The impact of common mental disorders on the work functioning of nurses and allied health professionals: A systematic review

Objective: This study aims to inventory aspects of work functioning of nurses and allied health professionals that are affected by common mental disorders. Design: A systematic review of psychological and occupational health literature was performed. Data sources: A sensitive systematic literature search based on index terms and text words was conducted in four electronic databases: PubMed, PsycINFO, Embase, and Cinahl. The literature search was limited to journal articles published between 1998 and 2008, written in English, German, or Dutch. Review methods: For inclusion, studies had to examine a relationship between common mental disorders and a measure of work functioning in nurses or allied health professionals. No restrictions on study design were handled. Methodological quality was assessed for each study. The data were categorized into themes, for which the strength of evidence was assessed using six levels of evidence. Results: Sixteen of 2792 studies met the inclusion criteria, of which 13 had a cross-sectional design, 1 was a vignette study, and 2 were narrative reviews. In all studies, the subjects were nurses. The retrieved aspects of sub-optimal work functioning due to common mental disorders were merged into 15 themes. Strong evidence was found for five themes: general errors, medication errors, near misses, patient safety, and patient satisfaction. Moderate evidence was found that common mental disorders are associated with complex motor skills and with general performance: while evidence for an association between common mental disorders and needle stick injuries was inconclusive. Seven themes had only narrative evidence: interpersonal behaviour, energy, focus on goals and responsibility, work speed, avoiding work while on the job, coping with emotions, and motivation. Conclusion: Common mental disorders were found to be associated with various impairments in work functioning in nurses, these include task-related, intrapersonal and interpersonal aspects of work. In particular, strong evidence was found for an association between common mental disorders and general errors, medication errors, near errors, patient safety, and patient satisfaction. These results provide input for preventive actions to improve both health and work functioning in health care workers. (C) 2010 Elsevier Ltd. All rights reserved.