Discussion

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Statistical analysis

Hypothesis

As mentioned earlier, this study is aimed to investigate the psychological impact of the COVID-

19 pandemic on the healthcare workers in Riyadh, Saudi Arabia. Based on an extensive review of the

literature, the following hypothesis is developed and would be investigated throughout the research project. Ho:There is no significant relationship between the COVID-19 pandemic and psychological impact on

healthcare workers in Riyadh, Saudi Arabia. H1:There is a significant relationship between the COVID-19 pandemic and psychological impact on

healthcare workers in Riyadh, Saudi Arabia.

DASS-21:

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Statistical analysis of the data

Data were fed to the computer and analyzed using IBM SPSS software package (Armonk, NY: IBM Corp). Qualitative data were described using number and percent. The Kolmogorov-Smirnov test was used to verify the normality of distribution. Quantitative data were described using mean, standard deviation. Significance of the obtained results was judged at the 5% level.

The used tests were

1 - Chi-square test For categorical variables, to compare between different groups

2 - Monte Carlo correction Correction for chi-square when more than 20% of the cells have expected count less

than 5

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Table (1): Distribution of the studied cases according to demographic characterizes of participants (n = 379)

Demographic characterizes of participants No. %

Gender Male 217 57.3

Female 162 42.7

Marital Status Single 191 50.4

Married 179 47.2

Divorce 9 2.4

Occupational Physician (Consultant) 66 17.4

Physician (Specialist) 53 14.0

Physician (Resident) 55 14.5 Physician (Internship) 26 6.9

Nurse (Specialist) 52 13.7

Nurse (technician) 21 5.5 Supportive staff 106 28.0

Sector of the healthcare system of your hospital

MOH (Ministry of Health) 169 44.6 Government sector 161 42.5

Private sector 49 12.9

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Table (2): Distribution of the studied cases according to DASS-21 severity categories of participants (n = 379)

Q DASS-21 severity categories of participants

Did not apply to me

at all

Applied to me to some degree, or

some of the time

Applied to me to a

considerable degree or a good part of

time

Applied to me very much or

most of the time

No. % No. % No. % No. % Stress

1 Found it hard to wind down 106.0 28.0 149.0 39.3 88.0 23.2 36.0 9.5 6 I tended to over-react to situations 156.0 41.2 120.0 31.7 78.0 20.6 25.0 6.6 8 I felt that I was using a lot of nervous energy 130.0 34.3 130.0 34.3 78.0 20.6 41.0 10.8 11 I found myself getting agitated 156.0 41.2 116.0 30.6 79.0 20.8 28.0 7.4 12 I found it difficult to relax 107.0 28.2 147.0 38.8 80.0 21.1 45.0 11.9

14 I was intolerant of anything that kept me from getting on with what I was doing 163.0 43.0 129.0 34.0 63.0 16.6 24.0 6.3

18 I felt that I was rather touchy 198.0 52.2 107.0 28.2 52.0 13.7 22.0 5.8 Anxiety

2 I was aware of dryness of my mouth 174.0 45.9 118.0 31.1 48.0 12.7 39.0 10.3 4 I experienced breathing difficulty 216.0 57.0 84.0 22.2 61.0 16.1 18.0 4.7 7 I experienced trembling 231.0 60.9 89.0 23.5 42.0 11.1 17.0 4.5

9 I was worried about situations in which I might panic and make a fool of myself 182.0 48.0 109.0 28.8 58.0 15.3 30.0 7.9

15 I felt I was close to panic 203.0 53.6 107.0 28.2 45.0 11.9 24.0 6.3

19 I was aware of the action of my heart in the absence of physical exertion 198.0 52.2 107.0 28.2 57.0 15.0 17.0 4.5

20 I felt scared without any good reason 196.0 51.7 110.0 29.0 50.0 13.2 23.0 6.1 Depression

3 I Couldn't seem to experience any positive feeling at all 144.0 38.0 132.0 34.8 75.0 19.8 28.0 7.4

5 I found it difficult to work up the initiative to do things 120.0 31.7 154.0 40.6 70.0 18.5 35.0 9.2

10 I felt that I had nothing to look forward to 195.0 51.5 113.0 29.8 47.0 12.4 24.0 6.3 13 I felt down-hearted and blue 187.0 49.3 107.0 28.2 49.0 12.9 36.0 9.5

