Professional quality of life as potential mediators of the association between anxiety and depression among Chinese health-care clinicians

Xue, Guojun, Li, Wendy, and McDermott, Brett (2021) Professional quality of life as potential mediators of the association between anxiety and depression among Chinese health-care clinicians. The International Journal of Psychiatry in Medicine, 56 (2). pp. 83-96.

PDF (Accepted Author Version) - Accepted Version
Download (489kB) | Preview
View at Publisher Website:


Objective: Building upon the tripartite model of anxiety and depression, the current study aims to examine mechanisms of comorbidity between anxiety and depression using the ProQOL (including the constructs of burnout, secondary traumatic stress and compassion satisfaction) in a sample of Chinese healthcare clinicians.

Method: A randomised cross-sectional survey was distributed to 1620 participants who were recruited from eight state-owned hospitals in a city in southern China between January and May 2017. A total of 1562 questionnaires were returned (a response rate of 96.4%). After the cases with more than 10% missing variables and multivariate outliers being removed, 1,423 valid cases remained. Multiple mediator models were used for mediation analysis that was conducted using the PROCESS v3.1 macro for SPSS.

Results: The indirect effects of anxiety upon depression through burnout (a1=.601 [95%CI: .552, .650], p < .001; b1 = .137 [95%CI: .101, .174], p < .001) and compassion satisfaction (a3= -.297 [95%CI: -.352, -.241], p < .001; b3 = -.069 [95%CI: -.100, -.039], p < .001) were significant, while there was no evidence that anxiety influenced depression by changing secondary traumatic stress. The indirect effects of depression upon anxiety through secondary traumatic stress (a2=.535 [95%CI: .483, .588], p < .001); b2 = .154 [95%CI: .120, .188], p < .001) was both positive and significant, while there was no evidence that depression influenced anxiety by changing burnout and compassion satisfaction.

Conclusions: In the current sample, burnout and compassion satisfaction mediated the effect of anxiety upon depression and secondary traumatic stress mediated the effect of depression upon anxiety. The findings of the current study offer support to the tripartite model.

Item ID: 62881
Item Type: Article (Research - C1)
ISSN: 1541-3527
Keywords: the tripartite model, anxiety, depression, burnout, secondary traumatic stress, compassion satisfaction
Copyright Information: © The Author(s) 2020. Under SAGE's Green Open Access policy, the Author Accepted Version of the article may be posted in the author's institutional repository and reuse is restricted to non-commercial and no derivative uses.
Funders: Health and Family Planning Bureau of Foshan City, China
Projects and Grants: Foshan City’s Major Medical and Scientific Research Project (Ref: 2016AB002181), Key Project of Medical Research in the “13th Five-Year Plan” of Foshan City (Ref: FSZDZK135031)
Date Deposited: 20 Apr 2020 19:17
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 50%
42 HEALTH SCIENCES > 4202 Epidemiology > 420209 Occupational epidemiology @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health @ 100%
Downloads: Total: 1010
Last 12 Months: 16
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page