Results and Discussion
A. Impact
of COVID 19 on health
Anxiety
and depression
The
results of the article [1] found that most health workers reported a
significant increase in psychological problems where (54%) health workers
experienced anxiety and depressive symptoms (27%). In line with research by Adhikari et al., (2021)
which stated that the prevalence of anxiety and depression was 46.95% and
41.31% in health workers. The results of the research article [2] revealed that
levels of anxiety, depression and moderate stress were found to be 35.5%, 27.9%
and 72%, respectively, among health workers. This increased level of anxiety
and depression suggests a potential increase in stress-related disorders. In
line with the results of the study Preti et al., (2020) stated that health
workers, especially including doctors, nurses, and auxiliary staff, reported
symptoms of post-traumatic stress during an outbreak, with symptoms lasting
after 1-3 years in 10-40%. Depression symptoms were reported
27.5-50.7%, and severe anxiety symptoms 45% this is in line with the research
theory. The results of the research article [4]
where from 276 respondents (10.1%) showed increased symptoms of depression. the
prevalence of depressive symptoms was more common among nurses than among other
health professionals. 25.4% of respondents showed symptoms of anxiety. In line
with the research of Khanal et al., (2020) found that 41.9% of health workers
had symptoms of anxiety and 37.5% had symptoms of depression.
The article [9] found that nearly 43% of mental
health problems were work-related including fatigue, anxiety, stress,
depression and emotional distress. This is in line with the research by Huang
& Zhao, (2020) conducted by front-line health workers involved in the
direct diagnosis, treatment, and care of patients with COVID-19 were associated
with a higher risk of depressive symptoms (P = 0.01), anxiety (OR, P <
.001), and distress (P < 0.001).
The
article [7] revealed the same thing where 36% of medical staff had mental
health disorders below the threshold, 34.4% of health workers had mild
disorders, 22.4% had moderate disorders and 6.2% had severe disorders. The
results of the two articles found are in line with the research of Gupta et
al., (2020) showing the prevalence of anxiety disorders is 37.3% among health
workers, with the majority of participants having mild anxiety and 8% of
participants experiencing depression. Work stress can be caused by various
factors such as a pandemic situation that can trigger stress on the pandemic
phenomenon, stress during this pandemic is a form of alertness to exposure to
the COVID-19 virus.dilingkungan kerja (Priyatna et al., 2021).
Other factors that cause stress are organizational factors
where personal protective equipment is depleted, concerns about not being able
to provide competent care, lack of access to up-to-date information and
communication, lack of certain medications, shortage of ventilators and
intensive care unit beds needed to treat surges. patients exposed to COVID 19
(Hasibuan, 2020).
B.
Negative results
The
results of the article [7] stated that health workers with changing work
schedules such as night shifts, rotating shifts and flexible hours also
resulted in employee absenteeism and intention to move. Thus, further mutations
from the COVID-19 pandemic will contribute to increased stress and resignations
as health workers. This is in line with the research of Kwaghe et al., (2021)
who expressed frustration and sometimes wanted to quit their job. Higher
perceived COVID-19 risk and induced psychological distress were associated with
burnout among healthcare employees. Burnout is usually caused by prolonged
stress at work and is associated with unfriendly working conditions, which have
an adverse effect on employee performance [7]. in line with the research of De
los Santos & Larague, (2021) showed that the perceived risk and fear of
contracting the virus resulted in demotivation and low morale among employees.
In addition, absenteeism from work is usually caused by the psychological
pressure felt to work meet the demands of work, work
discomfort, excessive workload, and long working hours. Working in the midst of
media and everyone's attention, the long duration of work may not be
unprecedented for health workers triggering negative psychological effects on
work outcomes. Psychological effects that are felt are emotional disturbances,
depression, stress, bad moods, panic attacks, phobias, symptoms of insomnia and
emotional exhaustion (Handayani et al., 2020).
C.
COVID 19 handling training
The
results of the study [9] stated that almost all doctors reported obtaining
information on COVID 19 from institutional or professional sources, 46% from
newspapers and TV. Almost half reported having received training for telephone
triage, while only 14% received formal training in the management of COVID 19.
The results of this study are not in line with the research conducted by Kotian
et al., (2020) who conducted a study on COVID-19 based on knowledge and
understanding among the public. medical imaging professionals, where they
reported that only 46.5% of participants had received training in the safe use
of PPE.
1.
Risk
factors for anxiety during COVID 19
2.
