Despite the much heralded epidemic of adjustment difficulties, health-care workers (HCW), who are likely to be at risk and impacted with mental health issues, have received scant attention. This study aimed to determine whether definable profiles exist in a cohort of HCWs associated with demographic and mental health problems.

Methods

An online cross-sectional survey was conducted in Oman. Demographic and mental health data were collected from 8 to 17 April 2020. A total of 1132 participants returned their completed questionnaire. A two-step cluster analysis was used to split the sample into three clusters.

Results

Cluster A (n = 416) was from HCW in non-frontline roles, and constituted “low-risk and least-impacted”. Cluster B (n = 412) and Cluster C (n = 304) were from frontline HCW and constituted ‘high-risk and moderate-impacted’ and ‘high-risk and high-impacted’ groups, respectively. HCWs in Cluster C reported more depression (P < 0.001), anxiety (P < 0.001), stress (P < 0.001) and clinical insomnia (P < 0.001) compared with those in the other clusters. HCWs in Cluster C were at the highest risk for mental health problems during the pandemic.

Conclusions

Early psychological interventions targeting this vulnerable group may be beneficial. Management should develop different tailor-made strategic plans to address different mental health needs for each profile group.

Summary statement

What is already known about this topic?

Nurses, physicians and allied health-care workers (HCWs) experienced many kinds of psychological problems, including depression, anxiety, stress and insomnia during the COVID-19 outbreak.

What this paper adds?

The HCWs in Cluster A were more experienced, did not work in the frontline and reported a lower prevalence of depression, anxiety, stress and insomnia. This group was labelled as the ‘low risk and least impacts’ group.
The HCWs in Cluster B were predominantly nurses and doctors working in the frontline and reported a higher prevalence of anxiety and stress. This cluster was labelled as the ‘high risk but moderate impacts’ group.
The HCWs in Cluster C were predominantly nurses who were younger, with less working experience and work in the frontline but reporting a higher prevalence of depression, anxiety, stress and insomnia. This cluster was labelled as the ‘high risk and high impacts’ group.

The implications of this paper:

Management should develop different tailor-made strategic plans to address different mental health needs for each profile group.
Online cognitive behaviour therapy targeting this vulnerable group may be beneficial during the COVID-19 pandemic.

CONFLICT OF INTEREST

The authors declare no conflicts of interest.

Open Research

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request. The data are not publicly available due to the raw data containing information that could compromise research participant privacy/consent.

