key: cord-0685652-erxsr520
authors: Bakar, A.Y.A.; Ramli, S.
title: Psychosocial Support for Healthcare Frontliners during COVID-19 Pandemic in Malaysia
date: 2020-07-01
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102272
sha: fca6121acdc709a6a94ebcf6794960058831024b
doc_id: 685652
cord_uid: erxsr520

nan

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. On 11 March 2020, the World Health Organization (WHO) declared the outbreak of Coronavirus Novel 2019 or COVID-19 as a worldwide pandemic. The declaration served as a worldwide red flag that all nations are potentially-affected and therefore to be equipped with strategic action plans in order to counteract the widespread of the novel virus. Malaysia is one of the Southeast Asian countries affected by COVID-19. As a preventive measure, the Malaysian government has gazzetted the implementation of Movement Control Order (MCO) commencing on 18 th March 2020. Based on the viral widespread curves and supported by medical advices of the Malaysian Ministry of Health think tanks, the MCO phases have already been extended five times from its original plan and the current phase is expected to end on 9 th June 2020. This is eminent in order to deprive the spreading of the virus by breaking the 'chain' in the community (Brooks, 2020) through daily practices of social distancing and health-consciousness routines such as the normalization of face-masks and hand-sanitizers usage during this movement control period.

MCO has shown positive trend in flattening the curve of the pandemic in Malaysia proven as per the the illustrated statistics in Table 1 dated 7 th June 2020.

Although Malaysia had past experiences in handling several epidemic outbreaks such as Severe Acute Respiratory Syndrome (SARS), Japanese Encephalitis (JE), influenza A H1N1, Ebola, and Zika (Abdullah & Rahim, 2016) , the pandemic COVID-19 is an unprecedented health fiasco faced by the local health crisis management system. It is interesting to note that the existing national standard operating procedures (SOP) of crisis management are centralized on the physical preparedness of the crises such as organizational structures, communication networks, food supplies, and other logistic apparatuses. However, it is alarming to find that spiritual quotient awareness amongst the healthcare frontliners such as psychological, emotional, social and spiritual aspects are seemingly considered to be of lesser importance.

Healthcare 'frontliners' inclusive of doctors, matrons, nurses, and medical assistants are the 'unsung' heroes during this continous battle against COVID-19. The long working hours under uncomfortable and stressful conditions may jeopardize their psychological wellbeings as well as their morale and work performance (Waleed, Sonia & Shamim, 2020). Apart from the social pressures faced at home and in the society due to the implementation of MCO, these critical frontliners are also at high risks of to be exposed to serious mental health issues resulted in symptoms such as being stressful, severe depression, decline of work motivation, fatigueness, and over-anxiety (Jianbo et al., 2020) . As a matter of fact, since the virus had started to spread from Wuhan, China in late 2019 (Cuiyan et al., 2020) , many quarters including WHO and International Council of Nurses (ICN) produced guidelines and manuals to provide the healthcare frontliners with sufficiently holistic psychosocial support system in order to minimize the effects that may disrupt their psychological well-being. This action addressed on the relationship of COVID-19 and mental health (Tandon 2020), particularly focusing in healthcare frontliners' population.

All in all, the holistic preparedness of healthcare fronftliners in battling the pandemic COVID-19 in Malaysia must comprise a holistic approach of both 'hardware' elementsskills and knowledge to be utilized in job routine -as well as the 'softskills' in terms of self psychological management. Although there is reactive support system in terms of Psychological First Aid (PFA) and online counseling services provided throughout this period of COVID-19 pandemic, there is a vital need of a more proactive provision for these frontliners in the future (Bakar 2020) . It is more beneficial if a psychoeducational training module, for instance, could be developed and integrated in the national SOP for health crisis management. This training module could help these frontliners to enhance their selfpsychological management skills so that they could manage their mental, emotional, social, and spiritual capacities prior to entering the uncertain conditions of battling other pandemic health crises in the future. The psychological support training could also internally prepare the community at large to be more ready, if the similar pandemic were to happen again (Yanping et al., 2020) . 

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Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China

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