Health care worker occupational experiences during the COVID-19 outbreak: A cross-sectional study

Table 1 General characteristics and work experiences of medical staff treating coronavirus disease 2019 cases in Wuhan city and Qinghai province (n = 173)

Characteristic	n (%)	Item
		Support/security	Work environment	Protection experience	Social relationships	Sense of worth	Total score	Working (d)
Hospital grade
Tertiary	101 (58.4)	17.38 (4.55)b	16.37 (6.77)	8.73 (4.78)	16.57 (6.54)	7.96 (1.96)	66.34 (16.37)	22.99 (9.01)a
Secondary	72 (41.6)	14.29 (5.42)	14.79 (6.05)	8.44 (4.03)	16.31 (6.18)	7.61 (1.45)	63.43 (12.08)	25.82 (7.93)
Geographic location of work
Wuhan city	108 (62.4)	15.12 (5.27)b	14.74 (6.13)a	8.19 (4.19)	16.76 (6.31)	7.81 (1.61)	65.05 (13.45)	26.41 (7.83)b
Qinghai province	65 (37.6)	17.71 (4.53)	17.32 (6.86)	9.32 (4.86)	15.97 (6.50)	7.83 (2.02)	65.26 (16.83)	20.45 (8.77)
Work department
Fever clinic	15 (8.7)	13.87 (5.18)	15.40 (5.74)	9.87 (5.88)	5.95 (1.47)a	6.00 (3.05)b	50.00 (25.39)b	22.93 (8.99)
Observation ward	15 (8.7)	14.20 (7.38)	15.07 (7.45)	7.93 (5.79)	7.50 (1.51)	7.87 (2.20)	65.56 (18.33)	26.87 (6.12)
General isolation ward	67 (38.7)	15.87 (6.45)	15.28 (6.48)	7.90 (4.31)	6.43 (1.81)	7.73 (1.54)	64.43 (12.86)	25.36 (8.60)
Critical isolation unit	53 (30.6)	17.51 (6.49)	16.26 (6.98)	9.23 (4.15)	5.88 (1.86)	8.13 (1.36)	67.77 (11.33)	23.62 (9.71)
Mobile (temporary field) hospital	19 (11)	19.95 (4.52)	16.42 (5.52)	9.00 (3.73)	6.07 (1.66)	8.47 (1.12)	70.61 (9.37)	19.95 (4.99)
Other	4 (2.3)	14.25 (3.50)	15.75 (7.41)	8.50 (3.11)	6.34 (1.65)	8.50 (0.58)	70.84 (4.81)	26.00 (12.19)
Profession
Doctor	24 (13.9)	14.38 (5.18)	15.29 (5.55)	7.38 (3.79)	15.2 (4.66)	7.38 (1.74)	61.46 (14.50)	27.88 (7.57)
Nurse	142 (82.1)	16.46 (5.06)	15.73 (6.72)	8.74 (4.51)	16.52 (6.65)	7.92 (1.75)	66.02 (14.59)	23.62 (8.65)
Infection control staff1	5 (2.9)	14.40 (7.37)	17.80 (6.42)	11.00 (6.20)	19.60 (5.55)	7.00 (2.45)	58.33 (20.41)	23.60 (9.63)
Other2	2 (1.2)	14.50 (0.71)	14.00 (4.24)	8.50 (4.95)	18.50 (6.36)	7.50 (2.12)	62.50 (17.68)	20.00 (16.97)
Work experience (yr)
< 2	10 (5.8)	18.30 (2.91)	16.80 (4.34)	9.50 (2.22)	15.00 (5.73)	7.70 (2.16)	64.17 (18.02)	16.50 (8.55)a
≥ 2 - < 5	27 (15.6)	15.63 (5.85)	15.56 (7.11)	9.93 (4.35)	16.22 (6.68)	7.74 (1.87)	64.51 (15.61)	20.67 (8.87)
≥ 5 - < 10	67 (38.7)	16.09 (5.37)	15.70 (7.06)	8.78 (4.26)	17.25 (6.46)	7.69 (1.92)	64.05 (16.04)	24.67 (8.61)
