Covid-19 Pandemisi Sürecinde Sağlık Çalışanlarının Akılcı Olmayan İnançları, Kaygı ve Depresyon Düzeyleri

Öz

Amaç: İnançlar veya mantıksız inançlar, bireylerin COVID-19 salgını gibi tehdit edici bir duruma tepki verme veya uyum sağlama şeklini etkilemektedir. Bu çalışma, COVID-19 salgını sırasında sağlık çalışanlarının mantıksız inançları, depresyon ve kaygı düzeyleri arasındaki ilişkiyi değerlendirmektedir. Materyal ve Metot: Bu çalışma, Kısaltılmış Genel Tutum ve İnanç Ölçeği, Beck Depresyon Envanteri ve Beck Anksiyete Envanteri kullanılarak 212 sağlık çalışanına uygulanan nicel bir çalışma olarak tasarlanmıştır. Toplanan veriler t-testi, ANOVA, korelasyon ve regresyon analizlerleri ile değerlendirilmiştir. Bulgular:Araştırma, erkek katılımcıların anlamlı derecede yüksek düzeyde başkalarını Değersizleştirme/irrasyonel inançlara sahip olduğunu, kadınların ve evli olmayan bireylerin ise anlamlı düzeyde daha yüksek kaygı düzeylerine sahip olduğunu ortaya koymuştur. Ayrıca Akılcı Olmayan İnançlar/rahatlık ihtiyacı ve kadın cinsiyet faktörünün kaygı düzeylerini, Akılcı Olmayan İnançlar/rahatlık ihtiyacı ve yaş faktörünün ise depresyon düzeylerini yordadığı bulunmuştur. Sonuç: Araştırma sonuçları sağlık çalışanlarının mantıksız inançlarının, depresyon ve kaygı düzeylerinin değerlendirilmesi gerektiğine işaret etmekte ve değerlendirmenin potansiyel müdahalelerin geliştirilmesine rehberlik edebileceğine işaret etmektedir.

Anahtar Kelimeler

• akılcı olmayan inançlar
• depresyon
• anksiyete
• covid-19
• sağlık çalışanları

Healthcare Workers' Irrational Beliefs and Anxiety and Depression Levels During the Covid-19 Pandemic

Öz

Objectives: The beliefs or irrational beliefs impact the way individuals react or adapt to a threatening situation like the COVID-19 pandemic. This study assesses the relationship between healthcare workers' irrational beliefs, depression, and anxiety levels during the COVID-19 pandemic. Materials and Metods: This study was designed as a quantitative study that used the Shortened General Attitude and Belief Scale (SGABS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) to 212 healthcare workers. The collected data was subjected to t-tests, ANOVA, correlation, and regression analyses. Results: The study found that male participants had significantly higher levels of Devaluation of Others / irrational beliefs, while females and unmarried individuals had significantly higher levels of anxiety. Additionally, there was a predictive effect of Irrational Beliefs / need for comfort and female gender factor on anxiety levels, and a predictive effect of Irrational Beliefs / need for comfort and age factor on depression levels. Conclusion: The results indicate the need to assess healthcare workers' irrational beliefs, depression, and anxiety levels and suggest that assessment can guide the development of potential interventions.

Anahtar Kelimeler

• irrational beliefs
• depression
• anxiety
• covid-19
• healthworkers

Kaynakça

1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn).10.1176/appi.books.9780890425596 Google Scholar.
2. Amutio, A., & Smith, J. C. (2008). Stress and irrational beliefs in college students. Ansiedad y Estrés, 14(2–3), 211–220.
3. Arpacıoğlu, S., Baltalı, Z., & Ünübol, B. (2021). Burnout, fear of Covid, depression, occupational satisfaction levels and related factors in healthcare professionals in the COVID-19 pandemic. Çukurova Medical Journal, 88 – 100, 2021.
4. Ayanian, J. Z. (2020). Mental Health Needs of Health Care Workers Providing Frontline COVID-19 Care. JAMA Health Forum, 1(4), e200397.
5. Balkıs, M., & Duru, E. (2019). The protective role of rational beliefs on the relationship between irrational beliefs, emotional states of stress, depression and anxiety. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 37(1), 96-112. https://doi.org/10.1007/s10942-018-0305-7.
6. Balkıs, M., & Duru, E. (2023). Negative Life Events Associated with COVID-19 and Psychological Distress: The Role of Irrational and Rational Beliefs. J Rat-Emo Cognitive-Behav Ther 41,144–161. https://doi.org/10.1007/s10942-022-00457-z.
7. Bannister, D. (1968). The Psychology of Anxiety. By Eugene E. Levitt, Bobbs-Merrill. 1967. Pp. 223. Price $6. The British Journal of Psychiatry, 114(508), 370-370. https://doi.org/10.1192/bjp.114.508.370.
8. Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.

