THE PSYCHOLOGICAL TOLL OF THE COVID-19 PANDEMIC ON HEALTHCARE WORKERS IN SAUDI ARABIA: A CROSS-SECTIONAL STUDY
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Abstract
An Overview of the Introduction Researchers in the Kingdom of Saudi Arabia (KSA) have paid little attention to how COVID-19 has affected the mental health of healthcare professionals (HCWs). We identified risk factors that put Saudi Arabian healthcare professionals at risk for psychological distress and measured its frequency and intensity during the COVID-19 pandemic. Techniques The 1,985 healthcare workers (HCWs) from 6 hospitals around the country who are responsible for caring for COVID-19 patients were surveyed online using a cross-sectional design from April 16, 2020, to June 21, 2020. We analysed our data using logistic regressions. In addition, ordered logistic regressions with forward stepwise model selection were employed to examine the correlation between risk factors and psychological distress. End Results Medical professionals in Saudi Arabia frequently reported mild to severe psychological anguish. Those who dealt with COVID-19 patients, were younger, female, and/or had loved ones afflicted by the virus were most likely to experience psychological anguish. Loneliness, insomnia, fear of transmission, and separation from loved ones were the risk variables that most heavily predicted increased distress levels among HCWs. Finally, in the initial months of the COVID-19 pandemic, several HCWs in Saudi Arabia reported increasing levels of psychological distress. Mental health professionals and public health policymakers in KSA should pay special attention to the variables that put healthcare workers at risk for psychological discomfort.
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1. 1.Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ. 2020;368: m1211. pmid:32217624 o View Article o PubMed/NCBI o Google Scholar 2. 2.Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to Coronavirus disease 2019. JAMA Netw Open. 2020;3: e203976. pmid:32202646 o View Article o PubMed/NCBI o Google Scholar 3. 3.Ayanian JZ. Mental health needs of health care workers providing frontline COVID-19 care. JAMA Health Forum. 2020;1: e200397. o View Article o Google Scholar 4. 4.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: 112936. pmid:32276196 o View Article o PubMed/NCBI o Google Scholar 5. 5.Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann Intern Med. 2020;173: 317–320. pmid:32251513 o View Article o PubMed/NCBI o Google Scholar 6. 6.Du J, Dong L, Wang T, Yuan C, Fu R, Zhang L, et al. Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. Gen Hosp Psychiatry. 2020;67: 144–145. pmid:32381270 o View Article o PubMed/NCBI o Google Scholar 7. 7.Zhang W-R, Wang K, Yin L, Zhao W-F, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom. 2020;89: 242–250. pmid:32272480 o View Article o PubMed/NCBI o Google Scholar 8. 8.Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88: 559–565. pmid:32330593 o View Article o PubMed/NCBI o Google Scholar 9. 9.Li Z, Ge J, Yang M, Feng J, Qiao M, Jiang R, et al. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immun. 2020;88: 916–919. pmid:32169498 o View Article o PubMed/NCBI o Google Scholar 10. 10.Montemurro N. The emotional impact of COVID-19: From medical staff to common people. Brain, behavior, and immunity. Elsevier BV; 2020. Pp. 23–24. https://doi.org/10.1016/j.bbi.2020.03.032 11. 11.Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004;55: 1055–1057. pmid:15345768 o View Article o PubMed/NCBI o Google Scholar 12. 12.Pfefferbaum B, North CS. Mental health and the covid-19 pandemic. N Engl J Med. 2020;383: 510–512. pmid:32283003 o View Article o PubMed/NCBI o Google Scholar 13. 13.Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun. 2020;87: 34–39. pmid:32298803 o View Article o PubMed/NCBI o Google Scholar 14. 14.Nezlek JB, Wesselmann ED, Wheeler L, Williams KD. Ostracism in everyday life. Group Dyn. 2012;16: 91–104. o View Article o Google Scholar 15. 15.Choi KR, Heilemann MV, Fauer A, Mead M. A second pandemic: Mental health spillover from the novel Coronavirus (COVID-19). J Am Psychiatr Nurses Assoc. 2020;26: 340–343. pmid:32340586 o View Article o PubMed/NCBI o Google Scholar 16. 16.Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry. 2020;7: e15–e16. pmid:32085839 o View Article o PubMed/NCBI o Google Scholar 17. 17.Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. The lancet. Psychiatry. Elsevier BV; 2020. Pp. 300–302. https://doi.org/10.1016/S2215-0366(20)30073-0 18. 18.Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42: 377–381. pmid:18929686 o View Article o PubMed/NCBI o Google Scholar 19. 19.Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95: 103208. pmid:31078660 o View Article o PubMed/NCBI o Google Scholar 20. 20.Xiao H, Zhang Y, Kong D, Li S, Yang N. 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: e923549. pmid:32132521 o View Article o PubMed/NCBI o Google Scholar 21. 21.Zhang SX, Wang Y, Rauch A, Wei F. Unprecedented disruption of lives and work: Health, distress and life satisfaction of working adults in China one month into the COVID-19 outbreak. Psychiatry Res. 2020;288: 112958. pmid:32283450 o View Article o PubMed/NCBI o Google Scholar 22. 22.AlAteeq DA, Aljhani S, Althiyabi I, Majzoub S. Mental health among healthcare providers during coronavirus disease (COVID-19) outbreak in Saudi Arabia. J Infect Public Health. 2020;13: 1432–1437. pmid:32933881 o View Article o PubMed/NCBI o Google Scholar 23. 23.Pierce M, McManus S, Jessop C, John A, Hotopf M, Ford T, et al. Says who? The significance of sampling in mental health surveys during COVID-19. Lancet Psychiatry. 2020;7: 567–568. pmid:32502467 o View Article o PubMed/NCBI o Google Scholar 24. 24.Hardesty DM, Bearden WO. The use of expert judges in scale development. J Bus Res. 2004;57: 98–107. o View Article o Google Scholar 25. 25.Ministry of Health Saudi Arabia. 2020 Health Indicators. Available: https://www.moh.gov.sa/en/Ministry/Statistics/Indicator/Pages/Indicator-2020.aspx. Accessed 23 Feb 2022. o View Article o Google Scholar 26. 26.Saudi Arabia announces first case of coronavirus. Arab news. 2 Mar 2020. Available: https://www.arabnews.com/node/1635781/saudi-arabia. Accessed 1 Mar 2022. 27. 27.Saudi Arabia extends curfew as coronavirus cases reach 900. Arab news. 25 Mar 2020. Available: https://www.arabnews.com/node/1647141/saudi-arabia. Accessed 1 Mar 2022. 28. 28.Kalin S. Saudi Arabia closes mosques, calls G20 leaders to meet over coronavirus. Reuters. 17 Mar 2020. Available: https://www.reuters.com/article/us-health-coronavirus-saudi/saudi-arabia-closes-mosques-calls-g20-leaders-to-meet-over-coronavirus-idUSKBN2143DH. Accessed 23 Feb 2022. 29. 29.Naar I. Saudi Arabia suspends all schools until further notice amid coronavirus concerns. 2020. Available: https://english.alarabiya.net/News/gulf/2020/03/08/Coronavirus-Saudi-Arabia-suspends-all-schools-universities-until-further-notice. Accessed 23 Feb 2022. o View Article o Google Scholar 30. 30.Saudi Press Agency. Kingdom’s government decides to suspend attendance at workplaces in all government agencies for period of (16) days except for health, security, military and electronic security center. 2020. Available from: https://www.spa.gov.sa/viewfullstory.php?lang=en&newsid=2047989. Accessed 23 Feb 2022. o View Article o Google Scholar 31. 31.Saudi Press Agency. Official Source at Ministry of Interior: Clarification of Curfews’ Exceptions. 