Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study
Open accessAbstract
The severe 2019 outbreak of novel coronavirus disease (COVID-19), which was first reported in Wuhan, would be expected to impact the mental health of local medical and nursing staff and thus lead them to seek help. However, those outcomes have yet to be established using epidemiological data. To explore the mental health status of medical and nursing staff and the efficacy, or lack thereof, of critically connecting psychological needs to receiving psychological care, we conducted a quantitative study. This is the first paper on the mental health of medical and nursing staff in Wuhan. Notably, among 994 medical and nursing staff working in Wuhan, 36.9% had subthreshold mental health disturbances (mean PHQ-9: 2.4), 34.4% had mild disturbances (mean PHQ-9: 5.4), 22.4% had moderate disturbances (mean PHQ-9: 9.0), and 6.2% had severe disturbance (mean PHQ-9: 15.1) in the immediate wake of the viral epidemic. The noted burden fell particularly heavily on young women. Of all participants, 36.3% had accessed psychological materials (such as books on mental health), 50.4% had accessed psychological resources available through media (such as online push messages on mental health self-help coping methods), and 17.5% had participated in counseling or psychotherapy. Trends in levels of psychological distress and factors such as exposure to infected people and psychological assistance were identified. Although staff accessed limited mental healthcare services, distressed staff nonetheless saw these services as important resources to alleviate acute mental health disturbances and improve their physical health perceptions. These findings emphasize the importance of being prepared to support frontline workers through mental health interventions at times of widespread crisis.
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In a survey of 994 medical and nursing staff in Wuhan, 36% used mental health books, 50.4% used online coping methods, and 17.5% had participated in counseling or psychotherapy.
“To manage distress, 36% accessed books on mental health, 50.4% sought online coping methods, and 17.5% had participated in counseling or psychotherapy.”
From Overview of sleep management during COVID-19. (2022) · cites this paper as [42]
The Results (‘Accessed mental healthcare services’; page not provided) report 36.3% receiving psychological materials, 50.4% obtaining resources through media, and 17.5% participating in counseling or psychotherapy. The Methods (‘Questionnaire’; page not provided) define those materials as leaflets, brochures or books, and media as online platforms or TV news. The claim correctly conveys the percentages approximately, but the source does not establish that all 36% accessed books or that all 50.4% used online methods. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA large proportion of healthcare workers in Wuhan were affected and mental health support was necessary even for mild psychological reactions.
“another study performed in the original center of the epidemic, Wuhan, showed that a large proportion of HCW in Wuhan were affected and that mental health support was necessary even for mild psychological reactions (Kang et al., 2020).”
From Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis (2020) · cites this paper as Kang et al., 2020
The included studies had higher percentages of females (64.3-82.7%) and nurses (up to 82.7%), with average ages ranging from 26 to 40 years.
“All studies found higher percentages of females (64.3–82.7%) and nurses (up to 82.7%), with average ages ranging from 26 to 40 years (Chew et al., 2020; Kang et al., 2020; Lai et al., 2020; Li et al., 2020; Tan et al., 2020; Xiao et al., 2020; Zhang et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
In Kang et al. (2020), healthcare workers were assigned to four groups with subthreshold, mild, moderate, and severe disturbances comprising 36%, 34%, 22.4%, and 6.2% of the sample, with mean IES-R scores of 6.1, 22.9, 39.9, and 60, respectively.
“Groups 1, 2, 3, and 4 had subthreshold, mild, moderate, and severe disturbances (36, 34, 22.4, and 6.2% of the sample, respectively) and mean IES-R scores of 6.1, 22.9, 39.9, and 60, respectively.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
Chew et al. (2020) and Kang et al. (2020) associated having physical symptoms with an increased probability of high scores for trauma-related stress.
“Like to the finding of Chew et al. (2020) and Kang et al. (2020) associated having physical symptoms with an increased probability of high scores for trauma-related stress.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
Kang et al. (2020) found that exposure to infected patients negatively impacted mental health, which in turn influenced subjective perception of physical health.
“Ultimately, that study showed that exposure to infected patients negatively impacted mental health, which in turn influenced subjective perception of physical health.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
Kang et al. (2020) found that access to mental health services had a partial mediating effect between the risk of contact with COVID-19 positive patients and the mental health of respondents.
“Access to mental health services had a partial mediating effect between the risk of contact with COVID-19 positive patients and the mental health of the respondents (Kang et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
In Kang et al. (2020), group 4 was exposed to possible COVID-19 positive persons more often, had less access to psychological material, and worse self-perceived health status than the other three groups.
