Table1_Trends and determinants of nurses’ mental health following the COVID-19 pandemic in China: a longitudinal, comparative study over a two-year period.docx

IntroductionThe COVID-19 pandemic has placed nurses at the forefront of healthcare, exposing them to various mental health challenges such as depression, anxiety, and post-traumatic stress disorder (PTSD). However the long-term effects and risk factors of the COVID-19 pandemic on nurses’ mental health are unknown. The objective of our study is to investigate the enduring impact of the COVID-19 pandemic on the psychological distress and PTSD of nurses, while also identifying the factors that influence these outcomesMethodsTo investigate this question, we conducted a self-reported questionnaire survey of 8785 registered nurses recruited using snowball sampling methodology from 22 provinces in China, at five time points (T0-T4). At all times, we took measures of general health, while at the last four times we also measured PTSD. And we used logistic regression analysis to explore their impacts.ResultsThe incidence of whole levels psychological distress among nurses was 27.7% at T0, peaking at 57.6% at T4. For severe psychological distress, it began at 5.5% at T0 and rose to 9.5% at T4. PTSD rates among nurses were recorded at 7.8% in T1, reaching a maximum of 14.7% in T4. They all got progressively worse in the volatility. In all times, coping strategies are independent factors for various levels of psychological distress and PTSD, while social support is a key factor for severe psychological distress and PTSD.ConclusionsOur findings indicated a gradual deterioration in the mental health of nurses following the COVID-19 outbreak. In all instances, coping strategies exhibit an independent correlation with all grades of psychological distress and post-traumatic stress disorder (PTSD), whereas social support emerges as an independent protective factor mitigating the risk of severe psychological distress and PTSD.

引言COVID-19疫情将护士置于医疗保健的前沿，使他们面临诸如抑郁、焦虑和创伤后应激障碍（PTSD）等多种心理健康挑战。然而，COVID-19疫情对护士心理健康的长远影响及其风险因素尚不明确。本研究旨在探讨COVID-19疫情对护士心理压力和PTSD的持久影响，并识别影响这些结果的因素。
方法为了探究这一问题，我们采用雪球抽样方法，从中国22个省份招募了8785名注册护士，在五个时间点（T0-T4）进行自我报告问卷调查。在所有时间点，我们测量了总体健康状况，而在最后四个时间点，我们还测量了PTSD。我们使用逻辑回归分析来探讨其影响。
结果护士的整体心理压力发生率在T0时为27.7%，在T4时达到峰值57.6%。对于严重心理压力，从T0时的5.5%上升到T4时的9.5%。护士的PTSD比率在T1时为7.8%，在T4时达到最高点14.7%。在所有时间点，应对策略都是不同级别心理压力和PTSD的独立因素，而社会支持是严重心理压力和PTSD的关键因素。
结论我们的研究发现，在COVID-19疫情爆发后，护士的心理健康逐渐恶化。在所有情况下，应对策略均与所有级别的心理压力和创伤后应激障碍（PTSD）呈独立相关性，而社会支持则成为减轻严重心理压力和PTSD风险的独立保护因素。