The Psychological Effect of COVID-19 on Home-Quarantined Nursing Students in China.

Coronavirus disease 2019 (COVID-19) has significantly caused socioeconomic impacts. However, little is known about the psychological effect of COVID-19 on home-quarantined nursing students. The present study aimed to identify the prevalence and major determinants of anxiety, depression and post-traumatic stress symptoms (PTSS) in Chinese nursing students during the COVID-19 pandemic quarantine period. An online survey was conducted on a sample of 6,348 home-quarantined nursing students. Mental health status was assessed by the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9) and the Post Traumatic Stress Disorder Check List-Civilian version (PCL-C), respectively. Logistic regression analyses were performed to identify risk factors of anxiety, depression and PTSS. The overall prevalence of anxiety was 34.97%, and the rates of "mild," "moderate," and "severe" anxiety were 26.24, 7.04, and 1.69%, respectively. Depression was detected in 40.22% of the nursing students, and the prevalence of "mild," "moderate," "moderately severe," and "severe" depression was 27.87, 7.18, 4.08, and 1.09%, respectively. The overall prevalence of PTSS was 14.97%, with the prevalence of "mild" and "moderate-to-severe" PTSS reported at 7.04 and 7.93%, respectively. Male gender and insufficient social support were common risk factors for anxiety, depression and PTSS. In conclusion, about one-third, two-fifths, and one-seventh of Chinese nursing students had anxiety, depression and PTSS during the period of home quarantine, respectively. Timely and appropriate psychological interventions for nursing students should be implemented to reduce the psychological harm caused by COVID-19 pandemic.

The relationship between personal-job fit and physical and mental health among medical staff during the two years after COVID-19 pandemic: Emotional labor and burnout as mediators.

BACKGROUND: In the context of the Corona Virus Disease 2019 (COVID-19) pandemic, research on personal-job fit and physical and mental health was inadequate. We aimed to explore the relationship between personal-job fit and physical and mental health among medical staff during the two years after COVID-19 pandemic and verify emotional labor and burnout as mediators. METHODS: A total of 2868 medical staff from two general hospitals, were included from July 3 to July 27, 2022, in Wuhan, China. SPSS was used for statistical description, and AMOS was used for structural equation modeling (SEM) to analyze the mediating effect of emotional labor and burnout. RESULTS: In the SEM, the total effect of personal-job fit on physical and mental health was significant (ß = 0.855, 95 % CI: 0.748-0.972). The mediating effect of surface acting between personal-job fit and physical and mental health was significant (ß = 0.078, 95 % CI: 0.053-0.110). The mediating effect of burnout was significant (ß = 0.220, 95 % CI: 0.175-0.274), but the mediating effect of deep acting was not significant (ß = 0.006, 95 % CI: -0.013-0.025). The chain mediating effect of surface acting or deep acting and burnout between personal-job fit and physical and mental health was significant (ß = 0.082, 95 % CI: 0.059-0.108; ß = 0.049, 95 % CI: 0.038-0.063). LIMITATIONS: Owing to the cross-sectional study, causal relationship, and direction of effects among variables could not be determined. CONCLUSIONS: Personal-job fit has significant direct and indirect effects on physical and mental health. Monitoring and intervening in personal-job fit, emotional labor, and burnout might be effective ways to promoting physical and mental health among medical staff during the COVID-19 pandemic.

Burnout and post-traumatic stress disorder symptoms among medical staff two years after the COVID-19 pandemic in Wuhan, China: Social support and resilience as mediators.

BACKGROUND: Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience. METHODS: A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms. RESULTS: Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect). LIMITATIONS: Owing to the cross-sectional design, only clues to causal explanations can be provided. CONCLUSIONS: Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.

Posttraumatic stress disorder and depression of Chinese medical staff after 2 years of COVID-19: A multicenter study.

BACKGROUND: In December 2019, coronavirus disease (COVID-19) was first reported in Wuhan, China, and has had a negative psychological impact on the medical staff. However, the long-term psychological effects of COVID-19 were still unclear. We aimed to assess the posttraumatic stress disorder (PTSD) and depression among medical staff 2 years after COVID-19 pandemic in Wuhan, China. METHODS: We conducted a multicenter study in five general hospitals in Wuhan, China. PTSD was assessed using the PTSD Checklist-5. Depression was measured by the Center for Epidemiologic Studies Depression Scale. Multivariate adjusted logistic regression models were used to evaluate the association among demographic variables, depressive indicators, and PTSD. RESULTS: In a sample of 1795 medical staff, 295 (16.40%) participants reported PTSD and 329 (18.30%) reported depression. After multivariate adjusted logistic regression analyses, participants involved in COVID-19 clinical work, unsafe working environment, poor doctor-patient relationship, unhealth status, work dissatisfaction, and low family support were at a high risk for PTSD and depression 2 years after the outbreak of COVID-19 pandemic. CONCLUSIONS: Although it has been more than 2 years after the COVID-19 pandemic outbreak, the mental health of medical staff remains a concern. In particular, medical staff involved in the clinical care of COVID-19 patients showed a higher risk of PTSD and depression 2 years after the COVID-19 pandemic. This study may provide some useful suggestions for psychological interventions for medical staff.

