In a pandemic, health care workers face greater risk of infection and undertake higher work intensity as compared with the general population. This can lead to excessive fatigue and tension which led to anxiety, sadness, grievance, helplessness, and depression, among other emotions. As our results showed, 8.2% of the respondents frequently felt anxious, which is similar to the findings from Liu et al.
Multivariate analysis showed that the socio-demographic characteristics associated with HRQoL of the respondents were gender, age, occupation and education. Females were associated with worse scoring than males in emotional functioning and cognitive functioning. We hypothesize that the HRQoL of doctors was worse than that of nurses because doctors receive patients first, and they need to conduct physical patient examinations (e.g., pharynx examinations), leading to a relatively higher risk of infection than nurse. The HRQoL of respondents living in Hubei Province was worse, which may be related to the more serious epidemic situation and higher risk of infection.
Multivariate analysis also showed that HRQoL was closely related to COVID-19 protection-related characteristics, especially establishment of independent settings for the fever clinic and isolation area, as well as the treatment of patients with COVID-19 or suspected COVID-19. We hypothesize that these two factors were closely related to the risk of infection. The higher the possibility of infection, the more likely professionals are to suffer from anxiety. According to the joint investigation report from the China-World Health Organization and the relevant data released by the Chinese government, nosocomial infections among medical staff largely occurred in the early stage of COVID-19 infection, primarily in Wuhan when there was a lack of materials and experience in dealing with the disease.These findings suggest that it is critical to strengthen the safety of health care workers. Measures should be taken to reduce the risk of nosocomial infection, such as triage outside of hospitals (e.g., in tents or other shelters), establishment of an independent fever clinic and isolation area, and an adequate supply of protective equipment.
After the outbreak of the epidemic, the National Health Commission of China issued the guideline for emergency psychological crisis intervention during the outbreak of COVID-19 on January 26, 2020. This guideline has formulated psychological intervention programs and key points for different personnel, such as people infected with COVID-19, personnel under quarantine, front-line staff, and the general public. According to our results, we believe that in addition to adopting the guidelines for daily psychological crisis intervention, we should also consider more targeted interventions according to the characteristics of pediatric medical staff to allay their concerns and improve their HRQoL. If the conditions permit, measures could be taken to meet their personal needs, such as care of an older family member and providing front-line staff with accommodations near the hospital. This would help maintain individual and team performance over the long run and improve the mental and physical health of these health care professionals.
There are some limitations in this study. First, since this study is a cross-sectional survey it is not possible to elucidate causal relationships. Second, the survey was conducted online, which may result in respondent bias. However, face-to-face surveys were not possible during the pandemic.