Sex differences and anti-epidemic work in psychological symptoms of healthcare workers in intensive care units during the COVID-19 pandemic: a nationwide cross-sectional study.

Abstract

Sex-based differences in psychological symptoms have been well documented but remain significantly underexplored among healthcare workers who work in intensive care units (ICUs). This study aimed to explore the sex-based differences in psychological symptoms among Chinese ICU healthcare workers and compare psychological symptoms between those who directly participated in COVID-19 anti-epidemic work and those who did not. This cross-sectional study evaluated the psychological symptoms of ICU healthcare workers using the Chinese version of the Symptom Checklist-90 (SCL-90), with higher scores indicating more severe psychological symptoms. Generalised linear models were applied to explore sex-based differences and compare those who directly participated in COVID-19 anti-epidemic work and those who were not psychologically symptomatic after controlling for sociodemographic variables. A total of 3871 ICU healthcare workers, consisting of 2186 women and 1685 men, were included. There were significant differences between male and female scores of somatisation (adjusted unstandardised regression coefficients (B)=-0.611; 95% CI=-1.190 to -0.032; p=0.039), depression (adjusted B=-0.765; 95% CI=-1.484 to -0.046; p=0.037) and paranoid ideation (adjusted B=0.318; 95% CI=0.023 to 0.613; p=0.035), adjusting for sociodemographic variables. Participants who had directly engaged in COVID-19 anti-epidemic work had significantly lower scores on the 10 SCL-90 subscales and total scores than did those who had not (all p<0.05). Female ICU healthcare workers presented more severe somatisation and depression, whereas men presented more severe paranoid ideation. Healthcare workers directly involved in COVID-19 anti-epidemic work had better mental health status than those who were not. Scheduling rest time reasonably helps alleviate somatisation and depression. More optimistic attitudes and better communication skills are beneficial for reducing paranoid ideation.