ASSESSMENT OF THE MENTAL HEALTH STATUS OF HEALTHCARE WORKERS DURING COVID-19 PANDEMIC IN UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN-CITY: A COMPARATIVE STUDY
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BACKGROUND: Globally, COVID-19 pandemic emerged as a major public health concern and has had severe, wide-reaching effects on the functioning of societies, economies, social and healthcare systems worldwide. In addition to the ongoing health crisis, mental health crisis has been unfolding. During the COVID-19 pandemic, healthcare workers had high workload and exposure to multiple psychosocial stressors. The psychological impact of the pandemic on healthcare workers has been assessed worldwide, but there are limited data on how health care workers have been affected in Low and Middle Income Countries (LMICs). OBJECTIVES: The objectives of this study were to assess and compare the knowledge, attitude, prevalence and effect of COVID-19 on the mental health status of Frontline and Non-Frontline Health Workers of University of Benin Teaching Hospital (UBTH) and also to identify their coping strategies. METHODOLOGY: A comparative cross-sectional study was conducted from August 2021 through June 2023 among Frontline Health Workers and Non-Frontline Health Workers of University of Benin Teaching Hospital, Benin-City using a systemic random sampling technique. The sample size was calculated using the formula for estimating two proportions for a comparative cross-sectional study. Ethical approval was obtained from the Ethics and Research
Committee, University of Benin Teaching Hospital. Data was collected using a structured self administered questionnaire adapted and modified from the World Health Organization (WHO) Interim Guidance document on the knowledge, attitude and practice of health care workers during COVID-19 pandemic, General Health Questionnaire (GHQ-12) and the Brief-COPE Strategy scale. Data was analyzed with IBM SPSS version 25.0 and the level of significance was set at p < 0.05. Data presentation was done using graphs, frequency tables and prose. RESULT: A total of 500 respondents with mean age (SD) of 37.5 ± 5.6 and 39.9 ± 6.2 years for Frontline and Non-Frontline Health Workers participated in this study respectively. Findings from the World Health Organization (WHO) Interim Guidance document on the knowledge, attitude and practice of health care workers during COVID-19 used to assess knowledge and attitude of respondents revealed that: majority 145 (86.8%) and 191 (57.4%) of the Frontline and Non-Frontline Health Workers had overall good knowledge of COVID-19 (p < 0.001, 0.006 respectively) and a high proportion 134 (80.2%) and 284 (85.3%) of the Frontline and Non Frontline Health Workers had overall positive attitude towards COVID-19 (p = 0.054, 0.096 respectively). The General Health Questionnaire (GHQ-12) tool used to assess the mental health status of respondents showed that majority 148 (88.6%) of the Frontline Health Workers experienced depression, anxiety and PTSD while 286 (85.8%) of the Non-Frontline Health Workers experienced depression, anxiety and psychological distress (p = 0.240, 0.547 respectively). Being more aware (good knowledge), Frontline Health Workers were 24.7% times more likely to be psychologically affected (depression, anxiety and PTSD) by COVID-19 compared to Non As a result of positive attitude, Frontline Health Workers were 85.5% times more likely to be psychologically affected (depression, anxiety and PTSD) by COVID-19 compared to Non Frontline Health Workers. This was also statistically significant (p= 0.444, OR: 1.855, 95% CI: 0.381– 9.021). The Brief-COPE Strategy scale used to assess coping styles of respondents showed that most 137 (82.0%) of the Frontline Health Workers coping styles were religion, getting support from people, making fun and being positive of the situation while 255 (76.6%) of the Non-Frontline Health Workers coping styles were getting support from people, concentrating on their work and use of drugs and alcohol (p = 0.128, p= 0.162 respectively). Coping styles were effective for both categories. Frontline Health Workers with tertiary level of education were 10.3% times less likely to be psychologically affected (depression, anxiety and PTSD) by COVID-19 compared to Non Frontline Health Workers. This was however not statistically significant (p= 0.082, OR: 0.897, 95% CI: 0.216– 3.734).
CONCLUSION: From this study, respondents had overall good knowledge of COVID-19. Good knowledge was higher among Frontline Health Workers than in Non-Frontline Health Workers. Majority of the respondents had positive attitude towards COVID-19, and it was observed to be higher among Frontline Health Workers than in Non-Frontline Health Workers.
