Table 1 Overview of included studies
From: Mental health and psychological wellbeing of maritime personnel: a systematic review
References | Country | Participants: ‘n’ and job role | Participant demographics | Relevant measures | Quality (%) |
|---|---|---|---|---|---|
Akamangwa [66] | UK | 41 Staff at a UK-based global shipping company and aboard two of its ships—34 ship crew, 7 managers | Not reported | Semi-structured interviews about experiences complying with health, safety and wellbeing requirements on board | 70 |
Andrei et al. [67] | Australia | Unclear; study states n = 199 but also reports that 25 were members of command team and the other 125 were members of crew Seafarers working for marine operations of a large global mining company | 99% male Mean age 36.65 | 3 items from Questionnaire on the Experience and Assessment of Work; 4 items adapted from existing research on monotony and attention capacity literature; 3 items from Work Design Questionnaire relating to decision-making authority; 4 items adapted from existing scale on perceived availability of instrumental support from colleagues and direct supervisor; 10 items developed for previous study to measure different types of fatigue; 4 items adapted from previous literature on common sleep problems | 65 |
Andruskiene et al. [34] | Lithuania | 393 Students at Lithuanian Maritime Academy studying either Marine Navigation, Marine Engineering, or Port and Shipping Management/Finances of Port and Shipping Companies/Maritime Transport Logistics Technologies | 78.9% male Mean age 20.71 | Pittsburgh Sleep Quality Index; Hospital Anxiety and Depression Scale | 60 |
Arcury-Quandt et al. [25] | USA | 598 Active-duty ship-assigned military personnel—US Navy and Marine Corps | 71.2% male Mean age 26.3 | CES-D; CAGE questionnaire and abbreviated AUDIT-C; modified Holmes-Rahe Stress Scale | 70 |
Barbarewicz et al. [70] | Germany | 60 Maritime pilots; 12 on a 1-week rotation system and 48 on 4-month rotation system | Gender not reported Mean age 48.7 | RESTQ-work 27; Berlin Questionnaire; validated short version of the 'evening morning protocols'—a sleep diary; Resilience Scale RS-13 | 80 |
Bergheim et al. [31] | Norway | 486 in Study 1; 594 in Study 2 Maritime workers from 3 shipping companies | Study 1: 100% male Mean age 40.8 Study 2: 99% male Mean age 40 | Study 1: Norwegian offshore risk and safety climate inventory; Psychological Capital Questionnaire Study 2: As above, plus three items from Job Satisfaction Scale—short version | 70 |
Bergheim Valdersnes et al. [43] | Norway | 397 Seafarers from a Norwegian company in the offshore oil and gas industry | Gender not reported 32.9% aged between 30–39; mean not reported | Subscale of Swedish Occupational Fatigue Inventory; questionnaire based on hazard categories used in official reports from Norwegian Maritime Directorate; Psychological Capital Questionnaire; Safety Climate Questionnaire | 65 |
Bobdey et al. [76] | India | 568 Personnel posted on a capital ship of the Indian Navy | Not reported | Interpersonal Support Evaluation List | 65 |
Brasher et al. [46] | UK | 144 submariners within the Royal Navy v 144 general service controls | Not reported | Work and Wellbeing Questionnaire; GHQ-12 | 70 |
Carotenuto et al. [48] | Authors in Italy; participants were from Argentina, Bulgaria, India, Italy and Romania | 162 Seafarers on board merchant ships for at least two weeks—7 tankers belonging to the same shipping company | 100% male Mean age 34.9 | Psychological General Well-being Index | 60 |
Chambers and Main [82] | Australia and New Zealand | 50 Maritime pilots employed across ports in Australia and New Zealand | 98% male Mean age 51.42 | 9-item Vitality Scale from the short form Health Survey; 10-item symptoms of fatigue checklist; 10-item coping strategies checklist | 60 |
Chowdhury et al. [78] | India, Madagascar, Philippines, Ukraine, and 'cross-regional' | 615 International Transport Workers' Federation—seafarer affiliates | 100% male India; 80% male Madagascar; 98.4% male Philippines; 99% male Ukraine; 88% male cross-regional Age not reported | Study-specific questionnaire establishing knowledge, attitudes and behaviour regarding HIV/AIDS, health and wellness, health-seeking or risk-taking behaviour and the role of the workplace and union in promoting health | 45 |
Chung et al. [29] | South Korea | 160 Seafarers on shipping vessels belonging to a Korean shipping company, docked at Busan Port | 99.35% male Mean age 35.77 | Copenhagen Burnout Inventory; Siegrist's ERI Scale; Epworth Sleepiness Scale; Emotion Regulation Questionnaire | 70 |
