Mental Health Status of Healthcare Workers During the Coronavirus Disease 2019 Pandemic: A Survey of Hospitals in Shiraz, Iran

Authors

  • Seyed Taghi Heydari Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Arash Mani esearch Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mani Kharazi Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mohammad Reza Yousefi Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Ali Akbary Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad, Iran
  • Morteza Banakar Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Hossein Molavi Vardanjani Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Leila Zarei Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mohammad Khabaz Shirazi Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • Kamran Bagheri Lankarani Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran

DOI:

https://doi.org/10.31661/gmj.v12i.2512

Keywords:

COVID-19, Health Care Workers, Mental Health, Anxiety, Depression, Insomnia, Post-Traumatic Stress Disorder

Abstract

Background:Healthcare workers (HCWs) directly or indirectly involved in the coronavirus disease 2019 (COVID-19) treatment process may experience severe mental consequences of the pandemic. Hence, this study aimed to evaluate the mental health status of HCWs in hospitals affiliated with Shiraz University of Medical Sciences, Iran. Materials and Method:This cross-sectional study was performed on 503 HCWs from five hospitals in Shiraz, including one COVID-19 front-line hospital, two COVID-19 second-line hospitals, and two without COVID-19 wards. Then, to assess the levels of anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD) among HCWs, the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), and Global Psychotrauma Screen (GPS) questionnaires were placed, respectively. Results:The mean age of participants was 33.94±8.26 years, and 252 (50.1%) were females. Anxiety, depression, insomnia, and moderate to high levels of PTSD were observed in 40.4%, 37.8%, 24.5%, and 71% of participants, respectively. A history of mental disorders was associated with all four outcomes (P<0.05). Females gender and living with elderly and/or children were correlated with anxiety and PTSD (P<0.05). Working at COVID-19 front- and second-line hospitals were similarly linked to higher insomnia and PTSD levels (P<0.05). Also, working in COVID-19 wards or non-clinical settings was associated with anxiety and depression (P<0.05). Conclusion:Most of the HCWs in this study may experience mental difficulties. Some factors may increase their risk of experiencing these difficulties. Hence, in the crisis era, mental health monitoring and identification of groups with predisposing factors are required to provide appropriate care as quickly as feasible.

