Analysis of anxiety and depression among tuberculosis prevention and control staff in primary healthcare institutions in Hunan Province

doi:10.19982/j.issn.1000-6621.20250185

Abstract

Abstract:

Objective: To explore the prevalence and influencing factors of anxiety and depression among tuberculosis (TB) control staff in primary healthcare institutions in Hunan Province. Methods: A stratified cluster sampling approach was employed. In March to April 2023, six counties and districts across three cities and prefectures (Changde City, Yongzhou City, and Xiangxi Autonomous Prefecture) were selected from Hunan Province, which include a total of 1256 primary healthcare institutions. Overall, 1289 TB control staff served as the research subjects. Social-demographic data and work-related details were collected through self-administered online questionnaire. Self-Rating Anxiety Scale and Self-Rating Depression Scale were utilized to assess the anxiety and depression level of the research subjects. Results: One thousand one hundred and sixty-one valid pieces of questionnaire were collected with a response rate of 90.07% (1161/1289). A total of 138 staff (11.89%, 138/1161) were identified as having varying degrees of anxiety. The overall average anxiety score was 41.12±8.07. Multivariable analysis indicated that TB control staff with poor self-rated health (β=2.003, t=5.618, P<0.001), younger age (β=-0.091, t=-4.270, P<0.001), professional qualification as village doctor or nurse (β=0.729, t=2.685,P=0.007), monthly income≤2000 yuan (β=-1.052, t=-3.099, P=0.002), and working in community health service center or township health center (β=-1.135, t=-2.311, P=0.021) had higher anxiety scores. Regarding depression, 358 staff (30.84%, 358/1161) were evaluated to have varying degrees of depression. The overall average depression score was 44.51±12.84. Multivariable analysis revealed that TB control staff with younger age (β=-0.138, t=-3.590, P<0.001), poor self-rated health (β=2.634, t=4.687, P<0.001), monthly income ≤2000 yuan (β=-1.415, t=-2.699, P=0.007), professional qualification as village doctor or nurse (β=1.182, t=2.728, P=0.006), engagement of TB work ≤5 years (β=-1.553, t=-3.156, P=0.002), and working in Xiangxi Autonomous Prefecture and Yongzhou City (β=1.411, t=2.710, P=0.007) had higher depression scores. Conclusion: The proportion of anxiety and depression among TB control staff in primary healthcare institutions in Hunan Province is higher than that of the general Chinese population. Self-rated health, professional qualification, age and income are common factors influencing occurrence of anxiety and depression.

Key words: Tuberculosis, Medical staff, Anxiety, Depression, Sickness impact profile

CLC Number:

R52
R749.7+2

Zhou Meng, Xu Zuhui, Fan Jiangjing. Analysis of anxiety and depression among tuberculosis prevention and control staff in primary healthcare institutions in Hunan Province[J]. Chinese Journal of Antituberculosis, 2025, 47(11): 1465-1473. doi: 10.19982/j.issn.1000-6621.20250185