Prevalence and Related Factors of Anxiety Among University Teachers 1 Year After the COVID-19 Pandemic Outbreak in China: A Multicenter Study.

Objectives: This study aimed to evaluate the prevalence of anxiety among university teachers 1 year after the onset of the coronavirus disease 2019 (COVID-19) pandemic and provide empirical evidence of psychological intervention. Methods: A multicenter study was conducted to examine the prevalence of anxiety among 10,302 teachers in 21 Chinese universities from February 12 to April 23, 2021. The generalized Anxiety Disorder 7-item Scale (GAD-7) was used to assess symptoms of anxiety. Multivariate logistic regression models were used to analyze the relationship between potential influence and anxiety symptoms. Results: The overall prevalence of anxiety was 40.0% 1 year after the onset of the COVID-19 pandemic, which was found to be higher in women than in men (41.32% vs. 38.22%; p < 0.0001). The multivariate logistic regression showed that being the female (OR = 1.207; 95%CI: 1.103-1.318), age ≥60 years (OR = 2.004; 95%CI: 1.128-3.560), being married (OR = 1.319; 95%CI: 1.150-1.513), and poor family economic status (OR = 1.580; 95%CI: 1.321-1.891) were significantly associated with anxiety. Participants with moderate, slight, or no impact of COVID-19 on life (OR for moderate, 0.557; 95%CI, 0.508-0.611; OR for slight/no, 0.377; 95%CI, 0.323-0.439) showed a reduced risk of anxiety compared to those who reported a significant effect. Conclusions: Symptoms of anxiety were found in about two-fifths of Chinese university teachers 1 year after the outbreak of the COVID-19 pandemic. Our findings suggest that the government should improve the dynamic tracking of mental health and adopt long-term intervention strategies.

Burnout Among Medical Staff 1 Year After the Beginning of the Major Public Health Emergency in Wuhan, China

Objectives Wuhan is the city where coronavirus disease (COVID-19) was first reported and developed into a pandemic. However, the impact of the prolonged COVID-19 pandemic on medical staff burnout remains limited. We aimed to identify the prevalence and major determinants of burnout among medical staff 1 year after the beginning of the COVID-19 pandemic in Wuhan, China. Materials and Methods A total of 1,602 medical staff from three hospitals in Wuhan, China, were included from November 1–28, 2021. Chi-square tests were conducted to compare the prevalence of burnout across groups based on sociodemographic and professional characteristics. A multivariate analysis was performed using a forward stepwise logistic regression model. Results Approximately 37.39% of the medical staff experienced burnout 1 year after COVID-19 pandemic. Emotional exhaustion (EE) was the most common symptom of burnout, with 1,422 (88.76%) participants reporting a severe EE. Burnout was associated with insufficient social support and “neutral” or “dissatisfied” patient-physician relationships. Respondents who participated in the care of COVID-19 patients had a higher risk of burnout symptoms than those who did not participate. In particular, mental resilience was negatively associated with burnout among the medical staff. Conclusion Nearly two-fifths of the participants had symptoms of burnout, with reduced personal accomplishment being the predominant symptom 1 year after COVID-19. Healthcare organizations should regularly measure and monitor burnout among the medical staff. In addition, creating positive work environments and improving the mental resilience of medical staff may be effective ways to reduce burnout.

Professional identity of Chinese nursing students during the COVID-19 pandemic outbreak: A nation-wide cross-sectional study.

Practicing in unprecedented working environment and fighting against the COVID-19 crisis influenced the image of nursing in the general population, as well as among nurses themselves. This study aimed to describe the sense of professional identity among Chinese nursing students during the COVID-19 outbreak and to explore the relationship between psychological resilience and the sense of professional identity in this cohort. A nationwide online cross-sectional survey was conducted. Nursing students were recruited from 18 Chinese universities. The 10-item Connor-Davidson resilience scale (CD-RISC-10) evaluated psychological resilience and professional identity was assessed by the Professional Identity Questionnaire for Nursing Students (PIQNS). A total of 6348 respondents had a moderate level of professional identity to nursing (average PIQNS score at 62.02 ± 12.02). About 86% of respondents attributed the response to the COVID-19 pandemic in elevating the nursing image. Psychological resilience was the strongest contributor to professional identity (ß = 0.371, P < 0.001). There was a high level of professional identity among Chinese nursing students during the COVID-19 crisis. Policy support and courses to enhance psychological resilience are critical to sustain professional identity among nursing students.

Mental health of college students during the COVID-19 epidemic in China.

