Anxiety, Depression and Burnout Levels of Turkish Healthcare Workers at the End of the First Period of COVID-19 Pandemic in Turkey

Mental health status and related factors influencing healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The mental health of healthcare workers during the coronavirus-2019 pandemic was seriously affected, and the risk of mental health problems was high. The present study sought to systematically evaluate the mental health problems of healthcare workers worldwide during the pandemic and to determine the latest global frequency of COVID-19 associated mental health problems.

METHODS

Data in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Elsevier, MEDLINE, PubMed, PsycINFO and the Web of Science before November 11, 2022, were systematically searched. Cohort, case-control and cross-sectional studies were included. The meta-analysis used a random effects model to synthesize the comprehensive prevalence rate of mental health problems. Subgroup analyses were performed based on time of data collection; whether the country was or was not developed; continent; doctors and nurses; doctors/nurses vs. other healthcare workers; and psychological evaluation scale.

RESULTS

A total of 161 studies were included, including 341,014 healthcare workers worldwide, with women accounting for 82.8%. Occupationally, 16.2% of the healthcare workers were doctors, 63.6% were nurses and 13.3% were other medical staff. During the pandemic, 47% (95% confidence interval [CI], 35-60%) of healthcare workers reported job burnout, 38% (95% CI, 35-41%) experienced anxiety, 34% (95% CI 30-38%) reported depression, 30% (95% CI, 29-31%) had acute stress disorder, and 26% (95% CI, 21-31%) had post-traumatic stress disorder.

CONCLUSIONS

The study found that there were common mental health problems among health care workers during the COVID-19 pandemic. The most common was job burnout, followed by anxiety, depression, acute stress and post-traumatic stress disorder. Although the global pandemic has been brought under control, its long-term impact on the mental health of healthcare workers cannot be ignored. Additional research is required to develop measures to prevent, monitor and treat psychological disorders among healthcare workers.

Psychosocial Status of Healthcare Workers During the COVID-19 Pandemic

Objective

This study aimed to determine the depression, anxiety, and stress levels of healthcare workers (HCWs) working actively in different health services during the pandemic.

Materials and Methods

This cross-sectional study was conducted in Ankara at the Provincial Health Directorate Numune Campus between January and April 2022. The depression, anxiety, and stress levels of HCWs working actively in different health services during the pandemic were evaluated using the Depression, Anxiety and Stress Scale 21 (DASS-21). Univariate and multivariate linear regression analyses were performed to analyze the data.

Results

The study included 381 healthcare workers, 272 (71.4%) of whom were female. The mean age was 40.0±9.9 (21-63) years, and 44.9% (n=171) of the HCWs had a COVID-19 infection at some point. While 28.6% of HCWs needed psychological support before the pandemic, the rate increased to 36.2% during the pandemic (p<0.001). DASS-21 results showed that the frequency of depression was 31.0%, anxiety 47.2%, and stress 22.8% among participants during the pandemic.

Conclusion

One out of three HCWs reported experiencing mental health problems. It is essential to improve the working conditions of HCWs to help them cope with the effects of the pandemic on their mental health and to provide psychosocial support.

The Impact of COVID-19 on Psychiatric Health in the Korean Population

Coronavirus disease 2019 (COVID-19) has multiple negative impacts on the psychiatric health of both those previously infected and not infected with severe acute respiratory syndrome coronavirus 2. Moreover, the negative impacts of COVID-19 are closely associated with geographical region, culture, medical system, and ethnic background. We summarized the evidence of the impact of COVID-19 on the psychiatric health of the Korean population. This narrative review included thirteen research articles, which investigated the impact of COVID-19 on the psychiatric health of Koreans. COVID-19 survivors were reported to have a 2.4 times greater risk of developing psychiatric disorders compared to members of a control group, and anxiety and stress-related disorders were the most common newly diagnosed psychiatric illnesses. Studies also reported that COVID-19 survivors had a 3.33-fold higher prevalence of insomnia, a 2.72-fold higher prevalence of mild cognitive impairment, and a 3.09-fold higher prevalence of dementia compared to the control group. In addition, more than four studies have highlighted that the medical staff members, including nurses and medical students, exhibit a greater negative psychiatric impact of COVID-19. However, none of the articles investigated the biological pathophysiology or mechanism linking COVID-19 and the risk of diverse psychiatric disorders. Moreover, none of the studies were actual prospective studies. Thus, longitudinal studies are needed to more clearly elucidate the effect of COVID-19 on the psychiatric health of the Korean population. Lastly, studies focusing on preventing and treating COVID-19-associated psychiatric problems are needed to provide a benefit in real clinical settings.

Sex Differences in COVID-19 Infection Fear in a Community Sample of Korean Adults Using Quantile Regression

This study aims to explore the impact of distributional changes in coronavirus disease 2019 (COVID-19) infection fear with sex differences. A quota sampling strategy was followed and 483 Korean adults were surveyed in a community sample. Self-report questionnaires were used to assess COVID-19 infection fear, depressive symptoms, and general characteristics. Quantile regression was used to explore the regression relationship of COVID-19 infection fear and an individual's sex. There was a significant difference in COVID-19 infection fear (P = 0.001) and depression (P = 0.008) between the sexes - male and female. The differences between sexes at the 20th and 30th percentiles were significant (β = 2.04, P = 0.006; β = 1.5, P = 0.004, respectively). The results demonstrate that sex significantly predicts COVID-19 infection fear and women had significantly greater fear than men in the mild-level of COVID-19 infection fear.

Mental Health and Sleep Quality of Healthcare Providers After Partial Relief of COVID-19 in Saudi Arabia: A Cross-Sectional Study

Purpose

We aimed to assess sleep quality and psychological distress among healthcare workers (HCWs) in the context of mitigated governmental restrictions during COVID-19 pandemic in Saudi Arabia.

Methods

This cross-sectional study included 370 HCWs from a single tertiary healthcare institution in Riyadh, Saudi Arabia. Sleep quality and psychological distress were measured using the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety and Stress Scale - 21 (DASS-21).

Results

The median stress score for HCWs aged between 20 and 29 years was higher compared to HCWs aged between 30 and 39 years (p=0.002) and HCWs aged between 50 and 59 years (p<0.001). The median anxiety score of the age group between 20 and 29 years was also significantly higher compared to the age groups between 40 and 49 and 50-59 years (all p<0.05). HCWs living with family showed higher anxiety and depression scores compared to those living with non-family members (p=0.006 and p=0.005, respectively). Handling COVID-19 patients on multiple occasions during routine patient care was significantly associated with higher anxiety and depression scores among HCWs. The results also showed higher PSQI scores among younger HCWs (20-29 years) and trainees (all p<0.05). In addition, PSQI correlate significantly with depression (r=0.268) and anxiety (r=0.278) scores of DASS-21 scale (all p<0.001).

Conclusion

Poor psychological well-being and sleep quality were observed among certain groups of HCWs, even after the mitigation of COVID-19 restrictions. This study highlights the need for strategies to manage HCWs at risk of developing psychological distress during future catastrophes.

Burnout in primary healthcare physicians and nurses in Turkey during COVID-19 pandemic

BACKGROUND

Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout.

AIM

To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic.

METHODS

An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately.

FINDINGS

Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs.

CONCLUSION

PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies.