Comparison of COVID Anxiety Among Nurses Working in Clinical Wards and Operating Rooms

Received: 15-Dec-2021, Manuscript No. CSRP-21-49935; Editor assigned: 17-Dec-2021, Pre QC No. CSRP-21-49935(PQ); Reviewed: 31-Dec-2021, QC No. CSRP-21-49935; Revised: 05-Jan-2022, Manuscript No. CSRP-21-49935(R); Published: 12-Jan-2022, DOI: 10.3371/CSRP.AMNB.011222

Introduction

COVID-19 is an infectious disease caused by Coronavirus 2 (SARSCoV-2), which was first identified in Wuhan, China in 2019 and quickly became a global pandemic [1-3]. The World Health Organization declared this virus a new coronavirus in January 12, 2020. As the disease continued, it was officially named COVID-19 in February 11, 2020 [4]. In January 30, 2020 it was also declared as a public health emergency and a global concern by WHO [5], as it was high contagious and able to quickly infect people in the world [6]. By March 30, 2020, more than 204 countries had been infected by the disease [7]. According to the WHO report on August 22, 23 million people had been infected by the disease in the world [8], and on March 5, 2020, the number of deaths due to COVID-19 was 95,122, accounting for 3% of all deaths in the world [9].

Nurses and medical staff are exposed to the highest levels of stress and anxiety as they provide the first line of care for COVID patients [10]. Exacerbation of these stresses causes chronic anxiety and stress that reduces coping skills [11]. Stressful work environment along with the high workload have a negative effect on the health and well-being of medical staff and nurses caring for COVID patients [12]. Nurses are also more vulnerable to infection due to the close contact they have with COVID patients and also, they can spread the virus among colleagues and family members [13]. Lack of personal protective equipment can lead to illness among nurses when they provide care for patients with COVID-19, and this keeps them away from work at least for fourteen days. This also leads to staff shortages, increased workload and excessive fatigue among them [14]. The level of anxiety in nurses is higher than others due to fear of transmitting the disease to family members and relatives [15]. Operation room nurses are also exposed to stressors due to their close contact with patients [16]. Studies show that the level of stress in operation room nurses is higher than clinical nurses working in other departments, and ICU nurses in particular [17].

Studies show that COVID anxiety in operating room and anesthesia nurses is higher than nurses working in other departments [18]. Therefore, the researcher decided to conduct this study with the aim of comparing COVID anxiety between clinical nurses and operating room nurses.

Methods

This descriptive-comparative study was conducted on nurses working in hospital wards and operating rooms in Golestan province in 2020. The environment of this study included medical wards, gynecology departments, emergency rooms, ICUs and operating rooms of hospitals in Golestan province. The sample in this study was determined to be 135 nurses, who had been selected by convenience sampling method among all nurses working in the operating room and wards of hospitals in Golestan province (65 operating room nurses and 65 ward nurses). Inclusion criteria were; nurses with 1 year of work experience, lack of chronic mental illness, and working in the hospital for the last 6 months. Exclusion criterion was; nurses with more than 1 month of sick leave due to pregnancy or other illnesses. Data collection tools included demographic information form and Corona Disease Anxiety Scale (CDAS), which was designed by Alipour et al., In Iran. This scale contains of 18 questions (the first 9 questions are related to psychological symptoms and the second 9 questions are related to physical symptoms). In this scale, scoring is based on Likert’s scale ranging from Never (0), Sometimes (1), Most of the time (2), and Always (3). The final score is between 0 and 54 with higher score indicating higher COVID anxiety [19]. The reliability of this tool in the study of Alipour et al., was 0.87 and 0.86 for the first and second parts and 0.091 for the whole questionnaire using Cronbach’s alpha. The validity of this tool has also been confirmed by exploratory and confirmatory factor analysis (19). The reliability of this questionnaire was confirmed in the Einey et al., study with a Cronbach's alpha coefficient of 0.93 [20].

