DOI: https://doi.org/10.14710/nmjn.v14i3.60744

Anxiety and Sleep Disturbances Among Nurses Working at COVID-19 Dedicated Hospitals in Bangladesh

*Sujit Mondal  -  Dhaka Medical College Hospital, Bangladesh
Mohammad Nurul Anowar  -  Faculty of Nursing, National Institute of Advanced Nursing Education and Research, Bangladesh
Mosammet Khaleda Akter  -  Faculty of Nursing, National Institute of Advanced Nursing Education and Research, Bangladesh
Shanzida Khatun  -  Faculty of Nursing, National Institute of Advanced Nursing Education and Research, Bangladesh
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: The coronavirus disease (COVID-19) pandemic has exposed nurses to conditions that threaten their health, well-being, and ability to work. While the physical health of nurses has received more attention, there has been limited focus on the long-term psychological effects. In Bangladesh, there is very limited research on anxiety and sleep disturbances among nurses during the COVID-19 pandemic.

Purpose: This study aimed to assess the relationship among anxiety, sleep disturbances, and sociodemographic factors among nurses working at COVID-19 dedicated hospitals in Bangladesh.

Methods: A descriptive correlational study was conducted from July 2021 to June 2022 among 102 nurses selected using a convenience sampling technique from two dedicated COVID-19 hospitals. The Self-administered Anxiety Scale and the Medical Outcome Study Sleep Scale were used to collect data. Both descriptive and inferential statistics were used. Descriptive statistics included frequency, percentage, mean, standard deviation, minimum, and maximum. Pearson product-moment correlation (r), t-tests, and ANOVA were used for inferential analysis.

Results: Nearly half (40.2%) of the nurses had mild to moderate levels of anxiety, and most of the nurses (84.3%) experienced sleep disturbances. A significant positive correlation (r=0.54, p<0.05) was found between anxiety and sleep disturbances. There was also a significant relationship between nurses' age and anxiety (p<0.05), marital status (p<0.05), highest professional education (p<0.05), working duration (r=–0.38, p<0.05), COVID-19 positive history (p<0.05), training (p<0.05), and presence of comorbidities (p<0.05). Additionally, nurses' age (p<0.05), marital status (p < .05), highest professional education (p<0.05), working duration (r=0.363, p<0.05), training (p<0.05), and presence of comorbidities (p<0.05) were significantly associated with sleep disturbances.

Conclusion: The findings indicate that age, gender, education, family type, marital status, training, and comorbidities were significantly associated with increased levels of anxiety and sleep disturbances. These results highlight the importance of addressing these sociodemographic factors in mental health interventions to better support the well-being of frontline nurses during the pandemic.

Fulltext
Keywords: Anxiety; COVID-19 dedicated hospitals; pandemic; sleep disturbances

