Depression, Anxiety and Associated Factors among Frontline Hospital Healthcare Workers in the Fourth Wave of COVID-19: Empirical Findings from Vietnam

(1) Background: This study aims to assess the magnitude of, and factors associated with, depression and anxiety among Vietnamese frontline hospital healthcare workers in the fourth wave of COVID-19; (2) Methods: A hospital based cross-sectional study was carried out within two weeks, October 2020, at a central COVID-19 treatment hospital. Depression and anxiety were measured with PHQ-9 and GAD-7, respectively. Bivariate and multivariate logistic regression analysis were applied to recognize variables related to depression and anxiety, respectively; (3) Results: Among 208 frontline hospital healthcare workers, overall prevalence of depressive symptoms, anxiety symptoms, and both symptoms of depression and anxiety was 38.94%, 25.48% and 24.04%, respectively, in healthcare workers. In a reduced model after using multivariate stepwise logistic regression, age (OR = 0.9, p = 0.001), marital status (OR = 7.84, p = 0.027), profession (OR = 0.39, p = 0.028), having experienced traumatic stress following a work event (OR = 46.24, p < 0.001), feeling at very high risk for COVID-19 (OR = 0.02, p < 0.04), and affected by workplace conditions (OR = 5.36, p < 0.001) were associated with the symptoms of depression. With regard to symptoms of anxiety, single status (OR: 12.18, p = 0.002), being medical technician (OR: 68.89, p < 0.001), alcohol use (OR: 6.83, p = 0.014), using pain relief medications (OR: 25.50, p = 0.047), having experienced traumatic stress following a family event (OR: 130.32, p = 0.001), having experienced traumatic stress following a work event (OR: 181.55, p = 0.002), reporting at very high risk for COVID-19 (OR: 29.64, p = 0.011), treating moderate (OR: 6.46, p = 0.038) and severe (OR: 18.96, p = 0.004) COVID-19 patients, and being significantly affected by the community (OR: 6.33, p = 0.003) were increased risk factors for the symptoms of anxiety. Meanwhile, those living with 4–5 people (OR: 0.15, p = 0.011), specializing in infectious disease (OR: 0.13, p = 0.044)/resuscitation and emergency medicine (OR: 0.04, p = 0.046), and having knowledge preparation before participating in COVID-19 (OR: 0.008, p = 0.014) were less associated with the symptoms of anxiety; (4) Conclusions: There was a relatively high prevalence among Vietnamese hospital healthcare workers exhibiting symptoms of depression and anxiety during the ongoing pandemic. Greater attention to training in psychological skills should be suggested for those belonging to a younger age group, being single/widowed/divorced, treating moderate and severe COVID-19 patients, feeling at very high risk for COVID-19, being significantly affected a lot the community or workplace conditions, or experiencing traumatic stress following a family/work event in the past week.

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Symptoms of Depression and Anxiety, and Screening for Mental Disorders in Migrainous Patients

Cephalalgia ◽

10.1046/j.1468-2982.2003.00461.x ◽

2003 ◽

Vol 23 (2) ◽

pp. 79-89 ◽

Cited By ~ 12

Author(s):

F Kowacs ◽

MP Socal ◽

SC Ziomkowski ◽

VF Borges-Neto ◽

DP Toniolo ◽

...

Keyword(s):

Logistic Regression ◽

Mental Disorders ◽

Healthy Subjects ◽

Univariate Analysis ◽

Cross Sectional Study ◽

Depression And Anxiety ◽

Sectional Study ◽

Cross Sectional ◽

Symptoms Of Depression ◽

Gender Education

The purpose of this clinic-based study was the assessment of symptoms of depression, anxiety, and non-specific psychiatric disorders amongst patients with migraine, compared with healthy subjects and with individuals with a non-neurological chronic disease. A cross-sectional study was carried out in which 178 individuals (migraine 51; psoriasis 35; healthy 92) were submitted to three scales: MADRS (depression), STAI-T (anxiety) and SRQ (screening for mental disorders). The subjects with migraine and psoriasis were from the Out-patient Clinics of Headache and of Dermatology, and the healthy volunteers were persons who were accompanying out-patients in the same hospital. Scores were analysed by MANOVA and by association analysis and logistic regression. Scores of all instruments were higher in the migrainous group, but the univariate analysis of association (using cut-offs) showed significance only for suspicion of mental disorders (SRQ). By logistic regression, variables with strongest association to migraine were gender, education, and SRQ in decreasing order.

