Mental health status and its related factors among healthcare workers during novel coronavirus epidemics in Shanghai

doi:10.16138/j.1673-6087.2023.05.002

Abstract

Abstract: Objective To evaluate the psychological status of primary healthcare workers in Shanghai during the novel coronavirus epidemic in the past three years, analyze the related factors, and provide a scientific basis for follow-up intervention and management. Methods A questionnaire survey was conducted from January to February in 2023 among the healthcare workers in Shanghai primary care institutions, their basic personal information and survey results were collected to clarify the mental health status during the epidemic, and the related factors were analyzed. Results There were 72.0% and 57.6% of Shanghai primary health care workers suffered depression and anxiety, respectively. Work-family conflict was positively associated with depression(r=0.391, P<0.05) and anxiety(r=0.370, P<0.05). The total work-family conflict scores were higher among nurses and the healthcare workers who had associate or lower degree, had higher job stress, work intensity or lower salary satisfaction, 11%-30% decreased annual income than that before the epidemic, or participated in public health emergency management previously (P<0.05); depression and anxiety scale scores were higher among nurse and healthcare workers who were female, 30-39 years old, had associate or lower degree, intermediate title, <10 years of work experience, and had higher job stress and work intensity, or less salary satisfaction, or participated in epidemic-related public health emergency management previously. Conclusions The novel coronavirus epidemic showed negative impact on the mental health of primary healthcare workers in Shanghai. Increasing salary and wages, conducting psychological counseling and guidance, and rationalizing work shift, rotation and scheduling can improve the psychological health in primary healthcare staff.

Key words: Novel coronavirus pneumonia, Healthcare workers, Anxiety, Depression

CLC Number:

R511

LI Xiaoli, Mukadas Rahman, ZHENG Li, GE Yuxin, JIANG Jie, TONG Jianjing. Mental health status and its related factors among healthcare workers during novel coronavirus epidemics in Shanghai[J]. Journal of Internal Medicine Concepts & Practice, 2023, 18(05): 316-321.

Figures/Tables 5

变量	WFCS 平均分	PHQ-9 平均分	GAD-7 平均分
性别
男(n=58)	46.2±10.9	4.8±3.9	4.9±3.5
女(n=178)	44.9±8.9	8.4±5.9	5.9±4.9
P	0.363	<0.001	<0.001
年龄（岁）
<30(n=24)	42.1±8.6	7.0±7.6	4.8±5.9
30~39(n=72)	44.8±10.1	9.1±5.6¹⁾	6.8±5.5¹⁾
40~49(n=118)	44.6±9.4	8.1±5.6¹⁾	5.4±4.2¹⁾
≥50(n=22)	42.2±8.5	5.5±4.6¹⁾	3.4±4.6¹⁾
P	0.473	<0.001	<0.001
学历
硕士及以上(n=66)	44.1±10.1	8.1±6.4	5.6±4.7
本科(n=151)	45.1±9.3¹⁾	8.3±6.2¹⁾	5.7±5.1¹⁾
大专及以下(n=19)	46.0±9.2¹⁾	9.2±5.0¹⁾	6.2±4.9¹⁾
P	0.035	<0.001	<0.001
职称类型
初级(n=55)	43.5±9.2	8.2±6.2	5.4±5.3
中级(n=120)	43.8±9.8	8.3±6.0¹⁾	5.7±4.8¹⁾
高级(n=61)	45.7±9.7	5.8±2.3¹⁾	3.8±2.6¹⁾
P	0.341	0.016	0.007
年收入增减情况
-50%~-31%(n=18)	42.4±10.8	8.8±6.5	6.6±5.6
-30%~-11%(n=90)	46.4±9.4¹⁾	9.5±6.7	6.4±5.2
-10%~-1%(n=65)	42.9±8.1	7.9±5.6	5.8±4.6
0~10%(n=53)	43.8±9.5	6.8±5.7	4.3±4.7
11%~30%(n=8)	41.4±7.3	6.7±3.0	5.0±2.4
31%~50%(n=2)	22.0±16.9	6.6±4.3	4.5±4.9
P	0.002	0.181	0.261
工作年限（年）
≤5(n=41)	41.6±10.3	9.7±6.7	7.2±6.3
6~10(n=15)	43.1±11.9	9.2±6.4	5.4±4.9
11~15(n=56)	47.0±8.3	8.7±7.4	5.8±4.7
16~20(n=60)	44.9±9.3	8.0±4.9¹⁾²⁾	5.3±4.3¹⁾
21~25(n=39)	42.5±9.2	6.9±5.0¹⁾²⁾	4.8±3.8¹⁾
>25(n=25)	43.7±8.9	5.8±5.3¹⁾²⁾	4.8±3.8¹⁾
P	0.072	<0.001	<0.001
职务类型
全科医师(n=158)	44.9±9.5	8.7±6.5	5.8±5.1
护士(n=78)	46.4±8.4	7.9±5.1	5.0±3.9
P	0.024	<0.001	<0.001
参加公共卫生突发事件经历
是(n=87)	46.8±9.5	9.1±6.3	6.4±5.4
否(n=149)	43.3±8.7	7.9±5.9	5.3±4.6
P	0.048	0.043	0.047
工作强度
较小(n=6)	42.3±9.5	6.8±2.8	4.7±2.9
一般(n=40)	42.0±10.1	6.6±5.3	4.3±3.8
较大(n=190)	44.7±9.3¹⁾	8.7±6.3¹⁾	6.0±5.1²⁾
P	0.043	0.002	0.043
工作压力
较小(n=6)	44.2±9.2	7.2±2.6	4.6±3.9
一般(n=39)	43.8±9.7	7.4±5.6	5.9±5.1
较大(n=191)	44.8±9.4¹⁾	8.5±6.3¹⁾	6.2±5.3¹⁾
P	0.037	0.014	0.036
薪酬满意度
较小(n=129)	44.7±9.4	8.4±6.2	5.9±5.7
一般(n=85)	44.5±8.9	8.2±6.1	5.7±4.5
较大(n=22)	43.4±8.8¹⁾	6.4±4.7¹⁾	4.8±5.0¹⁾
P	0.049	0.026	0.048

