Psychological impact of COVID-19 on healthcare workers in Sri Lanka

BackgroundHealthcare workers (HCWs) are at risk of mental health problems during a pandemic. Whether they are stationed at the frontline or not may also have implications on their mental health. Differences in perceptions about social and occupational circumstances, as well as coping methods, affect outcomes. The aim of our study was to assess depression, anxiety and stress among HCWs, and to explore differences between frontline and non-frontline workers. MethodsA cross-sectional study was conducted on HCWs, including both frontline and non-frontline personnel, at a COVID-19 screening tertiary hospital located in a densely-populated suburb in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS)-21. Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square, and logistic regression was used to adjust for confounders. Odds ratios were calculated for the effect of different perceptions on psychological morbidity. ResultsA total of 467 HCWs participated, consisting of 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with a female preponderance (n=341, 77%). The prevalence of depression, anxiety and stress among HCWs in general were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p&lt;0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026) compared to the frontline group. Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and the lack of training to cope with the situation predicted poor mental health outcomes. Non-frontline HCWs were more likely to hold such perceptions. ConclusionsDepression, anxiety and stress were more prevalent in non-frontline HCWs when compared to frontline workers in a tertiary COVID-19 screening teaching hospital. Addressing factors that lead to negative psychological outcomes in HCWs should be a key concern during this pandemic.<br>