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European Journal of Applied Sciences – Vol. 10, No. 3
Publication Date: June 25, 2022
DOI:10.14738/aivp.103.12473. Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19
Isolation Centres in Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
Services for Science and Education – United Kingdom
Prevalence of Panic Disorder and Associated Factors among
Nurses Working in Covid-19 Isolation Centres in Lagos, Nigeria
Rasheed, Tajudeen Olusegun
Department of Health, Safety and Environment Studies
Training and Research Institute, Economic and
Financial Crimes Commission, Academy
Karu, Abuja, Nigeria
Aina, Joseph Oyeniyi
Department of Mental Health/Psychiatric Nursing
Babcock University, Ilishan-Remo
Ogun State, Nigeria
ABSTRACT
Nurses suffered panic disorder due to virulent high aerosol spreading rate of
coronavirus and limited data on definitive treatment of affected COVID-19 patients.
This study assessed the prevalence of panic disorder and associated factors among
nurses working in COVID-19 isolation centres in Lagos, Nigeria. The study was a
quantitative, cross-sectional survey design. A population of N=75 nurses was
sampled using a total enumeration sampling technique. Purposive sampling
method was used to select the two isolation centres where the study was conducted.
A structured self-administered questionnaire with validity and reliability
established was used to collect data from nurses between 7th February and 25th
March, 2022. Data were collated, screened and imported into SPSS version 25 for
analysis. Significance levels of associated factors were established with Fisher’s
Exact Test and Multivariate Logistic Regressions at significant level of p < 0.05 and
95% confidence interval. The results showed the mean age of nurses was m=37.6 +
10.2 years and 20.6% developed panic disorder. The age p=0.002, and living with
vulnerable persons p=0.005 were significantly associated with panic disorder p <
0.05. Nurses who felt there is threat to their life working in COVID-19 isolation
centre were 3.4 times more likely to develop panic disorder compared to nurses
who did not (AOR=3.4, 95% CI=2.337, 7.271, p=0.001). In conclusion, twenty
percent of nurses developed mild to severe panic disorder due to associated
psychological and working conditions factors. Counseling and support program is
recommended for affected nurses to improve quality of life.
Keywords: COVID-19 isolation Centre, Nigeria, Nurses, Panic Disorder, Prevalence
INTRODUCTION
Nurses experienced feelings of panic disorder when the first case of COVID-19 was diagnosed
on a foreign visitor on the 27th of February 2020 in Lagos, Nigeria [1]. The panic disorder
heightened for nurses working in the COVID-19 isolation centres when it was discovered that
the novel coronavirus (SARS-nCOV-2) has a unique high aerosol spreading rate, and that there
is limited data on the definitive treatment of the viral infection with poor prognosis and death
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Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
[2]. Therefore, nurses are at increased risk of developing panic disorder due to response of the
body and mind to a threatening situation [3, 4].
Caldirola et al. [5] described the symptoms of panic disorder experienced by nurses as either
with or without agoraphobia and these includes intense panic attack which begins suddenly
without warning and reaches a peak within a minute and last for 10 to 20 minutes. But, in
extreme cases, it may last more than an hour. Though individual experiences do differ and the
signs vary from palpitation to racing heartbeat, shortness of breath, and feelings of choking,
nausea, dizziness, lightheadedness, and sweating, trembling, change in mental state, feeling of
depersonalization, tingling sensation in hand or feet, chest pain and fear that one might die [6].
Worldwide, nurses were confronted with enormous mental health pressure and physical
exhaustion as they dealt relentlessly with the unprecedented demands of the COVID-19
patients in isolation centres [6, 7, 8]. The global estimated pooled prevalence of panic disorder
is 79.62% with significant difference across regions and counties [9]. Nurses’ well-being may
have been threatened especially with the fear of transmission of the virus to their loved ones at
home [10, 11].
In Nigeria, nurses caring for COVID-19 patients experienced uneasiness or apprehension due
to anticipation or perceived threat to their lives [12]. Also, nurses were faced with emotional
stress, physical exhaustion, and pressures on their mental health leading to panic attack [13].
Higher levels of panic disorder will increase psychological trauma, impair bodily functions,
leading to negative coping mechanisms among nurses [13].
During COVID-19 pandemic, the strategies typically involved control of infection through
intense focus on breaking the pathway of the pathogen transmission, contact tracing,
surveillance for persons at risk, and health system strengthens (WHO, 2020). Conversely,
responders may have overlook the psychological trauma and the effects on individuals,
community and healthcare workers especially nurses and this oversight might lead to long- lasting psychological distress as the consequences [14].
Researchers have observed that nurses as one of the frontline health workers were exposed to
panic disorder due to fear associated with contact with coronavirus patients in isolation
centres. The panic disorder was compounded as they continue to have regular contact with
COVID-19 patients with symptoms leading to susceptibility of the nurses to coronavirus
infection which has a virulent spreading rate. The situation precipitated emotional imbalance,
worries, and panic disorder. Also, nurses experienced shortage of personal protective
equipment in COVID-19 isolation centres and this might have heightened the panic disorder
due to inadequate protection. Furthermore, nurses were unable to relate freely with their
family due to fear of infecting them leading to concerns and panic disorder.
The theoretical model of stress and responses as a product of transaction between a person and
his or her complex environment “Transactional Theory of Stress and Coping (TTSC)” by Lazarus
[15] was applied to this study. Lazarus stated that noxious stressors influencing work
environment of nurses is moderated by individual responses and adaptive mechanism
exhibited. This will depend on the combination of working conditions, personal attributes, and
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healthcare facilities factors. There is a transaction between a nurse (physical, physiological,
psychological, cognitive, affective, and neurological) and his or her complex and stressful
environment with either negative or positive health outcome [16]. Individual nurses need to
maintain a state of equilibrium to avert the psychological distress and traumatic factors
associated with the disequilibrium brought about by COVID-19 pandemic stressors at the
workplace.
Lagos being an epicenter in Nigeria experienced high burden of COVID-19 pandemic and this
might have increased panic disorder for nurses working in isolation centres. The psychological
wellbeing of the nurses might have been compromised, so, assessing nurses for panic disorder
is important to protect their health and conserve their life [17]. There is a dearth in literature
on studies that focus on panic disorder experienced by nurses working in isolation centres in
Lagos, Nigeria. Thus, this study was conducted to fill the gap in knowledge as it focuses on
prevalence and factors associated with the panic disorder among nurses working in Covid-19
isolation centres in Lagos. The specific objective of this study were to; determine the levels of
prevalence of panic disorder, identify socio-demographic characteristics, psychological and
working conditions factors that are related to prevalence of panic disorder.
The justification for this study is that mental health challenges that do arise from pandemic are
often neglected as all efforts are being directed towards containment of the plague. The scope
of this study covered assessment of the prevalence of panic disorder, psychological trauma
experiences like feelings of (immediate threat to life, stressful working environment, regular
contact with COVID-19 patient experiencing symptoms, and regular contact with COVID-19
patient that died, and witnessing unexpected death) that could influence the prevalence of
panic disorder were assessed and working conditions factors. The significance of this study is
that it provided data on the prevalence of panic disorder among nurses working in COVID-19
isolation centres in Lagos. The study may improve the quality of life of nurses and reduce the
morbidity and disability that might be associated with the care of COVID-19 patients.
METHODS AND MATERIALS
Research Design
This study was a quantitative, cross-sectional survey design. The study design measured the
outcome of exposures of nurses to psychological and working conditions factors during COVID- 19 pandemic in isolation centres. The research design was preferred because it established the
relationship that exists between dependent and independent variables. It is not expensive,
requires less time, establishes the causal-effect, and the results could be generalized to the
entire population.
