Work Stress And Anxiety Among County-level CDC Staff In Shandong Province:the Mediating Role Of Resilience

BackgroundCounty-level disease prevention and control centers(County-level CDC)are the "first responders" to public health emergencies,and human resources are the core of public health emergency response capacity.The county-level CDC staff played an important role in the epidemiological investigation,disease tracing,community prevention and control and other emergency response work during the Corona Virus Disease 2019(COVID-19)epidemic.At the same time,problems such as many emergency situations,high work intensity,and difficulties in professional title promotion have led to increasing pressure on employees,who were prone to mental health problems such as anxiety.As a protective factor,resilience could effectively curb the occurrence of negative emotions.It is of great significance to study the current situation of staffs work stress,resilience and anxiety and the relationship between them,and to explore the key problems and countermeasures for the construction of disease control system and the improvement of emergency response to public health emergencies.ObjectiveTo understand the current situation of work stress,resilience and anxiety among county-level CDC staff,analyze the influence on resilience and anxiety,explore the relationship between work stress,resilience and anxiety,and investigate the mediating role of resilience between challenge-hindrance stressors and anxiety,so as to make recommendations for policy formulation in relevant departments.MethodsUsing a stratified random sampling method,5216 active employees from 87 counties(cities and districts)level CDC of 8 prefecture-level cities in Shandong Province were selected as the study population in August 2022.The survey instruments used were the Challenge-Hindrance Stressors Scale(C-HSS),Brief Resilience Scale(BRS),Generalized Anxiety Disorder-7(GAD-7)and other general scales,and the survey included information related to basic demographic characteristics,economic situation,healthy lifestyle,work status and social support.Epidata 3.1 was used to establish the database and enter the data,and SPSS 25.0 and Stata 17.0 were applied to analyze the data.First,the basic information of county-level CDC staff was analyzed descriptively.Second,independent sample t-test and one-way ANOVA were used to compare the differences in scores of work stress,resilience and anxiety among county-level CDC staff with different characteristics.Third,multiple linear regression was used to analyze the influencing factors of resilience and anxiety.Fourth,Pearson correlation analysis was applied to explore the relationship between work stress,resilience and anxiety.Finally,preliminary analysis of the mediating effect of resilience between challenging-hindering stressors and anxiety using hierarchical multiple linear regression was conducted,and the existence of the mediating effect was further verified using the Hayes Process 4.0 plug-in.Main ResultsThe mean scores of challenge and hindrance stressors of county-level CDC staff in Shandong Province were 21.80±4.80 and 11.60±4.48,respectively.The mean score of resilience was 19.16±3.91.The resilience of female or stressed workers was poor,and those with undergraduate and graduate education,more outgoing personality,better self-rated health,4 to 10 and more than 10 times of exercise per month,6 to 8 hours of sleep per day,and higher social support had good resilience.The mean score of anxiety was 6.22±5.23,and personnel with average daily working hours of 10 hours and 12 hours and high work stress were prone to be anxious,while those with better self-rated health,average daily sleeping hours of 6 to 8 hours and more than 8 hours,high social support status,and good mental resilience had less anxiety.Pearson correlation analysis showed that there was a positive correlation between challenge-hindrance stressors and anxiety(r=0.371,P<0.01;r=0.521,P<0.01),a negative correlation with resilience(r=-0.167,P<0.01;r=-0.400,P<0.01),and a negative correlation between resilience and anxiety(r=-0.502,P<0.01).There was a partial mediating effect of resilience between challenging stressors and anxiety,with a mediating effect value of 0.047 and a mediating effect percentage of 14.2%,and there was also a partial mediating effect of resilience between hindering stressors and anxiety,with a mediating effect value of 0.103 and a mediating effect percentage of 21.1%of the total effect.Specifically,the binary dimension of work stress among county-level CDC staff can lead directly to anxiety and can also have an indirect effect on anxiety symptoms through resilience.Conclusions and suggestionsThe work stress of county level CDC staff were positively correlated with anxiety,and resilience played a partially mediating role in the dual dimensions of work stress and anxiety.Work stress can not only directly affect anxiety,but also indirectly affect anxiety through resilience.In order to relieve the pressure of CDC workers and improve their mental health,the following suggestions are put forward:(1)Establish an early warning mechanism to reasonably regulate different work stressors;(2)Formulate a post-training plan to improve the resilience of employees in various aspects;(3)Foster correct cognition and strengthen humanistic care to alleviate the anxiety of employees.