OBJECTIVES: To assess the psychological status of college students in China during the COVID-19 outbreak, and offer some theoretical evidence for psychological intervention of college students. METHODS: An online survey was conducted from May 10, 2020 to June 10, 2020. Anxiety symptoms were measured by the Generalized Anxiety Disorder 7-Item Scale (GAD-7). Categorical data were reported as number and percentage, while continuous data were reported as mean ± SD. Multivariate logistic regression models were used to evaluate the association between different factors and anxiety symptoms. RESULTS: A total of 89,588 college students participated in the current study, among which 36,865 students (41.1%) reported anxiety symptoms. Multivariate logistic regression analysis revealed that the risk factors for anxiety symptoms included the age of 26-30 (OR=1.456), sophomore (OR=1.038), junior (OR=1.087) and senior grades (OR=1.161), a higher paternal education level (OR=1.055), low economic status (OR=1.520), and low social support (OR=1.542). CONCLUSIONS: About two-fifths of Chinese college students experienced anxiety symptoms during the COVID-19 epidemic. Timely and appropriate psychological interventions for college students should be implemented to reduce the psychological harm caused by COVID-19 epidemic.

Clinical Characteristics and Risk Factors for Disease Severity and Death in Patients With Coronavirus Disease 2019 in Wuhan, China.

Objective: To describe the clinical manifestations and outcomes of COVID-19, and explore the risk factors of deterioration and death of the disease. Methods: In this retrospective study, we collected data from 121 COVID-19 cases confirmed by RT-PCR and next-generation sequencing in Renmin Hospital of Wuhan University from January 30, 2019, to March 23, 2020, and conducted statistical analysis. Results: A total of 121 patients were included in our study, the median age was 65 years (IQR, 55.0-71.5 years), and 54.5% cases were men. Among those cases, 52 (43.0%) cases progressed to severe, and 14 (11.6%) died. Overall, the most common manifestations were fever (78.5%) and respiratory symptoms (77.7%), while neurological symptoms were found in only 9.9% of the patients. 70.2% of all the cases had comorbidities, including hypertension (40.5%) and diabetes (20.7%). On admission, cases usually show elevated levels of neutrophils (27.3%), D-dimer (72.6%), Interleukin-6 (35.2%), Interleukin-10 (64.4%), high-sensitivity C-reactive protein (82.6%), and lactate dehydrogenase (62.0%), and decreased levels of lymphocytes (66.9%), CD3 cells (67.2%), and CD4 cells (63.0%). The proportional hazard Cox models showed that the risk factors for severity progression and death included comorbidities (HR: 4.53, 95% CI: 1.78-11.55 and HR: 7.81, 95% CI: 1.02-59.86), leukocytosis (HR: 1.13; 95% CI: 1.05-1.22 and HR: 1.25, 95% CI: 1.10-1.42), neutrophilia (HR: 1.15, 95% CI: 1.07-1.13 and HR: 1.28, 95% CI: 1.13-1.46, and elevated LDH (HR: 1.14, 95% CI: 1.12-1.15 and HR: 1.11, 95% CI: 1.10-1.12). Elevated D-dimer (HR: 1.02, 95% CI: 1.01-1.03), IL-6 (HR: 1.01, 95% CI: 1.00-1.02) and IL-10 levels (HR: 1.04, 95% CI: 1.01-1.07) were also risk factors for the progression of disease severity. Meanwhile, lymphopenia and wake immune responses [e.g., lower CD3, CD4, or CD19 counts (all HR < 1)] were associated with disease deterioration and death. Conclusions: Severe cases and death of COVID-19 are associated with older age, comorbidities, organ dysfunction, lymphopenia, high cytokines, and weak immune responses.

Psychological health, sleep quality, and coping styles to stress facing the COVID-19 in Wuhan, China.

To understand Wuhan residents' psychological reactions to the COVID-19 epidemic and offer a reference point for interventions, an online questionnaire survey was conducted. It included the Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9), Athens Insomnia Scale, and Simplified Coping Style Questionnaire. Categorical data were reported as numbers and percentages. Multivariate logistic regression models were used to evaluate the association between demographic factors and anxiety, depression, sleep disorder, and passive coping style. A total of 1242 Wuhan residents investigated, 27.5% had anxiety, 29.3% had depression, 30.0% had a sleep disorder, and 29.8% had a passive response to COVID-19. Being female was the risk factor for anxiety (OR = 1.62) and sleep disorder (OR = 1.36); being married was associated with anxiety (OR = 1.75); having a monthly income between 1000 and 5000 CNY (OR = 1.44, OR = 1.83, OR = 2.61) or >5000 CNY (OR = 1.47, OR = 1.45, OR = 2.14) was a risk factor for anxiety, depression, and sleep disorder; not exercising (OR = 1.45, OR = 1.71, OR = 1. 85, OR = 1.71) was a common risk factor for anxiety, depression, sleep disorder, and passive coping style; and having a higher education level (bachelor's degree and above) (OR = 1.40) was associated with having a sleep disorder. Wuhan residents' psychological status and sleep quality were relatively poorer than they were before the COVID-19 epidemic; however, the rate of passive coping to stress was relatively higher.

Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China.

BACKGROUND: The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China. METHODS: Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020. OUTCOMES: A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD. INTERPRETATION: The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.