Coronavirus Disease 2019 Pandemic In China Research Articles

Effects of COVID-19 infection risk perception on depressive symptoms among pregnant women in different periods of the COVID-19 pandemic in China: A mediation model.

The study investigated the mediation mechanisms between coronavirus disease 2019 (COVID-19) infection risk perception and depressive symptoms among pregnant women during the different periods of the COVID-19 pandemic. Study data were derived from a sample of 463 pregnant women in Hubei Province, the province with the most severe COVID-19 outbreak in China. Data were collected in two phases (during and after the acute phase of the COVID-19 pandemic) using the COVID-19 infection risk perception scales, the Edinburg Postnatal Depression Scale (EPDS), the Perceived Stress Scale (PSS), and the Peritrauma Distress Inventory (PDI). Mediation model analysis was used for data analysis, overall and by groups. The level of depressive symptoms among pregnant women after the acute phase of the COVID-19 pandemic was moderate (median, 9.00 [25th percentile, 75th percentile = 5.00, 12.00]), higher than the acute group (median, 7.00 [25th percentile, 75th percentile = 4.50, 10.00]). Perceived stress and traumatic stress fully mediated the relationship between infection worry (total indirect effect, 0.39 [95% confidence interval, 0.24-0.54])/infection possibility (total indirect effect, 0.41 [95% confidence interval, 0.22-0.61]) and depressive symptoms among pregnant women during the acute phase of the COVID-19 pandemic, whereas the relationship was only fully mediated by perceived stress after the acute pandemic. Effects of risk perception on depressive symptoms varied by periods of COVID-19. These findings have important implications for developing effective prevention and early psychoeducational intervention strategies for pregnant women with a high risk of depressive symptoms during different periods of emerging infectious diseases.

Association Between Baseline Echocardiographic Parameters and Acute Coronavirus Disease 2019 Infection in Hospitalized Patients.

Background The current study aimed toexamine the association between baseline clinical and echocardiographic parameters with new-onset coronavirus disease 2019 (COVID-19) infection. Methodology We retrospectively enrolled consecutive hospitalized patients from our center during the national outbreak of the COVID-19 pandemic in China. Overall, 100 patients were enrolled, including 38 patients with COVID-19 infection. Results Compared with those without infection, patients with COVID-19 infection were more likely male (63.2% vs. 35.5%, p = 0.008), were older (59.08 vs. 52.35 years, p = 0.022), had higher heart failure (31.6% vs. 11.3%, p = 0.018) and hypertension (52.6% vs. 30.6%, p = 0.036) rates, had lower left ventricular ejection fraction (LVEF) (61.16% vs. 65.76%, p = 0.018), had higher A-wave velocity (86.84 vs. 73.63 cm/s, p = 0.003), and had and lower E/A ratio (0.85 vs 1.04, p = 0.015). On univariate and multivariate analysis, baseline echocardiographic parameters (LVEF and A-wave velocity) were independent risk factors for COVID-19 infection. There were no significant changes in echocardiographic parameters during the one-month follow-up period in patients infected and not infected with COVID-19. Conclusions In conclusion, baseline echocardiographic parameters were significantly associated with acute COVID-19 infection.

Risk factors for poor progression of addictive internet use across different COVID-19 periods in China.

Addictive behaviors are serious factors for mental health and usually increase during public crises. We identified the vulnerable characteristics for bad prognosis of addictive internet use across different periods of the coronavirus disease 2019 (COVID-19) pandemic. Self-reported questionnaires were delivered in three waves through jdh.com during the outbreak (n = 17,960), remission (n = 15,666), and dynamic zero (n = 12,158) periods of COVID-19 pandemic in China. Internet addiction degree was assessed using the Internet Addiction Test. The different progression groups were divided using a latent class growth modelamong 1679 longitudinal participants. Risk factors for bad progression were identified by two-step logistic regression. A total of 40.16% of participants reported an increase in the addictive degree of internet use compared with prepandemic. Across different COVID-19 periods, the overall trend of addictive internet use was downward among general Chinese study participants (Mslope = -1.56). Childhood traumatic experiences, deterioration of physical health, depression, and anxiety during remission and dynamic periods were the main risk factors for the bad progression of pandemic-induced addictive internet use. Addictive internet use was remitted following relaxed control policies during the COVID-19 pandemic. Negative childhood experiences and bad mental status during the recovery period were harmful to coping with pandemic-related addictive internet use. Our findings profiled the general trend of addictive internet use and the vulnerable characteristics of its bad progression across different periods of the first wave of COVID-19 pandemic in China. Our findings provide valuable insights for preventing the long-term adverse effects of negative public events on Internet addiction.

