Keywords: COVID-19, pandemic, anxiety, depression, healthcare workers, primary care
Coronavirus disease 2019 (COVID-19) pandemic has had a profound negative effect on the population's mental health. Healthcare workers (HCW) are among the high-risk group to face mental and physical consequences associated with exposure to the COVID-19 related stressors.
The study aimed to evaluate the prevalence and risk factors associated with depression and anxiety episodes among HCW during COVID-19 pandemic in the primary healthcare centre (PHC) and nursing home (NH).
A cross-sectional survey among 36 PHC and 33 NH HCW was performed in December 2020. Depression, anxiety, and COVID-19 coping strategies were assessed with PHQ-9, GAD-7, and brief COPE questionnaires, respectively. Additionally, exposure to twenty-two COVID-19 related stressors was assessed on a 5-point Likert scale. An independent samples t-test, chi-squared test, ROC analysis, and logistic regression model were used for statistical analysis.
The prevalence of depression and anxiety was 30.4% and 20.3%, respectively. Significantly higher levels of depression (45.5 % vs. 16.7%, p = 0.009) and anxiety (30.3% vs. 11.1%, p = 0.048) were observed in NH compared to PHC group. Independent predictors of depression were high school education (OR 7.68, 95% CI 1.77-33.33, p = 0.006) and exposure to ≥7 COVID-19 stressors (OR 4.81, 95% CI 1.27-18.20, p = 0.021). Independent predictors of anxiety were high school education (OR 9.93, 95% CI 2.14-46.08, p = 0.003), years of service (OR 0.95, 95% CI 0.90-0.99, p = 0.034) and exposure to >10 COVID-19 stressors (OR 6.38, 95% CI 1.71-34.01, p = 0.021).
COVID-19 pandemic is associated with significantly higher levels of depression and anxiety in NH compared to PHC HCW. High school education and exposure to a higher number of COVID-19 stressors were independently predictive of depressive and anxiety episode.
Points for discussion:
What might be the reasons for a higher prevalence of depression and anxiety among NH than PHC HCW?
Which strategies should be introduced at the start of the pandemic to alleviate the physical and mental burden on the HCW?