Investigation on the Mental Health of Healthcare Workers for Aid in Hu Bei Province During the Outbreak of Covid-19 Based on the Network Survey

Investigation on the Mental Health of Healthcare Workers for Aid in Hu Bei Province During the Outbreak of Covid-19 Based on the Network Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Investigation on the Mental Health of Healthcare Workers for Aid in Hu Bei Province During the Outbreak of Covid-19 Based on the Network Survey Peng Zhpu, Na Du, Yingjie OuYang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-34118/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The objective of this study isto explore the mental health of healthcare workers went to Hubei for assistance during the outbreak of COVID-19.A total of 210 medical staff who traveled to Hubei Province for assistance in the first time completed the online questionnaire, including the Sleep Self-Assessment Scale (SRSS), Generalized Anxiety Scale (GAD-7), and 9-item patient health questionnaire (PHQ-9). Results: The average score of the SRSS of all the subjects（25.13±6.41）was significantly higher than the national norm（22.14±5.48）(p <0.001). The average score of the GAD-7 of all subjects（12.37±4.89）was at the level of moderate anxiety, while the average score of the PHQ-9 of them （8.90±5.42）was at the level of mild depression. The scores of SRSS and GAD-7 of all males（26.60±6.38, 14.45±3.80）were significantly higher than those of females（23.67±6.12, 10.28±4.99）(p <0.01). Conclusions: In this epidemic, the sleep quality of frontline medical staff in Hubei Province is poor, and the symptoms of anxiety and depression are common, while the anxiety is more prominent. Among them, the sleep and anxiety symptoms of males are more obvious than that of women, suggesting that we should pay attention to the psychological support of male doctors and nurses and provide them with appropriate psychological decompression training. Psychology mental health healthcare workers SRSS GAD-7 PHQ-9 COVID-19 1. Background The COVID-19 beginning in late 2019 has spread for almost four months. This calamity drove to the execution of the city closure policy in Hubei Province, and the worst-hit areas, Wuhan, is a city that everyone talks approximately. Since the virus is exceedingly contagious and pathogenic, it has caused a particular stun to the general public. In this exceptionally period, when the virus was raging, there was a group of people who were risking infection, applied for providing medical assistance in Hubei Province. For conventional people, they can choose to cancel, delay or alter the way they work, but the healthcare workers choose to take on more heavy work; and fight against danger. In this manner, this group of healthcare specialists in Hubei is not only under work pressure but also may be under tremendous mental pressure. Relevant researches have found that during the SARS flare-up in 2003, front-line healthcare workers experienced substantial mental pressure and work pressure[ 1 – 3 ].Simultaneously ,during the outbreak of 2015 Middle East respiratory syndrome(MERS) Co-V, the hospital workers in South Korea also experienced various negative emotions and stress[ 4 ]. Other examples include novel swine-origin influenza A (H1N1) that originated in Mexico in 2009, Ebola in Guinea in 2013, the front-line medical workers,were reported have experienced a great deal of emotional stress related to their work[ 5 ].However, in the outbreak of COVID-19 in Hubei Province, an expansive number of healthcare workers from other provinces and cities went to support, and they stationed at the source nearly two months, and long-term separation from family members and adaptation to new places may further increase their pressure because being assigned to unfamiliar work groups could reduce collegial interaction[ 6 ]. What’s more, the related report has suggested that the group of healthcare workers were at the forefront of the ‘special battle’ against infectious diseases, placing them at a greater risk of infection[ 7 ]. Therefore, the potential risk may aggravate their mental burden further. The latest report on COVID-19 has discovered that front-line healthcare workers are vulnerable to the emotional impact of COVID-19[ 8 ]. But up to now, there is little information of the mental health of the healthcare workers went to Hubei for assistance. To understand the mental health of the above-mentioned particular groups, this study intends to utilize them as a research participant to analyze the mental health status of this group in order to explore the psychological structure characteristics of this particular group. Furthermore, we intend to provide guidance for their intervention support programs after returning. 2. Method Subjects From January to February 2020, the healthcare workers sent to Hubei Province for medical assistance from exterior Hubei Area were selected as the objects of the investigation. The questionnaire was distributed to these healthcare workers in the form of network, and the principle of voluntary filling was adopted. The research has got the institutional review board (IRB) approval of West China Hospital. Two hundred twenty questionnaires were sent out in total, 210 qualified questionnaires were recovered, and the recuperation rate of the questionnaire was 95.4%. Measures The research tool (scale) are self-assessment questionnaire, and the following survey items are completed according to the unified guidance, including (1) general situation survey: including the gender, age, education background, marriage, occupation, education level. (2) Self-Rating Scale of Sleep(SRSS) [ 9 ]: it is composed of 10 items, 1–5 points score each item, and the final total score is the sum of the scores of each item, and the total score range is 10–50 points. The higher score, the more serious the sleep problem. The national norm score of the scale is 22.14 ± 5.48 [ 10 ]. (3) Generalized Anxiety Scale(GAD-7) [ 11 ]: it consists of 7 items, each item is scored by 0–3 points, and the total score range is 0–21 points. Among them, 0–4 points were no anxiety; 5–9 points were mild anxiety; 10–14 points were moderate anxiety; 15–21 points were severe anxiety. (4) 9-item patient health questionnaire (PHQ-9) [ 12 ]: it is composed of nine items, 0–3 points score each item, and the total score range is 0–27 points. Among them, 0–4 points were no depression; 5–9 points were mild depression; 10–14 points were moderate depression; 15–19 points were moderate and severe depression; 20–27 points were severe depression. Statistical analyses Descriptive statistics were computed for all variables. The mean scores were then used for comparison among groups using T-test statistics. A P value of < 0.05 was used for statistical significance testing. All statistical analyses were carried out by the Statistical Package for Social Science, (version 11.0). 