When educators are locked down: transitioning an international faculty development program from in-person to online during the COVID-19 pandemic in China.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic forced international faculty development programs in medical education to forgo in-person activities and transition to online learning. We sought to examine changes in international medical educators' evaluations of our faculty development program as it transitioned due to the pandemic. Methods: We compared survey responses from participants in our International Medical Educators Program between 2019 (in-person) and 2020 (online). The 43-item survey addressed aspects such as program evaluation and self-assessment of curriculum development and teaching skills. We analyzed data using t-tests to compare means and chi-square test for categorical variables, and performed thematic analysis of open-ended responses. Results: We found that trainees in both cohorts rated the program highly with regard to overall program quality and self-assessed learning outcomes, but the 2019 group reported stronger relationships with peers and instructors. Some scores for self-assessed outcomes were lower for the 2020 class, but no statistically significant differences were found in pre- and post- training scores between the two cohorts. Four themes emerged from the feedback: positive program utility, IMEP as an example of good curriculum design, timing issues, and online learning environment challenges. Conclusions: Despite pandemic challenges, the transition to online faculty development was favorably evaluated, with high confidence in the applicability of learned skills. Future efforts should focus on fostering community and optimizing interaction times to enhance learning experiences. The study contributes insights for global medical education communities in pandemic circumstances.

Mental health and cognitive function among medical students after the COVID-19 pandemic in China.

Chinese people experienced a nationwide coronavirus disease 2019 (COVID-19) pandemic after the adjustment of epidemic response policies from December 2022 to January 2023. This study aims to explore the prevalence of mental and cognitive symptoms and their associated factors among medical students after the COVID-19 pandemic. A cross-sectional study was conducted between February 27th and March 8th, 2023. The symptoms of anxiety, depression, insomnia, post-traumatic stress disorder (PTSD), and cognitive function among medical students were examined using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Athens Insomnia Scale (AIS), the Impact of Event Scale-6 (IES-6), and the Perceived Deficits Questionnaire-Depression-5 (PDQ-D-5). Data on demographic information was also collected. Statistical analyses were conducted to describe the prevalence and explore the associated factors of mental and cognitive symptoms. Among 947 participants, the proportion of students experiencing anxiety, depression, insomnia, and PTSD symptoms was 37.8, 39.3, 28.3, and 29.5%, respectively. The self-reported COVID-19 infection rate was 72.2%. Higher grades, childhood, and current rural residence were identified as potential risk factors for mental and cognitive symptoms. Gender, age, average monthly household income, and COVID-19 diagnosis were not associated with mental and cognitive symptoms among medical students. Our findings revealed a high prevalence of mental and cognitive symptoms among Chinese medical students after the COVID-19 pandemic. Special attention should be paid to the mental health of higher-grade students and those residing in rural areas.

