Socio-demographic characteristics of the respondents
A total of 133 and 266 frontline medical staffs from obstetrics emergency and abortion care clinic and COVID-19 treatment centers respectively were included in this study. The mean age of the respondents for those who were working in obstetrics emergency and abortion care clinic was 27.47 (SD=3.46) years as well as it was 28.12 (SD=4.09) years for the other groups. In the case of the respondents from obstetrics emergency and abortion care clinic, the majority 66 (49.6%) were in age range of 26 – 30 years, 94 (70.7%) were male and 95 (71.4%) were single. Further, 59 (44.4%) were Resident/Intern in profession, 70 (52.6%) & 129 (97%) were working at delivery unit and saint Paul hospital millennium medical college (SPHMMC) respectively. In addition, 112 (84.2 %) of them had no child, 88 (66.2%) were not living with family at time of outbreak, 69 (51.9%) had emergency obstetric/ abortion care treatment and prevention related training and 68 (51.1%) had intermediate level of social support. (Table 1)
Table1: - Socio demographic, professional and social support related description among frontline medical staffs in case of obstetrics emergency and abortion care clinic, Addis Ababa, Ethiopia, 2020.
Variables
|
Frequency
|
Percent (%)
|
Age
|
25 years and below
|
44
|
33.1
|
|
26-30 years
|
66
|
49.6
|
|
31 and above years
|
23
|
17.3
|
Sex
|
Male
|
94
|
70.7
|
|
Female
|
39
|
29.3
|
Marital status
|
Married
|
38
|
28.6
|
|
Single
|
95
|
71.4
|
Place of work
|
Triage
|
6
|
4.5
|
|
Delivery unit
|
70
|
52.6
|
|
Abortion clinic
|
2
|
1.5
|
|
Obstetrics operation room
|
5
|
3.8
|
|
Emergency OBY/GNY
|
50
|
37.6
|
Profession
|
Nurse
|
9
|
6.8
|
|
Midwifery
|
42
|
31.6
|
|
Physician (GP)
|
6
|
4.5
|
|
Obstetric Specialist
|
10
|
7.5
|
|
Gynecology specialist
|
7
|
5.3
|
|
Resident/Intern
|
59
|
44.4
|
Clinical experience
|
2 years and below
|
80
|
60.2
|
|
3-4 year
|
25
|
18.8
|
|
5 year and above
|
28
|
21.1
|
Employer institution
|
YekaKotebe Hospital
|
2
|
1.5
|
|
SPHMMC
|
129
|
97.0
|
|
St. peter Specialize Hospital
|
2
|
1.5
|
Have a child
|
Yes
|
21
|
15.8
|
|
No
|
112
|
84.2
|
Living with family at time of outbreak
|
Yes
|
45
|
33.8
|
|
No
|
88
|
66.2
|
Have ever trained in emergency obstetric/ abortion care treatment and prevention
|
Yes
|
64
|
48.1
|
|
No
|
69
|
51.9
|
Social support
|
Poor social support
|
53
|
39.8
|
|
Intermediate social support
|
68
|
51.1
|
|
Good social support
|
12
|
9.0
|
With respect to the study participants in the case of COVID-19 treatment centers, the majority 137 (51.5%) were in age range of 26 – 30 years, 155 (58.3%) were male and 177 (66.5%) were single. Further, 219 (82.3%) were Emergency medicine and Critical Care Specialist in profession, 143 (53.8 %) & 170 (63.9%) were working at clinical care unit and saint Paul hospital millennium medical college (SPHMMC) respectively. In addition, 195 (73.3%) of them had no child, 148 (55.6%) were not living with family at time of outbreak, 205 (77.1%) had no COVID-19 treatment and prevention related training and 155 (58.3%) had poor level of social support. (Table 2)
Table2: - Socio demographic, professional and social support related description among frontline medical staffs in case of COVID-19 treatment centers, Addis Ababa, Ethiopia, 2020.
Variables
|
Frequency
|
Percent (%)
|
Age
|
25 and below years
|
75
|
28.2
|
|
26-30 years
|
137
|
51.5
|
|
31 years and above
|
54
|
20.3
|
Sex
|
Male
|
155
|
58.3
|
|
Female
|
111
|
41.7
|
Marital status
|
Married
|
83
|
31.2
|
|
Single
|
177
|
66.5
|
|
Divorced/widowed
|
6
|
2.3
|
Place of work
|
Critical Care Unit
|
143
|
53.8
|
|
Emergency Medicine
|
75
|
28.2
|
|
Outpatient Family Medicine
|
35
|
13.2
|
|
Ward
|
5
|
1.9
|
|
Triage
|
8
|
3.0
|
Profession
|
Emergency medicine and Critical Care Specialist
|
219
|
82.3
|
|
Physician (GP)
|
44
|
16.5
|
|
Nurse
|
3
|
1.1
|
Clinical experience
|
2 years and below
|
89
|
33.5
|
|
3-4 years
|
82
|
30.8
|
|
5 years and above
|
95
|
35.7
|
Employer institution
|
YekaKotebe Hospital
|
46
|
17.3
|
|
SPHMMC
|
170
|
63.9
|
|
St. peter Specialize Hospital
|
46
|
17.3
|
|
Volunteers
|
4
|
1.5
|
Have a child
|
Yes
|
71
|
26.7
|
|
No
|
195
|
73.3
|
Living with family at time of outbreak
|
Yes
|
118
|
44.4
|
|
No
|
148
|
55.6
|
Ever trained in COVID-19 treatment and prevention
|
Yes
|
205
|
77.1
|
|
No
|
61
|
22.9
|
Social support
|
Poor social support
|
155
|
58.3
|
|
Intermediate social support
|
111
|
41.7
|
Level of emotional response among front line medical staffs
This study revealed that, 72.9% (CI 66.2, 80.5) and 5.6% (CI 3, 8.3) of the study participant from obstetrics emergency and abortion clinic and COVID-19 treatment centers had positive emotional response respectively. (Fig.1) The Cronbach’s alpha coefficient of emotional response categories of obstetrics emergency and abortion clinic and COVID-19 treatment centers are 0.704 and 0.743 respectively.