REFERENCES

Al-Awaidy, S. T., & Khamis, F. (2020). Preparing the community for a vaccine against COVID-19. Oman Medical Journal, 35(6), e193. https://doi.org/10.5001/omj.2020.130
10.5001/omj.2020.130
CAS PubMed Google Scholar
Alshekaili, M., Hassan, W., Al-Said, N., Alsulaimani, F., Kumar, S., Al-Mawali, A., Chan, M. F., Mahadevan, S., & Al-Adawi, S. (2020). Factors associated with mental health outcomes in Oman during COVID19: Frontline versus non-frontline healthcare workers. BMJ Open, 10(10), e042030. https://doi.org/10.1136/bmjopen-2020-042030
10.1136/bmjopen-2020-042030
PubMed Web of Science® Google Scholar
Chan, M. F. (2006). Investigating nurses' knowledge, attitudes, and skills patterns towards clinical management system: Results of a cluster analysis. Medical Informatics and the Internet in Medicine, 31(3), 161–174. https://doi.org/10.1080/14639230600643608
10.1080/14639230600643608
CAS PubMed Google Scholar
Chew, N. W. S., Cheong, C., Kong, G., Phua, K., Ngiam, J. N., Tan, B. Y. Q., Wang, B., Hao, F., Tan, W., Han, X., Tran, B. X., Hoang, M. T., Pham, H. Q., Vu, G. T., Chen, Y., Danuaji, R., Komalkumar, R. N., Meenakshi, P. V., Talati, K., … Sharma, V. K. (2021). An Asia-Pacific study on healthcare workers' perceptions of, and willingness to receive, the COVID-19 vaccination. International Journal of Infectious Diseases, 106, 52–60. https://doi.org/10.1016/j.ijid.2021.03.069
10.1016/j.ijid.2021.03.069
CAS PubMed Web of Science® Google Scholar
Chew, N. W. S., Lee, G. K. H., Tan, B. Y. Q., Jing, M., Goh, Y., Ngiam, N. J. H., Yeo, L. L. L., Ahmad, A., Ahmed Khan, F., Napolean Shanmugam, G., Sharma, A. K., Komalkumar, R. N., Meenakshi, P. V., Shah, K., Patel, B., Chan, B. P. L., Sunny, S., Chandra, B., Ong, J. J. Y., … Sharma, V. K. (2020). A multinational, multicenter study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, Behavior, an Immunity., 88, 559–565. https://doi.org/10.1016/j.bbi.2020.04.049
10.1016/j.bbi.2020.04.049
CAS PubMed Web of Science® Google Scholar
Chowdhury, S. R., Sunna, T. C., Das, D. C., Kabir, H., Hossain, A., Mahmud, S., & Ahmed, S. (2021). Mental health symptoms among the nurses of Bangladesh during the COVID-19 pandemic. Middle East Current Psychiatry, 28, 23. https://doi.org/10.1186/s43045-021-00103-x
10.1186/s43045-021-00103-x
Google Scholar
Hair, J. F. J., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Multivariate data analysis, chapter 8. In Cluster Analysis ( 7th ed.) (pp. 415–474). Essex, England: Pearson Education Limited.
Google Scholar
Hao, F., Tan, W., Jiang, L., Zhang, L., Zhao, X., Zou, Y., Hu, Y., Luo, X., Jiang, X., McIntyre, R. S., Tran, B., Sun, J., Zhang, Z., Ho, R., Ho, C., & Tam, W. (2020). Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain, Behavior, and Immunity, 87, 100–106. https://doi.org/10.1016/j.bbi.2020.04.069
10.1016/j.bbi.2020.04.069
CAS PubMed Web of Science® Google Scholar
Hendy, A., Abozeid, A., Sallam, G., Abboud Abdel Fattah, H., & Ahmed Abdelkader Reshia, F. (2021). Predictive factors affecting stress among nurses providing care at COVID-19 isolation hospitals at Egypt. Nursing Open, 8(1), 498–505. https://doi.org/10.1002/nop2.652
10.1002/nop2.652
Web of Science® Google Scholar
Ho, C. S. H., Lim, L. J. H., Lim, A. Q., Chan, N. H. C., Tan, R. S., Lee, S. H., & Ho, R. C. M. (2020). Diagnostic and predictive applications of functional near-infrared spectroscopy for major depressive disorder: A systematic review. Frontiers in Psychiatry, 11, 378. https://doi.org/10.3389/fpsyt.2020.00378
10.3389/fpsyt.2020.00378
PubMed Web of Science® Google Scholar
