Risk Factors and Psychological Consequences of COVID-19 Outbreak: Perspective and Experience of Iranian Healthcare Workers on the Front Lines.

Frontline Healthcare workers (HCWs) caring for patients with COVID-19 have a high risk of developing mental health problems. Recognizing the risk factors and consequences of care in this group of people can lead to preventive and interventional measures to maintain and improve their mental health and ultimately improve the quality of their care. This qualitative content analysis study was conducted between September 2020 and February 2021 in Iran. Data were collected through face-to-face interviews with 22 HCWs working directly with COVID-19 patients. Data were analyzed with conventional content analysis method. Results showed that data analysis led to the production of 163 codes, 45 categories (16 risk factors and 29 consequences) and 9 themes including "late understanding of the nature of the disease", "sudden changes in roles", "difficult and overwhelming management" "Care for the older adults: Double Care", "Crisis at the Heart of the Crisis", "Ethical Dilemmas", "Obsessive Behaviors and Thoughts: The Consequences of Mass Death Anxiety ","Positive Outcomes of Caring for COVID-19 patients" and "threatening strategies". Overall, these results suggest that caring for a patient with COVID-19 is associated with positive and negative psychological consequences. Therefore, measures such as increasing sensitivity to crisis situations, self-adjustment skills training, pre-job training and in-service training, using "Coordinator Manager" and "Assistant Managers" in crisis situations, access to an experienced psychologist, implementation of the plan "Discharge nurse", training family caregivers and identifying signs of job burnout due to moral conflicts can reduce or eliminate the risk factors for negative psychological consequences in HCWs.