2020. Available from: https://www.spa.gov.sa/viewfullstory.php?lang=en&newsid=2050408. Accessed 23 Feb 2022. o View Article o Google Scholar 32. 32.Altwaijri YA, Al-Habeeb A, Bilal L, Shahab MK, Pennell B-E, Mneimneh Z, et al. The Saudi National Mental Health Survey: Survey instrument and field procedures. Int J Methods Psychiatr Res. 2020;29. pmid:33245571 o View Article o PubMed/NCBI o Google Scholar 33. 33.Shahab M, Al-Tuwaijri F, Bilal L, Hyder S, Al-Habeeb AA, Al-Subaie A, et al. The Saudi National Mental Health Survey: Methodological and logistical challenges from the pilot study. Int J Methods Psychiatr Res. 2017;26: e1565. pmid:28497533 o View Article o PubMed/NCBI o Google Scholar 34. 34.Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32: 959–976. pmid:12214795 o View Article o PubMed/NCBI o Google Scholar 35. 35.Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60: 184–189. pmid:12578436 o View Article o PubMed/NCBI o Google Scholar 36. 36.Forman-Hoffman VL, Muhuri PK, Novak SP, Pemberton MR, Ault KL, Mannix D. CBHSQ DATA REVIEW. 2014 [cited 23 Feb 2022]. Available: https://www.samhsa.gov/data/sites/default/files/CBHSQ-DR-C11-MI-Mortality-2014/CBHSQ-DR-C11-MI-Mortality-2014.pdf. o View Article o Google Scholar 37. 37.Prochaska JJ, Sung H-Y, Max W, Shi Y, Ong M. Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization. Int J Methods Psychiatr Res. 2012;21: 88–97. pmid:22351472 o View Article o PubMed/NCBI o Google Scholar 38. 38.Furukawa TA, Kessler RC, Slade T, Andrews G. The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med. 2003;33: 357–362. pmid:12622315 o View Article o PubMed/NCBI o Google Scholar 39. 39.Al Ammari M, Sultana K, Thomas A, Al Swaidan L, Al Harthi N. Mental health outcomes amongst health care workers during COVID 19 pandemic in Saudi Arabia. Front Psychiatry. 2020;11: 619540. pmid:33519559 o View Article o PubMed/NCBI o Google Scholar 40. 40.Almalki AH, Alzahrani MS, Alshehri FS, Alharbi A, Alkhudaydi SF, Alshahrani RS, et al. The psychological impact of COVID-19 on healthcare workers in Saudi Arabia: A year later into the pandemic. Front Psychiatry. 2021;12: 797545. pmid:34975592 o View Article o PubMed/NCBI o Google Scholar 41. 41.Mohsin SF, Agwan MA, Shaikh S, Alsuwaydani ZA, AlSuwaydani SA. COVID-19: Fear and anxiety among healthcare workers in Saudi Arabia. A cross-sectional study. Inquiry. 2021;58: 469580211025225. pmid:34291693 o View Article o PubMed/NCBI o Google Scholar 42. 42.Abolfotouh MA, Almutairi AF, BaniMustafa AA, Hussein MA. Perception and attitude of healthcare workers in Saudi Arabia with regard to Covid-19 pandemic and potential associated predictors. BMC Infect Dis. 2020;20: 719. pmid:32993538 o View Article o PubMed/NCBI o Google Scholar 43. 43.Al Mutair A, Al Mutairi A, Ambani Z, Shamsan A, AlMahmoud S, Alhumaid S. The impact of COVID-19 pandemic on the level of depression among health care workers: cross-sectional study. PeerJ. 2021;9: e11469. pmid:34046264 o View Article o PubMed/NCBI o Google Scholar 44. 44.Temsah M-H, Al-Sohime F, Alamro N, Al-Eyadhy A, Al-Hasan K, Jamal A, et al. The psychological impact of COVID-19 pandemic on health care workers in a MERS-CoV endemic country. J Infect Public Health. 2020;13: 877–882. pmid:32505461 o View Article o PubMed/NCBI o Google Scholar 45. 45.Al-Subaie AS, Al-Habeeb A, Altwaijri YA. Overview of the Saudi National Mental Health Survey. Int J Methods Psychiatr Res. 2020;29: e1835. pmid:33245612 o View Article o PubMed/NCBI o Google Scholar 46. 46.Gengler JJ, Tessler M, Lucas R, Forney J. ‘why do you ask?’ the nature and impacts of attitudes towards public opinion surveys in the Arab world. Br J Polit Sci. 2021;51: 115–136. o View Article o Google Scholar 47. 