BRIEF RESEARCH REPORT article

Front. Psychol., 15 October 2021

Sec. Health Psychology

Volume 12 - 2021 | https://doi.org/10.3389/fpsyg.2021.731525

Physical Activity and Mental Health Among Physicians in Tertiary Psychiatric Hospitals: A National Crosssectional Survey in China

  • 1. School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China

  • 2. Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China

  • 3. School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

  • 4. Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States

  • 5. Substance Abuse Treatment Program, Atlanta VA Medical Center, Decatur, GA, United States

Abstract

This study aimed to examine the level of mental health and its correlates, particularly physical activity (PA) frequency, among physicians in tertiary psychiatric hospitals. In a national crosssectional survey, 4,520 physicians nested in 41 tertiary psychiatric hospitals from 29 provinces completed the online questionnaire. Their mean age was 38.5 ± 8.6 years, and 41.86% of physicians were men. More than one-third (35.24%) of physicians reported no PA in the past month, and only 21.88% reported happiness. Only 55.15 and 58.10% of the physicians reported normal status of depression and anxiety, respectively. In the adjusted multivariable ordinal logistic regression, higher PA frequency was associated with depression, anxiety, and happiness, except those who reported PA almost every day. Programs that aim to increase PA may promote the mental health of physicians in tertiary psychiatric hospitals.

Introduction

Mental health can be defined as more than an absence or lack of mental disorders (Kumar et al., 2021). It is generally related to physical, social, and spiritual wellness, including positive moods, such as happiness. Happiness, an essential measure of overall well-being, is defined as the subjective state of mind characterized by enjoyment and contentment (Zhang et al., 2020). Happiness among physicians is an important research topic in recent decades (Werdecker and Esch, 2021). Many studies showed that a low level of happiness (unhappiness) not only affects the personal life and subjective well-being of physicians, but also impacts the healthcare quality that occurs due to medical errors or inefficacy (Wallace et al., 2009; Hall et al., 2016; Dewa et al., 2017). To date, few studies have focused on happiness among Chinese physicians.

Physical activity (PA), for example, physical exercise, sports, and physically active hobbies (Gottschlich et al., 2019), is known as an essential factor related to psychological health (Zhang and Chen, 2019). Several studies have documented a positive relationship between PA and happiness (Zhang and Chen, 2019). For example, in the Student Activity and Sports Participation Survey Ireland program, students with moderate and high physical activity according to the International Physical Activity Questionnaire-Short Form were more likely to be happy (Murphy et al., 2018). Based on the 2014 China Family Panel Study, residents with frequent PA (≥4 times/month) were more likely to have a higher subjective well-being (Xu et al., 2019). In the Study on Global Ageing and Adult Health (SAGE), the authors demonstrated that meeting physical activity guidelines (≥150 min of moderate-to-vigorous physical activity/week) was significantly associated with more happiness (Felez-Nobrega et al., 2021). Meanwhile, PA has also been proven as a promising adjunct intervention for mood disorders, including bipolar and major depressive disorder (Wang and Ashokan, 2021).

Mental health is an essential concern among Chinese physicians due to long working hours/day and heavy workload. According to a national survey, Chinese physicians generally worked 9.62 h/day, and 62.58% complained about hefty workload. Meanwhile, 31.28% of physicians reported burnout (Wu et al., 2019, 2020). In another survey, the prevalence of depressive symptoms in Chinese physicians was 42.3%, which was much higher than Chinese residents (Huang et al., 2019; Fu et al., 2021). Furthermore, a recent study found that nearly half of Chinese physicians working in intensive care units experienced psychological symptoms (Chen et al., 2021).

Physical activity is an essential factor for mental health, but few studies have examined the relationship between PA frequency and mental health among physicians (Zhang and Chen, 2019). To address this research gap, our national psychiatric hospital's survey provided a unique opportunity. We aimed to examine the association between PA frequency and mental health using this dataset, controlling for a series of covariates among Chinese physicians.

