It might as well be 100 trials3/10/2023 The questionnaire response time was approximately 20 minutes. Therefore, all collected questionnaires were complete without missing data. On the first page of the questionnaire, the aims, objectives, instructions, and questions were designed as the mandatory field, so nurses who had not completed all the questions would receive a warning before submitting. Finally, more than 130 000 nurses from 30 provinces (excluding Tibet, Hong Kong, Macao, and Taiwan) and 243 hospitals in China have been involved, and the size of the studied population was much larger than the required sample size. And thus the response rate is hard to calculate. Nurses who were interested in the study would participate voluntarily and fill in the questionnaire. Owing to the influence of the epidemic, these questionnaires were posted on an online and open access survey platform Questionnaire Star ( ) and circulated via a social networking mobile App WeChat ( ). The survey was distributed to hospitals in 30 provinces through a third-party agency. Together with the current results, governments and health policymakers everywhere should pay more attention to the mental health of nurses and take corresponding countermeasures to prevent and reduce psychological symptoms. Additionally, the poor mental well-being of nurses adversely impacts the quality and safety of health care. There was a worldwide shortage of nurses before the COVID-19 outbreak, however, this situation has become even more critical for the overwhelming workload of infection screening and prevention throughout the pandemic, which was demonstrated the most common risk factor correlated with increased risk of psychological symptoms. The findings demonstrate that the prevalence of psychological symptoms among Chinese nurses during the COVID-19 pandemic was relatively high. This study investigated a large number of nurses engaged in 243 hospitals of different levels, located in diverse geographical regions across China, which is a nationally representative investigation of mental health status. Through detecting the discrimination of adverse mental health among nurses in different geographical regions, hospital statuses, and hospital types, we noted that the psychological symptoms have been greatly underrecognized and undertreated, especially during the COVID-19 pandemic, irrespective of the location or the classification of hospitals, but with more intensiveness in less economically developed regions. Owing to the participants surveyed in this study covered most provinces in China, we are able to draw a relatively complete picture of the prevalence of psychological symptoms among Chinese nurses during the COVID-19 epidemic. This was a cross-sectional survey, based on 138,279 nurse participants covering three geographical regions of China (eastern, middle, and western). To our knowledge, the current national study provided reliable data for assessing the burden of psychological symptoms among nurses, depicted its characteristics, and showed potential risk factors for preventing negative effects on mental health in China. The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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