Background
Methods
Study setting and participants
Content of the questionnaire
Questions | 0 Never | 1 Rarely | 2 Sometimes | 3 Always | |
---|---|---|---|---|---|
Q1 | I felt anxious about being infected. | ||||
Q2 | I felt anxious about infecting my family. | ||||
Q3 | I felt burdened by the increased quantity of work. | ||||
Q4 | I felt burdened by the changed quality of work. | ||||
Q5 | I felt anxious about being infected during commuting. | ||||
Q6 | I felt lacking knowledge about prevention and protection. | ||||
Q7 | I felt lacking in knowledge about infectiosity and virulence. | ||||
Q8 | I felt avoided by others. | ||||
Q9 | I felt protected by my country or local government. | ||||
Q10 | I felt protected by my hospital. | ||||
Q11 | I felt anxious about compensation in the case of being infected. | ||||
Q12 | I felt hesitant to work. | ||||
Q13 | I felt isolated. | ||||
Q14 | I felt an elevated mood. | ||||
Q15 | I had insomnia. | ||||
Q16 | I was exhausted physically. | ||||
Q17 | I was exhausted mentally. | ||||
Q18 | I felt motivated to work. | ||||
Q19 | I felt I had no choice but to work due to obligation. |
Statistical analysis
Results
First Assessment | Second Assessment | ||||
---|---|---|---|---|---|
n
| (%) |
n
| (%) | ||
Total valid respondents | 951 | 719 | |||
Gender | |||||
Male | 311 | (32.7) | 211 | (29.3) | |
Female | 640 | (67.3) | 508 | (70.7) | |
Age group (years) | |||||
20–29 | 311 | (32.7) | 193 | (26.8) | |
30–39 | 244 | (25.7) | 179 | (24.9) | |
40–49 | 223 | (23.4) | 164 | (22.8) | |
50–59 | 129 | (13.6) | 143 | (19.9) | |
60+ | 44 | (4.6) | 40 | (5.6) | |
Job | |||||
Medical doctor | 157 | (16.5) | 105 | (14.6) | |
Nurse | 343 | (36.1) | 166 | (23.1) | |
Others | 451 | (47.4) | 448 | (62.3) |
Mental health outcomes 2 years after the pandemic onset
First Assessment | Second Assessment | Welch’s two-sample t-test | ||||||
---|---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | df |
t
|
p
| ||
F1 (anxiety about infection) | ||||||||
10.07 | 3.03 | 9.08 | 3.06 | 1536.51 | 6.58 | < 0.001 | ||
F2 (exhaustion) | ||||||||
4.20 | 2.51 | 5.11 | 2.36 | 1590.31 | -7.59 | < 0.001 | ||
F3 (workload) | ||||||||
2.38 | 1.52 | 3.25 | 1.55 | 1532.43 | -11.60 | < 0.001 | ||
F4 (feeling of being protected) | ||||||||
2.05 | 1.21 | 2.44 | 1.16 | 1578.14 | -6.64 | < 0.001 | ||
IES-R | ||||||||
12.71 | 13.35 | 13.93 | 15.45 | 1416.13 | -1.69 | 0.91 |
Regression analysis
F1(anxiety about infection): Q1,Q2,Q5,Q7,Q6,Q11 | F2(exhaustion): Q16,Q17,Q15,Q14 | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Univariable | Multivariable | Univariable | Multivariable | |||||||||||||||||||||||||||||
