ObjectivesWork-related fatigue is a serious safety risk to nurses and their patients. This study aimed to assess self-reported work-related accumulative fatigue of nurses and its associated factors.MethodsA questionnaire survey of 2,918 clinical nurses conveniently sampled from 48 public hospitals across six provinces in China was conducted. The “Self-diagnosis Checklist for Assessment of Workers' Accumulated Fatigue” was adopted to assess the level of work-related accumulative fatigue of the study participants. Chi-square tests and ordinal regression analyses were performed to determine the sociodemographic characteristics associated with work-related accumulative fatigue.ResultsAbout one third of respondents reported low work-related accumulative fatigue, compared with 23.1% reporting high and 24.6% reporting very high levels of work-related accumulative fatigue. Higher levels of work-related accumulative fatigue were associated with female gender (AOR = 0.614 for male relative to female, p = 0.005), age between 30 and 40 years (AOR = 1.346 relative to >40 years, p = 0.034), 5–10 years of work experience (AOR = 1.277 relative to >10 years, p = 0.034), and bachelor or above degree qualifications (AOR = 0.806 for associate degree relative to bachelor or above degree, p = 0.007). Those who worked in rural county hospitals (AOR = 0.816 for metropolitan relative to rural county hospitals, p = 0.006) and resided in central China (AOR = 1.276 relative to western China, p = 0.004) had higher odds of reporting higher levels of work-related accumulative fatigue.ConclusionHigh levels of work-related accumulative fatigue are evident in nurses of public hospitals in China. The problem is more serious in the female nurses in their mid-career and those who worked in the central region and rural setting.

ObjectivesTo assess the quality of working life (QWL) of medical doctors and associated risk factors.Setting and participantsA cross-sectional questionnaire survey of 2915 medical doctors from 48 hospitals was conducted in China.MethodsThe QWL-7–32 scale was adopted to assess seven domains of QWL: physical health, mental health, job and career satisfaction, work passion and initiative, professional pride, professional competence, and balance between work and family.Primary and secondary outcome measuresData were analysed using SPSS V.19.0. Analysis of variance tests and multivariate linear regression analyses were performed to identify the sociodemographic characteristics and job factors associated with overall QWL and its seven subdomain scores.ResultsOn average, the respondents reported an overall QWL score of 92.51 (SD=17.74) of a possible 160. Over 35% of respondents reported more than 60 hours of weekly working time; 59.9% experienced night sleep deprivation frequently; 16.6% encountered workplace violence frequently. The multivariate regression models revealed that the eastern region (β≤−2.887 for non-eastern regions, p<0.001), shorter working hours (β≤−2.638 for over 40 hours a week, p<0.01), less frequent night sleep deprivation (β≤−5.366 for sometimes or frequent, p<0.001), higher income (β≥2.795 for lower income, p<0.001) and less frequent encounters of workplace violence (β≤−9.267 for sometimes or frequent, p<0.001) were significant predictors of higher QWL. Night sleep deprivation and workplace violence were common predictors (p<0.05) for all seven domains of QWL.ConclusionThe low QWL of medical doctors working in public hospitals in China is evident, which is associated with high workloads, low rewards and workplace violence. There are also significant regional differences in the QWL of medical doctors, with the eastern developed region featuring better QWL. Public hospitals in China are facing serious challenges in occupational health and safety, which needs to be addressed through a systems approach.

Objectives: Response capacities for public health emergencies (PHEs) amongst healthcare workers play important roles in the prevention and control of PHEs. This study assessed the attitudes and response capacities of PHE workers in primary healthcare (PHC) institutions. Methods: An online anonymous questionnaire survey of 803 healthcare workers sampled from 13 PHC institutions in Wuhan, China, was conducted from April to June 2020. The Kruskal–Wallis test and linear regression model were used to analyze the response capacities of PHE workers and associated factors. Results: The healthcare workers with longer working years, particularly 30 years and above, had higher knowledge (OR = 7.323, p < 0.001) and practical ability scores (OR = 8.012, p < 0.001) when compared to those with less than 5 working years. The nurses had higher practical ability scores (OR = 2.188, p = 0.049), and pharmacists had lower practical ability scores (OR = 0.166, p = 0.007), when compared to doctors. Moreover, the healthcare workers who had never participated in educational activities related to PHE management in the past two years (OR = 0.540, p = 0.038; OR = 0.282, p = 0.001), had not participated in a PHE drill activity (OR = 0.327, p < 0.001; OR = 0.340, p = 0.004), and had never been involved in emergency management of PHEs (OR = 0.254, p < 0.001; OR = 0.174, p < 0.001) had lower knowledge and practical ability scores. Conclusion: The healthcare workers with longer working years had better response capacities, and nurses had better practical abilities when compared to doctors. More emergency management education and chances to be involved in PHE drill activities were encouraged amongst healthcare workers in PHC institutions for better prevention and control of PHEs. Moreover, inter-institution cooperation, a flexible response system, and dynamic adjustment of healthcare workers were suggested during PHEs.

Objective: Socio-economic related health inequalities are a global challenge for public policy. The aim of this study is to investigate the status of health inequality among residents in Hubei, China and examine the contribution of its determinants to the health inequality to inform future policy decision making. Methods: A cross-sectional study was conducted based on a random questionnaire survey among residents from 7 cities in Hubei province. Health inequality was quantified by concentration index and a logistic regression was applied to analyze the determinants of health equality. Concentration index was further decomposed by Wagstaff method to measure the contribution of each determinant to the inequality. Results: The prevalence of ill-health among the participants was 34% in Hubei. The income-related concentration index of poor Self-rated health was -0.0311, indicating a pro-rich inequality of health among residents. The logistic regression results showed that socio-economic factors (employment status, income and education), demographic factors (age), and lifestyle (regular physical exercise and diet) were the main determinants of health inequality. Decomposition of concentration index revealed that factors with strong contributions to the inequality in health were age (-74.11%), followed by employment status (-50.44%), income (-29.52%) and education (-26.57%). Conclusions Socioeconomic factors are the main determinants of health inequality. Effective strategies or actions are needed to reduce health inequality and improve the health condition of the population in Hubei, China.