Immediate psychological impact on nurses working at 42 government-designated hospitals during COVID-19 outbreak in China: A cross-sectional study

Abstract

Highlights A multicenter, cross-sectional survey was conducted to assess the immediate psychological impact of COVID-19 on frontline nurses. Psychological morbidities as depression, anxiety, somatization, as well as suicidal ideation were measured. The risk and protective factors of the psychological morbidities and suicidal ideation were identified. Effective risk communication and mental health interventions for targeted segments should be implemented since the initial phase of the outbreak.

The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review

“…(2020) ( Du et al., 2020 ) China Cross-sectional COVID-19 134 health care workers (60 from Wuhan and 74 from outside Wuhan) 5 days, February 2020 PSS and BDI-II Elbay et al. (2020) ( Elbay et al., 2020 ) Turkey Cross-sectional COVID-19 442 physicians 5 days, March 2020 DAS-21 Garcia-Fernandez (2020) ( García-Fernández et al., 2020 ) Spain Cross-sectional COVID-19 781 health care workers (385 physicians, 233 nurses and 164 other professionals) 8 days, March to April 2020 HARS, BDI and ASDI Hong et al. (2020) ( Hong et al., 2020 ) China Cross-sectional COVID-19 4,692 nurses 7 days, February 2020 PHQ-9, GAD-7 and PHQ-15 Hu et al.…”

“…The most common psychiatric disorders diagnosed were post-trauma stress syndrome (PTSS), depression and anxiety, as assessed in 32 studies ( Ji et al., 2017 ; Wu et al., 2009 ; Chan and Huak, 2004 ; Rossi et al., 2020 ; García-Fernández et al., 2020 ; Liu et al., 2020a ; Kang et al., 2020 ; Zhang et al., 2020b ; Mo et al. ; Zhou et al., 2020 ; Xiaoming et al., 2020 ; Wilson et al., 2020 ; Wasim et al., 2020 ; Wańkowicz et al., 2020 ; Wang et al., 2020 ; Tian et al., 2020 ; Shechter et al., 2020 ; Sandesh et al., 2020 ; Pouralizadeh et al., 2020 ; Liu et al., 2020b ; Lin et al., 2020 ; Korkmaz et al., 2020 ; Juan et al., 2020 ; Hu et al., 2020 ; Hong et al., 2020 ; Elbay et al., 2020 ; Du et al., 2020 ; Di Tella et al., 2020 ; Chew et al., 2020 ; Cai et al., 2020b ; An et al., 2020 ; Bai et al., 2004 ). In the COVID-19 pandemic, somatization was reported frequently ( Xiaoming et al., 2020 ; Juan et al., 2020 ; Hong et al., 2020 ) with 42.7% (2,005 of 4,692) of frontline nurses identifying somatic symptoms ( Hong et al., 2020 ), particularly headaches, throat pain and lethargy, which were significantly associated with psychological outcomes ( Chew et al., 2020 ).…”

“…; Zhou et al., 2020 ; Xiaoming et al., 2020 ; Wilson et al., 2020 ; Wasim et al., 2020 ; Wańkowicz et al., 2020 ; Wang et al., 2020 ; Tian et al., 2020 ; Shechter et al., 2020 ; Sandesh et al., 2020 ; Pouralizadeh et al., 2020 ; Liu et al., 2020b ; Lin et al., 2020 ; Korkmaz et al., 2020 ; Juan et al., 2020 ; Hu et al., 2020 ; Hong et al., 2020 ; Elbay et al., 2020 ; Du et al., 2020 ; Di Tella et al., 2020 ; Chew et al., 2020 ; Cai et al., 2020b ; An et al., 2020 ; Bai et al., 2004 ). In the COVID-19 pandemic, somatization was reported frequently ( Xiaoming et al., 2020 ; Juan et al., 2020 ; Hong et al., 2020 ) with 42.7% (2,005 of 4,692) of frontline nurses identifying somatic symptoms ( Hong et al., 2020 ), particularly headaches, throat pain and lethargy, which were significantly associated with psychological outcomes ( Chew et al., 2020 ). Sleep disorders including insomnia were also frequently identified ( Wasim et al., 2020 ; Wańkowicz et al., 2020 ; Tian et al., 2020 ; Lin et al., 2020 ; Chew et al., 2020 ; Cai et al., 2020b ).…”

“…Female nurses with close contact to COVID-19 patients appeared to have the highest mental health risks ( Pouralizadeh et al., 2020 ), ( Romero et al., 2020 ; Elbay et al., 2020 ) However, it is important to note that most studies included predominantly female participants, especially nurses, with only one study suggesting higher stress levels amongst males ( Liu et al., 2020b ). Specifically, being female conferred greater risks for depression, anxiety and higher levels of stress ( Xiaoming et al., 2020 ; Pouralizadeh et al., 2020 ; Elbay et al., 2020 ; Du et al., 2020 ; Di Tella et al., 2020 ; Babore et al., 2020 ) Suicidal ideation was identified amongst 6.5% (306 of 4,692) of HCWs with lower self-perceived health status listed as an additional risk factor ( Xiaoming et al., 2020 ; Hong et al., 2020 ). At the early stages of the COVID-19 pandemic, a Wuhan study ( Kang et al., 2020 ) found that 34.4% (342 of 994) of medical and nursing staff had mild mental health disturbances while 6.2% (62) had severe disturbances, while in another study ( Cai et al., 2020a ) of 1,521 Chinese HCWs 14.1% had psychological abnormalities.…”

“…A major theme was anxiety, especially across most of the COVID-19 studies ( Lai et al., 2020 ; Cai et al., 2020a ; Rossi et al., 2020 ; García-Fernández et al., 2020 ; Liu et al., 2020a ; Zhang et al., 2020b ; Mo et al. ; Lu et al., 2020 ; Xiaoming et al., 2020 ; Wilson et al., 2020 ; Wasim et al., 2020 ; Wańkowicz et al., 2020 ; Wang et al., 2020 ; Tian et al., 2020 ; Shechter et al., 2020 ; Sandesh et al., 2020 ; Pouralizadeh et al., 2020 ; Liu et al., 2020b ; Lin et al., 2020 ; Korkmaz et al., 2020 ; Juan et al., 2020 ; Hu et al., 2020 ; Hong et al., 2020 ; Elbay et al., 2020 ; Du et al., 2020 ; Di Tella et al., 2020 ; Chew et al., 2020 ; Cai et al., 2020b ). In a Chinese study ( Liu et al., 2020a ) the most important factor in HCWs with high anxiety was being suspected of having COVID-19 infection when compared to those who were not suspected of infection.…”