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Effects of a High Dose of the Contrast Medium Iodixanol on Renal Function in Patients Following Percutaneous Coronary Intervention

Angiology ◽

10.1177/0003319720953044 ◽

2020 ◽

pp. 000331972095304

Author(s):

Ning Zhao ◽

Zaiyan Chen ◽

Yinpin Zhou ◽

Qiang Xu ◽

Zhonglin Xu ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Logistic Regression ◽

Renal Function ◽

Regression Analysis ◽

High Risk ◽

Logistic Regression Analysis ◽

Coronary Intervention ◽

High Dose ◽

Percutaneous Coronary ◽

Very High

Iodixanol is associated with lower rates of contrast-induced acute kidney injury (CI-AKI). However, the effects of high volumes of iodixanol on renal function after percutaneous coronary intervention (PCI) have not been fully elucidated. This study evaluates the effects of high-dose (>300 mL) iodixanol on renal function within 72 hours of PCI. We retrospectively reviewed 676 consecutive patients who received high-dose (>300 mL) iodixanol during PCI between October 2015 and December 2017 in 4 centers. Logistic regression analysis was used to identify significant independent predictors for CI-AKI. The incidence of CI-AKI was 3.5% (23/651). In patients administered 300 to 500 mL and >500 mL iodixanol, the incidence of CI-AKI was 3.9% and 1.7%, respectively. In patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, the incidence of CI-AKI was 2.6%. In high-risk and very high-risk patients, stratified by the Mehran risk score, the incidence of CI-AKI was 3.3% and 4.3%, respectively. In patients received high-dose iodixanol (>300 mL), logistic regression analysis demonstrated that female sex, chronic kidney disease, and eGFR were independent risk factors for CI-AKI, but contrast volume was not. The administration of high (300-500 mL) and very high (>500 mL) dose of iodixanol is associated with low rates of CI-AKI.

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Depressive and Anxiety Symptoms Among People Under Quarantine During the COVID-19 Epidemic in China: A Cross-Sectional Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.566241 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tong Yan ◽

Wang Zhizhong ◽

Zheng Jianzhong ◽

Ying Yubo ◽

Liu Jie ◽

...

Keyword(s):

High Risk ◽

Online Survey ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Middle School Education ◽

Depression And Anxiety ◽

Cross Sectional ◽

Symptoms Of Depression ◽

Patient Health ◽

Effective Public Health

Background: During the coronavirus disease 2019 (COVID-19) pandemic, quarantine as an effective public health measure has been widely used in China and elsewhere to slow down the spread, while high-risk psychological response populations remain under-reported.Objective: The aim of the study is to investigate the depressive and anxiety symptoms among the high-risk individuals quarantined during the COVID-19 pandemic in China.Methods: An online survey was conducted from February 29 to April 10, 2020, among individuals quarantined for at least 2 weeks due to the high-risk exposure. Chinese versions of the nine-item Patient Health Questionnaire (PHQ-9) with a seven-item Generalized Anxiety Disorder (GAD-7) were applied to assess depressive and anxiety symptoms, respectively. Compliance with quarantine and knowledge of COVID-19 was also assessed. An unconditional logistic regression model was performed to identify the correlators.Results: Of the 1,260 participants completing the full survey, 14.0% (95% CI: 12.2–16.1%), 7.1% (95% CI: 5.9–8.7%), and 6.3% (95% CI: 5.1–7.8%) had at least moderate symptoms of depression, anxiety, and a combination of depression and anxiety (CDA), respectively; 14.8% (95% CI: 13.0–16.9%) had at least one condition. Multivariate analysis showed that participants with an undergraduate or above degree were more likely to report depressive (OR = 2.98, 95% CI: 1.56–5.72) and anxiety symptoms (OR = 2.95, 95% CI: 1.14–7.63) than those with middle school education. Those who were unemployed (OR = 0.37, 95% CI: 0.21–0.65 for depression; OR = 0.31, 95% CI: 0.14–0.73 for anxiety), students (OR = 0.14, 95% CI: 0.04–0.48 for depression; OR = 0.11, 95% CI: 0.01–0.85 for anxiety), and more knowledgeable of COVID-19 (OR = 0.84, 95% CI: 0.73–0.96 for depression, OR = 0.82, 95% CI: 0.68–0.98 for anxiety) were less likely to report depressive and anxiety symptoms. Higher quarantine compliance correlated with lower risks of depressive (OR = 0.94, 95% CI: 0.91–0.96) and anxiety symptoms (OR = 0.95, 95% CI: 0.91–0.98).Conclusion: Individuals under quarantine during the COVID-19 pandemic suffered prevalent depressive and anxiety symptoms. Consequently, comprehensive interventional measures, including knowledge dissemination, timely virus tests, and strengthened communication, may minimize quarantine's adverse effects.