Devereux and Wadsworth [77] | Authors in UK; participants were British, Polish, Romanian, Norwegian, Russian Swedish, Dutch and Filipino | 37 Seafarers berthed in UK ports on 4 vessels—one offshore vessel and three chemical/product tankers | 97.3% male Mean age 39 | Semi-structured interviews covering seafarers’ experiences of the arrangements made to manage risks to their health and safety | 80 |
Dohrmann et al. [49] | Denmark | 193 Employees of Danish ferry shipping industry; most slept at home or in onshore watch-rooms | 89% male Mean age 47.6 | Swedish Occupational Fatigue Inventory; two subscales of Copenhagen Psychosocial Questionnaire (work-family conflict and supervisor support) | 70 |
Dohrmann et al. [61] | Denmark | As above | As above | Swedish Occupational Fatigue Inventory; two subscales of Copenhagen Psychosocial Questionnaire (job demands and control) | 65 |
Doyle et al. [27] | Authors in Ireland, participants international | 387 Seafarers of tanker vessels in an international gas and crude oil shipping company who had been on board between 0–24 weeks; 1% catering, 28% rating/crew, 65% officer/engineer | 98% male 21% aged 18–29, 37% between 30–39, 41%between 40–64, and 1% 65; mean not reported | 2 questions each asking number of weeks participants had been on board since last shore leave and how long they have worked as a seafarer; Dispositional Resilience Scale-15; 4-item version of Perceived Stress Scale; The Employees Survey—an annual survey of work attitudes and experiences completed anonymously by employees | 70 |
Hystad and Eid [42] | Authors in Norway, participants international | 742 Seafarers working in the offshore re-supply industry (402) and seafarers working on board combined passenger and cargo ships (340) | Gender not reported Offshore supply: 12.2% aged 24 or under, 16.9% aged 25–29, 32.3% aged 30–39, 27.6% aged 40–54, 9.7% aged 55 or over Seafarers on freight and passenger ferries: Mean age 37.02 | Psychological Capital Questionnaire; Swedish Occupational Fatigue Inventory; Pittsburgh Sleep Quality Index; asked to judge the extent to which they felt disturbed by different environmental factors such as noise and motion; asked how long they had been on board since last shore leave and length of seafaring career | 65 |
Hystad et al. [30] | Authors in Norway, vessels operating in North Sea and Southeastern Asia | 402 Seafarers working in offshore oil and gas re-supply industry | Gender not reported 12.2% aged 24 or under, 16.9% aged 25–29, 32.3% aged 30–39, 27.6% aged 40–54, 9.7% aged 55 or over | Swedish Occupational Fatigue Inventory; Zohar and Luria's scale of safety climate; questions on psychological demands and job control from General Nordic Questionnaire for psychological and social factors at work | 65 |
Jegaden et al. [50] | France | 80 seafarers (40 officers, 40 crew) vs 63 office staff from the same shipping company | 100% male Mean age 40.3 for officers, 42.3 for crew members, 43.6 for office staff | Farmer and Sundberg Boredom Proneness Scale; Hospital Anxiety and Depression Scale; Job Content Questionnaire | 45 |
Jezewska et al. [41] | Poland | 300 Seafarers employed in the Polish fleet and foreign flag vessels | 100% male Mean age 44 | WHOWOL-BREF; Survey for people working at sea; NEO-FFI Questionnaire; PTS Temperament Questionnaire | 60 |
Jo and Koh [33] | South Korea | 146 officers on Navy ships, 98 officers on submarines | Ship officers: 97.5% male, mean age 30.7 Submarine officers: 100% male, mean age 29.61 | Items from Korea National Health and Nutrition Examination Survey; Job-Related Affective Well-Being Scale | 75 |
Kalvaitiene and Sencila [69] | Lithuania | 45 Marine navigation, marine engineering and electrical engineering students at the Lithuanian Maritime Academy, all with seagoing practice experience | Not reported | Semi-structured interview with questions about difficulties on board; communication with ship's crew members; and measures taken to make it easier to adapt on board | 30 |
Kelley et al. [75] | USA | 108 US Navy personnel assigned to a homeported Arleigh Burke-class destroyer anticipating deployment within 2 months | 70.4% male Mean age 28.15 | AUDIT; Command Stress Assessment; CES-D-10; Friendship Scale Assessment; Relationship Assessment Scale | 75 |
Kelley et al. [81] | USA | 101 US Navy personnel assigned to an Arleigh Burke-class destroyer who experienced an 8-month deployment | 71.3% male Mean age 28.34 | Command Stress Assessment; Pittsburgh Sleep Quality Index; AUDIT; CESD-10 | 75 |
Kim and Jang [28] | South Korea | 149 Marine officers working at a harbor (people in command of a commercial vessel and the crew) | 100% male Mean age not reported, but half were in their 20 s and 30 s | SCL-90-R; survey on job stress modified and customised for seafarers; modified tool based on Job Descriptive Index | 75 |
