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. 2020 Sep 25;16(1):89.
doi: 10.1186/s12992-020-00621-z.

Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Pratik Khanal  1 , Navin Devkota  2 , Minakshi Dahal  3 , Kiran Paudel  4 , Devavrat Joshi  2
Affiliations

Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal

Pratik Khanal et al. Global Health. .

Abstract

Background: Health care workers exposed to COVID-19 might be at increased risk of developing mental health problems. The study aimed to identify factors associated with anxiety, depression and insomnia among health workers involved in COVID-19 response in Nepal.

Methods: This was a cross-sectional web-based survey conducted between April 26 and May 12, 2020. A total of 475 health workers participated in the study. Anxiety and depression were measured using a 14-item Hospital Anxiety and Depression Scale (HADS: 0-21) and insomnia was measured by using a 7-item Insomnia Severity Index (ISI: 0-28). Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes.

Results: Overall, 41.9% of health workers had symptoms of anxiety, 37.5% had depression symptoms and 33.9% had symptoms of insomnia. Stigma faced by health workers was significantly associated with higher odds of experiencing symptoms of anxiety (AOR: 2.47; 95% CI: 1.62-3.76), depression (AOR: 2.05; 95% CI: 1.34-3.11) and insomnia (AOR: 2.37; 95% CI: 1.46-3.84). History of medication for mental health problems was significantly associated with a higher likelihood of experiencing symptoms of anxiety (AOR: 3.40; 95% CI:1.31-8.81), depression (AOR: 3.83; 95% CI: 1.45-10.14) and insomnia (AOR: 3.82; 95% CI: 1.52-9.62) while inadequate precautionary measures in the workplace was significantly associated with higher odds of exhibiting symptoms of anxiety (AOR: 1.89; 95% CI: 1.12-3.19) and depression (AOR: 1.97; 95% CI: 1.16-3.37). Nurses (AOR: 2.33; 95% CI: 1.21-4.47) were significantly more likely to experience anxiety symptoms than other health workers.

Conclusion: The study findings revealed a considerate proportion of anxiety, depression and insomnia symptoms among health workers during the early phase of the pandemic in Nepal. Health workers facing stigma, those with history of medication for mental health problems, and those reporting inadequate precautionary measures in their workplace were more at risk of developing mental health outcomes. A focus on improving mental wellbeing of health workers should be immediately initiated with attention to reduction of stigma, ensuring an adequate support system such as personal protective equipments, and family support for those with history of mental health problems.

Keywords: Anxiety; COVID-19; Depression; Health workers; Insomnia; Mental health; Nepal.

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Conflict of interest statement

Authors have no competing interest associated with this paper. The author’s affiliation does not necessarily reflect the view of their employing organisations. The authors prepared a policy brief of 2 pages based on preliminary findings and have shared it with the Ministry of Health and Population.

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