N
| (%) | mean | (SD) | p-value | β | p-value | mean | (SD) | p-value | β | p-value | |||||||||||||||||||||
Sex | ||||||||||||||||||||||||||||||||
Male | 211 | (29.3) | 8.03 | (3.16) | < .001 | - | 4.82 | (2.40) | .036 | - | ||||||||||||||||||||||
Female | 508 | (70.7) | 9.52 | (2.92) | 1.175 | < .001 | 5.22 | (2.34) | 0.371 | .097 | ||||||||||||||||||||||
Age (years) | ||||||||||||||||||||||||||||||||
20–29 | 193 | (26.8) | 9.32 | (3.29) | .59 | - | 5.25 | (2.51) | .54 | - | ||||||||||||||||||||||
30–39 | 179 | (25.0) | 8.85 | (3.20) | -0.209 | .507 | 5.08 | (2.44) | -0.042 | .866 | ||||||||||||||||||||||
40–49 | 164 | (22.8) | 9.00 | (2.72) | -0.114 | .726 | 5.19 | (2.19) | 0.089 | .733 | ||||||||||||||||||||||
50–59 | 143 | (19.9) | 9.22 | (3.07) | 0.231 | .516 | 4.97 | (2.29) | -0.031 | .914 | ||||||||||||||||||||||
60+ | 40 | (5.6) | 8.82 | (2.60) | 0.101 | .850 | 4.62 | (2.25) | -0.307 | .470 | ||||||||||||||||||||||
Job | ||||||||||||||||||||||||||||||||
Medical doctor | 105 | (14.6) | 7.35 | (2.90) | < .001 | - | 4.82 | (2.32) | .18 | - | ||||||||||||||||||||||
Nurse | 166 | (23.1) | 9.39 | (2.58) | 1.300 | .002 | 5.36 | (2.22) | 0.300 | .370 | ||||||||||||||||||||||
Others | 448 | (62.3) | 9.37 | (3.14) | 1.689 | < .001 | 5.08 | (2.42) | 0.199 | .472 | ||||||||||||||||||||||
Exposure to COVID-19 | ||||||||||||||||||||||||||||||||
Non-frontliner | 528 | (73.4) | 9.01 | (3.01) | .314 | - | 5.02 | (2.34) | .094 | - | ||||||||||||||||||||||
Frontliner | 191 | (26.6) | 9.27 | (3.21) | 0.68 | .010 | 5.35 | (2.41) | 0.366 | .082 | ||||||||||||||||||||||
Experience of the Great Hanshin-Awaji Earthquake | ||||||||||||||||||||||||||||||||
N | 575 | (80.0) | 9.14 | (3.12) | .337 | - | 5.18 | (2.39) | .081 | - | ||||||||||||||||||||||
Y | 144 | (20.0) | 8.86 | (2.81) | -0.536 | .076 | 4.80 | (2.26) | -0.371 | .124 | ||||||||||||||||||||||
Experience of engagement in DMAT | ||||||||||||||||||||||||||||||||
N | 696 | (96.8) | 9.09 | (3.06) | .541 | - | 5.12 | (2.37) | .450 | - | ||||||||||||||||||||||
Y | 23 | (3.20) | 8.70 | (3.36) | 0.132 | .836 | 4.74 | (2.32) | -0.143 | .780 | ||||||||||||||||||||||
F3(workload): Q4,Q3
|
F4(feeling of being protected): Q10,Q9
|
IES-R
| ||||||||||||||||||||||||||||||
Univariable
|
Multivariable
|
Univariable
|
Multivariable
|
Univariable
|
Multivariable
| |||||||||||||||||||||||||||
mean
| (SD) |
p-value
|
β
|
p-value
|
mean
| (SD) |
p-value
|
β
|
p-value
|
mean
| (SD) |
p-value
|
β
|
p-value
| ||||||||||||||||||
Sex | ||||||||||||||||||||||||||||||||
