COVID-19 Pandemic's Psychological Impact on Healthcare Workers in Riyadh

1
Statistical analysis
Hypothesis
As mentioned earlier, this study is aimed to investigate the
psychological impact of the COVID-
19 pandemic on the healthcare workers in Riyadh, Saudi Arabia.
Based on an extensive review of the
literature, the following hypothesis is developed and would be
investigated throughout the research project.
Ho:There is no significant relationship between the COVID-19
pandemic and psychological impact on
healthcare workers in Riyadh, Saudi Arabia.
H1:There is a significant relationship between the COVID-19
pandemic and psychological impact on
healthcare workers in Riyadh, Saudi Arabia.
DASS-21:

2
Statistical analysis of the data
Data were fed to the computer and analyzed using IBM SPSS
software package
(Armonk, NY: IBM Corp). Qualitative data were described
using number and percent.
The Kolmogorov-Smirnov test was used to verify the normality
of distribution.
Quantitative data were described using mean, standard
deviation. Significance of the
obtained results was judged at the 5% level.
The used tests were
1 - Chi-square test
For categorical variables, to compare between different groups
2 - Monte Carlo correction
Correction for chi-square when more than 20% of the cells have
expected count less
than 5
3
Table (1): Distribution of the studied cases according to
demographic
characterizes of participants (n = 379)

Demographic characterizes of
participants No. %
Gender
Male 217 57.3
Female 162 42.7
Marital Status
Single 191 50.4
Married 179 47.2
Divorce 9 2.4
Occupational
Physician (Consultant) 66 17.4
Physician (Specialist) 53 14.0
Physician (Resident) 55 14.5
Physician (Internship) 26 6.9
Nurse (Specialist) 52 13.7
Nurse (technician) 21 5.5
Supportive staff 106 28.0
Sector of the healthcare system of your
hospital
MOH (Ministry of Health) 169 44.6
Government sector 161 42.5
Private sector 49 12.9

4
Table (2): Distribution of the studied cases according to DASS-
21 severity
categories of participants (n = 379)
Q DASS-21 severity categories of participants
Did not
apply to me
at all
Applied to
me to some
degree, or
some of the
time
Applied to
me to a
considerable
degree or a
good part of
time
Applied to
me very

much or
most of the
time
No. % No. % No. % No. %
Stress
1 Found it hard to wind down 106.0 28.0 149.0 39.3 88.0 23.2
36.0 9.5
6 I tended to over-react to situations 156.0 41.2 120.0 31.7 78.0
20.6 25.0 6.6
8 I felt that I was using a lot of nervous energy 130.0 34.3
130.0 34.3 78.0 20.6 41.0 10.8
11 I found myself getting agitated 156.0 41.2 116.0 30.6 79.0
20.8 28.0 7.4
12 I found it difficult to relax 107.0 28.2 147.0 38.8 80.0 21.1
45.0 11.9
14 I was intolerant of anything that kept me from getting on
with what I was doing 163.0 43.0 129.0 34.0 63.0 16.6 24.0 6.3
18 I felt that I was rather touchy 198.0 52.2 107.0 28.2 52.0
13.7 22.0 5.8
Anxiety
2 I was aware of dryness of my mouth 174.0 45.9 118.0 31.1
48.0 12.7 39.0 10.3
4 I experienced breathing difficulty 216.0 57.0 84.0 22.2 61.0
16.1 18.0 4.7
7 I experienced trembling 231.0 60.9 89.0 23.5 42.0 11.1 17.0
4.5
9 I was worried about situations in which I might panic and
make a fool of myself 182.0 48.0 109.0 28.8 58.0 15.3 30.0 7.9

