Providing targeted psychological support to frontline nurses involved in the management of COVID-19: An action research

Self-care practices among professional nurses employed in primary health care clinics

BACKGROUND

 Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves.

METHODS

 A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi's data analysis strategy, and data saturation was reached.

RESULTS

 Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants' holistic well-being was compromised, as they neglected their mental well-being.

CONCLUSION

 Self-care practices among professional nurses seem unachievable. The extent of this population's self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.

Exploring the role of communication in effective nurse leadership and patient care

Nurses have to be aware of their personal responsibility to demonstrate effective leadership and thereby contribute to safe and effective patient care. One of the primary skills that nurses can use to become effective leaders is communication. This article explores how communication is a vital tool in enabling nurse leaders to motivate their team members and advocate for patients. The author details some of the essential communication skills that nurses require if they are to promote person-centred care and explores the often-neglected areas of non-verbal and written communication. By possessing a full range of communication skills, nurses can empower themselves to lead clinical teams and advocate for patients.

A mixed methods study: The grief experience of registered nurses working on the frontlines during the COVID-19 pandemic

AIM AND OBJECTIVE

The purpose of this study was to generate a conceptual definition and theory of grief for nurses working on the frontlines during the COVID-19 pandemic using grounded theory methodology.

BACKGROUND

The COVID-19 pandemic has had a negative impact on nurses working on the frontlines. The increasing flow of diagnosed COVID-19 cases, diverse unknowns and demands in the treatment of patients with COVID-19, and depression related to countless deaths can trigger grief experiences.

DESIGN

A mixed methods approach, including the qualitative method of grounded theory and a quantitative 30-question survey, was used in this study.

METHODS

Eight focus group sessions were conducted with registered nurses working on the frontlines during the pandemic. Sessions were audio recorded and analysed using constant comparative data analysis. Following the interviews, a survey including demographics and self-report inventories was completed by participants. The COREQ checklist was used to assess study quality.

RESULTS

Major concepts that emerged include 'facing a new reality', 'frustrations', 'stress' and 'coping'. Core concepts were combined into a conceptual definition of grief and a grounded theory of the experience of nurses working on the frontlines during the pandemic. Cross comparisons of qualitative and quantitative findings were made and compared with the literature.

CONCLUSIONS

This study provides a better understanding of the grief experience of nurses working on the frontlines during the COVID-19 pandemic. It is necessary to recognise professional grief and develop intervention strategies that lead to grief reconciliation.

RELEVANCE TO CLINICAL PRACTICE

Findings provide useful insights for healthcare administrators to provide support and develop interventions to reduce frustrations and stress of frontline registered nurses.

PATIENT OR PUBLIC CONTRIBUTION

This study design involved registered nurses participating in focus group sessions. Participants detailed their experience working on the frontlines of the COVID-19 pandemic with patients, family and hospital administration.

Fear of COVID-19, Stress and Coping Strategies among Nurses during the COVID-19 Pandemic's Second Wave: A Quasi-Intervention Study

Background

The COVID-19 pandemic and its related consequences caused a higher risk of mental health problems for nurses. Hence, this study aims to reduce the level of fear and stress related to the COVID-19 pandemic and promote active coping among Egyptian nurses.

Methods

This quasi-intervention study was conducted on 125 nurses working at Benha's University hospitals, who were selected by a systematic random sampling technique within the time interval of March 2021 to July 2021. The study was conducted using the fear of COVID-19 scale, the stress scale of depression, anxiety and stress scales, and the Brief (COPE) inventory scale.

Results

The mean ages of the studied nurses were 36.70 ± 9.50. Almost half of the studied nurses were males and married. Before the intervention, 47.2% of nurses had severe stress levels while 82.4% had a high level of fear of COVID-19. Experience years, type of department, and worries about vaccine side effects were the predictors of the fear of COVID-19. A significant difference (p = .000) was found between both mean stress and fear scores pre-intervention (15.27 ± 5.47 and 25.56 ± 6.13) and post-intervention (4.87 ± 2.14 and 11.92 ± 2.43). The most prevalent coping strategies among nurses before the intervention were self-distraction (5.03 ± 1.53), followed by behavioral disengagement and self-blaming. However, after the intervention, religion was found to be the utmost coping mechanism (6.12 ± 1.17), followed by positive reframing and acceptance.

