Psychological Impact During the First Outbreak of COVID-19 on Frontline Health Care Workers in Shanghai

Background: The COVID-19 pandemic is a significant health threat. Health care worker(HCWs) are at significant risk of infection which may cause high levels of psychological distress. The aim of this study was to investigate the psychological impact of the COVID-19 on HCWs and factors which were associated with these stresses during the first outbreak in Shanghai. Methods: Between February 9th and 21st, 2020, a total of 3114 frontline HCWs from 26 hospitals in Shanghai completed an online survey.The questionnaire included questions on sociodemographic characteristics, 15 stress-related questions and General Health Questionnaire-12 (GHQ-12).Confirmatory factor analysis was applied to the 15 stress-related questions which produced four distinct factors for evaluation. Multiple linear regression models were performed to explore the association of personal characteristics with each score of the four factors. Binary logistic analysis were used to explain the association of personal characteristics and these four factors with GHQ-12. Results: There were 2691 valid answers received. The prevalence of emotional distress (defined as GHQ-12≥12) was noted in 47.7% (95%CI:45.7%-49.6%) HCWs. Female (OR=1.43, 95%CI:1.09-1.86) were more easily have psychological stress than male. However, there were less likely suffer psychological distress in HCWs who work in secondary hospitals (OR=0.71, 95%CI:0.58-0.87), or had no contact history (OR=0.45, 95%CI: 0.35-0.58). HCWs who were nurses, married and having known contact history were more easily to anxiety. HCWs working at tertiary hospitals felt more anxiety about infection, higher lack of knowledge and less protected compared with those who worked at secondary hospitals. Conclusions: Our study shows that the frontline HCWs present significant psychosocial distress during COVID-19 outbreak in Shanghai. HCWs felt lack of knowledge and had feelings of being not protected. It is necessary for hospitals and governments to provide additional trainings and psychological counseling to support the first-line HCWs.