IMPACT OF CORONAVIRUS DISEASE-19 (COVID-19) TO THE

PSYCHOLOGICAL HEALTH OF FRONTLINE WORKERS

IN LOUISIANA, LAGUNA
 Chapter 1
THE PROBLEM AND ITS SETTINGS

Introduction

Last December 2019, the new coronavirus disease 2019 (COVID- 2019) started

scattering in the Chinese city of Wuhan (Hubei province). The most typical symptoms of the

disease are fever, myalgia, fatigue, and dry cough. Other referred symptoms are chills, coryza,

sore throat, nausea, vomiting, and diarrhea (Chen et al., 2020; Huang et al., 2020). These

symptoms are usually mild, and some infected people are asymptomatic (Rothe, 2020; Ryu et al.,

2020). According to the World Health Organization (2020), about 80% of disease-ridden people

quickly recover from COVID-19 without specific treatment. In March 2020, the World Health

Organization declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic.

Hence, this pandemic has had a massive impact on healthcare systems and professionals (Adams

and Walls, 2020).

Based on previous studies, novel virus outbreaks may drastically increase psychological

distress among frontline workers during COVID-19. Emerging research on COVID-19 from

several countries indicates that frontline workers report depression, anxiety, and stress (Lai J, Ma

S, Wang Y, Cai Z, Hu J, Wei N, et al., 2020; Kannampallil TG, Goss CW, Evanoff BA,

Strickland JR, McAlister RP, Duncan J, 2020; Pappa S, Ntella V, Giannakas T, Giannakoulis

VG, Papoutsi E, Katsaounou P., 2020). Moreover, risk factors included deficiency of perceived

psychological preparedness and self-efficacy to help patients, social isolation, fear of improper

use or unavailability of personal protective equipment (PPE), and associated infection risks

(Xiao H, Zhang Y, Kong D, Li S, Yang N., 2020; De Kock JH, Latham HA, Leslie SJ, Grindle

M, Munoz S-A, Ellis L, et al., 2021; Spoorthy MS, Pratapa SK, Mahant S., 2020). This is
difficult because psychological distress may lead to ill-being, unfavorable effects on

professionals and healthcare organizations, and patient safety (Hall LH, Johnson J, Watt I, Tsipa

A, O'Connor DB., 2016). Therefore, the impact of COVID-19 on frontline workers' experiences

requires further exploration. A better understanding of the challenges and changes in the work

dynamics of frontline workers during the COVID-19 pandemic may help develop tailored

interventions that effectively support frontline workers' psychological health.

Though there has been a severe problem placed on frontline workers, much can still be

done to improve their health. Opening about the psychological impact of COVID-19 with other

colleagues, eliminating the stigma surrounding mental health issues among frontline workers,

and different strategies can help improve some of the symptoms of psychological distress. Novel

virus outbreaks, such as the COVID-19 pandemic, may increase psychological distress among

frontline workers. Psychological distress may lead to reduced performance, reduced

employability, or even exhaustion.

In line with these anticipated effects of the COVID-19 pandemic on frontline workers'

psychological needs and psychological distress, the researchers will determine the impact of

COVID-19 on the psychological health of frontline workers. The researcher will use quantitative

and qualitative data into frontline workers' experiences and perceptions in a dynamic and

complex work environment to gain more insights.

Background of the Study

A pandemic spreads a new illness throughout numerous countries or continents

worldwide, often known as an epidemic. Several bio-disasters have struck the world, including

SARS in China, portions of Asia, and Canada in 2003, Ebola in West Africa in 2014, and Middle
East Respiratory Syndrome (MERS) in 2016. Thousands of frontline workers were infected in

the most recent COVID-19 pandemic, which resulted in an unacceptably high global death toll

(Baud et al.). The rapid response to this new virus was likely to have had a significant impact on

the well-being of frontline hospital workers. Furthermore, COVID-19's quick transmission rate

enabled HCWs to perform activities that HCWs would not have been able to do otherwise.

