Investigation of Fear of COVID-19, Work Stress and Affecting Factors in Prehospital Emergency Healthcare Workers

Abstract

Background: Since healthcare workers work in the same environment with infected patients, they have a higher risk in terms of COVID-19 transmission compared to other parts of society, and accordingly, they experience more stress. Purpose: The aim of this study to investigate the fear of COVID-19, work stress, and affecting factors in prehospital healthcare workers. Methods: The research has a descriptive and cross-sectional design. The research was completed with a total of 399 individuals. Data were collected online using an introductory information form, the Fear of COVID-19 Scale, and the General Work Stress Scale. Results: The level of fear of COVID-19 was higher in women compared to men (B=-1.451, p=0.012), in married individuals compared to singles (B=-1.667, p=0.011), in those with low income compared to those with moderate or high income (B=-2.259, p<0.001), and in those who were vaccinated compared to those who were not vaccinated (B=-1.722, p=0.005). Conclusions: In prehospital emergency healthcare workers, the fear of COVID-19 was higher among women, married individuals, those with low income, those who were COVID-19-vaccinated, and those with high levels of anxiety and depression. Those with low income, high education level, and high anxiety level had a higher level of work stress.

Keywords

• Prehospital staff
• work stress
• mental health
• fear of covid 19
• covid 19 vaccine

References

1. 1. Zhou X, Snoswell CL, Harding LE, et al. The role of telehealth in reducing the mental health burden from COVID-19. Telemedicine and e-Health. 2020;26(4):377-379.
2. 2. Zu ZY, Jiang MD, Xu PP, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology. 2020;296(2):E15-E25.
3. 3. Velavan TP, Meyer CG. The COVID‐19 epidemic. Trop Med Int Health. 2020;25(3):278-280.
4. 4. World Health Organization. WHO Coronavirus (COVID-19) Dashboard 2021. Access Date: 31.12.2021. Available from: https://covid19.who.int/.
5. 5. T.C. Ministry of Health. Günlük Covid-19 tablosu [Daily Covid-19 chart] 2021. Access Date: 31.12.2021. Available from: https://covid19.saglik.gov.tr/.
6. 6. Centers for Disease Control and Prevention Coronavirus disease 2019 (COVID-19): Reducing stigma 2020. Access Date: 25.07.2021. Available from: https://www.cdc.gov/coronavirus/2019-ncov/about/related-stigma.html.
7. 7. Lin C-Y. Social reaction toward the 2019 novel coronavirus (COVID-19). Social Health and Behavior. 2020;3(1):1.
8. 8. Buhr K, Dugas MJ. The intolerance of uncertainty scale: Psychometric properties of the English version. Behav Res Ther. 2002;40(8):931-945.