Materials and Methods

Study Design and Participants

This national crosssectional study was conducted between March 18 and 31, 2019. The National Health Commission of China approved this project. Totally 41 tertiary psychiatric hospitals were selected from 29 provinces, except Gansu and Tibet, due to the lack of tertiary psychiatric hospitals. All physicians in these target hospitals were recruited to participate in this survey. Each physician voluntarily responded to a smartphone-based questionnaire anonymously (Xia et al., 2020). The QR code for the survey was posted online and was distributed to potential participants via WeChat. On average, it took the participants 10–15 min to complete the questionnaire.

The Ethics Committee in Chaohu Hospital of Anhui Medical University approved the study protocol. Each participant obtained an electronic consent form before the response to the questionnaire.

Measures

Physical Activity

Physical activity frequency was determined by asking about the “physical exercise in the last month when not on vacation.” A detailed operational definition for moderate-to-vigorous physical exercise was included in the questionnaire for better reliability. We grouped these responses as never (0 times), seldom (≤3 times/month), sometimes (4–8 times/month), often (9–20 times/month), and almost every day (≥21 times/month) (Xu et al., 2019).

Positive Mental Health

We adopted a widely used single-item happiness measure based on literature (Kye and Park, 2014; Richards et al., 2015). It was adopted from the 36-Item Short-Form Health Survey (SF-36)(Ware and Sherbourne, 1992): “In the past month, how often do you feel happy?” There were five response options recoded into an order-classified variable (1 = never, 2 = rare, 3 = sometimes, 4 = often, 5 = all the time) (Richards et al., 2015).

The job satisfaction of the physicians was measured through the short version of the Minnesota Satisfaction Questionnaire (MSQ) (Weiss et al., 1967; Jiang et al., 2018). The Cronbach's α of MSQ was 0.952.

Negative Mental Health

Meanwhile, a Chinese version of the depression anxiety stress scale-21(DASS-21) was used to assess depression, anxiety, and stress symptoms. We used the same cut-off values as reported previously (Jiang et al., 2020). The Cronbach's α of DASS-21 was 0.956.

Socio-Demographic and Occupational Characteristics

This part involved socio-demographic and occupational characteristics that were selected based on previous studies (Zhang and Chen, 2019; Felez-Nobrega et al., 2021), including age, gender, marital status, number of children, educational level, professional title, administration position, monthly income, geographical region, outpatient volume/week, night shifts/month, working hours/week, insomnia, and self-assessed health status. Alcohol use and cigarette were also asked.

Data Analysis

One sample K-S test was used to examine the normality of obtained data. Descriptive analyses about the socio-demographic and occupational characteristics, physical activity, happiness level, job satisfaction, depression, anxiety, and stress status of the sample were conducted.

We used ordinal logistic regression or linear regression analysis to determine the relationship between PA frequency and depression/anxiety/stress/happiness levels or job satisfaction, adjusted by socio-demographic and occupational variables within the whole sample.

All statistical analyses were performed using the STATA software version 16.0 (Stata Corporation, College Station, TX, USA), with the significance level at the p-value of 0.05 (two-tailed).

Results

Sample Characteristics

In total, 6,986 physicians were invited to participate, 4,576 physicians responded (response rate = 65.5%). Finally, 4,520 completed the questionnaire with no logical errors and were included in the statistical analysis. Their mean age was 38.5 ± 8.6 years, and 41.86% of the physicians were men.

Among them, 1,593 (35.24%) physicians reported having no PA, and 1,772 (39.2%) reported seldom having PA in the previous month. Meanwhile, only 21.88% of physicians reported feeling happy often or always in this sample, and the percentage of participants with normal scores on depression, anxiety, and stress was 55.15, 58.10, and 76.97%, respectively. The MSQ score was 65.89 ± 14.42. Table 1 shows the detailed characteristics.