Commuters’ intention to choose customized bus during COVID-19 pandemic: Insights from a two-phase comparative analysis

The Corona Virus Disease 2019 (COVID-19) has affected individuals’ health safety during commuting travel around the world. Therefore, a customized bus service was promoted to improve commuting health safety during the COVID-19 pandemic in China. This study intends to investigate the potential similarities and differences in terms of commuters’ intention to choose customized buses at the beginning of the COVID-19 pandemic (Phase I) and after adjusting to the COVID-19 pandemic (Phase II). A survey was designed for this purpose and conducted twice during the COVID-19 pandemic. A total of 1,285 responses were collected in two phases in Shanghai, China. Structural equation models (SEM) based on the theory of planned behavior (TPB) were developed to analyze the influential factors of the intention to commute by customized buses. Moreover, a multi-group analysis approach was used to determine the heterogeneity among commuters based on their socioeconomic and travel characteristics. Results show that “attitudes” in Phase I and “perceived behavioral control” in Phase II have significantly positive impacts on the intention to choose customized buses for commuting. In service quality, “comfort and convenience” and “public health safety” in Phase I and “operation and efficiency” and “comfort and convenience” in Phase II have a highly-significant positive impact on commuters’ attitudes toward customized buses. Through the multi-group analysis, differences in car ownership and commuting mode after the pandemic in Phase I and gender in Phase II are explored. Model estimation results can be used to assist in formulating policies and prioritizing policies in different phases of the pandemic to develop customized bus services.

Change from low to out-of-season epidemics of influenza in China during the COVID-19 pandemic: A time series study.

Nonpharmaceutical interventions to limit the coronavirus disease 2019 (COVID-19) pandemic might reduce the transmission of influenza viruses and disrupt the typical seasonality of influenza. However, changes in epidemiology and seasonal patterns of influenza remain unknown in China during the COVID-19 pandemic. Data on influenza-like illness (ILI) and influenza cases between surveillance Week 14 in 2010 and Week 6 in 2023 and ILI outbreaks between Week 14 in 2013 and Week 6 in 2023 were collected from the weekly reports of the Chinese National Influenza Center. A total of 32 10 735 ILI specimens were tested between Week 14 in 2010 and Week 6 in 2023 in China, with 12.4% of specimens positive for influenza. The influenza-positive percentage ranged from 11.8% to 21.1% in southern China and 9.5% to 19.5% in northern China between the 2010/2011 and 2019/2020 influenza seasons. The influenza-positive percentage was 0.7% in southern China and 0.2% in northern China in the 2020/2021 season. An increasing trend in influenza-positive percentage was observed in southern China in Weeks 18-27 in the 2022/2023 season, with a peak of 37.3%. A total of 768 ILI outbreaks reported in southern China in Weeks 14-26 in the 2022/2023 season were much more than those in the same period in the 2020/2021 and 2021/2022 seasons. In summary, seasonal influenza shifted from low to out-of-season epidemics during the COVID-19 pandemic in China, especially in southern China. Influenza vaccination and everyday preventive actions, such as mask wearing, appropriate air exchange, and good hand hygiene practices, are essential for the prevention of influenza virus infection during the COVID-19 pandemic.

The impact of employment stress on college students: psychological well-being during COVID-19 pandemic in China.

Employment among final year college students in China has encountered unprecedented difficulties during the Coronavirus disease 2019 (COVID-19) pandemic, the high unemployment rate had led college graduates faced inadvertently mental health issues such as anxiety and depression. This study aims to investigate the impact of employment stress on college students' psychological well-being during the COVID-19 pandemic in China. An online survey consisting of demographic items (i.e., age, gender, subject major, type of university, and perceived severity of the current employment situation), Employment Stress scale, Employment Anxiety Scale, and Patient Health Questionnaire was employed for data collection. A total of 2,627 final year college students were recruited, with participants displayed below moderate levels of employment stress and anxiety. Approximately 13.2% of participants were depressed and 53.3% considered the current employment situation as severe. Female students were stressed by individual factors and anxious, whilst male students were more depressed. Arts students were less depressed and students from comprehensive universities were more depressed and anxious compared to other types of universities. Students who perceived the employment situation as very severe displayed the lowest level of employment stress and anxiety. Gender, university type, family stress, college stress, and individual stress are predictors of psychological well-being among college students. The family environment, female identity, and stress from university play a crucial role in college students' psychological well-being. The government should pay more attention to the psychological well-being of graduate students and develop feasible measures to help them secure a job during this unprecedented time.

