Published: 2022-03-25

The psychological impact of the COVID-19 pandemic on physiotherapists in Sri Lanka: a cross-sectional online-based study

Jithmi N. Samarakoon, Asha H. Wettasinghe


Background: The COVID-19 pandemic is currently a severe challenge for healthcare workers, with significant implications for their mental health. Physiotherapy is one of the healthcare professions on the frontline managing this pandemic and is directly exposed to the virus. The aim of the study was to determine the impact of this pandemic on the psychological health of physiotherapists in Sri Lanka.

Methods: A descriptive cross-sectional study was conducted among physiotherapists who were recruited from government and private hospitals via purposive sampling.  Depression-anxiety-stress scale-21 was used to assess psychological health and was distributed online.

Results: The sample comprised 48 participants (males=33.3%; females=66.7%; age=30.2±3.8 years). The rates with extremely severe, severe, moderate and mild stress were 4.8%, 33.3%, 35.7% and 16.7% respectively and 9.5% of them had no stress perceived. No physiotherapists were found in normal or mild anxiety and depression categories. Moderate, severe and extremely severe anxiety levels were found in 9.5%, 28.6% and 61.9% of physiotherapists respectively. There were 28.6% physiotherapists with extremely severe depression, 19.0% with severe depression and 52.4% with moderate depression. There was a positive correlation and a significant association of stress with depression (r=0.876, p<0.001), stress with anxiety (r=0.780, p<0.001) and anxiety with depression (r=0.752, p<0.001).  Stress, anxiety and depression had no significant associations with age and gender (p>0.05). Fear of infecting family members was found as the main cause of stress (81%).

Conclusions: Physiotherapists had elevated levels of anxiety, depression, and stress, highlighting the significance of systematically monitoring physiotherapists’ mental health and implementing supportive measures to improve their well-being during the crisis.



COVID-19, Stress, Anxiety, Depression, Physiotherapists

Full Text:



Ministry of Health. Corona Virus, 2020. Available at:〈=en&Itemid=. Accessed on 10 February 2022.

Papoutsi E, Giannakoulis VG, Ntella V, Pappa S, Katsaounou P. Global burden of COVID-19 pandemic on healthcare workers. ERJ Open Res. 2020;6(2):00195-2020.

Righetti RF, Onoue MA, Politi FVA, Teixeira DT, Souza PN, Kondo CS, et al. Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience. Clinics (Sao Paulo). 2020;75:2017.

Karia R, Gupta I, Khandait H, Yadav A, Yadav A. COVID-19 and its Modes of Transmission. SN Compr Clin Med. 2020;1-4.

Lucas GN. COVID-19 pandemic and school education. Sri Lanka J Child Health. 2020;49(3):207-9.

Sagar SKS, Ahmed MT. Professional stress levels among healthcare workers of Nelamangala: a cross sectional study. Int J Community Med Public Health. 2017;4(12):4685.

Punyawardena BVR. The Solis of Sri Lanka. World Soils Book Series. Cham: Springer; 2020: 13-22.

Vidua RK, Chouksey VK, Bhargava DC, Kumar J. Problems arising from PPE when worn for long periods. Med Leg J. 2020;88(1):47-9.

Yuan N, Yang WX, Lu JL, Lv ZH. Investigation of adverse reactions in healthcare personnel working in Level 3 barrier protection PPE to treat COVID-19. Postgrad Med J. 2021;97(1148):351-4.

Wosik J, Fudim M, Cameron B, Gellad ZF, Cho A, Phinney D, et al. Telehealth transformation: COVID-19 and the rise of virtual care. J Am Med Inform Assoc. 2020;27(6):957-62.

Blandford A, Wesson J, Amalberti R, Hazme R, Allwihan R. Opportunities and challenges for telehealth within, and beyond, a pandemic. Lancet Glob Health. 2020;8(11):1364-5.

UIC. Challenges Facing the Telehealth Industry, 2020. Available at: https://healthinformatics. Accessed on 10 February 2022.

Epidemiology for public health. COVID-19: stress management among healthcare workers, 2020. Available at: Accessed on 10 February 2022.

Epicentro. Epidemiology for public health Covid-19: Stress management, 2020. Available at: Accessed on 10 February 2022.

