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Raney JH, Al-Shoaibi AA, Ganson KT, Testa A, Jackson DB, Singh G, Sajjad OM, Nagata JM. Associations between adverse childhood experiences and early adolescent problematic screen use in the United States. BMC Public Health 2023; 23:1213. [PMID: 37349707 PMCID: PMC10286460 DOI: 10.1186/s12889-023-16111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 06/13/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Problematic screen use, defined as an inability to control use despite private, social, and professional life consequences, is increasingly common among adolescents and can have significant mental and physical health consequences. Adverse Childhood Experiences (ACEs) are important risk factors in the development of addictive behaviors and may play an important role in the development of problematic screen use. METHODS Prospective data from the Adolescent Brain Cognitive Development Study (Baseline and Year 2; 2018-2020; N = 9,673, participants who did not use screens were excluded) were analyzed in 2023. Generalized logistic mixed effects models were used to determine associations with ACEs and the presence of problematic use among adolescents who used screens based on cutoff scores. Secondary analyses used generalized linear mixed effects models to determine associations between ACEs and adolescent-reported problematic use scores of video games (Video Game Addiction Questionnaire), social media (Social Media Addiction Questionnaire), and mobile phones (Mobile Phone Involvement Questionnaire). Analyses were adjusted for potential confounders including age, sex, race/ethnicity, highest parent education, household income, adolescent anxiety, depression, and attention-deficit symptoms, study site, and participants who were twins. RESULTS The 9,673 screen-using adolescents ages 11-12 years old (mean age 12.0) were racially and ethnically diverse (52.9% White, 17.4% Latino/Hispanic, 19.4% Black, 5.8% Asian, 3.7% Native American, 0.9% Other). Problematic screen use rates among adolescents were identified to be 7.0% (video game), 3.5% (social media), and 21.8% (mobile phone). ACEs were associated with higher problematic video game and mobile phone use in both unadjusted and adjusted models, though problematic social media use was associated with mobile screen use in the unadjusted model only. Adolescents exposed to 4 or more ACEs experienced 3.1 times higher odds of reported problematic video game use and 1.6 times higher odds of problematic mobile phone use compared to peers with no ACEs. CONCLUSIONS Given the significant associations between adolescent ACE exposure and rates of problematic video and mobile phone screen use among adolescents who use screens, public health programming for trauma-exposed youth should explore video game, social media, and mobile phone use among this population and implement interventions focused on supporting healthy digital habits.
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Affiliation(s)
- Julia H Raney
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA.
| | - Abubakr A Al-Shoaibi
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gurbinder Singh
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
| | - Omar M Sajjad
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Jason M Nagata
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
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Ali AM, Al-Dossary SA, Almarwani AM, Atout M, Al-Amer R, Alkhamees AA. The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event. Healthcare (Basel) 2023; 11:healthcare11060892. [PMID: 36981549 PMCID: PMC10048280 DOI: 10.3390/healthcare11060892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/18/2023] [Accepted: 03/12/2023] [Indexed: 03/30/2023] Open
Abstract
The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87-0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt
| | - Saeed A Al-Dossary
- Department of Psychology, College of Education, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Abdulaziz Mofdy Almarwani
- Department of Psychiatric Nursing, College of Nursing, Taibah Univesity, Janadah Bin Umayyah Road, Tayba, Medina 42353, Saudi Arabia
| | - Maha Atout
- School of Nursing, Philadelphia University, Amman 19392, Jordan
| | - Rasmieh Al-Amer
- Faculty of Nursing, Isra University, Amman 11953, Jordan
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia
| | - Abdulmajeed A Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
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Shi J, van der Maas M, Yu L, Jiang Q, Agasee S, Turner NE. Current prevention strategies and future directions for problem Internet use. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Psychometric evaluation of the Depression Anxiety Stress Scale 8 among women with chronic non-cancer pelvic pain. Sci Rep 2022; 12:20693. [PMID: 36450770 PMCID: PMC9712382 DOI: 10.1038/s41598-022-15005-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/16/2022] [Indexed: 12/05/2022] Open
Abstract
Psychiatric comorbidity and abusive experiences in chronic pelvic pain (CPP) conditions may prolong disease course. This study investigated the psychometrics of the Depression Anxiety Stress Scale 8 (DASS-8) among women with CPP (N = 214, mean age = 33.3 ± 12.4 years). The DASS-8 expressed excellent fit, invariance across age groups and menopausal status, good know-group validity (differentiating women with psychiatric comorbidity from those without comorbidity: U = 2018.0, p = 0.001), discriminant validity (HTMT ratios < 0.85), excellent reliability (alpha = 0.90), adequate predictive and convergent validity indicated by strong correlation with the DASS-21 (r = 0.94) and high values of item-total correlations (r = 0.884 to 0.893). In two-step cluster analysis, the DASS-8 classified women into low- and high-distress clusters (n = 141 and 73), with significantly higher levels of distress, pain severity and duration, and physical symptoms in cluster 2. The DASS-8 positively correlated with pain severity/duration, subjective symptoms of depression/anxiety, experiences of sexual assault, fatigue, headache severity, and collateral physical symptoms (e.g., dizziness, bloating, fatigue etc.) at the same level expressed by the parent scale and the DASS-12, or even greater. Accordingly, distress may represent a target for early identification of psychiatric comorbidity, CPP severity, experiences of sexual assault, and collateral physical complaints. Therefore, the DASS-8 is a useful brief measure, which may detect mental distress symptoms among women with CPP.