Dealing with a significant global health calamity involves an uncharted trip into the

unknown at multiple levels. To forecast infection rates, government agencies use data from other

countries. For most people, the high level of uncertainty connected with new infections adds to

their sense of anxiety and makes for a terrible overall experience. Individuals who use their

coping skills and work together in teams can make positive changes because of their problems.

Leaders' transformation can help countries prepare for future calamities by strengthening their

preparation.

The numerous threats to frontline workers' well-being are not well-understood. After

SARS, some study has been done in this area, but little is known about the psychological

consequences of infectious illness outbreaks in general (Mak et al., 2009). Even after an attack,

adverse effects such as exhaustion, traumatic stress, anxiety, and depressive symptoms have been

documented, implying long-term consequences (Lancee et al., 2008). Given the likely increased

rate of psychological problems amongst frontline workers', these factors must be addressed.

Various factors contribute to the high prevalence of mental illness, sleeplessness,

somatization, and other stress-related symptoms. Fear of the unknown, self-isolation during

quarantines, a lack of suitable equipment or medical supplies, and other job-related variables all

contributed to the psychological discomfort experienced by frontline employees as they

responded to the pandemic (Bennett, 2021).

 In addition, Bennet (2021) stated in her article one of many healthcare workers and first

responders experienced was infection-related fears. Reports spanning 17 studies identified fear as

the primary stressor for frontline workers, with the most common fears being: (1) fear of the

unknown; (2) fear of becoming infected; and (3) fear of threats to their mortality. Worried not

only for their health but the health of their loved ones, frontline workers commonly reported fear

of bringing the virus to vulnerable family members and colleagues. Many of their loved ones fell

victim to the virus, which caused further depression and insomnia. The working conditions under

the COVID-19 pandemic significantly impacted frontline workers' physical and emotional

health. Long hours, most of the day spent on their feet, and a steady flow of patients made

medical centers a stressful place to work for the duration of the pandemic.es. Many healthcare

workers also doubted the efficiency of such protective gear, contributing to higher levels of

depression, anxiety, and stress than those who believed their equipment to be adequate.

This timely review is pertinent and urgent considering the COVID-19 pandemic. Those

working on the front lines with infected patients or afflicted areas need the right tactics and tools

to deal with various issues. There are few comprehensive reviews focused on the mental health

consequences experienced by frontline HCWs during an outbreak. There is also a lack of

knowledge in the research about preventing the best psychological discomfort and what efforts

are required to mitigate harm to HCWs' well-being. The psychological impact on HCWs during

severe epidemics is investigated in this study and techniques for dealing with it.
Conceptual Framework

1. Demographic Profile 1. Systematic Review The Impact of COVID-

of the Respondents Analysis 19 to the Psychological
2. Extent of 2. Data Gathering Health of Frontline
psychological impact Procedure through Workers in Luisiana,
assessed by infected Survey Questionnaire Laguna

Process
survivors

Output
3. Statistical Analysis
Input

3. Literature Review of Data

on the Impact of
COVID-19 to the
Psychological Health
of Frontline Workers

Figure 1
Research Paradigm

Figure 1 shows the study’s conceptual framework that aims to illustrate the

organization of ideas and clarify the study’s concepts. This also contains the study's variables,

theories, and related parts. Moreover, the researcher aims to explore the impact of COVID-19 on

the psychological health of frontline workers, which includes the demographic profile, effects of

COVID-19 on the psychological health of infected survivors, and literature reviews,

Furthermore, systematic review analysis and a self-made and standard questionnaire

will gather the needed information. The researcher will do the tallying and run statistical analysis

of data interpreted and analyzed with the statistician's guide.

The researcher will conduct the current systematic review and meta-analysis to assess

the latest psychological impact of the COVID-19 pandemic among healthcare workers to

implement appropriate strategies to prevent or intervene in the adverse psychological effects on

frontline workers and provide help to relieve the burden. The psychological impact of COVID-

19 on frontline workers was investigated in this meta-analysis, which also highlighted the

differences in anxiety and depression prevalence rates between frontline and non-front-line

workers.

Statement of the Problem

This study will explore the impact of COVID-19 on the psychological health of

frontline workers in Louisana, Laguna.