Research Setting
The research settings for this study were the two selected COVID-19 isolation centres located
at Lagos State Infectious Disease Hospital (IDH), Yaba and General Hospital Gbagada. The Yaba
COVID-19 isolation centre is owned by Lagos State and located inside the Mainland Infectious
Disease Hospital (IDH), Yaba, Lagos, Nigeria. The total number of hospital beds is 265. There is
male and female ward and a designated Intensive Care Unit (ICU) for critically-ill COVID-19
patients. The General Hospital Gbagada COVID-19 isolation centre is also owned by Lagos state
government and is located at T-junction of 3 major express at No 1, Hospital Road, Gbagada,
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Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
Kosofe, Lagos. It has 180 beds, male and female wards, and Intensive Care Unit (ICU) for
critically-ill patients.
Population
The target population for this study was 75 nurses, male and female working in the two selected
COVID-19 isolation centres in Lagos. The inclusion eligibility criteria included only nurses
whose duty post was Yaba, and Gbagada COVID-19 isolation centre since outbreak of the
pandemic in Nigeria till date. The exclusion criteria included nurses who follow patients on
emergency situations to Yaba or Gbagada COVID-19 isolation centres. Also, nurses’ working in
other COVID-19 isolation centres in Lagos either belonging to government or private
institutions were excluded.
Sample size Determination and sampling Technique
This study sample size was a total inclusion of all nurses working in the two selected COVID-19
isolation centres in Lagos. As at the time of data collection the number of nurses working in
Lagos State COVID-19 isolation centres, Yaba was n=59 and n=16 in General Hospital Gbagada.
Therefore, the total sample size for this study was 75. Purposive sampling method was used to
select the two COVID-19 isolation centres that were in active operations since the outset of the
pandemic. Total enumeration sampling technique was used to select all the nurses in COVID- 19 isolation centres. However, the risk of negative bias due to incomplete coverage of the entire
population was avoided to guide against error of under coverage.
Instrumentation
A self-administered structured questionnaire consists of four (4) sections was used for this
survey. The sections were divided into A, B, C and D. Section A: consist of 10 questions and
collected data on socio-demographic characteristics of the respondents. Section B: consist of 10
questions and collected data on prevalence of panic disorder. The questions were close-ended
adapted from standardized and validated self-reporting assessment scales for panic disorder.
The adapted self-reporting scale formatted in English language had been used widely and
extensively by researchers (PDSS-10). Section C: consist of 5 questions and collected data on
psychological trauma factors suffered by nurses’ while, Section D: consist of 7 questions and
collected data on working conditions factors of nurses in COVID-19 isolation centres.
Reliability of Instrument
Test-retest method of establishing reliability of instrument was done. The questionnaire was
administered to 10 nurses working in COVID-19 isolation centre, Olodo, Ibadan, Oyo state. It
was collected back immediately after filling was completed. Two weeks later, another new set
of the same questionnaires were given to the same nurses. The results were analyzed with
Cronbach’s Alpha test. The results showed that 32 items tested for reliability in the instrument
have Cronbach’s Alpha value of between α = 0.792 to α = 0.927. The results of reliability test
shows that the instrument was reliable and appropriate for the study.
Validity of Instrument
The face and content validity of the instrument was established by my supervisors and 3 other
experts in the field of study for clarity, relatedness, meaningfulness and adequacy of the
content. Confirmatory Factorial Analysis (CFA) was also run using SPSS to confirm instrument
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validity. The value of internal correlation coefficient of the questions was between 0.4 - 0.79
and it indicates the scale measured what it intended to measure.
Procedure of Data Collection
The procedure and strategy employed for data collection was by going to the isolation centres
daily from Monday to Friday by the researcher to seek nurse’s participation. The data collection
was carried out between 7th February to 25th March, 2022 among nurses working in COVID-19
isolation centre in Yaba and Gbagada. Informed Consent form was giving to nurses to fill and
their consent was secured freely without compelling them before questionnaire was
completed. Compensation was not offered to the nurses and the filled questionnaires were
collated and kept in a safe and secure locker by the investigator who solely has access for
security of the data.
