COVID-19 has been listed as Class B infectious disease under the Law of Prevention and treatment of Infectious Diseases in China, and it is managed according to Class A infectious diseases. As an emerging infectious disease, much is still unknown about how the COVID-19 spreads, so it is easy to cause panic and psychological problems. A population-based cross-sectional study[16] explored the psychological reaction of people in China in the early stages of the COVID-19 outbreak, and found that the rates of moderate and severe anxiety among volunteers fighting the epidemic in were 32.7% and 20.4% in Wuhan and Shanghai, respectively, suggesting that during the rising stage of the outbreak, the physical and mental reactions of the masses were significant. In order to win this battle, the health care workers in China have made great efforts. As front-line personnel in the fight against the COVID-19 epidemic, they not only undertake heavy prevention and control tasks, but also bear tremendous psychological pressure.
Studies have shown that there is a significant positive correlation between depression and loneliness, 36.4% of health care workers had depression, which was higher than that reported in a previous study by Qi et al[17], and the depression scores of health care workers with lower job title and educational background were higher. The score of loneliness of doctors was higher than that of medical technicians, the scores of depression and loneliness of health care workers in isolation ward, fever clinic and pre-check triage were higher than those of non-prevention and control posts, It shows that the psychological problems of doctors, especially doctors with low job titles and academic qualifications, as well as those in epidemic prevention and control positions are relatively serious. Shao et al[18] found that during the period of fighting against SARS, the mental health level of health care workers was lower than the domestic norm, and there were mental health problems such as anxiety, fear, etc. And doctors, especially health care workers in prevention and control posts such as isolation wards and fever clinics, rushed to the front line of the epidemic. Due to the high infectivity and unknown nature of the new coronavirus, problems encountered in clinical work could not be solved in time, and there is no one to talk to in the face of the pressure of the epidemic, and there is no psychological comfort. In particular, some doctors are directly engaged in the diagnosis and treatment of COVID-19 in the isolation ward, and they are in a state of isolation for a long time and cannot be reunited with their families, but also worried about the risk of family infection, making them feel lonely and helpless, extremely prone to psychological problems.
In addition, this study found that depression had statistically significant differences in gender, occupation, professional title, education level and different positions. Among them, the depression score of nurses was higher than that of doctors. Qi et al[17] found that clinical nurses have psychological problems in the special period of facing COVID-19, another study by Jiao et al[19] shows that in the fight against the epidemic, nurses have a high intensity of tasks, as well as greater physical and mental pressure. There are several reasons that might cause this situation, first of all, during the fight against the COVID-19 epidemic, nurses work intensively, have heavy tasks, and are in a state of physical and mental exhaustion. Secondly, some nurses work at front line in COVID-19 fight, thus they have a high probability of contact with infected patients, and face the risk of being isolated at any time. Moreover, COVID-19 is highly contagious and has various clinical manifestations, so there is no specific drug at present, and the drugs previously used to treat other coronaviruses may be effective, but they need to be verified by further clinical trials[20]. Therefore, in the face of many uncertainties, clinical nurses are prone to varying degrees of psychological problems, such as depression, anxiety, etc. At the same time, the lack of in-depth understanding of COVID-19 aggravates the fear of nurses.
This study suggests that the social support of health care workers was negatively correlated with the scores of depression and loneliness. Further analysis of the social support of health care workers is particularly important for a comprehensive understanding of mental health status. Among them, the scores of social support of health care workers in prevention and control positions were lower. The reason is that doctors in prevention and control positions, are more likely to come into contact with COVID-19 patients, and there is a risk of infection. Their family and friends may be worried about being infected and have low support for them. In the absence of social support, health care workers tend to choose negative coping styles, such as self-attack and retreat, thus affecting their mental health[21]. Therefore, close attention should be paid to improving the psychological coping ability of health care workers under stress[22], in order to enhance their mental health level, and then carry out epidemic prevention and control work more effectively.
In the face of the psychological problems that need to be solved urgently, this study continues to investigate the psychological needs of health caregivers, in order to provide a better solution for hospital management and improve mental health. The following reference improvement measures are obtained from the study, such as mental health lectures, psychological counseling and psychological guidance for them, because healthy psychological counseling can maintain a positive and stable state of mind to deal with unexpected situations and reduce the risk of mental disorders such as anxiety and depression[23]. In addition, it is also very important to actively care for the families of health care workers and make them feel at ease with their work. It is suggested that managers should communicate more, understand their difficulties encountered in work and life, give timely help, improve their family conditions and reduce their life stress[24].
Mental health is not only related to individual health, but also affects social function and professional ability[25]. During the fight against COVID-19, health care workers, as front-line personnel in the fight against the epidemic, face both physical and mental pressure. The quality of their work is not only related to the life safety of patients, but also related to whether the epidemic can be effectively controlled and social stability. Therefore, we should actively take mental health intervention measures for health care workers according to the psychological needs of them. This study points out that the health care workers who need to pay attention to during the epidemic can provide reference for the prevention and management of public health emergencies.