Cohort profile: the nurses' mental health study

Owing to the special nature of work and practice environment, nurses face relatively higher mental health risks. The mental health problems of nurses in China's tertiary hospitals are particularly prominent. However, nationally representative longitudinal data on nurses' mental health in China are lacking. The present paper describes the design and initial findings of the Nurses' Mental Health Study (NMHS).

The study population comprised registered nurses employed at 67 tertiary hospitals across 31 provinces in mainland China. Survey content covers sociodemographic information, work-related factors, health status, lifestyle habits, objective experiences, family and social relationships, current affairs opinions, overall evaluation, and identity information. Data are collected annually and have been collected twice to date, with an initial follow-up period of five years.

The baseline survey (December 2023-January 2024) collected 132,910 valid questionnaires (effective response rate 89.9%, 93.5% female, ages 18-65 years), and the first follow-up (December 2024-January 2025) collected 131,713 valid questionnaires (effective response rate 90.8%, 92.9% female, ages 18-66 years). A total of 84,252 questionnaires were successfully matched between baseline and the first follow-up (matching rate 63.4%). Among the participants, 55.2% of participants reported depressive symptoms, 39.3% reported anxiety symptoms, and 45.0% reported insomnia symptoms. It should be noted that severity bands (e.g., mild) reflect symptom burden rather than clinical diagnoses. Suicidal ideation and self-harm behaviors were reported by 3.1% and 1.2% of participants, respectively. In the past year, 6.9% of nurses sought help from psychiatric or psychological services, and 15.4% participated in mental health promotion activities.

Our findings suggest that a substantial proportion of NMHS participants reported experiencing mental and psychological symptoms. However, the mental health service use rate was low. These findings highlight the necessity of routine psychological screening and the optimization of mental health promotion services.