Bibliographic record
Abstract
Background: The COVID-19 pandemic has resulted in a high level of mental health problems for the population worldwide including healthcare workers. It highlighted the need to better understand levels and determinants of mental health problems among dental professionals. Several studies have assessed these mental health problems using generic and specific measures of anxiety. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a self-report measure developed to assess maladaptive forms of coping with COVID-19. Prior to our study, its validation has been limited. Objectives: 1) validate the COVID-19 Anxiety Syndrome Scale (C-19ASS) questionnaire against the Generalised Anxiety Disorder-7 (GAD-7) tool in a population of dentists in Canada; 2) describe the anxiety levels among dentists in Canada during the COVID-19 pandemic and how they varied over time; 3) estimate the differences in the anxiety levels in dentists in Canada following vaccination against SARS-CoV2; 4) To estimate the differences in the anxiety levels in dentists in Canada by age, sex and practice type; and 5) describe the economic impact of the COVID-19 pandemic and the anxiety due to this impact among dentists in Canada. Methods: To address the aims of this study, data were used from a prospective cohort study conducted to estimate the incidence rate of COVID-19 among licensed dentists in Canada over a 12-month study period. To evaluate the validity of the C-19ASS, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. We used Cronbach’s alpha to evaluate internal reliability and compared scores with the GAD-7 scale for external validity. To address the remaining aims, mixed effects ordinal logistic regression models were used. Results: Concerning the validity of the C-19ASS, the EFA revealed a 2-factor solution that explained 47% of the total variance. The CFA showed a good model fit on the data in both English and French languages. The Cronbach’s alpha indicated acceptable levels of reliability. Furthermore, the C-19ASS showed excellent divergent validity from the Generalized Anxiety Disorder-7 (GAD-7) scale. Regarding anxiety levels over time, the odds of being in a more severe category of anxiety were reduced by 26% (OR 0.74, 95% C.I. 0.72-0.76) with every 30-day increase in the follow-up time. The odds of being in a more severe category of anxiety increased by 20% (Odds Ratio =1.20, 95% C.I.= 1.12-1.27) with each 10,000 COVID-19 case increase in the dentists’ work province during the 14 days prior to data collection. Age, sex and practice type were significantly associated with COVID-19 related anxiety in dentists. Reduced revenue collection, the ability to offer limited dental treatments, reduced number of patients and increased costs involved in practice were the major practice-related factors that led to increased anxiety in dentists. With every 11-year age increase, the odds of the dentists having more severe economic burden increased by 4% (OR 1.04, 95% CI 1.02 –1.05). The odds for the dentists in Ontario having higher economic burden were increased by 97% (OR 1.97, 95% CI 0.96 – 4.0) as compared to the Atlantic provinces. Specialists had 42% reduced odds for severe economic burden compared to general dentists (OR 0.58, 95% CI 0.31- 1.09). The odds for dental practice-owners having more severe economic burden were increased by 59% (OR 1.59, 95% CI 0.99 – 2.57) compared to non-owners. Conclusions: The C-19ASS is valid and reliable instrument to measure COVID-19 related anxiety in English and French among Canadian dentists. It is sensitive to change over time and with external anxiety stimuli. COVID-19 related anxiety among dentists was associated with age, sex and practice type. Age, sex, province, dental practice ownership and practice-related factors were associated with their anxiety levels. Their economic burden was associated with age, province, practice type and dental practice ownership
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".