Jing Zhang1, Yijing Wang1, Jingdong Xu2, Hua You3, Yan Li4, Yuan Liang5, Shan Li6, Lina Ma2, Joseph Tak-Fai Lau7, Yuantao Hao1,8, Shilin Chen1, Jing Zeng1, Jinghua Li9,10, Jing Gu11,12. 1. School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. 2. Hubei Province Center for Disease Control and Prevention, Wuhan, 430097, China. 3. School of Public Health, Nanjing Medical University, Nanjing, 210000, China. 4. Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China. 5. School of Public Health, Huazhong University of Science and Technology, Wuhan, 430074, China. 6. Zigong Center for Disease Control and Prevention, Zigong, 643000, China. 7. Centre for Health Behaviors Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. 8. Sun Yat-Sen University Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, China. 9. School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. lijinghua3@mail.sysu.edu.cn. 10. Sun Yat-Sen University Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, China. lijinghua3@mail.sysu.edu.cn. 11. School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. gujing5@mail.sysu.edu.cn. 12. Sun Yat-Sen University Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, China. gujing5@mail.sysu.edu.cn.
Abstract
BACKGROUND: Poor 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. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: This 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.
BACKGROUND: Poor 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. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: This 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.
Entities:
Keywords:
Anxiety; Depression; Effort–reward imbalance; Public health worker; Reward
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