Occupational Stress and Mental Health: A Comparison Between Frontline Medical Staff and Non-frontline Medical Staff During the 2019 Novel Coronavirus Disease Outbreak

Xie Zhang; Ke Zhao; Guohua Zhang; Ruihua Feng; Jianjun Chen; Dongwu Xu; Xiaodong Liu; Arlette J Ngoubene-Atioky; Hong Huang; Yanlong Liu; Li Chen; Wei Wang

doi:10.3389/fpsyt.2020.555703

Occupational Stress and Mental Health: A Comparison Between Frontline Medical Staff and Non-frontline Medical Staff During the 2019 Novel Coronavirus Disease Outbreak

Front Psychiatry. 2020 Dec 23:11:555703. doi: 10.3389/fpsyt.2020.555703. eCollection 2020.

Authors

Xie Zhang¹, Ke Zhao^{2

3}, Guohua Zhang^{2

3}, Ruihua Feng², Jianjun Chen³, Dongwu Xu^{2

3}, Xiaodong Liu⁴, Arlette J Ngoubene-Atioky⁵, Hong Huang⁴, Yanlong Liu^{2

3

4}, Li Chen^{2

3}, Wei Wang^{2

3}

Affiliations

¹ Department of Pharmacy, Ningbo Medical Center Li Huili Hospital, Ningbo, China.
² The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
³ School of Mental Health, Wenzhou Medical University, Wenzhou, China.
⁴ Center for Health Assessment, Wenzhou Medical University, Wenzhou, China.
⁵ Center for Psychology, Goucher College, Baltimore, MD, United States.

Abstract

Background: During an epidemic, both frontline and non-frontline medical staff endure stressful work circumstances that render their mental health a major public health concern. This study aims at investigating and comparing the prevalence and severity of mental health symptoms (i.e., anxiety, depression and insomnia) between frontline medical staff and non-frontline medical staff during the coronavirus disease 2019 (COVID-19) outbreak. It also seeks to evaluate the association of their mental health with occupational stress. Methods: A cross-sectional study was conducted in Wenzhou, China from 2020 February 16th to 2020 March 2th. A total of 524 medical staff responded to the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, the Insomnia Severity Index, the Occupational stress Questionnaire, and a demographic data form. Data were principally analyzed with logistic regression. Results: Of the 524 participants, 31.3% reported depression, 41.2% reported anxiety, and 39.3% reported insomnia. Compared with the citizens during the COVID-19 epidemic, medical staff experienced higher level of anxiety, depression and insomnia, especially the frontline medical staff. Furthermore, male, married medical staff with poorer physical health reported lower mental health. Frontline medical staff endorsed higher self-reported occupational stress, especially higher occupational hazards, than non-frontline medical staff. In addition, four indicators on occupational stress (working intensity, working time, working difficulty and working risk) were correlated positively with mental health symptoms. Regression analyses found a significant association between occupational stress and mental health symptoms in both frontline and non-frontline medical staff during COVID-19 outbreak. Conclusion: The results indicated that during the COVID-19 epidemic, medical staff experienced higher levels of anxiety, depression and insomnia than citizens, and their occupational stress had positive effects on their psychological distress. These findings emphasize the importance of occupational stress management interventions to decrease the risk of developing mental health problems among the medical staff during a biological disaster.

Keywords: COVID-19; anxiety; depression; insomnia; medical staff; occupational stress.