Anxiety and Insomnia Mediate the Association of Fear of Infection and Fatigue: A Cross-Sectional Survey of Nurses Deployed to a COVID-19 Epicenter in China

Zhixin Liu; Huanyu Zhang; Nan Wang; Yajie Feng; Junping Liu; Lin Wu; Zhaoyue Liu; Xinru Liu; Libo Liang; Jie Liu; Qunhong Wu; Chaojie Liu

doi:10.2147/JMDH.S421619

Anxiety and Insomnia Mediate the Association of Fear of Infection and Fatigue: A Cross-Sectional Survey of Nurses Deployed to a COVID-19 Epicenter in China

J Multidiscip Healthc. 2023 Aug 24:16:2439-2448. doi: 10.2147/JMDH.S421619. eCollection 2023.

Authors

Zhixin Liu^#^{1

2}, Huanyu Zhang¹, Nan Wang^#¹, Yajie Feng^#¹, Junping Liu¹, Lin Wu¹, Zhaoyue Liu¹, Xinru Liu¹, Libo Liang¹, Jie Liu³, Qunhong Wu¹, Chaojie Liu⁴

Affiliations

¹ Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, People's Republic of China.
² Department of Health Policy and Management, School of Public Health, Peking University, Beijing, People's Republic of China.
³ Intensive Care Unit, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China.
⁴ Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.

^# Contributed equally.

Abstract

Background: This study aimed to test the mediating role of anxiety and insomnia in the association between fear of infection and fatigue.

Methods: A cross-sectional questionnaire survey was conducted on the nurses deployed to Heihe. A serial multiple mediation model was established to determine the role of anxiety and insomnia in the association between fear of infection and fatigue.

Findings: Over half (53.0%) of the study participants reported experiencing fear of infection despite stringent personal protection measures. The scores of anxiety (11.87±5.19), insomnia (16.33±5.95), and fatigue (45.94±12.93) were moderately correlated, with a Pearson correlation coefficient ranging from 0.501 to 0.579. Anxiety, either alone or in combination with insomnia, mediated the association between fear of infection and fatigue.

Conclusion: The findings suggest that anxiety and insomnia play a mediating role in the relationship between fear of infection and fatigue. These results emphasize the importance of implementing targeted mental health interventions and work arrangements to address the well-being of healthcare professionals.

Keywords: COVID-19; anxiety; fatigue; fear of infection; insomnia.

Grants and funding

This study was supported by the National Natural Science Foundation of China (Grant Number 71974049).