≥ 10 - < 20	50 (28.9)	16.72 (4.27)	16.22 (6.00)	7.90 (4.79)	16.26 (5.95)	8.10 (1.50)	67.50 (12.51)	25.56 (7.65)
≥ 20 - < 30	15 (8.7)	13.73 (5.75)	14.27 (5.73)	7.53 (4.96)	15.87 (6.96)	7.67 (1.72)	63.89 (14.32)	29.60 (6.24)
≥ 30	4 (2.3)	14.75 (7.41)	13.25 (8.42)	7.75 (6.80)	13.25 (9.18)	7.75 (1.26)	64.59 (10.49)	20.75 (11.47)
Sex
Male	31 (17.9)	16.19 (5.08)	14.90 (6.38)	8.90 (4.62)	15.97 (5.95)	7.71 (1.99)	64.25 (16.55)	24.48 (9.26)
Female	142 (82.1)	16.07 (5.18)	15.89 (6.55)	8.55 (4.45)	16.57 (6.48)	7.84 (1.73)	65.32 (14.40)	24.10 (8.57)
Marital status
Unmarried	50 (28.9)	17.00 (5.47)	17.06 (6.20)	9.88 (4.49)	17.48 (5.99)	7.70 (2.21)	64.17 (18.39)	22.10 (8.47)
Married	114 (65.9)	15.47 (5.05)	15.05 (6.54)	8.00 (4.38)	15.77 (6.35)	7.81 (1.58)	65.06 (13.16)	24.84 (8.85)
Divorced	7 (4)	20.14 (0.90)	16.57 (7.85)	9.71 (4.68)	19.57 (8.81)	9.00 (0.00)	75.00 (0.00)	28.43 (5.19)
Widowed	2 (1.2)	14.50 (0.71)	16.50 (7.78)	8.00 (4.24)	19.50 (4.95)	7.00 (2.83)	58.34 (23.57)	22.50 (2.12)
Level of education
College degree or below	42 (24.3)	16.02 (5.24)	16.19 (6.07)	9.21 (4.51)	16.52 (5.58)	7.79 (1.79)	64.88 (14.90)	21.05 (8.75)a
Undergraduate	126 (72.8)	16.22 (5.15)	15.66 (6.66)	8.41 (4.55)	16.50 (6.69)	7.85 (1.78)	65.41 (14.84)	25.16 (8.35)
Graduate student	5 (2.9)	13.40 (4.56)	13.00 (6.78)	8.60 (1.14)	15.00 (5.10)	7.20 (1.64)	60.00 (13.69)	25.40 (11.41)
Professional title
Primary	100 (57.8)	16.28 (5.24)	15.86 (6.70)	9.15 (4.21)	16.76 (6.49)	7.78 (1.95)	64.83 (16.22)	22.65 (8.91)a
Intermediate	57 (32.9)	16.51 (4.63)	16.00 (6.64)	7.72 (4.64)	16.05 (6.72)	7.95 (1.48)	66.23 (12.34)	26.11 (7.63)
Advanced	16 (9.2)	13.44 (5.85)	13.75 (4.52)	8.44 (5.19)	16.06 (4.20)	7.56 (1.63)	63.02 (13.60)	26.75 (9.13)
Age (yr)
< 25	19 (11.0)	17.67 (5.53)	16.94 (6.00)	9.83 (4.46)	17.11 (6.26)	7.17 (2.50)	59.72 (20.86)	19.28 (8.97)a
25-29	52 (30.1)	15.31 (6.01)	15.48 (6.84)	9.35 (4.18)	16.77 (6.09)	7.81 (1.97)	65.06 (16.42)	22.73 (9.03)
30-34	53 (30.6)	16.58 (4.05)	15.96 (6.78)	7.94 (4.33)	15.94 (7.05)	7.94 (1.47)	66.20 (12.28)	24.40 (8.58)
35-39	22 (12.7)	17.73 (4.13)	16.64 (6.87)	8.36 (5.21)	17.55 (5.89)	8.41 (1.05)	70.08 (8.78)	27.45 (6.23)
40-44	20 (11.6)	14.45 (5.13)	15.30 (4.77)	8.35 (4.59)	16.55 (5.78)	7.55 (1.88)	62.92 (15.64)	28.05 (7.62)
≥ 45	7 (4.0)	13.86 (6.39)	11.71 (6.58)	6.71 (5.15)	14.43 (6.75)	7.57 (1.51)	63.10 (12.60)	24.86 (9.60)

