{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:12:56Z","timestamp":1790838776271,"version":"4.1.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"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. Public Health"],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Understanding gender differences in responses of health-care workers (HCWs) to COVID-19 outbreak is an effective way to promote customized supports.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> During February 2020, 103 HCWs infected with COVID-19 (64 females and 39 males) and 535 uninfected HCWs (383 females and 152 males) were recruited in a cross-sectional study. Level of attention, six emotional status, and self-evaluation of eight protective measures were recorded. Multivariable Firth's logistic regressions were applied to explored independent effect of gender.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> During early outbreak, female HCWs were more likely to give greater attention, adjusted OR:1.92 (95%CI 1.14\u20133.23) in total HCWs. Higher proportion of anxiety was observed in female HCWs, adjusted OR:3.14 (95%CI 1.98\u20134.99) for total HCWs, 4.32(95%CI 1.32\u201314.15) for infected HCWs and 2.97 (1.78, 4.95) for uninfected HCWs. Proportion of pessimism, fear, full of fighting spirit, and optimism were low, and no gender differences were observed. During a later outbreak, a majority of HCWs reported being very familiar with eight protective measures. After training, a proportion of high self-evaluation in hand hygiene, wearing gloves, and surgical masks increased independently in female HCWs, and adjusted ORs were 3.07 (95% CI 1.57\u20135.99), 2.37 (95% CI 1.26\u20134.49), and 1.92 (95% CI 1.02\u20133.62), respectively. Infection status amplified gender difference in anxiety, hand hygiene, and glove wearing.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Female HCWs perceived the outbreak seriously, effective emotional and psychological well-ness should be targeted at female HCWs preferentially, and male HCWs should be encouraged to express their feelings and be further trained.<\/jats:p>","DOI":"10.3389\/fpubh.2021.638975","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T04:36:52Z","timestamp":1615437412000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Gender Differences in Psychological and Behavioral Responses of Infected and Uninfected Health-Care Workers During the Early COVID-19 Outbreak"],"prefix":"10.3389","volume":"9","author":[{"given":"Qiao","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Sha","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Yun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Hui","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian-Tao","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1101\/2020.01.23.916395","article-title":"Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak","volume":"92","author":"Zhao","year":"2020","journal-title":"Int J Infect Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s40779-020-0233-6","article-title":"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)","volume":"7","author":"Jin","year":"2020","journal-title":"Mil Med Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2267","DOI":"10.1056\/NEJMc2005696","article-title":"Death from Covid-19 of 23 health care workers in China","volume":"382","author":"Zhan","year":"2020","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1016\/S2215-0366(20)30078-X","article-title":"Mental health care for medical staff in China during the COVID-19 outbreak","volume":"7","author":"Chen","year":"2020","journal-title":"Lancet Psychiat"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e203976","DOI":"10.1001\/jamanetworkopen.2020.3976","article-title":"Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019","volume":"3","author":"Lai","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B6","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1016\/j.jhin.2020.03.017","article-title":"Hand hygiene and the novel coronavirus pandemic: the role of healthcare workers","volume":"105","author":"Lotfinejad","year":"2020","journal-title":"J Hosp Infect"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1016\/j.fertnstert.2017.04.012","article-title":"Sex and gender: you should know the difference","volume":"107","author":"Broughton","year":"2017","journal-title":"Fertil Steril"},{"key":"B8","doi-asserted-by":"publisher","first-page":"385","DOI":"10.7326\/M20-1941","article-title":"Sex and gender differences in health: what the COVID-19 pandemic can teach us","volume":"173","author":"Spagnolo","year":"2020","journal-title":"Ann Intern Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"507","DOI":"10.5811\/westjem.2020.4.47536","article-title":"Sex- and gender-specific Observations and Implications for COVID-19","volume":"21","author":"Walter","year":"2020","journal-title":"West J Emerg Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"145","DOI":"10.3760\/cma.j.issn.0254-6450.2020.02.003","article-title":"[The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]","volume":"41","author":"Response","year":"2020","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"B11","doi-asserted-by":"publisher","first-page":"152","DOI":"10.3389\/fpubh.2020.00152","article-title":"Gender differences in patients with COVID-19: focus on severity and mortality","volume":"8","author":"Jin","year":"2020","journal-title":"Front Public Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1038\/s41586-020-2700-3","article-title":"Sex differences in immune responses that underlie COVID-19 disease outcomes","volume":"588","author":"Takahashi","year":"2020","journal-title":"Nature"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1093\/eurheartj\/ehaa373","article-title":"Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors","volume":"41","author":"Sama","year":"2020","journal-title":"Eur Heart J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1038\/nature02145","article-title":"Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus","volume":"426","author":"Li","year":"2003","journal-title":"Nature"},{"key":"B15","doi-asserted-by":"publisher","first-page":"27285","DOI":"10.1073\/pnas.2012520117","article-title":"Gender differences in COVID-19 attitudes and behavior: Panel evidence from eight countries","volume":"117","author":"Galasso","year":"2020","journal-title":"Proc Natl Acad Sci USA"},{"key":"B16","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1016\/S0140-6736(20)30526-2","article-title":"COVID-19: the gendered impacts of the