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      Mental Health and Health-Related Quality-of-Life Outcomes Among Frontline Health Workers During the Peak of COVID-19 Outbreak in Vietnam: A Cross-Sectional Study


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          Mental health is an important component of the protection strategy for healthcare workers (HCWs). However, it has not been well described in Vietnam during the COVID-19 outbreak. This study aims to measure the psychological distress and health-related quality-of-life among frontline healthcare workers during the peak of the outbreak in Vietnam.

          Patients and Methods

          We conducted a cross-sectional survey on 173 health workers at two national tertiary hospitals in Hanoi, Vietnam from March to April 2020. The psychological distress was measured by the Depression, Anxiety, and Stress Scale – 21 Items (DASS-21), Impact of Event Scale – Revised (IES-R), and the Insomnia Severity Index (ISI). EQ-5D-5L was used to determine the health-related quality-of-life (HRQoL) outcomes.


          Among 173 HCWs, the proportion of reported depression symptoms, anxiety symptoms, and stress was 20.2%, 33.5%, and 12.7%, respectively. The median EQ-5D-5L index score was 0.93 (IQR=0.85–0.94), and the anxiety/depression aspect had the highest reported problems. The most COVID-19-specific concerns among frontline HCWs were the reduction of income (59%) and the increase of living costs (54.3%). HCWs working in the COVID-19-designated hospital had a significantly higher rate of mental health problems and had a lower HRQoL outcome than those working in non-COVID-19-designated hospitals. Other factors associated with psychological distress and sleep problems include age, job title, income, chronic diseases status, and years of working in healthcare settings. HCWs who were ≥30 years old, had higher working years, had higher incomes, and had mental health and sleep problems were more likely to have lower HRQoL scores.


          We reported a moderate rate of psychological distress and lower HRQoL outcomes among frontline HCWs during the COVID-19 outbreak in Vietnam. Various factors were found to be associated with mental health and HRQoL that might be useful for implementing appropriate interventions for HCWs in low-resource settings.

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          Most cited references56

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          Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

          Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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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 Socio-Economic Implications of the Coronavirus and COVID-19 Pandemic: A Review

              The COVID-19 pandemic has resulted in over 1.4 million confirmed cases and over 83,000 deaths globally. It has also sparked fears of an impending economic crisis and recession. Social distancing, self-isolation and travel restrictions forced a decrease in the workforce across all economic sectors and caused many jobs to be lost. Schools have closed down, and the need of commodities and manufactured products has decreased. In contrast, the need for medical supplies has significantly increased. The food sector has also seen a great demand due to panic-buying and stockpiling of food products. In response to this global outbreak, we summarise the socio-economic effects of COVID-19 on individual aspects of the world economy.

                Author and article information

                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                Risk Management and Healthcare Policy
                08 December 2020
                : 13
                : 2927-2936
                [1 ]Emergency Department, National Hospital for Tropical Diseases , Hanoi, Vietnam
                [2 ]Center for Tropical Diseases, Bach Mai Hospital , Hanoi, Vietnam
                [3 ]National Hospital for Tropical Diseases , Hanoi, Vietnam
                [4 ]Oxford University Clinical Research Unit, Hospital for Tropical Diseases , Ho Chi Minh City, Vietnam
                [5 ]Department of Public Health, Thang Long University , Hanoi, Vietnam
                [6 ]Bach Mai Hospital , Hanoi, Vietnam
                Author notes
                Correspondence: Cuong Duy Do Center for Tropical Diseases, Bach Mai Hospital , No. 78, Giai Phong Street, Dong Da District, Hanoi100000, VietnamTel +84 983 264 868 Email doduy.cuong@bachmai.edu.vn

                These authors contributed equally to this work

                © 2020 Manh Than et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 0, Tables: 14, References: 57, Pages: 10
                Funded by: not receive any financial support;
                The authors did not receive any financial support for the survey work or for publication of the article.
                Original Research

                Social policy & Welfare
                covid-19,sars-cov-2,mental health,psychological distress,health-related quality-of-life,health workers


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