Abstract
Background:
Working in a primary healthcare facility amidst the Covid-19 pandemic may have detrimental effects on the mental health of nurse clinicians. A complex interplay of biological (e.g., genetics or exposure to infections), psychological (e.g., trauma or loss of a loved one), social (e.g., peer networks, age), and work-related (e.g., work setting, household patterns) elements may lead to mental health issues. There is mounting evidence that both the workload and atmosphere of employment might influence the emergence of mental health issues in the workplace. Low staff morale, absenteeism and increased patient complaints on service delivery warrant a study which will address the problem of anxiety, depression and burnout.
Objectives:
The study aimed to assess the risk factors associated with mental illness (anxiety, depression and burnout) among primary healthcare (PHC) nurse clinicians working in facilities affected by the Covid-19 pandemic, in the Ekurhuleni Health District.
Methods:
A cross-sectional study was conducted, where semi-structured self-administered questionnaires were distributed to 218 PHC nurses. The questionnaire focused on socio-demographic data, occupational history, prevalence of mental illness and exposure to Covid-19. Generalized Anxiety Disorder-7 tool, Patient Health Questionnaire-2 and Oldenburg Burnout Inventory tools were used to assess the prevalence of prevalence of mental illness as defined by anxiety, depression and burnout. A dataset was created and entered into SPSS version 28 where analysis was done. Descriptive statistics were used to analyse the socio-demographic variables as well as the prevalence of mental illness (i.e., anxiety, depression, and burnout) and Covid-19 exposure. Non-parametric tests (i.e., Mann-Whitney U test, Kruskal-Walli’s test) were conducted to assess the relationship between dependent and independent variables.
Results:
A total of 218 semi-structured self-administered questionnaires were completed after obtaining the relevant consent from participants. Data was collected at 15 provincial facilities of which 1 facility declined to participate and a total of 35 participants did not return their questionnaires, leaving a response rate of 84%. The descriptive analysis revealed that of the 183 participants, 86.3% were female, 86.9 % black, 29.5 % between the ages of 45-54 years and 84.7 % had a support system. Occupational history showed that 55.1% of PHC nurses were employed for 1-10 years and 39.3% employed in the same facility for 1-5 years. Furthermore 57.4% experienced mild anxiety, while 80.9% experienced mild depression and 52.5% experienced burnout. There was significant difference between generalized anxiety disorder and having a support system. Working in a Covid area together with shift work showed a significant association with having depression. Burnout showed significant associations with age, working in a Covid area, shift work, number in household, as well as the period of testing positive for Covid-19.
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Conclusion:
In this study we found a relationship between certain demographic, work-related risk factors, and mental health outcomes. The findings of this study will facilitate health promotion through interventions, strengthen preventive and response strategies, and encourage education and training of health care professionals on mental health in the workplace, in particular burnout which was shown to be more prevalent.
KEYWORDS
Covid-19, SARS-COV 2, Coronavirus
Anxiety, Burnout, Mental health, Depression
Primary Health Care Nurse Clinicians, Nurses, Healthcare workers.