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      The relationship between nurses' risk assessment and management, fear perception, and mental wellbeing during the COVID-19 pandemic in Saudi Arabia

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          Abstract

          During this pandemic, it is crucial to implement early interventions to help nurses manage their mental wellbeing by providing them with information regarding coping skills, preventive risk assessment approaches (such as hospital preparedness and rapid risk assessment), and the ability to respond. This study evaluated the effect of fear and risk assessment management on nurses' mental wellbeing during the COVID-19 pandemic in Saudi Arabia. A total of 507 nurses who worked in tertiary public hospitals were asked to take a descriptive design survey. Three survey scales were used to assess the survey: the Risk Assessment Scale, the Fear of COVID-19 Scale, and the Warwick-Edinburgh Mental Wellbeing Scale. Independent t-tests and a one-way ANOVA were used to examine the association between fear of COVID-19 and nurses' demographic characteristics on their mental wellbeing. A multiple regression analysis was performed to examine the predictors associated with mental wellbeing. Findings revealed that almost half of the participants showed moderate positive mental wellbeing, 49.7%, while only 14% had low levels of fear on the Warwick-Edinburgh Mental Well being Scale. Most of the respondents had low levels of fear on the Fear of COVID-19 Scale, 45%, while only 15% had high levels of fear on the scale. Then, some demographic variables, such as “age,” “nationality,” “total years of experience in the current hospital,” and “region you work at” had statistically significant differences with p < 0.5. Meanwhile, risk assessment is also associated with mental wellbeing scores. All items on the Fear of COVID-19 Scale showed no significant difference with a P > 0.05. In conclusion, most nurses providing direct patient care to a patient with COVID-19 emphasized the importance of wearing PPE and performing hand hygiene before and after any clean or aseptic procedure. Meanwhile, although almost all nurses were vaccinated, they were still afraid of a COVID-19 infection. Additionally, the results reported that the older the nurses are, the better their mental wellbeing scores. Non-Saudi nurses had higher perceived mental wellbeing scores than Saudi nurses, and different working environments corresponded to different mental wellbeing scores. Finally, nurses' risk assessment was associated with mental wellbeing scores.

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          The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation

          Background There is increasing international interest in the concept of mental well-being and its contribution to all aspects of human life. Demand for instruments to monitor mental well-being at a population level and evaluate mental health promotion initiatives is growing. This article describes the development and validation of a new scale, comprised only of positively worded items relating to different aspects of positive mental health: the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Methods WEMWBS was developed by an expert panel drawing on current academic literature, qualitative research with focus groups, and psychometric testing of an existing scale. It was validated on a student and representative population sample. Content validity was assessed by reviewing the frequency of complete responses and the distribution of responses to each item. Confirmatory factor analysis was used to test the hypothesis that the scale measured a single construct. Internal consistency was assessed using Cronbach's alpha. Criterion validity was explored in terms of correlations between WEMWBS and other scales and by testing whether the scale discriminated between population groups in line with pre-specified hypotheses. Test-retest reliability was assessed at one week using intra-class correlation coefficients. Susceptibility to bias was measured using the Balanced Inventory of Desired Responding. Results WEMWBS showed good content validity. Confirmatory factor analysis supported the single factor hypothesis. A Cronbach's alpha score of 0.89 (student sample) and 0.91 (population sample) suggests some item redundancy in the scale. WEMWBS showed high correlations with other mental health and well-being scales and lower correlations with scales measuring overall health. Its distribution was near normal and the scale did not show ceiling effects in a population sample. It discriminated between population groups in a way that is largely consistent with the results of other population surveys. Test-retest reliability at one week was high (0.83). Social desirability bias was lower or similar to that of other comparable scales. Conclusion WEMWBS is a measure of mental well-being focusing entirely on positive aspects of mental health. As a short and psychometrically robust scale, with no ceiling effects in a population sample, it offers promise as a tool for monitoring mental well-being at a population level. Whilst WEMWBS should appeal to those evaluating mental health promotion initiatives, it is important that the scale's sensitivity to change is established before it is recommended in this context.
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            Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study

            Summary Background Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. Methods We did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509. Findings Among 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors. Interpretation In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed. Funding Zoe Global, Wellcome Trust, Engineering and Physical Sciences Research Council, National Institutes of Health Research, UK Research and Innovation, Alzheimer's Society, National Institutes of Health, National Institute for Occupational Safety and Health, and Massachusetts Consortium on Pathogen Readiness.
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              The psychological impact of COVID-19 pandemic on the general population of Saudi Arabia

              Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging infection causing a widely spread pandemic of Coronavirus disease 2019 (COVID-19). The current COVID-2019 pandemic is prompting fear of falling sick, dying, helplessness and stigma, urgent and timely understanding of mental health status is needed to help the community. Our investigation designed to survey the general population in Saudi Arabia to assess the degree of psychological impact during the pandemic. Methods During the early stage of the outbreak, we conducted an online-based survey using a snowballing sample technique. The surveys collected data about several aspects of participant sociodemographic, knowledge, concerns, psychological impact, and mental health status. We assessed the psychological impact and mental health status using the Impact of Event Scale-Revised (IES-R), and the Depression, Anxiety, and Stress Scale (DASS-21). Results Our survey recruited 1160 respondents of the general public of Saudi Arabia. Of them, 23.6% reported moderate or severe psychological impact of the outbreak, 28.3%,24%, and 22.3% reported moderate to severe depressive, anxiety, and stress symptoms, respectively. Females reported IES-R (B: 5.46, 95% CI: 3.61 to 7.31) and DASS subscales B coefficient ranged from 1.65 to 2.63, along with high-school students, working in the medical field, and poor self-reported health status was significantly associated with a high level of IES-R and DASS scales (p < .05). Experiencing breathing difficulty and dizziness showed a stronger association with higher IES-R and DASS subscales than other somatic symptoms (e.g., headache and fever);(p < .001). Respondents who practiced specific preventative measures (e.g., hand washing, social distancing) demonstrated a protective effect against stress, anxiety, and depression symptoms. Social distancing appeared to be protective on stress and anxiety subscales (B: -1.49, 95% CI: −2.79 to −0.19),(B: -1.53, 95% CI: −2.50 to −0.57),respectively; and hand hygiene on depression subscale (B: -2.43, 95% CI: −4.44 to −0.42). Conclusion Throughout the early stage of the COVID-19 outbreak in Saudi Arabia, the results showed that nearly one-fourth of the sampled general population experienced moderate to severe psychological impact. Following specific precautionary measures appeared to have a protective effect on the individual's mental health. Our findings can be used to construct psychological interventions directed toward vulnerable populations and to implement public mental health strategies in the early stages of the outbreak.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                10 November 2022
                2022
                10 November 2022
                : 10
                : 992466
                Affiliations
                [1] 1Nursing Education Department, Nursing College, Imam Abdulrahman Bin Faisal University , Dammam, Saudi Arabia
                [2] 2Public Health Nursing Department, Faculty of Nursing, King Abdul-Aziz University , Jeddah, Saudi Arabia
                [3] 3Nursing Department, College of Applied Medical Sciences, University of Hafr Al Batin , Hafar Al Batin, Saudi Arabia
                [4] 4College of Nursing, University of Hail , Hail, Saudi Arabia
                [5] 5Department of Nursing Education, Nursing College, Qassim University , Buraydah, Saudi Arabia
                [6] 6Medical and Surgical Department, Nursing College, Taibah University , Medina, Saudi Arabia
                [7] 7Nursing Department, College of Applied Medical Sciences, Majmaah University , Al Majma'ah, Saudi Arabia
                [8] 8Nursing Administration and Education Department, College of Nursing, King Saud University , Riyadh, Saudi Arabia
                [9] 9Community Health Nursing Department, College of Nursing, Princess Nourah Bint Abdulrahman University , Riyadh, Saudi Arabia
                [10] 10Community Health Nursing Department, Nursing College, Taibah University , Medina, Saudi Arabia
                [11] 11Nursing Department, College of Applied Medical Sciences, University of Hafr Albatin , Hafar Al Batin, Saudi Arabia
                [12] 12Medicine Department, Nazarbayev University School of Medicine, Nazarbayev University , Astana, Kazakhstan
                Author notes

                Edited by: Oriol Yuguero, Lleida Institute for Biomedical Research (IRBLleida), Spain

                Reviewed by: Fatih Sekercioglu, Ryerson University, Canada; Bushra Elhusein, London Health Sciences Centre, Canada

                This article was submitted to Occupational Health and Safety, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2022.992466
                9685659
                36438216
                a9b5794e-d29b-4484-8f81-1f8cb04daae2
                Copyright © 2022 Al-Dossary, AlMahmoud, Banakhar, Alamri, Albaqawi, Al Hosis, Aljohani, Alrasheadi, Falatah, Almadani, Aljohani, Alharbi and Almazan.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 July 2022
                : 03 October 2022
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 61, Pages: 17, Words: 11642
                Categories
                Public Health
                Original Research

                covid-19,fear perception,risk assessment and management,mental wellbeing,pandemic

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