Assessing stress among community health workers due to COVID-19 related work: A comparative study from Vietnam

Abstract

Background

Community health workers (CHWs) involved in COVID-19 response might be at increased risk of stress, though evidence remains absent.

Objective

To assess the effects of COVID-19 related work on stress and identified factors associated with the risk of deteriorating to severe stress among CHWs in Vietnam.

Methods

Using a nation-wide survey among 979 CHWs involved in COVID-19 response, we applied multivariable logistic regression to estimate the risk of deteriorating to high stress levels between before the epidemic (average June–December 2019) and at its peak (January–March 2021). Stress levels were measured using the Perceived Stress Scale (PSS-10).

Results

Median stress levels among CHWs increased from 10 (IQR = 7–16) before COVID-19 to 15 (IQR = 11–19) on the PSS-10 during the COVID-19 outbreak. The proportion of CHWs with low stress levels decreased from 67.6% to 42.2% (p-value <0.001), while the proportion of CHWs with moderate and high stress levels increased 1.8 and 4.2-fold, respectively. Less sleep and poor sleep quality, working in unfavorable work environments, and being involved in daily high-risk SARS-CoV-2 exposure activities were associated with an increased risk of deterioration to high stress levels.

Conclusions

We found a substantial increase in stress levels among CHWs in Vietnam that is probably due to their COVID-19 related work; the observed 2 and 4-fold increase in CHWs suffering from moderate and high stress levels, respectively, is particularly worrisome. Targeted support for CHWs is crucial to ensure the sustainability of health interventions during COVID-19 and future epidemics.