3. Results 3.1 General information on healthcare workers aiding Hubei (see Table 1 below). There were 210 healthcare workers in Hubei Province, including 105 males and 105 females. According to the occupational situation, 147 nurses, accounting for 70%; 63 doctors, accounting for 30%. The age range of them is 23–40 years old, with an average of 30.47 ± 4.53 years. Among them, education background is as follows: secondary school 14, accounting for 6.7%; junior college 77, accounting for 36.7%; undergraduate 105, accounting for 50%; graduate 14, accounting for 6.7%. The marriage situation is as follows: 98 unmarried people, accounting for 46.7%; 112 married people, accounting for 53.3%. The working years of all subjects ranged from 2 to 20 years, with an average of 8.61 ± 4.37 years. After grouping all subjects according to different genders or occupations, and comparing their average age and working years, it was found that the average age of men was higher than that of women (t = 5.456, P < 0.001), the working years were longer (t = 2.890, P = 0.004), the average age of doctors was higher than that of nurses (t = 10.159, P < 0.001), and the working years were longer (t = 6.780, P < 0.001). Table 1 Comparative Analysis of age and working years according to gender and occupation groups Project Gender classification T value Male (n = 105) Female (n = 105) Average age 32.07 ± 4.30 28.87 ± 4.20 5.456 b Working years 9.47 ± 3.42 7.75 ± 5.02 2.890 a Project Occupation Classification T value Doctor (n = 63) Nurse (n = 147) Average age 34.44 ± 3.33 28.76 ± 3.87 10.159 b Working years 11.44 ± 4.06 7.39 ± 3.92 6.780 b a:P < 0.01;b:P < 0.001 3.2 Investigation results of GAD-7 and PHQ-9 for healthcare workers in Hubei Province (see Table 2 below) We can see from the table that the average score of anxiety scale of healthcare workers is at the level of moderate anxiety, while the average score of depression scale is at the level of mild depression. Among them, the proportion of people with moderate anxiety level is the highest, accounting for 43.3%; while the proportion of people with moderate depression level is the highest, accounting for 35.7%. Table 2 the scores of GAD-7 and PHQ-9 of healthcare workers in Hubei Province Survey items Average score Severity No Light Moderate Moderate severe Severe Number Percentage (%) Number Percentage (%) Number Percentage (%) Number Percentage (%) Number Percentage (%) GAD-7 12.37 ± 4.89 19 9.0 30 14.3 91 43.3 - - 70 33.3 PHQ-9 8.90 ± 5.42 59 28.1 47 22.4 75 35.7 23 11.0 6 2.9 3.3 Comparison of scores of SRSS, GAD-7 and PHQ-9 of healthcare workers in Hubei Province under different genders and occupational categories (see Table 3 below) The results showed that the score of male sleep scale was significantly higher than that of female (t = 3.397, P = 0.001), i.e. the sleep quality of male was worse than that of the female; the score of male anxiety scale was significantly higher than that of female (t = 6.832, P < 0.001), i.e. the anxiety level of the male was higher than that of the female; however, there was no significant difference in the score of depression scale between male and female(t = 1.611,p = 0.109)。 The results showed that there was no significant difference in sleep quality, anxiety level and depression level between doctors and nurses. Table 3 Comparative Analysis of SRSS,GAD-7 and PHQ-9 according to gender and occupation groups Project Gender classification T value Male (n = 105) Female (n = 105) SRSS 26.60 ± 6.38 23.67 ± 6.12 3.397 a GAD-7 PHQ-9 14.45 ± 3.80 9.50 ± 5.37 10.28 ± 4.99 8.30 ± 5.42 6.832 b 1.611 Project Occupation Classification T value Doctor (n = 63) Nurse (n = 147) SRSS 24.22 ± 4.82 25.52 ± 6.96 1.351 GAD-7 PHQ-9 13.16 ± 3.25 8.06 ± 4.69 12.03 ± 5.42 9.27 ± 5.68 1.540 1.477 a:P < 0.01;b:P < 0.001 4. Discussion Due to the sudden outbreak, rapid contagious, and the lack of anti-virus vaccines and medicine, it is inevitable that healthcare workers participating in clinical first-line treatment will sustain enormous pressure and expose themselves to hazard. However, healthcare workers from other provinces and cities have left their hometown and come to a particular area. They work in conjunction with the local healthcare workers in the anti-epidemic work. Therefore, they will moreover confront the corresponding pressure. In order to understand the mental health status of the particular population, this study uses the way of network questionnaire to investigate their sleep quality, anxiety level and depression level in this part of Hubei Province, to provide guidance on how to carry out the corresponding psychological intervention after their return journey. This study showed that the sleep quality of all the healthcare workers was significantly worse than that of the ordinary people, which indicated that the healthcare workers in Hubei Province could not have a good rest due to the limited accommodation conditions and heavy work tasks during the working period. Even some people might have some sleep disorders. According to the investigation of the first-line healthcare workers during the SARS outbreak in 2003, 26.62% of them suffered from insomnia [ 13 ]. According to media reports, we can see that due to the shortage of protective materials, in arrange to save materials, medical personnel need to work continuously for 6–7 hours after wearing protective clothing. This kind of high-intensity work would inevitably lead to excessive exhaustion of energy and pressure of the human body, and under the excessive pressure, the main performance of the human body may be sleep problems. Therefore, for these particular groups, the government should give them appropriate leaving system after their return to ensure that everyone has enough sleep, to help them to adjust their daily life and return to regular work. Through the analysis of the scores of anxiety and depression self-assessment scale of all healthcare workers, it can be found that there are some anxiety and depression in healthcare workers, and the performance of anxiety is more prominent than depression. About 14.3% of them are at the level of mild anxiety, 43.3% are at the level of moderate anxiety, and 33.3% are at the level of severe anxiety. It can be seen that anxiety symptoms are the most common and prominent manifestation of the aid workers. Some scholars have believed that the psychological reactions of individuals after encountering stress events mainly include depression and anxiety [ 14 , 15 ]. However, our