This study was approved by the Research Committee of Islamic Azad University of Chalouse and ethics code was obtained. The researcher also obtained permission from hospitals’ officials and then attended the setting for data collection. First he/she explained the method and objectives of study to the participants and ensured them that this research is anonymous and safe. The participants were also informed that they can withdraw from the study at any time. Then, the researcher sent the questionnaires to the operating room and ward nurses, and after being completed by self- reporting method, collected them. The collected data were entered into SPSS-21 software for analysis using descriptive (mean and standard deviation) and inferential statistics (paired t-test, U Mann-Whitney) at a significant level of 0.05.

Results

Statistical test did not show a significant deference between the two groups of nurses (operating room and ward nurses) in terms of demographic characteristics. Chi-square test also did not show a significant difference between the two groups in terms of age (p=0.12), gender (p=0.42), marital status (p=0.28) and work experience (p=0.21), (Table 1).

The mean score of COVID anxiety was 30.33 ± 7.83 for the ward nurses and 31.11 ± 8.03 for the operating room nurses, and independent t-test showed no significant difference between the two groups in this regard (p=0.68).

A significant difference was observed between COVID anxiety score and demographic characteristics such as gender (p=0.01) and work experience (p=0.002), (Table 2).

Discussion

Results of this study showed no significant difference between COVID anxiety of operating room nurses and medical/surgical ward nurses. Similar studies have not been performed to compare COVID anxiety between operating room nurses and ward nurses. Also in Iran, few studies have been conducted on COVID stress and anxiety of nursing staff. Asadi et al., did not show a significant relationship between COVID anxiety and nurses’ working place in hospital [21].

Sarboozi Hosein Abadi, reported the rate of stress, depression and anxiety of nurses at above average (5). In general, hospitalization causes stress [22]. Rahmani , reported the anxiety level of nurses at moderate (38.2%) and severe (11.2%) levels. He also showed a significant relationship between COVID anxiety and burnout [23]. Einey, showed high levels of COVID anxiety among nursing staff [24].

Mokhtari et al., reported the level of COVID anxiety among intensive care unit nurses at 17.2% [25]. Han, in his study showed that all hospital personnel, from physicians and nurses to operating room staff, are exposed to COVID anxiety, which negatively affects their mental health [18]. Most nurses endure high level of stress and anxiety due to factors, such as lack of protective equipment like special masks, being away from family and children, and fear of transferring the disease from hospital to home [26,27].

Nurses and medical staff are under high level of stress due to the fear of COVID-19 and this issue threatens their psychological health and wellbeing [18]. Consistent with most studies conducted on COVID anxiety, in the present study, the rate of COVID anxiety in the two groups was above average.

The results of this study in relation to correlation between COVID anxiety and demographic characteristics showed a significant difference between COVID anxiety, gender and work experience, so that the rate of COVID anxiety was higher in women and those with higher work experience. The rate of COVID anxiety was also higher in female nurses with more work experience in operating room.

Lai, stated that, the level of COVID anxiety in female nurses is higher than male nurses [28]. Ranjbar et al., did not show a significant difference between COVID anxiety and gender [29].

One of the reasons for the high level of COVID anxiety among women could be their higher sensitivity and obsession with health protocols [30]. Women also have more anxious personalities due to their maternal instinct and care more about children and family [31,32].

In the present study, there was a significant relationship between COVID anxiety and work experience, so that nurses with more work experience had higher level of anxiety. The results of other studies also show that older people with more work experience are more anxious, because they care about their children and family [21]. Sarboozi Hosein Abadi, also did not show a significant difference between work experience and COVID anxiety in nurses [5]. This is while, a direct relationship has been reported between age, general health and anxiety level in nurse, so that the more work experience they have, the higher their adaptive skills become [5,33].

Overall, the results of this study showed that hospital staff suffers more psychological stress due to working in critical conditions such as observing patients' deaths, high hospitalization rate, long work shifts, being away from family and worrying about transmitting the disease to family members [21]. It is necessary for hospital and health officials to reduce the stress of medical staff by planning special trainings [15]. The use of empowerment programs and coping strategies has an important role in increasing the quality of care and mental health of nurses [34,35].

One of the limitations of this study was its sample size, so future studies are recommended to use more samples.

