The current wave and future trend of the novel coronavirus disease 2019 (COVID-19) has triggered public uncertainty, causing unbearable psychological pressure on people. A cross-sectional online questionnaire was conducted among back-to-school students in Wuhan from 31 August 2020, to 14 September 2020, by using convenience sampling. A total of 1017 participants voluntarily provided sociodemographic characteristics and accomplished the following scales: the Intolerance of Uncertainty Scale (IUS-12), the Social Support Scale (SSQ), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index-7 (ISI-7). Results revealed that the levels of anxiety, depression, and insomnia were moderate, moderate and subthreshold, respectively. A one-way multivariate analysis of variance indicated that those with different attitudes toward the trajectory of the COVID-19 epidemic in China showed significantly different results in anxiety and depression (p < 0.001). Moderation modeling implicated that social support significantly moderated the predictive relationship between intolerance of uncertainty and mental health variables including anxiety and depression, but failed on insomnia. Findings indicate that back-to-school students in Wuhan experience mental health problems and improving social support measures could buffer the effect of intolerance of uncertainty with respect to COVID-19 on mental health.

Outbreaks of an epidemic, such as coronavirus disease 2019 (COVID-19), always brings about far-ranging discrimination and stigmatization to the epicenter. This was a cross-sectional survey conducted to assess experienced discrimination, internalized stigma, shame, and mental health (anxiety, depression, distress, insomnia) among college students who merely had a perceived linkage with COVID-19, and explore the linkage between discrimination and negative mental health outcomes through the mediating effects of shame and internalized stigma. A total of 995 participants (53% female) were involved in this study, in which 40.9% of college students were reported to be discriminated against because of their experience in Wuhan. The experience of COVID-19-related discrimination is indirectly associated with anxiety, depression, and insomnia, in which shame and internalized stigma play a complete mediating effect. Meanwhile, it is both directly and indirectly associated with distress through shame and internalized stigma. The findings of this study suggest that COVID-19-related discrimination is associated with shame and internalized stigma, which in turn predict psychological symptoms over time.

This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.

Background: The COVID-19 pandemic had brought the increased levels of depression and anxiety on people. Our study investigated the levels of mental health and influencing factors among back-to-Wuhan university students. Methods: A cross-sectional questionnaire survey was conducted from 31 August 2020, to 14 September 2020 by convenience sampling on the back-to-Wuhan university students, which included the Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), the Insomnia Severity Index-7 (ISI-7), the revised Impact of Event Scale (IES-R) scales, and the basic demographic characteristics. Moreover, quantile regression analysis was used to identify the key factors related to the mental health variables of the back-to-Wuhan university students during the COVID-19 period. Results: The results from 1017 participants suggested that the prevalence rates of the anxiety, depression, insomnia, and distress were 44%, 47.5%, 37.7%, 57.7%, respectively. Quantile regression showed that mental health scores were negatively associated to age, years from graduation, being discriminated against owing to the experience in Wuhan, and the attitude on the future of COVID-19, while was positively related to the education level (P < 0.05). Especially, the education level was highly related with anxiety (25th = 1.64, 50th = 2.54). Conclusion: The finding showed that the respondents who were near graduation, discriminated owing to the experience in Wuhan, and worried about the future trend of COVID-19 had a higher risk of negative psychologic status, especially in the bottom and median quantile, and might require more psycho-social interventions or support.

Objectives: The effectiveness of rural outreach remains limited due to the lack of suitable incentives within the county medical community. Based on the Existence, Relatedness and Growth (ERG) theory and work motivation theory, our study explored the incentive mechanisms of rural outreach through a new framework that incorporates external incentives, work-related personality traits and job performance. Design: An explanatory sequential mixed-methods study comprises a cross-sectional quantitative study (Study 1) and a qualitative study (Study 2). Setting: County hospitals within the county medical community in Hubei province, China. Participants: 511 and 20 specialists who participated in rural outreach at county hospitals were recruited for the quantitative study and qualitative study, respectively. Primary and secondary outcome measures: Hierarchical regression analysis was used to explore the relationship among external incentives (suggested by the ERG theory), work-related personality traits and job performance. In-depth interviews were used to explain why the existence factors had no effect on job performance of rural outreach. Results: In Study 1, our findings showed that relatedness and growth factors significantly improved job performance, with work-related personality traits acting as a mediating factor (p0.05). In Study 2, our findings revealed that existence factors may weaken specialists’ altruism. Most specialists viewed rural outreach as a chance to enhance their clinical skills and advance their career development rather than as an opportunity for financial compensation. Conclusion: We recommend that policymakers should foster a supportive and growth-oriented environment for rural outreach programmes. Enhancing work-related personality traits may strengthen specialists’ intrinsic motivation and promote sustained engagement in rural service.

There is little theoretical explanation or robust evidence to support the relationship between career plateau and job performance in physicians. This study adopts the cognitive appraisal theory of stress as a new theoretical framework for the relationships between career plateau, emotional exhaustion, perceived organizational support (POS), and job performance. A survey was conducted among physicians in Chinese public hospitals, yielding 466 valid responses. Hierarchical regression analysis and the PROCESS macro (Model 5) were used to explore mediation and moderation effects using 5,000 bootstrap samples. Both hierarchy plateau and job content plateau are related to poor job performance and are indirectly associated with poor job performance via emotional exhaustion ( p < 0.001). Additionally, POS can buffer the negative association between job content plateau and job performance ( p < 0.05) but does not moderate the relationship between hierarchial plateau and job performance ( p > 0.05). This study provides a novel theoretical explanation of how career plateau is negatively associated with physicians’ job performance and offers practical guidance for hospital managers in managing poor performance and the negative emotions that may trigger it.