Specifically, it aims to answer the following questions:

1. What is the demographic profile of covid-19 infected survivors in terms of:

1.1. Age

1.2. Gender

1.3. Education

1.4. Marital status

1.5. Occupation

2. What is the extent of psychological impact assessed by infected survivors in terms of:

2.1. Motivation

2.2. Attitude

2.3. Behaviour Change

2.4. Perception

2.5. Learning

3. Is there any significant relationship between the demographic profile and the

psychological impact of covid-19 infected frontline workers?

 4. Based on the data gathered, what coping strategies can be formulated to address the

psychological distress?

Hypothesis

The researcher posited the null hypothesis that was subjected to acceptance and

rejection.

H0: There is no significant relationship between the demographic profile of the

respondents and the psychological impact of COVID-19 infected frontline workers.

Objectives of the Study

To satisfy the goal of this study, here is the following objective constructed by the

researchers:

1. To implement appropriate strategies to prevent or intervene in the adverse psychological

effects on frontline workers and provide help to relieve the burden.

2. To assess the psychological impact of COVID-19 on the frontline workers and

summarize the different prevalence rates of anxiety and depression between frontline and

non-front-line workers.

Significance of the Study

This study will be beneficial to the following sectors:

For the Frontline Workers. This research can help to guide current and future

research goals in the field of frontline worker well-being. Change must begin with politicians,

who must provide a broader range of resources to frontline workers who play a crucial role

during large-scale disease outbreaks.

 Healthcare Organizations. Psychological distress among frontline workers is

problematic and requires attention from healthcare organizations to reduce the burden on the

clinical staff during a pandemic. This study will suggest implications for practice to help

organizations better support their professionals.

Disaster Readiness and Risk Reduction Management. Creating stability within

teams and providing flexible training and education when new insights arise in treatment and

new team members join the group later. This helps promote professionals’ competence and foster

reciprocal relationships and belongingness within teams.

Scope and Delimitation

This study will explore the impact of COVID-19 on the mental health of student-

athletes and include factors associated with their mental health or psychological wellbeing. As

most papers used self-reported measures, to ensure the inclusion of high-quality and adequately

powered research, this study needs to include at least 100 frontline workers infected survivors.

Frontline workers are required to be working in proximity with infected patients. Moreover, this

study will assess the psychological impact of COVID-19 on the frontline workers and summarize

the different prevalence rates of anxiety and depression of frontline workers.

 Chapter 2
REVIEW OF RELATED LITERATURE AND STUDIES

This chapter contains the various literature and studies that’ll further support the

details indicated in the survey. Furthermore, it tackles the concepts circulating the ideas and

knowledge about the study.

The Psychological Impact of Epidemics

The psychological impact of severe epidemics on frontline health workers was

investigated in all of the research included in this review. According to 32 research, the most

prevalent psychiatric diseases diagnosed were post-traumatic stress syndrome (PTSS), sadness,

and anxiety (Ji et al., 2017; Wu et al., 2009; Chan and Huak, 2004; Rossi et al., 2020; García-

Fernandez et al., 2020; Liu et al., 2020a; Kang et al., 2020; Zhang et al., 2020b; Mo et al.; Zhou

et al., 2020; Xiaoming et al., 2020; Wilson et al., 2020; Wasim et al., 2020; Wankowicz et al.,

2020; Wang et al., 2020; Tian et al., 2020; Shechter et al., 2020; Sandesh et al., 2020;

Pouralizadeh et al., 2020; Liu et al., 2020b; Lin et al., 2020; Korkmaz et al., 2020; Juan et al.,

2020; Hu et al., 2020; Hong et al., 2020; Elbay et al., 2020; Du et al., 2020; Di Tella et al., 2020;

Chew et al., 2020; Cai et al., 2020b; An et al., 2020; Bai et al., 2004). In the COVID-19

pandemic, somatization was reported frequently (Xiaoming et al., 2020; Juan et al., 2020; Hong

et al., 2020), with 42.7% (2,005 of 4,692) of frontline nurses identifying somatic symptoms

