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.

Status quo and influencing factors of post-traumatic stress disorder among front-line anti-epidemic medical staff

[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.

The Effect of Recombinant Human Interferon Alpha Nasal Drops to Prevent COVID-19 Pneumonia for Medical Staff in an Epidemic Area.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as Coronavirus disease-2019 (COVID-19), has caused the sixth world's public health emergency. Healthcare staff, as the frontline population fighting the pandemic, are exposed to a high risk of infection. Therefore, developing a protective intervention for medical staff is of significant importance. OBJECTIVE: The aim of the study was to explore the effectiveness and safety of recombinant human interferon alpha (rhIFN-α) nasal drops for the prevention of coronavirus disease 2019 (COVID-19) through administering it to medical staff. METHODS: This was a prospective open-label clinical trial with parallel intervention assignment conducted on 2944 medical staff including both doctors and nurses from Taihe Hospital, Shiyan City, Hubei Province, China from January 21, 2020 to July 30, 2020. The participants were bifurcated into two groups of low risk and high risk groups according to the level of direct exposure to COVID-19 patients. The individuals of the low-risk group received rhIFN-α nasal drops for one month in addition to first level protection, and the high-risk group received a combination of rhIFN-α nasal drops coupled with thymosin-α1 with either second or third-level protection protocol. Moreover, the new-outset of COVID-19 pneumonia diagnosed by chest computed tomography (CT), after thirty days, was the primary outcome. The adverse reactions were recorded in all participants. RESULTS: 2415 of 2944 individuals belonged to the low-risk group, while 529 to the high-risk group. There was no COVID-19 pneumonia in either of the group after thirty days. The pulmonary CT scans were negative for COVID-19 pneumonia in both the groups with no new clinical symptoms. No serious adverse event was observed during the course of the intervention. CONCLUSION: The rhIFN-α nasal drops along with augmented safeguards based on standard physical isolation could effectively protect medical staff against COVID-19 pneumonia.