Impact of severe respiratory syndrome on anxiety levels of front-line health care workers.

Poon, E; Liu, K S; Cheong, D L; Lee, C K; Yam, L Y C; Tang, W N

OBJECTIVE To identify anxiety levels among front-line health care workers during the 2003 severe acute respiratory syndrome outbreak. DESIGN Questionnaire survey. SETTING Regional hospital, Hong Kong. PARTICIPANTS All hospital staff were given a questionnaire; administrative staff who had not had any patient contact served as controls. MAIN OUTCOME MEASURES Levels of contact with patients who had severe acute respiratory syndrome were measured and correlated with anxiety levels as determined by the State-Trait Anxiety Inventory. RESULTS Of 4252 questionnaires distributed between May and June 2003, 2040 (48.0%) were returned and 1926 (45.3%) were valid for analysis. Overall, 534 (27.7%) respondents had had contact with patients with severe acute respiratory syndrome. Anxiety scores ranged from 20 to 80, and mean (standard deviation) scores were higher among staff who had had contact with patients with severe acute respiratory syndrome than among those who had not (52.6 [10.5] versus 49.8 [10.1], respectively; P<0.01). Mean anxiety levels were higher among workmen, health care assistants, and nurses than among administrative staff controls or doctors (P<0.01). Anxiety scores were correlated with burnout scores (Pearson's correlation coefficient, 0.52-0.59) and with discomfort from wearing protective gear (0.21-0.32). CONCLUSION Severe acute respiratory syndrome has likely stressed the public health care system. Prediction and early identification of adverse factors in a crisis situation would allow early implementation of interventions to reduce and counteract the impact of this stress.