Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Mei Ieng Lam; Pan Chen; Qinge Zhang; Sha Sha; Feng-Rong An; Zhaohui Su; Teris Cheung; Gabor S Ungvari; Chee H Ng; Yu-Tao Xiang; Yuan Feng

doi:10.3389/fpubh.2023.1280688

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Front Public Health. 2023 Oct 30:11:1280688. doi: 10.3389/fpubh.2023.1280688. eCollection 2023.

Authors

Mei Ieng Lam^#^{1

2}, Pan Chen^#^{1

3}, Qinge Zhang^#⁴, Sha Sha^#⁴, Feng-Rong An^#⁴, Zhaohui Su⁵, Teris Cheung⁶, Gabor S Ungvari^{7

8}, Chee H Ng⁹, Yu-Tao Xiang^{1

3}, Yuan Feng⁴

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.
² Kiang Wu Nursing College of Macau, Macao, Macao SAR, China.
³ Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China.
⁴ Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
⁵ School of Public Health, Southeast University, Nanjing, China.
⁶ School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
⁷ Section of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia.
⁸ Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.
⁹ Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia.

^# Contributed equally.

Abstract

Background: China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

Methods: A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

Results: A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

Conclusion: This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

Keywords: COVID-19; fear; mental health professionals; network analysis; quality of life.

Publication types

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

MeSH terms

COVID-19* / epidemiology
China / epidemiology
Cross-Sectional Studies
East Asian People
Fear
Humans
Mental Health
Pandemics
Policy
Prevalence
Quality of Life*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The study was supported by Beijing High Level Public Health Technology Talent Construction Project (Discipline Backbone-01-028 & Discipline Backbones-02-38) and the University of Macau (MYRG2019-00066-FHS; MYRG2022-00187-FHS).