Aim: First aim is to measure the magnitude of stress due to COVID-19 among Healthcare workers (HCWs). Secondly, personal and professional factors associated to their psychological health will be explored. Thirdly, stress levels of front-line and second-line HCWs will be compared. Method: This cross-sectional, direct questionnaire-based survey was carried out in Portiuncula hospital between 18th May 2021 and 5th June 2021. From 184 HCWs doctors and nurses, 148 participated in the survey. HCWs were taken from Anaesthetics/ICU, ED, Gynaecology and Surgery department. Result: Nurses, married and frontline HCWs were found to have more stress “some of the times” 46 (46.9%), 151 (48.6%), and 37 (46.3%) respectively. Around half of the female HCWs 52 (49.5%) suffered from mental stress compared to males. Irish and Middle aged HCWs (31 - 50 years) were more stressed than their counterparts. Frontline HCWs were shown to have 2.65 times more mental stress (CI: 1.24 - 5.67; p = 0.012) than second-line HCWs. Besides, physical stress was 1.55 times (CI: 0.72 - 3.31; p = 0.26) more in frontline compared to second-line HCWs. Conclusion: Frontline HCWs are more stressed mentally and physically than second-line HCWs due to COVID-19. Middle aged, married, females and frontline nurses are in state of distress compared to their counterparts. Fear of transmitting infection to family members was the main consternation amongst HCWs. Psychological support is imperative to overcome stress and mental exhaustion caused by the pandemic.
Cite this paper
Goni, A. , Hasan, M. J. and Kotseva, K. (2022). Stress among Health Care Workers (Doctors and Nurses) as an Impact of COVID-19 Pandemic. Open Access Library Journal, 9, e8507. doi: http://dx.doi.org/10.4236/oalib.1108507.
National Health Commission of the People’s Republic of China (2020, February 16) Update on the Novel Coronavirus Pneumonia Outbreak: China.
http://www.nhc.gov.cn/xcs/yqtb/202002/18546da875d74445bb537ab014e7a1c6.shtml.
Coronaviridae Study Group of the International Committee on Taxonomy of Virus (2020) The Species Severe Acute Respiratory Syndrome-Related Coronavirus: Classifying 2019-nCoV and Naming It SARS-CoV-2. Nature Microbiology, 5, 536-544.
https://doi.org/10.1038/s41564-020-0695-z
Meng, L., Hua, F. and Bian, Z. (2020) Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. Journal of Dental Research, 99, 481-487. https://doi.org/10.1177/0022034520914246
World Health Organization (2020, March 11) WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19. World Health Organization, Geneva.
https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Pfefferbaum, B. and North, C.S. (2020) Mental Health and the Covid-19 Pandemic. The New England Journal of Medicine, 383, 510-512.
https://doi.org/10.1056/NEJMp2008017
Wu, P., Fang, Y., Guan, Z., Fan, B., Kong, J., Yao, Z., et al. (2009) The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk. The Canadian Journal of Psychiatry, 54, 302-311. https://doi.org/10.1177/070674370905400504
Lu, Y.C., Chang, Y.Y. and Shu, B.C. (2009) Mental Symptoms in Different Health Professionals during the SARS Attack: A Follow-Up Study. Psychiatric Quarterly, 80, Article No. 107. https://doi.org/10.1007/s11126-009-9095-5
Santarone, K., McKenney, M. and Elkbuli, A. (2020) Preserving Mental Health and Resilience in Frontline Healthcare Workers during COVID-19. The American Journal of Emergency Medicine, 38, 1530-1531. https://doi.org/10.1016/j.ajem.2020.04.030
Nicola, M., O’Neill, N., Sohrabi, C., Khan, M., Agha, M. and Agha, R. (2020) Evidence Based Management Guideline for the COVID-19 Pandemic: Review Article. International Journal of Surgery, 77, 206-216.
https://doi.org/10.1016/j.ijsu.2020.04.001
Kimball, A., Hatfield, K.M., Arons, M., James, A., Taylor, J., Spicer, K. and Public Health—Seattle & King County, CDC COVID-19 Investigation Team (2020) Asymptomatic and Pre-Symptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility—King County, Washington, March 2020. Morbidity and Mortality Weekly Report, 69, 377-381.
https://doi.org/10.15585/mmwr.mm6913e1
MacIntyre, C.R. and Wang, Q. (2020) Physical Distancing, Face Masks, and Eye Protection for Prevention of COVID-19. Lancet, 395, 1950-1951.
