Protective Predictors Associated With Posttraumatic Stress and Psychological Distress in Chinese Nurses During the Outbreak of COVID-19

Abstract

Background: The novel coronavirus disease 2019 (COVID-19) posed an unprecedented threat to Chinese healthcare professionals. Nevertheless, few studies notably focused on the mental health conditions of nurses and explored protective factors to prevent posttraumatic stress and psychological distress. This study aimed to explore the prevalence and the predictive factors especially defensive predictors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic.Methods: In this online study, 1,728 nurses (~77.5% came from the COVID-19 pandemic frontline) were included in the final analysis. Posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (PCL-5) and Self-Reporting Questionnaire (SRQ) was used to assess posttraumatic stress and psychological distress.Results: The results demonstrated that the prevalence of posttraumatic stress and psychological distress in nurses throughout China between February 1, 2020 and February 13, 2020 was 39.12 and 24.36%, respectively. Multivariate logistic regression indicated that insomnia, high panic intensity, and high impact of the COVID-19 pandemic were risk predictors of posttraumatic stress and psychological distress in nurses. Married participants had a 1.58 times increased risk of having posttraumatic stress when compared with the single participants. Frontline medical staff were more likely to suffer from psychological distress. The adequate exercise was a protective predictor of psychological distress [adjusted odds ratio (AOR) = 0.655, 95% CI = 0.486–0.883], but not with posttraumatic stress. High-quality diet was a protective predictor of posttraumatic stress (AOR = 0.112, 95% CI = 0.037–0.336) and psychological distress (AOR = 0.083, 95% CI = 0.028–0.247).Conclusions: Our study revealed the prevalence and factors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic. Low panic intensity, low level of impact, satisfactory sleep, adequate exercise, and better diet were protective factors of posttraumatic stress and psychological distress. It indicated that the psychological status of nurses (particularly those from the COVID-19 pandemic frontline) should be monitored, and protective factors associated with posttraumatic stress and psychological distress should be increased.

Influencing Factors of High PTSD Among Medical Staff During COVID-19: Evidences From Both Meta-analysis and Subgroup Analysis

“…These articles published reports on the prevalence of doctors and nurses of different races (Asian, Caucasian). Fourteen studies could obtain doctors’ PTSD prevalence and sample size, 27 items the prevalence and sample size of nurses' PTSD could be obtained in the research; five studies[ 30 , 31 , 32 , 33 , 34 ] used offline self-filled questionnaires to conduct surveys, and the remaining 23 studies[ 14 , 10 , 11 , 12 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]were investigated online through the Internet. All studies were cross-sectional studies.…”

“…Since the outbreak of COVID-19, some medical staff have even died from this epidemic. The high-risk working environment had greatly stimulated the psychology of medical staff, which mad medical staff afraid of contracting the new coronavirus[ 14 , 37 , 43 ]. When the corresponding symptoms of new coronary pneumonia appear, medical staff would suspect whether they are infected with the new coronavirus[ 42 , 43 ].…”

“…The high-risk working environment had greatly stimulated the psychology of medical staff, which mad medical staff afraid of contracting the new coronavirus[ 14 , 37 , 43 ]. When the corresponding symptoms of new coronary pneumonia appear, medical staff would suspect whether they are infected with the new coronavirus[ 42 , 43 ]. Moreover, medical staff with previous psychological problems were particularly vulnerable to the adverse psychological effects of the COVID-19[ 37 , 42 ].…”

“…Working in a high-pressure environment for a long time, lack of sleep, and facing a higher infection rate and death risk of COVID-19, these made medical staff with higher professional titles more likely to develop PTSD[ 11 , 41 ]. In this study, marriage was also a potential risk factor for PTSD[ 41 , 43 ]. Compared with single medical staff, they are more worried about their own infection and their families are infected, and they have more burden of taking care of family members.…”

Common mental disorders and associated factors in nursing workers in COVID-19 units

“…In 2019, the emergence of the pandemic caused by the new coronavirus (COVID- 19) and the triggering of a health alert worldwide put the role of nursing in vogue, especially for professionals who work on the front line in assisting users. This scenario has been pointed out as a potentiator of the impacts on workers' mental health, evidencing an important illness in this context (11)(12) .…”