The Psychological Impact of the COVID-19 Pandemic on Health Professionals in Sudan 2020
Keywords:
COVID-19, psychological impact, health workers, Sudan, GAD-7, PHQ-9, IES-R
Abstract
Background: The 2019 novel coronavirus (COVID-19) is highly contagious with pandemic transmission, and is therefore associated with severe health problems and high public anxiety, with healthcare community speculation to be the most distressed because they are at the highest risk of infection. This study aimed to investigate the psychological impact on frontline medical staff in Khartoum state, Sudan, during the COVID-19 pandemic between January and March 2020.
Materials and Methods: Patient Health Questionnaire-9 (PHQ-9) scale, Generalized Anxiety Disorders (GAD-7) scale, and the Revised Impact of Event Scale (IES-R) were used to assess depression, anxiety, and Post-traumatic Stress Disorders (PTSD) on the participants, respectively, through an online questionnaire. The data were analyzed using the Statistical Package for Social Science (SPSS) version 24.
Results: PHQ-9 depression scale showed that 285 (82%) staff members had some degree of depression, with mild depression being the most frequent, seen in 96 (24.2%), whereas, severe depression was found to be more common among the age group between 45 and 65 years and was associated with working in the emergency room (ER) (P = 0.03). The PTSD among our participants was assessed by the IES-R that showed that 116 (29.3%) had subclinical PTSD, 124 (31.3%) had mild PTSD symptoms, 98 (24.7%) had moderate PTSD symptoms, and 58 (14.6%) had severe PTSD symptoms. Also, a statistical association was seen between the IES-R mean score and the age group between 25 and 34 years (P < 0.0001), having a friend or family member infected with the disease (P < 0.0001), and having a history of contact with a positive case of COVID-19 (P < 0.0001). We used GAD-7 anxiety score that showed mild anxiety in 32 (23.2%) participants, moderate anxiety in 53 (13.4%), and severe anxiety 66 (16.7%).
Conclusion: This study aimed to explore the psychological impact of COVID-19 pandemic on medical staff’s perception and its determinants. Most of our participants were found to be suffering from anxiety and depression with combining personal variables and working conditions as predictors.
References
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[2] Phelan, A. L., Katz, R., and Gostin, L. O. (2020). The novel coronavirus originating in Wuhan, China:challenges for global health governance. JAMA, vol. 323, no. 8, pp. 709–710.
[3] WHO. (2020). Novel Coronavirus - China Disease Outbreak News. Retrieved from: https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/
[4] Kalichman, S. C. and Simbayi, L. (2004). Traditional beliefs about the cause of AIDS and AIDS-relatedstigma in South Africa. AIDS Care, vol. 16, no. 4, pp. 572–558.
[5] McAlonan, G. M., Lee, A. M., Lee, A. M., et al. (2007). Immediate and sustained psychological impact ofan emerging infectious disease outbreak on health care workers. The Canadian Journal of Psychiatry,vol. 52, no. 5, pp. 241–247.
[6] Tiong, W. W. and Koh, G. C. H. (2013). Ethical considerations in the review of Singapore’s H1N1 pandemicresponse framework in 2009. Annals of the Academy of Medicine of Singapore, vol. 42, no. 5, pp.246–250.
[7] Chong, M. Y., Wang, W. C., Hsieh, W. C., et al. (2004). Psychological impact of severe acute respiratorysyndrome on health workers in a tertiary hospital. British Journal of Psychiatry, vol. 185, no. 2, pp.127–133.
[8] Sim, K. and Chua, H. C. (2004). The psychological impact of SARS: a matter of heart and mind. CanadianMedical Association Journal, vol. 170, no. 5, pp. 811–812.
[9] WHO. (2003). Summary Table of SARS Cases By Country, 1 November 2002–7 August 2003. Geneva,CH: WHO.
[10] SARS Commission. (2006). Spring of Fear, Volumes 1, 2 and 3. Toronto, ON: SARS Commission (Canada).
