An Examination of The Factors Related To Depression, Anxiety, and Stress During The COVID-19 Pandemic in Hospital Workers

Öz

Aim: The aim of this cross-sectional study was to examine the relationships between depression, anxiety, stress and social support and stress coping variables in radiology technicians during the COVID-19 period. Method: The study data were obtained from 429 individuals registered with the Turkish Medical Radiotechnology Association between 01.03.2021 and 01.05.2021. Descriptive statistics, correlation analysis, and regression analysis were used to evaluate the data. Results: In the study, negative significant relationships were determined between depression, anxiety, stress and social support sub-dimensions. Positive significant relationships were found between depression, anxiety, stress, and "emotion-oriented coping". At the same time, positive significant relationships were found between anxiety, stress, and "avoidance coping ". It has been determined that the factors affecting depression and stress are only " significant other" in the dimension of social support, and " emotion-oriented coping" in the dimensions of coping with stress. Among the factors affecting anxiety, it was observed that only "friend" in the dimension of social support and "emotion-oriented coping" from the dimensions of coping with stress. Conclusion: The negative relationships between depression, anxiety, and stress with social support and coping strategies during the COVID-19 period emphasize the importance of social support systems and effective coping methods in strengthening mental health.

Anahtar Kelimeler

• COVID-19
• depression
• anxiety
• social support
• Mental health
• Radiology technician

Hastane çalışanlarında COVID-19 salgını sırasında depresyon, anksiyete ve stresle ilişkili faktörlerin incelenmesi

Öz

Amaç: Bu kesitsel çalışmanın amacı, COVID-19 döneminde radyoloji teknisyenlerinde depresyon, anksiyete, stres ile sosyal destek ve stresle başa çıkma değişkenleri arasındaki ilişkileri incelemektir. Yöntem: Çalışma verileri 01.03.2021-01.05.2021 tarihleri arasında Türk Medikal Radyoteknoloji Derneği'ne kayıtlı 429 kişiden elde edilmiştir. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, korelasyon analizi ve regresyon analizi kullanılmıştır. Bulgular: Çalışmada depresyon, anksiyete, stres ile sosyal destek alt boyutları arasında negatif yönde anlamlı ilişkiler belirlenmiştir. Depresyon, anksiyete, stres ile "duygusal başa çıkma" arasında pozitif yönde anlamlı ilişkiler bulunmuştur. Aynı zamanda anksiyete, stres ve "kaçınmacı başa çıkma" arasında pozitif yönde anlamlı ilişkiler bulunmuştur. Depresyon ve stresi etkileyen faktörlerin yalnızca sosyal destek boyutunda "özel insan", stresle başa çıkma boyutlarında ise "duygusal başa çıkma" olduğu belirlenmiştir. Anksiyeteyi etkileyen faktörler arasında sosyal destek boyutunda sadece “arkadaş”, stresle başa çıkma boyutlarından ise "duygusal başa çıkma" faktörlerinin yer aldığı görülmüştür. Sonuç: COVID-19 sürecinde depresyon, anksiyete ve stres ile sosyal destek ve başa çıkma stratejileri arasındaki olumsuz ilişkiler, ruh sağlığının güçlendirilmesi açısından sosyal destek sistemlerinin ve etkili başa çıkma yöntemlerinin önemini ortaya koymaktadır.

Anahtar Kelimeler

• COVID-19
• depresyon
• anksiyete
• sosyal destek
• Ruh sağlığı
• Radyoloji teknisyeni

Kaynakça

1. 1. Kiefer L, Volberg C, Graw JA, Bösner S. “It was simply disturbing“ - evaluation of the stress factors of nursing staff on special COVID-19 wards during the pandemic: a qualitative study. BMC Nurs. 2025;24(1):120. doi:10.1186/s12912-025-02773-y
2. 2. Labrague LJ, Santos JAA. Fear of COVID‐19, psychological distress, work satisfaction and turnover intention among frontline nurses. J Nurs Manag. 2021;29(3):395-403. doi:10.1111/jonm.13168
3. 3. Santos TCC, ve et al. Nurses’ workload during the COVID-19 pandemic: potential for experiences of moral distress. Rev Bras Enferm. 2024;77(suppl 4):e20230200. doi:10.1590/0034-7167-2023-0200
4. 4. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian Journal of Psychiatry. 2020;51:102119. doi:10.1016/j.ajp.2020.102119
5. 5. Minelli A, Silva RC, Barlati S, et al. The Elephant in the Room: A Cross-Sectional Study on the Stressful Psychological Effects of the COVID-19 Pandemic in Mental Healthcare Workers. Brain Sciences. 2022;12(3):408. doi:10.3390/brainsci12030408
6. 6. Olaya B, et al. Prevalence of Depression among Healthcare Workers during the COVID-19 Outbreak: A Systematic Review and Meta-Analysis. JCM. 2021;10(15):3406. doi:10.3390/jcm10153406
7. 7. Aljohani AAAA, et al. Impact of COVID-19 on burnout among healthcare workers in intensive care units and emergency departments: Review. Int J of Health Sci. 2022;6(S10):2227-2241. doi:10.53730/ijhs.v6nS10.15421
8. 8. Grigorescu S, Cazan AM, Rogozea L, Grigorescu DO. Predictive Factors of the Burnout Syndrome Occurrence in the Healthcare Workers During the COVID-19 Pandemic. Front Med. 2022;9:842457. doi:10.3389/fmed.2022.842457

