Prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in Southern Ethiopia

Depressive and anxiety symptoms amid COVID-19 pandemic among healthcare workers in a low-resource setting: a systematic review and meta-analysis from Ethiopia

Background

Coronavirus disease 2019 (COVID-19) outbreak is one of the public health problems that pose a serious mental health concern due to its high morbidity and mortality rate. The healthcare workers are at risk of developing mental health symptoms like depression and anxiety because they are the first point of contact in the diagnosis, treatment, and care of patients with COVID-19. This study aimed to systematically review the prevalence and the associated factors of depression and anxiety disorders among healthcare workers amid COVID-19 pandemic in Ethiopia.

Method

A systematic review and meta-analysis study was conducted. Different primary studies that assessed the depressive and anxiety disorders during amid COVID-19 pandemic in the Ethiopian healthcare workers were extracted by Microsoft Excel and exported to STATA version 11 for further analysis. Random-effects model meta-analysis was used to the estimate pooled effect size and the effect of each study with their 95% confidence interval. Funnel plot analysis and Egger regression tests were conducted to detect the presence of publication bias. Subgroup analysis and sensitivity analysis were conducted.

Results

Thirteen studies with 5,174 participants were included in this systematic review and meta-analysis study. The pooled prevalence of depression and anxiety disorders was 40.39% (95% CI: 28.54, 52.24) and 44.93% (95% CI: 31.39, 58.46), respectively. Being a woman, being married, working in the frontline, and having high perceived susceptibility were significantly associated with depression among the Ethiopian healthcare workers. Similarly, being a woman, being older in age, working in the frontline, and having high perceived susceptibility were the factors associated with anxiety disorder among the Ethiopian healthcare workers during the COVID-19 pandemic.

Conclusion

The prevalence of depression and anxiety disorders in the Ethiopian healthcare workers was high. The timely detection and appropriate management of mental health problems is essential for the quality of healthcare services, and proactive support methods for the female, married, and older-age healthcare professionals could result in these outcomes.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022299074.

Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations

BACKGROUND

Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR).

METHODS

We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes.

RESULTS

The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted.

DISCUSSION

PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.

Mental health status and related factors influencing healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The mental health of healthcare workers during the coronavirus-2019 pandemic was seriously affected, and the risk of mental health problems was high. The present study sought to systematically evaluate the mental health problems of healthcare workers worldwide during the pandemic and to determine the latest global frequency of COVID-19 associated mental health problems.

METHODS

Data in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Elsevier, MEDLINE, PubMed, PsycINFO and the Web of Science before November 11, 2022, were systematically searched. Cohort, case-control and cross-sectional studies were included. The meta-analysis used a random effects model to synthesize the comprehensive prevalence rate of mental health problems. Subgroup analyses were performed based on time of data collection; whether the country was or was not developed; continent; doctors and nurses; doctors/nurses vs. other healthcare workers; and psychological evaluation scale.

RESULTS

A total of 161 studies were included, including 341,014 healthcare workers worldwide, with women accounting for 82.8%. Occupationally, 16.2% of the healthcare workers were doctors, 63.6% were nurses and 13.3% were other medical staff. During the pandemic, 47% (95% confidence interval [CI], 35-60%) of healthcare workers reported job burnout, 38% (95% CI, 35-41%) experienced anxiety, 34% (95% CI 30-38%) reported depression, 30% (95% CI, 29-31%) had acute stress disorder, and 26% (95% CI, 21-31%) had post-traumatic stress disorder.

CONCLUSIONS

The study found that there were common mental health problems among health care workers during the COVID-19 pandemic. The most common was job burnout, followed by anxiety, depression, acute stress and post-traumatic stress disorder. Although the global pandemic has been brought under control, its long-term impact on the mental health of healthcare workers cannot be ignored. Additional research is required to develop measures to prevent, monitor and treat psychological disorders among healthcare workers.

A cross-sectional study on coping strategies of frontline healthcare workers amid the COVID-19 pandemic in a developing country

Objectives

Frontline healthcare workers encountered a heightened susceptibility to negative psychological symptoms and behavioral shifts in light of the coronavirus disease 2019 pandemic. This study determined the coping strategies adopted by frontline healthcare workers in Ghana as well as assessed any differences based on demographics, job title, and ranking in four coronavirus disease 2019-designated centers in the Greater Accra region of Ghana.

Methods

Using a hospital-based, mixed-method approach, the study was conducted between May 2021 and September 2021. A total of 94 frontline healthcare workers were randomly sampled and given a self-administered questionnaire, while 13 healthcare workers took in-depth interviews. Data from the survey were analyzed using both IBM SPSS and IBM AMOS and the interview data were transcribed verbatim and coded using thematic analysis.

Results

The study revealed that coronavirus disease 2019 has affected the psycho-social life of frontline healthcare workers mainly in the form of depression, anxiety, and stress. The three main coping strategies adopted by frontline healthcare workers include personal preventative measures (most dominant), seeking external expert support, and obtaining institutional support. While healthcare workers within the age group 30-39 years were found most compliant with the adoption of personal preventive measures and those below 30 years were found least compliant.

