Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Background: China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.Methods: A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."Results: A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score >= 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).Conclusion: This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.