outbreak","volume":"395","author":"Wenham","year":"2020","journal-title":"Lancet"},{"key":"B17","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s40779-020-00254-8","article-title":"Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey","volume":"7","author":"Jin","year":"2020","journal-title":"Mil Med Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1136\/bmjopen-2020-044028","article-title":"[Development and preliminary validation of questionnaire for 2019 novel coronavirus related nosocomial infection]","volume":"30","author":"Wang","year":"2020","journal-title":"Yixue Xinzhi Zazhi"},{"key":"B19","doi-asserted-by":"publisher","first-page":"S243","DOI":"10.1037\/tra0000751","article-title":"Are women still \u201cthe other\u201d? Gendered mental health interventions for health care workers in Spain during COVID-19","volume":"12","author":"Lopez-Atanes","year":"2020","journal-title":"Psychol Trauma"},{"key":"B20","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1111\/inm.12080","article-title":"Differences in job stress experienced by female and male Japanese psychiatric nurses","volume":"23","author":"Yada","year":"2014","journal-title":"Int J Ment Health Nurs"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1016\/j.jamda.2020.09.035","article-title":"Burnout and associated factors among health care workers in singapore during the COVID-19 pandemic","volume":"21","author":"Tan","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e2017271","DOI":"10.1001\/jamanetworkopen.2020.17271","article-title":"Prevalence of health care worker burnout during the coronavirus disease 2019 (COVID-19) pandemic in Japan","volume":"3","author":"Matsuo","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B23","doi-asserted-by":"publisher","first-page":"113129","DOI":"10.1016\/j.psychres.2020.113129","article-title":"Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic","volume":"290","author":"Barello","year":"2020","journal-title":"Psychiatry Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"597624","DOI":"10.3389\/fpsyg.2020.597624","article-title":"The effect of stress, anxiety and burnout levels of healthcare professionals caring for COVID-19 patients on their quality of life","volume":"11","author":"Celmece","year":"2020","journal-title":"Front Psychol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3389\/fgwh.2020.596690","article-title":"Occupational stress, burnout, and depression in women in healthcare during COVID-19 pandemic: rapid scoping review","volume":"1","author":"Sriharan","year":"2020","journal-title":"Front. Glob. Womens Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1586\/14737175.4.5.851","article-title":"Role of progesterone and other neuroactive steroids in anxiety disorders","volume":"4","author":"Le Melledo","year":"2004","journal-title":"Expert Rev Neurother"},{"key":"B27","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.yhbeh.2018.04.008","article-title":"Progesterone and women's anxiety across the menstrual cycle","volume":"102","author":"Reynolds","year":"2018","journal-title":"Horm Behav"},{"key":"B28","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1080\/01436597.2015.1108827","article-title":"Ebola, gender and conspicuously invisible women in global health governance","volume":"37","author":"Harman","year":"2016","journal-title":"Third World Q"},{"key":"B29","first-page":"1065","article-title":"What caused seriously shortage of Chinese nurses?","volume":"47","author":"Zhou","year":"2018","journal-title":"Iran J Public Health"},{"key":"B30","unstructured":"Press Conference of the Joint Prevention and Control Mechanism of the State Council on Feb 29, 2020"},{"key":"B31","unstructured":"Press Conference of the Joint Prevention and Control Mechanism of the State Council on April 7, 2020"},{"key":"B32","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12992-021-00665-9","article-title":"COVID-19 and healthcare system in China: challenges and progression for a sustainable future","volume":"17","author":"Sun","year":"2021","journal-title":"Global Health"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e790","DOI":"10.1016\/S2214-109X(20)30204-7","article-title":"The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study","volume":"8","author":"Liu","year":"2020","journal-title":"Lancet Glob Health"},{"key":"B34","doi-asserted-by":"publisher","first-page":"689","DOI":"10.4103\/0972-5229.142179","article-title":"Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital","volume":"18","author":"Chavali","year":"2014","journal-title":"Indian J Crit Care Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1177\/1062860609332369","article-title":"Hand hygiene compliance rates in the United States\u2013a one-year multicenter collaboration using product\/volume usage measurement and feedback","volume":"24","author":"McGuckin","year":"2009","journal-title":"Am J Med Qual"},{"key":"B36","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1177\/1557988316630953","article-title":"Reviewing the assumptions about men's mental health: an exploration of the gender binary","volume":"12","author":"Smith","year":"2018","journal-title":"Am J Mens Health"},{"key":"B37","first-page":"27","author":"Griffith","year":"2019","journal-title":"Men's Health Equity: A Handbook"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e48","DOI":"10.22374\/ijmsch.v3i1.42","article-title":"COVID-19, equity and men's health. using evidence to inform future public health policy, practice and research responses in pandemics","volume":"3","author":"Smith","year":"2020","journal-title":"Int J Men Soc Commun Health"},{"key":"B39","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1080\/18902138.2020.1762307","article-title":"COVID-19, masculinity and risk\/at risk","volume":"15","author":"Mellstr\u00f6m","year":"2020","journal-title":"NORMA"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1001\/jama.2020.3972","article-title":"Supporting the health care workforce during the COVID-19 global epidemic","volume":"323","author":"Adams","year":"2020","journal-title":"JAMA"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.638975\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T04:37:03Z","timestamp":1615437423000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.638975\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,11]]},"references-count":40,"alternative-id":["10.3389\/fpubh.2021.638975"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2021.638975","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,11]]},"article-number":"638975"}}