Article Text

Original research
Impacts and interactions of COVID-19 response involvement, health-related behaviours, health literacy on anxiety, depression and health-related quality of life among healthcare workers: a cross-sectional study
  1. Tien V Tran1,2,
  2. Hoang C Nguyen3,4,
  3. Linh V Pham5,6,
  4. Minh H Nguyen7,
  5. Huu Cong Nguyen8,9,
  6. Tung H Ha10,
  7. Dung T Phan11,12,
  8. Hung K Dao13,
  9. Phuoc B Nguyen14,
  10. Manh V Trinh15,
  11. Thinh V Do16,
  12. Hung Q Nguyen17,
  13. Thao T P Nguyen18,19,
  14. Nhan P T Nguyen20,
  15. Cuong Q Tran21,22,
  16. Khanh V Tran23,
  17. Trang T Duong24,
  18. Hai X Pham25,
  19. Lam V Nguyen26,27,
  20. Tam T Vo28,
  21. Binh N Do1,29,
  22. Thai H Duong3,30,
  23. Minh Khue Pham31,32,
  24. Thu T M Pham31,33,
  25. Kien Trung Nguyen34,
  26. Shwu-Huey Yang35,36,
  27. Jane C J Chao35,37,
  28. Tuyen Van Duong35
  1. 1Department of Infectious Diseases, Vietnam Military Medical University, Ha Noi, Viet Nam
  2. 2Director Office, Military Hospital 103, Hanoi, Hanoi, Viet Nam
  3. 3Director Office, Thai Nguyen National Hospital, Thai Nguyen, Viet Nam
  4. 4President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam
  5. 5Department of Pulmonary & Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Haiphong, Viet Nam
  6. 6Director Office, Hai Phong University of Medicine and Pharmacy Hospital, Haiphong, Viet Nam
  7. 7International Ph.D. Program in Medicine, Taipei Medical University, Taipei, Taiwan
  8. 8Director Office, E Hospital, Hanoi, Hanoi, Viet Nam
  9. 9Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Viet Nam
  10. 10Director Office, General Hospital of Agricultural, Hanoi, Viet Nam
  11. 11Nursing Office, Thien An Obstetrics and Gynecology Hospital, Hanoi, Viet Nam
  12. 12Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Viet Nam
  13. 13Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, UK
  14. 14Director Office, Kien An Hospital, Haiphong, Viet Nam
  15. 15Director Office, Quang Ninh General Hospital, Quang Ninh, Viet Nam
  16. 16Director Office, Bai Chay Hospital, Quang Ninh, Viet Nam
  17. 17Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Viet Nam
  18. 18Health Management Training Institute, University of Medicine and Pharmacy, Hue University, Thua Thien Hue, Viet Nam
  19. 19Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
  20. 20General Planning Department, Danang Oncology Hospital, Danang, Viet Nam
  21. 21Director Office, Thu Duc District Health Center, Ho Chi Minh, Viet Nam
  22. 22Faculty of Health, Mekong University, Vinh Long, Viet Nam
  23. 23Director Office, Hospital District 2, Ho Chi Minh, Viet Nam
  24. 24Nursing Office, Tan Phu District Hospital, Ho Chi Minh, Viet Nam
  25. 25Director Office, District 9 Health Center, Ho Chi Minh, Viet Nam
  26. 26President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam
  27. 27Aesthetic Plastic Surgery & Skin Care Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Viet Nam
  28. 28Director Office, Trieu Phong District Health Center, Quang Tri, Viet Nam
  29. 29Division of Military Science, Military Hospital 103, Hanoi, Hanoi, Viet Nam
  30. 30Department of Internal Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam
  31. 31Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Haiphong, Viet Nam
  32. 32President Office, Hai Phong University of Medicine and Pharmacy, Haiphong, Viet Nam
  33. 33School of Public Health, Taipei Medical University, Taipei, Taiwan
  34. 34Department of Health Education, Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Viet Nam
  35. 35School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
  36. 36Research Center of Geriatric Nutrition, Taipei Medical University, Taipei, Taiwan
  37. 37Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
  1. Correspondence to Dr Tuyen Van Duong; duongtuyenvna{at}gmail.com

Abstract

Objectives 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).

Design A cross-sectional study was conducted. Data were collected 6 April to 19 April 2020 using online-based, self-administered questionnaires.

Setting 19 hospitals and health centres in Vietnam.

Participants 7 124 HCWs aged 21–60 years.

Results 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.

Conclusions 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.

  • epidemiology
  • public health
  • infection control
  • occupational & industrial medicine
  • anxiety disorders
  • depression & mood disorders
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Footnotes

  • Contributors TVT and TVD drafted the first version of manuscript. TVD performed the statistical analyses. TVT, MKP, BND, S-HY, JC and TVD interpreted the findings. TVT, HCN, LVP, MHN, HCN, THH, DTP, HKD, PBN, MVT, TVD, HQN, TTPN, NPTN, CQT, KVT, TTD, HXP, LVN, TTV, BND, THD, MKP, TTMP, KTN, S-HY, JC and TVD contributed to study conceptualisation, investigation, methodology, validation, revising the manuscript. TVT and TVD participated in funding acquisition. All authors have approved the final version to be published.

  • Funding This work was supported by Military Hospital 103, and Taipei Medical University, grant number (108-6202-008-112; 108-3805-022-400).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was reviewed and approved by the Institutional Ethical Review Committee of Ha Noi University of Public Health, Vietnam (IRB number 133/2020/YTCC-HD3). The consent form was obtained before administering the survey.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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