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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 4  |  Page : 239-243

Occurrence of depression, anxiety, stress, and fear of COVID-19 among staff nurses of South India during COVID-19 pandemic


1 Department of Physiology, Vinayaka Mission's Kirupananda Variyar Medical College and Hospital, Salem, Tamil Nadu, India
2 Department of Medicine, Government Erode Medical College and Hospital, Erode, Tamil Nadu, India
3 Department of Medical Physiology, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, Tamil Nadu, India
4 Department of Pulmonology, Government Erode Medical College and Hospital, Erode, Tamil Nadu, India
5 Department of Physiology, Government Erode Medical College and Hospital, Erode, Tamil Nadu, India
6 Department of Nursing, Government Erode Medical College and Hospital, Erode, Tamil Nadu, India

Date of Submission04-Jul-2021
Date of Decision05-Aug-2021
Date of Acceptance11-Aug-2021
Date of Web Publication20-Oct-2021

Correspondence Address:
Dr. Panneerselvam Periasamy
Department of Medical Physiology, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajim.ajim_70_21

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  Abstract 


Background: Besides the general population, the psychologically connected problems associated with COVID-19 had also affected the frontline health-care workers, such as nurses and doctors, who faced prominent challenges 'with respect to their mental health. According to recent studies concerning COVID-19, the nurses happened to be those health-care workers who faced the more psychological problems resulting from COVID-19 outbreak. Materials and Methods: This was a cross-sectional study evaluating the fear of COVID-19 using the fear of COVID-19 scale and depression, anxiety, and stress levels using Depression Anxiety and Stress Score. The participants' demographic data such as gender, age, working category, hospital unit, and work shift were collected in addition to the above-mentioned questionnaires. Results: There were 277 staff nurses, out of which 259 were females and 18 were males participated in this study. The common age of the study group was between 21 and 40 years and most of them (47%) worked at government primary health-care centers. Discussion: The nurses who were younger at age tend to be more stressed than the older nurses which could be due to the fact that younger nurses might have felt nervous due to their inexperience and poor preparation for their occupational role at work. Conclusion: Increasing the awareness and educating nurses toward the essential need for addressing their mental health issues with timely and adequate support measures is recommended.

Keywords: Anxiety, COVID-19, depression, staff nurses, stress


How to cite this article:
Suganthi V, Kanchana V, Periasamy P, Saravanakumar R, Chandrabose A, Sasikala G, Bharathi C, Priyadharshini S. Occurrence of depression, anxiety, stress, and fear of COVID-19 among staff nurses of South India during COVID-19 pandemic. APIK J Int Med 2021;9:239-43

How to cite this URL:
Suganthi V, Kanchana V, Periasamy P, Saravanakumar R, Chandrabose A, Sasikala G, Bharathi C, Priyadharshini S. Occurrence of depression, anxiety, stress, and fear of COVID-19 among staff nurses of South India during COVID-19 pandemic. APIK J Int Med [serial online] 2021 [cited 2021 Nov 29];9:239-43. Available from: https://www.ajim.in/text.asp?2021/9/4/239/328681




  Introduction Top


The world is facing COVID-19 outbreak since December 2019, caused by the novel COVID-19. COVID-19 was first reported in Wuhan city of China, and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1] The advancing COVID-19 diffusion can be due to the main factors that determine the diffusion of infectious diseases, including the demographic factors, respiratory diseases or illnesses of people, air pollution, and atmospheric instabilities. In spite of the respiratory pattern of illness, provided by higher prevalence in the overall population of most of the countries, its intensely infectious nature and novelty have also added to the development of psychological problems.[2] Besides the general population, the psychologically connected problems associated with COVID-19 had also affected the frontline health-care workers, such as nurses and doctors, who faced prominent challenges toward their mental health. According to recent studies concerning COVID-19, the nurses happened to be those health-care workers who faced the more psychological problems resulting from COVID-19 outbreak.[3] Higher levels of anxiety and stress, increased workload, and unexpected changes in the working environment and medical procedures during the COVID-19 outbreak made the health-care workers impossible to implement the preventive practices completely, even though the purpose of those practices, measures, and the potential risks of violating them are clearly told and informed.[4]

To address and bridge the gap in the growing literature regarding the psychological concerns of staff nurses during COVID-19, the primary aim of this study was to evaluate the prevalence and frequency of associated factors of depression, anxiety, and stress affecting them. The secondary aim of this study is to assess the levels of fear against COVID-19 among the staff nurses.


  Materials and Methods Top


This was a cross-sectional study evaluating the fear of COVID-19 using the fear of COVID-19 scale (FCV-19S) and depression, anxiety, and stress levels using Depression Anxiety and Stress Score (DASS-21). The participants' demographic data such as gender, age, working category, hospital unit, and work shift were collected in addition to the above-mentioned questionnaires. The FCV-19S is a seven-item questionnaire for evaluating the fear of the global pandemic caused by the SARS-CoV-2.[5] DASS-21 scale is a 21 item with a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three DASS-21 scales contains 7 items, divided into subscales with similar content.[6]

A total of 277 participants were surveyed during August–December 2020, where the participants were staff nurses of different hospitals of Tamil Nadu. Physical copies of the survey were distributed to the staff nurses. Inclusion criteria were being at least 18 years old and willing to participate in the study. The data were tabulated in Microsoft Excel and analyzed using SPSS software (version 24.0 for Windows; IBM SPSS, Armonk, NY, USA). Student's t test and one-way ANOVA F-test were used to analyze continuous variables, and a probability level of P < 0.05 was considered significant. The internal reliability of the scale was good, with Cronbach's alpha of 0.902.