Method of Data Analysis
The errors that might have occurred during the field work corrected since primary data were
collected. Data were screened before imported into SPSS version 25 for analysis. All dependent
variables were categorized for easy measurement before commencement of the analysis. The
acceptable significant alpha (α) level was p < 0.05 because the study has to do with the
screening of human subject for a disorder; so, the level of error was set at minimal value. Also,
the association that exists between dependent and independent variables were established and
tested at p < 0.05 and 95% Confidence Interval (CI). Fisher’s Exact Test was run to test the level
of significant of socio-demographic characteristic associated with prevalence of panic disorder.
This statistical model was preferred because some of the values in the cells were lower than 5.
Multiple logistic regressions statistical model was run to test the level of significance of
psychological and working conditions factors associated with prevalence of panic disorder.
Measurement of Variables
Dependent variables: the panic disorder among nurses during COVID-19 pandemic was
measured by 10-items questions in the “Severity Measure for Panic Disorder” (PDSS-10) self- reporting scale [18]. Nurses were asked to describe symptoms they felt in term of fear or fright,
feel anxious, had thought of losing control, dying, going crazy, racing heartbeat, trouble
sleeping, participation at work minimally and needed help to cope at the outset of the COVID- 19 pandemic were rated on a 5-points scale for each question on the checklist. The rating on
the likert include (0 = never), (1 = occasionally), (2 = Half of the time), (3 = most of the time),
and (4 = All of the time) (APA, 2013). The range of total score is from 0 to 40, with higher scores
indicating greater severity of panic disorder [18]. The severity was calculated by adding the
raw scores for each item in the section to obtain a total raw score. Individual’s panic disorder
was categorized into normal (0 – 9), mild (10 – 19), moderate (20 – 29), severe (30 – 40).
Independent variables: the socio-demographic characteristics of the participants that were
measured include age, gender, education level, marital status, year of experience, family size,
and living with vulnerable persons. The psychological trauma experiences variables that may
lead to panic disorder were measured with NO and YES responses on a scale of 0 and 1
respectively, and they includes (immediate threat to life, stressful working environment,
regular contact with COVID-19 patient experiencing symptoms, regular contact with Covid-19
patient that die and witnessing unexpected death). Working conditions independent variables
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Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
were measured with NO and YES responses on a scale of 0 and 1 respectively, and they include
(increase workload, inadequate staffing, and hours on duty per shift, PPE availability, safety
guideline provided, training on Infection Prevention (IP).
Ethical Considerations and Participant Rights
Ethical issues and right of the participants were protected during the conduct of this study. The
Babcock University Health Research Ethical Committee (BUHREC) approval number is 830/21
and the permission to collect data was obtained from Lagos State Health Services Commission.
Confidentiality and rights of the participants was maintained throughout this study. Informed
consent form was giving to participant to read, understand and consented freely before
participation in the study and no identifiers were collected from the participants. Data collected
were protected and only used for the research purpose.
RESULTS
Figure 1 shows the level of prevalence of panic disorder among the nurses working in COVID- 19 isolation centres in Lagos. More than half of the respondents n=41 (54.7%) did not suffer
panic disorder. But, n=25 (33.3%) developed mild, n=2 (2.67%) had moderate, while only n=7
(9.3%) had severe panic disorder.
Table 1, shows that N=75 nurses’ participated in the study and no missing value (N) recorded.
The finding of the survey showed that n=28 (37.3%) of the respondents were between the age
range of 21-30 years, while n=9 (12.0%) were in the age range 51-59 years. The mean age of
the respondents m=37.6 + 10.2 years. Majority of the respondents were female nurses n=53
(70.7%). The respondents n=35 (46.7%) had worked in the COVID-19 isolation centres for the
period more than twelve months. Only n=10 (13.3%) of the respondents were not living with
vulnerable persons, and n=37 (49.3%) of the respondents’ were holders of RN/RM/RPHN
qualifications. In Table 2, the results revealed that age p=0.002, living with vulnerable persons
p=0.005, duration of period working in COVID-19 isolation centre p=0.019, and year of
experience p=0.001 were significantly associated with the prevalence of panic disorder with p
< 0.05. The nurses’ gender, marital status, and education level were not significantly associated
with the prevalence of panic disorder at p > 0.05.
