Systematic Review and Meta-analysis of Depression and Anxiety in the Middle East during the Covid-19 Pandemic

Background: Depression and anxiety are the psychological problems that have intensified during Covid-19 and have affected the psychological well-being of people. The purpose of this study was to systematically review the prevalence of anxiety and depression in Middle East countries. Methods: In this review, we searched for studies aiming to estimate the prevalence of depression and anxiety during the Covid-19 pandemic among the general population in databases including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar from January 2020 to February 2021. We used the Comprehensive Meta-Analysis-2 software for data analyses and generated forest plots of the summary pooled prevalence. Results: In this systematic review, 55 articles with a total sample size of 28128 people were included. The pooled analysis of depression and anxiety amid the pandemic was estimated at 41% and 39%, respectively. Based on the study results, Iraq and Egypt had the highest prevalence rates of depression at 88% and 82%, respectively. Regarding anxiety, the highest and lowest prevalence rates were reported for Egypt with 91% and Qatar with 17%. Conclusion: To effectively provide mental health services for people, particularly the ones who are suspected of higher risk of depression and anxiety, it is necessary to identify individuals who are more likely to be suffered from psychological problems. © 2023 Authors. All rights reserved.

The Relationship Between Anxiety, Stress and Protective Behavior in Nurses During COVID-19 Pandemic

Introduction: Health workers, especially nurses, are facing a high risk of contracting the COVID-19 and consequent mental disorders such as stress, anxiety and depression. We aimed to study the relationship between anxiety, stress and the protective behavior of nurses during the Covid-19 pandemic. Material and Methods: This cross-sectional study was conducted on nurses working in COVID-19 referral hospitals in Qazvin, Iran, in 2020. Out of 645 nurses working in two hospitals, 260 of them were selected randomly. Three questionnaires including demographic and contextual information, COVID-19 anxiety, stress and precautionary behaviors against COVID-19 were used. Descriptive statistical methods, Pearson correlation, t-test and one-way analysis of variance and binary logistic regression analysis were applied at 95% confidence interval. Results: The prevalence of anxiety symptoms in nurses was 32.08%, the mean score of protective behavior was 18.45+5.66 and the maximum score was 22.06+4.7. The negative relationship between anxiety and nurses precautionary behavior) β=-0.36, P<0.05) and the significant effect of COVID-19 stress on nurses’ behavior) β=-0.22, P<0.05) were confirmed. Furthermore, adding stress as an interfering factor, affirmed the mediating role of stress in the relationship between anxiety and nurses’ precautionary behavior (β=-0.18, P<0.05). Nurses under 35 years of age were more likely (OR=1.62, P=0.004) to follow the protective rules;those with 6 to 10 years of hospital experience were respectively 32 times and 37 times more probable to use personnel protective equipment (PPE) (OR=1.32, P=0.002). Conclusion: The probability of effective use of PPE and observance of protective guidelines among nurses with severe and very severe anxiety levels was less than their counterparts. While in those with controlled level of stress level such obedience was much more probable. Therefore, all health service providers, need to develop supportive programs to emphasize on the promotion of employees’ mental health. © 2022 The Authors.

COVID-19 crisis overshadowing the health workforces' rights and resilience: a systematic review

Purpose In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis. Design/methodology/approach This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis. Findings Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies;organizational climate and work environment;education and empowerment and economic and financial. Originality/value This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.

Risk assessment of exposure to COVID-19 virus: a cross-sectional study among health-care workers

Purpose Health-care workers (HCWs) are at increased risk of exposure to the COVID-19 virus, which necessitates implementing transmission prevention measures in health-care delivery facilities, particularly hospitals. This study aims to assess COVID-19 risk in a health-care setting and recommend managerial strategies to cope with existing risk procedures. Design/methodology/approach This cross-sectional study was conducted among HCWs working in a general hospital in Qazvin, northwest of the country. A total of 310 employees working at different clinical and non-clinical occupational levels participated in the study. The WHO COVID-19 risk assessment tool categorised HCWs in high- or low-risk groups exposed to COVID-19 infection. Findings Findings revealed statistically significant relationships between workplace exposure to the COVID-19 virus and variables, including job type, performing the aerosol-generating procedure, access to personal protective equipment (PPE) and being trained on Infection Prevention and Control (IPC) guidelines (p < 0.05). HCWs older than 36 years were at 8% more risk of COVID-19 virus. Being a medical doctor or delivering health-care services as a nurse were relatively 28% and 32% times more likely to be at high risk of infection than other hospital staff categories. Having inadequate access to PPE and lack of training on IPC guidelines were also key determinants of high-risk infection. Originality/value As most cases at risk of COVID-19 infection belonged to frontline health-care staff in older age groups, this study recommend limiting the exposure of vulnerable staff to COVID-19 patients, increasing protective measures for HCWs and providing essential information about infection control procedures.