Research Article
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Comparison of anxiety in Covid-19 inpatients vs healthcare workers in the same ward and at the same time

Year 2023, Volume: 62 Issue: 3, 364 - 375, 18.09.2023

Ebru Şahan

https://doi.org/10.19161/etd.1360363

Abstract

Aim: Demonstrating which population has the highest anxiety symptoms and its predictors is important for the coordination of psychiatric care and services. Hospitalized patients with Covid-19 and healthcare professionals caring for them are the two groups with the highest risk of psychiatric disorders during the SARS-CoV-2 pandemic. We aimed to assess the state and trait anxiety levels of Covid-19 patients and healthcare professionals simultaneously in the same Covid-19 ward of a tertiary center hospital.
Materials and Methods: Given the nature of this observational single-center study, purposive sampling of all patients and staff in the Covid-19 ward between 5-10 April 2020 was planned. The data was collected via an online survey using “Sociodemographic Form” and “State-Trait Anxiety Inventory (STAI)”.
Results: The state anxiety levels of hospitalized patients with Covid-19 were significantly higher than healthcare workers in t-test (p = .012) however this was resolved in regression analysis (β = .029, t = .19, p = .85). Not being in a marital bond (p = .035) and having a lifetime psychiatric disorder (p = .002) were predictors of state anxiety; older age (p = .006), being female (p = .007) and having a lifetime psychiatric disorder (p = .002) were associated with trait anxiety scores in patients and healthcare workers in the Covid-19 ward.
Conclusion: Having a lifetime psychiatric disorder was the common item for both state and trait anxiety of patients, doctors, and nurses in the Covid ward. Psychiatrists should be accessible in the Covid-19 ward primarily for individuals whom they evaluated or treated before the pandemic.

Keywords

Coronavirus Crisis intervention Mental health Lifetime psychiatric disorder Consultation and liaison