15 I felt I was close to panic 203.0 53.6 107.0 28.2 45.0 11.9
24.0 6.3
19 I was aware of the action of my heart in the absence of
physical exertion 198.0 52.2 107.0 28.2 57.0 15.0 17.0 4.5
20 I felt scared without any good reason 196.0 51.7 110.0 29.0
50.0 13.2 23.0 6.1
Depression
3 I Couldn't seem to experience any positive feeling at all 144.0
38.0 132.0 34.8 75.0 19.8 28.0 7.4
5 I found it difficult to work up the initiative to do things 120.0
31.7 154.0 40.6 70.0 18.5 35.0 9.2
10 I felt that I had nothing to look forward to 195.0 51.5 113.0
29.8 47.0 12.4 24.0 6.3
13 I felt down-hearted and blue 187.0 49.3 107.0 28.2 49.0 12.9
36.0 9.5
16 I was unable to become enthusiastic about anything 163.0
43.0 128.0 33.8 58.0 15.3 30.0 7.9
17 I felt I wasn't worth much as a person 222.0 58.6 85.0 22.4
45.0 11.9 27.0 7.1
21 I felt that life was meaningless 217.0 57.3 85.0 22.4 48.0
12.7 29.0 7.7
5

Table (3): Distribution of the studied cases according to level of
DASS-21
severity categories of participants (n = 379)
DASS-21 severity categories of
participants No. %
Stress
Normal (0 – 10) 169 44.6
Mild (11 – 18) 99 26.1
Moderate (19 – 26) 68 17.9
Severe (27 – 34) 32 8.4
Extremely severe (35 – 42) 11 2.9
Total Score 13.70 ± 10.14
Anxiety
Normal (0 – 6) 170 44.9
Mild (7 – 9) 28 7.4
Moderate (10 – 14) 77 20.3
Severe (15 – 19) 36 9.5
Depression
Normal (0 – 9) 177 46.7
Mild (10 – 12) 51 13.5
Moderate (13 – 20) 86 22.7

Severe (21 – 27) 32 8.4
SD: Standard deviation
6
Table (4): Relation between stress and demographic
characterizes of
participants (n = 379)
Stress
χ2 p
Demographic
characterizes of
participants
Normal
(0 – 10)
(n = 169)
Mild
(11 – 18)
(n = 99)
Moderate

(19 – 26)
(n = 68)
Severe
(27 – 34)
(n = 32)
Extremely
severe
(35 – 42)
(n = 11)
No. % No. % No. % No. % No. %
Gender
Male 113 66.9 52 52.5 30 44.1 18 56.3 4 36.4
14.051* 0.007*
Female 56 33.1 47 47.5 38 55.9 14 43.8 7 63.6
Marital Status
Single 78 46.2 49 49.5 38 55.9 21 65.6 5 45.5
9.723
MCp=
0.231 Married 87 51.5 49 49.5 27 39.7 11 34.4 5 45.5
Divorce 4 2.4 1 1.0 3 4.4 0 0.0 1 9.1
Occupational
Physician (Consultant) 35 20.7 12 12.1 12 17.6 5 15.6 2 18.2
17.248
MCp=
0.817

Physician (Specialist) 22 13.0 17 17.2 10 14.7 4 12.5 0 0.0
Physician (Resident) 27 16.0 11 11.1 11 16.2 3 9.4 3 27.3
Physician (Internship) 9 5.3 11 11.1 4 5.9 2 6.3 0 0.0
Nurse (Specialist) 20 11.8 17 17.2 7 10.3 6 18.8 2 18.2
Nurse (technician) 9 5.3 7 7.1 2 2.9 2 6.3 1 9.1
Supportive staff 47 27.8 24 24.2 22 32.4 10 31.3 3 27.3
Sector of the healthcare
system of your hospital
MOH
(Ministry of Health)
79 46.7 47 47.5 28 41.2 11 34.4 4 36.4
6.173
MCp=
0.622 Government sector 71 42.0 37 37.4 31 45.6 15 46.9 7 63.6
Private sector 19 11.2 15 15.2 9 13.2 6 18.8 0 0.0
c2: Chi square test MC: Monte Carlo
*: Statistically significant at p ≤ 0.05
7
Table (5): Relation between anxiety and demographic
characterizes of
Anxiety

