1. Introduction
The New Coronavirus Illness (COVID-19) appeared in the Chinese city of Wuhan on 31 December 2019, and spread rapidly to other countries, threatening all of humanity with a pandemic 1. In Turkey, the first case was confirmed on 11 March 20202; and the WHO declared COVID-19 to be a public health emergency of international importance. Because the virus has the ability to pass from person to person and because of the high death rates, there was a need for emergency prevention and treatment strategies3,4; and taking these characteristics of the virus into account, it was necessary to take measures to restrict movement and to reduce the rates of infection 5. Also, no vaccination has yet been developed against the coronavirus causing the pandemic 6, and so, in the absence of pharmaceutical measures, ways to control the spread of the virus are more source control and prevention of infection 7. In Turkey, the first step in combating infectious diseases when cases are reported is contact tracing, with the aim of establishing the agent, source, and path of infection of the disease 8. Contact tracing work is of critical importance in preventing the spread of the disease and being able to effectively initiate and carry out health monitoring by establishing the agent and source at an early stage7. Bu çalışmalar kapsamında Since 24 July, 5.35% of the total population have been tested as part of this work, and the proportion of cases in the country has been determined as 5.02%. In addition, the fatality rate in Turkey of 2.49% 9 is lower than the world average of 4.05% and that of countries with high death rates such as the USA (3.56%), Italy (14.3%), France (17.8%) and Iran (5.36%) 10. It is thought that faster and earlier identification of possible cases by effective contact tracing over the whole country will be effective.
COVID-19 passing from one person to another is a cause of psychological stress not only for the general public but in particular for health workers 3,11,12. In combating this critical situation, health care workers, who are on the front line in dealing directly with the diagnosis, treatment and care of COVID-19 patients, are at risk of psychological stress and other health problems. The growing number of diagnosed and suspected cases, the very heavy work load, the shortage of personal protective equipment, the widespread coverage by the media, the shortage of specific drugs and inadequate emotional support may all cause an increase in the mental burden of health care workers13. Also, health personnel worry about becoming infected when procedures are not properly followed in the workplace, or about family members becoming infected and an outbreak occurring, and this causes stress. Stress in turn is known to be a primary cause of sleep problems. Worry about catching the virus, uncertainty about the pandemic, the safety of co-workers, loneliness, and high personal expectations can cause anger, anxiety, insomnia and stress11. ). In such situations, fear and anxiety appear in the early stages, then after depression, psychosocial symptoms and trauma, symptoms of stress are seen, and the effects last for a long time 14.
The support of coworkers is a concept to explain the support which comes from those a person works with under the same job description15 and which can affect a person’s perception of their work environment. Coworkers have the potential to enrich a person’s work experience and their perception of the organization, and are a source of support, lightening the workload 16. Organizational support theory can be defined as organizational values, taking account of workers’ contributions and happiness. In places where workers see equal organizational treatment, support from their superiors and rewards for working well, workers will place a greater value on their institutions in return for a high level of support according to this theory, and make greater efforts to achieve the aims of the institution, showing loyalty and effort in return for material and social rewards. Belief in having institutional support not only reduces the stress of the workplace, but at the same time helps to combat work-related fatigue which can lead to depression 17-19 and has positive effects on mental health by securing positive work attitudes and results20.
It has been found that health workers’ psychosocial and mental states are affected by the pandemic 13,14,21-23 and that rates of post-traumatic stress disorder, depression and anxiety are higher in primary healthcare workers who are in the closest contact with cases both in the acute and in the recovery phases 24. Psychological problems such as stress or insomnia which may occur because of work load in health workers performing contact tracing in the field carry the risk of increasing COVID-19 related morbidity and mortality rates when reduced organization and coworker support prevent effective contact tracing. In Turkey as far as we know, no study has yet been conducted taking as its focus primary healthcare workers and contact tracers, and including in a single model anxiety and related factors in health workers during the COVID-19 outbreak. For this reason, this study was planned with the aim of providing standardization for studies on determining anxiety levels in primary contact tracers and family health center workers during COVID-19, bringing under control the insomnia and stress which may result, and strengthening institutional ties by providing training with organizational and coworker support.