Objective  To examine the prevalence and influencing factors of depressive symptoms among emergency nurses in China.

  Methods  Totally 21 912 nurses working in emergency departments at least for 6 months were recruited with stratified multistage random sampling in 31 provincial level administrative divisions across China for a self-administered questionnaire survey conducted during July – September, 2019. The Center for Epidemiological Studies Depression Scale (CES-D), two scales designed by domestic experts on lifestyle and workplace violence, and a self-designed questionnaire were used to collect relevant information of the participants. Descriptive statistics, chi-square test and multivariate binary logistic regression analysis were performed in data analyses with SPSS 22.0.

  Results  Of 20 316 participants with valid responses, 26.82% were assessed as having depressive symptoms based on the total CES-D score of 20 and above. The results of logistic regression analysis demonstrated that the participants with following characteristics were more likely to have depression symptoms: alcohol drinking (odds ratio OR = 1.425), abstaining from alcohol consumption (OR = 1.391), averagely working 10 hours or more per work day (OR = 1.272), perceiving a higher working pressure (OR = 2.358) or very high working pressure (OR = 5.731), and ever experiencing workplace violence (OR = 1.675/3.290/5.982 for low/moderate/high severity); while, the participants elder than 44 years (OR = 0.710), being married (OR = 0.707), having a senior professional title (OR = 0.677), with a good or fair self-assessed health (OR = 0.276 or 0.506), and with good or fair sleep quality (OR = 0.358 or 0.575) were less likely to have depression symptoms.

  Conclusion  Among emergency nurses in China, depression symptom is associated with working stress, unhealthy behavioral lifestyle, and workplace violence. Working framework and management strategies for emergency departments should be improved to reduce depression symptoms in emergency nurses.