Assessment of Anxiety in Healthcare Providers Working in ICU during COVID-19 Pandemics

Main Article Content

Hakan Dal
Esra Sultan Karabulut Keklik
Baris Kaki


Objective: After onset of coronavirus disease (COVID-19), the risk for exposure or having the disease is increased among healthcare providers involved in the treatment of the disease. There are reports of healthcare providers died due to COVID-19 disease who became ill during work. This resulted in psychological distress in healthcare providers. In this study, we aimed to investigate anxiety in healthcare providers working at intensive care units, considered as an area at highest risk, and to confirm social psychological factors among healthcare providers working in hospitals.

Materials and Methods: The study included 106 healthcare providers working in intensive care unit who accepted participation to the survey. The healthcare providers responded to survey were stratified into 2 groups as those working in pandemic intensive care unit (pandemic group; n=55) and those working in remaining intensive care units (others; n=51). The relationship between sociodemographic characteristics and levels of anxiety and depression was evaluated using State-Trait Anxiety Inventory.

Results: In our study, it was found that STAI anxiety scores were higher in healthcare providers working in pandemic intensive care unit during COVID-19 outbreak (p<0.05). In the pandemic group, anxiety scores were significantly higher in male healthcare providers when compared to female healthcare providers (p>0.05). However, it was seen that healthcare providers with work experience of 1-10 years had higher mean anxiety level in STAI-II scale. It was also seen that anxiety score was significantly higher in those with work experience of 1-10 years when compared to those work experience of 11-20 years or ≥21 years (p<0.05). Work setting, male gender, experience of intensive care and concerns about outbreak were identified as factors associated to anxiety.

Conclusion: Our study showed that STAI anxiety scores were higher in healthcare providers working in pandemic ICU during COVID-19 outbreak. The COVID-19 period has led psychological problems in healthcare providers working in ICU. It is important to provide psychological support and information, and to monitor psychological status in healthcare providers.

COVID-19, anxiety, psychology, mental health, emotional epidemiology, intensive care unit, STAI

Article Details

How to Cite
Dal, H., Keklik, E. S. K., & Kaki, B. (2020). Assessment of Anxiety in Healthcare Providers Working in ICU during COVID-19 Pandemics. Asian Journal of Medicine and Health, 18(6), 46-53.
Original Research Article


Yilmaz Y, Kamer E. Planning and safety of surgical operation in COVID-19 Pandemic. Ege Klin Tıp Derg. 2020;58(1)Supp: 55-61.

Kamer E, Çolak T. What to do when a patient ınfected With COVID-19 Needs An Operation: A Pre-surgery, Peri-surgery and Post-surgery Guide. Turk J Colorectal Dis. 2020;30:1-8.

DOI: 10.4274/tjcd.galenos.2020.2020-3-7

Mavioğlu HL, Ünal EU, Aşkın G, Küçüker ŞA, Özatik MA. Perioperative planning for cardiovascular operations in the COVID-19 pandemic. Turk Gogus Kalp Dama. 2020; 28:236-243.

DOI: 10.5606/tgkdc.dergisi.2020.09294

Göçer H, Durukan AB. ACE-gene polymorphism, particularly “D/I”, may play a role in the occurrence of COVID-19 pneumonia in hypertensive elderly patients. Cardiovasc Surg Int. 2020;7(1):39


DOI: 10.5606/e-cvsi.2020.779

WHO Coronavirus Disease (COVID-19) Dashboard; 2020.

(Accessed: May 19, 2020)


Zhang C, Yang L, Liu S, et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel coronavirus disease outbreak. Front Psychiatry. 2020;11:306.

DOI: 10.3389/fpsyt.2020.00306

Centers for Disease Control and Prevention: Severe acute respiratory syndrome Taiwan, 2003. MMWR Morb Mortal Wkly Rep. 2003;52:461-466.


Oyebode F, Anxiety, panic, irritability, phobia and obsession, Sims' Symptoms in the Mind: Textbook of Descriptive Psychopathology 6th Edition, Elsevier, London. 2018;251-263.

Demir A, Akyurt D, Ergün B, et al. Anxiety therapy in cardiac surgery patients. Turk Gogus Kalp Dama 2010;18:177-182. Available:

Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients-experience of a single unit. Acta Anaesthesiologica Taiwanica. 2012;50:3-6. 10.


Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occup Environ Med. 2018;60:248-257.

DOI: 10.1097/JOM.0000000000001235

Marteau TM, Bekker H. The Development of a Six-Item Short-Form of the State Scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992; 31:301-306.

DOI: 10.1111/j.2044-8260.1992.tb00997.x.

Karadağ Arlı Ş. Evaluation of the Preoperative Anxiety With APAIS and STAI-I Scales. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2017;4:38-47.


Kirwan M, Pickett SM, Jarrett NL. Emotion regulation as a moderator between anxiety symptoms and insomnia symptom severity. Psychiatry Res. 2017;254:40-47.

DOI: 10.1016/j.psychres.2017.04.028

Jehan S, Zizi F, Pandi–Perumal SR, et al.: Shift work and sleep: medical implications and management. Sleep Med Disord. 2017;1:pii:00008.

DOI: 10.15406/smdij.2017.01.00008

Zhang B, Wing Y. Sex differences in insomnia: A meta–analysis. Sleep. 2006; 29:85-93.

DOI: 10.1093/sleep/29.1.85

Johal SS. Psychosocial impacts of quarantine during disease outbreaks and interventions that may help to relieve strain. NZ Med J. 2009;122:47-52.

Marjanovic Z, Greenglass ER, Coffey S: The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007;44:991-998.

DOI: 10.1016/j.ijnurstu.2006.02.012

Nickell LA, Crighton EJ, Tracy CS, et al. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ. 2004;170:793-798.

DOI: 10.1503/cmaj.1031077

Phua DH, Tang HK, Tham KY. Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak. Acad Emerg Med. 2005;12:322-328.

DOI: 10.1197/j.aem.2004.11.015

Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7:300-302.

DOI: 10.1016/S2215-0366(20)30073-0

Orrù G, Ciacchini R, Gemignani A, Conversano C: Psychological intervention measures during the COVID-19 pandemic. Clinical Neuropsychiatry. 2020,17:76-79.

DOI: 10.36131/CN20200208

Taking Care of Patients During the Coronavirus Outbreak: A Guide for Psychiatrists; 2020.

(Accessed: May 19, 2020)


Hekimler ve sağlık çalışanları için COVID-19 korku ve kaygısal baş etme rehberi; 2020.

(Accessed: May 19, 2020)


TC. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19 Rehberi; 2020.

(Accessed: May 19, 2020)