{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:46:25Z","timestamp":1790189185214,"version":"4.1.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The H1N1 influenza, a highly contagious acute respiratory disease, causes a significant burden on public health, especially during the winter season when the number of cases surges. Emergency department nurses, who are on the frontline of patient care during this period, are exposed to high - stress situations, increasing their risk of developing post - traumatic stress disorder (PTSD). Understanding the status of PTSD among them and its influencing factors is crucial for safeguarding their mental health and ensuring quality healthcare. This study aims to investigate the status of post-traumatic stress disorder (PTSD) among emergency department nurses in multiple tertiary hospitals in Shanghai, China during the winter H1N1 influenza season and analyze its influencing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross - sectional study design was adopted from October 2023 to December 2023. A total of 116 emergency department nurses from multiple tertiary hospitals in Shanghai were selected as research subjects using cluster sampling during the peak period of winter H1N1 influenza. The Impact of Event Scale-Revised (IES-R), Maslach Burnout Inventory (MBI), Simplified Coping Style Questionnaire (SCSQ), Connor-Davidson Resilience Scale (CD-RISC), and Social Support Rating Scale (SSRS) were used for data collection. PTSD was defined as IES-R score \u2265 35, and participants were grouped as PTSD positive or negative. The relationship between PTSD and occupational burnout, coping styles, psychological resilience, and social support was analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 116 participants, the rate of PTSD positivity was 44.86% (48\/107). The MBI scores in all dimensions were significantly higher in the PTSD positive group compared to the PTSD negative group. The positive coping scores in the SCSQ were lower in the positive group, while the negative coping scores were higher. The CD-RISC scores in all dimensions were significantly lower in the PTSD positive group, as were the SSRS scores in all dimensions. Higher emotional exhaustion was significantly associated with increased odds of PTSD (OR\u202f=\u202f1.16), indicating that for each one-point increase in emotional exhaustion, the odds of PTSD increased by 16%. Greater reliance on negative coping strategies was also independently associated with PTSD (OR\u202f=\u202f1.23). In contrast, higher levels of optimism (a resilience factor) and greater subjective social support were protective, significantly lowering the odds of PTSD (OR\u202f=\u202f0.76 and OR\u202f=\u202f0.70, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The occurrence of PTSD among emergency department nurses during the winter H1N1 influenza season is considerable and closely related to occupational burnout, psychological resilience, coping styles, and social support. These findings highlight the urgent need for attention to this issue. However, this study has several limitations. The sample was only from top - tier hospitals in Shanghai during the winter influenza season, which may limit the generalizability of the findings. Also, relying on self-reported questionnaires may be subject to recall bias and self - reporting subjectivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1514330","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:37:39Z","timestamp":1781588259000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Post-traumatic stress status among emergency department nurses during the winter H1N1 influenza season and correlations with burnout, coping, resilience, and support"],"prefix":"10.3389","volume":"16","author":[{"given":"Zheping","family":"Zheng","sequence":"first","affiliation":[{"name":"Shanghai Public Health Clinical Center Emergency Department","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Shen","sequence":"additional","affiliation":[{"name":"Shanghai Public Health Clinical Center Emergency Department","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingqun","family":"Shi","sequence":"additional","affiliation":[{"name":"Shanghai Public Health Clinical Center Emergency Department","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chai","sequence":"additional","affiliation":[{"name":"Shanghai Public Health Clinical Center Emergency Department","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Shanghai Public Health Clinical Center Emergency Department","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"138","DOI":"10.30476\/BEAT.2023.98245.1421","article-title":"Post-traumatic stress disorder among emergency medical technicians and its relationship with occupational stress and depression: post-Corona screening, Zanjan, 2022","volume":"11","author":"Asadi Aghajari","year":"2023","journal-title":"Bull Emerg Trauma"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1007\/s11126-022-10003-w","article-title":"The role of social support in coping with psychological trauma: an integrated biopsychosocial model for posttraumatic stress recovery","volume":"93","author":"Calhoun","year":"2022","journal-title":"Psychiatry Q."