χ2 p
Demographic
characterizes of
participants
Normal
(0 – 6)
(n = 170)
Mild
(7 – 9)
(n = 28)
Moderate
(10 – 14)
(n = 77)
Severe
(15 – 19)
(n = 36)
Extremely
severe
(20 – 42)
(n = 68)
No. % No. % No. % No. % No. %
Gender
Male 113 66.5 19 67.9 38 49.4 16 44.4 31 45.6
15.347* 0.004*

Female 57 33.5 9 32.1 39 50.6 20 55.6 37 54.4
Marital Status
Single 68 40.0 16 57.1 44 57.1 21 58.3 42 61.8
18.777*
MCp=
0.008* Married 98 57.6 12 42.9 32 41.6 12 33.3 25 36.8
Divorce 4 2.4 0 0.0 1 1.3 3 8.3 1 1.5
Occupational
35.690*
MCp=
0.042*
MOH
77 45.3 14 50.0 35 45.5 16 44.4 27 39.7
7.284 0.506

Government sector 76 44.7 9 32.1 29 37.7 13 36.1 34 50.0
Private sector 17 10.0 5 17.9 13 16.9 7 19.4 7 10.3
8
Table (6): Relation between depression and demographic
characterizes of
Depression
χ2 p
Demographic
characterizes of
participants
Normal
(0 – 9)
(n = 177)
Mild
(10 – 12)
(n = 51)
Moderate
(13 – 20)
(n = 86)

Severe
(21 – 27)
(n = 32)
Extremely
severe
(28 – 42)
(n = 33)
No. % No. % No. % No. % No. %
Gender
Male 118 66.7 36 70.6 33 38.4 12 37.5 18 54.5
27.842* <0.001*
Female 59 33.3 15 29.4 53 61.6 20 62.5 15 45.5
Marital Status
Single 80 45.2 22 43.1 48 55.8 18 56.3 23 69.7
13.253
MCp=
0.068 Married 94 53.1 28 54.9 34 39.5 14 43.8 9 27.3
Divorce 3 1.7 1 2.0 4 4.7 0 0.0 1 3.0
Occupational
25.370
MCp=
0.344

MOH
85 48.0 25 49.0 31 36.0 14 43.8 14 42.4
7.939 0.439
Government sector 73 41.2 18 35.3 41 47.7 12 37.5 17 51.5
Private sector 19 10.7 8 15.7 14 16.3 6 18.8 2 6.1
2
2
Turkey’s research
Perceived Risk and Mental Health Problems among Healthcare
Professionals during COVID-19 Pandemic: Exploring the
Mediating Effects of Resilience and Coronavirus Fear
Background
In Turkey, during the time of the COVID-19 pandemic, there
were high risks of healthcare professionals evolving signs of
mental health complications because of them being on the
frontline in fighting against the virus (Yıldırım, Arslan &
Özaslan,2020). The research involved recruiting tw o hundred

and four healthcare professionals, with 50 percent of the
recruited being females with a minimum age of thirty-two. The
purpose of the study was to examine the interceding roles of
resilience and fear of coronavirus in the connection between
mental health problems and perceived risk among all healthcare
professionals treating patients nonstop. Method. The method
used for the study is the participation method, and the
participants were healthcare professionals who took the role of
in the inpatient clinics, outpatients, and intensive care unit.
Results. The results of the study showed that there was a
significant perceived risk forecasted in coronavirus fear, but
there was a non-important analyst of resilience. Coronavirus
had a complete mediation on the consequence of supposed risk
on resilience, and there was a 29 percent variation in
coronavirus fear.
Italian research
Mental Health Conditions of Italian Healthcare Professionals
during the COVID-19 Disease Outbreak
Background
The disease in Italy represented a risk in relation to mental
distress. Therefore, there was a need to investigate the
healthcare professionals’ psychological health during the
pandemic outbreak (Bettinsoli et al.,2020). The research was
based on assessing the current mental distress of the
participants and the coping approaches during the virus
outbreak. The front-liners were asked to report how they recall
feeling before the outbreak. The purpose of the study was to
examine the psychological condition of the medical personnel
before and during the outbreak of coronavirus in Italy. The
methods used were questionnaires and participation, and they
distributed the questionnaires online to all healthcare personnel
living in various Italian regions. Results. The research outcome
showed that thirty-three percent of the healthcare professionals

