Relationship between perceived stress and depression in Chinese front-line medical staff during COVID-19: A conditional process model

Liang, Zhen; Yuan, Zhaojing; Li, Guohua; Wang, Yanni; Huang, Wei; Zeng, Lingyun; Yang, Jiezhi; Zhou, Xin; Li, Junchang; Su, Li; Zhou, Yongjie

doi:10.1016/j.jad.2022.05.064

Cited by 11 publications

(9 citation statements)

References 58 publications

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“…Similar to findings from other study, a high level of stress was associated with a high degree of emotional exhaustion as well as lack of personal accomplishment among physicians in primary health care (24). Meanwhile, higher level of perceived stress was significantly positively related to severe insomnia and depression among medical staff (25). As expected, these results manifest that the increased level of stress led to poorer depression symptoms, however, further more studies are required to determine whether this is a long-term effect.…”

Section: Discussionsupporting

confidence: 85%

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Zhang,

Xu,

Qin

et al. 2023

Front. Psychiatry

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BackgroundWellbeing of healthcare workers is crucial for the effective functioning of primary health systems. This study aimed to examine the association between occupational stress and subclinical depression among primary healthcare workers, and to establish the foundation for future preventive strategies.MethodsA cross-sectional study was conducted in Tai’an City, Shandong Province, China. Data were collected from 832 medical staff in primary health institutions using a structured self-administered questionnaire. The participants completed the Challenge and Hindrance-Related Self-Reported Stress (C-HSS) Scale and Patient Health Questionnaire-9. Multivariable logistic regression analysis was conducted to explore the relationship between occupational stress and subclinical depression among primary healthcare workers.ResultsThe prevalence of subclinical depression among primary healthcare workers was 11.66%. Participants with subclinical depression have a significant higher level of occupational stress (including challenge-stress and hindrance-stress). Regression analysis result indicated that higher level of occupational stress was significantly associated with more severe subclinical depression, and the risk of subclinical depression remained after adjusting other covariates (OR = 4.57, 95%CI, 3.14–6.63). The association between challenge-stress and subclinical depression was not statistically significant when controlling for hindrance-stress. Subgroup analysis showed that male healthcare workers who perceived higher level of challenge stress were more likely to develop subclinical depression than female healthcare workers.ConclusionThe level of subclinical depression among Chinese primary healthcare workers was high, and occupational stress especially hindrance stress may contribute to subclinical depression. Findings were also robust in subgroup analysis after adjusting for other covariates. These findings emphasize the importance of occupational stress psychosocial interventions to decrease the risk of developing depression among the primary healthcare workers.

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Section: Discussionsupporting

confidence: 85%

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Zhang,

Xu,

Qin

et al. 2023

Front. Psychiatry

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“…Multilevel models showed an additional predictive value of perceived stress on changes in depressive symptoms, an association that confirms findings from previous studies on stress and depression in HCW during the pandemic (Li et al, 2022) and that has been discussed in a recent narrative review (de Sousa, Vargas, et al, 2021).…”

Section: Rq1: Temporal Increase In Mean Values Of Depressive Symptoms...supporting

confidence: 86%

Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers

Hoffmann,

Schulze,

Löffler

et al. 2023

Int J Soc Psychiatry

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Background: Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. Methods: The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95% confidence interval). Results: Depression scores increased significantly during the study period (β = .03, 95% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95% CI [0.13, 0.38]), but not in administrators (β = .03, 95% CI [−0.04, 0.11]). Conclusion: Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.

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“…We found that people with a higher level of psychological resilience had a lower level of depressive symptoms and co-occurrence in the post-pandemic era, which agreed with previous studies during the COVID-19 pandemic ( 39 , 80 ). The finding might be explained by the fact that healthcare workers with different levels of resilience could moderate the effects of perceived stress on depression by adopting different coping styles ( 81 ). In the post-pandemic era, our study found that work-family conflict was still be positively associated with anxiety symptoms while job burnout was also found to be positively associated with depressive symptoms, anxiety symptoms and their co-occurrence among healthcare workers, which were also confirmed in other studies during the pandemic ( 41 , 42 , 82 – 84 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of depressive and anxiety symptoms among healthcare workers in the post-pandemic era of COVID-19 at a tertiary hospital in Shenzhen, China: A cross-sectional study

Liang

Wang

Wei

et al. 2023

Front. Public Health

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BackgroundHealthcare workers were at high risk of psychological problems during the COVID-19 pandemic, but it remains not well-investigated in the post-pandemic era of COVID-19, with regular epidemic prevention and control embedded in burdened healthcare work. This study aimed to investigate the prevalence and potential risk factors of the symptoms of depression and anxiety among healthcare workers at a tertiary hospital in Shenzhen.MethodOur cross-sectional study was conducted among 21- to 64-year-old healthcare workers in December 2021 at a tertiary hospital in Shenzhen, using a simple random sampling strategy. A wide range of socio-demographic characteristics, individual information, and psychological condition of the subjects were extracted. Healthcare workers' psychological conditions were tested with the Center for Epidemiologic Studies Depression (CESD-10), General Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), Work-Family Conflict Scale (WFCS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and 17-item of Maslach's Burnout Inventory-Human Services Survey (MBI-HSS-17). Data were collected based on these questionnaires. Descriptive statistics were used to assess the difference between healthcare workers with depressive and anxiety symptoms among different groups. Hierarchical logistic regression analyses were conducted to investigate the association between focused variables and mental health outcomes.ResultsA total of 245 healthcare workers were enrolled. The proportion of depressive symptoms, anxiety symptoms and their co-occurrence were 34.7, 59.6, and 33.1%, respectively. Logistic regression showed that for the three outcomes, no history of receiving psychological help and self-rated good or higher health were protective factors, whereas more severe insomnia and job burnout were risk factors. Junior or lower job title and higher psychological resilience were related to a lower prevalence of depressive symptoms, while relatively longer working hours and larger work-family conflict were positively associated with the anxiety symptoms. Psychological resilience was inversely associated with the co-occurrence of depressive and anxiety symptoms.ConclusionsOur study revealed a high proportion of psychological problems and proved that several similar factors which were significant during the pandemic were also associated with the symptoms of depression and anxiety among healthcare workers in the post-pandemic era of COVID-19. These results provide scientific evidence for psychological interventions for healthcare workers.

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Relationship between perceived stress and depression in Chinese front-line medical staff during COVID-19: A conditional process model

Cited by 11 publications

References 58 publications

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers

Prevalence and associated factors of depressive and anxiety symptoms among healthcare workers in the post-pandemic era of COVID-19 at a tertiary hospital in Shenzhen, China: A cross-sectional study

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