Table 3 shows the psychological factors that nurses were exposed to as they work in COVID-19
isolation centres. Majority of the respondents n=59 (78.7%) indicated they had regular contact
with COVID-19 patients with symptoms in isolation centres, while n=16 (21.3%) had no regular
contact with COVID-19 patients experiencing symptoms. In Table 4., the results revealed that
nurses who felt there is threat to their life by working in COVID-19 isolation centre were 3.4
times more likely to experience psychological trauma leading to panic disorder compared to
nurse who did not (AOR=3.4, 95% CI=2.337, 7.271, p=0.001).
Table 5 shows respondents’ working conditions factors in COVID-19 isolation centres. Majority
of the respondents n=53 (70.7%) indicated they were spending extra hours on duty per week
due to inadequate staffing of COVID-19 isolation centres. Similarly, n=52 (69.3%) stated that
there was inadequate supply of PPE and lack of regular training on infection prevention and
control.
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In Table 6, the finding revealed that adequate supply of PPE to nurses working in COVID-19
isolation centre was 5.7 times more likely to reduce prevalence of panic disorder among nurses
(AOR=5.7, 95% CI=0.710, 9.913, p=0.003). Similarly, the study revealed that availability of
safety guideline in the workplace was 1.9 times more likely to alleviate feeling of threat to life
and reduce panic disorder among nurses (AOR=1.9, 95% CI=0.002, 8.870, p=0.002) compared
to when nurses were working in COVID-19 isolation centre without safety guideline.
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Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
Table 1: Socio-Demographic characteristics of the respondents
Variables Frequency
(N=75)
Percent
(100%)
Age of Nurses
21 - 30 28 37.3
31 - 40 21 28.0
41 - 50 17 22.7
51 - 60 09 12.0
Gender of Nurse
Male 22 29.3
Female 53 70.7
Marital Status
Married 44 58.7
Not Married 31 41.3
Education Level
RN/RM/RPHN 37 49.3
BNSc 35 46.7
MSN 03 4.0
Living with vulnerable persons
Young children ≤ 2 years of age 16 21.3
Young children ≥ 2 years of age 28 37.3
Adults ≥ 60 years of age 17 22.7
Aged 65 years and above 04 5.3
Not living with vulnerable person 10 13.3
Duration in Covid-19 isolation centre
< 3 months 12 16.0
3 – 12 months 28 37.3
> 12 months 35 46.7
Year of professional experience
< 5 years 20 26.7
5 – 9 years 23 30.7
10 years and above 32 42.7
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Table 2: Respondents’ Crosstab of Socio-Demographic Characteristics Factors Associated with
Prevalence of Panic Disorder in COVID-19 Isolation Centres in Lagos
Dependent Variable Statistical
Panic Disorder (PD) Total Analysis
None Present N=75 (95% CI)
Independent Variables n (%), < 10 n (%), ≥ 10 n (100%) p-value
Age of Nurses
21 - 30 16 (21.4) 12 (16.0) 28 (37.4)
31 - 40 06 (8.0) 15 (20.0) 21 (28.0) 0.002
41 - 50 13 (17.3) 04 (5.3) 17 (22.6)
51 - 60 06 (8.0) 03 (4.0) 09 (12.0)
Gender of Nurse
Male 13 (17.3) 09 (12.0) 22 (29.3) 0.113
Female 28 (37.3) 25 (33.4) 53 (70.7)
Marital Status
Married 24 (32.0) 20 (26.7) 44 (58.7) 0.282
Not Married 17 (22.7) 14 (18.6) 31 (41.3)
