Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic: A multicenter cross-sectional study

Table 1 Technical profiles, demographic characteristics, and experiences related to COVID-19 of all included healthcare workers (n = 1412)

Variable	n	%
Technical profile
Healthcare position
Doctors	618	43.8
Nurses	583	41.3
Nonfrontline1	211	14.9
Technical title
Junior	855	60.6
Intermediate	432	30.6
Senior	125	8.9
Place of residence
Urban	1319	93.4
Rural	93	6.6
Served hospital level
Level III	829	58.7
Level II	423	30.0
Level I	109	7.7
Community	51	3.6
Demographic characteristics
Region
Western	441	31.2
Middle	502	35.6
Eastern	469	33.2
Sex
Male	609	43.1
Female	803	56.9
Age, yr
18-34	691	48.9
35-49	443	31.4
≥ 50	278	19.7
Education level
≤ Undergraduate	980	69.4
≥ Postgraduate	432	30.6
Marriage status
Unmarried	425	30.1
Married	955	67.6
Divorced/widowed	32	2.3
Experience related to COVID-19
Clinical practice during COVID-19
Isolated care of COVID-19 contacts	574	40.7
Hospitalized care of infections	445	31.5
None	393	27.8
Experience of COVID-19
Infected without hospitalization	1145	81.1
Hospitalization related to COVID-19	253	17.9
Did not infected	14	1.0
Experience of families/friends
Hospitalization related to COVID-19	601	42.6
Death related to COVID-19	387	27.4
None	424	3
Psychological intervention from COVID-19
Yes	1086	76.9
Public psychological education	994	70.4
Individual counseling	102	7.2
None	326	23.1

¹Pharmacist, laboratorian, and other healthcare workers who indirectly exposed patients but also served in healthcare settings.

HCWs: Healthcare workers; COVID-19: Coronavirus disease 2019.

Table 2 Mental health, insomnia problems, and their correlations of all included healthcare workers (n = 1412)

Mental health and insomnia problems	n	%
Scale/symptom
GAD-7
Anxiety symptoms	254	18.0
Severe anxiety symptoms	58	4.1
PHQ-9
Depression symptoms	231	16.4
Severe depression symptoms	49	3.5
ISI
Insomnia symptoms	289	20.5
Severe insomnia symptoms	111	7.9
Correlation	r	P
GAD-7 with PHQ-9	0.494	0.09
GAD-7 with ISI	0.719	< 0.001a
PHQ-9 with ISI	0.684	< 0.001a

^aP < 0.01.

HCWs: Healthcare workers; GAD-7: Generalized Anxiety Disorder-7 Scale; PHQ-9: Patient Health Questionnaire-9; ISI: Insomnia Severity Index.

Table 3 Factors associated with anxiety symptoms (Generalized Anxiety Disorder-7 Scale) of all included healthcare workers (n = 1412) by multivariate logistic regression

Variable	OR	95%CI	P value
Healthcare position
Doctors	Contract	-	-
Nurses	1.114	1.054-1.178	0.001b
Nonfrontline	0.978	0.919-1.039	0.57
Sex
Male	Contract	-	-
Female	1.052	1.003-1.105	0.04a
Clinical practice during COVID-19
Isolated care of COVID-19 contacts	Contract	-	-
Hospitalized care of infections	2.047	1.675-2.236	< 0.001b
None	0.941	0.872-1.016	0.14
Experience of families/friends
Hospitalization related to COVID-19	Contract	-	-
Death related to COVID-19	1.048	0.982-1.120	0.17
None	0.870	0.817-1.126	0.32

^aP < 0.05.

^bP < 0.01.

HCWs: Healthcare workers; GAD-7: Generalized Anxiety Disorder-7 Scale; COVID-19: Coronavirus disease 2019; OR: Odds ratio.

Table 4 Factors associated with depression symptoms (Patient Health Questionnaire-9) of all included healthcare workers (n = 1412) by multivariate logistic regression

Variable	OR	95%CI	P value
Healthcare position
Doctors	Contract	-	-
Nurses	1.092	1.029-1.160	0.014a
Nonfrontline	0.958	0.898-1.021	0.244
Gender
Male	Contract	-	-
Female	1.148	1.085-1.214	< 0.001b
Clinical practice during COVID-19
Isolated care of COVID-19 contacts	Contract	-	-
Hospitalized care of infections	1.662	1.476-1.855	< 0.001b
None	0.924	0.752-1.136	0.48
Experience of families/friends
Hospitalization related to COVID-19	Contract	-	-
Death related to COVID-19	1.077	0.991-1.170	0.09
None	0.970	0.893-1.052	0.48

^aP < 0.05.

^bP < 0.01.

HCWs: Healthcare workers; PHQ-9: Patient Health Questionnaire-9; COVID-19: Coronavirus disease 2019; OR: Odds ratio.

Table 5 Factors associated with insomnia symptoms (Insomnia Severity Index) of all included healthcare workers (n = 1412) by multivariate logistic regression

Variable	OR	95%CI	P value
Healthcare position
Doctors	Contract	-	-
Nurses	1.126	1.057-1.199	< 0.001b
Nonfrontline	0.936	0.876-1.001	0.07
Sex
Male	Contract	-	-
Female	1.074	1.019-1.131	0.009b
Clinical practice during COVID-19
Isolated care of COVID-19 contacts	Contract	-	-
Hospitalized care of infections	1.085	1.016-1.159	0.01a
None	0.971	0.743-1.271	0.83
Experience of families/friends
Hospitalization related to COVID-19	Contract	-	-
Death related to COVID-19	2.082	1.765-2.510	< 0.001b
None	0.986	0.904-1.029	0.19

^aP < 0.05.

^bP < 0.01.

HCWs: Healthcare workers; ISI: Insomnia Severity Index; COVID-19: Coronavirus disease 2019; OR: Odds ratio.