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Effects of a Brief Electronic Mindfulness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Women: Exploratory Pilot Study (Preprint)

10.2196/preprints.17593 ◽

2019 ◽

Author(s):

Maren Goetz ◽

Claudia Schiele ◽

Mitho Müller ◽

Lina M Matthies ◽

Thomas M Deutsch ◽

...

Keyword(s):

Pilot Study ◽

High Risk ◽

Anxiety Disorders ◽

Pregnant Women ◽

Depression And Anxiety ◽

Cutoff Value ◽

Symptoms Of Depression ◽

Peripartum Depression ◽

Anxiety Levels ◽

Related Stress

BACKGROUND Peripartum depression and anxiety disorders are highly prevalent and are correlated with adverse maternal and neonatal outcomes. Antenatal care in Germany does not yet include structured screening and effective low-threshold treatment options for women facing peripartum depression and anxiety disorders. Mindfulness-based interventions (MBIs) are increasingly becoming a focus of interest for the management of such patients. Studies have shown a decrease in pregnancy-related stress and anxiety in expectant mothers following mindfulness programs. OBJECTIVE The aim of this study was to explore the clinical effectiveness of a 1-week electronic course of mindfulness on prenatal depression and anxiety in hospitalized, high-risk pregnant women. We hypothesized that participating in a 1-week electronic MBI (eMBI) could alleviate symptoms of depression and anxiety during the hospital stay. METHODS A prospective pilot study with an explorative study design was conducted from January to May 2019 in a sample of 68 women hospitalized due to high-risk pregnancies. After enrolling into the study, the participants were given access to an eMBI app on how to deal with stress, anxiety, and symptoms of depression. Psychometric parameters were assessed via electronic questionnaires comprising the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-S), and abridged version of the Pregnancy-Related Anxiety Questionnaire (PRAQ-R). RESULTS We observed a high prevalence of peripartum depression and anxiety among hospitalized high-risk pregnant women: 39% (26/67) of the study participants in the first assessment and 41% (16/39) of the participants in the second assessment achieved EPDS scores above the cutoff value for minor/major depression. The number of participants with anxiety levels above the cutoff value (66% [45/68] of the participants in the first assessment and 67% [26/39] of the participants in the second assessment) was significantly more than that of the participants with anxiety levels below the cutoff value, as measured with the STAI-S. After completing the 1-week electronic course on mindfulness, the participants showed a significant reduction in the mean state anxiety levels (<i>P</i><.03). Regarding pregnancy-related anxiety, participants who completed more than 50% of the 1-week course showed lower scores in PRAQ-R in the second assessment (<i>P</i><.05). No significant changes in the EPDS scores were found after completing the intervention. CONCLUSIONS Peripartum anxiety and depression represent a relevant health issue in hospitalized pregnant patients. Short-term eMBIs could have the potential to reduce anxiety levels and pregnancy-related anxiety. However, we observed that compliance to eMBI seems to be related to lower symptoms of pregnancy-related stress among high-risk patients. eMBIs represent accessible mental health resources at reduced costs and can be adapted for hospitalized patients during pregnancy.