9. 9. Pappas G, Kiriaze I, Giannakis P, Falagas M. Psychosocial consequences of infectious diseases. Clinical Microbiology and Infection. 2009;15(8):743-747.
10. 10. Li W, Yang Y, Liu Z-H, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol. 2020;16(10):1732.
11. 11. Mo Y, Deng L, Zhang L, et al. Work stress among Chinese nurses to support Wuhan in fighting against COVID‐19 epidemic. J Nurs Manag. 2020;28(5):1002-1009.
12. 12. Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses’ knowledge and anxiety toward COVID-19 during the current outbreak in Iran. Arch Clin Infect Dis. 2020;15(COVID-19):e102848.
13. 13. Ornell F, Schuch JB, Sordi AO, Kessler FHP. “Pandemic fear” and COVID-19: mental health burden and strategies. Braz J Psychiatry. 2020;42(3):232-235.
14. 14. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General Psychiatry. 2020;33(2).
15. 15. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729.
16. 16. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-1242.
17. 17. Li L, Wan C, Ding R, et al. Mental distress among Liberian medical staff working at the China Ebola Treatment Unit: a cross sectional study. Health Qual Life Outcomes. 2015;13(1):1-6.
18. 18. Shah K, Kamrai D, Mekala H, Mann B, Desai K, Patel RS. Focus on mental health during the coronavirus (COVID-19) pandemic: applying learnings from the past outbreaks. Cureus. 2020;12(3):e7405.
19. 19. Smith MW, Smith PW, Kratochvil CJ, Schwedhelm S. The psychosocial challenges of caring for patients with Ebola virus disease. Health Secur. 2017;15(1):104-109.
20. 20. Chen Q, Liang M, Li Y, et al. Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020;7(4):e15-e16.
21. 21. Arpacıoğlu MS, Baltalı Z, Ünübol B. COVID-19 pandemisinde sağlık çalışanlarında tükenmişlik, Covid korkusu, depresyon, mesleki doyum düzeyleri ve ilişkili faktörler [Burnout, fear of Covid, depression, occupational satisfaction levels and related factors in healthcare professionals in the COVID-19 pandemic]. Cukurova Med J. 2021;46(1):88-100.
22. 22. Adriaenssens J, De Gucht V, Maes S. Causes and consequences of occupational stress in emergency nurses, a longitudinal study. J Nurs Manag. 2015;23(3):346-358.
23. 23. Crabbe J, Bowley D, Boffard K, Alexander DA, Klein S. Are health professionals getting caught in the crossfire? The personal implications of caring for trauma victims. Emerg Med J. 2004;21(5):568-572.
24. 24. Kilcoyne M, Dowling M. Working in an overcrowded accident and emergency department: nurses' narratives. Aust J Adv Nurs. 2007;25(2):21-27.
25. 25. Sakaoğlu HH, Orbatu D, Emiroglu M, Çakır Ö. Covid-19 salgını sırasında sağlık çalışanlarında spielberger durumluk ve sürekli kaygı düzeyi: Tepecik hastanesi örneği [Spielberger state and trait anxiety level in healthcare professionals during the Covid-19 outbreak: a case of Tepecik Hospital]. Tepecik Eğit ve Araşt Hast Dergisi. 2020;30(2):1-9.
26. 26. Wujtewicz MA, Dylczyk-Sommer A, Aszkiełowicz A, Zdanowski S, Piwowarczyk S, Owczuk R. COVID-19–what should anaethesiologists and intensivists know about it? Anaesthesiol Intensive Ther. 2020;52(1):34.
27. 27. Ilczak T, Rak M, Ćwiertnia M, et al. Predictors of stress among emergency medical personnel during the COVID-19 pandemic. Int J Occup Med. 2021;34(2):139-149.
28. 28. Sultana A, Sharma R, Hossain MM, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19 pandemic: Challenges and evidence-based interventions. Indian J Med Ethics. 2020;5(4):308-311.
29. 29. Özdemir Ş, Kerse G. The effects of COVID 19 on health care workers: Analysing of the interaction between optimism, job stress and emotional exhaustion. International and Multidisciplinary Journal of Social Sciences. 2020;9(2):178-201.
30. 30. Yakut E, Kuru Ö, Güngör Y. Sağlık personelinin Covid-19 korkusu ile tükenmişliği arasındaki ilişkide aşırı iş yükü ve algılanan sosyal desteğin etkisinin yapısal eşitlik modeliyle belirlenmesi [Determination of the influence of work overload and perceived social support in the effect of the COVID-19 fears of healthcare personnel on their burnout by structural equation modelling]. Ekev Akademi Dergisi. 2020;83:241-262.
31. 31. Sümbüloğlu V, Sümbüloğlu K. Klinik ve Saha Araştırmalarında Örnekleme Yöntemleri ve Örneklem Büyüklüğü [Sampling Methods and Sampling Size in Clinical and Field Research]. Ankara: Alp Ofset Matbaacılık; 2005.
32. 32. Babore A, Lombardi L, Viceconti ML, et al. Psychological effects of the COVID-2019 pandemic: Perceived stress and coping strategies among healthcare professionals. Psychiatry Res. 2020;293:113366.
33. 33. Hu D, Kong Y, Li W, et al. Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study. EClinical Medicine. 2020;24:100424.
34. 34. Ledda C, Costantino C, Cuccia M, Maltezou HC, Rapisarda V. Attitudes of healthcare personnel towards vaccinations before and during the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(5):2703-2714.