Kim and Jang [44] | South Korea | 280 Seafarers of a shipping firm, living and working on a ship for more than 6 months | Gender not reported 80.4% in 20 s-30 s, 19.6% aged 40 + | Modified version of organisational culture tool; tool based on tool for emotional and instrumental support; Cho et al.'s self-efficacy measurement; short form of Park et al.'s perceived fatigue tool; modified version of Psychological General Well-Being Index (PGWBI-S) | 70 |
Kingdom and Smith [83] | UK | 282 Coastguards | 76% male Mean age not reported, but 64% aged between 41–60 | Questionnaire measuring exposure to physical agents and noise; job demands-control-support; effort-reward imbalance; organisational culture; management of change; leader-member exchange; team-member exchange; bullying; role conflict and ambiguity; training; how stressful work is; number of sick days in past year; work-related illness; Hospital Anxiety and Depression Scale; Epworth Sleepiness Scale; symptoms and medication; insomnia; accidents and injuries; memory; risk-taking; smoking and drinking; weight and exercise; time to relax; time spent on hobbies; impact of family on job; impact of job on family; negative affectivity; coping | 60 |
Kum and Ertas [73] | Turkey | 50 Shipping company personnel | 78% male Mean age not reported, but 40% under 30, 40% between 30–40, 20% over 40 | Questionnaire derived from Work Harassment Scale | 60 |
Lefkowitz et al. [23] | Authors in USA, data international | Examined 278 mental illness claims between 2007–2015 from marine insurance provider for seafarers on Gard vessels | N/A | N/A | 77.8 |
Lefkowitz et al. [45] | USA | 233 Domestic shipping vessel masters (captains) and pilots at two vessel piloting training centres | Gender not reported Mean age 46 | PHQ-9; GAD-7; Sleep Condition Indicator | 65 |
Matsangas and Shattuck [56] | USA | 892 Sailors on US Navy surface ships | 78.8% male Median age 25 (mean not reported) | Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Insomnia Severity Index; Profile of Mood States | 65 |
McVeigh and MacLachlan [60] | Philippines | 32 Merchant seafarers on board liquefied natural gas carriers, product oil tankers and crude oil tankers | 100% male Age not reported | Focus groups to discuss perceptions and experiences of stress, resilience and wellbeing | 80 |
McVeigh et al. [35] | Not reported; authors based in Ireland, South Africa, Czechia, and the UK | 512 at Time0, 276 at Time1 (approximately 10 months later) Merchant seafarers within a large shipping organisation (officers and ratings/crew) | Time0: 98.2% male, 41% aged 40–64 Time1: 98.2% male, 39.9% aged 40–64 | The organisation's Employees Survey; Dispositional Resilience Scale-15; Perceived Stress Scale-4 | 65 |
McVeigh et al. [68] | Not reported; authors based in Ireland, South Africa, and Czechia | 24 Superintendents (office-based, n = 5), and officers and crew (n = 19) of a large shipping company | Not reported | 11 interviews and 1 focus group with 13 participants The first six interviews assessed perceptions of the pilot resilience programme and perceptions and experiences of resilience Remaining interviews and focus group covered perceptions and experiences of wellbeing, resilience and stress | 70 |
Nielsen et al. [63] | Norway | 541 Seafarers from 2 large Norwegian shipping companies | 99% male Mean age 40 | 3 items about intentions to leave; three items from Job Satisfaction Scale—short version; Brief Norwegian offshore risk and safety climate inventory (Brief-NORSCI); 5 items from Multifactor Leadership Questionnaire; Authentic Leadership Questionnaire' 3 items on job demands; Negative Acts Questionnaire Revised; 4 items from Platoon Cohesion Index adapted for maritime context | 75 |
Oldenburg et al. [32] | Germany | 251 Seafarers in merchant marine service | 92.8% male Mean age 41.9 | Study-specific scale of shipboard stressors; emotional exhaustion scale of the Maslach Burnout Inventory; one question each; Epworth Sleepiness Scale | 75 |
Oldenburg et al. [58] | Germany | 104 Sailors on board container ships (19 nautical officers, 51 deck ratings and 34 engine room employees) | 100% male Mean age 35.4 | Questionnaire used in the authors’ previous maritime studies, provided in form of a standardised interview, asking participants to rate whether they experienced various physical environmental influences and a free-text response on physical influences during their stay on board | 75 |