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Effects of a Brief Electronic Mindfulness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Women: Exploratory Pilot Study

Journal of Medical Internet Research ◽

10.2196/17593 ◽

2020 ◽

Vol 22 (8) ◽

pp. e17593

Author(s):

Maren Goetz ◽

Claudia Schiele ◽

Mitho Müller ◽

Lina M Matthies ◽

Thomas M Deutsch ◽

...

Keyword(s):

Pilot Study ◽

High Risk ◽

Anxiety Disorders ◽

Pregnant Women ◽

Depression And Anxiety ◽

Cutoff Value ◽

Symptoms Of Depression ◽

Peripartum Depression ◽

Anxiety Levels ◽

Related Stress

Background Peripartum depression and anxiety disorders are highly prevalent and are correlated with adverse maternal and neonatal outcomes. Antenatal care in Germany does not yet include structured screening and effective low-threshold treatment options for women facing peripartum depression and anxiety disorders. Mindfulness-based interventions (MBIs) are increasingly becoming a focus of interest for the management of such patients. Studies have shown a decrease in pregnancy-related stress and anxiety in expectant mothers following mindfulness programs. Objective The aim of this study was to explore the clinical effectiveness of a 1-week electronic course of mindfulness on prenatal depression and anxiety in hospitalized, high-risk pregnant women. We hypothesized that participating in a 1-week electronic MBI (eMBI) could alleviate symptoms of depression and anxiety during the hospital stay. Methods A prospective pilot study with an explorative study design was conducted from January to May 2019 in a sample of 68 women hospitalized due to high-risk pregnancies. After enrolling into the study, the participants were given access to an eMBI app on how to deal with stress, anxiety, and symptoms of depression. Psychometric parameters were assessed via electronic questionnaires comprising the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-S), and abridged version of the Pregnancy-Related Anxiety Questionnaire (PRAQ-R). Results We observed a high prevalence of peripartum depression and anxiety among hospitalized high-risk pregnant women: 39% (26/67) of the study participants in the first assessment and 41% (16/39) of the participants in the second assessment achieved EPDS scores above the cutoff value for minor/major depression. The number of participants with anxiety levels above the cutoff value (66% [45/68] of the participants in the first assessment and 67% [26/39] of the participants in the second assessment) was significantly more than that of the participants with anxiety levels below the cutoff value, as measured with the STAI-S. After completing the 1-week electronic course on mindfulness, the participants showed a significant reduction in the mean state anxiety levels (P<.03). Regarding pregnancy-related anxiety, participants who completed more than 50% of the 1-week course showed lower scores in PRAQ-R in the second assessment (P<.05). No significant changes in the EPDS scores were found after completing the intervention. Conclusions Peripartum anxiety and depression represent a relevant health issue in hospitalized pregnant patients. Short-term eMBIs could have the potential to reduce anxiety levels and pregnancy-related anxiety. However, we observed that compliance to eMBI seems to be related to lower symptoms of pregnancy-related stress among high-risk patients. eMBIs represent accessible mental health resources at reduced costs and can be adapted for hospitalized patients during pregnancy.

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Impact of COVID-19 on the Mental Health of Healthcare Workers: A Cross-Sectional Study From Pakistan

Frontiers in Public Health ◽

10.3389/fpubh.2021.603602 ◽

2021 ◽

Vol 9 ◽

Author(s):

Khezar Hayat ◽

Muhammad Arshed ◽

Iqra Fiaz ◽

Urooj Afreen ◽

Faiz Ullah Khan ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Online Survey ◽