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Walking Exercise and Its Effect on Functional Capacity and Productivity in Post-Coronary Artery Bypass Graft (CABG) Patients: A Randomized Controlled Trial Effects of Massage Therapy on Anxiety in Heart Disease Patients Global Trends of Diabetic Erectile Dysfunction Research from 2012 to 2022: A Bibliometric and Visualized Study More recent articles
Most cited articles
Social Support and Coping of Indonesian Family Caregivers Caring for Persons with Schizophrenia A Review of the Quality Improvement in Discharge Planning through Coaching in Nursing STUDI FENOMENOLOGI: PENGALAMAN MENYUSUI EKSKLUSIF IBU BEKERJA DI WILAYAH KENDAL JAWA TENGAH Motivation among Indonesian Nurses in Pursuing Continuing Professional Education and Its Relationship to Their Competencies Work-Related Fatigue Factors among Hospital Nurses: An Integrative Literature Review More cited articles
  1. Abrams, R. M. (2015). Sleep deprivation. Obstetrics and Gynecology Clinics, 42(3), 493-506. https://doi.org/10.1016/j.ogc.2015.05.012
  2. Al Maqbali, M., Al Sinani, M., & Al-Lenjawi, B. (2020). Prevalence of stress, depression, anxiety, and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Psychosomatic Research, Article 110343. https://doi.org/10.1016/j.jpsychores.2020.110343
  3. Al Maqbali, M., Al Sinani, M., & Al-Lenjawi, B. (2021). Prevalence of stress, depression, anxiety, and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Psychosomatic Research, 141, 110343. https://doi.org/10.1016/j.jpsychores.2020.110343
  4. Alnazly, E., Khraisat, O. M., Al-Bashaireh, A. M., & Bryant, C. L. (2021). Anxiety, depression, stress, fear, and social support during COVID-19 pandemic among Jordanian healthcare workers. PLOS ONE, 16(3), Article e0247679. https://doi.org/10.1371/journal.pone.0247679
  5. Andersen, K. G., Rambaut, A., Lipkin, W. I., Holmes, E. C., & Garry, R. F. (2020). The proximal origin of SARS-CoV-2. Nature Medicine, 26(4), 450-452. https://doi.org/10.1038/s41591-020-0820-9
  6. Arnetz, J. E., Goetz, C. M., Arnetz, B. B., & Arble, E. (2020). Nurse reports of stressful situations during the COVID-19 pandemic: Qualitative analysis of survey responses. International Journal of Environmental Research and Public Health, 17(21), 8126. https://doi.org/10.3390/ijerph17218126
  7. Chew, N. W., Lee, G. K., Tan, B. Y., Jing, M., Goh, Y., Ngiam, N. J., ... & Shanmugam, G. N. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, Behavior, and Immunity, 88, 559-565. https://doi.org/10.1016/j.bbi.2020.05.021
  8. Chowdhury, S. R., Sunna, T. C., Das, D. C., Kabir, H., Hossain, A., Mahmud, S., & Ahmed, S. (2021). Mental health symptoms among the nurses of Bangladesh during the COVID-19 pandemic. Middle East Current Psychiatry, 28(1), 1-8. https://doi.org/10.1186/s43045-021-00107-4
  9. Cui, S., Jiang, Y., Shi, Q., Zhang, L., Kong, D., Qian, M., & Chu, J. (2020). Impact of COVID-19 on psychology of nurses working in the emergency and fever outpatient: A cross-sectional survey. Journal of Affective Disorders, 276, 152-158. https://doi.org/10.1016/j.jad.2020.07.139
  10. Dong, H.-s., Gao, J.-j., Dong, Y.-X., Han, C.-x., & Sun, L. (2021). Prevalence of insomnia and anxiety among healthcare workers during the COVID-19 pandemic in Jilin Province. Brazilian Journal of Medical and Biological Research, 54(6), e10920. https://doi.org/10.1590/1414-431X2021e10920
  11. Dunstan, D. A., & Scott, N. (2020). Norms for Zung’s self-rating anxiety scale. BMC Psychiatry, 20(1), Article 90. https://doi.org/10.1186/s12888-019-2427-6
  12. Ferreira, T., Franco, S., & Peralta, J. (2021). Professional quality of life, sleep disturbance and health among nurses: A cross-sectional study. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.15647