(Hong et al., 2020), particularly headaches, throat pain and lethargy, which were significantly

associated with psychological outcomes (Chew et al., 2020). Sleep disorders, including

insomnia, were also frequently identified (Wasim et al., 2020; Wankowicz et al., 2020; Tian et

al., 2020; Lin et al., 2020; Chew et al., 2020; Cai et al., 2020b).
 Female nurses who worked closely with COVID-19 patients appeared to be at the most

significant risk for mental illness (Pouralizadeh et al., 2020). However, Romero et al. (2020);

Elbay et al. (2020), it is essential to highlight that the majority of studies comprised mostly

female participants, particularly nurses, with only one study indicating that males have higher

stress levels (Liu et al., 2020b). Being a woman increased the likelihood of depression, anxiety,

and higher levels of stress (Xiaoming et al., 2020; Pouralizadeh et al., 2020; Elbay et al., 2020;

Du et al., 2020; Di Tella et al., 2020; Babore et al., 2020) Suicidal thoughts were found in 6.5

percent of frontline workers (306 out of 4,692), with a worse self-perceived health status being

recognized as an additional risk factor (Xiaoming et al., 2020; Hong et al., 2020). A Wuhan

study (Kang et al., 2020) found that 34.4 percent (342 of 994) of medical and nursing personnel

had mild mental health disturbances, while 6.2 percent (62) had severe disorders, while another

study (Cai et al., 2020a) found that 14.1 percent of 1,521 Chinese healthcare workers had

psychological abnormalities. In Hubei province, 12.5 percent (64 of 512) of medical personnel

were anxious, with the level of anxiety being higher among those who had direct contact with

infected patients (Liu et al., 2020a). Female workers with depression, anxiety, and acute stress

symptoms were 14.2 percent (621 of 4,369), 25.2 percent (1,101), and 31.6 percent (1,382) two

weeks after Wuhan was placed under lockdown (Li et al., 2020b). One study indicated moderate

burnout among 2,014 HCWs working in two Wuhan hospitals, with high levels of fear reported

(Hu et al., 2020).

Two months after the SARS outbreak in Singapore, about 20% of healthcare workers

(127 out of 661) experienced PTSD (Chan and Huak, 2004). During the SARS pandemic, 5%

(17 of 338) of staff workers at a hospital in East Taiwan matched the criteria for Acute Stress

Disorder (ASD) (Bai et al., 2004). HCWs and other personnel who had direct contact or
exposure to Ebola patients also had various psychological symptoms, including obsession-

compulsion, interpersonal sensitivity, sadness, and paranoid ideation (Ji et al., 2017). Around

10% (55 of 549) of Beijing hospital staff experienced severe post-traumatic stress symptoms in

the three years following the 2003 SARS outbreak, which was closely linked to SARS exposure,

quarantine, and a relative or friend contracting SARS (Wu et al., 2009). A study of 1,800

healthcare workers (Lee et al., 2018) looked at the psychological impact during the early phases

of the MERS outbreak and one month later. Those who completed MERS-related tasks

experienced more distress and bothersome symptoms. They also had the highest risk of

developing PTSD symptoms one month later, and this risk was elevated even after returning

home. Healthcare workers who were sequestered at home slept less well and felt more numbness

than those who were not.

In terms of the influence on different types of health professionals, a recent study (Zhang

et al., 2020b) found that medical HCWs (927) had significantly greater levels of sleeplessness,

anxiety, depression, somatization, and obsessive-compulsive symptoms than non-medical HCWs

(1,255). HCWs (613) experienced higher symptoms of acute stress than non-HCWs, according to

a Spanish study (Garca-Fernandez et al., 2020). (164). Anxiety and insomnia were also

considerably more significant in frontline HCWs than in non-front line HCWs (Wankowicz et

al., 2020; Lin et al., 2020; Cai et al., 2020b). Doctors and nurses were compared in eight research

(Tam et al., 2004; Maunder et al., 2004; Lung et al., 2009; Lai et al., 2020; Liu et al., 2020b;

Korkmaz et al., 2020; Wong et al., 2005; Chan et al., 2005). Four of these studies looked into

SARS and discovered that nurses were more stressed. One study (Maunder et al., 2004) found

that nurses and individuals are directly contacting infected patients were more distressed. In two