The irreplaceable role of medical massive open online courses in China during the COVID-19 pandemic

BackgroundMassive open online courses (MOOCs) have become innovative open-learning approach in medical education. This study aimed to evaluate the dynamic changes in the construction and application of medical MOOCs before and after the coronavirus disease 2019 (COVID-19) pandemic in China.MethodsThe dynamic changes of usages about medical MOOCs before and after 2020 were mainly searched on the Smart Education of China Higher Education platform, and the detailed learning profiles and outcome indicators were further analyzed using 40 national first-class medical MOOCs from ‘zhihuishu’ platform.ResultsA total of 2,405 medical MOOCs were exported from the Smart Education of China Higher Education platform, of which 1,313 (54.6%) were launched since 2020. The total and average numbers of participants of 141 national first-class medical MOOCs peaked during the initial spread of COVID-19 in 2020. We further analyzed the dynamic usage of MOOCs from 2018 to 2022 based on 40 national first-class medical MOOCs launched on the ‘Zhihuishu’ platform. The findings revealed that the number of registered learners (3,240 versus 2,654), questions and answers (27,005 versus 5,116) and students taking the final examination (2,782 versus 1,995) per semester were significantly higher since 2020 compared to these before 2020. Especially, the number of registered learners, registered schools, questions and answers, and students participating in online discussion, taking the unit quiz, taking final examinations and passing final examinations all peaked in the 2020 spring–summer semester. Pearson's correlation analysis found that the number of questions and answers and the number of learners who participated in online discussion were both positively correlated with the number of students who passed the final examination, and the correlation was especially strong since 2020. Moreover, the number of publications on medical MOOC research has soared since 2020 and has maintained a continuous upward trend.ConclusionsHigh-quality medical MOOCs have been launched rapidly since the COVID-19 pandemic in China. The number of participants and online interactions of medical MOOCs peaked during the initial spread of COVID-19 in 2020. MOOCs are reliable and valid digital sources that facilitate medical higher education and play irreplaceable roles in emergency management.

Changes in cigarette consumption and intention to quit in response to the COVID-19 pandemic in China.

Significant changes occurred in the way people socialize and interact with each other since China reported its first COVID-19 cases. However, little is known about how smoking behaviors may have changed due to the COVID-19 pandemic in China. The aim of this study was to assess changes in smoking behavior and intention to quit during the early stage of the COVID-19 pandemic in China and to investigate the associated factors. An online cross-sectional survey was conducted among Chinese adult smokers. Participants were recruited through snowball sampling from 19 March to 2 April 2020. A total of 1388 smokers participated in this study. Of those, 1014 (73.0%) reported not changing their cigarette consumption, 104 (7.5%) reported smoking more and 268 (19.3%) reported smoking less due to the pandemic. Average daily cigarette consumption among all participants decreased from 15.0 (IQR: 10.0-20.0) to 13.0 (IQR: 8.0-20.0) (W=6.919, p<0.001). For intention to quit, 270 (19.5%) respondents reported becoming more willing to quit, and 91 (6.6%) reported becoming less willing to quit. Multivariate analyses showed that tobacco addiction, overall knowledge about the relationship between smoking and COVID-19, level of attention devoted to COVID-19, anxiety, living alone, and number of smokers in the family were significantly correlated with cigarette consumption and intention to quit, and living alone was the strongest factor associated with increased cigarette consumption (AOR=5.29; 95% CI: 1.51-18.56). The COVID-19 pandemic led to a slight decrease in cigarette consumption and an increase in quitting intention among Chinese smokers. During the early stages of the pandemic, it was important to focus on the anxiety of smokers, dispel smokers' misunderstandings of smoking and COVID-19 and create a supporting environment in the family to help smokers quit.

