COVID-19 is an infectious disease caused by a newly discovered coronavirus that is pandemic, with more than 338 thousand cases worldwide. Geometrically increasing numbers of cases and deaths from COVID 19 in the world, both medical staff and the public have been experiencing psychological problems, including anxiety, depression, and stress, which can cause disability and functional impairment of the individual. One of the most stressful situations is the unpredictability of the situation and the uncertainty of when to control the disease and the seriousness of the risk. These challenges and stress can trigger a common mental disorder. This study aimed to determine the burden of stress anxiety and depression among all employees of Eye and ENT hospitals.
A hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services Bhaktapur during the COVID-19 pandemic lockdown using an online self-administered questionnaire through Google forms. The tools were adopted from Hospital Anxiety and Depression scale (HADS) Nepali version on a Likert's scale of 0 to 3 validated by Risal A. et al. and WHO Disability Assessment Schedule (WHODAS S2.0) on a Likert's scale of 1 to 5 to assess functional impairment.
The mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants was equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, p<0.01) and depression (18.6% vs 9.3%, p=0.351). The mean (SD) anxiety, depression and functional impairment scores were 7.27 (4.621), 5.13 (4.023) and 19.47 (6.228), respectively. Females had a very strong association with both anxiety (AOR=5.008 (95% CI; 1.593-15.741)) and depression (AOR=2.173 (95% CI; 0.599-7.882)). Married participants had a positive association with anxiety (AOR 4.379 (95% CI; 1.121-17.106)) and depression (AOR 1.542 (95% CI; 0.379-6.276)). Clinical and supporting staff both had a higher prevalence of both anxiety (31.0% and 20.5%, p=0.265) and depression (16.7% and 11.4%, p=0.478). The mean 12-item WHO disability assessment schedule score (WHODAS 2.0) among all participants and participants with anxiety and depression was 19.47 (95% CI: 18.13-20.80), 21.27 (95% CI: 18.08-24.46) and 19.92 (15.28-24.56), respectively. The life activities domain of WHODAS 2.0 was significantly higher in participants with anxiety (1.91 vs 1.56, p<0.01) and depression (1.75 vs 1.63, p<0.001) than in those without anxiety.
Anxiety and depression during COVID-19 pandemic lockdown were highly prevalent both in clinical and non-clinical employees, causing mild to moderate functional impairment.