ABSTRACT
Aims and objectives: This study demonstrates the impact of the full liberalization of COVID-19 on the psychological issues and the prevalence rate and associated factors of depressive symptoms, anxiety, and insomnia among frontline nurses. Background: It has been demonstrated that frontline nurses fighting against the epidemic were under great psychological stress. However, there is a lack of studies assessing the prevalence rates of anxiety, depression, and insomnia among frontline nurses after the full liberalization of COVID-19 in China. Design: Cross-sectional study. Methods: Of 1766 frontline nurses were invited to complete a self-reported online questionnaire by convenience sampling. The survey included six main sections: the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, the Insomnia Severity Index, the Perceived Stress Scale, sociodemographic information, and work information. Multiple logistic regression analyses were applied to identify the potential risk factors for psychological issues. Reporting of this research according to the STROBE checklist. Results: 90.83% of frontline nurses were infected with COVID-19, and 33.64% had to work while infected COVID-19. The overall prevalence of depressive symptoms, anxiety and insomnia among frontline nurses was 69.20%, 62.51%, and 76.78%, respectively. Multiple logistic analyses revealed that job satisfaction, attitude toward the current pandemic management, and perceived stress were associated with depressive symptoms, anxiety, and insomnia. Conclusions: This study demonstrated that the full liberalization of COVID-19 had a significant psychological impact on frontline nurses. Early detection of mental health issues and preventive and promotive interventions should be implemented according to the associated factors to improve mental health of nurses. Relevance to clinical practice: This study highlighted that nurses were suffering from varying degrees of depressive symptoms, anxiety, and insomnia, which needed early screening and preventive and promotive interventions for preventing a more serious psychological impact on frontline nurses.