Education Level
RN/RM/RPHN 17 (22.7) 20 (26.7) 37 (49.4)
BNSc 21 (28.0) 13 (17.3) 34 (45.3) 0.663
MSN 03 (4.0) 01 (1.3) 4 (5.3)
Living with vulnerable persons
Young children ≤ 2 years of age 07 (9.3) 09 (12.0) 16 (21.3)
Young children ≥ 2 years of age 18 (24.0) 10 (13.3) 28 (37.3)
Adults ≥ 60 years of age 09 (12.0) 08 (10.6) 17 (22.6) 0.005
Aged 65 years and above 02 (2.7) 02 (2.7) 04 (5.4)
Not living with vulnerable person 05 (6.7) 05 (6.7) 10 (13.4)
Duration in Covid-19 isolation centre
< 3 months 04 (5.3) 08 (10.7) 12 (16.0)
3 – 12 months 12 (16.0) 16 (21.4) 28 (37.4) 0.019
> 1 year 25 (33.3) 10 (13.3) 35 (46.6)
Year of experience
< 5 years 06 (8.0) 14 (18.8) 20 (26.8)
5 – 9 years 10 (13.3) 13 (17.3) 23 (30.6) 0.001
10 years and above 25 (33.3) 07 (9.3) 32 (42.6)
Note: Fisher’s Extract Test Crosstab, p < 0.05 at 95% Confidence Interval considered significant.
Panic disorders score < 10 indicate not present, while ≥ 10 is panic disorder present
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Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
Table 3: Respondents’ Psychological Trauma Factors in COVID-19 Isolation Centres, Lagos
Variables
Frequency
N=75
Percent
(100%)
Did you feel there is immediate threat
to your life working in COVID-19
isolation centre?
NO 54 72.0%
YES 21 28.0%
Did you feel working in COVID-19
isolation centre is stressful?
NO 22 29.3%
YES 53 70.7%
Did you have regular contact with
COVID-19 patients experiencing
symptoms?
NO 16 21.3%
YES 59 78.7%
Did you have regular contact with
COVID-19 patients that died?
NO 26 34.7%
YES 49 65.3%
Did you witness unexpected death of
admitted COVID-19 patients?
NO 17 22.7%
YES 58 77.3%
Total 75 100.0%
Table 4: Respondents’ Psychological Factors Related to Prevalence of Panic Disorder in COVID- 19 Isolation Centres in Lagos
Independent Variables
Adjusted
Odd Ratio
Dependent Variable
Statistical
Analysis
Prevalence of Panic Disorder
(95% CI, N=75)
Psychological Factors (AOR) Lower limit Upper
limit
p-value
Feel threat to life for working in
covid-19 isolation centres
NO 3.435 2.337 7.271 0.001
YES 1 [Reference]
Feel work environment is stressful
NO 0.135 0.587 1.512 0.893
YES 1 [Reference]
Regular contact with Covid-19
patients with symptoms
NO 0.551 0.824 2.467 0.584
YES 1 [Reference]
Regular contact with covid-19
patients that died
NO 2.158 1.244 5.128 0.034
YES 1 [Reference]
Witnessing unexpected death of
admitted Covid-19 patients
NO 1.215 1.084 3.264 0.228
YES 1 [Reference]
Note: Multiple logistic regression tests, p < 0.05 at 95% Confidence Interval (CI) was
considered significant. Model adjusted for covariate variables (age, gender, marital status,
education, living with vulnerable persons, duration in covid-19 centre and years of experience)
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Table 5. Respondents’ Working Conditions Factors in COVID-19 Isolation Centres, Lagos
Variables
Frequency
N=75
Percent
(100%)
Are you witnessing increased workload
in COVID-19 isolation centre?
NO 27 36.0%
YES 48 64.0%
Did you have adequate nursing staff
caring for COVID-19 patients?
NO 49 65.3%
YES 26 34.7%
Are you spending extra hours on duty
per week?