Conclusion

Since medical staff suffers from COVID anxiety, health managers and stakeholders are expected to promote the mental health of medical staff and promote nursing care by providing counseling programs and stress management classes, along with understanding and paying attention to the psychological and physical needs of medical staff.

Acknowledgment

With special thanks to Dr. Hamid Hojjati for guiding this research project, which was approved by the Research Committee of the Faculty of Medical Sciences at the Islamic Azad University, Aliabad Kotoul Branch, with the code number: IR.IAU.CHALUS.REC.1399.021.

References

1. Chen, Yiyin, Sabra L Klein, Brian T Garibaldi and Huifen Li, et al. “Aging in COVID-19: Vulnerability, Immunity and Intervention.” Ageing Res Rev 65 (2021): 101205.

   [Crossref] [Goggle Scholar] [Pubmed]

2. Wollina, Uwe. “Challenges of COVID-19 Pandemic for Dermatology”. Dermatol Ther 33 (2020): e13430.

   [Crossref] [Goggle Scholar] [Pubmed]

3. Hsih WH, Cheng MY, Ho MW, and Chou CH Lin PC, et al. “Featuring COVID-19 Cases via Screening Symptomatic Patients with Epidemiologic Link During Flu Season in a Medical Center of Central Taiwan.” J Microbiol Immunol Infect 53 (2020):S1684-182.

   [Crossref] [Goggle Scholar] [Pubmed]

4. Jahanpeyma, Parinaz, Afzal Shamsi, Rahim Nejad Rahim and Kooros Aghazadeh Sarhangipour. “Knowledge of the Covid-19 Virus, from Diagnosis to Prevention and Treatment: A Narrative Review.” Military Caring Sciences Journal 7 (2020): 289-300.

   [Crossref] [Goggle Scholar]

5. Sarboozi Hosein Abadi, Tahere, Mohammadreza Askari, Kheizaran Miri and Mohammad Namazi Nia. “Depression, Stress and Anxiety of Nurses in COVID-19 Pandemic in Nohe-Dey Hospital in Torbat-e-Heydariyeh City, Iran.” Journal Mil Med 22 (2020): 526-533.

   [Crossref] [Goggle Scholar]

6. Shahyad, Shima, and Mohammad Taghi Mohammadi. “Psychological Impacts of Covid-19 Outbreak on Mental Health Status of Society Individuals: A Narrative Review.” J Military Medicine 22 (2020): 184-192.

   [Goggle Scholar]

7. Roy, Deblina, Sarvodaya Tripathy, Sujita Kumar Kar and Nivedita Sharma, et al. “Study of Knowledge, Attitude, Anxiety and Perceived Mental Healthcare Need in Indian Population During COVID-19 Pandemic.” Asian Journal of Psychiatry 51 (2020): 102083.

   [Crossref] [Goggle Scholar] [Pubmed]

8. Kiros, Mulugeta, Henok Andualem, Teklehaimanot Kiros and Wasihun Hailemichael, et al. “COVID-19 Pandemic: Current Knowledge about the Role of Pets and Other Animals in Disease Transmission.” Virol J 17 (2020): 1-8.

   [Crossref] [Goggle Scholar] [Pubmed]

9. Gupta, Ritesh, Amerta Ghosh, Awadhesh Kumar Singh and Anoop Misra. “Clinical Considerations for Patients with Diabetes in Times of COVID-19 Epidemic.” Diabetes and metabolic syndrome 14 (2020): 211.

   [Crossref] [Goggle Scholar] [Pubmed]

10. Xiao, Han, Yan Zhang, Desheng Kong and Shiyue Li, et al. “The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China.” Med Sci Monit 26 (2020): e923549-1.

    [Crossref] [Goggle Scholar] [Pubmed]

11. Khamisa, Natasha, Brian Oldenburg, Karl Peltzer, and Dragan Ilic. “Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses.” Int J Environ Res Public Health 12 (2015): 652-666.

    [Crossref] [Goggle Scholar] [Pubmed]

12.  Vahdat, Sahar. "The Complex Effects of Adipokines in the Patients with Kidney Disease." J Res Med Sci 23 (2018): 60.