16 I was unable to become enthusiastic about anything 163.0 43.0 128.0 33.8 58.0 15.3 30.0 7.9

17 I felt I wasn't worth much as a person 222.0 58.6 85.0 22.4 45.0 11.9 27.0 7.1 21 I felt that life was meaningless 217.0 57.3 85.0 22.4 48.0 12.7 29.0 7.7

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Table (3): Distribution of the studied cases according to level of DASS-21 severity categories of participants (n = 379)

DASS-21 severity categories of participants No. %

Stress Normal (0 – 10) 169 44.6

Mild (11 – 18) 99 26.1 Moderate (19 – 26) 68 17.9

Severe (27 – 34) 32 8.4

Extremely severe (35 – 42) 11 2.9

Total Score 13.70 ± 10.14 Anxiety

Normal (0 – 6) 170 44.9

Mild (7 – 9) 28 7.4

Moderate (10 – 14) 77 20.3 Severe (15 – 19) 36 9.5

Extremely severe (20 – 42) 68 17.9

Total Score 10.29 ± 9.36 Depression

Normal (0 – 9) 177 46.7

Mild (10 – 12) 51 13.5 Moderate (13 – 20) 86 22.7

Severe (21 – 27) 32 8.4

Extremely severe (28 – 42) 33 8.7

Total Score 11.69 ± 9.99

SD: Standard deviation

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Table (4): Relation between stress and demographic characterizes of participants (n = 379)

Stress

χ2 p Demographic

characterizes of participants

Normal (0 – 10)

(n = 169)

Mild (11 – 18) (n = 99)

Moderate (19 – 26) (n = 68)

Severe (27 – 34) (n = 32)

Extremely severe

(35 – 42) (n = 11)

No. % No. % No. % No. % No. % Gender

Male 113 66.9 52 52.5 30 44.1 18 56.3 4 36.4 14.051* 0.007*

Female 56 33.1 47 47.5 38 55.9 14 43.8 7 63.6 Marital Status

Single 78 46.2 49 49.5 38 55.9 21 65.6 5 45.5 9.723

MCp= 0.231 Married 87 51.5 49 49.5 27 39.7 11 34.4 5 45.5

Divorce 4 2.4 1 1.0 3 4.4 0 0.0 1 9.1 Occupational

Physician (Consultant) 35 20.7 12 12.1 12 17.6 5 15.6 2 18.2

17.248 MCp= 0.817

Physician (Specialist) 22 13.0 17 17.2 10 14.7 4 12.5 0 0.0 Physician (Resident) 27 16.0 11 11.1 11 16.2 3 9.4 3 27.3 Physician (Internship) 9 5.3 11 11.1 4 5.9 2 6.3 0 0.0 Nurse (Specialist) 20 11.8 17 17.2 7 10.3 6 18.8 2 18.2 Nurse (technician) 9 5.3 7 7.1 2 2.9 2 6.3 1 9.1 Supportive staff 47 27.8 24 24.2 22 32.4 10 31.3 3 27.3

Sector of the healthcare system of your hospital

MOH (Ministry of Health)

79 46.7 47 47.5 28 41.2 11 34.4 4 36.4 6.173

MCp= 0.622 Government sector 71 42.0 37 37.4 31 45.6 15 46.9 7 63.6

Private sector 19 11.2 15 15.2 9 13.2 6 18.8 0 0.0

c2: Chi square test MC: Monte Carlo *: Statistically significant at p ≤ 0.05

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Table (5): Relation between anxiety and demographic characterizes of participants (n = 379)

Anxiety

χ2 p Demographic

characterizes of participants

Normal (0 – 6)

(n = 170)

