Anxiety and depression in nurses during Covid-19 pandemic. A systematic review

Abstract

Introduction: The increased demands on the public health sector due to the COVID-19 pandemic are affecting both the physical and mental health of nurses.

Aim: The aim of this systematic review was to explore anxiety and depression in nurses during the COVID-19 pandemic and the associated factors.

Methodology: A systematic review of the current, international literature was performed in the electronic databases: PubMed, Google Scholar, Cochrane, Science Direct, BMJ, Pro-Quest.
Studies included in the systematic review were published between July 2020 and December 2021.

Results: The total sample size in studies was 30,469 nurses. In almost all studies, the majority of the sample was female ranging from 74.8% to 98.6%. The prevalence of anxiety ranged from 29.8% to 78% and depression from 18.4% to 84.3%. Moreover, frequent caregiving for patients with COVID-19, social restrictions, conflict, and the death of a family member were associated with high levels of anxiety and depression. Regarding demographic characteristics, female gender, having children, and younger age were associated with anxiety and depression. Social and organizational support, personal resilience were associated with anxiety. In terms of factors related to COVID-19 infection, fear of infection and transmission of the SARS-CoV-2 virus to family members was associated with anxiety. Independent risk factors for depression were poor sleep quality, lack of optimism and lack of friends.

Conclusions: Nurses’ depression and anxiety have serious consequences for both the individual and the health care organization as they impair the quality and safety of care provided, increase the risk of errors and adverse events, decrease patients’ level of satisfaction, and affect personal well-being and caregiver relationships, leading to chronic health problems, substance abuse, and even suicide. It is imperative that healthcare leaders address the mental health needs of nursing staff and create a culture of support, in post-pandemic era.