met the psychiatric indisposition threshold. After the study, it
was found that the participants viewed their psychological
conditions to have worsened during the coronavirus outbreak
rather than before the outbreak. This perception was a fact
among female health professionals.
Spanish research
Symptoms of Posttraumatic Stress, Anxiety, Depression, Levels
of Resilience and Burnout in Spanish Health Personnel during
the COVID-19 Pandemic
Background
Spain had the highest number of infected health workers with
COVID-19 in the world. They aimed to analyze the
posttraumatic stress, anxiety, and depression during the period
of the virus (Yıldırım, Arslan & Özaslan,2020). They analyzed
several associations such as burnout, work, and others on the
variation of COVID-19—the purpose of the research. The
purpose was to analyze the symptoms presented to health
workers in Spain with posttraumatic stress, depression, and
anxiety during the COVID-19 pandemic. Methods. Several
methods were used during the examination, such as using
participants who were the health workers. There was also
measurement of variables and instruments. The researchers
collected data through the use of demographic variables.
Results. The study's findings were as follows; there were gender
variations in the symptoms of the three disorders. There were
differences in the depersonalization burnout scale between men
and women. Women are mostly and positively linked to
posttraumatic stress, anxiety, and depression, and age is
negatively and significantly linked to the three symptoms.

Analysis & Conclusion
For discussion part
Both three studies had a similar objective and goal: to examine
and analyze the mental health of healthcare personnel before
and during the outbreak of the coronavirus pandemic. Both
studies focused more on the mental well-being of female
healthcare workers. Both three studies emphasized their
research on how Covid-19 impacted the lives and the mental
health of the health workers. Moreover, the three studies were
focused on certain ages; not all health workers on the frontline
were participants in the study. However, there were differences
in the study with some similarities since these are three
different countries. In Italy, their examinations were on the
associations between psychological distress with mental health
and perceptions of infection; in Spain, their analysis was based
on associations between burnouts, resilience, demographics, and
work with COVID-19 variables. In contrast, Turkey's
examination was on the mediation roles of resilience and the
fear of coronavirus relating to the perceived risk and the
problems with their mental health.
Health personnel was greatly affected by the outbreak of the
coronavirus pandemic because they were on the frontline trying
to save the lives of the infected people. It was a challenging
time all over the world, and thus, cases of increasing mental
health problems were widespread. Many health workers had
these underlying issues before the pandemic, but witnessing
people die before themselves increased the cases. They take
care of people without having someone to take care of them;
thus, the research was necessary, and if the results were used to
improve their health, it would be better than just mere research.
References
1. Bettinsoli, M. L., Di Riso, D., Napier, J. L., Moretti, L.,
Bettinsoli, P., Delmedico, M., ... & Moretti, B. (2020). Mental
health conditions of Italian healthcare professionals during the
COVID‐ 19 disease outbreak. Applied Psychology: Health and

Well‐ Being, 12(4), 1054-1073.
2. Luceño-Moreno, L., Talavera-Velasco, B., García-Albuerne,
Y., & Martín-García, J. (2020). Symptoms of posttraumatic
stress, anxiety, depression, levels of resilience, and burnout in
Spanish health personnel during the COVID-19 pandemic.
International journal of environmental research and public
health, 17(15), 5514.
3. Yıldırım, M., Arslan, G., & Özaslan, A. (2020). Perceived
risk and mental health problems among healthcare professionals
during COVID-19 pandemic: Exploring the mediating effects of
resilience and coronavirus fear. International Journal of Mental
Health and Addiction, 1-11.

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