healthcare workers in Hubei Province have to face not only the highly infectious new COVID-19 but also heavy physical consumption and enormous mental pressure every day. In this manner, anxiety and depression are inevitable. As this study found, approximately 35.7% of the people are moreover at the level of moderate depression. As Tian et al. [ 13 ] analyzed when investigating the mental health level of healthcare workers on the front-line of SARS prevention and treatment, these front-line workers must treat and care patients in the condition of wearing protective clothing, gloves, hats, masks and eye masks, and must receive isolation observation after work, which will increase their mental pressure. Besides, since few healthcare workers in Hubei Province have ever been exposed to the prevention and control of infectious diseases, they may also have some deficiencies in the knowledge and skills related to epidemic prevention and control. The temporary multiple training tasks before entering the front-line will also increase their mental pressure. During the period of aiding Hubei, the time of communication with family and companions will be significantly reduced, which will further diminish their sources of social support, resulting in an increase in the probability of mental problems. Besides, according to the report of the aid specialists in Hubei Province, they are all temporarily living in the hotels designated by the government, one person living in one room, and they need to avoid gathering as much as possible after returning from work. Therefore, most people can only live alone in a narrow space, and this monotonous living environment will inevitably lead to inevitable depression. Therefore, the above results suggest that we need to pay more attention to the mental health level of healthcare workers in Hubei Province, and may need to provide them with appropriate relaxation training and positive suggestion training, so as to assist them better through the involvement of Hubei Province. Because there are some differences in the psychological characteristics and expression ways between men and women, this study compared and analyzed the sleep, anxiety and depression scale of healthcare workers in Hubei Province according to different genders. After analysis, we found relatively extraordinary results that the sleep quality of men was worse than that of women, and their anxiety level was higher. From the previous research results, we found that in the face of the SARS outbreak, the anxiety severity of women in the population is generally higher than that of men [ 16 ]. Wang and others also found that women healthcare workers may be more prone to anxiety and depression than men in mental status changes [ 17 ]. However, our research results are different from others, and the specific situation needs specific analysis. We can see that the previous research object is the general public or the local healthcare workers, and no one has analyzed the mental health of the particular group of healthcare workers aiding Wuhan. The reason for the male sleep deviation and massive anxiety maybe, on the one hand, due to the fact that the age of male aid workers is generally older, their physical strength and energy recovery level will not be as fast as that of young women, so they are more prone to fatigue and insomnia; on the other hand, more of these men have already married, so long-term absence from home and less communication with spouse or children will make it difficult for them to release the negative emotions caused by stress expeditiously, in the case of chronic stress. There is bound to be an increment in anxiety levels.Additionally,since numerous women belong to the nurse group, and they are youthful, their estrogen level secretion is in an intense period, so it is also a protective factor for their emotions. Women are more inclined to express their emotions at any time, so less negative emotions will be overstocked. From the above results, we can see that in the past, we need to pay more attention to the mental wellbeing of female health workers. However, male health workers may also require psychological counselling, and learn to actively express emotions, in order to diminish their anxiety level further. Conclusions Finally, through this study, we can discover that there is a specific lopsidedness in mental health level and sleep of healthcare workers in Hubei Province. Male anxiety performance and sleep disorders may be more prominent, which suggests that we may also need to provide appropriate psychological intervention for these particular groups, so as to assist them to put into their original working position after returning from Hubei Province. Declarations Ethics approval and consent to participate: The research has got the institutional review board (IRB) approval of West China Hospital, and all the subjects were recruited in the principle of voluntary. Consent for publication: Not applicable. Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests: The authors declare that they have no competing interests. Funding: Not applicable Authors' contributions: Peng Zhou was a major contributor in writing the manuscript, and he also was responsible for recruited the subjects in this survey. Na Du was responsible for the corresponding part of this manuscript, and she designed the investigation. Yingjie OuYang collected and analyzed the data, and she also translated this article to English. All authors read and approved the final manuscript. Acknowledgements: We sincerely thank all the healthcare workers who took part in our survey for their assistance in this study. References Maunder R, Hunter J, Vincent L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Can Med Assoc J. 2003;168(10):1245–51. Maunder RG, Lancee WJ, Rourke S, et al. Factors associated with the psychological impact of severe acute respiratory syndrome on nurses and other hospital workers in Toronto. Psychosomatic Med. 2004;66(6):938–42. Wong TW, Yau JK, Chan CL, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. Eur J Emerg Med. 2005;12(1):13–8. Heejung S, Wang JL, Hyun SK, et al. Examination of hospital workers’ emotional responses to an infectious disease outbreak: lessons from the 2015 MERS Co-V outbreak in South Korea. Disaster Med Public Health Prep. 2019;13(3):504–10. Wheeler HH. A review of nurse occupational stress research: 1. BJN. 1997;6(11):642–5. https://doi.org/10.12968/bjon.1997.6.11.642 . Goldbloom DS, Petryshen PM. The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned. Edited by McLean AR, May RM, Pattison J, et al, Oxford University Press Publishing; 2005. Grobler L, Mehtar S, Dheda K, et al. The epidemiology of tuberculosis in health care workers in South Africa: a systematic review. BMC Health Serv Res. 2016;16(1):416. Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7:228–9. Li JM. Seff–Rating Scale of Sleep(SRSS). China journal of health psychology. 2012;20(12):1851. Li JM, Yin SF, Duan JX, et al. Analysis rating of sleep state of 13273 normal persons. Health psychology journal. 2000;8(3):351–3. He XX, Li CB, Qian J, et al. Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients. Shanghai archives of psychiatry. 2010;22(4):200–3. Martin A, Rief W, Klaiberg A. et a1. Validity of the brief patient health questionnaire mood scale(PHQ-9)in the general population. Gen Hosp Psychiat. 2006;28(1):71–7. Tian XY, Wang XH, Li YQ, et al. The immediate psychological and behavioral response of health workers from SARS treatment specific hospitals. Chinese general practice. 2003;6(7):595–7. Huang L, Yang TZ, Ji ZM. Applicability of the positive and negative affect scale in Chinese. China journal of health psychology. 2003;17(1):54–6. Hardy GE, Woods D, Wall TD. The impact of psychological distress on absence from work. J Appl Psychol. 2003;88(2):306–14. Wang XY, Jin KX, Wang QC, et al. Survey of different crowd psychological status during SARS. Health psychology journal. 2003;11(6):441–2. Wang LW, Yang LH, Chen XB, et al. The investigation of psychological status of medical staff during epidemic outbreak stage of SARS in Wuhan. Chinese journal of behavioral medical science. 2003;12(5):76–8. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-34118","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":657332,"identity":"ab3e8cdb-9683-435b-9769-e9c5466b692f","order_by":0,"name":"Peng Zhpu","email":"","orcid":"","institution":"Sichuan University West China Hospital","correspondingAuthor":false,"prefix":"","firstName":"Peng","middleName":"","lastName":"Zhpu","suffix":""},{"id":657333,"identity":"c1cbf096-efb3-4052-ba21-fd817fa485c8","order_by":1,"name":"Na Du","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA60lEQVRIiWNgGAWjYBACNv7mgw8S/9nUs8mf//ggoaKGsBY+iWPJBh/Y0hL4JRiMDR6cOUZYixxDjpnkDLbDCZIzGMwkH7YwE+EwhjMG0jw8aXkGtxvSKhIb2Bj427sT8Gthbisw5pGwKTa4c+DYjcQdMgwSZ85uIGDL4Q3JPAZpjBsOJLbdSDzDxmAgkUtIS4LBYZ6Ew0AtyWwFiW3MxGhJMWycceBw4swZaWwMxGkBBjLDx4Y0Y36eM8wSCWeO8RD0i3x/8/EfiQ02cmzsPYwff1TUyPG39+LXggF4SFM+CkbBKBgFowArAAA3pkzBD3XQ3QAAAABJRU5ErkJggg==","orcid":"","institution":"The Fourth People's Hospital of Chengdu","correspondingAuthor":true,"prefix":"","firstName":"Na","middleName":"","lastName":"Du","suffix":""},{"id":657334,"identity":"953b880e-1b08-40e8-8912-5bef5140bc34","order_by":2,"name":"Yingjie OuYang","email":"","orcid":"","institution":"the Fourth People's Hospital of Chengdu","correspondingAuthor":false,"prefix":"","firstName":"Yingjie","middleName":"","lastName":"OuYang","suffix":""}],"badges":[],"createdAt":"2020-06-08 21:26:38","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-34118/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-34118/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13539234,"identity":"47426229-7187-4473-8d22-3c31d85d40f4","added_by":"auto","created_at":"2021-09-17 01:42:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":255644,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-34118/v1/4865ea9e-30d7-4c63-8184-e51abfefdfbb.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eInvestigation on the Mental Health of Healthcare Workers for Aid in Hu Bei Province During the Outbreak of Covid-19 Based on the Network Survey\u003c/p\u003e","fulltext":[{"header":"1. Background","content":" \u003cp\u003eThe COVID-19 beginning in late 2019 has spread for almost four months. This calamity drove to the execution of the city closure policy in Hubei Province, and the worst-hit areas, Wuhan, is a city that everyone talks approximately. Since the virus is exceedingly contagious and pathogenic, it has caused a particular stun to the general public. In this exceptionally period, when the virus was raging, there was a group of people who were risking infection, applied for providing medical assistance in Hubei Province. For conventional people, they can choose to cancel, delay or alter the way they work, but the healthcare workers choose to take on more heavy work; and fight against danger. In this manner, this group of healthcare specialists in Hubei is not only under work pressure but also may be under tremendous mental pressure.\u003c/p\u003e \u003cp\u003eRelevant researches have found that during the SARS flare-up in 2003, front-line healthcare workers experienced substantial mental pressure and work pressure[\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].Simultaneously ,during the outbreak of 2015 Middle East respiratory syndrome(MERS) Co-V, the hospital workers in South Korea also experienced various negative emotions and stress[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Other examples include novel swine-origin influenza A (H1N1) that originated in Mexico in 2009, Ebola in Guinea in 2013, the front-line medical workers,were reported have experienced a great deal of emotional stress related to their work[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].However, in the outbreak of COVID-19 in Hubei Province, an expansive number of healthcare workers from other provinces and cities went to support, and they stationed at the source nearly two months, and long-term separation from family members and adaptation to new places may further increase their pressure because being assigned to unfamiliar work groups could reduce collegial interaction[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. What\u0026rsquo;s more, the related report has suggested that the group of healthcare workers were at the forefront of the \u0026lsquo;special battle\u0026rsquo; against infectious diseases, placing them at a greater risk of infection[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Therefore, the potential risk may aggravate their mental burden further.\u003c/p\u003e \u003cp\u003eThe latest report on COVID-19 has discovered that front-line healthcare workers are vulnerable to the emotional impact of COVID-19[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. But up to now, there is little information of the mental health of the healthcare workers went to Hubei for assistance. To understand the mental health of the above-mentioned particular groups, this study intends to utilize them as a research participant to analyze the mental health status of this group in order to explore the psychological structure characteristics of this particular group. Furthermore, we intend to provide guidance for their intervention support programs after returning.