Skip to main content
Top
Published in: BMC Psychiatry 1/2021

Open Access 01-12-2021 | Mood Disorders | Research article

The prevalence and risk factors for depressive symptoms in frontline nurses under COVID-19 pandemic based on a large cross-sectional study using the propensity score-matched method

Authors: Hongyan Wang, Xiaoling Dai, Zichuan Yao, Xianqing Zhu, Yunzhong Jiang, Jia Li, Bin Han

Published in: BMC Psychiatry | Issue 1/2021

Login to get access

Abstract

Introduction

To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic.

Methods

This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression.

Results

Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920).

Conclusions

This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.
Literature
1.
go back to reference Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. LANCET. 2020;395:689–97.CrossRef Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. LANCET. 2020;395:689–97.CrossRef
3.
go back to reference Garrouste-Orgeas M, Perrin M, Soufir L, et al. The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture. INTENS CARE MED. 2015;41:273–84.CrossRef Garrouste-Orgeas M, Perrin M, Soufir L, et al. The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture. INTENS CARE MED. 2015;41:273–84.CrossRef
4.
go back to reference Kang L, Li Y, Hu S, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiat. 2020;7:e14.CrossRef Kang L, Li Y, Hu S, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiat. 2020;7:e14.CrossRef
5.
go back to reference Gotlib IHHC. Handbook of depression. New York: Guilford Publications; 2009. Gotlib IHHC. Handbook of depression. New York: Guilford Publications; 2009.
6.
go back to reference Romera I, et al. Social and occupational functioning impairment in patients in partial versus complete remission of a major depressive disorder episode. A six-month prospective epidemiological study. Eur Psychiatry. 2010;25(1):58–65.CrossRef Romera I, et al. Social and occupational functioning impairment in patients in partial versus complete remission of a major depressive disorder episode. A six-month prospective epidemiological study. Eur Psychiatry. 2010;25(1):58–65.CrossRef
7.
go back to reference Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res. 2020;126:134–40. Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res. 2020;126:134–40.
9.
go back to reference Donisi V, et al. Prediction of community mental health service utilization by individual and ecological level socio-economic factors. Psychiatry Res. 2013;209(3):691–8.CrossRef Donisi V, et al. Prediction of community mental health service utilization by individual and ecological level socio-economic factors. Psychiatry Res. 2013;209(3):691–8.CrossRef
10.
go back to reference de Oliveira GJ, et al. The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg. 2013;117(1):182–93.CrossRef de Oliveira GJ, et al. The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg. 2013;117(1):182–93.CrossRef
11.
go back to reference Wang JN, et al. Prevalence and associated factors of depressive symptoms among Chinese doctors: a cross-sectional survey. Int Arch Occup Environ Health. 2010;83(8):905–11.CrossRef Wang JN, et al. Prevalence and associated factors of depressive symptoms among Chinese doctors: a cross-sectional survey. Int Arch Occup Environ Health. 2010;83(8):905–11.CrossRef
12.
go back to reference Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRef Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRef
13.
go back to reference Buysse DJ, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRef Buysse DJ, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRef
14.
go back to reference Eisenberger R. S.F., perceived organizational support: fostering enthusiastic and productive employees. J Appl Psychol. 2011;3(71):500–7. Eisenberger R. S.F., perceived organizational support: fostering enthusiastic and productive employees. J Appl Psychol. 2011;3(71):500–7.
15.
go back to reference Luthans F. A.B.A.J., Positive psychological capital: measurement and relationship with performance and satisfaction. Pers Psychol. 2007;60:541–72.CrossRef Luthans F. A.B.A.J., Positive psychological capital: measurement and relationship with performance and satisfaction. Pers Psychol. 2007;60:541–72.CrossRef
16.
go back to reference Zhang K, Z.S.D.Y. Positive psychological capital: measurement and its association with mental health. Stu Psychol Behav. 2010;8:58–64. Zhang K, Z.S.D.Y. Positive psychological capital: measurement and its association with mental health. Stu Psychol Behav. 2010;8:58–64.
17.
go back to reference Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.CrossRef Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.CrossRef
18.
go back to reference Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011;46(3):399–424.CrossRef Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011;46(3):399–424.CrossRef
