Volume 23, Issue 5 (December & January - Special Issue on COVID-19 2020)                   J Arak Uni Med Sci 2020, 23(5): 710-723 | Back to browse issues page


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Rahmanian M, Kamali A R, Mosalanezhad H, Foroughian M, Kalani N, Hatami N, et al . A Comparative Study on Anxiety of Medical and Non-medical Staff due to Exposure and Non-exposure ‎to the Novel Coronavirus Disease. J Arak Uni Med Sci 2020; 23 (5) :710-723
URL: http://jams.arakmu.ac.ir/article-1-6418-en.html
1- Critical Care and Pain Management Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
2- Department of Anesthesiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
3- Department of Health, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
4- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5- Center for Health and the Social Sciences, Jahrom University of Medical Sciences, Jahrom, Iran.
6- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
7- Department of Emergency Medicine, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. , e.rayat.dost@gmail.com
8- Department of Emergency Medicine, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
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1. Introduction
oronavirus disease (Covid-19), caused by SARS-COV-2 virus, was first diagnosed in December 2019 in Wuhan, China [1]. The lack of any definitive treatment or preventive method, and the prediction of some epidemiologists that at least 60% of the population is infected with Covid-19, has caused a lot of stress and anxiety in people [2]. Fear and anxiety caused by a disease are destructive and can lead to mental disorders. Fear and stress by stimulating the hypothalamus in the brain and subsequently increasing the secretion of cortisol from the adrenal gland and stimulating the sympathetic nerves throughout the body in the short term is beneficial for the body to deal with stressors [3], but if this fear and stress and the body’s response (increased cortisol levels and sympathetic stimulation) continue for a long time, it is destructive and can lead to a weakened immune system and reduced ability of the body to fight diseases such as Covid-19 [4].
2. Materials and Methods
In this descriptive cross-sectional study, 402 medical and administrative staff working in hospitals and health centers of Jahrom city in Iran who were exposed to or not exposed to Covid-19 were selected for the study using census method. Researchers first visited the health centers and hospitals in Jahrom city, and after obtaining permission from them, data were collected by using a demographic form (surveying age, gender, marital status, level of education, occupation, place of residence, workplace department, work experience, number of people living together at home, history of domestic or international travel in the past month, having/not having Covid-19, and type of employment), and the Corona Disease Anxiety Scale (CDAS). Collected data were analyzed in SPSS V. 21 software by using descriptive statistics (frequency, mean, percentage) and statistical tests including ANOVA, considering a significance level of P<0.05.
3. Results
As shown in Table 1, the mean overall score of anxiety in the medical staff (16.12) was higher than in the administrative staff (14.46) during the Covid-19 pandemic in Jahrom city. 


The mean score of mental symptoms in the medical staff (46.91) was also higher than in the administrative staff (42.63) as well as the mean score of physical symptoms (12.80 vs. 10.94).There was a significant difference between medical and administrative staff in terms of mean anxiety (P=0.030). Comparison of the estimated marginal means showed that the mean score of anxiety in the medical staff (17.68) was higher than in the administrative staff (14.049). The estimated marginal mean of anxiety in female medical staff was higher than in female administrative staff, and was higher in male medical staff than in female administrative staff. Comparison of the estimated marginal means showed that the mean score of mental symptoms in the medical staff (12.59) was higher than in the administrative staff (11.12). The estimated marginal mean of physical symptoms in female medical staff was higher than in female administrative staff, and was higher in male medical staff than in male administrative staff. In the age groups of <30 years and 31-40 years, there was no significant difference in the physical symptoms between the medical and administrative staff, but in the age groups of 41-50 years and >50 years, the mean anxiety of medical staff was significantly higher than that of administrative staff (Table 2). 


4. Discussion and Conclusion
The present study compared the level of anxiety in medical and non-medical staff to identify risk factors and their level of anxiety. The results of the present study showed that working in a hospital and caring for patients with Covid-19 was a risk factor for increasing anxiety scores in the medical staff compared to non-medical staff. The results of the present study showed that there was a significant difference between the medical and administrative staff in terms of Covid-19-induced anxiety. Benjamin et al. (2020) conducted a study to investigate the psychological impact of COVID-19 on 470 health care workers in Singapore. Their results showed that the non-medically trained hospital personnel experience more anxiety than the medically trained hospital personnel during the Covid-19 outbreak [28]. This is against our results. In our study, the anxiety level of medical staff was higher than that of administrative staff. The level of anxiety reported in the present study is lower than in the studies conducted in this field [32، 31، 20، 13], and higher than the level presented in other study [21]. This difference in anxiety may be due to the use of different tools to measure anxiety. Moreover, the time of the present study coincided with the second wave of COVID-19 outbreak in Iran, while the above studies were conducted before the second wave. At this time, the Iranian Ministry of Health and Medical Education and the Coronavirus Disease Control Headquarters took more precautions to prevent the disease. This resulted in a higher level of anxiety among the medical staff. Considering the importance of mental health including anxiety in the medical staff and the important role it plays in strengthening safety, special measures should be taken to reduce anxiety among health care providers.

Ethical Considerations
Compliance with ethical guidelines

This study was extracted from a research proposal and approved by the Jahrom University of Medical Sciences (Code: IR.JUMS.REC.1399.046).

Funding
This study was supported by the Clinical Research Development Unit of Peymaniyeh Hospital in Jahrom, Iran.

Authors' contributions
Conseptualization, problem design, writing – review & editing: All Authors; Methodology and data analysis: Navid Kalani, Nasser Hatami and Mohammad Heidarnejad.

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgements
The authors would like to thank the Clinical Research Development Unit of Peymaniyeh Hospital in Jahrom, Iran for their support and cooperation.


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Type of Study: Original Atricle | Subject: COVID-19
Received: 2020/08/22 | Accepted: 2020/11/4

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