Conclusion

The majority of the nurses in the study reported a significant fear of COVID-19, and around half of the nurses had severe stress as a result. After the intervention, the stress and fear scores were reduced by half or even less. Age, longer work experience, and worries about the vaccine were the predictors of fear of COVID-19. The coping strategies used after the intervention shifted toward active coping strategies. Clinical Trial Registration Number: 10-11-008-701.

Grief experiences of nurses who lose their first-degree relatives with the diagnosis of COVID-19: A qualitative study

The grief experiences of healthcare professionals have both short- and long-term effects. This qualitative study was conducted between December 2022 and January 2023 to examine the grief experiences of nurses who lost their first-degree relatives to COVID-19. In this study, 22 nurses working in hospitals in Turkey were selected through a snowball sampling process. Data were collected with the "Nurse Information Form" and "Semi-Structured Interview Form." Nurses were interviewed individually approximately 30 minutes. Collaizzi's phenomenological analysis and MAXQDA 2020 software were used to analyze the data. A COREQ Statement Checklist was followed in the preparation of this study. The following five themes were identified: (1) Complex and deep feelings, (2) An inevitable end, (3) An innocent death, (4) Secluded funerals and rituals that could not be performed, and (5) Endless mourning. It is recommended to plan methods to protect nurses' psychosocial health and maintain their hopes during the grieving process.

Community Health Nursing During the COVID-19 Pandemic in Korea: Consequences, Challenges, and Directions

PURPOSE

To explore the consequences, challenges, and future directions based on community health nurses' experiences during COVID-19.

DESIGN

Qualitative study. Four focus group interviews were conducted with 27 community health nurses.

FINDINGS

Three major themes emerged: 1) Coordination of roles and duties, 2) Identifying deterioration of patients' health and increasing demand for visits, and 3) Changing service delivery strategies: a testing ground for new services.

CONCLUSIONS

Community health nurses were essential public healthcare providers during the pandemic. The findings are informative for nurses and policy makers who can develop and suggest different services in the post-COVID era.

An integrative review of factors and interventions affecting the well-being and safety of nurses during a global pandemic

BACKGROUND

Nurses experienced physical and mental exhaustion during the COVID-19 pandemic. Understanding the impact of the pandemic on nurses and effective strategies to support them is critical for increasing nurse resilience and reducing burnout.

AIMS

The aims of this study were (1) to synthesize the literature examining how factors associated with the COVID-19 pandemic affected the well-being and safety of nurses (2) and to review interventions which may promote nurse mental health during crises.

METHODS

Using an integrative review approach, a comprehensive search of the literature was conducted in March 2022 using the following databases: PubMed, CINAHL, Scopus, and Cochrane. We included quantitative, qualitative, and mixed-method primary research articles published in English in peer-reviewed journals from March 2020 through February 2021. Included articles focused on nurses caring for COVID-19 patients and addressed psychological factors, supportive hospital leadership strategies, or interventions to support well-being. Studies were excluded if they focused on professions outside of nursing. Included articles were summarized and appraised for quality. Findings were synthesized using content analysis.

RESULTS

Of the 130 articles initially identified, 17 were included. Articles were quantitative (n = 11), qualitative (n = 5), and mixed methods (n = 1). Three themes were identified: (1) loss of life, hope, and professional identity; (2) lack of visible and supportive leadership; and (3) insufficient planning and response. These experiences contributed to increased symptoms of anxiety, stress, depression, and moral distress in nurses.

Perceived social support and professional identity in nursing students during the COVID-19 pandemic era: the mediating effects of self-efficacy and the moderating role of anxiety

BACKGROUND

Health professionals, including nurses, experienced heavy workloads and significant physical and mental health challenges during the coronavirus disease (COVID) 19 pandemic, which may affect career choices for those considering nursing and for nursing students. The COVID-19 pandemic is not only a period of risk, but also an occasion to redeploy the professional identity (PI) of nursing students. However, the relationship between perceived social support (PSS), self-efficacy (SE), PI and anxiety remains unclear under the background of COVID-19. This study aims to explore whether PSS has an indirect effect on PI through mediation of SE and whether the anxiety can moderate the relationship between PSS and SE in nursing students during their internship period.

METHODS

An observational, national cross-sectional study was conducted following the STROBE guidelines. An online questionnaire was completed by 2,457 nursing students from 24 provinces in China during their internship during September to October 2021. Measures included Chinese translations of the Professional Identity Questionnaire for Nursing Students, the Perceived Social Support Scale, the General Self-Efficacy Scale, the 7-item Generalized Anxiety disorder scale.