Table 1

CharacteristicN%
Gender
Male1,89241.86
Female2,62858.14
Marital status
Single69015.27
Married3,66881.15
Divorced or widowed1623.58
Children
None1,78839.56
One2,14647.48
More than one58612.96
Educational levela
Bachelor degree or below2,98966.13
Master's degree1,25727.81
Doctorate degree2746.06
Professional title
Junior1,40531.08
Middle1,55134.31
Senior1,56434.60
Administration position
Yes95421.11
No3,56678.89
Average monthly income
Low (<5,000 RMBs)72015.93
Middle (5,000–9,999 RMBs)2,37852.61
Upper middle (10,000–20,000 RMBs)1,30828.94
High (>20,000 RMBs)1142.52
Region
East China1,86041.15
Central China1,46332.37
West China1,19726.48
Outpatient volume/week
0–102,03344.98
11–501,25427.74
>501,23327.28
Number of charged beds
0–102,23049.34
11–201,40631.11
>2088419.56
Night shifts/month
0–22,02244.73
3–51,71838.01
>578017.26
Insomnia
No72616.06
Seldom (≤3 times/month)1,36930.29
Sometimes (1–2 times/week)1,37930.51
Often (3–5 times/week)87819.42
Daily1683.72
Cigarette use
No3,80984.27
Former smoker1904.20
Current smoker52111.53
Alcohol use
Never2,09046.24
Sometimes (1–4times/month)2,25649.91
Often (>4times/month)1743.85
Health status
Very dissatisfied53611.86
Dissatisfied1,62836.02
Neutral1,81340.11
Satisfied49010.84
Very satisfied531.17
Depression
Normal2,49355.15
Mild70715.64
Moderate1,00622.26
Serious1563.45
Extremely serious1583.50
Anxiety
Normal2,62658.10
Mild3367.43
Moderate1,04623.14
Serious2655.86
Extremely serious2475.46
Stress
Normal3,47976.97
Mild49010.84
Moderate3036.70
Serious1773.92
Extremely serious711.57
PA frequency
No1,59335.24
Seldom (≤3 times/month)1,77239.20
Sometimes (4–8 times/month)79617.61
Often (9–20 times/month)2916.44
Almost every day (≥21 times/month)681.50
Happiness
Never1212.68
Rarely79917.68
Sometimes2,60857.70
Often86719.18
Always1252.77
MeanSD
Age (years)38.508.60
Working hours/week53.0116.22
Job satisfaction (MSQ)65.8914.42

Characteristics of physicians in Chinese tertiary psychiatric hospitals (N = 4,520).

a

In China, medical school graduates are awarded a bachelor's degree in medicine (similar to the European and Russian systems). Some obtained a master's or doctorate degree in addition to their medical degree.

Association of PA Frequency and Mental Health

In the ordinal logistic regression, PA frequency (seldom/often, reference: No PA) was significantly associated with depression (PA sometimes as well) and anxiety, whereas PA almost every day was not significantly associated with them (Table 2).

