Prevalence and factors associated with anxiety, depression and stress in a COVID-19 nursing team

Appel, Ana Paula; Carvalho, Ariana Rodrigues da Silva; Santos, Reginaldo Passoni dos

doi:10.1590/1983-1447.2021.20200403

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Revista Gaúcha de Enfermagem

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Original Article • Rev. Gaúcha Enferm. 42 (spe) • 2021 • https://doi.org/10.1590/1983-1447.2021.20200403 copy

Prevalence and factors associated with anxiety, depression and stress in a COVID-19 nursing team

Prevalencia y factores asociados con ansiedad, depresión y estrés en un equipo de enfermería COVID-19

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To investigate the levels of anxiety, depression and stress and their associated factors, among nursing professionals who make up the team working against COVID-19 of a University Hospital in the south of Brazil.

Method

Exploratory, descriptive, cross-sectional study conducted from May to July 2020.

Results

From the total number of professionals, 53.8% had anxiety; 38.4% depression; and 40.3%, stress. Age, length of service in the profession, job satisfaction and work shift showed a statistically significant association with depression, while the employment contract, length of service in the UH, length of service in the unit prior to the opening of the COVID-19 unit and satisfaction at work showed a significant association with stress.

Conclusions

The nursing professionals of the COVID-19 team have important levels of anxiety, depression and stress, and the factors associated with depression and stress have been identified.

Keywords
Anxiety; Depression; Occupational stress; Coronavirus infections; Risk factors

Variables	n (%)	Mean±S.D.	Median	Interval
Gender
Female	46 (88.5)
Male	6 (11.5)
Age (years)		38.38±7.13	39.5	23 a 54
≤ 30	8 (15.4)
31 to 40	22 (42.3)
41 to 50	19 (36.5)
> 50	3 (5.8)
Marital status
Married/Consensual union	27 (51.9)
Single	19 (36.5)
Divorced	5 (9.6)
Widower	1 (1.9)
Children
Yes	35 (67.3)
No	17 (32.7)
Profession
Nursing assistant	3 (5.8)
Nursing Technician	37 (71.2)
Nurse	12 (23.1)
Employment contract
SSP- Simplified Selection Process	16 (30.8)
Public Call	18 (34.6)
Public Service Examination	18 (34.6)
Length of service in the profession (years)		12.1±7.46	11	0.25 to 30
Length of service at the institution (years)		5.9±6.6	3	0.2 to 20
Length of service at the unit before the COVID unit		4.2±5.2	1.9	0.2 to 18
Location/unit where worked before the COVID unit (n=50)
Adult wards	8 (16.0)
Pediatric ward	4 (8.0)
Adult ICU	10 (20.0)
Neonatal and Pediatric ICU	4 (8.0)
Emergency	4 (8.0)
SC/OR	6 (11.5)
SMC	1 (2.0)
Another area of activity at UH	1 (2.0)
Did not work at UH	12 (24.0)
Work shift
Morning	12 (23.1)
Afternoon	12 (23.1)
Night	28 (53.8)
Weekly workload in the UH		38.4±5.8	36	36-76
36	32 (61.5)
40	18 (34.6)
>40	2 (3.8)

	Mean±S.D.	Median	Interval	Cronbach’s Alpha
Anxiety	10.4±8.3	9.0	0-32	0.83
Depression	8.8±8.2	8.0	0-34	0.85
Stress	13.9±9.7	14.0	0-34	0.89

