Effect of concern about COVID-19 on professional self-efficacy, psychological distress, anxiety, and depression in Peruvian health personnel

Oscar Mamani-Benito, Renzo Felipe Carranza Esteban, José Ventura-León, Tomás Caycho-Rodríguez, Rosa Farfán Solís, Darwin Hidalgo Blanco Shocosh

DOI: https://doi.org/10.17711/SM.0185-3325.2021.028


Introduction. Concern about becoming infected with COVID-19 is one of the reactions that has affected the mental health of Peruvian health care workers.

Objective. To determine the effect of concern about COVID-19 on professional self-efficacy, psychological distress, anxiety, and depression in health personnel in the Puno region of Peru.

Method. An explanatory, cross-sectional study was conducted with the voluntary participation of 401 health workers (such as nurses, physicians, nursing technicians, obstetricians, dentists, psychologists, and nutritionists) of both sexes (24.2% men and 75.5% women) from 12 health networks in the region of Puno, Peru. They were asked to answer the Scale of Concern for the Transmission of COVID-19 in Health Personnel (EPPC-Cov19), Patient Health Questionnarie-2 (PHQ-2, Generalized Anxiety Disorder Scale-2 (GAD-2) and the Professional Self Efficacy Scale (AU-10). Structural Equation Modeling (SEM) was used for data analysis.

Results. The factor loads of the explanatory model showed a good fit: χ² (286) = 797.31, p
Discussion and conclusion. Concern about the spread of COVID-19 affects depression, anxiety, psychological distress and work self-efficacy among Peruvian health workers in the Puno region of Peru.


Coronavirus; self-efficacy; psychological distress; depression; anxiety; health personnel

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Algado-Sellés, N., Gras-Valentí, P., Chico-Sánchez, P., Mora-Muriel, J. G., Soler-Molina, V. M., Hernández-Maldonado, M., … Sánchez-Payá, J. (2020). Frequency, associated risk factors, and characteristics of COVID-19 among healthcare personnel in a Spanish health department. American Journal of Preventive Medicine, 59(6), e221-e229. doi: 10.1016/j.amepre.2020.07.014

Arias-Reyes, C., Zubieta-DeUrioste, N., Poma-Machicao, L., Aliaga-Raduan, F., Carvajal-Rodriguez, F., Dutschmann, M., … Soliz, J. (2020). Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?. Respiratory Physiology & Neurobiology, 277, 103443. doi: 10.1016/j.resp.2020.103443

Ato, M., López, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038-1059. doi: 10.6018/analesps.29.3.178511

Bashirian, S., Jenabi, E., Khazaei, S., Barati, M., Karimi-Shahanjarini, A., Zareian, S., … Moeini, B. (2020). Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: an application of the Protection Motivation Theory. Journal of Hospital Infection, 105(3), 430-433. doi: 10.1016/j.jhin.2020.04.035

Buitrago Ramírez, F., Ciurana Misol, R., Fernández Alonso, M. C., & Tizón, J. L. (2021). COVID-19 pandemicand mental health: Initial considerations from spanish primaryhealthcare. Atención Primaria, 53(1) 89-101. doi: 10.1016/j.aprim.2020.06.006

Calderón-De la Cruz, G. A., Domínguez-Lara, S. A., & Arroyo-Rodríguez, F. (2018). Análisis psicométrico preliminar de una medida breve de autoeficacia profesional en trabajadores peruanos: AU-10. Psicogente, 21(39), 12-24. doi: 10.17081/psico.21.39.2819

Chang, W. H. (2020). The influences of the COVID-19 pandemic on medical service behaviors. Taiwanese Journal of Obstetrics and Gynecology, 59(6), 821-827. doi: 10.1016/j.tjog.2020.09.007

Cheung, V. K.-L., So, E. H.-K., Ng, G. W.-Y., So, S.-S., Hung, J. L.-K., & Chia, N.-H. (2020). Investigating effects of healthcare simulation on personal strengths and organizational impacts for healthcare workers during COVID-19 pandemic: a cross-sectional study. Integrative Medicine Research, 9(3), 100476. doi: 10.1016/j.imr.2020.100476

Dar, K. A., Iqbal, N., & Mushtaq, A. (2017). Intolerance of uncertainty, depression, and anxiety: Examining the indirect and moderating effects of worry. Asian Journal of Psychiatry, 29, 129-133. doi: 10.1016/j.ajp.2017.04.017

Dominguez-Lara, S., & Alarcón-Parco, D. (2020). Análisis estructural de la escala de malestar psicológico de Kessler (K6) en universitarios peruanos. Educación Médica, 21(2), 155-156. doi: 10.1016/j.edumed.2019.10.008

Dosil Santamaría, M., Ozamiz-Etxebarria, N., Redondo Rodríguez, I., Jaureguizar Alboniga-Mayor, J., & Picaza Gorrotxategi, M. (2021). Psychological impactofCOVID-19 on a sample of Spanish health professionals. Revista de Psiquiatría y Salud Mental, 14(2), 106-112. doi: 10.1016/j.rpsm.2020.05.004

