Abstract
BACKGROUND: Self-isolation is a key public health strategy for infectious disease control. Globally implemented during the COVID-19 pandemic, self-isolation remains an essential strategy in ongoing mitigation efforts. Healthcare workers (HCWs) often face isolation due to occupational exposure to infectious diseases and may face unique psychological challenges. AIMS: This systematic review synthesized evidence on (i) the impact of self-isolation on HCWs' psychological wellbeing, (ii) factors associated with wellbeing, and (iii) the effectiveness of interventions to improve wellbeing during or after isolation for COVID-19. METHODS: A pre-registered systematic review (PROSPERO: CRD42024559971) was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. Searches in PsycInfo, Embase, MEDLINE, PubMed and grey literature included studies on HCWs' psychological wellbeing during or after self-isolation. Risk of bias was assessed using ROBINS-E (Risk of Bias in Non-randomized Studies for Exposure) or CASP (Critical Appraisal Skills Programme) tools. RESULTS: From 20,798 records screened, 19 studies (10 quantitative, 7 qualitative, 2 mixed methods) were included. Quantitative findings on anxiety, depressive and stress symptoms were inconsistent. Qualitative studies consistently reported distress, loneliness and stigma. Factors associated with wellbeing included socio-cultural influences and protective factors. No studies assessed interventions targeting wellbeing during self-isolation. CONCLUSIONS: Self-isolation appears to have variable effects on HCWs' wellbeing, including significant challenges and opportunities for resilience. Public health strategies should prioritize timely, clear communication, accessible evidence-based psychological support and practical resources. Future research should prioritize evaluation of interventions to mitigate psychological harm and support HCWs during infectious disease outbreaks.