Archive \ Volume.12 2021 Issue 2

General Anxiety Predictors among Frontline Warriors of COVID: Cross-Sectional Study among Nursing Staff in Punjab, Pakistan

Tahir Mehmood Khan , Humera Tahir , Muhammad Salman , Zia Ul Mustafa , Muhammad Hussnain Raza , Noman Asif , Naureen Shehzadi , Khalid Hussain , Yaser Mohammed Al-Worafi , Mirza R. Baig

COVID-19 pandemic has increased the generalized anxiety among nursing staff. This cross-sectional questionnaire-based study aimed to determine the generalized anxiety disorders among the nursing staff working in secondary and tertiary care hospitals in Punjab province, Pakistan. A GAD-7 scale was used to assess anxiety. Non-parametric statistics were applied to estimate the difference among the groups. Multiple regression model was adopted to explore the impact of covariates on the GAD-7 score. A total of 133 nurses responded to this survey. It was revealed that being female (7.38±4.20, p=0.032) and having an age of ≥ 31 years (7.68±5.14) might lead to a higher GAD-7 score. 19.6% of the respondents had a high level of generalized anxiety (GAD-7 score ≥ 10), and about 49.6% were falling in the range of mild anxiety. Female nursing staff have the probability of higher GAD-7 score up to 15% [0.148(-0.450 – 4.697), p= 0.049]. Job experience, especially being new to the field (≤ 3 years) might increase the likelihood of having a higher GAD-7 score by 14%. In conclusion, 19.6% of the respondents were meeting the GAD-7 criteria of moderate-severe level of generalized anxiety and depressive disorder. Being female, having less job experience, and no training on how to handle COVID patients were revealed to the main factors influencing the GAD-7 score. Risk of getting COVID, transmission of COVID to family members through them, and uncertainty about the consequence of COVID in Pakistan were some of the common stressors reported by the nurses who participated in this study

How to cite:
Khan T M, Tahir H, Salman M, Ul Mustafa Z, Raza M H, Asif N, et al. General Anxiety Predictors among Frontline Warriors of COVID: Cross-Sectional Study among Nursing Staff in Punjab, Pakistan. Arch. Pharm. Pract. 2021;12(2):40-44.
Khan, T. M., Tahir, H., Salman, M., Ul Mustafa, Z., Raza, M. H., Asif, N., & et al (2021). General Anxiety Predictors among Frontline Warriors of COVID: Cross-Sectional Study among Nursing Staff in Punjab, Pakistan. Archives Of Pharmacy Practice, 12(2),40-44.

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1.        Maben J, Bridges J. Covid-19: Supporting nurses’ psychological and mental health. J Clin Nurs. 2020;29(15-16):2742-50

2.        Salman M, Mustafa Z, Asif N, Zaidi HA, Shehzadi N, Khan TM, et al. Knowledge, attitude and preventive practices related to COVID-19 among health professionals of Punjab province of Pakistan. J Infect Dev Ctries. 2020;14(07):707-12.

3.        Ahmadi SA, Zamahani M, Barkhordar N, Sabet Tavasoli M. The relationship between Job stress and performance among the hospitals nurses. World Sci J. 2013;1(2):165-80.

4.        Bhatia N, Kishore J, Anand T, Jiloha RC. Occupational stress amongst nurses from two tertiary care hospitals in Delhi. Australas Med J (Online). 2010;3(11):731-8.

5.        McVicar A. Workplace stress in nursing: a literature review. J Adv Nurs. 2003;44(6):633-42.

6.        Jennings BM. Work stress and burnout among nurses: Role of the work environment and working conditions. Patient safety and quality: An evidence-based handbook for nurses. 2008.

7.        Albureikan M O. COVID-19 Outbreak in Terms of Viral Transmission and Disease Biocontrol by Healthy Microbiome‎. Int J Pharm Phytopharmacol Res. 2020;10(3):139-46.

8.        Eltayeb LB. An update about Coronaviruses with Emphasis on Newly Emerged COVID 19. J Biochem Technol. 2020;11(3):14-20.