9. Beck, A. T. (1985). Theoretical perspectives on clinical anxiety. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the Anxiety Disorders (pp. 183–196). Lawrence Erlbaum Associates, Inc.
10. Beck, A. T. (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy, 1, 5-37.
11. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006X.56.6.893.
12. Beck, A. T., Rush, A., Shaw, B., & Emery, G. (1979). Cognitive Therapy of Depression. New York: The Guilford Press.
13. Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
14. Bernard, M.E. (1998). Validation of the General Attitude and Belief Scale. Journal of Rational Emotive & Cognitive-Behavior Therapy, 16,183–196. https://doi.org/10.1023/A:1024911014579.
15. Bilge, F., & Arslan, A. (2000). Problem solving skills of university students whose irrational thoughts are different. Turkish Psychological Counseling and Guidance Journal, 2 (13), 7-18.
16. Brown, G. W., & Harris, T. (1978). Social origins of depression: a reply. Psychological Medicine, 8(4), 577–588. https://doi.org/10.1017/s0033291700018791.
17. Buschmann, T., Horn, R. A., Blankenship, V. R., Garcia, Y. E., & Bohan, K. B. (2018). The relationship between automatic thoughts and irrational beliefs predicting anxiety and depression. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 36(2), 137-162. https://doi.org/10.1007/s10942-017-0278-y.
18. Calvete, E., & Cardeñoso, O. (2005). Gender differences in cognitive vulnerability to depression and behavior problems in adolescents. Journal of Abnormal Child Psychology, 33(2), 179–192. https://doi.org/10.1007/s10802-005-1826-y.
19. Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934. https://doi.org/10.1016/j.psychres.2020.112934.
20. Carlson, N. R. (2014). Foundations of Behavioral Neuroscience. (Ed. Muzaffer Şahin), İstanbul: Nobel Yayınevi.
21. Caserta, D. A., Dowd, E. T., David, D., & Ellis, A. (2010). Rational and irrational beliefs in primary prevention and mental health. In D. David, S. J. Lynn, & A. Ellis (Eds.), Rational and irrational beliefs: Research, theory, and clinical practice. (pp. 173–194). Oxford University Press.
22. Cebeci, S.P., & Durmaz, H. (2021). Determination of Depression, Anxiety and Stress Levels among Nurses Caring for Corona Virus Patients. Journal of Ankara Health Sciences, 10(1), 46-56. https://doi.org/10.46971/ausbid.876837.
23. Chadwick, P., Trower, P., & Dagnan, D. (1999). Measuring Negative Person Evaluations: The Evaluative Beliefs Scale. Cognitive Therapy and Research, 23,549–559. https://doi.org/10.1023/A:1018776522497.
24. Chan, H. W. Q., & Sun, C. F. R. (2020). Irrational beliefs, depression, anxiety, and stress among university students in Hong Kong. Journal of American College Health : J of ACH, 69(8), 827–841. https://doi.org/10.1080/07448481.2019.1710516.
25. Chen, Y., Zhou, H., Zhou, Y., & Zhou, F. (2020). Prevalence of self-reported depression and anxiety among pediatric medical staff members during the COVID-19 outbreak in Guiyang, China. Psychiatry Research, 288, 113005. https://doi.org/10.1016/j.psychres.2020.113005.
26. Çırakoğlu, O. (2011). The Investigation of Swine Infl uenza (H1N1) Pandemic Related Perceptions in terms of Anxiety and Avoidance Variables. Turkish Journal of Psychology, 26(67), 49-64.
27. Çivitci, A. (2006). Irrational beliefs in adolescents: An investigation according to socio-demographic variables. Pamukkale University Journal of Education, 8(19), 9-19.
28. Culhane, S. E., & Watson, P. J. (2003). Alexithymia, irrational beliefs, and the rational-emotive explanation of emotional disturbance. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21(1), 57–72. https://doi.org/10.1023/A:1024133218634.
29. David, D., Lynn, S. J., & Ellis, A. (2010). The role of rational and irrational beliefs in human functioning and disturbances: Implications for research, theory, and clinical practice. Oxford University Press.
