Department of Infectious Diseases, Vietnam Military Medical University, Ha Noi, Viet Nam.
Director Office, Military Hospital 103, Hanoi, Hanoi, Viet Nam.
BMJ Open. 2020 Dec 7;10(12):e041394. doi: 10.1136/bmjopen-2020-041394.
We examined impacts and interactions of COVID-19 response involvement, health-related behaviours and health literacy (HL) on anxiety, depression, and health-related quality of life (HRQoL) among healthcare workers (HCWs).
A cross-sectional study was conducted. Data were collected 6 April to 19 April 2020 using online-based, self-administered questionnaires.
19 hospitals and health centres in Vietnam.
7 124 HCWs aged 21-60 years.
The COVID-19 response-involved HCWs had higher anxiety likelihood (OR (95% CI)=4.41 (3.53 to 5.51)), higher depression likelihood (OR(95% CI)=3.31 (2.71 to 4.05)) and lower HRQoL score (coefficient, b(95% CI)=-2.14 (-2.89 to -1.38)), compared with uninvolved HCWs. Overall, HCWs who smoked or drank at unchanged/increased levels had higher likelihood of anxiety, depression and lower HRQoL scores; those with unchanged/healthier eating, unchanged/more physical activity and higher HL scores had lower likelihood of anxiety, depression and higher HRQoL scores. In comparison to uninvolved HCWs who smoked or drank at never/stopped/reduced levels, involved HCWs with unchanged/increased smoking or drinking had lower anxiety likelihood (OR(95% CI)=0.34 (0.14 to 0.83)) or (OR(95% CI)=0.26 (0.11 to 0.60)), and lower depression likelihood (OR(95% CI)=0.33 (0.15 to 0.74)) or (OR(95% CI)=0.24 (0.11 to 0.53)), respectively. In comparison with uninvolved HCWs who exercised at never/stopped/reduced levels, or with those in the lowest HL quartile, involved HCWs with unchanged/increased exercise or with one-quartile HL increment reported lower anxiety likelihood (OR(95% CI)=0.50 (0.31 to 0.81)) or (OR(95% CI)=0.57 (0.45 to 0.71)), lower depression likelihood (OR(95% CI)=0.40 (0.27 to 0.61)) or (OR(95% CI)=0.63 (0.52 to 0.76)), and higher HRQoL scores (b(95% CI)=2.08 (0.58 to 3.58)), or (b(95% CI)=1.10 (0.42 to 1.78)), respectively.
Physical activity and higher HL were found to protect against anxiety and depression and were associated with higher HRQoL. Unexpectedly, smoking and drinking were also found to be coping behaviours. It is important to have strategic approaches that protect HCWs' mental health and HRQoL.
本研究旨在探讨参与新冠疫情应对、健康相关行为和健康素养（HL）对医护人员（HCWs）焦虑、抑郁和健康相关生活质量（HRQoL）的影响和相互作用。
本研究采用横断面研究设计，于 2020 年 4 月 6 日至 4 月 19 日期间通过在线自填式问卷收集数据。
越南 19 家医院和医疗中心。
年龄在 21-60 岁之间的 7124 名 HCWs。
与未参与的 HCWs 相比，参与新冠疫情应对的 HCWs 焦虑可能性更高（OR（95%CI）=4.41（3.53 至 5.51）），抑郁可能性更高（OR（95%CI）=3.31（2.71 至 4.05）），HRQoL 评分更低（系数，b（95%CI）=-2.14（-2.89 至-1.38））。总体而言，吸烟或饮酒水平不变/增加的 HCWs 焦虑、抑郁的可能性更高，HRQoL 评分更低；饮食不变/更健康、体力活动不变/更多以及 HL 评分更高的 HCWs 焦虑、抑郁的可能性更低，HRQoL 评分更高。与从不/停止/减少吸烟或饮酒的未参与 HCWs 相比，从不/停止/减少吸烟或饮酒的参与 HCWs 焦虑可能性更低（OR（95%CI）=0.34（0.14 至 0.83））或（OR（95%CI）=0.26（0.11 至 0.60）），抑郁可能性更低（OR（95%CI）=0.33（0.15 至 0.74））或（OR（95%CI）=0.24（0.11 至 0.53））。与从不/停止/减少运动的未参与 HCWs 或 HL 处于最低四分位数的 HCWs 相比，运动水平不变/增加的参与 HCWs 或 HL 增加一个四分位数的参与 HCWs 焦虑可能性更低（OR（95%CI）=0.50（0.31 至 0.81））或（OR（95%CI）=0.57（0.45 至 0.71）），抑郁可能性更低（OR（95%CI）=0.40（0.27 至 0.61））或（OR（95%CI）=0.63（0.52 至 0.76）），HRQoL 评分更高（b（95%CI）=2.08（0.58 至 3.58））或（b（95%CI）=1.10（0.42 至 1.78））。
本研究发现体力活动和较高的 HL 可预防焦虑和抑郁，并与较高的 HRQoL 相关。出乎意料的是，吸烟和饮酒也被发现是应对行为。因此，采取战略方法保护 HCWs 的心理健康和 HRQoL 非常重要。