Variables	Anxiety			Depression			Stress
	Y	N	p*	Y	N	p*	Y	N	p*
	n (%)	n (%)	p*	n (%)	n (%)	p*	n (%)	n (%)	p*
Gender			0.284			0.784			0.208
Female	26 (56.5)	20 (43.5)		18 (39.1)	28 (60.9)		20 (43.5)	26 (56.5)
Male	2 (33.3)	4 (66.7)		2 (33.3)	4 (66.7)		1 (16.7)	5 (83.3)
Marital status			0.223			0.354			0.510
Single	9 (47.4)	10 (52.6)		10 (52.6)	9 (47.4)		7 (36.8)	12 (63.2)
Married/consensual union	17 (63.0)	10 (37.0)		9 (33.3)	18 (66.7)		13 (48.1)	14 (51.9)
Divorced	1 (20.0)	4 (80.0)		1 (20.0)	4 (80.0)		1 (20.0)	4 (80.0)
Widower	1 (100.0)	0		0	1 (100.0)		0	1 (100.0)
Children			0.274			0.779			0.198
Yes	17 (48.6)	18 (51.4)		13 (37.1)	22 (62.9)		12 (34.3)	23 (65.7)
No	11 (64.7)	6 (35.3)		7 (41.2)	10 (58.8)		9 (52.9)	8 (47.1)
Profession			0.703			0.644			0.418
Nursing assistant	1 (33.3)	2 (66.7)		1 (33.3)	2 (66.7)		2 (66.7)	1 (33.3)
Nursing Technician	21 (56.8)	16 (43.2)		13 (35.1)	24 (64.9)		13 (35.1)	24 (64.9)
Nurse	6 (50.0)	6 (50.0)		6 (50.0)	6 (50.0)		6 (50.0)	6 (50.0)
Location/unit in which worked in the UH before the COVID Unit			0.670			0.453			0.402
Adult wards	5 (10.0)	3 (6.0)		2 (4.0)	6 (12.0)		1 (2.0)	7 (14.0)
Pediatric ward	2 (4.0)	2 (4.0)		2 (4.0)	2 (4.0)		2 (4.0)	2 (4.0)
Adult ICU	7 (14.0)	3 (6.0)		6 (12.0)	4 (8.0)		6 (12.0)	4 (8.0)
Neonatal and Pediatric ICU	2 (4.0)	2 (4.0)		1 (2.0)	3 (6.0)		2 (4.0)	2 (4.0)
Emergency	2 (4.0)	2 (4.0)		2 (4.0)	2 (4.0)		2 (4.0)	2 (4.0)
SC/OR	2 (4.0)	4 (8.0)		1 (2.0)	5 (10.0)		3 (6.0)	3 (6.0)
SMC	1 (2.0)	0		1 (2.0)	0		1 (2.0)	0
Another area of activity at UH	1 (2.0)	0		0	1 (2.0)		1 (2.0)	0
Did not work at UH	6 (12.0)	6 (12.0)		5 (10.0)	7 (14.0)		3 (6.0)	9 (18.0)
Work shift			0.240			0.044			0.425
Morning	9 (75.0)	3 (25.0)		5 (41.7)	7 (58.3)		6 (50.0)	6 (50.0)
Afternoon	6 (50.0)	6 (50.0)		8 (66.7)	4 (33.3)		6 (50.0)	6 (50.0)
Night	13 (46.4)	15 (53.6)		7 (25.0)	21 (75.0)		9 (32.1)	19 (67.9)
Employment contract			0.565			0.204			0.017
SSP	10 (19.2)	6 (11.5)		8 (15.4)	8 (15.4)		5 (9.6)	11 (21.2)
Public Call	8 (15.4)	10 (19.2)		8 (15.4)	10 (19.2)		4 (7.7)	14 (26.9)
Public Service Examination	10 (19.2)	8 (15.4)		4 (7.7)	14 (26.9)		12 (23.1)	6 (11.5)
Weekly workload (in hours)			0.747			0.464			0.477
36	16 (30.8)	16 (30.8)		12 (23.1)	20 (38.5)		13 (25.0)	19 (36.5)
40	11 (21.2)	7 (13.5)		8 (15.4)	10 (19.2)		8 (15.4)	10 (19.2)
>40	1 (1.9)	1 (1.9)		0	2 (3.8)		0	2 (3.8)

Variables	Anxiety			Depression			Stress
	Y	N	p*	Y	N	p*	Y	N	p*
	Mean±S.D.	Mean±S.D.	p*	Mean±S.D.	Mean±S.D.	p*	Mean±S.D.	Mean±S.D.	p*
Age	37.7±7.1	39.2±7.2	0.446	34.7±6.1	40.7±6.8	0.002	38.0±7.7	38.7±6.8	0.723
Length of service in the profession (in years)	11.5±7.9	12.8±7.1	0.520	7.4±6.0	15.0±6.9	0.000	13.0±7.7	11.4±7.4	0.453
Length of service at UH (in years)	6.4±7.0	5.3±6.1	0.550	4.5±5.8	6.7±6.9	0.229	9.1±7.0	3.7±5.3	0.003
Length of service at the unit in which worked before the COVID unit (in years)	3.9±4.9	4.5±5.5	0.673	3.8±4.2	4.4±5.7	0.703	5.9±6.1	3.0±4.1	0.049
Weekly workload (in years)	38.0±2.8	38.8±8.1	0.613	37.6±2.0	38.9±7.3	0.449	37.5±2.0	39.0±7.4	0.387
Job satisfaction	7.6±2.1	8.1±1.7	0.331	7.0±2.3	8.3±1.5	0.015	7.0±2.3	8.4±1.4	0.007

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[1] Corresponding author:
Ariana Rodrigues da Silva Carvalho E-mail: arscarvalho@gmail.com