Prevalence and factors associated with generalized anxiety disorder in healthcare workers at China-Uganda Friendship Hospital Naguru and Kiruddu National Referral Hospital

Abstract

Background: Generalized anxiety disorder is common in health workers and is associated with reduced productivity at the work place as the patients are usually restless and, on the edge, irritable with difficulty in concentrating. They also usually have sleep problems and this further affects their quality of work. For the healthcare workers (HCWs) whose work usually requires a high level of attention and concentration this can be challenging and often results in poor quality of services provided. However, the majority of literature on generalized anxiety in health workers is not from low resource settings which may have different drivers of the illness. More studies in health care workers from sub-Saharan Africa including Uganda are required to inform appropriate policy formulation. Objectives: The aim of this study was to determine the prevalence and factors associated with generalized anxiety disorder in health care workers at China Uganda Friendship Hospital Naguru (CUFH-N) and Kiruddu National Referral Hospital (KNRH) Methods: This was a cross-sectional study in which data was collected from 288 health care workers over a period of six weeks. We recruited health care workers who were above 18 years of age. Probability proportionate to size sampling method selected the number of participants to recruit per cadre of the HCWs in CUFH-N and Kiruddu NRH. Consecutive sampling then selected the participants to be recruited. After obtaining informed consent, the module for generalized anxiety disorder from the MINI 7.0.2 was used to diagnose GAD. Data on socio-demographics, coping skills, perceived stress and occupational stress were collected using a socio-demographic questionnaire, the Brief-COPE inventory by Carver, perceived stress scale by Sheldon Cohen and work stress questionnaire by Holmgren respectively. Descriptive statistics estimated the prevalence of GAD while factors associated with GAD were analyzed using multivariable logistic regression. Results The prevalence of generalized anxiety disorder was 9.03% among health care workers at the China Uganda Friendship Hospital, Naguru and Kiruddu National Referral hospital. 64.2% of the participants were female. 56.3% were nurses. The factors associated with generalized anxiety disorder were a positive family history of mental illness (AOR 3.03[95% CI: 1.28; 7.14]; p-11

value= 0.011), perceived stress per unit increase (AOR 1.16 [95% CI: 1.06; 1.26]; p=0.001), avoidant coping (AOR 1.27 [95% CI: 1.13; 1.43]; p-value=< 0.001), occupational stress due to individual demands and commitment (AOR 1.20 [95% CI: 1.09; 1.31]; p=< 0.001) and work to leisure time interference(AOR 1.25 [95% CI: 1.06; 1.48];p=0.007). Conclusion The results indicate a high prevalence of generalized anxiety disorder in health care workers at the China Uganda Friendship hospital, Naguru and Kiruddu national referral hospital. Health care workers with higher levels of perceived stress per unit increase, poor coping, work stress and with longer years of employment have an increased likelihood of developing generalized anxiety disorder. These findings call for health promotion interventions specially designed for health workers to regularly screen for stress and anxiety symptoms.