30. DiGiuseppe, R., Leaf, R., Gorman, B., & Robin, M. W. (2017). The development of a measure of irrational/rational beliefs. Journal of Rational-Emotive & Cognitive-Behavior Therapy, https://doi.org/10.1007/s10942-017-0273-3.
31. DiGiuseppe, R.A., Doyle, K.A., Dryden, W., & Backx W. (2014). A practitioner's guide to rational emotive behavior therapy. Oxford University Press.
32. Dryden, W., & Branch, R. (2008). Fundamentals of rational emotive behaviour therapy: A training handbook. John Wiley & Sons.
33. Dudău, D.P., Sfeatcu, I. R., Sfeatcu, C., & Dumitrache, M. A. (2015). Professional stress in relation to anxiety, depression and irrational beliefs among dental and psychotherapy students. Procedia-Social and Behavioral Sciences, 187, 158-162.
34. Duru, E., & Balkıs, M. (2022). COVID-19 Related Negative Life Events and Psychological Distress: The Role of Emotion and Cognitive Emotion Regulation Strategies. Journal of Rational-Emotive and Cognitive-Behavior Therapy: RET, 1–23. Advance online publication. https://doi.org/10.1007/s10942-022-00488-6.
35. Dutheil, F., Mondillon, L., & Navel, V. (2021). PTSD as the second tsunami of the SARS-Cov-2 pandemic. Psychological Medicine, 51(10), 1773–1774. https://doi.org/10.1017/S0033291720001336.
36. Elbay, R. Y., Kurtulmuş, A., Arpacıoğlu, S., & Karadere, E. (2020). Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Research, 290, 113130. https://doi.org/10.1016/j.psychres.2020.113130.
37. Ellis, A. & Dryden, W. (1987). The Practice of Rational Emotive Therapy. New York: Springer Publishing Company.
38. Ellis, A. (1974). Psychotherapy: Theory, research and practice. Institute for Advanced Study in Rational Psychotherapy, 11(3), 194-198.
39. Ellis, A. (1994). Reason and emotion in psychotherapy, revised. NY: Kensington.
40. Ellis, A. (2001). Overcoming Destructive Beliefs, Feelings, and Behaviors, Prometheus Books, New York.
41. Ellis, A. (2003a). Diferentiating preferential from exaggerated and musturbatory beliefs in rational emotive behavior therapy. In W. Dryden (Ed.), Rational emotive behavior therapy: Theoretical developments. (pp. 22–34). New York: Brunner Routledge.
42. Ellis, A. (2003b). Discomfort anxiety: A new cognitive-behavioral construct (Part 1). Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21(3-4), 183–191. https://doi.org/10.1023/A:1025881810501.
43. Ellis, A., & Dryden, W. (1997). The practice of rational emotive behavior therapy (2nd ed.). Springer Publishing Co.
44. Greenberg, N., Docherty, M., Gnanapragasam, S., & Wessely, S. (2020). Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ. https://doi.org/10.1136/bmj.m1211.
45. Hao, F., Tan, W., Jiang, L., Zhang, L., Zhao, X., Zou, Y., Hu, Y., Luo, X., Jiang, X., McIntyre, R.
46. S., Tran, B., Sun, J., Zhang, Z., Ho, R., Ho, C., & Tam, W. (2020). Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain, Behavior, and Immunity, 87, 100–106. https://doi.org/10.1016/j.bbi.2020.04.069.
47. Hart, K. E., & Hittner, J. B. (1991). Irrational beliefs, perceived availability of social support, and anxiety. Journal of Clinical Psychology, 47(4), 582–587. https://doi.org/10.1002/1097-4679(199107)47:4<582:aid-jclp2270470418>3.0.co;2-z.
48. Heilbron, N., Prinstein, M. J., & Hilt, L. M. (2008). A lab-based examination of adolescent girls' expressed negative cognitions in response to an in vivo social stressor: Links to depressive symptoms. International Journal of Cognitive Therapy, 1(4), 298–312. https://doi.org/10.1521/ijct.2008.1.4.298.
49. Hisli, N. (1989). Reliability and validity of Beck Depression Inventory among university students. Journal of Turkish Psychology, 7, 3–13.
50. Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., Ford, T., John, A., Kabir, T., King, K., Madan, I., Michie, S., Przybylski, A. K., Shafran, R., Sweeney, A., Worthman, C. M., … Bullmore, E. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry, 7(6), 547–560. https://doi.org/10.1016/S2215-0366(20)30168-1.
