ORIGINAL ARTICLE
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Comparison of anxiety levels of hospitalized COVID-19 patients, individuals under quarantine, and individuals in society
Makbule Tokur Kesgin PhD,
Hümeyra Hançer Tok MSc,
Lütfiye N. Uzun MSc,
Şenay Pehlivan PhD,
Makbule Tokur Kesgin PhD
Department of Public Health Nursing, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorHümeyra Hançer Tok MSc
Bolu Department of Mental Health and Diseases Training and Research Hospital, Bolu, Turkey
Search for more papers by this authorLütfiye N. Uzun MSc
Department of Nursing, Bolu State Hospital, Bolu, Turkey
Search for more papers by this authorCorresponding Author
Şenay Pehlivan PhD
Department of Public Health Nursing, Faculty of Health Sciences, Alanya Alaaddin Keykubat University, Antalya, Turkey
Correspondence Şenay Pehlivan, Department of Nursing, Faculty of Health Sciences, Alanya Alaaddin Keykubat University, Kestel Faculty St. Number: 80, Alanya, Antalya 07450, Turkey.
Email: [email protected]
Search for more papers by this authorMakbule Tokur Kesgin PhD,
Hümeyra Hançer Tok MSc,
Lütfiye N. Uzun MSc,
Şenay Pehlivan PhD,
Makbule Tokur Kesgin PhD
Department of Public Health Nursing, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorHümeyra Hançer Tok MSc
Bolu Department of Mental Health and Diseases Training and Research Hospital, Bolu, Turkey
Search for more papers by this authorLütfiye N. Uzun MSc
Department of Nursing, Bolu State Hospital, Bolu, Turkey
Search for more papers by this authorCorresponding Author
Şenay Pehlivan PhD
Department of Public Health Nursing, Faculty of Health Sciences, Alanya Alaaddin Keykubat University, Antalya, Turkey
Correspondence Şenay Pehlivan, Department of Nursing, Faculty of Health Sciences, Alanya Alaaddin Keykubat University, Kestel Faculty St. Number: 80, Alanya, Antalya 07450, Turkey.
Email: [email protected]
Search for more papers by this authorAbstract
Purpose
This study aims to compare the anxiety levels of COVID-19 patients, individuals under quarantine, and healthy individuals in society.
Design and Methods
This cross-sectional study was conducted from May 25, 2020 to June 25, 2020 in a city located in the northwest of Turkey. The data were collected using a personal information form, the Beck Anxiety Scale, administered in face-to-face interviews, and online questionnaires. The data were analyzed using descriptive statistics, Kruskal–Wallis, Mann–Whitney U, and logistic regression analyses.
Findings
The anxiety level of individuals under quarantine (Median: min–max = 1: 0–55) was significantly lower statistically compared to that of the rest of the society (Median: min–max = 6: 0–63) and hospitalized COVID-19 patients (Median: min–max = 5: 0–42) (p = 0.0001). Female gender, being 61 years of age and older, having psychiatric and chronic illnesses, and experiencing disrupted sleep patterns were determined to be the factors associated with high levels of anxiety.
Practice Implications
This study found that society in general and hospitalized COVID-19 patients had high anxiety levels. The study results can be useful for creating training and population-based screening programs to control the anxiety of individuals under quarantine, hospitalized COVID-19 patients, and the rest of the society during the pandemic. Additionally, the finding from this study on groups at risk for anxiety will provide important data for future research on this subject and for the planning of health services offered to these groups.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
REFERENCES
- 1 La Rosa G, Mancini P, Bonanno Ferraro G, et al. SARS-CoV-2 has been circulating in northern Italy since December 2019: evidence from environmental monitoring. Sci Total Environ. 2021; 750:141711. https://doi.org/10.1016/j.scitotenv.2020.141711
- 2 WHO. Covid 19 statistics. 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200415-sitrep-86-covid-19.pdf. Accessed May 14, 2021.
- 3 Kong X, Zheng K, Tang M, et al. Prevalence and factors associated with depression and anxiety of hospitalized patients with COVID-19. medRxiv [preprint]. 2020. https://doi.org/10.1101/2020.03.24.20043075
- 4 Tran BX, Nguyen HT, Le HT, et al. Impact of COVID-19 on economic well-being and quality of life of the Vietnamese during the national social distancing. Front Psychol. 2020; 11:565153. https://doi.org/10.3389/fpsyg.2020.565153
- 5 Wang C, Chudzicka-Czupała A, Grabowski D, et al. 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. Front Psychiatry. 2020; 11:569981. https://doi.org/10.3389/fpsyt.2020.569981
- 6 Li J-B, Yang A, Dou K, Cheung RY. Self-control moderates the association between perceived severity of the coronavirus disease 2019 (COVID-19) and mental health problems among the Chinese public. Int J Environ Res Public Health. 2020; 17: 4820.