References

  • Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (Form Y1–Y2). Palo Alto, CA: Consulting Psychologists Press; 1983;Volume IV.
  • Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr 2020;52:102066.
  • Canadian Mental Health Association [homepage on the Internet]. British Columbia Division: Covid-19: Tips for managing anxiety. [cited 10 Nov 2020]. Available from: https://cmha.bc.ca/covid-19/tips-for-managinganxiety/
  • Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology 2020;296(2):E15-E25.
  • World Health Organization. Novel Coronavirus (2019-nCoV) Situation Report.2020-1. [cited 20 June 2020] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  • World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report. 2020-52. [cited 20 June 2020] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus- 2019/situation-reports
  • Republic of Turkey Ministry of Health Corona Table [cited 13 Dec 2020]. Available from: https://covid19.saglik.gov.tr/
  • Krishnamoorthy Y, Nagarajan R, Saya GK, Menon V. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res. 2020;293:113382.
  • Şahan E, Ünal SM, Kırpınar İ. Can we predict who will be more anxious and depressed in the COVID-19 ward? J Psychosom Res 2021;140:110302.
  • Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020;7(7):611-27.
  • Mazza MG, De Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behav Immun 2020;89:594-600.
  • Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA 2020;323(21):2133-4.
  • McAlonan GM, Lee AM, Cheung V, Cheung C, Tsang KW, Sham PC, et al. Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers. Can J Psychiatry 2007;52(4):241-7.
  • Şahan E, Tangılntız A. State and trait anxiety among medical staff during the first month of COVID-19 pandemic: A sample from Turkey. Int J Psychiatry Med 2022;57(4):338-56.
  • Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol Sci 2020;16(10):1732.
  • Vahedian-Azimi A, Moayed MS, Rahimibashar F, Shojaei S, Ashtari S, Pourhoseingholi MA. Comparison of the severity of psychological distress among four groups of an Iranian population regarding COVID-19 pandemic. BMC Psychiatry 2020;20(1):1-7.
  • Erdfelder E, Faul F, Buchner A. "GPOWER: A general power analysis program.Behav Res Methods Instrum Comput 1996;28(1):1-11.
  • Öner N, Le Compte VA. State-trait anxiety inventory handbook. Bogazici University, Istanbul, Turkey. 1985:1- 26.
  • Bendau A, Kunas SL, Wyka S, Petzold MB, Plag J, Asselmann E, et al. Longitudinal changes of anxiety and depressive symptoms during the COVID-19 pandemic in Germany: the role of pre-existing anxiety, depressive, and other mental disorders. J Anxiety Disord 2021;79:102377.
  • Pan KY, Kok AA, Eikelenboom M, Horsfall M, Jörg F, Luteijn RA, et al. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry 2021;8(2): 121-9.
  • Zhang J, Yang Z, Wang X, Li J, Dong L, Wang F, et al. The relationship between resilience, anxiety, and depression among patients with mild symptoms of COVID‐19 in China: A cross‐sectional study. J Clin Nurs 2020;29(21-22):4020-9.
  • Mosheva M, Hertz‐Palmor N, Dorman Ilan S, Matalon N, Pessach IM, Afek A, et al. Anxiety, pandemicrelated stress and resilience among physicians during the COVID‐19 pandemic. Depress Anxiety 2020;37(10):965-71.
  • Labrague LJ, De los Santos JAA. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag 2020;28(7):1653-61. doi:10.1111/jonm.13121
  • Song S, Yang X, Yang H, Zhou P, Ma H, Teng C, et al. Psychological resilience as a protective factor for depression and anxiety among the public during the outbreak of COVID-19. Front Psychol 2020;11:4104.
  • Thomas J, Barbato M, Verlinden M, Gaspar C, Moussa M, Ghorayeb J, et al. Psychosocial Correlates of Depression and Anxiety in the United Arab Emirates During the COVID-19 Pandemic. Front Psychiatry 2020. https://doi.org/10.3389/fpsyt.2020.564172
  • Pyszczynski T, Lockett M, Greenberg J, Solomon S. Terror Management Theory and the COVID-19 Pandemic. J Humanist Psychol 2020: 0022167820959488. doi:10.1177/0022167820959488
  • Courtney EP, Goldenberg JL, Boyd P. The contagion of mortality: A terror management health model for pandemics. Br J Soc Psychol 2020;59(3):607-17. doi:10.1111/bjso.12392
  • Bronheim HE, Fulop G, Kunkel EJ, Muskin PR, Schindler BA, Yates WR, et al. The Academy of Psychosomatic Medicine Practice Guidelines for Psychiatric Consultation in the General Medical Setting. Psychosomatics 1998;39(4): S8-S30. doi:https://doi.org/10.1016/S0033-3182(98)71317-9
  • Li Z, Ge J, Feng J, Jiang R, Zhou Q, Xu X, et al. Less Social Support for Patients With COVID-19: Comparison With the Experience of Nurses. Front Psychiatry 2021;12:44.doi: 10.3389/fpsyt.2021.554435
  • Berg-Weger M, Morley JE. Loneliness and social isolation in older adults during the Covid-19 pandemic: Implications for gerontological social work. J Nutr Health Aging 2020;24:456–8. https://doi.org/10.1007/s12603-020-1366-8
  • Mehra A, Rani S, Sahoo S, Parveen S, Singh AP, Chakrabarti S, Grover S. A crisis for elderly with mental disorders: Relapse of symptoms due to heightened anxiety due to COVID-19. Asian J Psychiatr 2020;51:102114.
  • Zhang WR., Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom 2020;89(4):242-50.
  • Hacimusalar Y, Kahve AC, Yasar AB, Aydin MS. Anxiety and hopelessness levels in COVID-19 pandemic: A comparative study of healthcare professionals and other community sample in Turkey. J Psychiatr Res 2020;129:181-8.
  • Yang L, Wu D, Hou Y, Wang X, Dai N, Wang G, et al. Analysis of psychological state and clinical psychological intervention model of patients with COVID-19. MedRxiv. 2020 Jan 1. https://doi.org/10.1101/2020.03.22.20040899.
  • Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control 2020;48(6):592-8.
  • Decio V, Pirard P, Pignon B, Bouaziz O, Perduca V, Chin F, et al. Hospitalization for COVID-19 is associated with a higher risk of subsequent hospitalization for psychiatric disorders: a French nationwide longitudinal study comparing hospitalizations for COVID-19 and for other reasons. Eur Psychiatry Cambridge University Press; 2022;1–44.
  • Kong X, Zheng K, Tang M, Kong F, Zhou J, Diao L, et al. Prevalence and factors associated with depression and anxiety of hospitalized patients with COVID-19. MedRxiv 2020. https://doi.org/10.1101/2020.03.24.20043075.
  • Neto MLR, Almeida HG, Esmeraldo JDA, Nobre CB, Pinheiro WR, de Oliveira CRT, et al. When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak. Psychiatry Res 2020;288:112972.
  • Ramsetty A, Adams C. Impact of the digital divide in the age of COVID-19. J Am Med Inform Assoc 2020;27(7):1147-8.
  • Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3):e14.