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Ali AM, Alameri RA, Hendawy AO, Al-Amer R, Shahrour G, Ali EM, Alkhamees AA, Ibrahim N, Hassan BH. Psychometric evaluation of the depression anxiety stress scale 8-items (DASS-8)/DASS-12/DASS-21 among family caregivers of patients with dementia. Front Public Health 2022; 10:1012311. [PMID: 36388286 PMCID: PMC9641276 DOI: 10.3389/fpubh.2022.1012311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023] Open
Abstract
Patients with dementia express a set of problematic and deteriorating symptoms, along with self-care dependency. Over time, the mental health of family caregivers of persons with dementia may be affected, putting them at a high risk for psychopathology, which may be associated with endangered wellbeing of people with dementia. This cross-sectional instrumental design study examined the psychometric properties of the Depression Anxiety Stress Scale 8-items (DASS-8), DASS-12, and DASS-21 in a convenient sample of 571 caregivers from northern Italy and southern Switzerland (mean age = 53 years, SD = 12, range = 24-89 years). A bifactor structure of the three measures had the best fit; some items of the DASS-12/DASS-21 failed to load on their domain-specific factors. The three-factor structure was invariant across various groups (e.g., gender and education), expressed adequate reliability and convergent validity, and had strong positive correlation with the three-item UCLA Loneliness Scale (UCLALS3). Distress scores did not differ among carers of different types of dementia (Alzheimer's disease vs. other types, e.g., vascular dementia). However, distress scores were significantly high among female individuals, adult children caregivers, those caring for dependent patients, and those who received help with care. For 54.9 and 38.8% of the latter, care was provided by relatives and health professionals, respectively. Since the DASS-8 expresses adequate psychometrics comparable with the DASS-21, it may be used as a brief measure of distress in this population.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Rana Ali Alameri
- Fundamentals of Nursing Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amin Omar Hendawy
- Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Damanhour, Egypt
| | - Rasmieh Al-Amer
- Faculty of Nursing, Isra University, Amman, Jordan
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Ghada Shahrour
- Jordan University of Science and Technology, Faculty of Nursing, Irbid, Jordan
| | - Esraa M. Ali
- Department of Basic and Educational Sciences, Faculty of Education for Early Childhood, Alexandria University, Alexandria, Egypt
| | - Abdulmajeed A. Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah, Saudi Arabia
| | - Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Bothaina Hussein Hassan
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Gerontological Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Raja N AA, Osman NA, Alqethami AM, Abd El-Fatah NK. The relationship between the high-risk disordered eating and social network navigation among Saudi college females during the COVID pandemic. Front Public Health 2022; 10:949051. [PMID: 36148353 PMCID: PMC9486004 DOI: 10.3389/fpubh.2022.949051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023] Open
Abstract
Background Disordered eating behaviors (DEBs) are complex health issues that may lead to negative physical and mental health outcomes among college students. More studies should be directed toward the screening of DEBs. This study aimed to determine the prevalence of DEBs among Saudi female university students and their association with social networking site (SNSs) usage and composite lifestyle behaviors during the unprecedented period of COVID-19. Methods This cross-sectional study included 445 females recruited using stratified random sampling. The participants self-reported demographic, social, medical, and lifestyle data and completed the validated Arabic version of the Eating Attitudes Test-26, Social Networking Sites (SNSs) Usage Questionnaire, Bergen Social Media Addiction Scale, and Body Shape Questionnaire. Results The prevalence of DEBs was 27.2% among the female students at Taif University. From the pre-pandemic period until the current time, the DEBs-risk group had a significantly higher SNS navigation rate (36.4%) than the normal group (20.4%) (X 2 = 30.015, p = 0.001). The regression analysis revealed that females with a significant body image concern, higher number of SNSs friends, and frequent visits to SNSs, and those seeking social-dependent information in relation to weight loss/dieting were more likely to develop DEBs (Overall Model: Chi-Square X 2 = 158.071, p < 0.000**). Conclusions SNSs usage and DEBs were associated during the COVID-pandemic. However, the composite lifestyle score did not demonstrate a significant association with DEBs among the female students at Taif University. Investigating the magnitude of DEBs and understanding the role of SNS are essential for preventing disordered eating among young females.