    [Crossref] [Goggle Scholar] [Pubmed]

13. Pappa, Sofia, Vasiliki Ntella, Timoleon Giannakas and Vassilis G Giannakoulis, et al. “Prevalence of Depression, Anxiety, and Insomnia among Healthcare Workers during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.” Brain Behav Immun 88 (2020): 901-907.

    [Crossref] [Goggle Scholar] [Pubmed]

14. Zheng, Rujun, Yuhong Zhou, Yan Fu and Qiufen Xiang, et al. “Prevalence and Associated Factors of Depression and Anxiety Among Nurses during the Outbreak of COVID-19 in China: A Cross-Sectional Study.” Int J Nurs Stud 14 (2021): 103809.

    [Crossref] [Goggle Scholar] [Pubmed]

15. Li, Ruilin, Youlin Chen, Jianlin Lv and Linlin Liu, et al. “Anxiety and Related Factors in Frontline Clinical Nurses Fighting COVID-19 in Wuhan.” Medicine 99 (2020): e21413.

    [Crossref] [Goggle Scholar] [Pubmed]

16. Sharafi, Hossein, Parisa Gholami, Susan Sadeghi and Mostafa Ghorbani, et al. “Job Stress and Related Factors Among Staff of the Operation room in Bandar Abbas.” Iranian IJRN 4 (2018): 29-34.

    [Goggle Scholar]

17. Akhavan, Maede, Parand Pourghane, Zeynab Karimi and Fateme Mohseni. “Frequency of Hypochondria Disorder in Operating Room Personnel of Educational Hospitals of Guilan University of Medical Sciences.” Shenakht J Psycho Psychiatry 6 (2019): 83-92.

    [Crossref] [Goggle Scholar]        

18. Li, Xin-yi, Jin Wang, Rui-xian Zhang and Luhua Chen, et al. “Psychological Status Among Anesthesiologists and Operating Room Nurses During the Outbreak Period of COVID-19 in Wuhan, China.” Frontiers in Psychiatry 11 (2020): 1324.

    [Crossref] [Goggle Scholar] [Pubmed]

19. Alipour, Ahmad, Abolfazl Ghadami, Zahra Alipour and Hasan Abdollahzadeh. “Preliminary Validation of the Corona Disease Anxiety Scale (CDAS) in the Iranian Sample.” Quarterly J of Health Psychology 8 (2020): 163-175. [Crossref]

    [Goggle Scholar]

20. Eyni, Sanaz, Matineh Ebadi, and Naghme Torabi. “Developing a Model of Corona Anxiety in Students Based on Optimism and Resilience: The Mediating Role of the Perceived Social Support.” Counseling Culture and Psycotherapy 11 (2020): 1-32.

    [Goggle Scholar]

21. Asadi, Neda, Fatemeh Salmani, Siroos Pourkhajooyi and Masoomeh Mahdavifar, et al. “Investigating the Relationship between Corona Anxiety and Nursing Care Behaviors Working in Corona's Referral Hospitals.” Iranian J of Psychiatry and Clinical Psychology 26 (2020): 306-319.

    [Crossref] [Goggle Scholar]

22. Yolme, Aman Bibi Soltani, Hamid Hojjati, and Golbahar Akhoundzadeh. “The Effect of Islamic Semanticism on Self-Reporting and Lifestyles of Mothers of Adolescents with Thalassemia.” Int J Adolesc Med Health 2020 (2020): 6.

    [Crossref] [Goggle Scholar] [Pubmed]

23. Rahmani, Ramin, Venus Sargazi, Mehdi Shirzaei Jalali and Mohammad Babamiri. “Relationship Between COVID-19-Caused Anxiety and Job Burnout Among Hospital Staff: A Cross-Sectional Study in the Southeast of Iran.” Journal of Occupational Hygiene Engineering 7 (2021): 61-69.

    [Goggle Scholar]

24. Eyni, Sanaz, Matineh Ebadi and Zohreh Hashemi. “Corona Anxiety in Nurses: The Predictive Role of Perceived Social Support and Sense of Coherence.” Iranian Journal of Psychiatry Clinical Psychology 26 (2020): 320-331.

