<p>Generalized Anxiety Disorder and Its Associated Factors Among Health Care Workers Fighting COVID-19 in Southern Ethiopia</p>

Abstract

Background: Healthcare workers (HCWs) are among the many groups of people who are in the frontline caring for people and facing heavy workloads, life-or-death decisions, risk of infection, and have been facing various psychosocial problems. So, monitoring mental health issues to understand the mediating factors and inform evidence-based interventions in a timely fashion is vital. Purpose: This study aimed to assess generalized anxiety disorder and its associated factors among HCWs fighting COVID-19 in Southern Ethiopia. Patients and Methods: An institution-based cross-sectional study was conducted among 798 HCWs from 20 May to 20 June 2020. A pre-tested and structured intervieweradministered KOBO collect survey tool was used to collect data. The study participants were selected using a simple random sampling technique by allocating a proportion to each health institute. The association between the level of generalized anxiety disorder and its independent variables was examined by ordinal logistic regression. Assumptions for the proportional odds model were checked using parallel line tests. An adjusted proportional odds ratio with a 95% CI was used to calculate the strength of the statistical association between the independent and dependent variables. Results: The prevalence of mild and moderate anxiety disorder among HCWs was 29.3% and 6.3%, respectively. Contact with confirmed or suspected cases (aPOR =1.97; 95% CI: 1.239, 3.132), no COVID-19 updates (aPOR=4.816, 95% CI=2.957, 7.842), no confidence on coping with stresses (aPOR=2.74, 95% CI=1.633, 4.606), and COVID-19-related worry (aPOR=1.85, 95% CI=1.120, 3.056) were positively associated with higher-order anxiety disorder. However, not feeling overwhelmed by the demands of everyday life (aPOR=0.52, 95% CI=0.370, 0.733) and feeling cannot make it (aPOR=0.44, 95% CI=0.308, 0.626) were negatively associated with a higher order of anxiety. Conclusion: The study revealed that the prevalence of anxiety disorder among HCWs was high in the study area. The findings of the current study suggest immediate psychological intervention for health care workers in the study area is vital. Therefore, proactive measures should be taken by the stakeholders at different hierarchies to promote the psychological wellbeing of HCWs in order to control the impact of the pandemic on the HCWs, and containing the pandemic.

Magnitude and determinants of the psychological impact of COVID-19 among health care workers: A systematic review

“… 24 Anxiety was solely studied in China 27 and Ethiopia. 14 The magnitude of the depression was high in the two countries: the United States, 27.2%, 19 and China 58%. 29 PTS was highly reported in the study of China, Italy, India, Singapore, Malaysia, Vietnam, and Indonesia which ranges from 7.4% to 47.3%, 9 , 17 , 23 and insomnia has occurred in the study of China and Nepal 12 , 18 , 20 ( Table 2 ).…”

“…However, Nurses were dominant in Indonesia, 10 Oman, 31 Nepal, 20 Ethiopia, India, Singapore, Malaysia, and Vietnam Indonesia. 1 , 14 , 23 , 24 In the United Kingdom and the United States, all of the participants were physicians. 19 , 28 Variable reports were obtained in China 9 , 18 , 12 , 25 , 29 ( Table 1 ).…”

“…National Institute of Health quality assessment tool for observational cohort and cross-sectional studies was used to determine the quality of methodology. As per the tool, all queries were filled with “yes,” “no” or “cannot determine” and “not applicable” and “not reported.” 16 Accordingly, 10 articles were good, 12 , 14 , 17 – 24 7 were fair, 1 , 9 , 25 – 29 and 3 article was poor. 10 , 30 , 31 …”

“…The psychological status of health care professionals is impacted by a variety of factors like unknown isolation period, shortage of medical instruments, concerns about the disease, the rapid increase of the COVID-19 cases, overwhelming workload, plenty of information on the burden of the disease released on different social media, lack of treatment, and lack of social support, discrimination and stigma. 9 , 12 , 14 …”

“…Similarly, presence of comorbidities, rural residence, female gender, marital status, the title and level of professionalism, having children, and having close contact with the coronavirus disease (COVID-19) infected patients were the most common predictors of the negative psychological impacts among health care professional. 14 …”