The COVID 19 pandemic is a respiratory disorder that was first detected in Wuhan, China. Due to its rapid spread, the infection was declared a global pandemic. Besides, as the coronavirus cases increase, hospital workers are subjected to a more workload, increasing their chances of facing the adverse effects of the pandemic. Several studies reveal that hospital workers, especially those working in coronavirus designated hospitals, have higher chances of contracting the virus and are prone to psychological challenges. According to Lee et al., the more close and frequent hospital workers are to the coronavirus patients, the higher the chances of physical and mental infection.1 In this article,” Psychology impact of COVID-19 on hospital workers in nursing care hospitals,” Yang et al. conducted a survey to investigate the prevalence of depression and anxiety in hospital employees during the COVID 19 pandemic.2 The researchers obtained a direct link between coronavirus disease and negative psychological impacts on healthcare workers. However, this report explores some notable shortcomings in this article, such as a small sample and lack of a control group.
Yang et al. determined the major adverse consequences of Coronavirus disease (COVID-19) in nursing care hospitals on April 15, 2020. The researchers conducted a cross-sectional observational study among personnel of three nursing care hospitals dealing with coronavirus patients in South Korea who had not previously been diagnosed with any psychological distress. A total of 54 hospital employees from three nursing care hospitals participated in the survey, comprising 20 physical therapists, 17 nurses, 11 occupational therapists, four administrative workers and two radiographers. In addition, the age distribution of this study’s subjects was between 20 and 60 years. The qualitative data collection was performed using survey questionnaires which consisted of three parts; Epidemiology, generalized anxiety disorder scale, and the patient health questionnaire. Statistical analysis was done using chi-square tests, which evaluated the correlation of depression and anxiety on each tested demographic variable. Besides, the binary logistic regression model was used for confounding factors. The researchers found that anxiety was not affected by demographic variables. Moreover, they obtained that psychological stress was high in hospital employees with close relatives infected with COVID 19 disease and other chronic illnesses. For this reason, Yang et al. established that health workers living with people who have chronic illnesses have high chances of becoming anxious and depressed. To sum up, COVID-19 related psychiatric symptoms, such as anxiety and depression, were common among hospital workers in nursing care hospitals. The major outcome of this study was that a substantial number of hospital workers reported anxiety, depression, and other mental health disorders. As such, workers in nursing homes are vulnerable to adverse mental conditions.
The COVID 19 pandemic has greatly contributed to psychological distress among hospital workers. As the number of coronavirus patients increases, all healthcare workers are exposed to long working hours and tedious jobs, contributing to psychological disorders. In this article, Yang et al. examine the adverse psychological effects of coronavirus disease in healthcare workers dealing with COVID 19 patients. While the authors concluded that hospital workers who have close contact with COVID 19 patients in hospitals are highly exposed to mental disorders such as depression and anxiety, the generalization of findings was limited by a small sample and the lack of a control group. First, the survey questionnaires were given to healthcare workers in three nursing care hospitals in Korea. However, the number of respondents was very small. To elucidate, only 54 health care workers responded to the survey questionnaires. Besides, the number of respondents from different workgroups was very small. According to Bujang et al., smaller samples tend to be associated with a larger margin of error.3Besides, smaller samples are prone to misrepresent all the demographic variables of the larger population. Therefore, this study’s findings had a limited generalization power. Next, the researchers failed to include a control group during the experiment. Since not all hospitals are designated to handle coronavirus patients, there was a need to compare the prevalence of anxiety and depression in healthcare workers dealing with COVID 19 patients and those from other clinics. Besides, the authors did not compare the anxiety and depression scores of the experimental group with health care workers who had no interaction with coronavirus patients; hence there was no ascertainment of the specific causes of the psychological disorders. According to Kabir et al., control groups help to determine the causal association of variables.4Some researchers may claim that the study’s findings were reliable and could be generalized. They may argue that the small sample was ideal for a good assessment of the tested variables. For instance, Haas et al. claim that a small sample is cheap to recruit and saves time during statistical analysis and interpretation.5 Nevertheless, they fail to acknowledge the negative effects of a small sample, such as their likelihood of producing the wrong conclusion, limiting their generalization.
In conclusion, the authors established that healthcare workers who interact with coronavirus patients are prone to severe depression and anxiety. However, the small sample and lack of a control group limited the generalization power. The enrollment of only 54 hospital workers in the survey could not provide actual findings on the negative mental consequences of the COVID 19 pandemic. Besides, failure to include a control group limited the establishment of the primary causes of depression and anxiety in hospital employees. With this regard, further studies should be conducted to evaluate the adverse mental effects of hospital workers during the coronavirus pandemic. Moreover, there should be an active counselling department in every hospital that can assist the hospital workers to overcome various depressors, especially during the COVID 19 pandemic.
- Lee IK, Wang CC, Lin MC, Kung CT, Lan KC, Lee CT. Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in the hospital. The Journal of hospital infection. 2020 May;105(1):102. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124248/
- Yang S, Kwak SG, Chang MC. The psychological impact of COVID-19 on hospital workers in nursing care hospitals. Nursing Open. 2021 Jan;8(1):284-9.
- Bujang MA, Sa’at N, Bakar TM. Sample size guidelines for logistic regression from observational studies with large population: emphasis on the accuracy between statistics and parameters based on real-life clinical data. The Malaysian Journal of medical sciences: MJMS. 2018 Jul;25(4):122. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422534/
- Kabir SM. Basic Guidelines for Research. An Introductory Approach for All Disciplines. 2016:168-80. Available from: https://www.researchgate.net/profile/Syed-Muhammad
- Haas JP. Sample size and power. American Journal of infection control. 2012 October 1;40(8):766-7. Available from: https://www.ajicjournal.org/article/S0196-6553(12)00880-2/abstract