https://doi.org/10.1016/S0140-6736(20)31183-1
Chughtai, A.A., Seale, H., Islam, M.S., Owais, M. and Macintyre, C.R. (2020) Policies on the Use of Respiratory Protection for Hospital Health Workers to Protect from Coronavirus Disease (COVID-19). International Journal of Nursing Studies, 105, Article ID: 103567. https://doi.org/10.1016/j.ijnurstu.2020.103567
World Health Organization (2020) Coronavirus Disease (COVID-19) Advice for the Public: When and How to Use Masks. World Health Organization, Geneva.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks
Sharma, O., Sultan, A.A., Ding, H. and Triggle, C.R. (2020) A Review of the Progress and Challenges of Developing a Vaccine for COVID-19. Frontiers in Immunology, 11, Article ID: 585354. https://doi.org/10.3389/fimmu.2020.585354
McKay, D., Heisler, M., Mishori, R., Catton, H. and Kloiber, O. (2020) Attacks against Health-Care Personnel Must Stop, Especially as the World Fights COVID-19. Lancet, 395, 1743-1745. https://doi.org/10.1016/S0140-6736(20)31191-0
Iyengar, K.P., Jain, V.K. and Vaishya, R. (2020) Current Situation with Doctors and Healthcare Workers during COVID-19 Pandemic in India. Postgraduate Medical Journal, Published Online First. https://doi.org/10.1136/postgradmedj-2020-138496
Walton, M., Murray, E. and Christian, M.D. (2020) Mental Health Care for Medical Staff and Affiliated Healthcare Workers during the COVID-19 Pandemic. European Heart Journal. Acute Cardiovascular Care, 9, 241-247.
https://doi.org/10.1177/2048872620922795
Wang, H., Liu, Y., Hu, K., Zhang, M., Du, M., Huang, H., et al. (2020) Healthcare Worker’s Stress When Caring for COVID-19 Patients: An Altruistic Perspective. Nursing Ethics, 27, 1490-1500. https://doi.org/10.1177/0969733020934146
Foley, S.J., O’Loughlin, A. and Creedon, J. (2020) Early Experiences of Radiographers in Ireland during the COVID-19 Crisis. Insights into Imaging, 11, Article ID: 104. https://doi.org/10.1186/s13244-020-00910-6
Ceri, V. and Cicek, I. (2021) Psychological Well-Being, Depression and Stress during COVID-19 Pandemic in Turkey: A Comparative Study of Healthcare Professionals and Non-Healthcare Professionals. Psychology, Health & Medicine, 26, 85-97. https://doi.org/10.1080/13548506.2020.1859566
Gasparro, R., Scandurra, C., Maldonato, N.M., Dolce, P., Bochicchio, V., Valletta, A., et al. (2020) Perceived Job Insecurity and Depressive Symptoms among Italian dentists: The Moderating Role of Fear of COVID-19. International Journal of Environmental Research and Public Health, 17, Article No. 5338.
https://doi.org/10.3390/ijerph17155338
Guo, J., Liao, L., Wang, B., Li, X., Guo, L., Tong, Z., et al. (2020) Psychological Effects of COVID-19 on Hospital Staff: A National Cross-Sectional Survey of China Mainland. Lancet Psychiatry. SSRN ID: 3550050.
https://doi.org/10.2139/ssrn.3550050
Weilenmann, S., Ernst, J., Petry, H., Pfaltz, M.C., Sazpinar, O., Gehrke, S., et al. (2021) Health Care Workers’ Mental Health during the First Weeks of the SARS-CoV-2 Pandemic in Switzerland—A Cross-Sectional Study. Front Psychiatry, 12, Article ID: 594340. https://doi.org/10.3389/fpsyt.2021.594340
Erdem, H. and Lucey, D.R. (2021) Healthcare Worker Infections and Deaths Due to COVID-19: A Survey from 37 Nations and a Call for WHO to Post National Data on Their Website. International Journal of Infectious Diseases, 102, 239-241.
https://doi.org/10.1016/j.ijid.2020.10.064
Hindustan Times (2021, February 3) IMA Refutes Govts Data, Says 734 Doctors Died Due to Covid-19, Condemns Centres Apathy.
https://www.hindustantimes.com/india-news/ima-refutes-govt-s-data-says-734-doctors-died-due-to-covid-19-condemns-centre-s-apathy-101612365469868.html
Ruitenburg, M.M., Frings-Dresen, M.H. and Sluiter, J.K. (2012) The Prevalence of Common Mental Disorders among Hospital Physicians and Their Association with Self-Reported Work Ability: A Cross-Sectional Study. BMC Health Services Research, 12, Article No. 292. https://doi.org/10.1186/1472-6963-12-292
Bai, Y., Lin, C.C., Lin, C.Y., Chen, J.Y., Chue, C.M. and Chou, P. (2004) Survey of Stress Reactions among Health Care Workers Involved with the SARS Outbreak. Psychiatric Services, 55, 1055-1057. https://doi.org/10.1176/appi.ps.55.9.1055
Goulia, P., Mantas, C., Dimitroula, D., Mantis, D. and Hyphantis, T. (2010) General Hospital Staff Worries, Perceived Sufficiency of Information and Associated Psychological Distress during the A/H1N1 Influenza Pandemic. BMC Infectious Diseases, 10, Article No. 322. https://doi.org/10.1186/1471-2334-10-322
Pfefferbaum, B., Schonfeld, D., Flynn, B.W., Norwood, A.E., Dodgen, D., Kaul, R.E., et al. (2012) The H1N1 Crisis: A Case Study of the Integration of Mental and Behavioural Health in Public Health Crises. Disaster Medicine and Public Health Preparedness, 6, 67-71. https://doi.org/10.1001/dmp.2012.2
Ji, D., Ji, Y.J., Duan, X.Z., Li, W.G., Sun, Z.Q., Song, X.A., et al. (2017) Prevalence of Psychological Symptoms among Ebola Survivors and Healthcare Workers during the 2014-2015 Ebola Outbreak in Sierra Leone: A Cross-Sectional Study. Oncotarget, 8, 12784-12791. https://doi.org/10.18632/oncotarget.14498
World Health Organisation (2014) Psychological First Aid for Ebola Virus Disease Outbreak.