Negative Impact ◽

Transmission Rate ◽

Vulnerable Groups ◽

Depression Symptoms ◽

Depression And Anxiety ◽

Cross Sectional ◽

Symptoms Of Depression

Background: The novel coronavirus (COVID-19) pandemic has significantly increased the rate of mortality and morbidity worldwide due to its rapid transmission rate. The mental health status of individuals could have a negative impact attributed to this global situation. Therefore, this study was intended to explore the symptoms of depression and anxiety among healthcare workers (HCWs) of Pakistan during the ongoing COVID-19 pandemic.Methods: A cross-sectional survey was undertaken by administering a web-based questionnaire between May and June 2020. Two tools, including the Patient Health Questionnaire (PHQ9) and Generalized Anxiety Disorder-7 (GAD-7), were employed to measure anxiety and depression symptoms among HCWs. The data analyses were carried out using descriptive statistics, Man Whitney, and Kruskal Wallis tests.Results: Of 1094 HCWs who participated in this online survey, 742 (67.8%) were physicians, followed by nurses (n = 277, 25.3%) and pharmacists (n = 75, 6.9%). The survey respondents had a median depression and anxiety score of 5.00 (7.00–3.00) and 8.00 (11.00–5.00), respectively. A considerable number of HCWs (82.2%) utilized online psychological resources to deal with their psychological distress. Female HCWs, nurses, frontline HCWs, and HCWs aged 30–49 years were more likely to suffer from depression and anxiety (p < 0.05).Conclusion: During the recent ongoing pandemic of COVID-19, there is a mild level of symptoms of depression and anxiety among HCWs. Our findings call for urgent psychological interventions for vulnerable groups of Pakistani HCWs.

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Rise in Use of Digital Mental Health Tools and Technologies in the United States During the COVID-19 Pandemic: Survey Study (Preprint)

10.2196/preprints.26994 ◽

2021 ◽

Author(s):

Dara H Sorkin ◽

Emily A Janio ◽

Elizabeth V Eikey ◽

Margaret Schneider ◽

Katelyn Davis ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Logistic Regression ◽

Regression Models ◽

The United States ◽

Clinical Depression ◽

Depression And Anxiety ◽

Logistic Regression Models ◽

Symptoms Of Depression ◽

Time Point

BACKGROUND Accompanying the rising rates of reported mental distress during the COVID-19 pandemic has been a reported increase in the use of digital technologies to manage health generally, and mental health more specifically. OBJECTIVE The objective of this study was to systematically examine whether there was a COVID-19 pandemic–related increase in the self-reported use of digital mental health tools and other technologies to manage mental health. METHODS We analyzed results from a survey of 5907 individuals in the United States using Amazon Mechanical Turk (MTurk); the survey was administered during 4 week-long periods in 2020 and survey respondents were from all 50 states and Washington DC. The first set of analyses employed two different logistic regression models to estimate the likelihood of having symptoms indicative of clinical depression and anxiety, respectively, as a function of the rate of COVID-19 cases per 10 people and survey time point. The second set employed seven different logistic regression models to estimate the likelihood of using seven different types of digital mental health tools and other technologies to manage one’s mental health, as a function of symptoms indicative of clinical depression and anxiety, rate of COVID-19 cases per 10 people, and survey time point. These models also examined potential interactions between symptoms of clinical depression and anxiety, respectively, and rate of COVID-19 cases. All models controlled for respondent sociodemographic characteristics and state fixed effects. RESULTS Higher COVID-19 case rates were associated with a significantly greater likelihood of reporting symptoms of depression (odds ratio [OR] 2.06, 95% CI 1.27-3.35), but not anxiety (OR 1.21, 95% CI 0.77-1.88). Survey time point, a proxy for time, was associated with a greater likelihood of reporting clinically meaningful symptoms of depression and anxiety (OR 1.19, 95% CI 1.12-1.27 and OR 1.12, 95% CI 1.05-1.19, respectively). Reported symptoms of depression and anxiety were associated with a greater likelihood of using each type of technology. Higher COVID-19 case rates were associated with a significantly greater likelihood of using mental health forums, websites, or apps (OR 2.70, 95% CI 1.49-4.88), and other health forums, websites, or apps (OR 2.60, 95% CI 1.55-4.34). Time was associated with increased odds of reported use of mental health forums, websites, or apps (OR 1.20, 95% CI 1.11-1.30), phone-based or text-based crisis lines (OR 1.20, 95% CI 1.10-1.31), and online, computer, or console gaming/video gaming (OR 1.12, 95% CI 1.05-1.19). Interactions between COVID-19 case rate and mental health symptoms were not significantly associated with any of the technology types. CONCLUSIONS Findings suggested increased use of digital mental health tools and other technologies over time during the early stages of the COVID-19 pandemic. As such, additional effort is urgently needed to consider the quality of these products, either by ensuring users have access to evidence-based and evidence-informed technologies and/or by providing them with the skills to make informed decisions around their potential efficacy.