Table 2

DepressionAnxietyStress
OR (95%CI)OR (95%CI)OR (95%CI)
PA frequency (ref. No)
Seldom0.74 (0.65–0.85)**0.85 (0.74–0.98)*0.85 (0.72–1.01)
Sometimes0.75 (0.62–0.90)*0.83 (0.69–1.01)0.79 (0.63–1.00)
Often0.51 (0.38–0.70)**0.70 (0.52–0.94)*0.82 (0.56–1.20)
Almost every day1.00 (0.57–1.77)0.66 (0.34–1.28)0.80 (0.36–1.75)
Gender (ref. Male)0.92 (0.79–1.08)0.97 (0.83–1.14)0.96 (0.80–1.16)
Marital status (ref. Single)
Married0.81 (0.64–1.02)0.91 (0.73–1.15)1.05 (0.79–1.38)
Divorced or widowed1.16 (0.80–1.68)0.93 (0.63–1.36)1.23 (0.78–1.94)
Children (ref. No)
One0.98 (0.84–1.16)0.93 (0.79–1.10)0.88 (0.72–1.07)
More than one0.95 (0.76–1.18)0.87 (0.69–1.09)0.78 (0.59–1.02)
Educational level (ref. Bachelor degree or below)
Master's degree0.88 (0.76–1.02)0.85 (0.73–0.99)*1.00 (0.84–1.20)
Doctorate degree0.64 (0.48–0.86)*0.70 (0.52–0.95)*0.56 (0.37–0.84)**
Professional title (ref. Junior)
Middle1.21 (1.00–1.45)*1.08 (0.90–1.30)1.14 (0.92–1.42)
Senior1.36 (1.06–1.74)*1.22 (0.95–1.58)1.17 (0.86–1.59)
Administration position (ref. No)0.65 (0.54–0.79)**0.78 (0.64–0.95)*0.99 (0.78–1.26)
Average monthly income (ref. Low)
Middle0.78 (0.65–0.93)**0.77 (0.65–0.92)**0.90 (0.72–1.11)
Upper middle0.81 (0.65–1.00)0.64 (0.52–0.80)**0.78 (0.60–1.02)
High0.89 (0.58–1.38)0.85 (0.55–1.32)0.99 (0.57–1.73)
Region (ref. East China)
Central China1.10 (0.95–1.28)1.16 (0.99–1.35)1.08 (0.90–1.30)
West China1.25 (1.06–1.47)**1.07 (0.91–1.26)1.11 (0.91–1.36)
Outpatient volume/week (ref. 0–10)
11–501.00 (0.86–1.17)0.94 (0.80–1.10)0.81 (0.67–0.99)*
>500.94 (0.80–1.11)0.93 (0.79–1.10)0.87 (0.71–1.07)
Number of charged beds (ref. 0–10)
11–201.13 (0.97–1.31)0.99 (0.85–1.15)1.01 (0.85–1.21)
>200.97 (0.82–1.14)0.93 (0.78–1.10)0.89 (0.72–1.09)
Night shifts/month (ref. 0–2)
3–51.09 (0.94–1.26)1.04 (0.89–1.21)1.14 (0.95–1.37)
>51.11 (0.92–1.33)1.05 (0.87–1.26)1.11 (0.89–1.38)
Insomnia (ref. No)
Seldom2.13 (1.71–2.64)**2.50 (1.99–3.14)**2.14 (1.57–2.92)**
Sometimes1.58 (1.27–1.96)**1.74 (1.38–2.18)**1.57 (1.14–2.15)**
Often3.65 (2.89–4.60)**4.25 (3.33–5.42)**4.24 (3.08–5.83)**
Daily5.09 (3.55–7.29)**6.94 (4.83–9.97)**7.72 (5.10–11.69)**
Cigarette use (ref. No)
Used but quit1.40 (1.03–1.89)*1.37 (1.00–1.87)*1.12 (0.78–1.61)
Yes1.28 (1.04–1.57)*1.23 (0.99–1.52)1.02 (0.79–1.32)
Alcohol use (ref. Never)
Sometimes1.36 (1.18–1.56)**1.16 (1.01–1.34)*1.13 (0.95–1.34)
Often1.81 (1.30–2.54)**1.61 (1.15–2.25)**1.98 (1.36–2.89)**
Health status (ref. Very dissatisfied)
Dissatisfied0.46 (0.38–0.55)**0.44 (0.36–0.53)**0.46 (0.38–0.57)**
Neutral0.24 (0.20–0.30)**0.22 (0.18–0.27)**0.24 (0.19–0.30)**
Satisfied0.09 (0.06–0.12)**0.08 (0.06–0.11)**0.09 (0.06–0.15)**
Very satisfied0.03 (0.01–0.11)**0.05 (0.01–0.16)**0.04 (0.01–0.32)**
Age (years)1.00 (0.99–1.01)0.99 (0.98–1.01)0.98 (0.97–1.00)*
Working hours/week1.00 (1.00–1.01)1.01 (1.00–1.01)**1.01 (1.00–1.01)**

Ordinal logistic regression examining factors associated with depression, anxiety, and stress (N = 4,520).

*

p < 0.05,

**

p < 0.001.

Physical activity frequency was also not associated with job satisfaction of physicians (Table 3).

