Demographic variables included age, gender (male, female), marital status (single, married, divorced, widowed), academic degree diploma, Bachelor, Master, PhD), department of service (emergency, medical, surgical, intensive care unit), having been infected with Covid-19 (yes, no), the severity of symptoms (mild, moderate, severe) and are reported in Table 1. The participants' age mean was 31.78 (SD 8.73), 49.6% were female, and 48.6% were male (see Table 1).
Table 1
Frequency of demographic variables
| N / M | % / SD |
Age | 31. 78 | 8.73 |
Gender | | |
Male | 138 | 48.6 |
Female | 141 | 49.6 |
Marital status ** | | |
Single | 88 | 31 |
Married | 188 | 66.2 |
Academic degree | | |
Diploma | 59 | 20.8 |
Bachelor | 185 | 65.1 |
Master | 40 | 14.1 |
Department | | |
Emergency | 57 | 20.1 |
Medical | 82 | 28.9 |
Surgical | 72 | 25.4 |
Intensive care unit | 56 | 19.7 |
Infected with Covid-19 | | |
Yes | 148 | 52.1 |
No | 135 | 47.5 |
Severity of symptoms | | |
Mild | 38 | 26.6 |
Moderate | 67 | 46.9 |
Severe | 38 | 26.6 |
Note: The sample comprises single and married only. No divorced or widow nurses were among the participants. |
The results showed that there was a significant difference regarding gender in Covid-related-stress t(277) = -2.60; p = .01, anxiety t(277); t= -2.14; p = .03. Female nurses (M = 11.37, SD: 4.23) reported more fear of Covid-19 dangerousness and anxiety compared with males (M = 9.97, SD: 4.72). There was a significant difference in whether the infection of covid-19 was related to the dangerousness t(281) = 2.12, p = .03 and emotion-focused coping t(279) = -2.17, p = .03. Those who did not infect with covid-19 (M = 11.31, SD: 4.38) reported higher levels of fear of dangerousness (M = 10.16, SD: 4.61) compared to those who did. Those infected with covid-19 used more emotion-focused coping (M = 41.006, SD: 11.82) than those who had not been infected (M = 37.97, SD: 11.52).
One-way ANOVA indicated a significant difference in the department in which the nurses served related to fear of the dangerousness of covid, F(3,263) = 3.60, p = .01.
Bonferroni post-hoc tests showed that those who worked in the surgical department showed higher levels of fear of the dangerousness of covid (M = 12.09, SD: 4.20) than those who worked in the ER (M = 9.91, SD: 4.80, p = .04) and medical departments (M: 9.97, SD: 4.14, p = .02). There were no significant differences regarding marital status, academic degree, department, infection with Covid or not, and severity of the symptoms with the other variables.
The results also showed that there was a significant positive correlation between fear of the dangerousness of covid and fear of being infected by others (p < .001), fear of being infected by things (p < .001), self-esteem (p = .002), problem-focused coping (p = .02), anxiety (p < .001), depression (p < .001). Moreover, there was a significant positive correlation between fear of being infected by others and fear of being infected by things (p < .001), self-esteem (p = .004), problem-focused coping (p = .005), emotion-focused coping (p = .01), and anxiety (p = .01). There is a significant positive correlation between fear of infected by things and emotion-focused coping (p = .009), and anxiety (p < .001), depression (p = .03). Similarly, there is a significant positive correlation between self-esteem and problem-focused coping (p < .001). Likewise, there is a significant positive correlation between problem-focused and emotion-focused coping (p < .001). Likewise, there is a significant positive correlation between emotion-focused coping and anxiety (p = .002) and depression (p < .001). Finally, there is a significant positive correlation between anxiety and depression (p < .001) (see Table 2).
Table 2
Pearson correlation between Covid-19 stress, self-esteem, problem-focus coping, emotion-focused coping, anxiety and depression symptoms.
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
Fear of the dangerousness of covid | - | | | | | | | |
Fear of being infected by others | .673** | - | | | | | | |
Fear of being infected by things | .561** | .717** | - | | | | | |
Self-esteem | .186** | .172** | .030 | - | | | | |
Problem-focused coping | .131* | .167** | .092 | .212** | - | | | |
Emotion-focused coping | .097 | .146** | .156** | − .001 | .780** | - | | |
Anxiety | .253** | .143* | .209** | − .111 | .054 | .186** | - | |
Depression | .200** | .041 | .129* | − .091 | .076 | .226** | .744** | - |
** Correlation is significant at the 0.01 level (2-tailed).
* Correlation is significant at the 0.05 level (2-tailed).