Hong Kong studies (Tam et al., 2004; Wong et al., 2005), nurses reported considerably higher
overall distress levels than other HCWs, except for doctors. Nurses also reported higher levels of

stress and psychological morbidity than others professionals. One study of 1,470 nurses (Chan et

al., 2005) found that nurses working in moderate-risk locations had higher stress symptoms than

those working in high-risk areas, but the reasons for this are unknown. In two investigations

(Chan and Huak, 2004; Liu et al., 2020b), it was discovered that doctors and single nurses were

at higher risk than nurses and those who were married and that doctors had more stress and

anxiety than nurses. Furthermore, 27% (177 of 660) of participants experienced mental

symptoms, with doctors being 1.6 times more likely than nurses to have psychiatric symptoms,

and 20% (127 of 651) had PTSD. In contrast, research (Lung et al., 2005) found that comparing

127 HCWs impacted by SARS found no significant difference in feelings of stress between the

physicians, nurses, and other HCWs. An Italian study (Rossi et al., 2020) of 1,379 HCWs during

the COVID-19 pandemic showed that general practitioners were more likely to have PTSS than

other HCWs, while nurses and health care assistants were more likely to exhibit severe insomnia.

Similarly, another Chinese study (Li et al., 2020c) found that nurses (234) working in the

frontline against COVID-19 experienced significantly greater levels of vicarious traumatization

when compared to non-front line nurses (292). This theme was replicated with findings to

suggest that frontline HCWs in close contact with infected patients were 1.4 times more likely to

feel fear and twice more likely to suffer anxiety and depression when compared to non-clinical

staff (Lu et al., 2020).

During the COVID-19 outbreak, a survey of 1,257 HCWs (Lai et al., 2020) found

significant depression, anxiety, and insomnia rates, with over 70% experiencing psychological

distress. During the COVID-19 outbreak, a survey of Chinese HCWs indicated that 36.1 percent

(564 of 1,563) reported sleeplessness symptoms (Zhang et al., 2020a). HCWs in Wuhan, the
epicenter of the COVID-19 outbreak, had higher rates of sleeplessness and stress responses than

those in a different Chinese province, according to a study (Li et al., 2020a). According to one

study (Chua et al., 2004), HCWs were not more stressed than healthy controls (342), but 89

percent (241 of 271) of HCWs experienced negative psychological symptoms.

Six studies (Tam et al., 2004; Lancee et al., 2008; Lung et al., 2009; Wu et al., 2009; Lee

et al., 2018; Shih et al., 2007) looked at post-epidemic psychiatric symptoms, with two (Lung et

al., 2009; Wu et al., 2009) using long-term follow-up. About 40% (22 of 55) of Beijing HCWs

who had high PTS symptoms during the 2003 SARS outbreak still had a high PTS level at the

time of the interview three years later (Wu et al., 2009). A study of 123 HCWs recruited from a

Taiwanese hospital indicated that 17.3% (22 of 127) had mental symptoms early after the SARS

pandemic, and 15.4% (19 of 123) had mental health symptoms one year later (Lung et al., 2009).

Stressor Arising from an Epidemic

Six articles (Tam et al., 2004; Lancee et al., 2008; Lung et al., 2009; Wu et al., 2009; Lee

et al., 2018; Shih et al., 2007) focused wholly or in part on the period following an outbreak.

Two studies (Tam et al., 2004; Lancee et al., 2008) looked at predictors, while one (Shih et al.,

2007) looked at stressors before treatment. A previous history of psychiatric illness, years of

health care experience (inversely linked), and the sense of adequate training and support were all

predictors of the prevalence of new-onset episodes of psychiatric disorders after the SARS

pandemic. Five percent (7 of 139) of HCWs had new outbreaks of psychiatric illnesses (Lancee

et al., 2008). Nurses and younger HCWs were shown to have a higher rate of psychiatric illness

(Tam et al., 2004). The pre-care stage was found to contribute to fear among Taiwanese nurses.