Table 3

Subjective happinessCoefficient95.0% CI (Lower)95.0% CI (Upper)p
PA frequency (ref. No)
Seldom0.48−0.461.410.316
Sometimes1.05−0.162.260.090
Often1.71−0.063.490.058
Almost every day−1.10−4.492.290.525
Gender (ref. Male)0.97−0.041.980.060
Marital status (ref. Single)
Married1.42−0.092.920.065
Divorced or widowed−0.80−3.341.740.537
Children (ref. No)
One−0.84−1.900.220.121
More than one−1.02−2.480.440.170
Educational level (ref. Bachelor degree or below)
Master's degree−0.01−0.980.960.983
Doctorate degree−0.48−2.271.310.600
Professional title (ref. Junior)
Middle−2.32−3.52−1.11<0.001
Senior−2.81−4.46−1.160.001
Administration position (ref. No)4.653.415.88<0.001
Average monthly income (ref. Low)
Middle0.22−0.961.410.712
Upper middle2.140.703.580.004
High3.750.946.550.009
Region (ref. East China)
Central China−0.63−1.610.350.208
West China−0.86−1.930.210.116
Outpatient volume/week (ref. 0–10)
11–500.13−0.921.170.814
>500.64−0.451.730.251
Number of charged beds (ref. 0–10)
11–20−0.62−1.600.360.216
>200.00−1.111.100.998
Night shifts/month (ref. 0–2)
3–50.31−0.661.270.536
>5−1.61−2.86−0.370.011
Insomnia (ref. No)
Seldom−2.20−3.48−0.920.001
Sometimes−1.33−2.57−0.090.035
Often−4.11−5.55−2.67<0.001
Daily−6.50−8.89−4.11<0.001
Cigarette use (ref. No)
Used but quit0.23−1.842.300.825
Yes−1.68−3.08−0.270.020
Alcohol use (ref. Never)
Sometimes−1.23−2.15−0.320.008
Often−2.86−5.10−0.630.012
Health status (ref. Very dissatisfied)
Dissatisfied3.682.315.04<0.001
Neutral7.085.688.48<0.001
Satisfied10.979.1612.78<0.001
Very satisfied16.3612.4120.31<0.001
Age (years)−0.09−0.17−0.010.037
Working hours/week0.01−0.010.040.318

Regression examining factors associated with job satisfaction (N = 4,520).

Bold value for p < 0.05.

Physicians who had more frequent PA were more likely to report feeling happy, while PA almost every day was not associated with happiness (Table 4).

Table 4

Subjective happinessOR95.0% CI (Lower)95.0% CI (Upper)p
PA frequency (ref. No)
Seldom1.251.081.430.002
Sometimes1.391.161.670.000
Often1.831.402.390.000
Almost every day1.300.782.170.310
Gender (ref. Male)1.441.241.68<0.001
Marital status (ref. Single)
Married1.391.101.740.005
Divorced or widowed0.700.481.020.067
Children (ref. No)
One0.900.771.060.198
More than one1.100.881.360.413
Educational level (ref. Bachelor degree or below)
Master's degree1.020.881.180.763
Doctorate degree1.010.771.320.969
Professional title (ref. Junior)
Middle0.950.791.130.547
Senior0.900.701.150.385
Administration position (ref. No)1.831.522.21<0.001
Average monthly income (ref. Low)
Middle0.980.821.170.814
Upper middle1.000.811.240.995
High1.080.711.650.720
Region (ref. East China)
Central China0.960.821.110.542
West China0.880.751.030.114
Outpatient volume/week (ref. 0–10)
11–500.890.761.040.148
>500.930.791.100.419
Number of charged beds (ref. 0–10)
11–200.940.811.090.384
>200.920.781.090.355
Night shifts/month (ref. 0–2)
3–51.040.901.200.600
>50.910.751.090.308
Insomnia (ref. No)
Seldom0.560.460.68<0.001
Sometimes0.830.681.000.047
Often0.340.270.43<0.001
Daily0.190.130.27<0.001
Cigarette use (ref. No)
Used but quit0.840.611.150.276
Yes1.060.861.310.592
Alcohol use (ref. Never)
Sometimes0.840.730.960.010
Often0.990.711.400.974
Health status (ref. Very dissatisfied)
Dissatisfied2.351.922.89<0.001
Neutral4.773.835.93<0.001
Satisfied23.3217.5630.99<0.001
Very satisfied168.7889.32318.94<0.001
Age (years)0.990.981.000.195
Working hours/week1.000.991.000.116

Ordinal logistic regression examining factors associated with subjective happiness (N = 4,520).

Bold value for p < 0.05.

Further analysis showed that those who reported PA almost every day (N = 68) had the following features compared to those who did not report PA nearly every day: they were predominantly men (64.71 vs. 41.51%, p < 0.001), older (47.94 ± 10.58 vs. 38.36 ± 8.48 years, p < 0.001), and had significantly more smokers (16.18 vs. 11.46% current smokers, 11.76 vs. 4.09% past smokers, p < 0.05) and frequent alcohol users (>4 times/month) (10.29 vs. 3.75%, p < 0.05).