Trends in respiratory diseases before and after the COVID-19 pandemic in China from 2010 to 2021

BackgroundThe ongoing benefits of coronavirus disease 2019 (COVID-19) nonpharmaceutical interventions (NPIs) for respiratory infectious diseases in China are still unclear. We aimed to explore the changes in seven respiratory infectious diseases before, during, and after COVID-19 in China from 2010 to 2021.MethodsThe monthly case numbers of seven respiratory infectious diseases were extracted to construct autoregressive integrated moving average (ARIMA) models. Eight indicators of NPIs were chosen from the COVID-19 Government Response Tracker system. The monthly case numbers of the respiratory diseases and the eight indicators were used to establish the Multivariable generalized linear model (GLM) to calculate the incidence rate ratios (IRRs).ResultsCompared with the year 2019, the percentage changes in 2020 and 2021 were all below 100% ranging from 3.81 to 84.71%. Pertussis and Scarlet fever started to increase in 2021 compared with 2020, with a percentage change of 183.46 and 171.49%. The ARIMA model showed a good fit, and the predicted data fitted well with the actual data from 2010 to 2019, but the predicted data was bigger than the actual number in 2020 and 2021. All eight indicators could negatively affect the incidence of respiratory diseases. The seven respiratory diseases were significantly reduced during the COVID-19 pandemic in 2020 and 2021 compared with 2019, with significant estimated IRRs ranging from 0.06 to 0.85. In the GLM using data for the year 2020 and 2021, the IRRs were not significant after adjusting for the eight indicators in multivariate analysis.ConclusionOur study demonstrated the incidence of the seven respiratory diseases decreased rapidly during the COVID-19 pandemic in 2020 and 2021. At the end of 2021, we did see a rising trend for the seven respiratory diseases compared to the year 2020 when the NPIs relaxed in China, but the rising trend was not significant after adjusting for the NPIs indicators. Our study showed that NPIs have an effect on respiratory diseases, but Relaxation of NPIs might lead to the resurgence of respiratory diseases.

The status of emotional labour and its influence on job burnout among village doctors during the COVID-19 pandemic in China: a cross-sectional study

BackgroundVillage doctors in China are not only the gatekeepers of rural residents' health but also the net bottom of the medical security system. However, emotional labour is increasingly threatening the stability of the rural primary medical system. In addition, the ongoing coronavirus disease 2019 (COVID-19) pandemic has further exposed the vulnerability of human resources in China's rural health system. This study aims to evaluate the current situation of emotional labour among village doctors and explore the impact of emotional labour on job burnout during the COVID-19 pandemic in China.MethodsA cross-sectional survey was conducted in December 2021 in Shandong Province. We used structured questionnaires to collect data, including sociodemographic characteristics, emotional labour, and job burnout. Data were analysed by t test, analysis of variance (ANOVA), Pearson correlation analysis, and hierarchical multiple linear regression.ResultsA total of 1,093 village doctors from Shandong Province participated in the study. More than half of the participants were male (62.40%) and were between 41 and 50 years old (53.43%). The total mean score of emotional labour was 3.17 ± 0.67, of which the surface acting (SA) score was 2.28 ± 0.90, and the deep acting (DA) score was 3.91 ± 0.93. There were significant differences in SA according to gender and work content (P < 0.05) and in DA according to gender, age, education level, and work content (P < 0.05). Pearson correlation analysis showed that SA was positively correlated with job burnout (P < 0.001), and DA was negatively correlated with job burnout (P < 0.001). Hierarchical multiple linear regression analysis revealed that 29% of the variance in job burnout is attributable to SA (β = 0.530, P < 0.001) and DA (β = -0.154, P < 0.001).ConclusionVillage doctors in Shandong Province performed moderate levels of emotional labour during the COVID-19 pandemic. SA had a significant positive effect on job burnout, while DA had a significant negative effect on job burnout among village doctors. Administrators should enhance training on emotional labour for village doctors to play a positive role in alleviating their job burnout.

Nursing Home Residents' Perceptions of Challenges and Coping Strategies during COVID-19 Pandemic in China.

