Status quo and influencing factors of post-traumatic stress disorder among front-line anti-epidemic medical staff / 环境与职业医学

Background Front-line medical staff are an important group in fighting against Coronavirus Disease 2019 (COVID-19), and their mental health should not be ignored. Objective This study investigates the current situation and influencing factors of post-traumatic stress disorder (PTSD) among front-line anti-epidemic medical staff during COVID-19 epidemic. Methods Medical staff who had participated in fighting against the COVID-19 epidemic wereselected from three grade III Class A hospitals and four grade II Class A hospitals in a city of Hubei Province by convenient sampling method in May 2020. The survey was conducted online using the Post-traumatic Stress Checklist-Civilian Version (PCL-C) as the main survey tool to investigate current situation and characteristics of PTSD among these participants. A total of 1120 questionnaires were collected, of which 1071 were valid, and the effective rate was 95.6%. Results Of the 1071 participants, the average age was (32.59±5.21) years; the ratio of male to female was 1: 5.02; the ratio of doctor to nurse was 1:5.8; nearly 70% participants came from grade III Class A hospitals; married participants accounted for 75.4%; most of them held a bachelor degree or above (86.5%); members of the Communist Party of China (CPC) accounted for 22.9%; 50.9% had junior titles; the working years were mainly 5−10 years (42.8%); more than 80.0% participants volunteered to join the front-line fight; 95.1% participants received family support; 43.0% participated in rescue missions; 78.1% participants fought the epidemic in their own hospitals; more than 60% participants considered the workload was greater than before; 34.4% participants fought in the front-line for 2−4 weeks, and 23.5% participants did for more than 6 weeks. There were 111 cases of positive PTSD syndromes (PCL-C total score ≥38) with an overall positive rate of 10.4%, and the scores of reexperience [1.40 (1.00, 1.80)] and hypervigilance [1.40 (1.00, 2.00)] were higher than the score of avoidance [1.14 (1.00, 2.57)]. The results of univariate analysis revealed that PTSD occurred differently among participants grouped by age, political affiliation, working years, anti-epidemic activities location, accumulated working hours in fighting against COVID-19, having child parenting duty, voluntariness, family support, whether family members participated in front-line activities, and rescue mission assignment (P<0.05). The results of logistic regression analysis showed that the incidence rates of reporting PTSD syndromes in medical personnel aged 31−40 years (OR=0.346, 95%CI: 0.164−0.730) and aged 41 years and above (OR=0.513, 95%CI: 0.319-0.823) were lower than that in those aged 20−30 years; the incidence rates of reporting PTSD syndromes in medical staff who were CPC members (OR=0.499, 95%CI: 0.274−0.909), volunteered to participate (OR=0.584, 95%CI: 0.360−0.945), and received family support (OR=0.453, 95%CI: 0.222-0.921) were lower than those did not (P<0.05); the incidence rates of reporting PTSD syndromes among medical workers who had child parenting duty (OR=2.372, 95%CI: 1.392−4.042), whose family members participated in front-line activities (OR=1.709, 95%CI: 1.135−2.575), and who participated in rescue missions (OR=1.705, 95%CI: 1.133-2.565) were higher than those who did not (P<0.05). Conclusion The positive PTSD syndrome rate is 10.4% in the front-line anti-epidemic medical staff. Age, political affiliation, voluntariness, family support, having child parenting duty, with a family members participating in the fight, and rescue mission assignment are the influencing factors of PTSD.

Associations between childhood abuse experience,parentchild relationship and non-suicidal self-injury in middle school students / 中国学校卫生

Objective@#The aim of this paper is to understand the associations between childhood abuse experience,parent-child relationship and non-suicidal self-injury (NSSI) in middle school students.@*Methods@#Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen,Zhengzhou,Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on childhood abuse exposure,parent-child relationship and NSSI.@*Results@#The prevalence of NSSI was 14.81%,while it was higher among male students (15.95%) than female students (13.64%) (χ2=15.29,P<0.01). A multivariate Logistic regression models showed that the moderate and high level of childhood abuse (OR=2.23,3.27) and the low level of parents-child relationship (OR=1.80,1.36) were associated with high NSSI detection rate among middle school students (P<0.01). In each group of childhood abuse,low level of father-child relationship was associated with high NSSI detection rate among middle school students (OR=1.36,1.34,1.56,P<0.05). In the group with high level of childhood abuse experience,low level of mother-child relationship was associated with high NSSI detection rate (OR=1.20,P<0.05). Among male students,those with high level of childhood abuse experience,low level of parentchild relationship were associated with high NSSI detection rate (OR=1.46,1.35,P<0.01); regardless of the level of childhood abuse experience,low level of father-daughter relationship was associated with NSSI detection rate (OR=1.64,1.54,1.68,P<0.01) among females.@*Conclusion@#Childhood abuse experience and poor parent-child relationship are associated with NSSI in middle school students, with distinct gender difference. Prevention of childhood abuse and the improvement of parent-child relationship are beneficial to the prevention and control of NSSI.