Perceived stress and psychological disorders in healthcare professionals: a multiple chain mediating model of effort-reward imbalance and resilience.

Background: Healthcare professionals have shown more psychological disorders such as anxiety and depression due to the nature of work, which can cause job burnout, decrease the quality of medical services, and even endanger medical safety. The aim of the study is to explore the serial multiple mediating role of effort- reward imbalance and resilience between perceived stress and psychological disorders among healthcare professionals. Methods: A cross-sectional study was conducted in China from February to April 2023. A total of 2098 healthcare professionals at a tertiary general hospital was investigated by the following self-reported questionnaires: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), The Effort-Reward Imbalance (ERI), Healthcare professionals Resilience Scale (MSRS). Results: Anxiety and depression are interrelated (r = 0.362, p < 0.01), and they were positively related to perceived stress (r = 0.640/0.607, p < 0.01) and ERI (r = 0.422/0.383, p < 0.01), and negatively related to resilience (r = -0.343/-0.320, p < 0.01). After controlling demographic factors, the variance in anxiety and depression was explained by perceived stress was 37.7 and 35.0%. Bootstrap analyses examining the pathway of perceived stress-ERI-resilience-anxiety revealed significant direct effects [B = 0.560, 95%CI (0.528, 0.591)], as well as indirect effects mediated independently by ERI [B = 0.045, 95%CI (0.029, 0.060)], resilience [B = 0.031, 95%CI (0.017, 0.047)], or a combination of both [B = 0.004, 95%CI (0.002, 0.007)]. Similarly, in the path of perceived stress-ERI-resilience-anxiety-depression, significant direct effects were found [B = -0.310, 95%CI(0.265, 0.351)], along with indirect effects mediated individually by ERI [B = 0.033, 95%CI(0.013, 0.052)], resilience [B = 0.014, 95%CI (0.001, 0.028)], and anxiety [B = 0.218, 95%CI (0.190, 0.246)], or by both or three together (B = 0.032). Conclusion: This study proved the hypothesis that ERI and resilience played a mediating role in perceived stress and psychological disorders, revealed the potential mechanism of anxiety in stress and depression, and proposed a solution for perceived stress to psychological distress, which can provide a basis for the intervention of healthcare professionals in the face of mental health crisis.

Psychology, stress, insomnia, and resilience of medical staff in China during the COVID-19 policy opening: a cross-sectional survey.

Background: Since 8 January 2023 China has liberalized its control of COVID-19. In a short period of time, the infection rate of COVID-19 in China has risen rapidly, which has brought a heavy burden to medical staff. This study aimed to investigate the psychological status, stress, insomnia, effort-reward imbalance, resilience, and influencing factors of medical staff in China during the period of epidemic policy liberalization. Methods: This survey was conducted from 6 February to 27 March 2023 with non-random sampling. An online questionnaire survey was conducted using HADS, PSS-14, ISI, ERI, and the resilience assessment scale for medical staff. The levels of psychological, stress, insomnia, effort-reward imbalance, and resilience of medical staff during the pandemic policy opening period were measured. Results: A total of 2,038 valid questionnaires were collected. 68.5% and 53.9% of medical staff had different degrees of anxiety and depression, respectively. Excessive stress, insomnia, and high effort and low reward were 40.2%, 43.2%, and 14.2%, respectively. Gender, Profession, education level, and age are important factors that lead to anxiety and depression. Women, nurses, higher education, longer working years and hours, high effort, and low reward are risk factors for the above conditions. There was a certain correlation among the five scales, among which anxiety, depression, stress, insomnia, effort-reward imbalance, and other factors were positively correlated, while resilience was negatively correlated with these factors. Conclusion: This study found that anxiety, depression, stress, insomnia, and other psychological problems of medical staff in China during the policy opening period of COVID-19 were more serious than before. At the individual and organizational levels, it is necessary to improve the well-being of medical staff, optimize the allocation of human resources, and promote the mental health of medical staff with a focus on prevention and mitigation, with the entry point of improving resilience and preventing the effort-reward imbalance.

Hope and depression: the mediating role of social support and spiritual coping in advanced cancer patients.

BACKGROUND: Depression is the most common mental disorder in patients with advanced cancer, which may lead to poor prognosis and low survival rate. This study aims to explore the serial multiple mediating roles of social support and spiritual coping between hope and depression among patients with advanced cancer. METHODS: A cross-sectional study was conducted in China between May and August 2020. A total of 442 advanced cancer patients were investigated by the following self-reported questionnaires: Herth Hope Index (HHI), Spiritual Coping Questionnaire (SCQ, Chinese version), Social Support Rating Scale (SSRS), Hospital Anxiety and Depression Scale (HADS). RESULTS: Depression was negatively correlated with hope, social support, and positive spiritual coping (P < 0.01), and positively correlated with negative spiritual coping (P < 0.01). Hope explained 16.0% of the variance in depression. Bootstrap analyses of the hope--social support--positive spiritual coping--depression showed that there were direct [B = -0.220, 95%CI(- 0.354, - 0.072)] and indirect effects of hope on depression mediated solely by social support [B = -0.122, 95%CI(- 0.200, - 0.066)] and positive spiritual coping [B = -0.112, 95%CI(- 0.217,-0.025)], or by both together [B = -0.014, 95%CI(- 0.038,-0.003)]. Similarly, the hope--social support--negative spiritual coping--depression showed that there were direct [B = -0.302, 95%CI(- 0.404, - 0.190)] and indirect effects of hope on depression mediated solely by social support [B = -0.126, 95%CI(- 0.205, - 0.071)] and negative spiritual coping [B = -0.033, 95%CI(- 0.080,-0.002)], or by both together [B = -0.010, 95%CI(- 0.030,-0.001)]. CONCLUSIONS: This study proves the hypothesis that social support and spiritual coping play intermediary roles between hope and depression. Interventions established through hope, social support and spiritual coping can effectively prevent depression from occurring.