ABSTRACT
OBJECTIVE: There is an increasing amount of evidence exploring the adverse effects of perceived stress or anxiety and depression independently on sleep quality during the COVID-19 outbreak, although the underlying mechanisms are unclear. The aim of the current study was to explore the role of anxiety and depression as a potential mediator between perceived stress and sleep quality among health care workers. METHODS: Data were collected through an online survey using the snowball sampling method and comprised 588 current health care workers in Zhejiang and Hubei provinces, China, from February to March 2020. We administered the Sleep Quality Questionnaire (SQQ), the Perceived Stress Scale (PSS-10), the Patient Health Questionnaire (PHQ-4) and the sociodemographic characteristics and COVID-19-related characteristics questionnaire. Structural equation modelling (SEM) was used to examine the direct and indirect relationships between perceived stress, anxiety and depression, and sleep quality. RESULTS: The average scores for sleep quality and perceived stress were 16.01 (95% CI [15.40, 16.57]) and 15.46 (95% CI [15.05, 15.87]), respectively. The positive rates of anxiety and depression symptom tests were 9.86% and 10.37%, respectively. The SEM results indicated that the original relationship between perceived stress and sleep quality was beta = 0.52 (P < 0.001) and reduced to beta = 0.25 (P = 0.045) while introducing anxiety and depression as mediating variables. Perceived stress was positively associated with anxiety and depression (beta = 0.78, P = 0.014), and anxiety and depression were positively associated with sleep quality (beta = 0.42, P < 0.001). CONCLUSION: Poor sleep quality and high perceived stress were common during the COVID-19 crisis. Reducing perceived stress could help reduce anxiety and depression symptoms, thereby improving sleep quality among health care workers. In an attempt to promote psychological resources, we should perhaps take multiple measures, including personal tailored intervention and organizational humanistic concern.
ABSTRACT
AIM: This research aimed to shed light on the relationship between the sociodemographic characteristics of front-line medical workers and their anxiety and depression, to provide the basis and reference for targeted mental health education and for relevant departments to formulate appropriate policies during the COVID-19 outbreak. METHODS: This study adopted a convenient sampling method and examined the psychological status of 150 front-line medical workers from Zhejiang Province with questionnaire surveys using the Hamilton Anxiety and Depression Scale. RESULTS: The participants had severe anxiety and depression; the top three items under the category of anxiety were genitourinary symptoms, behavior at interview, and respiratory symptoms, whereas the top three items under depression were feelings of guilt, weight loss, and retardation. Among all personal data, the following factors influenced anxiety, in decreasing order: degree of suspicion of being infected when showing associated symptoms, degree of fear of yourself and your family being infected, and the affiliated hospital (p < .05). As for depression, the factors were the degree of suspicion of being infected when showing associated symptoms and the degree of fear of yourself and your family being infected (p < .05). CONCLUSION: This study revealed that front-line medical staff presented symptoms of anxiety and depression when dealing with the COVID-19 outbreak and the factors influencing their psychological stress. Guiding policies and psychological interventions is crucial to maintaining their psychological well-being. Different measures may be implemented to solve this problem.