9.        Lestari K, Sitorus T, Instiaty SM, Levita J. Molecular Docking of Quinine, Chloroquine and Hydroxychloroquine to Angiotensin Converting Enzyme 2 (ACE2) Receptor for Discovering New Potential COVID-19 Antidote. J Adv Pharm Educ Res. 2020;10(2):1-4.

10.      Mark G, Smith AP. Occupational stress, job characteristics, coping, and the mental health of nurses. Br J Health Psychol. 2012;17(3):505-21.

11.      Rich S. A brief examination of the effects of occupational stress on creativity and innovation. Psychol Manag J. 2016;19(2):107-21.

12.      Salman M, Mustafa ZU, Rao AZ, Khan QU, Asif N, Hussain K, et al. Serious Inadequacies in High Alert Medication-Related Knowledge Among Pakistani Nurses: Findings of a Large, Multicenter, Cross-sectional Survey. Front Pharmacol. 2020;11:1026.

13.      Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7.

14.      Salman M, Mustafa ZU, Asif N, Zaidi HA, Hussain K, Shehzadi N, et al. Knowledge, attitude and preventive practices related to COVID-19: a cross-sectional study in two Pakistani university populations. Drugs Ther Perspect. 2020;36:319-25.

15.      WHO. Coronavirus Disease (COVID-19) Pandemic. 2020. Available at:{adgroupsurvey}&gclid=CjwKCAjw-qeFBhAsEiwA2G7Nl8yrfVmFqb4StiDjn2U8wkcqcMVXmkWjoAgMxNECKbCuJlN4hvgRoC3AcQAvD_BwE

16.      Shirey MR, McDaniel AM, Ebright PR, Fisher ML, Doebbeling BN. Understanding nurse manager stress and work complexity: factors that make a difference. J Nurs Adm. 2010;40(2):82-91.

17.      Salman M, Asif N, Mustafa ZU, Khan TM, Shehzadi N, Tahir H, et al. Psychological Impairment and Coping Strategies during the COVID-19 Pandemic among Students in Pakistan: A Cross-Sectional Analysis. Disaster Med Public Health Prep. 2020:1-7.

18.      Wang S, Liu Y, Wang L. Nurse burnout: personal and environmental factors as predictors. Int J Nurs Pract. 2015;21(1):78-86.

19.      Almalki MJ, FitzGerald G, Clark M. Quality of work life among primary health care nurses in the Jazan region, Saudi Arabia: a cross-sectional study. Hum Resour Health. 2012;10(1):1-3.

20.      Alotaibi J, Paliadelis PS, Valenzuela FR. Factors that affect the job satisfaction of S audi A rabian nurses. J Nurs Manag. 2016;24(3):275-82.

21.      Obradović Z, Obradović A, Škoro IĆ. Nurses and burnout syndrome. J Health Sci. 2013;3(1):60-4.

22.      Jaafarpour M, Khani A. Evaluation of the nurses’ job satisfaction, and its association with their moral sensitivities and well-being. J Clin Diagn Res. 2012;6(10):1761.

23.      Badil HS, Ali SA, Siddiqui MA. Severity of stress in nurses everyday life in Karachi, Pakistan. J Liaquat Uni Med Health Sci. 2017;25(30):125.

24.      Al-Makhaita HM, Sabra AA, Hafez AS. Predictors of work-related stress among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia. J Family Community Med. 2014;21(2):79-84.

25.      Lee I, Wang HH. Perceived occupational stress and related factors in public health nurses. J Nurs Res. 2002;10(4):253-60.

26.      Verhaeghe R, Vlerick P, De Backer G, Van Maele G, Gemmel P. Recurrent changes in the work environment, job resources and distress among nurses: A comparative cross-sectional survey. Int J Nurs Stud. 2008;45(3):382-92.

27.      Tyson PD, Pongruengphant R. Five-year follow-up study of stress among nurses in public and private hospitals in Thailand. Int J Nurs Stud. 2004;41(3):247-54.

28.      Glazer S, Gyurak A. Sources of occupational stress among nurses in five countries. Int J Intercult Relat. 2008;32(1):49-66.