Study looks at anxiety of HCW during the COVID-19 pandemic

A team of scientists from Saudi Arabia has recently surveyed healthcare workers to evaluate their knowledge, attitudes, practices, and stress level during the coronavirus disease 2019 (COVID-19) pandemic.

The study reveals that healthcare workers from Saudi Arabia suffer from a high level of anxiety due to a higher risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study is currently available on the medRxiv* preprint server.


The recent outbreak of COVID-19 has put a lot of pressure on frontline workers' professional and personal lives, particularly healthcare workers. Because of fast-paced research works, new information related to the pandemic is emerging almost daily, which has made it challenging for healthcare workers to stay updated with the current knowledge. This can severely impact their attitudes and practices toward patient care.

In Saudi Arabia, during the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV), a high level of compliance and adaptive attitude toward infection prevention and control has been observed among healthcare workers.

In the current study, the scientists have evaluated the anxiety level and preparedness of healthcare workers related to COVID-19 management in a government tertiary care hospital in Saudi Arabia during the pandemic.

Study design

During the survey, online questionnaires were sent to 1,500 healthcare workers, bringing 957 responses. Of all respondents, the majority were females and nurses. Specifically, the information about COVID-19-related knowledge, attitudes toward control measures, variation in hygiene practices, and stress level was collected.  

Important observations

The scientists have compared the self-reported anxiety levels of healthcare workers during COVID-19, MERS-CoV, and seasonal influenza. The highest anxiety level was observed during the COVID-19 pandemic, with 88% of healthcare workers reporting a high anxiety level. However, the respondents have mentioned having a higher preparedness during COVID-19 compared to other viral outbreaks. About 97% of respondents have mentioned attending N95 mask fit testing, whereas only 58% have mentioned attending simulation sessions organized by the hospitals for COVID-19 management. Notably, about 25% of respondents have mentioned that their hospitals do not have any psychological support systems.

Regarding knowledge, attitude, and practices related to COVID-19, most respondents have mentioned that they understand the importance of control measures recommended by the hospitals and strongly believe in implementing them during COVID-19 patient care. An improvement in hygiene practices has been observed among respondents. However, their hygiene practice attitude has been found to associate significantly with higher anxiety levels.  

About 95% of respondents have mentioned being worried about acquiring SARS-CoV-2 infection regarding the source of anxiety. More than 50% have mentioned that they are worried about the shortage of personal protective equipment in the hospital, especially in high-risk wards. The respondents who use social media to gather COVID-19 related information has been found to have higher anxiety level.   

Importantly, a positive association was observed between the anxiety levels of healthcare workers and their clinical roles and work locations. Low anxiety level was seen among resident physicians and nurses compared to consultants. Similarly, a higher anxiety level was seen among healthcare workers serving general hospital wards, including COVID-19 wards and pediatric emergency wards. In general, a lower anxiety level was seen among healthcare workers who are working in a hospital with an appropriate psychological support system.    

The anxiety level of healthcare workers were found to increase over the period of the COVID-19 pandemic gradually. Similarly, the knowledge related to COVID-19 management and attitude toward hygiene practices increased significantly during the course of the COVID-19 pandemic. An increase in the frequency of receiving annual influenza vaccine also occurred among healthcare workers during the pandemic. Moreover, a tendency of rescheduling annual leave has been observed among them.

Study significance

The study reveals that healthcare workers in Saudi Arabia suffer from increased anxiety levels during the COVID-19 pandemic, mainly because of acquiring SARS-CoV-2 infection. Having proper emotional and psychological support systems at the workplace can help reduce their anxiety level and improve mental well-being.  

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Dr. Sanchari Sinha Dutta

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.


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