The DOI matches its Crossref record; 28 of the 31 references it cites were found in a registry or an index; none of the 19 sources its claims cite is checked for support yet.
Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China
Open accessAbstract
Background The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China.Methods Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020.Outcomes A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD.Interpretation The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.
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In the paper
“Many participants experienced psychological symptoms, with 3733 (25.2%) and 1353 (9.1%) qualifying as having depressive symptoms and PTSD, respectively.”
- Also stated in: § Discussion · plain
“In the current cross-sectional study of 14,825 medical staff, 25.2% and 9.1% of participants reported depressive symptoms and PTSD, respectively, during the COVID-19 epidemic in China.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Participant characteristics
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the final model, compared to those between the ages of 18 and 25, the ORs (95% CI) were 1.49 (1.28, 1.72), 1.43 (1.19, 1.72), and 1.36 (1.02, 1.81) for those between the age of 26 and 30 years, 31 and 40 years, and older than 40 years, respectively.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with depressive symptoms
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Many participants experienced psychological symptoms, with 3733 (25.2%) and 1353 (9.1%) qualifying as having depressive symptoms and PTSD, respectively.”
- Also stated in: § Discussion · plain
“In the current cross-sectional study of 14,825 medical staff, 25.2% and 9.1% of participants reported depressive symptoms and PTSD, respectively, during the COVID-19 epidemic in China.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Participant characteristics
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men were more likely to have depressive symptoms than women (OR: 1.12, 95% CI: 1.01, 1.24).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with depressive symptoms
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared with those who were married and technical school or college graduates, unmarried and undergraduates had a lower risk of PTSD, with ORs (95% CI) of 0.76 (0.64, 0.91) and 0.83 (0.72, 0.97), respectively.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with PTSD
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to working outside of the Hubei province, those who were working in the Hubei province but residing in another province had a lower risk of PTSD (OR: 0.39, 95% CI: 0.25, 0.63).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with PTSD
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men (OR: 1.75, 95% CI: 1.51, 2.03) and nurses (OR: 1.43, 95% CI: 1.20, 1.71) were more likely to have PTSD than women and physicians.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with PTSD
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men (OR: 1.75, 95% CI: 1.51, 2.03) and nurses (OR: 1.43, 95% CI: 1.20, 1.71) were more likely to have PTSD than women and physicians.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with PTSD
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the final model, compared to those between the ages of 18 and 25, the OR (95% CI) were 1.48 (1.18, 1.86) and 1.34 (1.02, 1.77) for those between the age of 26 and 30 years and 31 and 40 years, respectively.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with PTSD
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Low (OR: 5.49, 95% CI: 4.04, 7.45) and moderate (OR: 2.73, 95% CI: 2.42, 3.07) levels of social support were associated with a higher risk of PTSD compared to high levels of social support.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with PTSD
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- It may state two separate claims as one. 11
- Probably not a substantial claim. 6
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similar findings were obtained in the stratified analyses by gender (Table A.1) and occupation (Table A.2), although the magnitude of the associations varied between the different strata.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with depressive symptoms
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to married people, the ORs (95% CI) were 1.12 (1.00, 1.26) and 1.35 (1.07, 1.71) for unmarried and divorced/widowed people, respectively.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with depressive symptoms
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Low (OR: 9.59, 95% CI: 7.22, 12.74) and moderate (OR: 3.37, 95% CI: 3.11, 3.66) levels of social support were associated with higher risk of depressive symptoms compared to a high level of social support.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Results > Factors associated with depressive symptoms
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The Chinese version of the PCL-5 has been validated and is widely used in psychological research (Li et al., 2019, Wang et al., 2015).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Methods > Measurement of post-traumatic stress disorder (PTSD)
What the sources say
- Not checked yetcites Li et al., 2019
- Not checked yetcites Wang et al., 2015 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, social support had the greatest impacts on the mental health of medical staff; the lower the levels of social support, the greater the risk of depressive symptoms and PTSD.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“This finding may be because a nurse is more closely connected with the patient, with greater contact time (Chan, 2003).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
What the sources say
- Not checked yetcites Chan, 2003 source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The Chinese version of the PSSS has shown good reliability and validity in various populations (Feng et al., 2018, Wang et al., 2020, Zhang et al., 2018).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Methods > Measurement of social support
What the sources say
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These individuals were selected after their own registration, usually with adequate psychological preparations, and also received training of infectious disease protection before going to Hubei.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“According to the China-WHO joint investigation report of COVID-19, as of February 20, 2020 a total of 2055 laboratory-confirmed cases of COVID-19 infection among medical staff were reported in 476 hospitals in China (Health, 2020).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Introduction
What the sources say
- Not checked yetcites Health, 2020
Strength:plain· not yet calibratedn = 2,055Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Both the reliability and validity of the Chinese version has been confirmed (Sun et al., 2017).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Methods > Measurement of depressive symptoms
What the sources say
- Not checked yetcites Sun et al., 2017
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“A previous study conducted among medical staff in emergency departments during the SARS outbreak also showed that nurses were more likely to develop distress and use behavioral disengagement than physicians (Wong et al., 2005).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
What the sources say
- Not checked yetcites Wong et al., 2005 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As the center of the epidemic, most of the confirmed cases occurred in the Hubei province than other regions and medical staff were at a high risk of infection for a long time.”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The primary transmission route of COVID-19 is aerosol and close contact, putting medical staff at high risk of exposure (Li et al., 2020).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Introduction
What the sources say
- Not checked yetcites Li et al., 2020
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Since the COVID-19 outbreak, more than 30,000 medical staff from other provinces have worked in Hubei (Pan et al., 2020).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
What the sources say
- Not checked yetcites Pan et al., 2020 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Women tend to pay more attention to their experiences and feelings and are more willing to express their emotions. This behavior is conducive to the self-regulation of emotions (Neitzke, 2016).”
§ Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China > Discussion
What the sources say
- Not checked yetcites Neitzke, 2016 source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
Existing surveys of mental health among medical staff during the COVID-19 epidemic had sample sizes below 5000.
“However, the sample sizes of existing surveys are relatively small (<5000 people) due to the limited timeframe of the investigation.”
The paper relies on this without support.
The emergency department is a high-risk area in a hospital because it is often the first stop for febrile patients who are later diagnosed with COVID-19.
“Moreover, the emergency department is considered to be a high-risk area in a hospital, as it is often the first stop for febrile patients who are subsequently diagnosed with COVID-19.”
The paper relies on this without support.
The early COVID-19 conditions (increasing confirmed cases, insufficient psychological preparation, lack of understanding of COVID-19, overwhelming workload, and lack of personal protective equipment) may cause psychological pressure among medical staff.
“The increasing number of confirmed cases, insufficient psychological preparation, lack of understanding of COVID-19, overwhelming workload, and lack of personal protective equipment in the early stages of this disease may cause varying degrees of psychological pressure among medical staff.”
The paper relies on this without support.
The current study is the largest survey on the mental health of emergency department medical staff during the COVID-19 epidemic in China.
“First, to the best of our knowledge, this is the largest survey on the mental health of emergency department medical staff during the COVID-19 epidemic in China.”
The paper relies on this without support.
Medical staff, as the primary population dealing with public health emergencies, may experience destructive or unpleasant feelings in the initial emotional stages.
“Medical staff, as the primary population dealing with public health emergencies, may experience destructive or unpleasant feelings in the initial emotional stages.”
The paper relies on this without support.
None of the medical staff from other provinces who worked in Hubei were infected with COVID-19 while working there.
“Previous research has also shown that none of these individuals were infected with COVID-19 while working in the Hubei province.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“previous studies tended to measure PTSS in earlier periods [e.g., during February to March 2021 among Chinese HCWs [6], whereas PTSS sometimes takes time to develop and might be less observable during a traumatic period [7].”
From Associations between COVID-19 Work-Related Stressors and Posttraumatic Stress Symptoms among Chinese Doctors and Nurses: Application of Stress-Coping Theory (2022) · cites this paper as [6]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Nevertheless, most of these studies assessed the prevalence of PTSS during or shortly after the COVID-19 outbreak e.g., during February to March 2021 among Chinese HCWs [6] and during March to April 2021 among Italian HCWs [2], i.e., when the traumatic conditions were still ongoing.”
From Associations between COVID-19 Work-Related Stressors and Posttraumatic Stress Symptoms among Chinese Doctors and Nurses: Application of Stress-Coping Theory (2022) · cites this paper as [6]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The prevalence of PTSS in the current sample seemed higher than that recently reported in two other studies [6,35] and was similar to another recent study conducted among HCWs [36].”
The cited source says what the claim attributes to it.
In the citing paper
“It is plausible that separation or divorced HCWs were at higher risk as they could not be supported by a spouse [6].”
In the citing paper
“A number of studies found that nurses were more likely to develop PTSD (Tang et al., 2017; Barello et al., 2020; Song et al., 2020)”
From Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis (2020) · cites this paper as Song et al., 2020
In the citing paper
“in fact, in their study, the authors found that social support had the greatest impact on the mental health of HCWs: low (OR: 5.49, 95% CI: 4.04, 7.45) and moderate (OR: 2.73, 95% CI: 2.42, 3.07) levels of social support were associated with a higher risk of PTSD compared to high levels of social support [19].”
From Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review (2021) · cites this paper as [19]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Discussion reverses the PTSD finding for unmarried staff
MajorThe discussion says unmarried staff had a higher risk of PTSD, but the reported result says they had a lower risk than married staff (OR 0.76).
“the current study demonstrated that middle-aged as well as unmarried, divorced, or widowed medical staff were at a higher risk of depressive symptoms and PTSD”
“Compared with those who were married and technical school or college graduates, unmarried and undergraduates had a lower risk of PTSD, with ORs (95% CI) of 0.76 (0.64, 0.91) and 0.83 (0.72, 0.97), respectively.”
Citations
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Metadata
- Authors
- Song, X., Fu, W., Liu, X., Luo, Z., Wang, R., Zhou, N., Yan, S., & Lv, C.
- Affiliations
- Huazhong University of Science and Technology (CN)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Hainan Medical University (CN)
- Central People's Hospital of Zhanjiang (CN)
- Corresponding author
- Zhou, Ning
- Yan, Shijiao
- Lv, Chuanzhu
- Venue
- Brain Behavior and Immunity
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 88
- Pages
- 60-65
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7273140
- OpenAlex
- W3033726760
- Cited by
- 309
- References
- 31
- Citations by year
- 2026: 5 · 2025: 22 · 2024: 27 · 2023: 41 · 2022: 74 · 2021: 113 · 2020: 27
- FWCI
- 25.52
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Brain Behavior and Immunity (publishedVersion)
- SSRN Electronic Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hainan Provincial Department of Science and Technology
- Chinese Academy of Medical Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Keywords
- mental health, healthcare workers, emergency department staff, COVID-19 pandemic, depressive symptoms, post-traumatic stress disorder, nurses, physicians, social support, Hubei Province, psychological intervention
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, China, Depression, Emergency Medicine, Emergency Service, Hospital, Female, Humans, Male, Mental Health, Nurses, Personnel Staffing and Scheduling, Physicians, Pneumonia, Viral, Social Support, Stress Disorders, Post-Traumatic, Prevalence, Emergency Nursing, Age Distribution, Sex Distribution, Coronavirus Infections, Pandemics
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