Huang, J. Z., Han, M. F., Luo, T. D., Ren, A. K., & Zhou, X. P. (2020). Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19. 38(3), 192–195. Available from: https://pubmed.ncbi.nlm.nih.gov/32131151/. Accessed 13 Dec 2020. https://doi.org/10.3760/cma.j.cn121094-20200219-00063
Google Scholar
Husain, S. F., Ong, S. K., Cuizhen, L., Tran, B., Ho, R. C., & Ho, C. S. (2020). Functional near-infrared spectroscopy uring a decision-making task in patients with major depressive disorder. Australian and New Zealand Journal of Psychiatry Dec 10:4867420976856, 55(5), 485–493. https://doi.org/10.1177/0004867420976856
10.1177/0004867420976856
PubMed Web of Science® Google Scholar
Husain, S. F., Yu, R., Tang, T. B., Tam, W. W., Tran, B., Quek, T. T., Hwang, S. H., Chang, C. W., Ho, C. S., & Ho, R. C. (2019). Validating a functional near-infrared spectroscopy diagnostic paradigm for major depressive disorder. Scientific Reports, 10(1), 9740. https://doi.org/10.1038/s41598-020-66784-2
10.1038/s41598-020-66784-2
Web of Science® Google Scholar
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., Yang, B. X., Wang, Y., Hu, J., Lai, J., Ma, X., Chen, J., Guan, L., Wang, G., Ma, H., & Liu, Z. (2020). The mental health of medical Workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry, 7(3), e14. https://doi.org/10.1016/S2215-0366(20)30047-X
10.1016/S2215-0366(20)30047-X
PubMed Web of Science® Google Scholar
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R., & Tan, H. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
10.1001/jamanetworkopen.2020.3976
PubMed Web of Science® Google Scholar
Le, X. T. T., Nguyen, Q. T., Onyango, B., Nguyen, Q. N., Pham, Q. T., Ta, N. T. K., Nguyen, T. T., Le, H. T., Vu, L. G., Hoang, M. T., Vu, G. T., Latkins, C. A., Ho, R. C. M., & Ho, C. S. H. (2021). Perception toward exposure risk of COVID-19 among health workers in Vietnam: Status and correlated factors. Frontiers in Public Health, 9, 589317. https://doi.org/10.3389/fpubh.2021.589317
10.3389/fpubh.2021.589317
PubMed Web of Science® Google Scholar
Liu, C. Y., Yang, Y. Z., Zhang, X. M., Xu, X., Dou, Q. L., Zhang, W. W., & Cheng, A. S. (2020). The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey. Epidemiology & Infection, 148(Mar 8), 1, e98–7. https://doi.org/10.1017/S0950268820001107
Google Scholar
Marthoenis, M., Fathiariani, L., & Nassimbwa, J. (2021). Investigating the burden of mental distress among nurses at a provincial COVID-19 referral hospital in Indonesia: A cross-sectional study. BMC Nursing, 20, 76. https://doi.org/10.1186/s12912-021-00596-1
10.1186/s12912-021-00596-1
CAS PubMed Web of Science® Google Scholar
Moussa, M. T., Lovibond, P., Laube, R., & Megahead, H. A. (2017). Psychometric properties of an Arabic version of the depression anxiety stress scales (DASS). Research on Social Work Practice, 27, 375–386. https://doi.org/10.1177/1049731516662916
10.1177/1049731516662916
Web of Science® Google Scholar
Olszewska-Guizzo, A., Mukoyama, A., Naganawa, S., Dan, I., Husain, S. F., Ho, C. S., & Ho, R. (2021). Hemodynamic response to three types of urban spaces before and after lockdown during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18, 6118. https://doi.org/10.3390/ijerph18116118
10.3390/ijerph18116118
CAS PubMed Web of Science® Google Scholar
Pan, R., Zhang, L., & Pan, J. (2020). The anxiety status of Chinese medical workers during the epidemic of COVID-19: A meta-analysis. Psychiatry Investigation, 17(5), 475–480. https://doi.org/10.30773/pi.2020.0127
10.30773/pi.2020.0127
CAS PubMed Web of Science® Google Scholar
Prothom Alo. (2020). Healthcare frontliners struggle with stigma in Bangladesh. Available from: https://en.prothomalo.com/opinion/op-ed/healthcare-frontliners-struggle-with-stigma-in-bangladesh. Accessed 13 Dec 2020.