RESULTS

Both PSS (r = 0.46, p < 0.001) and SE (r = 0.51, p < 0.001) were positively correlated with PI. The indirect effect of PSS on PI through SE was positive (β = 0.348, p < 0.001), with an effect of 72.7%. The results of the moderating effect analysis showed that anxiety attenuated the effect of PSS on SE. Moderation models indicated that anxiety has a weak negative moderating effect on the effect of PSS on SE (β =-0.0308, p < 0.05).

CONCLUSIONS

A better PSS and higher scores in SE were associated with PI in nursing students, and a better PSS had an indirect effect on the PI of nursing students through SE. Anxiety played a negative moderating role in the relationship between PSS and SE.

Psychological distress experienced by nurses amid the fifth wave of the COVID-19 pandemic in Hong Kong: A qualitative study

Introduction

The fifth wave of COVID-19 has significantly overburdened the health care system in Hong Kong. Health care professionals, particularly nurses continue to experience significant levels of psychological distress when tackling this ongoing outbreak. Yet, no study has explored the psychological experiences of nurses during the most recent outbreak of the highly transmissible Omicron variant in Hong Kong. The aim of this qualitative study was to explore the psychological distress experienced by nurses during the fifth wave of the COVID-19 pandemic in Hong Kong.

Methods

Twenty-two nurses (14 female and 8 male nurses; average age, 36.7 ± 8.5 years) were recruited to attend the one-to-one semi-structured telephone interviews from June to July, 2022. Data were analyzed using thematic analysis.

Results

Four main themes emerged from the interview: (1) Intense fear, worry, and anxiety; (2) Feeling worn out and psychologically distress; (3) Impact on psychosocial and physical health; and (4) Limited options to cope with psychological distress during the difficult times.

Discussion

Our study findings may provide concerned stakeholders with useful insights into reducing the psychological distress experienced by nurses in Hong Kong. Offering psychological support is of paramount importance to address the unmet psychological needs of nurses and reduce their psychological distress during the pandemic, particularly when they are working under high levels of workplace stress.

A systematic review on the use of action research methods in mental health nursing care

AIMS

To identify and synthesize evidence on the use of action research methods in mental health nursing care.

DESIGN

Systematic review.

DATA SOURCES

CINAHL, Web of Science, PubMed and Scopus databases were searched in January 2021.

REVIEW METHODS

Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Two reviewers independently conducted the study selection, and quality appraisal using Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, data extraction and data analysis procedures.

RESULTS

Sixteen studies, half of which used participatory action research, were included in this review. Nurses, along with other stakeholders, were an active part of the action research process. The main topics of interest addressed were categorized as improving the adoption of a person-centred approach to care and improving decision-making procedures. The use of action research helped the participants to identify the meaning they attached to the topic of interest to be improved. Moreover, this method helped to identify needs and strategies for improving care. The studies concurred that the use of action research enabled participants to gain awareness, improve attitudes and acquire knowledge. In addition, it enabled participants to gain confidence and security in the group context, as key aspects of their empowerment.

CONCLUSION

This review shows the usefulness of action research in any mental health nursing context, contributing to the improvement of care at both the individual and collective levels.

IMPACT

This paper demonstrates the use of the action research method in the field of mental health nursing. Its use has improved the clinical practice of nurses as well as that of teams in both community and hospital settings, addressing issues of the person-centred approach to care and decision-making procedures.

The therapeutic relationship at the heart of nursing care: A participatory action research in acute mental health units

AIMS AND OBJECTIVES

To explore the process of change within the clinical practice of nurses in mental health inpatient units in the context of a participatory process to improve the nurse-patient therapeutic relationship.

DESIGN

Participatory Action Research.

METHODS

Ninety-six nurses from 18 mental health units participated. Data were collected through focus groups and reflective diaries between March 2018 and January 2020. Data were analysed using inductive content analysis. The COREQ guidelines were used.

RESULTS

The research process was carried out through two cycles of four stages each in which the nurses were able to identify the facilitating and limiting elements of their practice in relation to the therapeutic relationship. They then proposed two consensual improvement strategies for all the units, which they called reserved therapeutic space and postincident analysis. Finally, they implemented and evaluated the two strategies for change.

