Anxiety and depression among healthcare workers during the COVID-19 pandemic in Khujand, Tajikistan.

BACKGROUND

The COVID-19 pandemic strained healthcare worker (HCW) mental health worldwide. In Tajikistan, limited data on HCW mental health limit understanding of the pandemic's effect on HCWs. We assessed the prevalence of anxiety and depression and examined associated occupational and psychosocial factors among HCWs who provided care during the COVID-19 pandemic from March 2020 to December 2021.

METHODS

We conducted a cross-sectional survey of HCWs from three hospitals and three polyclinics in Khujand, Tajikistan, during July-August 2022. Participants were asked to recall their experiences from March 2020 through December 2021. Using systematic sampling, 400 HCWs who had provided care to patients with COVID-19 were interviewed in person. Moderate-to-severe anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (cut-off scores of ≥11). Associations with anxiety and depression were examined using multivariable mixed-effects models adjusting for hospital clustering.

RESULTS

Among 400 participants, 69% had depression, 26% anxiety, and 17% both. Most participants were female (82%), nurses (67%), and had more than 10 years of work experience (51%). Anxiety was independently associated with female sex [adjusted prevalence odds ratio (aPOR) = 3.2; 95% confidence interval (CI): 1.5-6.6], work fatigue (aPOR = 2.4; 95% CI: 1.0-5.7), prior COVID-19 (aPOR = 2.2; 95% CI: 1.3-3.9), working ≥12-h shifts vs. less (aPOR = 1.9; 95% CI: 1.1-3.2), and family separation during the pandemic (aPOR = 1.8; 95% CI: 1.0-3.2). Depression was associated with having had severe COVID-19 vs. mild or none (aPOR = 4.0; 95% CI: 1.4-11.8), nurse vs. physician role (aPOR = 3.5; 95% CI: 1.7-7.2), and work-related social avoidance vs. none (aPOR = 1.6; 95% CI: 1.0-2.6).

CONCLUSION

HCWs in Tajikistan experienced a substantial burden of anxiety and depression during the COVID-19 pandemic. These findings were used to inform mental health trainings, screening programs, and workplace interventions including counseling access, respite programs, and improved staffing patterns to support healthcare workers experiencing anxiety and depression.