Discussion

To our best knowledge, this study was one of the first to focus on the relationship between PA and mental health among Chinese physicians. This research demonstrated that PA frequency was positively associated with depression, anxiety, and happiness after controlling for relevant confounders, aligned with some other studies (Fisher et al., 2019; Kroencke et al., 2019; Xu et al., 2019; Zhang and Chen, 2019; Stevens et al., 2021; Ye et al., 2021).

One intriguing finding in this study is that the most frequent PA group (almost every day) was not significantly associated with depression, anxiety, or happiness. This may sound counterintuitive, but there are several possible explanations. First, individuals who reported highly frequent PA may represent a unique group, which might resemble the so-called “compulsive exercise” (Hausenblas and Downs, 2002). Second, most people, especially those as busy as physicians, do not have time to have PA almost every day. Highly frequent PA would consume much time and may affect the work–life balance (Gragnano et al., 2020), which may in turn decrease the level of mental health (Wan Mohd Yunus et al., 2020). This interesting finding needs further investigation (Zhang and Chen, 2019).

Physical activity might improve mental health through several physiological or psychological pathways (Zhang and Chen, 2019). For example, a previous study demonstrated that mobility and cognition explained the largest proportion of the association (Felez-Nobrega et al., 2021). According to a national survey, Chinese physicians have appropriate mobility and cognition in their daily life (Wu et al., 2019).

The overall level of mental health in Chinese physicians in this study was lower than samples from other reports. For example, the prevalence of generalized anxiety among American physicians was 14.9 and 11.7% for depression, much lower than our results (Sonis et al., 2021). Participants from 15 European Union countries reported 82.9% of them being happy (all the time, very often, or often) in the past month (Richards et al., 2015), against 21.88% in our research. Another research in Chinese residents demonstrated that 71.2% of participants had high subjective well-being or happiness (Xu et al., 2019). Given the value of regular PA to mental health, Chinese physicians should lead the way in adopting PA to get better mental health (Yancey et al., 2013).

This research has several limitations. First, as it was a crosssectional survey, causal relations cannot be inferred. Second, the samples in this study were from tertiary psychiatric hospitals, and so the results may not be generalized to all Chinese physicians. Third, happiness and PA frequency in this study were assessed using two single-item self-reported questions. Some potentially important information, such as the type and duration of PA, was not included. The reliability and validity of the evaluation may also be limited. Fourth, as inherent to this type of study, recall and response bias cannot be ruled out.

Conclusions

The current study showed the level of mental health in Chinese physicians in psychiatric hospitals is low. We also found an independent association of higher PA frequency (except PA almost every day) with depression/anxiety and happiness. Increasing PA frequency may promote mental health in Chinese physicians in tertiary psychiatric hospitals. Policy makers and hospital management should focus on interventions, including programs aiming to promote PA and mental health.

Funding

This research was funded by the Beijing Medical and Health Foundation (Grant No. MH180924).

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Statements

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving human participants were reviewed and approved by the Ethics Committee in Chaohu Hospital of Anhui Medical University. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author contributions

HL, FJ, and Y-LT made substantial contributions to the study design. YL collected data. JL analyzed the data. JL and FJ interpreted the results of analysis and completed the manuscripts. All authors have read and approved the published version of the manuscript.

Acknowledgments

The participating institutions and physicians are thanked for their contribution.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

  • 1

    ChenW.HeW.ZengL.LiX.GongR.PengT.et al. (2021). Mental health status of Chinese physicians working in intensive care unit. J. Crit. Care61, 227–232. 10.1016/j.jcrc.2020.11.005

  • 2

    DewaC. S.LoongD.BonatoS.TrojanowskiL. (2017). The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review. BMJ Open7:e015141. 10.1136/bmjopen-2016-015141

  • 3

    Felez-NobregaM.HaroJ. M.StubbsB.SmithL.KoyanagiA. (2021). Moving more, ageing happy: findings from six low- and middle-income countries. Age Ageing50, 488–497. 10.1093/ageing/afaa137

  • 4

    FisherJ. J.KaitelidouD.SamoutisG. (2019). Happiness and physical activity levels of first year medical students studying in Cyprus: a cross-sectional survey. BMC Med. Educ.19:475. 10.1186/s12909-019-1790-9