[11] Naushad, V. A., Bierens, J. J., Nishan, K. P., et al. (2019). A systematic review of the impact of disasteron the mental health of medical responders. Prehospital and Disaster Medicine, vol. 34, no. 6, pp.632–643.
[12] Hall, R. C. W., Hall, R. C. W., and Chapman, M. J. (2008). The 1995 Kikwit Ebola outbreak: lessonshospitals and physicians can apply to future viral epidemics. General Hospital Psychiatry, vol. 30, no.5, pp. 446–452.
[13] Tucci, V., Moukaddam, N., Meadows, J., et al. (2017). The forgotten plague: psychiatric manifestationsof Ebola, Zika, and emerging infectious diseases. Journal of Global Infectious Diseases, vol. 9, no. 4,pp. 151–156.
[14] Müller, N. (2014). Infectious diseases and mental health. In N. Sartorius, R. I. G. Holt, M. Maj M, (Ed.), KeyIssues in Mental Health. Basel: S. KARGER AG, pp. 99–113. Retrieved from: https://www.karger.com/Article/FullText/365542
[15] Sim, K., Huak, C. Y., Chong, P. N., et al. (2010). Psychosocial and coping responses within the communityhealth care setting towards a national outbreak of an infectious disease. Journal of PsychosomaticResearch, vol. 68, no. 2, pp. 195–202.
[16] Wang, C., Pan, R., Wan, X., et al. (2020). Immediate psychological responses and associated factorsduring the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the generalpopulation in China. International Journal of Environmental Research and Public Health, vol. 17, no. 5,p. 1729.
[17] Maunder, R., Hunter, J., Vincent, L., et al. (2003). The immediate psychological and occupational impactof the 2003 SARS outbreak in a teaching hospital. CMAJ, vol. 168, no. 10, pp. 1245–1251.
[18] Dwosh, H. A., Hong, H. H., Austgarden, D., et al. (2003). Identification and containment of an outbreakof SARS in a community hospital. CMAJ, vol. 168, no. 11, pp. 1415–1420.
[19] Mackay, B. (2003). SARS: “a domino effect through entire system.” CMAJ, vol. 16, no. 10, p. 1308.
[20] CDC. (2003). Cluster of severe acute respiratory syndrome cases among protected healthcare workers— Toronto, Canada, April 2003. MMWR, vol. 52, no. 19, pp. 433–436. Retrieved from: www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a1.htm
[21] Government of Canada. (2003). Epi-update: Interim Report on the SARS Outbreak in the GreaterToronto Area, Ontario, Canada. Ottawa: Health Canada. Retrieved from: www.hc-sc.gc.ca/pphb-dgspsp/sars-sras/pef-dep/gta-20030424_e.html
[22] Patrick, D. M. (2003). The race to outpace severe acute respiratory syndrome (SARS). CMAJ, vol. 168,no. 10, pp. 1265–1266.
[23] Wu, P., Fang, Y., Quan, Z., et al. (2009). The psychological impact of the SARS epidemic on hospitalemployees in China: exposure, risk perception, and altruistic acceptance of risk. The Canadian Journalof Psychiatry, vol. 54, no. 5, pp. 303–311.
[24] Barbisch, D., Koenig, K. L., and Shih, F. Y. (2015). Is there a case for quarantine? Perspectives fromSARS to Ebola. Disaster Med Public Health Prep, vol. 9, no. 5, pp. 547–553.
[25] Manuell, M.-E. and Cukor, J. (2011). Mother nature versus human nature: public compliance withevacuation and quarantine. Disasters, vol. 35, no. 2, pp. 417–442.
[26] Weiss, D. S. (2004). The Impact of Event Scale-revised. In: J. P. Wilson, T. M. Keane, (Eds.), AssessingPsychological Trauma and PTSD (2nd ed.). Guilford press, New York.