Google Scholar
Qunaibi, E., Basheti, I., Soudy, M., & Sultan, I. (2021). Hesitancy of Arab healthcare workers towards COVID-19 vaccination: A large-scale multinational study. Vaccines (Basel), 9(5), 446. https://doi.org/10.3390/vaccines9050446
10.3390/vaccines9050446
CAS PubMed Web of Science® Google Scholar
Romero, C. S., Catalá, J., Delgado, C., Ferrer, C., Errando, C., Iftimi, A., Benito, A., de Andrés, J., Otero, M., & PSIMCOV group. (2020). COVID-19 psychological impact in 3109 healthcare workers in Spain: The PSIMCOV group. Psychological Medicine, 1–14. https://doi.org/10.1017/S0033291720001671
10.1017/S0033291720001671
PubMed Web of Science® Google Scholar
Rossi, R., Socci, V., Pacitti, F., Di Lorenzo, G., Di Marco, A., & Siracusano, A. (2020). Mental health outcomes among frontline and second-line health care workers during the coronavirus disease 2019 (COVID-19) pandemic in Italy. JAMA Network Open, 3(5), e2010185. https://doi.org/10.1001/jamanetworkopen.2020.10185
10.1001/jamanetworkopen.2020.10185
PubMed Web of Science® Google Scholar
Sampaio, F., Sequeira, C., & Teixeira, L. (2021). Impact of COVID-19 outbreak on Nurses' mental health: A prospective cohort study. Environmental Research, 194, 110620. https://doi.org/10.1016/j.envres.2020.110620
10.1016/j.envres.2020.110620
CAS PubMed Web of Science® Google Scholar
Sasangohar, F., Jones, S. L., Masud, F. N., Vahidy, F. S., & Kash, B. A. (2020). Provider burnout and fatigue during the COVID-19 pandemic: Lessons learned from a high-volume intensive care unit. Anesthesia and Analgesia. Apr 20., 131, 106–111. https://doi.org/10.1213/ANE.0000000000004866
10.1213/ANE.0000000000004866
CAS PubMed Web of Science® Google Scholar
Sergeant, E. S. G. (2018). Epitools epidemiological calculators. Ausvet. Available at: http://epitools.ausvet.com.au
Google Scholar
Shensa, A., Sidani, J. E., Dew, M. A., Escobar-Viera, C. G., & Primack, B. A. (2018). Social media use and depression and anxiety symptoms: A cluster analysis. American Journal of Health Behavior, 42(2), 116–128. https://doi.org/10.5993/AJHB.42.2.11
10.5993/AJHB.42.2.11
PubMed Web of Science® Google Scholar
Soh, H. L., Ho, R. C., Ho, C. S., & Tam, W. W. (2020). Efficacy of digital cognitive Behavioural therapy for insomnia: A meta-analysis of randomized controlled trials. Sleep Medicine, 75, 315–325. https://doi.org/10.1016/j.sleep.2020.08.020
10.1016/j.sleep.2020.08.020
PubMed Web of Science® Google Scholar
Sohrabi, C., Alsafi, Z., O'Neill, N., Khan, M., Kerwan, A., al-Jabir, A., Iosifidis, C., & Agha, R. (2020). World health organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery, 76, 71–76. https://doi.org/10.1016/j.ijsu.2020.02.034
10.1016/j.ijsu.2020.02.034
PubMed Web of Science® Google Scholar
Suleiman, K. H., & Yates, B. C. (2011). Translating the insomnia severity index into Arabic. Journal of Nursing Scholarship, 43, 49–53. https://doi.org/10.1111/j.1547-5069.2010.01374.x
10.1111/j.1547-5069.2010.01374.x
PubMed Web of Science® Google Scholar
Tan, B. Y. Q., Chew, N. W. S., Lee, G. K. H., Jing, M., Goh, Y., Yeo, L. L. L., Zhang, K., Chin, H. K., Ahmad, A., Khan, F. A., Shanmugam, G. N., Chan, B. P. L., Sunny, S., Chandra, B., Ong, J. J. Y., Paliwal, P. R., Wong, L. Y. H., Sagayanathan, R., Chen, J. T., … Sharma, V. K. (2020). Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Annals of Internal Medicine, 173, M20–M1083. https://doi.org/10.7326/M20-1083
10.7326/M20-1083
Web of Science® Google Scholar
