Abstract
BackgroundPoor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic. This study used the effort–reward imbalance model to investigate the association between work-stress characteristics (effort, over-commitment, reward) and mental health problems (anxiety and depression) among front-line public health workers during the COVID-19 pandemic in China.MethodsA total of 4850 valid online questionnaires were collected through a self- constructed sociodemographic questionnaire, the adapted ERI questionnaire, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression analysis was conducted to investigate the association between ERI factors and mental health problems (i.e., depression and anxiety), with reward treated as a potential moderator in such associations.ResultsThe data showed that effort and over-commitment were positively associated with depression and anxiety, while reward was negatively associated with depression and anxiety. Development and job acceptance were the two dimensions of reward buffered the harmful effect of effort/over-commitment on depression and anxiety, whereas esteem was non-significant.ConclusionsThis study confirmed the harmful effects of effort and over-commitment on mental health among public health workers during the COVID-19 pandemic in China. Such effects could be alleviated through an appropriate reward system, especially the development and job acceptance dimensions of such a system. These findings highlight the importance of establishing an emergency reward system, comprising reasonable work-allocation mechanism, bonuses and honorary titles, a continuous education system and better career-development opportunities.
Highlights
Poor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic
Of the 7090 completed questionnaires, 528 (7.4%) did not pass the consistency checks, 245 (3.4%) did not report any COVID-19-related work and 1467 (20.7%) from Guangdong province contained uncompleted depression and anxiety sections, as these were set as optional sections for participants in Guangdong due to the length of the questionnaire
In this study an effort–reward imbalance model (ERI) model was used to measure the associations of work stress with mental health problems among 4850 Chinese front-line public health workers involved in healthcare response to the COVID-19 pandemic
Summary
Poor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic. Chinese public health workers, who work at the Chinese Centre for Disease Control and Prevention (China CDC) or primary health care institutes (PHIs), made various contributions to prevent and control the spread of COVID-19, such as epidemiological investigation, surveillance, professional technical guidance, specimen collection and examination, health education and report epidemic data [4, 5]. These workers are an indispensable section of the anti-pandemic effort. Poor mental health status is known to be significantly associated with low work efficiency, excess lost productive time, poor physical health and poor quality of life [13,14,15], all of which may detract from the effectiveness of workers’ COVID-19 prevention and control work
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