Psychological impact of COVID-19 outbreak on frontline nurses: A cross-sectional survey study.

This study aimed to portray the prevalence and associated factors of psychological distress among frontline nurses during COVID-19 outbreak. The COVID-19 outbreak has posed great threat to public health worldwide. Nurses fighting against the epidemic on the frontline might be under great physical and psychological distress. This psychological distress was predominantly described as sleep disturbance, symptoms of anxiety and depression, post-traumatic stress, inability to make decisions and even somatic symptoms. Cross-sectional study. Frontline nurses from designated hospitals for COVID-19 patients were invited to complete an online survey by convenience sampling, and the survey included six main sections: the General Health Questionnaire, the Perceived Social Support Scale, the Simplified Coping Style Scale, the Impact of Event Scale-Revised, socio-demographic, occupation and work history. Multiple logistic analysis was used to identify the potential risk factors of psychological distress. The study methods were compliant with the STROBE checklist. Of the 263 frontline nurses, 66 (25.1%) were identified as psychological distress. Multiple logistic analysis revealed that working in emergency department, concern for family, being treated differently, negative coping style and COVID-19-related stress symptom were positive related to psychological distress. Perceived more social support and effective precautionary measures were negatively associated with psychological distress. The study demonstrated that COVID-19 had a significant psychological impact on frontline nurses. Early detection of psychological distress and supportive intervention should be taken according to the associated factors to prevent more serious psychological impact on frontline nurses. This study highlighted that the frontline nurses were suffering from varying degrees of psychological distress, which needed early screening and supportive intervention for preventing more serious psychological impact on frontline nurses. Beside, more specific measurement should be combined with the GHQ-12 to assess the varying degrees of psychological distress in frontline nurses.

Nie A ，Su X ，Zhang S ，Guan W ，Li J ... -  《-》

A cross-sectional study of mental health status and self-psychological adjustment in nurses who supported Wuhan for fighting against the COVID-19.

To evaluate the mental health status, stressors and self-adjustment of nurses in isolation wards at different periods in Wuhan, China. Mental health issues easily occurred among the frontline medical workers of a major epidemic. However, the stressors and psychological adjustments experienced by nurses have not been well described. This is crucial to improving clinical quality and nursing safety and ensuring nurses' physical and psychological health. We performed a cross-sectional prospective study using the Self Reporting Questionnaire-20, stressor and self-adjustment questionnaire administered to frontline nurses in Wuhan at two time points: after they had worked in isolation wards for 7-10 days (T1 ) and 2 months (T2 ). This paper complies with the STROBE reporting guideline for cross-sectional studies. T1 has 92 respondents, and T2 has 86. The positive rates of mental health problems were 26.09% and 9.30%, respectively, showing significantly different in the two periods. The main factors influenced mental health were self-perceived stress and only child status. The most common stressors were as follows: a large infected population, high infectivity; concerned about family's health status; high mortality if not treated in time (T1 ); and long duration of the epidemic, separate from family for a long time (T2 ). In terms of self-adjustment, 97.83%(T1 )/88.04%(T2 ) of nurses thought it was necessary, but 9(T1 ) /5(T2 ) chose to avoid addressing it, and 8(T1 ) /5(T2 ) utilised a professional psychological counselling hotline. Mental health problems among frontline nurses fighting COVID-19 need special attention, so administrators should offer timely counselling and strengthen effective psychosocial support to improve their mental resilience. This study surveyed the mental problems and self-adjustment status among nurses working Wuhan during the outbreak of COVID-19, to provide administrators with a scientific basis to effectively intervene.

Chen H ，Sun L ，Du Z ，Zhao L ，Wang L ... -  《-》

Anxiety, depression, and insomnia among nurses during the full liberalization of COVID-19: a multicenter cross-sectional analysis of the high-income region in China.