References 20

[1]	Wang C, Horby PW, Hayden FG, et al. A novel coronavirus outbreak of global health concern[J]. Lancet, 2020, 395(10223): 470-473. doi: S0140-6736(20)30185-9 pmid: 31986257
[2]	陈雪萍, 马薇, 惠培林, 等. 疫情期间临床医护人员睡眠质量情况调查及影响因素分析[J]. 世界睡眠医学杂志, 2021, 8(2): 357-361.
[3]	Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019[J]. JAMA Netw Open, 2020, 3(3): e203976. doi: 10.1001/jamanetworkopen.2020.3976 URL
[4]	杜欣洁, 庞琳, 余红梅, 等. 中文版病毒流行压力和焦虑量表的信效度检验[J]. 护理研究, 2022, 36(17): 3009-3013.
[5]	梅莉, 梅佩, 李琴. 新冠肺炎疫情下首批一线医务人员心理状态及应对方式现状调查[J]. 齐鲁护理杂志, 2020, 26(13): 40-43.
[6]	赵苗苗, 彭德艳, 刘琼, 等. 新型冠状病毒肺炎疫情防控期间血液肿瘤患者心理状况调查及影响因素分析[J]. 中西医结合护理(中英文), 2020, 6(3): 38-41.
[7]	Asmundson GJG, Taylor S. Coronaphobia: fear and the 2019-nCoV outbreak[J]. J Anxiety Disord, 2020, 70:102196. doi: 10.1016/j.janxdis.2020.102196 URL
[8]	Liang Y, Wu K, Zhou Y, et al. Mental health in frontline medical workers during the 2019 novel coronavirus disease epidemic in China[J]. Int J Environ Res Public Health, 2020, 17(18): 6550. doi: 10.3390/ijerph17186550 URL
[9]	Wang Z, Wang D. The influence and enlightenment of five public health emergencies on public psychology since new century[J]. Int J Soc Psychiatry, 2021, 67(7):878-891. doi: 10.1177/00207640211002222 URL
[10]	林海燕, 蒋海仙, 潘疆疆, 等. 医护人员心理压力的现状调查分析及干预措施[J]. 浙江临床医学, 2019, 21(6): 875-876.
[11]	Lee SM, Kang WS, Cho AR, et al. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients[J]. Compr Psychiatry, 2018, 87: 123-127. doi: 10.1016/j.comppsych.2018.10.003 URL
[12]	王峰娟, 刘玉容, 周琰, 等. 疫情常态化期间医务人员心理压力影响因素分析[J]. 人类工效学, 2022, 28(2):35-39.
[13]	周晓平, 黄继峥, 任阿可, 等. 某市1 426名新冠肺炎抗疫一线医务人员心理应对能力调查[J]. 中国感染控制杂志, 2021, 20(4): 320-326.
[14]	Guille C, Frank E, Zhao Z, et al. Work-family conflict and the sex difference in depression among training physicians[J]. JAMA Intern Med, 2017, 177(12): 1766-1772. doi: 10.1001/jamainternmed.2017.5138 pmid: 29084311
[15]	吴际军, 荣娴, 陈飞, 等. 抗击新型冠状病毒肺炎疫情临床一线护士睡眠质量调查及其影响因素[J]. 护理研究, 2020, 34(4): 558-562.
[16]	徐明川, 张悦. 首批抗击新型冠状病毒感染肺炎的临床一线支援护士的心理状况调査[J]. 护理研究, 2020, 34(3): 368-370.
[17]	罗丹, 王彬, 罗芳, 等. COVID-19疫情期间湖北省一线女护士焦虑及抑郁状况调查[J]. 保健医学研究与实践, 2021, 18(3): 60-64.
[18]	Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-a review[J]. Asian J Psychiatr, 2020, 51: 102119. doi: 10.1016/j.ajp.2020.102119 URL
[19]	Lee J, Lim JE, Cho SH, et al. Association between work-family conflict and depressive symptoms in female workers: an exploration of potential moderators[J]. J Psychiatr Res, 2022, 151: 113-121. doi: 10.1016/j.jpsychires.2022.04.018 pmid: 35477075
[20]	蔡俊伟, 陈秋婵, 梁财相. 新型冠状病毒肺炎疫情下急诊医护人员的心理评估[J]. 医学食疗与健康, 2021, 19(3): 215-216.

