With the change of time, the medical staff no longer simply pursues the income but also pays more attention to their SWB. In this cross-sectional study, we measured the SWB of medical staff using the WEMWBS scale and explored the factors that influence medical staff SWB. We found that the SWB scores were low, which lower than previously reported [4, 27-30]. As far as we know, only a few studies used WEMWBS to measure the SWB of medical staff in mainland China. WEMWBS results can be used to measure mental health. In addition, our study can lead medical staff to adopt interventions to improve the SWB.
Comparison with other studies
We found that the SWB score of medical staff aged 20–29 was the highest, and those aged 40 and above had the lowest scores. This finding is different from that presented in a previous study that found that young age correlated with low SWB . The reason for the discrepancy may be differences in providing for the aged views, in China, people are responsible for their parents, and adults over 40 years old need to pay more attention to their children, who are passing through a critical time in their lives.
Government support policies  for the elderly abroad are excellent, and the development of nursing homes has improved, as a result, children are under less pressure to support their parents. In addition to these family factors, clinical pressure increases workload, including promotion-related stress and the conflict between clinical and academic requirements. All these factors can create challenges for medical staff. Younger medical staff are beginning their careers with less family and work pressure. These facts might explain why we found that SWB of medical staff over 40 years old was the lowest.
Marital status is another critical factor. Our study aligned with previous studies finding that marital status influences mental health. Unmarried medical staff scored slightly higher than married staff in our study. Interestingly, when we reviewed other studies, we found that married people had higher levels of SWB than those who were unmarried, divorced, or separated . This may be due to the more complex family structure and interpersonal relationships after marriage. Such individuals need to deal with relationships and financial issues from several families.
The divorce rate has increased recently . This fact indirectly suggests that married medical staff may be more vulnerable to the impact of marriage. Meanwhile, the age at marriage has become generally older. Furthermore, the minimum requirement for entering the medical industry is undergraduate education, and medical work typically begins at 23 years of age. Such individuals tend to have parents with relatively good physical status, therefore, these physicians might not need to care for their parents, resulting in less stress. Because of changes in fertility attitudes, most young medical staff are only children and prefer to be alone. They do not need the company of another person, therefore, unmarried people have a higher SWB than married medical staff.
BMI also affects the mental health of medical staff. Our study supports previous work demonstrating that low BMI correlates with high SWB . This finding might be related to the mainstream aesthetic ideal of thinness as beauty in China. With changes in health concepts, people are eating healthier, and their BMIs are more often in the normal range. Furthermore, the living standards of Chinese people have improved substantially in recent decades. Increasing numbers of Chinese people are willing to spend more time paying attention to nutrition-related knowledge and engage in more moderate food intake. Medical staff have more nutrition knowledge than the general population. Therefore, their BMIs are at healthier levels. Their physical health state can represent a healthier mental state.
While some situations lead to short-term fluctuations (and in some cases, long-term changes in well-being), substantial research has supported a dispositional perspective of well-being . Extroverts had the highest correlation with positive affect . They are more eager to socialize and show more significant affinity to others. By contrast, in the present study, medical staff who reported an introverted personality were happier . This finding may have resulted from the fact that extroverts could not go out and travel during the epidemic. Furthermore, extroverts could not spend time with friends as usual after work. Nevertheless, extroverts change more than introverts to adapt to this situation. Extroverts have more difficulty than introverts with adjusting to these changes.
There was an unexplained phenomenon in our study. Participants reported that medical staff who consume fruits and vegetables less than once per day had the highest SWB. This differs from Saverio's findings, which suggested that fruit and vegetable intake may play a potential role as a driver of physical and mental well-being in the general population . Medical staff consuming more fruits and vegetables have a healthier mental state. Further research is needed to explore the reasons for this discrepancy, nevertheless, the discrepancy might be related to the setting of this questionnaire. First, this questionnaire was translated directly from the English version. Due to the difference in eating habits at home and abroad, the number of vegetables and fruits in the questionnaire was somewhat unclear. Because of the epidemic, we conducted an online questionnaire, and we could not interpret questions face-to-face. Thus, the results of this paper differ from other studies. This topic needs further investigation and discussion.
Those who never engage in physical activity per week had the highest SWB score. We analyzed the possible reasons for the differences in results from other studies [40, 41] and speculated that this finding might be related to the nature of their work. The medical staff felt exhaustion when they exercised after work. The workload meets the guidelines for 30 to 90 minutes per day and 150 to 300 minutes per week of moderate physical fitness activity. Most medical staff will not use their spare time to engage in extra physical exercise.
Job type could also influence medical staff SWB. We found that physicians have the highest SWB, followed by nurses, others had lower scores, inconsistent with previous findings . This discrepancy might be related to the fact that patients trust physicians more than other positions. Their sense of accomplishment is relatively high, therefore, they have the highest sense of SWB. Doctors and nurses have more opportunities to contact patients. They provide more help to patients than others in the hospital. Doctors and nurses can better experience the joy of giving from it. Higher senses of accomplishment correlate with higher SWB. Nevertheless, it is worth discussing the results of this study, which had a higher percentage of nurses. The conclusion needs a more appropriate ratio among medical staff.
In other studies, the workload was related to decreased SWB [42, 43], consistent with our present findings. In the present study, medical staff who work 8–12 hours appeared to feel happier. Those who work 12–14 hours per day or 3-night shifts per week had the lowest mental health. This finding might be due to the shortage of medical staff, especially nurses. In China, the nurse-bed ratio is less than 0.4:1, and the daily workload is heavier . It is challenging for medical staff to obtain happiness in such conditions because of the imposed mental stress due to the demand for knowledge, heavy work tasks, and the tension between physicians and patients. They do not have too much time to pay attention to their health, which will affect their physical health for a long time and lead to lower SWB. Our findings suggest that reducing workload plays a significant role in improving the SWB of medical staff. Hospital managers should adjust work arrangements, and they should pay close attention to the mental state of doctors and nurses. In this manner, leaders could understand the medical staff’s basic situation and take adequate measures to reduce medical staff burdens and improve SWB.
We found that medical staff who reported better general health than one year earlier had higher SWB scores. General health is a subjective judgment made by individuals according to their health status, reflecting their psychological and physical status to a certain extent. Due to the unique nature of their profession, medical workers encounter dramatic changes in disease. As a result, they are more sensitive to health than other groups, especially new physicians and nurses. Medical staff who believe their health status is better than in the past pay more attention to themselves and are more enthusiastic about life. Studies have shown that medical staff are affected by life and death situations . Anxiety, depression, and other disorders are common, and negative emotions affect individual SWB. It has been shown that self-rated general health affects individual SWB indirectly by influencing mental health , poor general health correlates with poor mental health status. When medical staff feel uncomfortable, they are more likely to generate worse outcomes because of their expertise. They particularly worry about their physical health, which can lead to depression and even anxiety, and they relieve these feelings in many ways to improve their SWB [47, 48].
Our research is preliminary, therefore, some limitations warrant discussion. First, the sample size was small, and most of the participants were recruited from Zhejiang province, which may not be generalizable to other populations. Further investigation with larger samples of medical staff from other areas is necessary. Second, there were 521 women, accounting for 91.1% of the total. The ratio of men and women was not coordinated, and most were nurses, while doctors and other medical staff accounted for a small proportion. Finally, we used an online questionnaire due to the epidemic, and researchers could not supervise or explain the questions. Completion and recovery rates could not be guaranteed. Finally, respondents could only provide give answers based on established questions. They could gain a deeper understanding of their views.