NO 22 29.3%
YES 53 70.7%
Are you having adequate supply of
Personal Protective Equipment (PPE)?
NO 52 69.3%
YES 23 30.7%
Is there an availability of safety
guideline in the workplace?
NO 34 45.3%
YES 41 54.7%
Is there a regular training of nurses on
infection prevention and control?
NO 52 69.3%
YES 23 30.7%
Are you coping with psychological
trauma associated with caring for
COVID-19 patients?
NO 33 44.0%
YES 42 56.0%
Total 75 100.0%
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Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
Table 6. Respondents’ Working Conditions Factors Associated with Prevalence of Panic
Disorder in Covid-19 Isolation Centres in Lagos
Dependent Variable
Independent Variables
Adjusted
Odd Ratio
Prevalence of Panic Disorder
(95% CI, N=75)
Statistical
Analysis
Working Condition Factors (AOR) Lower limit Upper
limit
p-value
Witnessing increased workload in
covid-19 isolation centre
NO 1.211 0.171 7.100 0.751
YES 1 [Reference]
Adequate nursing staff caring for
covid-19 patients
NO 0.589 3.530 6.480 0.924
YES 1 [Reference]
Spend extra hours on duty per week
NO 2. 454 1.241 7.910 0.043
YES 1 [Reference]
Adequate supply of Personal
Protective Equipment (PPE)
NO 5.729 0.710 9.913 0.003
YES 1 [Reference]
Availability of safety guideline in the
workplace
NO 1.988 0.002 8.870 0.002
YES 1 [Reference]
Regular training on infection
prevention
NO 0.821 0.308 .739 0.414
YES 1 [Reference]
Coping with psychological trauma
associated with the caring for Covid- 19 patients
NO 1.539 0.868 3.112 0.080
YES 1 [Reference]
Note: Multiple logistic regression tests, p < 0.05 at 95% Confidence Interval (CI) was considered
significant. Model adjusted for covariate variables (age, gender, marital status, education, living
with vulnerable persons, duration in covid-19 centre, and years of experience).
DISCUSSION
This study assessed the prevalence of panic disorder among nurses working in COVID-19
isolation centres in Lagos, Nigeria. The study also determined the level of the prevalence and
established an association that exists between independent variables (socio-demographic
characteristics, psychological trauma factors, working conditions factors) and dependent
variables (panic disorder).
Level of Prevalence of Panic Disorder
This study revealed that 20.6% is the proportion of nurses having mild to severe panic disorder
while working in COVID-19 isolation centres in response to the pandemic. The percentage was
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high compared to the World Health Organization acceptable value of 3.6% across regions and
countries [2]. The finding of this study is not consistent with that of the study conducted in
Brazil where the prevalence was 22.8% [13]. The difference in the prevalence of panic disorder
might be related to level of emergency preparedness, severity of the pandemic and personal
resilience of coping with the psychological crisis of the pandemic. The implication of this finding
is that nurses suffered emotional stress as they dealt with demand of care required by COVID- 19 patients [7, 8].
Socio-demographic Characteristics Factors Associated with Prevalence of Panic Disorder
The socio-demographic characteristics of the respondents’ is an important factors for coping
with stressful working conditions and psychological trauma associated with the caring of
coronavirus patients in isolation centres. The prevalence of panic disorder was significantly
associated with the nurses’ age, living with vulnerable persons, duration of period working in
COVID-19 isolation centre, and year of experience. This study finding was supported by a
finding of the study conducted in China where these variables were significant predictors of
higher prevalence of panic disorder among nurses [19]. The odd of panic disorder was seven
times higher among nurses who worked in covid-19 isolation centres for more than one year
compared with those nurses who did not. The implication of this finding on duration is that the
longer the period of time nurses spent working in isolation centres the more the likelihood of
developing panic disorder based on continuous exposure to psychological trauma of dealing
with highly contagious coronavirus disease patients.
