Summary
The outbreak of coronavirus disease 2019 (COVID-19) posed an unprecedented threat to health care providers (HCPs) in Wuhan, China, especially for nurses who were frequently exposed to infected or suspected patients. Limited information was available about the working experience of nurses in fighting against the pandemic. To learn the physical and psychological responses of nurses during the pandemic and explore the potential determinants, we conducted a large-scale survey in Wuhan. This multicenter cross-sectional study enrolled 5521 nurses who worked in designated hospitals, mobile cabins, or shelters during the pandemic. A structured online questionnaire was distributed to assess the physical discomforts, emotional distress and cognitive reactions of nurses at work, and the log-binomial regression analysis was performed to explore potential determinants. A considerable proportion of nurses had symptoms of physical discomforts [3677 (66.6%)] and emotional distress [4721 (85.5%)]. Nurses who were directly involved in the care of patients (i.e., care for severe patients: RR, 2.35; 95% CI, 1.95–2.84), with irregular work schedules (RR, 2.36; 95% CI, 1.95–2.87), and working overtime (RR, 1.34; 95% CI, 1.08–1.65) were at a higher risk for physical discomforts. Nurses who were directly involved in the care of patients (i.e., care for severe patients: RR, 1.78; 95% CI, 1.40–2.29), with irregular work schedules (RR, 3.39; 95% CI, 2.43–4.73), and working overtime (RR, 1.51; 95% CI, 1.12–2.04) were at a higher risk for emotional distress. Therefore, formulating reasonable work schedules and improving workforce systems are necessary to alleviate the physical and emotional distress of nurses during the pandemic.
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National Health Commission of the People’s Republic of China. Updates on the novel coronavirus outbreak up to Aug 11, 2020. 2020. http://www.nhc.gov.cn/wjw/index.shtml.
National Health Commission of the People’s Republic of China. Mobile cabin hospital, the boat of hope. 2020. http://www.nhc.gov.cn/xcs/fkdt/202002/b9ae44874b52484cb7db89d93145d298.shtml.
Global Times. Hubei first-line critical care doctors and nurses have gaps of 30% and 50%, respectively. 2020. https://3w.huanqiu.com/a/c36dc8/9CaKrnKp7zv?agt=8.
National Health Commission of the People’s Republic of China. Armored in white. 2020. http://www.nhc.gov.cn/wjw/mtbd/202003/e0d5f8a773b54fc39113988dbcb19136.shtml.
Albott CS, Wozniak JR, Mcglinch BP, et al. Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Healthcare Workers during the COVID-19 Pandemic. Anesth Analg, 2020,131(1): 43–54
Ho SM, Kwong-Lo RS, Mak CW, et al. Fear of severe acute respiratory syndrome (SARS) among health care workers. J Consult Clin Psych, 2005,73(2):344–349
Koh D, Lim MK, Chia SE, et al. Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn? Med Care, 2005,43(7):676–682
Lai J, Ma S, Wang Y, et al. Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA, 2020, 3(3):e203976
Lee AM, Wong JG, Mcalonan GM, et al. Stress and emotional distress among SARS survivors 1 year after the outbreak. Can J Psychiatry, 2007,52(4):233–240
Styra R, Hawryluck L, Robinson S, et al. Impact on health care workers employed in high-risk areas during the Toronto SARS outbreak. J Psychosom Res, 2008,64(2):177–183
Benedek DM, Fullerton C, Ursano RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Publ Health, 2007,28:55–68
Chua SE, Cheung V, Cheung C, et al. Psychological effects of the SARS outbreak in Hong Kong on high-risk health care workers. Can J Psychiatry, 2004,49(6):391–393
Nickell LA, Crighton EJ, Tracy CS, et al. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ, 2004,170(5):793–798
Chan SS, Leung GM, Tiwari AF, et al. The impact of work-related risk on nurses during the SARS outbreak in Hong Kong. Fam Community Health, 2005,28(3):274–287
Balicer RD, Barnett DJ, Thompson CB, et al. Characterizing hospital workers willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment. Bmc Public Health, 2010,10: 436
Martin SD. Nurses’ ability and willingness to work during pandemic flu. J Nurs Manage, 2011,19(1):98–108
Martin SD, Brown LM, Reid WM. Predictors of nurses’ intentions to work during the 2009 influenza A (H1N1) pandemic. Am J Nurs, 2013,113(12):24–31
Belfroid E, Mollers M, Smit PW, et al. Positive experiences of volunteers working in deployable laboratories in West Africa during the Ebola outbreak. Plos One, 2018,13(4):e196320
Khalid I, Khalid TJ, Qabajah MR, et al. Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak. Clin Med Res, 2016,14(1):7–14
Washington Post. Covid-19 hits doctors, nurses and EMTs, threatening health system. Mar 17, 2020.https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses_x0002_emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html.
Mcnutt LA, Wu C, Xue X, et al. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol, 2003,157(10):940–943
Honey M, Wang WY. New Zealand nurses perceptions of caring for patients with influenza A (H1N1). Nurs Crit Care, 2013,18(2):63–69
Shih FJ, Gau ML, Kao CC, et al. Dying and caring on the edge: Taiwan’s surviving nurses’ reflections on taking care of patients with severe acute respiratory syndrome. Appl Nurs Res, 2007,20(4):171–180
De Castro AB, Fujishiro K, Rue T, et al. Associations between work schedule characteristics and occupational injury and illness. Int Nurs Rev, 2010,57(2):188–194
Yildirim D, Aycan Z. Nurses’ work demands and work-family conflict: a questionnaire survey. Int J Nurs Stud, 2008,45(9):1366–1378
Viswanathan R, Myers MF, Fanous AH. Support Groups and Individual Mental Health Care via Video Conferencing for Frontline Clinicians During the COVID-19 Pandemic. Psychosomatics, 2020,61(5):538–543
Perry L, Gallagher R, Duffield C, et al. Does nurses’ health affect their intention to remain in their current position? J Nurs Manage, 2016,24(8):1088–1097
Acknowledgements
We would like to express our sincere gratitude to nurses for participating in this study, and to express our deepest respect for their selfless contributions during the pandemic. During the Year of Nurse and Midwife 2020, the world has witnessed the courage and achievement of all nursing staff in fighting against the pandemic, they deserve all the honor and glory. We also acknowledge A-dan FU, Hane YUE, Hui WANG, Hui-fen WANG, Li HAN, Li WANG, Shan-ling LI, Xin-wen LIU, Yi-lan LIU, Yong-fang XIONG and the ten affiliated hospitals of Tongji Medical College, Huazhong University of Science and Technology for permitting and supporting the conduction of the study and for providing opportunities for advertising the survey among the staff.
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Wang, Q., Fan, Jy., Zhao, Hm. et al. A Large Scale of Nurses Participated in Beating down COVID-19 in China: The Physical and Psychological Distress. CURR MED SCI 41, 31–38 (2021). https://doi.org/10.1007/s11596-021-2314-5
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DOI: https://doi.org/10.1007/s11596-021-2314-5