Background and aim:At the initial stage of the fight against COVID-19, a large number of medical staff and materials were dispatched to Wuhan City and Hubei Province to contain the outbreak quickly and effectively. The national infection prevention and control strategy posed a challenge to the physical and psychological resilience of frontline healthcare workers(HCWs) outside the central epidemic area.This study aims to survey frontline HCWs outside the central epidemic area in China to understand their levels of perceived stress, anxiety, and depression during the initial stage of the fight against the COVID-19 outbreak.
Methods: From February 11 to February14, 2020, an online survey was conducted in Jinzhong, Shanxi Province using snowball sampling techniques. The survey consisted of two parts, namely, demographic data and psychological screening. Demographic information included gender, age, hospital classification, working department, profession type, and working experience. Perceived stress was assessed by Chinese simple Perceived Stress Scale 10, general anxiety was assessed by the General Anxiety Disorder Scale, and depression was evaluated by the Patient Health Questionnaire-9.
Results: A total of 1,315 HCWs were included, of which 646(49.1%) reported a moderate to severe stress (scores≥14), 141(10.7%) reported moderate to severe anxiety (score≥10), and 164(12.4%) reported a major depression (score≥10). Female gender was significantly associated with high levels of perceived stress, anxiety, and depression (P<0.05), and working time was negatively correlated with the level of perceived stress, anxiety, and depression (P<0.05). Statistical difference was observed in perceived stress score among different age groups, levels of hospital group, and working departments (P<0.05).
Conclusion: During the initial stage of the fight against COVID-19 in China, more than half of the frontline HCWs outside the central epidemic area rated perceived stress as moderate to severe, and nearly 23% of them reported moderate to severe anxiety or depression. Female gender, low hospital level, and emergency department were associated with a high level of perceived stress.