Direct and Indirect Effects of Risk Perception and Risk Information on PTSD in Frontline Healthcare Workers

Lili Wu,1,2,* Shiyu Geng,3,* Yaoguang Zhou,1,2,* Runda Jiao,4,* Hui Ouyang,1,2 Suhui Cheng,1,2 Zhilei Shang,1,2 Wenjie Yan,1,2 Jing Wang,1,2 Yanpu Jia,1,2 Xu Li,3 Weizhi Liu1,2 1Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Navy Medical University, Shanghai, 200433, People’s Republic of China; 2The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Navy Medical University, Shanghai, 200433, People’s Republic of China; 3Department of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China; 4Graduate School, PLA General Hospital, Beijing, 100853, People’s Republic of China*These authors contributed equally to this workCorrespondence: Weizhi Liu, Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China, Email [email protected] Xu Li, Department of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China, Tel +86-020-61642301, Email [email protected]: The COVID-19 Delta variant caused an outbreak in Guangdong in mid-May 2021. The risk information and risk perception of COVID-19 have been considered factors associated with mental health statuses, especially posttraumatic stress disorder (PTSD), in frontline healthcare workers.Objective: The aim of this study is to investigate the interactive relationship in risk information and risk perception of COVID-19 and PTSD in healthcare personnel from the emergency department.Design: We conducted a survey one month after the outbreak. A cross-sectional survey design is adopted, and 3078 participants are enrolled. The PTSD checklist for DSM-5 (PCL-5), risk information questionnaire, and risk perception questionnaire are utilized to collect data.Methods: Bivariate correlation analysis and structural equation modelling are performed to analyze the mediating role of risk perception in the relationship between risk information and PTSD.Results: The estimated prevalence of PTSD among frontline healthcare workers is 28.2%. The risk information for COVID-19, risk perception, and PTSD symptoms are mutually correlated. The specific paths from risk perception to PTSD show significant effects, in which two had negative effects and one had a positive effect. The risk perception feature in 2020 differed from that in 2019, which is largely due to the risk perception of the virus.Conclusion: The estimated prevalence of PTSD among frontline healthcare workers remains high. Risk information for COVID-19 has dual effects on PTSD through the mediation of risk perceptions. Unfamiliarity with the SAR-COVID-2 Delta variant increased the risk perception of COVID-19. Effective risk communication regarding COVID-19 can have a positive effect on the mental health of frontline healthcare workers.Keywords: risk perception, posttraumatic stress disorder, risk information, frontline healthcare workers, COVID-19