CONCLUSIONS

This study has shown that, despite the different cultural and structural realities of the participating units, it is possible to implement a collaborative process of change, provided the needs and expectations of both the participants and the organisations are similar.

RELEVANCE TO CLINICAL PRACTICE

The results obtained through Participatory Action Research were directly transferred to clinical practice, thus having an impact on individual nurses and patients, as well as on the collective dynamics of the teams and aspects related to the management of the units.

NO PATIENT OR PUBLIC CONTRIBUTION

Patient or public input is not directly applicable to this study. Patients were recipients of the changes that were occurring in the nurses as part of their daily clinical practice.

Does transformational leadership and psychological empowerment improve nurses' innovative behaviour during COVID-19 outbreak? A cross-sectional study

AIMS

To investigate the relationships between transformational leadership, psychological empowerment and innovative behaviour among nurses in China.

BACKGROUND

The innovative behaviour of nurses is important to adapt to the changing medical environment. However, there is currently a limited understanding of the relationship between nurses' innovative behaviour and transformational leadership and psychological empowerment during the pandemic.

METHODS

Convenience sampling was used to conduct an investigation involving 1317 nurses from 10 hospitals in China from January 2022 to April 2022. Data analysis was performed using correlation analysis, univariate analysis and multiple regression analysis. The STROBE checklist was followed when writing this manuscript.

RESULTS

High transformational leadership and high psychological empowerment were associated with high innovative behaviour. The results of the multiple linear regression analysis showed that physical condition, whether or not you have attended academic conferences or whether or not you have participated in fund research projects, transformational leadership and psychological empowerment were the main factors on nurses' innovative behaviour, together explaining 64.5% of the total variance.

CONCLUSION

Promotion of transformational leadership and psychological empowerment is vital for nurses to promote innovation, thereby meeting the urgent demand for innovative nurses and the rapid development of nursing disciplines.

IMPLICATIONS FOR NURSING MANAGEMENT

This study highlights the importance of transformational leadership in developing nurses' innovative behaviours. Understanding the role of psychological empowerment can help nurse managers formulate relevant intervention strategies and cultivate nurses' innovative behaviour.

Improvement of the psychosocial support for frontline nurses in public hospitals during COVID-19 pandemic

AIM

The aim of this study was to explore and describe the psychosocial support for frontline nurses during the COVID-19 pandemic in the Tshwane district, Gauteng Province, South Africa.

BACKGROUND

The COVID-19 pandemic has brought a lot of psychosocial distress for frontline nurses taking care of COVID-19 patients. The frontline nurses were scared of being infected with COVID-19, or exposing their families and loved ones to the risk of infection. A high number of nurses were infected with COVID-19, and some died due to the virus.

EVALUATION

This study followed a qualitative, explorative, and descriptive research design. Data were collected using semi-structured interviews and individual interviews were conducted. Seventeen participants, who consisted of all categories of nurses taking care of COVID-19 patients, were interviewed until data saturation was reached. Non-probability sampling method was used as a technique to select the participants. Data were analysed using Tesch's method of open coding.

KEY ISSUES

The following five themes are identified: (1) acknowledgement, appreciation, and recognition of frontline nurses, (2) conducive managerial practices, (3) debriefing and training of frontline nurses, (4) human resources support, and (5) psychological and social support for frontline nurses and their families.

CONCLUSION

The implementation of the psychosocial support for frontline nurses taking care of COVID-19 patients is critical in improving patient care.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings of this study should alert nurse managers to plan the best way to support frontline nurses caring for COVID-19 patients.

Prevalence Of Sleep Disorders Among Physicians And Nurses During COVID-19 Pandemic

The objective of our review was to analyze studies of prevalence sleep disorders among medical workers during COVID-19 pandemic. Material and Methods — Overall, during the analyzed period, studying domestic and foreign databases, we identified 94 publications on the development of sleep disorders among medical personnel working during COVID–19 pandemic in 2000-2021. However, only 88 of these publications complied with the objective of the review. We included 75 full-text publications in this review. Results — Physicians and nurses during COVID-19 pandemic do not have the opportunity to take therapy aimed at combating the symptoms of sleep disorders, due to the need to maintain sufficient attention and the risk of developing excessive drowsiness while on duty in a COVID -19 hospital. The latter can have a negative impact on their professional activities. Thus, this problem certainly requires professional psychotherapeutic correction. Unfortunately, not all medical institutions have such specialists. Conclusion — Based on the literature review, we found out that health care workers have a high risk of developing sleep disorders. This can include violations of the circadian rhythm, a decrease in the quality and duration of night sleep, daytime hypersomnia caused by shift work in a hospital. An additional factor affecting the frequency and severity of sleep disorders in healthcare workers (physicians and nurses) is chronic stress, the importance of which has increased during the COVID-19 pandemic. Currently, the above problem has not been completely solved and requires research in this area and the development of new programs to help medical personnel.