  Results Top


There are 277 staff nurses, out of which 259 are females and 18 were males participated in this study. The common age of the study population was between 21 and 40 years and most of them (47%) work at government primary health-care centers [Table 1]. The mean scoring in the FCV-19S was 20.77 ± 6.95 (mean ± SD) [Table 2]. Females, overweight, joint family. semi-urban, and PHC staff nurses are having more fear scores than others, which was confirmed using one-way ANOVA F-test and student independent t-test [Table 3]. Most of the nurses displayed moderate levels of stress, anxiety, and depression [Table 4].
Table 1: Demographic information

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Table 2: Fear of COVID-19 Scale

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Table 3: Association between fear of COVID-19 score and staffs demographic variables

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Table 4: Depression anxiety, and stress score Scale Score

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  Discussion Top


Out of 277 total study population, 259 nurses were females (93.5%), which is in line with a study conducted among the nurses working in Portugal. The most prevalent age of staff nurses ranges 31–40 years according to the Portuguese Order of Nurses, which was in accordance with our study (42%).[7] There were some factors which could not be directly connected to COVID-19 outbreak like women were about twice as likely as men to develop depression during their lifetime due to several underlying genetic, physiological, hormonal, psychological, and environmental factors.[8] The nurses who were younger at age tend to be more stressed than the older nurses which could be due to the fact that younger nurses might have felt nervous due to their inexperience and poor preparation for their occupational role at work.[9] The FCV-19S fear severity scores reported by García-Reyna et al. were similar with our scores (19.2 and 20.77), which could be positively and significantly related with the scores assessing depression, stress, and anxiety.[10] However, specific attention should be paid toward the staff nurses and their roles, considering that previous studies pointed out that an increased level of fear of COVID-19 and various other infectious diseases was associated with increased psychological stress, decreased job satisfaction, and increased professional and organizational turnover intentions.


  Conclusion Top


Staff Nurses' mental health status and psychological status which include fear of COVID-19 infection, levels of depression, anxiety, and stress diversified over the period of COVID-19 outbreak. The fear of getting infected and fear of infecting others are the critical factors that are directly related to the varied levels of stress, anxiety, and depression. Early identification and appropriate intervention are very crucial such as for the nurse's population who are at risk of presenting with notable symptoms of depression, anxiety, and stress. Increasing the awareness and educating nurses toward the essential need for addressing their mental health issues with timely and adequate support measures is recommended.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sampaio F, Sequeira C, Teixeira L. Impact of COVID-19 outbreak on nurses' mental health: A prospective cohort study. Environ Res 2021;194:110620.  Back to cited text no. 1
    
2.
Coccia M. Factors determining the diffusion of COVID-19 and suggested strategy to prevent future accelerated viral infectivity similar to COVID. Sci Total Environ 2020;729:138474.  Back to cited text no. 2
    
3.
Alnazly E, Khraisat OM, Al-Bashaireh AM, Bryant CL. Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers. PLoS One 2021;16:e0247679.  Back to cited text no. 3
    
4.
Si MY, Su XY, Jiang Y, Wang WJ, Gu XF, Ma L, et al. Psychological impact of COVID-19 on medical care workers in China. Infect Dis Poverty 2020;9:113.  Back to cited text no. 4
    
5.
Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: Development and initial validation. Int J Ment Health Addict 2020:1-9.  Back to cited text no. 5
    
6.
Lovibond S, Lovibond P. Psychology foundation; Sydney: Manual for the depression anxiety stress scales. Behav Res Ther. 1995;33:335-43.  Back to cited text no. 6
    
7.
Order of Nurses 2019 Statistical Yearbook (in Portuguese); 2020. Available from: https://www.ordemenfermeiros.pt/arquivo/estatistica/2019_AnuarioEstatisticos.pdf. [Last accessed on 2021 Jun 02].  Back to cited text no. 7
    
8.
Hu D, Kong Y, Han Q. Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study. Lancet 2020;24:100424.  Back to cited text no. 8
    
9.
Mathur S, Sharma D, Solanki RK, Goyal MK. Stress-related disorders in health-care workers in COVID-19 pandemic: A cross-sectional study from India. Indian J Med Spec 2020;11:180-4.  Back to cited text no. 9
  [Full text]  
10.
García-Reyna B, Castillo-García GD, Barbosa-Camacho FJ, Cervantes-Cardona GA, Cervantes-Pérez E, Torres-Mendoza BM, et al. Fear of COVID-19 scale for hospital staff in regional hospitals in Mexico: A brief report. Int J Ment Health Addict 2020: 1-12.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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