Volume 26, Issue 3 (Autumn- Special Issue on COVID-19 2020)                   IJPCP 2020, 26(3): 294-305 | Back to browse issues page

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Sirati Nir M, Karimi L, Khalili R. The Perceived Stress Level of Health Care and Non-health Care in Exposed to COVID-19 Pandemic. IJPCP 2020; 26 (3) :294-305
URL: http://ijpcp.iums.ac.ir/article-1-3217-en.html
1- Behavioral Sciences Research Center, Life Style Institute, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran.
2- Behavioral Sciences Research Center, Life Style Institute, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran. , khalili1120@gmail.com
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1. Introduction
n December 2019, a massive outbreak of pneumonia followed by coronavirus COVID-19 in Wuhan, Hubei Province, China, and attracted worldwide attention [1]. Since April 15, 2020, 204,952 COVID-19 patients have been identified in Iran, of which 9,623 died from the virus contamination. According to statistics, Iran ranks ninth globally in terms of the number of deaths caused by COVID-19 [2]. Fast transmission is one of the characteristics of this disease, and due to close contact; The epidemic is happening [5, 6]. In recent years, the outbreaks have reported a wide range of social and psychological effects on individuals with contagious infections [13]. 
Stress refers to a person’s adjustment process when faced with internal and external challenges. It has a wide range of psychological disorders (anxiety, depression, burnout, pain disorders) and various physical health outcomes such as cancer, cardiovascular diseases, asthma, and rheumatoid arthritis. The health care staff, especially those who work in hospitals with confirmed or suspected of having COVD-19, are most at risk for both infection and mental health problems such as stress, anxiety, depressive symptoms, Insomnia, denial, anger, and fear [15]. Such mental health problems not only affect the attention, understanding, and decision-making ability of staff but may also slow down the fight COVID-19 and can have some effect on their long-term health [17]. After an emergency encounter, understanding the response and psychological response can help the treatment and care staff prepare for a catastrophic social disaster [18]. Due to the prevalence of COVID-19 in Iran and the high population of hospitalization and care in all hospitals and medical centers in the country, and the possibility of the psychological impact of it; The study aim was to determine the perceived Stress level of health care worker and non-healthcare workers affiliated with Baqiyatallah University of Medical Sciences in exposed to COVID-19.
2. Method
The present study is a descriptive cross-sectional study. The study population included health care workers (physicians, nurses, nursing assistants and interns and seniors nursing students) and non-healthcare professionals(administrative jobs) exposed to COVID-19 who entered the study using the available sampling method. The sample size was 508 using Cochran’s formula, and a total of 528 samples were examined in this study regarding the possibility of sample attrition. The tools used in the study included two sections: the Demographic Information Questionnaire and the Perceived Stress Scale with 10 items. Perceived Stress scale questions were studied online in the hospital’s healthcare workers(physicians and nursing and students) and non-healthcare workers(administrative jobs). Finally, after the sample reaches the desired volume, the questionnaire’s variables were analyzed using SPSS V. 22.
3. Result 
The results of demographic research showed that among 528 participants in the study, (29.5%) single and (68.2%) married, (52.7%) male and (47.3%) female, and most samples (47.3%) were aged 64-46 years. Occupationally (57.4%) were employed in health care and (42.6%) in non-healthcare. The majority of the samples (50.9%) were official employees, and the economic status of the samples (68.6%) was moderate, and most people (92%) did not take medication. As shown in Table 1, most research units (90.2%) had moderate Perceived Stress (5.7%) mild or non-pathological stress only (4.2%) individuals had pathological and severe stress (Table 1). 

Women had more stress than men did, and health care workers than non- health care workers did by Comparing the meaningfulness in the Mann-Whitney test. The Kruskal–Wallis test showed that students had higher levels of stress than those with formal employment.
4. Discussion and Conclusion
The study results showed that the Perceived Stress level of those facing COVID-19 in most participants was moderate, and about (4.2%) was severe and pathological. Wang et al. Showed in a similar study that (8.1%) people under quarantine had moderate to severe stress during the COVID-19 epidemic, with poor personal hygiene (wearing a mask and handwashing) associated with higher levels of stress [23]. In the UK and the United Kingdom, Pieh and his colleagues estimated the average adult population to have a moderate to severe stress score [24]. In Iraq, Kamal and Osman also reported high public stress levels in COVID-19, higher in higher education people [25]. 
The results of our study showed that students showed more stress in women. In most internal and external investigations, the female community was more vulnerable to psychological disorders such as stress, anxiety, and depression [25, 353637]. Findings from the present study showed that more vulnerable groups in society, such as women, students, and health care workers, need to be prevented and cared for in the crisis. It is necessary to review effective coping strategies and manage the epidemic disease, through which access to medical resources and mental health services would be further strengthened. The planning of national strategies and first aid in crises through telemedicine and online services should be emphasized and considered to take optimal measures with a comprehensive intervention system such as monitoring, screening, targeted, and referral interventions to reduce psychological distress and prevent mental health problems.
Ethical Considerations
Compliance with ethical guidelines

The Ethics Committee of Baqiyatallah University of Medical Sciences approved the study (Code: IR.BMSU.REC.1399.029). Informed written consent was obtained from the participants.
The article is extracted from the research project with Code Number 99000023 by Dr Robabe Khalili in Deputy of Research and Information Technology of Baqiyatallah University of Medical Sciences.
Authors' contributions
Conceptualization, supervision: Masoud Sirati Nir, Robabeh Khalili; Investigation, writing – review & editing: All authors; Analysis and validation: Masoud Sirati Nir; final editing: Robabeh Khalili.
Conflicts of interest
The authors declared no conflict of interest.
We appreciate all participants in the present study, from the unit Development of clinical research of Baqiyatallah Al’Azam Hospital, Behavioral Sciences Research Center, and the Deputy of Research in Nursing Faculty of Baqiyatallah University of Medical Sciences.

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Type of Study: Original Research | Subject: Psychiatry and Psychology
Received: 2020/04/30 | Accepted: 2020/08/10 | Published: 2020/11/30

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