Psychological Impact During the First Outbreak of COVID-19 on Frontline Health Care Workers in Shanghai

Abstract

Background: The COVID-19 pandemic is a significant health threat. Health care worker (HCWs) are at a significant risk of infection which may cause high levels of psychological distress. The aim of this study was to investigate the psychological impact of the COVID-19 on HCWs and factors which were associated with these stresses during the first outbreak in Shanghai.Methods: Between February 9 and 21, 2020, a total of 3,114 frontline HCWs from 26 hospitals in Shanghai completed an online survey. The questionnaire included questions on their sociodemographic characteristics, 15 stress-related questions, and General Health Questionnaire-12 (GHQ-12). Exploratory factor analysis was applied to the 15 stress-related questions which produced four distinct factors for evaluation. Multiple linear regression models were performed to explore the association of personal characteristics with each score of the four factors. Binary logistic analysis was used to explain the association of personal characteristics and these four factors with the GHQ-12.Results: There were 2,691 valid surveys received. The prevalence of emotional distress (defined as GHQ-12 ≥ 12) was noted in 47.7% (95%CI:45.7–49.6%) HCWs. Females (OR = 1.43, 95%CI:1.09–1.86) were more likely to have a psychological distress than males. However, HCWs who work in secondary hospitals (OR = 0.71, 95% CI:0.58–0.87) or had a no contact history (OR = 0.45, 95%CI: 0.35–0.58) were less likely to suffer psychological distress. HCWs who were nurses, married, and had a known contact history were highly likely to have anxiety. HCWs working at tertiary hospitals felt an elevated anxiety regarding the infection, a lack of knowledge, and less protected compared to those who worked at secondary hospitals.Conclusions: Our study shows that the frontline HCWs had a significant psychosocial distress during the COVID-19 outbreak in Shanghai. HCWs felt a lack of knowledge and had feelings of being not protected. It is necessary for hospitals and governments to provide additional trainings and psychological counseling to support the first-line HCWs.

Perceived Stress and Psychological Impact Among Healthcare Workers at a Tertiaty Hospital in China During the COVID-19 Outbreak: The Moderating Role of Resilience and Social Support

“…The non-probabilistic sampling we used may somewhat hinder the validity of our findings, as has been reported in many published literatures during the early stage of the pandemic ( 26 , 35 , 36 ). However, our sample's prevalence of psychological distress was close to that of other studies conducted during the same period, indicating that our sample was somewhat representative of all HCWs in our hospital ( 12 ). In addition, the cross-sectional design led to a lack of causal relationships between variables.…”

“…A meta-analysis of studies conducted by April 17, 2020, found that the rate of depression and anxiety among HCWs in the pandemic was 23.2 and 22.8%, respectively ( 23 ). Notably, Feng et al applied the GHQ-12 to examine the mental health of staff from 26 hospitals in Shanghai between February 9 and 21, 2020, and found that the rate of psychological distress was 47.7% ( 12 ). Considering Changzhou is relatively near to Shanghai (200 km), and both studies were conducted during the early stages of the pandemic, the result of our study was similar to what was found in Shanghai.…”

“…A sample size of 402 was calculated by a two-sided 95% confidence interval with a width equal to 0.1 when the sample proportion is 50%. The sample proportion is the estimated prevalence of psychological distress in our hospital based on other studies ( 12 ).…”

“…The fourpoint Likert scoring method was applied in this study. Item responses range from 0 to 3, and the overall score ranges from 0 to 36, with more than 12 being defined as cases (12). The Chinese version has been validated in different groups of Chinese (13)(14)(15).…”

No Sex Differences in Psychological Burden and Health Behaviors of Healthcare Workers During the COVID-19 Stay-at-Home Orders

“…Healthcare workers, a unique population who continued working during the COVID-19 state-ordered home isolation, with their frontline peers directly engaged in the clinical management of patients with COVID-19, are at high risk of mental morbidity (9)(10)(11) and negative health behaviors (12)(13)(14). A cross-sectional study consisting of 1,257 healthcare workers from China showed that females working in hospitals were predisposed to be psychologically stressed, with greater symptoms of anxiety, depression and distress than their male counterparts (15).…”