Become
a health worker
The
results of the study [1] most of the health workers fell ill due to COVID 19
but they considered the risk of infection as part of their job. Significantly
higher percentage of staff, more conflict among coworkers, increased workload, unusual
extra tasks and greater fear of infection. This is in line with the research of
Kwaghe et al., (2021) Accepting COVID-19 assignments is mostly expressed as a
call to duty based on specialization. They felt it was something they had to
do. However, this is not without initial fear and anxiety as expressed by some
respondents. The results of the study [3] that the risk factors for anxiety
were significantly related to the lack of training in controlling infection. In
contrast, severe stress levels are only associated with existing medical
problems. This is because medical practitioners on the front lines of the fight
against the virus are experiencing traumatic events arising from the patient's
condition and high mortality rate. There have been reports of traumatic stress
among medical practitioners in the fight against COVID 19, including cases of
medical practitioners taking their lives. This is in line with research by
Susanti et al., (2020) showing that health workers have a strong sense of
responsibility and teamwork when facing great pressure from heavy workloads,
lack of protective equipment and feelings of helplessness with patients. The
results of the research on risk factors for anxiety that occur due to the
limited availability of health resources and lack of training on pandemic
management are the reasons for higher levels of health workers in Pakistan.
article [7] also shows that most of the medical
workers experiencing high levels of fatigue amid the COVID pandemic adjusting
to new work schedules. The risk of infection of health workers can be reduced
by adequate precautions in health facilities. Primarily, this involves the use
of personal protective equipment (PPE) including gowns, gloves, face masks, and
face shields or goggles. Carefully putting on and taking off this equipment
remains the main defense, but requires adequate training and supervision. Findings
from the article [8] extension of health care emergencies requiring sustained
high levels of workload in the context of continued uncertainty on the
effectiveness of safety procedures and clinical management protocols have led
to a significant increase in symptoms of depression and fatigue among
healthcare workers. This is in line with the research of Ran et al., (2020) The risk of
infection in health workers seems to be related to shift duration and hand
hygiene. Longer working hours have a widespread negative influence on mental
health. While excessive working hours have become commonplace under disease
outbreaks, the health staff is very fragile, with mental health so fragile it
needs to be recognized as soon as possible to avoid further harm. Long work
duration triggers negative psychological effects including emotional
disturbance, depression, stress, low mood, irritability, panic attacks,
phobias, symptoms, insomnia, anger, and emotional exhaustion (Brooks et al., 2020).
3.
Community
stigma
Stigmatization,
fear of infection, and perception of high risk to their work. This is an issue
of great concern to medical care workers in the COVID-19 outbreak and other
similar pandemics, and has been shown to be associated with adverse
psychological outcomes [2]. In line with the study of Miconi et al., (2021)
health workers reported 17.3% of the sample reported having experienced
discrimination related to COVID 19, with the highest prevalence reported by
East and South Asian participants.
The
results of the article [3] reported the absence of social support. In addition,
the absence of social support can be attributed to the lack of security
measures taken by health agencies to protect their staff, thus resulting.
psychological tension of the participants, as they not only face the threat of
fighting the pandemic, but also from being attacked. In line with research
Adhikari et al., (2021) found that frontline worker status was associated with
stigma so that frontline workers were three times more likely to experience
stigma compared to those who did not work in the frontline. Infectious disease
outbreaks have been found to cause stigma among health care workers.
The global health emergency due to the
COVID-19 pandemic has triggered a social crisis marked by discriminatory
behavior and stigma against people who are considered suspects, diagnosed, or
survivors of the virus. Ironically, despite their role in treating COVID-19
sufferers, health workers are no exception to being stigmatized (Bagcchi, 2020).
Around the world, health workers also
experience negative actions that are a result of stigmatization, such as
harassment and violent attacks inside and outside their workplace which are
exacerbated by long working hours, psychological stress, burnout, and job
burnout that are often attached to work. they. Stigma and harassment leading to
intimidation and violence against health workers. These acts of violence have
been shown to increase stress levels and, consequently, exacerbate the
psychological sequelae of moral injury. People who have experienced
discrimination and stigma are at high risk for mental illness, including
anxiety, depression, post-traumatic stress disorder and suicide (Brewis et al., 2020)
4.
Limited
access to mental health services
The results of the article [6] revealed the lack of
availability of psychologists and psychiatrists for psychological treatment for
distressed medical personnel, including less personalized sources of support
such as psychological materials andpsychological resources
available from the media. The availability of psychologists and psychiatrists
positively contributes to reducing mental health problems and physical
discomfort caused by risk factors such as exposure to close contact with COVID
19. This is not in line with the research of Kang et al.,
(2020) where in China psychological assistance (consisting
of volunteers) who had received training in psychological assistance in dealing
with the pandemic provided telephone guidance to help with mental health
issues.Hundreds of medical workers received these interventions, with good
response, and their provision extended to more people and hospitals.
The number of people suffering from mental health
impacts after the COVID-19 event is greater than the number of people who are
physically injured, and mental health effects can last much longer.
Nonetheless, mental health attracts far fewer personnel for planning and
resources (Allsopp et al., 2019). The Global
Mental Health Commission's observation that the use of digital technology can
provide a variety of mental health interventions (Patel et
al., 2018).
Psychological advice and guidance in printed resources
and disseminated in the media can provide a level of protection for medical and
nursing staff, improve mental health by reducing the impact of stress caused by
a high risk of infection (West et al., 2014)
Conclusion
The
results of the 9 articles that have been reviewed by researchers are the impact
of COVID 19 on health workers and risk factors for anxiety during the COVID 19
period. The impact of COVID on health workers is anxiety and depression,
negative work results and training in handling COVID. The factors that cause
COVID are being a health worker, community stigma and limited access to mental
health services.
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