  • 5

    FuC.WangG.ShiX.CaoF. (2021). Social support and depressive symptoms among physicians in tertiary hospitals in China: a cross-sectional study. BMC Psychiatry21:217. 10.1186/s12888-021-03219-w

  • 6

    GottschlichE. A.LarsonK.SiskB.Pat FrintnerM. (2019). Sleep, physical activity, and general health status: US Pediatricians and the general US adult population. Acad. Pediatr.19, 269–277. 10.1016/j.acap.2018.08.002

  • 7

    GragnanoA.SimbulaS.MigliorettiM. (2020). Work-life balance: weighing the importance of work-family and work-health balance. Int. J. Environ. Res. Public Health. 17:907. 10.3390/ijerph17030907

  • 8

    HallL. H.JohnsonJ.WattI.TsipaA.O'connorD. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS ONE11:e0159015. 10.1371/journal.pone.0159015

  • 9

    HausenblasH. A.DownsD. S. (2002). How much is too much? the development and validation of the exercise dependence scale. Psychol. Health17, 387–40410.1080/0887044022000004894

  • 10

    HuangY.WangY.WangH.LiuZ.YuX.YanJ.et al. (2019). Prevalence of mental disorders in China a cross-sectional epidemiological study. Lancet Psychiatry3, 211–22410.1016/S2215-0366(18)30511-X

  • 11

    JiangF.HuL.RakofskyJ.LiuT.WuS.ZhaoP.et al. (2018). Sociodemographic characteristics and job satisfaction of psychiatrists in china: results from the first nationwide survey. Psychiatr Serv.69, 1245–1251. 10.1176/appi.ps.201800197

  • 12

    JiangL. C.YanY. J.JinZ. S.HuM. L.WangL.SongY.et al. (2020). The depression anxiety stress Scale-21 in Chinese hospital workers: reliability, latent structure, and measurement invariance across genders. Front. Psychol.11:247. 10.3389/fpsyg.2020.00741

  • 13

    KroenckeL.HarariG. M.KatanaM.GoslingS. D. (2019). Personality trait predictors and mental well-being correlates of exercise frequency across the academic semester. Soc. Sci. Med.236:112400. 10.1016/j.socscimed.2019.112400

  • 14

    KumarS.JhaP. C.NegiB. S.HaidryN.KulkarniP.GulatiS.et al. (2021). Oral health status and treatment need in geriatric patients with different degrees of cognitive impairment and dementia: a cross-sectional study. J. Family Med. Prim. Care10, 2171–2176. 10.4103/jfmpc.jfmpc_2481_20

  • 15

    KyeS. Y.ParkK. (2014). Health-related determinants of happiness in Korean adults. Int. J. Public Health59, 731–738. 10.1007/s00038-014-0588-0

  • 16

    MurphyM. H.CarlinA.WoodsC.NevillA.MacdonnchaC.FergusonK.et al. (2018). Active students are healthier and happier than their inactive peers: the results of a large representative cross-sectional study of university students in Ireland. J. Phys. Act. Health15, 737–746. 10.1123/jpah.2017-0432

  • 17

    RichardsJ.JiangX.KellyP.ChauJ.BaumanA.DingD. (2015). Don't worry, be happy: cross-sectional associations between physical activity and happiness in 15 European countries. BMC Public Health15:53. 10.1186/s12889-015-1391-4

  • 18

    SonisJ.PathmanD. E.ReadS.GaynesB. N.CanterC.CurranP.et al. (2021). Generalized anxiety, depression and posttraumatic stress disorder in a national sample of U.S. internal medicine physicians during the COVID-19 pandemic. Gen. Hosp. Psychiatry71, 142–144. 10.1016/j.genhosppsych.2021.05.004

  • 19

    StevensM.LieschkeJ.CruwysT.CárdenasD.PlatowM. J.ReynoldsK. J. (2021). Better together: how group-based physical activity protects against depression. Soc. Sci. Med.286:114337. 10.1016/j.socscimed.2021.114337

  • 20

    WallaceJ. E.LemaireJ. B.GhaliW. A. (2009). Physician wellness: a missing quality indicator. Lancet374, 1714–1721. 10.1016/S0140-6736(09)61424-0

