Prevalence of Depression and Anxiety, Their Associated Risk Factors and Coping Strategies Among Health Care Providers of Critically Ill Patients at the Kenyatta National Hospital

Abstract

Background: Health care providers frequently develop psychological distress in their line of duty due to the demanding nature of work thus exposing them to a higher risk of developing disorders such as anxiety and depression, However, whether interactions with critically ill patients in hospital exacerbate their occurrence is not known. Information on the risk factors for depression and anxiety disorders, and the coping strategies of affected Kenyan healthcare workers is scanty, which prevents a gap for the detection and management of the disorders. Study site: Kenyatta National Hospital’s Critical Care Units Objectives: To determine the prevalence, risk factors and coping strategies for depression and anxiety disorders among health care providers of critically ill patients. Methodology: A cross-sectional study was conducted in the year 2022 in which 174 health care providers of critically ill patients were recruited after provision of informed consent. A study questionnaire was used to collected data on socio-demographic information such as the age, speciality, experience, and work environment of participants. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate their depression and anxiety symptoms and Brief-COPE used to evaluate the coping styles of participants who were found to be depressed and anxious. Data analysis was conducted using the Statistical Package for Social Scientists (SPSS) for Windows (version 25). Sociodemographic data was summarised using frequency distributions and measures of central tendency. The prevalence of anxiety and depression were calculated using the Clopper Pearson method and the coping styles evaluated by computing the mean scores for Brief cope subscales, which were categorised into three coping styles; problem focussed coping, emotional focussed coping, and avoidance coping. Chi square or Fisher’s test and Logistic regression were used to assess risk factors at 95% CI. Results: One hundred and seventy-four (174) participants with a median age of 33 years (IQR =30-36) were recruited. Most were female (67.8%), medical officers (45.4%), married (60.1%), and had 5-10 years of experience (53.4%). 51.7% consumed alcohol, 6.9% were smokers, 9.8% were using recreational drugs, and 11.0% reported having had a suicidal intent in the past year. The prevalence of depression was 40.8% (95% CI=33.4-48.5) and anxiety 35.6% (95% CI=28.5-43.2). The risk factors for depression were having a bachelor’s degree compared to a diploma (OR=2.71 (95% CI=1.26-6.19)), p=0.012, recreational drug use (OR=2.96 (95% CI=1.01-8.41), p=0.035), and comorbidities (OR= 3.62 (955 CI=1.35-9.93)), p<0.001). The risk factors for anxiety were being a female (OR=2.06 (95% CI=0.99-4.28), p=0.044), comorbidities (OR=3.60 (95% CI=1.35-9.17), p=0.007), and having depression (OR=11.49 (5.61-22.7), p<0.01). Increasing age (30-40 years compared to <30) and being a consultant were protective factors (OR=0.36 (95% CI=0.16-0.82), p=0.014) and OR= 0.22 (95% CI=0.06-0.82), p=0.024). Problem focused coping style was preferred for both anxiety and depression. Conclusion: Depression and anxiety is high among health care workers of critically ill patients. Low education level, recreational drug use, and comorbidities were risk factors for depression, while the risk factors for anxiety were female gender, comorbidities, and being depressed. The health care workers prefer using problem focussed coping strategies for depression and anxiety.