^aP ≤ 0.05.

^bP ≤ 0.01.

¹Hospital infection control workers.

²Logistics support personnel and health administrator.

Values in the table are shown as mean ± SD unless otherwise indicated.

Table 2 Exploratory factor analysis of the work experiences questionnaire

	Common elements
	1	2	3	4	5
Support guarantee
Adequate knowledge and skill training before taking up the post	-0.059	0.916	0.137	0.068	0.008
Prepared for an outbreak	-0.082	0.928	0.157	0.084	0.021
Adequate nursing staff	-0.119	0.918	0.102	0.034	0.027
Hospital layout conforming to requirements of nosocomial infection control	-0.058	0.869	0.119	0.06	0.035
Presence of logistic support (e.g., catering, oxygen, provision of appropriate equipment)	-0.053	0.898	0.124	0.108	-0.017
Good quality sleeping environment	-0.152	0.878	0.07	0.008	-0.063
Adequate nutritional support	-0.05	0.93	0.091	0.047	-0.004
Occupational environment
Lack of personal protective equipment use and infection prevention measures	0.616	-0.041	0.23	-0.145	0.025
Fear of infection, uncertainty regarding adequate protection (e.g., fear that masks are not suitable and allow for leakage around the edges)	0.577	0.006	0.358	-0.18	-0.102
Wearing protective equipment makes it difficult to communicate with patients and blocks sound	0.477	-0.111	0.553	-0.196	0.037
Wearing protective equipment makes it difficult to communicate with patients and blocks sound	0.364	-0.071	0.657	-0.362	0.03
The difficulty of conducting nursing procedures increased while wearing protective equipment	0.368	-0.12	0.617	-0.274	0.023
Various types of protective equipment models are not known to meet protection requirements	0.619	-0.007	0.415	-0.271	-0.063
The most authoritative scientific practice guidance cannot be obtained in a timely manner	0.829	0.119	-0.155	0.065	-0.297
Inconsistent work guidelines and recommendations from different channels cause confusion	0.813	0.118	0.043	0.086	-0.348
The hospital does not have sound working systems and processes	0.807	0.043	-0.134	0.086	-0.259
I do not know how to implement my duties and carry out procedures	0.819	0.05	-0.109	0.063	-0.313
Occupational protection
Lack of materials: Protective equipment, safety I.V. cannulae, blood syringes, etc	0.617	-0.058	-0.113	0.127	-0.31
Exhaustion regarding dealing with media, publicity and interviews	0.703	0.055	-0.096	0.109	-0.098
Lack of effective communication between nurses and patients that impairs provision of high-quality care	0.786	0.025	-0.081	0.031	-0.121
Unfamiliar work environment	0.72	0.017	-0.065	0.102	-0.103
Social relationships
Family and friends did not support my work and even criticized me	0.728	0.022	-0.297	0.198	0.203
Felt discriminated against because people nearby were afraid of infection; I felt unwelcome	0.724	0.099	-0.105	0.121	0.318
Working in the isolation ward left me feeling lonely and helpless	0.793	0.048	-0.221	0.154	0.115
I became a scapegoat for patients to vent their dissatisfaction and even societal complaints	0.763	0.036	-0.231	0.143	0.385
I blame myself for coming into contact with patients who were isolated and unable to care for their families	0.611	0.107	0.215	-0.152	0.315
Managed, argued with and received complaints from visiting family members	0.669	0.024	-0.095	0.028	0.34
Exhaustion due to repeated collection of tedious medical histories from patients	0.774	0.061	-0.077	-0.11	0.194
I answering many telephone calls results in exhaustion (involving family, friends, colleagues)	0.807	0.036	-0.011	0.015	0.179
Social relationships
Sense of accomplishment when patients recover and are discharged from hospital	-0.072	-0.313	0.623	0.568	0.028
Appreciated by leaders and colleagues; colleagues support one other	-0.084	-0.237	0.386	0.564	0.117
Social responsibility makes me proud	-0.02	-0.331	0.602	0.542	-0.058