Aynı tarihte aynı serviste bulunan Covid-19 yatan hastaları ile sağlık çalışanlarında anksiyetenin karşılaştırılması

Year 2023, Volume: 62 Issue: 3, 364 - 375, 18.09.2023

Ebru Şahan

https://doi.org/10.19161/etd.1360363

Abstract

Amaç: Hangi popülasyonun en yüksek anksiyete belirtilerine sahip olduğunu ve bunun yordayıcılarını göstermek, psikiyatrik bakım ve hizmetlerin koordinasyonu için önemlidir. SARS-CoV-2 pandemisi sırasında hastanede yatan Covid-19 hastaları ve onlara bakan sağlık çalışanları, psikiyatrik rahatsızlık riski en yüksek olan iki gruptur. Çalışmamızda üçüncü basamak bir hastanede tedavi gören Covid-19 hastaları ve onlarla ilgilenen sağlık çalışanlarının durumluk ve sürekli kaygı düzeylerini aynı zaman diliminde değerlendirmeyi amaçladık.
Gereç ve Yöntem: Bu gözlemsel tek merkezli çalışmanın doğası gereği, 5-10 Nisan 2020 tarihleri arasında Covid-19 servisinde bulunan tüm hasta ve personelden amaçlı örnekleme planlanmıştır. Veriler “Sosyodemografik Form” ve “Durumluk-Sürekli Kaygı Envanteri (STAI)” ni içeren çevrimiçi bir anket aracılığıyla toplanmıştır.
Bulgular: Hastanede yatan Covid-19 hastalarının durumluk kaygı düzeyleri t-testinde sağlık çalışanlarına göre anlamlı derecede yüksekti (p = .012) ancak regresyon analizinde bu anlamlılık kayboldu (β = .029, t = .19, p = .85). Covid-19 servisinde yatan hastalarda ve sağlık çalışanlarında
yaşam boyu herhangi bir psikiyatrik bozukluğa sahip olmak (p = .002) ve evlilik bağı içinde olmamak (p= .035) durumluk kaygının yordayıcılarıydı; ileri yaşta (p = .006), kadın olmak (p = .007) ve yaşam boyu psikiyatrik bozukluğa sahip olmak (p = .002) sürekli kaygı puanları ile ilişkiliydi.
Sonuç: Yaşam boyu psikiyatrik bozukluğa sahip olmak, Covid servisinde yatan hastalar ile onlara bakım veren doktor ve hemşirelerin hem durumluk hem de sürekli kaygılarının ortak belirleyicisiydi. Psikiyatristler öncelikle pandemi öncesi muayene veya tedavi ettikleri kişiler için Covid-19 servisinden
ulaşılabilir olmalıdır.