Frontline nurses fighting against the epidemic were under great psychological stress. However, there is a lack of studies assessing the prevalence rates of anxiety, depression, and insomnia among frontline nurses after the full liberalization of COVID-19 in China. This study demonstrates the impact of the full liberalization of COVID-19 on the psychological issues and the prevalence rate and associated factors of depressive symptoms, anxiety, and insomnia among frontline nurses. A total of 1766 frontline nurses completed a self-reported online questionnaire by convenience sampling. The survey included six main sections: the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7), the 7-item Insomnia Severity Index (ISI), the 10-item Perceived Stress Scale (PSS-10), sociodemographic information, and work information. Multiple logistic regression analyses were applied to identify the potential significantly associated factors for psychological issues. The study methods were compliant with the STROBE checklist. 90.83% of frontline nurses were infected with COVID-19, and 33.64% had to work while infected COVID-19. The overall prevalence of depressive symptoms, anxiety and insomnia among frontline nurses was 69.20%, 62.51%, and 76.78%, respectively. Multiple logistic analyses revealed that job satisfaction, attitude toward the current pandemic management, and perceived stress were associated with depressive symptoms, anxiety, and insomnia. This study highlighted that frontline nurses were suffering from varying degrees of depressive symptoms, anxiety, and insomnia during full liberalization of COVID-19. Early detection of mental health issues and preventive and promotive interventions should be implemented according to the associated factors to prevent a more serious psychological impact on frontline nurses.

Xiao J ，Liu L ，Peng Y ，Wen Y ，Lv X ，Liang L ，Fan Y ，Chen J ，Chen Y ，Hu H ，Peng W ，Wang H ，Luo W ... -  《Frontiers in Public Health》

Mental distress and influencing factors in nurses caring for patients with COVID-19.

Nurses are experiencing tremendous stress during the new coronavirus disease 2019 (COVID-19) pandemic, especially intensive care nurses. The pandemic of the disease is a tragedy, which may leave a catastrophic psychological imprint on nurses. Understanding nurses' mental distress can help when implementing interventions to mitigate psychological injuries to nurses. To quantify the severity of nurses' post-traumatic stress disorder (PTSD) symptoms and stress and explore the influencing factors of their psychological health when caring for patients with COVID-19. A cross-sectional survey. The PTSD Checklist-Civilian and the Perceived Stress Scale were administered from 11 to 18 March 2020, to 90 nurses selected from another city to go and help an intensive care unit (ICU) in Wuhan, China. These nurses were selected because of their high levels of clinical performance and resilience status. Nurses' average PTSD score was 24.62 ± 6.68, and five (5.6%) of the nurses reported a clinically significant level of PTSD symptoms (>38 points). Nurses' perceived stress averaged 19.33 ± 7, and 20 nurses (22.22%) scored positively >25 points. Nurses' stress and PTSD symptoms were positively correlated (P < .01). Major stress sources included working in an isolated environment, concerns about personal protective equipment shortage and usage, physical and emotional exhaustion, intensive workload, fear of being infected, and insufficient work experiences with COVID-19. This study showed that even relatively highly resilient nurses experienced some degree of mental distress, including PTSD symptoms and perceived stress. Our findings highlight the importance of helping nurses cultivate resilience and reduce stress. Recommendations for practice include providing adequate training and orientation before assigning nurses to ICU to help, offering disaster-emergency-preparedness training to keep nurses prepared, providing caring and authentic nursing leadership, offering ongoing psychological support to frontline nurses.

Leng M ，Wei L ，Shi X ，Cao G ，Wei Y ，Xu H ，Zhang X ，Zhang W ，Xing S ，Wei H ... -  《-》

Prevalence and Influencing Factors on Fatigue of First-line Nurses Combating with COVID-19 in China: A Descriptive Cross-Sectional Study.

Zhan YX ，Zhao SY ，Yuan J ，Liu H ，Liu YF ，Gui LL ，Zheng H ，Zhou YM ，Qiu LH ，Chen JH ，Yu JH ，Li SY ... -  《-》