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Table 4 Certainty of evidence for the protective factors associated with mitigating adverse mental health outcomes on health and care staff during the COVID-19 pandemic

From: A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

No of studies Design Risk of bias Additional considerations Certainty (overall score)a
Factor: Support (Community, social, team, government) [24, 37, 44, 46]
4 2 2 No serious inconsistencies. High
Factor: Adequate personal protective equipment (PPE) [24, 46]
2 2 0 Few studies assessed PPE directly as a protective factor. Many found it to be a risk factor when inadequate. Low
Factor: Being in a committed relationship [36]
1 2 0 Only one study assessed this factor. Very low
Factor: Prior outbreak experience/COVID-19 Knowledge [22, 24, 46, 61]
4 2 1 No serious inconsistencies, but the data also included one low quality uncontrolled pre and post exposure study, as well as a qualitative study. Moderate
Factor: Resilience [36, 44, 61]
3 2 1 Resilience was empirically measured with validated scores High
Factor: Altruistic acts [37]
1 2 1 Only one qualitative study assessed this factor. Low
Factor: Personal growth [37]
1 2 1 Only one qualitative study assessed this factor. Low
Factor: Gratitude, Positive self-attitude [24, 37]
2 2 1 This factor was not empirically measured. Low
Factor: Sense of purpose [37]
1 2 1 Only one qualitative study assessed this factor. Low
Factor: Safety of family [24]
1 2 0 Only one study assessed this factor. Very low
  1. a4 High = This research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different** is low
  2. 3 Moderate = This research provides a good indication of the likely effect. The likelihood that the effect will be substantially different** is moderate
  3. 2 Low = This research provides some indication of the likely effect. However, the likelihood that it will be substantially different** is high
  4. 1 Very low = This research does not provide a reliable indication of the likely effect. The likelihood that the effect will be substantially different** is very high
  5. ** Substantially different = a large enough difference that it might affect a decision