Table 3 Scores for each item and dimension of medical staff work experience (n = 173)

Item	Score (mean ± SD)
Presence of logistics support (e.g., catering, oxygen, equipment)	2.42 ± 0.84
Prepared for another outbreak	2.39 ± 0.83
Adequate knowledge and skills training before taking up the post	2.37 ± 0.90
Adequate nutritional support	2.36 ± 0.86
Adequate support by nursing staff	2.31 ± 0.88
Good quality sleeping environment	2.14 ± 0.95
Hospital layout conformed to nosocomial infection control requirements	2.11 ± 0.87
Support/security dimension	2.30 ± 0.74
The hospital does not have sound working systems and processes	2.05 ± 1.04
I do not know how to implement my work systems and procedures	2.02 ± 1.02
The most relevant scientific and authoritative guidance cannot be obtained in a timely manner	2.01 ± 1.03
Lack of effective communication between nurses and patients, impairing provision of high-quality care	1.98 ± 0.98
Lack of materials (i.e., protective equipment, safety I.V. cannulae, blood collection syringes)	1.95 ± 1.10
Exhaustion from dealing with media, publicity and interviews	1.93 ± 1.02
Inconsistent work guidelines and recommendations from different channels cause confusion	1.90 ± 1.02
The working environment is unfamiliar	1.88 ± 1.04
Work environment dimension	1.97 ± 0.81
Lack of personal protective equipment practice and infection prevention measures	1.81 ± 1.06
Fear of infection, uncertainty whether protection is adequate; for example, fear that masks are not tight-fitting and leak	1.69 ± 1.07
Wearing protective equipment makes it difficult to communicate with patients and blocks sound	1.42 ± 0.94
Various types of protective equipment models not known to meet protection requirements	1.40 ± 1.02
Protective equipment was uncomfortable and the work was difficult, producing difficulty breathing, sweating, poorer vision, and headache if worn for a long time	1.15 ± 1.01
The difficulty of conducting nursing procedures increased while wearing protective equipment	1.15 ± 1.05
Occupational protection dimension	1.44 ± 0.75
My family and friends did not support my work and even criticized me	2.42 ± 1.01
Working in the isolation ward left me feeling lonely and helpless	2.23 ± 0.98
I became a scapegoat for patients to vent their dissatisfaction and societal complaints	2.13 ± 1.05
Managed, argued with and received complaints from visiting family members	2.11 ± 1.04
Felt discriminated against because surrounding individuals feared infection; I felt unwelcome	2.10 ± 1.04
Exhaustion from answering telephone calls from family, friends and colleagues	1.92 ± 1.04
Collecting tedious medical history and receiving patients and visitors can be exhausting	1.92 ± 1.03
Blaming yourself for coming into contact with patients who were isolated and unable to care for their families	1.64 ± 1.17
Social relationship dimension	2.06 ± 0.80
Sense of accomplishment when patients recover and are discharged from hospital	2.79 ± 0.56
Social responsibility makes me proud	2.72 ± 0.68
Feeling appreciated by leaders and colleagues; colleagues support each other	2.31 ± 0.91
Occupational value	2.61 ± 0.59