Oldenburg and Jensen [38] | Germany | 323 Seafarers on board container ships (nautical officers, deck ratings, engine room personnel) | 100% male Mean age 38.3 | Study-specific questionnaire about communication of crews with their home | 70 |
Oldenburg and Jensen [51] | Authors in Germany, participants European and Southeast Asian | 323 Sailors on container ships | 100% male Mean age 38.3 | Participants recorded working time, leisure time, lying/sleeping time and sport time; SenseWear armband monitor and Polar watch worn continuously to give an objective measure of strain (watch measures heart rate and heart rate variability; armband monitors physical activity and calorie expenditure); asked about subjectively experienced stress due to job-related physical or mental impacts, working hours, and sleep deficit | 75 |
Oldenburg and Jensen [57] | Germany | 323 Seafarers on board container ships (nautical officers, deck ratings, engine room personnel) | 100% male Mean age 38.2 | Study-specific questions on mental and physical strain as a result of activities carried out in the respective voyage episodes and various seafaring stressors, derived from their own previously published study | 75 |
Oldenburg and Jensen [79] | Germany | 323 Seafarers on board container ships (nautical officers, deck ratings, engine room personnel) | 100% male Mean age not reported, median 37 | Study-specific questionnaire asking about use of and needs for recreational facilities on board and strategies for coping with stress; daily log of leisure activities and sleeping time | 70 |
Osterman et al. [22] | Sweden | 1980 (survey); 29 (interviews) Survey: Service crew on passenger ships Interviews: 5 HR department, 4 hotel, restaurant and cruise managers, and 20 ratings service department including safety delegates and union representatives, and seafarers working in bars, restaurants, housekeeping, shops, warehouses and spas on board | Survey: Mostly men but exact statistics not reported; largest age group 20–30 Interviews: 51.7% male; age not reported | Survey based on questionnaires from the International Social Survey Program, Work Orientations III relating to organisational and occupational commitment, job satisfaction and work experiences Unclear what the semi-structured interview questions were | 85 |
Othman et al. [52] | Malaysia | 60 Seafarers—20 senior deck cadets, 20 senior deck officers, 20 junior deck officers | Not reported | ‘Technique for Order Performance by Similarity to the Ideal Solution’ method used to rank the root causes of distractions causing accidents at work | 25 |
Peplinska et al. [39] | Poland | 210 Mariners working on deep-sea ships | Gender not reported Age range 25–60, mean not reported | Purpose In Life Test; State-Trait Anxiety Inventory; Perceived Stress Questionnaire; Questionnaire of Suitable Marriage | 45 |
Peplinska et al. [40] | Poland | 210 Mariners working on deep-sea ships | Gender not reported Age range 25–60, mean not reported | State-Trait Anxiety Inventory; Levestein's Stress Level Questionnaire; Well-Matched Marriage Questionnaire | 50 |
Pesel et al. [64] | Authors in Spain, Italy and Denmark; participants international—54% from Asian countries, 17% from European countries, 28% from Russian and former USSR countries, 1.3% other | 72 Seafarers on container ships | 100% male Mean age 39 | GHQ12 with three extra questions about COVID precautions on board | 65 |
Rapoliene et al. [84] | Lithuania | Baseline: 180 (65 balneotherapy intervention v 50 music intervention v 65 controls) Completed intervention: 55 v 35 v 50 respectively Seamen who had been working at sea for more than 5 years | 100% male Mean age 47.5 for balneotherapy group, 47.6 for music group, 46.2 for controls | Overall reported health, medication use, pain, mood, changes in feelings assessed in GP evaluation; General Symptoms Distress Scale; Multidimensional Fatigue Inventory; Cognitive Failures Questionnaire | 75 |
Saitzyk and Vorm [24] | USA | Retrospective database analysis of 425 cases of self-directed violence found in records Military personnel on board US Navy aircraft carriers | 61.4% male Mean age not reported, majority under 25 | N/A | 77.8 |
Schmied et al. [59] | USA | 22 Active duty service members from naval commands, assigned to sea duty | 77.8% male 16.7% aged 18–24, 38.9% aged 25–29, 44.4% aged 30 + | Semi-structured interviews assessing experiences of sleeping in shipboard environments | 80 |
