Negative Emotions in Chinese Frontline Medical Staff During the Early Stage of the COVID-19 Epidemic: Status, Trend, and Influential Pathways Based on a National Investigation

Objective: The outbreak of coronavirus disease 2019 (COVID-19), declared as a major public health emergency, has had profound effects on public mental health especially emotional status. Due to professional requirements, medical staff are at a higher risk of infection, which might induce stronger negative emotions. This study aims to reveal the emotional status of Chinese frontline medical staff in the early epidemic period to better maintain their mental health, and provide adequate psychological support for them.Methods: A national online survey was carried out in China at the early stage of the COVID-19 epidemic. In total, 3025 Chinese frontline medical staff took part in this investigation which utilized a general information questionnaire, the Emotion Regulation Questionnaire (ERQ), and the Berkeley Expressivity Questionnaire (BEQ).Results: At the early stage of COVID-19, anxiety was the most common negative emotion of Chinese medical staff, followed by sadness, fear, and anger, mainly at a mild degree, which declined gradually over time. Nurses had the highest level of negative emotions compared with doctors and other healthcare workers. Women experienced more fear than men, younger and unmarried medical staff had more anxiety and fear compared with elders and married ones. Risk perception and emotional expressivity increased negative emotions, cognitive reappraisal reduced negative emotions, while negative emotions led to more avoidant behavior and more physical health disturbances, in which negative emotions mediated the effect of risk perception on avoidant behavior tendency in the model test.Conclusion: Chinese frontline medical staff experienced a mild level of negative emotions at the early stage of COVID-19, which decreased gradually over time. The findings suggest that during the epidemic, nurses' mental health should be extensively attended to, as well as women, younger, and unmarried medical staff. To better ensure their mental health, reducing risk perception and improving cognitive reappraisal might be important, which are potentially valuable to form targeted psychological interventions and emotional guidance under crisis in the future.