Sadra Medical Journal

COVID-19-induced Anxiety and Depression among Two Vulnerable Groups: Medical Staff and Pregnant Women

Document Type : Original Article

Authors

Masumeh Ghazanfarpour 1
Fahimeh Shakeri 2
Maryam Soleimani Houni 3
Abolfazl Hosseinnataj 4
Firoozeh Mirzaee 5
Zahra Kashfi 6
Zeinab Moslemi Zadeh 6
Iman Nosratabadi 6
Atefeh Ahmadi 7

1 Assistant Professor, Nursing Research Center, Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

2 Instructor, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Iran

3 Instructor, Nursing Research Center, Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

4 Assistant Professor, Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran

5 Associate Professor, Nursing Research Center, Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

6 Student Research Committee, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

7 Associate Professor, Family, Reproductive Health and Population Research Center, Counselling in Midwifery Department, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

https://doi.org/10.30476/smsj.2023.98078.1402
Abstract
Introduction: Considering the priority of supporting vulnerable groups when fighting against COVID-19, the present study aimed to evaluate the levels of COVID-19-induced anxiety and depression in two vulnerable groups: medical staff and pregnant women.
Methods: The present study is a descriptive cross-sectional study performed on 140 treatment staff and 338 pregnant women. The questionnaire used in this study includes demographic characteristics and the Hospital Anxiety and Depression Scale- modified. Univariate and multiple linear regression analysis and analysis of variance were used to identify the effect of variables on anxiety and depression.
Results: Among the staff, 88.6% were women. The mean and standard deviation of their COVID-19-induced anxiety and depression were 12.76 ± 1.78 and 7.75 ± 2.27, respectively. The staff exhibited high levels of abnormal anxiety, with 92.9% reporting symptoms. In contrast, the prevalence of abnormal depression among the staff was lower, with only 11.4% reporting symptoms. Marital status (p=0.05) and exercise (p=0.03) significantly affected the covid-19-induced depression of the medical staff. The mean and standard deviation of COVID-19-induced anxiety and depression in pregnant women were 10.53 ± 2.04 and 11.15 ± 2.09, respectively, and these scores were significantly different compared to the medical staff groups.
Conclusion: Vulnerable groups had high levels of anxiety and depression associated with COVID-19. Nurses prioritized psychological programs targeting anxiety reduction, while pregnant women prioritized psychological programs addressing depression reduction.

