The prevalence of depression, anxiety, and stress among nurses during the coronavirus disease 2019: A comparison between nurses in the frontline and the second line of care delivery


1 Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran

2 Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 Department of Healthcare Management, School of Public Health, Kerman University of Medical Science, Kerman, Iran

4 Department of Environmental Health, Sirjan School of Medical Sciences, Sirjan, Iran


Background: The coronavirus disease 2019 (COVID-19) can significantly affect mental health among healthcare providers, particularly nurses in the frontline (FL) and the second line (SL) of care delivery to afflicted patients. Objective: This study aimed at evaluating the prevalence of depression, anxiety, and stress among FL and SL nurses during the COVID-19 pandemic. Methods: This cross-sectional descriptive-analytical study was conducted in June–September 2020. Participants were 146 FL nurses and 206 SL nurses who were in direct contact with COVID-19 patients in two hospitals in Sirjan, Iran. They were recruited to the study through a census. Data were collected using a demographic questionnaire and the 21-item Depression Anxiety Stress Scale. Data analysis was done through the Shapiro-Wilk, Chi-square, Mann-Whitney U, and independent-sample t tests. Results: The mean scores of depression, anxiety, and stress were, respectively, 15.87 ± 4.32, 8.35 ± 4.74, and 13.4 ± 4.39 among FL nurses and 9.91 ± 5.96, 6.91 ± 5.48, and 7.38 ± 3.95 among SL nurses. The between-group differences regarding these mean scores were statistically significant (P < 0.001). Conclusion: Depression, anxiety, and stress are highly prevalent among both FL and SL nurses who provide care to patients with COVID-19. Psychological support and education about stress management strategies for nurses can help them manage their depression, anxiety, and stress.


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