A Cross-Sectional Survey of the Workplace Factors Contributing to Symptoms of Anxiety and Depression Among Nurses and Physicians During the First Wave of COVID-19 Pandemic in Two US Healthcare Systems

Abstract

Background Anxiety and depression among physicians and nurses during the COVID-19 pandemic in the USA are not well described and their modifiable causes are poorly understood. Methods We conducted a cross-sectional survey of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) among physicians and nurses in two US healthcare systems in June through September 2020; participation rate was 5–10%. We described features of work as well as their perceptions and associated concerns in relation to the risk of anxiety and depression, while controlling for health history via regression and path analyses. Results About a third of 684 nurses and 185 physicians surveyed showed symptoms of anxiety or depression, and the excess of symptoms of mood disorders was particularly prominent in nurses. The belief that one was infected was a dominant correlate of both anxiety and depression. This belief was more associated with history of symptoms of pneumonia than the contact with COVID-19 diagnosed patients. Factors found to be associated with reduced anxiety and depression in this working environment were having confidence in the competent use of and access to personal protective equipment, maintaining usual working hours, being surrounded by colleagues who were both sufficient in numbers and not stressed, and the support of immediate family and religious communities. Involvement in aerosol-generating procedures with infected patients was linked with lower depression in nurses but higher among physicians. Likewise, the setting of recent patient encounters affected risk of anxiety and depression differently for physicians and nurses. Conclusions Our findings may help develop mitigation measures and underscore the need to help nurses and physicians bear the psychological burden of the COVID-19 pandemic and similar events in the future.

Stress and Burnout Related to Electronic Health Record Use among Healthcare Providers during the COVID-19 Pandemic in Saudi Arabia: A Preliminary National Randomized Survey

“…In addition, caring for suspected COVID-19 cases was associated with higher burnout rates among participants than providing care to non-COVID-19 cases. This reflects that participants were concerned about themselves and their families' safety [36], which was in line with studies reporting fear of being infected was a leading risk factor of anxiety and depression in the workplace [42,43]. These safety concerns need to be addressed to decrease burnout experience among HCPs by providing a safe hospital environment, safety training, and developing up-to-date safety guidelines and protocols [36].…”

“…These safety concerns need to be addressed to decrease burnout experience among HCPs by providing a safe hospital environment, safety training, and developing up-to-date safety guidelines and protocols [36]. These solutions might help decrease the chances of burnout due to safety concerns but may not necessarily work for all HCPs [43]. As the pandemic evolved, healthcare institutions need to develop an integrated psychological response for HCPs with the occupational and psychological challenge of MERS-CoV outbreaks, especially that anxiety over COVID-19 may increase during the pandemic [44][45][46].…”

Pride and adversity among nurses and physicians during the pandemic in two US healthcare systems: a mixed methods analysis

“…Study design and data collection Details of the survey methodology and participating healthcare systems can be found in our earlier publication (Burstyn & Holt, 2021). We conducted a cross-sectional survey of all physicians and nurses employed and contracted by the Tower Health in Southeastern Pennsylvania (TH) and the University Medical Center, Las Vegas, Nevada (UMC), and licensed to practice in these states, corresponding to the early phases of the COVID-19 pandemic in the US.…”

“…However, the specific perceptions of the events by nurses and physicians related to these mental health challenges are poorly captured, which may hinder effective interventions. Our prior analysis of risk factors for anxiety and depression among nurses and physicians during the first wave of COVID-19 in two health care systems in the US, who are also subjects in this report, posited that concern about contracting COVID-19 was a correlate of both anxiety and depression, especially among those who experienced recent bouts of poor health (Burstyn & Holt, 2021). Furthermore, the risk of anxiety and depression was reduced among those who felt competent using personal protective equipment and had access to it, reported few changes to working hours, and were surrounded by sufficient numbers of colleagues who were not seem as stressed.…”

“…We did not delve into the specifics of experiences in the first report but only captured them on visual-analogue scales, thus potentially missing important features that contributed to mood disorders. We speculated that the “impact of work organization on anxiety and depression … may be related to the role of the safety climate or culture in moderating impact of the pandemic on work-induced mental health issues” (Dollard et al, 2019; Dollard & Bakker, 2010; Rickard et al, 2012), and that Self-Determination Theory (SDT) may offer a suitable framework for addressing these issues (Burstyn & Holt, 2021).…”