35. 35. Öztürk MH, Gezer N. The effect of role conflict and ambiguity on work stress in health staff working in emergency service and 112. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2021;5(1):72-83.
36. 36. Tengilimoğlu D, Zekioğlu A, Tosun N, Işık O, Tengilimoğlu O. Impacts of COVID-19 pandemic period on depression, anxiety and stress levels of the healthcare employees in Turkey. Leg Med. 2021;48:101811.
37. 37. Williams B, King C, Shannon B, Gosling C. Impact of COVID-19 on paramedicine students: A mixed methods study. Int Emerg Nurs. 2021;56:100996.
38. 38. Ahorsu DK, Lin C-Y, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: development and initial validation. Int J Ment Health Addict. 2020;Mar 27:1-9.
39. 39. Ladikli N, Bahadır E, Yumuşak FN, Akkuzu H, Karaman G, Türkkan Z. Kovid-19 korkusu ölçeğinin Türkçe güvenirlik ve geçerlik çalışması [The reliability and validity of Turkish version of the fear of Covid-19 scale]. International Journal of Social Science. 2020;3(2):71-80.
40. 40. De Bruin GP. The dimensionality of the general work stress scale: A hierarchical exploratory factor analysis. SA J Ind Psychol. 2006;32(4):68-75.
41. 41. Teleş M. Validity and reliability of the Turkish version of the general work stress scale. J Nurs Manag. 2021;29(4):710-720.
42. 42. Tabachnick BG, Fidell LS, Ullman JB. Using Multivariate Statistics. Sixth ed. Boston: MA Pearson; 2013.
43. 43. Özgünay S, Akça F, Karasu D, Eminoğlu S, Gamlı M. Evaluation of anesthetists' fear levels and prophylaxis practices in the Coronavirus (COVID-19) pandemic. JARSS. 2021;29(1):25-31.
44. 44. García-Reyna B, Castillo-García GD, Barbosa-Camacho FJ, et al. Fear of COVID-19 scale for hospital staff in regional hospitals in Mexico: A brief report. Int J Ment Health Addict. 2020;Nov 4:1-12.
45. 45. Ember CR, Ember M. Encyclopedia of Sex and Gender: Men and Women in the World's Cultures Topics and Cultures AK-Volume 1; Cultures LZ: Springer Science & Business Media; 2003.
46. 46. Eckert P, McConnell-Ginet S. Language and gender: Cambridge University Press; 2013.
47. 47. Tarhan N. Kadın Psikolojisi [Female Psychology]. İstanbul: Nesil Basım Yayın; 2011.
48. 48. Gümüş İ. Çalışma hayatının iki büyük korkusu: işsizlik ve iş güvencesizliği [Two big fear of working life: unemployment and job insecurity]. İş Ahlakı Dergisi. 2013;6(1):187-193.
49. 49. Paramedic Salaries by Country. Paramedic salaries 2021. Access Date: 15.01.2022. Available from: https://www.salaryexpert.com/salary/browse/countries/paramedic.
50. 50. Bendau A, Plag J, Petzold MB, Ströhle A. COVID-19 vaccine hesitancy and related fears and anxiety. Int Immunopharmacol. 2021;97:107724.
51. 51. McElfish PA, Willis DE, Shah SK, Bryant-Moore K, Rojo MO, Selig JP. Sociodemographic determinants of COVID-19 vaccine hesitancy, fear of infection, and protection self-efficacy. J Prim Care Community Health. 2021;12:1-7.
52. 52. Willis DE, Andersen JA, Bryant‐Moore K, et al. COVID‐19 vaccine hesitancy: race/ethnicity, trust, and fear. Clin Transl Sci. 2021;00:1-8.
53. 53. Barlow DH, Chorpita BF, Turovsky J. Fear, panic, anxiety, and disorders of emotion. Nebr Symp Motiv. 1996;43:251-328.
54. 54. Amin F, Sharif S, Saeed R, Durrani N, Jilani D. COVID-19 pandemic-knowledge, perception, anxiety and depression among frontline doctors of Pakistan. BMC Psychiatry. 2020;20(1):1-9.
55. 55. Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatry Res. 2020;288:1-5.
56. 56. Mattila E, Peltokoski J, Neva MH, Kaunonen M, Helminen M, Parkkila A-K. COVID-19: anxiety among hospital staff and associated factors. Ann Med. 2021;53(1):237-246.
57. 57. Erşan EE, Yıldırım G, Doğan O, Doğan S. Sağlık çalışanlarının iş doyumu ve algılanan iş stresi ile aralarındaki ilişkinin incelenmesi [Job satisfaction and perceived job stress of the health professionals and the relationship between them]. Anadolu Psikiyatri Dergisi. 2013;14(2):115-121.
58. 58. Hendy A, Abozeid A, Sallam G, Abboud Abdel Fattah H, Ahmed Abdelkader Reshia F. Predictive factors affecting stress among nurses providing care at COVID‐19 isolation hospitals at Egypt. Nurs Open. 2021;8(1):498-505.
59. 59. Aydın İ. İş Yaşamında Stres [Stress in Job Life]. Forth ed. Ankara: Pegem Yayıncılık; 2016.
60. 60. Zandian H, Alipouri-sakha M, Nasiri E, Zahirian Moghadam T. Nursing work intention, stress, and professionalism in response to the COVID-19 outbreak in Iran: a cross-sectional study. Work. 2021;68(4):969-979.
61. 61. Braham BJ. Stres Yönetimi Ateş Altında Sakin Kalabilmek [Managing Stress Keeping Calm Under Fire]. İstanbul: Hayat Yayınları; 1998.
62. 62. Baltaş Z, Baltaş A. Stres ve Başaçıkma Yolları [Stress and Ways to Coping with]. İstanbul: Remzi Kitap Evi; 2013.