19.
go back to reference Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions. 3rd ed. New York: Wiley; 2003.CrossRef Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions. 3rd ed. New York: Wiley; 2003.CrossRef
20.
go back to reference Newcombe RG. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 1998;17(8):857–72.CrossRef Newcombe RG. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 1998;17(8):857–72.CrossRef
21.
go back to reference Mira JJ, Carrillo I, Guilabert M, et al. Acute stress of the healthcare workforce during the COVID-19 pandemic evolution: a cross-sectional study in Spain. BMJ Open. 2020;10(11):e042555.CrossRef Mira JJ, Carrillo I, Guilabert M, et al. Acute stress of the healthcare workforce during the COVID-19 pandemic evolution: a cross-sectional study in Spain. BMJ Open. 2020;10(11):e042555.CrossRef
22.
go back to reference Kocalevent RD, Hinz A, Brahler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013;35(5):551–5.CrossRef Kocalevent RD, Hinz A, Brahler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013;35(5):551–5.CrossRef
23.
go back to reference Erzen E, Çikrikci Ö. The effect of loneliness on depression: a meta-analysis. Int J Soc Psychiatry. 2018;64(5):427–35.CrossRef Erzen E, Çikrikci Ö. The effect of loneliness on depression: a meta-analysis. Int J Soc Psychiatry. 2018;64(5):427–35.CrossRef
24.
go back to reference Bhandari PM, et al. Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal. BMC Psychiatry. 2017;17(1):106.CrossRef Bhandari PM, et al. Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal. BMC Psychiatry. 2017;17(1):106.CrossRef
25.
go back to reference Raniti MB, et al. Sleep duration and sleep quality: associations with depressive symptoms across adolescence. Behav Sleep Med. 2017;15(3):198–215.CrossRef Raniti MB, et al. Sleep duration and sleep quality: associations with depressive symptoms across adolescence. Behav Sleep Med. 2017;15(3):198–215.CrossRef
27.
go back to reference Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration, and inflammation: a systematic review and Meta-analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry. 2016;80(1):40–52.CrossRef Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration, and inflammation: a systematic review and Meta-analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry. 2016;80(1):40–52.CrossRef
28.
go back to reference Dantzer R, et al. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9(1):46–56.CrossRef Dantzer R, et al. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9(1):46–56.CrossRef
29.
30.
go back to reference Mahar I, et al. Stress, serotonin, and hippocampal neurogenesis in relation to depression and antidepressant effects. Neurosci Biobehav Rev. 2014;38:173–92.CrossRef Mahar I, et al. Stress, serotonin, and hippocampal neurogenesis in relation to depression and antidepressant effects. Neurosci Biobehav Rev. 2014;38:173–92.CrossRef
31.
go back to reference Dinis J, Braganca M. Quality of sleep and depression in college students: a systematic review. Sleep Sci. 2018;11(4):290–301.CrossRef Dinis J, Braganca M. Quality of sleep and depression in college students: a systematic review. Sleep Sci. 2018;11(4):290–301.CrossRef
32.
go back to reference Wang Z, et al. Associations between occupational stress, burnout and well-being among manufacturing workers: mediating roles of psychological capital and self-esteem. BMC Psychiatry. 2017;17(1):364.CrossRef Wang Z, et al. Associations between occupational stress, burnout and well-being among manufacturing workers: mediating roles of psychological capital and self-esteem. BMC Psychiatry. 2017;17(1):364.CrossRef
33.
go back to reference Liu L, et al. The mediating role of psychological capital on the association between occupational stress and depressive symptoms among Chinese physicians: a cross-sectional study. BMC Public Health. 2012;12:219.CrossRef Liu L, et al. The mediating role of psychological capital on the association between occupational stress and depressive symptoms among Chinese physicians: a cross-sectional study. BMC Public Health. 2012;12:219.CrossRef
34.
go back to reference Heinitz K, et al. Positive organizational behavior: longitudinal effects on subjective well-being. PLoS One. 2018;13(6):e0198588.CrossRef Heinitz K, et al. Positive organizational behavior: longitudinal effects on subjective well-being. PLoS One. 2018;13(6):e0198588.CrossRef
Metadata
Title
The prevalence and risk factors for depressive symptoms in frontline nurses under COVID-19 pandemic based on a large cross-sectional study using the propensity score-matched method
Authors
Hongyan Wang
Xiaoling Dai
Zichuan Yao
Xianqing Zhu
Yunzhong Jiang
Jia Li
Bin Han
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03143-z

Other articles of this Issue 1/2021

BMC Psychiatry 1/2021 Go to the issue