\u003c/p\u003e "},{"header":"2. Method","content":" \u003cp\u003e \u003cem\u003eSubjects\u003c/em\u003e \u003c/p\u003e \u003cp\u003eFrom January to February 2020, the healthcare workers sent to Hubei Province for medical assistance from exterior Hubei Area were selected as the objects of the investigation. The questionnaire was distributed to these healthcare workers in the form of network, and the principle of voluntary filling was adopted. The research has got the institutional review board (IRB) approval of West China Hospital. Two hundred twenty questionnaires were sent out in total, 210 qualified questionnaires were recovered, and the recuperation rate of the questionnaire was 95.4%.\u003c/p\u003e \u003cp\u003e \u003cem\u003eMeasures\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe research tool (scale) are self-assessment questionnaire, and the following survey items are completed according to the unified guidance, including (1) general situation survey: including the gender, age, education background, marriage, occupation, education level. (2) Self-Rating Scale of Sleep(SRSS) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]: it is composed of 10 items, 1\u0026ndash;5 points score each item, and the final total score is the sum of the scores of each item, and the total score range is 10\u0026ndash;50 points. The higher score, the more serious the sleep problem. The national norm score of the scale is 22.14\u0026thinsp;\u0026plusmn;\u0026thinsp;5.48 [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. (3) Generalized Anxiety Scale(GAD-7) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]: it consists of 7 items, each item is scored by 0\u0026ndash;3 points, and the total score range is 0\u0026ndash;21 points. Among them, 0\u0026ndash;4 points were no anxiety; 5\u0026ndash;9 points were mild anxiety; 10\u0026ndash;14 points were moderate anxiety; 15\u0026ndash;21 points were severe anxiety. (4) 9-item patient health questionnaire (PHQ-9) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]: it is composed of nine items, 0\u0026ndash;3 points score each item, and the total score range is 0\u0026ndash;27 points. Among them, 0\u0026ndash;4 points were no depression; 5\u0026ndash;9 points were mild depression; 10\u0026ndash;14 points were moderate depression; 15\u0026ndash;19 points were moderate and severe depression; 20\u0026ndash;27 points were severe depression.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eStatistical analyses\u003c/em\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eDescriptive statistics were computed for all variables. The mean scores were then used for comparison among groups using T-test statistics. A P value of \u0026lt;\u0026thinsp;0.05 was used for statistical significance testing.\u003c/p\u003e \u003cp\u003eAll statistical analyses were carried out by the Statistical Package for Social Science, (version 11.0).\u003c/p\u003e "},{"header":"3. Results","content":" \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e 3.1 General information on healthcare workers aiding Hubei (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below).\u003c/h2\u003e \u003cp\u003eThere were 210 healthcare workers in Hubei Province, including 105 males and 105 females. According to the occupational situation, 147 nurses, accounting for 70%; 63 doctors, accounting for 30%. The age range of them is 23\u0026ndash;40\u0026nbsp;years old, with an average of 30.47\u0026thinsp;\u0026plusmn;\u0026thinsp;4.53\u0026nbsp;years. Among them, education background is as follows: secondary school 14, accounting for 6.7%; junior college 77, accounting for 36.7%; undergraduate 105, accounting for 50%; graduate 14, accounting for 6.7%. The marriage situation is as follows: 98 unmarried people, accounting for 46.7%; 112 married people, accounting for 53.3%. The working years of all subjects ranged from 2 to 20 years, with an average of 8.61\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u0026nbsp;years.\u003c/p\u003e \u003cp\u003eAfter grouping all subjects according to different genders or occupations, and comparing their average age and working years, it was found that the average age of men was higher than that of women (t\u0026thinsp;=\u0026thinsp;5.456, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the working years were longer (t\u0026thinsp;=\u0026thinsp;2.890, P\u0026thinsp;=\u0026thinsp;0.004), the average age of doctors was higher than that of nurses (t\u0026thinsp;=\u0026thinsp;10.159, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the working years were longer (t\u0026thinsp;=\u0026thinsp;6.780, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative Analysis of age and working years according to gender and occupation groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGender classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eT value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;105)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;105)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.07\u0026thinsp;\u0026plusmn;\u0026thinsp;4.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.87\u0026thinsp;\u0026plusmn;\u0026thinsp;4.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.456\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.47\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.75\u0026thinsp;\u0026plusmn;\u0026thinsp;5.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.890\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eOccupation Classification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eT value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctor (n\u0026thinsp;=\u0026thinsp;63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNurse (n\u0026thinsp;=\u0026thinsp;147)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34.44\u0026thinsp;\u0026plusmn;\u0026thinsp;3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.76\u0026thinsp;\u0026plusmn;\u0026thinsp;3.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.159\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.39\u0026thinsp;\u0026plusmn;\u0026thinsp;3.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.780\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003ea:P\u0026thinsp;\u0026lt;\u0026thinsp;0.01;b:P\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e3.2 Investigation results of GAD-7 and PHQ-9 for healthcare workers in Hubei Province (see\u003c/em\u003e Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e \u003cem\u003ebelow)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eWe can see from the table that the average score of anxiety scale of healthcare workers is at the level of moderate anxiety, while the average score of depression scale is at the level of mild depression. Among them, the proportion of people with moderate anxiety level is the highest, accounting for 43.3%; while the proportion of people with moderate depression level is the highest, accounting for 35.7%.