“…This study also found that depressed ENT healthcare workers were more likely to smoke (Nilan et al, 2019;Schneider et al, 2019) According to the distress/protection model of QOL (Voruganti et al, 1998), QOL is the result of the interaction between protective (e.g., high selfesteem and good social support) and distressing factors (e.g., physical and psychological stress). Consistent with previous findings (Benedek et al, 2007;Mammen and Faulkner, 2013;Roche et al, 2020) depressed ENT nurses had a poorer QOL compared to the those without depression in this survey . This could be explained by the negative health outcomes of depression, such as impaired psychosocial functioning and somatic symptoms of fatigue, loss of appetite or weight, and insomnia (Anosike et al, 2020;Malhi and Mann, 2018;Parisi et al, 2014;Rakofsky et al, 2013).…”