@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2020;12(4):241-248

Background
COVID-19 started on December 31, 2019, in Wuhan, China, and spread to most countries of the world [1]. ... [2-5].
Previous Studies
... [6-8]. The lack of any definitive treatment or preventive measures for this disease has caused high levels of stress and anxiety in communities [9, 10]. .... [11, 12]. COVID-19-related fear and anxiety have created a high and destructive psychological burden that can lead to mental disorders, weakening the immune system and reducing the body's ability to fight disease in people, including the treatment team (such as nurses and doctors) [13]. ... [14-17]. Lee et al. conducted a study entitled “The Impact of the COVID-19 Pandemic on Psychological Consequences”, in which the subjects were most concerned about their own health and that of their families [18]. ... [19].
Aim(s)
The aim of this study was to determine the depression, anxiety, and stress of nurses' families during the COVID-19 pandemic.
Research type
The present research was a descriptive study.
Research society, place and time
This research was conducted from April 2020 to June 2020.
Sampling method and number
The sample size included 222 family members of nurses working in the wards, in which patients with COVID-19 were hospitalized in the hospitals of Torbat Heydariyeh. The sample size was obtained using Cochran's formula. Inclusion criteria included family members of nurses working in the wards assigned to patients with COVID-19 in Torbat Heydariyehhospitals who had informed consent to participate in the study.
Used devices&materials
Data collection tools included a demographic information questionnaire with 10 questions (age, gender, relationship with the nurse, marital status, work experience of the nurse (year), history of COVID-19, employment status of the nurse, the rate of study of the nurse’s family in order to increase awareness about COVID-19, positive or suspicious cases of COVID-19 in relatives, the average working hours per week, and the quarantine status of the nurse after the end of each shift) and the DASS-21 to assess depression, anxiety, and stress of the nurses' family [20]. In Iran, the reliability of this tool in a sample of the general population of Mashhad has been reported to be 0.70 for depression, 0.66 for anxiety, and 0.76 for stress [21]. The validity and reliability of this tool have been reviewed and approved by Mahdipour and Najafi [22, 23]. The research was performed after obtaining official permission from Torbat Heydariyeh University of Medical Sciences and the approval of the Regional Committee for Research Ethics (IR.THUMS.REC.1398.060) and coordinating with the hospital manager and nurses dealing with COVID-19 patients. Questionnaires were prepared in an online format and sent electronically to the families of nurses working in the wards related to patients with COVID-19. The obtained data were statistically analyzed using SPSS 16 software. Descriptive statistics (frequency and mean distribution) were used to describe and categorize the data. After determining the normality of data distribution and assuming equality of variance, one-way ANOVA and LSD post hoc test were used to correlate demographic variables and scores in the DASS-21. In all the tests used, the 95% confidence level and the significance level of 0.05 were considered.
Findings by Text
A total of 222 family members of nurses participated in this study with an age range of 10 to 70 years and the average age was 33.57±15.6 years, of whom 94 cases (42.3%) were spouses of the nurses.The prevalence of depression was 43.7%, of whom 19.8% (44 patients) had mild depression. Also, the prevalence of anxiety was 35.6%, of whom 20.3% (45 people) had moderate anxiety. The prevalence of stress was 43.7%, of whom 23.0% (51 people) had moderate stress (Table 1). Kolmogorov-Smirnov test was used to test the hypothesis of normal distribution of variables, and based on the results, all data had a normal distribution (p<0.05). Leven’s test confirmed the assumption of the equality of variances (0.287, 0.456, and 0.511). Of the participants, 54.1% (120 people) were female and 70.7% (157 people) were married. Also, 87.7% (195 people) had no history of disease and 60.8% (135 people) of nurses were working about 36-72 hours. The work experience of 77% (171 people) of nurses was 1 to 5 years (Table 2). The mean scores of depression, anxiety, and stress showed that there was a statistically significant difference between being married and be a relative of the treatment team, and depression (p<0.05). Anxiety was higher in female family members (p<0.05). There was also a statistically significant difference between nurses' family member anxiety and age group, employment status and quarantine status, and between family member stress and employment status (p<0.05; Table 2). The results of the LSD post hoc test showed that there was a statistically significant difference in the mean score of depression between the single-married group and between the groups of parents-spouse, spouse-child, child-others (p<0.05). Also, regarding the mean score of anxiety of nurses’ family members, there was a statistically significant difference between the age groups of 10 to 30-31 to 50 years and 31 to 50-51 to 70 years (p<0.05). There was a statistically significant difference in the mean anxiety score between the groups of project-contract, project -contractual, project-non-governmental, and contractual-formal (p<0.05). There was also a statistically significant difference between the following groups: back to home- quarantine at home and quarantine at home - quarantine at the new home (p<0.05). There was a significant difference in the mean stress score between the groups with project-contractual, project- employment contract, project-formal, contract- cooperate, and formal- cooperate employment status (p<0.05; Table 3).
Main comparison to the similar studies
According to the aim of the present study, "determining depression, anxiety, and stress of families of nurses working in Torbat Heydarieh hospitals during the COVID-19 pandemic", the severity of most of the mentioned disorders in nurses’ family members was at a moderate level. In the total population, the rate of depression, anxiety, and stress was 43.7%, 35.6%, and 43.7%, respectively. This rate is higher than the reported level among the general population of Iran [10]. However, this rate was lower than that observed in nurses during the prevalence of COVID-19 in a similar study [24]. These findings, to some extent, showed the psychological impact of the COVID-19 pandemic on nurses' family members. In the present study, there was a significant relationship between age and anxiety that was consistent with the results of the study conducted by Khamseh et al. [28]. The results of the present study showed that anxiety scores are higher in female family members. According to the results of a study conducted in Wuhan, China during the COVID-19 outbreak, women reported higher rates of stress and anxiety symptoms [31]. Other studies have also shown that women are more likely to develop anxiety than men [32-35].
Suggestions
It is suggested that similar studies be conducted in other cities by random sampling due to cultural differences.
Limitations
One of the limitations of this research was its cross-sectional design because more accurate results may be obtained by increasing the duration of the research.
Conclusions
Our findings showed evidence of psychological burden and significant levels of depression, anxiety, and stress in the families of nurses working in hospitals, in which COVID-19 patients are hospitalized.
Acknowledgments
We would like to thank the director and management of the hospital, the supervisors, the nurses, and the families who have made great efforts and collaborations in order to carry out this study.
Conflict of interest
None declared.
Ethical Permissions
IR.THUMS.REC.1398.060.
Funding Sources
This article is taken from an approved research supported by the Vice Chancellor for Research of Torbat Heydariyeh University of Medical Sciences.

TABLES and CHARTS

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