key: cord-0889627-oyoajuzw authors: Malik, A.; Hafeez, M. M.; Rana, M. A.; Waquar, S.; alam, r. title: Anxiety Levels among Healthcare Professionals during Covid-19 Pandemic: A Multifactorial Study date: 2020-10-18 journal: nan DOI: 10.1101/2020.10.14.20212167 sha: 1b307d27da3da6e384d0041fa4c419ee289f9e22 doc_id: 889627 cord_uid: oyoajuzw The current study focuses on psychological stress level among doctors, estimated by calculating anxiety score. For the assessment of anxiety levels, the GAD-7 scale was used. Chi-Square test and Odd ratios were calculated among the exposed and not exposed groups involved in the management of COVID-19 patients. Results revealed increased anxiety levels in the exposed group. Besides, the availability of personal protective equipments and stress from the family to quit the job were the substantial contributing factors that increased anxiety. Based on the results, it is proposed that the concern administrative authorities should consider these findings to facilitate medical healthcare professionals. Anxiety has been identified as one of the top-ranked mental issues among health care professionals that can dynamically influence individual performances. Different external factors like working hours at the hospital, personal relationships, financial problems and certain other extraneous factors including medical illness of family members can contribute to elevated stress levels (Koay et al., 2020) . It is pertinent to mention here that anxiety and depression levels generally prevailing among the population worldwide (Fonagy et al., 2016). Such non-communicable disorders could potentially lead to disability (Murray et al., 1996) . More specifically, in developing countries like Pakistan, psychiatric disorders in combination with numerous infectious diseases and malnutrition can further aggravate the problem. On a gender basis, women are more prone to this disorder compared with male counterparts (Mirza et al., 2004) . Keeping in view the available literature, the present study investigated anxiety levels among healthcare professionals during COVID-19 pandemic that added extra stress among the medical community, especially frontline healthcare professionals. So far, the COVID-19 infection has caused casualties including 278 doctors that were confirmed but more than reported deaths of doctors are expected (Ing et al., 2020) . Somehow, the mental health condition of those who were actively involved in treating a mass of the population was neglected or very little focused. It this extremely unavoidable situation, All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted October 18, 2020. . https://doi.org/10.1101/2020.10.14.20212167 doi: medRxiv preprint a very important aspect of anxiety levels among health professionals therefore remained unnoticed. In the present study, we investigated the prevalence of anxiety levels and associated contributing factors among health care physicians during COVID-19 pandemic. A total of 156 doctors were recruited to study the mental stress and anxiety levels during a cross-sectional comparative study from April to June (2020). They were further divided into two groups. Participants of group A were never directly exposed while those of group B were exposed to the treatment of COVID-19 patients. Questionnaires were distributed among the participants from both groups. Responses were collected from different hospitals of Lahore (31.5204° N; 74.3587° E) Punjab, Pakistan. Doctors having already some mental illness or on anti-psychotics were excluded from the study. For the assessment of anxiety GAD-7 scoring system was used and outcomes were assessed (Spitzer et al., 2006) . Scores obtained in between 0-21 was encoded as follows: Scores of 5-9 for mild anxiety, 10-14 moderate anxiety, and The data were statistically analyzed with the help of a Chi-square test using SPSS software (version 20). In addition, the p-values of less than 95 % confidence index (p<0.05) remained statistically significant. The study assessed different variables in the identification of anxiety levels within the doctors. Male to female ratio in group A was 36:25, whereas, in group B, it was 64:31. Chisquare analysis depicted no significant difference in anxiety levels of two groups based on gender (p=0.187). By contrast, significantly increased levels of anxiety were recorded among members of group B (p=0.005) that are directly in contact with COVID-19 patients (Table-1 ). All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted October 18, 2020. . https://doi.org/10.1101/2020.10.14.20212167 doi: medRxiv preprint Doctors included in the study further were inquired about the factors that contributed to the aggravation of their anxiety levels. Of these, two major contributing factors included stress from the family to quit the job and the availability of proper personal protective equipment's (PPE's). The findings indicated that there are 4.92 times and 1.80 times greater risk of anxiety in those who were facing stress because of inadequate supply of PPEs and from their families respectively (Table-2 ). All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted October 18, 2020. . https://doi.org/10.1101/2020.10.14.20212167 doi: medRxiv preprint The COVID-19 is the most devastating and challenging public health crises since the influenza pandemic in 1918. Global statistics show millions of cases and about half of million deaths by May 2020 (WHO, 2020). Our results indicated that professionals engaged in the treatment of COVID-19 patients were significantly influenced by anxiety. In agreement with our findings, it has been indicated that linear spread of the virus has undeniable effects over the population worldwide but doctors and nurses who are in direct contact with the affected individuals deal with constant stress and fear that drives them into an anxious state of mind From the results, it is evident that levels of anxiety among health care professionals are directly associated with i) direct exposure to COVID-19 infected patients ii) family support and iii) personal protective equipment (PPEs). It is, therefore, concluded that everyone has to play his role to cope with the situation like a pandemic. Modifiable aggravating factors for anxiety levels like proper provision of PPEs can be easily managed with the cooperation of hospital management and administrative officials, it may eradicate the fears of healthcare professionals to work in such a pandemic situation. Similarly, family support is also linked with the anxiety free and well protected environment of hospitals. Community Gardening: Stress, Well-Being, and Resilience The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: summary. World Health Organization Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review Physician deaths from corona virus (COVID-19) disease The emotional impact of COVID-19: From medical staff to common people Epidemic of COVID-19 in China and associated Psychological Problems. Asian journal of psychiatry How Large Was the Mortality Increase Directly and Indirectly Caused by the COVID-19 Epidemic? An Analysis on All-Causes Mortality Data in Italy COVID 19 pandemic: perspectives on an unfolding crisis. The British journal of surgery A brief measure for assessing generalized anxiety disorder: the GAD-7 Focus on mental health during the coronavirus (COVID-19) pandemic: applying learnings from the past outbreaks Using social and behavioural science to support COVID-19 pandemic response Perceived Risk and Protection from Infection and Depressive Conserving supply of personal protective equipment-a call for ideas