All (200) had difficulty keeping up with daily changing knowledge and abilities and being
concerned about their safety and the safety of their families, customers, and coworkers (Shih et

al., 2007).
Infection Related Fears

Fear was the most common stressor reported by participants in seventeen research (Tam

et al., 2004; Maunder et al., 2004; Ji et al., 2017; Wu et al., 2009; Chua et al., 2004; Koh et al.,

2005; Mo et al., 2020; Hu et al., 2020; Du et al., 2020; Bai et al., 2004; Wong et Fear of the

unknown, infection, and risks to their mortality, in particular. According to an Italian study

(Rossi et al., 2020), being exposed to contagion was connected with depression symptoms,

having a colleague hospitalized or placed in quarantine was associated with PTSS, and having a

colleague die was associated with depression and sleeplessness.

Anxiety was a common theme in almost all of the COVID-19 studies (Lai et al., 2020;

Cai et al., 2020a; Rossi et al., 2020; Garcia— Fernandez et al., 2020; Liu et al., 2020a; Zhang et

al., 2020b; Mo et al., 2020; Lu et al., 2020; Xiaoming et al., Among a Chinese study (Liu et al.,

2020a), is suspected of having COVID-19 infection was the most critical factor in HCWs with

high anxiety when compared to those who were not suspected of infection. In Singapore, 76

percent of 10,511 HCWs reported an increased risk of disease, 56 percent cited work stress, and

53 percent indicated growing workloads. Doctors, nurses, staff who work with SARS patients

regularly, and workers from SARS-affected institutions reported much higher anxiety levels than

other HCWs (Koh et al., 2005).

Dread was linked to the following variables in 466 questionnaires (Wong et al., 2005) of

doctors and nurses during the SARS outbreak: loss of control/vulnerability, fear for self-health,

and virus transmission. HCWs' psychological morbidity in Hong Kong was linked to their

feelings of personal vulnerability, stress, and workplace support. Approximately 57 percent (370

of 652) expressed psychological anguish, while 68 percent (444 of 652) reported a high-stress

level. Similarly, after the MERS outbreak, a poll of 117 HCWs (Khalid et al., 2016) indicated
that safety risks for themselves and others were a prominent concern, as were anxieties of

spreading the disease to their relatives and friends. Fear was voiced by all 200 nurses who

responded to a qualitative survey (Shih et al., 2007) about a lack of defensive protection against

the disease and challenges keeping up with daily changing knowledge/skills. The media has also

been blamed for exacerbating doubt (Shih et al., 2007).

Social and Cultural Aspects

Ten studies (Tam et al., 2004; Maunder et al., 2004; Chan and Huak, 2004; Zhou et al.,

2020; Wankowicz et al., 2020; Korkmaz et al., 2020; Hu et al., 2020; Hong et al., 2020; Babor et

al., 2020; Khee et al., 2004; Khee et al. (Wa nkowicz et al., 2020). While treating SARS patients,

nurses who choose to be away from their families face social isolation and a lack of family

support (Chan and Huak, 2004). Similarly, during the SARS outbreak, a lack of social support

led to discrimination in society and behavior that distanced HCWs from their own families (Khee

et al., 2004). Three attitudes (health fear, social isolation, and job stress) were found to mediate

the link between interaction with SARS patients and psychological stress in a study of 1,557

nurses (Maunder et al., 2004). Chinese HCWs' feelings of concern, anxiety, and self-efficacy

appeared to be influenced by their social support and sleep quality during the COVID-19

pandemic in Wuhan (Xiao et al., 2020).

Stigma was identified as a prominent factor in five studies (Maunder et al., 2004; Park et

al., 2018; Koh et al., 2005; Juan et al., 2020; Khee et al., 2004), and it was linked to a higher risk

of depressive symptoms during the COVID-19 pandemic (Juan et al., 2020). In a large-scale

survey of 10,511 HCWs (Koh et al., 2005), 49 percent reported social stigmatization, and 31

percent said family ostracism. Similar studies among nurses (187) during a MERS outbreak in

Korea indicated that stigma severely impacted nurses' mental health directly and indirectly
through stress (Park et al., 2018). Findings from a survey of 338 HCWs revealed that 20% (66 of

338) felt ostracized and rejected in their community because of their hospital work, and 9% (20

of 218) expressed reluctance to work or had contemplated quitting (Bai et al., 2004).
 Chapter 3
RESEARCH METHODOLOGY

This chapter will explain how the researcher will collect the data and information used in

the study. The research method, population and sampling technique, description of the

respondents, data gathering procedure, and research instrument are all included.

