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COVID-19 大流行期间医生的心理健康:工作要求和恢复体验的作用。

Doctors' Mental Health in the Midst of COVID-19 Pandemic: The Roles of Work Demands and Recovery Experiences.

机构信息

Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.

Ministry of Health Malaysia, Federal Government Administrative Centre, Putrajaya 62590, Malaysia.

出版信息

Int J Environ Res Public Health. 2020 Oct 8;17(19):7340. doi: 10.3390/ijerph17197340.

Abstract

The COVID-19 pandemic potentially increases doctors' work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors' fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj. = 2.73), chronic fatigue (adj. = 3.64), depression (adj. = 0.57), anxiety (adj. = 0.47), and stress (adj. = 0.64), while relaxation experiences were negatively associated with acute fatigue (adj. = -0.53), chronic fatigue (adj. = -0.53), depression (adj. = -0.14), anxiety (adj. = -0.11), and stress (adj. = -0.15). However, higher detachment experience was associated with multiple mental health parameters in the opposite of the expected direction such as higher level of chronic fatigue (adj. = 0.74), depression (adj. = 0.15), anxiety (adj. = 0.11), and stress (adj. = 0.11), and lower level of intershift recovery (adj. = -0.21). In conclusion, work demands generally worsen, while recovery experiences protect mental health during the COVID-19 pandemic with the caveat of the role of detachment experiences.

摘要

新型冠状病毒肺炎大流行可能增加医生的工作需求并限制其恢复机会;这会使他们面临严重的心理健康问题的风险。本研究旨在评估医生的疲劳、恢复、抑郁、焦虑和压力水平,并探讨其与工作需求和恢复体验的关系。这是一项在马来西亚雪兰莪州所有政府医疗机构工作的所有医生中进行的横断面研究。数据于 2020 年 5 月在马来西亚 COVID-19 疫情高峰期后通过在线方式使用自我报告问卷收集。总共有 1050 名医生参加。大多数参与者是非居民非专科医生(55.7%),工作地点在医院(76.3%)。工作需求的最高程度是心理需求(M = 7.54,SD = 1.998),而恢复体验的最低程度是分离(M = 9.22,SD = 5.043)。参与者报告的急性疲劳水平(M = 63.33,SD = 19.025)高于慢性疲劳(M = 49.37,SD = 24.473)和轮班后恢复(M = 49.97,SD = 19.480)。他们中的大多数人没有抑郁(69.0%)、没有焦虑(70.3%)和没有压力(76.5%)。较高的工作需求和较低的恢复体验通常与不良心理健康有关。例如,情绪需求与急性疲劳(adj. = 2.73)、慢性疲劳(adj. = 3.64)、抑郁(adj. = 0.57)、焦虑(adj. = 0.47)和压力(adj. = 0.64)呈正相关,而放松体验与急性疲劳(adj. = -0.53)、慢性疲劳(adj. = -0.53)、抑郁(adj. = -0.14)、焦虑(adj. = -0.11)和压力(adj. = -0.15)呈负相关。然而,更高的分离体验与多个心理健康参数呈相反方向相关,例如慢性疲劳(adj. = 0.74)、抑郁(adj. = 0.15)、焦虑(adj. = 0.11)和压力(adj. = 0.11)水平较高,以及轮班后恢复水平较低(adj. = -0.21)。总之,在 COVID-19 大流行期间,工作需求普遍恶化,而恢复体验则保护心理健康,但需要注意分离体验的作用。

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