A cross-sectional survey of the workplace factors contributing to symptoms of anxiety and depression among nurses and physicians during the first wave of COVID-19 pandemic in two US healthcare systems

Background: Anxiety and depression among physicians and nurses during COVID-19 pandemic in the USA is not well described and its modifiable causes poorly understood. Methods: We conducted a cross-sectional survey of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) among physicians and nurses in two US healthcare systems June-Sept 2020. We ascertained features of work as well as its perceptions and associated concerns in relation to risk of anxiety and depression, while controlling for health history via regression and path analyses. Results: About a third of 684 nurses and 185 physicians surveyed showed symptoms of anxiety or depression, the excess was particularly prominent in nurses. Belief in having been infected was a dominant cause of anxiety and depression, more related to history of symptoms of pneumonia, then the contact with infected patients. Having confidence in competent use and access to personal protective equipment, maintaining usual working hours and being surrounded by colleagues who were both sufficient in numbers and not stressed, was protective. Having support of immediate family and religious communities lessened anxiety and depression after accounting for other factors. Involvement in aerosol-generating procedures with infected patients was linked with lower depression in nurses but higher among physicians. Likewise, the setting of recent patient encounters affected risk differently for physicians and nurses. Conclusions: Our findings may help develop mitigation measures and underscore the need to help nurses and physicians bear the psychological burden of COVID-19 pandemic and similar events in the future.