The psychological impact of COVID-19 pandemic in health care workers: a cross-sectional study in Nepal

BACKGROUND: COVID-19 pandemic has affected the healthcare workers (HCWs) worldwide. We plan to assess the psychological impact of this pandemic in different groups of HCWs including female community health volunteers (FCHVs) at various types of health facilities in Nepal, factors associated with it and the degree of satisfaction with the ongoing mental health support system. METHODS: A cross-sectional web-based survey with an option of telephone interview was conducted from June 20 to July 7, 2020. The questionnaire included socio-demographic characteristics, work related characteristics, substance use history, and degree of satisfaction with family, society and institutional support. Depression, anxiety, and stress scales (DASS-21) and the impact of events scale-revised (IES-R) tool were used to access the level of psychological impact. Linear regression was used to analyze factors associated with psychological outcome. RESULTS: Out of 608 respondents, the overall prevalence of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) was 20.89%. 24.18%, 13.82%, and 15.46% respectively. Nurses had higher depression, anxiety, stress, and PTSD scores while FCHVs had high depression and PTSD compared to doctors. For various types of health facilities, HCWs working in provincial-level hospitals had high-stress level. Similarly, "have to go into quarantine" and increased level of substance abuse were directly associated with poor psychological impact. Finally, 62% of HCWs did not have any institutional mental health support system. Among those who had institutional mental health support, 39.4% were not satisfied. CONCLUSIONS: We found mild to extremely severe level of depression, anxiety, stress, and PTSD among HCWs in Nepal. Urgent plans are required to mitigate the mental health risk caused by this current pandemic.