Study reveals significant psychological burden among health care workers during pandemic

The mental health impact of COVID-19 on health care providers in China was assessed in this cross-sectional, survey-based study.

Study design

Health care providers from 34 Chinese hospitals with fever clinics or COVID-19 wards were surveyed on their mental health over a 6-day period from January 29 to February 3, 2020. Included in the study were 20 hospitals in Wuhan, 7 hospitals in the wider Hubei province and 7 hospitals from other provinces. Health care providers in Wuhan made up 60% of all respondents. Chinese versions of the 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder scale, 7-item insomnia severity index and 22-item impact of Event Scale-revised were performed.

Outcomes

The overall participation rate was 69%. Of the 1,257 individuals who completed the survey, 60% were nurses, 40% were physicians and 41% were front-line workers. Close to three-quarters of respondents were women. Symptoms of depression were reported by 50% of respondents, 45% reported anxiety, 34% insomnia and 71% were experiencing distress. Nurses, women, front-line workers and those in Wuhan had more severe degrees of all measurements compared with others. Health care workers in the Hubei province outside of Wuhan had a lower risk of experiencing symptoms of distress.

Limitations

More than 80% of participants were from the Hubei province, limiting this study’s generalizability to other regions. It also had a short time frame and lacks longitudinal follow-up. Additionally, the broader mental health impact of the pandemic, both before and after the survey, and the impact of the psychological assistance hotline established by the Chinese government on the second to last day of the survey were not accounted for. This study was unable to distinguish between preexisting mental health symptoms and new symptoms. Lastly, there is potential response bias if nonrespondents were too stressed or not at all stressed enough to respond.

Clinical significance

Respondents of this survey reported significant psychological burdens while caring for COVID-19 patients. Nurses, women, those in the worst affected areas and those on the front line were most at risk for developing symptoms of diminished mental health. Health care providers on the front lines must be offered psychological support both during and after the COVID-19 pandemic. Longitudinal studies on psychological stress during pandemics and the mental health aftermath for health care providers are needed to better prepare us for future crises.