General Anxiety Predictors among Frontline Warriors of COVID: Cross-Sectional Study among Nursing Staff in Punjab, Pakistan

COVID-19 pandemic has increased the generalized anxiety among nursing staff. This cross-sectional questionnaire-based study aimed to determine the generalized anxiety disorders among the nursing staff working in secondary and tertiary care hospitals in Punjab province, Pakistan. A GAD-7 scale was used to assess anxiety. Non-parametric statistics were applied to estimate the difference among the groups. Multiple regression model was adopted to explore the impact of covariates on the GAD-7 score. A total of 133 nurses responded to this survey. It was revealed that being female (7.38 +/- 4.20, p=0.032) and having an age of >= 31 years (7.68 +/- 5.14) might lead to a higher GAD-7 score. 19.6% of the respondents had a high level of generalized anxiety (GAD-7 score >= 10), and about 49.6% were falling in the range of mild anxiety. Female nursing staff have the probability of higher GAD-7 score up to 15% [0.148(-0.450 - 4.697), p= 0.049]. Job experience, especially being new to the field (<= 3 years) might increase the likelihood of having a higher GAD-7 score by 14%. In conclusion, 19.6% of the respondents were meeting the GAD-7 criteria of moderate-severe level of generalized anxiety and depressive disorder. Being female, having less job experience, and no training on how to handle COVID patients were revealed to the main factors influencing the GAD-7 score. Risk of getting COVID, transmission of COVID to family members through them, and uncertainty about the consequence of COVID in Pakistan were some of the common stressors reported by the nurses who participated in this study.