Mild (7 – 9)

(n = 28)

Moderate (10 – 14) (n = 77)

Severe (15 – 19) (n = 36)

Extremely severe

(20 – 42) (n = 68)

No. % No. % No. % No. % No. % Gender

Male 113 66.5 19 67.9 38 49.4 16 44.4 31 45.6 15.347* 0.004*

Female 57 33.5 9 32.1 39 50.6 20 55.6 37 54.4 Marital Status

Single 68 40.0 16 57.1 44 57.1 21 58.3 42 61.8 18.777*

MCp= 0.008* Married 98 57.6 12 42.9 32 41.6 12 33.3 25 36.8

Divorce 4 2.4 0 0.0 1 1.3 3 8.3 1 1.5 Occupational

Physician (Consultant) 43 25.3 5 17.9 9 11.7 2 5.6 7 10.3

35.690* MCp=

0.042*

Physician (Specialist) 27 15.9 3 10.7 8 10.4 7 19.4 8 11.8 Physician (Resident) 30 17.6 2 7.1 11 14.3 4 11.1 8 11.8 Physician (Internship) 5 2.9 3 10.7 7 9.1 5 13.9 6 8.8 Nurse (Specialist) 16 9.4 5 17.9 11 14.3 7 19.4 13 19.1 Nurse (technician) 7 4.1 2 7.1 5 6.5 1 2.8 6 8.8 Supportive staff 42 24.7 8 28.6 26 33.8 10 27.8 20 29.4

Sector of the healthcare system of your hospital

MOH (Ministry of Health)

77 45.3 14 50.0 35 45.5 16 44.4 27 39.7 7.284 0.506

Government sector 76 44.7 9 32.1 29 37.7 13 36.1 34 50.0 Private sector 17 10.0 5 17.9 13 16.9 7 19.4 7 10.3

c2: Chi square test MC: Monte Carlo *: Statistically significant at p ≤ 0.05

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Table (6): Relation between depression and demographic characterizes of participants (n = 379)

Depression

χ2 p Demographic

characterizes of participants

Normal (0 – 9)

(n = 177)

Mild (10 – 12) (n = 51)

Moderate (13 – 20) (n = 86)

Severe (21 – 27) (n = 32)

Extremely severe

(28 – 42) (n = 33)

No. % No. % No. % No. % No. % Gender

Male 118 66.7 36 70.6 33 38.4 12 37.5 18 54.5 27.842* <0.001*

Female 59 33.3 15 29.4 53 61.6 20 62.5 15 45.5 Marital Status

Single 80 45.2 22 43.1 48 55.8 18 56.3 23 69.7 13.253

MCp= 0.068 Married 94 53.1 28 54.9 34 39.5 14 43.8 9 27.3

Divorce 3 1.7 1 2.0 4 4.7 0 0.0 1 3.0 Occupational

Physician (Consultant) 38 21.5 7 13.7 13 15.1 2 6.3 6 18.2

25.370 MCp= 0.344

Physician (Specialist) 25 14.1 9 17.6 15 17.4 2 6.3 2 6.1 Physician (Resident) 29 16.4 6 11.8 9 10.5 5 15.6 6 18.2 Physician (Internship) 13 7.3 3 5.9 7 8.1 3 9.4 0 0.0 Nurse (Specialist) 19 10.7 7 13.7 14 16.3 7 21.9 5 15.2 Nurse (technician) 11 6.2 0 0.0 5 5.8 3 9.4 2 6.1 Supportive staff 42 23.7 19 37.3 23 26.7 10 31.3 12 36.4

Sector of the healthcare system of your hospital

MOH (Ministry of Health)

85 48.0 25 49.0 31 36.0 14 43.8 14 42.4 7.939 0.439

Government sector 73 41.2 18 35.3 41 47.7 12 37.5 17 51.5 Private sector 19 10.7 8 15.7 14 16.3 6 18.8 2 6.1

c2: Chi square test MC: Monte Carlo *: Statistically significant at p ≤ 0.05