References

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1016/S0140-6736(20)30183-5PMid:31986264 Di Tella M, Romeo A, Benfante A, Castelli L. Mental health of healthcare workers during the COVID-19 pandemic in Italy. J Eval Clin Pract. 2020;26(6):1583-7. https://doi.org/10.1111/jep.13444PMid:32710481 Mani A, Fereidooni R, Salehi-Marzijarani M, Ardekani A, Sasannia S, Habibi P, et al. The prevalence and risk factors of death anxiety and fear of COVID-19 in an Iranian community: A cross-sectional study. Health Sci Rep. 2022 Jun 19;5(4):e706. https://doi.org/10.1002/hsr2.706PMid:35765604 PMCid:PMC9207499 Mowla A, Ardekani A, Feili A, Rahimian Z. Effects of COVID-19 pandemic and lockdown on mental health of Iranian people. Przegl Epidemiol. 2021;75(4):484-489. https://doi.org/10.32394/pe.75.44PMid:35543421 Pfefferbaum B, North CS. Mental Health and the Covid-19 Pandemic. N Engl J Med. 2020;383(6):510-2. https://doi.org/10.1056/NEJMp2008017PMid:32283003 Montemurro N. The emotional impact of COVID-19: From medical staff to common people. Brain Behav Immun. 2020;87:23-4. https://doi.org/10.1016/j.bbi.2020.03.032PMid:32240766 PMCid:PMC7138159 Farì G, de Sire A, Giorgio V, Rizzo L, Bruni A, Bianchi FP, et al. Impact of COVID-19 on the mental health in a cohort of Italian rehabilitation healthcare workers. J Med Virol. 2022;94(1):110-8. https://doi.org/10.1002/jmv.27272PMid:34387886 PMCid:PMC8426878 Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Netw Open. 2020;3(5):e2010185. https://doi.org/10.1001/jamanetworkopen.2020.10185PMid:32463467 PMCid:PMC7256664 Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976PMid:32202646 PMCid:PMC7090843 Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland S, et al. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res. 2020;293:113441. https://doi.org/10.1016/j.psychres.2020.113441PMid:32898840 PMCid:PMC7462563 Rossi R, Socci V, Jannini TB, Pacitti F, Siracusano A, Rossi A, et al. Mental Health Outcomes Among Italian Health Care Workers During the COVID-19 Pandemic. JAMA Netw Open. 2021;4(11):e2136143. https://doi.org/10.1001/jamanetworkopen.2021.36143PMid:34817580 PMCid:PMC8613589 Doosti-Irani A, Haghdoost AA, Najafi F, Eybpoosh S, Moradi G, Bagheri Amiri F, et al. How Can the Epidemic Curve of COVID-19 in Iran Be Interpreted? J Res Health Sci. 2020;20(3):e00491. https://doi.org/10.34172/jrhs.2020.27PMid:33169723 PMCid:PMC7585769 Meo SA, Meo AS, Al-Jassir FF, Klonoff DC. Omicron SARS-CoV-2 new variant: global prevalence and biological and clinical characteristics. Eur Rev Med Pharmacol Sci. 2021;25(24):8012-8. Rayani S, Rayani M, Najafi-Sharjabad F. Correlation between anxiety and resilience of healthcare workers during COVID-19 pandemic in the southwest of Iran. Environ Sci Pollut Res Int. 2022; 29(15):21528-21536. https://doi.org/10.1007/s11356-021-17284-xPMid:34762238 PMCid:PMC8581131 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.xPMid:6880820 Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of Anxiety and Depression Hospital Scales (HADS): Iranian patients with anxiety and depression disorders. Tehran Univ Med J. 2009;67(5):379-85. Lundh L-GJSJOBT. Morin, cm: Insomnia: Psychological assessment and management. 1994. Yazdi Z, Sadeghniiat-Haghighi K, Zohal MA, Elmizadeh K. Validity and reliability of the Iranian version of the insomnia severity index. Malays J Med Sci. 2012;19(4):31-6. Olff M, Bakker A, Frewen P, Aakvaag H, Ajdukovic D, Brewer D, et al. Screening for consequences of trauma - an update on the global collaboration on traumatic stress. Eur J Psychotraumatol. 2020;11(1):1752504. https://doi.org/10.1080/20008198.2020.1752504PMid:32489523 PMCid:PMC7241533 Noorbala AA, Faghihzadeh S, Kamali K, Bagheri Yazdi SA, Hajebi A, Mousavi MT, et al. Mental Health Survey of the Iranian Adult Population in 2015. Arch Iran Med. 2017;20(3):128-34. Saffari M, Raei M, Pourhoseingholi MA, Khosh Fetrat M. Psychological Aspects of COVID-19 in Iran: How the Disease May Affect Mental Health of Medical Staff and General Population? International Journal of Travel Medicine and Global Health (IJTMGH). 2021;9(2):94-9. https://doi.org/10.34172/ijtmgh.2021.15 Rezapour M, Zarghami M, Sheikhmoonesi F. Psychological Experience and Needs of Front-line Nurses during COVID-19 Outbreak in Iran: A Qualitative Study. J Mazandaran Univ Med Sci. 2021;31(196):125-35. Rouhbakhsh A, Badrfam R, Nejatisafa AA, Soori M, Sharafi SE, Etesam F, et al. Health Care Professionals' Perception of Stress During COVID-19 Pandemic in Iran: A Qualitative Study. Front Psychiatry. 2021;12:804637. https://doi.org/10.3389/fpsyt.2021.804637PMid:35177999 PMCid:PMC8844024 Zandifar A, Badrfam R. Fighting COVID-19 in Iran; Economic Challenges Ahead. Arch Iran Med. 2020;23(4):284. https://doi.org/10.34172/aim.2020.14PMid:32271606 Hassannia L, Taghizadeh F, Moosazadeh M, Zarghami M, Taghizadeh H, Dooki AF, et al. Anxiety and Depression in Health Workers and General Population During COVID-19 in IRAN: A Cross-Sectional Study. Neuropsychopharmacol Rep. 2021;41(1):40-9. https://doi.org/10.1002/npr2.12153PMid:33369264 PMCid:PMC8182959 Azizi M, Kamali M, Moosazadeh M, Aarabi M, Ghasemian R, Hasannezhad Reskati M, et al. Assessing mental health status among Iranian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study. Brain Behav. 2021;11(8):e2304. https://doi.org/10.1002/brb3.2304PMid:34333852 PMCid:PMC8413818 Lasalvia A, Bonetto C, Porru S, Carta A, Tardivo S, Bovo C, et al. Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy. Epidemiol Psychiatr Sci. 2020;30:e1. https://doi.org/10.1017/S2045796020001158PMid:33331255 PMCid:PMC7804082 Gao YD, Ding M, Dong X, Zhang JJ, Kursat Azkur A, Azkur D, et al. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy. 2021;76(2):428-55. https://doi.org/10.1111/all.14657PMid:33185910 Cohen AK, Nussbaum J, Weintraub MLR, Nichols CR, Yen IH. Association of Adult Depression With Educational Attainment, Aspirations, and Expectations. Preventing chronic disease. 2020;17:E94. https://doi.org/10.5888/pcd17.200098PMid:32857033 PMCid:PMC7478148 Stamatakis KA, Kaplan GA, Roberts RE. Short sleep duration across income, education, and race/ethnic groups: population prevalence and growing disparities during 34 years of follow-up. Ann Epidemiol. 2007;17(12):948-55. https://doi.org/10.1016/j.annepidem.2007.07.096PMid:17855122 PMCid:PMC2140008 Khurshid KA. Comorbid Insomnia and Psychiatric Disorders: An Update. Innov Clin Neurosci. 2018;15(3-4):28-32. Riemann D. Insomnia and comorbid psychiatric disorders. Sleep medicine. 2007;8 Suppl 4:S15-20. https://doi.org/10.1016/S1389-9457(08)70004-2PMid:18346672 Slavish DC, Contractor AA, Dietch JR, Messman B, Lucke HR, Briggs M, et al. Characterizing Patterns of Nurses' Daily Sleep Health: a Latent Profile Analysis. Int J Behav Med. 2022 Jan 5. https://doi.org/10.1007/s12529-021-10048-4PMid:34988862 Rouhbakhsh A, Arbabi M, Nejatisafa A-A, Sharafi SE, Etesam F, Shahmansouri N, et al. Mental Health of Health Care Workers at Imam Khomeini Hospital in Tehran During COVID-19 Pandemic. JIMC. 2021;4(4):209-20. https://doi.org/10.18502/jimc.v4i4.8468

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Published

2023-02-17

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