Factors associated with mental health outcomes across healthcare settings in Oman during COVID-19: frontline versus non-frontline healthcare workers.

This study aims to assess and compare demographic and psychological factors and sleep status of frontline healthcare workers (HCWs) in relation to non-frontline HCWs. This cross-sectional study was conducted from 8 April 2020 to 17 April 2020 using an online survey across varied healthcare settings in Oman accruing 1139 HCWs.The primary and secondary outcomes were mental health status and sociodemographic data, respectively. Mental health status was assessed using the Depression, Anxiety, and Stress Scale (DASS-21), and insomnia was evaluated by the Insomnia Severity Index. Samples were categorised into the frontline and non-frontline groups. χ2 and t-tests were used to compare groups by demographic data. The Mantel-Haenszel OR was used to compare groups by mental health outcomes adjusted by all sociodemographic factors. This study included 1139 HCWs working in Oman. While working during the pandemic period, a total of 368 (32.3%), 388 (34.1%), 271 (23.8%) and 211 (18.5%) respondents were reported to have depression, anxiety, stress and insomnia, respectively. HCWs in the frontline group were 1.5 times more likely to report anxiety (OR=1.557, p=0.004), stress (OR=1.506, p=0.016) and insomnia (OR=1.586, p=0.013) as compared with those in the non-frontline group. No significant differences in depression status were found between the frontline and non-frontline groups (p=0.201). To our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on different grades of HCWs. This study suggests that frontline HCWs are disproportionally affected compared to non-frontline HCWs, with managing sleep-wake cycles and anxiety symptoms being highly endorsed among frontline HCWs. As psychosocial interventions are likely to be constrained owing to the pandemic, mental healthcare must first be directed to frontline HCWs.

Alshekaili M ，Hassan W ，Al Said N ，Al Sulaimani F ，Jayapal SK ，Al-Mawali A ，Chan MF ，Mahadevan S ，Al-Adawi S ... -  《BMJ Open》

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.

Lai J ，Ma S ，Wang Y ，Cai Z ，Hu J ，Wei N ，Wu J ，Du H ，Chen T ，Li R ，Tan H ，Kang L ，Yao L ，Huang M ，Wang H ，Wang G ，Liu Z ，Hu S ... -  《JAMA Network Open》

Mental Health in Frontline Medical Workers during the 2019 Novel Coronavirus Disease Epidemic in China: A Comparison with the General Population.

Liang Y ，Wu K ，Zhou Y ，Huang X ，Zhou Y ，Liu Z ... -  《-》

Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis.

COVID-19 pandemic has the potential to significantly affect the mental health of healthcare workers (HCWs), who stand in the frontline of this crisis. It is, therefore, an immediate priority to monitor rates of mood, sleep and other mental health issues in order to understand mediating factors and inform tailored interventions. The aim of this review is to synthesize and analyze existing evidence on the prevalence of depression, anxiety and insomnia among HCWs during the Covid-19 outbreak. A systematic search of literature databases was conducted up to April 17th, 2020. Two reviewers independently assessed full-text articles according to predefined criteria. Risk of bias for each individual study was assessed and data pooled using random-effects meta-analyses to estimate the prevalence of specific mental health problems. The review protocol is registered in PROSPERO and is available online. Thirteen studies were included in the analysis with a combined total of 33,062 participants. Anxiety was assessed in 12 studies, with a pooled prevalence of 23·2% and depression in 10 studies, with a prevalence rate of 22·8%. A subgroup analysis revealed gender and occupational differences with female HCPs and nurses exhibiting higher rates of affective symptoms compared to male and medical staff respectively. Finally, insomnia prevalence was estimated at 38·9% across 5 studies. Early evidence suggests that a considerable proportion of HCWs experience mood and sleep disturbances during this outbreak, stressing the need to establish ways to mitigate mental health risks and adjust interventions under pandemic conditions.

Pappa S ，Ntella V ，Giannakas T ，Giannakoulis VG ，Papoutsi E ，Katsaounou P ... -  《-》

Depression, anxiety and insomnia among frontline healthcare workers amid the coronavirus pandemic (COVID-19) in Jordan: a cross-sectional study.

This study aimed to explore the prevalence and factors associated with depression, anxiety and insomnia among frontline healthcare workers (HCWs) in Jordan. A cross-sectional design was conducted among 122 frontline HCWs who have dealt with suspected or confirmed cases of COVID-19. The study survey included standardised questionnaires of the 7-item Generalized Anxiety Disorder (GAD-7) Scale, 9-item Patient Health Questionnaire (PHQ-9) and the Insomnia Severity Index (ISI). Data were collected online during the active surge period of cases from 11 May 2020 to 13 June 2020. The statistical analysis included descriptive statistics, analysis of variance, bivariate correlation and multivariate linear regression analyses. A total of 122 HCWs participated in the study (response rate=64.2%). Among the participants, 44.3% were physicians, 32.8% were nurses and 17.2% were paramedics. The mean age of participants was 32.1 (±5.8) years, and the majority were males (80.3%). The mean scores for GAD-7, PHQ-9 and ISI were 8.5 (±5.2), 9.5 (±5.7) and 11.2 (±6.4), respectively. Results showed that the participants reported severe symptoms of anxiety (29.5%), depression (34.5%) and insomnia (31.9%), with no observed differences based on gender, job title, marital status or educational level. Moreover, in the multivariate linear regression, none of the independent factors were associated with GAD-7, PHQ-9 or ISI scores, and the only exception was increased severity of insomnia among paramedics. The COVID-19 pandemic has exerted strenuous emotional, psychological and physical pressures on the health of frontline HCWs.

Oteir AO ，Nazzal MS ，Jaber AF ，Alwidyan MT ，Raffee LA ... -  《BMJ Open》