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ethe scores of GAD-7 and PHQ-9 of healthcare workers in Hubei Province\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"16\"\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSurvey items\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003cp\u003escore\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"14\" nameend=\"c16\" namest=\"c3\"\u003e \u003cp\u003eSeverity\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eLight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"3\" rowspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c13\" namest=\"c12\"\u003e \u003cp\u003eModerate severe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"3\" rowspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c16\" namest=\"c15\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGAD-7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e12.37\u0026thinsp;\u0026plusmn;\u0026thinsp;4.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e43.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePHQ-9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e8.90\u0026thinsp;\u0026plusmn;\u0026thinsp;5.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e3.3 Comparison of scores of SRSS, GAD-7 and PHQ-9 of healthcare workers in Hubei Province under different genders and occupational categories (see\u003c/em\u003e Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e \u003cem\u003ebelow)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eThe results showed that the score of male sleep scale was significantly higher than that of female (t\u0026thinsp;=\u0026thinsp;3.397, P\u0026thinsp;=\u0026thinsp;0.001), i.e. the sleep quality of male was worse than that of the female; the score of male anxiety scale was significantly higher than that of female (t\u0026thinsp;=\u0026thinsp;6.832, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), i.e. the anxiety level of the male was higher than that of the female; however, there was no significant difference in the score of depression scale between male and female(t\u0026thinsp;=\u0026thinsp;1.611,p\u0026thinsp;=\u0026thinsp;0.109)。\u003c/p\u003e \u003cp\u003eThe results showed that there was no significant difference in sleep quality, anxiety level and depression level between doctors and nurses.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative Analysis of SRSS,GAD-7 and PHQ-9 according to gender and occupation groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGender classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eT value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;105)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;105)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSRSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.60\u0026thinsp;\u0026plusmn;\u0026thinsp;6.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.67\u0026thinsp;\u0026plusmn;\u0026thinsp;6.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.397\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGAD-7\u003c/p\u003e \u003cp\u003ePHQ-9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.45\u0026thinsp;\u0026plusmn;\u0026thinsp;3.80\u003c/p\u003e \u003cp\u003e9.50\u0026thinsp;\u0026plusmn;\u0026thinsp;5.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.28\u0026thinsp;\u0026plusmn;\u0026thinsp;4.99\u003c/p\u003e \u003cp\u003e8.30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.832\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e1.611\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eOccupation Classification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eT value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctor (n\u0026thinsp;=\u0026thinsp;63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNurse (n\u0026thinsp;=\u0026thinsp;147)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSRSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.22\u0026thinsp;\u0026plusmn;\u0026thinsp;4.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.52\u0026thinsp;\u0026plusmn;\u0026thinsp;6.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.351\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGAD-7\u003c/p\u003e \u003cp\u003ePHQ-9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e \u003cp\u003e8.06\u0026thinsp;\u0026plusmn;\u0026thinsp;4.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.03\u0026thinsp;\u0026plusmn;\u0026thinsp;5.42\u003c/p\u003e \u003cp\u003e9.27\u0026thinsp;\u0026plusmn;\u0026thinsp;5.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.540\u003c/p\u003e \u003cp\u003e1.477\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003ea:P\u0026thinsp;\u0026lt;\u0026thinsp;0.01;b:P\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e "},{"header":"4. Discussion","content":" \u003cp\u003eDue to the sudden outbreak, rapid contagious, and the lack of anti-virus vaccines and medicine, it is inevitable that healthcare workers participating in clinical first-line treatment will sustain enormous pressure and expose themselves to hazard. However, healthcare workers from other provinces and cities have left their hometown and come to a particular area. They work in conjunction with the local healthcare workers in the anti-epidemic work. Therefore, they will moreover confront the corresponding pressure. In order to understand the mental health status of the particular population, this study uses the way of network questionnaire to investigate their sleep quality, anxiety level and depression level in this part of Hubei Province, to provide guidance on how to carry out the corresponding psychological intervention after their return journey.\u003c/p\u003e \u003cp\u003eThis study showed that the sleep quality of all the healthcare workers was significantly worse than that of the ordinary people, which indicated that the healthcare workers in Hubei Province could not have a good rest due to the limited accommodation conditions and heavy work tasks during the working period. Even some people might have some sleep disorders. According to the investigation of the first-line healthcare workers during the SARS outbreak in 2003, 26.62% of them suffered from insomnia [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. According to media reports, we can see that due to the shortage of protective materials, in arrange to save materials, medical personnel need to work continuously for 6\u0026ndash;7 hours after wearing protective clothing. This kind of high-intensity work would inevitably lead to excessive exhaustion of energy and pressure of the human body, and under the excessive pressure, the main performance of the human body may be sleep problems. Therefore, for these particular groups, the government should give them appropriate leaving system after their return to ensure that everyone has enough sleep, to help them to adjust their daily life and return to regular work.