1. Introduction
In December 2019, an outbreak of pneumonia-like illness caused by severe
acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was identified in
Wuhan, Hubei province of China and infected millions of individuals
worldwide rapidly. On February 11th 2020, the World
Health Organization (WHO) named the disease the novel coronavirus-2019
(COVID-19) and declared COVID-19 pandemic on March
11th 20201. Until December 2020,
there have been a total of 74.299.042 confirmed cases including
1.669.982 deaths worldwide2. The COVID-19 outbreak has
been one of the most serious and tragic health crises of the last
century and caused significant social, economic, and mental
consequences.
Healthcare workers (HCWs) play an essential role in the COVID-19
outbreak, providing care at the frontlines. In addition to overwhelming
workload, they also suffer from psychological impacts of the outbreak
with the fear of being infected and infecting their loved
ones3. In the literature, anxiety and burnout syndrome
have been described among HCWs. During the COVID-19 outbreak, the degree
of despair and anxiety has been shown to increase in HCWs than the
general population4. In a study conducted in Wuhan,
many HCWs were infected with COVID-19 with a significantly greater risk
of infection and contamination5. In this study, HCWs
faced with mental health problems due to excessive workload,
frustration, discrimination, isolation, fear, and exhaustion.
Since the declaration of the pandemic, the prevalence of psychological
distress has increased among HCWs. In a multi-center study, the HCWs who
were involved in the care of COVID-19 patients experienced
post-traumatic stress disorder (PTSD) more frequently and the risk of
development of other psychiatric illness was significantly higher in
this population6. In a systematic review, the impact
of COVID-19 on mental health was evaluated among hospital-based HCWs and
the prevalence of mental health outcomes were found to be as follows:
depression 13.5 to 44.7%, anxiety 12.3 to 35.6%, acute stress reaction
5.2 to 32.9%, PTSD 7.4 to 37.4%, insomnia 33.8 to 36.1%, and
occupational burnout 3.1 to 43.0%7. In addition,
direct exposure to COVID-19 patients was the most prevalent risk factor
for all mental health outcomes, except for occupational burnout. Not
surprisingly, the worst outcomes were reported in nurses, frontline
HCWs, and those with low social support and fewer years of working
experience. In another review evaluating mental health problems faced by
the HCWs during the COVID-19 pandemic, sociodemographic characteristics
such as sex, profession, age, and place and department of work were
associated with an increased severity of mental health
problems8. Additionally, psychological variables such
as low social support and self-efficacy were related to increased
stress, anxiety, depression, and insomnia symptoms. The authors
concluded that there was growing evidence suggesting that COVID-19 could
be an independent risk factor for stress in HCWs.
In the present study, we aimed to assess fear, anxiety, anxiety
sensitivity, burnout, and insomnia of HCWs during COVID-19 outbreak and
to identify their relation to sociodemographic and clinical
characteristics in this population.