51. Hyland, P., Shevlin, M., Adamson, G., & Boduszek, D. (2014). The moderating role of rational beliefs in the relationship between irrational beliefs and posttraumatic stress symptomology. Behavioural and Cognitive Psychotherapy, 42(3), 312–326. https://doi.org/10.1017/S1352465813000064.
52. Jackson, P.B., & Finney, M. (2002). Negative life events and psychological distress among young adults. Social Psychology Quarterly, 65(2), 186–201. https://doi.org/10.2307/3090100.
53. Kassinove, H. (1986). Self-reported affect and core irrational thinking: A preliminary analysis. Journal of Rational-Emotive Therapy, 4(2), 119–130. https://doi.org/10.1007/BF01074170.
54. Kaya, B. (2020). Effects of pandemic on mental health. Turkish Journal of Clinicay Psychiatry, 23(2),123-124. https://doi.org/10.5505/kpd.2020.64325.
55. Khaledian, M., Saghafi, F., Moradi, S., & Khairkhah, Z. (2013). Investigating the Relationship of Irrational Beliefs with Anxiety and Their Effect in Two Different Academic Systems in Iran (Under graduate Collage students of Payam Nour University and Islamic Azad University). Journal of International Research Journal of Applied and Basic Sciences, 4(5), 1185-1191.
56. Koopmans, P.C., Sanderman, R., Timmerman, I., & Emmelkamp, P.M.G. (1994). The Irrational Beliefs Inventory (IBI): Development and psychometric evaluation. European Journal of Psychological Assessment, 10(1), 15-27.
57. Leahy, R.L. (2020). Coronavirus Anxiety: How to handle fear while pursuing safety. Retrieved May,4,2023 from https://www.psychologytoday.com/us/blog/anxietyfiles/202003/coronavirus-anxiety.
58. Leal, P.C., Goes, T.C., da Silva, L.C.F., & Teixeira-Silva, F. (2017). Trait vs State anxiety in different threatening situations. Trends in Psychiatry and Psychotherapy, 39(3), 147–157. https://doi.org/10.1590/2237-6089-2016-0044.
59. Lei, L., Huang, X., Zhang, S., Yang, J., Yang, L., & Xu, M. (2020). Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China. Medical science monitor: International Medical Journal of Experimental and Clinical Research, 26, e924609. https://doi.org/10.12659/MSM.924609.
60. Li, Z., Ge, J., Yang, M., Feng, J., Qiao, M., Jiang, R., Bi, J., Zhan, G., Xu, X., Wang, L., Zhou, Q., Zhou, C., Pan, Y., Liu, S., Zhang, H., Yang, J., Zhu, B., Hu, Y., Hashimoto, K., Jia, Y., Yang, C. (2020). Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain, Behavior, and Immunity, 88,916–919. https://doi.org/10.1016/j.bbi.2020.03.007.
61. Liang, Y., Chen, M., Zheng, X., & Liu, J. (2020). Screening for Chinese medical staff mental health by SDS and SAS during the outbreak of COVID-19. Journal of Psychosomatic Research, 133, 110102. https://doi.org/10.1016/j.jpsychores.2020.110102.
62. Lindner, H., Kirkby, R., Wertheim, E., & Birch, P. (1999). A brief assessment of irrational thinking: The shortened General Attitude and Belief Scale. Cognitive Therapy and Research, 23(6), 651–663. https://doi.org/10.1023/A:1018741009293.
63. Liu, J., Zhang, S., Wu, Z., Shang, Y., Dong, X., Li, G., Zhang, L., Chen, Y., Ye, X., Du, H., Liu, Y., Wang, T., Huang, S., Chen, L., Wen, Z., Qu, J., & Chen, D. (2020). Clinical outcomes of COVID-19 in Wuhan, China: a large cohort study. Annals of Intensive Care, 10(1), 99. https://doi.org/10.1186/s13613-020-00706-3.
64. Luyten, P., Sabbe, B., Blatt, S. J., Meganck, S., Jansen, B., De Grave, C., Maes, F., & Corveleyn, J. (2007). Dependency and self-criticism: relationship with major depressive disorder, severity of depression, and clinical presentation. Depression and Anxiety, 24(8), 586–596. https://doi.org/10.1002/da.20272.
65. MacInnes, D. (2003). Evaluating an assessment scale of irrational beliefs for people with mental health problems. Nurse Researcher, 10(4), 53–67. https://doi.org/10.7748/nr2003.07.10.4.53.c5907.
