Objective  To explore adverse emotional response and its influencing factors among frontline health workers during coronavirus disease 2019 (COVID-19) epidemic and to provide evidences for promoting the workers' mental health.

  Methods  Using random sampling, we conducted a self-administered anonymous questionnaire survey among 258 frontline health workers during COVID-19 epidemic (February 4 – 7, 2020) at 5 cities in Fujian province. A self-designed questionnaire on general information, the Psychological Questionnaire for Public Health Emergent Event (PQPHEE) and the Simplified Coping Style Questionnaire (SCSQ) were adopted in the survey. Multivariate linear stepwise regression model and non-recursive path analysis were used to analyze the influencing factors for the participants′ emotional response.

  Results  Valid information were collected from all the participants. The domain scores of PQPHEE were 0.63 ± 0.49 for phobia, 0.24 ± 0.39 for depression, 0.22 ± 0.34 for hypochondria, 0.18 ± 0.32 for neurasthenia, and 0.10 ± 0.23 for obsessive anxiety; the domain scores of SCSQ were 1.20 ± 0.72 for positive problem-focused coping, 1.45 ± 0.82 for positive emotion-focused coping, 0.62 ± 0.57 for negative problem-focused coping, 0.75 ± 0.65 for negative emotion-focused coping, and 1.41 ± 1.01 for psychological counseling, respectively. The results of multivariate linear stepwise regression analysis revealed that the participants with poor self-protection and high negative problem-focused coping were more likely to have depression; the participants with poor self-protection, ever having close contact with suspected or confirmed COVID-19 cases, high negative emotion-focused coping and low positive problem-focused coping were more likely to have neurasthenia; the participants being female and with poor self-protection were more likely to have phobia; the participants with poor self-protection, high negative emotion-focused coping, and low positive emotion-focused coping were more likely to have obsessive anxiety; the participants being female, with poor self-protection, and ever having close contact with suspected or confirmed COVID-19 cases were more likely to have hypochondria. The non-recursive path analysis demonstrated that poor self-protection exerted impact on phobia (standardized totaldirect plus indirect effect indicator = 0.336), neurasthenia (0.354), depression (0.274), hypochondria (0.286), and obsessive anxiety (0.294). Negative emotion- and problem-focused coping were complete mediating factors for phobia and obsessive anxiety.

  Conclusion  Coping style moderates relationships between impact factors and emotional responses among frontline health workers engaged in the containment of coronavirus disease 2019 epidemic. Promoting self-protection and changing negative coping style could alleviate negative emotion of the frontline health workers.