Factors Associated With Healthcare Workers' Insomnia Symptoms and Fatigue in the Fight Against COVID-19, and the Role of Organizational Support.

Xia Zou, Shaokun Liu, Jie Li, Wen Chen, Jiali Ye, Yuan Yang, Fenfen Zhou, Li Ling
Author Information
  1. Xia Zou: Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
  2. Shaokun Liu: Department of Information, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China.
  3. Jie Li: Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
  4. Wen Chen: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
  5. Jiali Ye: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
  6. Yuan Yang: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
  7. Fenfen Zhou: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
  8. Li Ling: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Abstract

Healthcare workers (HCWs) have been exposed to increased risks of insomnia and fatigue during the COVID-19 pandemic. In this study, we identify important risk factors associated with insomnia symptoms and fatigue among HCWs, and evaluate the effect of organizational support on insomnia and fatigue symptoms. This is an online cross-sectional survey of HCWs in China administered during the COVID-19 epidemic (from February 27, 2020 to March 12, 2020). We employed the AIS-8 scale for insomnia screening, and a self-reported ten-point scale to evaluate subjects' degrees of fatigue. We also designed a four-point scale to assess the degree of social support provided on an organizational level. Additionally, we conducted logistic regression analysis to identify risk factors. This study included a total of 3,557 participants, 41% of which consisted of non-frontline HCWs and 59% of which was frontline HCWs. Of the non-frontline HCWs, 49% reported insomnia symptoms, and 53.8% reported a moderate to high degree of fatigue. Meanwhile, among the frontline HCWs, the percentages for insomnia and moderate to high fatigue were 63.4% and 72.2%, respectively. Additionally, frontline HCWs and HCWs employed at Centers for Disease Control and Prevention (CDCs) had elevated risks of insomnia and fatigue. However, with increased organizational support, insomnia symptoms decreased among frontline HCWs. Also, organizational support mitigated the positive correlation between daily working hours and degree of fatigue among HCWs. Frontline HCWs and staff in Chinese CDCs have been at a high risk of insomnia symptoms and fatigue during the fight against COVID-19. This study provides evidence for the positive effects of organizational support in relation to insomnia and fatigue among HCWs. This sheds light on government responses to the COVID-19 epidemic for other countries.

Keywords

References

  1. Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Mar 6;54(3):239-244 [PMID: 32064856]
  2. Soc Sci Med. 2004 Oct;59(8):1719-30 [PMID: 15279928]
  3. J Psychiatr Res. 2019 Oct;117:24-30 [PMID: 31272015]
  4. Lancet. 2020 Jul 25;396(10246):213 [PMID: 32711779]
  5. J Family Med Prim Care. 2016 Oct-Dec;5(4):780-784 [PMID: 28348990]
  6. Soc Psychiatry Psychiatr Epidemiol. 2005 Feb;40(2):126-32 [PMID: 15685404]
  7. J Clin Med. 2020 Feb 20;9(2): [PMID: 32093211]
  8. Lancet Psychiatry. 2020 Mar;7(3):e14 [PMID: 32035030]
  9. Psychol Med. 1998 May;28(3):731-5 [PMID: 9626729]
  10. Sleep Breath. 2018 Dec;22(4):1221-1231 [PMID: 29959635]
  11. J Affect Disord. 2003 Sep;76(1-3):255-9 [PMID: 12943956]
  12. J Psychosom Res. 2003 Sep;55(3):263-7 [PMID: 12932801]
  13. JAMA Netw Open. 2020 Mar 2;3(3):e203976 [PMID: 32202646]
  14. Lancet Psychiatry. 2020 Mar;7(3):228-229 [PMID: 32032543]
  15. Gen Hosp Psychiatry. 1997 Jul;19(4):245-50 [PMID: 9327253]
  16. BMJ. 2019 Apr 9;365:l1476 [PMID: 30967483]
  17. Scand J Work Environ Health. 2010 Nov;36(6):458-465 [PMID: 20414629]
  18. Curr Psychiatry Rep. 2009 Dec;11(6):437-42 [PMID: 19909664]
  19. Nutrition. 2016 Nov-Dec;32(11-12):1193-9 [PMID: 27377580]
  20. Behav Sleep Med. 2019 Jan-Feb;17(1):70-80 [PMID: 28128982]
  21. J Psychiatr Res. 2007 Jan-Feb;41(1-2):119-30 [PMID: 16460760]
  22. Curr Med Sci. 2020 Aug;40(4):625-635 [PMID: 32767264]
  23. Sleep Med Rev. 2019 Feb;43:71-83 [PMID: 30529432]
  24. J Clin Nurs. 2020 Nov 20;: [PMID: 33219569]
  25. J Psychosom Res. 2000 Jun;48(6):555-60 [PMID: 11033374]
  26. Int J Biol Sci. 2020 Mar 15;16(10):1732-1738 [PMID: 32226291]
  27. J Psychiatr Res. 2003 Jan-Feb;37(1):9-15 [PMID: 12482465]
  28. Psychother Psychosom. 2020;89(4):242-250 [PMID: 32272480]
  29. Gen Hosp Psychiatry. 2011 Jan-Feb;33(1):78-81 [PMID: 21353132]
  30. Sleep. 2006 Jun;29(6):751-7 [PMID: 16796213]
  31. Eur Psychiatry. 2019 Aug;60:79-85 [PMID: 31234011]
  32. Behav Sleep Med. 2019 Jul-Aug;17(4):379-387 [PMID: 28783373]
  33. Can J Psychiatry. 2007 Apr;52(4):241-7 [PMID: 17500305]
  34. Neuropsychopharmacology. 2020 Jan;45(1):74-89 [PMID: 31071719]
  35. Lancet Psychiatry. 2020 Apr;7(4):e15-e16 [PMID: 32085839]
  36. Sleep. 1991 Oct;14(5):386-91 [PMID: 1759090]
  37. Crit Care. 2020 Mar 18;24(1):107 [PMID: 32188482]
  38. Scand J Psychol. 2018 Aug;59(4):451-461 [PMID: 29717791]
  39. Sleep. 2009 Aug;32(8):1027-37 [PMID: 19725254]

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