Prevalence of depression, anxiety, and stress and associated reasons among Iranian primary healthcare workers: a mixed method study

Edris Kakemam; Katayoun Maassoumi; Somayeh Azimi; Madineh Abbasi; Fateme Tahmasbi; Mahasti Alizadeh

doi:10.1186/s12875-024-02268-w

Prevalence of depression, anxiety, and stress and associated reasons among Iranian primary healthcare workers: a mixed method study

BMC Prim Care. 2024 Jan 26;25(1):40. doi: 10.1186/s12875-024-02268-w.

Authors

Edris Kakemam¹, Katayoun Maassoumi², Somayeh Azimi³, Madineh Abbasi⁴, Fateme Tahmasbi¹, Mahasti Alizadeh⁵

Affiliations

¹ Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
² Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
³ Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran.
⁴ Infectious and Tropical Diseases Research Center, Tabriz University of Medical sciences, Tabriz, Iran.
⁵ Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. alizadm@yahoo.com.

Abstract

Background: Different mental disorders may be associated with many work-related factors to which primary health care workers (PHCWs) are exposed. The current research aims to measure the rates of depression, anxiety, and stress among PHCWs, and their associated causes in primary health care (PHC) settings.

Methods: An explanatory sequential mixed methods design was employed in this research from January 2021 to January 2022 in Tabriz, Iran's PHC centers. First, this study followed an online-based cross-sectional survey using a self-reported questionnaire. The Depression, Anxiety and Stress Scale-21 Items (DASS-21) and questions on demographic and work-related characteristics were completed by 303 frontline PHCWs during the quantitative phase. In the qualitative phase, a semi-structured interview was held with 12 PHCWs who had the highest level of depression, anxiety, and stress to identify the reasons and sources of mental health prevalence. Quantitative data were analyzed using descriptive statistics via SPSS-26. A content analysis was performed to analyze qualitative data.

Results: The results showed that self-reported stress, anxiety, and depression had a prevalence of 40.3%, 42.9%, and 42.6%, respectively. Symptoms of at least one mental disorder were experienced by 54% of respondents, while 28% had all three. Major sources of stress, anxiety, and depression among PHCWs were working environment conditions, organizational policies, job-related reasons, and interpersonal relations.

Conclusions: The results of current study indicated that PHCWs experienced high levels of depression, anxiety, and stress. The main factors and reasons that contributed to these mental health issues among PHCWs were work environment conditions, organizational policies, job-related reasons and interpersonal relations. Therefore, interventions should be implemented to promote mental health of PHCWs. This can include measures such as psychological screening, supportive care, workload management, flexible scheduling, and access to mental health resources. Additionally, training programs can be implemented to enhance resilience and coping skills among healthcare professionals.

Keywords: Anxiety; Depression; Mental health; Primary health care; Stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety* / epidemiology
Anxiety* / etiology
Cross-Sectional Studies
Depression* / epidemiology
Health Personnel / psychology
Humans
Iran / epidemiology
Prevalence