Conclusion

This study concludes that frontline healthcare workers have been affected by a considerable level of anxiety, stress, and depression during the coronavirus disease 2019 pandemic. The study recommends a robust psychological support system at various levels of health care and an Employee Assistance Program with access to a 24-h hotline counseling service for frontline healthcare workers, continuous personal protective equipment provision, regular evidence-based updates on the management of coronavirus disease 2019 patients, and increased commitment from the government in addressing the medical needs of infected frontline healthcare workers.

Change in depression during the COVID-19 pandemic among healthcare providers in Addis Ababa, Ethiopia

Background

The COVID-19 pandemic has increased mental health problems among healthcare workers globally. However, studies from low- and middle-income countries on this matter were minimal. This study assessed the change in depression prevalence during the first year of the COVID-19 pandemic and associated factors among healthcare providers in Addis Ababa, Ethiopia.

Methods

We conducted surveys among healthcare workers in Addis Ababa at two-time points, September 2020 and October 2021. A total of 577 study participants were randomly selected based on registers obtained from professional associations. Computer-assisted telephone interviewing technique was used for data collection. The Patient Health Questionnaire (PHQ-9) was used to screen for depression. Multivariable logistic regression analysis was performed to identify potential factors associated with depression.

Result

The prevalence of depression among healthcare workers was 2.3% (95% CI [1.1-4.8]) in Time 1 and 6.5% (95% CI [4.1-10.1]) in Time 2; nearly a three-fold increase in Time 2 compared to Time 1. The most frequently reported symptoms at both times based on the PHQ-9 item were having poor energy, sleep problem, and anhedonia, while reported suicidal ideation was less than 5%. Depression showed a positive and significant association with a positive COVID-19 test result (AOR 7.25 95% CI [1.32-39.4]) in Time 1, and with being a female healthcare provider (AOR 3.96 95% CI [1.08-14.51]) and lack of COVID-19 related policy or guidelines at the workplace (AOR 3.22 95% CI [1.11-9.35]) in Time 2.

Conclusion

The prevalence of depression among healthcare workers tripled during the first year of the COVID-19 pandemic. Panic reaction to positive COVID-19 test result seems to have a negative effect at the beginning while lack of disease-specific prevention guidelines and comprehensive psychological interventions for healthcare providers had an adverse effect on the mental health of health workers.

Depression and insomnia among healthcare professionals during COVID-19 pandemic in Ethiopia: a systematic review and meta-analysis

Introduction

Healthcare professionals play a great role in the struggle against COVID-19. They are highly susceptible to COVID-19 due to their responsibilities. This susceptibility directly affects their mental health status. Comprehensive evidence on prevalence of depression and insomnia during this pandemic is vital. Thus, this study aims to provide the pooled prevalence of depression and insomnia, and their associated factors during the COVID-19 pandemic.

Materials and methods

This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Studies were searched from PubMed, Cochrane Library, CrossRef, African Journals Online and Google Scholar databases from the occurence of the pandemic to June 2022. Study selection, data extraction and methodological quality assessment were done by two authors independently. The I ² statistics was used for testing heterogeneity. A random effect model was used. Stata version 16.0 was used for statistical analysis.

Results

Eight studies were incorporated for this systematic review and meta-analysis. From seven studies the pooled prevalence of depression was 40% (95% CI [0.23-0.57]; I ² = 99.00%; P = 0.00). From three studies the pooled prevalence of insomnia was 35% (95% CI [0.13-0.58]; I ² = 98.20; P = 0.00). Associated factors of depression on healthcare workers (HCWs) were being female pooled AOR: 2.09; 95% CI [1.41-2.76], been married (pooled AOR = 2.95; 95% CI [1.83-4.07]). Due to limited studies available on the factors associated with insomnia, it is impossible to pool and associated factors were presented in narrative synthesis.

Conclusion

COVID-19 is highly associated with the prevalence of depression and insomnia among healthcare professionals in Ethiopia. The pooled prevalence of depression and insomnia were significantly higher among healthcare professionals. Appropriate psychological counseling package should be realized for healthcare workers (HCWs) in order to recover the general mental health problems. Trial registration. This review was registered PROSPERO with registration number CRD42022314865.

A Cross-Sectional Study on the Prevalence of Depressive Symptoms and Its Associated Sociodemographic Factors in Peru during the COVID-19 Pandemic

The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. Depression severity rates were estimated for each symptom, and responses were modeled through the Rating Scale Model to obtain a depression measure used as dependent variable on a Generalized Mixed Linear Model. The most frequent depression symptoms were emotional, such as discouragement, sad mood, hopelessness, and lack of pleasure when doing activities. Our model showed that, after controlling the effects of all the variables considered, the most relevant predictors were gender, education level, physiographic region, age, marital status, and number of coresidents. Higher depression levels were found in women, people who did not complete higher education, participants living in the Highlands, older adults, single participants, and people living alone. Thus, interventions to promote or prevent depression severity during similar situations as the pandemic should focus on specific sociodemographic groups and their particular needs.