About half of the respondents tested positive to COVID-19. Positive test was higher in Frontline Health Workers than Non-Frontline Health Workers. Higher proportion of the population were affected mentally. Negative mental health effect was
noticed to be higher among Frontline Health Workers compared to Non-Frontline Health Workers. Domains such as depression, anxiety, PTSD and psychological distress were identified as areas responsible for the psychological symptoms. Good knowledge of COVID-19, positive attitude towards COVID-19 and religion were predictors of coping styles among Non-Frontline Health Workers while knowledge of COVID 19, attitude towards COVID-19, level of education and marriage were identified as predictors of coping styles of Frontline Health Workers. Timely identification and implementation of an appropriate support to vulnerable groups would effectively mitigate the mental health impact of future pandemics on Health Care Workers. KEYWORDS: COVID-19, Health Care Workers, Mental Health, Depression, Anxiety, PTSD, coping strategies
Committee, University of Benin Teaching Hospital. Data was collected using a structured self administered questionnaire adapted and modified from the World Health Organization (WHO) Interim Guidance document on the knowledge, attitude and practice of health care workers during COVID-19 pandemic, General Health Questionnaire (GHQ-12) and the Brief-COPE Strategy scale. Data was analyzed with IBM SPSS version 25.0 and the level of significance was set at p < 0.05. Data presentation was done using graphs, frequency tables and prose. RESULT: A total of 500 respondents with mean age (SD) of 37.5 ± 5.6 and 39.9 ± 6.2 years for Frontline and Non-Frontline Health Workers participated in this study respectively. Findings from the World Health Organization (WHO) Interim Guidance document on the knowledge, attitude and practice of health care workers during COVID-19 used to assess knowledge and attitude of respondents revealed that: majority 145 (86.8%) and 191 (57.4%) of the Frontline and Non-Frontline Health Workers had overall good knowledge of COVID-19 (p < 0.001, 0.006 respectively) and a high proportion 134 (80.2%) and 284 (85.3%) of the Frontline and Non Frontline Health Workers had overall positive attitude towards COVID-19 (p = 0.054, 0.096 respectively). The General Health Questionnaire (GHQ-12) tool used to assess the mental health status of respondents showed that majority 148 (88.6%) of the Frontline Health Workers experienced depression, anxiety and PTSD while 286 (85.8%) of the Non-Frontline Health Workers experienced depression, anxiety and psychological distress (p = 0.240, 0.547 respectively). Being more aware (good knowledge), Frontline Health Workers were 24.7% times more likely to be psychologically affected (depression, anxiety and PTSD) by COVID-19 compared to Non As a result of positive attitude, Frontline Health Workers were 85.5% times more likely to be psychologically affected (depression, anxiety and PTSD) by COVID-19 compared to Non Frontline Health Workers. This was also statistically significant (p= 0.444, OR: 1.855, 95% CI: 0.381– 9.021). The Brief-COPE Strategy scale used to assess coping styles of respondents showed that most 137 (82.0%) of the Frontline Health Workers coping styles were religion, getting support from people, making fun and being positive of the situation while 255 (76.6%) of the Non-Frontline Health Workers coping styles were getting support from people, concentrating on their work and use of drugs and alcohol (p = 0.128, p= 0.162 respectively). Coping styles were effective for both categories. Frontline Health Workers with tertiary level of education were 10.3% times less likely to be psychologically affected (depression, anxiety and PTSD) by COVID-19 compared to Non Frontline Health Workers. This was however not statistically significant (p= 0.082, OR: 0.897, 95% CI: 0.216– 3.734).
CONCLUSION: From this study, respondents had overall good knowledge of COVID-19. Good knowledge was higher among Frontline Health Workers than in Non-Frontline Health Workers. Majority of the respondents had positive attitude towards COVID-19, and it was observed to be higher among Frontline Health Workers than in Non-Frontline Health Workers.
About half of the respondents tested positive to COVID-19. Positive test was higher in Frontline Health Workers than Non-Frontline Health Workers. Higher proportion of the population were affected mentally. Negative mental health effect was
noticed to be higher among Frontline Health Workers compared to Non-Frontline Health Workers. Domains such as depression, anxiety, PTSD and psychological distress were identified as areas responsible for the psychological symptoms. Good knowledge of COVID-19, positive attitude towards COVID-19 and religion were predictors of coping styles among Non-Frontline Health Workers while knowledge of COVID 19, attitude towards COVID-19, level of education and marriage were identified as predictors of coping styles of Frontline Health Workers. Timely identification and implementation of an appropriate support to vulnerable groups would effectively mitigate the mental health impact of future pandemics on Health Care Workers. KEYWORDS: COVID-19, Health Care Workers, Mental Health, Depression, Anxiety, PTSD, coping strategies
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