  • 21

    Wan Mohd YunusW. M. A.BadriS. K. Z.PanatikS. A.MukhtarF. (2020). The unprecedented movement control order (lockdown) and factors associated with the negative emotional symptoms, happiness, and work-life balance of malaysian university students during the Coronavirus Disease (COVID-19) pandemic. Front. Psychiatry11:566221. 10.3389/fpsyt.2020.566221

  • 22

    WangY.AshokanK. (2021). Physical exercise: an overview of benefits from psychological level to genetics and beyond. Front. Physiol.12:731858. 10.3389/fphys.2021.731858

  • 23

    WareJ. E.Jr.SherbourneC. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care30, 473–48310.1097/00005650-199206000-00002

  • 24

    WeissD. J.DawisR. V.EnglandG. W. (1967). Manual for the minnesota satisfaction questionnaire. Minnesota Studies in Vocational Rehabilitation. APA PsycTests22:120. 10.1037/t05540-000

  • 25

    WerdeckerL.EschT. (2021). Burnout, satisfaction and happiness among German general practitioners (GPs): a cross-sectional survey on health resources and stressors. PLoS ONE16:e0253447. 10.1371/journal.pone.0253447

  • 26

    WuY.CaoM.WuS.LiuY.WangH.ChenX.et al. (2019). Survey on the self-rated health of doctors and nurses at China′s 144 tertiary public hospitals. Chin. J. Hosp. Admin.35, 712–718. (in Chinese) 10.3760/cma.j.issn.1000-6672.2019.09.002

  • 27

    WuY.JiangF.MaJ.TangY. L.WangM.LiuY. (2020). Experience of medical disputes, medical disturbances, verbal and physical violence, and burnout among physicians in China. Front. Psychol.11:556517. 10.3389/fpsyg.2020.556517

  • 28

    XiaL.JiangF.RakofskyJ.ZhangY.ZhangK.LiuT.et al. (2020). Cigarette smoking, health-related behaviors, and burnout among mental health professionals in china: a nationwide survey. Front. Psychiatry11:706. 10.3389/fpsyt.2020.00706

  • 29

    XuW.SunH.ZhuB.BaiW.YuX.DuanR.et al. (2019). Analysis of factors affecting the high subjective well-being of Chinese residents based on the 2014 China Family panel study. Int. J. Environ. Res Public Health16:2566. 10.3390/ijerph16142566

  • 30

    YanceyA. K.SallisR. E.BastaniR. (2013). Changing physical activity participation for the medical profession. JAMA309, 141–142. 10.1001/jama.2012.127989

  • 31

    YeS.ChengH.ZhaiZ.LiuH. (2021). Relationship between social anxiety and internet addiction in chinese college students controlling for the effects of physical exercise, demographic, and academic variables. Front. Psychol.12:698748. 10.3389/fpsyg.2021.698748

  • 32

    ZhangZ.ChenW. (2019). A systematic review of the relationship between physical activity and happiness. J. Happiness Stud.20, 1305–1322. 10.1007/s10902-018-9976-0

  • 33

    ZhangZ.HeZ.ChenW. (2020). The relationship between physical activity intensity and subjective well-being in college students. J. Am. Coll. Health2020, 1–6. 10.1080/07448481.2020.1790575

Summary

Keywords

physical activity, happiness, physician, psychiatric hospital, China

Citation

Luo J, Liu H, Liu Y, Jiang F and Tang Y-L (2021) Physical Activity and Mental Health Among Physicians in Tertiary Psychiatric Hospitals: A National Crosssectional Survey in China. Front. Psychol. 12:731525. doi: 10.3389/fpsyg.2021.731525

Received

27 June 2021

Accepted

06 September 2021

Published

15 October 2021

Volume

12 - 2021

Edited by

Chun-Qing Zhang, Sun Yat-sen University, China

Reviewed by

Chun Hu, Northwestern Polytechnical University, China; Wei Liang, Hong Kong Baptist University, Hong Kong, SAR China

Updates

Copyright

© 2021 Luo, Liu, Liu, Jiang and Tang.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Feng Jiang

This article was submitted to Health Psychology, a section of the journal Frontiers in Psychology

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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