ABSTRACT
Background With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recog-nition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health conse-quences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associ-ated factors among nurses in China.Methods We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom.Findings A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial propor-tion of nurses reported symptoms of burnout (34%), depression (55.5%), and anxiety (41.8%). In line with the dispro-portionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression.Interpretation Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating counter-measures to safeguard nurses' health.Funding The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17]Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)