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P1554Is self-reported sleep-disordered breathing associated with increased cardiovascular risk?

European Heart Journal ◽

10.1093/eurheartj/ehz748.0314 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

L Korostovtseva ◽

O Rotar ◽

A Alieva ◽

M Bochkarev ◽

M Boyarinova ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cardiovascular Risk ◽

Sleep Apnea ◽

High Risk ◽

Sleep Disordered Breathing ◽

Population Based ◽

Chi Square ◽

Very High ◽

Score Risk

Abstract Background Sleep-disordered breathing (SDB) is associated with the increased cardiovascular (CV) morbidity and mortality. However, sleep apnea is not considered in the standard scales used for the risk stratification. Purpose We evaluated the association between self-reported SDB and SCORE risk (the 10-year risk of fatal CV events according to the systemic coronary risk evaluation) in the population-based sample from St Petersburg. Methods We selected 1555 subjects without previously known CV events (550 males, 35%; mean age 46.7±11.6 years old) out of 1600 participants of the population-based sample (from the epidemiological study ESSE-RF, St Petersburg). All subjects were interviewed (questions about lifestyle, medical history, complaints) using standard questionnaire. We assessed self-reported snore (“Do you snore?”) and sleep apnea (“Do you have sleep apneas?”). Affirmative response was considered diagnostic. Daytime sleepiness was assessed based on the answers >3 times/week to the question “How often have you been unable to refrain sleeping when required?”. The 10-year risk of fatal CV events was assessed by the SCORE high-risk charts calculator. For statistical analysis we used parametric statistics, frequency and contingency analyses (Chi-square), multiple logistic regression analysis (stepwise inclusion; the parameters not evaluated in the SCORE scale were considered, i.e. body mass index, glucose level, triglyceride, HDL-cholesterol, creatinine, C-reactive protein, self-reported insomnia). Results Based on the SCORE assessment the participants were divided as following: low risk (<1%) was the most predominant category (n=864, 55.6%); moderate risk (≥1% and <5%) was found in 468 (30.1%), high risk (5–10%) – in 184 (11.8%), and very high risk – in 39 (2.5%) subjects. In total, 740 (47.6%) subjects had snoring, while only 77 (5%) subjects reported sleep apneas. Neither self-reported snoring nor sleep apnea were associated with daytime sleepiness (p>0.05). High-to-very-high SCORE risk was found more often in subjects with self-reported snoring compared to non-snorers: 21.2% vs. 8.1%, respectively (Chi-square=54.3, p<0.001). At the same time no association was found between self-reported sleep apneas and cardiovascular risk. Logistic regression demonstrated an association between SCORE risk and self-reported snoring (OR=3.06 95% CI 2.25–4.16, p<0.001). Multiple regression analysis confirmed the impact of snoring in the increased SCORE risk (OR=2.16 95% CI 1.55–3.02, p<0.001) after adjustment for the other factors. Conclusions Our study demonstrated that in Russian population-based sample self-reported snoring (unlike self-reported sleep apnea) is associated with the increased 10-year risk of fatal CV events. The lack of association between SCORE risk and sleep apnea might be related to the subjective assessment based on the questionnaire. Acknowledgement/Funding The study was supported by the Grant of the President of Russian Federation for the Leading Scientific Schools of Russia (agreement No. 075-02-2018-57,

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Psychological impact of COVID-19 pandemic among healthcare workers in Paraguay: A descriptive and preliminary study

Medicina Clínica y Social ◽

10.52379/mcs.v4i3.156 ◽

2020 ◽

Vol 4 (3) ◽

pp. 93-97

Author(s):

Jorge Villalba-Arias ◽

Gladys Estigarribia ◽

José Andrés Bogado ◽

Julieta Méndez ◽

Santiago Toledo ◽

...