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Affiliation(s)
- Alotaibi Abdulaziz Raja N
- Department of Public Health, Directorate of Health Affairs in Taif, Ministry of Health, Riyadh, Saudi Arabia
| | - Nermin A. Osman
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Abdullah Muidh Alqethami
- Department of Public Health, Directorate of Health Affairs in Taif, Ministry of Health, Riyadh, Saudi Arabia
| | - Nesrin Kamal Abd El-Fatah
- Department of Nutrition, High Institute of Public Health, Alexandria University, Alexandria, Egypt,*Correspondence: Nesrin Kamal Abd El-Fatah
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Internet-Related Instruments (Bergen Social Media Addiction Scale, Smartphone Application-Based Addiction Scale, Internet Gaming Disorder Scale-Short Form, and Nomophobia Questionnaire) and Their Associations with Distress among Malaysian University Students. Healthcare (Basel) 2022; 10:healthcare10081448. [PMID: 36011105 PMCID: PMC9408412 DOI: 10.3390/healthcare10081448] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
The present study evaluated the psychometric properties of four instruments related to internet use, namely the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), (nine-item) Internet Gaming Disorder Scale Short Form (IGDS9-SF), and Nomophobia Questionnaire (NMPQ) as well as their associations with psychological distress among Malaysian university students. A total of 380 Malaysian university students (71.6% females, mean age 24.0 years) were recruited through convenience sampling and completed an online survey including questions concerning socio-demographic background, social media addiction, smartphone addiction, internet gaming disorder, and nomophobia. Confirmatory factor analysis and Rasch analysis were applied to evaluate the psychometric properties of the instruments and Cronbach’s alpha value and McDonald’s omega value were used to confirm the internal consistency reliability of the instruments. The unidimensional structure was confirmed for the BSMAS, SABAS, and IGDS9-SF while the four-factor structure was confirmed for NMPQ. All instruments showed good internal consistency reliability. Promising validity and reliability were confirmed for BSMAS, SABAS, IGDS9-SF, and NMPQ. Therefore, they are useful to assess different types of problematic internet use among university students in Malaysia. Furthermore, a significant association was observed between internet use and psychological distress. The present study is the first to investigate the validity and reliability of BSMAS, SABAS, IGDS9-SF, and NMPQ among Malaysian university students using rigorous psychometric testing methods (i.e., Rasch analysis).
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Al-Amer R, Malak MZ, Burqan HMR, Stănculescu E, Nalubega S, Alkhamees AA, Hendawy AO, Ali AM. Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels. J Pers Med 2022; 12:912. [PMID: 35743695 PMCID: PMC9224616 DOI: 10.3390/jpm12060912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 02/07/2023] Open
Abstract
Although vaccination has been adopted by the WHO to limit worldwide transmission of COVID-19, people's worries about COVID-19 vaccines may suppress their desire for vaccination despite vaccine availability. This study aimed to investigate anxiety and stress symptoms among 250 Jordanians (mean age = 43.18 ± 6.34 years, 72% females) who received their first vaccine dose. The respondents completed the anxiety and stress subscales of the Depression Anxiety and Stress scale 21 (DASS-21) before and after vaccination. The respondents expressed more moderate-severe levels of stress before than after vaccination (20.8% and 13.2%, respectively). Meanwhile, 37.2% and 45.2% of the respondents expressed moderate-severe anxiety before and after vaccination, respectively. Wilcoxon signed-rank test revealed that the drop in the level of stress from before- (median (IQR) = 5 (1-8)) to after vaccination (median (IQR) = 3 (1-7)) was statistically significant (z = -3.81, p = 0.001, r = 0.17) while the increase in anxiety was not. Anxiety significantly dropped postvaccination among individuals experiencing mild to severe anxiety before vaccination. Similarly, stress and anxiety significantly increased among individuals expressing normal anxiety before vaccination (z = -3.57 and -8.24, p values = 0.001, r = 0.16 and 0.37, respectively). Age positively correlated with postvaccination anxiety among respondents with mild prevaccination anxiety, and it negatively correlated with the prevaccination level of stress in the normal-anxiety group. Gender, marital status, respondents' level of education, and history of COVID-19 infection had no significant correlation with anxiety or stress at either point of measurement. Overcoming their hesitancy to receive COVID-19 vaccines, individuals with normal levels of anxiety experienced a rise in their distress symptoms following immunization. On the contrary, vaccination seemed to desensitize anxious individuals. Policymakers need to formulate a population-specific plan to increase vaccine preparedness and promote psychological well-being over all during the pandemic.