  13. Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). GPower 3: A flexible statistical power analysis program. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/BF03193146
  14. Gold, M. S., Sehayek, D., Gabrielli, S., Zhang, X., McCusker, C., & Ben-Shoshan, M. (2020). COVID-19 and comorbidities: A systematic review and meta-analysis. Postgraduate Medicine, 132(8), 749-755. https://doi.org/10.1080/00325481.2020.1786969
  15. Hays, R. D., Martin, S. A., Sesti, A. M., & Spritzer, K. L. (2005). Psychometric properties of the medical outcomes study sleep measure. Sleep Medicine, 6(1), 41-44. https://doi.org/10.1016/j.sleep.2004.07.006
  16. Hurley, D. (2020). Sleep neurologists call it ‘covid-somnia’—increased sleep disturbances linked to the pandemic. Neurology Today, 20(13), 1-26. https://doi.org/10.1097/01.NT.0000689207.78791.60
  17. Jahrami, H., BaHammam, A. S., AlGahtani, H., Ebrahim, A., Faris, M., AlEid, K., ... & Marzooq, H. (2021). The examination of sleep quality for frontline healthcare workers during the outbreak of COVID-19. Sleep and Breathing, 25(1), 503-511. https://doi.org/10.1007/s11325-020-02135-9
  18. Kalmbach, D. A., Arnedt, J. T., Song, P. X., Guille, C., & Sen, S. (2017). Sleep disturbance and short sleep as risk factors for depression and perceived medical errors in first-year residents. Sleep, 40(3), zsw073. https://doi.org/10.1093/sleep/zsw073
  19. Kibret, S., Teshome, D., Fenta, E., Hunie, M., & Tamire, T. (2020). Prevalence of anxiety towards COVID-19 and its associated factors among healthcare workers in a Hospital of Ethiopia. PLOS ONE, 15(12), e0243022. https://doi.org/10.1371/journal.pone.0243022
  20. Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., ... & Li, R. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976-e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
  21. Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Studies, 44(7), 393-401. https://doi.org/10.1080/07481187.2020.1748481
  22. Li, R., Chen, Y., Lv, J., Liu, L., Zong, S., Li, H., & Li, H. (2020). Anxiety and related factors in frontline clinical nurses fighting COVID-19 in Wuhan. Medicine, 99(30). https://doi.org/10.1097/MD.0000000000021330
  23. Liu, J., Ouyang, L., Guo, P., Wu, H., Fu, P., Chen, Y., ... & Alwalid, O. (2020). Epidemiological, clinical characteristics and outcome of medical staff infected with COVID-19 in Wuhan, China: A retrospective case series analysis. MedRxiv. https://doi.org/10.1101/2020.03.29.20054142
  24. Oh, C.-M., Kim, H. Y., Na, H. K., Cho, K. H., & Chu, M. K. (2019). The effect of anxiety and depression on sleep quality of individuals with high risk for insomnia: A population-based study. Frontiers in Neurology, 10, 849. https://doi.org/10.3389/fneur.2019.00849
  25. Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLOS ONE, 15(12), e0246454. https://doi.org/10.1371/journal.pone.0246454
  26. Que, J., Le Shi, J. D., Liu, J., Zhang, L., Wu, S., Gong, Y., ... & Sun, Y. (2020). Psychological impact of the COVID-19 pandemic on healthcare workers: A cross-sectional study in China. General Psychiatry, 33(3). https://doi.org/10.1136/gpsych-2020-100259
  27. Richards, A., Kanady, J., & Neylan, T. (2019). Sleep disturbance in PTSD and other anxiety-related disorders: an updated review of clinical features, physiological characteristics, and psychological and neurobiological mechanisms. Neuropsychopharmacology, 45, 55-73. https://doi.org/10.1038/s41386-019-0486-5
  28. Repon, M. A. U., Pakhe, S. A., Quaiyum, S., Das, R., Daria, S., & Islam, M. R. (2021). Effect of COVID-19 pandemic on mental health among Bangladeshi healthcare professionals: A cross-sectional study. Science Progress, 104(2), 00368504211026409. https://doi.org/10.1177/00368504211026409
