Prevalence and Associated Risk Factors of Self-Harm Among Health Care Workers: Protocol for Systematic Review and Meta-Analysis (Preprint)

BACKGROUND Self-harm is a major public health concern, with prevalence increasing worldwide, particularly after the COVID-19 pandemic and associated lockdown restrictions. Health care workers (HCWs) face various challenges, such as pressures of social and familial responsibilities, a lack of integration within the profession, heavier workload, bullying at the workplace, and limited support in the workplace, that impact their mental health and often lead to self-harm. OBJECTIVE We aim to synthesize the evidence on the pooled prevalence of self-harm worldwide and identify risk factors for self-harm among HCWs. METHODS We will conduct a systematic review of observational and experimental studies that investigated the overall prevalence of self-harm among HCWs. We will search the PubMed, PsycINFO, Embase, and CINAHL databases for eligible articles from inception until March 2025 using specific search terms developed using the population, exposure, comparison, and outcome framework. Study selection and reporting will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the Meta-Analysis of Observational Studies in Epidemiology guidelines. We will contact the corresponding author via email if the required data are not available in the article. After completing the article search, duplicate records will be removed. Titles and abstracts will then be screened according to the inclusion and exclusion criteria, followed by retrieval of the full texts for detailed screening. All the required data for the review, such as names of authors, publication year, prevalence of self-harm, type of profession, associated risk factors to self-harm, and others, will be extracted using a standardized data extraction form. The quality of the studies will be assessed using the Joanna Briggs Institute guidelines based on the study design. Random-effects meta-analysis will be used to derive the pooled prevalence using Stata (version 17.0) software. We will conduct a subgroup meta-analysis on sex, regions, and the type of profession (physicians or nurses). We will also examine the association of risk factors of self-harm with sociodemographic factors to observe their relationship. Both analyses will be performed using RevMan software. Publication bias will be examined using the funnel plot and Egger test. RESULTS Data analysis is expected to be completed by August 2025, and manuscript preparation is expected to be completed by October 2025. This review is expected to be completed and published by January 2026. CONCLUSIONS We will provide a comprehensive synthesis of the overall prevalence of self-harm among HCWs. We will also provide important information to develop effective strategies for preventing and managing self-harm among HCWs. CLINICALTRIAL PROSPERO CRD42024581791; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024581791 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/67059