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      Depression, anxiety, and stress among Iranian nurses in COVID-19 care wards

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          Abstract

          Background

          Nurses are at the frontline of care provision to patients with coronavirus disease 2019 (COVID-19). The high communicability of COVID-19, high levels of stress associated with the disease, and challenges of care provision to afflicted patients faced nurses in Iran with problems such as depression, anxiety, and stress. The aim of the study was to assess depression, anxiety, and stress among Iranian nurses who provided care to patients with COVID-19.

          Methods

          This cross-sectional descriptive-analytical study was conducted in 2020–2021. Participants were 468 nurses purposively selected from university hospitals in Iran. They completed two online instruments, namely a demographic questionnaire and the 21-item Depression Anxiety Stress Scale. Data were analyzed using the SPSS software (v. 23.0).

          Results

          Most participants were female (75.9%) and married (73.4%) and held bachelor’s degree (88%). The means of participants’ age and work experience were 33.59 ± 6.40 years and 10.26 ± 6.61 years, respectively. The mean scores and the prevalence rates of depression, anxiety, and stress were 13.56 ± 5.37 and 74.1%, 13.21 ± 4.90 and 89.7%, and 15.13 ± 4.76 and 54.9%, respectively. The prevalence rates of moderate to severe depression, anxiety, and stress were 43.7%, 73%, and 24%, respectively. The mean scores of participants’ depression, anxiety, and stress had significant relationship with their employment status ( p < 0.05). Besides, the mean scores of their anxiety had significant relationship with their educational level, employment status, and work shift ( p < 0.05).

          Conclusion

          Most nurses who provide care to patients with COVID-19 suffer from depression, anxiety, and stress. Psychological support services may be needed for nurses in order to protect and promote their mental health.

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          Most cited references48

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          Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

          Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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            The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample.

            To test the construct validity of the short-form version of the Depression anxiety and stress scale (DASS-21), and in particular, to assess whether stress as indexed by this measure is synonymous with negative affectivity (NA) or whether it represents a related, but distinct, construct. To provide normative data for the general adult population. Cross-sectional, correlational and confirmatory factor analysis (CFA). The DASS-21 was administered to a non-clinical sample, broadly representative of the general adult UK population (N = 1,794). Competing models of the latent structure of the DASS-21 were evaluated using CFA. The model with optimal fit (RCFI = 0.94) had a quadripartite structure, and consisted of a general factor of psychological distress plus orthogonal specific factors of depression, anxiety, and stress. This model was a significantly better fit than a competing model that tested the possibility that the Stress scale simply measures NA. The DASS-21 subscales can validly be used to measure the dimensions of depression, anxiety, and stress. However, each of these subscales also taps a more general dimension of psychological distress or NA. The utility of the measure is enhanced by the provision of normative data based on a large sample.
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              Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.

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                Author and article information

                Contributors
                fallahi@uswr.ac.ir
                Journal
                BMC Psychol
                BMC Psychol
                BMC Psychology
                BioMed Central (London )
                2050-7283
                20 August 2022
                20 August 2022
                2022
                : 10
                : 205
                Affiliations
                [1 ]GRID grid.411950.8, ISNI 0000 0004 0611 9280, Nursing Department, Nahavand School of Allied Medical Sciences, , Hamadan University of Medical Sciences, ; Hamadan, Iran
                [2 ]GRID grid.472458.8, ISNI 0000 0004 0612 774X, Nursing Department, , University of Social Welfare and Rehabilitation Sciences, ; Tehran, Iran
                [3 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Health System Research Committee, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                [4 ]GRID grid.508728.0, ISNI 0000 0004 0612 1516, Shahid Rahimi Hospital in Khorramabad, Lorestan University of Medical Sciences, ; Khorramabad, Iran
                [5 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Medical Student, Faculty of Medicine, , Alborz University of Medical Sciences, ; Karaj, Iran
                Article
                911
                10.1186/s40359-022-00911-8
                9392054
                35987839
                43fc2e8e-0c4c-458b-8e66-99f47d97d342
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 14 March 2022
                : 16 August 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                coronavirus disease 2019,stress,anxiety,depression,nurse
                coronavirus disease 2019, stress, anxiety, depression, nurse

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