Predictors of anxiety and depression
1. Predicting anxiety and depression by fear of the dangerousness of covid
The following steps were applied to establish a mediation. First, we entered exposure to fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) in the regression model as a predictor of anxiety and depression (DV). Second, we entered fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) in the regression model as a predictor for each mediator variable: self-esteem, problem-focused coping, and emotion-focused coping. Finally, we entered the fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) and the mediator variables (self-esteem, problem-focused coping, emotion-focused coping) together in the regression model to predict anxiety and depression (DV).
Simple linear regression shows that fear of the dangerousness of covid significantly predicted anxiety (β = .253, p < .001) and depression (β = .200, p < .001). Second, we entered fear of the dangerousness of covid (IV) in the regression model as a predictor for each mediator variable: self-esteem, problem-focused coping, and emotion-focused coping. Simple linear regression shows that fear of the dangerousness of covid significantly predicted self-esteem (β = .186, p = .002), problem-focused coping (β = .258, p = .02. Finally, we entered fear of dangerousness of covid (IV) and the mediator variables (self-esteem, problem-focused coping, emotion-focused coping) together in the regression model to predict anxiety and depression (DV). The results showed that self-esteem (β = − .123, p = .04), problem-focused coping (β = − .201, p = .03) and emotion-focused coping (β = .318, p < .001) significantly mediate the effect of the dangerousness of covid on anxiety (β = .251, p < .001). For depression, the results showed that problem-focused coping (β = − .237, p = .01) and emotion-focused coping (β = .393, p < .001) significantly mediate the effect of the dangerousness of covid on depression (β = .187, p = .001) (see Table 3).
Table 3
Hierarchical regression analysis for predicting anxiety and depression by fear of dangerousness of covid
| Step 1 (Fear of dangerousness of covid predicted anxiety and depression) | Step 2 (Fear of dangerousness of covid predicted mediators) | Step 3 (Fear of dangerousness of covid and mediators predicted anxiety and depression) |
Anxiety | Depression |
B [95% CI] | β | B [95% CI] | β | B [95% CI] | β | B [95% CI] | β |
Anxiety | .232 [.128, .337]*** | .253 | | | .227 [.125, .330]*** | .251 | | |
Depression | .182 [.077, .286]*** | .200 | | | | | .168 [.066, .270]** | .187 |
Self-esteem | | | .160 [.061, .260]** | .186 | − .128 [-.252, − .003]* | − .123 | − .085 [-.208, .038] | − .083 |
Problem-focused coping | | | .336 [.036, .635]* | .131 | − .071 [-.137, − .004]* | − .201 | − .083 [-.149, − .017]* | − .237 |
Emotion-focused coping | | | .245 [-.052, .561] | .097 | .110 [.046, .173]*** | .318 | .134 [.071, .198]*** | .393 |
R2 | | | | | .349 | | .113 | |
Adjusted R2 | | | | | .109 | | .100 | |
* p < 0.05. |
** p < 0.01 |
*** p < 0.001 |
† R2 change: Anxiety: F(4, 277) = 9.61, p < .001, Depression: F(4, 277) = 8.81, p < .001 |
PLEASE INSERT Table 3 HERE
2. Predicting anxiety and depression by fear of being infected by others
The following steps were applied to establish a mediation. First, we entered exposure to fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) in the regression model as a predictor of anxiety and depression (DV). Second, we entered fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) in the regression model as a predictor for each mediator variable: self-esteem, problem-focused coping, and emotion-focused coping. Finally, we entered the fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) and the mediator variables (self-esteem, problem-focused coping, emotion-focused coping) together in the regression model to predict anxiety and depression (DV). Simple linear regression shows that fear of being infected by others significantly predicted anxiety (β = .143, p = .01). Second, we entered fear of being infected by others (IV) in the regression model as a predictor for each mediator variable: self-esteem, problem-focused coping, emotion-focused coping. Simple linear regression shows that fear of being infected by others significantly predicted self-esteem (β = .172, p = .004), problem-focused coping (β = .167, p = .002, emotion-focused coping (β = .146, p = .01. Finally, we entered fear of being infected by others and the mediator variables (self-esteem, problem-focused coping, emotion-focused coping) together in the regression model to predict anxiety and depression (DV). The results showed that problem-focused coping (β = − .195, p = .04) and emotion-focused coping (β = .319, p = .001) significantly mediate the effect of fear of being infected by others on anxiety (β = .127, p = .03). For depression, the results showed that problem-focused coping (β = − .288, p = .02) and emotion-focused coping (β = .403, p < .001) significantly mediate the effect of fear of infected by others on depression (β = .008, p = .89). (see Table 4).
