Prevalence and Influencing Factors of Severe Depression in Nurses During and After the COVID-19 Pandemic: A Large-Scale Multicenter Study.

Background: During the COVID-19 epidemic, nurses are facing tremendous psychological pressure. However, there is a lack of research on severe depression and its related factors in nurses after COVID-19. This study aimed to compare the prevalence and explore the influencing factors of severe depression among Chinese nurses during and after the COVID-19 pandemic. Methods: This study recruited 937 frontline nurses during the outbreak and 784 frontline nurses who had participated in the initial recruitment after the pandemic. The self-rating depression scale (SDS), self-rating anxiety scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were used to assess subjects' depression, anxiety, and sleep disorders, respectively. Chi-square test, t-test, and binary logistic regression were used to identify factors influencing severe depression. Receiver operating characteristic (ROC) curves were used to assess the predictive value of severe depression-related variables. Results: The study found that the incidence of severe depression among nurses after the epidemic (4.9%) was significantly higher than that during the epidemic (1.7%). In addition, academic qualifications, health status, frequency of exercise per week, anxiety, and sleep disorders were associated with severe depression among nurses after the COVID-19 epidemic. ROC analyses showed that SAS scores and PSQI scores had good predictive value for nurses' severe depression after the pandemic. Conclusions: The prevalence of severe depression among nurses after COVID-19 is higher than that during COVID-19. Nurses continue to face severe psychological stress after the COVID-19 pandemic. Therefore, it is desperately needed for nurses to provide timely psychological support and establish a mental health support system after the COVID-19 epidemic.