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      Anxiety, depression, and uncertainty appraisal and factors affecting uncertainty risk and opportunity appraisal of health care workers in Korea during the COVID-19 outbreak : Uncertainty risk and opportunity appraisal

      research-article
      a , b , c
      Health Psychology and Behavioral Medicine
      Routledge
      Uncertainty, risk, opportunity, health care workers, COVID-19

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          ABSTRACT

          Background:

          Due to the prolonged period of COVID-19, the uncertainty related to COVID-19 is bound to increase for healthcare workers (HCWs) in tertiary medical institutions as much as for the HCWs in dedicated hospitals.

          Purpose:

          To assess anxiety, depression, and uncertainty appraisal, and to determine the factors affecting uncertainty risk and opportunity appraisal experienced by HCWs at the forefront of COVID-19 treatment.

          Method:

          This was a descriptive, cross-sectional study. The participants were HCWs at a tertiary medical center in Seoul. HCWs included medical (doctors, nurses) and non-medical (nutritionists, pathologists, radiologists, office workers, etc.) personnel. Self-reported structured questionnaires (patient health questionnaire, generalized anxiety disorder scale, and uncertainty appraisal) were obtained. Finally, responses from 1337 people were used to evaluate factors affecting uncertainty risk and opportunity appraisal using a quantile regression analysis.

          Results:

          The average ages of medical and non-medical HCWs were 31.69 ± 7.87 and 38.66 ± 11.42 years, and the proportion of females was high. The rates of moderate to severe depression (23.23%) and anxiety (6.83%) were higher in medical HCWs. The uncertainty risk score was higher than the uncertainty opportunity score for all the HCWs. Factors that increased uncertainty opportunity were a decrease in depression in medical HCWs and a decrease in anxiety in non-medical HCWs. Increase in age was directly proportional to uncertainty opportunity in both groups.

          Conclusion:

          There is a need to devise a strategy to reduce uncertainty among HCWs who inevitably face various infectious diseases that appear in the near future. In particular, since there are various types of non-medical as well as medical HCWs in medical institutions who can prepare an intervention plan that comprehensively considers the characteristics of each occupation and the distribution of risks and opportunities of uncertainty will be able to improve the quality of life of HCWs and further promote the health of the people.

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          Most cited references34

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls

              Most studies have some missing data. Jonathan Sterne and colleagues describe the appropriate use and reporting of the multiple imputation approach to dealing with them
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                Author and article information

                Journal
                Health Psychol Behav Med
                Health Psychol Behav Med
                Health Psychology and Behavioral Medicine
                Routledge
                2164-2850
                24 February 2023
                2023
                24 February 2023
                : 11
                : 1
                : 2182306
                Affiliations
                [a ]Department of Emergency Department, Konkuk University Medical Center , Seoul, Republic of Korea
                [b ]Department of Nursing, Konkuk University , Chungju-si, Republic of Korea
                [c ]Department of Preventive Medicine, School of Medicine, Konkuk University , Seoul, Republic of Korea
                Author notes
                [CONTACT ] Jong Sun Ok sokei@ 123456kku.ac.kr Department of Nursing, Konkuk University , 268 Chungwon-daero, Chungju-si, Chungcheongbuk-do 27478, Republic of Korea
                Author information
                https://orcid.org/0000-0002-1885-3015
                Article
                2182306
                10.1080/21642850.2023.2182306
                9970208
                36860423
                d0ed755d-7dae-497c-91fa-401b49cdef2a
                © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 36, Pages: 16
                Categories
                Research Article
                Research Article

                uncertainty,risk,opportunity,health care workers,covid-19
                uncertainty, risk, opportunity, health care workers, covid-19

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