The prevalence of and factors associated with depressive and anxiety symptoms during the COVID-19 pandemic among healthcare workers in South Africa

PLoS One. 2024 Mar 7;19(3):e0299584. doi: 10.1371/journal.pone.0299584. eCollection 2024.

Abstract

Introduction: Healthcare workers globally have experienced increased social and occupational stressors in their working environments and communities because of COVID-19 which has increased the risk of mental health concerns. This study aimed to explore the prevalence and correlates of depression and anxiety amongst healthcare workers during the COVID-19 pandemic in the Western Cape, South Africa. In addition, role-related stressors and coping strategies were explored.

Material and methods: We conducted a cross-sectional survey of doctors and nurses working in public healthcare facilities across the Western Cape, South Africa. Participants completed the Generalized Anxiety Disorder-7 (GAD-7), the Center for Epidemiologic Studies Depression (CES-D), the Professional Quality of Life (PROQL-R-IV), and the Brief Coping Orientation to Problems Experienced (COPE-R) scales. Data were analysed using multivariable logistic regression analysis.

Results: The sample comprised 416 health workers (303 nurses, 113 doctors). Almost 40% of the sample (n = 161) had CES-D scores suggestive of probable depression, and 45.9% (n = 186) had GAD-7 scores suggestive of anxiety. In the logistic regression model, the odds of probable depression were higher for female participants compared to men (OR = 2.26, 95% CI 1.00-5.10) and for participants who used behavioural disengagement as a coping strategy (OR = 1.50, 95% CI 1.14-1.97). More time spent working with COVID patients was associated with increased odds of having high levels of anxiety [OR = 1.13, 95% CI (1.02-1.25). Substance use (OR = 1.39, 95% CI 1.08-1.81), venting (OR = 1.31, 95% CI 1.01-1.70), and self-blame (OR = 1.42, 95% CI 1.08-1.87) were some of the coping strategies used by healthcare workers. High levels of secondary traumatic stress and burnout were found to increase the odds of both depression and anxiety.

Conclusion: Findings of this study suggest that there is a high prevalence of mental health issues among healthcare workers, and a critical need to focus on workplace mental health interventions to support these frontline workers.

MeSH terms

  • Anxiety / epidemiology
  • Anxiety / etiology
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / etiology
  • Female
  • Health Personnel / psychology
  • Humans
  • Male
  • Pandemics
  • Prevalence
  • Psychological Tests*
  • Quality of Life
  • SARS-CoV-2
  • Self Report*
  • South Africa / epidemiology

Supplementary concepts

  • Coping Orientation to Problems Experienced Questionnaire