[27] Löwe, B., Decker, O., Müller, S., et al. (2008). Validation and standardization of the generalized anxietydisorder screener (GAD-7) in the general population. Medical Care, vol. 46, no. 3, pp. 266–274.
[28] Kroenke, K., Spitzer, R. L., and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severitymeasure. Journal of General Internal Medicine, vol. 16, no. 9, pp. 606–613.
[29] Weiss, D. S. (2007). The Impact of Event Scale: Revised. New York: Guilford Press, pp. 399–411.
[30] Alhadi, A. N., Alateeq, D. A., Sharif, E. A., et al. (2017) An arabic translation, reliability, and validation of Patient Health Questionnaire in a Saudi sample. Annals of General Psychiatry, vol. 16, p. 32.
[31] Bai, T., Hospital, W. U., Chen, J., et al. (2020). Multiple risk factors of depression and anxiety in medicalstaffs: a cross-sectional study at the outbreak of SARS-CoV-2 in China. The Lancet Psychiatry, [preprint]. Retrieved from: https://www.ssrn.com/abstract=3551414.
[32] Kang, L., Ma, S., Chen, M., et al. (2020). Impact on mental health and perceptions of psychologicalcare among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak:a cross-sectional study. Brain, Behavior, and Immunity, vol. 87, pp. 11–17. Retrieved from: http://www.sciencedirect.com/science/article/pii/S0889159120303482
[33] Lai, J., Ma, S., Wang, Y., et al. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease. JAMA Network Open, vol. 3, no. 3, e203976.
[34] Tan, B. Y. Q., Chew, N. W. S., Lee, G. K. H. (2020). Psychological impact of the COVID-19 pandemic onhealth care workers in Singapore Annals of Internal Medicine. Retrieved from: https://doi.org/10.7326/M20-1083
[35] Min, S., Sub, W., Cho, A., et al. (2018). Psychological impact of the 2015 MERS outbreak on hospitalworkers and quarantined hemodialysis patients. Comprehensive Psychiatry, vol. 87, no. 8, pp. 123–127.Retrieved from: https://doi.org/10.1016/j.comppsych.2018.10.003
[36] Wang, C., Pan, R., Wan, X., et al. (2020). A Longitudinal Study on the Mental Health of General Populationduring the COVID-19 Epidemic in China. Brain, Behavior, and Immunity. Retrieved from: doi: https://doi.org/10.1016/j.bbi.2020.04.028
[37] Zhu, Z., Ph, D., Xu, S., et al. (2020). COVID-19 in Wuhan: Immediate Psychological Impact on 5062 HealthWorkers. MedRxiv. Retrieved from: https://www.medrxiv.org/content/10.1101/2020.02.20.20025338v2
[38] Simonds, A. K. and Sokol, D. K. (2009). Lives on the line? Ethics and practicalities of duty of care inpandemics and disasters. European Respiratory Society Journal, vol. 34, no. 2, pp. 303–309.
[39] Cai, H., Tu, B., Ma, J., et al. (2020). Psychological impact and coping strategies of frontline medicalstaff in hunan between January and March 2020 during the outbreak of Coronavirus disease 2019(COVID-19) in Hubei, China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, vol. 26, e924171.
[40] Kraut, R., Olson, J., Banaji, M., et al. (2004). Psychological research online: report of Board of Scientific Affairs’ Advisory Group on the Conduct of Research on the Internet. American Psychologist, vol. 59, no. 2, pp. 105–117.
[41] Buchanan, T. and Smith, J. L. (1999). Using the Internet for psychological research: personality testing on the World Wide Web. British Journal of Psychology, vol. 90, no. 1, pp. 125–144.
[42] Federal Ministry of Health, Sudan. Committee for Health Emergency Response April 11 2020. Retrieved from: http://fmoh.gov.sd/index.php/files/index/116 .
Published
2021-09-02
Section
Original Articles