Male | 3.24 | (1.57) | .845 | - | 2.55 | (1.14) | .108 | - | 14.37 | (15.45) | .623 | - | ||||||||||||||||||||
Female | 3.26 | (1.54) | -0.07 | .618 | 2.39 | (1.17) | -0.13 | .239 | 13.75 | (15.47) | -1.68 | .251 | ||||||||||||||||||||
Age (years) | ||||||||||||||||||||||||||||||||
20–29 | 3.26 | (1.62) | .24 | - | 2.32 | (1.24) | .20 | - | 16.23 | (17.61) | .14 | - | ||||||||||||||||||||
30–39 | 3.36 | (1.65) | 0.16 | .301 | 2.39 | (1.07) | 0.04 | .763 | 12.86 | (14.84) | -4.15 | .012 | ||||||||||||||||||||
40–49 | 3.24 | (1.45) | 0.17 | .292 | 2.47 | (1.14) | 0.12 | .332 | 14.04 | (15.16) | -2.86 | .091 | ||||||||||||||||||||
50–59 | 3.28 | (1.43) | 0.36 | .044 | 2.55 | (1.18) | 0.18 | .194 | 12.27 | (13.77) | -4.79 | .010 | ||||||||||||||||||||
60+ | 2.73 | (1.40) | -0.15 | .582 | 2.70 | (1.20) | 0.30 | .152 | 13.08 | (13.02) | -3.69 | .184 | ||||||||||||||||||||
Job | ||||||||||||||||||||||||||||||||
Medical doctor | 3.07 | (1.57) | < .001 | - | 2.62 | (1.18) | .22 | - | 11.70 | (15.15) | .27 | - | ||||||||||||||||||||
Nurse | 3.78 | (1.45) | 0.83 | < .001 | 2.41 | (1.02) | -0.10 | .544 | 14.01 | (14.41) | 2.61 | .232 | ||||||||||||||||||||
Others | 3.10 | (1.54) | 0.25 | .152 | 2.40 | (1.21) | -0.19 | .169 | 14.42 | (15.88) | 3.70 | .041 | ||||||||||||||||||||
Exposure to COVID-19 | ||||||||||||||||||||||||||||||||
Non-frontliner | 3.03 | (1.50) | < .001 | - | 2.45 | (1.15) | .495 | - | 13.47 | (15.45) | .189 | - | ||||||||||||||||||||
Frontliner | 3.87 | (1.51) | 0.75 | < .001 | 2.39 | (1.21) | -0.08 | .413 | 15.19 | (15.42) | 1.87 | .173 | ||||||||||||||||||||
Experience of the Great Hanshin-Awaji Earthquake | ||||||||||||||||||||||||||||||||
N | 3.31 | (1.55) | .056 | - | 2.40 | (1.18) | .107 | - | 13.85 | (15.87) | .781 | - | ||||||||||||||||||||
Y | 3.03 | (1.51) | -0.34 | .026 | 2.58 | (1.10) | 0.12 | .324 | 14.25 | (13.70) | 1.67 | .289 | ||||||||||||||||||||
Experience of engagement in DMAT | ||||||||||||||||||||||||||||||||
N | 3.25 | (1.54) | .875 | - | 2.43 | (1.16) | .591 | - | 13.88 | (15.45) | .655 | - | ||||||||||||||||||||
Y | 3.30 | (1.74) | 0.08 | .803 | 2.57 | (1.20) | 0.03 | .919 | 15.35 | (15.80) | 1.34 | .687 |
Burnout
Burnout | Nonburnout | Total | p-value* | ||
---|---|---|---|---|---|
n = 123 (17.1%) | n = 596 (82.9%) | ||||
Gender | Male | 33 (15.6) | 178 (84.4) | 211 | 0.501 |
Female | 90 (17.7) | 418 (82.3) | 508 | ||
Age (years) | 20–29 | 39 (20.2) | 154 (79.8) | 193 | 0.126 |
30–39 | 36 (20.1) | 143 (79.9) | 179 | ||
40–49 | 21 (12.8) | 143 (87.2) | 164 | ||
50–59 | 24 (16.8) | 119 (83.2) | 143 | ||
60+ | 3 (7.5) | 37 (92.5) | 40 | ||
Job | Medical doctor | 18 (17.1) | 87 (82.9) | 105 | 0.068 |
