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Non-medically trained health care workers caring for patients with coronavirus disease 2019 (COVID-19) have an increased prevalence of anxiety compared with medically trained health care workers, according to a research letter published online April 6 in the Annals of Internal Medicine.
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Benjamin Y.Q. Tan, M.D., from the National University of Singapore, and colleagues examined psychological distress, depression, anxiety, and stress experienced by health care workers in Singapore during the COVID-19 pandemic. Health care workers from two major tertiary institutions who were caring for patients with COVID-19 were invited to participate in a self-administered questionnaire from Feb. 19 to March 13, 2020. The questionnaire included the validated Depression, Anxiety, and Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. Four hundred seventy health care workers participated in the study and scores were compared between medically and non-medically trained hospital personnel.

The researchers found that 14.5, 8.9, 6.6, and 7.7 percent of participants screened positive for anxiety, depression, stress, and clinical concern of posttraumatic stress disorder. After adjustment for age, sex, ethnicity, marriage status, survey completion date, and comorbidity, the prevalence of anxiety was higher for nonmedical health care workers versus medical personnel (20.7 versus 10.8 percent; adjusted prevalence ratio, 1.85). Similarly, nonmedical health care workers had higher mean DASS-21 anxiety and stress subscale scores and higher IES-R total and subscale scores.

"Our findings are consistent with those of a recent COVID-19 study demonstrating that frontline nurses had significantly lower vicarious traumatization scores than non-frontline nurses and the general public," the authors write. "Reasons for this may include reduced accessibility to formal psychological support, less firsthand medical information on the outbreak, less intensive training on personal protective equipment and infection control measures."

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