66. Macsinga, I., & Dobrita, O. (2010). More educated, less irrational: Gender and educational differences in perfectionism and irrationality. Romanian Journal of Applied Psychology, 12(2), 79-85.
67. Malhotra, N. K., Kim, S. S., & Agarwal, J. (2004). Internet Users' Information Privacy Concerns (IUIPC): The Construct, the Scale, and a Causal Model. Information Systems Research, 15(4), 336–355. https://doi.org/10.1287/isre.1040.0032.
68. Masiero, M., Mazzocco, K., Harnois, C., Cropley, M., & Pravettoni, G. (2020). From Individual To Social Trauma: Sources Of Everyday Trauma In Italy, The US And UK During The Covid-19 Pandemic. Journal of trauma & dissociation : The Official Journal of the International Society for the Study of Dissociation (ISSD), 21(5), 513–519. https://doi.org/10.1080/15299732.2020.1787296.
69. Masterson, J. F. (1993). The emerging self: A developmental, self and object relations approach to the treatment of closet narcissistic disorder of the self. New York: Brunner/Mazel.
70. McDermut, J. F., Haaga, D. A. F., & Bilek, L. A. (1997). Cognitive bias and irrational beliefs in major depression and dysphoria. Cognitive Therapy and Research, 21(4), 459–476. https://doi.org/10.1023/A:1021936427625.
71. Naldan, M. E., Karayağmurlu, A., Yayık, M., & Arı, M. A. (2019). Burnout, Job Satisfaction, Depression on the Healthcare Professionals Working in the Operation Room. / Selcuk Medıcal Journal, 35(3), 152-8. https://doi.org/10.30733/std.2019.01117.
72. O’Donohue, W., Fisher, J. & Hayes, S. (2009). Cognitive Behavior Threapy: Appliying Emricially Supported Tecniques in Your Practise. New Jersey: John Wiiley&Sons.
73. Och Dag, Y. N., Mehlig, K., Rosengren, A., Lissner, L., & Rosvall, M. (2020). Negative emotional states and negative life events: Consequences for cardiovascular health in a general population. Journal of Psychosomatic Research, 129, 109888. https://doi.org/10.1016/j.jpsychores.2019.109888.
74. Oltean, H. R., Hyland, P., Vallières, F., & David, D. O. (2017). An empirical assessment of REBT models of psychopathology and psychological health in the prediction of anxiety and depression symptoms. Behavioural and Cognitive Psychotherapy. https://doi.org/10.1017/S1352465817000133.
75. Ouattara, E., Bruandet, A., Borde, A., Lenne, X., Binder-Foucard, F., Le-Bourhis-Zaimi, M., Muller, J., Tran ba loc, P., Séguret, F., Tezenas du Montcel, S., & Gilleron, V. (2021). Risk factors of mortality among patients hospitalised with COVID-19 in a critical care or hospital care unit: Analysis of the French national medicoadministrative database. BMJ Open Respiratory Research, 8(1), e001002. https://doi.org/10.1136/bmjresp-2021-001002.
76. Özer, E. A., & Akgün, E. Ö. (2015). The effects of irrational beliefs on academic motivation and academic self-efficacy of candidate teachers of computer and instructional technologies education department. Procedia - Social and Behavioral Sciences, 197, 1287 – 1292.
77. Polat, Ö. P., & Coşkun, F. (2020). Determining the Relationship Between Personal Protective Equipment Uses of Medical Healthcare Workers and Depression, Anxiety and Stress Levels in the COVID-19 Pandemic. Medical Journal of Western Black Sea, 4(2), 51-58. https://doi.org /10.29058/mjwbs.2020.2.3.
78. Robichaud, M., Koerner, N., & Dugas, M. J. (2019). Cognitive behavioral treatment for generalized anxiety disorder: From Science to Practice (2nd ed.). Routledge/Taylor & Francis Group. https://doi.org/10.4324/9781315709741.
79. Rossi, R., Socci, V., Pacitti, F., Di Lorenzo, G., Di Marco, A., Siracusano, A., & Rossi, A. (2020). Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open, 3(5), e2010185. https://doi.org/10.1001/jamanetworkopen. 2020.10185.
80. Savaşır, I. & Şahin, N. H. (1997). Bilişsel-davranışçı terapilerde değerlendirme: Sık kullanılan ölçekler. Ankara: Türk Psikologlar Derneği Yayınları.
