Psychological Reactions of Healthcare Workers Deployed to Wuhan from Shanxi Province and How They Cope During Coronavirus Disease 2019 (COVID-19) Outbreak
The COVID-19 pandemic posed unprecedented challenges to healthcare systems worldwide, particularly in Wuhan, China, where the outbreak first emerged. Healthcare workers (HCWs) from Shanxi Province were among those who volunteered to travel to Wuhan to provide emergency medical care. This study aimed to investigate the psychological reactions of these HCWs and the coping strategies they employed during the COVID-19 outbreak. The findings shed light on the mental health challenges faced by HCWs in crisis situations and offer valuable insights into effective interventions to support their well-being.
Study Design and Methodology
The study was conducted from January 26 to February 20, 2020, during which 500 HCWs from Shanxi Province were deployed to Wuhan. A self-assessment questionnaire was administered, and 456 valid responses were collected. The questionnaire comprised four sections: demographic information, emotional state, sources of emotional distress, and stress-relief methods. The Depression Anxiety Stress Scale (DASS) was used to assess emotional distress, with scores calculated by summing individual items and multiplying by two for each subscale (depression, anxiety, and stress). Additional non-scale questionnaires were used to evaluate emotional factors and coping strategies.
Demographic Characteristics
The respondents had a mean age of 37.1 years, ranging from 23 to 59 years. The majority (68.0%) were nursing staff, reflecting the critical role nurses played in patient care during the pandemic. The study highlighted the diverse backgrounds of the HCWs, including their educational levels, marital status, and prior experience in emergency response situations.
Emotional Distress Among HCWs
The study revealed that anxiety was the most prevalent form of emotional distress, affecting 34.6% of respondents. Stress and depression were reported by 21.5% and 20.2% of HCWs, respectively. Insomnia was a significant issue, affecting 30.7% of the participants. These findings underscore the severe psychological toll of working in a high-stress, high-risk environment.
Sources of Emotional Distress
The factors contributing to emotional distress were categorized into three areas: epidemic situation-related factors, social-related factors, and medical care capacity. The most common sources of distress included fear of contagion (79.4%), worries about protective equipment interfering with quality care (57.5%), and concerns about insufficient personal protective equipment (54.4%). Additionally, 49.6% of HCWs reported that a lack of experience in treating COVID-19 was a significant source of distress. Communication difficulties with patients and colleagues also exacerbated emotional challenges.
Coping Strategies
The study identified several effective coping strategies employed by HCWs. Ensuring sufficient rest or time off was the most widely reported method (86.0%), followed by adequate sleep (83.3%) and communication with fellow HCWs from Shanxi (83.8%). Other strategies included social encouragement and praise (77.2%), skills training (75.4%), and listening to music (71.9%). These findings highlight the importance of both professional and personal support systems in mitigating emotional distress.
Factors Influencing Emotional Distress
Multiple linear regression analysis was conducted to identify factors associated with emotional distress. Stress was significantly linked to occupation, time of arrival in Wuhan, and communication. Anxiety was associated with educational background, prior emergency rescue experience, and professional training. Depression was influenced by prior emergency rescue experience, public health training, and professional training. These results suggest that prior experience and training play a crucial role in reducing emotional distress among HCWs.
Differences Between Nurses and Doctors
The study found that nurses experienced higher levels of stress compared to doctors. This aligns with previous research during the SARS epidemic, which attributed the increased stress among nurses to their more direct and prolonged contact with patients. The findings emphasize the need for targeted support for nursing staff in crisis situations.
Impact of Training and Experience
HCWs with prior experience in emergency response situations reported lower levels of anxiety and depression. Similarly, those who had undergone public health training exhibited lower depression scores. These findings underscore the importance of comprehensive training programs to prepare HCWs for future emergencies.
Communication and Social Support
Effective communication with colleagues and experts was identified as a critical factor in reducing emotional distress. HCWs reported that sharing experiences and seeking advice from senior staff were more effective than communicating with family and friends. This highlights the value of peer support and professional networks in crisis situations.
Practical Recommendations
The study concluded that strengthening professional training, particularly skills training, is essential to enhance the capacity of HCWs and reduce emotional distress. Additionally, ensuring adequate rest, providing social support, and fostering open communication are vital for maintaining the mental health of HCWs in high-stress environments. The findings also call for the development of psychological pre-intervention programs to better prepare HCWs for future emergencies.
Conclusion
The COVID-19 pandemic placed immense psychological pressure on HCWs, particularly those deployed to Wuhan from Shanxi Province. This study provides a comprehensive understanding of the emotional challenges faced by HCWs and the coping strategies they employed. The findings highlight the need for targeted interventions, including enhanced training, social support, and psychological pre-intervention, to support the mental health of HCWs in crisis situations. By addressing these issues, healthcare systems can better prepare for future emergencies and ensure the well-being of their workforce.
doi.org/10.1097/CM9.0000000000001201
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