Nurse | 38 (22.9) | 128 (77.1) | 166 | ||
Others | 67 (15.0) | 381 (85.0) | 448 | ||
Exposure to COVID-19 | Non-frontliner | 87 (16.5) | 441 (83.5) | 528 | 0.456 |
Frontliner | 36 (18.8) | 155 (81.2) | 191 |
MBI-GS (emotional exhaustion): Q1,Q2,Q3,Q4,Q6 | MBI-GS (cynicism):Q5,Q7,Q10,Q11,Q12,Q16 | MBI-GS(professional efficacy): Q8,Q9,Q13,Q14,Q15 | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Univariable | Multivariable | Univariable | Multivariable | Univariable | Multivariable | |||||||||||||
mean | (SD) | p-value | β | p-value | mean | (SD) | p-value | β | p-value | mean | (SD) | p-value | β | p-value | ||||
Sex | ||||||||||||||||||
Male | 2.51 | (1.61) | 0.001 | - | 2.42 | (1.22) | < 0.001 | - | 1.68 | (1.30) | 0.238 | - | ||||||
Female | 2.98 | (1.68) | 1.72 | 0.025 | 1.99 | (1.10) | -1.05 | 0.096 | 1.81 | (1.43) | 0.20 | 0.757 | ||||||
Age (years) | ||||||||||||||||||
20–29 | 3.31 | (1.66) | < 0.001 | - | 2.03 | (1.09) | 0.013 | - | 2.13 | (1.54) | < 0.001 | - | ||||||
30–39 | 2.88 | (1.68) | -1.57 | 0.069 | 2.11 | (1.16) | 0.15 | 0.835 | 1.74 | (1.32) | -1.92 | 0.008 | ||||||
40–49 | 2.76 | (1.66) | -2.22 | 0.013 | 2.05 | (1.17) | -0.01 | 0.987 | 1.74 | (1.43) | -1.91 | 0.011 | ||||||
50–59 | 2.46 | (1.53) | -3.80 | < 0.001 | 2.15 | (1.08) | 0.55 | 0.493 | 1.42 | (1.15) | -3.66 | < 0.001 | ||||||
60+ | 2.03 | (1.64) | -5.83 | < 0.001 | 2.71 | (1.42) | 3.55 | 0.003 | 1.54 | (1.21) | -3.00 | 0.015 | ||||||
Job | ||||||||||||||||||
Medical doctor | 2.70 | (1.52) | < 0.001 | - | 2.90 | (1.24) | < 0.001 | - | 1.78 | (1.32) | < 0.001 | - | ||||||
Nurse | 3.41 | (1.56) | 1.71 | 0.136 | 1.93 | (1.00) | -4.91 | < 0.001 | 2.15 | (1.46) | 1.08 | 0.263 | ||||||
Others | 2.66 | (1.70) | − 0.96 | 0.313 | 2.00 | (1.11) | -4.85 | < 0.001 | 1.63 | (1.36) | -0.82 | 0.303 | ||||||
Exposure to COVID-19 | ||||||||||||||||||
Non-frontliner | 2.78 | (1.68) | 0.120 | - | 2.10 | (1.17) | 0.681 | - | 1.70 | (1.38) | 0.036 | - | ||||||
Frontliner | 3.00 | (1.63) | 0.45 | 0.534 | 2.14 | (1.10) | − 0.15 | 0.798 | 1.95 | (1.40) | 0.72 | 0.233 | ||||||
Experience of the Great Hanshin-Awaji Earthquake | ||||||||||||||||||
N | 2.87 | (1.67) | 0.274 | - | 2.12 | (1.17) | 0.843 | - | 1.76 | (1.39) | 0.778 | - | ||||||
Y | 2.70 | (1.69) | 0.54 | 0.0510 | 2.10 | (1.10) | 0.00 | 0.998 | 1.80 | (1.38) | 1.45 | 0.037 | ||||||
Experience of engagement in DMAT | ||||||||||||||||||
N | 2.84 | (1.67) | 0.589 | - | 2.11 | (1.14) | 0.681 | - | 1.77 | (1.40) | 0.891 | - | ||||||
Y | 2.65 | (1.68) | 0.424 | 0.808 | 2.24 | (1.46) | -0.24 | 0.864 | 1.73 | (1.21) | 0.13 | 0.929 |