Abstract

Background: Various coping strategies have differing effects on ameliorating or potentiating anxiety symptoms. There was a dearth of empirical data to corroborate this assertion among health care workers (HCWs) during the coronavirus (COVID-19) pandemic in Nigeria.


Objectives: The general objective of this study is to assess the coping strategies that were predominantly used by the health care workers and determine the relationship between coping strategy and anxiety disorder.


Materials and Methods: The study was cross-sectional observational in design conducted among eligible healthcare workers at a tertiary institution in Benin City. The 28-item Brief COPE Inventory, 7-item Generalized Anxiety Disorder (GAD-7) Scale and a Socio-demographic data collection sheet were used to collect data from health care workers who met the study eligibility criteria, and were selected using convenience sampling technique. Data analysis was done using SPSS version 26 and the level of significance was set at <0.05.


Results: Two hundred and thirteen (213) HCWs participated in the study, their mean age was 37.31+9.917 years and the prevalence of GAD among them was 25.4%. In terms of the frequency of use, Acceptance, Active coping and Instrumental support were the adaptive styles most frequently practiced with mean scores of 4.24, 4.23 and 4.23 respectively, but in terms of the proportion of respondents that practiced each style, emotional support (44.6%), active coping (46.0%), instrumental support (45.5%) and acceptance (44.6%) were practiced by the highest proportions of the HCWs. Although none of these coping strategies was significantly independently associated with a reduction in the risk of anxiety disorder, they had a significant joint effect in reducing its risk (OR = 4.210, p < 0.001, and 95% CI = 0.182- -0.066). In the maladaptive scale, the highest mean score (4.00) was recorded on the Self- distraction subscale and the same strategy was also adhered to by the majority (58.7%) of the respondents. Both self-distraction and substance use significantly independently increase the risk of anxiety disorder (OR = 1.622, p = <0.001, 95% CI = 1.301 – 2.023 and OR = 1.481, p = 0.015, 95% CI = 1.079 – 2.033) respectively.  Maladaptive coping strategies had significant joint effect in increasing the risk of anxiety disorder (OR= 3.992, p = < 0.001, 95% CI = 0.130 – 0.382)).


Conclusion


Among the adaptive coping strategies, Acceptance, Active coping and Instrumental support were most frequently used; while self-distraction was most frequently used among the maladaptive coping strategies. Emotional support, active coping, instrumental support, and acceptance were the strategies practiced by the highest proportions of the HCWs. Expectedly, adaptive coping strategies jointly had significant inverse relationship with anxiety symptoms (reduced risk of anxiety symptoms); while maladaptive coping strategies jointly had significant direct relationship with anxiety symptoms (increased risk of anxiety). Planning and development of effective treatment intervention for HCWs should take cognisance of the coping strategies of the majority of them and aim at appropriately directing their coping mechanisms as this will go a long way to enhance their mental stability.


Key words: Coping strategies, Anxiety, Coronavirus, Healthcare workers