Gestión. (2020). COVID-19: En Puno y Cusco se disparan las cifras de exceso de fallecidos por dia. Retrieved from https://gestion.pe/peru/politica/covid-19-en-puno-y-cusco-se-disparan-las-cifras-de-exceso-de-fallecidos-por-dia-nczg-noticia/

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. doi: 10.1080/10705519909540118

Huarcaya-Victoria, J. (2020). Consideraciones sobre la salud mental en la pandemia de COVID-19. Revista Peruana de Medicina Experimental y Salud Pública, 37(2), 327-334. doi: 10.17843/RPMESP.2020.372.5419

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284-1292. doi: 10.1097/01.MLR.0000093487.78664.3C

Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007). Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146(5), 317-325. doi: 10.7326/0003-4819-146-5-200703060-00004

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., … Hu, S. (2020). Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open, 3(3), e203976. doi: 10.1001/jamanetworkopen.2020.3976

Lefèvre, H., Stheneur, C., Cardin, C., Fourcade, L., Fourmaux, C., Tordjman, E., … Lachal, J. (2021). The Bulle: Support and prevention of psychological decompensation of health care workers during the trauma of the COVID-19 epidemic. Journal of Pain and Symptom Management, 61(2), 416-422. doi: 10.1016/j.jpainsymman.2020.09.023

Li, C.-H. (2016). Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares. Behavior Research Methods, 48(3), 936-949. doi: 10.3758/s13428-015-0619-7

Lin, R.-M., Xie, S.-S., Yan, Y.-W., & Yan, W.-J. (2017). Intolerance of uncertainty and adolescent sleep quality: The mediating role of worry. Personality and Individual Differences, 108, 168-173. doi: 10.1016/j.paid.2016.12.025

Lozano-Vargas, A. (2020). Impacto de la epidemia del Coronavirus (COVID-19) en la salud mental del personal de salud y en la población general de China. Revista de Neuro-Psiquiatria, 83(1), 51-56. doi: 10.20453/rnp.v83i1.3687

Maben, J., & Bridges, J. (2020). Covid-19: Supporting nurses’ psychological and mental health. Journal of Clinical Nursing, 29(15-16), 2742-2750. doi: 10.1111/jocn.15307

Mhango, M., Dzobo, M., Chitungo, I., & Dzinamarira, T. (2020). COVID-19 Risk Factors Among Health Workers: A Rapid Review. Safety and Health at Work, 11(3), 262-265. doi: 10.1016/j.shaw.2020.06.001

Nguépy Keubo, F. R., Mboua, P. C., Djifack Tadongfack, T., Fokouong Tchoffo, E., Tasson Tatang, C., Ide Zeuna, J., … Folefack, G. O. (2021). Psychological distress among health care professionals of the three COVID-19 most affected Regions in Cameroon: Prevalence and associated factors. Annales Médico-Psychologiques, Revue Psychiatrique, 179(2), 141-146. doi: 10.1016/j.amp.2020.08.012

Nguyen, L. H., Drew, D. A., Graham, M. S., Joshi, A. D., Guo, C. G., Ma, W., … Chan, A. T. (2020). Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. The Lancet Public Health, 5(9), e475-e483. doi: 10.1016/S2468-2667(20)30164-X

Ornell, F., Chwartzmann Halpern, S., Paim Kessler, F. H., & Narvaez, J. C. de M. (2020). The impact of the COVID-19 pandemic on the mental health of healthcare professionals. Cadernos de Saude Publica, 36(4), e00063520. doi: 10.1590/0102-311X00063520

Roy, D., Tripathy, S., Kar, S. K., Sharma, N., Verma, S. K., & Kaushal, V. (2020). Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian Journal of Psychiatry, 51, 102083. doi: 10.1016/j.ajp.2020.102083

Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and Addressing Sources of Anxiety among Health Care Professionals during the COVID-19 Pandemic. JAMA - Journal of the American Medical Association, 323(21), 2133-2134. doi: 10.1001/jama.2020.5893

Shaukat, N., Ali, D. M., & Razzak, J. (2020). Physical and mental health impacts of COVID-19 on healthcare workers: A scoping review. International Journal of Emergency Medicine, 13(1), 40. doi: 10.1186/s12245-020-00299-5

Spoorthy, M. S., Pratapa, S. K., & Mahant, S. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian Journal of Psychiatry, 51, 102119. doi: 10.1016/j.ajp.2020.102119

Ventura-León, J. L., & Caycho-Rodríguez, T. (2017). El coeficiente Omega: un método alternativo para la estimación de la confiabilidad. Revista Latinoamericana de Ciencias Sociales, Niñez y Juventud, 15(1), 625-627. Retrieved from https://www.redalyc.org/pdf/773/77349627039.pdf

Vignaud, P., & Prieto, N. (2020). Impact psychique de la pandémie de Covid-19 sur les professionnels soignants. Actualités Pharmaceutiques, 59(599), 51-53. doi: 10.1016/j.actpha.2020.08.013

Yook, K., Kim, K.-H., Suh, S. Y., & Lee, K. S. (2010). Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 24(6), 623-628. doi: 10.1016/j.janxdis.2010.04.003