Healthcare providers are vital resources for any country. Their health and safety are very important not only for continuous and safe care of the patient but also for controlling the spread of the disease. With the onset of Covid-19, public health care providers were exposed to extreme stress, anxiety, depression, and insomnia due to the risk of infection with Covid-19(1). COVID- 19 has posed major health threats to global public health and has attracted international attention as a public health emergency of international concern(2). Most countries faced this epidemic and its economic, social, health and medical consequences. Due to the increasing prevalence of this disease and with the prolongation of the disease process in the world, especially in Iran, it has caused an excessive workload on medical staff so that many medical centers sometimes faced with over-admission of patients and lack of medical staff. In such circumstances, the availability of health care providers is a determining factor in overcoming the virus epidemic (3).
Health care system in Iran also experienced a significant impact of this epidemic on employees. In the face of this unknown disease and the unpredictable dangers, health care providers feared infection and the fear of spreading it to their families, but in response to this challenge, they took responsibility, focused on their duties, and showed a spirit of unity and professionalism. The dedication of health care providers has played a key role in treating patients with COVID-19, and they have tried to provide the best care to patients in difficult situations. Like many new infectious diseases, such as Ebola, there is still no definitive effective cure for the disease, and patient care is primarily nursing care(1). In addition to caring for patients, wearing protective clothing for long hours can also cause physical distress and fatigue. Limited resources, and prolonged epidemic have disrupted sleep and balance of life. Exposure ot COVID-19 has led to physical and mental fatigue, stress and anxiety, and burnout in public health care providers(4). Due to the increased pressure to choose between family responsibilities and their inner feelings towards patients, Covid-19 frontline caregivers suffer from emotional problems and burnout. These special conditions cause excessive stress and fatigue in medical staff and make them incapacitated and exhausted (5).
The results of a study showed that the prevalence of depression, anxiety, insomnia and nonspecific anxiety symptoms in frontline clinics especially in nurses were 50.4%, 44.6%, 34.0% and 71.5%, respectively(1). Other studies have shown an immediate effect of COVID-19 on health care providers, with 29.8%, 13.5%, and 24.1% reporting symptoms of stress, depression, and anxiety, respectively(6).
Given the current situation, it seems that health care providers have to work continuously and under severe daily stress, which will lead not only to physical suffering and damage, but also to certain psychological damages, including reduced quality of life. Due to the effect of depression and anxiety on the quality of work life of health care providers(7), it is necessary to focus on the mental health of HCWs during the outbreak of COVID-19(8).
Quality of work life(QWL) is often considered as a real working condition including employee rights, facilities, health and safety issues, participation in decision-making, managerial approach and job diversity and flexibility (9). QWL includes various aspects such as fair payment and benefits, health and safety of working conditions and social integration that enable people to use and develop their abilities and capacities (10).QWL is the result of evaluating individuals by comparing their expectations, hopes, and demands of an organization to the actual performance of the organization(11). High QWL is recognized as a basic condition and background for the empowerment of human resources required by the health care system(12). Improving the QWL of nurses and physicians is one of the important factors to ensure the stability of the health system(13). High QWLleads to employee competence, innovation and creativity. Among the health care team, nurses play a major role among other health care providers. Therefore, they should experience better QWL to provide complete high quality care to those in need(14). Improving QWL reduces depression, anxiety and stress in health care providers (15).
During COVID-19 epidemic, front-line physicians and nurses were under a great deal of physical and psychological stress(16, 17). Such conditions cause COVID-19 front-line medical personnel to become psychologically and mentally exhausted(7). Fatigue is a psychological condition that is associated with lack of energy, general weakness, irritability, decreased motivation and activity(18). Long working hours and changing the tasks, along with stressful work, can lead to extreme weakness and fatigue(19, 20). Nurses working in such a physical and psychological challenge often experience fatigue, burnout, mental fatigue, and emotional separation(21).
According to the above, the present study was conducted to investigate the effect of the prevalence of Covid-19 on anxiety, quality of work life and fatigue in health care providers in centers involved with Covid-19.