Anxiety Among Healthcare Workers During COVID-19 Pandemic in Lebanon: The Importance of the Work Environment and Personal Resilience

Abstract

Background Healthcare workers (HCWs) have been severely impacted by the COVID-19 pandemic. In addition to their risk of direct exposure to the virus, they were subjected to long working hours, scarcity of PPE, and additional stressors that impacted their psychological wellbeing. The purpose of this study was to assess anxiety and its predictors among a sample of HCWs at the American University of Beirut Medical Center (AUBMC) and to evaluate the association between resilience and anxiety. Methods This cross-sectional study was conducted using an online survey between March and June 2021 among HCWs at AUBMC. The psychosocial scale section included the 7-item generalized anxiety disorder (GAD-7) scale and a 25-item resilience scale, validated tools used to assess anxiety and resilience respectively. Data were analyzed on SPSS version 27, and descriptive statistics were applied. Predictors were evaluated using bivariate and multivariate linear regression. Results From a total of 92 participants, 75% were involved in direct patient care, and of those, 95% worked directly with suspected or confirmed COVID-19 patients. The majority (83%) had minimal to mild anxiety, whereas the rest had moderate to high anxiety levels. Around 41% reported moderately high to high resilience, 47% were found to be between the low end and moderate resilience scale and only 12% had very low or low resilience. More than 80% of the participants received PPE training, reported always working with adequate preventive infection control measures, and were vaccinated. Further, more than 70% of participants reported trusting the management and agreed that the safety of the workers is considered a high priority. No significant association between sociodemographic and COVID-19 work exposure factors with anxiety was found. Multivariate analysis results showed that a lower anxiety score was associated with higher resilience (p = 0.011). Conclusion This study has shown a strong association between low anxiety levels and high resilience scores in this group of mostly vaccinated HCWs caring for COVID-19 patients. The high percentage of vaccination along with PPE availability could explain the low anxiety levels reported among the participants.

The lived experiences of emergency care personnel in the Western Cape, South Africa during the COVID-19 pandemic: A longitudinal hermeneutic phenomenological study

“…[ 45 ] The “PRISM at work” programme followed a skills-based coaching design that covered the science of resilience, stress management, goal setting, cognitive reframing, meaning making, and coming together and moving forward in 1-hourly sessions over a 6-week period. These results echoed other resilience studies conducted amongst HCWs, [ 46 , [48] , [49] , [50] ] highlighting the importance of resilience training as part of support structures and response preparedness during a pandemic. Importantly though, it is our belief that resilience training should be embedded in everyday HCW training and not only be initiated during times when the healthcare system may be under strain from shocks such as pandemics or disasters.…”

Comparison of General Anxiety among Healthcare Professionals before and after COVID-19 Vaccination

“…A gender difference was also noted; looking at other studies, it appeared that females had higher levels of anxiety than men during the pandemic. This is supported by evidence that females exhibited elevated levels of symptoms in particular [33,34]. In contrast to other research findings, it was discovered that experts in healthcare in Lebanon experienced comparatively less anxiety during the pandemic, with only 23% of Lebanese healthcare professionals showing signs of anxiety.…”

“…The reason behind this correlation could be that healthcare workers were working long hours during the day and not having any idea of what would happen next. This resulted in a domino effect that leads to a lack of sleep, making minor errors in diagnosis, fatigue, and ultimately mental and physical burnout [33]. According to our data, the GAD-7 score was significantly higher, especially in unvaccinated individuals.…”

“…Social media have grown massively, and during the pandemic, a lot of false information/myths about the vaccine's arrival were propagated, for example, that vaccines may be hazardous to humans. Many other studies, such as [33,36], concluded that vaccinated people had lower anxiety levels and were happier with their lives. The COVID-19 pandemic vastly affected the quality of life of healthcare workers, which was directly related to their mental health.…”

Association of individual resilience with organizational resilience, perceived social support, and job performance among healthcare professionals in township health centers of China during the COVID-19 pandemic

“…Third, township health centers with resilience pay more attention to improving the work environment, such as through the provision of appropriate personal protective equipment and disinfection of hospital communal facilities, which alleviates anxiety about COVID-19 infection among primary healthcare professionals. The association between low anxiety levels and high resilience scores among healthcare professionals has been shown to be strong ( Sakr et al, 2022 ).…”