9. 9. Nagle E, Šuriņa S, Griškēviča I. Healthcare Workers’ Moral Distress during the COVID-19 Pandemic: A Scoping Review. Social Sciences. 2023;12(7):371. doi:10.3390/socsci12070371
10. 10. Shaukat N, Ali DM, Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: a scoping review. Int J Emerg Med. 2020;13(1):40. doi:10.1186/s12245-020-00299-5
11. 11. Lai J, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976
12. 12. Saatci E. COVID-19 Pandemic and health professionals: Keep them alive or survive? (in Turkish). Turkish Journal of Family Practice. 2020;24(3):153-166.
13. 13. Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychological Trauma: Theory, Research, Practice, and Policy. 2020;12(S1):S55-S57. doi:10.1037/tra0000703
14. 14. Nabi RL, Wolfers LN, Walter N, Qi L. Coping with COVID-19 stress: The role of media consumption in emotion- and problem-focused coping. Psychology of Popular Media. 2022;11(3):292-298. doi:10.1037/ppm0000374
15. 15. Atkinson R, Atkinson R, Smith E, Bem D, Hoeksema S. Introduction to Psychology. In: 14th ed.; 2006.
16. 16. Ai T, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):E32-E40. doi:10.1148/radiol.2020200642
17. 17. Sourili S. What are the radiological criteria for identifying the Corona virus in CT scan images? Eurasian Journal of Chemical, Medicinal and Petroleum Research. 2024;3(2):577-593.
18. 18. Woznitza N, Nair A, Hare SS. COVID-19: A case series to support radiographer preliminary clinical evaluation. Radiography. 2020;26(3):e186-e188. doi:10.1016/j.radi.2020.04.002
19. 19. Nas F. Multidisciplinary COVID-19. In: Management of novel Coronavirus (COVID-19) Patients in interventional radiology units, (in Turkish). 1st ed. Bursa Medical Chamber Continuing Medical Education Pandemic Book; 2020:291-298.
20. 20. Kooraki S, Hosseiny M, Myers L, Gholamrezanezhad A. Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know. Journal of the American College of Radiology. 2020;17(4):447-451. doi:10.1016/j.jacr.2020.02.008
21. 21. Demirjian NL, et al. Impacts of the Coronavirus Disease 2019 (COVID-19) pandemic on healthcare workers: A nationwide survey of United States radiologists. Clinical Imaging. 2020;68:218-225. doi:10.1016/j.clinimag.2020.08.027
22. 22. Open Source Epidemiologic Statistics for Public Health. https://www.openepi.com/Menu/OE_Menu.htm
23. 23. Akın A, Çetin B. The Depression, Anxiety and Stress Scale (DASS): The Study of Validity and Reliability. Educ Sci Theory Pract. 2007;7(7):260-268.
24. 24. Eker D, Arkar H, Yaldız H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support, (in Turkish). Turkish Journal of Psychiatry. 2001;12(1):17-25.
25. 25. Boysan M. Validity of the Coping Inventory For Stressful Situations - Short Form (CISS-21) in a non-clinical Turkish sample / Stresli Durumlarla Başa Çıkma Envanteri Kısa Formu’nun (SDBÇE-21) klinik dışı Türk örnekleminde geçerliliği. Dusunen Adam. Published online June 12, 2012:101-107. doi:10.5350/DAJPN2012250201
26. 26. Chew QH, et al. Perceived Stress, Stigma, Traumatic Stress Levels and Coping Responses amongst Residents in Training across Multiple Specialties during COVID-19 Pandemic—A Longitudinal Study. IJERPH. 2020;17(18):6572. doi:10.3390/ijerph17186572
27. 27. Cong CW, Ling WS, Aun TS. Problem-focused coping and depression among adolescents: Mediating effect of self-esteem. Curr Psychol. 2021;40(11):5587-5594. doi:10.1007/s12144-019-00522-4
28. 28. Sharma S, et al. Coping strategies and emotional responses adopted by health care workers during COVID-19 pandemic-braving the storm. Journal of Anaesthesiology Clinical Pharmacology. 2023;39(4):628-636. doi:10.4103/joacp.joacp_196_22
29. 29. Ćufta M. Stress and Religious Faiths, (in Turkish). Pamukkale Üniversitesi İlahiyat Fakültesi Dergisi. 2016;0(5):50-70. doi:10.17859/pauifd.14501
30. 30. Wang H. Workplace Violence (WPV) Prevention Training Program for a Healthcare Organization. Doctor of Nursing Practice (DNP) Scholarly Projects. 2022. https://digitalcommons.spu.edu/shs_dnp/36/
