Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China

Abstract

<b><i>Background:</i></b> As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. <b><i>Objective:</i></b> During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. <b><i>Methods:</i></b> An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. <b><i>Results:</i></b> There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; <i>p</i> = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18–1.31; <i>p</i> < 0.01), depression (OR = 1.23; 95% CI 1.17–1.29; <i>p</i> < 0.01), somatization (OR = 1.20; 95% CI 1.14–1.25; <i>p</i> < 0.01), hostility (OR = 1.24; 95% CI 1.18–1.30; <i>p</i> < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34–1.66; <i>p</i> < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78–0.89; <i>p</i> < 0.01), subjective support (OR = 0.84; 95% CI 0.80–0.88; <i>p</i> < 0.01), utilization of support (OR = 0.80; 95% CI 0.72–0.88; <i>p</i> < 0.01), social support (OR = 0.90; 95% CI 0.87–0.93; <i>p</i> < 0.01), and global well-being (OR = 0.30; 95% CI 0.22–0.41; <i>p</i> < 0.01) were negatively associated. <b><i>Conclusions:</i></b> In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

The Role of Illness Behavior in the COVID-19 Pandemic

“…Varying degrees of worry severity have been described across several populations and subgroups, worry being more present in places where the largest number of confirmed COVID-19 cases was found, as well as among groups with greater social vulnerabilities [ 3 ]. Further, distress related to COVID-19 may have a substantial negative impact on the most vulnerable subgroups, such as healthcare workers, older people, psychiatric patients, as well as individuals at risk of developing mental disorders [ 3 , 4 , 5 ].…”

“…When environmental challenges exceed individual coping resources, allostatic overload ensues [ 22 ]. Comparably high levels of post-COVID-19 allostatic load were reported among medical and nonmedical workers in China [ 4 ], with psychological distress and dysfunctional illness behavior acting as risk factors for allostatic load. Conversely, COVID-19 illness-denying behaviors, particularly disregard of preventive measures, might be sustained by psychological reactance, a motivational force that leads individuals to fear loss of control [ 23 ], that was found to be associated with treatment nonadherence and resistance [ 24 , 25 ].…”

“…Conversely, COVID-19 illness-denying behaviors, particularly disregard of preventive measures, might be sustained by psychological reactance, a motivational force that leads individuals to fear loss of control [ 23 ], that was found to be associated with treatment nonadherence and resistance [ 24 , 25 ]. Greater clinical attention should thus be devoted to the individual's psychological characteristics that may lead to dysfunctional responses to the current pandemic [ 4 , 5 , 6 ].…”

Beurteilung des Infektionsrisikos durch SARS-CoV-2 für medizinisches Personal – Erkenntnisse aus der Praxis

“…Mit zunehmender Tragezeit kann dadurch psychischer Stress entstehen, der zu zunehmender Fehleranfälligkeit und damit Eigen- und Fremdgefährdung führen kann [ 22 ]. Im Rahmen der Tätigkeiten, in der Literatur aus anderen Ländern dargestellt in Ausnahmesituation der Triagenotwendigkeit, werden die Beschäftigten mit Situationen konfrontiert, die zu einer psychischen Belastung führen können [ 33 , 34 ]. Aufgrund der aktuell vorliegenden Lage ist zudem bei Angehörigen, Patienten und potenziellen Besuchern mit Angst- und Stressreaktionen zu rechnen.…”

Expert opinion in anxiety disorder: Corona-phobia, the new face of anxiety

“…The world is now facing the second wave of infection and the experts already worry for the third one. However, another wave has occurred in between and within the waves of infection; it is the wave of mental health problems [1,4] caused directly by the infection or by its secondary consequences.…”