47.Benstead LJ. Survey research in the Arab world: Challenges and opportunities. PS Polit Sci Polit. 2018;51: 535–542. o View Article o Google Scholar 48. 48.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. Gen Psychiatr. 2020;33: e100213. pmid:32215365 o View Article o PubMed/NCBI o Google Scholar 49. 49.Yang Y, Li W, Zhang Q, Zhang L, Cheung T, Xiang Y-T. Mental health services for older adults in China during the COVID-19 outbreak. Lancet Psychiatry. 2020;7: e19. pmid:32085843 o View Article o PubMed/NCBI o Google Scholar 50. 50.Ruiz MA, Gibson C-AM. Emotional impact of the COVID-19 pandemic on U.S. health care workers: A gathering storm. Psychol Trauma. 2020;12: S153–S155. pmid:32478556 o View Article o PubMed/NCBI o Google Scholar 51. 51.Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395: 912–920. pmid:32112714 o View Article o PubMed/NCBI o Google Scholar 52. 52.Wong TW, Yau JKY, Chan CLW, Kwong RSY, Ho SMY, Lau CC, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. Eur J Emerg Med. 2005;12: 13–18. pmid:15674079 o View Article o PubMed/NCBI o Google Scholar 53. 53.Xiang Y-T, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7: 228–229. pmid:32032543 o View Article o PubMed/NCBI o Google Scholar 54. 54.Freeman D, Sheaves B, Waite F, Harvey AG, Harrison PJ. Sleep disturbance and psychiatric disorders. Lancet Psychiatry. 2020;7: 628–637. pmid:32563308 o View Article o PubMed/NCBI o Google Scholar 55. 55.Ferini-Strambi L, Zucconi M, Casoni F, Salsone M. COVID-19 and sleep in medical staff: Reflections, clinical evidences, and perspectives. Curr Treat Options Neurol. 2020;22: 29. pmid:32834711 o View Article o PubMed/NCBI o Google Scholar 56. 56.McGinty EE, Presskreischer R, Han H, Barry CL. Psychological distress and loneliness reported by US adults in 2018 and April 2020. JAMA. 2020;324: 93–94. pmid:32492088 o View Article o PubMed/NCBI o Google Scholar 57. 57.Chan-Yeung M. Severe acute respiratory syndrome (SARS) and healthcare workers. Int J Occup Environ Health. 2004;10: 421–427. pmid:15702757 o View Article o PubMed/NCBI o Google Scholar 58. 58.Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA. 2020;323: 1439–1440. pmid:32163102 o View Article o PubMed/NCBI o Google Scholar 59. 59.Saudi Arabia ready to launch vaccine campaign. Arab news. 12 Dec 2020. Available: https://www.arabnews.com/node/1775896/saudi-arabia. Accessed 1 Mar 2022. 60. 60.Kun P, Han S, Chen X, Yao L. Prevalence and risk factors for posttraumatic stress disorder: a cross-sectional study among survivors of the Wenchuan 2008 earthquake in China. Depress Anxiety. 2009;26: 1134–1140. pmid:19842170 o View Article o PubMed/NCBI o Google Scholar 61. 61.Program to help Saudi health workers manage stress. Arab news. 16 Jun 2020. Available: https://www.arabnews.com/node/1690391/saudi-arabia. Accessed 1 Mar 2022. 62. 62.Lima CKT, Carvalho PM de M, Lima I de AAS, Nunes JVA de O, Saraiva JS, de Souza RI, et al. The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatry Res. 2020;287: 112915. pmid:32199182 o View Article o PubMed/NCBI o Google Scholar 63. 63.Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, Arango C, Moreno C, Ferre F, et al. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. J Affect Disord. 2020;275: 48–57. pmid:32658823 o View Article o PubMed/NCBI o Google Scholar 64. 64.Cheng P. Supporting frontline health care professionals: Lessons from Wuhan experience. Psychiatr News. 2020;55. o View Article o Google Scholar 65. 65.de Girolamo G, Cerveri G, Clerici M, Monzani E, Spinogatti F, Starace F, et al. Mental Health in the Coronavirus disease 2019 emergency-the Italian response. JAMA Psychiatry. 2020;77: 974–976. pmid:32352480 o View Article o PubMed/NCBI o Google Scholar
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