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Frontline Nurses’ Burnout, Anxiety, Depression, and Fear Statuses and Their Associated Factors During the COVID-19 Outbreak in Wuhan, China: A Big-Scale Cross-Sectional Study

24 Pages Posted: 22 Apr 2020

See all articles by Deying Hu

Deying Hu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Nursing

Yue Kong

Xiamen University - Division of Nursing

Wengang Li

Xiamen University - School of Medicine

Qiuying Han

Xiamen University - Division of Nursing

Xin Zhang

Fifth Medical Center of Chinese PLA General Hospital - Division of Nursing

Li Xia Zhu

National University of Singapore (NUS) - Alice Lee Centre for Nursing Studies

Su Wei Wan

National University of Singapore (NUS) - Alice Lee Centre for Nursing Studies

Zuofeng Liu

Xiamen University - School of Medicine

Qu Shen

Xiamen University - School of Medicine

Jingqiu Yang

Xiamen University - School of Medicine

Hong-Gu He

National University of Singapore (NUS) - Alice Lee Centre for Nursing Studies

Jie Min Zhu

Xiamen University - Department of Nursing

More...

Abstract

Background: During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses remain unknown. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China.

Methods: A big-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020.

Findings: On average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n=1,218, 60.5%), depersonalization (n=853, 42.3%), and personal accomplishment (n=1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n=1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness.

Interpretation: The frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness.

Funding Statement: 2020 COVID-19 Emergency Response Special Fund from XMU & HUST

Declaration of Interests: None.

Ethics Approval Statement: Ethical approval was obtained from the participating hospitals’ ethical review boards as well as the last author’s university. All nurses provided consent by ticking the “yes” box to indicate their willingness to participate in the online survey. Voluntary participation and data confidentiality were emphasized. A token of appreciation of 50 RMB (equivalent to 7 USD) was provided to each participant via the WeChat red packet on the completion of the online survey.

Keywords: COVID-19; frontline nurses; mental health; burnout; anxiety; Depression; fear; China

Suggested Citation

Hu, Deying and Kong, Yue and Li, Wengang and Han, Qiuying and Zhang, Xin and Zhu, Li Xia and Wan, Su Wei and Liu, Zuofeng and Shen, Qu and Yang, Jingqiu and He, Hong-Gu and Zhu, Jie Min, Frontline Nurses’ Burnout, Anxiety, Depression, and Fear Statuses and Their Associated Factors During the COVID-19 Outbreak in Wuhan, China: A Big-Scale Cross-Sectional Study (3/27/2020). Available at SSRN: https://ssrn.com/abstract=3566144 or http://dx.doi.org/10.2139/ssrn.3566144

Deying Hu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Nursing

Wuhan
China

Yue Kong

Xiamen University - Division of Nursing

Fuzhou
China

Wengang Li

Xiamen University - School of Medicine

Xiamen, Fujian 361005
China

Qiuying Han

Xiamen University - Division of Nursing

Xiamen
China

Xin Zhang

Fifth Medical Center of Chinese PLA General Hospital - Division of Nursing

Beijing
China

Li Xia Zhu

National University of Singapore (NUS) - Alice Lee Centre for Nursing Studies

Level 2, Clinical Research Centre, Block MD11
10 Medical Drive
Singapore, 117597
United States

Su Wei Wan

National University of Singapore (NUS) - Alice Lee Centre for Nursing Studies

Level 2, Clinical Research Centre, Block MD11
10 Medical Drive
Singapore, 117597
United States

Zuofeng Liu

Xiamen University - School of Medicine

Xiamen, Fujian 361005
China

Qu Shen

Xiamen University - School of Medicine

Xiamen, Fujian 361005
China

Jingqiu Yang

Xiamen University - School of Medicine

Xiamen, Fujian 361005
China

Hong-Gu He

National University of Singapore (NUS) - Alice Lee Centre for Nursing Studies ( email )

Level 2, Clinical Research Centre, Block MD11
10 Medical Drive
Singapore, 117597
United States

Jie Min Zhu (Contact Author)

Xiamen University - Department of Nursing ( email )

Room 222, Alice Lee Building
Xiangan Campus
Xiamen, Fujian 361102
China

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