- 7 Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020; 17(5):1729. https://doi.org/10.3390/ijerph17051729
- 8 Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020; 288:112954. https://doi.org/10.1016/j.psychres.2020.112954
- 9 Ahmed H, Patel K, Greenwood DC, et al. Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis. J Rehabil Med. 2020; 52(5): 2-25. https://doi.org/10.1101/2020.04.16.20067975
- 10 Berger E, Reupert A. The COVID-19 pandemic in Australia: lessons learnt. Psychol Trauma. 2020; 12(5): 494-496. https://doi.org/10.1037/tra0000722
- 11 Alcı D, Aydın O, Aydemir Ö. Reliability and validity of the Turkish form of the severity scale for DSM-5 Generalized Anxiety Disorder. J Clin Psychiatry. 2019; 22(4): 389-395. https://doi.org/10.5505/kpd.2019.97759
- 12 Chew NWS, Lee GKH, Tan BYQ, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020; 88: 559-565. https://doi.org/10.1016/j.bbi.2020.04.049
- 13 Tan YQ, Wang Z, Yap QV, et al. Psychological health of surgeons in a time of COVID-19: a global survey [published online ahead of print January 22, 2021]. Ann Surg. https://doi.org/10.1097/SLA.0000000000004775
- 14 Shevlin M, McBride O, Murphy J, et al. Anxiety, depression, traumatic stress, and COVID-19 related anxiety in the UK general population during the COVID-19 pandemic. BJPsych Open. 2020; 6(6):e125.
- 15 Le HT, Lai AJX, Sun J, et al. Anxiety and depression among people under the nationwide partial lockdown in Vietnam. Front Public Health. 2020; 8:589359. https://doi.org/10.3389/fpubh.2020.589359
- 16 Hao F, Tam W, Hu X, et al. A quantitative and qualitative study on the neuropsychiatric sequelae of acutely ill COVID-19 inpatients in isolation facilities. Transl Psychiatry. 2020; 10(1): 355. https://doi.org/10.1038/s41398-020-01039-2
- 17 Ozdin S, Bayrak Ozdin S. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: the importance of gender. Int J Soc Psychiatry. 2020; 66(5): 504-511. https://doi.org/10.1177/0020764020927051
- 18 Sogut S, Dolu I, Cangol E. The relationship between COVID-19 knowledge levels and anxiety states of midwifery students during the outbreak: a cross-sectional web-based survey. Perspect Psychiatr Care. 2020; 57: 246-252. https://doi.org/10.1111/ppc.12555
- 19 Lemeshow S, Hosmer DW, Klar J, Lwanga SK. The Adequacy of the Sample Size in Health Research. 1990. Chichester, UK: Wiley (on behalf of the World Health Organization); 2016.
- 20 Du J, Dong L, Wang T, et al. Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. Gen Hosp Psychistry. 2020; 67: 144-145. https://doi.org/10.1016/j.genhosppsych.2020.03.011
- 21 Holmeses EA, O'Connor RC, Perry VH, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry. 2020; 7(6): 547-560.
- 22 Miranda-Ackermannda-Ackerman RC, Lira-Trujillo M, Gollaz-Cervantez AC, et al. Associations between stressors and difficulty sleeping in critically ill patients admitted to the intensive care unit: a cohort study. BMC Health Serv Res. 2020; 20(1): 1-10.
- 23 Torales J, O'Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry. 2020; 66(4): 317-320. https://doi.org/10.1177/0020764020915212
- 24 Clay JM, Parker MO. Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis? Lancet Public Health. 2020; 5(5): e259. https://doi.org/10.1016/S2468-2667(20)30088-8
- 25 Yesilyurt S, Capraz C. A roadmap for content validity used in scale development studies. Erzincan Univ J Educ Fac. 2018; 20(1): 251-264.
- 26 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988; 56(6): 893-897. https://doi.org/10.1037//0022-006x.56.6.893
- 27 Ulusoy M, Sahin NH, Erkmen H. The Beck anxiety inventory: psychometric properties. J Cogn Psychother. 1998; 12(2): 163-172. https://doi.org/10.1016/0887-6185(92)90026-4
- 28 Demir E, Saatcioglu Ö, Imrol F. Examination of educational researches published in international journals in terms of normality assumptions. Curr Res Educ. 2016; 2(3): 130-148.
- 29 Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses’ knowledge and anxiety toward COVID-19 during the current outbreak in Iran. Arch Clin Infect Dis. 2020; 15:e102848. https://doi.org/10.5812/archcid.102848
- 30 Mertens G, Gerritsen L, Duijndam S, Salemink E, Engelhard IM. Fear of the coronavirus (COVID-19): predictors in an online study conducted in March 2020. J Anxiety Disord. 2020; 74:102258. https://doi.org/10.1016/j.janxdis.2020.102258
- 31 Bakioglu F, Korkmaz O, Ercan H. Fear of COVID-19 and positivity: mediating role of intolerance of uncertainty, depression, anxiety, and stress [published online ahead of print May 28, 2020]. Int J Mental Health Addict. 1-14. https://doi.org/10.1007/s11469-020-00331-y
- 32 Zhongg B-L, Luo W, Li, H-M. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey. Int J Biol Sci. 2020; 16(10): 1745-1752. https://doi.org/10.7150/ijbs.45221
- 33 Michaela N, Hancock C, Shaantanu D. The relationship between chronic disease and COVID-19. 2020. https://www.healtheuropa.eu/the-relationship-between-chronic-disease-and-covid-19/101845/. Accessed August 14, 2020.