“These findings indicated that group 4 was exposed to possible COVID-19 positive persons more often, had less access to psychological material and worse self-perceived health status, than the other three groups.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
The COVID-19 pandemic had an important psychological traumatic impact on frontline and non-frontline healthcare workers, as indicated by almost all included studies and highlighted by this review.
“The psychological traumatic impact of COVID-19 in frontline and non-frontline HCWs is a great issue, as emerged by almost all the included studies (Kang et al., 2020; Lai et al., 2020; Xiao et al., 2020; Zhang et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
Risk factors for traumatic symptoms in healthcare workers include being female, younger, a frontline worker, a nurse, having less work experience, exposure to infected people, poor social support, difficult access to psychological material, insomnia, and physical symptoms.
“Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Kang et al., 2020
Literature on the COVID-19 pandemic has identified specific risk factors that predict worse mental health outcomes among healthcare workers, including fear of infection, higher exposure to death, role and less job seniority, younger age, female gender, absence of social support, and being frontline workers.
“Literature on the COVID-19 pandemic has pointed out that there are many specific risk factors that can predict worse outcomes regarding HW’s mental health status, such as the fear of being infected and/or to infect loved ones, higher exposure to death, role and less job seniority, younger age, female gender, absence of social support, and being frontline workers [2,9,10,11,12,13,14].”
From Anxiety, depression and risk of post-traumatic stress disorder in health workers: the relationship with burnout during COVID-19 pandemic in Italy (2021) · cites this paper as [9]
In early COVID-19, a Wuhan study found 34.4% (342 of 994) of medical and nursing staff had mild mental health disturbances and 6.2% (62) had severe disturbances.
“At the early stages of the COVID-19 pandemic, a Wuhan study (Kang et al., 2020) found that 34.4% (342 of 994) of medical and nursing staff had mild mental health disturbances while 6.2% (62) had severe disturbances”
From The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review (2020) · cites this paper as Kang et al., 2020
Women in particular were likely to experience anxiety, fears, depression, anger, guilt, grief and loss, post-traumatic stress, stigmatization, negative alterations in cognition or mood, and hyper-arousal during the Covid-19 outbreak.
“Women in particular were likely to experience anxiety, fears, depression, anger, guilt, grief and loss, post-traumatic stress, stigmatization, negative alterations in cognition or mood, and hyper-arousal (23, 29, 30).”
From Cancer Care During COVID-19 Era: The Quality of Life of Patients With Thyroid Malignancies (2020) · cites this paper as [23]
Younger age and female sex have already emerged as risk factors for psychological distress during the Covid-19 outbreak in China.
“Younger age and female sex have been already emerged as risk factors for psychological distress during the Covid-19 outbreak in China.”
From Cancer Care During COVID-19 Era: The Quality of Life of Patients With Thyroid Malignancies (2020) · cites this paper as [23]
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- Authors
- Kang, L., Ma, S., Chen, M., Yang, J., Wang, Y., Li, R., Yao, L., Bai, H., Cai, Z., Xiang Yang, B., Hu, S., Zhang, K., Wang, G., Ma, C., & Liu, Z.
- Affiliations
- Renmin Hospital of Wuhan University (CN)
- Huazhong University of Science and Technology (CN)
- First Affiliated Hospital Zhejiang University (CN)
- Shanxi Medical University (CN)
- University of California San Diego (US)
- Corresponding author
- Ma, Simeng
- Ma, Ci
- Liu, Zhongchun
- ORCID
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 87
- Pages
- 11-17
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7118532
- OpenAlex
- W3013752275
- Cited by
- 1,516
- References
- 27
- Citations by year
- 2026: 10 · 2025: 56 · 2024: 123 · 2023: 200 · 2022: 348 · 2021: 479 · 2020: 296 · 2019: 2 · 2018: 1
- FWCI
- 132.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81771472)
- National Key Research and Development Program of China (2018YFC1314600)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- COVID-19 pandemic, mental health, psychological distress, doctors and nurses, frontline workers, help-seeking, PHQ-9, young women, Wuhan
- MeSH terms
- Patient Health Questionnaire, Betacoronavirus, Psychological Distress, COVID-19, SARS-CoV-2, Adaptation, Psychological, Adolescent, Adult, Anxiety, Anxiety Disorders, China, Cross-Sectional Studies, Depression, Depressive Disorder, Disease Outbreaks, Female, Health Services Accessibility, Humans, Sleep Initiation and Maintenance Disorders, Male, Mental Health, Mental Health Services, Middle Aged, Nurses, Physicians, Pneumonia, Viral, Surveys and Questionnaires, Coronavirus Infections, Young Adult, Pandemics
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