Older people in nursing homes are at a high risk of being infected by coronavirus disease 2019 (COVID-19). They also experienced nursing home lockdowns that harm their psychological wellbeing. Better support for this vulnerable population requires understanding their perceptions of challenges and coping strategies during the COVID-19 pandemic. A qualitative descriptive study was conducted using semi-structured interviews. Thematic analysis approach was used to analyze the data. Participants were recruited from six nursing homes in three cities in Hunan Province, China. Fourteen nursing home residents participated in the study. Four themes were identified from interviews and described as: mental stress and coping strategies, self-regulation to respond to lockdown, the lack of social connection and coping strategies, and the need for medical care services and coping strategies. This study revealed that nursing home residents perceived stress during the nursing home lockdown, but they reported initiating activities to maintain health and connections with their families and peers. Resilience improvement interventions are necessary to enable residents' autonomy and develop their resilience in coping with difficulties and hardship during crises. The findings also indicate that a supportive environment with interactions from families, peers, and staffs played a key role in enabling residents' positive health and wellbeing during the lockdown.

A long trend of sexually transmitted diseases before and after the COVID-19 pandemic in China (2010-21).

The longer ongoing benefits of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) for sexually transmitted diseases (STDs) in China are still unclear. We aimed to explore the changes in five STDs (AIDS, hepatitis B, hepatitis C, gonorrhoea, and syphilis) before, during, and after the COVID-19 pandemic in mainland China, from 2010 to 2021. The number of the monthly reported cases of the five STDs were extracted from the website to construct the Joinpoint regression and autoregressive integrated moving average (ARIMA) models. Eight indicators reflecting NPIs were chosen from the COVID-19 Government Response Tracker system. The STDs and eight indicators were used to establish the Multivariable generalised linear model (GLM) to calculate the incidence rate ratios (IRRs). With the exception of hepatitis B, the other four STDs (AIDS, hepatitis C, gonorrhoea, and syphilis) had a positive average annual percent change over the past 12years. All the ARIMA models had passed the Ljung-Box test, and the predicted data fit well with the data from 2010 to 2019. All five STDs were significantly reduced in 2020 compared with 2019, with significant estimated IRRs ranging from 0.88 to 0.92. In the GLM, using data for the years 2020 (February-December) and 2021, the IRRs were not significant after adjusting for the eight indicators in multivariate analysis. Our study demonstrated that the incidence of the five STDs decreased rapidly during the COVID-19 pandemic in 2020. A recovery of STDs in 2021 was found to occur compared with that in 2020, but the rising trend disappeared after adjusting for the NPIs. Our study demonstrated that NPIs have an effect on STDs, but the relaxation of NPI usage might lead to a resurgence.

The change in pediatric subject symptoms during the COVID-19 pandemic in China: an increase in cardiac consultation

BackgroundIt is reported that the adverse impact of nonpharmaceutical interventions (NPIs) on the mental health of children and adolescents may lead to psychologically related disorders during the coronavirus disease 2019 (COVID-19) period. Subject symptoms such as chest pain, chest tightness, and palpitation may be related to increased stress and anxiety in children and adolescents. The present research aimed to determine the number of pediatric consults and etiology of subject symptoms during the COVID-19 pandemic period and compared it with the same timelines in 2019 and 2021 to discuss the impact of different periods on the organic disease onset of children with subject symptoms, especially in cardiac involvement.MethodsChildren who visited Qingdao Women and Children’s Hospital, Qingdao University between January 23 to April 30, 2019 (pre-COVID-19 period), January 23 to April 30, 2020 (COVID-19 period), and January 23 to April 30, 2021 (post-COVID-19 period) presenting chest pain, chest tightness, and palpitation were recruited. Information to determine gender, age, medical history, department for the initial visit, clinical manifestations, time from the latest onset to the visit, and diagnosis were recorded.ResultA total of 891 patients were enrolled in the present study (514 males; median age: 7.72). One hundred twenty-three patients presented during the pre-COVID-19 period while 130 during the COVID-19 period, nevertheless, the number substantially increased during the post-COVID-19 period (n = 638). Cardiac etiology accounted for 1.68% (n = 15) of the patient population, including arrhythmias (n = 10, 1.12%), myocarditis (n = 4, 0.44%), and atrial septal defect (n = 1, 0.11%). There was no significant difference among groups in the distribution of organic etiology. The median time from the latest onset to the visit during the pre-COVID-19 period was 7 days compared to 10 days during the COVID-19 period and 3 days during the post-COVID period.ConclusionDuring the post-COVID-19 period, the median time from the latest onset to the visit was significantly shorter than that in the pre-COVID-19 period or COVID-19 period. The pediatric consult of children with subject symptoms presented increased substantially during the post-COVID-19 period, while there was no significant difference in the number of patients involving the cardiac disease. Clinicians ought to be more careful to screen heart diseases to prevent missed diagnosis and misdiagnosis during special periods.