Seyle et al. [26] | India, Philippines and Ukraine | 101 seafarers who had been held hostage by pirates in the past 10 years vs. 363 not exposed to piracy | Not exposed to piracy: India—100% male, mean age 29.46 (n = 103), Philippines – 99% male, mean age 40.34 (n = 144), Ukraine—87% male, mean age 34.85 (n = 127) (Note: it is unclear why 374 participants are described when ‘n’ is reported to be 363) Exposed to piracy: India – 100% male, mean age 37.41 (n = 44), Philippines – 100% male, mean age 40.34, Ukraine – 96% male, mean age 42.88 (n = 26) | Previous trauma exposure; 2 items about training and how helpful it was; PCL-C; CES-D; Duke Health Profile; three study-specific items about the impact of piracy on work decisions | 65 |
Shevchenko et al. [53] | Ukraine | 80 Cadets specialising in sea and river transport—students from two Maritime Academies on their first or second course (n = 40) or third/fourth (n = 40), who had undergone long-term floating practice lasting over 3 months | Not reported | Coping-Strategy Indicator; Well-being-Activity-Mood questionnaire | 40 |
Sliskovic [65] | Author in Croatia; participants international – 57 countries represented | 752 Seafarers employed in the global shipping sector | 89.23% male Mean age 37.34 | Questionnaire with questions on sociodemographic and work characteristics and one open question about personal experiences relating to the COVID-19 pandemic | 70 |
Sliskovic and Penezic [55] | Croatia | 530 Seafarers on cargo ships | Gender not reported Mean age 37.7 | Job satisfaction scale; 10 questions on specific aspects of job; 2 open questions about sources of satisfaction and dissatisfaction | 60 |
Sliskovic and Penezic [71] | Croatia | 298 Officers on cargo ships | Gender not reported Mean age 39.16 | 3 questions on contract (number of months contracted to be on board, number of months at home, compliance with contract regarding changes to ship and home periods); 1 question on free and unlimited access to the internet on board; Overall Job Satisfaction scale; Satisfaction with Life Scale; 5-item version of Mental Health Inventory | 75 |
Sliskovic and Penezic [47] | Croatia | 530 Seafarers employed in international shipping | Gender not reported Mean age 37.7 | Study-specific scale assessing smoking, alcohol, sleeping, exercise and diet; newly-developed instrument for stress on board; Mental Health Inventory-5 | 70 |
Tedesco et al. [36] | Authors in Italy, participants international | 801 Seafarers of Italian shipping companies | 94.5% male Mean age 36.4 | Study-specific survey on health status and smoking/drinking/drug habits; Karasek Demand-Control-Support Questionnaire | 90 |
Turkistanli and Sevgili [54] | Turkey | 266 Undergraduate maritime students (marine transportation engineering or marine engineering) | 89% male Mean age 21.43 | Survey created for a previous study, on awareness of health risks, general perception of danger and discomfort in the workplace and risks of contracting diseases | 55 |
Xia et al. [80] | China | 71 Crew members of a hospital ship for approximately 3 months | 100% female Mean age 32.1 | SCL-90 | 60 |
Xiao et al. [62] | China | 917 Crew members from Nantong Entry-Exit Inspection and Quarantine Bureau | 100% male Mean age 33.5 | Social Support Rating Scale; Zung Self-Rating Depression Scale; Occupational Stress Questionnaire; World Health Organization Quality of Life-BREF | 65 |
Xue and Tang [74] | China | 55 Crew members and shore management of two shipping companies | Not reported | Semi-structured interviews about experiences of implementing the International Safety Management code and the outcomes and impacts of management’s safety inspections on ships | 80 |
Yuen et al. [72] | Singapore | 202 Deck officers, engine officers and ratings from containers, dry bulk, liquid bulk, and specialised carriers | Not reported | Multifactor Leadership Questionnaire; Multidimensional Scale of Perceived Social Support; scale based on literature review assessing physical environment, task-related factor, technology-related factor, organisational factor and individual factor; PsyCap Questionnaire; burnout scale from Maslach Burnout Inventory; safety behaviour scale obtained from Lu et al | 60 |
Zhao et al. [37] | China and two European countries (not specified) | 880 questionnaires and 60 interviews Questionnaires: Seafarers from two Chinese and two European shipping companies Interviews: Seafarers and managers from two Chinese and two European shipping companies | Questionnaires: 99.1% male, mean age 36.1 Interviews: gender and age not reported | Questionnaires: Shortened version of questionnaire from Cardiff Seafarers' Fatigue Research Programme—sections focusing on job/vessel, hours of work and rest, fatigue at sea, work, sleep patterns and health-related behaviours, and travel to/from vessel Interviews covered work shift schedule, work hours, workload, sleep, on-leave, fatigue and company supports | 80 |