Table 4
Hierarchical regression analysis for predicting anxiety and depression by fear of infected by others
| Step 1 (Fear of infected by others predicted anxiety and depression) | Step 2 (Fear of infected by others predicted mediators) | Step 3 (Fear of infected by others and mediators predicted anxiety and depression) |
Anxiety | Depression |
B [95% CI] | β | B [95% CI] | β | B [95% CI] | β | B [95% CI] | β |
Anxiety | .121 [.023, .219]* | .143 | | | .106 [.009, .203]* | .127 | | |
Depression | .035 [-.063, .133] | .041 | | | | | .006 [-.089, .102] | .008 |
Self-esteem | | | .137 [.045, .229]** | .172 | − .105 [-.232, .022] | − .101 | − .055 [-.180, .071] | − .053 |
Problem-focused coping | | | .394 [.121, .668]** | .167 | − .069 [-.137, − .001]* | − .195 | − .079 [-.147, − .012]* | − .288 |
Emotion-focused coping | | | .351 [.071, .631]* | .146 | .110 [.045, .176]** | .319 | .138 [.073, .202]*** | .403 |
R2 | | | | | .087 | | .079 | |
Adjusted R2 | | | | | .073 | | .066 | |
* p < 0.05. |
** p < 0.01 |
*** p < 0.001 |
† R2 change: Anxiety: F(4, 277) = 5.75, p < .001, Depression: F(4, 277) = 5.96, p < .00 |
PLEASE INSERT Table 4 HERE
3. Predicting anxiety and depression by fear of being infected by things
The following steps were applied to establish a mediation. First, we entered exposure to fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) in the regression model as a predictor of anxiety and depression (DV). Second, we entered fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) in the regression model as a predictor for each mediator variable: self-esteem, problem-focused coping, and emotion-focused coping. Finally, we entered the fear of the dangerousness of covid, fear of being infected by others and fear of being infected by things (IVs) and the mediator variables (self-esteem, problem-focused coping, emotion-focused coping) together in the regression model to predict anxiety and depression (DV). Simple linear regression shows that fear of being infected by things significantly predicted anxiety (β = .209, p < .001) and depression (β = .129, p = .03). Second, we entered fear of being infected by things in the regression model as a predictor for each mediator variable: self-esteem, problem-focused coping, emotion-focused coping. Simple linear regression shows that fear of being infected by things significantly predicted emotion-focused coping (β = .156, p = .009). Finally, in the regression model, we entered fear of being infected by things and the mediator variables (self-esteem, problem-focused coping, emotion-focused coping) together to predict anxiety and depression (DV). The results showed that emotion-focused coping (β = .294, p = .002) significantly mediates the effect of fear of being infected by things on anxiety (β = .161, p = .006). Concerning depression, the results showed that problem-focused coping (β = − .221, p = .02) and emotion-focused coping (β = .338, p < .001) significantly mediate the effect of fear of being infected by things on depression (β = .067, p = .25). (see Table 5).
Table 5
Hierarchical regression analysis for predicting anxiety and depression by fear of being infected by things
| Step 1 (Fear of being infected by things predicted anxiety and depression) | Step 2 (Fear of being infected by things predicted mediators) | Step 3 (Fear of being infected by things and mediators predicted anxiety and depression) |
Anxiety | Depression |
B [95% CI] | β | B [95% CI] | β | B [95% CI] | β | B [95% CI] | β |
Anxiety | .174 [.078, .269]*** | .209 | | | .132 [.038, .225]** | .161 | | |
Depression | .105 [.010, .201]* | .129 | | | | | .054 [-.039, .147] | .067 |
Self-esteem | | | .024 [.068, .116] | .030 | − .092 [-.218, − .033] | − .089 | − .057 [-.181, .067] | − .055 |
Problem-focused coping | | | .213 [-.059, .485] | .092 | − .061 [-.128, .007] | − .172 | − .077 [-.144, − .010]* | − .221 |
Emotion-focused coping | | | .368 [.093, .643]** | .156 | .102 [.036, .167]* | .294 | .133 [.068, .198]*** | .388 |
R2 | | | | | .087 | | .084 | |
Adjusted R2 | | | | | .073 | | .070 | |
* p < 0.05. |
** p < 0.01 |
*** p < 0.001 |
† R2 change: Anxiety: F(4, 277) = 6.56, p < .001, Depression: F(4, 277) = 6.32, p < .001 |
PLEASE INSERT Table 5 HERE