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Prevalence and Factors Associated with Mental Health Outcomes among Healthcare Workers Exposed to COVID-19 Pandemic in Nepal

Introduction: Corona virus disease (COVID-19) is an infectious disease caused by a newly discovered corona virus. Healthcare workers are at risk of developing psychological distress and other mental health related symptoms. This study was intended to evaluate the prevalence and predictors of depression, anxiety, stress, and fear during COVID-19 pandemic among healthcare workers of Nepal. 
Methods: A cross-sectional survey was conducted between June and July 2020 with 167 healthcare workers. Mental health outcome, specially, fear was estimated using fear of COVID-19 scale (FCV-19S) whereas depression, anxiety and stress were assessed using DASS-21 survey questionnaire. Statistical analysis used: Chi-square test was performed to observe the association between mental health outcomes variables among health workers and the significance level was considered to be a p-value less than 0.05. 
Results: There were 15.0%, 24.0%, and 5.4% of the respondents who had severe and extremely severe level of depression, anxiety, and stress respectively and 44.3% of the respondents had fear during COVID-19 pandemic. The gender and job position were statistically significant with depression. The gender, job position, and respondents who had any health problems were statistically significant with anxiety. The respondents who had any health problems were statistically significant with stress. The gender, education, and job position were statistically significant with fear. 
Conclusion: During the COVID-19 outbreak, the frontline healthcare workers have experienced a varying level of depression, anxiety, stress, and fear. Specific counseling, support system, training on handling COVID-19 patient, and assigning normal working hour as government protocol to all healthcare workers are needed to enhance their psychological wellbeing and strengthen the healthcare systems capacity during pandemic.