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Affiliation(s)
- Rasmieh Al-Amer
- Faculty of Nursing, Isra University, Amman 11953, Jordan;
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia
| | - Malakeh Z. Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Hala Mohammad Ramadan Burqan
- School of Nursing, Alghad International Colleges for Applied Medical Sciences, Riyadh Branch, Riyadh 13315, Saudi Arabia;
| | - Elena Stănculescu
- Faculty of Psychology and Educational Sciences, University of Bucharest, 050663 Bucharest, Romania;
| | - Sylivia Nalubega
- Department of Nursing, School of Health Sciences, Soroti University, Soroti City 211, Uganda;
| | - Abdulmajeed A. Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Amin Omar Hendawy
- Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Damanhour 22516, Egypt;
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, Alexandria 21527, Egypt;
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The Arabic Version of the Impact of Event Scale-Revised: Psychometric Evaluation among Psychiatric Patients and the General Public within the Context of COVID-19 Outbreak and Quarantine as Collective Traumatic Events. J Pers Med 2022; 12:jpm12050681. [PMID: 35629104 PMCID: PMC9144426 DOI: 10.3390/jpm12050681] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/06/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
The Coronavirus Disease-19 (COVID-19) pandemic has provoked the development of negative emotions in almost all societies since it first broke out in late 2019. The Impact of Event Scale-Revised (IES-R) is widely used to capture emotions, thoughts, and behaviors evoked by traumatic events, including COVID-19 as a collective and persistent traumatic event. However, there is less agreement on the structure of the IES-R, signifying a need for further investigation. This study aimed to evaluate the psychometric properties of the Arabic version of the IES-R among individuals in Saudi quarantine settings, psychiatric patients, and the general public during the COVID-19 outbreak. Exploratory factor analysis revealed that the items of the IES-R present five factors with eigenvalues > 1. Examination of several competing models through confirmatory factor analysis resulted in a best fit for a six-factor structure, which comprises avoidance, intrusion, numbing, hyperarousal, sleep problems, and irritability/dysphoria. Multigroup analysis supported the configural, metric, and scalar invariance of this model across groups of gender, age, and marital status. The IES-R significantly correlated with the Depression Anxiety Stress Scale-8, perceived health status, and perceived vulnerability to COVID-19, denoting good criterion validity. HTMT ratios of all the subscales were below 0.85, denoting good discriminant validity. The values of coefficient alpha in the three samples ranged between 0.90 and 0.93. In path analysis, correlated intrusion and hyperarousal had direct positive effects on avoidance, numbing, sleep, and irritability. Numbing and irritability mediated the indirect effects of intrusion and hyperarousal on sleep and avoidance. This result signifies that cognitive activation is the main factor driving the dynamics underlying the behavioral, emotional, and sleep symptoms of collective COVID-19 trauma. The findings support the robust validity of the Arabic IES-R, indicating it as a sound measure that can be applied to a wide range of traumatic experiences.
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Alzahrani NS, Almarwani AM, Asiri SA, Alharbi HF, Alhowaymel FM. Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study. Front Psychiatry 2022; 13:912157. [PMID: 35990067 PMCID: PMC9387387 DOI: 10.3389/fpsyt.2022.912157] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/13/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families. AIM This study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic. METHODS A cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21-54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM). RESULTS Based on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables-namely, work location and physical exercise in the anxiety model and physical exercise in the depression model. CONCLUSION Emergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses' psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.
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Affiliation(s)
- Naif S Alzahrani
- Department of Medical Surgical Nursing, College of Nursing, Taibah University, Medina, Saudi Arabia
| | | | - Saeed A Asiri
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Hanan F Alharbi
- Department of Maternity and Child Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fahad M Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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