Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chairperson; Jane M. Georges, PhD, RN, Committee Member; My Hanh (Theresa) Nguyen, PhD, PMHNP, Committee Member.


Anxiety, Agitation, Adults, COVID-19


Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through December 31, 2020. Patients without COVID-19 tests and prisoners were excluded. Descriptive and inferential statistics were utilized to analyzed the data.

Findings: The final sample comprised of 183 adults 18 years of age and older with a COVID-19 tests at the start of the COVID-19 lockdown. Gender was evenly distributed between males (50.8%, n = 93) and females (49.2%, n = 90); average age was 43 years (SD = 17.20), and 23.5% (n = 43) were married. The majority of patients self-identified as White (56.8%), followed by Hispanic (26.2%). Patients with a current COVID-19 diagnosis on admission (χ2= 2.48, p = .493), or a history of COVID-19 infection (χ2= 1.98, p = .592) were not significantly associated with anxiety-agitation level. Binomial logistic regression identified factors that increased the likelihood of participants reporting (1) anxiety versus agitation. Patients diagnosed with alcohol abuse, and chief complaint of mood or anxiety disorder were 2.06 times (p = .044), 2.87 (p = .002) and 2.17 (p = .028) more likely to meet criteria for anxiety. Binomial logistic regression also identified factors that increased the likelihood of participants reporting (2) mild agitation versus moderate-severe agitation. Patients who were single were 3.30 times more likely to meet criteria for moderate-severe agitation (p = .030); those diagnosed with chief complaint schizophrenia/psychotic disorder were 3.76 times more likely to demonstrate moderate-severe agitation (p = .024); and those diagnosed chief complaint with homicidal/suicidal ideation were 4 times more likely to demonstrate mild agitation (p = .006).

Implications for Research: Nurses may perform qualitative research in the management of the agitated patient during a public health crisis.

Document Type

Dissertation: Open Access



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