Anxiety in Residents in China: Prevalence and Risk Factors in a Multicenter Study

Acad Med. 2021 May 1;96(5):718-727. doi: 10.1097/ACM.0000000000003913.

Abstract

Purpose: To explore the prevalence of major anxiety and its associated risk factors in residents in China.

Method: This multicenter, cross-sectional study was conducted from December 2019 to February 2020; 1,343 residents from 8 hospitals in Northeast China were included in the final analysis (effective response rate of 86.48%). Demographic characteristics, dietary habits, life-related factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. This questionnaire measured sleep quality, physical activity, anxiety, perceived organizational support, psychological capital, and burnout. Adjusted odds ratios (ORs) and 95% confidence intervals were determined using binary logistic regression. Cutoff values and the area under the curve were calculated for risk factors using receiver operating characteristic curve analysis.

Results: Of participants, 441 (32.80%) reported anxiety symptoms and 133 (9.90%) reported major anxiety symptoms. Four independent risk factors for major anxiety were identified: poor sleep quality (OR = 1.282, P < .001) and 3 dimensions of burnout: higher emotional exhaustion (OR = 1.085, P < .001), higher depersonalization (OR = 1.064, P = .002), and reduced personal accomplishment (OR = 0.951, P < .001). The optimal cutoff values for these risk factors were 7, 10, 9, and 22 scores, respectively.

Conclusions: This study found a considerable prevalence of major anxiety symptoms in residents in China and identified poor sleep quality and higher levels of burnout as having a close association with major anxiety. These findings enrich the existing literature on anxiety and demonstrate a critical need for additional studies that investigate intervention strategies to improve sleep quality and combat burnout, which could improve the mental health of residents.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / epidemiology*
  • Burnout, Professional / epidemiology
  • China / epidemiology
  • Cross-Sectional Studies
  • Emotions
  • Female
  • Humans
  • Internship and Residency*
  • Male
  • Physicians / psychology*
  • Prevalence
  • Risk Factors
  • Sleep Wake Disorders / epidemiology
  • Surveys and Questionnaires