http://www.who.int/mental_health/emergencies/psychological_first_aid_ebola/en/#
World Health Organization (2017) Pandemic Influenza Risk Management: A WHO Guide to Inform and Harmonize National and International Pandemic Preparedness and Response. World Health Organization, Geneva.
Argentero, P. and Setti, I. (2011) Engagement and Vicarious Traumatization in Rescue Workers. International Archives of Occupational and Environmental Health, 84, 67-75. https://doi.org/10.1007/s00420-010-0601-8
Lenzo, V., Quattropani, M.C., Sardella, A., Martino, G. and Bonanno, G.A. (2021) Depression, Anxiety, and Stress among Healthcare Workers during the COVID-19 Outbreak and Relationships with Expressive Flexibility and Context Sensitivity. Frontiers in Psychology, 12, Article ID: 623033.
https://doi.org/10.3389/fpsyg.2021.623033
Cheung, T. and Yip, P.S. (2015) Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 12, 11072-11100.
https://doi.org/10.3390/ijerph120911072
Barello, S., Palamenghi, L. and Graffigna, G. (2020) Burnout and Somatic Symptoms among Frontline Healthcare Professionals at the Peak of the Italian COVID-19 Pandemic. Psychiatry Research, 290, Article ID: 113129.
https://doi.org/10.1016/j.psychres.2020.113129
Ali, S., Maguire, S., Marks, E., Doyle, M. and Sheehy, C. (2020) Psychological Impact of the COVID-19 Pandemic on Healthcare Workers at Acute Hospital Settings in the South-East of Ireland: An Observational Cohort Multicentre Study. BMJ Open, 10, Article ID: e042930. https://doi.org/10.1136/bmjopen-2020-042930
Chatterjee, S.S., Malathesh Barikar, C. and Mukherjee, A. (2020) Impact of COVID-19 Pandemic on Pre-Existing Mental Health Problems. Asian Journal of Psychiatry, 51, Article ID: 102071. https://doi.org/10.1016/j.ajp.2020.102071
Rossi, R., Socci, V., Pacitti, F., Di Lorenzo, G., Di Marco, A., Siracusano, A., et al. (2020) Mental Health Outcomes among Frontline and Second-Line Health Care workers during the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open, 3, Article ID: e2010185.
https://doi.org/10.1001/jamanetworkopen.2020.10185
Sritharan, J., Jegathesan, T., Vimaleswaran, D. and Sritharan, A. (2020) Mental Health Concerns of Frontline Workers during the COVID-19 Pandemic: A Scoping Review. Global Journal of Health Science, 12, 89-105.
https://doi.org/10.5539/gjhs.v12n11p89
Ornell, F., Halpern, S.C., Kessler, F.H. and Narvaez, J.C. (2020) The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Professionals. Cad Saude Publica, 36, Article ID: e00063520. https://doi.org/10.1590/0102-311x00063520
Crawford, J.R., Henry, J.D. (2003) The Depression Anxiety Stress Scales (DASS): Normative Data and Latent Structure in a Large Non-Clinical Sample. British Journal of Clinical Psychology, 42, 111-131.
https://doi.org/10.1348/014466503321903544
Lovibond, P.F. and Lovibond, S.H. (1995) The Structure of Negative Emotional States: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335-343.
https://doi.org/10.1016/0005-7967(94)00075-U
Antony, M.M., Bieling, P.J., Cox, B.J., Enns, M.W. and Swinson, R.P. (1998) Psychometric Properties of the 42-Item and 21-Item Versions of the Depression Anxiety Stress Scales in Clinical Groups and a Community Sample. Psychological Assessment, 10, 176-181. https://doi.org/10.1037/1040-3590.10.2.176
Tran, T.D., Tran, T. and Fisher, J. (2013) Validation of the Depression Anxiety Stress Scales (DASS) 21 as a Screening Instrument for Depression and Anxiety in a Rural Community-Based Cohort of Northern Vietnamese Women. BMC Psychiatry, 13, Article No. 24. https://doi.org/10.1186/1471-244X-13-24
Oei, T.P., Sawang, S., Goh, Y.W. and Mukhtar, F. (2013) Using the Depression Anxiety stress Scale 21 (DASS-21) across Cultures. International Journal of Psychology, 48, 1018-1029. https://doi.org/10.1080/00207594.2012.755535
Minihan, E., Gavin, B., Kelly, B.D. and McNicholas, F. (2020) COVID-19, Mental Health and Psychological First Aid. Irish Journal of Psychological Medicine, 37, 259-263. https://doi.org/10.1017/ipm.2020.41