WHO. Occupational health: Stress at the workplace, 2020. Available at Accessed on 10 February 2022.

Well OR. What is occupational well-being, 2016. Available at Accessed on 10 February 2022.

Chen X, Tan X. Health problem and occupational stress among Chinese doctors. Chinese Med. 2013;4(1):1.

Mohammad MA. Occupational stress and its consequences: Implications for health policy and management. Leadership Health Serv. 2014;27(3):224-39.

Nabirye RC, Brown KC, Pryor ER, Maples EH. Occupational stress, job satisfaction and job performance among hospital nurses in Kampala, Uganda. J Nurs Manag. 2011;19(6):760-8.

Pniak B, Leszczak J, Adamczyk M, Rusek W, Matłosz P, Guzik A. Occupational burnout among active physiotherapists working in clinical hospitals during the COVID-19 pandemic in south-eastern Poland. Work. 2021;68(2):285-95.

Aly HM, Nemr NA, Kishk RM, Elsaid NMAB. Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study. BMJ Open. 2021;11(4):45281.

Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al. Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore. Ann Intern Med. 2020;173(4):317-20.

Si MY, Su XY, Jiang Y, Wang WJ, Gu XF, Ma L, et al. Psychological impact of COVID-19 on medical care workers in China. Infect Dis Poverty. 2020;9(1):113.

Srivastav AK, Sharma N, Samuel AJ. Impact of Coronavirus disease-19 (COVID-19) lockdown on physical activity and energy expenditure among physiotherapy professionals and students using web-based open E-survey sent through WhatsApp, Facebook and Instagram messengers. Clin Epidemiol Glob Health. 2021;9:78-84.

Tayyib NA, Alsolami FJ. Measuring the extent of stress and fear among Registered Nurses in KSA during the COVID-19 Outbreak. J Taibah Univ Med Sci. 2020;15(5):410-6.

Yang S, Kwak SG, Ko EJ, Chang MC. The Mental Health Burden of the COVID-19 Pandemic on Physical Therapists. Int J Environ Res Public Health. 2020;17(10):3723.

Wilson W, Raj JP, Rao S, Ghiya M, Nedungalaparambil NM, Mundra H, et al. Prevalence and Predictors of Stress, anxiety, and Depression among Healthcare Workers Managing COVID-19 Pandemic in India: A Nationwide Observational Study. Indian J Psychol Med. 2020;42(4):353-8.

Windarwati HD, Ati NAL, Paraswati MD, Ilmy SK, Supianto AA, Rizzal AF, et al. Stressor, coping mechanism, and motivation among health care workers in dealing with stress due to the COVID-19 pandemic in Indonesia. Asian J Psychiatr. 2021;56:102470.

Ritchie H, Mathieu E, Guirao LR, Appel C, Giattino C, Ospina EO, et al. Coronavirus Pandemic (COVID-19), 2021. Available at: https://ourworldindata. org/coronavirus. Accessed on 10 February 2022.

Samaranayake WAMP, Jayawardena GPC, Roshan ALL, Wijewardene MAM, Siraj MI. COVID-19 infection among health care workers: Experience in Base Hospital Wathupitiwala, Sri Lanka. MedRix. 2021.

Our World in data. Coronavirus Pandemic (COVID-19), 2021. Available at: https://ourworldindata. org/coronavirus. Accessed on 10 February 2022.

Mahmood A, Zamir S, Qurat-ul-Ain, Nudrat S, Zahoor F. Impact of age and level of experience on occupational stress of academic managers at higher educational level. Mediterranean J Social Sci. 2013;4(1):535-41.

Perera B, Wickramarachchi B, Samanmalie C, Hettiarachchi M. Psychological experiences of healthcare professionals in Sri Lanka during COVID-19. BMC Psychol. 2021;9(1):49.

Park C, Hwang JM, Jo S, Bae SJ, Sakong J. COVID-19 Outbreak and Its Association with Healthcare Workers' Emotional Stress: a Cross-Sectional Study. J Korean Med Sci. 2020;35(41):372.

Daily Mirror. Govt. response to alarming predictions of 200 daily deaths, 2021. Available at: Accessed on 10 February 2022.