  29. Rossi, R., Socci, V., Pacitti, F., Di Lorenzo, G., Di Marco, A., Siracusano, A., & Rossi, A. (2020). Mental health outcomes among frontline and second-line health care workers during the coronavirus disease 2019 (COVID-19) pandemic in Italy. JAMA Network Open, 3(5), e2010185-e2010185. https://doi.org/10.1001/jamanetworkopen.2020.10185
  30. Şahin, C. U., & Kulakaç, N. (2022). Exploring anxiety levels in healthcare workers during COVID-19 pandemic: Turkey sample. Current Psychology, 41(2), 1057-1064. https://doi.org/10.1007/s12144-021-01359-0
  31. Salari, N., Khazaie, H., Hosseinian-Far, A., Khaledi-Paveh, B., Kazeminia, M., Mohammadi, M., ... & Eskandari, S. (2020). The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: A systematic review and meta-regression. Human Resources for Health, 18(1), 1-14. https://doi.org/10.1186/s12960-020-00544-1
  32. Santabárbara, J., Bueno-Notivol, J., Lipnicki, D. M., Olaya, B., Pérez-Moreno, M., Gracia-García, P., ... & Ozamiz-Etxebarria, N. (2021). Prevalence of anxiety in health care professionals during the COVID-19 pandemic: A rapid systematic review (on published articles in Medline) with meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 110244. https://doi.org/10.1016/j.pnpbp.2021.110244
  33. Sanyaolu, A., Okorie, C., Marinkovic, A., Patidar, R., Younis, K., Desai, P., ... & Altaf, M. (2020). Comorbidity and its impact on patients with COVID-19. SN Comprehensive Clinical Medicine, 2(8), 1069-1076. https://doi.org/10.1007/s42399-020-00363-4
  34. Simonetti, V., Durante, A., Ambrosca, R., Arcadi, P., Graziano, G., Pucciarelli, G., ... & Cicolini, G. (2021). Anxiety, sleep disorders and self‐efficacy among nurses during COVID‐19 pandemic: A large cross‐sectional study. Journal of Clinical Nursing, 30(9-10), 1360-1371. https://doi.org/10.1111/jocn.15794
  35. Sun, N., Wei, L., Shi, S., Jiao, D., Song, R., Ma, L., ... & You, Y. (2020). A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control, 48(6), 592-598. https://doi.org/10.1016/j.ajic.2020.03.018
  36. Tasnim, R., Sujan, M., Hossain, S., Islam, M., Ritu, A. H., Siddique, M., ... & Hasan, A. (2021). Prevalence and correlates of anxiety and depression in frontline healthcare workers treating people with COVID-19 in Bangladesh. BMC Psychiatry, 21(1), 1-14. https://doi.org/10.1186/s12888-020-03048-x
  37. Tehrani, H., Rakhshani, T., Shojaeezadeh, D., Hosseini, S. M., & Bagheriyan, S. (2013). Analyzing the relationship between job stress to mental health, personality type and stressful life events of the nurses occupied in Tehran 115 emergency. Iranian Journal of Nursing and Midwifery Research, 18(4), 326-333. https://www.ijnmr.org/text.asp?2013/18/4/326/116715
  38. Xing, L.-Q., Xu, M.-L., Sun, J., Wang, Q.-X., Ge, D.-D., Jiang, M.-M., & Li, Q. (2021). Anxiety and depression in frontline health care workers during the outbreak of COVID-19. International Journal of Social Psychiatry, 67(6), 656-663. https://doi.org/10.1177/0020764020968113
  39. Yang, G., Li, C., Zhu, X., Yan, J., & Liu, J. (2021). Prevalence of and risk factors associated with sleep disturbances among healthcare personnel directly exposed to COVID-19 in China. Sleep Medicine, 80, 16-22. https://doi.org/10.1016/j.sleep.2021.01.039
  40. Zheng, R., Zhou, Y., Fu, Y., Xiang, Q., Cheng, F., Chen, H., & Ye, L. (2021). Prevalence and associated factors of depression and anxiety among nurses during the outbreak of COVID-19 in China: A cross-sectional study. International Journal of Nursing Studies, 114, 103809. https://doi.org/10.1016/j.ijnurstu.2020.103809
  41. Zou, X., Liu, S., Li, J., Chen, W., Ye, J., Yang, Y., & Ling, L. (2021). Factors associated with healthcare workers' insomnia symptoms and fatigue in the fight against COVID-19, and the role of organizational support. Frontiers in Psychiatry, 12, 356. https://doi.org/10.3389/fpsyt.2021.617131

Last update:

No citation recorded.

Last update: 2025-05-08 03:23:04

No citation recorded.