Keywords

Anxiety
COVID-19
Depression
Health personnel
Pregnant women
  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020; 395(10223): 497-506.
  2. Yang Y, Sun S, Hu S, Tang C, Zhang Y, Lin H. Comparative Effectiveness of Multiple Psychological Interventions for Psychological Crisis in People Affected by Coronavirus Disease 2019: A Bayesian Network Meta-Analysis. Frontiers in psychology. 2021; 12.
  3. Jiang L-c, Yan Y-j, Jin Z-S, Hu M-L, Wang L, Song Y, et al. The depression anxiety stress Scale-21 in Chinese hospital workers: reliability, latent structure, and measurement invariance across genders. Frontiers in psychology. 2020; 11.
  4. Blake H, Bermingham F, Johnson G, Tabner A. Mitigating the psychological impact of COVID-19 on healthcare workers: a digital learning package. International journal of environmental research and public health. 2020; 17(9): 2997.
  5. Talevi D, Socci V, Carai M, Carnaghi G, Faleri S, Trebbi E, et al. Mental health outcomes of the CoViD-19 pandemic. Rivista di psichiatria. 2020; 55(3): 137-44.
  6. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. The Lancet. 2020; 395(10224): e37-e8.
  7. Control CfD, Prevention. Interim infection prevention and control recommendations for hospitalized patients with Middle East respiratory syndrome coronavirus (MERS-CoV). 2015.
  8. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. American journal of obstetrics and gynecology. 2004; 191(1): 292-7.
  9. Lam CM, Wong SF, Leung TN, Chow KM, Yu WC, Wong TY, et al. A case‐controlled study comparing clinical course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome. BJOG: An International Journal of Obstetrics & Gynaecology. 2004; 111(8): 771-4.
  10. Delavar Gavam S, Alizadeh Goradel J. The role of metacognitive beliefs and positive and negative affect in the Fear of childbirth of pregnant women with first experience. Iranian Journal of Nursing Research. 2014; 9(3): 10-8. (Persian)
  11. Khoursandi M, Vakilian K, Torabi Goudarzi M, Abdi M. Childbirth preparation using behavioral-cognitive skill in childbirth outcomes of primiparous women. Journal of Babol University of Medical Sciences. 2013; 15(4): 76-80. (Persian)
  12. Akbarzadeh, m., et al., Effect of Relaxation and Attachment Behaviors Training on Anxiety in First-time Mothers in Shiraz City, 2010: A Randomized Clinical Trial. Qom University of Medical Sciences Journal, 2012; 6(4): p. 14-23.
  13. Toosi M, Akbarzadeh M, Zare N, Sharif F. Effect of attachment training on anxiety and attachment behaviors of first-time mothers. Journal of hayat. 2011; 17(3): 69-79. (Persian)
  14. Karamoozian M, Gh A. Effectiveness of cognitive-behavioral stress management intervention on anxiety and depression during pregnancy. Journal of Kerman University of Medical Sciences. 2014.
  15. Wu W, Zhang Y, Wang P, Zhang L, Wang G, Lei G, et al. Psychological stress of medical staffs during outbreak of COVID‐19 and adjustment strategy. Journal of medical virology. 2020; 92(10): 1962-70.
  16. Petzold MB, Plag J, Ströhle A. Dealing with psychological distress by healthcare professionals during the COVID-19 pandemia. Der Nervenarzt. 2020.
  17. Chen Q, Zhang Y, Zhuang D, Mao X, Mi G, Wang D, et al. Health anxiety in medical employees: A multicentre study. Journal of International Medical Research. 2019; 47(10): 4854-61.
  18. Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry research. 2020; 288: 112936.
  19. Lasalvia A, Bonetto C, Porru S, Carta A, Tardivo S, Bovo C, et al. Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy. Epidemiology and psychiatric sciences. 2021; 30.
  20. Wu D, Jiang C, He C, Li C, Yang L, Yue Y. Stressors of nurses in psychiatric hospitals during the COVID-19 outbreak. Psychiatry research. 2020; 288: 112956.
  21. Bocéréan C, Dupret E. A validation study of the Hospital Anxiety and Depression Scale (HADS) in a large sample of French employees. BMC psychiatry. 2014; 14(1): 1-11.
  22. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7(4): e15-e6.
  23. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica. 1983;67(6):361-70.
  24. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health and quality of life outcomes. 2003; 1(1): 14.
  25. Amini P, Maroufizadeh S, Samani RO. Evaluating the factor structure, item analyses, and internal consistency of hospital anxiety and depression scale in Iranian infertile patients. International Journal of Reproductive BioMedicine. 2017; 15(5): 287.
  26. Evans SJ, Bassis CM, Hein R, Assari S, Flowers SA, Kelly MB, et al. The gut microbiome composition associates with bipolar disorder and illness severity. Journal of psychiatric research. 2017; 87: 23-9.
  27. Oliveira EBd, Silva SRCdSd, Sora ABd, Oliveira TSd, Valério RL, Dias LBS. Minor psychic disorders in nursing workers at a psychiatric hospital. Revista da Escola de Enfermagem da USP. 2020; 54.
  28. Kwok KO, Li KK, Chan HHH, Yi YY, Tang A, Wei WI, et al. Community responses during early phase of COVID-19 epidemic, Hong Kong. Emerging infectious diseases. 2020; 26(7): 1575.
  29. Chen W-K, Cheng Y-C, Chung Y-T, Lin C-C. The impact of the SARS outbreak on an urban emergency department in Taiwan. Medical care. 2005: 168-72.
  30. Wong TW, Yau JK, Chan CL, Kwong RS, Ho SM, Lau CC, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. European Journal of Emergency Medicine. 2005; 12(1): 13-8.
  31. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020; 3 (3): e203976. PubMed: https://www ncbi nlm nih gov/pubmed/32202646.
  32. Tan BY, Chew NW, Lee GK, Jing M, Goh Y, Yeo LL, et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Annals of internal medicine. 2020; 173(4): 317-20.
  33. Seale H, Wang Q, Yang P, Dwyer DE, Zhang Y, Wang X, et al. Hospital health care workers’ understanding of and attitudes toward pandemic influenza in Beijing. Asia Pacific Journal of Public Health. 2012; 24(1): 39-47.
  34. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. Journal of affective disorders. 2020; 277: 5-13.
  35. Sun F, Zhu J, Tao H, Ma Y, Jin W. A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women. Journal of Psychosomatic Obstetrics & Gynecology. 2021; 42(2): 91-9.
  36. Wu Y-T, Zhang C, Liu H, Duan C-C, Li C, Fan J-X, et al. Perinatal depression of women along with 2019 novel coronavirus breakout in China. 2020.
  37. Liu S, Yang L, Zhang C, Xiang Y, Liu Z, Hu S, et al. Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry. 2020; 7 (4): e17-e18.
  38. The State Council of China. A notification to set up nationwide psychological assistance hotlines against the 2019-nCoV outbreak. Published February 2, 2020. Accessed March 3, 2020. Available from: http://www.gov.cn/xinwen/2020-02/02/content_5473937.htm.
  39. Labrague LJ, De los Santos JAA. COVID‐19 anxiety among front‐line nurses: Predictive role of organisational support, personal resilience and social support. Journal of nursing management. 2020;28(7):1653-61.
  40. Liu C-Y, Yang Y-z, Zhang X-M, Xu X, Dou Q-L, Zhang W-W, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiology & Infection. 2020; 148.
  41. Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses’ knowledge and anxiety toward COVID-19 during the current outbreak in Iran. Archives of Clinical Infectious Diseases. 2020; 15(COVID-19).
  42. Liu C-Y, Yang Y-z, Zhang X-M, Xu X, Dou Q-L, Zhang W-W, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiology & Infection. 2020:1-17.
  43. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry research. 2020:112954.
  44. McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. Journal of psychiatric research. 2011; 45(8): 1027-35.
  45. Su T-P, Lien T-C, Yang C-Y, Su YL, Wang J-H, Tsai S-L, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan. Journal of psychiatric research. 2007;41(1-2):119-30.
  46. Gong Y, Han T, Chen W, Dib HH, Yang G, Zhuang R, et al. Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study. PloS one. 2014;9(7):e103242.
  47. Wipfli BM, Rethorst CD, Landers DM. The anxiolytic effects of exercise: a meta-analysis of randomized trials and dose–response analysis. Journal of Sport and Exercise Psychology. 2008; 30(4): 392-410.
  48. Arabzadeh, E., et al., The relationship between physical activity pre COVID-19 pandemic with mental health, depression, and anxiety in COVID-19 patients: a cross-sectional study. Sport Sciences for Health, 2023.
  49. Bawardi-Shomar Principals' attitudes toward the inclusion of students with disabilities in elementary schools in California 2012.
  50. Zhang Y, Zhao Y, Mao S, Li G, Yuan Y. Investigation of health anxiety and its related factors in nursing students. Neuropsychiatric disease and treatment. 2014; 10: 1223.
Sadra Medical Journal
Volume 11, Issue 3
Summer 2023
Pages 305-320

Article View 26,277
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