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      Psychological distress surveillance and related impact analysis of hospital staff during the COVID-19 epidemic in Chongqing, China

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          Abstract

          Background: Hospital staff are vulnerable and at high risk of novel coronavirus disease (COVID-19) infection. The aim of this study was to monitor the psychological distress in hospital staff and examine the relationship between the psychological distress and possible causes during the COVID-19 epidemic.

          Methods: An online survey was conducted from February 1 to February 14, 2020. Hospital staff from five national COVID-19 designated hospitals in Chongqing participated. Data collected included demographics and stress responses to COVID-19: 1) the impact of event scale to measure psychological stress reactions; 2) generalized anxiety disorder 7 to measure anxiety symptoms; 3) Patient Health Questionnaire 9 to measure depression symptoms; 4) Yale-Brown Obsessive-Compulsive Scale to measure obsessive-compulsive symptoms (OCS); and 5) Patient Health Questionnaire 15 to measure somatization symptoms. Multiple logistic regression analysis was used to identify factors that were correlated with psychological distress.

          Results: Hospital staff that participated in this study were identified as either doctors or nurses. A total of 456 respondents completed the questionnaires with a response rate of 91.2%. The mean age was 30.67 ± 7.48 years (range, 17 to 64 years). Of all respondents, 29.4% were men. Of the staff surveyed, 43.2% had stress reaction syndrome. The highest prevalence of psychological distress was OCS (37.5%), followed by somatization symptoms (33.3%), anxiety symptoms (31.6%), and depression symptoms (29.6%). Univariate analyses indicated that female subjects, middle aged subjects, subjects in the low income group, and subjects working in isolation wards were prone to experience psychological distress. Multiple logistic regression analysis showed “Reluctant to work or considered resignation” (odds ratio [OR], 5.192; 95%CI, 2.396–11.250; P<.001), “Afraid to go home because of fear of infecting family” (OR, 2.099; 95%CI, 1.299–3.391; P=.002) “Uncertainty about frequent modification of infection and control procedures” (OR, 1.583; 95%CI, 1.061–2.363; P=.025), and“Social support” (OR, 1.754; 95%CI, 1.041–2.956; P=.035) were correlated with psychological reactions. “Reluctant to work or considered resignation” and “Afraid to go home because of fear of infecting family” were associated with a higher risk of symptoms of Anxiety (OR, 3.622; 95% CI, 1.882–6.973; P<.001; OR, 1.803; 95% CI, 1.069–3.039; P = .027), OCS (OR, 5.241; 95% CI, 2.545–10.793; P<.001; OR, 1.999; 95% CI, 1.217–3.282; P=.006) and somatization (OR, 5.177; 95% CI, 2.595–10.329; P<.001; OR, 1.749; 95% CI, 1.051–2.91; P=.031). “Stigmatization and rejection in neighborhood because of hospital work”, “Reluctant to work or considered resignation” and “Uncertainty about frequent modification of infection and control procedures” were associated with a higher risk of symptoms of Depression(OR, 2.297; 95% CI, 1.138–4.637; P=.020; OR, 3.134; 95% CI, 1.635–6.006; P= .001; OR, 1.645; 95% CI, 1.075–2.517; P=.022).

          Conclusions: Hospital staff showed different prevalence of psychological distress during the COVID-19 epidemic. Our study confirmed the severity of negative psychological distress on hospital staff and identified factors associated with negative psychological distress that can be used to provide valuable information for psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.

          Highlights

          • Hospital staff showed psychological distress in the COVID-19 epidemic in Chongqing.

          • We confirmed the severity of negative psychological distress on hospital staff.

          • Factors associated with negative psychological distress were identified.

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          Most cited references18

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          Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

          Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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            Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

            Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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              The Fear of COVID-19 Scale: Development and Initial Validation

              Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.
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                Author and article information

                Contributors
                Journal
                Compr Psychiatry
                Compr Psychiatry
                Comprehensive Psychiatry
                The Authors. Published by Elsevier Inc.
                0010-440X
                1532-8384
                12 August 2020
                12 August 2020
                Affiliations
                [a ]Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
                [b ]Department of Cardiology, General Hospital of Chongqing Group, Chongqing 400000, China
                [c ]Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 401120, China
                [d ]Department of Neurology, Daping Hospital, Army special medical center of PLA, 10 changjiang branch Road, Chongqing, 400042, China
                [e ]Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Yuzhong Road, Chongqing 400010, China
                Author notes
                [* ]Corresponding author at: Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing, 401120, China. laiyujie0206@ 123456163.com
                [1]

                These authors contributed equally to this work.

                Article
                S0010-440X(20)30040-7 152198
                10.1016/j.comppsych.2020.152198
                7419281
                04fc851f-acaf-4c44-9475-e6247e589ac1
                © 2020 The Authors. Published by Elsevier Inc.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                Categories
                Article

                viral infection,covid-19,mental health,hospital staff,ocs, obsessive-compulsive symptoms,sars, severe acute respiratory syndrome

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