Health needs assessment: knowing the psychological risks of frontline rescue workers for COVID-19 by simplified risk probability scale (SRPS)
Authors: Bo Yan , Chen Yifei , Zhai Fei 
Published: February 2025

BACKGROUND: Frontline rescue workers during the COVID-19 pandemic faced elevated psychological risks, yet existing tools (e.g., PHQ-9, GAD-7) lack specificity for crisis contexts. AIM: To develop a Simplified Risk Probability Scale (SRPS) tailored for rapid self-assessment of depression and anxiety in frontline rescue teams, integrating socio-economic and occupational predictors unique to pandemic rescue operations. METHODS: The present SRPS study employed a cross-sectional observational research design, utilising the statistical principle of snowball sampling to complete data collection via questionnaires. Lanzhou, China was designated as the questionnaire delivery city for snowball sampling. The questionnaire included a COVID-19 self-made survey scale, as well as the self-assessed anxiety scale (SAS) and the self-assessed depression scale (SDS) questionnaires to assess depression and anxiety symptoms. The statistical analysis process primarily employed univariate and multivariate analyses to identify the key variables necessary for establishing the SRPS. Ultimately, the binary logistic regression models and nomogram were utilised to establish the SRPS. The accuracy and sensitivity of the SRPS were assessed by receiver operating characteristic (ROC) curves. RESULTS: During the study period from 1 October to 1 November 2022, the 273 valid participants, the depression detection rate was 93/273 and the anxiety detection rate was 98/273. Univariate analyses showed that monthly income affected depression, with the lowest number of detections among participants with a monthly income of 3000-4000 CNY and the highest number of detections among those with a monthly income of more than 7000 CNY; age, marital status, and risk level of the area in which they lived affected anxiety, with the highest number of detections among those who lived in a high-risk area, were married, and were no older than 30 years of age. Attitude toward the rescue rotation system was a common significant single factor for depression and anxiety, with the highest number of detections of depression among participants who were able to accept the rotation system; diagnosis of COVID-19 infection in participants or their friends, and attitude toward work stress also affected anxiety, with the lowest number of detections of anxiety among participants who could not tolerate work stress. While univariate analysis indicated higher depression rates in the >7000 CNY group (32/77), multifactorial models revealed middle-income (3000-4000 CNY) as a significant risk factor [OR = 3.666 (1.085 - 12.385) , p=0.036], possibly mediated by job insecurity, and not being able to tolerate work stress during COVID-19 was a risk factor for anxiety [OR = 14.258 (4.213 - 58.983)]. A prediction model was constructed with a 70% sample size and plotted on a column chart, and it was found that age and monthly income were predictors of depression status, and attitude towards work stress during the epidemic was a predictor of anxiety status; the model was validated with a 30% sample size, and the areas under the ROC curves for depression and anxiety status were 0.572 and 0.662, respectively. CONCLUSION: We successfully constructed the SRPS based on the perspective of social rescue. The SRPS provides a rapid screening tool for rescue teams, with potential integration into mobile health platforms (e.g., via QR code scanning). Future training programs should prioritize interventions targeting middle-income workers and stress tolerance strategies.