Effect of a group-based acceptance and commitment therapy program on the mental health of clinical nurses during the COVID-19 sporadic outbreak period

Aim

To develop and implement of a group‐based acceptance and commitment therapy programme in helping clinical nurses with mental health problems during the sporadic COVID‐19 outbreak period.

Background

In the face of the continuing COVID‐19 pandemic, clinical nurses have a high risk of mental health issues.

Methods

A quasi‐experimental design was used. Two hundred twenty‐six nurses were recruited from four general hospitals to receive 10 sessions of acceptance and commitment therapy programme. The Symptom Checklist‐90, Perceived Stress Scale and Connor–Davidson Resilience Scale were used to assess nurses' mental health symptom, perceived stress and psychological resilience at pre‐intervention and 4‐week post‐intervention.

Results

The mean attendance sessions was 5.78. The Symptom Checklist‐90 score was significantly lower at post‐intervention than pre‐intervention (P < 0.01), and there were no significant changes of perceived stress and psychological resilience. There were significant correlations among the changed rates of mental health, perceived stress and psychological resilience (P < 0.01).

Conclusion

The acceptance and commitment therapy programme was effective in relieving mental health symptoms for clinical nurses and could protect clinical nurses' perceived stress and psychological resilience. However, a randomized controlled trial is needed to confirm the findings.

Implication for Nursing Management

To facilitate clinical nurses' psychological health in crisis situation, nursing management team should provide and allocated appropriate resources to support the healthcare providers.

The Communication Challenges and Strength of Nurses' Intensive Corona Care during the Two First Pandemic Waves: A Qualitative Descriptive Phenomenology Study

Intensive care nurses working with patients with severe COVID-19 illness are at the center and frontline of the dynamic pandemic, which poses communication challenges and demands of unusual strength on their part. The study aim was to capture the lived experience of intensive care COVID nurses' communication challenges and strengths as they cared for COVID-19 intensive care patients during the two first pandemic waves. The study used qualitative descriptive-phenomenology research designs. Twenty-two nurses were selected using snowball sampling, and online interviews were conducted with them. Data were recorded and transcribed, then reflexively double-coded for increased rigor. Four major themes emerged from the data. The first two expressed the communication challenges and difficulties communicating with patients due to the extreme protection needed and/or their medical condition. However, the other two themes expressed the nurses' strengths-sharing feelings with other caregivers and family. Accordingly, we recommend using simple language and ensuring patient comprehension, as well as creating an optimistic environment for fostering caregiver bonding.

Factors Associated With Post-traumatic Stress Disorder Among Nurses During COVID-19

OBJECTIVE

To investigate post-traumatic stress disorder (PTSD), perceived professional benefits and post-traumatic growth (PTG) status among Chinese nurses in the context of the COVID-19 pandemic and to compare the differences between nurses working inside and outside Hubei.

METHODS

From February 18 to February 25, 2020, the authors constructed the questionnaire using the Questionnaire Star platform, and convenience sampling was used to distribute the questionnaire via WeChat. Nurses who worked at the hospital during the COVID-19 pandemic were the research subjects.

RESULTS

A total of 3,419 questionnaires were received, of which 2,860 nurses were working outside Hubei Province and 559 nurses were working inside Hubei Province. Both groups were exposed to COVID-19. The results indicated that gender, job title, department, average monthly income, the number of night shifts per month, hospital classification, specialization, and previous experience with assisting during disasters were statistically significant. The t-test results showed that the difference in perceived professional benefits scores between the two groups was not statistically significant, and the differences in PTG scores and PTSD scores between the two groups were statistically significant. The chi-square test indicated that the difference in PTSD prevalence between nurses working outside and inside Hubei Province was statistically significant and that the PTSD prevalence of nurses working outside Hubei Province was higher than that of nurses working inside Hubei Province. One-way ANOVA and independent sample t-test results showed that age, job title, job assignment, length of service, average monthly income, number of night shifts per month, number of children, and the Nurses' Perceived Professional Benefits Scale (NPPBS) and post-traumatic growth inventory (PTGI) scores influenced the prevalence of PTSD. Logistic regression showed that the occurrence of PTSD was associated with average monthly income, length of service, number of children, and the PTGI and NPPBS scores.