Keywords

Koronavirüs Krize müdahale Akıl sağlığı Yaşam boyu psikiyatrik bozukluk Konsultasyon ve liyazon

References

  • Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (Form Y1–Y2). Palo Alto, CA: Consulting Psychologists Press; 1983;Volume IV.
  • Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr 2020;52:102066.
  • Canadian Mental Health Association [homepage on the Internet]. British Columbia Division: Covid-19: Tips for managing anxiety. [cited 10 Nov 2020]. Available from: https://cmha.bc.ca/covid-19/tips-for-managinganxiety/
  • Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology 2020;296(2):E15-E25.
  • World Health Organization. Novel Coronavirus (2019-nCoV) Situation Report.2020-1. [cited 20 June 2020] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  • World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report. 2020-52. [cited 20 June 2020] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus- 2019/situation-reports
  • Republic of Turkey Ministry of Health Corona Table [cited 13 Dec 2020]. Available from: https://covid19.saglik.gov.tr/
  • Krishnamoorthy Y, Nagarajan R, Saya GK, Menon V. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res. 2020;293:113382.
  • Şahan E, Ünal SM, Kırpınar İ. Can we predict who will be more anxious and depressed in the COVID-19 ward? J Psychosom Res 2021;140:110302.
  • Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020;7(7):611-27.
  • Mazza MG, De Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behav Immun 2020;89:594-600.
  • Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA 2020;323(21):2133-4.
  • McAlonan GM, Lee AM, Cheung V, Cheung C, Tsang KW, Sham PC, et al. Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers. Can J Psychiatry 2007;52(4):241-7.
  • Şahan E, Tangılntız A. State and trait anxiety among medical staff during the first month of COVID-19 pandemic: A sample from Turkey. Int J Psychiatry Med 2022;57(4):338-56.
  • Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol Sci 2020;16(10):1732.
  • Vahedian-Azimi A, Moayed MS, Rahimibashar F, Shojaei S, Ashtari S, Pourhoseingholi MA. Comparison of the severity of psychological distress among four groups of an Iranian population regarding COVID-19 pandemic. BMC Psychiatry 2020;20(1):1-7.
  • Erdfelder E, Faul F, Buchner A. "GPOWER: A general power analysis program.Behav Res Methods Instrum Comput 1996;28(1):1-11.
  • Öner N, Le Compte VA. State-trait anxiety inventory handbook. Bogazici University, Istanbul, Turkey. 1985:1- 26.
  • Bendau A, Kunas SL, Wyka S, Petzold MB, Plag J, Asselmann E, et al. Longitudinal changes of anxiety and depressive symptoms during the COVID-19 pandemic in Germany: the role of pre-existing anxiety, depressive, and other mental disorders. J Anxiety Disord 2021;79:102377.
  • Pan KY, Kok AA, Eikelenboom M, Horsfall M, Jörg F, Luteijn RA, et al. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry 2021;8(2): 121-9.
  • Zhang J, Yang Z, Wang X, Li J, Dong L, Wang F, et al. The relationship between resilience, anxiety, and depression among patients with mild symptoms of COVID‐19 in China: A cross‐sectional study. J Clin Nurs 2020;29(21-22):4020-9.
  • Mosheva M, Hertz‐Palmor N, Dorman Ilan S, Matalon N, Pessach IM, Afek A, et al. Anxiety, pandemicrelated stress and resilience among physicians during the COVID‐19 pandemic. Depress Anxiety 2020;37(10):965-71.
  • Labrague LJ, De los Santos JAA. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag 2020;28(7):1653-61. doi:10.1111/jonm.13121
