Qom University of Medical Sciences Journal

Introduction
Recently, the new coronavirus disease 2019 (COVID-19) has caused a lot of stress and anxiety around the world. It affected important economic, political, social and even military aspects of almost all countries in the world. This disease mostly affects the respiratory system of infected people. The lack of any definitive treatment for this disease and the prediction of some epidemiologists regarding the fact that more people in the world would be infected with COVID-19 created a lot of stress, anxiety, and worry in the countries. Stress and anxiety can weaken the body’s immune system and make them vulnerable to diseases, such as COVID-19. Identifying and screening the anxiety level of medical and non-medical staff in hospitals during the pandemic is essential to maintain the mental health of these people with appropriate psychological solutions and techniques. In this regard and considering that there has been no study on assessing the anxiety of medical and non-medical staff in Khorramabad city during the pandemic, this study aims to evaluate and compare the COVID-19-related anxiety between medical and non-medical staff of selected hospitals in Khorramabad, Iran.
Methods
This is an analytical cross-sectional study that was conducted on 150 medical staff and 150 non-medical (administrative) staff working in Shohadaye Ashayer and Shahid Rahimi hospitals in Khorramabad in 2021 (coincided with the fourth and fifth waves of COVID-19). The sampling method was multi-stage method (cluster and convenience methods). The sample size was determined 135 in each group, which increased to 150 by taking into account a 10% dropout in each group. Data collection tools were a demographic information form (surveying age, gender, marital status, level of education, working hospital, work experience, history of infection with COVID-19, history of vaccination, number of vaccine doses received, type of employment, and number of work shifts), and the coronavirus disease anxiety scale (CDAS). The CDAS questionnaire was developed by Alipour et al. It has 18 items and two subscales of psychological symptoms and physical symptoms. The items 1-9 measure psychological symptoms and items 10-18 measure physical symptoms. The items are scored on a four-point Likert scale (0=Never , 1=Sometimes , 2=Often, and 3=Always). The total score ranges from 0 to 54. After collecting the data, they were entered into SPSS software, version 22 (statistical) and analyzed using statistical methods including analysis of covariance, one-way analysis of variance followed by Sheffe’s post hoc test, chi-square test, and independent t-test.
Results
The mean age of non-medical staff was 33.37±5.49 years ranged 25-49 years and the mean age of medical staff was 30.32±3.48 years ranged 24-40 years. There was a significant difference between the two groups in terms of age (P<0.001). In terms of education, most of the participants had a bachelor’s degree (70% of medical staff and 44% of non-medical staff) and there was a significant difference in terms of educational level between the two groups (P<0.001). In terms of gender, the frequency of females was higher in the medical staff (68%), but the frequency of males was more in the non-medical staff (52%) and there was a significant difference between the two groups (P<0.001). In terms of vaccination history, in both groups, more than 65% had received two doses of the vaccine. There was a significant difference between the two groups in terms of vaccination dose (P<0.001).
The mean total CDAS scores for the medical and non-medical staff were 9.31±0.188 and 9.10±0.188, respectively, but this difference was not statistically significant (P=0.459). In terms of anxiety dimensions, the mean scores of psychological and physical symptoms were higher in medical staff, but the difference was not statistically significant (P=0.426 and 0.617). In terms of age, gender, educational level, marital status, history of vaccination, previous history of infection with COVID-19, working hospital, and type of employment, no significant difference in anxiety was found neither among the medical staff nor among the non-medical staff (P>0.05).
Discussion
The results of the present study showed that although the COVID-19-related anxiety score in total and in its domains were higher in the medical staff of hospitals in Khorramabd city compared to the non-medical (administrative) staff, but the difference between the two groups was not statistically significant. The results of studies by Tan et al., Rahmanian eta l., and Sirati Nir et al. [5-7] are not consistent with the results of the present study. This difference may be due to the use of different tools to measure the level of anxiety and the difference in the cities/countries under study. Moreover, the current study was conducted at the time of fourth and fifth waves of COVID-19 in Iran when more measures had been taken to prevent the disease, while the mentioned studies were conducted before the second wave of COVID-19. Overall, it can be concluded that there is no difference between medical and non-medical staff of hospitals in Khorramabad in terms of COVID-19-related anxiety. Considering the importance of mental health in both groups, it is recommended to take special measures to reduce their anxiety during the COVID-19 pandemic. Some of the limitations of this study were the relatively low number of samples and the use of a self-report tool. Moreover, since the study was conducted in a city in Iran, the results cannot be generalized to the hospital staff of all hospitals in Iran. More studies should be conducted on other mental health variables of medical and non-medical staff in other provinces of Iran during the pandemic.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the research ethics committee of Lorestan University of Medical Sciences (Code: IR.LUMS.REC.1400.246). A written informed consent was obtained from all participants.
Funding
This study was extracted from the professional doctorate thesis ofRaheleh Najmi at the Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad.
Authors contributions
Conceptualization, methodology, and data collection: Raheleh Najmi; Data analysis, and project administration: Parastoo Baharvand; Writing initial draft, validation, editing & review, and supervision: Farideh Malekshahi. All authors have read and approved the manuscript.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank the staff of Shohadaye Ashayer and Shahid Rahimi hospitals in Khorramabad for their cooperation.