Tan, Y. Q., Wang, Z., Yap, Q. V., Chan, Y. H., Ho, R. C., Hamid, A. R. A. H., Landaluce-Olavarria, A., Pellino, G., Gauhar, V., Chand, M., Wroclawski, M. L., Hameed, B. M. Z., Ling, S. K. K., Sengupta, S., Gallo, G., Chiu, P. K. F., Tanidir, Y., Tallada, M. P. V., Garcia, B. N., … Chiong, E. (2021). Psychological health of surgeons in a time of COVID-19: A global survey. Annuals of Surgery. Jan 22, Ahead of Print. https://doi.org/10.1097/SLA.0000000000004775
10.1097/SLA.0000000000004775
Google Scholar
Tee, M. L., Tee, C. A., Anlacan, J. P., Aligam, K. J. G., Reyes, P. W. C., Kuruchittham, V., & Ho, R. C. (2020). Psychological impact of COVID-19 pandemic in the Philippines. Journal of Affective Disorders, 277, 379–391. https://doi.org/10.1016/j.jad.2020.08.043
10.1016/j.jad.2020.08.043
CAS PubMed Web of Science® Google Scholar
Wang, C., Chudzicka-Czupala, A., Grabowski, D., Pan, R., Adamus, K., Wan, X., Hetnał, M., Tan, Y., Olszewska-Guizzo, A., Xu, L., McIntyre, R. S., Quek, J., Ho, R., & Ho, C. (2020). The association between physical and mental health and face mask use during the COVID-19 pandemic: A comparison of two countries with different views and practices. Frontiers in Psychiatry, 11, 569981. https://doi.org/10.3389/fpsyt.2020.569981
10.3389/fpsyt.2020.569981
PubMed Web of Science® Google Scholar
Wang, C., Fardin, M. A., Shirazi, M., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Tran, B., Quek, T. T. C., Husain, S. F., Wang, J., Ho, C., & Ho, R. (2021). Mental health of the general population during the 2019 coronavirus disease (COVID-19) pandemic: A tale of two developing countries. Psychiatry International., 2(1), 71–84. https://doi.org/10.3390/psychiatryint2010006
10.3390/psychiatryint2010006
Google Scholar
Wang, C., Lopez-Nunez, M. I., Pan, R., Wan, X., Tan, Y., Xu, L., Choo, F., Ho, R., Ho, C., & Aparicio García, M. E. (2021). The impact of the COVID-19 pandemic on physical and mental health in China and Spain: Cross-sectional study. JMIR Formative Research, 5(5), e27818. https://doi.org/10.2196/27818
10.2196/27818
PubMed Google Scholar
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K., & Ho, C. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 87, 40–48. https://doi.org/10.1016/j.bbi.2020.04.028
10.1016/j.bbi.2020.04.028
CAS PubMed Web of Science® Google Scholar
World Health Organization [WHO]. (2020). Regional Office for the Eastern Mediterranean. Oman: WHO collaboration in Oman's response to COVID-19. http://www.emro.who.int/omn/oman-news/who-collaboration-on-omans-response-to-covid-19.html
Google Scholar
Zhang, M. W. B., & Ho, R. C. M. (2017). Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technology and Health Care, 25(1), 163–165. https://doi.org/10.3233/THC-161261
10.3233/THC-161261
PubMed Web of Science® Google Scholar
Zhang, S. X., Liu, J., Afshar Jahanshahi, A., Nawaser, K., Yousefi, A., Li, J., & Sun, S. (2020). At the height of the storm: Healthcare staff's health conditions and job satisfaction and their associated predictors during the epidemic peak of COVID-19. Brain, Behavior, and Immunity, S0889-1591(20), 30783–30782. https://doi.org/10.1016/j.bbi.2020.05.010
Google Scholar

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Volume27, Issue6

December 2021

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Mental health outcomes among health-care workers in Oman during COVID-19: A cluster analysis

Abstract

Aim

Methods

Results

Conclusions

Summary statement

CONFLICT OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

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Mental health outcomes among health-care workers in Oman during COVID-19: A cluster analysis

Abstract

Aim

Methods

Results

Conclusions

Summary statement

CONFLICT OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Related

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