CONCLUSION

During the COVID-19 pandemic, nurses working outside Hubei Province reported greater PTSD than those working inside Hubei Province. The occurrence of PTSD was related to average monthly income, length of service, number of children, and the PTGI and NPPBS scores.

Mediating role of career self-efficacy between clinical learning environment and professional identity in nursing students

AIMS

To explore whether the clinical learning environment (CLE) has an indirect effect on professional identity through the mediation of career self-efficacy (CSE) in nursing students.

BACKGROUND

The shortage of nurses has become a universal problem worldwide. Improving nurses' professional identity is considered an effective way to reduce the turnover rate of nurses. However, little is known about the relationship between the CLE, CSE and professional identity.

DESIGN

An observational, questionnaire-based, cross-sectional study.

METHODS

A web-based survey was completed by 212 undergraduate nursing students from June to August 2018. Measures included Chinese translations of the CLE, the Career Self-Efficacy Scale, and the Professional Identity Scale.

RESULTS

Both the CLE (r = 0.552, p < 0.01) and CSE (r = 0.868, p < 0.01) correlated positively with professional identity. The indirect effect of the CLE on professional identity through CSE was positive (β = 0.342, p < 0.05) and the effect was 77.2%.

CONCLUSIONS

A better CLE and higher scores in CSE were associated with professional identity in nursing students, and a better CLE had an indirect effect on the professional identity of students through CSE.

The organisational and managerial challenges experienced by nurses recovered from COVID-19: A phenomenological study

Aim

This study was conducted to discover the organisational and managerial challenges of nurses recovered from COVID‐19.

Background

Nurses, who are at the front line of fighting against COVID‐19, face numerous organisational and managerial challenges that impose a burden on their already heavy burden of infection. Working in challenging situations can affect the quality of nursing care.

Methods

This qualitative study was conducted through an interpretive phenomenological approach. To collect the data, 18 semistructured interviews were held with 15 recovered nurses, which were then analysed using van Manen's method.

Results

The data analysis led to the extraction of four themes: nurses as victims of organisational prejudice, a profession surrounded by problems, insufficient sources for dealing with COVID‐19 and post‐COVID‐19 development.

Conclusion

This study showed the organisational and managerial challenges of recovered nurses from COVID‐19. Although these nurses had positive experiences, they needed eliminating organisational prejudice, minimizing concerns and sufficient resources to deal with the crisis.

Implications for nursing management

It is believed that these results can be used as a guide to nurse managers to improve the experience of recovered nurses from COVID‐19 by treating all employees with equal kindness, considering to their problems and minimizing burden by actively providing resources.

Protective and Risk Factors for Medical and Nursing Staff Suffering From Psychological Symptoms During COVID-19

Background: With the outbreak of the coronavirus disease 2019 (COVID-19) epidemic in China, the general public but also medical staff were confronted with psychological challenges, suffering from the highly infectious and unknown characteristics of COVID-19. In this study, we surveyed psychological symptoms including anxiety, depression, and sleep disorders in medical staff.

Method: A questionnaire star/WeChat link-based survey assessing the Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9 depression, the Insomnia Severity Index, Social Support scales in addition to lifestyle, and income level was conducted and included 8,288 medical staff from 24 provinces in China. Pearson Chi-square and Mann-Whitney U-tests were used to evaluate single risk factors and significant differences in psychological symptoms before and during the outbreak of COVID-19. Binary logistic regression analyses were conducted for the risk factors of anxiety, depression, and sleep disorder symptoms.

Results: Medical staff had a high incidence of psychological symptoms, which was more prominent during the COVID-19 epidemic. Comparatively, females, nurses, first-line department, never exercised, and low income were risk factors for psychological symptoms. Social support including objective support, subjective support, support utility, and regular sports over 3 times per week were protective and manageable elements that could protect from and manage the psychological symptoms of medical staff.

Conclusion: The susceptibility of psychological symptoms among medical staff should be of concern to policymakers and the public in the long-term, and the aggravation of mental health problems of medical staff could be eased by providing adequate social support during and after the COVID-19 outbreak.