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e2021428","DOI":"10.23750\/abm.v92iS2.11796","article-title":"Burnout and post-traumatic stress disorder in frontline nurses during the COVID-19 pandemic: a systematic literature review and meta-analysis of studies published in 2020","volume":"92","author":"Caruso","year":"2021","journal-title":"Acta Biomed"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/j.jad.2022.12.152","article-title":"Mental condition and function of resilience among families of frontline medical workers during COVID-19: potential influencing factors and mediating effect","volume":"324","author":"Cheng","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s11800-008-0132-2","article-title":"The impact of event scale - revised (IES-R)","volume":"21","author":"Christianson","year":"2012","journal-title":"Medsurg Nurs."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1002\/da.10113","article-title":"Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC)","volume":"18","author":"Connor","year":"2003","journal-title":"Depress. Anxiety"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12960-020-00469-9","article-title":"Burnout in nursing: a theoretical review","volume":"18","author":"Dall'Ora","year":"2020","journal-title":"Hum. Resour. Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.ajog.2023.12.013","article-title":"Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis","volume":"230","author":"Dekel","year":"2024","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref9","first-page":"219","article-title":"Post-traumatic stress disorder: a psychiatric disorder requiring urgent attention","author":"Du","year":"2022"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1780","DOI":"10.3390\/ijerph19031780","article-title":"Burnout: a review of theory and measurement","volume":"19","author":"Ed\u00fa-Valsania","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e0220154","DOI":"10.1371\/journal.pone.0220154","article-title":"Well-being and PTSD in German emergency medical services - a nationwide cross-sectional survey","volume":"14","author":"Eiche","year":"2019","journal-title":"PLoS One"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1007\/s40750-024-00235-4","article-title":"Evolutionary roots of occupational burnout: social rank and belonging","volume":"10","author":"Garcia","year":"2024","journal-title":"Adapt. Hum. Behav. Physiol."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"8172","DOI":"10.3390\/ijerph18158172","article-title":"The burden of burnout among healthcare professionals of intensive care units and emergency departments during the COVID-19 pandemic: a systematic review","volume":"18","author":"Gualano","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1152823","DOI":"10.3389\/fpsyg.2023.1152823","article-title":"The effect of the social support on PTSD and PTG about university student volunteers in the prevention and controlling of coronavirus: with coping style as the intermediary","volume":"14","author":"Hao","year":"2023","journal-title":"Front. Psychol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2176","DOI":"10.3390\/v15112176","article-title":"Epidemiology of influenza-like illness and respiratory viral etiology in adult patients in Taiyuan City, Shanxi Province, China between 2018 and 2019","volume":"15","author":"Jia","year":"2023","journal-title":"Viruses"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s00420-017-1263-6","article-title":"Relationship between burnout and PTSD symptoms in firefighters: the moderating effects of a sense of calling to firefighting","volume":"91","author":"Jo","year":"2018","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref17","first-page":"115","article-title":"The burnout and loneliness levels of housewives in home-quarantine during COVID-19 pandemic","volume-title":"Cyprus Turkish Journal of Psychiatry and Psychology (CTJPP)","author":"Kaplan","year":"2021"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.resuscitation.2017.05.026","article-title":"Traumatic stress in the work of paramedics","volume":"71","author":"Kosydar-Bochenek","year":"2017","journal-title":"Przegl. Epidemiol."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"557","DOI":"10.12740\/PP\/68514","article-title":"Coping styles and dispositional optimism as predictors of post-traumatic stress disorder (PTSD) symptoms intensity in paramedics","volume":"52","author":"Kucmin","year":"2018","journal-title":"Psychiatr. Pol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1483771","DOI":"10.3389\/fpsyg.2024.1483771","article-title":"Unique and cumulative effects of different subtypes of sleep problems on burnout among Chinese nurses","volume":"15","author":"Lin","year":"2024","journal-title":"Front. Psychol."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.ccm.2022.11.018","article-title":"The impact of coronavirus disease 2019 on viral, bacterial, and fungal respiratory infections","volume":"44","author":"Losier","year":"2023","journal-title":"Clin. Chest Med."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"103385","DOI":"10.1016\/j.nepr.2022.103385","article-title":"Perceived stress, coping style and burnout of Chinese nursing students in late-stage clinical practice: a cross-sectional study","volume":"62","author":"Ma","year":"2022","journal-title":"Nurse Educ. Pract."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1038\/srep15314","article-title":"A narrative review of influenza: a seasonal and pandemic disease","volume":"42","author":"Moghadami","year":"2017","journal-title":"Iran. J. Med. Sci."