    [Crossref] [Goggle Scholar]

25. Mokhtari, Razieh, Siamak Moayedi, and Mohamad Golitaleb. “COVID-19 Pandemic and Health Anxiety Among Nurses of Intensive Care Units.” Int J Ment Health Nurs 29 (2020): 1275.

    [Crossref] [Goggle Scholar] [Pubmed]

26. Tavakoli, Ahmad, Katayon Vahdat and Mohsen Keshavarz. “Novel Coronavirus Disease 2019 (COVID-19): An Emerging Infectious Disease in the 21st Century.” ISMJ 22 (2020): 432-450.

    [Crossref] [Goggle Scholar]

27. Pradhan, Megha, Alisha Chettri, and Saurabh Maheshwari. "Fear of Death in the Shadow of COVID-19: The Mediating role of Perceived Stress in the Relationship between Neuroticism and Death Anxiety.” Death Studies 16 (2020): 1-5.

    [Crossref] [Goggle Scholar] [Pubmed]

28. Lai, Jianbo, Simeng Ma, Ying Wang and Zhongxiang Cai, et al. “Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.” JAMA Network Open 3 (2020): e203976-e203976.

    [Crossref] [Goggle Scholar] [Pubmed]

29. Hajabadi, Negar Ranjbar, Roya Ebrahimi, Sakine Farhadi and Hojjati Hamid, et al. “The Relationship between Frequency of Prayer and Death Anxiety in Cancer Patients.” Indian Journal of Forensic Medicine Toxicology 14 (2020): 2163-7.

    [Crossref] [Goggle Scholar]

30. Pouyan Fard, Sahar, Amir Abbas Taheri, Mahdiyeh Ghvami and Seyed Mojtaba Ahmadi, et al. “Individual, Gender Differences and Corona: The Relationship between Personality Traits and Gender Differences with Corona Self Care Behaviour.” Shenakht Journal Psychology Psychiatry 7 (2020): 67-77.

    [Crossref] [Goggle Scholar]

31. Sajadi, Hanieh, Golbahar Akhoundzadeh and Hamid Hojjati. “The Effect of Empowerment Program on Participation of Mothers with Premature Infants Hospitalized in Neonatal Intensive Care Unit of Sayyed Shirazi Hospital in Gorgan, in 2018.” Indian Journal of Forensic Medicine Toxicology 14, no. 2 (2020):1269-1276.

    [Crossref] [Goggle Scholar]

32. Hojjati, Hamid, Azam Sarbani and Khalil Alimmohammadzadeh. “The Relationship between Daily Spiritual Experiences and Perceived Stress in the Spouses of War Veterans with Post-Traumatic Stress.” Journal of Military Medicine 19 (2017): 135-142.

    [Goggle Scholar]

33. Hamid, Hojati, Jalalmanesh Shamsolmolok and Fesharaki Mohammad. “Sleeplessness Effect on the General Health of Hospitals Nightshift Nurses in Gorgan, Iran.” 11 (2009): 70-75.

    [Goggle Scholar]

34. Hosseini, Nahid, Golbahar Akhoundzadeh and Hamid Hojjati. “The Effect of Child-Parent Relationship Therapy on Social Skills of Preschool Children: A Semi-Experimental Study.” Int J Adolescent Medicine Health 2019 (2019): 1.

    [Crossref] [Goggle Scholar] [Pubmed]

35. Yazarloo M, Hojjati H and Gharebagh ZA. “The Effect of Spiritual Self-care Education on Stress of Mothers of Premature Infants Admitted to NICU of Hospitals Affiliated to Golestan University of Medical Sciences (2019).” Pakistan J Medical Health Sci 14 (2020): 1615-9.  

    [Goggle Scholar]

Citation: Mazloumi, Amir Hossein, Najimeh Beygi, Fatemeh Talebian and Zhila Fereidouni, et al. "Comparison of COVID Anxiety Among Nurses Working in Clinical Wards and Operating Rooms." Clin Schizophr Relat Psychoses 16S (2022). Doi: 10.3371/CSRP.MANB.011222.

Copyright: © 2022 Mazloumi AH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.