Prevalence and Associated factors of Anxiety symptoms among front-line Health care workers in Tigrai region quarantine and Treatment centers, Southern Ethiopia 2020; Cross-sectional study

doi:10.21203/rs.3.rs-2951008/v2

Background

The global psychological effects of the corona virus disease (COVID-19) are widespread. One of the many categories of people at risk of direct viral infection on the front lines are healthcare personnel. The study's goal was to evaluate the prevalence of anxiety symptoms and related factors among medical staff caring for COVID-19 patients in quarantine and treatment facilities in the Tigray region.

Methods

From June 2020 to September 2020, 155 study participants underwent a cross-sectional study at quarantine and treatment facilities in the Tigrai region. A survey was conducted online to gather data. An analysis of binary logistic regression was used to determine the variables that influence anxiety symptoms. A p-value of 0.05 and a 95% confidence interval (CI) for an adjusted odds ratio (AOR) were used to indicate statistical significance.

Results

According to the study, there were 23.9% of health care professionals who reported having anxiety symptoms. Additionally, this study found that institutional support AOR 3.244:95%CI [1.930-5.438] and gender AOR 2.310:95%CI [1.301-4.641] were significant predictors of anxiety symptoms among healthcare professionals.

Conclusion

The prevalence of anxiety symptoms among HCWs in Tigray region during the pandemic is comparable with other countries.

Nursing

COVID-19

anxiety

healthcare workers

pandemic

Coronaviruses are positive-sense, single-strand RNA viruses that are non-segmented, enclosed, and non-segmented (1). There are six different coronavirus species that harm humans. The majority of coronavirus species that infect humans result in mild respiratory illnesses; however, in recent decades, lethal coronavirus species have begun to emerge, including the Middle East respiratory syndrome coronavirus in 2012 and the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002(2).

SARS-CoV-2, a novel coronavirus that is extremely contagious and acute respiratory syndrome-related, first appeared in Wuhan, China, in December 2019. The World Health Organization (WHO) classified COVID-19 as a pandemic on March 11th, 2020(3). Generally speaking, COVID-19 is an acute deadly illness that may result in death from developing respiratory complications(4).In addition to its physical effects, COVID-19 can have negative psychological consequences on individuals(5).

Health care personnel are under strain as they battle the virus on the front lines due to the pandemic's dramatic increase in prevalence around the globe. This in turn has an effect on the mental health of the medical staff. According to the previous studies, frontline medical professionals reportedly experienced anxiety symptoms of corona virus sickness during the epidemics of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) (6-9). Studies have also indicated that factors such as gender, lack of personal protective equipment’s, being away from family and history of Anxiety were known to predict anxiety symptoms among health care workers during the corona virus disease (Covid-19) pandemic (7-9).

The Tigrai region (Southern Ethiopia) is currently experiencing the pandemic's most dangerous stage, with the virus already present in the population. The infection is being faced by healthcare personnel, who are vulnerable to psychological effects. Therefore, the purpose of this study is to evaluate the frequency of anxiety symptoms and their risk factors among healthcare professionals handling COVID-19 in Tigray region quarantine and treatment centers.

Study design, area and period

A cross sectional study was conducted in Mekelle city quarantine centers from June to October 202

Data collection tool and technique

Information was gathered through friend circle forwarding and Telegram groups while using the Electronic "Questionnaire Star"Questionnaire as the survey tool for the study. A reputable online survey platform called "Questionnaire Star" can be used for voting, evaluations, questionnaire surveys, and other things. "Questionnaire Star" has the clear advantages of being quick, inexpensive, simple to learn, and straightforward to use (10) as compared to conventional survey methodologies

The study's questionnaire is divided into three parts. Demographic information about the study participants was requested in the first section of the questionnaire. In the second component of the survey, anxiety was measured using a standard questionnaire (the Zung self-rating anxiety scale) (11).Examining the variables that influence Nurse's anxiety is covered in the third portion of the questionnaire (7, 12, 13). As in prior studies (16), we utilized 50 as the cut point.

Data processing and analysis

Epi-Info version 7 for Windows was used to edit, visually inspect for completeness, code, input, and clean the obtained data before exporting it to SPSS version 23.0 for statistical analysis. The results of the computation of descriptive statistics were summarized in tables and figures. The mean, frequency, and percentage were computed. At a significance level of p0.25, binary logistic regression was employed to ascertain the size, direction, and strength of the link between a group of independent variables and the outcome variable. Then, only factors that were associated with the outcome variable and significant at p 0.25 were chosen for multivariate analysis. A significant relationship will be described as having a p-value of 0.05 or lower and an odds ratio with a 95% confidence level. The fitness model will be examined using the Hosmer-Lemeshow test.

Seciodemographic characteristics

From the online survey, which had a 100% recovery rate, we collected 155 valid questionnaires. The study subjects ranged in age from 32.8 to 4.8 years on average. Men made up 111 (71.6%) of the study participants, the majority. Most participants in the study, 126 (81.3%) had experience of less than or equal to ten years. Additionally, 91 (58.71%) of the study participants were married (Table-1).

Table-1: Seciodemogrphic characteristics health care workers in Tigrai region quarantine and Treatment centers, Southern Ethiopia (N=155).

Variable	Category	Frequency n (%)
Gender	Female	44(28)
Gender	Male	111(72)
Age	>33year	49(32)
Age	<=33year	106(68)
Marital status	Married	91(59)
	Single	48(31)
	Divorce	16(10)
Profession	Doctor	29(19)
	Nurse	53(34)
	Others	73(47)
Year of experience	>10year	29(19)
Year of experience	<=10year	126(81)
History of anxiety	No	103(66)
History of anxiety	Yes	52(34)
Family history of anxiety	No	128(83)
Family history of anxiety	Yes	27(17)

Psychological characteristics

The findings showed that 116 participants in the study, or 74.84 percent of them, expressed concern about the spread of the coronavirus disease (Covid-19). Similarly, 102 (88.7%) of the study participants expressed satisfaction with the institutional support. Additionally, this result showed that 81 (52.23%) of the study participants spent their free time playing online games (Table 2).

