Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background: Health care workers exposed to COVID-19 might be at risk of developing mental health problems. The study aimed to identify factors associated with anxiety, depression and insomnia among health workers involved in COVID-19 response in Nepal. Methods: This was a cross-sectional web-based survey conducted in between April 26 to May 12, 2020. A total of 475 health workers participated in the study. Anxiety and depression were measured using 14-item Hospital Anxiety and Depression Scale (HADS: 0- 21) and insomnia was measured by using 7-item Insomnia Severity Index (ISI: 0-28). Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes. Results: Overall, 41.9% of health workers had symptoms of anxiety, 37.5% had depression symptoms and 33.9% had symptoms of insomnia. Stigma faced by health workers was significantly associated with higher odds of experiencing symptoms of anxiety (AOR: 2.47; 95% CI: 1.62-3.76), depression (AOR: 2.05; 95% CI: 1.34-3.11) and insomnia (AOR: 2.37; 95% CI: 1.46-3.84). History of medication for mental health problems was significantly associated with higher likelihood of experiencing symptoms of anxiety (AOR: 3.40; 95% CI:1.31-8.81) , depression (AOR: 3.83; 95% CI: 1.45-10.14) and insomnia (AOR: 3.82; 95% CI: 1.52-9.62) while inadequate precautionary measures in the workplace was significantly associated with higher odds of exhibiting symptoms of anxiety (AOR: 1.89; 95% CI: 1.12-3.19) and depression (AOR: 1.97; 95% CI: 1.16-3.37). Nurses (AOR: 2.33; 95% CI: 1.21-4.47) were significantly more likely to experience anxiety symptoms than other health workers. Conclusion: The study findings revealed higher proportion of anxiety, depression and insomnia among health workers during the early phase of the pandemic in Nepal. Health workers facing stigma, those with history of medication for mental health problem, and those reporting to having inadequate precautionary measures in their workplace were more at risk of developing mental health outcomes. A focus on improving mental health wellbeing of health workers should be immediately initiated with attention to reduction of stigma, ensuring adequate support system such as personal protective equipments, and family support for those with history of mental health problems.</jats:p>

Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis

“…The overall pooled point estimates of prevalence for anxiety varied between 8% and 91%, which was reported by 73 studies [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [28] , [29] , [30] , 32 , 34 , 35 , [37] , [38] , [39] , [42] , [43] , [44] , [45] , [46] , 48 , 49 , 51 , [53] , [54] , [55] , [56] , [57] , 62 , [64] , [65] , [66] , [67] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] ,…”

The prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic: An umbrella review of meta-analyses

“…A study in China also showed that nurses experienced more unfavorable mental health outcomes than other health staff ( Khanal et al, 2020 ; Lai et al, 2020 ; Maunder et al, 2004 ). Of note, poor mental health in healthcare workers will affect the quality of the health care provided ( Khanal et al, 2020 ; Brooks et al, 2018 ; Maharaj et al, 2019 ). Therefore, hospital leadership should pay special attention to the mental well-being of their employees, especially nurses, as the mismanagement of their mental health can lead to dire public health consequences.…”

“…In their study, Khanal et al reported that inadequate isolation precautions were significantly associated with signs of anxiety and depression among healthcare workers ( Khanal et al, 2020 ). A shortage in preventive measures, such as insufficient PPE, can render the work environment dangerous, leading to a feeling of insecurity and vulnerability to the infection.…”

Assessment of COVID-19 Pandemic in Nepal: A Lockdown Scenario Analysis

“…Quarantine, social isolation and travel restrictions had negatively impacted the mental health of people who have COVID-19 and their families. A few preliminary studies have shown the psychological issues such as stress, anxiety, depression, insomnia among the general population (13)(14)(15) as well as frontline health workers (16,17). A study by Gupta, Mehra (16) conducted among 150 health workers showed that 38 % of the healthcare workers on COVID-19 duty in Nepal suffered anxiety and/or depression (16).…”

“…A study by Gupta, Mehra (16) conducted among 150 health workers showed that 38 % of the healthcare workers on COVID-19 duty in Nepal suffered anxiety and/or depression (16). Another online survey conducted among 475 health workers showed that 41.9% of health workers had symptoms of anxiety, 37.5% had depression symptoms and 33.9% had symptoms of insomnia (17). Incidents of stigmatization and social discrimination of healthcare workers, people who have COVID-19 and their families were also reported in Nepal during the lockdown (18,19).…”