A cross sectional study on resilience and coping strategies among medical officers during the Covid-19 pandemic and it's association with depression and anxiety / Rahul Yong Wern Kean

Rahul Yong , Wern Kean (2021) A cross sectional study on resilience and coping strategies among medical officers during the Covid-19 pandemic and it's association with depression and anxiety / Rahul Yong Wern Kean. Masters thesis, Universiti Malaya.

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Abstract

Introduction: The mental well-being of medical officers during the Covid-19 pandemic is becoming an increasing concern. The on-going pandemic has drastically increased work demands for doctors and this resulted in high levels of stress, depression and burnout among medical officers. Objectives: This study aims to determine the patterns of resilience and coping strategies of front-line medical officers during the Covid-19 pandemic, as well as their association with depression and anxiety. Study design: This is a single center, cross sectional study on Covid-19 front-line medical officers posted in medical wards in Hospital Tuanku Ja’afar, Seremban. The instruments used were a sociodemographic questionnaire, Brief Resilience Scale (BRS), Brief COPE, Coronavirus Anxiety Scale (CAS), and Hospital Anxiety and Depression Scale (HADS). Data was collected over a six-month period from February 2021 to July 2021. Statistical data analysis done using the Statistical Package for the Social Sciences (SPSS) version 28.0. included using a Pearson Chi-square test to investigate the association between categorical explanatory variables (sociodemographic, medical conditions, and job-related) with the categorical anxiety and depression symptoms. Continuous variables were tested with a t-test, or Mann-Whitney against the outcome variables, depending on the normality of the data. A multiple logistic regression analysis was carried out using “Enter” method to analyse all factors with a p-value < 0.05 in association with anxiety and depression symptoms among medical officers. iv Results: A total of 140 front line medical officers from Covid-19 wards participated in this study, with the majority being female (69.3), Malay (60%), single (61%), from medical department (53.6%) and on average had three months duration of posting in Covid-19 wards. The prevalence of symptoms of anxiety and depression was 45.0% and 24.3% respectively. The majority of the participants had normal to high resilience (79.3%) with the average score of resilience being 3.25. Low levels of resilience were significantly associated with depression (p = 0.018, aOR (95%CI) 0.292 (0.105-0.808). Among problem�based coping strategies, the use of informational support and planning were associated with anxiety symptoms (p=0.001). Among emotion-focused coping strategies, those that were associated with anxiety symptoms were emotional support (p=0.002), venting (p<0.001), humor (p<0.001), acceptance (p=0.014), and self-blame (p<0.001). As for avoidance coping strategy, three out of four sub-components, notably self-distraction (p<0.001), denial (p=0.001), and behavioral disengagement (p < 0.001), were correlated with anxiety symptoms. After multiple logistic regression analysis, only venting (p=0.028, aOR (95%CI) 1.556 (1.049-2.308)) and behavioral disengagement (p=0.016, aOR (95% CI) 1.607 (1.092-2.365)) were associated with anxiety symptoms. Emotion based coping strategies venting (p=0.022) and humor (p<0.001), self-blame (p=0.006), and avoidance coping strategies denial(p<0.001) and behavioral disengagement (0.001) were associated with depressive symptoms. After multiple logistic regression analysis was done, only lower resilience (p=0.018, aOR(95% CI) 0.292 (0.105-.808)) and humor (p=0.004, aOR (95% CI) 1.506 (1.140-1.991)) were associated with depressive symptoms. v Multiple logistic regression analysis reported no significant association with sociodemographic factors such as age, gender, number of children, previous posting with depression or anxiety among front-line medical officers. Conclusion: The prevalence of anxiety and depression is high among front-line medical officers. The overall good levels of resilience among medical officers are protective against depression. Remedial steps should be taken to preserve psychological well-being among front-line medical officers.

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