Psychological Trauma Factors Associated with Prevalence of Panic Disorder
The causal relationships between frequency of exposure to coronavirus infected patients with
symptoms, and associated mental disorders are suggestive reflection of emotional feelings and
worries. The finding of this study shows that nurses who felt their life is being threatened by
working in COVID-19 isolation centres were three times more likely to develop panic disorder.
The psychological factors like work environment is stressful, regular contact with Covid-19
patient that died, and witnessing unexpected death of COVID-19 patients was not significantly
associated with panic disorders. The implication of this finding is that limited knowledge about
definitive treatment of the coronavirus at the onset of pandemic and lack of emergency
preparedness was obvious as an overwhelming circumstances resulting into panic disorder.
Working Conditions Factors Associated with Prevalence of Panic Disorder
Majority of the nurses reported they were spending extra hours on duty per week due to
inadequate staffing of COVID-19 isolation centres. The odd of having adequate number of staff
in COVID-19 isolation centre is five times more likely to improve working conditions, reduce
workload, and prevalence of panic disorder compared with when there is inadequate staffing.
This study finding is consistent with that of the study conducted by Luceno-Moreno et al. [20]
where the researchers found that the risk variable for prevalence of panic disorder included
nurses working longer hours and excessive workload due to inadequate staffing (Luceno- Moreno et al., 2020). This study result on PPE was consistent with the finding of the study
conducted in Michigan, USA by [21] where the researchers found that availability of PPE in
COVID-19 isolation centres was four times more likely to improve the working conditions and
reduce the prevalence of nurses panic disorder compared with when there is inadequate supply
of PPE. The implication of these findings is that environmental stressors may constitute stress
Page 14 of 16
517
Rasheed, T. O., & Aina, J. O. (2022). Prevalence of Panic Disorder and Associated Factors among Nurses Working in Covid-19 Isolation Centres in
Lagos, Nigeria. European Journal of Applied Sciences, 10(3). 504-519.
URL: http://dx.doi.org/10.14738/aivp.103.12473
for the nurses in the course of duty in the face of deadly COVID-19 pandemic. Providing
necessary supporting safety materials for nurses could reduce panic disorder.
CONCLUSION
In conclusion, the study revealed that twenty percent was the proportion of nurses who had
mild to severe panic disorder while working in COVID-19 isolation centres in response to the
pandemic in Lagos. The outcomes of this study is evidence that personal attributes,
psychological and working conditions factors interplay with emotions, worries and irritability
suffered by nurses.
RECOMMENDATIONS
Counseling is recommended for affected nurses’ and government should develop a national
program on how to protect nurses from physical and biological hazards during pandemic. The
stakeholders should provide proactive measures and functioning support system with
appropriate tools and adequate staffing.
IMPLICATION OF THE STUDY FOR NURSING
This study contributed to the body of knowledge in nursing research because it determined the
proportions of nurses who had mild to severe prevalence of panic disorder in response to
COVID-19 pandemic. The study could improve the quality of life of nurses who worked in
COVID-19 isolation centres, and reduce the morbidity and disability. The implication of this
study is that it improves the knowledge of nurses on factors associated with prevalence of panic
disorder. Nurses are now aware that personal attributes, psychological trauma experiences and
working conditions may influence prevalence of panic disorder.
LIMITATIONS
This study has limitations; it utilized a total enumeration sampling of nurses’ in a single state
out of 36 states of the federation. The results may not be generalized to the total population of
Nigeria nurses. Studied participants were from various departments in COVID-19 isolation
centres but differences between participants working in various departments were not
analyzed. It Further investigation in the area of causal-factors associated with the prevalence
of panic disorder among nurses working in COVID-19 isolation centres is suggested.
ACKNOWLEDGEMENT
We authors thank all nurses for their cooperation and time their time spent filling the
questionnaire. Also, we thank reviewers and those who contributed towards successful
completion of this project.
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European Journal of Applied Sciences (EJAS) Vol. 10, Issue 3, June-2022
Services for Science and Education – United Kingdom
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