Keyword(s):

Psychological Distress ◽

Traumatic Stress ◽

Work Experience ◽

Healthcare Workers ◽

Demographic Data ◽

Psychological Impact ◽

Post Traumatic Stress ◽

Cross Sectional ◽

Symptoms Of Depression ◽

Post Traumatic

Introduction: Healthcare workers exposed to SARS-CoV-2 are vulnerable to psychological distress. The goal of this study is to evaluate the psychological impact of exposure to the SARS-CoV-2 among healthcare workers in Paraguay. Methodology: A descriptive cross-sectional study was carried out in 5 tertiary hospitals in the Central, San Pedro and Caaguazú Departments of Paraguay during the COVID-19 pandemic from April to June 2020. The pilot study included 125 healthcare workers as participants, 25 for each hospital. Demographic data and occupational exposure data were collected with an ad-hoc questionnaire. Symptoms of depression and anxiety were evaluated employing the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder scale-7. The prevalence of post-traumatic stress was determined using the Post-Traumatic Stress Disorder Check List-C. Results: Of the 125 participants, 68 (54.8%) were doctors, 37 (29.8) nurses, 7 (5.6%) biochemists, 3 (2.4%) obstetricians, and 9 (7.3%) other healthcare workers. Most participants were females (86 [68.8%]), with an average age of 33.8 years (SD ± 7.4), single (71 [56.8%]), with a postgraduate educational level (83 [66.4%]), and reporting a junior level of work experience (52 [41.6%]). A total of 71 (57.3%) were classified as high-risk healthcare workers after exposure to SARS-CoV-2. 61 (48.8%) of participants presented symptoms of depression, and 68 (54.4%) presented symptoms of anxiety. A small group reported symptoms of post-traumatic stress (9 [7.2%]). Conclusion: Healthcare workers in Paraguay reported a significant prevalence of depressive and anxious symptoms during the COVID-19 pandemic. These findings lend support to the idea that healthcare workers are vulnerable to psychological distress and that they may require specific mental health interventions.

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Facilitators and Barriers to Detection and Treatment of Depression, Anxiety and Experiences of Domestic Violence in Pregnant Women Attending Midwife Obstetric Units (MOUs) in Cape Town, South Africa: A Qualitative Study

10.21203/rs.3.rs-512424/v3 ◽

2021 ◽

Author(s):

Zulfa Abrahams ◽

Sonet Boisits ◽

Marguerite Schneider ◽

Simone Honikman ◽

Crick Lund

Keyword(s):

South Africa ◽

Domestic Violence ◽

Pregnant Women ◽

Healthcare Workers ◽

Service Providers ◽

Qualitative Interviews ◽

Service Users ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

Facilitators And Barriers

Abstract Background In South Africa, symptoms of common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period and linked to experiences of domestic violence. However, limited routine detection and treatment is available to pregnant women with these problems, even though evidence suggests that screening and treating CMDs during pregnancy improves the health and economic outcomes of mothers and their children, and has been suggested as a key approach to improving the health of perinatal women and children. We investigated facilitators and barriers of service-providers and service-users in detecting and treating pregnant women with symptoms of CMDs and experiences of domestic violence. Methods This study was conducted in four midwife obstetric units (MOUs) in Cape Town, South Africa, and in the NPOs providing community-based support in the communities surrounding the MOUs. Service-provider perspectives were informed by qualitative interviews with 37 healthcare workers providing care to pregnant women. Qualitative interviews with 38 pregnant women attending the same MOUs for their first antenatal care visit provided service-user perspectives. Results Facilitators identified included the availability of a mental health screening questionnaire and the perceived importance of detection and treatment by both service-providers and -users. Barriers contributing to the low detection rates included service-users concerns about the lack of confidentiality and feelings of shame related to experiences of domestic violence as well as service providers discomfort in dealing with mental health issues, their limited time available and heavy patient load. In addition, service-providers highlighted the lack of standardised referral pathways and the poor uptake of referrals by women with symptoms of depression and anxiety, or experiences of domestic violence Conclusions While the system-level barriers need to be addressed at a policy level, the patient- and provider-level barriers identified indicate the need to strengthen health systems by training antenatal care nurses to detect symptoms of CMDs and experiences of domestic violence in pregnant women, developing standardised referral pathways and training lay healthcare workers to provide treatment for mild symptoms of depression and anxiety.

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