项目	PHQ-9平均分	GAD-7平均分	WIF平均分	FIW平均分	WFCS平均分
PHQ-9平均分	1.000	0.850^1）	0.382^1）	0.239^1）	0.391^1）
GAD-7平均分	0.850^1）	1.000	0.355^1）	0.232^1）	0.370^1）

变量	OR	95%CI	P
性别（参照男）
女	1.597	1.059~2.379	0.027
年龄（参照<30岁）
30~39	8.317	1.084~15.608	0.042
40~49	10.370	1.106~17.226	0.041
≥50	2.450	1.153~4.206	0.526
学历（参照硕士及以上）
本科	1.627	0.723~3.659	0.239
大专及以下	1.721	0.532~2.387	0.301
职称（参照初级）
中级	2.506	0.312~2.825	0.388
高级	2.552	0.517~2.962	0.226
年收入增减情况（参照-50%~-31%）
-30%~-11%	1.132	0.299~2.290	0.855
-10%~-1%	1.587	0.390~2.459	0.519
0~10%	0.512	0.128~2.053	0.345
11%~30%	1.839	0.137~2.673	0.645
31%~50%	0.218	0.006~1.957	0.407
工作年限（参照≤5年）
6~10	0.264	0.037~1.873	0.183
11~15	0.359	0.068~1.905	0.029
16~20	0.476	0.086~2.625	0.026
21~25	0.268	0.027~1.046	0.004
>25	0.419	0.043~2.075	0.012
职业类型（参照全科医师）
护士	1.602	1.152~2.739	<0.001
参加公共卫生突发事件经历（参照无）
有	1.788	1.376~2.648	<0.001
工作强度（参照较小）
一般	1.025	1.001~2.285	0.062
较大	1.054	1.015~2.336	0.047
工作压力（参照较小）
一般	1.215	1.164~3.419	0.972
较大	2.136	1.047~5.246	0.003
薪酬满意度（参照较小）
一般	1.192	1.003~3.315	0.184
较大	0.971	0.421~2.942	0.104

变量	OR	95%CI	P
性别（参照男）
女	1.137	1.052~2.339	0.036
年龄（参照<30岁）
30~39	3.427	2.010~8.058	0.027
40~49	9.849	1.300~10.615	0.031
≥50	1.739	0.117~2.791	0.688
学历（参照硕士及以上）
本科	0.699	0.340~1.438	0.331
大专及以下	1.688	0.376~3.589	0.495
职称（ref=初级）
中级	3.265	0.482~4.121	0.646
高级	3.448	0.527~4.962	0.372
年收入增减情况（参照-50%~-31%）
-30%~-11%	1.109	0.324~3.800	0.869
-10%~-1%	1.002	0.279~3.602	0.998
0~10%	0.477	0.131~1.743	0.263
11%~30%	0.281	0.037~2.141	0.220
31%~50%	0.359	0.012~2.518	0.556
工作年限（参照≤5年）
6~10	0.411	0.071~2.391	0.322
11~15	0.455	0.106~1.943	0.004
16~20	0.408	0.093~1.786	0.032
21~25	0.510	0.103~2.516	0.006
>25	0.617	0.178~1.706	0.007
职业类型（参照全科医师）
护士	1.425	1.102~2.339	<0.001
参加公共卫生突发事件经历（参照无）
有	1.560	1.289~1.986	<0.001
工作强度（参照较小）
一般	1.157	1.027~3.157	0.281
较大	1.246	1.136~2.693	0.037
工作压力（参照较小）
一般	1.536	1.042~3.025	0.057
较大	2.257	1.184~3.294	0.049
薪酬满意度（参照较小）
一般	1.072	1.003~2.194	0.157
较大	0.974	0.021~2.044	0.385