\u003c/p\u003e \u003cp\u003eThrough the analysis of the scores of anxiety and depression self-assessment scale of all healthcare workers, it can be found that there are some anxiety and depression in healthcare workers, and the performance of anxiety is more prominent than depression. About 14.3% of them are at the level of mild anxiety, 43.3% are at the level of moderate anxiety, and 33.3% are at the level of severe anxiety. It can be seen that anxiety symptoms are the most common and prominent manifestation of the aid workers. Some scholars have believed that the psychological reactions of individuals after encountering stress events mainly include depression and anxiety [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, our healthcare workers in Hubei Province have to face not only the highly infectious new COVID-19 but also heavy physical consumption and enormous mental pressure every day. In this manner, anxiety and depression are inevitable. As this study found, approximately 35.7% of the people are moreover at the level of moderate depression. As Tian et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] analyzed when investigating the mental health level of healthcare workers on the front-line of SARS prevention and treatment, these front-line workers must treat and care patients in the condition of wearing protective clothing, gloves, hats, masks and eye masks, and must receive isolation observation after work, which will increase their mental pressure. Besides, since few healthcare workers in Hubei Province have ever been exposed to the prevention and control of infectious diseases, they may also have some deficiencies in the knowledge and skills related to epidemic prevention and control. The temporary multiple training tasks before entering the front-line will also increase their mental pressure. During the period of aiding Hubei, the time of communication with family and companions will be significantly reduced, which will further diminish their sources of social support, resulting in an increase in the probability of mental problems. Besides, according to the report of the aid specialists in Hubei Province, they are all temporarily living in the hotels designated by the government, one person living in one room, and they need to avoid gathering as much as possible after returning from work. Therefore, most people can only live alone in a narrow space, and this monotonous living environment will inevitably lead to inevitable depression. Therefore, the above results suggest that we need to pay more attention to the mental health level of healthcare workers in Hubei Province, and may need to provide them with appropriate relaxation training and positive suggestion training, so as to assist them better through the involvement of Hubei Province.\u003c/p\u003e \u003cp\u003eBecause there are some differences in the psychological characteristics and expression ways between men and women, this study compared and analyzed the sleep, anxiety and depression scale of healthcare workers in Hubei Province according to different genders. After analysis, we found relatively extraordinary results that the sleep quality of men was worse than that of women, and their anxiety level was higher. From the previous research results, we found that in the face of the SARS outbreak, the anxiety severity of women in the population is generally higher than that of men [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Wang and others also found that women healthcare workers may be more prone to anxiety and depression than men in mental status changes [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, our research results are different from others, and the specific situation needs specific analysis. We can see that the previous research object is the general public or the local healthcare workers, and no one has analyzed the mental health of the particular group of healthcare workers aiding Wuhan. The reason for the male sleep deviation and massive anxiety maybe, on the one hand, due to the fact that the age of male aid workers is generally older, their physical strength and energy recovery level will not be as fast as that of young women, so they are more prone to fatigue and insomnia; on the other hand, more of these men have already married, so long-term absence from home and less communication with spouse or children will make it difficult for them to release the negative emotions caused by stress expeditiously, in the case of chronic stress. There is bound to be an increment in anxiety levels.Additionally,since numerous women belong to the nurse group, and they are youthful, their estrogen level secretion is in an intense period, so it is also a protective factor for their emotions. Women are more inclined to express their emotions at any time, so less negative emotions will be overstocked. From the above results, we can see that in the past, we need to pay more attention to the mental wellbeing of female health workers. However, male health workers may also require psychological counselling, and learn to actively express emotions, in order to diminish their anxiety level further.\u003c/p\u003e "},{"header":"Conclusions","content":"\u003cp\u003eFinally, through this study, we can discover that there is a specific lopsidedness in mental health level and sleep of healthcare workers in Hubei Province. Male anxiety performance and sleep disorders may be more prominent, which suggests that we may also need to provide appropriate psychological intervention for these particular groups, so as to assist them to put into their original working position after returning from Hubei Province.\u003c/p\u003e "},{"header":"Declarations","content":" \u003cp\u003e \u003ch2\u003eEthics approval and consent to participate:\u003c/h2\u003e \u003cp\u003eThe research has got the institutional review board (IRB) approval of West China Hospital, and all the subjects were recruited in the principle of voluntary.