31. 31. Dyer O. US hospitals tighten security as violence against staff surges during pandemic. BMJ. Published online October 5, 2021:n2442. doi:10.1136/bmj.n2442
32. 32. Rodríguez-Bolaños R, et al.The Urgent Need to Address Violence Against Health Workers During the COVID-19 Pandemic. Medical Care. 2020;58(7):663-663. doi:10.1097/MLR.0000000000001365
33. 33. Devi S. COVID-19 exacerbates violence against health workers. The Lancet. 2020;396(10252):658. doi:10.1016/S0140-6736(20)31858-4
34. 34. Tengilimoğlu D, et al. Impacts of COVID-19 pandemic period on depression, anxiety and stress levels of the healthcare employees in Turkey. Legal Medicine. 2021;48:101811. doi:10.1016/j.legalmed.2020.101811
35. 35. Ing EB, Xu Q (A), Salimi A, Torun N. Physician deaths from corona virus (COVID-19) disease. Occupational Medicine. 2020;70(5):370-374. doi:10.1093/occmed/kqaa088
36. 36. Tabah A, et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey. Journal of Critical Care. 2020;59:70-75. doi:10.1016/j.jcrc.2020.06.005
37. 37. Chen Q, et al. Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020;7(4):e15-e16. doi:10.1016/S2215-0366(20)30078-X
38. 38. Huang L, et al. Factors Influencing anxiety of health care workers in the Radiology Department with high exposure risk to COVID-19. Med Sci Monit. 2020;26. doi:10.12659/MSM.926008
39. 39. Kırılmaz H, Yorgun S, Atasoy A. A Research on determination of psychosocial risk factors in health employee. International Journal of Cultural and Social Studies (IntJCSS). 2016;2(1):66-82.
40. 40. Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Research. 2020;290:113130. doi:10.1016/j.psychres.2020.113130
41. 41. Mo Y, et al. Work stress among Chinese nurses to support Wuhan in fighting against COVID‐19 epidemic. J Nurs Manag. 2020;28(5):1002-1009. doi:10.1111/jonm.13014
42. 42. Mahamid FA, Veronese G, Bdier D. Fear of coronavirus (COVID-19) and mental health outcomes in Palestine: The mediating role of social support. Curr Psychol. 2023;42(10):8572-8581. doi:10.1007/s12144-021-02395-y
43. 43. Schmuck J, et al. Sense of coherence, social support and religiosity as resources for medical personnel during the COVID-19 pandemic: A web-based survey among 4324 health care workers within the German Network University Medicine. Doering S, ed. PLoS ONE. 2021;16(7):e0255211. doi:10.1371/journal.pone.0255211
44. 44. Küçükkavradım U. Investigation of the Relationship between Body and Social Support Perception to Depression Level in a Group of Women with Mastectomy, (in Turkish). MSc. Thesis. Işık University; 2020.
45. 45. Alnazly E, Khraisat OM, Al-Bashaireh AM, Bryant CL. Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers. Fernández-Alcántara M, ed. PLoS ONE. 2021;16(3):e0247679. doi:10.1371/journal.pone.0247679
46. 46. Kaşdarma E, Kantar A. Depression and Locus of Control: The multiple mediating role of stress coping strategies, (in Turkish). ETU Journal of Social Sciences Institute. 2021;(13):21-41. doi:10.29157/etusbed.896708
47. 47. Xiao H, 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. 2020;26. doi:10.12659/MSM.923549
48. 48. Sasangohar F, et al. Provider Burnout and Fatigue During the COVID-19 Pandemic: Lessons Learned From a High-Volume Intensive Care Unit. Anesthesia & Analgesia. 2020;131(1):106-111. doi:10.1213/ANE.0000000000004866
49. 49. Kılınç T, Sis Çelik A. Relationship between the social support and psychological resilience levels perceived by nurses during the COVID‐19 pandemic: A study from Turkey. Perspect Psychiatr Care. 2021;57(3):1000-1008. doi:10.1111/ppc.12648
50. 50. Munawar K, Choudhry FR. Exploring stress coping strategies of frontline emergency health workers dealing Covid-19 in Pakistan: A qualitative inquiry. American Journal of Infection Control. 2021;49(3):286-292. doi:10.1016/j.ajic.2020.06.214
51. 51. Folkman S, Lazarus RS. An analysis of coping in a Middle-Aged Community Sample. Journal of Health and Social Behavior. 1980;21(3):219. doi:10.2307/2136617