High Work-related Stress and Anxiety Response to COVID-19 among Healthcare Workers: A Cross-Sectional Online Survey Study in South Korea

Background: Healthcare workers experienced severe psychological impacts of the COVID-19 outbreak. It is important to establish a process of psychological assessment and interventions for healthcare workers affected by epidemics. Objective: We investigated the risk factors associated with the psychological impact of each healthcare worker group, to help optimize psychological interventions for healthcare workers in countries affected by COVID-19. Methods: Participants (N = 1,787) from two hospitals in Korea, completed an online survey from April 14 to 30, 2020, by obtaining information on demographics, psychiatric history and the Stress and Anxiety to Viral Epidemics-9 (SAVE-9), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scales. Logistic regression analyses were performed to assess contributing factors as predictor variables and healthcare workers' depression as outcome variables. Results: Among the 1,783 healthcare workers, compared with other healthcare workers, nursing professionals had significantly higher levels of depression (PHQ-9 score; 5.5 ± 4.6 vs. 3.8 ± 4.2; P < .01), general anxiety (GAD-7 score; 4.0 ± 4.1 vs. 2.7 ± 3.6; P < .01), and virus-related anxiety symptoms (SAVE-9 score; 21.6 ± 5.9 vs. 18.6 ± 6.3; P < .01). In the nursing professionals group, single workers reported more severe depressive symptoms than married workers (PHQ-9 score ≥ 10; 20.3% vs. 14.1%; P < .01), and junior (<40 years) workers reported more anxiety about the viral epidemic (SAVE-9 anxiety score; 15.6 ± 4.1 vs. 14.7 ± 4.4; P < .01). Logistic regression analysis revealed that the hospital factor (adjusted odds ratio [aOR] = 1.45, 95% confidence interval, CI [1.06-1.99]), nursing professionals (aOR = 1.37, 95% CI [1.02-1.98]), single workers (aOR = 1.51, 95% CI [1.05-2.16]), higher stress and anxiety to the viral infection (high SAVE-9 score, aOR = 1.20, 95% CI [1.17-1.24]), and past psychiatric history (aOR = 3.26, 95% CI [2.15-4.96]) were positively associated with depression. Conclusions: Psychological support and interventions should be considered for healthcare workers, especially nursing professionals, those who are single, and those with high SAVE-9 level.