Figures/Tables 4

因素	人数 (名)	焦虑			抑郁
因素	人数 (名)	得分($\bar{x} \pm s$)	统计检验值	P值	得分($\bar{x} \pm s$)	统计检验值	P值
性别			t=―1.128	0.259		t=―2.005	0.045
男性	654	40.89±8.22			43.85±13.00
女性	507	41.42±7.88			45.37±12.58
年龄组(岁)			F=4.323	0.002		F=8.638	<0.001
20~29	108	43.03±7.75			49.26±13.45
30~39	215	42.12±8.05			46.81±13.01
40~49	375	41.09±7.76			44.00±12.65
50~59	318	39.86±8.28			42.09±12.07
≥60	145	41.06±8.27			44.22±12.88
婚姻状况			F=1.656	0.191		F=1.965	0.141
已婚	1011	40.98±8.16			44.25±12.86
未婚	98	42.53±7.78			46.87±12.90
离异或丧偶	52	41.21±6.51			45.29±11.88
文化程度			F=1.990	0.114		F=1.682	0.169
初中及以下	78	41.04±9.30			45.27±12.60
高中/职高/中专	584	40.80±7.64			44.02±12.67
大学专科	307	40.95±8.32			44.15±13.27
大学本科及以上	192	42.41±8.35			46.29±12.66
职称			F=0.727	0.536		F=0.843	0.470
无职称	620	41.36±8.01			45.04±12.65
初级	398	40.64±7.99			43.99±13.25
中级	133	41.39±8.54			43.82±12.41
高级	10	41.70±8.59			41.80±13.69
执业资格			F=3.953	0.019		F=5.240	0.005
执业(助理)医师	341	40.11±8.21			42.70±12.46
执业护士	106	41.16±7.92			44.23±11.99
乡村医生	714	41.60±7.99			45.42±13.06
地区			F=4.426	0.012		F=8.285	<0.001
常德	297	40.60±7.75			42.85±12.46
永州	495	40.67±8.13			43.91±12.84
湘西	369	42.15±8.17			46.66±12.87
月平均收入(元)			F=3.078	0.046		F=4.686	0.009
≤2000	529	41.62±7.91			45.42±12.92
2001~3000	369	41.13±8.17			44.67±12.83
>3000	263	40.11±8.18			42.48±12.5
自评健康状况			F=15.761	<0.001		F=10.141	<0.001
很好	835	40.50±8.02			43.81±12.97
较好	214	41.55±7.66			44.61±12.28
一般及以下	112	44.95±8.16			49.58±11.75
慢性疾病史			t=―1.195	0.232		t=―1.549	0.122
无	1044	41.03±8.03			44.32±12.85
有	117	41.97±8.42			46.26±12.62
工作单位类别			F=3.595	0.028		F=2.824	0.060
社区卫生服务中心	51	41.39±7.75			43.63±12.45
乡镇卫生院	244	42.32±8.45			46.24±12.85
村卫生室	866	40.77±7.95			44.08±12.83
劳动人事关系			F=0.060	0.942		F=0.398	0.672
在编	379	41.24±8.17			44.67±13.18
合同制	762	41.07±8.05			44.50±12.64
退休后返聘	20	41.00±7.15			42.05±13.99
从事结核病健康管理工作年限(年)			F=5.255	0.005		F=11.024	<0.001
≤5	498	41.82±8.17			45.95±13.04
6~10	185	41.58±7.49			46.06±12.31
>10	478	40.21±8.11			42.42±12.56
每月服务天数(d)			t=―1.778	0.076		t=―0.052	0.959
<10	843	40.85±7.90			44.22±12.50
≥10	318	41.78±8.45			44.26±13.10
岗位状态			t=―0.985	0.325		t=―0.914	0.361
兼职	887	40.99±8.12			44.30±12.80
专职	274	41.54±7.91			45.06±12.93
总体得分	1161	41.12±8.07			44.51±12.84

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相关变量	变量名	赋值说明	相关变量	变量名	赋值说明
焦虑得分	Y₁	原值输入	地区	X₄	常德市=1;永州市=2;湘西自治州=3
抑郁得分	Y₂	原值输入	月平均收入	X₅	≤2000元=1;2001~3000元=2;>3000元=3
性别	X₁	男性=1;女性=2	自评健康状况	X₆	很好=1;较好=2;一般及以下=3
年龄(岁)	X₂	原值输入	工作单位类别	X₇	社区卫生服务中心=1;乡镇卫生院=2;村卫生室=3
执业资格	X₃	执业(助理)医师=1;执业护士=2;乡村医生=3	从事结核病健康管理工作年限	X₈	≤5年=1;6~10年=2;>10年=3

变量	回归系数	标准误	标准化偏回归系数	t值	P值	容忍度	方差膨胀因子
常量	45.810	1.965	-	23.307	<0.001	-	-
自评健康状况一般及以下	2.003	0.357	0.162	5.618	<0.001	0.977	1.024
年龄低	―0.091	0.021	―0.133	―4.270	<0.001	0.836	1.196
执业资格为乡村医生或护士	0.729	0.271	0.081	2.685	0.007	0.896	1.116
月平均收入≤2000元	―1.052	0.339	―0.103	―3.099	0.002	0.732	1.366
工作单位为社区卫生服务中心或乡镇卫生院	―1.135	0.491	―0.077	―2.311	0.021	0.741	1.350

变量	回归系数	标准误	标准化偏回归系数	t值	P值	容忍度	方差膨胀因子
常量	47.201	2.658	-	17.759	<0.001	-	-
年龄低	―0.138	0.039	―0.127	―3.590	<0.001	0.641	1.560
自评健康状况一般及以下	2.634	0.562	0.134	4.687	<0.001	0.980	1.020
月平均收入≤2000元	―1.415	0.524	―0.087	―2.699	0.007	0.766	1.305
执业资格为乡村医生或护士	1.182	0.433	0.083	2.728	0.006	0.876	1.142
从事结核病健康管理工作年限≤5年	―1.553	0.492	―0.111	―3.156	0.002	0.651	1.537
地区为湘西自治州或永州市	1.411	0.520	0.083	2.710	0.007	0.858	1.165