Abstract: Objective To explore the depression level and influencing factors among district-level medical workers after major public health events, and to provide reference for psychological intervention and health promotion strategies. Methods A convenient sampling method was used to select all the staff members of medical and health institutions in Panyu District of Guangzhou to conduct an online questionnaire survey, which included basic information and psychological feelings. Psychological resilience, self-esteem, and depression were measured by scale, and the influencing factors of depression were analyzed by univariate analysis and multivariate logistic regression. Results A total of 5 321 district-level medical workers were surveyed, with the majority being female （3 974 individuals, 74.7%）. The total score for psychological resilience was 62 （50, 75）, for self-esteem was 30 （28, 34）, and for depression was 33 （27, 42）. The depressive mood was detected in 43.1% （2 291 cases）, and 41.7% （2 219 cases） felt under pressure. Multivariate logistic regression analysis indicated that self-rated happiness as average and unhappiness （OR=1.551, 2.276）, feeling very stressed or relatively stressed （OR=3.570, 2.444）, psychological resilience scores of 63-75, 50-62, and <50 （OR=1.992, 3.687, 6.856）, as well as low and moderate levels of self-esteem （OR=7.784, 3.310） were identified as risk factors for depression among district-level medical workers. Non-hospital-infection-control positions （OR=0.713）, general and good health conditions （OR=0.497, 0.299）, and the feeling of distress was normal and did not agree to be in distress （OR=0.518, 0.255） were identified as protective factors against depression among district-level medical workers. Conclusions District-level medical workers experience high levels of stress and have a relatively high detection rate of depression. Unhappiness, high stress, low psychological resilience, and low self-esteem are risk factors for the development of depressive. On the other hand, non-hospital-infection-control positions, good health conditions, lower perceived stress, and a lesser sense of being in difficult situations are protective factors against depressive symptoms. It is recommended to provide psychological interventions such as resilience training for district-level medical workers to enhance their ability to cope with public health emergencies.

Key words: Public health event, Medical worker, Depression, Psychological resilience, Self-esteem