  • Song S, Yang X, Yang H, Zhou P, Ma H, Teng C, et al. Psychological resilience as a protective factor for depression and anxiety among the public during the outbreak of COVID-19. Front Psychol 2020;11:4104.
  • Thomas J, Barbato M, Verlinden M, Gaspar C, Moussa M, Ghorayeb J, et al. Psychosocial Correlates of Depression and Anxiety in the United Arab Emirates During the COVID-19 Pandemic. Front Psychiatry 2020. https://doi.org/10.3389/fpsyt.2020.564172
  • Pyszczynski T, Lockett M, Greenberg J, Solomon S. Terror Management Theory and the COVID-19 Pandemic. J Humanist Psychol 2020: 0022167820959488. doi:10.1177/0022167820959488
  • Courtney EP, Goldenberg JL, Boyd P. The contagion of mortality: A terror management health model for pandemics. Br J Soc Psychol 2020;59(3):607-17. doi:10.1111/bjso.12392
  • Bronheim HE, Fulop G, Kunkel EJ, Muskin PR, Schindler BA, Yates WR, et al. The Academy of Psychosomatic Medicine Practice Guidelines for Psychiatric Consultation in the General Medical Setting. Psychosomatics 1998;39(4): S8-S30. doi:https://doi.org/10.1016/S0033-3182(98)71317-9
  • Li Z, Ge J, Feng J, Jiang R, Zhou Q, Xu X, et al. Less Social Support for Patients With COVID-19: Comparison With the Experience of Nurses. Front Psychiatry 2021;12:44.doi: 10.3389/fpsyt.2021.554435
  • Berg-Weger M, Morley JE. Loneliness and social isolation in older adults during the Covid-19 pandemic: Implications for gerontological social work. J Nutr Health Aging 2020;24:456–8. https://doi.org/10.1007/s12603-020-1366-8
  • Mehra A, Rani S, Sahoo S, Parveen S, Singh AP, Chakrabarti S, Grover S. A crisis for elderly with mental disorders: Relapse of symptoms due to heightened anxiety due to COVID-19. Asian J Psychiatr 2020;51:102114.
  • Zhang WR., Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom 2020;89(4):242-50.
  • Hacimusalar Y, Kahve AC, Yasar AB, Aydin MS. Anxiety and hopelessness levels in COVID-19 pandemic: A comparative study of healthcare professionals and other community sample in Turkey. J Psychiatr Res 2020;129:181-8.
  • Yang L, Wu D, Hou Y, Wang X, Dai N, Wang G, et al. Analysis of psychological state and clinical psychological intervention model of patients with COVID-19. MedRxiv. 2020 Jan 1. https://doi.org/10.1101/2020.03.22.20040899.
  • Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control 2020;48(6):592-8.
  • Decio V, Pirard P, Pignon B, Bouaziz O, Perduca V, Chin F, et al. Hospitalization for COVID-19 is associated with a higher risk of subsequent hospitalization for psychiatric disorders: a French nationwide longitudinal study comparing hospitalizations for COVID-19 and for other reasons. Eur Psychiatry Cambridge University Press; 2022;1–44.
  • Kong X, Zheng K, Tang M, Kong F, Zhou J, Diao L, et al. Prevalence and factors associated with depression and anxiety of hospitalized patients with COVID-19. MedRxiv 2020. https://doi.org/10.1101/2020.03.24.20043075.
  • Neto MLR, Almeida HG, Esmeraldo JDA, Nobre CB, Pinheiro WR, de Oliveira CRT, et al. When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak. Psychiatry Res 2020;288:112972.
  • Ramsetty A, Adams C. Impact of the digital divide in the age of COVID-19. J Am Med Inform Assoc 2020;27(7):1147-8.
  • Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3):e14.
There are 40 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Articles
Authors

Ebru Şahan 0000-0002-1287-8166

Publication Date September 18, 2023
Submission Date August 22, 2022
Published in Issue Year 2023Volume: 62 Issue: 3

Cite

Vancouver Şahan E. Comparison of anxiety in Covid-19 inpatients vs healthcare workers in the same ward and at the same time. EJM. 2023;62(3):364-75.
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