health
Nursing
,
37
(5), 757–763.
https://doi.org/10.1111/phn.12768
NEWS - dob CI. Ini Alasan 24.400 Pasien
Positif Covid di Klaster Rumah Sakit.
NEWS - dob, C. I. 23 S. 2020 1327
[Internet]. 2020; A. from: https://www.
cnbcindonesia.
com/news/20200923124145-4-
188835/ini-alasan-24400-pasien-
positif-covid-di-klaster-rumah-sakit.
(n.d.).
No Title
.
Ramanathan, K., Antognini, D., Combes, A.,
Paden, M., Zakhary, B., Ogino, M.,
Maclaren, G., & Brodie, D. (2020).
Since January 2020 Elsevier has
created a COVID-19 resource centre
with free information in English and
Mandarin on the novel coronavirus
COVID- research that is available on
the COVID-19 resource centre -
including this for unrestricted
research re-use a
.
January
, 19–21.
Shoja, E., Aghamohammadi, V., Bazyar, H.,
Moghddam, H. R., Nasiri, K., Dashti,
M., Choupani, A., Garaee, M., &
Asgari, A. (2020).
Covid-19 effects on
1499 | The Workload Impact on Healthcare Workers At The Hospital In Covid-19 Era: A Systematic
Review
the workload and mental health of
Iranian healthcare workers
. 1–7.
https://doi.org/10.21203/rs.3.rs-
27866/v1
Vanhaecht, K., Seys, D., Bruyneel, L. U. K.,
Cox, B., Kaesemans, G., Cloet, M.,
Broeck, K. V. A. N. D. E. N., Cools, O.,
Witte, A. D. E., Lowet, K., & Claes, S.
(2020). OUP accepted manuscript.
International Journal For Quality In
Health Care
,
00
(December), 1–6.
https://doi.org/10.1093/intqhc/mzaa1
58
World Health Organisation. (2014).
Hospital Preparedness for Epidemics
.
71.
Yuki Furuse, Eiichiro Sando, Naho Tsuchiya,
Reiko Miyahara, Ikkoh Yasuda, Yura K.
Ko, et al. Cluster of Coronavirus
Disease in Communities, Japan, J.-A.
2020. E. I. Dis. 2020; (n.d.).
No Title
.
Zhang, Y., Xiang, D., & Alejok, N. (2020).
Coping with COVID-19 in United
Nations peacekeeping field hospitals:
Increased workload and mental stress
for military healthcare providers.
BMJ
Military Health
,
September 2019
, 1–5.
https://doi.org/10.1136/bmjmilitary-
2020-001642
Zheng, Z. hong, Luo, Z. chen, Zhang, Y.,
Chan, W. C. H., Li, J. qiong, Pang, J.,
Jia, Y. ling, & Tang, J. (2020). Hospice
care self-efficacy among clinical
medical staff working in the
coronavirus disease 2019 (COVID-19)
isolation wards of designated
hospitals: a cross–sectional study.
BMC Palliative Care
,
19
(1), 1–12.
https://doi.org/10.1186/s12904-020-
00692-0
© 2023 by the authors. Submitted
for possible open access publication
under the terms and conditions of the Creative
Commons Attribution (CC BY SA) license
(https://creativecommons.org/licenses/by-sa/4.0/).