Trauma exposure and depression among frontline health professionals during COVID-19 outbreak in China: the role of intrusive rumination and organizational silence

Chaofan Li; Qiaobing Wu; Debin Gu; Shiguang Ni

doi:10.1186/s12888-022-04011-0

Trauma exposure and depression among frontline health professionals during COVID-19 outbreak in China: the role of intrusive rumination and organizational silence

BMC Psychiatry. 2022 May 31;22(1):366. doi: 10.1186/s12888-022-04011-0.

Authors

Chaofan Li^{1

2}, Qiaobing Wu³, Debin Gu⁴, Shiguang Ni^{5

6}

Affiliations

¹ Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
² NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
³ Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
⁴ Institute for Hospital Management, Tsinghua University, Shenzhen, 518055, China.
⁵ Institute for Hospital Management, Tsinghua University, Shenzhen, 518055, China. ni.shiguang@sz.tsinghua.edu.cn.
⁶ Shenzhen International Graduate School, Tsinghua University, Room 403, Information Technology Tower, Tsinghua Campus, Shenzhen University Town, Shenzhen, 518055, Guangdong, China. ni.shiguang@sz.tsinghua.edu.cn.

Abstract

Background: Healthcare professionals bared particularly high risk and stress during the COVID-19 outbreak. Previous studies have demonstrated that healthcare professionals exposed to COVID-19 incurred various affective disorders including depressive symptoms, anxiety, insomnia, and distress. However, the mechanism underlying the relationship between trauma exposure and depressive symptom among frontline hospital staff has yet to be investigated. This study aims to assess the prevalence of depressive symptoms among frontline healthcare professionals in Shenzhen, China, and elucidate the complex relationship among trauma exposure, intrusive rumination, and organizational silence.

Methods: The data of this study were collected through a time-lagged panel questionnaire survey with three rounds of measurements from February 2020 to May 2020 at an infectious disease hospital in Shenzhen, in which all the confirmed cases of COVID-19 patients were accommodated. Based on cluster sampling design, a total of 134 frontline healthcare professionals directly involved in providing diagnosis, treatment, and nursing services for COVID-19 patients completed three times of web survey. The depressive symptom and trauma exposure were measured via the 12-items General Health Questionnaire and the Explosion Exposure Questionnaire respectively. A moderated mediation model examined the complex interplay among the major study variables. Gender and working year were included as control variables.

Results: Trauma exposure was significantly associated with depression in frontline healthcare professionals. Intrusive rumination mediated the effect of trauma exposure on the depressive symptom, which was moderated by organizational silence. Intrusive rumination presented a more substantial impact on depression while organization silence was lower.

Conclusions: This research demonstrates that intrusive rumination and organizational silence are imperative for predicting the depressive symptoms among the frontline healthcare professionals during the COVID-19 pandemic.

Keywords: COVID-19; Depression; Healthcare professional; Intrusive rumination; Organization silence; Trauma exposure.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Depression / epidemiology
Depression / psychology
Disease Outbreaks
Health Personnel
Humans
Pandemics