Abstract

Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. Being stationed at the frontline or not may have implications on their mental health. The aims of this study were to assess depression, anxiety and stress among HCWs, to explore differences between frontline and non-frontline workers, and to investigate associated factors. In this cross-sectional study, frontline and non-frontline HCWs were recruited from a COVID-19 screening hospital in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS-21). Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square and logistic regression. Odds ratios were calculated for the effect of different perceptions on psychological morbidity. A total of 467 HCWs participated, comprising 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with female preponderance (n=341, 77%). Prevalence of depression, anxiety and stress among HCWs were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p<0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026). Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions. Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic.

Highlights

  • Healthcare workers (HCWs) are at risk of mental health problems during a pandemic

  • Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions

  • Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic

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Summary

Introduction

Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. The ever-rising numbers of cases and deaths announced repeatedly on media, often paired with cues of danger and despair, and the ensuing fear of contracting the disease, have understandably placed the human population at risk of mental health sequelae [2]. Healthcare workers (HCWs), whose services were brought to the limelight during this pandemic, are at a higher risk of psychological distress, as they interact with patients potentially having COVID-19 infection. Even though not many HCWs in Sri Lanka had contracted COVID-19 at the time of this study, the staggering numbers of HCWs infected with COVID-19 as reported from other countries [7] may have led FL workers in Sri Lanka to vicariously experience this danger

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