Table-2: Psychological characteristics of study participants (N=155)

Variable	Category	Frequency n (%)
Satisfied with the presence of personal equipment’s	No	61(39)
Satisfied with the presence of personal equipment’s	Yes	94(61)
Satisfied with institutional support	No	53(34)
Satisfied with institutional support	Yes	102(66)
Concern about the spread	No	39(25)
Concern about the spread	Yes	116(75)
Leisure activities	Online entertainment	80(52)
	Talking with friends	40(26)
	Nothing	35(22)

Factors associated with anxiety symptoms

The multiple logistic regression model output indicated that gender, history of anxiety and institutional supports were significantly associated with the outcome variable.

Females were twice as likely as males to experience symptoms of anxiety (AOR: 2.310, 95%CI [1.301-4.989]).Health professionals without a history of anxiety were 99.2% less likely to have symptoms of anxiety than those who had (AOR: 0.008, 95%CI [0.000-0.144]).In comparison to those who were dissatisfied, those who were satisfied with institutional support had a 3 times higher likelihood of not becoming anxious (AOR: 3.244, 95%CI [1.930-5.438]) (Table 3).

Variable	Category	Anxiety		P-value	COR	AOR[CI]
Variable	Category	yes	no	P-value	COR	AOR[CI]

Gender	female	15	29
Gender	Male	22	89	0.021	2.092	2.310 [1.301- 4.989]
Age	>33year	7	42
Age	<=33year	30	76	0.321	0.422
Marital status	Married	23	68
	Single	8	40	0.212	1.691
	Divorce	6	10	0.089	0.563
Profession	Doctor	5	24
	Nurse	13	40	0.314	0.641
	Others	19	54	0.243	0.592
Year of experience	>10year	5	24
Year of experience	<=10year	32	94	0.071	0.612
History of anxiety	No	20	83
History of anxiety	Yes	17	35	0.001	0.496	0.008[0.000-0.144]
Family history of anxiety	No	30	98
Family history of anxiety	Yes	7	20		0.875
Satisfied with the presence of personal equipment’s	No	20	41
Satisfied with the presence of personal equipment’s	Yes	17	77	0.130	2.209
Satisfied with institutional support	No	18	35
Satisfied with institutional support	Yes	19	83	0.002	2.245	3.244[1.930–5.438]
Concern about the spread	No	9	30
Concern about the spread	Yes	28	88	0.325	0.943
Leisure activities	Online entertainment	19	61
Leisure activities	Talking with friends	10	30	0.082	0.934
	Nothing	8	27	0.210	1.051

Table-3 Factors associated with anxiety symptoms [N=155]

According to this cross-sectional study, there were 23.9% of HCWs handling COVID-19 who reported having anxiety symptoms, with a 95% confidence interval of [18.7-29.7]. This result is less than that found in earlier research from Nepal and China (13, 14). However, it is higher than the results reported in India and other parts of China (7, 12). The difference might be due to disparity in the incidence of the pandemic, measures towards the virus, Sociodemographic and economic differences. The current study's findings, on the other hand, are consistent with a prior study that was carried out in Wuhan, China, the core of the viral outbreak, and which discovered a prevalence of anxiety symptoms among healthcare professionals to be 24.1% (8).

The present study revealed that gender, history of anxiety and institutional support status were significantly associated with anxiety symptoms. Females were approximately two times more likely to have anxiety symptoms than their counter parts. This finding is similar to the findings of previous studies (7, 8, 12). The results of the current study also showed that medical professionals were more likely to have anxious symptoms if they had a history of anxiety. The results are consistent with those of a study conducted in Gansu, China, to evaluate the prevalence and influencing factors of anxiety and depressive symptoms among first-line medical personnel battling COVID-19 (15). Additionally, the current study's findings revealed that healthcare professionals who were happy with the assistance they received from their organizations were less likely to have symptoms of anxiety. This study and the one carried out in Hong Cong, China, during the SARS outbreak are comparable (16).

The prevalence of anxiety symptoms among HCWs in Tigray region during the pandemic is comparable with other countries. It also indicated that gender, history of anxiety and intuitional support were predictors of anxiety symptoms among HCWs

Ethical consideration; We have verified that our study was carried out in conformity with the Helsinki Declaration. The Mekelle University institutional review board granted us ethical clearance and approval. All of the participants voluntarily provided written informed consent, which we also received.

Consent for publication: Not applicable

Availability of data and materials: The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Competing interests: The authors report no conflicts of interest in this work.

Funding: We did not receive funds from any organization

Authors' contributions: All authors agreed to submit the article to the current journal, gave final approval of the version to be published, made significant contributions to conception and design, data collection, analysis, and interpretation, participated in its writing or critically revised it for important intellectual content, and agreed to be responsible for all aspects of the work.

Acknowledgements: We would want to thank Mekelle University from the bottom of our hearts. We also thank the study participants and data collectors for their cooperation.

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No competing interests reported.

Prevalence and Associated factors of Anxiety symptoms among front-line Health care workers in Tigrai region quarantine and Treatment centers, Southern Ethiopia 2020; Cross-sectional study

Status:

Version 2

Abstract

Introduction

Methods

Study design, area and period

Data collection tool and technique

Data processing and analysis

Results

Discussion

Conclusion

Declarations

References

Additional Declarations

Status:

Version 2