81. Simione, L., & Gnagnarella, C. (2020). Differences Between Health Workers and General Population in Risk Perception, Behaviors, and Psychological Distress Related to COVID-19 Spread in Italy. Frontiers in Psychology, 11, 2166. https://doi.org/10.3389/fpsyg.2020.02166.
82. Song, X., Fu, W., Liu, X., Luo, Z., Wang, R., Zhou, N., Yan, S., & Lv, C. (2020). Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China. Brain, Behavior, and Immunity, 88, 60–65. https://doi.org/10.1016/j.bbi.2020.06.002.
83. Spoorthy, M. S., Pratapa, S. K., & Mahant, S. (2020). Mental health problems faced by healthcare workers due to the Covıd-19 pandemic–A review. Asian Journal of Psychiatry, 51, 102119. https://doi.org/10.1016/j.ajp.2020.102119.
84. Sun, N., Wei, L., Shi, S., Jiao, D., Song, R., Ma, L., Wang, H., Wang, C., Wang, Z., You, Y., Liu, S., & Wang, H. (2020). A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control, 48(6), 592–598. https://doi.org/10.1016/j.ajic.2020.03.018.
85. Szentagotai, A., & Jones, J. (2010). The behavioral consequences of irrational beliefs. In D. David, S. J. Lynn, & A. Ellis (Eds.), Rational and irrational beliefs: Research, theory and clinical practice (pp. 75–197). New York: Oxford University Press.
86. Tabachnick, B. G., & Fidell, L. S. (2013). Using Multivariate Statistics (6th ed.). Boston, MA: Pearson.
87. Terán, V. G., Velásquez, E. E., & Fuentes, M. A. (2020). Irrational thinking and psychological distress: A cross-racial/ethnic examination. Personality and Individual Differences, 164,110102. doi:10.1016/j.paid.2020.110102.
88. Tian, F., Li, H., Tian, S., Yang, J., Shao, J., & Tian, C. (2020). Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19. Psychiatry Research, 288, 112992. https://doi.org/10.1016/j.psychres.2020.112992.
89. Turner, M. J., Carrington, S., & Miller, A. (2019). Psychological distress across sport participationgroups: The mediating efects of secondary irrational beliefs on the relationship between primary irrational beliefs and symptoms of anxiety, anger, and depression. Journal of Clinical Sport Psychology, 13(1), 17–40. https://doi.org/10.1123/jcsp.2017-0014.
90. Ulusoy, M., Şahin, N., & Erkman, H. (1998). Turkish version of the beck anxiety inventor, psychometric properties. Journal of Cognitive Psychotherapy: An International Quarterly, 12(2), 28-35.
91. Urfa, O., & Urfa, D. T. (2019). The Adaptatıon Of Shortened General Attıtude And Belıef Scale Into Turkısh. International Journal of Turkish Education Sciences, 7(12), 53-61.
92. Wang, C., & Zhao, H. (2020). The Impact of COVID-19 on Anxiety in Chinese University Students. Frontiers in Psychology, 11. doi:10.3389/fpsyg.2020.01168.
93. Warren, J. M., & Dowden, A. R. (2012). Elementary School Teachers’ Beliefs and Emotions: Implications for School Counselors and Counselor Educators. Journal of School Counseling, 10, 1-32.
94. World Health Organization (2021) WHO coronavirus (COVID-19) dashboard. Retrieved from https:// covid.19.who.int.
95. Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020). 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. Medical science monitor : International Medical Journal of Experimental and Clinical Research, 26, e923549. https://doi.org/10.12659/MSM.923549.
96. Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M. W., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, A., & McIntyre, R. S. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, 277, 55–64. https://doi.org/10.1016/j.jad.2020.08.001.
97. Yang, S., Kwak, S. G., Ko, E. J., & Chang, M. C. (2020). The Mental Health Burden of the COVID-19 Pandemic on Physical Therapists. International Journal of Environmental Research and Public Health, 17(10), 3723. https://doi.org/10.3390/ijerph17103723.
98. Zwemer, W. A., & Deffenbacher, J. L. (1984). Irrational beliefs, anger, and anxiety. Journal of Counseling Psychology, 31(3), 391–393. https://doi.org/10.1037/0022-0167.31.3.391.