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"25","DOI":"10.21876\/rcshci.v13i2.1380","article-title":"Risk factors for burnout syndrome in nurses at a public hospital in Mossor\u00f3\/RN, Brazil","volume":"13","author":"Nogueira Alves","year":"2023","journal-title":"Rev. Cienc. Saude"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s00420-021-01689-9","article-title":"Burnout and posttraumatic stress symptoms in police officers exposed to traumatic events: the mediating role of ruminations","volume":"94","author":"Ogi\u0144ska-Bulik","year":"2021","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2458406","DOI":"10.1080\/20008066.2025.2458406","article-title":"The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years","volume":"16","author":"Olff","year":"2025","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1038\/s41394-023-00566-6","article-title":"Post-traumatic stress disorder among individuals with traumatic spinal cord injury in Nepal: a cross-sectional study","volume":"9","author":"Parajuli","year":"2023","journal-title":"Spinal Cord Ser. Cases"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1007\/s00127-018-1539-5","article-title":"Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis","volume":"53","author":"Petrie","year":"2018","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.shaw.2022.06.003","article-title":"Influencing factors of high PTSD among medical staff during COVID-19: evidences from both Meta-analysis and subgroup analysis","volume":"13","author":"Qi","year":"2022","journal-title":"Saf. Health Work"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1038\/s41380-019-0383-7","article-title":"Resilience as a translational endpoint in the treatment of PTSD","volume":"24","author":"Rakesh","year":"2019","journal-title":"Mol. Psychiatry"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.1111\/jocn.16265","article-title":"Effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder among nurses: a systematic review and meta-analysis","volume":"32","author":"Ramachandran","year":"2023","journal-title":"J. Clin. Nurs."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.bpa.2020.07.008","article-title":"Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic","volume":"34","author":"Raudensk\u00e1","year":"2020","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/irv.12486","article-title":"Annual estimates of the burden of seasonal influenza in the United States: a tool for strengthening influenza surveillance and preparedness","volume":"12","author":"Rolfes","year":"2018","journal-title":"Influenza Other Respir. Viruses"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2769","DOI":"10.1111\/jocn.15288","article-title":"Post-traumatic stress disorder in nurses: an integrative review","volume":"29","author":"Schuster","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1016\/j.mayocp.2015.08.023","article-title":"Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014","volume":"90","author":"Shanafelt","year":"2015","journal-title":"Mayo Clin. Proc."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.mayocp.2021.11.021","article-title":"Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2020","volume":"97","author":"Shanafelt","year":"2022","journal-title":"Mayo Clin. Proc."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"100961","DOI":"10.1016\/j.lanepe.2024.100961","article-title":"Addressing burnout in the healthcare workforce: current realities and mitigation strategies","volume":"42","author":"Sipos","year":"2024","journal-title":"Lancet Reg Health Eur"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"745","DOI":"10.3390\/medicina55110745","article-title":"Towards a transversal definition of psychological resilience: a literature review","volume":"55","author":"Sisto","year":"2019","journal-title":"Medicina (Kaunas)"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.cnur.2021.11.011","article-title":"Nursing burnout and its impact on health","volume":"57","author":"Sullivan","year":"2022","journal-title":"Nurs. Clin. North Am."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1186\/s12912-023-01424-4","article-title":"Assessment of psychological and physical stressors among nurses in different functional areas before and during the COVID-19 pandemic: a cross-sectional study","volume":"22","author":"Winnand","year":"2023","journal-title":"BMC Nurs."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s40299-019-00446-4","article-title":"The impact of psychological capital and occupational stress on teacher burnout: mediating role of coping styles","volume":"28","author":"Zhang","year":"2019","journal-title":"Asia Pac. Educ. Res."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1186\/s40359-024-01779-6","article-title":"Work pressure, coping styles and occupational burnout among Chinese police officers: a meta-analytic review","volume":"12","author":"Zhou","year":"2024","journal-title":"BMC Psychol."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"101793","DOI":"10.1016\/j.ctcp.2023.101793","article-title":"Validity and reliability of the physical activity and social support scale among Chinese established adults","volume":"53","author":"Zou","year":"2023","journal-title":"Complement. Ther. Clin. Pract."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1514330\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:37:40Z","timestamp":1781588260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1514330\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":43,"alternative-id":["10.3389\/fpsyg.2025.1514330"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2025.1514330","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"1514330"}}