Aromatherapy on Psycho-Emotional Symptoms and Fatigue in Nursing Professionals in the COVID-19 Setting

Objective: To compare the effectiveness of aromatherapy with lavender essential oil (EO) versus an EO synergy on psycho-emotional symptoms and fatigue of nursing professionals in the COVID-19 setting. Materials and Methods: This is a quasi-experimental pilot study conducted in 2020. The professionals were randomized in Group 1 — lavender, and in Group 2 — lavender and other EOs synergy. The instruments were validated in Brazil, namely the Self-Reporting Questionnaire (SRQ-20) and the Fatigue Pictogram, which were applied at three moments: before the intervention, after 21 days of intervention, and three weeks after the end of the intervention follow-up. The data were evaluated using Pearson’s x2 test or Fisher’s exact test (dichotomous variables) and Student’s t-test or Mann-Whitney test (continuous variables). Results: A total of 18 professionals participated, and both groups presented improved SRQ-20 scores (p < 0.010), which was maintained in the follow-up for Group 1 compared to the pre-intervention moment (p = 0.033). There was a significant decrease in fatigue in professionals in both groups (p = 0.010), but no difference was observed in the improvement of the impact of fatigue on daily life. Conclusions: There was a reduction in psycho-emotional symptoms and fatigue in nursing professionals who used aromatherapy during the COVID-19 pandemic in both groups.

Anxiety and Stress due to COVID-19 Pandemic and Associated Factors Among Healthcare Workers in West Guji Zone Southern Ethiopia

Background

The COVID-19 pandemic caused a dramatic loss of life around the world and has caused mental and social problems that affect every country in the world. Healthcare workers involved in providing care are at high risk of developing mental health problems as they face heavy workloads, life-and-death decisions, and the risk of infection is high. This study aimed to assess the prevalence of COVID-19-related anxiety and stress and their associated factors among healthcare workers in Southern Ethiopia.

Methods

A cross-sectional survey was conducted in public health facility located in the West Guji district. A simple random sampling technique was used to select 283 study participants. Descriptive, binary, and multiple logistic regression statistics were used. Odds ratios adjusted with 95% CI were used, and statistical significance was declared with a p-value of < 0.05.

Results

A total of 275 participants were included, with a response rate of 97.2%. The prevalence of anxiety and stress were 25.5% and 9.1%, respectively. Factors associated with anxiety symptoms were age, psychoactive drug use, alcohol use, and monthly income, and stress symptoms were alcohol use, medical illness, and knowledge of healthcare workers due to COVID-19 pandemic.

Conclusion

The prevalence of anxiety and stress among healthcare workers due to COVID-19 were an average compared with studies in low-income and high-income countries. Health institutions must focus on the well-being of healthcare workers during the fighting for COVID-19 and comprehensive psychological assistance to support the mental well-being of healthcare workers by giving different training.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40615-022-01335-1.

Bienestar psicológico en enfermeras que realizan terapia de reemplazo renal en tiempos de COVID-19

Introducción: La pandemia por COVID-19 ha generado deterioro de la salud mental en los profesionales del sector salud, siendo desconocida su situación en las enfermeras al cuidado de pacientes con enfermedad renal crónica. Objetivo: Identificar el bienestar psicológico y sus diferencias de acuerdo a las variables demográficas y profesionales en enfermeras que realizan hemodiálisis en tiempos de COVID-19. Material y Método: Estudio cuantitativo, descriptivo transversal, realizado en 52 enfermeras que realizan terapia de reemplazo renal en unidades de cuidado intensivo y de terapia renal en tiempos de COVID-19. Fueron obtenidas variables de tipo sociodemográfico, académico, laboral y se empleó la escala PGWBI para establecer los niveles de bienestar psicológico. Se utilizó el test de Mann-Whitney y Kruskall-Wallis realizando el post test de Dunn para comparar diferencias entre las variables estudiadas. Resultados: La edad promedio fue de 36,56±6,95 años. Los niveles de bienestar psicológico fueron positivos en todas las categorías de la escala, con excepción de la ansiedad y la depresión. De igual forma, se encontró que las variables género, estado civil, estabilidad, antigüedad laboral, remuneración salarial y formación académica, muestran comportamiento diferenciado en las categorías que evalúa el instrumento. Conclusiones: Se identificaron altos niveles de bienestar psicológico en enfermeras que prestan cuidados en pacientes en terapia de reemplazo renal en tiempos de pandemia por COVID-19, donde factores como el estado civil, formación post gradual y tener estabilidad laboral con mejores ingresos salariales, influencian positivamente las categorías que contribuyeron a los resultados de bienestar psicológico de las enfermeras evaluadas.