A cross-sectional survey of the workplace factors contributing to symptoms of anxiety and depression among nurses and physicians during the first wave of COVID-19 pandemic in two US healthcare systems

Abstract

BackgroundAnxiety and depression among physicians and nurses during COVID-19 pandemic in the USA is not well described and its modifiable causes poorly understood.MethodsWe conducted a cross-sectional survey of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) among physicians and nurses in two US healthcare systems June-Sept 2020. We ascertained features of work as well as its perceptions and associated concerns in relation to risk of anxiety and depression, while controlling for health history via regression and path analyses.ResultsAbout a third of 684 nurses and 185 physicians surveyed showed symptoms of anxiety or depression, the excess was particularly prominent in nurses. Belief in having been infected was a dominant cause of anxiety and depression, more related to history of symptoms of pneumonia, then the contact with infected patients. Having confidence in competent use and access to personal protective equipment, maintaining usual working hours and being surrounded by colleagues who were both sufficient in numbers and not stressed, was protective. Having support of immediate family and religious communities lessened anxiety and depression after accounting for other factors. Involvement in aerosol-generating procedures with infected patients was linked with lower depression in nurses but higher among physicians. Likewise, the setting of recent patient encounters affected risk differently for physicians and nurses.ConclusionsOur findings may help develop mitigation measures and underscore the need to help nurses and physicians bear the psychological burden of COVID-19 pandemic and similar events in the future.

Experiences of coping with the first wave of COVID-19 epidemic in Philadelphia, PA: Mixed methods analysis of a cross-sectional survey of worries and symptoms of mood disorders

“…Having supportive "inner circle" of family, neighbours, and religious community appeared to be protective. Our findings largely agree with our in-depth look at sub-sample of our respondents who worked during the epidemic [9], within sub-sample who did not (S1 Table ), and in related work among healthcare workers done using similar instruments at a roughly the same time in Philadelphia [10].…”

“…We reported that anxiety and depression in general population of Philadelphia during the first wave of the pandemic can be due to widespread disruption of working lives, especially in “non-essential” low-income industries, on par with experience in healthcare [ 9 ]. We verified that levels of anxiety and depression were indeed on par with healthcare setting through a survey of physicians and nurses that gathered data using analogous instruments at the same time in the same region [ 10 ]. We now turn our attention to broader range of experiences of persons in our sample that transcend work-related circumstances.…”

Experiences of coping with the first wave of COVID-19 epidemic in Philadelphia, PA: Mixed methods analysis of a cross-sectional survey of worries and symptoms of mood disorders

“…Having supportive “inner circle” of family, neighbours, and religious community appeared to be protective. Our findings largely agree with our in-depth look at sub-sample of our respondents who worked during the epidemic [9], within sub-sample who did not ( Table in S1 Table ), and in related work among healthcare workers done using similar instruments at a roughly the same time in Philadelphia [10].…”

Differences in levels of psychological distress, perceived safety, trust, and efficacy amongst hospital personnel during the COVID‐19 pandemic

“…An interesting finding unique to nurses, was that in addition to perceived safety concerns, distress was also predicted by additional elements such as lower levels of religiosity, older age, and degree of self‐efficacy. With regard to religiosity, previous literature suggests that religion can offer protection against psychological morbidity (Allen et al, 2008; Burstyn & Holt, 2021; Papazisis et al, 2014; Vasegh & Mohammadi, 2007). In an ongoing disaster such as the current pandemic, individuals may feel a loss of control and autonomy whereby religion may provide individuals with a coping mechanism to accept such changing circumstances (Burstyn & Holt, 2021; Zoellner & Maercker, 2006).…”

“…With regard to religiosity, previous literature suggests that religion can offer protection against psychological morbidity (Allen et al, 2008; Burstyn & Holt, 2021; Papazisis et al, 2014; Vasegh & Mohammadi, 2007). In an ongoing disaster such as the current pandemic, individuals may feel a loss of control and autonomy whereby religion may provide individuals with a coping mechanism to accept such changing circumstances (Burstyn & Holt, 2021; Zoellner & Maercker, 2006). Our finding that older age in nurses increases the risk of distress is inconsistent with other studies (Moitra et al, 2021), however it may be derived from the increased vulnerability to severe illness from COVID‐19 as age increases (Liu et al, 2020).…”