- 34 Webb, L. Covid-19 lockdown: a perfect storm for older people's mental health. J Psychiatr Ment Health Nurs. 2020; 28: 300. https://doi.org/10.1111/jpm.12644
- 35 Trapp S, Blömeke S, Ziegler M. The openness-fluid-crystallized-intelligence (OFCI) model and the environmental enrichment hypothesis. Intelligence. 2019; 73: 30-40.
- 36 Akbas OZ, Dursun C. Working mothers who fit the public space in their private space during the coronavirus (COVID-19) pandemic. J Eurasian Soc Econ Studies. 2020; 7(5): 78-94.
- 37 Gemmatiti D, Varani K, Bramanti B, et al. “Bridging the gap” Everything that could have been avoided if we had applied gender medicine, pharmacogenetics and personalized medicine in the gender-omics and sex-omics era. Int J Mol Sci. 2020; 21(1): 1-36. https://doi.org/10.3390/ijms21010296
- 38 Theresa O. Biological Variation in Health and Illness: Race, Age, and Sex. 2nd ed. Boca Raton, FL: Taylor and Francis Group; 2018.
- 39 Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep. 2018; 8: 2861. https://doi.org/10.1038/s41598-018-21243-x
- 40 Nam H-S, Park JW, Ki M, Yeon M-Y, Kim J, Kim SW. High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea. Int J Infect Dis. 2017; 58: 37-42. https://doi.org/10.1016/j.ijid.2017.02.008
- 41 Papandreou C, Arija V, Aretouli E, Tsilidis KK, Bulló M. Comparing eating behaviours, and symptoms of depression and anxiety between Spain and Greece during the COVID-19 outbreak: cross-sectional analysis of two different confinement strategies. Eur Eat Disord Rev. 2020; 28(6): 836-846. https://doi.org/10.1002/erv.2772
- 42 Stantonton R, To QG, Khalesi S, et al. Depression, anxiety and stress during COVID-19: associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults. Int J Environ Res Public Health. 2020; 17(11):4065. https://doi.org/10.3390/ijerph17114065
- 43 Shimizu K. 2019-nCoV, fake news, and racism. The Lancet. 2020; 395(10225): 685-686.
- 44 Tran BX, Dang AK, Thai PK, et al. Coverage of health information by different sources in communities: implication for COVID-19 epidemic response. Int J Environ Res Public Health. 2020; 17(10):3577. https://doi.org/10.3390/ijerph17103577
- 45 Ho CS, Chee CY, Ho RC. Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Ann Acad Med Singapore. 2020; 49(3): 155-160.
- 46 Mishraa P, Bhadauria US, Dasar, PL. Knowledge, attitude and anxiety towards pandemic flu: a potential bio weapon among health professionals in Indore city. Przegl Epidemiol. 2016; 70(1): 41-45.
- 47 Srivastava P. Health care workers in COVID-19 pandemic: saviors need safety. EC Pulmonol Respir Med. 2020; 9(7): 1-4.
- 48 Adıguzel M. Covid-19 macroeconomic analysis of the effects of economy of Turkey pandemic. Istanbul Comm Univ J Soc Sci. 2020; 19(37): 191-221.
- 49 T.C. Official Newspaper. Regulation amending the regulation on short work and short work allowance. 2018. https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=14960%26MevzuatTur=7%26MevzuatTertip=5. Accessed November 9, 2018.
- 50 T.C. Official Newspaper. The law on reducing the effects of the new coronavirus (COVID-19) epidemic on economic and social life, and the law on amending some laws. 2020. https://www.resmigazete.gov.tr/eskiler/2020/04/20200417-2.htm. Accessed April 17, 2020.
- 51 Cabré-Riera A, Torrent M, Donaire-Gonzalez D, Vrijheid M, Cardis E, Guxens M. Telecommunication devices use, screen time and sleep in adolescents. Environ Res. 2019; 171: 341-347. https://doi.org/10.1016/j.envres.2018.10.036
- 52 Pars H. The roles of children and pediatric nurse in the COVID-19 pandemic. Hacettepe Univ Fac Nurs J. 2020; 7(Special Issue): 66-75. https://doi.org/10.31125/hunhemsire.776493
- 53 Zhang MW, Ho RC. Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technol healthc. 2017; 25(1): 163-165. https://doi.org/10.3233/THC-161261
- 54 Soh HL, Ho RC, Ho CS, Tam WW. Efficacy of digital cognitive behavioural therapy for insomnia: a meta-analysis of randomised controlled trials. Sleep Med. 2020; 75: 315-325. https://doi.org/10.1016/j.sleep.2020.08.020
- 55 Wang C, Chudzicka-Czupała A, Tee ML, et al. A chain mediation model on COVID-19 symptoms and mental health outcomes in Americans, Asians and Europeans. Sci Rep. 2021; 11: 6481. https://doi.org/10.1038/s41598-021-85943-7
