EC Psychology and Psychiatry

Research Article Volume 12 Issue 6 - 2023

Factors Associated with Anxiety Disorders among Healthcare Workers (HCWS) Involved in the Health Crisis COVID 19

Carole Pélissier1,2*, Mariasole Varano1, Martine Moulin1, Pierre Carcasset1 and Luc Fontana1,2

1Occupational Health Service University Hospital of Saint-Etienne, Saint Etienne, France

2Univ Lyon, Univ Lyon 1, Univ St Etienne, Univ Gustave Eiffel, Saint Etienne, France

*Corresponding Author: Carole Pélissier, Occupational Health Service University Hospital of Saint-Etienne, Saint Etienne, France.
Received: March 30, 2023; Published:June 29, 2023



This study aims to assess the prevalence of anxiety disorders in healthcare workers (HCWs) by COVID-19 sectors and to investigate medical, personal, and occupational factors associated with anxiety disorder among.

In France, in May 2020, a monocentric observational cross-sectional study was proposed to 285 HCWs of the University Hospital of Saint-Etienne, working in 3 types of randomly selected care services. Information was collected using an anonymous self-questionnaire offered to eligible HCWs. Validated questionnaires were used to assess anxiety (Hospital anxiety and Depression Scale) and burnout (Maslach Burnout Inventory).

Of the 164 HCWs who participated in the study (57% participation rate), 69 (42%) caregivers had anxious symptomatology. The prevalence of anxiety disorders did not differ significantly by type of service. Anxiety disorders are significantly associated with occupational factors (increased COVID-19 stress level, increased emotional load, increased mental load, high work/life stress during confinement, emotional exhaustion and loss of empathy), with medical factors (medical history of anxiety disorders, psychotropic treatment and impaired sleep quality) and personal factors (concern about working conditions and/or media reports).

Preventive actions focusing on organizational factors could be carried out to reduce the emotional and mental load, the level of stress and the burnout of HCWs.

Keywords: COVID 19 and Mental Health; Occupational Stress; Burnout; Employee Mental Health

  1. Dhama K., et al. “COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics”. Human Vaccines and Immunotherapeutics (2020): 232‑23
  2. Mizumoto K and Chowell G. “Estimating Risk for Death from 2019 Novel Coronavirus Disease, China, January-February 2020”. Emerging Infectious Diseases 6 (2020).
  3. World Health Organization. Coronavirus disease (COVID-19) advice for the public (2020).
  4. Ramiz L., et al. “A longitudinal study of mental health before and during COVID-19 lockdown in the French population”. Global Health 1 (2021): 29.
  5. Ferioli M., et al. “Protecting healthcare workers from SARS-CoV-2 infection: practical indications”. The European Respiratory Review (2020).
  6. Liu C., et al. “The prevalence and influencing factors for anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey”. Med Rxiv (2020): 20032003.
  7. Pappa S., et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis (2020).
  8. Lu W., et al. “Psychological status of medical workforce during the COVID- 19 pandemic: A cross-sectional study”. Psychiatry Research 288 (2020): 112936.
  9. Altmayer V., et al. “Coronavirus disease 2019 crisis in Paris: A differential psychological impact between regular intensive care unit staff members and reinforcement workers”. Australian Critical Care 2 (2021): 142‑145.
  10. Horn M., et al. “Psychological impact of the COVID-19 pandemic on non-frontline healthcare workers”. General Hospital Psychiatry (2021): S0163-8343.
  11. World Health Organization Coronavirus Disease [COVID-19], Situation Dashboard (2020).
  12. Bjelland I., et al. “The validity of the Hospital Anxiety and Depression Scale - An updated literature review”. Journal of Psychosomatic Research 52 (2002): 69‑77.
  13. Lesage FX and Chamoux A. “Utilisation de l’échelle visuelle analogique (EVA) dans l’évaluation du stress au travail: limites et perspectives. Revue de la littérature”. Archives des Maladies Professionnelles et de l’Environnement 5 (2008): 667‑671.
  14. Maslach C., et al. “Maslach Burnout Inventory manual”. Palo Alto, CA7 Consulting Psychological Press (1996).
  15. Muller AE., et al. “The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review”. Psychiatry Research 293 (2020): 113441.
  16. Lai J., et al. “Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019”. JAMA Network Open 3 (2020): e203976‑e203976.
  17. Leung GM., et al. “Longitudinal Assessment of Community Psychobehavioral Responses during and after the 2003 Outbreak of Severe Acute Respiratory Syndrome in Hong Kong”. Clinical Infectious Diseases12 (2005): 1713‑1720.
  18. Xiao X., et al. “Psychological impact of healthcare workers in China during COVID-19 pneumonia epidemic: A multi-center cross-sectional survey investigation”. Journal of Affective Disorders 274 (2020): 405‑4
  19. Woon LSC., et al. “Mental Health Status of University Healthcare Workers during the COVID-19 Pandemic: A Post–Movement Lockdown Assessment”. International Journal of Environmental Research and Public Health 24 (2020): 9155.
  20. Kalmbach DA., et al. “Insomnia symptoms and short sleep predict anxiety and worry in response to stress exposure: a prospective cohort study of medical interns”. Sleep Medicine 55 (2019): 40‑4
  21. Janati Idrissi A., et al. “Sleep quality and mental health in the context of COVID-19 pandemic and lockdown in Morocco”. Sleep Medicine 74 (2020): 248‑2
  22. Biggs QM., et al. “Acute stress disorder, depression, and tobacco use in disaster workers following 9/11”. American Journal of Orthopsychiatry 4 (2010): 586‑592.
  23. Arafa A., et al. “Depressed, anxious, and stressed: What have healthcare workers on the frontlines in Egypt and Saudi Arabia experienced during the COVID-19 pandemic?” Journal of Affective Disorder 278 (2021): 365‑3
  24. El-Hage W., et al. “[Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?]”. Encephale (2020): S73‑S
  25. Zhang W Rui., et al. “Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China”. PPS 4 (2020): 242‑250.
  26. Lenzo V., et al. “Depression, Anxiety, and Stress Among Healthcare Workers During the COVID-19 Outbreak and Relationships with Expressive Flexibility and Context Sensitivity”. Frontiers in Psychology 12 (2021): 623033.
  27. Mo Y., et al. “Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic”. Journal of Nursing Management 5 (2020): 1002‑1009.
  28. Triana‐Palencia E., et al. “Use of assessment scales, turnover and job strain in nursing staff: A study in a Colombian hospital”. Journal of Nursing Management 1 (2019): 42‑51.
  29. Patel RS., et al. “Factors Related to Physician Burnout and Its Consequences: A Review”. Behavioral Sciences 11 (2018).
  30. Shah K., et al. “How Essential Is to Focus on Physician’s Health and Burnout in Coronavirus (COVID-19) Pandemic?” Cureus 4 (2020): e7538.

Carole Pélissier., et al. Factors Associated with Anxiety Disorders among Healthcare Workers (HCWS) Involved in the Health Crisis COVID 19. EC Psychology and Psychiatry 12.6 (2023): 21-32.