Research Design

The researcher uses the quantitative method, which, according to Babbie (2010),

emphasizes objective measurements and statistical, mathematical, or numerical analysis of data

obtained by-polls, questionnaires, and surveys and manipulating pre-existing statistical data

using computational techniques. In this way, the researcher will collect numerical data to achieve

the study’s objectives.

Furthermore, the descriptive research design is used to conduct this study. As cited by

McCombes (2019), descriptive research seeks to describe a group, condition, or phenomena

systematically and accurately. It answers questions about what, where, when, and how. Inline, it

aims to describe the impact of COVID-19 on the psychological health of frontline works in

Louisana, Laguna.

Respondents of the Study

Inclusion criteria are living in Lousiana, Laguna, during the current COVID- 19 crisis

and being at least 18 years old. Exclusion criteria did not infect by COVID-19 and not a frontline

worker. These are stated in the informed consent that is presented before the questionnaire.
Research Sampling

The researchers will use snowball sampling to participate in this study swiftly and

efficiently. It's a quick and easy sampling procedure. When accessing participants with the

desired features is difficult, this strategy is used. Existing research subjects recruit future study

subjects from their connections utilizing this strategy. Sampling will continue until the data is

saturated.

The researcher used 100 respondents to represent the entire population in the study. The

respondents will be chosen based on the study's objectives. Following the identification of

respondents, the questionnaires will be provided with an online survey to collect the necessary

information.

Research Instrument

The researcher will construct and adapt the research instrument in a modified and

standardized checklist-type of questionnaire to answer the stated research problems.

Construction of Questionnaire. The researcher made questionnaires using google forms

to collect information needed for this study. The questionnaire will consist of three parts. The

first part is the demographic profile of the respondents. The second part is their broad experience

as frontline workers. After that, psychological health standardized test will follow. After that is

the impact of COVID-19 on their psychological health, most of the items will be answered

objectively by using the Likert Scale. 

Validation. The questionnaire will be checked and reviewed by experts in the field of

research and selected individuals who have enough knowledge on psychological health.
 Administration. The researchers used Google Forms to distribute the questionnaires in

administering questionnaires. Also, they contacted the respondents via social media platforms

and clarified the terms and conditions regarding their participation.

Retrieval. After the respondents answered the questionnaires, the data gathered

underwent evaluation, tabulation, and interpretation.

Data Gathering Procedure

The researcher dedicated a significant amount of time, effort, and teamwork to creating

their respondents' questionnaire and converting it into Google Forms. After that, the researcher

prepared a request letter for the approval of the questionnaires.

The conduct of the study began by securing permission from the Adviser and other panel

members, and the Municipal Mayor. After the signing of request letters, the behavior of the

survey with the respondents started. Respondents were solicited and treated with the application

of selected and appropriate statistical tools.

The researchers used Google Forms to distribute the questionnaires in administering

questionnaires. Also, they contacted the respondents via social media platforms and clarified the

terms and conditions regarding their participation. After the respondents answered the

questionnaires, the data gathered underwent evaluation, tabulation, and interpretation.

Statistical Treatment of Data

The statistical treatment of data used in this study are the following:

1. Frequency. It's a statistical method for displaying the number of times the respondents

selected each answer. The symbol of frequency is denoted as f.

 2. Percentage. It is defined as any proportion about a whole. In percentage, a whole always

has a value of a hundred percent. Rate is calculated by dividing a certain number of parts

into 100 parts. The symbol denotes the rat::

f
Formula: %= × 100
n

Where:

% = Percentage

f = Frequency

n = Total number of Sampling Population

3. Weighted Mean. A weighted mean is a similar concept to an average. Rather than each

data point contributing evenly to the final standard, specific data points add more

"weight." Weighted means are prevalent, particularly when studying populations.

Σwx
Formula:
Σw