key: cord-0333812-9ccbl3wg authors: Khanal, Pratik; Devkota, Navin; Dahal, Minakshi; Paudel, Kiran; Mishra, Shiva Raj; Joshi, Devavrat title: Corona virus fear among health workers during the early phase of pandemic response in Nepal: a web-based cross-sectional study date: 2020-11-04 journal: bioRxiv DOI: 10.1101/2020.11.04.367912 sha: 7b89b5d3f5d977ab2f1c6a67a6f87cec46dfd235 doc_id: 333812 cord_uid: 9ccbl3wg Background Health workers involved in COVID-19 response might be at risk of developing fear and psychological distress. This study aimed to identify factors associated with COVID-19 fear among health workers in Nepal during the early phase of pandemic. Methods A web-based cross-sectional survey was conducted in the month of April-May 2020 among 475 health workers directly involved in COVID-19 management. The Fear Scale of COVID 19 (FCV-19S) was used to measure the status of fear. Scatter plots were used to observe the relationship between fear and other psychological outcomes: anxiety, depression and insomnia. Multivariable logistic regression was done to identify factors associated with COVID fear. Results COVID-19 fear score was moderately correlated with anxiety and depression, and weakly correlated with insomnia (p<0.001). Nurses (AOR=2.29; 95% CI: 1.23-4.26), health workers experiencing stigma (AOR=1.83; 95% CI: 1.12-2.73), those working in affected district(AOR=1.76; 95% CI: 1.12-2.77) and presence of family member with chronic diseases (AOR=1.50; 95% CI: 1.01-2.25) was associated with higher odds of developing COVID-19 fear as compared to other health workers, health workers not experiencing stigma, working in non-affected district and not having family member with chronic diseases respectively. Conclusion Nurses, health workers facing stigma, those working in affect district and having family member with chronic diseases were more at risk of developing COVID-19 fear. It is thus recommended to improve work environment to reduce fear among health workers, employ stigma reduction interventions, and ensure personal and family support for those having family member with chronic diseases. The psychological implications as a result of disease outbreak is often neglected by the health 43 system [1] [2] [3] although studies have found that the proportion of mental health effects is higher [15, 16] . In this regard, this study aims to assess the status of COVID-19 fear among health 60 workers involved in COVID-19 response in a low resource setting. In addition, it aims to explore 61 the relationship of COVID-19 fear with other mental health outcomes among health workers. 1 to 5 with lower and higher value indicating strongly disagree and strongly agree respectively. The total scores ranges between 7 to 35 and the higher the score, the higher the fear of COVID- Table) . The COVID-19 fear score was 101 categorized as presence of fear and absence of fear of COVID-19 based on the median value. Those having scored more than median (>16) were categorized as presence of fear and less than 103 or equal to as absence of fear of COVID-19. Chi-square test was done between categorical 104 independent and categorical dependent variable (S3 Table) and those variables significant at 10% The The correlation analysis showed that FCV-19S was moderately correlated with HADS-A (r= with focus on nurses are thus required to avert COVID fear and psychological distress. In our study, more than half of the health workers experienced stigma during COVID-19. 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Learning from HIV research Psychosocial effects of SARS on 345 hospital staff: survey of a large tertiary care institution Psychological impact of the coronavirus disease 2019 347 (COVID-19) outbreak on healthcare workers in China The authors would like to acknowledge all the health workers involved in the study and the a letter of support for the study.