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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Cross-sectional study of traumatic stress disorder in frontline nurses 6 mo after the outbreak of the COVID-19 in Wuhan
Zhi-Qing Zhou, Ting Yuan, Xiu-Bing Tao, Long Huang, Yu-Xin Zhan, Li-Ling Gui, Mei Li, Huan Liu, Xiang-Dong Li
Zhi-Qing Zhou, Xiu-Bing Tao, Department of Nursing, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241001, Anhui Province, China
Ting Yuan, School of Nursing, Wannan Medical College, Wuhu 241001, Anhui Province, China
Long Huang, School of Humanities and Management, Wannan Medical College, Wuhu 241001, Anhui Province, China
Yu-Xin Zhan, Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Li-Ling Gui, Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China
Mei Li, Department of Intensive Care Unit, The Central Hospital of Wuhan Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
Huan Liu, Department of Blood Purification Centre, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui Province, China
Xiang-Dong Li, Department of Gerontology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241001, Anhui Province, China
Author contributions: All authors contributed to the concept of this study; Zhou ZQ, Liu H, and Li XD conceived the study; Tao XB and Huang L carried out the literature searches; Zhan YX, Gui LL, Li M, and Liu H distributed the online questionnaires and extracted the data; Tao XB assessed the study quality; Yuan T, Liu H performed the statistical analysis; Zhou ZQ and Yuan T wrote the manuscript; Zhou ZQ, Yuan T, Liu H, and Li XD revised the manuscript; all the authors read the published version of the manuscript and gave their consent.
Supported by Anhui Provincial Department of Education College Outstanding Talent Cultivation Funding Project, No. gxgwfx2019032; the Teaching Quality and Teaching Reform Project of Anhui Provincial Department of Education, No. 2020jyxm2090; Anhui Wuhu Novel Coronavirus Pneumonia Epidemic Prevention and Control Science and Technology Emergency Project, No. 2020rkx1-5; and Wannan Medical College Teaching Quality and Teaching Reform Project, No. 2019jyxm20.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology (Approval number 2020-0189).
Informed consent statement: All study participants provided informed consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest.
Data sharing statement: Participants gave informed consent for data sharing and the presented data are anonymized and the risk of identification is low.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiang-Dong Li, Doctor, Associate Chief Physician, Department of Gerontology, Yijishan Hospital Affiliated to Wannan Medical College, No. 2 Zheshan West Road, Wuhu 241001, Anhui Province, China. lxdvvc@163.com
Received: July 6, 2021
Peer-review started: July 6, 2021
First decision: September 5, 2021
Revised: September 18, 2021
Accepted: January 14, 2022
Article in press: January 14, 2022
Published online: February 19, 2022
Processing time: 225 Days and 17.2 Hours
BACKGROUND
Frontline nurses in Wuhan directly fighting severe acute respiratory syndrome coronavirus-2 diseases are at a high risk of infection and are extremely susceptible to psychological stress, especially due to the global coronavirus disease 2019 (COVID-19) pandemic. The psychological after-effects of this public health emergency on frontline nurses will last for years.
AIM
To assess factors influencing post-traumatic stress disorder (PTSD) among frontline nurses in Wuhan 6 mo after the COVID-19 pandemic began.
METHODS
A total of 757 frontline nurses from five hospitals in Wuhan, China, participated in an online survey from July 27 to August 13, 2020. This cross-sectional online study used a demographic information questionnaire, the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, the Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-4. The chi-square test and logistic regression were used to analyze the association of demographics, COVID-19-related variables, and PTSD. Logistic regression was also conducted to investigate which variables were associated with PTSD outcomes.
RESULTS
A total of 13.5%, 24.3%, and 21.4% of the frontline nurses showed symptoms of PTSD, depression, and anxiety, respectively. The multivariate logistic regression analysis showed that the following factors were strongly associated with PTSD: Having a relative, friend, or colleague who died of COVID-19; experiencing stigma; or having psychological assistance needs, depressive symptoms or anxiety. Showing resilience and receiving praise after the COVID-19 outbreak were protective factors.
CONCLUSION
Frontline nurses still experienced PTSD (13.5%) six months after the COVID-19 outbreak began. Peer support, social support, official recognition, reward mechanisms, exercise, better sleep, and timely provision of information (such as vaccine research progress) by the government via social media, and adequate protective supplies could mitigate the level of PTSD among nurses responding to COVID-19. Stigmatization, depression, and anxiety might be associated with a greater risk of PTSD among nurses.
Core Tip: The mental health of frontline nurses in Wuhan has been significantly affected by the coronavirus disease (COVID-19). This study aims to evaluate the influencing factors of post-traumatic stress disorder (PTSD) among frontline nurses in Wuhan six months after the COVID-19 pandemic began and implement a mental health plan. The prevalence rates of PTSD, depression and anxiety among frontline nurses were 13.5%, 24.3%, and 21.4%, respectively. The risk factors for nurses to develop PTSD are the death of a relative, friend, or colleague from COVID-19, stigma, depression, and anxiety. Resilience and reward mechanisms are protective factors to prevent PTSD.