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication:\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e \u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting interests:\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e \u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003ch2\u003eAuthors' contributions:\u003c/h2\u003e \u003cp\u003ePeng Zhou was a major contributor in writing the manuscript, and he also was responsible for recruited the subjects in this survey. Na Du was responsible for the corresponding part of this manuscript, and she designed the investigation. Yingjie OuYang collected and analyzed the data, and she also translated this article to English. All authors read and approved the final manuscript.\u003c/p\u003e \u003ch2\u003e Acknowledgements:\u003c/h2\u003e \u003cp\u003e We sincerely thank all the healthcare workers who took part in our survey for their assistance in this study.\u003c/p\u003e "},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eMaunder R, Hunter J, Vincent L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Can Med Assoc J. 2003;168(10):1245\u0026ndash;51.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMaunder RG, Lancee WJ, Rourke S, et al. Factors associated with the psychological impact of severe acute respiratory syndrome on nurses and other hospital workers in Toronto. Psychosomatic Med. 2004;66(6):938\u0026ndash;42.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWong TW, Yau JK, Chan CL, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. Eur J Emerg Med. 2005;12(1):13\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHeejung S, Wang JL, Hyun SK, et al. Examination of hospital workers\u0026rsquo; emotional responses to an infectious disease outbreak: lessons from the 2015 MERS Co-V outbreak in South Korea. Disaster Med Public Health Prep. 2019;13(3):504\u0026ndash;10.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWheeler HH. A review of nurse occupational stress research: 1. BJN. 1997;6(11):642\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.12968/bjon.1997.6.11.642\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGoldbloom DS, Petryshen PM. The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned. Edited by McLean AR, May RM, Pattison J, et al, Oxford University Press Publishing; 2005.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGrobler L, Mehtar S, Dheda K, et al. The epidemiology of tuberculosis in health care workers in South Africa: a systematic review. BMC Health Serv Res. 2016;16(1):416.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eXiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7:228\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLi JM. Seff\u0026ndash;Rating Scale of Sleep(SRSS). China journal of health psychology. 2012;20(12):1851.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLi JM, Yin SF, Duan JX, et al. Analysis rating of sleep state of 13273 normal persons. Health psychology journal. 2000;8(3):351\u0026ndash;3.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHe XX, Li CB, Qian J, et al. Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients. Shanghai archives of psychiatry. 2010;22(4):200\u0026ndash;3.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMartin A, Rief W, Klaiberg A. et a1. Validity of the brief patient health questionnaire mood scale(PHQ-9)in the general population. Gen Hosp Psychiat. 2006;28(1):71\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eTian XY, Wang XH, Li YQ, et al. The immediate psychological and behavioral response of health workers from SARS treatment specific hospitals. Chinese general practice. 2003;6(7):595\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHuang L, Yang TZ, Ji ZM. Applicability of the positive and negative affect scale in Chinese. China journal of health psychology. 2003;17(1):54\u0026ndash;6.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHardy GE, Woods D, Wall TD. The impact of psychological distress on absence from work. J Appl Psychol. 2003;88(2):306\u0026ndash;14.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWang XY, Jin KX, Wang QC, et al. Survey of different crowd psychological status during SARS. Health psychology journal. 2003;11(6):441\u0026ndash;2.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWang LW, Yang LH, Chen XB, et al. The investigation of psychological status of medical staff during epidemic outbreak stage of SARS in Wuhan. Chinese journal of behavioral medical science. 2003;12(5):76\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"mental health, healthcare workers, SRSS, GAD-7, PHQ-9, COVID-19","lastPublishedDoi":"10.21203/rs.3.rs-34118/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-34118/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003eThe objective of this study isto explore the mental health of healthcare workers went to Hubei for assistance during the outbreak of COVID-19.A total of 210 medical staff who traveled to Hubei Province for assistance in the first time completed the online questionnaire, including the Sleep Self-Assessment Scale (SRSS), Generalized Anxiety Scale (GAD-7), and 9-item patient health questionnaire (PHQ-9).\u003cstrong\u003e \u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003eThe average score of the SRSS of all the subjects（25.13±6.41）was significantly higher than the national norm（22.14±5.48）(p \u0026lt;0.001). The average score of the GAD-7 of all subjects（12.37±4.89）was at the level of moderate anxiety, while the average score of the PHQ-9 of them （8.90±5.42）was at the level of mild depression. The scores of SRSS and GAD-7 of all males（26.60±6.38, 14.45±3.80）were significantly higher than those of females（23.67±6.12, 10.28±4.99）(p \u0026lt;0.01).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eIn this epidemic, the sleep quality of frontline medical staff in Hubei Province is poor, and the symptoms of anxiety and depression are common, while the anxiety is more prominent. Among them, the sleep and anxiety symptoms of males are more obvious than that of women, suggesting that we should pay attention to the psychological support of male doctors and nurses and provide them with appropriate psychological decompression training. \u003c/p\u003e","manuscriptTitle":"Investigation on the Mental Health of Healthcare Workers for Aid in Hu Bei Province During the Outbreak of Covid-19 Based on the Network Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-06-11 17:47:18","doi":"10.21203/rs.3.rs-34118/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"deb75fe8-df5d-455e-8253-6f7c44e7e04a","owner":[],"postedDate":"June 11th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":118240,"name":"Psychology"}],"tags":[],"updatedAt":"2020-06-20T14:31:35+00:00","versionOfRecord":[],"versionCreatedAt":"2020-06-11 17:47:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-34118","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-34118","identity":"rs-34118","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}