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》

Anxiety and its association with perceived stress and insomnia among nurses fighting against COVID-19 in Wuhan: A cross-sectional survey.

To investigate the present status of anxiety among nurses fighting the spread of COVID-19 and its association with perceived stress and insomnia. With the outbreak of COVID-19, nurses have been caring for infected patients for a considerable length of time in Wuhan, China. Previous COVID-19 studies generally focused on patients' medical treatment, but few considered healthcare workers' psychological needs while working with a pandemic involving an unfamiliar infectious disease. Numerous nurses have experienced mental health problems, such as anxiety. The STROBE guidelines for a cross-sectional questionnaire were implemented. An online survey of 643 frontline nurses working with COVID-19-infected patients was conducted from 3-10 March 2020. Sociodemographic data were collected, and the Generalized Anxiety Disorder Scale, the Chinese Perceived Stress Scale and the Athens Insomnia Scale were administered. One-third (33.4%) of participants reported anxiety, which was associated with perceived stress and insomnia among Chinese frontline nurses in Wuhan during the COVID-19 pandemic. Significant associations were found between anxiety, perceived stress, insomnia, working four-night shifts per week, experience working during more than two epidemics and fear of COVID-19. This study found that a substantial proportion of frontline nurses caring for COVID-19-infected patients experienced anxiety. We recommend that nurse managers focus on working conditions and cultivate safe and satisfactory work environments. Meanwhile, frontline nurses should foster awareness of mental health and rely on online resources for psychological training to alleviate anxiety. The findings of this study could facilitate better understanding of anxiety among frontline nurses; more importantly, healthcare authorities and nursing managers need to pay more attention to ensuring intervention training to reduce anxiety for frontline nurses worldwide.

Shen Y ，Zhan Y ，Zheng H ，Liu H ，Wan Y ，Zhou W ... -  《-》

The prevalence and risk factors of psychological disturbances of frontline medical staff in china under the COVID-19 epidemic: Workload should be concerned.

To our best knowledge, this was the first time to investigate the prevalence and risk factors of psychological disturbances, including depression, anxiety, somatization symptoms, insomnia and suicide, among frontline medical staff, who were working with the COVID-10 infected patients directly. Patient Health Questionnaire Depression (PHQ-9), Generalized Anxiety Disorder Questionnaire scale (GAD-7), Symptom Check List-90 (SCL-90) somatization, Insomnia Severity Index (ISI), and the suicidal module of the Mini International Neuropsychiatric Interview were used for online survey. A total of 606 frontline hospital staff and1099 general population were recruited. The prevalence of depression, anxiety, somatization symptoms, insomnia, and suicide risk in frontline medical staffs were 57.6%, 45.4%, 12.0%, 32.0% and 13.0%, respectively. Except for suicide risk, the prevalence of other psychological disorders in frontline medical staff were higher than those in general population (all p<0.01). Among the frontline medical staff, the daily working hours were associated with all psychological disturbance (all p<0.01), women with anxiety (p = 0.02), body mass index (BMI) with anxiety and insomnia (p = 0.02, p = 0.03). Age was negatively associated with depression, anxiety, and insomnia (all p<0.01). Finally, years of working and family income were negatively associated with suicide risk (p = 0.03, p<0.001). Our study demonstrates that during the outbreak of COVID-19, the frontline medical staff are more likely to suffer from psychological disturbances than general population. It is noticeable that daily working hours are a risk factor for all measured psychological disturbances, and some other variables may be involved in certain psychological disturbances of frontline medical staff.

Zhou Y ，Wang W ，Sun Y ，Qian W ，Liu Z ，Wang R ，Qi L ，Yang J ，Song X ，Zhou X ，Zeng L ，Liu T ，Li Z ，Zhang X ... -  《-》

Depression, anxiety and insomnia among frontline healthcare workers amid the coronavirus pandemic (COVID-19) in Jordan: a cross-sectional study.

This study aimed to explore the prevalence and factors associated with depression, anxiety and insomnia among frontline healthcare workers (HCWs) in Jordan. A cross-sectional design was conducted among 122 frontline HCWs who have dealt with suspected or confirmed cases of COVID-19. The study survey included standardised questionnaires of the 7-item Generalized Anxiety Disorder (GAD-7) Scale, 9-item Patient Health Questionnaire (PHQ-9) and the Insomnia Severity Index (ISI). Data were collected online during the active surge period of cases from 11 May 2020 to 13 June 2020. The statistical analysis included descriptive statistics, analysis of variance, bivariate correlation and multivariate linear regression analyses. A total of 122 HCWs participated in the study (response rate=64.2%). Among the participants, 44.3% were physicians, 32.8% were nurses and 17.2% were paramedics. The mean age of participants was 32.1 (±5.8) years, and the majority were males (80.3%). The mean scores for GAD-7, PHQ-9 and ISI were 8.5 (±5.2), 9.5 (±5.7) and 11.2 (±6.4), respectively. Results showed that the participants reported severe symptoms of anxiety (29.5%), depression (34.5%) and insomnia (31.9%), with no observed differences based on gender, job title, marital status or educational level. Moreover, in the multivariate linear regression, none of the independent factors were associated with GAD-7, PHQ-9 or ISI scores, and the only exception was increased severity of insomnia among paramedics. The COVID-19 pandemic has exerted strenuous emotional, psychological and physical pressures on the health of frontline HCWs.

Oteir AO ，Nazzal MS ，Jaber AF ，Alwidyan MT ，Raffee LA ... -  《BMJ Open》

Status quo and influencing factors for anxiety, depression, and insomnia among 4 237 nurses in Hunan Province.

Liang M ，Chen Q ，Li Y ，Fan X ，Wang Q ，Wang J ，He L ，Li X ，Tao H ，Xie L ，Nie H ... -  《-》