Level of perceived stressor among the study participants
This study revealed that the level of perceived stressor was 84.2% (CI 77.4, 89.5) and 95.5% (CI 92.9, 97.7) among frontline medical staffs working at obstetrics emergency and abortion care unit and at COVID-19 treatment centers respectively. The Cronbach’s alpha result was 0.764 and 0.903 for perceived stressor of the study participants working at COVID-19 treatment centers and obstetrics emergency/abortion care units, respectively. (Fig.2)
Factors associated with emotional response and perceived stressor among frontline medical staffs
For each explanatory variable, bivariate analysis was done and factors such as place of working unit, profession and motivational status among frontline medical staffs working at obstetrics emergency and abortion care unit and factors such as social support and motivational factors among those who are working at COVID-19 treatment centers were variables fulfilled the minimum requirement at p-value < 0.05 significance level for further multivariate logistic analysis of emotional response. Whereas emotional response was the only factor which fulfill the minimum requirement at p-value less than 0.05 during the bivariate analysis for further multivariate analysis with perceived stressor among health care providers working at obstetrics emergency and abortion care unit. But, there was no factor which had an association with perceived stressor during the bivariate analysis among those who are working at COVID-19 treatment centers.
During the multivariate analysis for emotional response; factors motivational factors, profession and place of working unit had statistically significant associated with low level of emotional response among health care providers working at obstetrics emergency and abortion care unit; whereas only social support status had statistically significant association with emotional response among those frontline healthcare providers working at COVID-19 treatment centers. By using multivariate logistic regression, who had low level of motivational factors (AOR 2.78, 95% CI (1.13, 6.84)), nurses (AOR 10.53, 95% CI (1.31, 85.26)) and who were working at triage (AOR 8.61, 95% CI (1.15, 64.81))) had statistically significant association with low level of emotional response among health care providers working at obstetrics emergency and abortion care units. Further, those who had low social support (AOR 8.02, 95% CI (1.01, 64.00)) had statistically significant association with negative emotional response during the multivariate logistic regression among front line medical staffs working at COVID-19 treatment centers. (table 3)
Table 3; Factors associated with emotional response among frontline medical staffs working at obstetrics emergency/abortion care unit and COVID-19 treatment centers, Addis Ababa, Ethiopia, 2020
Explanatory Variables
|
Emotional response
|
COR,95%(CI)
|
AOR,95%(CI)
|
p-value
|
Positive response
|
Negative response
|
Place of work (a1)
|
|
|
Triage
|
2
|
4
|
7.09, (1.44, 43.96)*
|
8.61,(1.15, 64.81)**
|
0.037
|
Delivery unit
|
49
|
21
|
1.52, (0.66, 3.53)
|
1.50, (0.57, 3.95)
|
0.417
|
Abortion clinic
|
2
|
0
|
0.00,(0.00, 0.00)
|
0.00,(0.00, 0.00)
|
0.999
|
Obstetrics operation room
|
5
|
0
|
0.00,( 0.00, 0.00)
|
0.00,( 0.00, 0.00)
|
0.999
|
Emergency OB/GYN
|
39
|
11
|
1
|
1
|
|
Profession(a1)
|
|
|
|
|
|
OBY/GYN specialist
|
15
|
2
|
1
|
1
|
|
Nurse
|
4
|
5
|
9.38,(1.30, 67.65)*
|
10.53, (1.31, 85.26)**
|
0.027
|
Midwifery
|
26
|
16
|
4.62, (0.93, 22.89)
|
3.68, (0.68, 20.09)
|
0.132
|
Intern/GP/Resident
|
52
|
13
|
1.88, (0.38, 9.25)
|
1.86, (0.35, 10.00)
|
0.470
|
Motivational level (a1)
|
|
|
|
|
|
low level of motivation
|
12
|
121
|
2.13, (1.09, 4.69)*
|
2.78,(1.13, 6.84)**
|
0.026
|
high level of motivation
|
3
|
130
|
1
|
1
|
|
Social support (b2)
|
|
|
|
|
|
Poor/low social support
|
14
|
141
|
10.92,(1.41,84.34)*
|
8.02, (1.01, 64.00)**
|
0.049
|
Intermediate social support
|
1
|
110
|
1
|
1
|
|
Motivational status (b2)
|
|
|
|
|
|
low level of motivation
|
12
|
121
|
4.30, (1.18, 15.60)*
|
0.36, (0.10, 1.36)
|
0.133
|
high level of motivation
|
3
|
130
|
1
|
1
|
|
* Significant association (p-value < 0.05 in bivariate) **-significant association (p-value<0.05in multivariate analysis);
a1 – factors associated emotional response among HCP working at obstetrics emergency/abortion care unit
b2- factors associated emotional response among front line medical staffs working at COVID-19 treatment centers