The psychological impact of COVID-19 disease on nurses in two tertiary healthcare centers in Akwa Ibom State, Nigeria

Henry E. Jombo, Timothy Amos Ekwere, Victor A. Umoh, Nkemakolam F. Ndionuka, Effiong E. Akpan


Background: The onset of COVID-19 disease pandemic worldwide has been associated with a high level of psychological distress. Health workers are amongst the high-risk groups for contracting COVID-19 and may be particularly vulnerable to a variety of mental health problems. This study was conducted to determine the psychological impact of the pandemic on mental well-being of Nigerian nurses who are among the frontline health workers in the fight against the disease.

Methods: This was a cross-sectional study conducted on a sample of nurses in two tertiary healthcare setting. A simple random sample of 111 nurses completed the general healthcare questionnaire (GHQ 12).

Results: The mean age of respondents was 36.86±8.2 years, consisting of 38.7% males and 61.3% females. The prevalence of psychological distress was 64.9%. Females had significantly higher psychological distress than males (p=0.003). Also, respondents performing duties in COVID-19 ICU hosting institution had significantly higher distress score than those from non COVID-19 hosting centre (p=0.02). Psychological distress was also significantly higher for respondents with a history of exposure to suspected (p=0.001) or confirmed cases (p<0.001). Formal infection prevention training was a protective factor for the development of psychological stress (p=0.002).

Conclusions: A large proportion of nursing staffs have a high level of psychological distress during the ongoing COVID-19 pandemic. Mental health interventions may be required to mitigate mental health risks in these health workers.



COVID-19 disease, Nigeria, Nurses, Psychological distress

Full Text:



Carlos WG, Dela Cruz CS, Cao B, Pasnick S, Jamil S. Novel Wuhan (2019-nCoV) coronavirus. Am J Respir Crit Care Med. 2020;201(4):7-8.

Adhikari SP, Meng S, Wu YJ, Mao YP, Ye RX, Wang QZ, et al. Epdermiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreal period: a scoping review. Infect Dis Poverty. 2020;9(1):29

Bhagavathula AS, Aldhaleei WA, Rahmani J, Mahabadi MA, Bandari DK. Novel coronavirus (COVID-19) knowledge and perceptions: a survey on healthcare workers. MedRxiv. 2020.

World Health Organization. Considerations for quarantine of individuals in the context of containment for coronavirus disease (‎‎COVID-19)‎‎: interim guidance, 19 March 2020. World Health Organization; 2020.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912-20.

Dong L, Bouey J. Public mental health crisis during COVID-19 pandermic, China. Emerg Infect Dis. 2020;26(7).

Johal SS. Psychosocial impacts of quarantine during disease outbreaks and interventions that may help to relieve strain. N Z Med J. 2009;122(1296):47-52.

Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729.

Xiao C. A novel approach of consultation on 2019 novel coronavirus (COVID-19)-related psychological and mental problems: structured letter therapy. Psychiatr Investig. 2020;17(2):175-6.

Lee SM, Kang WS, Cho AR, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatr. 2018;87:123-7.

Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singapore. 2004;33(6):743-8.

Hope K, Massey PD, Osbourn M, Durrheim DN, Kewley CD, Turner C. Senior clinical nurses effectively contribute to the pandemic influenza public health response. Austral J Adv Nurs. 2011;28(3):47.

World Health Organization, 2020. State of the World’s Nursing 2020: Investing in education, jobs and leadership. Nursing-report-2020. Available from: Accessed on 20 August 2020.

Seale H, Leask J, Po K, MacIntyre CR. “Will they just pack up and leave?”- attitudes and intended behaviour of hospital health care workers during an influenza pandemic. BMC Health Serv Res. 2009;9(1):1-8.

Zhang WR, Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom. 2020:1-9.

Goldberg DP, Gater R, Satorius N, Üstün TB, Piccinelli M, Gureje O, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191-7.

Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.

Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatr. 2020:7(4):e15-6.

Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020:3(3):e203976.

Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020;26:e923549.

Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, et al. Psychological impact and coping strategies of frontline medical staff in hunan between January and March 2020 during the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China. Med Sci Monit. 2020;26:e924171-16.

Rana W, Mukhtar S, Mukhtar S. Mental health of medical workers in Pakistan during the pandemic COVID-19 outbreak. Asian J Psychiatr. 2020:102080.

Styra R, Hawryluck L, Robinson S, Kasapinovic S, Fones C, Gold WL. Impact on health care workers employed in high-risk areas during the Toronto SARS outbreak. J Psychosom Res. 2008;64(2):177-83.

Ali S, Noreen S, Farooq I, Bugshan A, Vohra F. Risk assessment of healthcare workers at the frontline against COVID-19. Pak J Med Sci. 2020:36(COVID19-S4).

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7.

Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatr Res. 2020:112936.

Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, et al. Survey of insomnia and related social-psychological factors among medical staff involved in the 2019 novel coronavirus disease outbreak. Front Psychiatr. 2020.11:306.