Prevalence of COVID-19 fear and its association with quality of life among fire service recruits after ceasing the dynamic zero-COVID policy in China

BackgroundAfter the Chinese government announced the end of the dynamic zero-COVID policy on January 8, 2023, the COVID-19 pandemic peaked. Frontline nursing staff are at high risk of infection transmission due to their frequent contact with COVID-19 patients. In addition, due to the ending of China’s dynamic zero-COVID policy, frontline nursing staff have grappled with increased workload, fatigue, and more. This study aimed to explore the prevalence of insomnia symptoms in frontline nursing staff and its influencing factors following the end of the policy.MethodsBetween January and February 2023, this study was conducted by the Wenjuanxing platform to survey frontline nursing staff in a hospital in Wuhu City, Anhui Province. All the nursing staff included in this study had a COVID-19 infection. The questionnaires included the Athens Insomnia Scale (AIS), PC-PTSD-5 Chinese Version Scale, the Fear of COVID-19 Scale, The 2-item Connor-Davidson Resilience Scale (CD-RISC-2) Scale, and the burden of COVID-19 Scale. Binary logistic regression methods were used to identify variables associated with insomnia symptoms.ResultsAmong the 694 frontline nursing staff, 74.5% (517/694) exhibited insomnia symptoms. Fear of COVID-19 (p < 0.001), the burden of COVID-19 (p < 0.05), PTSD (p < 0.001), and higher technical titles (p < 0.008) were highly correlated with insomnia symptoms in frontline nursing staff. Psychological resilience (p < 0.001) was a protective factor for insomnia symptoms among frontline nursing staff.ConclusionAfter ending China’s dynamic zero-COVID policy, the prevalence of insomnia symptoms among frontline nursing staff is generally higher. This study highlights the association between insomnia symptoms and PTSD, fear of COVID-19, COVID-19 burden, and resilience. Psychological assistance is needed for frontline nursing staff to prevent insomnia symptoms and protect the mental health of frontline nursing staff after the end of China’s dynamic zero-COVID policy.

Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of insomnia symptoms after ending China’s dynamic zero-COVID policy: a cross-sectional survey of frontline nursing staff in Chinese hospitals

Zhang,

Chi,

Liu

et al. 2024

“…Moreover, excessive activities and insomnia could increase the risk of fatigue ( 90 ). After ceasing the dynamic zero-COVID policy in China, fire service recruits remained prone to experience physical fatigue and depression ( 93 ), which might be partly due to ongoing rigorous physical training, strict isolation and a lack social support and recreational activities. Therefore, the occurrence and development of mental health problems, including physical fatigue and negative emotions persisted ( 94 ).…”

Section: Discussionmentioning

confidence: 99%

A network analysis of the interrelationships between depression, anxiety, insomnia and quality of life among fire service recruits

Liu,

Gui,

Chen

et al. 2024

Self Cite

BackgroundResearch on the mental health and quality of life (hereafter QOL) among fire service recruits after the end of the COVID-19 restrictions is lacking. This study explored the network structure of depression, anxiety and insomnia, and their interconnections with QOL among fire service recruits in the post-COVID-19 era.MethodsThis cross-sectional study used a consecutive sampling of fire service recruits across China. We measured the severity of depression, anxiety and insomnia symptoms, and overall QOL using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI) questionnaire, and World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. We estimated the most central symptoms using the centrality index of expected influence (EI), and the symptoms connecting depression, anxiety and insomnia symptoms using bridge EI.ResultsIn total, 1,560 fire service recruits participated in the study. The prevalence of depression (PHQ-9 ≥ 5) was 15.2% (95% CI: 13.5–17.1%), while the prevalence of anxiety (GAD-7 ≥ 5) was 11.2% (95% CI: 9.6–12.8%). GAD4 (“Trouble relaxing”) had the highest EI in the whole network model, followed by ISI5 (“Interference with daytime functioning”) and GAD6 (“Irritability”). In contrast, PHQ4 (“Fatigue”) had the highest bridge EI values in the network, followed by GAD4 (“Trouble relaxing”) and ISI5 (“Interference with daytime functioning”). Additionally, ISI4 “Sleep dissatisfaction” (average edge weight = −1.335), which was the central symptom with the highest intensity value, had the strongest negative correlation with QOL.ConclusionDepression and anxiety were important mental health issues to address among fire service recruits in the post-COVID-19 era in China. Targeting central and bridge symptoms identified in network analysis could help address depression and anxiety among fire service recruits in the post-COVID-19 era.

“…Notably, the media's role in amplifying negative information during a pandemic, as Bagus et al (6) highlighted, could contribute to mass over-concern among the population (6). While previous studies focused on COVID-19 panic under restrictive measures (7,8), some scholars have observed an increase in COVID-19 over-concern when the Zero-COVID Policy is lifted (9). Considering the rapid transmission rate of COVID-19 and the typical recovery period for most individuals, there is a limited timeframe for conducting this study.…”

Section: Introductionmentioning

confidence: 99%

The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China

Hao,

Zhang,

Lau

et al. 2024

BackgroundThis study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China.MethodsA team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals.Results1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (β = 0.07, p < 0.001), concerns about family members getting COVID-19 (β = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (β = 0.03, p = 0.012), impact on incomes, employment and studies (β = 0.045, p < 0.001) and impact on families (β = 0.03, p = 0.01).ConclusionAfter removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.