The Impact Of COVID-19-Related Work Stress On Mental Health Among Primary Health Care Workers

ObjectivesThis study aims to investigate the current situation of COVID-19-work stress and mental health of primary health care workers,establish a model of COVID-19-related work stress influencing mental health,and explore the influencing mechanism and mediating role of social support and resilience.Furthermore,we propose strategies for managing work stress and promoting the mental health of primary health care workers.Methods1.Literature research method:Literature research is used to review the relevant studies systematically about the relationship between COVID-19-related work stress and mental health and its mediating variables,to provide theoretical support for subsequent studies.2.Expert consultation method:Some experts were invited in the form of symposiums to control the quality of construction of the theoretical model,design and selection of measurement tool,investigation scheme,data analysis methods,countermeasures and suggestions,laying an important foundation for the overall research design and implementation.3.Questionnaire survey:The questionnaire mainly included basic information of the respondents,COVID-19-related Work Stress Questionnaire revised based on the Effort-Reward Imbalance questionnaire,Social Support Rating Scale,Brief Resilience Scale,and Hospital Anxiety and Depression Scale.A stratified cluster random sampling method was used to investigate primary medical staff in 17 community health service centers in Guangzhou.4.Statistical analysis method:The Common method bias was tested using Harman single factor test;The single-sample Kolmogorov-Smirnov test and skewness and kurtosis value were used to comprehensively verify whether research variables followed the univariate and multivariate normality;Cronbach’s a coefficient method and confirmatory factor analysis method were used to evaluate the reliability and validity of the measurement tool.Descriptive statistical analysis,Chi-square test,Mann-Whitney U test and Kruskal-Wallis H test were used for statistical description and single-factor analysis of variables.Spearman correlation analysis,Logistic regression analysis,Structural Equation Model and Nonparametric percentile Bootstrap method after deviation correction were used to verify the mediating relationship between variables.ResultsThe incidence rates of imbalance between efforts and rewards,and overload were 68.5%and 65.7%,respectively,and the positive rates of anxiety and depression were 68.1%and 55.6%,respectively among primary health care workers.There was a correlation between the effort-reward ratio,overcommitment,social support,resilience,anxiety,and depression.Logistic regression analysis showed that the effort-reward ratio and overcommitment had a significant positive impact on anxiety and depression,while social support and resilience were protective factors.The results of the structural equation model analysis show that the mediating model fitted well,and there are three indirect pathways for COVID-19-related work stress to affect anxiety and depression:COVID-19-related work stress→social support→anxiety and depression;COVID-19-related work stress→resilience→anxiety and depression;The mediating effects of COVID-19-related work stress→ social support→resilience→anxiety and depression.The results of the Bootstrap method after correcting deviation show that the indirect effect values account for 6.9%,41.7%,and 7.2%of the total effect,respectively.ConclusionCOVID-19-related work stress and mental health of primary medical staff are not optimistic.Social support and resilience play an independent and chain mediating role between COVID-19-related work stress and mental health,and resilience plays the most role in the mediating relationship.Comprehensive measures should be taken from the aspects of the welfare distribution system,supportive working environment,regular health promotion,psychological intervention management,and social care system to promote the timely relief of COVID-19-related work stress and effective intervention of anxiety and depression among primary health care workers.