Depressive symptoms and physical function among the elderly in nursing homes during the COVID-19 pandemic in China: A cross-sectional study.

The coronavirus disease 2019 (COVID-19) pandemic has placed a heavy burden on global healthcare. Depressive symptoms and physical function impairment are 2 common health problems among the elderly, but the association between depressive symptoms and physical function in nursing homes have not been extensively investigated during the COVID-19 pandemic. The purpose of this study was to investigate the current status of depressive symptoms and physical function and analyze the prevalence and related factors of depression among elderly people in nursing homes during the COVID-19 pandemic in China. A cross-sectional study was conducted. 381 elderly people were included in 4 nursing homes who were 60 to 100 years old with more than 3 months' residential in Weifang City, Shandong Province using convenience cluster sampling. The Patient Health Questionnaire (PHQ-9) was performed to evaluate geriatric depression, the Barthel Index (BI) was administered to assess the activities of daily living, and a self-designed demographic data questionnaire was used to collect the demographic data. Multiple logistic regression analysis was conducted. 103 (27.0%) old residents reported depression according to PHQ-9. 279 (73.2%) old residents reported impaired self-care ability according to BI. The mean score of PHQ-9 and BI in the elderly was 3.56 ± 3.76 and 5.76 ± 7.05. The total PHQ-9 score of the elderly in nursing homes was positively correlated with the total activities of daily living score (R = 0.503, P < .01). Regression analysis showed that gender, self-care ability, more chronic diseases and medicines, especially Alzheimer's disease and cataract were risk factors for depression among elderly people in nursing homes (P < .05). Our study showed 27.0% depression rate among old residents in nursing homes in China in the context of the COVID-19 pandemic. Depression is relatively prevalent among the elderly in China, and we should pay attention to those with poor self-care ability and more chronic diseases and medicines.

Prosocial modelling matters: the association between parent and faculty involvement in fighting COVID-19 with medical students’ career commitment

Background Role models are essential in medical education, yet empirical research is relatively insufficient on the influence of prosocial modelling on medical students’ career commitment. The prosocial behaviour of medical staff involved in the fight against the novel coronavirus disease 2019 (COVID-19) at the beginning of 2020 presents an opportunity to fill the research gap. We explored and compared the different associations of the two most important role models for medical students – parents and faculty- with medical students’ career commitment. Methods The cross-sectional study was conducted with 99,559 undergraduate students majoring in clinical medicine in mainland China. Questions were asked to collect information about participants in the battle against COVID-19, medical students’ determination to practice medicine after graduation, as well as students’ socio-demographic characteristics. Chi-square tests and hierarchical regressions were performed to examine the associations between parent and faculty involvement and students’ career commitment. Results The results showed statistically significant associations between prosocial modelling during the COVID-19 pandemic in China and students’ intention to pursue medical careers. The association of faculty involvement (OR = 1.165, p < .001) with students’ career commitment was greater than that of parents (OR = 0.970, p > .05). For faculty involvement, the association was stronger among male students (OR = 1.323, p < .001) and students who were already determined to be doctors (OR = 1.219, p < .001) before the pandemic. Conclusions Our study provides new evidence on the potential roles of parents and faculty in shaping medical students’ career commitment. Encouraging faculty to act as positive role models could help medical students increase their intention to become doctors. KEY MESSAGES Prosocial modelling could enhance students’ intention to pursue medical careers. The association of prosocial behaviour of faculty is larger than that of parents on medical students. Those who have prior medical career commitment are much more likely to persist in the medical profession, and prosocial modelling of faculty is positively associated with their medical career commitment.

Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China

BackgroundWith the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recognition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health consequences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associated factors among nurses in China.MethodsWe launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom.FindingsA total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial proportion of nurses reported symptoms of burnout (34%), depression (55·5%), and anxiety (41·8%). In line with the disproportionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression.InterpretationNurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating countermeasures to safeguard nurses' health.FundingThe strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17]

Psychological outcomes and associated factors amongst healthcare workers during a single wave, deeper into the COVID-19 pandemic in China.

BackgroundTo date, the repeated breakout of the novel coronavirus disease 2019 (COVID-19) pandemic across many regions in China has caused continuous physical and mental harm to health care workers. This study investigates the psychological burden of the pandemic and its associated risk factors among Chinese healthcare workers (HCWs) during a single wave of COVID-19.MethodsFor this cross-sectional web-based survey conducted from January 16, 2022 to February 5, 2022, a total of 412 HCWs from Northwestern China were recruited. Their socio-demographic data and COVID-19 related survey variables were then collected using online self-rating questionnaires. In addition, the Chinese versions of well-validated instruments, including the 12-item General Health Questionnaire for psychiatric morbidity, the Generalized Anxiety Disorder Scale-7 for anxiety, the Patient Health Questionnaire-9 for depression and the Insomnia Severity Index-7 for insomnia, were used to assess the participants' mental health status. Multivariate logistic regression analysis was eventually performed to identify the risk factors associated with the psychological outcomes.ResultsOf the 388 participants who were included in the final study (94.17% response rate), the prevalence of anxiety, depression, and insomnia symptoms were 25.3% (95% CI: 20.9-29.6%), 40.7% (95% CI: 35.8-45.6%), and 30.9% (95% CI: 26.3-35.5%), respectively. Multivariate logistic regression analysis revealed that being a woman and having a perceived need for psychological support were risk factors for all psychological outcomes, while poor disease cognition and perceived susceptibility were risk factors for anxiety. Poor disease cognition and being unvaccinated against COVID-19 were risk factors for depression, with the latter also being an independent risk factor for insomnia.ConclusionThis study has identified a relatively lower prevalence rate of psychological disorders among Chinese HCWs during a single wave, deeper into the COVID-19 pandemic. Female HCWs, and those who had a perceived need for psychological support, had poor disease cognition, were perceived as susceptible to COVID-19 and had not been vaccinated against COVID-19 deserve more attention.

When educators are locked down: transitioning an international faculty development program from in-person to online during the COVID-19 pandemic in China

Introduction: The coronavirus disease 2019 (COVID-19) pandemic forced international faculty development programs in medical education to forgo in-person activities and transition to online learning. We sought to examine changes in Chinese medical educators’ evaluations of our faculty development program as it transitioned from in-person intensive to online longitudinal due to the pandemic. Methods: A 30-item program evaluation and self-assessment of curriculum development and teaching skills was sent to our 2020 cohort. Results were compared to our 2019 cohort. We analyzed data using t-tests to compare means and chi-square test for categorical variables. Results: We found that trainees in both cohorts rated the program highly with regard to overall program quality and self-assessed learning outcomes. Comparison of cohorts also showed similar growth in pre- and post-training assessment. However, the 2020 cohort rated their relationships with instructors and peers less strongly than the 2019 cohort. Conclusions: Despite the rapid transition to online learning due to social distancing measures, trainees were as confident in the skills they learned as the prior in-person participants. Time zone differences placed additional restrictions on the implementation of the training program, which affected the amount of face-to-face interaction time available.